Sample records for fatigue

  1. Cognitive and Physical Fatigue Tasks Enhance Pain, Cognitive Fatigue and Physical Fatigue in People with Fibromyalgia

    PubMed Central

    Dailey, Dana L; Keffala, Valerie J; Sluka, Kathleen A

    2014-01-01

    Objective Fibromyalgia is a condition characterized by chronic widespread muscle pain and fatigue. The primary objective of this study was to determine if pain, perceived cognitive fatigue, and perceived physical fatigue were enhanced in participants with fibromyalgia compared to healthy controls during a cognitive fatigue task, a physical fatigue task and a dual fatigue task. Methods Twenty four people with fibromyalgia and 33 healthy controls completed pain, fatigue and function measures. A cognitive fatigue task (Controlled Oral Word Association Test) and physical fatigue task (Valpar peg test) were done individually and combined for a dual fatigue task. Resting pain, perceived cognitive fatigue and perceived physical fatigue were assessed during each task using visual analogue scales. Function was assessed with shoulder range of motion and grip. Results People with fibromyalgia had significantly higher increases in pain, cognitive fatigue and physical fatigue when compared to healthy controls after completion of a cognitive fatigue task, a physical fatigue task, or a dual fatigue task (p<0.01). People with fibromyalgia performed equivalently on measures of physical performance and cognitive performance on the physical and cognitive fatigue tasks, respectively. Conclusions These data show that people with fibromyalgia show larger increases in pain, perceived cognitive fatigue and perceived physical fatigue to both cognitive and physical fatigue tasks compared to healthy controls. The increases in pain and fatigue during cognitive and physical fatigue tasks could influence subject participation in daily activities and rehabilitation. PMID:25074583

  2. The role of central and peripheral muscle fatigue in postcancer fatigue: a randomized controlled trial.

    PubMed

    Prinsen, Hetty; van Dijk, Johannes P; Zwarts, Machiel J; Leer, Jan Willem H; Bleijenberg, Gijs; van Laarhoven, Hanneke W M

    2015-02-01

    Postcancer fatigue is a frequently occurring problem, impairing quality of life. Little is known about (neuro)physiological factors determining postcancer fatigue. It may be hypothesized that postcancer fatigue is characterized by low peripheral muscle fatigue and high central muscle fatigue. The aims of this study were to examine whether central and peripheral muscle fatigue differ between fatigued and non-fatigued cancer survivors and to examine the effect of cognitive behavioral therapy (CBT) on peripheral and central muscle fatigue of fatigued cancer survivors in a randomized controlled trial. Sixteen fatigued patients in the intervention group (CBT) and eight fatigued patients in the waiting list group were successfully assessed at baseline and six months later. Baseline measurements of 20 fatigued patients were compared with 20 non-fatigued patients. A twitch interpolation technique and surface electromyography were applied, respectively, during sustained contraction of the biceps brachii muscle. Muscle fiber conduction velocity (MFCV) and central activation failure (CAF) were not significantly different between fatigued and non-fatigued patients. Change scores of MFCV and CAF were not significantly different between patients in the CBT and waiting list groups. Patients in the CBT group reported a significantly larger decrease in fatigue scores than patients in the waiting list group. Postcancer fatigue is neither characterized by abnormally high central muscle fatigue nor by low peripheral muscle fatigue. These findings suggest a difference in the underlying physiological mechanism of postcancer fatigue vs. other fatigue syndromes. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  3. The mediating role of emotional symptomatology between anticipatory fatigue and the perception of fatigue.

    PubMed

    Rodríguez Testal, Juan F; Fuentes Márquez, Sandra; Senín Calderón, Cristina; Carrasco, Miguel A

    2016-05-01

    Clinical research stresses the importance of cognitive variables for predisposition, onset, and especially, perpetuation of perceived fatigue. The aim was to analyze the mediating effects of emotional symptomatology (somatic, depressive and anxiety) between anticipatory fatigue and perception of physical and cognitive fatigue. The sample was composed of 317 participants (29% from a clinical population) aged 18 to 76. Anticipatory fatigue and perception of fatigue were measured by fatigue scales. Emotional symptoms were assessed by the General Health Questionnaire, GHQ-28.  Results : Depressive symptomatology mediated the relationship between anticipatory fatigue and cognitive fatigue in both groups, and also somatic symptoms/somatization in patients. The indirect effect of physical fatigue was observed only in the clinical group, with depressive symptoms partially mediating the anticipatory fatigue and cognitive fatigue relationship. Anticipatory fatigue has a partial indirect effect on total physical fatigue, and full indirect effect on cognitive fatigue, mediated by depressive and somatic symptoms. Anticipatory fatigue is a relevant cognitive factor in the design of psychological intervention for improvement of cognitive and physical fatigue.

  4. Investigation into Fretting Fatigue Under Cyclic Contact Load and in Conjunction with Plain Fatigue of Titanium Alloy

    DTIC Science & Technology

    2008-03-01

    by plain fatigue and the process kept alternating or finishing all fretting fatigue cycles first followed by plain fatigue...fatigue and the process kept alternating or finishing all fretting fatigue cycles first followed by plain fatigue. 127  6.2.2. Phase Difference...component’s life. Figure 1.2 illustrates the process of combination of fretting fatigue and plain fatigue, by using three parts. The first part of this figure

  5. Fatigue in neuromuscular disorders: focus on Guillain-Barré syndrome and Pompe disease.

    PubMed

    de Vries, J M; Hagemans, M L C; Bussmann, J B J; van der Ploeg, A T; van Doorn, P A

    2010-03-01

    Fatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular disorders, but in reaction to neuromuscular disease fatigue of central origin can be an important protective mechanism to restrict further damage. In most cases, severity of fatigue seems to be related with disease severity, possibly with the exception of fatigue occurring in a monophasic disorder like Guillain-Barré syndrome. Treatment of fatigue in neuromuscular disease starts with symptomatic treatment of the underlying disease. When symptoms of fatigue persist, non-pharmacological interventions, such as exercise and cognitive behavioral therapy, can be initiated.

  6. College students with depressive symptoms with and without fatigue: Differences in functioning, suicidality, anxiety, and depressive severity

    PubMed Central

    Nyer, Maren; Mischoulon, David; Alpert, Jonathan E.; Holt, Daphne J.; Brill, Charlotte D.; Yeung, Albert; Pedrelli, Paola; Baer, Lee; Dording, Christina; Huz, Ilana; Fisher, Lauren; Fava, Maurizio; Farabaugh, Amy

    2015-01-01

    BACKGROUND We examined whether fatigue was associated with greater symptomatic burden and functional impairment in college students with depressive symptoms. METHODS Using data from the self-report Beck Depression Inventory (BDI), we stratified a group of 287 students endorsing significant symptoms of depression (BDI score ≥13) into 3 levels: no fatigue, mild fatigue, or moderate/severe fatigue. We then compared the 3 levels of fatigue across a battery of psychiatric and functional outcome measures. RESULTS Approximately 87% of students endorsed at least mild fatigue. Students with moderate/severe fatigue had significantly greater depressive symptom severity compared with those with mild or no fatigue and scored higher on a suicide risk measure than those with mild fatigue. Students with severe fatigue evidenced greater frequency and intensity of anxiety than those with mild or no fatigue. Reported cognitive and functional impairment increased significantly as fatigue worsened. CONCLUSIONS Depressed college students with symptoms of fatigue demonstrated functional impairment and symptomatic burden that worsened with increasing levels of fatigue. Assessing and treating symptoms of fatigue appears warranted within this population. PMID:25954936

  7. Real-Time Assessment of Fatigue in Patients With Multiple Sclerosis: How Does It Relate to Commonly Used Self-Report Fatigue Questionnaires?

    PubMed

    Heine, Martin; van den Akker, Lizanne Eva; Blikman, Lyan; Hoekstra, Trynke; van Munster, Erik; Verschuren, Olaf; Visser-Meily, Anne; Kwakkel, Gert

    2016-11-01

    (1) To assess real-time patterns of fatigue; (2) to assess the association between a real-time fatigue score and 3 commonly used questionnaires (Checklist Individual Strength [CIS] fatigue subscale, Modified Fatigue Impact Scale (MFIS), and Fatigue Severity Scale [FSS]); and (3) to establish factors that confound the association between the real-time fatigue score and the conventional fatigue questionnaires in patients with multiple sclerosis (MS). Cross-sectional study. MS-specialized outpatient facility. Ambulant patients with MS (N=165) experiencing severe self-reported fatigue. Not applicable. A real-time fatigue score was assessed by sending participants 4 text messages on a particular day (How fatigued do you feel at this moment?; score range, 0-10). Latent class growth mixed modeling was used to determine diurnal patterns of fatigue. Regression analyses were used to assess the association between the mean real-time fatigue score and the CIS fatigue subscale, MFIS, and FSS. Significant associations were tested for candidate confounders (eg, disease severity, work status, sleepiness). Four significantly different fatigue profiles were identified by the real-time fatigue score, namely a stable high (n=79), increasing (n=57), stable low (n=16), and decreasing (n=13). The conventional questionnaires correlated poorly (r<.300) with the real-time fatigue score. The Epworth Sleepiness Scale significantly reduced the regression coefficient between the real-time fatigue score and conventional questionnaires, ranging from 15.4% to 35%. Perceived fatigue showed 4 different diurnal patterns in patients with MS. Severity of sleepiness is an important confounder to take into account in the assessment of fatigue. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Multidimensional fatigue in pulmonary hypertension: prevalence, severity and predictors.

    PubMed

    Tartavoulle, Todd M; Karpinski, Aryn C; Aubin, Andrew; Kluger, Benzi M; Distler, Oliver; Saketkoo, Lesley Ann

    2018-01-01

    Pulmonary hypertension is a potentially fatal disease. Despite pharmacological advances in pulmonary hypertension, fatigue remains common in patients with pulmonary hypertension. A convenience sample of 120 participants at an international patient conference completed the Multidimensional Fatigue Inventory (MFI)-20 scale. Data on New York Heart Association Functional Class, body mass index, oxygen use and medication type/use were also collected. There was a high prevalence of "severe" to "very severe" fatigue for each dimension: General Fatigue (60%), Physical Fatigue (55.8%), Reduced Activity (41.7%), Reduced Motivation (32.5%) and Mental Fatigue (27.5%). The mean±sd overall MFI-20 score was 58±5.1. Dimensions with the highest averaged levels were General Fatigue (13.40±3.61), Physical Fatigue (13.23±3.67) and Reduced Activity (11.33±4.16). Body mass index correlated with higher fatigue scores. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination negatively predicted General Fatigue, Physical Fatigue, Reduced Motivation and Reduced Activity. Triple therapy was a significant predictor of General Fatigue, Physical Fatigue and Reduced Activity. There were no significant predictors of Mental Fatigue. Multidimensional fatigue is common and severe in patients with pulmonary hypertension. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination resulted in lower scores in most fatigue dimensions. Comprehensive assessment of fatigue should be considered in the clinical care of patients with pulmonary hypertension and clinical research to develop formal interventions that target this disabling symptom.

  9. Psychometric properties and Dutch norm data of the PedsQL Multidimensional Fatigue Scale for Young Adults.

    PubMed

    Haverman, Lotte; Limperg, Perrine F; van Oers, Hedy A; van Rossum, Marion A J; Maurice-Stam, Heleen; Grootenhuis, Martha A

    2014-12-01

    The aim of this study was to assess internal consistency and construct validity (known-groups validity) and to provide Dutch norm data for the Dutch Pediatric Quality of Life Inventory Multidimensional Fatigue Scale for Young Adults ages 18-30 years (PedsQL fatigue_YA). A Dutch sample of 649 young adults completed online a sociodemographic questionnaire and the PedsQL fatigue_YA including three subscales: general fatigue, sleep/rest fatigue and cognitive fatigue (0-100: Higher scores indicate less fatigue symptoms). The PedsQL fatigue_YA showed satisfactory to good internal consistency (Cronbach's alpha = .70-.94), except for one scale (.68). The mean scale scores were 68.23 (SD 19.15) for 'general fatigue,' 67.04 (SD 15.54) for 'sleep/rest fatigue' and 74.62 (SD 19.02) for 'cognitive fatigue.' Men reported significantly higher scores on 'general fatigue' and 'sleep/rest fatigue' than women. The PedsQL fatigue_YA distinguished between healthy young adults and young adults with chronic health conditions, with higher scores on all scales in healthy young adults than in those with a chronic health condition. The results demonstrate good psychometric properties of the PedsQL fatigue_YA in a sample of Dutch young adults. With the current norms available, it is possible to evaluate fatigue in the Netherlands from childhood to adulthood with the PedsQL Multidimensional Fatigue Scale.

  10. Exertion fatigue and chronic fatigue are two distinct constructs in people post-stroke.

    PubMed

    Tseng, Benjamin Y; Billinger, Sandra A; Gajewski, Byron J; Kluding, Patricia M

    2010-12-01

    Post-stroke fatigue is a common and neglected issue despite the fact that it impacts daily functions, quality of life, and has been linked with a higher mortality rate because of its association with a sedentary lifestyle. The purpose of this study was to identify the contributing factors of exertion fatigue and chronic fatigue in people post-stroke. Twenty-one post-stroke people (12 males, 9 females; 59.5 ± 10.3 years of age; time after stroke 4.1 ± 3.5 years) participated in the study. The response variables included exertion fatigue and chronic fatigue. Participants underwent a standardized fatigue-inducing exercise on a recumbent stepper. Exertion fatigue level was assessed at rest and immediately after exercise using the Visual Analog Fatigue Scale. Chronic fatigue was measured by the Fatigue Severity Scale. The explanatory variables included aerobic fitness, motor control, and depressive symptoms measured by peak oxygen uptake, Fugl-Meyer motor score, and the Geriatric Depression Scale, respectively. Using forward stepwise regression, we found that peak oxygen uptake was an independent predictor of exertion fatigue (P = 0.006), whereas depression was an independent predictor of chronic fatigue (P = 0.002). Exertion fatigue and chronic fatigue are 2 distinct fatigue constructs, as identified by 2 different contributing factors.

  11. The effects of fatigue on performance in simulated nursing work.

    PubMed

    Barker, Linsey M; Nussbaum, Maury A

    2011-09-01

    Fatigue is associated with increased rates of medical errors and healthcare worker injuries, yet existing research in this sector has not considered multiple dimensions of fatigue simultaneously. This study evaluated hypothesised causal relationships between mental and physical fatigue and performance. High and low levels of mental and physical fatigue were induced in 16 participants during simulated nursing work tasks in a laboratory setting. Task-induced changes in fatigue dimensions were quantified using both subjective and objective measures, as were changes in performance on physical and mental tasks. Completing the simulated work tasks increased total fatigue, mental fatigue and physical fatigue in all experimental conditions. Higher physical fatigue adversely affected measures of physical and mental performance, whereas higher mental fatigue had a positive effect on one measure of mental performance. Overall, these results suggest causal effects between manipulated levels of mental and physical fatigue and task-induced changes in mental and physical performance. STATEMENT OF RELEVANCE: Nurse fatigue and performance has implications for patient and provider safety. Results from this study demonstrate the importance of a multidimensional view of fatigue in understanding the causal relationships between fatigue and performance. The findings can guide future work aimed at predicting fatigue-related performance decrements and designing interventions.

  12. Development of an algorithm for an EEG-based driver fatigue countermeasure.

    PubMed

    Lal, Saroj K L; Craig, Ashley; Boord, Peter; Kirkup, Les; Nguyen, Hung

    2003-01-01

    Fatigue affects a driver's ability to proceed safely. Driver-related fatigue and/or sleepiness are a significant cause of traffic accidents, which makes this an area of great socioeconomic concern. Monitoring physiological signals while driving provides the possibility of detecting and warning of fatigue. The aim of this paper is to describe an EEG-based fatigue countermeasure algorithm and to report its reliability. Changes in all major EEG bands during fatigue were used to develop the algorithm for detecting different levels of fatigue. The software was shown to be capable of detecting fatigue accurately in 10 subjects tested. The percentage of time the subjects were detected to be in a fatigue state was significantly different than the alert phase (P<.01). This is the first countermeasure software described that has shown to detect fatigue based on EEG changes in all frequency bands. Field research is required to evaluate the fatigue software in order to produce a robust and reliable fatigue countermeasure system. The development of the fatigue countermeasure algorithm forms the basis of a future fatigue countermeasure device. Implementation of electronic devices for fatigue detection is crucial for reducing fatigue-related road accidents and their associated costs.

  13. Intensity, Chronicity, Circumstances, and Consequences of HIV-Related Fatigue: A Longitudinal Study

    PubMed Central

    Barroso, Julie; Harmon, James L.; Madison, Jane Leserman; Pence, Brian Wells

    2013-01-01

    HIV-related fatigue remains the most troubling complaint of seropositive people. Researchers often use tools to measure fatigue that were developed for other patient populations; thus, the measurement of fatigue specific to HIV is needed. This article describes results from the HIV-Related Fatigue Scale (HRFS) including: (a) the variability in intensity and chronicity of HIV-related fatigue, (b) the circumstances surrounding changes in fatigue, (c) the impact of fatigue on activities of daily living (ADLs), and (d) the consequences of HIV-related fatigue. We collected data every 3 months over a 3-year period from 128 people. HIV-related fatigue was chronic and did not appear to remit spontaneously; those who were the most fatigued at the beginning of the study remained the most fatigued over 3 years. Fatigue interfered more with instrumental activities of daily living than basic ADLs; it also interfered with work, family, and social life. Stress and depression increased fatigue. PMID:23814175

  14. A critical review of the psychophysiology of driver fatigue.

    PubMed

    Lal, S K; Craig, A

    2001-02-01

    Driver fatigue is a major cause of road accidents and has implications for road safety. This review discusses the concepts of fatigue and provides a summary on psychophysiological associations with driver fatigue. A variety of psychophysiological parameters have been used in previous research as indicators of fatigue, with electroencephalography perhaps being the most promising. Most research found changes in theta and delta activity to be strongly linked to transition to fatigue. Therefore, monitoring electroencephalography during driver fatigue may be a promising variable for use in fatigue countermeasure devices. The review also identified anxiety and mood states as factors that may possibly affect driver fatigue. Furthermore, personality and temperament may also influence fatigue. Given the above, understanding the psychology of fatigue may lead to better fatigue management. The findings from this review are discussed in the light of directions for future studies and for the development of fatigue countermeasures.

  15. Influence of fatigue time and level on increases in postural sway.

    PubMed

    Pline, Kevin M; Madigan, Michael L; Nussbaum, Maury A

    2006-12-15

    The purpose of this study was to investigate the influence of fatigue time and fatigue level on the increases in postural sway during quiet standing. Centre of pressure-based measures of postural sway were collected both before and after fatiguing participants using three different fatigue levels and two different fatigue times. Results showed increasing fatigue time increased sway velocity and sway area, and increasing fatigue level increased sway velocity. Fatigue time effects are important to consider when applying laboratory-based findings to the field given that the fatigue time can differ substantially between the two. Fatigue level effects imply a dose - response relationship between localized muscle fatigue and risk of falling that can have important implications in work/rest cycle scheduling for occupations at risk of injurious falls.

  16. Driving fatigue in professional drivers: a survey of truck and taxi drivers.

    PubMed

    Meng, Fanxing; Li, Shuling; Cao, Lingzhi; Li, Musen; Peng, Qijia; Wang, Chunhui; Zhang, Wei

    2015-01-01

    Fatigue among truck drivers has been studied extensively; however, less is known regarding the fatigue experience of taxi drivers in heavily populated metropolitan areas. This study aimed to compare the differences and similarities between truck and taxi driver fatigue to provide implications for the fatigue management and education of professional drivers. A sample of 274 truck drivers and 286 taxi drivers in Beijing was surveyed via a questionnaire, which included items regarding work characteristics, fatigue experience, accident information, attitude toward fatigue, and methods of counteracting fatigue. Driver fatigue was prevalent among professional drivers, and it was even more serious for taxi drivers. Taxi drivers reported more frequent fatigue experiences and were involved in more accidents. Among the contributing factors to fatigue, prolonged driving time was the most important factor identified by both driver groups. Importantly, the reason for the engagement in prolonged driving was neither due to the lack of awareness concerning the serious outcome of fatigue driving nor because of their poor detection of fatigue. The most probable reason was the optimism bias, as a result of which these professional drivers thought that fatigue was more serious for other drivers than for themselves, and they thought that they were effective in counteracting the effect of fatigue on their driving performance. Moreover, truck drivers tended to employ methods that require stopping to counteract fatigue, whereas taxi drivers preferred methods that were simultaneous with driving. Although both driver groups considered taking a nap as one of the most effective means to address fatigue, this method was not commonly used. Interestingly, these drivers were aware that the methods they frequently used were not the most effective means to counteract fatigue. This study provides knowledge on truck and taxi drivers' characteristics in fatigue experience, fatigue attitude, and fatigue countermeasures, and these findings have practical implications for the fatigue management and education of professional drivers.

  17. Patient factors related to the presentation of fatigue complaints: results from a women's general health care practice.

    PubMed

    de Rijk, A E; Schreurs, K M; Bensing, J M

    2000-01-01

    The aim of this study was to examine which patient-related factors predicted: (1) fatigue, (2) the intention to discuss fatigue and (3) the actual discussion of fatigue during consultation with a GP in a women's general health care practice. Patients were asked to complete two questionnaires: one before and one after consultation. The patient-related factors included: social-demographic characteristics; fatigue characteristics; absence of cognitive representations of fatigue; nature of the requests for consultation; and other complaints. Some 74% of the 155 respondents reported fatigue. Compared to the patients that were not fatigued, the fatigued patients were more frequently employed outside the home, had higher levels of general fatigue, and a higher need for emotional support from their doctor. A minority (12%) intended to discuss fatigue during consultation. Of the respondents returning the second questionnaire (n = 107), 22% reported actually discussing their fatigue with the GP while only 11% had intended to do so. In addition to the intention to discuss fatigue during consultation, the following variables related to actually discussing fatigue: living alone, caring for young children, higher levels of general fatigue, absence of cognitions with regard to the duration of the fatigue, and greater psychological, neurological, digestive, and/or musculoskeletal problems as the reason for consultation. Fatigue was found to be the single reason for consultation in only one case. It is concluded that fatigue does not constitute a serious problem for most patients and that discussion of fatigue with the GP tends to depend on the occurrence of other psychological or physical problems and the patient's social context.

  18. Multidimensional fatigue in pulmonary hypertension: prevalence, severity and predictors

    PubMed Central

    Tartavoulle, Todd M.; Karpinski, Aryn C.; Aubin, Andrew; Kluger, Benzi M.; Distler, Oliver; Saketkoo, Lesley Ann

    2018-01-01

    Pulmonary hypertension is a potentially fatal disease. Despite pharmacological advances in pulmonary hypertension, fatigue remains common in patients with pulmonary hypertension. A convenience sample of 120 participants at an international patient conference completed the Multidimensional Fatigue Inventory (MFI)-20 scale. Data on New York Heart Association Functional Class, body mass index, oxygen use and medication type/use were also collected. There was a high prevalence of “severe” to “very severe” fatigue for each dimension: General Fatigue (60%), Physical Fatigue (55.8%), Reduced Activity (41.7%), Reduced Motivation (32.5%) and Mental Fatigue (27.5%). The mean±sd overall MFI-20 score was 58±5.1. Dimensions with the highest averaged levels were General Fatigue (13.40±3.61), Physical Fatigue (13.23±3.67) and Reduced Activity (11.33±4.16). Body mass index correlated with higher fatigue scores. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination negatively predicted General Fatigue, Physical Fatigue, Reduced Motivation and Reduced Activity. Triple therapy was a significant predictor of General Fatigue, Physical Fatigue and Reduced Activity. There were no significant predictors of Mental Fatigue. Multidimensional fatigue is common and severe in patients with pulmonary hypertension. Phosphodiesterase inhibitor plus endothelin receptor antagonist combination resulted in lower scores in most fatigue dimensions. Comprehensive assessment of fatigue should be considered in the clinical care of patients with pulmonary hypertension and clinical research to develop formal interventions that target this disabling symptom. PMID:29577043

  19. Low cycle fatigue

    NASA Technical Reports Server (NTRS)

    Solomon, H. D. (Editor); Kaisand, L. R. (Editor); Halford, G. R. (Editor); Leis, B. N. (Editor)

    1988-01-01

    The papers contained in this volume focus on various aspects of low cycle fatigue, including cyclic deformation, crack propagation, high-temperature low cycle fatigue, microstructural defects, multiaxial and variable amplitude loading, and life prediction. Papers are presented on the low cycle fatigue of some aluminum alloys, prediction of crack growth under creep-fatigue loading conditions, high-temperature low cycle fatigue behavior and lifetime prediction of a nickel-base ODS alloy, and an integrated approach to creep-fatigue life prediction. Other topics discussed include thermal fatigue testing of coated monocrystalline superalloys, low cycle fatigue of Al-Mg-Si alloys, and the effect of superimposed stresses at high frequency on low cycle fatigue.

  20. Exploring nurse leader fatigue: a mixed methods study.

    PubMed

    Steege, Linsey M; Pinekenstein, Barbara J; Arsenault Knudsen, Élise; Rainbow, Jessica G

    2017-05-01

    To describe hospital nurse leaders' experiences of fatigue. Fatigue is a critical challenge in nursing. Existing literature focuses on staff nurse fatigue, yet nurse leaders are exposed to high demands that may contribute to fatigue and associated risks to patient, nurse and organisational outcomes. A mixed method approach comprising semi-structured interviews and the Occupational Fatigue Exhaustion Recovery scale with 21 nurse administrators (10 nurse managers and 11 nurse executives) from hospitals in a Midwestern state. Most nurse leaders experience fatigue; nurse managers reported higher levels of chronic fatigue. Participants identified multiple sources of fatigue including 24 h accountability and intensity of role expectations, and used a combination of wellness, restorative, social support and boundary setting strategies to cope with fatigue. The consequences of nurse leader fatigue include an impact on decision-making, work-life balance and turnover intent. The high prevalence of nurse leader fatigue could impact the turnover intent of nurse administrators and quality of care. This study highlights the significance and consequences of nurse leader fatigue. As health care organisations continue to raise awareness and establish systems to reduce nurse fatigue, policies and programmes must be adapted to address nurse leader fatigue. © 2017 John Wiley & Sons Ltd.

  1. [Research Progress on the Interaction Effects and Its Neural Mechanisms between Physical Fatigue and Mental Fatigue].

    PubMed

    Zhang, Lixin; Zhang, Chuncui; He, Feng; Zhao, Xin; Qi, Hongzhi; Wan, Baikun; Ming, Dong

    2015-10-01

    Fatigue is an exhaustion state caused by prolonged physical work and mental work, which can reduce working efficiency and even cause industrial accidents. Fatigue is a complex concept involving both physiological and psychological factors. Fatigue can cause a decline of concentration and work performance and induce chronic diseases. Prolonged fatigue may endanger life safety. In most of the scenarios, physical and mental workloads co-lead operator into fatigue state. Thus, it is very important to study the interaction influence and its neural mechanisms between physical and mental fatigues. This paper introduces recent progresses on the interaction effects and discusses some research challenges and future development directions. It is believed that mutual influence between physical fatigue and mental fatigue may occur in the central nervous system. Revealing the basal ganglia function and dopamine release may be important to explore the neural mechanisms between physical fatigue and mental fatigue. Future effort is to optimize fatigue models, to evaluate parameters and to explore the neural mechanisms so as to provide scientific basis and theoretical guidance for complex task designs and fatigue monitoring.

  2. Fatigue-induced early onset of anticipatory postural adjustments in non-fatigued muscles: support for a centrally mediated adaptation.

    PubMed

    Strang, Adam J; Berg, William P; Hieronymus, Mathias

    2009-08-01

    Muscle fatigue has been shown to result in early onset of anticipatory postural adjustments (APAs) relative to those produced in a non-fatigued state. This adaptation is thought to reflect an attempt to preserve postural stability during a focal movement performed in a fatigued state. It remains unclear, however, whether this adaptation is of central (e.g., central nervous system motor command) or peripheral (e.g., muscle contractile properties), origin. One way to confirm that this adaptation is centrally driven is to identify fatigued-induced early APA onsets in non-fatigued muscles. In this study, APAs were obtained using a rapid bilateral reaching maneuver and recorded via surface electromyography before and after conditions of rest (n = 25) or fatigue (n = 25). Fatigue was generated using isokinetic exercise of the right leg. Results showed that fatigue-induced early APA onsets occurred in fatigued and non-fatigued muscles, confirming that fatigue-induced early APA onset is a centrally mediated adaptation.

  3. The Family Experience of Fatigue in Heart Failure.

    PubMed

    Whitehead, Lisa

    2017-02-01

    Fatigue is a symptom experienced almost universally by people living with a chronic illness. People diagnosed with heart failure have described experiencing significant levels of fatigue. The family experience of fatigue, that is, how families perceive, respond to, and manage fatigue, is unknown. Semistructured family group interviews with 22 families ( N = 62 family members) were conducted. Thematic analysis was undertaken to explore the family experience of fatigue. Fatigue was described as a significant symptom that affected physical, emotional, and social functioning at a family level. Fatigue was described as difficult to manage, and while most family members interviewed had developed a shared understanding of fatigue, some family members found acceptance of this invisible symptom more difficult. Spouses were more likely to express concern that fatigue, and especially increased fatigue, represented a decline in health. The study highlighted the importance of a shared understanding of fatigue from a family perspective.

  4. Fatigue in older adults with stable heart failure.

    PubMed

    Stephen, Sharon A

    2008-01-01

    The purpose of this study was to describe fatigue and the relationships among fatigue intensity, self-reported functional status, and quality of life in older adults with stable heart failure. A descriptive, correlational design was used to collect quantitative data with reliable and valid instruments. Fifty-three eligible volunteers completed a questionnaire during an interview. Those with recent changes in their medical regimen, other fatigue-inducing illnesses, and isolated diastolic dysfunction were excluded. Fatigue intensity (Profile of Mood States fatigue subscale) was associated with lower quality of life, perceived health, and satisfaction with life. Fatigue was common, and no relationship was found between fatigue intensity and self-reported functional status. Marital status was the only independent predictor of fatigue. In stable heart failure, fatigue is a persistent symptom. Clinicians need to ask patients about fatigue and assess the impact on quality of life. Self-reported functional status cannot serve as a proxy measure for fatigue.

  5. Experimental Investigation and Finite Element Analysis on Fatigue Behavior of Aluminum Alloy 7050 Single-Lap Joints

    NASA Astrophysics Data System (ADS)

    Zhou, Bing; Cui, Hao; Liu, Haibo; Li, Yang; Liu, Gaofeng; Li, Shujun; Zhang, Shangzhou

    2018-03-01

    The fatigue behavior of single-lap four-riveted aluminum alloy 7050 joints was investigated by using high-frequency fatigue test and scanning electron microscope (SEM). Stress distributions obtained by finite element (FE) analysis help explain the fatigue performance. The fatigue test results showed that the fatigue lives of the joints depend on cold expansion and applied cyclic loads. FE analysis and fractography indicated that the improved fatigue lives can be attributed to the reduction in maximum stress and evolution of fatigue damage at the critical location. The beneficial effects of strengthening techniques result in tearing ridges or lamellar structure on fracture surface, decrease in fatigue striations spacing, delay of fatigue crack initiation, crack deflection in fatigue crack propagation and plasticity-induced crack closure.

  6. Active and Passive Fatigue in Simulated Driving: Discriminating Styles of Workload Regulation and Their Safety Impacts

    PubMed Central

    Saxby, Dyani J.; Matthews, Gerald; Warm, Joel S.; Hitchcock, Edward M.; Neubauer, Catherine

    2015-01-01

    Despite the known dangers of driver fatigue, it is a difficult construct to study empirically. Different forms of task-induced fatigue may differ in their effects on driver performance and safety. Desmond and Hancock (2001) defined active and passive fatigue states that reflect different styles of workload regulation. In 2 driving simulator studies we investigated the multidimensional subjective states and safety outcomes associated with active and passive fatigue. Wind gusts were used to induce active fatigue, and full vehicle automation to induce passive fatigue. Drive duration was independently manipulated to track the development of fatigue states over time. Participants were undergraduate students. Study 1 (N = 108) focused on subjective response and associated cognitive stress processes, while Study 2 (N = 168) tested fatigue effects on vehicle control and alertness. In both studies the 2 fatigue manipulations produced different patterns of subjective response reflecting different styles of workload regulation, appraisal, and coping. Active fatigue was associated with distress, overload, and heightened coping efforts, whereas passive fatigue corresponded to large-magnitude declines in task engagement, cognitive underload, and reduced challenge appraisal. Study 2 showed that only passive fatigue reduced alertness, operationalized as speed of braking and steering responses to an emergency event. Passive fatigue also increased crash probability, but did not affect a measure of vehicle control. Findings support theories that see fatigue as an outcome of strategies for managing workload. The distinction between active and passive fatigue is important for assessment of fatigue and for evaluating automated driving systems which may induce dangerous levels of passive fatigue. PMID:24041288

  7. All Fatigue is Not Created Equal: The Association of Fatigue and Its Subtypes on Pain Interference in Orofacial Pain.

    PubMed

    Boggero, Ian A; Rojas-Ramirez, Marcia V; Carlson, Charles R

    2017-03-01

    Fatigue is known to be a pathway through which depression, psychological distress, pain intensity, and sleep disturbance influence pain interference, but the independent effects of fatigue on pain interference after controlling for these variables remains unknown. In addition, no study to date has tested whether fatigue subtypes of general fatigue, mental fatigue, emotional fatigue, physical fatigue, or vigor differentially predict pain interference. The current study tested these associations using archival medical data of 2133 chronic orofacial pain patients, who completed a battery of psychological questionnaires at the time of their first appointment at an orofacial pain clinic. Hierarchical linear regression analysis revealed that after controlling for depression, psychological distress, sleep disturbance, pain intensity, and demographic variables, fatigue predicted higher pain interference (B=0.70, SE=0.17, P<0.001, η=0.01). Physical fatigue (B=1.70, SE=0.48, P<0.001, η=0.01) and vigor (B=-3.24, SE=0.47, P<0.001, η=0.03) were independently associated with pain interference after controlling for the aforementioned variables. The findings suggest that fatigue is an important independent predictor of pain interference and not merely a mediator. These findings also suggest that not all fatigue is created equal. Interventions aimed at reducing pain interference should target specific fatigue symptoms of physical fatigue and vigor. Future research investigating the independent associations of fatigue subtypes on pain outcomes may help clarify the nature of the interrelationships between pain and fatigue.

  8. [Cancer related fatigue in patients with breast cancer after chemotherapy and coping style].

    PubMed

    Jiang, Pinglan; Wang, Shuhong; Jiang, Dongmei; Yu, Lingli

    2011-04-01

    To study the relevance between cancer related fatigue and coping styles in breast cancer patients after chemotherapy. A survey was conducted in 396 patients with breast cancer after chemotherapy on cancer related fatigue scale and Jalowiec coping scale, and the relation was analyzed. The rate of overall fatigue in breast cancer patients was 96.97%, mostly moderate fatigue. The rate of fatigue dimensions from high to low was physical fatigue, feeling fatigue and cognitive fatigue, respectively. The score of coping styles in patients with breast cancer after chemotherapy from high to low was optimistic coping, facing bravely, support seeking, self-reliance, emotional catharsis, avoidance, fatalism, and conservation. The most widely used coping style was optimistic coping style, and the least was emotional catharisis. There was a positive correlation between coping style of emotional catharsis and cancer related fatigue of all dimensions (P<0.01). There was a negative correlation between emotional fatigue and optimistic,facing bravely, support seeking, self-reliance, or conservation (P<0.05). There was also a negative correlation between physical fatigue and optimistic or support seeking (P<0.05), but there was a positive correlation between avoidance or fatalism and the dimensions of general fatigue, physical fatigue, and cognitive fatigue (P<0.05). There is prevalent cancer related fatigue in patients with breast cancer after chemotherapy. We should guide the patients to more active coping styles, to enhance the ability of psychological adaption in patients, reduce cancer related fatigue, and improve the quality of life.

  9. An Experimental Investigation of the Effects of Vacuum Environment on the Fatigue Life, Fatigue-Crack-Growth Behavior, and Fracture Toughness of 7075-T6 Aluminum Alloy. Ph.D. Thesis - North Carolina State Univ.

    NASA Technical Reports Server (NTRS)

    Hudson, C. M.

    1972-01-01

    Axial load fatigue life, fatigue-crack propagation, and fracture toughness tests were conducted on 0.090-inch thick specimens made of 7075-T6 aluminum alloy. The fatigue life and fatigue-crack propagation experiments were conducted at a stress ratio of 0.02. Maximum stresses ranged from 33 to 60 ksi in the fatigue life experiments, and from 10 to 40 ksi in the fatigue-crack propagation experiments, and fatigue life experiments were conducted at gas pressures of 760, 0.5, 0.05, and 0.00000005 torr. Fatigue-crack-growth and fracture toughness experiments were conducted at gas pressures of 760 and 5 x 10 to the minus 8th power torr. Residual stress measurements were made on selected fatigue life specimens to determine the effect of such stresses on fatigue life. Analysis of the results from the fatigue life experiments indicated that fatigue life progressively increased as the gas pressure decreased. Analysis of the results from the fatigue-crack-growth experiments indicates that at low values of stress-intensity range, the fatigue crack growth rates were approximately twice as high in air as in vacuum. Fracture toughness data showed there was essentially no difference in the fracture toughness of 7075-T6 in vacuum and in air.

  10. Fatigue and neuromuscular diseases.

    PubMed

    Féasson, L; Camdessanché, J-P; El Mandhi, L; Calmels, P; Millet, G-Y

    2006-07-01

    To identify the role of fatigue, its evaluation and its causes in the pathophysiology context of acquired or hereditary neuromuscular diseases of the spinal anterior horn cell, peripheral nerve, neuromuscular junction and muscle. A literature review has been done on Medline with the following keywords: neuromuscular disease, peripheral neuropathy, myopathy, fatigue assessment, exercise intolerance, force assessment, fatigue scale and questionnaire, then with the terms: Fatigue Severity Scale, Chalder Fatigue Scale, Fatigue Questionnaire, Piper Fatigue Scale, electromyography and the combination of the word Fatigue with the following terms: Amyotrophic Lateral Sclerosis (ALS), Post-Polio Syndrome (PPS), Guillain-Barre Syndrome, Immune Neuropathy, Charcot-Marie-Tooth Disease, Myasthenia Gravis (MG), Metabolic Myopathy, Mitochondrial Myopathy, Muscular Dystrophy, Facioscapulohumeral Dystrophy, Myotonic Dystrophy. Fatigue is a symptom very frequently reported by patients. Fatigue is mainly evaluated by strength loss after an exercise, by change in electromyographic activity during a given exercise and by questionnaires that takes into account the subjective (psychological) part of fatigue. Due to the large diversity of motor disorders, there are multiple clinical expressions of fatigue that differ in their presentation, consequences and therapeutic approach. This review shows that fatigue has to be taken into account in patients with neuromuscular diseases. In this context, pathophysiology of fatigue often implies the motor component but the disease evolution and the physical obligates of daily life also induce an important psychological component.

  11. Perceived Fatigue Interference and Depressed Mood: Comparison of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis Patients with Fatigued Breast Cancer Survivors.

    PubMed

    Hall, Daniel L; Antoni, Michael H; Lattie, Emily G; Jutagir, Devika R; Czaja, Sara J; Perdomo, Dolores; Lechner, Suzanne C; Stagl, Jamie M; Bouchard, Laura C; Gudenkauf, Lisa M; Traeger, Lara; Fletcher, MaryAnn; Klimas, Nancy G

    Persistent fatigue and depressive symptoms are both highly prevalent among patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) as well as breast cancer survivors. This study aimed to assess and directly compare perceptions of fatigue as highly interfering in one's daily functioning in both patient populations to better understand their relationships with depressed mood. Participants were 95 female CFS/ME patients and 67 females who were approximately 5 years post-treatment for stage 0-III breast cancer presenting with clinically elevated fatigue severity. Self-report measures were obtained on participants' fatigue-related interference in daily functioning and fatigue severity as well as depressed mood. Hierarchical regression was used to test effects controlling for relevant demographic, psychosocial, and medical covariates. CFS/ME patients endorsed greater depressed mood and fatigue interference than did fatigued breast cancer survivors, p's <.001. These factors were significantly positively correlated among CFS/ME patients (β=.36, p <.001), but not the fatigued breast cancer survivors (β=.18, p =.19). CFS/ME patients reported elevated fatigue symptoms and depression relative to fatigued breast cancer survivors. In the former group, greater depressed mood was highly and significantly associated with greater fatigue-related inference in daily activities. Potential targets for cognitive behavioral interventions are discussed.

  12. Severe fatigue in type 1 diabetes: Exploring its course, predictors and relationship with HbA1c in a prospective study.

    PubMed

    Menting, Juliane; Nikolaus, Stephanie; van der Veld, William M; Goedendorp, Martine M; Tack, Cees J; Knoop, Hans

    2016-11-01

    To prospectively identify the course of severe fatigue, its predictors and the relationship with HbA 1c in patients with type 1 diabetes. 214 adult patients completed questionnaires on fatigue severity and fatigue-related factors at baseline. HbA 1c was retrieved from medical records. After 43months, fatigue severity and HbA 1c were reassessed in 194 patients. A logistic regression analysis was used to determine predictors of severe fatigue at follow-up with various cognitive-behavioral and clinical factors as potential predictors. The relationship between fatigue and HbA 1c was investigated in a sub-analysis by differentiating between patients with suboptimal glucose control [HbA 1c >7% (53mmol/mol)] and optimal glucose control [HbA 1c ⩽7% (53mmol/mol)]. The prevalence of severe fatigue was 40% at baseline and 42% at follow-up. In three out of four severely fatigued patients at baseline (76%), severe fatigue persisted over time. More depressive symptoms, more pain, sleep disturbances, lower self-efficacy concerning fatigue, less confidence in diabetes self-care, more fatigue severity at baseline and more diabetes complications predicted severe fatigue at follow-up. Over time, HbA 1c at baseline was positively associated with fatigue severity at follow-up in both groups (suboptimal glucose control: r=.18, p<.05; optimal glucose control: r=.09, p<.05). About three quarters of fatigued[corrected] patients with type 1 diabetes suffer from persistent fatigue. Aside from the number of diabetes complications, no clinical factors explained the persistence of fatigue. HbA 1c and fatigue were weakly associated in a sub-analysis. Since the strongest predictors of severe fatigue were cognitive-behavioral factors, behavioral interventions might be effective in decreasing fatigue. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Fatigue and Depression in Sick-Listed Chronic Low Back Pain Patients

    PubMed Central

    Snekkevik, Hildegun; Eriksen, Hege R; Tangen, Tone; Chalder, Trudie; Reme, Silje E

    2014-01-01

    Objective The relationship between fatigue and pain has been investigated previously, but little is known about the prevalence of substantial fatigue in patients sick-listed for chronic low back pain (CLBP) and about how fatigue is associated with depression, pain, and long-term disability. The aims of the study were to examine the prevalence of substantial fatigue; associations between fatigue, depression, and pain; and whether fatigue predicted long-term disability. Methods Five hundred sixty-nine patients participating in a randomized controlled trial and sick-listed 2–10 months for LBP were included in the study. Cross-sectional analyses were conducted to investigate the prevalence and independent associations between fatigue, depression, pain, and disability, while longitudinal analyses were done to investigate the association between fatigue and long-term disability. Results The prevalence of substantial fatigue was 69.7%. Women reported significantly more fatigue than men (t = −3.6, df = 551; P < .001). Those with substantial fatigue had higher pain intensity (t = −3.3, df = 534; P = 0.01), more depressive symptoms (t = −10.9, df = 454; P < 0.001), and more disability (t = −7.6, df = 539; P < 0.001) than those without substantial fatigue. Musculoskeletal pain and depression were independently associated with substantial fatigue. In the longitudinal analyses, fatigue predicted long-term disability at 3, 6, and 12 months' follow-up. After pain and depression were controlled for, fatigue remained a significant predictor of disability at 6 months' follow-up. Conclusions The vast majority of the sick-listed CLBP patients reported substantial fatigue. Those with substantial fatigue had more pain and depressive symptoms and a significant risk of reporting more disability at 3, 6, and 12 months. Substantial fatigue is disabling in itself but also involves a risk of developing chronic fatigue syndrome and long-term disability. PMID:24716799

  14. The Neural Mechanisms of Re-Experiencing Mental Fatigue Sensation: A Magnetoencephalography Study

    PubMed Central

    Ishii, Akira; Karasuyama, Takuma; Kikuchi, Taiki; Tanaka, Masaaki; Yamano, Emi; Watanabe, Yasuyoshi

    2015-01-01

    There have been several studies which have tried to clarify the neural mechanisms of fatigue sensation; however fatigue sensation has multiple aspects. We hypothesized that past experience related to fatigue sensation is an important factor which contributes to future formation of fatigue sensation through the transfer to memories that are located within specific brain structures. Therefore, we aimed to investigate the neural mechanisms of fatigue sensation related to memory. In the present study, we investigated the neural activity caused by re-experiencing the fatigue sensation that had been experienced during a fatigue-inducing session. Thirteen healthy volunteers participated in fatigue and non-fatigue experiments in a crossover fashion. In the fatigue experiment, they performed a 2-back test session for 40 min to induce fatigue sensation, a rest session for 15 min to recover from fatigue, and a magnetoencephalography (MEG) session in which they were asked to re-experience the state of their body with fatigue that they had experienced in the 2-back test session. In the non-fatigue experiment, the participants performed a free session for 15 min, a rest session for 15 min, and an MEG session in which they were asked to re-experience the state of their body without fatigue that they had experienced in the free session. Spatial filtering analyses of oscillatory brain activity showed that the delta band power in the left Brodmann’s area (BA) 39, alpha band power in the right pulvinar nucleus and the left BA 40, and beta band power in the left BA 40 were lower when they re-experienced the fatigue sensation than when they re-experienced the fatigue-free sensation, indicating that these brain regions are related to re-experiencing the fatigue sensation. Our findings may help clarify the neural mechanisms underlying fatigue sensation. PMID:25826300

  15. Tired, weak, or in need of rest: fatigue among general practice attenders.

    PubMed

    David, A; Pelosi, A; McDonald, E; Stephens, D; Ledger, D; Rathbone, R; Mann, A

    1990-11-24

    To determine the prevalence and associations of symptoms of fatigue. Questionnaire survey. London general practice. 611 General practice attenders. Scores on a fatigue questionnaire and reasons given for fatigue. 10.2% Of men (17/167) and 10.6% of women (47/444) had substantial fatigue for one month or more. Age, occupation, and marital status exerted minor effects. Subjects attributed fatigue equally to physical and non-physical causes. Physical ill health, including viral infection, was associated with more severe fatigue. Women rather than men blamed family responsibilities for their fatigue. The profile of persistent fatigue did not differ from that of short duration. Only one person met criteria for the chronic fatigue syndrome. Fatigue is a common complaint among general practice attenders and can be severe. Patients may attribute this to physical, psychological, and social stress.

  16. A Constitutive Relationship between Fatigue Limit and Microstructure in Nanostructured Bainitic Steels

    PubMed Central

    Mueller, Inga; Rementeria, Rosalia; Caballero, Francisca G.; Kuntz, Matthias; Sourmail, Thomas; Kerscher, Eberhard

    2016-01-01

    The recently developed nanobainitic steels show high strength as well as high ductility. Although this combination seems to be promising for fatigue design, fatigue properties of nanostructured bainitic steels are often surprisingly low. To improve the fatigue behavior, an understanding of the correlation between the nanobainitic microstructure and the fatigue limit is fundamental. Therefore, our hypothesis to predict the fatigue limit was that the main function of the microstructure is not necessarily totally avoiding the initiation of a fatigue crack, but the microstructure has to increase the ability to decelerate or to stop a growing fatigue crack. Thus, the key to understanding the fatigue behavior of nanostructured bainite is to understand the role of the microstructural features that could act as barriers for growing fatigue cracks. To prove this hypothesis, we carried out fatigue tests, crack growth experiments, and correlated these results to the size of microstructural features gained from microstructural analysis by light optical microscope and EBSD-measurements. Finally, we were able to identify microstructural features that influence the fatigue crack growth and the fatigue limit of nanostructured bainitic steels. PMID:28773953

  17. [Epidemiology of fatigue in general practice].

    PubMed

    Fuhrer, R

    1994-11-01

    The epidemiology of fatigue is not well known in France, and this study reports on factors associated with fatigue in a sample of 3,784 general practice patients. Prevalence rates according to several definitions of fatigue are presented and factors are examined that have been reported to be associated with fatigue. Although 41.2% of the sample report having experienced symptoms of fatigue for at least three days, only 7.6% declare fatigue as a reason for consulting a doctor. Women report more symptoms of fatigue, but they do not consult more often than men for this reason. Age is strongly correlated with fatigue, but this is found only for men. Socioprofessional category bears no relationship to fatigue as a reason for consultation, however, the diagnosis of fatigue is more often attributed to professionals and upper management than it is to office staff or skilled and unskilled workers. We do find a strong relationship between depressive symptomatology as measured by the Center for Epidemiologic Studies (CES-D) and fatigue; nonetheless, fatigue is neither sensitive nor specific to the diagnosis of depression.

  18. The role of cognitive, emotional and personality factors in the experience of fatigue in a university and community sample.

    PubMed

    Kangas, Maria; Montgomery, Guy H

    2011-05-01

    The aim of this study was to investigate the contribution of cognitive, emotional and personality factors to the experience of fatigue severity in healthy adult individuals. Specifically, the study examined whether fatigue catastrophising and emotional distress mediated the relationships between neuroticism, general irrational and rational thoughts to fatigue severity. One hundred and eighty nine university students and community volunteers completed self-report questionnaires assessing fatigue catastrophising and symptom severity, neuroticism, general rational and irrational thoughts and emotional distress. A series of correlational and path analyses were conducted to test the study hypotheses. Neuroticism and more general negative, irrational cognitions were associated with elevated fatigue catastrophising and fatigue severity, whereas more adaptive, rational cognitions were related to lower fatigue catastrophising and fatigue severity. Both elevated fatigue catastrophising and emotional distress uniquely and simultaneously mediated the relationships between irrational and rational cognitions and neuroticism to fatigue severity. These findings demonstrate that cognitions play a role in fatigue severity. The results have implications in the assessment and treatment of fatigue disturbances in the general community.

  19. Severe fatigue after treatment of ductal carcinoma in situ: A comparison with age-matched breast cancer survivors and healthy controls.

    PubMed

    Abrahams, H J G; Smits, L; Lugt, M de; Roos, W K de; Kamm, Y; Heins, M J; Verhagen, C A H H V M; Gielissen, M F M; Knoop, H

    2017-02-01

    Severe fatigue after treatment of ductal carcinoma in situ (DCIS) has not been studied before. The current study examined (i) the prevalence of severe fatigue in DCIS patients versus breast cancer survivors (BCS) and healthy controls (HC), (ii) quality of life and functioning of severely versus non-severely fatigued DCIS patients and BCS, and (iii) the association of fatigue with psychosocial and behavioral factors in DCIS patients. 89 patients treated for DCIS were matched on age and gender to 67 BCS and 178 HC (ratio 1:1:2). Fatigue was measured with the Fatigue Severity subscale of the Checklist Individual Strength. 23% of DCIS patients, 25% of BCS, and 6% of HC were severely fatigued (DCIS versus HC: p < 0.001). Severely fatigued DCIS patients had a lower quality of life and were more impaired in all domains of functioning than non-severely fatigued DCIS patients. Sleep problems, dysfunctional cognitions regarding fatigue, avoidance of activities, all-or-nothing behavior, perceived lack of social support, DCIS-related coping problems, and fear of future cancer occurrence were related to fatigue. The prevalence of severe fatigue in DCIS patients was similar to BCS, but higher than in HC. Severely fatigued DCIS patients had a lower quality of life and more functional impairments. The psychosocial and behavioral fatigue-related factors in DCIS patients are known to perpetuate fatigue in BCS. These factors can be targeted in interventions for cancer-related fatigue. Our findings suggest that the same treatment elements might be applicable to severely fatigued DCIS patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Prevalence, Incidence, and Classification of Chronic Fatigue Syndrome in Olmsted County, Minnesota, as Estimated Using the Rochester Epidemiology Project

    PubMed Central

    Vincent, Ann; Brimmer, Dana J.; Whipple, Mary O.; Jones, James F.; Boneva, Roumiana; Lahr, Brian D.; Maloney, Elizabeth; St. Sauver, Jennifer L.; Reeves, William C.

    2012-01-01

    Objective To estimate the prevalence and incidence of chronic fatigue syndrome in Olmsted County, Minnesota, using the 1994 case definition and describe exclusionary and comorbid conditions observed in patients who presented for evaluation of long-standing fatigue. Patients and Methods We conducted a retrospective medical record review of potential cases of chronic fatigue syndrome identified from January 1, 1998, through December 31, 2002, using the Rochester Epidemiology Project, a population-based database. Patients were classified as having chronic fatigue syndrome if the medical record review documented fatigue of 6 months' duration, at least 4 of 8 chronic fatigue syndrome–defining symptoms, and symptoms that interfered with daily work or activities. Patients not meeting all of the criteria were classified as having insufficient/idiopathic fatigue. Results We identified 686 potential patients with chronic fatigue, 2 of whom declined consent for medical record review. Of the remaining 684 patients, 151 (22%) met criteria for chronic fatigue syndrome or insufficient/idiopathic fatigue. The overall prevalence and incidence of chronic fatigue syndrome and insufficient/idiopathic fatigue were 71.34 per 100,000 persons and 13.16 per 100,000 person-years vs 73.70 per 100,000 persons and 13.58 per 100,000 person-years, respectively. The potential cases included 482 patients (70%) who had an exclusionary condition, and almost half the patients who met either criterion had at least one nonexclusionary comorbid condition. Conclusion The incidence and prevalence of chronic fatigue syndrome and insufficient/idiopathic fatigue are relatively low in Olmsted County. Careful clinical evaluation to identify whether fatigue could be attributed to exclusionary or comorbid conditions rather than chronic fatigue syndrome itself will ensure appropriate assessment for patients without chronic fatigue syndrome. PMID:23140977

  1. Active and passive fatigue in simulated driving: discriminating styles of workload regulation and their safety impacts.

    PubMed

    Saxby, Dyani J; Matthews, Gerald; Warm, Joel S; Hitchcock, Edward M; Neubauer, Catherine

    2013-12-01

    Despite the known dangers of driver fatigue, it is a difficult construct to study empirically. Different forms of task-induced fatigue may differ in their effects on driver performance and safety. Desmond and Hancock (2001) defined active and passive fatigue states that reflect different styles of workload regulation. In 2 driving simulator studies we investigated the multidimensional subjective states and safety outcomes associated with active and passive fatigue. Wind gusts were used to induce active fatigue, and full vehicle automation to induce passive fatigue. Drive duration was independently manipulated to track the development of fatigue states over time. Participants were undergraduate students. Study 1 (N = 108) focused on subjective response and associated cognitive stress processes, while Study 2 (N = 168) tested fatigue effects on vehicle control and alertness. In both studies the 2 fatigue manipulations produced different patterns of subjective response reflecting different styles of workload regulation, appraisal, and coping. Active fatigue was associated with distress, overload, and heightened coping efforts, whereas passive fatigue corresponded to large-magnitude declines in task engagement, cognitive underload, and reduced challenge appraisal. Study 2 showed that only passive fatigue reduced alertness, operationalized as speed of braking and steering responses to an emergency event. Passive fatigue also increased crash probability, but did not affect a measure of vehicle control. Findings support theories that see fatigue as an outcome of strategies for managing workload. The distinction between active and passive fatigue is important for assessment of fatigue and for evaluating automated driving systems which may induce dangerous levels of passive fatigue. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  2. A Preliminary Review of Fatigue Among Rail Staff

    PubMed Central

    Fan, Jialin; Smith, Andrew P.

    2018-01-01

    Background: Fatigue is a severe problem in the rail industry, which may jeopardize train crew's health and safety. Nonetheless, a preliminary review of all empirical evidence for train crew fatigue is still lacking. The aim of the present paper is, therefore, to provide a preliminary description of occupational fatigue in the rail industry. This paper reviews the literature with the research question examining the risk factors associated with train crew fatigue, covering both papers published in refereed journals and reports from trade organizations and regulators. It assesses the progress of research on railway fatigue, including research on the main risk factors for railway fatigue, the association between fatigue and railway incidents, and how to better manage fatigue in the railway industry. Methods: Systematic searches were performed in both science and industry databases. The searches considered studies published before August 2017. The main exclusion criterion was fatigue not being directly measured through subjective or objective methods. Results: A total of 31 studies were included in the main review. The causes of fatigue included long working hours, heavy workload, early morning or night shifts, and insufficient sleep. Poor working environment, particular job roles, and individual differences also contributed to fatigue. Conclusion: Fatigue in the rail industry includes most of the features of occupational fatigue, and it is also subject to industry-specific factors. The effect of fatigue on well-being and the fatigued population in the railway industry are still not clear. Future studies can consider associations between occupational risk factors and perceived fatigue by examining the prevalence of fatigue and identifying the potential risk factors in staff within the railway industry. PMID:29867630

  3. Fatigue and radiotherapy: (B) experience in patients 9 months following treatment.

    PubMed Central

    Smets, E. M.; Visser, M. R.; Willems-Groot, A. F.; Garssen, B.; Schuster-Uitterhoeve, A. L.; de Haes, J. C.

    1998-01-01

    Little is known regarding the prevalence and course of fatigue in cancer patients after treatment has ended and no recurrence found. The present study examines fatigue in disease-free cancer patients after being treated with radiotherapy (n = 154). The following questions are addressed. First, how do patients describe their fatigue 9 months after radiotherapy and is this different from fatigue in a nonselective sample from the general population (n = 139)? Secondly, to what degree is fatigue in patients associated with sociodemographic, medical, physical and psychological factors? Finally, is it possible to predict which patients will suffer from fatigue 9 months after radiotherapy? Results indicated that fatigue in disease-free cancer patients did not differ significantly from fatigue in the general population. However, for 34% of the patients, fatigue following treatment was worse than anticipated, 39% listed fatigue as one of the three symptoms causing them most distress, 26% of patients worried about their fatigue and patients' overall quality of life was negatively related to fatigue (r = -0.46). Fatigue in disease-free patients was significantly associated with: gender, physical distress, pain rating, sleep quality, functional disability, psychological distress and depression, but not with medical (diagnosis, prognosis, co-morbidity) or treatment-related (target area, total radiation dose, fractionation) variables. The degree of fatigue, functional disability and pain before radiotherapy were the best predictors of fatigue at 9-month follow-up, explaining 30%, 3% and 4% of the variance respectively. These findings are in line with the associations found with fatigue during treatment as reported in the preceding paper in this issue. The significant associations between fatigue and both psychological and physical variables demonstrate the complex aetiology of this symptom in patients and point out the necessity of a multidisciplinary approach for its treatment. PMID:9764582

  4. Chronicity and remission of fatigue in patients with established HIV infection.

    PubMed

    Pence, Brian Wells; Barroso, Julie; Harmon, James L; Leserman, Jane; Salahuddin, Naima; Hammill, Bradley G

    2009-04-01

    Fatigue is one of the most common and debilitating complaints of HIV-positive individuals, potentially leading to important functional limitations. We recruited 128 HIV-positive individuals (fatigued and nonfatigued) between March 2005 and May 2006; 66% were male, 66% were African American, 45% had greater than a high school education, 67% were unemployed, and ages ranged from 26-66 (median, 44). Every 3 months for 15 months, participants completed a 56-item self-report fatigue scale developed and validated by the authors. Participants were classified as fatigued or not fatigued at each assessment and received scores for fatigue intensity and impact of fatigue on functioning. We used linear mixed-effects models to assess longitudinal variation in fatigue scores and generalized estimating equations for binary outcomes to model predictors of fatigue remission among those fatigued at baseline. At baseline, 88% of the sample was fatigued. Fatigue measures were highly correlated across time points (rho 0.63-0.85 [intensity], 0.63-0.80 [functioning]) and showed no evidence of overall improvement, deterioration, or convergence over time. Predictors of lower fatigue scores included higher income, employment, longer time since HIV diagnosis, and antiretroviral therapy use. Those employed at baseline were likely to show improvements in fatigue while those unemployed were not. Of those fatigued at baseline, 11% experienced remission during follow-up; remission was associated with Caucasian race and employment. In summary, fatigue intensity and related functional limitations were persistent, stable, and unlikely to remit over 15 months of follow-up in this sample of patients with established HIV infection.

  5. Fatigue in young survivors of extracranial childhood cancer: a Finnish nationwide survey.

    PubMed

    Mört, Susanna; Lähteenmäki, Päivi M; Matomäki, Jaakko; Salmi, Toivo T; Salanterä, Sanna

    2011-11-01

    To evaluate self-reports of fatigue by young cancer survivors (aged 11-18 years), to compare young survivors' fatigue scores with the scores of a healthy control group and of the parent proxy evaluation, and to analyze whether demographic or disease-related factors are associated with young survivors' fatigue. Cross-sectional quantitative study. An urban hospital in southwestern Finland. 384 survivors diagnosed with an extracranial malignancy at age 16 or younger, who have survived four or more years postdiagnosis, and who are free of cancer. General matched population controls were randomly selected from the Finnish Population Registry. Demographic data and a self-report written fatigue questionnaire. Total fatigue (TF), general fatigue (GF), sleep or rest fatigue (SF), and cognitive fatigue. The control populations reported significantly more issues with TF, GF, and SF than did the survivor population. In survivors, older age, the need for remedial education at school, and a sarcoma diagnosis were associated with increasing fatigue, whereas female gender, better school grades, and greater health-related quality-of-life (HRQOL) scores were associated with lower fatigue. The study variables explained 49%-65% of the variation in fatigue scores. Although survivors and their matched controls seem to have similar fatigue, subgroups of survivors do experience excessive fatigue, which may have an impact on their HRQOL. This study increases the knowledge about fatigue levels of young survivors of extracranial malignancies and identifies the need for instruments specifically designed to assess fatigue in this population. The healthcare team should pay attention to the fatigue level of young survivors, particularly SF.

  6. An exploration of the relationship between fatigue and physical functioning in patients with end stage renal disease receiving haemodialysis.

    PubMed

    O'Sullivan, Dawn; McCarthy, Geraldine

    2007-11-01

    To measure fatigue and physical functioning in patients with end stage renal disease (ESRD) receiving haemodialysis and to investigate the relationships between fatigue and physical functioning. Fatigue and reduced physical functioning are among the most bothersome symptoms experienced by individuals receiving haemodialysis for ESRD. Research has shown that increasing activity levels has resulted in decreased fatigue levels and improved physical functioning in individuals with cancer. Establishing whether or not a relationship exists between both concepts in haemodialysis patients is a preliminary step in identifying potential fatigue reducing strategies necessary for improved wellbeing. A quantitative exploratory correlational design was used with 46 individuals completing the Multi-dimensional Fatigue Inventory, the Medical Outcomes Study Short-Form 36-item questionnaire and a Demographic Questionnaire. Results indicated fatigue was prevalent with highest scores achieved for physical fatigue; reduced activity and general fatigue. Substantial limitations in physical functioning were found. A significant moderate negative relationship between general fatigue and physical functioning indicated that, as physical functioning levels increased, fatigue levels decreased. A significant difference was also found between general fatigue scores for males and females. Significant relationships were found between overall physical functioning, older age and employment status. The research indicates the prevalence of fatigue and limitations in physical functioning in individuals with ESRD. However, as physical functioning increased fatigue decreased; a finding relevant to clinical nursing. Understanding the levels of fatigue and the value of exercise is of relevance to clinical practice thus assessment of fatigue and physical functioning ability in the clinical setting is necessary.

  7. Identification of distinct fatigue trajectories in patients with breast cancer undergoing adjuvant chemotherapy.

    PubMed

    Junghaenel, Doerte U; Cohen, Jules; Schneider, Stefan; Neerukonda, Anu R; Broderick, Joan E

    2015-09-01

    The goal of this study was to characterize changes in daily fatigue in women undergoing chemotherapy for breast cancer. We examined whether there are subgroups of patients with distinct fatigue trajectories and explored potential psychosocial and biomedical predictors of these subgroups. Participants were 77 women with breast cancer receiving adjuvant chemotherapy with AC-T (2-week cycle) and TC or TCH (3-week cycle) regimens. They completed 28 daily ratings online using an adapted version of the Patient-Reported Outcomes Measurement Information System (PROMIS®) fatigue instrument. Both regimens followed an "inverted-U-shaped" fatigue pattern over approximately 2 weeks. Growth mixture modeling identified three patient subgroups with distinct trajectories. Fatigue scores in the "low fatigue" group (23 %) increased following the infusion and quickly abated. The "transient fatigue" (27 %) group had a very pronounced increase. Patients in the "high fatigue" (50 %) group reported consistently elevated fatigue with a relatively small increase. Demographic and medical variables were not associated with fatigue trajectory. Patients in the "high fatigue" group reported significantly poorer physical, emotional, and social functioning, poorer general health, and more depressed mood than patients in the "low fatigue" group. The "transient fatigue" group reported significantly better physical and social functioning than the "high fatigue" group, but emotional distress and depression similar to the "high fatigue" group. The identification of patient subgroups with distinct fatigue trajectories during chemotherapy is an essential step for developing preventative strategies and tailored interventions. Our results suggest that different trajectories are associated with patients' psychosocial and general health.

  8. A randomized controlled trial of qigong exercise on fatigue symptoms, functioning, and telomerase activity in persons with chronic fatigue or chronic fatigue syndrome.

    PubMed

    Ho, Rainbow T H; Chan, Jessie S M; Wang, Chong-Wen; Lau, Benson W M; So, Kwok Fai; Yuen, Li Ping; Sham, Jonathan S T; Chan, Cecilia L W

    2012-10-01

    Chronic fatigue is common in the general population. Complementary therapies are often used by patients with chronic fatigue or chronic fatigue syndrome to manage their symptoms. This study aimed to assess the effect of a 4-month qigong intervention program among patients with chronic fatigue or chronic fatigue syndrome. Sixty-four participants were randomly assigned to either an intervention group or a wait list control group. Outcome measures included fatigue symptoms, physical functioning, mental functioning, and telomerase activity. Fatigue symptoms and mental functioning were significantly improved in the qigong group compared to controls. Telomerase activity increased in the qigong group from 0.102 to 0.178 arbitrary units (p < 0.05). The change was statistically significant when compared to the control group (p < 0.05). Qigong exercise may be used as an alternative and complementary therapy or rehabilitative program for chronic fatigue and chronic fatigue syndrome.

  9. Examination of Cognitive Fatigue in Multiple Sclerosis using Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging

    PubMed Central

    Genova, Helen M.; Rajagopalan, Venkateswaran; DeLuca, John; Das, Abhijit; Binder, Allison; Arjunan, Aparna; Chiaravalloti, Nancy; Wylie, Glenn

    2013-01-01

    The present study investigated the neural correlates of cognitive fatigue in Multiple Sclerosis (MS), looking specifically at the relationship between self-reported fatigue and objective measures of cognitive fatigue. In Experiment 1, functional magnetic resonance imaging (fMRI) was used to examine where in the brain BOLD activity covaried with “state” fatigue, assessed during performance of a task designed to induce cognitive fatigue while in the scanner. In Experiment 2, diffusion tensor imaging (DTI) was used to examine where in the brain white matter damage correlated with increased “trait” fatigue in individuals with MS, assessed by the Fatigue Severity Scale (FSS) completed outside the scanning session. During the cognitively fatiguing task, the MS group had increased brain activity associated with fatigue in the caudate as compared with HCs. DTI findings revealed that reduced fractional anisotropy in the anterior internal capsule was associated with increased self-reported fatigue on the FSS. Results are discussed in terms of identifying a “fatigue-network” in MS. PMID:24223850

  10. Examination of cognitive fatigue in multiple sclerosis using functional magnetic resonance imaging and diffusion tensor imaging.

    PubMed

    Genova, Helen M; Rajagopalan, Venkateswaran; Deluca, John; Das, Abhijit; Binder, Allison; Arjunan, Aparna; Chiaravalloti, Nancy; Wylie, Glenn

    2013-01-01

    The present study investigated the neural correlates of cognitive fatigue in Multiple Sclerosis (MS), looking specifically at the relationship between self-reported fatigue and objective measures of cognitive fatigue. In Experiment 1, functional magnetic resonance imaging (fMRI) was used to examine where in the brain BOLD activity covaried with "state" fatigue, assessed during performance of a task designed to induce cognitive fatigue while in the scanner. In Experiment 2, diffusion tensor imaging (DTI) was used to examine where in the brain white matter damage correlated with increased "trait" fatigue in individuals with MS, assessed by the Fatigue Severity Scale (FSS) completed outside the scanning session. During the cognitively fatiguing task, the MS group had increased brain activity associated with fatigue in the caudate as compared with HCs. DTI findings revealed that reduced fractional anisotropy in the anterior internal capsule was associated with increased self-reported fatigue on the FSS. Results are discussed in terms of identifying a "fatigue-network" in MS.

  11. Synergistic Effects of Temperature, Oxidation and Stress Level on Fatigue Damage Evolution and Lifetime Prediction of Cross-Ply SiC/CAS Ceramic-Matrix Composites Through Hysteresis-Based Parameters

    NASA Astrophysics Data System (ADS)

    Li, Longbiao

    2017-12-01

    The damage development and cyclic fatigue lifetime of cross-ply SiC/CAS ceramic-matrix composites have been investigated at different testing temperatures in air atmosphere. The relationships between the fatigue hysteresis-based damage parameters, i.e., fatigue hysteresis dissipated energy, fatigue hysteresis modulus and fatigue peak strain and the damage mechanisms of matrix multicracking, fiber/matrix interface debonding, interface sliding and fibers failure, have been established. With the increase in the cycle number, the evolution of the fatigue hysteresis modulus, fatigue peak strain and fatigue hysteresis dissipated energy depends upon the fatigue peak stress levels, interface and fibers oxidation and testing temperature. The fatigue life S-N curves of cross-ply SiC/CAS composite at room and elevated temperatures have been predicted, and the fatigue limit stresses at room temperature, 750 and 850 °C, are 50, 36 and 30% of the tensile strength, respectively.

  12. Fatigue and its associated factors in liver transplant recipients in Beijing: a cross-sectional study

    PubMed Central

    Lin, Xiao-Hong; Teng, Sha; Wang, Lu; Zhang, Jing; Shang, Ya-Bin; Liu, Hong-Xia; Zang, Yun-Jin

    2017-01-01

    Objectives Fatigue is a highly prevalent symptom experienced by patients who underwent the liver transplantation. However, the influencing factors of fatigue are poorly understood by healthcare professionals. The aim of this study was to examine the intensity, interference, duration and prevalence of fatigue in liver transplantation recipients and to explore the influencing factors of post-transplantation fatigue. Design A cross-sectional design was used in this study. Methods A convenience sample of liver transplant recipients was recruited at an outpatient transplant clinic of a general hospital in Beijing, China. Self-report survey data were provided by liver transplant recipients using the Fatigue Symptom Inventory (FSI), the Hospital Anxiety and Depression Scale (HADS), the Perceived Social Support Scale (PSSS) and the Athens Insomnia Scale (AIS). Demographic, clinical and psychosocial parameters were evaluated as fatigue influencing factors. Results Participants (n=285) included 69 women and 216 men. Fatigue was found in 87.0% of liver transplant recipients. Mean scores of fatigue intensity items were 4.47±2.85, 1.93±1.97, 3.15±2.13 and 2.73±2.42 (most fatigue, least fatigue, average fatigue in the week prior to assessment and fatigue at the point of assessment). The mean score of fatigue interference was 2.27±2.09.The number of days fatigued in the week prior to assessment was 2.26±2.02 and the amount of time fatigued each day was 2.75±2.44. Spearman's correlation analysis showed that fatigue intensity was positively associated with anxiety, depression and insomnia (p<0.001 for all), while fatigue interference was positively associated with gender, anxiety, depression and insomnia (p<0.05 for all). In the multiple linear regression analysis, anxiety and insomnia were positively associated with fatigue intensity (p<0.001), and insomnia, depression and anxiety were positively associated with fatigue interference (p<0.001). Conclusions Fatigue is common in liver transplant recipients, and it is strongly associated with insomnia, anxiety and depression. PMID:28235963

  13. Fatigue in palliative care patients -- an EAPC approach.

    PubMed

    Radbruch, Lukas; Strasser, Florian; Elsner, Frank; Gonçalves, Jose Ferraz; Løge, Jon; Kaasa, Stein; Nauck, Friedemann; Stone, Patrick

    2008-01-01

    Fatigue is one of the most frequent symptoms in palliative care patients, reported in .80% of cancer patients and in up to 99% of patients following radio- or chemotherapy. Fatigue also plays a major role in palliative care for noncancer patients, with large percentages of patients with HIV, multiple sclerosis, chronic obstructive pulmonary disease or heart failure reporting fatigue. This paper presents the position of an expert working group of the European Association for Palliative Care (EAPC), evaluating the available evidence on diagnosis and treatment of fatigue in palliative care patients and providing the basis for future discussions. As the expert group feels that culture and language influence the approach to fatigue in different European countries, a focus was on cultural issues in the assessment and treatment of fatigue in palliative care. As a working definition, fatigue was defined as a subjective feeling of tiredness, weakness or lack of energy. Qualitative differences between fatigue in cancer patients and in healthy controls have been proposed, but these differences seem to be only an expression of the overwhelming intensity of cancer-related fatigue. The pathophysiology of fatigue in palliative care patients is not fully understood. For a systematic approach, primary fatigue, most probably related to high load of proinflammatory cytokines and secondary fatigue from concurrent syndromes and comorbidities may be differentiated. Fatigue is generally recognized as a multidimensional construct, with a physical and cognitive dimension acknowledged by all authors. As fatigue is an inherent word only in the English and French language, but not in other European languages, screening for fatigue should include questions on weakness as a paraphrase for the physical dimension and on tiredness as a paraphrase for the cognitive dimension. Treatment of fatigue should include causal interventions for secondary fatigue and symptomatic treatment with pharmacological and nonpharmacological interventions. Strong evidence has been accumulated that aerobic exercise will reduce fatigue levels in cancer survivors and patients receiving cancer treatment. In the final stage of life, fatigue may provide protection and shielding from suffering for the patient and thus treatment may be detrimental. Identification of the time point, where treatment of fatigue is no longer indicated is important to alleviate distress at the end of life.

  14. A Taxonomy of Fatigue Concepts and Their Relation to Hearing Loss

    PubMed Central

    Hornsby, Benjamin W.Y.; Naylor, Graham; Bess, Fred H.

    2016-01-01

    Fatigue is common in individuals with a variety of chronic health conditions and can have significant negative effects on quality of life. Although limited in scope, recent work suggests persons with hearing loss may be at increased risk for fatigue, in part due to effortful listening that is exacerbated by their hearing impairment. However, the mechanisms responsible for hearing loss-related fatigue, and the efficacy of audiologic interventions for reducing fatigue, remain unclear. To improve our understanding of hearing loss-related fatigue, as a field it is important to develop a common conceptual understanding of this construct. In this paper the broader fatigue literature is reviewed to identify and describe core constructs, consequences and methods for assessing fatigue and related constructs. Finally, our current knowledge linking hearing loss and fatigue is described and may be summarised as follows: Hearing impairment increases the risk of subjective fatigue and vigor deficits.Adults with hearing loss require more time to recover from fatigue after work, and have more work absences.Sustained, effortful, listening can be fatiguing.Optimal methods for eliciting and measuring fatigue in persons with hearing loss remain unclear and may vary with listening condition.Amplification may minimize decrements in cognitive processing speed during sustained effortful listening. Future research is needed to develop reliable measurement methods to quantify hearing loss-related fatigue; explore factors responsible for modulating fatigue in people with hearing loss; and identify and evaluate potential interventions for reducing hearing loss-related fatigue. PMID:27355763

  15. The Nature of Self-Regulatory Fatigue and "Ego Depletion": Lessons From Physical Fatigue.

    PubMed

    Evans, Daniel R; Boggero, Ian A; Segerstrom, Suzanne C

    2015-07-30

    Self-regulation requires overriding a dominant response and leads to temporary self-regulatory fatigue. Existing theories of the nature and causes of self-regulatory fatigue highlight physiological substrates such as glucose, or psychological processes such as motivation, but these explanations are incomplete on their own. Historically, theories of physical fatigue demonstrate a similar pattern of useful but incomplete explanations, as recent views of physical fatigue emphasize the roles of both physiological and psychological factors. In addition to accounting for multiple inputs, these newer views also explain how fatigue can occur even in the presence of sufficient resources. Examining these newer theories of physical fatigue can serve as a foundation on which to build a more comprehensive understanding of self-regulatory fatigue that integrates possible neurobiological underpinnings of physical and self-regulatory fatigue, and suggests the possible function of self-regulatory fatigue. © 2015 by the Society for Personality and Social Psychology, Inc.

  16. Physiological and psychological markers associated with HIV-related fatigue.

    PubMed

    Barroso, Julie; Carlson, John R; Meynell, Janet

    2003-02-01

    Fatigue is among the most common and debilitating complaints of HIV-positive individuals. These data are part of a larger exploratory study investigating the relationships of selected psychological and physiological factors among 40 participants with HIV-related fatigue. Fatigue severity was measured using the HIV-Related Fatigue Scale. Fatigue was correlated with depression (r = .40, p < .01), state anxiety (r = .40, p <.01), and trait anxiety (r = .46, p <.01). Of the physiological factors, there were three statistically significant correlations: thyroid-stimulating hormone was negatively correlated with fatigue severity (r = -.36, p = .02), and platelets (r = .35, p = .03) and alkaline phosphatase (r = .27, p = .09) were positively correlated with fatigue severity. There were no correlations between fatigue severity and CD4 count (r = -.16, p = .31) or fatigue severity and HIV viral load levels (r = .031, p = .84). Even among the group with excellent viral suppression, fatigue scores were still very high for many participants.

  17. The nature of self-regulatory fatigue and “ego depletion”: Lessons from physical fatigue

    PubMed Central

    Evans, Daniel R.; Boggero, Ian A.; Segerstrom, Suzanne C.

    2016-01-01

    Self-regulation requires overriding a dominant response, and leads to temporary self-regulatory fatigue. Existing theories of the nature and causes of self-regulatory fatigue highlight physiological substrates such as glucose or psychological processes such as motivation, but these explanations are incomplete on their own. Historically, theories of physical fatigue demonstrate a similar pattern of useful but incomplete explanations, as recent views of physical fatigue emphasize the roles of both physiological and psychological factors. In addition to accounting for multiple inputs, these newer views also explain how fatigue can occur even in the presence of sufficient resources. Examining these newer theories of physical fatigue can serve as a foundation on which to build a more comprehensive understanding of self-regulatory fatigue that integrates possible neurobiological underpinnings of physical and self-regulatory fatigue, and suggests the possible function of self-regulatory fatigue. PMID:26228914

  18. Tired, weak, or in need of rest: fatigue among general practice attenders.

    PubMed Central

    David, A; Pelosi, A; McDonald, E; Stephens, D; Ledger, D; Rathbone, R; Mann, A

    1990-01-01

    OBJECTIVES--To determine the prevalence and associations of symptoms of fatigue. DESIGN--Questionnaire survey. SETTING--London general practice. PARTICIPANTS--611 General practice attenders. MAIN OUTCOME MEASURES--Scores on a fatigue questionnaire and reasons given for fatigue. RESULTS--10.2% Of men (17/167) and 10.6% of women (47/444) had substantial fatigue for one month or more. Age, occupation, and marital status exerted minor effects. Subjects attributed fatigue equally to physical and non-physical causes. Physical ill health, including viral infection, was associated with more severe fatigue. Women rather than men blamed family responsibilities for their fatigue. The profile of persistent fatigue did not differ from that of short duration. Only one person met criteria for the chronic fatigue syndrome. CONCLUSIONS--Fatigue is a common complaint among general practice attenders and can be severe. Patients may attribute this to physical, psychological, and social stress. PMID:2261560

  19. Heat shock proteins and chronic fatigue in primary Sjögren's syndrome.

    PubMed

    Bårdsen, Kjetil; Nilsen, Mari Mæland; Kvaløy, Jan Terje; Norheim, Katrine Brække; Jonsson, Grete; Omdal, Roald

    2016-04-01

    Fatigue occurs frequently in patients with cancer, neurological diseases and chronic inflammatory diseases, but the biological mechanisms that lead to and regulate fatigue are largely unknown. When the innate immune system is activated, heat shock proteins (HSPs) are produced to protect cells. Some extracellular HSPs appear to recognize cellular targets in the brain, and we hypothesize that fatigue may be generated by specific HSPs signalling through neuronal or glial cells in the central nervous system. From a cohort of patients with primary Sjögren's syndrome, 20 patients with high and 20 patients with low fatigue were selected. Fatigue was evaluated with a fatigue visual analogue scale. Plasma concentrations of HSP32, HSP60, HSP72 and HSP90α were measured and analysed to determine if there were associations with the level of fatigue. Plasma concentrations of HSP90α were significantly higher in patients with high fatigue compared with those with low fatigue, and there was a tendency to higher concentrations of HSP72 in patients with high fatigue compared with patients with low fatigue. There were no differences in concentrations of HSP32 and HSP60 between the high- and low-fatigue groups. Thus, extracellular HSPs, particularly HSP90α, may signal fatigue in chronic inflammation. This supports the hypothesis that fatigue is generated by cellular defence mechanisms. © The Author(s) 2016.

  20. Perceived Fatigue Interference and Depressed Mood: Comparison of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis Patients with Fatigued Breast Cancer Survivors

    PubMed Central

    Hall, Daniel L.; Antoni, Michael H.; Lattie, Emily G.; Jutagir, Devika R.; Czaja, Sara J.; Perdomo, Dolores; Lechner, Suzanne C.; Stagl, Jamie M.; Bouchard, Laura C.; Gudenkauf, Lisa M.; Traeger, Lara; Fletcher, MaryAnn; Klimas, Nancy G.

    2015-01-01

    Objective Persistent fatigue and depressive symptoms are both highly prevalent among patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) as well as breast cancer survivors. This study aimed to assess and directly compare perceptions of fatigue as highly interfering in one’s daily functioning in both patient populations to better understand their relationships with depressed mood. Methods Participants were 95 female CFS/ME patients and 67 females who were approximately 5 years post-treatment for stage 0-III breast cancer presenting with clinically elevated fatigue severity. Self-report measures were obtained on participants’ fatigue-related interference in daily functioning and fatigue severity as well as depressed mood. Hierarchical regression was used to test effects controlling for relevant demographic, psychosocial, and medical covariates. Results CFS/ME patients endorsed greater depressed mood and fatigue interference than did fatigued breast cancer survivors, p’s<.001. These factors were significantly positively correlated among CFS/ME patients (β=.36, p<.001), but not the fatigued breast cancer survivors (β=.18, p=.19). Conclusions CFS/ME patients reported elevated fatigue symptoms and depression relative to fatigued breast cancer survivors. In the former group, greater depressed mood was highly and significantly associated with greater fatigue-related inference in daily activities. Potential targets for cognitive behavioral interventions are discussed. PMID:26180660

  1. Dangerous intersections? A review of studies of fatigue and distraction in the automated vehicle.

    PubMed

    Matthews, Gerald; Neubauer, Catherine; Saxby, Dyani J; Wohleber, Ryan W; Lin, Jinchao

    2018-04-10

    The impacts of fatigue on the vehicle driver may change with technological advancements including automation and the increasing prevalence of potentially distracting in-car systems. This article reviews the authors' simulation studies of how fatigue, automation, and distraction may intersect as threats to safety. Distinguishing between states of active and passive fatigue supports understanding of fatigue and the development of countermeasures. Active fatigue is a stress-like state driven by overload of cognitive capabilities. Passive fatigue is produced by underload and monotony, and is associated with loss of task engagement and alertness. Our studies show that automated driving reliably elicits subjective symptoms of passive fatigue and also loss of alertness that persists following manual takeover. Passive fatigue also impairs attention and automation use in operators of Remotely Piloted Vehicles (RPVs). Use of in-vehicle media has been proposed as a countermeasure to fatigue, but such media may also be distracting. Studies tested whether various forms of phone-based media interacted with automation-induced fatigue, but effects were complex and dependent on task configuration. Selection of fatigue countermeasures should be guided by an understanding of the form of fatigue confronting the operator. System design, regulation of level of automation, managing distraction, and selection of fatigue-resilient personnel are all possible interventions for passive fatigue, but careful evaluation of interventions is necessary prior to deployment. Copyright © 2018. Published by Elsevier Ltd.

  2. Physiological and neurophysiological determinants of postcancer fatigue: design of a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Postcancer fatigue is a frequently occurring, severe, and invalidating problem, impairing quality of life. Although it is possible to effectively treat postcancer fatigue with cognitive behaviour therapy, the nature of the underlying (neuro)physiology of postcancer fatigue remains unclear. Physiological aspects of fatigue include peripheral fatigue, originating in muscle or the neuromuscular junction; central fatigue, originating in nerves, spinal cord, and brain; and physical deconditioning, resulting from a decreased cardiopulmonary function. Studies on physiological aspects of postcancer fatigue mainly concentrate on deconditioning. Peripheral and central fatigue and brain morphology and function have been studied for patients with fatigue in the context of chronic fatigue syndrome and neuromuscular diseases and show several characteristic differences with healthy controls. Methods/design Fifty seven severely fatigued and 21 non-fatigued cancer survivors will be recruited from the Radboud University Nijmegen Medical Centre. Participants should have completed treatment of a malignant, solid tumour minimal one year earlier and should have no evidence of disease recurrence. Severely fatigued patients are randomly assigned to either the intervention condition (cognitive behaviour therapy) or the waiting list condition (start cognitive behaviour therapy after 6 months). All participants are assessed at baseline and the severely fatigued patients also after 6 months follow-up (at the end of cognitive behaviour therapy or waiting list). Primary outcome measures are fatigue severity, central and peripheral fatigue, brain morphology and function, and physical condition and activity. Discussion This study will be the first randomized controlled trial that characterizes (neuro)physiological factors of fatigue in disease-free cancer survivors and evaluates to which extent these factors can be influenced by cognitive behaviour therapy. The results of this study are not only essential for a theoretical understanding of this invalidating condition, but also for providing an objective biological marker for fatigue that could support the diagnosis and follow-up of treatment. Trial registration The study is registered at http://ClinicalTrials.gov (NCT01096641). PMID:22708881

  3. Cumulative fatigue damage behavior of MAR M-247

    NASA Technical Reports Server (NTRS)

    Mcgaw, Michael A.; Halford, Gary R.; Kalluri, Sreeramesh

    1991-01-01

    The objective was to examine the room temperature fatigue and nonlinear cumulative fatigue damage behavior of the cast nickel-based superalloy, MAR M-247. The fatigue test matrix consisted of single-level, fully reversed fatigue experiments. Two series of tests were performed: one of the two baseline fatigue LCF (Low-Cycle Fatigue) life levels was used in the first loading block, and the HCF (High-Cycle Fatigue) baseline loading level was used in the second block in each series. For each series, duplicate tests were performed at each applied LCF life fraction.

  4. Driver fatigue: electroencephalography and psychological assessment.

    PubMed

    Lal, Saroj K L; Craig, Ashley

    2002-05-01

    Fatigue has major implications for transportation system safety; therefore, investigating the psychophysiological links to fatigue could enhance our understanding and management of fatigue in the transport industry. This study examined the psychophysiological changes that occurred during a driver simulator task in 35 randomly selected subjects. Results showed that significant electroencephalographic changes occur during fatigue. Delta and theta activity were found to increase significantly during fatigue. Heart rate was significantly lower after the driving task. Blink rate also changed during the fatigue task. Increased trait anxiety, tension-anxiety, fatigue-inertia and reduced vigor-activity were shown to be associated with neurophysiological indicators of fatigue such as increased delta and theta activity. The results are discussed in light of directions for future studies and for the development of a fatigue countermeasure device.

  5. Fatigue With Systolic Heart Failure

    PubMed Central

    Fink, Anne M.; Sullivan, Shawna L.; Zerwic, Julie J.; Piano, Mariann R.

    2010-01-01

    Background and Research Objective Fatigue is one of the most prevalent symptoms in persons with systolic heart failure (HF). There remains insufficient information about the physiological and psychosocial underpinnings of fatigue in HF. The specific aims of this study were to (1) determine the psychometric properties of 2 fatigue questionnaires in patients with HF, (2) compare fatigue in patients with HF to published scores of healthy adults and patients with cancer undergoing treatment, and (3) identify the physiological (eg, hemoglobin, B-type natriuretic peptide, body mass index, and ejection fraction) and psychosocial (eg, depressed mood) correlates of fatigue in HF. Subjects and Methods A convenience sample of 87 HF outpatients was recruited from 2 urban medical centers. Patients completed the Fatigue Symptom Inventory, Profile of Mood States, and Short Form-36 Health Survey. Results and Conclusions Patients with HF and patients with cancer reported similar levels of fatigue, and both patient groups reported significantly more fatigue than did healthy adults. Physical functioning and hemoglobin categories explained 30% of the variance in Fatigue Symptom Inventory-Interference Scale scores, whereas depressed mood and physical functioning explained 47% of the variance in Profile of Mood States Fatigue subscale scores. Patients with HF experienced substantial fatigue that is comparable with cancer-related fatigue. Low physical functioning, depressed mood, and low hemoglobin level were associated with HF-related fatigue. PMID:19707101

  6. Psychosocial correlates of fatigue in multiple sclerosis.

    PubMed

    Schwartz, C E; Coulthard-Morris, L; Zeng, Q

    1996-02-01

    To explore: (1) the interrelation among the neuropsychological, psychological, and psychosocial factors and fatigue as measured by the Multidimensional Assessment of Fatigue scale, and (2) the impact of fatigue on role performance. Clinical interview with neuropsychological testing and cross-sectional study by mail. Multiple sclerosis (MS) clinic registry of a large Boston teaching hospital. 139 MS patients representing a broad range of disability. The Multidimensional Assessment of Fatigue (MAF) scale, the Extended Disability Status Scale, the Sickness Impact Profile, Rao cognitive battery, the Trailmaking Test, depression, anxiety, and social activity limitations subscales from the Arthritis Impact Measurement Scales, and the Ryff Happiness Scale. Stepwise multiple regression analyses revealed that having a low sense of environmental mastery was the best psychosocial predictor of both global fatigue and fatigue-related distress, after adjusting for sociodemographic and medical factors. Further, people who reported being more depressed tended to report more severe fatigue. Neuropsychological performance was not associated with fatigue. Fatigue was found to limit social, work, and overall role performance, but not physical role performance. People who feel that they can choose or create environments suitable to their psychic or physical conditions report less global fatigue and less fatigue-related distress, and fatigue can have an important impact on role performance. The implications of these findings for designing fatigue management interventions are discussed.

  7. Conditioning monitoring by microstructural evaluation of cumulative fatigue damage

    NASA Astrophysics Data System (ADS)

    Fukuoka, C.; Nakagawa, Y. G.; Lance, J. J.; Pangborn, R. N.

    1996-12-01

    The objective of this work is to evaluate the damage induced below and above the fatigue limit (Δ σ t =360 MPa) in pressure vessel steels, such as SA508. Fatigue damage was induced in samples taken from an SA508 steel plate by various loading histories in order to examine the influence of prior cyclic loading below the fatigue limit. Cell-to-cell misorientation differences were measured by the selected area diffraction (SAD) method. Surface cracking was also studied by the replication method. Small cracks were observed after precycling both below and above the fatigue limit. It was, however, found that fatigue test bars had a longer lifetime after precycling below the fatigue limit, while precycling above the fatigue limit caused other specimens to fail even when subsequently cycled below the fatigue limit. Cell-to-cell misorientation usually increases with accumulation of fatigue damage, but it was found that the misorientations measured after precycling below the fatigue limit decreased again at the beginning of the subsequent cycling above the fatigue limit. It should be noted that the misorientation at failure was always about 4 to 5 deg, regardless of loading histories. Misorientation showed good correlation with the fatigue lifetime of the samples.

  8. Distinguishing patients with chronic fatigue from those with chronic fatigue syndrome: a diagnostic study in UK primary care.

    PubMed

    Darbishire, L; Ridsdale, L; Seed, P T

    2003-06-01

    Chronic fatigue syndrome (CFS) has been defined, but many more patients consult in primary care with chronic fatigue that does not meet the criteria for CFS. General practitioners (GPs) do not generally use the CFS diagnosis, and have some doubt about the validity of CFS as an illness. To describe the proportion of patients consulting their GP for fatigue that met the criteria for CFS, and to describe the social, psychological, and physical differences between patients with CFS and those with non-CFS chronic fatigue in primary care. Baseline data from a trial of complex interventions for fatigue in primary care. Twenty-two general practices located in London and the South Thames region of the United Kingdom recruited patients to the study between 1999 and 2001. One hundred and forty-one patients who presented to their GP with unexplained fatigue lasting six months or more as a main symptom were recruited, and the Centers for Disease Control (CDC) case definition was applied to classify CFS. Approximately two-thirds (69%) of patients had chronic fatigue and not CFS. The duration of fatigue (32 months) and perceived control over fatigue were similar between groups; however, fatigue, functioning, associated symptoms, and psychological distress were more severe in the patients in the CFS group, who also consulted their GP significantly more frequently, were twice as likely to be depressed, and more than twice as likely to be unemployed. About half (CFS = 50%; chronic fatigue = 55%) in each group attributed their fatigue to mainly psychological causes. In primary care, CFS is a more severe illness than chronic fatigue, but non-CFS chronic fatigue is associated with significant fatigue and is reported at least twice as often. That half of patients, irrespective of CFS status, attribute their fatigue to psychological causes, more than is observed in secondary care, indicates an openness to the psychological therapies provided in that setting. More evidence on the natural history of chronic fatigue and CFS in primary care is required, as are trials of complex interventions. The results may help determine the usefulness of differentiating between chronic fatigue and CFS.

  9. The Relation Between Child Versus Parent Report of Chronic Fatigue and Language/Literacy Skills in School-Age Children with Cochlear Implants.

    PubMed

    Werfel, Krystal L; Hendricks, Alison Eisel

    2016-01-01

    Preliminary evidence suggests that children with hearing loss experience elevated levels of chronic fatigue compared with children with normal hearing. Chronic fatigue is associated with decreased academic performance in many clinical populations. Children with cochlear implants as a group exhibit deficits in language and literacy skills; however, the relation between chronic fatigue and language and literacy skills for children with cochlear implants is unclear. The purpose of this study was to explore subjective ratings of chronic fatigue by children with cochlear implants and their parents, as well as the relation between chronic fatigue and language and literacy skills in this population. Nineteen children with cochlear implants in grades 3 to 6 and one of their parents separately completed a subjective chronic fatigue scale, on which they rated how much the child experienced physical, sleep/rest, and cognitive fatigue over the past month. In addition, children completed an assessment battery that included measures of speech perception, oral language, word reading, and spelling. Children and parents reported different levels of chronic child physical and sleep/rest fatigue. In both cases, parents reported significantly less fatigue than did children. Children and parents did not report different levels of chronic child cognitive fatigue. Child report of physical fatigue was related to speech perception, language, reading, and spelling. Child report of sleep/rest and cognitive fatigue was related to speech perception and language but not to reading or spelling. Parent report of child fatigue was not related to children's language and literacy skills. Taken as a whole, results suggested that parents under-estimate the fatigue experienced by children with cochlear implants. Child report of physical fatigue was robustly related to language and literacy skills. Children with cochlear implants are likely more accurate at reporting physical fatigue than cognitive fatigue. Clinical practice should take fatigue into account when developing treatment plans for children with cochlear implants, and research should continue to develop a comprehensive model of fatigue in children with cochlear implants.

  10. Effects of local and widespread muscle fatigue on movement timing.

    PubMed

    Cowley, Jeffrey C; Dingwell, Jonathan B; Gates, Deanna H

    2014-12-01

    Repetitive movements can cause muscle fatigue, leading to motor reorganization, performance deficits, and/or possible injury. The effects of fatigue may depend on the type of fatigue task employed, however. The purpose of this study was to determine how local fatigue of a specific muscle group versus widespread fatigue of various muscle groups affected the control of movement timing. Twenty healthy subjects performed an upper extremity low-load work task similar to sawing for 5 continuous minutes both before and after completing a protocol that either fatigued all the muscles used in the task (widespread fatigue) or a protocol that selectively fatigued the primary muscles used to execute the pushing stroke of the sawing task (localized fatigue). Subjects were instructed to time their movements with a metronome. Timing error, movement distance, and speed were calculated for each movement. Data were then analyzed using a goal-equivalent manifold approach to quantify changes in goal-relevant and non-goal-relevant variability. We applied detrended fluctuation analysis to each time series to quantify changes in fluctuation dynamics that reflected changes in the control strategies used. After localized fatigue, subjects made shorter, slower movements and exerted greater control over non-goal-relevant variability. After widespread fatigue, subjects exerted less control over non-goal-relevant variability and did not change movement patterns. Thus, localized and widespread muscle fatigue affected movement differently. Local fatigue may reduce the available motor solutions and therefore cause greater movement reorganization than widespread muscle fatigue. Subjects altered their control strategies but continued to achieve the timing goal after both fatigue tasks.

  11. Fatigue in adults with Marfan syndrome, occurrence and associations to pain and other factors.

    PubMed

    Bathen, Trine; Velvin, Gry; Rand-Hendriksen, Svend; Robinson, Hilde Stendal

    2014-08-01

    This study aims to investigate how fatigue affects adults with verified Marfan syndrome (MFS) in their daily lives, by examining fatigue levels and prevalence of severe fatigue compared to the general Norwegian population and individuals with other comparable chronic conditions. We investigated associations between socio-demographic characteristics, Marfan-related health problems, pain and fatigue. A cross-sectional study was conducted, using a postal questionnaire including the Fatigue Severity Scale (FSS) and questions on socio-demographic characteristics, Marfan-related health problems and pain. One hundred seventeen persons with MFS were invited to participate, 73 answered (62%). Participants reported significantly higher FSS scores and prevalence of severe fatigue compared to the general Norwegian population and patients with rheumatoid arthritis (RA), but lower than for other chronic conditions. Participants with chronic pain reported higher fatigue scores than those without chronic pain. Participants on disability benefits reported higher fatigue scores than participants who were working or enrolled in higher education. Marfan-related health problems like aortic dissection and use of blood pressure medication were not significantly associated with fatigue. In multivariable regression analyses chronic pain and employment status were significantly associated with fatigue. The final multivariable model explained 24% of the variance in fatigue scores. Our results show that fatigue is common in MFS patients and that it interferes with their daily lives. Chronic pain and employment status show significant associations to fatigue. This implies that fatigue is important to address when meeting MFS patients in clinical practice. There is need for more research on fatigue in Marfan syndrome. © 2014 Wiley Periodicals, Inc.

  12. Fatigue in sarcoidosis and idiopathic pulmonary fibrosis: differences in character and severity between diseases.

    PubMed

    Atkins, Christopher Peter; Gilbert, Daniel; Brockwell, Claire; Robinson, Sue; Wilson, Andrew Malcolm

    2016-08-01

    Sarcoidosis and idiopathic pulmonary fibrosis (IPF) are two common forms of interstitial lung disease. Fatigue is a recognised feature of sarcoidosis but an association between IPF and fatigue has not been investigated. To investigate the frequency and severity of fatigue in these groups, and variables affecting fatigue scores. A cross-sectional questionnaire study of patients with sarcoidosis and IPF followed-up at a single hospital was undertaken. Questionnaire data included validated measures of fatigue, anxiety, depression, sleepiness and dyspnoea, plus measures of disease severity including spirometry data. Questionnaires were administered to 232 patients (82 healthy volunteers, 73 sarcoidosis patients and 77 IPF patients). Sarcoidosis patients had statistically higher sleepiness scores but no significant difference was seen between overall measures of fatigue, anxiety or depression. Stratification by severity revealed a non-statistically significant tendency towards more severe fatigue scores in sarcoidosis. Regression analysis failed to identify any significant predictor variables measured in the sarcoidosis cohort, though in the IPF group both dyspnoea and sleepiness scores were significant predictors of fatigue (R2=0.74). Both sarcoidosis and IPF patients suffer with fatigue, although sarcoidosis patients tended towards reporting more severe fatigue scores, suggesting a subgroup with severe fatigue. The fatigue experienced by the two groups appears to be different; sarcoidosis patients report greater frequency of mental fatigue whereas IPF patients appear to suffer exhaustion, potentially related to dyspnoea. Dyspnoea and sleepiness scores modeled the majority of fatigue in the IPF group, whereas no single factor was able to predict fatigue in sarcoidosis.

  13. Clinical, laboratory, and neuroimaging characteristics of fatigue in HIV-infected individuals.

    PubMed

    Schifitto, Giovanni; Deng, Lijuan; Yeh, Tzu-Min; Evans, Scott R; Ernst, Thomas; Zhong, Jianhui; Clifford, David

    2011-02-01

    Fatigue is among the most common symptoms reported by HIV-infected individuals. Previous reports suggest that the prevalence of fatigue varies by disease status with rates close to 80% in patients with AIDS. However, most studies have not been conducted in the setting of a controlled trial and have not assessed the association of fatigue with cellular markers of brain activity. Data for this study were derived from baseline and longitudinal evaluations in ACTG A5090, a randomized, double-blind, placebo-controlled trial of the Selegiline Transdermal System for the treatment of HIV-associated cognitive impairment. Fatigue was assessed using the Fatigue Severity Scale with scores of >4 considered "fatigued". Participants in a substudy underwent brain magnetic resonance spectroscopy (MRS) imaging, an in vivo method for assessing brain metabolites associated with neuronal and glia activity. Differences between fatigued and non-fatigued participants were evaluated with respect to demographics and clinical characteristics, plasma and CSF HIV-1 RNA concentration, CD4 counts, and brain metabolites. One hundred and twenty-eight participants were enrolled (88% male, median age = 45 years) and 82 participants (64%, 95% confidence interval 55%, 72%) were fatigued at baseline. MRS was conducted in 62 of the 128 participants. Fatigued participants were significantly younger (p = 0.011), had lower Karnofsky scores (p = 0.032), and had higher levels of depressive symptoms on the Center for Epidemiologic Studies Depression (CES-D) scale (p < 0.001) than non-fatigued participants. Statistically significant differences between fatigued and non-fatigued groups were not detected for plasma and CSF HIV-1RNA concentration, CD4 counts, or on neuropsychological tests. MRS revealed significantly lower levels of the cellular energy marker total creatine (p = 0.002) in the basal ganglia of fatigued participants. Statistically significant differences in other brain metabolites were not detected. Longitudinal data showed that fatigue persisted and worse fatigue at baseline was predictor of future fatigue. Among the cognitive tests, baseline Stroop score was associated with future fatigue. Fatigue was present in 64% of A5090 study participants and persisted during the 24 weeks of follow-up. Fatigue was associated with worse functional performance and depressive mood. Lower cellular energy levels in the basal ganglia, as measured by MRS total creatine concentration, suggest energy dysmetabolism in this brain region. This observation, taken together with the association between fatigue and neuropsychological tests of frontal lobe performance is consistent with the hypothesis of a striatal-cortical circuitry involvement in the symptoms of fatigue.

  14. Effect of Fatigue Training on Safety, Fatigue, and Sleep in Emergency Medical Services Personnel and Other Shift Workers: A Systematic Review and Meta-Analysis

    DOT National Transportation Integrated Search

    2018-01-11

    Background: Fatigue training may be an effective way to mitigate fatigue-related risk. We aimed to critically review and synthesize existing literature on the impact of fatigue training on fatigue-related outcomes for Emergency Medical Services (EMS)...

  15. Risk factors of fatigue status among Chinese adolescents.

    PubMed

    Jin, Yuelong; Peng, Baozhen; Li, Yijun; Song, Lei; He, Lianping; Fu, Rui; Wu, Qianqian; Fan, Qingxiu; Yao, Yingshui

    2015-01-01

    In recent years, fatigue is common among adolescents. The aim of this study is to evaluate fatigue status and find related factors of fatigue among students ranged from 13-26 years from Wuhu, China. This is a case-control, cross-sectional observational study. The students from six middle schools (high school? 26 years old?) in Wuhu city were recruited, Self-Rating Fatigue Scale (SFS) was used to measure the fatigue status among students ranged from 13-26 years, and some demographic characteristics of students also was determined. A total of 726 students are included in our study. A significant difference was observed between fatigue status and grade, a balanced diet, the partial eclipse, picky for food, lack of sleep, excessive fatigue, drinking (P < 0.05). The risk factors of fatigue status include myopia, partial eclipse, picky for food, lacking of sleep, drinking; grade while a balanced diet is the protective factor of fatigue. Therefore, the school should pay more attention to the fatigue among students in middle school in China, and take some properly measures to reduce the fatigue.

  16. A literature review and inventory of the effects of environment on the fatigue behavior of metals

    NASA Technical Reports Server (NTRS)

    Hudson, C. M.; Seward, S. K.

    1976-01-01

    The current state of knowledge of the effects of gas environments (at atmospheric pressure and below) on the fatigue behavior of metals is reviewed. Among the topics considered are the mechanisms proposed to explain the differences observed in the fatigue behavior of vacuum- and air-tested specimens, the effects of environment on the surface topography of fatigue cycled specimens, the effect of environment on the various phases of the fatigue phenomenon, the effect of prolonged exposure to vacuum on fatigue life, the variation of fatigue life with decreasing gas pressure, and gas evolution during fatigue cycling. Analysis of the findings of this review indicates that hydrogen embrittlement is primarily responsible for decreased fatigue resistance in humid environments, and that dislocations move more easily during tests in vacuum than during test in air. It was found that fatigue cracks generally initiated and propagated more rapidly in air than in vacuum. Prolonged exposure to vacuum does not adversely affect fatigue resistance. The variation of fatigue life with decreasing gas pressure is sometimes stepped and sometimes continuous.

  17. Low cycle fatigue and creep-fatigue behavior of Ni-based alloy 230 at 850 C

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chen, Xiang; Yang, Zhiqing; Sokolov, Mikhail A

    Strain-controlled low cycle fatigue (LCF) and creep-fatigue testing of Ni-based alloy 230 were carried out at 850 C. The material creep-fatigue life decreased compared with its low cycle fatigue life at the same total strain range. Longer hold time at peak tensile strain further reduced the material creep-fatigue life. Based on the electron backscatter diffraction, a novel material deformation characterization method was applied, which revealed that in low cycle fatigue testing as the total strain range increased, the deformation was segregated to grain boundaries since the test temperature was higher than the material equicohesive temperature and grain boundaries became weakermore » regions compared with grains. Creep-fatigue tests enhanced the localized deformation, resulting in material interior intergranular cracking, and accelerated material damage. Precipitation in alloy 230 helped slip dispersion, favorable for fatigue property, but grain boundary cellular precipitates formed after material exposure to the elevated temperature had a deleterious effect on the material low cycle fatigue and creep-fatigue property.« less

  18. Role of Inflammation in Human Fatigue: Relevance of Multidimensional Assessments and Potential Neuronal Mechanisms

    PubMed Central

    Karshikoff, Bianka; Sundelin, Tina; Lasselin, Julie

    2017-01-01

    Fatigue is a highly disabling symptom in various medical conditions. While inflammation has been suggested as a potential contributor to the development of fatigue, underlying mechanisms remain poorly understood. In this review, we propose that a better assessment of central fatigue, taking into account its multidimensional features, could help elucidate the role and mechanisms of inflammation in fatigue development. A description of the features of central fatigue is provided, and the current evidence describing the association between inflammation and fatigue in various medical conditions is reviewed. Additionally, the effect of inflammation on specific neuronal processes that may be involved in distinct fatigue dimensions is described. We suggest that the multidimensional aspects of fatigue should be assessed in future studies of inflammation-induced fatigue and that this would benefit the development of effective therapeutic interventions. PMID:28163706

  19. The Experience and Self-Management of Fatigue in Hemodialysis Patients

    PubMed Central

    Horigan, Ann E.; Schneider, Susan M.; Docherty, Sharron; Barroso, Julie

    2013-01-01

    Fatigue is a common and debilitating symptom for adult patients with end stage renal disease on hemodialysis and has been associated with decreased survival and quality of life. Patients on hemodialysis must find ways to manage their fatigue and mitigate its effects on their lives. Currently, there is no description of the experience of fatigue for patients on hemodialysis living in the U.S., nor is there any description of the ways in which they manage their fatigue. The purpose of this qualitative descriptive work was to describe the experience and self-management of fatigue. Several themes were identified which included: the nature of fatigue, management of fatigue, consequences of fatigue, and factors associated with fatigue. This information will be valuable to nephrology nurses as they continue to care for and educate patients on hemodialysis. PMID:23767335

  20. Level and appraisal of fatigue are not specific in burnout.

    PubMed

    Van Dam, Arno; Keijsers, Ger; Verbraak, Marc; Eling, Paul; Becker, Eni

    2015-01-01

    Fatigue is a main feature of the burnout syndrome but also very common in other psychiatric disorders such as major depression and anxiety disorders. This raises the question of whether the level and appraisal of fatigue is experienced differently by individuals suffering from burnout than by those exhibiting anxiety disorders and major depression. If fatigue is experienced differently in burnout compared with other disorders, this may clarify why fatigue is the main feature of the burnout syndrome. This knowledge may lead to the application of specific therapeutic interventions aimed at the experience of fatigue in burnout. In the present study, we investigated whether fatigue is experienced differently in burnout patients than in patients suffering from anxiety disorders or major depression. We presented 73 burnout patients, 67 depressed patients, 57 patients with an anxiety disorder and 127 healthy participants with a rating scale containing statements about the fatigue-performance relationship, and we assessed the level of fatigue, depression and anxiety. The level of fatigue reported by burnout patients was high but did not differ from that of the other patient groups. The appraisal of fatigue also did not differ among the patient groups. The burnout patients did not appraise their fatigue as a result of unrewarding activities nor did they catastrophize fatigue in an exceptional way. Thus, the level of fatigue and the appraisal of fatigue may be less relevant to the understanding of the specific pathological processes associated with burnout than is often presumed. Copyright © 2013 John Wiley & Sons, Ltd.

  1. Fatigue in Patients with Multiple Sclerosis: Is It Related to Pro- and Anti-Inflammatory Cytokines?

    PubMed Central

    Malekzadeh, Arjan; Van de Geer-Peeters, Wietske; De Groot, Vincent; Elisabeth Teunissen, Charlotte; Beckerman, Heleen; TREFAMS-ACE Study Group

    2015-01-01

    Objective. To investigate the pathophysiological role of pro- and anti-inflammatory cytokines in primary multiple sclerosis-related fatigue. Methods. Fatigued and non-fatigued patients with multiple sclerosis (MS) were recruited and their cytokine profiles compared. Patients with secondary fatigue were excluded. Fatigue was assessed with the self-reported Checklist Individual Strength (CIS20r), subscale fatigue. A CIS20r fatigue cut-off score of 35 was applied to differentiate between non-fatigued (CIS20r fatigue ≤34) and fatigued (CIS20r fatigue ≥35) patients with MS. Blood was collected to determine the serum concentrations of pro-inflammatory cytokines (IL-1β, IL-2, IL-6, IL-8, IL-12p70, IL-17, TNFα, and IFN-γ) and anti-inflammatory cytokines (IL-4, IL-5, IL-10, and IL-13). We controlled for the confounding effect of age, gender, duration of MS, disease severity, type of MS, and use of immunomodulatory drugs. Results. Similar cytokine levels were observed between MS patients with (n = 21) and without fatigue (n = 14). Adjusted multiple regression analyses showed a single significant positive relationship, that of IL-6 with CIS20r fatigue score. The explained variance of the IL-6 model was 21.1%, once adjusted for the confounding effect of age. Conclusion. The pro-inflammatory cytokine interleukin-6 (IL-6) may play a role in the pathophysiology of primary fatigue in patients with MS. Trial Registrations. ISRCTN69520623, ISRCTN58583714, and ISRCTN82353628. PMID:25722532

  2. Peripheral and Central Mechanisms of Fatigue in Inflammatory and Non-Inflammatory Rheumatic Diseases

    PubMed Central

    Staud, Roland

    2013-01-01

    Fatigue is a common symptom in a large number of medical and psychological disorders including many rheumatologic illnesses. A frequent question for health care providers is related to whether reported fatigue is “in the mind” or “in the body” i.e. central or peripheral. If fatigue occurs at rest without any exertion this suggests psychological or central origins. If patients relate their fatigue mostly to physical activities including exercise then their symptoms can be considered peripheral. However, most fatiguing syndromes seem to depend on both peripheral and central mechanisms. Sometimes muscle biopsy with histochemistry may be necessary for the appropriate tissue diagnosis whereas serological tests generally provide little reliable information about the origin of muscle fatigue. Muscle function and peripheral fatigue can be quantified by contractile force and action potential measurements whereas validated questionnaires are frequently used for assessment of mental fatigue. Fatigue is a hallmark of many rheumatologic conditions including fibromyalgia, myalgic encephalitis/chronic fatigue syndrome, rheumatoid arthritis, systemic lupus, Sjogren’s syndrome and ankylosing spondylitis. Whereas many studies have focused on disease activity as a correlate to these patients’ fatigue it has become apparent that other factors including negative affect and pain are some of the most powerful predictors for fatigue. Conversely sleep problems, including insomnia seem to be less important for fatigue. There are several effective treatment strategies available for fatigued patients with rheumatologic disorders including pharmacological and non-pharmacological therapies PMID:22802155

  3. The PedsQL multidimensional fatigue scale in pediatric obesity: feasibility, reliability and validity.

    PubMed

    Varni, James W; Limbers, Christine A; Bryant, William P; Wilson, Don P

    2010-01-01

    The PedsQL (Pediatric Quality of Life Inventory) is a modular instrument designed to measure health-related quality of life (HRQOL) and disease-specific symptoms in children and adolescents. The PedsQL Multidimensional Fatigue Scale was designed as a child self-report and parent proxy-report generic symptom-specific instrument to measure fatigue in pediatric patients. The objective of the present study was to determine the feasibility, reliability, and validity of the PedsQL Multidimensional Fatigue Scale in pediatric obesity. The 18-item PedsQL Multidimensional Fatigue Scale (General Fatigue, Sleep/Rest Fatigue, and Cognitive Fatigue domains) and the PedsQL 4.0 Generic Core Scales were completed by 41 pediatric patients with a physician-diagnosis of obesity and 43 parents from a hospital-based Pediatric Endocrinology Clinic. The PedsQL Multidimensional Fatigue Scale evidenced minimal missing responses (1.6%, child report; 0.5%, parent report), achieved excellent reliability for the Total Fatigue Scale Score (alpha = 0.90 child report, 0.90 parent report), distinguished between pediatric patients with obesity and healthy children, and was significantly correlated with the PedsQL 4.0 Generic Core Scales supporting construct validity. Pediatric patients with obesity experienced fatigue comparable with pediatric patients receiving cancer treatment, demonstrating the relative severity of their fatigue symptoms. The results demonstrate the measurement properties of the PedsQL Multidimensional Fatigue Scale in pediatric obesity. The findings suggest that the PedsQL Multidimensional Fatigue Scale may be utilized in the standardized evaluation of fatigue in pediatric patients with obesity.

  4. Fatigue in people with localized colorectal cancer who do and do not receive chemotherapy: a longitudinal prospective study

    PubMed Central

    Vardy, J. L.; Dhillon, H. M.; Pond, G. R.; Renton, C.; Dodd, A.; Zhang, H.; Clarke, S. J.; Tannock, I. F.

    2016-01-01

    Background Fatigue is associated with cancer and chemotherapy and may be sustained. Here, we describe a prospective longitudinal study evaluating fatigue and putative mechanisms in people with colorectal cancer (CRC). Patients and methods People with localized CRC completed the Functional Assessment of Cancer Treatment-Fatigue (FACT-F) questionnaire at baseline (before chemotherapy, if given), 6, 12, and 24 months. Healthy controls (HCs) were assessed at the first three time points. Fatigue was defined by standardized FACT-F scores ≤68/100. Quality-of-life (QoL, assessed by the FACT-G questionnaire), affective, and cognitive symptoms were evaluated. Associations were sought between fatigue, baseline factors, and blood tests (including hemoglobin, cytokines, and sex hormones). Regression analyses, Fisher's exact tests, and Wilcoxon rank-sum tests assessed levels of fatigue at each time point and change in fatigue from baseline. A repeated-measures analysis investigated prognostic factors of fatigue across all time points. Results A total of 289 subjects with localized CRC (173 received chemotherapy) and 72 HCs were assessed. More CRC patients had fatigue than HCs at baseline (52% versus 26%, P < 0.001). Fatigue was increased in the chemotherapy (CTh) group at 6 months [CTh+ 70% versus CTh− 31% (P < 0.001), HCs 22%] and remained more common at 12 [CTh+ 44% versus CTh− 31% (P = 0.079)] and 24 months [CTh+ 39% versus CTh− 24% (P = 0.047)]. There was no significant difference between those not receiving chemotherapy and HCs at follow-up assessments. Fatigue was associated with poor QoL, affective and cognitive symptoms, but not consistently with cytokine levels. Predictors for sustained fatigue were baseline fatigue, treatment group, cognitive and affective symptoms, poorer QoL, and comorbidities. Conclusions CRC patients have more fatigue than HCs at baseline. Fatigue peaks immediately after adjuvant chemotherapy, but remains common for 2 years in those who receive chemotherapy. Cognitive and affective symptoms, QoL, comorbidities, chemotherapy, and baseline fatigue predict for longer term fatigue. PMID:27443634

  5. Fatigue in industry.

    PubMed Central

    Grandjean, E

    1979-01-01

    Physical fatigue is a painful phenomenon which is localised in overstressed muscles. Mental fatigue is a diffuse sensation of weariness; it is a functional state, one of several intermediate conditions between the two extremes of alarm and sleep. A neurophysiological model of fatigue, involving an activating and inhibitory system has been developed. Fatigue in industrial practice has clinical symptoms: psychic instability, fits of depression and increased liability to illness. Indicators of fatigue are work of performance, subjective feelings of fatigue, electroencephalography, flicker-fusion frequency and various psychomotor and mental tests. Several field studies do, to some extent, confirm the above-mentioned concept of fatigue. PMID:40999

  6. A review of concepts regarding the origin of respiratory muscle fatigue

    NASA Astrophysics Data System (ADS)

    Kuraszkiewicz, Bożena; Piotrkiewicz, Maria

    2011-01-01

    In this review, the classification of respiratory muscle fatigue from the perspective of its origin is presented. The fatigue is classified as central or peripheral, and the latter further subdivided into high- and low-frequency fatigue. However, muscle fatigue is a complex process and all three types of fatigue probably occur simultaneously in the overloaded respiratory muscles. The relative importance of each type depends on the duration of respiratory loading and other physiological variables. However, central and high-frequency fatigue resolve rapidly once muscle overload is removed, whereas low-frequency fatigue persists over long time.

  7. Computational inverse methods of heat source in fatigue damage problems

    NASA Astrophysics Data System (ADS)

    Chen, Aizhou; Li, Yuan; Yan, Bo

    2018-04-01

    Fatigue dissipation energy is the research focus in field of fatigue damage at present. It is a new idea to solve the problem of calculating fatigue dissipation energy by introducing inverse method of heat source into parameter identification of fatigue dissipation energy model. This paper introduces the research advances on computational inverse method of heat source and regularization technique to solve inverse problem, as well as the existing heat source solution method in fatigue process, prospects inverse method of heat source applying in fatigue damage field, lays the foundation for further improving the effectiveness of fatigue dissipation energy rapid prediction.

  8. Fatigue-Induced Damage in Zr-Based Bulk Metallic Glasses

    PubMed Central

    Chuang, Chih-Pin; Yuan, Tao; Dmowski, Wojciech; Wang, Gong-Yao; Freels, Matt; Liaw, Peter K.; Li, Ran; Zhang, Tao

    2013-01-01

    In the present work, we investigate the effect of “fatigue” on the fatigue behavior and atomic structure of Zr-based BMGs. Fatigue experiments on the failed-by-fatigue samples indicate that the remnants generally have similar or longer fatigue life than the as-cast samples. Meanwhile, the pair-distribution-function (PDF) analysis of the as-cast and post-fatigue samples showed very small changes of local atomic structures. These observations suggest that the fatigue life of the 6-mm in-diameter Zr-based BMG is dominated by the number of pre-existing crack-initiation sites in the sample. Once the crack initiates in the specimen, the fatigue-induced damage is accumulated locally on these initiated sites, while the rest of the region deforms elastically. The results suggest that the fatigue failure of BMGs under compression-compression fatigue experiments is a defect-controlled process. The present work indicates the significance of the improved fatigue resistance with decreasing the sample size. PMID:23999496

  9. The relation between pathological worrying and fatigue in a working population.

    PubMed

    Andrea, H; Beurskens, A J H M; Kant, Ij; Davey, G C L; Field, A P; van Schayck, C P

    2004-10-01

    This study aimed to explore cross-sectional and longitudinal associations between pathological worry and fatigue in a working population. In employees with very low or very high fatigue levels, psychometrics of the Penn State Worry Questionnaire (PSWQ; measuring pathological worry) and the Checklist Individual Strength (CIS; measuring fatigue) were examined and their cross-sectional and longitudinal associations were explored. Pathological worry and fatigue can be measured as different constructs. However, pathological worry and fatigue were also associated on a cross-sectional level. Pathological worry predicted fatigue level 10 months later, but this association disappeared after adjustment for the cross-sectional association between pathological worry and fatigue. Although they can be measured as different constructs, pathological worry and fatigue seem to be associated. When studying longitudinal relations between pathological worry and fatigue, their cross-sectional association should be taken into account. Pathological worry might not be a risk factor for fatigue per se, but might act more like a mediating factor.

  10. Serum cytokine levels related to multiple dimensions of fatigue in patients with primary Sjögren's syndrome

    PubMed Central

    Hartkamp, A; Geenen, R; Bijl, M; Kruize, A; Godaert, G; Derksen, R

    2004-01-01

    Methods: Sixty female patients with pSS filled out a questionnaire to assess multiple dimensions of fatigue. Scores were compared with values in a population based control group (n = 139). Levels of interleukin (IL)1ß, IL2, IL6, IL10, and tumour necrosis factor α were measured in serum with commercial sandwich ELISAs. The relationship between self reported dimensions of fatigue and these serum cytokine levels was determined. Results: Patients with pSS had high scores at all dimensions of fatigue (p<0.001): general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue. Fatigue levels were not related to serum cytokine levels. The incidental finding that reduced motivation was higher in patients with detectable serum levels of IL10 (p = 0.04) disappeared after correction for multiple testing. Conclusion: Fatigue is prominent in patients with pSS and involves all dimensions of fatigue. The findings do not suggest a widespread effect of circulating cytokines on multiple aspects of fatigue. PMID:15361396

  11. Increased Incidence of Fatigue in Patients with Primary Immunodeficiency Disorders: Prevalence and Associations Within the US Immunodeficiency Network Registry.

    PubMed

    Hajjar, Joud; Guffey, Danielle; Minard, Charles G; Orange, Jordan S

    2017-02-01

    Patients with primary immunodeficiency (PID) often report fatigue, yet this symptom has not been studied in PID. Fatigue affects 6-7.5% of healthy adults. The goal of this study is to estimate the prevalence of fatigue in patients with PID and investigate its associated factors. We analyzed 2537 PID patients registered in USIDNET to determine responses to the field "fatigue" in the core registry form. Demographics, immune phenotypes, and comorbid conditions were compared between fatigued and non-fatigued patients to identify relevant associations and potential drivers. A focused analysis was performed for patients with predominantly antibody deficiency disorders (PADs). Fatigue was reported in 25.9% (95% CI 23.7-28.3) of PAD patients, compared to 6.4% (95% CI 4.9-8.2) of non-PAD. Patients with common variable immunodeficiency (CVID) had the highest prevalence of fatigue (p < 0.001) among all PID diagnoses. Other factors that were associated with a higher rate of fatigue among PAD patients included female sex, higher BMI, depression, bronchiectasis, and autoimmunity. Additionally, fatigued PAD patients had lower absolute lymphocyte, CD3, CD4, and CD8 counts compared to non-fatigued patients. Our findings suggest that fatigue is overrepresented in PAD patients. Prospective studies to estimate prevalence, risk factors, and fatigue etiology in PID are warranted, so therapeutic interventions can be considered.

  12. [Therapy of fatigue in multiple sclerosis : A treatment algorithm].

    PubMed

    Veauthier, C; Paul, F

    2016-12-01

    Fatigue is one of the most frequent symptoms of multiple sclerosis (MS) and one of the main reasons for underemployment and early retirement. The mechanisms of MS-related fatigue are unknown but comorbid disorders play a major role. Anemia, diabetes, side effects of medication and depression should be ruled out. Moreover, excessive daytime sleepiness (EDS) should be differentiated from fatigue. No approved medicinal therapy of MS fatigue is currently available. Presentation of current treatment strategies with a particular focus on secondary fatigue due to sleep disorders. A review of the literature was carried out. All MS patients suffering from fatigue should be questioned with respect to EDS and if necessary sleep medical investigations should be carried out; however, pure fatigue without accompanying EDS can also be caused by a sleep disorder. Medications, particularly freely available antihistamines, can also increase fatigue. Furthermore, anemia, iron deficits, diabetes and hypothyroidism should be excluded. Self-assessment questionnaires show an overlap between depression and fatigue. Several studies have shown that cognitive behavioral therapy and various psychotherapeutic measures, such as vertigo training, progressive exercise training and individualized physiotherapy as well as fatigue management interventions can lead to a significant improvement of MS-related fatigue. There is currently no medication which is suitable for treatment of fatigue, with the exception of fampridine for the treatment of motor functions and motor fatigue.

  13. Psychometric properties of instruments used to measure fatigue in children and adolescents with cancer: a systematic review.

    PubMed

    Tomlinson, Deborah; Hinds, Pamela S; Ethier, Marie-Chantal; Ness, Kirsten K; Zupanec, Sue; Sung, Lillian

    2013-01-01

    Despite the recognized distressing symptom of fatigue in children with cancer, little information is available to assist in the selection of an instrument to be used to measure fatigue. The objectives of this study were to 1) describe the instruments that have been used to measure cancer-related fatigue in children and adolescents and 2) summarize the psychometric properties of the most commonly used instruments used to measure fatigue in children and adolescents with cancer. Five major electronic databases were systematically searched for studies using a fatigue measurement scale in a population of children or adolescents with cancer. Fatigue scales used in those studies were included in the review. From a total of 1753 articles, 25 were included. We identified two main fatigue measurement instruments used in a pediatric oncology population: 1) the Fatigue Scale-Child/Fatigue Scale-Adolescent and the proxy report versions for parents and staff and 2) the PedsQL™ Multidimensional Fatigue Scale. These two scales show similar attributes with reasonably good internal consistency and responsiveness. Either the Fatigue Scale or PedsQL Multidimensional Fatigue Scale can be incorporated into clinical research. Future research should focus on identifying specific fatigue measures more suited to different purposes such as comparative trials or identification of high-risk groups. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  14. Subjective Fatigue in Children With Hearing Loss: Some Preliminary Findings

    PubMed Central

    Hornsby, Benjamin W. Y.; Werfel, Krystal; Camarata, Stephen; Bess, Fred H.

    2014-01-01

    Purpose In this study, the authors examined the effect of hearing loss on subjective reports of fatigue in school-age children using a standardized measure. Methods As part of a larger ongoing study, the authors obtained subjective ratings of fatigue using the Pediatric Quality of Life Inventory (PedsQL) Multidimensional Fatigue Scale (Varni, Burwinkle, Katz, Meeske, & Dickinson, 2002). This standardized scale provides a measure of general fatigue, sleep/rest fatigue, cognitive fatigue, and an overall composite measure of fatigue. To date, data from 10 children with hearing loss (CHL) and 10 age-matched children with normal hearing (CNH) have been analyzed. Results These preliminary results show that subjective fatigue is increased in school-age children with hearing loss (Cohen's d = 0.78–1.90). In addition, the impact of hearing loss on fatigue in school-age children appears pervasive across multiple domains (general, sleep/rest, and cognitive fatigue). Conclusion School-age CHL reported significantly more fatigue than did CNH. These preliminary data are important given the negative academic and psychosocial consequences associated with fatigue. Further research is needed to determine the underlying mechanisms responsible for this increased fatigue in school-age children with hearing loss, and to identify factors that may modulate (e.g., degree of loss) and mediate (e.g., hearing aid or cochlear implant use) its impact. PMID:23824428

  15. Fatigue and Muscle Strength Involving Walking Speed in Parkinson's Disease: Insights for Developing Rehabilitation Strategy for PD.

    PubMed

    Huang, Ying-Zu; Chang, Fang-Yu; Liu, Wei-Chia; Chuang, Yu-Fen; Chuang, Li-Ling; Chang, Ya-Ju

    2017-01-01

    Background . Problems with gait in Parkinson's disease (PD) are a challenge in neurorehabilitation, partly because the mechanisms causing the walking disability are unclear. Weakness and fatigue, which may significantly influence gait, are commonly reported by patients with PD. Hence, the aim of this study was to investigate the association between weakness and fatigue and walking ability in patients with PD. Methods . We recruited 25 patients with idiopathic PD and 25 age-matched healthy adults. The maximum voluntary contraction (MVC), twitch force, and voluntary activation levels were measured before and after a knee fatigue exercise. General fatigue, central fatigue, and peripheral fatigue were quantified by exercise-induced changes in MVC, twitch force, and activation level. In addition, subjective fatigue was measured using the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale (FSS). Results . The patients with PD had lower activation levels, more central fatigue, and more subjective fatigue than the healthy controls. There were no significant differences in twitch force or peripheral fatigue index between the two groups. The reduction in walking speed was related to the loss of peripheral strength and PD itself. Conclusion . Fatigue and weakness of central origin were related to PD, while peripheral strength was important for walking ability. The results suggest that rehabilitation programs for PD should focus on improving both central and peripheral components of force.

  16. Chronic fatigue in Hodgkin lymphoma survivors and associations with anxiety, depression and comorbidity

    PubMed Central

    Daniëls, L A; Oerlemans, S; Krol, A D G; Creutzberg, C L; van de Poll-Franse, L V

    2014-01-01

    Background: Fatigue is a frequent and persistent problem among Hodgkin lymphoma (HL) survivors. We investigated the prevalence of clinically relevant fatigue in HL survivors and the relation between fatigue and anxiety and depression. Methods: Fatigue was measured through the generic European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) and Fatigue Assessment Scale (FAS). Anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Questionnaires were mailed to 267 HL survivors. Results were compared with a Dutch age-matched normative population. Results: Response rate was 68% (median age 46 years, mean time since diagnosis 4.6 years). Prevalence of fatigue was significantly higher among HL survivors than in the norm population (FAS 41% vs 23%, QLQ-C30 43% vs 28%), as were fatigue levels. There was a significant association between fatigue, anxiety and depression. Of the HL survivors with high symptom levels of depression, 97% also reported fatigue. In multivariate analysis, depression was strongly associated with high levels of fatigue and, to a lesser extent, anxiety and comorbidity. Conclusions: Prevalence rates of fatigue are significantly higher in HL survivors than in the general population and differences are clinically relevant. Depression and anxiety were strongly associated with high levels of fatigue. Reducing fatigue levels by treatment of depression and anxiety should be further explored. PMID:24434433

  17. Women's experience of SLE-related fatigue: a focus group interview study.

    PubMed

    Pettersson, Susanne; Möller, Sonia; Svenungsson, Elisabet; Gunnarsson, Iva; Welin Henriksson, Elisabet

    2010-10-01

    The aim of this study was to describe women's experience of SLE-related fatigue, how they express the feeling of fatigue, impact on life and strategies developed to manage fatigue in daily living. Seven, semi-structured focus group discussions with 33 women were audio-taped, transcribed verbatim and analysed according to qualitative content analysis. Perceptions of SLE-related fatigue were sorted into four themes. Nature of Fatigue, involved the sensation, occurrence and character. Aspects Affected by Fatigue described emotions that arose together with fatigue as well as aspects of work, family life, social contacts and leisure activities that were affected by fatigue. Striving Towards Power and Control concluded the array of ways used to manage daily life and were categorized into the mental struggle, structure, restrict and provide. Factors Influencing the Perception of Fatigue described understanding from their surroundings and pain as strongly influencing the experience and perception of fatigue. SLE-related fatigue was portrayed as an overwhelming phenomenon with an unpredictable character, resulting in the feeling that fatigue dominates and controls most situations in life. The choice of strategies was described as a balance with implications for how fatigue limited a person's life. Health care professionals are advised to take a more active role to empower people with SLE to find their own balance as a way to achieve a feeling of being in control.

  18. Central fatigue in multiple sclerosis: a review of the literature

    PubMed Central

    Newland, Pamela; Starkweather, Angela; Sorenson, Matthew

    2016-01-01

    Concept Fatigue is a major concern for patients with multiple sclerosis (MS). A clear definition of MS-related fatigue is a prerequisite for appropriate instruments for fatigue assessment. In turn, accurate assessment of fatigue in MS will enhance exploration of plausible mechanisms underlying this common and distressing symptom. Content/Objectives To provide an integrative review of the current literature on theoretical models used to study fatigue in MS, instruments used to assess fatigue and other factors that impact fatigue during the various phases of MS. Methods Data sources: PUBMED, OVID, Ovid Health Star, Ovid MEDINE, CINAHL, Health and Psychosocial Instruments (HaPI), and PsycINFO. Seventeen articles fit the inclusion criteria and were included in the review. Results Definitions of MS-related fatigue are reviewed. Several studies found a link with neurotransmitter dysfunction, circadian rhythm, and the timing of fatigue. Central fatigue in MS is associated with neurotransmitters disruptions as well as circadian rhythm disorders, but the evidence is not strong. Perceptions of fatigue or fatigability may arise as either a primary or secondary manifestation of disease. Based on findings from the literature review, a theoretical model of fatigue in MS is proposed. Conclusion Future research on MS-related fatigue may consider a longitudinal design with a carefully selected self-report instrument to advance understanding of the underlying pathological mechanisms. PMID:27146427

  19. Beyond pain in fibromyalgia: insights into the symptom of fatigue

    PubMed Central

    2013-01-01

    Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue. PMID:24289848

  20. Prevalence of operator fatigue in winter maintenance operations.

    PubMed

    Camden, Matthew C; Medina-Flintsch, Alejandra; Hickman, Jeffrey S; Bryce, James; Flintsch, Gerardo; Hanowski, Richard J

    2018-02-02

    Similar to commercial motor vehicle drivers, winter maintenance operators are likely to be at an increased risk of becoming fatigued while driving due to long, inconsistent shifts, environmental stressors, and limited opportunities for sleep. Despite this risk, there is little research concerning the prevalence of winter maintenance operator fatigue during winter emergencies. The purpose of this research was to investigate the prevalence, sources, and countermeasures of fatigue in winter maintenance operations. Questionnaires from 1043 winter maintenance operators and 453 managers were received from 29 Clear Road member states. Results confirmed that fatigue was prevalent in winter maintenance operations. Over 70% of the operators and managers believed that fatigue has a moderate to significant impact on winter maintenance operations. Approximately 75% of winter maintenance operators reported to at least sometimes drive while fatigued, and 96% of managers believed their winter maintenance operators drove while fatigued at least some of the time. Furthermore, winter maintenance operators and managers identified fatigue countermeasures and sources of fatigue related to winter maintenance equipment. However, the countermeasures believed to be the most effective at reducing fatigue during winter emergencies (i.e., naps) were underutilized. For example, winter maintenance operators reported to never use naps to eliminate fatigue. These results indicated winter maintenance operations are impacted by operator fatigue. These results support the increased need for research and effective countermeasures targeting winter maintenance operator fatigue. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Poststroke Fatigue: Who Is at Risk for an Increase in Fatigue?

    PubMed Central

    van Eijsden, Hanna Maria; van de Port, Ingrid Gerrie Lambert; Visser-Meily, Johanna Maria August; Kwakkel, Gert

    2012-01-01

    Background. Several studies have examined determinants related to post-stroke fatigue. However, it is unclear which determinants can predict an increase in poststroke fatigue over time. Aim. This prospective cohort study aimed to identify determinants which predict an increase in post-stroke fatigue. Methods. A total of 250 patients with stroke were examined at inpatient rehabilitation discharge (T0) and 24 weeks later (T1). Fatigue was measured using the Fatigue Severity Scale (FSS). An increase in post-stroke fatigue was defined as an increase in the FSS score beyond the 95% limits of the standard error of measurement of the FSS (i.e., 1.41 points) between T0 and T1. Candidate determinants included personal factors, stroke characteristics, physical, cognitive, and emotional functions, and activities and participation and were assessed at T0. Factors predicting an increase in fatigue were identified using forward multivariate logistic regression analysis. Results. The only independent predictor of an increase in post-stroke fatigue was FSS (OR 0.50; 0.38–0.64, P < 0.001). The model including FSS at baseline correctly predicted 7.9% of the patients who showed increased fatigue at T1. Conclusion. The prognostic model to predict an increase in fatigue after stroke has limited predictive value, but baseline fatigue is the most important independent predictor. Overall, fatigue levels remained stable over time. PMID:22028989

  2. 75 FR 27419 - Airworthiness Directives; BAE Systems (Operations) Limited Model BAe 146 and Avro 146-RJ70A, 146...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... environmental and fatigue inspections would not have detected the corrosion or fatigue damage. Corrosion or fatigue damage in this area, if not detected and corrected, could lead to degradation of the structural... fatigue inspections would not have detected the corrosion or fatigue damage. Corrosion or fatigue damage...

  3. 49 CFR 228.407 - Analysis of work schedules; submissions; FRA review and approval of submissions; fatigue...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES; RECORDKEEPING AND REPORTING; SLEEPING QUARTERS Substantive... fatigue mitigation tools to reduce the risk for fatigue to a level that does not violate the fatigue... mitigation tools so as to present a risk for a level of fatigue that does not violate the applicable fatigue...

  4. 49 CFR 228.407 - Analysis of work schedules; submissions; FRA review and approval of submissions; fatigue...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES; RECORDKEEPING AND REPORTING; SLEEPING QUARTERS Substantive... fatigue mitigation tools to reduce the risk for fatigue to a level that does not violate the fatigue... mitigation tools so as to present a risk for a level of fatigue that does not violate the applicable fatigue...

  5. 49 CFR 228.407 - Analysis of work schedules; submissions; FRA review and approval of submissions; fatigue...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES; RECORDKEEPING AND REPORTING; SLEEPING QUARTERS Substantive... fatigue mitigation tools to reduce the risk for fatigue to a level that does not violate the fatigue... mitigation tools so as to present a risk for a level of fatigue that does not violate the applicable fatigue...

  6. Characterizing Fatigue: The Effects of Ethnicity and Acculturation

    PubMed Central

    Cordero, Elizabeth D.; Loredo, Jose S.; Murray, Kate E.; Dimsdale, Joel E.

    2012-01-01

    It is unknown if fatigue measures like the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF; Stein, Jacobsen, Blanchard, & Thors, 2004) appropriately describe fatigue in Hispanics or if acculturation plays a role in fatigue. This study compared fatigue in community samples of Hispanics and Anglos. The MFSI-SF and pertinent questionnaires were administered to adults in San Diego County via telephone survey. Some differences in fatigue were observed in initial comparisons between Hispanics and Anglos, including when acculturation was considered. When age and education were controlled, Hispanics reported less general fatigue than Anglos, regardless of acculturation status, p = < .01. Exploratory factor analyses indicate that the MFSI-SF general-fatigue subscale was problematic for Hispanics. Implications, limitations, and future directions are discussed. PMID:22773899

  7. Clinical, laboratory, and neuroimaging characteristics of fatigue in HIV-infected individuals

    PubMed Central

    Schifitto, Giovanni; Deng, Lijuan; Yeh, Tzu-min; Evans, Scott R.; Ernst, Thomas; Zhong, Jianhui; Clifford, David

    2011-01-01

    Fatigue is among the most common symptoms reported by HIV-infected individuals. Previous reports suggest that the prevalence of fatigue varies by disease status with rates close to 80% in patients with AIDS. However, most studies have not been conducted in the setting of a controlled trial and have not assessed the association of fatigue with cellular markers of brain activity. Data for this study were derived from baseline and longitudinal evaluations in ACTG A5090, a randomized, double-blind, placebo-controlled trial of the Selegiline Transdermal System for the treatment of HIV-associated cognitive impairment. Fatigue was assessed using the Fatigue Severity Scale with scores of >4 considered “fatigued”. Participants in a substudy underwent brain magnetic resonance spectroscopy (MRS) imaging, an in vivo method for assessing brain metabolites associated with neuronal and glia activity. Differences between fatigued and non-fatigued participants were evaluated with respect to demographics and clinical characteristics, plasma and CSF HIV-1 RNA concentration, CD4 counts, and brain metabolites. One hundred and twenty-eight participants were enrolled (88% male, median age=45 years) and 82 participants (64%, 95% confidence interval 55%, 72%) were fatigued at baseline. MRS was conducted in 62 of the 128 participants. Fatigued participants were significantly younger (p=0.011), had lower Karnofsky scores (p=0.032), and had higher levels of depressive symptoms on the Center for Epidemiologic Studies Depression (CES-D) scale (p<0.001) than non-fatigued participants. Statistically significant differences between fatigued and non-fatigued groups were not detected for plasma and CSF HIV-1RNA concentration, CD4 counts, or on neuropsychological tests. MRS revealed significantly lower levels of the cellular energy marker total creatine (p=0.002) in the basal ganglia of fatigued participants. Statistically significant differences in other brain metabolites were not detected. Longitudinal data showed that fatigue persisted and worse fatigue at baseline was predictor of future fatigue. Among the cognitive tests, baseline Stroop score was associated with future fatigue. Fatigue was present in 64% of A5090 study participants and persisted during the 24 weeks of follow-up. Fatigue was associated with worse functional performance and depressive mood. Lower cellular energy levels in the basal ganglia, as measured by MRS total creatine concentration, suggest energy dysmetabolism in this brain region. This observation, taken together with the association between fatigue and neuropsychological tests of frontal lobe performance is consistent with the hypothesis of a striatal–cortical circuitry involvement in the symptoms of fatigue. PMID:21181521

  8. Perception, consequences, communication, and strategies for handling fatigue in persons with rheumatoid arthritis of working age--a focus group study.

    PubMed

    Feldthusen, Caroline; Björk, Mathilda; Forsblad-d'Elia, Helena; Mannerkorpi, Kaisa

    2013-05-01

    The aim of this study was to describe how persons with rheumatoid arthritis (RA) of working age experience and handle their fatigue in everyday life. Six focus group discussions were conducted focusing on experiences of fatigue in 25 persons with RA (19 women, 6 men), aged 20-60 years. The discussions were recorded, transcribed verbatim, and analyzed according to qualitative content analysis. The analyses resulted in four categories. (1) Perception of fatigue: Fatigue was experienced different from normal tiredness, unpredictable, and overwhelming. It was associated with negative emotions, changed self-image, and fears. Feelings of frustration and shame were central when the persons were forced to omit valued life activities. (2) Consequences due to fatigue: The fatigue caused changes in cognitive ability, ability to act, and overall activity pattern where the increased need for rest and sleep caused an imbalance in daily life. The participants struggled not to let the fatigue interfere with work. The fatigue also brought negative consequences for their significant others. (3) Communicating fatigue: Fatigue was difficult to gain understanding for, and the participants adjusted their communication accordingly; it was important to keep up appearances. During medical consultation, fatigue was perceived as a factor not given much consideration, and the participants expressed taking responsibility for managing their fatigue symptoms themselves. (4) Strategies to handle fatigue: Strategies comprised conscious self-care, mental strategies, planning, and prioritizing. Fatigue caused considerable health problems for persons with RA of working age: negative emotions, imbalance in daily life due to increased need for rest, and difficulties gaining understanding. This draws attention to the importance of developing new modes of care to address fatigue in RA. Person-centered care to improve balance in life may be one approach needing further investigations.

  9. A Chronic Fatigue Syndrome (CFS) severity score based on case designation criteria.

    PubMed

    Baraniuk, James N; Adewuyi, Oluwatoyin; Merck, Samantha Jean; Ali, Mushtaq; Ravindran, Murugan K; Timbol, Christian R; Rayhan, Rakib; Zheng, Yin; Le, Uyenphuong; Esteitie, Rania; Petrie, Kristina N

    2013-01-01

    Chronic Fatigue Syndrome case designation criteria are scored as physicians' subjective, nominal interpretations of patient fatigue, pain (headaches, myalgia, arthralgia, sore throat and lymph nodes), cognitive dysfunction, sleep and exertional exhaustion. Subjects self-reported symptoms using an anchored ordinal scale of 0 (no symptom), 1 (trivial complaints), 2 (mild), 3 (moderate), and 4 (severe). Fatigue of 3 or 4 distinguished "Fatigued" from "Not Fatigued" subjects. The sum of the 8(Sum8) ancillary criteria was tested as a proxy for fatigue. All subjects had history and physical examinations to exclude medical fatigue, and ensure categorization as healthy or CFS subjects. Fatigued subjects were divided into CFS with ≥4 symptoms or Chronic Idiopathic Fatigue (CIF) with ≤3 symptoms. ROC of Sum8 for CFS and Not Fatigued subjects generated a threshold of 14 (specificity=0.934; sensitivity=0.928). CFS (n=256) and CIF (n=55) criteria were refined to include Sum8≥14 and ≤13, respectively. Not Fatigued subjects had highly skewed Sum8 responses. Healthy Controls (HC; n=269) were defined by fatigue≤2 and Sum8≤13. Those with Sum8≥14 were defined as CFS-Like With Insufficient Fatigue Syndrome (CFSLWIFS; n=20). Sum8 and Fatigue were highly correlated (R(2)=0.977; Cronbach's alpha=0.924) indicating an intimate relationship between symptom constructs. Cluster analysis suggested 4 clades each in CFS and HC. Translational utility was inferred from the clustering of proteomics from cerebrospinal fluid. Plotting Fatigue severity versus Sum8 produced an internally consistent classifying system. This is a necessary step for translating symptom profiles into fatigue phenotypes and their pathophysiological mechanisms.

  10. Method of Fatigue-Life Prediction for an Asphalt Mixture Based on the Plateau Value of Permanent Deformation Ratio.

    PubMed

    Sun, Yazhen; Fang, Chenze; Wang, Jinchang; Yuan, Xuezhong; Fan, Dong

    2018-05-03

    Laboratory predictions for the fatigue life of an asphalt mixture under cyclic loading based on the plateau value (PV) of the permanent deformation ratio (PDR) were carried out by three-point bending fatigue tests. The influence of test conditions on the recovery ratio of elastic deformation (RRED), the permanent deformation (PD) and PDR, and the trends of RRED, PD, and PDR were studied. The damage variable was defined by using PDR, and the relation of the fatigue life to PDR was determined by analyzing the damage evolution process. The fatigue equation was established based on the PV of PDR and the fatigue life was predicted by analyzing the relation of the fatigue life to the PV. The results show that the RRED decreases with the increase of the number of loading cycles, and the elastic recovery ability of the asphalt mixture gradually decreases. The two mathematical models proposed are based on the change laws of the RRED, and the PD can well describe the change laws. The RRED or the PD cannot well predict the fatigue life because they do not change monotonously with the fatigue life, and one part of the deformation causes the damage and the other part causes the viscoelastic deformation. The fatigue life decreases with the increase of the PDR. The average PDR in the second stage is taken as the PV, and the fatigue life decreases in a power law with the increase of the PV. The average relative error of the fatigue life predicted by the fatigue equation to the test fatigue life is 5.77%. The fatigue equation based on PV can well predict the fatigue life.

  11. Assessing fatigue in inflammatory bowel disease: comparison of three fatigue scales.

    PubMed

    Norton, C; Czuber-Dochan, W; Bassett, P; Berliner, S; Bredin, F; Darvell, M; Forbes, A; Gay, M; Ream, E; Terry, H

    2015-07-01

    Fatigue is commonly reported by patients with inflammatory bowel disease (IBD), both in quiescent and active disease. Few fatigue scales have been tested in IBD. To assess three fatigue assessment scales in IBD and to determine correlates of fatigue. Potential participants (n = 2131) were randomly selected from an IBD organisation's members' database; 605 volunteered and were posted three fatigue scales: Inflammatory Bowel Disease Fatigue scale, Multidimensional Fatigue Inventory and Multidimensional Assessment Fatigue scale and questionnaires assessing anxiety, depression, quality of life (QoL) and IBD activity. The questionnaires were tested for stability over time with another group (n = 70) of invited participants. Internal consistency was measured by Cronbach's alpha and test-retest reliability by the intraclass correlation coefficient (ICC). Four hundred and sixty-five of 605 (77%) questionnaires were returned; of 70 invited, 48/70 returned test (68.6%) and 41/70 (58.6%) returned retest. The three scales are highly correlated (P < 0.001). Test-retest suggests reasonable agreement with ICC values between 0.65 and 0.84. Lower age, female gender, IBD diagnosis, anxiety, depression and QoL were associated with fatigue (P < 0.001) on univariable analysis. However, on multivariable analysis only depression and low QoL were consistently associated with fatigue, while female gender was associated on most scales. IBD diagnosis, age and other factors were not consistently associated with severity or impact of fatigue once other variables were controlled for. All three fatigue scales are likely to measure IBD fatigue adequately. Responsiveness to change has not been tested. Depression, poorer QoL and probably female gender are the major associations of fatigue in IBD. © 2015 John Wiley & Sons Ltd.

  12. Fatigue in the first year after traumatic brain injury: course, relationship with injury severity, and correlates.

    PubMed

    Beaulieu-Bonneau, Simon; Ouellet, Marie-Christine

    2017-10-01

    The objectives of this study were to document the evolution of fatigue in the first year after traumatic brain injury (TBI), and to explore correlates of fatigue. Participants were 210 adults who were hospitalised following a TBI. They completed questionnaires 4, 8, and 12 months post-injury, including the Multidimensional Fatigue Inventory (MFI). Participants with severe TBI presented greater mental and physical fatigue, and reduced activity compared to participants with moderate TBI. For all MFI subscales except reduced motivation, the general pattern was a reduction of fatigue levels over time after mild TBI, an increase of fatigue after severe TBI, and stable fatigue after moderate TBI. Fatigue was significantly associated with depression, insomnia, cognitive difficulties, and pain at 4 months; the same variables and work status at 8 months; and depression, insomnia, cognitive difficulties, and work status at 12 months. These findings suggest that injury severity could have an impact on the course of fatigue in the first year post-TBI. Depression, insomnia, and cognitive difficulties remain strong correlates of fatigue, while for pain and work status the association with fatigue evolves over time. This could influence the development of intervention strategies for fatigue, implemented at specific times for each severity subgroup.

  13. Conditioning monitoring by microstructural evaluation of cumulative fatigue damage

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fukuoka, C.; Nakagawa, Y.G.; Lance, J.J.

    1996-12-01

    The objective of this work is to evaluate the damage induced below and above the fatigue limit ({Delta}{sigma}{sub t} = 360 MPa) in pressure vessel steels, such as SA508. Fatigue damage was induced in samples taken from an SA508 steel plate by various loading histories in order to examine the influence of prior cyclic loading below the fatigue limit. Cell-to-cell misorientation differences were measured by the selected area diffraction (SAD) method. Surface cracking was also studied by the replication method. Small cracks were observed after precycling both below and above the fatigue limit. It was, however, found that fatigue testmore » bars had a longer lifetime after precycling below the fatigue limit, while precycling above the fatigue limit caused other specimens to fail even when subsequently cycled below the fatigue limit. Cell-to-cell misorientation usually increases with accumulation of fatigue damage, but it was found that the misorientations measured after precycling below the fatigue limit decreased again at the beginning of the subsequent cycling above the fatigue limit. It should be noted that the misorientation at failure was always about 4 to 5 deg, regardless of loading histories. Misorientation showed good correlation with the fatigue lifetime of the samples.« less

  14. Predictors of cognitive and physical fatigue in post-acute mild-moderate traumatic brain injury.

    PubMed

    Schiehser, Dawn M; Delano-Wood, Lisa; Jak, Amy J; Hanson, Karen L; Sorg, Scott F; Orff, Henry; Clark, Alexandra L

    2017-10-01

    Post-traumatic fatigue (PTF) is a common, disabling, and often chronic symptom following traumatic brain injury (TBI). Yet, the impact of chronic cognitive and physical fatigue and their associations with psychiatric, sleep, cognitive, and psychosocial sequelae in mild-moderate TBI remain poorly understood. Sixty Veterans with a history of mild-moderate TBI and 40 Veteran controls (VC) were administered the Modified Fatigue Impact Scale, a validated measure of TBI-related cognitive and physical fatigue as well as measures of neuropsychiatric, psychosocial, sleep, and objective cognitive functioning. Compared to VC, TBI Veterans endorsed significantly greater levels of cognitive and physical fatigue. In TBI, psychiatric symptoms, sleep disturbance, and post-traumatic amnesia (PTA) were associated with both cognitive and physical fatigue, while loss of consciousness (LOC) and poor attention/processing speed were related to elevations in cognitive fatigue only. In regression analyses, anxiety, sleep disturbance, and LOC significantly predicted cognitive fatigue, while only post-traumatic stress symptoms and PTA contributed to physical fatigue. Cognitive and physical fatigue are problematic symptoms following mild-moderate TBI that are differentially associated with specific injury and psychiatric sequelae. Findings provide potential symptom targets for interventions aimed at ameliorating fatigue, and further underscore the importance of assessing and treating fatigue as a multi-dimensional symptom following TBI.

  15. Psychological correlates of fatigue in rheumatoid arthritis: a systematic review.

    PubMed

    Matcham, F; Ali, S; Hotopf, M; Chalder, T

    2015-07-01

    Fatigue is common and debilitating in Rheumatoid Arthritis (RA). A focus on the psychological variables associated with fatigue may help to identify targets for intervention which could enhance the treatment of fatigue in RA. The purpose of this review was to systematically identify psychological variables related to fatigue in RA, with the overall aim of suggesting evidence-based targets for fatigue intervention in RA. Twenty-nine studies met inclusion criteria and were included in the narrative synthesis. A wide range of psychological variables were addressed, spanning 6 categories: affect and common mental disorders; RA-related cognitions; non-RA-related cognitions; personality traits; stress and coping; and social support/interpersonal relationships. The most consistent relationship was found between mood and fatigue, with low mood frequently associated with increased fatigue. Some evidence also highlighted the relationship between RA-related cognitions (such as RA self-efficacy) and fatigue, and non-RA-cognitions (such as goal ownership) and fatigue. Limited evidence was found to support the relationship between stress and coping or personality traits and fatigue, although mixed evidence was found for the relationship between social support and fatigue. The results of this review suggest the interventions for fatigue in RA may benefit from a focus on mental health, and disease-related cognitions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Influence of music on performance and psychophysiological responses during moderate-intensity exercise preceded by fatigue.

    PubMed

    Lopes-Silva, Joao P; Lima-Silva, Adriano E; Bertuzzi, Romulo; Silva-Cavalcante, Marcos D

    2015-02-01

    We examined the effects of listening to music on time to exhaustion and psychophysiological responses during moderate-intensity exercise performed in fatigued and non-fatigued conditions. Fourteen healthy men performed moderate-intensity exercise (60% Wmax) until exhaustion under four different conditions: with and without pre-fatigue (induced by 100 drop jumps) and listening and not listening to music. Time to exhaustion was lower in the fatigued than the non-fatigued condition regardless listening to music. Similarly, RPE was higher in the fatigued than the non-fatigued condition, but music had no effect. On the other hand, listening to music decreased the associative thoughts regardless of fatigue status. Heart rate was not influenced by any treatment. These results suggest that listening to music changes attentional focus but is not able to reverse fatigue-derived alteration of performance. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. High temperature tension-compression fatigue behavior of a tungsten copper composite

    NASA Technical Reports Server (NTRS)

    Verrilli, Michael J.; Gabb, Timothy P.

    1990-01-01

    The high temperature fatigue of a (O)12 tungsten fiber reinforced copper matrix composite was investigated. Specimens having fiber volume percentages of 10 and 36 were fatigued under fully-reversed, strain-controlled conditions at both 260 and 560 C. The fatigue life was found to be independent of fiber volume fraction because fatigue damage preferentially occurred in the matrix. Also, the composite fatigue lives were shorter at 560 C as compared to 260 C due to changes in mode of matrix failure. On a total strain basis, the fatigue life of the composite at 560 C was the same as the life of unreinforced copper, indicating that the presence of the fibers did not degrade the fatigue resistance of the copper matrix in this composite system. Comparison of strain-controlled fatigue data to previously-generated load-controlled data revealed that the strain-controlled fatigue lives were longer because of mean strain and mean stress effects.

  18. The Boeing 747 fatigue integrity program

    NASA Technical Reports Server (NTRS)

    Spencer, M. M.

    1972-01-01

    The fatigue integrity program which was established to insure economic operations and to provide foundation data for inspection and maintenance is discussed. Significant features of the 747 fatigue integrity program are: (1) fatigue analyses which are continually updated to reflect design changes, fatigue test results, and static and flight load survey measurements; (2) material selection and detail design by using initial fatigue analyses, service experience, and testing; and (3) fatigue testing to check detail design quality and to verify the analyses, culminated by the test of a structurally complete airframe. Fatigue stress analyses were performed with the aid of experimental as well as analytical procedures. Extensive application was made of the stress severity factor, developed at Boeing, for evaluating peak stresses in complex joints. A frame of reference was established by families of structural fatigue performance curves (S-N curves) encompassing the range of materials and fatigue qualities anticipated for the 747 airplane design.

  19. Docetaxel-related fatigue in men with metastatic prostate cancer: a descriptive analysis.

    PubMed

    Bergin, A R T; Hovey, E; Lloyd, A; Marx, G; Parente, P; Rapke, T; de Souza, P

    2017-09-01

    Fatigue is a prevalent and debilitating side effect of docetaxel chemotherapy in metastatic prostate cancer. A better understanding of the kinetics and nature of docetaxel-related fatigue may provide a framework for intervention. This secondary analysis was performed using the MOTIF database, from a phase III, randomised, double-blind, placebo-controlled study of modafinil (200 mg/day for 15 days) for docetaxel-related fatigue in men with metastatic prostate cancer [1]. The pattern of fatigue was analysed using the MDASI (MD Anderson Symptom Inventory) score. The impact of modafinil, cumulative docetaxel exposure, age and smoking status on fatigue kinetics were explored. Fatigue-related symptoms were assessed using the SOMA6 (fatigue and related symptoms) subset of the SPHERE (Somatic and Psychological Health Report). Mood was tracked using the short form 36 health survey questionnaire (SF-36). Across four docetaxel cycles, fatigue scores were higher in the first week and decreased over weeks two and three. Whilst men randomised to modafinil had reduced fatigue scores, cumulative docetaxel had little impact. Younger men (55-68 years) had significantly reduced fatigue scores, whereas current and ex-smokers had higher scores. There was no significant change in mood status or haemoglobin across treatment cycles. Men described both 'somnolence' and 'muscle fatigue' contributing significantly to their symptom complex. Assessment and management of docetaxel-related fatigue remains an important challenge. Given the complex, multifactorial nature of fatigue, identification through structured interview and interventions targeted to specific 'at risk' groups may be the most beneficial. Understanding the temporal pattern (kinetics) and nature of fatigue is critical to guide this process.

  20. Predictors and Trajectories of Morning Fatigue Are Distinct from Evening Fatigue

    PubMed Central

    Wright, Fay; Melkus, Gail D’Eramo; Hammer, Marilyn; Schmidt, Brian L.; Knobf, M. Tish; Paul, Steven M.; Cartwright, Frances; Mastick, Judy; Cooper, Bruce A.; Chen, Lee-May; Melisko, Michelle; Levine, Jon D.; Kober, Kord; Aouizerat, Bradley E.; Miaskowski, Christine

    2015-01-01

    Context Fatigue is the most common symptom in oncology patients during chemotherapy (CTX). Little is known about the predictors of interindividual variability in initial levels and trajectories of morning fatigue severity in these patients. Objectives An evaluation was done to determine which demographic, clinical, and symptom characteristics were associated with initial levels as well as the trajectories of morning fatigue and to compare findings with our companion paper on evening fatigue. Methods A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (N=586) completed demographic and symptom questionnaires a total of six times over two cycles of CTX. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling (HLM) was used to answer the study objectives. Results A large amount of interindividual variability was found in the morning fatigue trajectories. A piecewise model fit the data best. Patients with higher body mass index (BMI), who did not exercise regularly, with a lower functional status, and who had higher levels of state anxiety, sleep disturbance and depressive symptoms, reported higher levels of morning fatigue at enrollment. Variations in the trajectories of morning fatigue were predicted by the patients’ ethnicity and younger age. Conclusion The modifiable risk factors that were associated with only morning fatigue were BMI, exercise, and state anxiety. Modifiable risk factors that were associated with both morning and evening fatigue included functional status, depressive symptoms, and sleep disturbance. Using this information, clinicians can identify patients at higher risk for more severe morning fatigue and evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors. PMID:25828559

  1. Features that exacerbate fatigue severity in joint hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type.

    PubMed

    Krahe, Anne Maree; Adams, Roger David; Nicholson, Leslie Lorenda

    2018-08-01

    To assess the prevalence, severity and impact of fatigue on individuals with joint hypermobility syndrome (JHS)/Ehlers-Danlos syndrome - hypermobility type (EDS-HT) and establish potential determinants of fatigue severity in this population. Questionnaires on symptoms and signs related to fatigue, quality of life, mental health, physical activity participation and sleep quality were completed by people with JHS/EDS-HT recruited through two social media sites. Multiple regression analysis was performed to identify predictors of fatigue in this population. Significant fatigue was reported by 79.5% of the 117 participants. Multiple regression analysis identified five predictors of fatigue severity, four being potentially modifiable, accounting for 52.3% of the variance in reported fatigue scores. Predictors of fatigue severity were: the self-perceived extent of joint hypermobility, orthostatic dizziness related to heat and exercise, levels of participation in personal relationships and community, current levels of physical activity and dissatisfaction with the diagnostic process and management options provided for their condition. Fatigue is a significant symptom associated with JHS/EDS-HT. Assessment of individuals with this condition should include measures of fatigue severity to enable targeted management of potentially modifiable factors associated with fatigue severity. Implications for rehabilitation Fatigue is a significant symptom reported by individuals affected by joint hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type. Potentially modifiable features that contribute to fatigue severity in this population have been identified. Targeted management of these features may decrease the severity and impact of fatigue in joint hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type.

  2. The PedsQL Multidimensional Fatigue Scale in type 1 diabetes: feasibility, reliability, and validity.

    PubMed

    Varni, James W; Limbers, Christine A; Bryant, William P; Wilson, Don P

    2009-08-01

    The Pediatric Quality of Life Inventory (PedsQL, Mapi Research Trust, Lyon, France; www.pedsql.org) is a modular instrument designed to measure health-related quality of life and disease-specific symptoms in children and adolescents. The PedsQL Multidimensional Fatigue Scale was designed as a child self-report and parent proxy-report generic symptom-specific instrument to measure fatigue in pediatric patients. The objective of the present study was to determine the feasibility, reliability, and validity of the PedsQL Multidimensional Fatigue Scale in type 1 diabetes. The 18-item PedsQL Multidimensional Fatigue Scale (General Fatigue, Sleep/Rest Fatigue, and Cognitive Fatigue domains) and the PedsQL 4.0 Generic Core Scales were administered to 83 pediatric patients with type 1 diabetes and 84 parents. The PedsQL Multidimensional Fatigue Scale evidenced minimal missing responses (0.3% child report and 0.3% parent report), achieved excellent reliability for the Total Fatigue Scale score (alpha= 0.92 child report, 0.94 parent report), distinguished between pediatric patients with diabetes and healthy children, and was significantly correlated with the PedsQL 4.0 Generic Core Scales supporting construct validity. Pediatric patients with diabetes experienced fatigue that was comparable to pediatric patients with cancer on treatment, demonstrating the relative severity of their fatigue symptoms. The results demonstrate the measurement properties of the PedsQL Multidimensional Fatigue Scale in type 1 diabetes. The findings suggest that the PedsQL Multidimensional Fatigue Scale may be utilized in the standardized evaluation of fatigue in pediatric patients with type 1 diabetes.

  3. Fatigue in Adolescents With Cancer Compared to Healthy Adolescents

    PubMed Central

    Daniel, Lauren C.; Brumley, Lauren D.; Schwartz, Lisa A.

    2015-01-01

    Background Cancer-related fatigue is one of the most pervasive and debilitating side-effects of cancer treatment and adolescents consistently rate cancer-related fatigue as one of the most distressing aspects of treatment. Because fatigue is also high in adolescents without cancer, the current study aims to describe fatigue in adolescents with cancer relative to a control group and to identify associates of such fatigue. Knowing this is important for understanding the extent of the problem in adolescents with cancer relative to healthy adolescents and for understanding who is most at risk for fatigue and related distress. Procedure Adolescents with cancer and their caregivers (n =102) and adolescents without a history of chronic health conditions and their caregivers (n =97) completed the Multidimensional Fatigue Scale and measures of depression, quality of life (QoL), affect, coping, and family functioning. Results Adolescents with cancer and their caregivers reported significantly more adolescent fatigue across all domains (with the exception of adolescent reports of cognitive fatigue) relative to adolescents without chronic health conditions. Higher fatigue was significantly related to adolescent report of more symptoms of depression, poorer QoL, higher negative affect, less positive affect, and behavioral disengagement coping style. Fatigue was not related to active coping or family functioning. Conclusions Adolescents with cancer experience significantly more fatigue than peers without chronic health conditions. Reports of fatigue are closely related to multiple indicators of psychosocial well-being, suggesting that fatigue may be an important cancer-related symptom to assess and manage to improve adolescent QoL. PMID:23897651

  4. Levels of fatigue in people with ESRD living in far North Queensland.

    PubMed

    Bonner, Ann; Wellard, Sally; Caltabiano, Marie

    2008-01-01

    Levels of fatigue as experienced by people with end stage renal disease (ESRD), were assessed using the Fatigue Severity Scale (FSS). Fatigue, a common symptom reported by people with ESRD, is a multifaceted, subjective experience, which is readily understood by individuals but difficult to measure. There is limited understanding of the level of fatigue experienced by people with ESRD, with research currently limited to people treated with haemodialysis. The FSS was completed by 92 people with ESRD who were patients of a renal service in far North Queensland, Australia. Demographic and renal health history data were also collected with the self-report survey. Comparisons were preformed between overall fatigue levels and different renal disorders, genders, ethnicity and renal replacement therapy (RRT). Participants in this study were more fatigued than the general population; there was no difference in levels of fatigue between gender and ethnicity. Participants with diabetic nephropathy and those who were predialysis were the most fatigued. A significant difference between mean fatigue scores was found for type of RRT [F(3,88) = 2.4, p < 0.05], with participants using peritoneal dialysis reporting the most fatigue. Additionally, participants categorized according to type of RRT, erythropoietin replacement therapy and current haemoglobin levels revealed significant mean differences on fatigue levels [F(3,88) = 2.74, p < 0.05]. People with ESRD experience considerable fatigue; it is particularly important for nurses to understand this level of fatigue impacts on the daily life of patients. These findings provide the preliminary evidence to support the development of renal nursing practice guidelines related to symptom recognition and management of fatigue.

  5. Characterization of chronic fatigue in patients with sarcoidosis in clinical remission.

    PubMed

    Korenromp, Ingrid H E; Heijnen, Cobi J; Vogels, Oscar J M; van den Bosch, Jules M M; Grutters, Jan C

    2011-08-01

    Patients with sarcoidosis frequently complain of fatigue, even when sarcoidosis has come into clinical remission. The primary aim of this study was to assess the severity of fatigue in patients with sarcoidosis in clinical remission and to characterize it according to the international criteria for chronic fatigue syndrome (CFS). Furthermore, we evaluated whether fatigue is associated with depression and anxiety, health status, and patient-reported sleep quality, and we recorded physical activity levels and muscle strength as objective assessments of fatigue. Data on 75 patients with sarcoidosis in clinical remission were obtained by questionnaires (Checklist Individual Strength [CIS], Symptom Checklist-90, Beck Depression Inventory for primary care, Medical Outcomes Study 36-Item Short-Form Health Survey), standardized interview (CFS criteria), sleep diary, accelerometer, and muscle strength tests. Fatigue severity mean score in patients with sarcoidosis in clinical remission was high (CIS fatigue severity 30.5 ± 15.5), and criteria for CFS were met in 47% of fatigued participants. Median time since diagnosis was 9 years. Fatigue was associated with depression (P = .01), anxiety (P = .013), and reduced health status (P < .001). Scores on sleep quality were normal. Physical activity levels were reduced in fatigued participants. Muscle strength, particularly handgrip (P = .006) and quadriceps strength (P < .001), was significantly associated with fatigue. Fatigue in patients with sarcoidosis in clinical remission is a frequent symptom and can be characterized as a severe and long-lasting problem, symptomatically similar to CFS. Psychologic distress and reduced health status are associated with fatigue. Interestingly, we observed significantly reduced physical activity and muscle weakness in fatigued patients.

  6. Usefulness of multiple dimensions of fatigue in fibromyalgia.

    PubMed

    Ericsson, Anna; Bremell, Tomas; Mannerkorpi, Kaisa

    2013-07-01

    To explore in which contexts ratings of multiple dimensions of fatigue are useful in fibromyalgia, and to compare multidimensional fatigue between women with fibromyalgia and healthy women. A cross-sectional study. The Multidimensional Fatigue Inventory (MFI-20), comprising 5 subscales of fatigue, was compared with the 1-dimensional subscale of fatigue from the Fibromyalgia Impact Questionnaire (FIQ) in 133 women with fibromyalgia (mean age 46 years; standard deviation 8.6), in association with socio-demographic and health-related aspects and analyses of explanatory variables of severe fatigue. The patients were also compared with 158 healthy women (mean age 45 years; standard deviation 9.1) for scores on MFI-20 and FIQ fatigue. The MFI-20 was associated with employment, physical activity and walking capacity (rs = -0.27 to -0.36), while FIQ fatigue was not. MFI-20 and FIQ fatigue were equally associated with pain, sleep, depression and anxiety (rs = 0.32-0.63). Regression analyses showed that the MFI-20 increased the explained variance (R2) for the models of pain intensity, sleep, depression and anxiety, by between 7 and 29 percentage points, compared with if FIQ fatigue alone was included in the models. Women with fibromyalgia rated their fatigue higher than healthy women for all subscales of the MFI-20 and the FIQ fatigue (p < 0.001). Dimensions of fatigue, assessed by the MFI-20, appear to be valuable in studies of employment, pain intensity, sleep, distress and physical function in women with fibromyalgia. The patients reported higher levels on all fatigue dimensions in comparison with healthy women.

  7. Effect of unilateral knee extensor fatigue on force and balance of the contralateral limb.

    PubMed

    Arora, Shruti; Budden, Shawn; Byrne, Jeannette M; Behm, David G

    2015-10-01

    Fatigue in one limb can decrease force production in the homologous muscle as well as other muscles of the non-fatigued limb affecting balance. The objective of the study was to examine the effect of unilateral knee extensor fatigue on the non-fatigued limb's standing balance, muscle force and activation. Sixteen healthy male subjects performed pre-fatigue balance trials, warm-up exercises, maximum voluntary isometric contractions, a knee extensors fatigue protocol, and post-fatigue balance trials. The fatigue protocol consisted of sets of 15 consecutive isometric contractions of 16 s each with 4 s recovery between repetitions, which were performed at 30% peak force for the dominant knee extensor muscles. Additional sets of contractions continued until a 50% decrease in MVIC knee extensor force was observed. Pre- and post-fatigue balance assessment consisted of transition from double to single leg standing and also single leg standing trials, which were performed bilaterally and in randomized order. The peak force and F100 were significantly decreased by 44.8% (ES = 2.54) and 39.9% (ES = 0.59), respectively, for the fatigued limb post-fatigue. There were no significant changes in the non-fatigued limb's muscle force, activation, muscle onset timing or postural stability parameters. While the lack of change in non-fatigued limb force production is in agreement with some of the previous literature in this area, the lack of effect on postural measures directly contradicts earlier work. It is hypothesized that discrepancies in the duration and the intensity of the fatigue protocol may have accounted for this discrepancy.

  8. Nonlinear Fatigue Damage Model Based on the Residual Strength Degradation Law

    NASA Astrophysics Data System (ADS)

    Yongyi, Gao; Zhixiao, Su

    In this paper, a logarithmic expression to describe the residual strength degradation process is developed in order to fatigue test results for normalized carbon steel. The definition and expression of fatigue damage due to symmetrical stress with a constant amplitude are also given. The expression of fatigue damage can also explain the nonlinear properties of fatigue damage. Furthermore, the fatigue damage of structures under random stress is analyzed, and an iterative formula to describe the fatigue damage process is deduced. Finally, an approximate method for evaluating the fatigue life of structures under repeated random stress blocking is presented through various calculation examples.

  9. Prevalence of Fatigue and Associated Factors in a Spinal Cord Injury Population: Data from an Internet-Based and Face-to-Face Surveys.

    PubMed

    Cudeiro-Blanco, Javier; Onate-Figuérez, Ana; Soto-León, Vanesa; Avendaño-Coy, Juan; Mordillo-Mateos, Laura; Brocalero-Camacho, Angela; Esclarin-Ruz, Ana; Rotondi, Mario; Aguilar, Juan; Arias, Pablo; Oliviero, Antonio

    2017-08-01

    Fatigue has a profound impact on patients with spinal cord injury (SCI), but only limited treatments are available. The aim of this study was to determine the prevalence of fatigue in SCI and its association with clinical and demographic factors. We used an internet-based survey and a face-to-face interview to estimate the prevalence of fatigue in a SCI population. Fatigue was measured using the Fatigue Severity Scale (FSS). Clinically significant fatigue was defined as FSS scores greater than or equal to four. A total of 253 participants with SCI were included in the study. Clinically significant fatigue was present in one third of our sample. There was no relationship between fatigue and injury level or completeness. We found significant correlations between depression, pain, and level of injury. The relation of fatigue with completeness of injury and spasticity is less clear. Moreover, the online survey and the standard face-to-face interview showed similar results concerning fatigue evaluation. Several factors may contribute to fatigue, however. Future studies should be conducted to clarify which are the most relevant ones and, if possible, to determine which factors are modifiable.

  10. An analysis of isothermal, bithermal, and thermomechanical fatigue data of Haynes 188 and B1900+Hf by energy considerations

    NASA Technical Reports Server (NTRS)

    Radhakrishnan, V. M.; Kalluri, Sreeramesh; Halford, Gary R.

    1993-01-01

    The low-cycle fatigue behavior of Haynes 188 and B1900+Hf under isothermal, bithermal, and thermomechanical loading conditions has been analyzed on the basis of the total hysteresis energy expended per cycle. It has been observed that in the case of isothermal fatigue the total hysteresis energy correlates well with the fatigue life. In the case of bithermal 'high rate' fatigue, for a given total hysteresis energy per cycle, the fatigue life is equal to or greater than the isothermal fatigue life at the maximum bithermal temperature. This observation could be used to establish a lower bound on life for design purposes. In one case of bithermal creep-fatigue and in thermomechanical fatigue, the life is shorter than that corresponding to the isothermal life at the maximum temperature. The energy supplied, per se, may not always give a systematic correlation with the fatigue life in the cases where time-dependent creep and environmental effects are encountered. Thus, in bithermal creep-fatigue and thermomechanical fatigue, the role of creep and environment and their dependence on the energy supplied have to be properly accounted for before the energy term can be used for life prediction.

  11. Postpartum fatigue in the active-duty military woman.

    PubMed

    Rychnovsky, Jacqueline D

    2007-01-01

    (a) To describe fatigue levels in military active-duty women, (b) to describe the relationship among selected predictor variables of fatigue, and (c) to examine the relationship between predictor variables, fatigue levels, and performance (as measured by functional status) after childbirth. Based on the Theory of Unpleasant Symptoms, a longitudinal, prospective design. A large military medical facility in the southwest United States. A convenience sample of 109 military active-duty women. Postpartum fatigue. Women were found to be moderately fatigued across time, with no change in fatigue levels from 2 to 6 weeks after delivery. All variables correlated with fatigue during hospitalization and at 2 weeks after delivery, and depression, anxiety, maternal sleep, and functional status correlated with fatigue at 6 weeks after delivery. Regression analyses indicated that maternal anxiety predicted fatigue at 6 weeks after delivery. Over half the women had not regained full functional status when they returned to work, and 40% still displayed symptoms of postpartum depression and anxiety. Military women continue to experiencing postpartum fatigue when they return to the workplace. Future research is needed to examine issues surrounding fatigue and its associated variables during the first year after delivery.

  12. Fatigue Damage and Lifetime of SiC/SiC Ceramic-Matrix Composite under Cyclic Loading at Elevated Temperatures

    PubMed Central

    Li, Longbiao

    2017-01-01

    In this paper, the fatigue damage and lifetime of 2D SiC/SiC ceramic-matrix composites (CMCs) under cyclic fatigue loading at 750, 1000, 1100, 1200 and 1300 °C in air and in steam atmosphere have been investigated. The damage evolution versus applied cycles of 2D SiC/SiC composites were analyzed using fatigue hysteresis dissipated energy, fatigue hysteresis modulus, fatigue peak strain and interface shear stress. The presence of steam accelerated the damage development inside of SiC/SiC composites, which increased the increasing rate of the fatigue hysteresis dissipated energy and the fatigue peak strain, and the decreasing rate of the fatigue hysteresis modulus and the interface shear stress. The fatigue life stress-cycle (S-N) curves and fatigue limit stresses of 2D SiC/SiC composites at different temperatures in air and in steam condition have been predicted. The fatigue limit stresses approach 67%, 28%, 39% 17% and 28% tensile strength at 750, 1000, 1100, 1200 and 1300 °C in air, and 49%, 10%, 9% and 19% tensile strength at 750, 1000, 1200 and 1300 °C in steam conditions, respectively. PMID:28772736

  13. The Effects of Hot Corrosion Pits on the Fatigue Resistance of a Disk Superalloy

    NASA Technical Reports Server (NTRS)

    Gabb, Timothy P.; Telesman, Jack; Hazel, Brian; Mourer, David P.

    2009-01-01

    The effects of hot corrosion pits on low cycle fatigue life and failure modes of the disk superalloy ME3 were investigated. Low cycle fatigue specimens were subjected to hot corrosion exposures producing pits, then tested at low and high temperatures. Fatigue lives and failure initiation points were compared to those of specimens without corrosion pits. Several tests were interrupted to estimate the fraction of fatigue life that fatigue cracks initiated at pits. Corrosion pits significantly reduced fatigue life by 60 to 98 percent. Fatigue cracks initiated at a very small fraction of life for high temperature tests, but initiated at higher fractions in tests at low temperature. Critical pit sizes required to promote fatigue cracking were estimated, based on measurements of pits initiating cracks on fracture surfaces.

  14. Effects of the Electron Beam Welding Process on the Microstructure, Tensile, Fatigue and Fracture Properties of Nickel Alloy Nimonic 80A

    NASA Astrophysics Data System (ADS)

    Zhang, H.; Huang, Chongxiang; Guan, Zhongwei; Li, Jiukai; Liu, Yongjie; Chen, Ronghua; Wang, Qingyuan

    2018-01-01

    The purpose of this study was to evaluate rotary bending high-cycle fatigue properties and crack growth of Nimonic 80A-based metal and electron beam-welded joints. All the tests were performed at room temperature. Fracture surfaces under high-cycle fatigue and fatigue crack growth were observed by scanning electron microscopy. Microstructure, hardness and tensile properties were also evaluated in order to understand the effects on the fatigue results obtained. It was found that the tensile properties, hardness and high-cycle fatigue properties of the welded joint are lower than the base metal. The fracture surface of the high-cycle fatigue shows that fatigue crack initiated from the surface under the high stress amplitude and from the subsurface under the low stress amplitude. The effect of the welding process on the statistical fatigue data was studied with a special focus on probabilistic life prediction and probabilistic lifetime limits. The fatigue crack growth rate versus stress intensity factor range data were obtained from the fatigue crack growth tests. From the results, it was evident that the fatigue crack growth rates of the welded are higher than the base metal. The mechanisms and fracture modes of fatigue crack growth of welded specimens were found to be related to the stress intensity factor range ΔK. In addition, the effective fatigue crack propagation thresholds and mismatch of welded joints were described and discussed.

  15. Mirrored symptoms in mother and child with chronic fatigue syndrome.

    PubMed

    van de Putte, Elise M; van Doornen, Lorenz J P; Engelbert, Raoul H H; Kuis, Wietse; Kimpen, Jan L L; Uiterwaal, Cuno S P M

    2006-06-01

    Our aim with this study was to assess the relation between chronic fatigue syndrome in adolescents and fatigue and associated symptoms in their fathers and mothers, more specifically the presence of chronic fatigue syndrome-like symptoms and psychologic distress. In this cross-sectional study, 40 adolescents with chronic fatigue syndrome according to the Centers for Disease Control and Prevention criteria were compared with 36 healthy control subjects and their respective parents. Questionnaires regarding fatigue (Checklist Individual Strength), fatigue-associated symptoms, and psychopathology (Symptom Checklist-90) were applied to the children and their parents. Psychologic distress in the mother corresponds with an adjusted odds ratio of 5.6 for the presence of CFS in the child. The presence of fatigue in the mother and dimensional assessment of fatigue with the Checklist Individual Strength revealed odds ratios of, respectively, 5.29 and 2.86 for the presence of chronic fatigue syndrome in the child. An increase of 1 SD of the hours spent by the working mother outside the home reduced the risk for chronic fatigue syndrome in their child with 61%. The fathers did not show any risk indicator for chronic fatigue syndrome in their child. Mothers of adolescents with chronic fatigue syndrome exhibit fatigue and psychologic symptoms similar to their child in contrast with the fathers. The striking difference between the absent association in fathers and the evident association in mothers suggests that the shared symptom complex of mother and child is the result of an interplay between genetic vulnerability and environmental factors.

  16. Lower brain-derived neurotrophic factor levels associated with worsening fatigue in prostate cancer patients during repeated stress from radiation therapy.

    PubMed

    Saligan, L N; Lukkahatai, N; Holder, G; Walitt, B; Machado-Vieira, R

    2016-12-01

    Fatigue during cancer treatment is associated with depression. Neurotrophic factors play a major role in depression and stress and might provide insight into mechanisms of fatigue. This study investigated the association between plasma concentrations of three neurotrophic factors (BDNF, brain-derived neurotrophic factor; GDNF, glial-derived neurotrophic factor; and SNAPIN, soluble N-ethylmaleimide sensitive fusion attachment receptor-associated protein) and initial fatigue intensification during external beam radiation therapy (EBRT) in euthymic non-metastatic prostate cancer men. Fatigue, as measured by the 13-item Functional Assessment of Cancer Therapy-Fatigue (FACT-F), and plasma neurotrophic factors were collected at baseline (prior to EBRT) and mid-EBRT. Subjects were categorized into fatigue and no fatigue groups using a > 3-point change in FACT-F scores between the two time points. Multiple linear regressions analysed the associations between fatigue and neurotrophic factors. FACT-F scores of 47 subjects decreased from baseline (43.95 ± 1.3) to mid-EBRT (38.36 ± 1.5, P < 0.001), indicating worsening fatigue. SNAPIN levels were associated with fatigue scores (r s = 0.43, P = 0.005) at baseline. A significant decrease of BDNF concentration (P = 0.008) was found in fatigued subjects during EBRT (n = 39). Baseline SNAPIN and decreasing BDNF levels may influence worsening fatigue during EBRT. Further investigations are warranted to confirm their role in the pathophysiology and therapeutics of fatigue.

  17. The prevalence of severe fatigue in rheumatic diseases: an international study.

    PubMed

    Overman, Cécile L; Kool, Marianne B; Da Silva, José A P; Geenen, Rinie

    2016-02-01

    Fatigue is a common, disabling, and difficult-to-manage problem in rheumatic diseases. Prevalence estimates of fatigue within rheumatic diseases vary considerably. Data on the prevalence of severe fatigue across multiple rheumatic diseases using a similar instrument is missing. Our aim was to provide an overview of the prevalence of severe fatigue across a broad range of rheumatic diseases and to examine its association with clinical and demographic variables. Online questionnaires were filled out by an international sample of 6120 patients (88 % female, mean age 47) encompassing 30 different rheumatic diseases. Fatigue was measured with the RAND(SF)-36 Vitality scale. A score of ≤35 was taken as representing severe fatigue (90 % sensitivity and 81 % specificity for chronic fatigue syndrome). Severe fatigue was present in 41 to 57 % of patients with a single inflammatory rheumatic disease such as rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, Sjögren's syndrome, psoriatic arthritis, and scleroderma. Severe fatigue was least prevalent in patients with osteoarthritis (35 %) and most prevalent in patients with fibromyalgia (82 %). In logistic regression analysis, severe fatigue was associated with having fibromyalgia, having multiple rheumatic diseases without fibromyalgia, younger age, lower education, and language (French: highest prevalence; Dutch: lowest prevalence). In conclusion, one out of every two patients with a rheumatic disease is severely fatigued. As severe fatigue is detrimental to the patient, the near environment, and society at large, unraveling the underlying mechanisms of fatigue and developing optimal treatment should be top priorities in rheumatologic research and practice.

  18. Clinically distinct trajectories of fatigue and their longitudinal relationship with the disturbance of personal goals following a cancer diagnosis.

    PubMed

    Müller, Fabiola; Tuinman, Marrit A; Janse, Moniek; Almansa, Josué; Sprangers, Mirjam A G; Smink, Ans; Ranchor, Adelita V; Fleer, Joke; Hagedoorn, Mariët

    2017-09-01

    Most studies on fatigue in patients with cancer aggregate its prevalence and severity on a group level, ignoring the possibility that subgroups of patients may differ widely in their development of fatigue. This study aimed to identify subgroups of patients with clinically distinct trajectories of fatigue from diagnosis to 18 months post-diagnosis. As fatigue might trigger goal disturbance, the study also identified trajectories of concrete and abstract goal disturbance and longitudinally examined their co-occurrence with fatigue. Prospective design with quantitative and qualitative method of data collection. Patients with colorectal cancer (n = 183) reported on their levels of fatigue and goal disturbance shortly after diagnosis (T 1 ) and at 7 months (T 2 ) and 18 months (T 3 ) post-diagnosis. Growth mixture model analyses were performed to identify trajectories of fatigue and goal disturbance. Guidelines for the clinical relevance of fatigue were applied. Four clinically distinct trajectories of fatigue were identified as follows: (1) persistent severe fatigue (25.4%), (2) moderate fatigue (56.1%), (3) no fatigue (13.8%), and (4) rapidly improving fatigue (4.7%). The majority of patients with cancer reported high disturbance of their concrete goals, while high disturbance of abstract goals was less evident. Fatigue and concrete goal disturbance co-occurred longitudinally. The fatigue and goal disturbance experienced from diagnosis to 18 months post-diagnosis differ considerably for subgroups of patients with cancer. Fatigue and concrete goal disturbance are persistent burdens in the majority of patients. Investigating symptom burden beyond average trends can guide clinicians to identify patients most in need for treatment. Targeting goal disturbance might benefit the psychological well-being in patients suffering from persistent symptoms. Statement of contribution What is already known on this subject? Fatigue is a common and distressing symptom at all stages of the cancer experience. Earlier studies suggest that many patients recover from fatigue after treatment completion. Patients with cancer experience disturbance in their personal goals, which is related to poor psychological well-being. What does this study add? Developments of fatigue and goal disturbance differ between subgroups of patients with cancer but co-occur within these subgroups. About 30% of the patients experience severe fatigue after diagnosis, of which only few patients recover within 18 months post-diagnosis. Targeting goal disturbance might benefit patients with severe and ongoing symptoms. © 2017 The British Psychological Society.

  19. Effects of a One-to-One Fatigue Management Course for People With Chronic Conditions and Fatigue.

    PubMed

    Van Heest, Katy N L; Mogush, Ashley R; Mathiowetz, Virgil G

    We assessed the impact of a one-to-one fatigue management course on participants' fatigue, self-efficacy, quality of life, and energy conservation behaviors. This observational study used a one-group, pretest-posttest, follow-up design. Forty-nine people with chronic conditions and fatigue participated in the one-to-one fatigue management course in outpatient and community-based settings. The Functional Assessment of Chronic Illness Therapy-Fatigue Scale was used to measure fatigue; the Functional Assessment of Cancer Therapy-General measured quality of life; and the Self-Efficacy for Performing Energy Conservation Strategies Assessment was used to measure self-efficacy. Participants showed significant reductions in fatigue and significant increases in self-efficacy and quality of life at posttest. These beneficial effects were maintained at follow-up. The Social Well-Being subscale was the only measure on which outcomes did not change significantly. The one-to-one fatigue management course is a beneficial intervention for people with chronic conditions and fatigue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  20. Reciprocal relationship between acute stress and acute fatigue in everyday life in a sample of university students.

    PubMed

    Doerr, Johanna M; Ditzen, Beate; Strahler, Jana; Linnemann, Alexandra; Ziemek, Jannis; Skoluda, Nadine; Hoppmann, Christiane A; Nater, Urs M

    2015-09-01

    We investigated whether stress may influence fatigue, or vice versa, as well as factors mediating this relationship. Fifty healthy participants (31 females, 23.6±3.2 years) completed up to 5 momentary assessments of stress and fatigue during 5 days of preparation for their final examinations (exam condition) and 5 days of a regular semester week (control condition). Sleep quality was measured by self-report at awakening. A sub-group of participants (n=25) also collected saliva samples. Fatigue was associated with concurrent stress, stress reported at the previous measurement point, and previous-day stress. However, momentary stress was also predicted by concurrent fatigue, fatigue at the previous time point, and previous-day fatigue. Sleep quality mediated the association between stress and next-day fatigue. Cortisol and alpha-amylase did not mediate the stress-fatigue relationship. In conclusion, there is a reciprocal stress-fatigue relationship. Both prevention and intervention programs should comprehensively cover how stress and fatigue might influence one another. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Effect of Environment on Fatigue Behavior of a Nicalon(TM)/Si-N-C Ceramic Matrix Composite

    NASA Technical Reports Server (NTRS)

    Kalluri, Sreeramesh; Ojard, Greg C.; Verrilli, Michael J.; Kiraly, Louis J. (Technical Monitor)

    2002-01-01

    The effect of environmental exposure on the fatigue life of Nicalon(TM) /Si-N-C composite was investigated in this study. Test specimens with arrays of 1.8 mm diameter holes and two different open areas, 25 and 35%, were machined. Three environmental conditions were studied: 1) continuous fatigue cycling in air, 2) fatigue cycling in air alternating with humidity exposure, and 3) fatigue cycling in air alternating with exposure to a salt-fog environment. All fatigue testing on specimens with holes was performed with a load ratio, R = 0.05, and at a temperature of 910 C. In general, fatigue lives were shortest for specimens subjected to salt-fog exposure and longest for specimens subjected to continuous fatigue cycling in air. The fatigue data generated on the specimens with holes were compared with fatigue data generated in air on specimens with no holes. Fatigue strength reduction factors for different environmental conditions and open areas investigated in the study were calculated for the Nicalon(TM) /Si-N-C composite.

  2. Fatigue Life Estimation under Cumulative Cyclic Loading Conditions

    NASA Technical Reports Server (NTRS)

    Kalluri, Sreeramesh; McGaw, Michael A; Halford, Gary R.

    1999-01-01

    The cumulative fatigue behavior of a cobalt-base superalloy, Haynes 188 was investigated at 760 C in air. Initially strain-controlled tests were conducted on solid cylindrical gauge section specimens of Haynes 188 under fully-reversed, tensile and compressive mean strain-controlled fatigue tests. Fatigue data from these tests were used to establish the baseline fatigue behavior of the alloy with 1) a total strain range type fatigue life relation and 2) the Smith-Wastson-Topper (SWT) parameter. Subsequently, two load-level multi-block fatigue tests were conducted on similar specimens of Haynes 188 at the same temperature. Fatigue lives of the multi-block tests were estimated with 1) the Linear Damage Rule (LDR) and 2) the nonlinear Damage Curve Approach (DCA) both with and without the consideration of mean stresses generated during the cumulative fatigue tests. Fatigue life predictions by the nonlinear DCA were much closer to the experimentally observed lives than those obtained by the LDR. In the presence of mean stresses, the SWT parameter estimated the fatigue lives more accurately under tensile conditions than under compressive conditions.

  3. Prevalence of fatigue in a group of airline pilots.

    PubMed

    Reis, Cátia; Mestre, Catarina; Canhão, Helena

    2013-08-01

    Fatigue is a common phenomenon in airline pilots that can impair alertness and ability of crewmembers to safely operate an aircraft and perform safety related tasks. Fatigue can increase the risk of an incident or even an accident. This study provides the first prevalence values for clinically significant fatigue in Portuguese airline pilots. The hypothesis that medium/short-haul pilots may currently present different levels of fatigue than long-haul pilots was also tested. A survey was conducted by requesting Portuguese airline pilots to complete questionnaires placed in the pilots' personal lockers from 1 April until 15 May 2012. The questionnaire included the self-response Fatigue Severity Scale (FSS) to measure subjective fatigue and some additional questions concerning perception of fatigue by pilots. The prevalence values for total and mental fatigue achieved in the Portuguese airline pilots were: 89.3% (FSS > or = 4) and 94.1% (FSS > or = 4) when splitting the sample in two subsamples, long- and medium/short-haul pilots. Levels of total and mental fatigue were higher for medium/short-haul pilots. The analysis of fatigue levels in each type of aviator showed that medium/short-haul pilots presented the highest levels of total and mental fatigue. This study produced the first prevalence values of total and mental fatigue among Portuguese airline pilots, which represents a great step to understanding and addressing this critical phenomenon.

  4. Chronic Fatigue Syndrome (CFS) and Cancer Related Fatigue (CRF): two "fatigue" syndromes with overlapping symptoms and possibly related aetiologies.

    PubMed

    Rovigatti, Ugo

    2012-12-01

    In July 2010, at the Muscle Fatigue Meeting, I presented an overview of Chronic Fatigue Syndrome and Cancer Related Fatigue, emphasizing a critical interpretation of the potential association between Chronic Fatigue Syndrome and Cancer Related Fatigue and a newly discovered retrovirus: Xenotropic Murine Related Virus. Since this association was hotly debated at that time, I suggested at the Meeting that it was wrong and most likely due to the identification of the wrong virus culprit. Today, 20 months after the Meeting, the first part of our prediction has turned out to be correct, as Xenotropic Murine Related Virus was shown to be a laboratory-created artefact. Still, the potential association of fatigue-syndromes with an infection (most likely viral) is sustained by a plethora of evidence and this overview will initially summarize data suggesting prior viral infection(s). The principal hypothesized mechanisms for both peripheral and central Chronic Fatigue Syndrome/Cancer Related Fatigue will be then summarized, also indicating plausible associations and triggering factors. All evidence accrued so far suggests that further research work should be performed in this interesting area and in order to identify an infectious agent for Chronic Fatigue Syndrome/Cancer Related Fatigue. One candidate RNA virus, Micro-Foci inducing Virus, will be described in this overview. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Subjective Fatigue in Children With Hearing Loss Assessed Using Self- and Parent-Proxy Report

    PubMed Central

    Gustafson, Samantha J.; Lancaster, Hope; Cho, Sun-Joo; Camarata, Stephen; Bess, Fred H.

    2017-01-01

    Purpose The primary purposes of this study were to examine the effects of hearing loss and respondent type (self- vs. parent-proxy report) on subjective fatigue in children. We also examined associations between child-specific factors and fatigue ratings. Method Subjective fatigue was assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL-MFS; Varni, Burwinkle, Katz, Meeske, & Dickinson, 2002). We compared self- and parent-proxy ratings from 60 children with hearing loss (CHL) and 43 children with normal hearing (CNH). The children ranged in age from 6 to 12 years. Results School-age CHL experienced more overall and cognitive fatigue than CNH, although the differences were smaller than previously reported. Parent-proxy report was not strongly associated with child self-report, and parents tended to underestimate their child's fatigue, particularly sleep/rest fatigue. Language ability was also associated with subjective fatigue. For CHL and CNH, as language abilities increased, cognitive fatigue decreased. Conclusions School-age CHL experience more subjective fatigue than CNH. The poor association between parent-proxy and child reports suggests that the parent-proxy version of the PedsQL-MFS should not be used in isolation when assessing fatigue in school-age children. Future research should examine how language abilities may modulate fatigue and its potential academic consequences in CHL. PMID:29049623

  6. Proximal and distal muscle fatigue differentially affect movement coordination

    PubMed Central

    Cowley, Jeffrey C.

    2017-01-01

    Muscle fatigue can cause people to change their movement patterns and these changes could contribute to acute or overuse injuries. However, these effects depend on which muscles are fatigued. The purpose of this study was to determine the differential effects of proximal and distal upper extremity muscle fatigue on repetitive movements. Fourteen subjects completed a repetitive ratcheting task before and after a fatigue protocol on separate days. The fatigue protocol either fatigued the proximal (shoulder flexor) or distal (finger flexor) muscles. Pre/Post changes in trunk, shoulder, elbow, and wrist kinematics were compared to determine how proximal and distal fatigue affected multi-joint movement patterns and variability. Proximal fatigue caused a significant increase (7°, p < 0.005) in trunk lean and velocity, reduced humeral elevation (11°, p < 0.005), and increased elbow flexion (4°, p < 0.01). In contrast, distal fatigue caused small but significant changes in trunk angles (2°, p < 0.05), increased velocity of wrench movement relative to the hand (17°/s, p < 0.001), and earlier wrist extension (4%, p < 0.005). Movement variability increased at proximal joints but not distal joints after both fatigue protocols (p < 0.05). Varying movements at proximal joints may help people adapt to fatigue at either proximal or distal joints. The identified differences between proximal and distal muscle fatigue adaptations could facilitate risk assessment of occupational tasks. PMID:28235005

  7. Perceived stress and fatigue among students in a doctor of chiropractic training program.

    PubMed

    Kizhakkeveettil, Anupama; Vosko, Andrew M; Brash, Marissa; Ph, Dr; Philips, Michael A

    2017-03-01

    High levels of stress and fatigue are associated with decreased academic success, well-being, and quality of life. The objective of this research was to quantify levels of perceived stress and fatigue among chiropractic students to identify sources of and student coping mechanisms for perceived stress and fatigue and to identify the relationship between students' perceived stress and fatigue. A survey comprised of the Perceived Stress Scale, the Undergraduate Sources of Stress Survey, and the Piper Fatigue Scale was administered to chiropractic students in their 2nd, 5th, and 8th trimesters of doctoral study. Data were analyzed by descriptive statistics, 1-way analysis of variance, and linear correlation tests. Students reported having moderate to high levels of stress and fatigue, with higher levels of stress and fatigue seen in women than in men. A nonsignificant difference among stress scores and a significant difference among fatigue scores were observed based on program term. Levels of stress predicted levels of fatigue, and stress was strongly correlated with psychological health, relationships with family members, mood, and need for learning accommodations. Fatigue was strongly correlated with psychological health, academic demands, and conflicts between studies and other activities. There are differences in the reporting of perceived stress and fatigue levels in this chiropractic student population based on gender. The correlation between fatigue and stress also suggests that measures that may alleviate one may likely affect the other.

  8. [Effect of fatigue on the fitness to drive].

    PubMed

    Makowiec-Dabrowska, Teresa; Bortkiewicz, Alicja; Siedlecka, Jadwiga; Gadzicka, Elzbieta

    2011-01-01

    The 1995 U.S. Department of Transportation files contain a statement that driver fatigue has been a major problem among road vehicle professional drivers, while the consequences of participation in public road traffic of drivers affected by fatigue represent a serious threat to the public safety. Therefore, studies on the causes and consequences of fatigue in drivers are of significant practical value. The authors of this work discuss definitions of fatigue and fatigue classifications relative to the location of the functional changes (physical and mental fatigue, general and local - muscular, ocular, auditory) and relative to intensity (acute, sub-acute, chronic fatigue and weariness), and duration Particular attention has been paid to the factors contributing to fatigue in drivers. These may be classified into two groups: 1. sleep-related (SR), i.e. cumulative sleep deficit, long wake time, and time of the day; 2. task-related (TR), i.e. factors related with vehicle driving and working (driving) time. Studies on the effect of fatigue on driving performance (longer reaction time, poorer vigilance, slower information processing, impaired recent memory) have been analyzed. The major effect of driver fatigue is that he/she becomes gradually diverted from the road and road traffic, with the resultant poorer driving performance. Thus, the effects of fatigue in a driver are comparable to those after alcohol intake. This paper also discusses the methods used to counteract and prevent fatigue.

  9. Cognitive Fatigue Influences Time-On-Task during Bodyweight Resistance Training Exercise

    PubMed Central

    Head, James R.; Tenan, Matthew S.; Tweedell, Andrew J.; Price, Thomas F.; LaFiandra, Michael E.; Helton, William S.

    2016-01-01

    Prior investigations have shown measurable performance impairments on continuous physical performance tasks when preceded by a cognitively fatiguing task. However, the effect of cognitive fatigue on bodyweight resistance training exercise task performance is unknown. In the current investigation 18 amateur athletes completed a full body exercise task preceded by either a cognitive fatiguing or control intervention. In a randomized repeated measure design, each participant completed the same exercise task preceded by a 52 min cognitively fatiguing intervention (vigilance) or control intervention (video). Data collection sessions were separated by 1 week. Participants rated the fatigue intervention with a significantly higher workload compared to the control intervention (p < 0.001). Additionally, participants self-reported significantly greater energetic arousal for cognitively fatiguing task (p = 0.02). Cognitive fatigue did not significantly impact number of repetitions completed during the exercise task (p = 0.77); however, when cognitively fatigued, participants had decreased percent time-on-task (57%) relative to the no fatigue condition (60%; p = 0.04). RPE significantly changed over time (p < 0.001), but failed to show significant differences between the cognitive fatigue intervention and control intervention (p > 0.05). There was no statistical difference for heart rate or metabolic expenditure as a function of fatigue intervention during exercise. Cognitively fatigued athletes have decreased time-on-task in bodyweight resistance training exercise tasks. PMID:27635122

  10. Decision fatigue: A conceptual analysis.

    PubMed

    Pignatiello, Grant A; Martin, Richard J; Hickman, Ronald L

    2018-03-01

    Decision fatigue is an applicable concept to healthcare psychology. Due to a lack of conceptual clarity, we present a concept analysis of decision fatigue. A search of the term "decision fatigue" was conducted across seven research databases, which yielded 17 relevant articles. The authors identified three antecedent themes (decisional, self-regulatory, and situational) and three attributional themes (behavioral, cognitive, and physiological) of decision fatigue. However, the extant literature failed to adequately describe consequences of decision fatigue. This concept analysis provides needed conceptual clarity for decision fatigue, a concept possessing relevance to nursing and allied health sciences.

  11. The assessment of fatigue: Psychometric qualities and norms for the Checklist individual strength.

    PubMed

    Worm-Smeitink, M; Gielissen, M; Bloot, L; van Laarhoven, H W M; van Engelen, B G M; van Riel, P; Bleijenberg, G; Nikolaus, S; Knoop, H

    2017-07-01

    The Checklist Individual Strength (CIS) measures four dimensions of fatigue: Fatigue severity, concentration problems, reduced motivation and activity. On the fatigue severity subscale, a cut-off score of 35 is used. This study 1) investigated the psychometric qualities of the CIS; 2) validated the cut-off score for severe fatigue and 3) provided norms. Representatives of the Dutch general population (n=2288) completed the CIS. The factor structure was investigated using an exploratory factor analysis. Internal consistency and test-retest reliability were determined. Concurrent validity was assessed in two additional samples by correlating the CIS with other fatigue scales (Chalder Fatigue Questionnaire, MOS Short form-36 Vitality subscale, EORTC QLQ-C30 fatigue subscale). To validate the fatigue severity cut-off score, a Receiver Operating Characteristics analysis was performed with patients referred to a chronic fatigue treatment centre (n=5243) and a healthy group (n=1906). Norm scores for CIS subscales were calculated for the general population, patients with chronic fatigue syndrome (CFS; n=1407) and eight groups with other medical conditions (n=1411). The original four-factor structure of the CIS was replicated. Internal consistency (α=0.84-0.95) and test-retest reliability (r=0.74-0.86) of the subscales were high. Correlations with other fatigue scales were moderate to high. The 35 points cut-off score for severe fatigue is appropriate, but, given the 17% false positive rate, should be adjusted to 40 for research in CFS. The CIS is a valid and reliable tool for the assessment of fatigue, with a validated cut-off score for severe fatigue that can be used in clinical practice. Copyright © 2017. Published by Elsevier Inc.

  12. The High Costs of Low-Grade Inflammation: Persistent Fatigue as a Consequence of Reduced Cellular-Energy Availability and Non-adaptive Energy Expenditure.

    PubMed

    Lacourt, Tamara E; Vichaya, Elisabeth G; Chiu, Gabriel S; Dantzer, Robert; Heijnen, Cobi J

    2018-01-01

    Chronic or persistent fatigue is a common, debilitating symptom of several diseases. Persistent fatigue has been associated with low-grade inflammation in several models of fatigue, including cancer-related fatigue and chronic fatigue syndrome. However, it is unclear how low-grade inflammation leads to the experience of fatigue. We here propose a model of an imbalance in energy availability and energy expenditure as a consequence of low-grade inflammation. In this narrative review, we discuss how chronic low-grade inflammation can lead to reduced cellular-energy availability. Low-grade inflammation induces a metabolic switch from energy-efficient oxidative phosphorylation to fast-acting, but less efficient, aerobic glycolytic energy production; increases reactive oxygen species; and reduces insulin sensitivity. These effects result in reduced glucose availability and, thereby, reduced cellular energy. In addition, emerging evidence suggests that chronic low-grade inflammation is associated with increased willingness to exert effort under specific circumstances. Circadian-rhythm changes and sleep disturbances might mediate the effects of inflammation on cellular-energy availability and non-adaptive energy expenditure. In the second part of the review, we present evidence for these metabolic pathways in models of persistent fatigue, focusing on chronic fatigue syndrome and cancer-related fatigue. Most evidence for reduced cellular-energy availability in relation to fatigue comes from studies on chronic fatigue syndrome. While the mechanistic evidence from the cancer-related fatigue literature is still limited, the sparse results point to reduced cellular-energy availability as well. There is also mounting evidence that behavioral-energy expenditure exceeds the reduced cellular-energy availability in patients with persistent fatigue. This suggests that an inability to adjust energy expenditure to available resources might be one mechanism underlying persistent fatigue.

  13. On the role of the amygdala for experiencing fatigue in patients with multiple sclerosis.

    PubMed

    Hanken, Katrin; Francis, Yoselin; Kastrup, Andreas; Eling, Paul; Klein, Jan; Hildebrandt, Helmut

    2018-02-01

    Recently, we proposed a model explaining the origin of fatigue in multiple sclerosis (MS) patients. This model assumes that the feeling of fatigue results from inflammation-induced information processing within interoceptive brain areas. To investigate the association between self-reported cognitive fatigue and structural integrity of interoceptive brain areas in MS patients. 95 MS patients and 28 healthy controls participated in this study. All participants underwent diffusion tensor MRI and fractional anisotropy data were calculated for the amygdala, the stria terminalis and the corpus callosum, a non-interoceptive brain area. Based on the cognitive fatigue score of the Fatigue Scale for Motor and Cognition, patients were divided into moderately cognitively fatigued (cognitive fatigue score ≥ 28) and cognitively non-fatigued (cognitive fatigue score < 28) MS patients. Healthy controls were recruited as a third group. Repeated measures analyses of covariance, controlling for age, depression and brain atrophy, were performed to investigate whether the factor Group had a significant effect on the fractional anisotropy data. A significant effect of Group was observed for the amygdala (F = 3.389, p = 0.037). MS patients without cognitive fatigue presented lower values of the amygdala than MS patients with cognitive fatigue and healthy controls. For the stria terminalis and the corpus callosum, no main effect of Group was observed. The structural integrity of the amygdala in non-fatigued MS patients appears to be reduced. According to our model this might indicate that the absence of fatigue in non-fatigued MS patients might result from disturbed inflammation-induced information processing in the amygdala. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Cyclic fatigue behavior of nickel-titanium dental rotary files in clinical simulated root canals.

    PubMed

    Chi, Chih-Wen; Li, Chun-Chieh; Lin, Chun-Pin; Shin, Chow-Shing

    2017-04-01

    Dental rotary instruments can be applied in multiple conditions of canals, but unpredictable fatigue fracture may happen. This study evaluated the fatigue lives of two batches of nickel-titanium (NiTi) dental rotary files operating in clinically simulated root canals. Single-step cyclic fatigue tests were carried out to assess the performance of two batches of NiTi files (ProTaper and ProFile) in nine combinations of simulated canals (cylinder radii 5 mm, 7.5 mm, and 10 mm, and insertion angles 20°, 40°, and 60°). Two-step cyclic fatigue tests were carried out in simulated root canals with the same radius by using the following two sets of insertion angles: (20°, 40°), (20°, 60°), (40°, 20°), and (60°, 20°). Fracture surfaces were observed by scanning electron microscopy. The single-step cyclic fatigue results showed that cyclic fatigue lives of the files decreased with increasing insertion angles or decreasing cylinder radius. The ProFile #25 .04 file was more fatigue resistant than the ProTaper F2 file. In two-step cyclic fatigue tests, the total fatigue lives were usually more than 100% when the files operated at a lower strain and then at a higher strain. By scanning electron microscopy, a larger area of fatigue striation corresponded to a longer fatigue life. Cyclic fatigue life can be influenced by the strains and geometries of files. The fatigue life was prolonged when the files operated at a lower strain and then at a higher strain. However, the fatigue life was shortened if the loading sequence was reversed. Copyright © 2016. Published by Elsevier B.V.

  15. Lack of muscle contractile property changes at the time of perceived physical exhaustion suggests central mechanisms contributing to early motor task failure in patients with cancer-related fatigue.

    PubMed

    Kisiel-Sajewicz, Katarzyna; Davis, Mellar P; Siemionow, Vlodek; Seyidova-Khoshknabi, Dilara; Wyant, Alexandria; Walsh, Declan; Hou, Juliet; Yue, Guang H

    2012-09-01

    Fatigue is one of the most common symptoms reported by cancer survivors, and fatigue worsens when patients are engaged in muscle exertion, which results in early motor task failure. Central fatigue plays a significant role, more than muscle (peripheral) fatigue, in contributing to early task failure in cancer-related fatigue (CRF). The purpose of this study was to determine if muscle contractile property alterations (reflecting muscle fatigue) occurred at the end of a low-intensity muscle contraction to exhaustion and if these properties differed between those with CRF and healthy controls. Ten patients (aged 59.9±10.6 years, seven women) with advanced solid cancer and CRF and 12 age- and gender-matched healthy controls (aged 46.6±12.8 years, nine women) performed a sustained contraction of the right arm elbow flexion at 30% maximal level until exhaustion. Peak twitch force, time to peak twitch force, rate of peak twitch force development, and half relaxation time derived from electrical stimulation-evoked twitches were analyzed pre- and post-sustained contraction. CRF patients reported significantly greater fatigue as measured by the Brief Fatigue Inventory and failed the motor task earlier, 340±140 vs. 503±155 seconds in controls. All contractile property parameters did not change significantly in CRF but did change significantly in controls. CRF patients perceive physical exhaustion sooner during a motor fatigue task with minimal muscular fatigue. The observation supports that central fatigue is a more significant factor than peripheral fatigue in causing fatigue feelings and limits motor function in cancer survivors with fatigue symptoms. Copyright © 2012. Published by Elsevier Inc.

  16. Objectively measured muscle fatigue in Crohn's disease: correlation with self-reported fatigue and associated factors for clinical application.

    PubMed

    van Langenberg, D R; Della Gatta, P; Warmington, S A; Kidgell, D J; Gibson, P R; Russell, A P

    2014-02-01

    The association of fatigue with decreased physical performance and underlying mechanisms are poorly understood in Crohn's disease (CD). We aimed to measure and compare self-reported fatigue with skeletal muscle fatigue in CD subjects and healthy controls, and to identify associated factors that may be amenable to change. Demographic and clinical data were collected and fatigue assessed using the Fatigue Impact Scale (FIS) in 27 consecutive CD patients and 22 matched healthy controls. Circulating cytokines and growth factors were measured. The rate of quadriceps muscle fatigue was assessed using an isokinetic dynamometer as the decrement of force with 30 contractions performed over a 5-minute period. Compared with healthy controls, CD patients reported greater levels of fatigue (mean global FIS score 45.3 vs 10.5, physical dimension score 12.3 vs 2.7 respectively; each p<0.01) and muscle fatigue (-5.2 vs -1.3 Nm min(-1); p<0.05). The two indices were correlated (r = -0.52 in CD; p<0.01). Patients with CD had lower mean serum IGF-1 levels (16.1 vs 25.4 pmol/L, p<0.01) and higher oxidative stress (TBARS assay 4.3 vs 3.9 μM, p<0.05). On multivariate analysis, low serum vitamin D, IGF-1 and magnesium, and higher IL-6 levels were associated with increased muscle fatigue (all p ≤ 0.05). Subjects with CD had more muscle fatigue than matched healthy controls and this correlated well with self-reported fatigue. Of circulating factors that were independently associated with increased muscle fatigue, vitamin D, magnesium and IGF-1 could be targeted in future studies to reduce fatigue and improve physical performance. © 2013.

  17. The PedsQL Multidimensional Fatigue Scale in pediatric rheumatology: reliability and validity.

    PubMed

    Varni, James W; Burwinkle, Tasha M; Szer, Ilona S

    2004-12-01

    . The PedsQL (Pediatric Quality of Life Inventory) is a modular instrument designed to measure health related quality of life (HRQOL) in children and adolescents ages 2-18 years. The recently developed 18-item PedsQL Multidimensional Fatigue Scale was designed to measure fatigue in pediatric patients and comprises the General Fatigue Scale (6 items), Sleep/Rest Fatigue Scale (6 items), and Cognitive Fatigue Scale (6 items). The PedsQL 4.0 Generic Core Scales were developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 3.0 Rheumatology Module was designed to measure pediatric rheumatology-specific HRQOL. Methods. The PedsQL Multidimensional Fatigue Scale, Generic Core Scales, and Rheumatology Module were administered to 163 children and 154 parents (183 families accrued overall) recruited from a pediatric rheumatology clinic. Results. Internal consistency reliability for the PedsQL Multidimensional Fatigue Scale Total Score (a = 0.95 child, 0.95 parent report), General Fatigue Scale (a = 0.93 child, 0.92 parent), Sleep/Rest Fatigue Scale (a = 0.88 child, 0.90 parent), and Cognitive Fatigue Scale (a = 0.93 child, 0.96 parent) were excellent for group and individual comparisons. The validity of the PedsQL Multidimensional Fatigue Scale was confirmed through hypothesized intercorrelations with dimensions of generic and rheumatology-specific HRQOL. The PedsQL Multidimensional Fatigue Scale distinguished between healthy children and children with rheumatic diseases as a group, and was associated with greater disease severity. Children with fibromyalgia manifested greater fatigue than children with other rheumatic diseases. The results confirm the initial reliability and validity of the PedsQL Multidimensional Fatigue Scale in pediatric rheumatology.

  18. Cardiorespiratory and neuromuscular deconditioning in fatigued and non-fatigued breast cancer survivors.

    PubMed

    Neil, Sarah E; Klika, Riggs J; Garland, S Jayne; McKenzie, Donald C; Campbell, Kristin L

    2013-03-01

    Fatigue is one of the most commonly reported side effects during treatment for breast cancer and can persist following treatment completion. Cancer-related fatigue after treatment is multifactorial in nature, and one hypothesized mechanism is cardiorespiratory and neuromuscular deconditioning. The purpose of this study was to compare cardiorespiratory and neuromuscular function in breast cancer survivors who had completed treatment and met the specified criteria for cancer-related fatigue and a control group of breast cancer survivors without fatigue. Participants in the fatigue (n = 16) and control group (n = 11) performed a maximal exercise test on a cycle ergometer for determination of peak power, power at lactate threshold, and VO(2) peak. Neuromuscular fatigue was induced with a sustained submaximal contraction of the right quadriceps. Central fatigue (failure of voluntary activation) was evaluated using twitch interpolation, and peripheral fatigue was measured with an electrically evoked twitch. Power at lactate threshold was lower in the fatigue group (p = 0.05). There were no differences between groups for power at lactate threshold as percentage of peak power (p = 0.10) or absolute or relative VO(2) peak (p = 0.08 and 0.33, respectively). When adjusted for age, the fatigue group had a lower power at lactate threshold (p = 0.02) and absolute VO(2) peak (p = 0.03). There were no differences between groups in change in any neuromuscular parameters after the muscle-fatiguing protocol. Findings support the hypothesis that cardiorespiratory deconditioning may play a role in the development and persistence of cancer-related fatigue following treatment. Future research into the use of exercise training to reduce cardiorespiratory deconditioning as a treatment for cancer-related fatigue is warranted to confirm these preliminary findings.

  19. The High Costs of Low-Grade Inflammation: Persistent Fatigue as a Consequence of Reduced Cellular-Energy Availability and Non-adaptive Energy Expenditure

    PubMed Central

    Lacourt, Tamara E.; Vichaya, Elisabeth G.; Chiu, Gabriel S.; Dantzer, Robert; Heijnen, Cobi J.

    2018-01-01

    Chronic or persistent fatigue is a common, debilitating symptom of several diseases. Persistent fatigue has been associated with low-grade inflammation in several models of fatigue, including cancer-related fatigue and chronic fatigue syndrome. However, it is unclear how low-grade inflammation leads to the experience of fatigue. We here propose a model of an imbalance in energy availability and energy expenditure as a consequence of low-grade inflammation. In this narrative review, we discuss how chronic low-grade inflammation can lead to reduced cellular-energy availability. Low-grade inflammation induces a metabolic switch from energy-efficient oxidative phosphorylation to fast-acting, but less efficient, aerobic glycolytic energy production; increases reactive oxygen species; and reduces insulin sensitivity. These effects result in reduced glucose availability and, thereby, reduced cellular energy. In addition, emerging evidence suggests that chronic low-grade inflammation is associated with increased willingness to exert effort under specific circumstances. Circadian-rhythm changes and sleep disturbances might mediate the effects of inflammation on cellular-energy availability and non-adaptive energy expenditure. In the second part of the review, we present evidence for these metabolic pathways in models of persistent fatigue, focusing on chronic fatigue syndrome and cancer-related fatigue. Most evidence for reduced cellular-energy availability in relation to fatigue comes from studies on chronic fatigue syndrome. While the mechanistic evidence from the cancer-related fatigue literature is still limited, the sparse results point to reduced cellular-energy availability as well. There is also mounting evidence that behavioral-energy expenditure exceeds the reduced cellular-energy availability in patients with persistent fatigue. This suggests that an inability to adjust energy expenditure to available resources might be one mechanism underlying persistent fatigue. PMID:29755330

  20. Determinants of physical, affective, and cognitive fatigue during breast cancer therapy and 12 months follow-up.

    PubMed

    Schmidt, Martina E; Wiskemann, Joachim; Schneeweiss, Andreas; Potthoff, Karin; Ulrich, Cornelia M; Steindorf, Karen

    2018-03-15

    Fatigue is common in cancer survivors but often insufficiently treated. Due to its complexity a one-size-fits-all treatment seems not appropriate. To gain more information on influencing factors and sub-dimensions of fatigue we investigated potential determinants and correlates of physical, affective, and cognitive fatigue in breast cancer survivors during and after adjuvant therapy. Within the follow-up of two randomized controlled trials physical, affective, and cognitive fatigue were repeatedly assessed during and up to 12 months after cancer therapy with the 20-item Fatigue Assessment Questionnaire in 255 breast cancer survivors. Determinants of the different fatigue dimensions over time were explored with linear mixed models. Chemotherapy appeared as significant precipitating factor for physical fatigue. However, type of cancer therapy had no impact on fatigue one year post-treatment. Obesity was significantly associated with increased physical fatigue throughout all time points (Δ=15.5 at 12 months) whereas exercise appeared to be beneficial (Δ = -6.3). In contrast, affective fatigue was significantly associated with poor social support and worries about the future. In addition, poor sleep quality and previous use of psychopharmaceuticals were significantly associated with physical, affective, as well as cognitive fatigue. Further, hot flashes were associated with increased physical and cognitive fatigue. In conclusion, the broad diagnosis 'fatigue' in cancer survivors needs to be recognized as a diversity of symptoms determined by specific characteristics and likely different etiologies. Taking potential influencing factors such as obesity, physical inactivity, sleep problems, hot flashes, lack of social support, or psychological disorders into consideration might enable a better, individually-tailored fatigue treatment. © 2017 UICC.

  1. Prevalence and predictors of 6-month fatigue in patients with ischemic stroke: a population-based stroke incidence study in Auckland, New Zealand, 2002-2003.

    PubMed

    Feigin, Valery L; Barker-Collo, Suzanne; Parag, Varsha; Hackett, Maree L; Kerse, Ngaire; Barber, P Alan; Theadom, Alice; Krishnamurthi, Rita

    2012-10-01

    Although persistent and significant fatigue affects the daily life of stroke survivors, there are no population-based studies examining the prevalence of fatigue in 6-month survivors of ischemic stroke and few studies of predictors of poststroke fatigue. This article examined data from the Auckland Regional Community Stroke study conducted in Auckland, New Zealand, in 2002 to 2003. Presence of fatigue was evaluated at 6 months in 613 patients with ischemic stroke using a Short Form 36 Vitality Score (energy and fatigue) of ≤ 47. Multivariate logistic regression analysis was used to determine predictors of fatigue development 6 months poststroke. The prevalence of fatigue was 30% (28% in men and 33% in women). There was a clear association between increased prevalence of fatigue and advancing age. The only baseline variables independently associated with an increased risk of developing fatigue at 6 months poststroke were prestroke incontinence and being of New Zealand European ethnicity. Being independent and living alone at baseline were associated with significant reduction in the risk of being fatigued at 6 months poststroke. Severe depression at 6 months was significantly and independently associated with being fatigued. The prevalence of fatigue found in our study is at the lower level of range reported in other studies. The prevalence of fatigue increased with advancing age, as found in most previous studies. Because fatigue can have a negative impact on stroke recovery, particular attention needs to be paid to those who are older, incontinent before stroke, and those who report severe symptoms of depression at 6 months after stroke.

  2. Can the Cancer-related Fatigue Case-definition Criteria Be Applied to Chronic Medical Illness? A Comparison between Breast Cancer and Systemic Sclerosis.

    PubMed

    Kwakkenbos, Linda; Minton, Ollie; Stone, Patrick C; Alexander, Susanna; Baron, Murray; Hudson, Marie; Thombs, Brett D

    2015-07-01

    Fatigue is a crucial determinant of quality of life across rheumatic diseases, but the lack of agreed-upon standards for identifying clinically significant fatigue hinders research and clinical management. Case definition criteria for cancer-related fatigue were proposed for inclusion in the International Classification of Diseases. The objective was to evaluate whether the cancer-related fatigue case definition performed equivalently in women with breast cancer and systemic sclerosis (SSc) and could be used to identify patients with chronic illness-related fatigue. The cancer-related fatigue interview (case definition criteria met if ≥ 5 of 9 fatigue-related symptoms present with functional impairment) was completed by 291 women with SSc and 278 women successfully treated for breast cancer. Differential item functioning was assessed with the multiple indicator multiple cause model. Items 3 (concentration) and 10 (short-term memory) were endorsed significantly less often by women with SSc compared with cancer, controlling for responses on other items. Omitting these 2 items from the case definition and requiring 4 out of the 7 remaining symptoms resulted in a similar overall prevalence of cancer-related fatigue in the cancer sample compared with the original criteria (37.4% vs 37.8%, respectively), with 97.5% of patients diagnosed identically with both definitions. Prevalence of chronic illness-related fatigue was 36.1% in SSc using 4 of 7 symptoms. The cancer-related fatigue criteria can be used equivalently to identify patients with chronic illness-related fatigue when 2 cognitive fatigue symptoms are omitted. Harmonized definitions and measurement of clinically significant fatigue will advance research and clinical management of fatigue in rheumatic diseases and other conditions.

  3. Microstructural evaluation of cumulative fatigue damage below the fatigue limit

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fukuoka, C.; Nakagawa, Y.G.

    1996-05-01

    The objective of this work is to evaluate the microstructural changes induced near and below the fatigue limit in a pressure vessel steel plate, SA508. Dislocation cell to cell misorientation differences, {theta}, which increase with fatigue damage accumulation, are measured by the Selected Area Diffraction (SAD) method. The misorientation difference, {theta}, of the sample failed just above the fatigue limit is about 4.0 degrees on the average, which is about the same as that for the failure conditions of low cycle fatigue at higher stresses. The {theta} value increases even below the fatigue limit, but it does not increase atmore » stresses which are lower than 50% of the fatigue limit.« less

  4. Changes in lower extremity biomechanics due to a short-term fatigue protocol.

    PubMed

    Cortes, Nelson; Greska, Eric; Kollock, Roger; Ambegaonkar, Jatin; Onate, James A

    2013-01-01

    Noncontact anterior cruciate ligament injury has been reported to occur during the later stages of a game when fatigue is most likely present. Few researchers have focused on progressive changes in lower extremity biomechanics that occur throughout fatiguing. To evaluate the effects of a sequential fatigue protocol on lower extremity biomechanics during a sidestep-cutting task (SS). Controlled laboratory study. Laboratory. Eighteen uninjured female collegiate soccer players (age = 19.2 ± 0.9 years, height = 1.66 ± 0.5 m, mass = 61.6 ± 5.1 kg) volunteered. The independent variable was fatigue level, with 3 levels (prefatigue, 50% fatigue, and 100% fatigue). Using 3-dimensional motion capture, we assessed lower extremity biomechanics during the SS. Participants alternated between a fatigue protocol that solicited different muscle groups and mimicked actual sport situations and unanticipated SS trials. The process was repeated until fatigue was attained. Dependent variables were hip- and knee-flexion and abduction angles and internal moments measured at initial contact and peak stance and defined as measures obtained between 0% and 50% of stance phase. Knee-flexion angle decreased from prefatigue (-17° ± 5°) to 50% fatigue (-16° ± 6°) and to 100% fatigue (-14° ± 4°) (F2,34 = 5.112, P = .004). Knee flexion at peak stance increased from prefatigue (-52.9° ± 5.6°) to 50% fatigue (-56.1° ± 7.2°) but decreased from 50% to 100% fatigue (-50.5° ± 7.1°) (F2,34 = 8.282, P = 001). Knee-adduction moment at peak stance increased from prefatigue (0.49 ± 0.23 Nm/kgm) to 50% fatigue (0.55 ± 0.25 Nm/kgm) but decreased from 50% to 100% fatigue (0.37 ± 0.24) (F2,34 = 3.755, P = 03). Hip-flexion angle increased from prefatigue (45.4° ± 10.9°) to 50% fatigue (46.2° ± 11.2°) but decreased from 50% to 100% fatigue (40.9° ± 11.3°) (F2,34 = 6.542, P = .004). Hip flexion at peak stance increased from prefatigue (49.8° ± 9.9°) to 50% fatigue (52.9° ± 12.1°) but decreased from 50% to 100% fatigue (46.3° ± 12.9°) (F2,34 = 8.639, P = 001). Hip-abduction angle at initial contact decreased from prefatigue (-13.8° ± 6.6°) to 50% fatigue (-9.1° ± 6.5°) and to 100% fatigue (-7.8° ± 6.5°) (F2,34 = 11.228, P < .001). Hip-adduction moment decreased from prefatigue (0.14 ± 0.13 Nm/kgm) to 50% fatigue (0.08 ± 0.13 Nm/kgm) and to 100% fatigue (0.06 ± 0.05 Nm/kg) (F2,34 = 5.767, P = .007). The detrimental effects of fatigue on sagittal and frontal mechanics of the hip and knee were visible at 50% of the participants' maximal fatigue and became more marked at 100% fatigue. Anterior cruciate ligament injury-prevention programs should emphasize feedback on proper mechanics throughout an entire practice and not only at the beginning of practice.

  5. Changes in Lower Extremity Biomechanics Due to a Short-Term Fatigue Protocol

    PubMed Central

    Cortes, Nelson; Greska, Eric; Kollock, Roger; Ambegaonkar, Jatin; Onate, James A.

    2013-01-01

    Context: Noncontact anterior cruciate ligament injury has been reported to occur during the later stages of a game when fatigue is most likely present. Few researchers have focused on progressive changes in lower extremity biomechanics that occur throughout fatiguing. Objective: To evaluate the effects of a sequential fatigue protocol on lower extremity biomechanics during a sidestep-cutting task (SS). Design: Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: Eighteen uninjured female collegiate soccer players (age = 19.2 ± 0.9 years, height = 1.66 ± 0.5 m, mass = 61.6 ± 5.1 kg) volunteered. Intervention(s): The independent variable was fatigue level, with 3 levels (prefatigue, 50% fatigue, and 100% fatigue). Using 3-dimensional motion capture, we assessed lower extremity biomechanics during the SS. Participants alternated between a fatigue protocol that solicited different muscle groups and mimicked actual sport situations and unanticipated SS trials. The process was repeated until fatigue was attained. Main Outcome Measure(s): Dependent variables were hip- and knee-flexion and abduction angles and internal moments measured at initial contact and peak stance and defined as measures obtained between 0% and 50% of stance phase. Results: Knee-flexion angle decreased from prefatigue (−17° ± 5°) to 50% fatigue (−16° ± 6°) and to 100% fatigue (−14° ± 4°) (F2,34 = 5.112, P = .004). Knee flexion at peak stance increased from prefatigue (−52.9° ± 5.6°) to 50% fatigue (−56.1° ± 7.2°) but decreased from 50% to 100% fatigue (−50.5° ± 7.1°) (F2,34 = 8.282, P = 001). Knee-adduction moment at peak stance increased from prefatigue (0.49 ± 0.23 Nm/kgm) to 50% fatigue (0.55 ± 0.25 Nm/kgm) but decreased from 50% to 100% fatigue (0.37 ± 0.24) (F2,34 = 3.755, P = 03). Hip-flexion angle increased from prefatigue (45.4° ± 10.9°) to 50% fatigue (46.2° ± 11.2°) but decreased from 50% to 100% fatigue (40.9° ± 11.3°) (F2,34 = 6.542, P = .004). Hip flexion at peak stance increased from prefatigue (49.8° ± 9.9°) to 50% fatigue (52.9° ± 12.1°) but decreased from 50% to 100% fatigue (46.3° ± 12.9°) (F2,34 = 8.639, P = 001). Hip-abduction angle at initial contact decreased from prefatigue (−13.8° ± 6.6°) to 50% fatigue (−9.1° ± 6.5°) and to 100% fatigue (−7.8° ± 6.5°) (F2,34 = 11.228, P < .001). Hip-adduction moment decreased from prefatigue (0.14 ± 0.13 Nm/kgm) to 50% fatigue (0.08 ± 0.13 Nm/kgm) and to 100% fatigue (0.06 ± 0.05 Nm/kg) (F2,34 = 5.767, P = .007). Conclusions: The detrimental effects of fatigue on sagittal and frontal mechanics of the hip and knee were visible at 50% of the participants' maximal fatigue and became more marked at 100% fatigue. Anterior cruciate ligament injury-prevention programs should emphasize feedback on proper mechanics throughout an entire practice and not only at the beginning of practice. PMID:23675789

  6. Corrosion fatigue of high strength fastener materials in seawater

    NASA Technical Reports Server (NTRS)

    Tipton, D. G.

    1983-01-01

    Environmental effects which significantly reduce the fatigue life of metals are discussed. Corrosion fatigue is a major concern in the engineering application of high strength fasteners in marine environments. The corrosion fatigue failure of an AISI 41L4O high strength steel blade to hub attachment bolt at the MOD-OA 200 kW wind turbine generator was investigated. The reduction of fatigue strength of AISI 41L4O in marine environments and to obtain similar corrosion fatigue data for candidate replacement materials was studied. The AISI 4140, PH 13-8Mo stainless steel, alloy 718 and alloy MP-35N were tested in axial fatigue at a frequency of 20 Hz in dry air and natural seawater. The fatigue data are fitted by regression equations to allow determination of fatigue strength for a given number of cycles to failure.

  7. Corrosion fatigue of high strength fastener materials in seawater

    NASA Astrophysics Data System (ADS)

    Tipton, D. G.

    1983-12-01

    Environmental effects which significantly reduce the fatigue life of metals are discussed. Corrosion fatigue is a major concern in the engineering application of high strength fasteners in marine environments. The corrosion fatigue failure of an AISI 41L4O high strength steel blade to hub attachment bolt at the MOD-OA 200 kW wind turbine generator was investigated. The reduction of fatigue strength of AISI 41L4O in marine environments and to obtain similar corrosion fatigue data for candidate replacement materials was studied. The AISI 4140, PH 13-8Mo stainless steel, alloy 718 and alloy MP-35N were tested in axial fatigue at a frequency of 20 Hz in dry air and natural seawater. The fatigue data are fitted by regression equations to allow determination of fatigue strength for a given number of cycles to failure.

  8. Assessment of fatigue life of remanufactured impeller based on FEA

    NASA Astrophysics Data System (ADS)

    Xu, Lei; Cao, Huajun; Liu, Hailong; Zhang, Yubo

    2016-09-01

    Predicting the fatigue life of remanufactured centrifugal compressor impellers is a critical problem. In this paper, the S-N curve data were obtained by combining experimentation and theory deduction. The load spectrum was compiled by the rain-flow counting method based on the comprehensive consideration of the centrifugal force, residual stress, and aerodynamic loads in the repair region. A fatigue life simulation model was built, and fatigue life was analyzed based on the fatigue cumulative damage rule. Although incapable of providing a high-precision prediction, the simulation results were useful for the analysis of fatigue life impact factors and fatigue fracture areas. Results showed that the load amplitude greatly affected fatigue life, the impeller was protected from running at over-speed, and the predicted fatigue life was satisfied within the next service cycle safely at the rated speed.

  9. Frequency dependence of fatigue life and internal heating of a fiber-reinforced/ceramic-matrix composite

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Holmes, J.W.; Wu, X.; Sorensen, B.F.

    The influence of loading frequency on the fatigue life and internal (frictional) heating of unidirectional SiC-fiber/calcium aluminosilicate-matrix composites was investigated at room temperature. Specimens were subjected to tension-tension fatigue at sinusoidal loading frequencies from 25 to 350 Hz and maximum fatigue stresses of 180 to 240 MPa. The key findings of the study were that (1) fatigue life decreased sharply as the loading frequency was increased, (2) for all loading frequencies, fatigue failures occurred at stress levels that were significantly below the monotonic proportional limit stress if [approximately]285 MPa, and (3) pronounced internal heating occurred during fatigue, with the surfacemore » temperature of the fatigue specimens increasing by 160 K during 350-Hz fatigue at a peak stress of 240 MPa.« less

  10. The Effect of Moderate and High-Intensity Fatigue on Groundstroke Accuracy in Expert and Non-Expert Tennis Players

    PubMed Central

    Lyons, Mark; Al-Nakeeb, Yahya; Hankey, Joanne; Nevill, Alan

    2013-01-01

    Exploring the effects of fatigue on skilled performance in tennis presents a significant challenge to the researcher with respect to ecological validity. This study examined the effects of moderate and high-intensity fatigue on groundstroke accuracy in expert and non-expert tennis players. The research also explored whether the effects of fatigue are the same regardless of gender and player’s achievement motivation characteristics. 13 expert (7 male, 6 female) and 17 non-expert (13 male, 4 female) tennis players participated in the study. Groundstroke accuracy was assessed using the modified Loughborough Tennis Skills Test. Fatigue was induced using the Loughborough Intermittent Tennis Test with moderate (70%) and high-intensities (90%) set as a percentage of peak heart rate (attained during a tennis-specific maximal hitting sprint test). Ratings of perceived exertion were used as an adjunct to the monitoring of heart rate. Achievement goal indicators for each player were assessed using the 2 x 2 Achievement Goals Questionnaire for Sport in an effort to examine if this personality characteristic provides insight into how players perform under moderate and high-intensity fatigue conditions. A series of mixed ANOVA’s revealed significant fatigue effects on groundstroke accuracy regardless of expertise. The expert players however, maintained better groundstroke accuracy across all conditions compared to the novice players. Nevertheless, in both groups, performance following high-intensity fatigue deteriorated compared to performance at rest and performance while moderately fatigued. Groundstroke accuracy under moderate levels of fatigue was equivalent to that at rest. Fatigue effects were also similar regardless of gender. No fatigue by expertise, or fatigue by gender interactions were found. Fatigue effects were also equivalent regardless of player’s achievement goal indicators. Future research is required to explore the effects of fatigue on performance in tennis using ecologically valid designs that mimic more closely the demands of match play. Key Points Groundstroke accuracy under moderate-intensity fatigue is equivalent to performance at rest. Groundstroke accuracy declines significantly in both expert (40.3% decline) and non-expert (49.6%) tennis players following high-intensity fatigue. Expert players are more consistent, hit more accurate shots and fewer out shots across all fatigue intensities. The effects of fatigue on groundstroke accuracy are the same regardless of gender and player’s achievement goal indicators. PMID:24149809

  11. Ultrasonic Evaluation of Fatigue Damage

    NASA Astrophysics Data System (ADS)

    Bayer, P.; Singher, L.; Notea, A.

    2004-02-01

    Despite the fact that most engineers and designers are aware of fatigue, many severe breakdowns of industrial plant and machinery still occur due to fatigue. In effect, it's been estimated that fatigue causes at least 80% of the failures in modern engineering components. From an operational point of view, the detection of fatigue damage, preferably at a very early stage, is a critically important consideration in order to prevent possible catastrophic equipment failure and associated losses. This paper describes the investigation involving the use of ultrasonic waves as a potential tool for early detection of fatigue damage. The parameters investigated were the ultrasonic wave velocities (longitudinal and transverse waves) and attenuation coefficient before fatigue damage and after progressive stages of fatigue. Although comparatively small uncertainties were observed, the feasibility of utilizing the velocity of ultrasonic waves as a fatigue monitor was barely substantiated within actual research conditions. However, careful measurements of the ultrasonic attenuation parameter had demonstrated its potential to provide an early assessment of damage during fatigue.

  12. Investigation of the effect of vacuum environment on the fatigue and fracture behavior of 7075-T6.

    NASA Technical Reports Server (NTRS)

    Hudson, C. M.

    1972-01-01

    Axial-load fatigue-life, fatigue-crack propagation, and fracture-toughness experiments were conducted on sheet specimens made of 7075-T6 aluminum alloy. These experiments were conducted at air pressures ranging from 101 kN/sq m to 7 micronewtons/sq m to determine the effect of air pressure on fatigue behavior. Analysis of the results from the fatigue-life experiments indicated that for a given stress level, the lower the air pressure was the longer the fatigue life. At a pressure of 7 micronewtons/sq m, fatigue lives were 15 to 30 times longer than at 101 kN/sq m. Analysis of the results from the fatigue-crack-growth experiments indicates that at low values of stress-intensity range, the fatigue-crack-growth rates were approximately twice as high at atmospheric pressure as in vacuum. However, at higher values of stress-intensity range, the fatigue-crack-growth rates were nominally the same in vacuum and at atmospheric pressure.

  13. Prior Heat Stress Effects Fatigue Recovery of the Elbow Flexor Muscles

    PubMed Central

    Iguchi, Masaki; Shields, Richard K.

    2011-01-01

    Introduction Long-lasting alterations in hormones, neurotransmitters and stress proteins after hyperthermia may be responsible for the impairment in motor performance during muscle fatigue. Methods Subjects (n = 25) performed a maximal intermittent fatigue task of elbow flexion after sitting in either 73 or 26 deg C to examine the effects of prior heat stress on fatigue mechanisms. Results The heat stress increased the tympanic and rectal temperatures by 2.3 and 0.82 deg C, respectively, but there was full recovery prior to the fatigue task. While prior heat stress had no effects on fatigue-related changes in volitional torque, EMG activity, torque relaxation rate, MEP size and SP duration, prior heat stress acutely increased the pre-fatigue relaxation rate and chronically prevented long-duration fatigue (p < 0.05). Discussion These findings indicate that prior passive heat stress alone does not alter voluntary activation during fatigue, but prior heat stress and exercise produce longer-term protection against long-duration fatigue. PMID:21674526

  14. Evaluation of prolonged fatigue post-West Nile virus infection and association of fatigue with elevated antiviral and proinflammatory cytokines.

    PubMed

    Garcia, Melissa N; Hause, Anne M; Walker, Christopher M; Orange, Jordan S; Hasbun, Rodrigo; Murray, Kristy O

    2014-09-01

    This study aimed to characterize fatigue postinfection among study participants with a history of West Nile virus (WNV) infection and determine whether antiviral and pro-inflammatory cytokines were significantly elevated in those reporting prolonged fatigue. We found that 31% (44/140) of study participants experienced prolonged (more than 6 months) fatigue postinfection, with an average length of fatigue duration of 5 years. Females, those younger than 50 years of age, and those with symptomatic clinical WNV disease were significantly more likely to report fatigue. Pro-inflammatory and antiviral cytokines (granulocyte macrophage colony stimulating factor, interferon-γ, interferon-γ inducing protein 10, interleukin 2, interleukin 6, and interleukin 12p70) were significantly elevated in those reporting fatigue postinfection compared to those not reporting fatigue. Clinicians should consider history of WNV infection as a possible factor when evaluating causes of prolonged fatigue following a febrile viral illness in their patients.

  15. Daily Social Enjoyment Interrupts the Cycle of Same-day and Next-day Fatigue in Women with Fibromyalgia

    PubMed Central

    Yeung, Ellen W.; Davis, Mary C.; Aiken, Leona S.; Tennen, Howard A.

    2014-01-01

    Background Fatigue is a debilitating symptom of fibromyalgia (FM) that has limited treatment options. Some evidence, however, has linked positive social engagement with reduced within-day fatigue. Purpose This study elaborated longitudinal within-day and across-day relations between FM fatigue and social enjoyment. Methods 176 women with FM completed 21-day automated diaries assessing morning and end-of-day fatigue, and both afternoon social enjoyment and stress within two social domains: non-spousal and spousal. Results In the non-spousal domain, analysis supported a mediational path from lower morning fatigue to higher afternoon social enjoyment, which predicted lower end-of-day fatigue, and subsequently, lower next-morning fatigue. Enjoyment exerted a greater impact on within-day fatigue than did stress. Patterns in the spousal domain were similar, but the mediated path was nonsignificant. Conclusions Positive social engagement offers relief from FM fatigue that carries over across days and may provide an additional target to enhance the effectiveness of current interventions. PMID:25380634

  16. Chronic Fatigue and Personality: A Twin Study of Causal Pathways and Shared Liabilities

    PubMed Central

    Poeschla, Brian; Strachan, Eric; Dansie, Elizabeth; Buchwald, Dedra S.; Afari, Niloofar

    2013-01-01

    Background The etiology of chronic fatigue syndrome (CFS) remains unknown. Personality traits influence well-being and may play a role in CFS and unexplained chronic fatigue. Purpose To examine the association of emotional instability and extraversion with chronic fatigue and CFS in a genetically informative sample. Methods We evaluated 245 twin pairs for two definitions of chronic fatigue. They completed the Neuroticism and Extraversion subscales of the NEO-FFI. Using a co-twin control design, we examined the association between personality and chronic fatigue. Results Higher emotional instability was associated with both definitions of chronic fatigue and was confounded by shared genetics. Lower extraversion was also associated with both definitions of fatigue, but was not confounded by familial factors. Conclusions Both emotional instability and extraversion are related to chronic fatigue and CFS. Whereas emotional instability and chronic fatigue are linked by shared genetic mechanisms, the relationship with extraversion may be causal and bi-directional. PMID:23361410

  17. The Meaning and Measurement of Work Fatigue: Development and Evaluation of the Three-Dimensional Work Fatigue Inventory (3D-WFI)

    PubMed Central

    Frone, Michael R.; Tidwell, Marie-Cecile O.

    2015-01-01

    Although work fatigue represents an important construct in several substantive areas, prior conceptual definitions and measures have been inadequate in a number of ways. The goals of the present study were to develop a conceptual definition and outline the desirable characteristics of a work fatigue measure; briefly examine several prior measures of work fatigue-related constructs; and develop and evaluate a new measure of work fatigue. The Three-Dimensional Work Fatigue Inventory (3D-WFI) provides separate and commensurate assessments of physical, mental, and emotional work fatigue. Results from a pilot study (N = 207) and a broader evaluative study of U.S. wage and salary workers (N = 2,477) suggest that the 3D-WFI is psychometrically sound and evinces a meaningful pattern of relations with variables that comprise the nomological network of work fatigue. As with all new measures, additional research is required to evaluate fully the utility of the 3D-WFI in research on work fatigue. PMID:25602275

  18. Fatigue Damage of Collagenous Tissues: Experiment, Modeling and Simulation Studies

    PubMed Central

    Martin, Caitlin; Sun, Wei

    2017-01-01

    Mechanical fatigue damage is a critical issue for soft tissues and tissue-derived materials, particularly for musculoskeletal and cardiovascular applications; yet, our understanding of the fatigue damage process is incomplete. Soft tissue fatigue experiments are often difficult and time-consuming to perform, which has hindered progress in this area. However, the recent development of soft-tissue fatigue-damage constitutive models has enabled simulation-based fatigue analyses of tissues under various conditions. Computational simulations facilitate highly controlled and quantitative analyses to study the distinct effects of various loading conditions and design features on tissue durability; thus, they are advantageous over complex fatigue experiments. Although significant work to calibrate the constitutive models from fatigue experiments and to validate predictability remains, further development in these areas will add to our knowledge of soft-tissue fatigue damage and will facilitate the design of durable treatments and devices. In this review, the experimental, modeling, and simulation efforts to study collagenous tissue fatigue damage are summarized and critically assessed. PMID:25955007

  19. Muscle fatigue: general understanding and treatment

    PubMed Central

    Wan, Jing-jing; Qin, Zhen; Wang, Peng-yuan; Sun, Yang; Liu, Xia

    2017-01-01

    Muscle fatigue is a common complaint in clinical practice. In humans, muscle fatigue can be defined as exercise-induced decrease in the ability to produce force. Here, to provide a general understanding and describe potential therapies for muscle fatigue, we summarize studies on muscle fatigue, including topics such as the sequence of events observed during force production, in vivo fatigue-site evaluation techniques, diagnostic markers and non-specific but effective treatments. PMID:28983090

  20. Visual perception of fatigued lifting actions.

    PubMed

    Fischer, Steven L; Albert, Wayne J; McGarry, Tim

    2012-12-01

    Fatigue-related changes in lifting kinematics may expose workers to undue injury risks. Early detection of accumulating fatigue offers the prospect of intervention strategies to mitigate such fatigue-related risks. In a first step towards this objective, this study investigated whether fatigue detection was accessible to visual perception and, if so, what was the key visual information required for successful fatigue discrimination. Eighteen participants were tasked with identifying fatigued lifts when viewing 24 trials presented using both video and point-light representations. Each trial comprised a pair of lifting actions containing a fresh and a fatigued lift from the same individual presented in counter-balanced sequence. Confidence intervals demonstrated that the frequency of correct responses for both sexes exceeded chance expectations (50%) for both video (68%±12%) and point-light representations (67%±10%), demonstrating that fatigued lifting kinematics are open to visual perception. There were no significant differences between sexes or viewing condition, the latter result indicating kinematic dynamics as providing sufficient information for successful fatigue discrimination. Moreover, results from single viewer investigation reported fatigue detection (75%) from point-light information describing only the kinematics of the box lifted. These preliminary findings may have important workplace applications if fatigue discrimination rates can be improved upon through future research. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. [Analysis of work-related fatigue characteristics and its influencing factors in scientific and technical personnel].

    PubMed

    Yang, Ting; Zhou, Dinglun; Song, Mingying; Lan, Yajia

    2015-02-01

    To investigate the current status and characteristics of work-related fatigue among scientific and technical personnel and its associated factors, and to provide a scientific basis for further interventions. A cross-sectional survey was conducted in the staff from a single scientific institution, using a self-administered questionnaire. Basic information of participants, Fatigue Scale-14, and Job Content Questionnaire were collected. The prevalence of work-related fatigue among the scientific and technical personnel was 54.6%; work-related fatigue was positively correlated with occupational stress (rs = 0.384, P < 0.05). Significant differences in the scores, proportions, and types of fatigue were found between different types of occupational stress. The associated factors of work-related fatigue included occupational stress profiles, social support, and educational status. A higher risk of work-related fatigue was found in the staff under high stress, compared with those under low stress (OR = 8.5, 95%CI = 3.9∼18.7). Social support served as a protective factor for work-related fatigue, while a higher level of education was correlated with more severe work-related fatigue. Work-related fatigue is common and serious among scientific and technical personnel, especially in those under high stress. Effective interventions according to occupational stress are of great importance to reduce work-related fatigue.

  2. Effect of Heat Treatment Process on Microstructure and Fatigue Behavior of a Nickel-Base Superalloy

    PubMed Central

    Zhang, Peng; Zhu, Qiang; Chen, Gang; Qin, Heyong; Wang, Chuanjie

    2015-01-01

    The study of fatigue behaviors for nickel-base superalloys is very significant because fatigue damage results in serious consequences. In this paper, two kinds of heat treatment procedures (Pro.I and Pro.II) were taken to investigate the effect of heat treatment on microstructures and fatigue behaviors of a nickel-base superalloy. Fatigue behaviors were studied through total strain controlled mode at 650 °C. Manson-Coffin relationship and three-parameter power function were used to predict fatigue life. A good link between the cyclic/fatigue behavior and microscopic studies was established. The cyclic deformation mechanism and fatigue mechanism were discussed. The results show that the fatigue resistance significantly drops with the increase of total strain amplitudes. Manson-Coffin relationship can well predict the fatigue life for total strain amplitude from 0.5% to 0.8%. The fatigue resistance is related with heat treatment procedures. The fatigue resistance performance of Pro.I is better than that of Pro.II. The cyclic stress response behaviors are closely related to the changes of the strain amplitudes. The peak stress of the alloy gradually increases with the increase of total strain amplitudes. The main fracture mechanism is inhomogeneous deformation and the different interactions between dislocations and γ′ precipitates. PMID:28793559

  3. Understanding factors associated with misclassification of fatigue-related accidents in police record.

    PubMed

    Li, Yanyan; Yamamoto, Toshiyuki; Zhang, Guangnan

    2018-02-01

    Fatigue is one of the riskiest causes of traffic accidents threatening road safety. Due to lack of proper criteria, the identification of fatigue-related accidents by police officers largely depends on inferential evidence and their own experience. As a result, many fatigue-related accidents are misclassified and the harmfulness of fatigue on road safety is misestimated. In this paper, a joint model framework is introduced to analyze factors contributing to misclassification of a fatigue-related accident in police reports. Association rule data mining technique is employed to identify the potential interactions of factors, and logistic regression models are applied to analyze factors that hinder police officers' identification of fatigue-related accidents. Using the fatigue-related crash records from Guangdong Province during 2005-2014, factors contributing to the false positive and false negative detection of the fatigue-related accident have been identified and compared. Some variables and interactions were identified to have significant impacts on fatigue-related accident detection. Based on the results, it can be inferred that the stereotype of certain groups of drivers, crash types, and roadway conditions affects police officers' judgment on fatigue-related accidents. This finding can provide useful information for training police officers and build better criteria for fatigue identification. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

  4. Crew Factors in Flight Operations. 11; A Survey of Fatigue Factors in Regional Airline Operations

    NASA Technical Reports Server (NTRS)

    Co, Elizabeth L.; Gregory, Kevin B.; Johnson, Julie M.; Rosekind, Mark R.

    1999-01-01

    This report is the eleventh in a series on the physiological effects of flight operations on flight crews. A 119-question survey was completed by 1,424 flight crewmembers from 26 regional carriers to identify factors contributing to fatigue in regional airline operations. Eighty-nine percent of crewmembers identified fatigue as a moderate or serious concern with 88% reporting that it was a common occurrence and 92% reporting that, when it occurs, fatigue represents a moderate or serious safety issue. However, 86% reported they received no company training addressing fatigue issues. Identified fatigue factors included multiple flight segments, scheduling considerations, varying regulations, and others. The two most commonly cited fatigue factors regarded flying multiple (more than four) segments. Scheduling factors accounted for nine of the ten most common recommendations to reduce fatigue in regional operations. Differing requirements among regulations were cited as contributing to fatigue. Other identified factors were the flight deck environment, automation, and diet. The data suggested specific recommendations, including education of industry personnel about fatigue issues and examination of scheduling practices. Education plays a critical role in any effort to address fatigue. Analyzing scheduling practices and identifying potential improvements may result in reduced fatigue as well as other benefits to operations.

  5. The Psychometric Properties of an Arabic version of the PedsQL Multidimensional Fatigue Scale Tested for Children with Cancer.

    PubMed

    Al-Gamal, Ekhlas; Long, Tony

    2017-09-01

    Fatigue is considered to be one of the most reported symptoms experienced by children with cancer. A major aim of this study was to develop an Arabic version of the Pediatric Quality of Life (PedsQL) Multidimensional Fatigue Scale (child report) and to test its psychometric proprieties for the assessment of fatigue in Arabic children with cancer. The PedsQL Multidimensional Fatigue Scale (Arabic version) and the PedsQL TM 4.0 Generic Core scale (existing Arabic version) were completed by 70 Jordanian children with cancer. Cronbach's alpha coefficients were found to be 0.90 for the total PedsQL Multidimensional Fatigue Scale (Arabic version), 0.94 for the general fatigue subscale, 0.67 for the sleep/rest fatigue subscale, and 0.87 for the cognitive fatigue subscale. The PedsQL Multidimensional Fatigue Scale scores correlated significantly with the PedsQL TM 4.0 Generic Core scale and demonstrated good construct validity. The results demonstrate excellent reliability and good validity of the PedsQL Multidimensional Fatigue Scale (Arabic version) for children with cancer. This is the first validated scale that assesses fatigue in Arabic children with cancer. The English scale has been used with several pediatric clinical populations, so this Arabic version may be equally useful beyond the field of cancer.

  6. Fatigue in prostate cancer patients treated with external beam radiotherapy: a prospective 5-year long-term patient-reported evaluation.

    PubMed

    Fransson, Per

    2010-01-01

    Limited information is available regarding the long-term effect of external beam radiotherapy (EBRT) on fatigue in individuals with prostate cancer (PC). Men with PC treated with EBRT from January 1992 to June 2003 were enrolled in a prospective study. The QLQ-C30 questionnaire was used to evaluate pre-treatment fatigue and up to 5 years post-treatment. 407 men with 5-year assessments were analyzed. Fatigue increased between pre-treatment (mean: 15.5; CI: 13.6-17.4) and 5-years post-treatment (mean: 22.8; CI: 20.5-25.1; P<0.001). Pre-treatment fatigue was absent in 206/407 (59%) patients and 5-year post-treatment was reported by 264/407 (66%). Sixteen of 407 patients (4%) reported severe fatigue after 5 years. Physical-, emotional-, cognitive function, and dyspnea were the factors that correlated most to higher level of fatigue 5-year post-treatment. Fatigue is a common symptom among patients with PC. A large percentage of patients reported pre-treatment fatigue. Fatigue increased over time, with the highest level seen at the end of EBRT. Severe fatigue was reported by 4% 5-year post-treatment. More work is needed in order to identify which patients are most susceptible to developing fatigue especially during radiotherapy.

  7. Fatigue Analysis Before and After Shaker Exercise: Physiologic Tool for Exercise Design

    PubMed Central

    White, Kevin T.; Easterling, Caryn; Roberts, Niles; Shaker, Reza

    2016-01-01

    Recent studies suggest that the Shaker exercise induces fatigue in the upper esophageal sphincter (UES) opening muscles and sternocleidomastoid (SCM), with the SCMs fatiguing earliest. The aim of this study was to measure fatigue induced by the isometric portion of the Shaker exercise by measuring the rate of change in the median frequency (MF rate) of the power spectral density (PSD) function, which is interpreted as proportional to the rate of fatigue, from surface electromyography (EMG) of suprahyoid (SHM), infrahyoid (IHM), and SCM. EMG data compared fatigue-related changes from 20-, 40-, and 60-s isometric hold durations of the Shaker exercise. We found that fatigue-related changes were manifested during the 20-s hold. The findings confirm that the SCM fatigues initially and as fast as or faster than the SHM and IHM. In addition, upon completion of the exercise protocol, the SCM had a decreased MF rate, implying improved fatigue resistance, while the SHM and IHM showed increased MF rates, implying that these muscles increased their fatiguing effort. We conclude that the Shaker exercise initially leads to increased fatigue resistance of the SCM, after which the exercise loads the less fatigue-resistant SHM and IHM, potentiating the therapeutic effect of the Shaker exercise regimen with continued exercise performance. PMID:18369673

  8. Fatigue after stroke: frequency and effect on daily life.

    PubMed

    Crosby, Gail A; Munshi, Sunil; Karat, Aaron Sanjit; Worthington, Esme; Lincoln, Nadina B

    2012-01-01

    An audit was conducted to assess the frequency of fatigue after stroke, to determine the impact on daily life, and whether it was discussed with clinicians. Patients were recruited from Nottingham University Hospitals NHS Trust stroke service. Patients were interviewed about their fatigue, and the Fatigue Severity Subscale (FSS-FAI), Brief Assessment Schedule for Depression Cards (BASDEC), Barthel Index and Nottingham Extended Activities of Daily Living (EADL) Scale were administered. 64 patients were recruited, with a mean age 73.5 years (SD 14.0, range 37-94 years), 37 (58%) as in-patients and 27 (42%) as outpatients. There were 41 (64%) who reported significant levels of fatigue and 31 (48%) with significant fatigue on the Fatigue Severity Scale. Demographic and clinical variables were not significantly related to fatigue (p > 0.05), apart from gender, with women reporting significantly more fatigue than men (p = 0.006). There was a moderate correlation between the BASDEC and FSS (r(s) = 0.41, p = 0.002). Of the 41 participants who reported fatigue, 33 (81%) had not discussed this with their clinician. Fatigue was a common problem after stroke. There was a lack of awareness in both patients and clinicians and little advice being given to patients with fatigue.

  9. Subgroups of Chemotherapy Patients With Distinct Morning and Evening Fatigue Trajectories

    PubMed Central

    Kober, Kord M.; Cooper, Bruce A.; Paul, Steven M.; Dunn, Laura B.; Levine, Jon D.; Wright, Fay; Hammer, Marilyn J.; Mastick, Judy; Venook, Alan; Aouizerat, Bradley E.; Miaskowski, Christine

    2017-01-01

    Purpose Purposes of this study were to: identify subgroups of patients with distinct trajectories for morning and evening fatigue; evaluate for differences in demographic and clinical characteristics among these subgroups; and compare and contrast the predictors of subgroup membership for morning and evening fatigue. Methods Outpatients with breast, gastrointestinal, gynecological, or lung cancer (n=582) completed questionnaires a total of six times over two cycles of CTX. Morning and evening fatigue severity were evaluated using the Lee Fatigue Scale. Latent profile analysis (LPA) was used to identify distinct subgroups. Results Three latent classes were identified for morning fatigue (i.e., Low (31.8%), High (51.4%), and Very High (16.8%)) and for evening evening fatigue (i.e., Moderate (20.0%), High (21.8%), and Very High (58.2%)). Most of the disease and treatment characteristics did not distinguish among the morning and evening fatigue classes. Compared to the Low class, patients in the High and Very High morning fatigue class were younger, had a lower functional status and higher level of comorbidity. Compared to the Moderate class, patients in the Very High evening fatigue class were younger, more likely to be female, had child care responsibilities, had a lower functional status, and a higher level of comorbidity. Conclusion LPA allows for the identification of risk factors for more severe fatigue. Since an overlap was not observed across the morning and evening fatigue classes and unique predictors for morning and evening fatigue were identified, these findings suggest that morning and evening fatigue may have distinct underlying mechanisms. PMID:26361758

  10. Chronic fatigue syndrome after infectious mononucleosis in adolescents.

    PubMed

    Katz, Ben Z; Shiraishi, Yukiko; Mears, Cynthia J; Binns, Helen J; Taylor, Renee

    2009-07-01

    The goal was to characterize prospectively the course and outcome of chronic fatigue syndrome in adolescents during a 2-year period after infectious mononucleosis. A total of 301 adolescents (12-18 years of age) with infectious mononucleosis were identified and screened for nonrecovery 6 months after infectious mononucleosis by using a telephone screening interview. Nonrecovered adolescents underwent a medical evaluation, with follow-up screening 12 and 24 months after infectious mononucleosis. After blind review, final diagnoses of chronic fatigue syndrome at 6, 12, and 24 months were made by using established pediatric criteria. Six, 12, and 24 months after infectious mononucleosis, 13%, 7%, and 4% of adolescents, respectively, met the criteria for chronic fatigue syndrome. Most individuals recovered with time; only 2 adolescents with chronic fatigue syndrome at 24 months seemed to have recovered or had an explanation for chronic fatigue at 12 months but then were reclassified as having chronic fatigue syndrome at 24 months. All 13 adolescents with chronic fatigue syndrome 24 months after infectious mononucleosis were female and, on average, they reported greater fatigue severity at 12 months. Reported use of steroid therapy during the acute phase of infectious mononucleosis did not increase the risk of developing chronic fatigue syndrome. Infectious mononucleosis may be a risk factor for chronic fatigue syndrome in adolescents. Female gender and greater fatigue severity, but not reported steroid use during the acute illness, were associated with the development of chronic fatigue syndrome in adolescents. Additional research is needed to determine other predictors of persistent fatigue after infectious mononucleosis.

  11. Myoelectrical Manifestation of Fatigue Less Prominent in Patients with Cancer Related Fatigue

    PubMed Central

    Kisiel-Sajewicz, Katarzyna; Siemionow, Vlodek; Seyidova-Khoshknabi, Dilara; Davis, Mellar P.; Wyant, Alexandria; Ranganathan, Vinoth K.; Walsh, Declan; Yan, Jin H.; Hou, Juliet; Yue, Guang H.

    2013-01-01

    Purpose A lack of fatigue-related muscle contractile property changes at time of perceived physical exhaustion and greater central than peripheral fatigue detected by twitch interpolation technique have recently been reported in cancer survivors with fatigue symptoms. Based on these observations, it was hypothesized that compared to healthy people, myoelectrical manifestation of fatigue in the performing muscles would be less significant in these individuals while sustaining a prolonged motor task to self-perceived exhaustion (SPE) since their central fatigue was more prominent. The purpose of this study was to test this hypothesis by examining electromyographic (EMG) signal changes during fatiguing muscle performance. Methods Twelve individuals who had advanced solid cancer and cancer-related fatigue (CRF), and 12 age- and gender-matched healthy controls performed a sustained elbow flexion at 30% maximal voluntary contraction till SPE. Amplitude and mean power frequency (MPF) of EMG signals of the biceps brachii, brachioradialis, and triceps brachii muscles were evaluated when the individuals experienced minimal, moderate, and severe fatigue. Results CRF patients perceived physical “exhaustion” significantly sooner than the controls. The myoelectrical manifestation of muscular fatigue assessed by EMG amplitude and MPF was less significant in CRF than controls. The lower MPF even at minimal fatigue stage in CRF may indicate pathophysiologic condition of the muscle. Conclusions CRF patients experience less myoelectrical manifestation of muscle fatigue than healthy individuals near the time of SPE. The data suggest that central nervous system fatigue plays a more important role in limiting endurance-type of motor performance in patients with CRF. PMID:24391800

  12. Neuromuscular fatigue during exercise: Methodological considerations, etiology and potential role in chronic fatigue.

    PubMed

    Twomey, Rosie; Aboodarda, Saied Jalal; Kruger, Renata; Culos-Reed, Susan Nicole; Temesi, John; Millet, Guillaume Y

    2017-04-01

    The term fatigue is used to describe a distressing and persistent symptom of physical and/or mental tiredness in certain clinical populations, with distinct but ultimately complex, multifactorial and heterogenous pathophysiology. Chronic fatigue impacts on quality of life, reduces the capacity to perform activities of daily living, and is typically measured using subjective self-report tools. Fatigue also refers to an acute reduction in the ability to produce maximal force or power due to exercise. The classical measurement of exercise-induced fatigue involves neuromuscular assessments before and after a fatiguing task. The limitations and alternatives to this approach are reviewed in this paper in relation to the lower limb and whole-body exercise, given the functional relevance to locomotion, rehabilitation and activities of daily living. It is suggested that under some circumstances, alterations in the central and/or peripheral mechanisms of fatigue during exercise may be related to the sensations of chronic fatigue. As such, the neurophysiological correlates of exercise-induced fatigue are briefly examined in two clinical examples where chronic fatigue is common: cancer survivors and people with multiple sclerosis. This review highlights the relationship between objective measures of fatigability with whole-body exercise and perceptions of fatigue as a priority for future research, given the importance of exercise in relieving symptoms of chronic fatigue and/or overall disease management. As chronic fatigue is likely to be specific to the individual and unlikely to be due to a simple biological or psychosocial explanation, tailored exercise programmes are a potential target for therapeutic intervention. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Fatigue in osteoarthritis: a qualitative study

    PubMed Central

    Power, J Denise; Badley, Elizabeth M; French, Melissa R; Wall, Angela J; Hawker, Gillian A

    2008-01-01

    Background Fatigue is recognized as a disabling symptom in many chronic conditions including rheumatic disorders such as rheumatoid arthritis (RA) and lupus. Fatigue in osteoarthritis (OA) is not routinely evaluated and has only been considered in a very limited number of studies. To date, these studies have focused primarily on patients with OA under rheumatological care, which represent the minority of people living with OA. The purpose of this study was to increase our understanding of the fatigue experience in community dwelling people with OA. Methods In 2004, 8 focus groups were conducted with 28 men and 18 women (mean age 72.3) with symptomatic hip or knee OA recruited from a population-based cohort. Participants completed a self-administered questionnaire, which included demographics, measures of OA severity (WOMAC), depression (CES-D) and fatigue (FACIT). Sessions were audio taped and transcribed verbatim. Two researchers independently reviewed the transcripts to identify themes. Findings were compared and consensus reached. Results Mean pain, disability, depression and fatigue scores were 8.7/20, 27.8/68, 15.4/60, and 30.9/52, respectively. Participants described their fatigue as exhaustion, being tired and "coming up against a brick wall". Participants generally perceived fatigue as different from sleepiness and distinguished physical from mental fatigue. Factors believed to increase fatigue included OA pain and pain medications, aging, various types of weather and poor sleep. Mental health was identified as both affecting fatigue and being affected by fatigue. Participants described fatigue as impacting physical function, and their ability to participate in social activities and to do household chores. Rest, exercise, and avoiding or getting assistance with activities were cited as ways of coping. Participants generally did not discuss their fatigue with anyone except their spouses. Conclusion Participants with OA described experiencing notable amounts of fatigue and indicated that it had a substantial impact on their lives. Further research is required to better understand the role of fatigue in OA in order to identify strategies to reduce its impact. PMID:18452607

  14. Fatigue in rheumatoid arthritis; a persistent problem: a large longitudinal study

    PubMed Central

    van Steenbergen, Hanna W; Tsonaka, Roula; Huizinga, Tom W J; Boonen, Annelies; van der Helm-van Mil, Annette H M

    2015-01-01

    Objective Fatigue is prevalent and disabling in rheumatoid arthritis (RA). Surprisingly, the long-term course of fatigue is studied seldom and it is unclear to what extent it is influenced by inflammation. This study aimed to determine the course of fatigue during 8 years follow-up, its association with the severity of inflammation and the effect of improved treatment strategies. Methods 626 patients with RA included in the Leiden Early Arthritis Clinic cohort were studied during 8 years. Fatigue severity, measured on a 0–100 mm scale, and other clinical variables were assessed yearly. Patients included in 1993–1995, 1996–1998 and 1999–2007 were treated with delayed treatment with disease-modifying antirheumatic drugs (DMARDs), early treatment with mild DMARDs and early treatment with methotrexate respectively. After multiple imputation, the serial measurements were analysed using linear quantile mixed models. Results Median fatigue severity at baseline was 45 mm and remained, despite treatment, rather stable thereafter. Female gender (effect size=4.4 mm), younger age (0.2 mm less fatigue/year), higher swollen and tender joint counts (0.3 mm and 1.0 mm more fatigue/swollen or tender joint) and C reactive protein-levels (0.1 mm more fatigue per mg/L) were independently and significantly (p<0.05) associated with fatigue severity over 8 years. Although improved treatment strategies associated with less severe radiographic progression, there was no effect on fatigue severity (p=0.96). Conclusions This largest longitudinal study on fatigue so far demonstrated that the association between inflammation and fatigue is statistically significant but effect sizes are small, suggesting that non-inflammatory pathways mediate fatigue as well. Improved treatment strategies did not result in less severe fatigue. Therefore, fatigue in RA remains an ‘unmet need’. PMID:26509063

  15. The relationship between fatigue and light exposure during chemotherapy.

    PubMed

    Liu, Lianqi; Marler, Matthew R; Parker, Barbara A; Jones, Vicky; Johnson, Sherella; Cohen-Zion, Mairav; Fiorentino, Lavinia; Sadler, Georgia Robins; Ancoli-Israel, Sonia

    2005-12-01

    Fatigue is one of the most common and distressing complaints among cancer patients, not only during radiation and chemotherapy, but also for months to years after the completion of treatment. Fatigue interferes with patients' daily lives, reduces their quality of life, and is often a significant reason why patients discontinue treatment. We hypothesized that some of the fatigue may be related to disrupted circadian rhythms and low light exposure. The main objective of this study therefore was to investigate the association between fatigue and light exposure among patients with breast cancer. As part of a larger, ongoing prospective study on fatigue, sleep, and circadian rhythms in patients with breast cancer, an analysis of 63 women newly diagnosed with stage I-IIIA breast cancer and scheduled to receive four cycles of adjuvant or neoadjuvant anthracycline-based chemotherapy was conducted. Data were collected before and during weeks 1, 2, and 3 of cycle 1 and cycle 4. Fatigue was assessed using the Short Form of Multidimensional Fatigue Symptom Inventory. Light exposure was recorded with a wrist actigraph. There were significant correlations between fatigue levels and light exposure (r=-0.28 to -0.45) within both cycle 1 and cycle 4, such that higher levels of fatigue were associated with less light exposure. There were also significant correlations between changes in light exposure and changes in fatigue within the first 2 weeks of each cycle (r=-0.28 to -0.52). Increased fatigue was significantly correlated with decreased light exposure among patients with breast cancer. Although the cause and effect of exacerbated fatigue and decreased light exposure cannot be confirmed by the current study, and lower light exposure may just in part be due to the fatigued patients spending less time outdoors in bright light, two hypotheses are proposed about the mechanisms by which light may alleviate the fatigue of patients with breast cancer. These results suggest the need for prospective intervention studies of light therapy for breast-cancer-related fatigue.

  16. Fatigue - Multiple Languages

    MedlinePlus

    ... a new window. Arabic (العربية) Expand Section Fatigue - English PDF Fatigue - العربية (Arabic) PDF American Cancer Society ... Chinese, Traditional (Cantonese dialect) (繁體中文) Expand Section Fatigue - English PDF Fatigue - 繁體中文 (Chinese, Traditional (Cantonese dialect)) PDF ...

  17. 77 FR 21426 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-10

    ... combination of fatigue and stress corrosion. This AD requires repetitive general visual inspections for broken... revealed that the crack initiated due to fatigue, and propagated by a combination of fatigue and stress... subsequent fracture were initiated by fatigue and propagated by a combination of fatigue and stress corrosion...

  18. Simulation of Fatigue Behavior of High Temperature Metal Matrix Composites

    NASA Technical Reports Server (NTRS)

    Tong, Mike T.; Singhal, Suren N.; Chamis, Christos C.; Murthy, Pappu L. N.

    1996-01-01

    A generalized relatively new approach is described for the computational simulation of fatigue behavior of high temperature metal matrix composites (HT-MMCs). This theory is embedded in a specialty-purpose computer code. The effectiveness of the computer code to predict the fatigue behavior of HT-MMCs is demonstrated by applying it to a silicon-fiber/titanium-matrix HT-MMC. Comparative results are shown for mechanical fatigue, thermal fatigue, thermomechanical (in-phase and out-of-phase) fatigue, as well as the effects of oxidizing environments on fatigue life. These results show that the new approach reproduces available experimental data remarkably well.

  19. Effect of Pre-Strain on the Fatigue Behavior of Extruded AZ31 Alloys

    NASA Astrophysics Data System (ADS)

    Wu, Yanjun

    2017-09-01

    An attempt is made to rationalize the effect of pre-strain history on fatigue behaviors of AZ31 magnesium alloy. Axial fatigue tests were conducted in the extruded and pre-compressioned AZ31 alloy under low cycle total strain control fatigue conditions. The pre-strain process influences the plastic deformation mechanism activated during fatigue deformation, especially during tensile loading, by enhancing the activity of detwinning mechanism. The low-cycle fatigue lifetime of extruded AZ31 alloy can be enhanced by the pre-compression process. And the hysteresis energy was successfully used to predict the low-cycle fatigue lifetime.

  20. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Skochko, G.W.; Herrmann, T.P.

    Axial load cycling fatigue tests of threaded fasteners are useful in determining fastener fatigue failure or design properties. By using appropriate design factors between the failure and design fatigue strengths, such tests are used to establish fatigue failure and design parameters of fasteners for axial and bending cyclic load conditions. This paper reviews the factors which influence the fatigue strength of low Alloy steel threaded fasteners, identifies those most significant to fatigue strength, and provides design guidelines based on the direct evaluation of fatigue tests of threaded fasteners. Influences on fatigue strength of thread manufacturing process (machining and rolling ofmore » threads), effect of fastener membrane and bending stresses, thread root radii, fastener sizes, fastener tensile strength, stress relaxation, mean stress, and test temperature are discussed.« less

  1. High Speed Research Program Sonic Fatigue

    NASA Technical Reports Server (NTRS)

    Rizzi, Stephen A. (Technical Monitor); Beier, Theodor H.; Heaton, Paul

    2005-01-01

    The objective of this sonic fatigue summary is to provide major findings and technical results of studies, initiated in 1994, to assess sonic fatigue behavior of structure that is being considered for the High Speed Civil Transport (HSCT). High Speed Research (HSR) program objectives in the area of sonic fatigue were to predict inlet, exhaust and boundary layer acoustic loads; measure high cycle fatigue data for materials developed during the HSR program; develop advanced sonic fatigue calculation methods to reduce required conservatism in airframe designs; develop damping techniques for sonic fatigue reduction where weight effective; develop wing and fuselage sonic fatigue design requirements; and perform sonic fatigue analyses on HSCT structural concepts to provide guidance to design teams. All goals were partially achieved, but none were completed due to the premature conclusion of the HSR program. A summary of major program findings and recommendations for continued effort are included in the report.

  2. Effects of weld defects at root on rotating bending fatigue strength of small diameter socket welded pipe joints

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Higuchi, Makoto; Nakagawa, Akira; Chujo, Noriyuki

    1996-12-01

    Rotating bending fatigue tests were conducted on socket welded joints of a nominal diameter 20 mm, and effects of root defect and other various factors, including post-weld heat treatment (PWHT), pipe wall thickness, and socket wall thickness, were investigated. The socket joints exhibited, in the rotating bending fatigue mode, fatigue strengths that were markedly lower than the same 20 mm diameter joints in four-point bending fatigue. Also, where the latter specimens failed always at the toe, root-failures occurred in rotating bending fatigue. When PWHT`d, however, the fatigue strength showed a remarkable improvement, while the failure site reverted to toe. Thickermore » pipe walls and socket walls gave rise to higher fatigue strength. A formula relating the size of root defects to the fatigue strength reduction has been proposed.« less

  3. Compassion Fatigue: An Application of the Concept to Informal Caregivers of Family Members with Dementia

    PubMed Central

    Day, Jennifer R.; Anderson, Ruth A.

    2011-01-01

    Introduction. Compassion fatigue is a concept used with increasing frequency in the nursing literature. The objective of this paper is to identify common themes across the literature and to apply these themes, and an existing model of compassion fatigue, to informal caregivers for family members with dementia. Findings. Caregivers for family members with dementia may be at risk for developing compassion fatigue. The model of compassion fatigue provides an informative framework for understanding compassion fatigue in the informal caregiver population. Limitations of the model when applied to this population were identified as traumatic memories and the emotional relationship between parent and child, suggesting areas for future research. Conclusions. Research is needed to better understand the impact of compassion fatigue on informal caregivers through qualitative interviews, to identify informal caregivers at risk for compassion fatigue, and to provide an empirical basis for developing nursing interventions for caregivers experiencing compassion fatigue. PMID:22229086

  4. Factors Modulating Recovery Rate after Intermittent Tetanic Fatigue in Atrophic Soleus

    NASA Astrophysics Data System (ADS)

    Li, Hui; Jiao, Bo; Yu, Zhibin

    2008-06-01

    To specify the factors modulating the recovery rate after intermittent tetanic fatigue in soleus, and to seek the reasons for the decrease of recovery rate in atrophic soleus, we observed the recovery time course of different types of fatigue in isolated muscle strips. A 10 % or 50 % decrease in maximal contraction tension of tetani was defined respectively as slight or moderate fatigue. Tetanic tension recovery rates after short-term and long-term of slight or moderate fatigue were observed, some pharmacological intervention were also used. The results showed that slight fatigue only induced an inhibition to myofibril, while moderate fatigue induced an inhibition in myofibril and sarcoplasmic reticulum Ca2+ release channels. There were significant decreases in all of the fatigue groups in one-week tail-suspended rats. These suggest that both slight and moderate fatigue inhibit the myofibrils and the sarcoplasmic reticulum Ca2+ release channels in one-week unloaded soleus.

  5. The Nature of Fatigue in Chronic Fatigue Syndrome.

    PubMed

    Olson, Karin; Zimka, Oksana; Stein, Eleanor

    2015-10-01

    In this article, we report the findings of our study on the nature of fatigue in patients diagnosed with chronic fatigue syndrome. Using ethnoscience as a design, we conducted a series of unstructured interviews and card sorts to learn more about how people with chronic fatigue syndrome describe fatigue. Participants (N = 14) described three distinct domains: tiredness, fatigue, and exhaustion. Most participants experienced tiredness prior to diagnosis, fatigue during daily life, and exhaustion after overexertion. We also discuss participants' ability to adapt to a variety of stressors and prevent shifts to exhaustion, and relate our findings to stress theory and other current research. Primary strategies that promoted adaptation to stressors included pacing and extended rest periods. These findings can aid health care professionals in detecting impending shifts between tiredness, fatigue, and exhaustion and in improving adaptive strategies, thereby improving quality of life. © The Author(s) 2015.

  6. A Micromechanics-Based Method for Multiscale Fatigue Prediction

    NASA Astrophysics Data System (ADS)

    Moore, John Allan

    An estimated 80% of all structural failures are due to mechanical fatigue, often resulting in catastrophic, dangerous and costly failure events. However, an accurate model to predict fatigue remains an elusive goal. One of the major challenges is that fatigue is intrinsically a multiscale process, which is dependent on a structure's geometric design as well as its material's microscale morphology. The following work begins with a microscale study of fatigue nucleation around non- metallic inclusions. Based on this analysis, a novel multiscale method for fatigue predictions is developed. This method simulates macroscale geometries explicitly while concurrently calculating the simplified response of microscale inclusions. Thus, providing adequate detail on multiple scales for accurate fatigue life predictions. The methods herein provide insight into the multiscale nature of fatigue, while also developing a tool to aid in geometric design and material optimization for fatigue critical devices such as biomedical stents and artificial heart valves.

  7. Energy-based fatigue model for shape memory alloys including thermomechanical coupling

    NASA Astrophysics Data System (ADS)

    Zhang, Yahui; Zhu, Jihong; Moumni, Ziad; Van Herpen, Alain; Zhang, Weihong

    2016-03-01

    This paper is aimed at developing a low cycle fatigue criterion for pseudoelastic shape memory alloys to take into account thermomechanical coupling. To this end, fatigue tests are carried out at different loading rates under strain control at room temperature using NiTi wires. Temperature distribution on the specimen is measured using a high speed thermal camera. Specimens are tested to failure and fatigue lifetimes of specimens are measured. Test results show that the fatigue lifetime is greatly influenced by the loading rate: as the strain rate increases, the fatigue lifetime decreases. Furthermore, it is shown that the fatigue cracks initiate when the stored energy inside the material reaches a critical value. An energy-based fatigue criterion is thus proposed as a function of the irreversible hysteresis energy of the stabilized cycle and the loading rate. Fatigue life is calculated using the proposed model. The experimental and computational results compare well.

  8. The Effect of Porosity on Fatigue of Die Cast AM60

    NASA Astrophysics Data System (ADS)

    Yang, Zhuofei; Kang, Jidong; Wilkinson, David S.

    2016-07-01

    AM60 high-pressure die castings are known to contain significant porosity which can affect fatigue life. We have studied this using samples drawn from prototype AM60 shock towers by conducting strain-controlled fatigue tests accompanied by X-ray computed tomography analysis. The results show that the machined surface is the preferential location for fatigue crack development, with pores close to these surfaces serving as initiation sites. Fatigue life shows a strong inverse correlation with the size of the fatigue-crack-initiating pore. Pore shape and pore orientation also influence the response. A supplemental study on surface roughness shows that porosity is the dominant factor in fatigue. Tomography enables the link between porosity and fatigue crack initiation to be clearly identified. These data are complemented by SEM observations of the fracture surfaces which are generally flat and full of randomly oriented serration patterns but without long-range fatigue striations.

  9. A Three-Parameter Model for Predicting Fatigue Life of Ductile Metals Under Constant Amplitude Multiaxial Loading

    NASA Astrophysics Data System (ADS)

    Liu, Jia; Li, Jing; Zhang, Zhong-ping

    2013-04-01

    In this article, a fatigue damage parameter is proposed to assess the multiaxial fatigue lives of ductile metals based on the critical plane concept: Fatigue crack initiation is controlled by the maximum shear strain, and the other important effect in the fatigue damage process is the normal strain and stress. This fatigue damage parameter introduces a stress-correlated factor, which describes the degree of the non-proportional cyclic hardening. Besides, a three-parameter multiaxial fatigue criterion is used to correlate the fatigue lifetime of metallic materials with the proposed damage parameter. Under the uniaxial loading, this three-parameter model reduces to the recently developed Zhang's model for predicting the uniaxial fatigue crack initiation life. The accuracy and reliability of this three-parameter model are checked against the experimental data found in literature through testing six different ductile metals under various strain paths with zero/non-zero mean stress.

  10. Low-cycle thermal fatigue

    NASA Technical Reports Server (NTRS)

    Halford, G. R.

    1986-01-01

    A state-of-the-art review is presented of the field of thermal fatigue. Following a brief historical review, the concept is developed that thermal fatigue can be viewed as processes of unbalanced deformation and cracking. The unbalances refer to dissimilar mechanisms occurring in opposing halves of thermal fatigue loading and unloading cycles. Extensive data summaries are presented and results are interpreted in terms of the unbalanced processes involved. Both crack initiation and crack propagation results are summarized. Testing techniques are reviewed, and considerable discussion is given to a technique for thermal fatigue simulation, known as the bithermal fatigue test. Attention is given to the use of isothermal life prediction methods for the prediction of thermal fatigue lives. Shortcomings of isothermally-based life prediction methods are pointed out. Several examples of analyses and thermal fatigue life predictions of high technology structural components are presented. Finally, numerous dos and don'ts relative to design against thermal fatigue are presented.

  11. Reduction of perception of chronic fatigue in an observational study of patients receiving 12 weeks of Kampo therapy.

    PubMed

    Sekiya, Nobuyasu; Shimada, Yutaka; Shintani, Takahiro; Tahara, Eiichi; Kouta, Kazufumi; Shibahara, Naotoshi; Terasawa, Katsutoshi

    2005-10-01

    The aim of this study was to observe the influence of Kampo therapy on latent chronic fatigue of patients with chronic diseases. One hundred and seventy-three (173) consecutive patients with chronic diseases came to our department for the first time. This was a prospective study. Patients were divided into two groups: a chronic fatigue group (CFG) and a nonchronic fatigue group (NCFG). Based on Kampo diagnosis, both groups were prescribed Kampo formulae as an extract or decoction for 12 weeks. By using questionnaires, patients were assessed concerning their physical and mental types of fatigue, their sleep situation, and their attitude toward work or housekeeping, both before and after 12 weeks of treatment, according to Kampo diagnosis. The mental fatigue, physical fatigue, and sleep scores of both groups, and the work score of CFG, were decreased. The rate of reduction of the fatigue score was significantly greater in CFG than in NCFG. The factor responsible for this difference in fatigue score was physical fatigue. A reduction of the perception of chronic fatigue was observed in patients receiving 12 weeks of Kampo therapy.

  12. Familiality and Heritability of Fatigue in an Australian Twin Sample.

    PubMed

    Corfield, Elizabeth C; Martin, Nicholas G; Nyholt, Dale R

    2017-06-01

    Familial factors have previously been implicated in the etiology of fatigue, of which a significant proportion is likely attributable to genetic influences. However, family studies have primarily focused on chronic fatigue syndrome, while univariate twin studies have investigated broader fatigue phenotypes. The results for similar fatigue phenotypes vary between studies, particularly with regard to sex-specific contributions to the heritability of the traits. Therefore, the current study aims to investigate the familiality and sex-specific effects of fatigue experienced over the past few weeks in an older Australian population of 660 monozygotic (MZ) twin pairs, 190 MZ singleton twins, 593 dizygotic (DZ) twin pairs, and 365 DZ singleton twins. Higher risks for fatigue were observed in MZ compared to DZ co-twins of probands with fatigue. Univariate heritability analyses indicated fatigue has a significant genetic component, with a heritability (h 2) estimate of 40%. Sex-specific effects did not significantly contribute to the heritability of fatigue, with similar estimates for males (h 2 = 41%, 95% CI [18, 62]) and females (h 2 = 40%, 95% CI [27, 52]). These results indicate that fatigue experienced over the past few weeks has a familial contribution, with additive genetic factors playing an important role in its etiology.

  13. A sociological stance on fatigue and tiredness: Social inequalities, norms and representations.

    PubMed

    Loriol, Marc

    2017-04-01

    Fatigue is complex, representing simultaneously a physiological, psychological and social phenomenon. The sociological approach attempts to understand the experience of fatigue and its characterization at diverse periods and in various social contexts. After giving a sociological history of different forms of fatigue through the ages (acedia, melancholy, neurasthenia, chronic fatigue syndrome, etc.), this article proposes a social epidemiology of fatigue in the current period. Objectification of working and living conditions allows us to illustrate social inequalities in fatigue and exhaustion, but seems to contradict dominant social representations of fatigue today. It invites a critical discussion of contemporary theories of fatigue (such those of Alain Ehrenberg or Byung-Chul Han), which consider that fatigue is a condition of modern man, overwhelmed by his freedom. More modestly, analysis of the fatigue presented here rests on the capacity to be able to find a good balance between too much investment in work or life (which is exhausting) and not enough investment (which leads to boredom and lack of self-fulfillment). This balance depends on fragile and specific social norms in different professional or social circles and cannot be defined a priori. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  14. Fatigue influences lower extremity angular velocities during a single-leg drop vertical jump.

    PubMed

    Tamura, Akihiro; Akasaka, Kiyokazu; Otsudo, Takahiro; Shiozawa, Junya; Toda, Yuka; Yamada, Kaori

    2017-03-01

    [Purpose] Fatigue alters lower extremity landing strategies and decreases the ability to attenuate impact during landing. The purpose of this study was to reveal the influence of fatigue on dynamic alignment and joint angular velocities in the lower extremities during a single leg landing. [Subjects and Methods] The 34 female college students were randomly assigned to either the fatigue or control group. The fatigue group performed single-leg drop vertical jumps before, and after, the fatigue protocol, which was performed using a bike ergometer. Lower extremity kinematic data were acquired using a three-dimensional motion analysis system. The ratio of each variable (%), for the pre-fatigue to post-fatigue protocols, were calculated to compare differences between each group. [Results] Peak hip and knee flexion angular velocities increased significantly in the fatigue group compared with the control group. Furthermore, hip flexion angular velocity increased significantly between each group at 40 milliseconds after initial ground contact. [Conclusion] Fatigue reduced the ability to attenuate impact by increasing angular velocities in the direction of hip and knee flexion during landings. These findings indicate a requirement to evaluate movement quality over time by measuring hip and knee flexion angular velocities in landings during fatigue conditions.

  15. Fatigue and fatigability in neurologic illnesses

    PubMed Central

    Krupp, Lauren B.; Enoka, Roger M.

    2013-01-01

    Fatigue is commonly reported in many neurologic illnesses, including multiple sclerosis, Parkinson disease, myasthenia gravis, traumatic brain injury, and stroke. Fatigue contributes substantially to decrements in quality of life and disability in these illnesses. Despite the clear impact of fatigue as a disabling symptom, our understanding of fatigue pathophysiology is limited and current treatment options rarely lead to meaningful improvements in fatigue. Progress continues to be hampered by issues related to terminology and assessment. In this article, we propose a unified taxonomy and a novel assessment approach to addressing distinct aspects of fatigue and fatigability in clinical and research settings. This taxonomy is based on our current knowledge of the pathophysiology and phenomenology of fatigue and fatigability. Application of our approach indicates that the assessment and reporting of fatigue can be clarified and improved by utilizing this taxonomy and creating measures to address distinct aspects of fatigue and fatigability. We review the strengths and weaknesses of several common measures of fatigue and suggest, based on our model, that many research questions may be better addressed by using multiple measures. We also provide examples of how to apply and validate the taxonomy and suggest directions for future research. PMID:23339207

  16. Causes, consequences and countermeasures to driver fatigue in the rail industry: The train driver perspective.

    PubMed

    Filtness, A J; Naweed, A

    2017-04-01

    Fatigue is an important workplace risk management issue. Within the rail industry, the passing of a stop signal (signal passed at danger; SPAD) is considered to be one of the most major safety breaches which can occur. Train drivers are very aware of the negative consequences associated with a SPAD. Therefore, SPADs provide a practical and applied safety relevant context within which to structure a discussion on fatigue. Focus groups discussing contributing factors to SPADs were undertaken at eight passenger rail organisations across Australia and New Zealand (n = 28 drivers). Data relating to fatigue was extracted and inductively analysed identifying three themes: causes, consequences, and countermeasures (to fatigue). Drivers experienced negative consequences of fatigue, despite existing countermeasures to mitigate it. Organisational culture was a barrier to effective fatigue management. A fatigue assessment tool consistently informed rostering, however, shift swapping was commonplace and often unregulated, reducing any potential positive impact. In discussing fatigue countermeasure strategies, drivers talked interchangeably about mitigating task related fatigue (e.g. increasing cognitive load) and sleepiness (e.g. caffeine). Ensuring the concepts of fatigue and sleepiness are properly understood has the potential to maximise safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Frontier studies on fatigue, autonomic nerve dysfunction, and sleep-rhythm disorder.

    PubMed

    Tanaka, Masaaki; Tajima, Seiki; Mizuno, Kei; Ishii, Akira; Konishi, Yukuo; Miike, Teruhisa; Watanabe, Yasuyoshi

    2015-11-01

    Fatigue is defined as a condition or phenomenon of decreased ability and efficiency of mental and/or physical activities, caused by excessive mental or physical activities, diseases, or syndromes. It is often accompanied by a peculiar sense of discomfort, a desire to rest, and reduced motivation, referred to as fatigue sensation. Acute fatigue is a normal condition or phenomenon that disappears after a period of rest; in contrast, chronic fatigue, lasting at least 6 months, does not disappear after ordinary rest. Chronic fatigue impairs activities and contributes to various medical conditions, such as cardiovascular disease, epileptic seizures, and death. In addition, many people complain of chronic fatigue. For example, in Japan, more than one third of the general adult population complains of chronic fatigue. It would thus be of great value to clarify the mechanisms underlying chronic fatigue and to develop efficient treatment methods to overcome it. Here, we review data primarily from behavioral, electrophysiological, and neuroimaging experiments related to neural dysfunction as well as autonomic nervous system, sleep, and circadian rhythm disorders in fatigue. These data provide new perspectives on the mechanisms underlying chronic fatigue and on overcoming it.

  18. The Nottingham Fatigue After Stroke (NotFAST) study: results from follow-up six months after stroke.

    PubMed

    Hawkins, Louise; Lincoln, Nadina B; Sprigg, Nikola; Ward, Nick S; Mistri, Amit; Tyrrell, Pippa; Worthington, Esme; Drummond, Avril

    2017-12-01

    Background Post-stroke fatigue is common and disabling. Objectives The aim of NotFAST was to examine factors associated with fatigue in stroke survivors without depression, six months after stroke. Methods Participants were recruited from four UK stroke units. Those with high levels of depressive symptoms (score ≥7 on Brief Assessment Schedule Depression Cards) or aphasia were excluded. Follow-up assessment was conducted at six months after stroke. They were assessed on the Fatigue Severity Scale, Rivermead Mobility Index, Nottingham Extended Activities of Daily Living scale, Barthel Index, Beck Anxiety Index, Brief Assessment Schedule Depression Cards, Impact of Event Scale-Revised, and Sleep Hygiene Index. Results Of the 371 participants recruited, 263 (71%) were contacted at six months after stroke and 213 (57%) returned questionnaires. Approximately half (n = 109, 51%) reported fatigue at six months. Of those reporting fatigue initially (n = 88), 61 (69%) continued to report fatigue. 'De novo' (new) fatigue was reported by 48 (38%) of those not fatigued initially. Lower Nottingham Extended Activities of Daily Living scores and higher Beck Anxiety Index scores were independently associated with fatigue at six months. Conclusions Half the stroke survivors reported fatigue at six months post-stroke. Reduced independence in activities of daily living and higher anxiety levels were associated with the level of fatigue. Persistent and delayed onset fatigue may affect independence and participation in rehabilitation, and these findings should be used to inform the development of appropriate interventions.

  19. Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial.

    PubMed

    Heine, Martin; Verschuren, Olaf; Hoogervorst, Erwin Lj; van Munster, Erik; Hacking, Hub Ga; Visser-Meily, Anne; Twisk, Jos Wr; Beckerman, Heleen; de Groot, Vincent; Kwakkel, Gert

    2017-10-01

    Evidence supporting the effectiveness of aerobic training, specific for fatigue, in severely fatigued patients with multiple sclerosis (MS) is lacking. To estimate the effectiveness of aerobic training on MS-related fatigue and societal participation in ambulant patients with severe MS-related fatigue. Patients ( N = 90) with severe MS-related fatigue were allocated to 16-week aerobic training or control intervention. Primary outcomes were perceived fatigue (Checklist Individual Strength (CIS20r) fatigue subscale) and societal participation. An improvement of ⩾8 points on the CIS20r fatigue subscale was considered clinically relevant. Outcomes were assessed by a blinded observer at baseline, 2, 4, 6 and 12 months. Of the 89 patients that started treatment (median Expanded Disability Status Scale (interquartile range), 3.0 (2.0-3.6); mean CIS20r fatigue subscale (standard deviation (SD)), 42.6 (8.0)), 43 received aerobic training and 46 received the control intervention. A significant post-intervention between-group mean difference (MD) on the CIS20r fatigue subscale of 4.708 (95% confidence interval (CI) = 1.003-8.412; p  = 0.014) points was found in favour of aerobic training that, however, was not sustained during follow-up. No effect was found on societal participation. Aerobic training in MS patients with severe fatigue does not lead to a clinically meaningful reduction in fatigue or societal participation when compared to a low-intensity control intervention.

  20. The Distress Thermometer for screening for severe fatigue in newly diagnosed breast and colorectal cancer patients.

    PubMed

    Abrahams, H J G; Gielissen, M F M; de Lugt, M; Kleijer, E F W; de Roos, W K; Balk, E; Verhagen, C A H H V M; Knoop, H

    2017-05-01

    Internationally, the Distress Thermometer and associated Problem List are increasingly used in oncology as screening tools for psychological distress. Cancer-related fatigue is common but often overlooked in clinical practice. We examined if severe fatigue in cancer patients can be identified with the fatigue item of the Problem List. Newly diagnosed breast (N = 334) and colorectal (N = 179) cancer patients were screened for severe fatigue, which was defined as having a positive score on the fatigue item of the Problem List. The Fatigue Severity subscale of the Checklist Individual Strength was used as gold standard measure for severe fatigue. In total, 78% of breast cancer patients and 81% of colorectal cancer patients were correctly identified with the fatigue item. The sensitivity was 89% in breast cancer patients and 91% in colorectal cancer patients. The specificity was 75% in breast cancer patients and 77% in colorectal cancer patients. The positive predictive value was 53% in breast cancer patients and 64% in colorectal cancer patients, whereas the negative predictive value was 95% in both tumor types. The fatigue item of the Problem List performs satisfactorily as a quick screening tool for severe fatigue. However, a positive screen should be followed up with a more thorough assessment of fatigue, ie, a questionnaire with a validated cutoff point. Given time pressure of clinicians, this already implemented and brief screening tool may prevent severe fatigue from going undetected in clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Resilience and positive affect contribute to lower cancer-related fatigue among Chinese patients with gastric cancer.

    PubMed

    Zou, Guiyuan; Li, Ye; Xu, Ruicai; Li, Ping

    2018-04-01

    To investigate the prevalence of cancer-related fatigue and explore the relationship between resilience, positive affect, and fatigue among Chinese patients with gastric cancer. Cancer-related fatigue is the most distressing symptom reported frequently by cancer patients during both treatment and survival phases. Resilience and positive affect as vital protective factors against cancer-related fatigue have been examined, but the underlying psychological mechanisms are not well understood. A cross-sectional study. Two hundred and three gastric cancer patients were enrolled from three hospitals in China. The Cancer Fatigue Scale, the positive affect subscale of the Positive and Negative Affect Schedule and the Connor-Davidson Resilience Scale (CD-RISC10) were administered. Hierarchical linear regression modelling was conducted to examine the association between resilience and cancer-related fatigue, and the mediating effect of positive affect. The incidence of clinically relevant fatigue among patients with gastric cancer was 91.6%. Regression analysis showed that resilience was negatively associated with cancer-related fatigue, explaining 15.4% of variance in cancer-related fatigue. Mediation analysis showed that high resilience was associated with increased positive affect, which was associated with decreased cancer-related fatigue. Cancer-related fatigue is prevalent among patients with gastric cancer. Positive affect may mediate the relationship between resilience and cancer-related fatigue. Interventions that attend to resilience training and promotion of positive affect may be the focus for future clinical and research endeavours. © 2017 John Wiley & Sons Ltd.

  2. The process of cognitive behaviour therapy for chronic fatigue syndrome: which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    PubMed

    Heins, Marianne J; Knoop, Hans; Burk, William J; Bleijenberg, Gijs

    2013-09-01

    Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and behaviour are related to the decrease in fatigue. We included 183 patients meeting the US Centers for Disease Control criteria for CFS, aged 18 to 65 years, starting CBT. We measured fatigue and possible process variables before treatment; after 6, 12 and 18 weeks; and after treatment. Possible process variables were sense of control over fatigue, focusing on symptoms, self-reported physical functioning, perceived physical activity and objective (actigraphic) physical activity. We built multiple regression models, explaining levels of fatigue during therapy by (changes in) proposed process variables. We observed large individual variation in the patterns of change in fatigue and process variables during CBT for CFS. Increases in the sense of control over fatigue, perceived activity and self-reported physical functioning, and decreases in focusing on symptoms explained 20 to 46% of the variance in fatigue. An increase in objective activity was not a process variable. A change in cognitive factors seems to be related to the decrease in fatigue during CBT for CFS. The pattern of change varies considerably between patients, but changes in process variables and fatigue occur mostly in the same period. © 2013.

  3. Compression fatigue behavior and failure mechanism of porous titanium for biomedical applications.

    PubMed

    Li, Fuping; Li, Jinshan; Huang, Tingting; Kou, Hongchao; Zhou, Lian

    2017-01-01

    Porous titanium and its alloys are believed to be one of the most attractive biomaterials for orthopedic implant applications. In the present work, porous pure titanium with 50-70% porosity and different pore size was fabricated by diffusion bonding. Compression fatigue behavior was systematically studied along the out-of-plane direction. It resulted that porous pure titanium has anisotropic pore structure and the microstructure is fine-grained equiaxed α phase with a few twins in some α grains. Porosity and pore size have some effect on the S-N curve but this effect is negligible when the fatigue strength is normalized by the yield stress. The relationship between normalized fatigue strength and fatigue life conforms to a power law. The compression fatigue behavior is characteristic of strain accumulation. Porous titanium experiences uniform deformation throughout the entire sample when fatigue cycle is lower than a critical value (N T ). When fatigue cycles exceed N T , strain accumulates rapidly and a single collapse band forms with a certain angle to the loading direction, leading to the sudden failure of testing sample. Both cyclic ratcheting and fatigue crack growth contribute to the fatigue failure mechanism, while the cyclic ratcheting is the dominant one. Porous titanium possesses higher normalized fatigue strength which is in the range of 0.5-0.55 at 10 6 cycles. The reasons for the higher normalized fatigue strength were analyzed based on the microstructure and fatigue failure mechanism. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Increased Incidence of Fatigue in Patients with Primary Immunodeficiency Disorders: Prevalence and Associations Within the US Immunodeficiency Network Registry

    PubMed Central

    Guffey, Danielle; Minard, Charles G.; Orange, Jordan S.

    2017-01-01

    Introduction Patients with primary immunodeficiency (PID) often report fatigue, yet this symptom has not been studied in PID. Fatigue affects 6–7.5% of healthy adults. The goal of this study is to estimate the prevalence of fatigue in patients with PID and investigate its associated factors. Methods We analyzed 2537 PID patients registered in USIDNET to determine responses to the field “fatigue” in the core registry form. Demographics, immune phenotypes, and comorbid conditions were compared between fatigued and non-fatigued patients to identify relevant associations and potential drivers. A focused analysis was performed for patients with predominantly antibody deficiency disorders (PADs). Results Fatigue was reported in 25.9%(95% CI 23.7–28.3) of PAD patients, compared to 6.4% (95% CI 4.9–8.2) of non-PAD. Patients with common variable immunodeficiency (CVID) had the highest prevalence of fatigue (p < 0.001) among all PID diagnoses. Other factors that were associated with a higher rate of fatigue among PAD patients included female sex, higher BMI, depression, bronchiectasis, and autoimmunity. Additionally, fatigued PAD patients had lower absolute lymphocyte, CD3, CD4, and CD8 counts compared to non-fatigued patients. Conclusion Our findings suggest that fatigue is overrepresented in PAD patients. Prospective studies to estimate prevalence, risk factors, and fatigue etiology in PID are warranted, so therapeutic interventions can be considered. PMID:28124237

  5. Effect of Different Levels of Localized Muscle Fatigue on Knee Position Sense

    PubMed Central

    Gear, William S.

    2011-01-01

    There is little information available regarding how proprioceptive abilities decline as the amount of exertion increases during exercise. The purpose of this study was to determine the role of different levels of fatigue on knee joint position sense. A repeated measures design was used to examine changes in active joint reposition sense (AJRS) prior to and following three levels of fatigue. Eighteen participants performed knee extension and flexion isokinetic exercise until torque output was 90%, 70%, or 50% of the peak hamstring torque for three consecutive repetitions. Active joint reposition sense at 15, 30, or 45 degrees was tested following the isokinetic exercise session. Following testing of the first independent measure, participants were given a 20 minute rest period. Testing procedures were repeated for two more exercise sessions following the other levels of fatigue. Testing of each AJRS test angle was conducted on three separate days with 48 hours between test days. Significant main effect for fatigue was indicated (p = 0.001). Pairwise comparisons indicated a significant difference between the pre-test and following 90% of peak hamstring torque (p = 0.02) and between the pre-test and following 50% of peak hamstring torque (p = 0.02). Fatigue has long been theorized to be a contributing factor in decreased proprioceptive acuity, and therefore a contributing factor to joint injury. The findings of the present study indicate that fatigue may have an effect on proprioception following mild and maximum fatigue. Key points A repeated measures design was used to examine the effect of different levels of fatigue on active joint reposition sense (AJRS) of the knee at joint angles of 15°, 30° and 45° of flexion. A statistically significant main effect for fatigue was found, specifically between no fatigue and mild fatigue and no fatigue and maximum fatigue. A statistically significant interaction effect between AJRS and fatigue was not found. Secondary analysis of the results indicated a potential plateau effect of AJRS as fatigue continues to increase. Further investigation of the effect of increasing levels of fatigue on proprioception is warranted. PMID:24149565

  6. Effect of different levels of localized muscle fatigue on knee position sense.

    PubMed

    Gear, William S

    2011-01-01

    There is little information available regarding how proprioceptive abilities decline as the amount of exertion increases during exercise. The purpose of this study was to determine the role of different levels of fatigue on knee joint position sense. A repeated measures design was used to examine changes in active joint reposition sense (AJRS) prior to and following three levels of fatigue. Eighteen participants performed knee extension and flexion isokinetic exercise until torque output was 90%, 70%, or 50% of the peak hamstring torque for three consecutive repetitions. Active joint reposition sense at 15, 30, or 45 degrees was tested following the isokinetic exercise session. Following testing of the first independent measure, participants were given a 20 minute rest period. Testing procedures were repeated for two more exercise sessions following the other levels of fatigue. Testing of each AJRS test angle was conducted on three separate days with 48 hours between test days. Significant main effect for fatigue was indicated (p = 0.001). Pairwise comparisons indicated a significant difference between the pre-test and following 90% of peak hamstring torque (p = 0.02) and between the pre-test and following 50% of peak hamstring torque (p = 0.02). Fatigue has long been theorized to be a contributing factor in decreased proprioceptive acuity, and therefore a contributing factor to joint injury. The findings of the present study indicate that fatigue may have an effect on proprioception following mild and maximum fatigue. Key pointsA repeated measures design was used to examine the effect of different levels of fatigue on active joint reposition sense (AJRS) of the knee at joint angles of 15°, 30° and 45° of flexion.A statistically significant main effect for fatigue was found, specifically between no fatigue and mild fatigue and no fatigue and maximum fatigue.A statistically significant interaction effect between AJRS and fatigue was not found.Secondary analysis of the results indicated a potential plateau effect of AJRS as fatigue continues to increase.Further investigation of the effect of increasing levels of fatigue on proprioception is warranted.

  7. Effect of fatigue and gender on kinematics and ground reaction forces variables in recreational runners

    PubMed Central

    Durá-Gil, Juan V.; Palomares, Nicolás; Medina, Enrique; Llana-Belloch, Salvador

    2018-01-01

    The presence of fatigue has been shown to modify running biomechanics. Overall in terms of gender, women are at lower risk than men for sustaining running-related injuries, although it depends on the factors taken into account. One possible reason for these differences in the injury rate and location might be the dissimilar running patterns between men and women. The purpose of this study was to determine the effect of fatigue and gender on the kinematic and ground reaction forces (GRF) parameters in recreational runners. Fifty-seven participants (28 males and 29 females) had kinematic and GRF variables measured while running at speed of 3.3 m s−1 before and after a fatigue test protocol. The fatigue protocol included (1) a running Course-Navette test, (2) running up and down a flight of stairs for 5 min, and (3) performance of alternating jumps on a step (five sets of 1 minute each with 30 resting seconds between the sets). Fatigue decreased dorsiflexion (14.24 ± 4.98° in pre-fatigue and 12.65 ± 6.21° in fatigue condition, p < 0.05) at foot strike phase in females, and plantar flexion (−19.23 ± 4.12° in pre-fatigue and −18.26 ± 5.31° in fatigue condition, p < 0.05) at toe-off phase in males. These changes led to a decreased loading rate (88.14 ± 25.82 BW/s in pre-fatigue and 83.97 ± 18.83 BW/s in fatigue condition, p < 0.05) and the impact peak in females (1.95 ± 0.31 BW in pre-fatigue and 1.90 ± 0.31 BW in fatigue condition, p < 0.05), and higher peak propulsive forces in males (−0.26 ± 0.04 BW in pre-fatigue and −0.27 ± 0.05 BW in fatigue condition, p < 0.05) in the fatigue condition. It seems that better responses to impact under a fatigue condition are observed among women. Further studies should confirm whether these changes represent a strategy to optimize shock attenuation, prevent running injuries and improve running economy. PMID:29576960

  8. Effect of fatigue and gender on kinematics and ground reaction forces variables in recreational runners.

    PubMed

    Bazuelo-Ruiz, Bruno; Durá-Gil, Juan V; Palomares, Nicolás; Medina, Enrique; Llana-Belloch, Salvador

    2018-01-01

    The presence of fatigue has been shown to modify running biomechanics. Overall in terms of gender, women are at lower risk than men for sustaining running-related injuries, although it depends on the factors taken into account. One possible reason for these differences in the injury rate and location might be the dissimilar running patterns between men and women. The purpose of this study was to determine the effect of fatigue and gender on the kinematic and ground reaction forces (GRF) parameters in recreational runners. Fifty-seven participants (28 males and 29 females) had kinematic and GRF variables measured while running at speed of 3.3 m s -1 before and after a fatigue test protocol. The fatigue protocol included (1) a running Course-Navette test, (2) running up and down a flight of stairs for 5 min, and (3) performance of alternating jumps on a step (five sets of 1 minute each with 30 resting seconds between the sets). Fatigue decreased dorsiflexion (14.24 ± 4.98° in pre-fatigue and 12.65 ± 6.21° in fatigue condition, p  < 0.05) at foot strike phase in females, and plantar flexion (-19.23 ± 4.12° in pre-fatigue and -18.26 ± 5.31° in fatigue condition, p  < 0.05) at toe-off phase in males. These changes led to a decreased loading rate (88.14 ± 25.82 BW/s in pre-fatigue and 83.97 ± 18.83 BW/s in fatigue condition, p  < 0.05) and the impact peak in females (1.95 ± 0.31 BW in pre-fatigue and 1.90 ± 0.31 BW in fatigue condition, p  < 0.05), and higher peak propulsive forces in males (-0.26 ± 0.04 BW in pre-fatigue and -0.27 ± 0.05 BW in fatigue condition, p  < 0.05) in the fatigue condition. It seems that better responses to impact under a fatigue condition are observed among women. Further studies should confirm whether these changes represent a strategy to optimize shock attenuation, prevent running injuries and improve running economy.

  9. Patterns of morning and evening fatigue among adults with HIV/AIDS.

    PubMed

    Lerdal, Anners; Gay, Caryl L; Aouizerat, Bradley E; Portillo, Carmen J; Lee, Kathryn A

    2011-08-01

    Describe patterns of morning and evening fatigue in adults with HIV and examine their relationship to demographic and clinical factors and other symptoms. Most studies of HIV-related fatigue assess average levels of fatigue and do not address its diurnal fluctuations. Patterns of fatigue over the course of the day may have important implications for assessment and treatment. A cross-sectional, correlational design was used with six repeated measures over 72 hours. A convenience sample of 318 HIV-infected adults was recruited in San Francisco. Socio-demographic, clinical and symptom data were collected with questionnaires. CD4+ T-cell count and viral load were obtained from medical records. Participants completed a four-item version of the Lee Fatigue Scale each morning and evening for three consecutive days. Participants were grouped based on their diurnal pattern of fatigue (high evening only, high morning only, high morning and evening and low morning and evening). Group comparisons and logistic regression were used to determine the unique predictors of each fatigue pattern. The high evening fatigue pattern was associated with anxiety and the high morning pattern was associated with anxiety and depression. The morning fatigue pattern showed very little fluctuation between morning and evening, the evening pattern showed the largest fluctuation. The high morning and evening pattern was associated with anxiety, depression and sleep disturbance and this group reported the most fatigue-related distress and interference in functioning. These results provide initial evidence for the importance of assessing the patient's daily pattern of fatigue fluctuation, as different patterns were associated with different symptom experiences and perhaps different aetiologies. Different fatigue patterns may benefit from tailored intervention strategies. Management of depressive symptoms could be tested in patients who experience high levels of morning fatigue. © 2011 Blackwell Publishing Ltd.

  10. A Chronic Fatigue Syndrome (CFS) severity score based on case designation criteria

    PubMed Central

    Baraniuk, James N; Adewuyi, Oluwatoyin; Merck, Samantha Jean; Ali, Mushtaq; Ravindran, Murugan K; Timbol, Christian R; Rayhan, Rakib; Zheng, Yin; Le, Uyenphuong; Esteitie, Rania; Petrie, Kristina N

    2013-01-01

    Background: Chronic Fatigue Syndrome case designation criteria are scored as physicians’ subjective, nominal interpretations of patient fatigue, pain (headaches, myalgia, arthralgia, sore throat and lymph nodes), cognitive dysfunction, sleep and exertional exhaustion. Methods: Subjects self-reported symptoms using an anchored ordinal scale of 0 (no symptom), 1 (trivial complaints), 2 (mild), 3 (moderate), and 4 (severe). Fatigue of 3 or 4 distinguished “Fatigued” from “Not Fatigued” subjects. The sum of the 8(Sum8) ancillary criteria was tested as a proxy for fatigue. All subjects had history and physical examinations to exclude medical fatigue, and ensure categorization as healthy or CFS subjects. Results: Fatigued subjects were divided into CFS with ≥4 symptoms or Chronic Idiopathic Fatigue (CIF) with ≤3 symptoms. ROC of Sum8 for CFS and Not Fatigued subjects generated a threshold of 14 (specificity=0.934; sensitivity=0.928). CFS (n=256) and CIF (n=55) criteria were refined to include Sum8≥14 and ≤13, respectively. Not Fatigued subjects had highly skewed Sum8 responses. Healthy Controls (HC; n=269) were defined by fatigue≤2 and Sum8≤13. Those with Sum8≥14 were defined as CFS–Like With Insufficient Fatigue Syndrome (CFSLWIFS; n=20). Sum8 and Fatigue were highly correlated (R2=0.977; Cronbach’s alpha=0.924) indicating an intimate relationship between symptom constructs. Cluster analysis suggested 4 clades each in CFS and HC. Translational utility was inferred from the clustering of proteomics from cerebrospinal fluid. Conclusions: Plotting Fatigue severity versus Sum8 produced an internally consistent classifying system. This is a necessary step for translating symptom profiles into fatigue phenotypes and their pathophysiological mechanisms. PMID:23390566

  11. A comparison of patients with Q fever fatigue syndrome and patients with chronic fatigue syndrome with a focus on inflammatory markers and possible fatigue perpetuating cognitions and behaviour.

    PubMed

    Keijmel, Stephan P; Saxe, Johanna; van der Meer, Jos W M; Nikolaus, Stephanie; Netea, Mihai G; Bleijenberg, Gijs; Bleeker-Rovers, Chantal P; Knoop, Hans

    2015-10-01

    Comparison of Q fever fatigue syndrome (QFS) and chronic fatigue syndrome (CFS) patients, with a focus on markers of inflammation and fatigue-related cognitive-behavioural variables. Data from two independent prospective studies on QFS (n=117) and CFS (n=173), respectively, were pooled and analyzed. QFS patients were less often female, had a higher BMI, and had less often received treatment for depression before the onset of symptoms. After controlling for symptom duration and correcting for differences in diagnostic criteria for QFS and CFS with respect to the level of impairment and the presence of additional symptoms, differences in the proportion of females and BMI remained significant. After correction, QFS patients were also significantly older. In all analyses QFS patients were as fatigued and distressed as CFS patients, but reported less additional symptoms. QFS patients had stronger somatic attributions, and higher levels of physical activity. No differences were found with regard to inflammatory markers and in other fatigue-related cognitive-behavioural variables. The relationship between cognitive-behavioural variables and fatigue, previously established in CFS, could not be confirmed in QFS patients with the exception of the negative relationship between physical activity and fatigue. Differences and similarities between QFS and CFS patients were found. Although the relationship between perpetuating factors and fatigue previously established in CFS could not be confirmed in QFS patients, the considerable overlap in fatigue-related cognitive-behavioural variables and the relationship found between physical activity and fatigue may suggest that behavioural interventions could reduce fatigue severity in QFS patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Changes in the flexion relaxation response induced by lumbar muscle fatigue.

    PubMed

    Descarreaux, Martin; Lafond, Danik; Jeffrey-Gauthier, Renaud; Centomo, Hugo; Cantin, Vincent

    2008-01-24

    The flexion relaxation phenomenon (FRP) is an interesting model to study the modulation of lumbar stability. Previous investigations have explored the effect of load, angular velocity and posture on this particular response. However, the influence of muscular fatigue on FRP parameters has not been thoroughly examined. The objective of the study is to identify the effect of erector spinae (ES) muscle fatigue and spine loading on myoelectric silence onset and cessation in healthy individuals during a flexion-extension task. Twenty healthy subjects participated in this study and performed blocks of 3 complete trunk flexions under 4 different experimental conditions: no fatigue/no load (1), no fatigue/load (2), fatigue/no load(3), and fatigue/load (4). Fatigue was induced according to the Sorenson protocol, and electromyographic (EMG) power spectral analysis confirmed that muscular fatigue was adequate in each subject. Trunk and pelvis angles and surface EMG of the ES L2 and L5 were recorded during a flexion-extension task. Trunk flexion angle corresponding to the onset and cessation of myoelectric silence was then compared across the different experimental conditions using 2 x 2 repeated-measures ANOVA. Onset of myoelectric silence during the flexion motion appeared earlier after the fatigue task. Additionally, the cessation of myoelectric silence was observed later during the extension after the fatigue task. Statistical analysis also yielded a main effect of load, indicating a persistence of ES myoelectric activity in flexion during the load condition. The results of this study suggest that the presence of fatigue of the ES muscles modifies the FRP. Superficial back muscle fatigue seems to induce a shift in load-sharing towards passive stabilizing structures. The loss of muscle contribution together with or without laxity in the viscoelastic tissues may have a substantial impact on post fatigue stability.

  13. Fatigue is associated with inflammation in patients with head and neck cancer before and after intensity-modulated radiation therapy

    PubMed Central

    Beitler, Jonathan J.; Higgins, Kristin A.; Conneely, Karen; Dwivedi, Bhakti; Felger, Jennifer; Wommack, Evanthia C.; Shin, Dong M.; Saba, Nabil F.; Ong, Luke Yeeloo; Kowalski, Jeanne; Bruner, Deborah W.; Miller, Andrew H.

    2016-01-01

    Patients with head and neck cancer (HNC) receiving intensity-modulated radiation therapy (IMRT) have particularly high rates of fatigue, and pre- and post-radiotherapy fatigue are prognostic factors for pathologic tumor responses and poor survival. Although inflammation has been proposed as one of the potential mechanisms of fatigue in cancer patients, findings have not been consistent, and there is a dearth of longitudinal studies. Accordingly, we conducted a prospective study in 46 HNC patients pre- and one-month post-IMRT. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI)-20 at both time points along with the assessment of peripheral blood inflammatory markers including interleukin (IL)-6, soluble tumor necrosis factor receptor 2, and C-reactive protein (CRP) and gene expression. Generalized estimating equations were used to examine the association between inflammatory markers and fatigue. Gene enrichment analysis using MetaCore software was performed using up-regulated genes that were significantly associated with IMRT and fatigue. Significant associations between fatigue and IL-6 as well as CRP, which were independent of time, were observed. In addition the change in fatigue from pre- to post-IMRT was positively associated with the change in IL-6 and CRP. Analysis of up-regulated gene transcripts as a function of IMRT and fatigue revealed overrepresentation of transcripts related to the defense response and nuclear factor kappa B. In conclusion, our findings support the hypotheses that inflammation is associated with fatigue over time in HNC patients. Future studies on how inflammation contributes to fatigue as well as strategies targeting inflammation to reduce fatigue are warranted. PMID:26515035

  14. A Rasch Analysis of Assessments of Morning and Evening Fatigue in Oncology Patients Using the Lee Fatigue Scale.

    PubMed

    Lerdal, Anners; Kottorp, Anders; Gay, Caryl; Aouizerat, Bradley E; Lee, Kathryn A; Miaskowski, Christine

    2016-06-01

    To accurately investigate diurnal variations in fatigue, a measure needs to be psychometrically sound and demonstrate stable item function in relationship to time of day. Rasch analysis is a modern psychometric approach that can be used to evaluate these characteristics. To evaluate, using Rasch analysis, the psychometric properties of the Lee Fatigue Scale (LFS) in a sample of oncology patients. The sample comprised 587 patients (mean age 57.3 ± 11.9 years, 80% women) undergoing chemotherapy for breast, gastrointestinal, gynecological, or lung cancer. Patients completed the 13-item LFS within 30 minutes of awakening (i.e., morning fatigue) and before going to bed (i.e., evening fatigue). Rasch analysis was used to assess validity and reliability. In initial analyses of differential item function, eight of the 13 items functioned differently depending on whether the LFS was completed in the morning or in the evening. Subsequent analyses were conducted separately for the morning and evening fatigue assessments. Nine of the morning fatigue items and 10 of the evening fatigue items demonstrated acceptable goodness-of-fit to the Rasch model. Principal components analyses indicated that both morning and evening assessments demonstrated unidimensionality. Person-separation indices indicated that both morning and evening fatigue scales were able to distinguish four distinct strata of fatigue severity. Excluding four items from the morning fatigue scale and three items from the evening fatigue scale improved the psychometric properties of the LFS for assessing diurnal variations in fatigue severity in oncology patients. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  15. Prevalence and characteristics of moderate-to-severe fatigue: a multicenter study in cancer patients and survivors

    PubMed Central

    Wang, Xin Shelley; Zhao, Fengmin; Fisch, Michael J.; O’Mara, Ann M.; Cella, David; Mendoza, Tito R.; Cleeland, Charles S.

    2013-01-01

    PURPOSE Effective management of fatigue in cancer patients requires a clear delineation of what constitutes nontrivial fatigue. We defined numeric cutpoints for fatigue severity based on functional interference and described fatigue’s prevalence and characteristics in cancer patients and survivors. METHODS In a multicenter study, outpatients with breast, prostate, colorectal, or lung cancer rated fatigue severity and symptom interference with functioning on the M. D. Anderson Symptom Inventory (MDASI) 0–10 scale. MDASI ratings of symptom interference guided selection of numeric rating cutpoints between mild, moderate, and severe fatigue levels. Regression analysis identified significant factors related to reporting moderate/severe fatigue. RESULTS The statistically optimal cutpoints were ≥4 for moderate fatigue and ≥7 for severe fatigue. Moderate/severe fatigue was reported by 45% (983/2177) of patients undergoing active treatment and was more likely to occur in patients taking strong opioids (odds ratio [OR], 3.00), had poor performance status (OR, 2.00), had >5% weight loss within 6 months (OR, 1.60), were taking >10 medications (OR, 1.58), had lung cancer (OR, 1.55), or had a history of depression (OR, 1.42). Among survivors (patients with complete remission or no evidence of disease, and no current cancer treatment), 29% (150/515) had moderate/severe fatigue that was associated with poor performance status (OR, 3.48) and a history of depression (OR, 2.21). CONCLUSION This study statistically defined fatigue-severity categories related to significantly increased symptom interference. The high prevalence of moderate/severe fatigue in both actively treated cancer patients and survivors warrants the promoting of routine assessment and management of patient-reported fatigue. PMID:24436136

  16. The contribution of clinical and psychosocial factors to fatigue in 182 patients with inflammatory bowel disease: a cross-sectional study.

    PubMed

    Artom, M; Czuber-Dochan, W; Sturt, J; Murrells, T; Norton, C

    2017-02-01

    Fatigue is a frequently reported and predominant symptom experienced by patients with inflammatory bowel disease (IBD) and its impact has been associated with poorer quality of life (QoL). The complex interplay between disease-related variables and potentially modifiable psychosocial factors in IBD-fatigue has yet to be unravelled. To evaluate the contribution of clinical, sociodemographic and psychosocial factors to the severity and impact of IBD-fatigue and QoL. In a cross-sectional study, 182 patients with IBD were recruited from three tertiary referral hospitals' out-patient clinics in London. Fatigue was assessed utilising the Inflammatory Bowel Disease-Fatigue Scale (IBD-F), the Multidimensional Fatigue Inventory (MFI); and QoL by the Inflammatory Bowel Disease Questionnaire (IBDQ). Patients completed self-report questionnaires evaluating emotional, cognitive and behavioural factors potentially correlated with fatigue. Sociodemographic data were collected. Disease-related and laboratory data were retrieved from patients' hospital electronic medical records. In hierarchical regression models, disease activity was the only clinical factor consistently associated with severity and impact of fatigue and QoL (P = 0.01). More negative fatigue perceptions were significantly associated with greater IBD-F1 scores (P = 0.01). When controlling for clinical factors (disease activity and anti-TNF therapy), negative perceptions of fatigue, and all-or-nothing and avoidance behaviours explained an additional 41% of the variance in fatigue impact (IBD-F2). Apart from disease activity, emotional and behavioural factors and patients' negative fatigue perceptions may be key factors to be addressed. Further exploration of these factors in longitudinal and intervention studies may help to develop effective models of fatigue management. © 2016 John Wiley & Sons Ltd.

  17. Classifying Lower Extremity Muscle Fatigue during Walking using Machine Learning and Inertial Sensors

    PubMed Central

    Zhang, Jian; Lockhart, Thurmon E.; Soangra, Rahul

    2013-01-01

    Fatigue in lower extremity musculature is associated with decline in postural stability, motor performance and alters normal walking patterns in human subjects. Automated recognition of lower extremity muscle fatigue condition may be advantageous in early detection of fall and injury risks. Supervised machine learning methods such as Support Vector Machines (SVM) have been previously used for classifying healthy and pathological gait patterns and also for separating old and young gait patterns. In this study we explore the classification potential of SVM in recognition of gait patterns utilizing an inertial measurement unit associated with lower extremity muscular fatigue. Both kinematic and kinetic gait patterns of 17 participants (29±11 years) were recorded and analyzed in normal and fatigued state of walking. Lower extremities were fatigued by performance of a squatting exercise until the participants reached 60% of their baseline maximal voluntary exertion level. Feature selection methods were used to classify fatigue and no-fatigue conditions based on temporal and frequency information of the signals. Additionally, influences of three different kernel schemes (i.e., linear, polynomial, and radial basis function) were investigated for SVM classification. The results indicated that lower extremity muscle fatigue condition influenced gait and loading responses. In terms of the SVM classification results, an accuracy of 96% was reached in distinguishing the two gait patterns (fatigue and no-fatigue) within the same subject using the kinematic, time and frequency domain features. It is also found that linear kernel and RBF kernel were equally good to identify intra-individual fatigue characteristics. These results suggest that intra-subject fatigue classification using gait patterns from an inertial sensor holds considerable potential in identifying “at-risk” gait due to muscle fatigue. PMID:24081829

  18. Oxidative stress and fatigue in systemic lupus erythematosus.

    PubMed

    Segal, B M; Thomas, W; Zhu, X; Diebes, A; McElvain, G; Baechler, E; Gross, M

    2012-08-01

    The objective of this study is to investigate the relationship of oxidative stress to fatigue in systemic lupus erythematosus (SLE). Patients with a confirmed diagnosis of SLE by ACR criteria and healthy controls completed validated questionnaires to assess depression and fatigue. Fatigue was measured with the Fatigue Severity Scale (FSS) and the Profile of Fatigue (Prof-F). Visual analogue scales (VAS) were also used to assess fatigue and pain. Depression was measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Plasma F(2)-isoprostane was measured with gas chromatography/mass spectroscopy to assess oxidative stress. Evaluation included medical record review, physical exam and calculation of body mass index (BMI), disease activity (SLEDAI) and damage (SLICC) in the SLE patients. Seventy-one SLE patients with low disease activity (mean SLEDAI = 1.62 standard error (SE) 0.37, range 0-8) were compared to 51 controls. Fatigue-limiting physical activity (defined as FSS ≥ 4) was present in 56% of patients and 12% of controls. F(2)-isoprostane was higher in SLE patients with fatigue compared to not-fatigued SLE subjects (p = .0076) who were otherwise similar in ethnicity, disease activity and cardiovascular risk factors. Plasma F(2)-isoprostane was strongly correlated with FSS and Profile of Somatic Fatigue (Prof-S) (p < .0001), VAS fatigue (p = .005), CES-D (p = .008) and with BMI (p = .0001.) In a multivariate model, F(2)-isoprostane was a significant predictor of FSS after adjustment for age, BMI, pain and depression (p = .0002). Fatigue in SLE patients with low disease activity is associated with increased F(2)-isoprostane. F2-isoprostane could provide a useful biomarker to explore mitochondrial function and the regulation of oxidative pathways in patients with SLE in whom fatigue is a debilitating symptom.

  19. Comparisons of Damage Evolution between 2D C/SiC and SiC/SiC Ceramic-Matrix Composites under Tension-Tension Cyclic Fatigue Loading at Room and Elevated Temperatures

    PubMed Central

    Li, Longbiao

    2016-01-01

    In this paper, comparisons of damage evolution between 2D C/SiC and SiC/SiC ceramic-matrix composites (CMCs) under tension–tension cyclic fatigue loading at room and elevated temperatures have been investigated. Fatigue hysteresis loops models considering multiple matrix cracking modes in 2D CMCs have been developed based on the damage mechanism of fiber sliding relative to the matrix in the interface debonded region. The relationships between the fatigue hysteresis loops, fatigue hysteresis dissipated energy, fatigue peak stress, matrix multiple cracking modes, and interface shear stress have been established. The effects of fiber volume fraction, fatigue peak stress and matrix cracking mode proportion on fatigue hysteresis dissipated energy and interface debonding and sliding have been analyzed. The experimental fatigue hysteresis dissipated energy of 2D C/SiC and SiC/SiC composites at room temperature, 550 °C, 800 °C, and 1100 °C in air, and 1200 °C in vacuum corresponding to different fatigue peak stresses and cycle numbers have been analyzed. The interface shear stress degradation rate has been obtained through comparing the experimental fatigue hysteresis dissipated energy with theoretical values. Fatigue damage evolution in C/SiC and SiC/SiC composites has been compared using damage parameters of fatigue hysteresis dissipated energy and interface shear stress degradation rate. It was found that the interface shear stress degradation rate increases at elevated temperature in air compared with that at room temperature, decreases with increasing loading frequency at room temperature, and increases with increasing fatigue peak stress at room and elevated temperatures. PMID:28773966

  20. The extent of using mobility assistive devices can partly explain fatigue among persons with late effects of polio - a retrospective registry study in Sweden.

    PubMed

    Santos Tavares Silva, I; Sunnerhagen, K S; Willén, C; Ottenvall Hammar, I

    2016-11-18

    Fatigue is reported as one of the most disabling symptoms and is common among persons living with late effects of polio. Although fatigue has been studied in the context of people living with late effects of polio, there is a lack of knowledge concerning the association of fatigue and variables of importance for participation in daily life. Therefore, the aim of this study was to explore possible factors associated with fatigue among persons with late effects of polio in Sweden. This retrospective registry study consisted of 89 persons with late effects of polio living in Sweden. Fatigue was measured with the Multidimensional Fatigue Inventory (MFI-20) scale, Swedish version. Pearson's correlation coefficient was used to analyse the correlation between the factors and fatigue, and a multiple linear regression was carried out to explore factors for fatigue. Fatigue statistically significantly correlated with age (r = 0.234, p < 0.05) and the use of mobility assistive devices (r = 0.255, p < 0.05). The multiple linear regression model showed that the factors age (β = 0.304, p < 0.019) and mobility assistive devices (β = 0.262, p < 0.017) were associated with fatigue among persons living with late effects of polio, and the model partly explained 14% of the variation of fatigue. Fatigue could partly be explained by the extent of using mobility assistive devices and age. Healthcare professionals should provide and demonstrate the importance of assistive devices to ensure management of fatigue in persons living with late effects of polio.

  1. Fatigue in the Presence of Corrosion (Fatigue sous corrosion)

    DTIC Science & Technology

    1999-03-01

    Fatigue Crack Growth Propagation of Aluminum Lithium cycle managers to safely delay repairs to a more appropriate Alloys " described the effect of... effects of service corrosion on fatigue lab tests with 2024 -T3, because 7178 life , if any, can be established in this was not available. However, we did not... life and the fatigue crack growth behavior of the cases where a structural member is the 2024 alloy was studied as well. stressed or fatigued

  2. Shift work and employee fatigue: implications for occupational health nursing.

    PubMed

    Yumang-Ross, Doreen J; Burns, Candace

    2014-06-01

    Long work hours and irregular shifts are part of the nation's 24-hour society and contribute to employee fatigue. Factors affecting employee fatigue are circadian rhythm, sleep quality and quantity, individual health, the environment, and work tasks. Employee fatigue contributes to accidents and injuries, and affects occupational performance, safety, and health. These findings should be used by occupational health nurses to address fatigue management and develop comprehensive fatigue management programs. Copyright 2014, SLACK Incorporated.

  3. Recent Developments in Assessing Microstructure-Sensitive Early Stage Fatigue of Polycrystals (Postprint)

    DTIC Science & Technology

    2014-04-01

    can strongly affect formation of fatigue cracks. El Bartali et al. [7] quantified plastic strain at the grain scale in a duplex stainless steel and mea... Fatigue Fract Eng Mater Struct 2013. [7] El Bartali A, Aubin V, Degallaix S. Fatigue damage analysis in a duplex stainless steel by digital image...S. Surface observation and measurement techniques to study the fatigue damage micromechanisms in a duplex stainless steel . Int J Fatigue 2009;31:2049

  4. Fatigue and physical fitness of mildly disabled persons with multiple sclerosis: a cross-sectional study.

    PubMed

    Valet, Maxime; Lejeune, Thierry; Glibert, Yumiko; Hakizimana, Jean C; Van Pesch, Vincent; El Sankari, Souraya; Detrembleur, Christine; Stoquart, Gaëtan

    2017-09-01

    Fatigue is frequent and disabling in persons with multiple sclerosis (pwMS) with mild neurological disability. These patients also have impaired physical fitness. Whether mildly disabled pwMS are deconditioned, and this deconditioning is linked to fatigue, remains unknown. Our aim is to determine the physical fitness of mildly disabled patients with multiple sclerosis and study its relationship with perceived fatigue and to link perceived fatigue with other parameters. Twenty patients (14 women; mean age: 45.5 years) with mild disability (Expanded Disability Status Scale 0-4) underwent a 2-min walking test, Timed Up-and-Go test, aerobic capacity testing, and isometric knee extension testing to assess strength and neuromuscular fatigability. They completed questionnaires assessing perceived fatigue, psychological status, and physical activity. Correlation coefficients and multivariate regression were used to analyze the relationships among variables. Seventeen (85%) patients reported a high level of fatigue. Thirteen (65%) patients had subnormal aerobic capacity. Fatigue was weakly to moderately associated with aerobic capacity, mobility, walking capacity, depression, and neuromuscular fatigability. An association of disease duration, aerobic capacity, and the neuromuscular fatigability index explained 65.1% of fatigue. A high proportion of pwMS with mild neurological disability are fatigued and deconditioned. Perceived fatigue is linked to aerobic capacity, neuromuscular fatigability, depression, mobility, and walking capacity. Focusing on these parameters could help in the management of fatigue.

  5. Analysis of cancer-related fatigue based on smart bracelet devices.

    PubMed

    Shen, Hong; Hou, Honglun; Tian, Wei; Wu, MingHui; Chen, Tianzhou; Zhong, Xian

    2016-01-01

    Fatigue is the most common symptom associated with cancer and its treatment, and profoundly affects all aspects of quality of life for cancer patients. It is very important to measure and manage cancer-related fatigue. Usually, the cancer-related fatigue scores, which estimate the degree of fatigue, are self-reported by cancer patients using standardized assessment tools. But most of the classical methods used for measurement of fatigue are subjective and inconvenient. In this study, we try to establish a new method to assess cancer-related fatigue objectively and accurately by using smart bracelet. All patients with metastatic pancreatic cancer wore smart bracelet for recording the physical activity including step count and sleep time before and after chemotherapy. Meantime, their psychological state was assessed by completing questionnaire tables as cancer-related fatigue scores. Step count record by smart bracelet reflecting the physical performance dramatically decreased in the initial days of chemotherapy and recovered in the next few days. Statistical analysis showed a strong and significant correlation between self-reported cancer-related fatigue and physical performance (P= 0.000, r=-0.929). Sleep time was also significantly correlated with fatigue (P= 0.000, r= 0.723). Multiple regression analysis showed that physical performance and sleep time are significant predictors of fatigue. Measuring activity using smart bracelets may be an appropriate method for quantitative and objective measurement of cancer-related fatigue by using smart bracelet devices.

  6. Probabilistic Flexural Fatigue in Plain and Fiber-Reinforced Concrete

    PubMed Central

    Ríos, José D.

    2017-01-01

    The objective of this work is two-fold. First, we attempt to fit the experimental data on the flexural fatigue of plain and fiber-reinforced concrete with a probabilistic model (Saucedo, Yu, Medeiros, Zhang and Ruiz, Int. J. Fatigue, 2013, 48, 308–318). This model was validated for compressive fatigue at various loading frequencies, but not for flexural fatigue. Since the model is probabilistic, it is not necessarily related to the specific mechanism of fatigue damage, but rather generically explains the fatigue distribution in concrete (plain or reinforced with fibers) for damage under compression, tension or flexion. In this work, more than 100 series of flexural fatigue tests in the literature are fit with excellent results. Since the distribution of monotonic tests was not available in the majority of cases, a two-step procedure is established to estimate the model parameters based solely on fatigue tests. The coefficient of regression was more than 0.90 except for particular cases where not all tests were strictly performed under the same loading conditions, which confirms the applicability of the model to flexural fatigue data analysis. Moreover, the model parameters are closely related to fatigue performance, which demonstrates the predictive capacity of the model. For instance, the scale parameter is related to flexural strength, which improves with the addition of fibers. Similarly, fiber increases the scattering of fatigue life, which is reflected by the decreasing shape parameter. PMID:28773123

  7. Probabilistic Flexural Fatigue in Plain and Fiber-Reinforced Concrete.

    PubMed

    Ríos, José D; Cifuentes, Héctor; Yu, Rena C; Ruiz, Gonzalo

    2017-07-07

    The objective of this work is two-fold. First, we attempt to fit the experimental data on the flexural fatigue of plain and fiber-reinforced concrete with a probabilistic model (Saucedo, Yu, Medeiros, Zhang and Ruiz, Int. J. Fatigue, 2013, 48, 308-318). This model was validated for compressive fatigue at various loading frequencies, but not for flexural fatigue. Since the model is probabilistic, it is not necessarily related to the specific mechanism of fatigue damage, but rather generically explains the fatigue distribution in concrete (plain or reinforced with fibers) for damage under compression, tension or flexion. In this work, more than 100 series of flexural fatigue tests in the literature are fit with excellent results. Since the distribution of monotonic tests was not available in the majority of cases, a two-step procedure is established to estimate the model parameters based solely on fatigue tests. The coefficient of regression was more than 0.90 except for particular cases where not all tests were strictly performed under the same loading conditions, which confirms the applicability of the model to flexural fatigue data analysis. Moreover, the model parameters are closely related to fatigue performance, which demonstrates the predictive capacity of the model. For instance, the scale parameter is related to flexural strength, which improves with the addition of fibers. Similarly, fiber increases the scattering of fatigue life, which is reflected by the decreasing shape parameter.

  8. Is the notion of central fatigue based on a solid foundation?

    PubMed

    Contessa, Paola; Puleo, Alessio; De Luca, Carlo J

    2016-02-01

    Exercise-induced muscle fatigue has been shown to be the consequence of peripheral factors that impair muscle fiber contractile mechanisms. Central factors arising within the central nervous system have also been hypothesized to induce muscle fatigue, but no direct empirical evidence that is causally associated to reduction of muscle force-generating capability has yet been reported. We developed a simulation model to investigate whether peripheral factors of muscle fatigue are sufficient to explain the muscle force behavior observed during empirical studies of fatiguing voluntary contractions, which is commonly attributed to central factors. Peripheral factors of muscle fatigue were included in the model as a time-dependent decrease in the amplitude of the motor unit force twitches. Our simulation study indicated that the force behavior commonly attributed to central fatigue could be explained solely by peripheral factors during simulated fatiguing submaximal voluntary contractions. It also revealed important flaws regarding the use of the interpolated twitch response from electrical stimulation of the muscle as a means for assessing central fatigue. Our analysis does not directly refute the concept of central fatigue. However, it raises important concerns about the manner in which it is measured and about the interpretation of the commonly accepted causes of central fatigue and questions the very need for the existence of central fatigue. Copyright © 2016 the American Physiological Society.

  9. Effects of Relaxing Music on Mental Fatigue Induced by a Continuous Performance Task: Behavioral and ERPs Evidence.

    PubMed

    Guo, Wei; Ren, Jie; Wang, Biye; Zhu, Qin

    2015-01-01

    The purpose of this study was to investigate whether listening to relaxing music would help reduce mental fatigue and to maintain performance after a continuous performance task. The experiment involved two fatigue evaluation phases carried out before and after a fatigue inducing phase. A 1-hour AX-continuous performance test was used to induce mental fatigue in the fatigue-inducing phase, and participants' subjective evaluation on the mental fatigue, as well as their neurobehavioral performance in a Go/NoGo task, were measured before and after the fatigue-inducing phase. A total of 36 undergraduate students (18-22 years) participated in the study and were randomly assigned to the music group and control group. The music group performed the fatigue-inducing task while listening to relaxing music, and the control group performed the same task without any music. Our results revealed that after the fatigue-inducing phase, (a) the music group demonstrated significantly less mental fatigue than control group, (b) reaction time significantly increased for the control group but not for the music group, (c) larger Go-P3 and NoGo-P3 amplitudes were observed in the music group, although larger NoGo-N2 amplitudes were detected for both groups. These results combined to suggest that listening to relaxing music alleviated the mental fatigue associated with performing an enduring cognitive-motor task.

  10. High-Cycle Fatigue of High-Strength Low Alloy Steel Q345 Subjected to Immersion Corrosion for Mining Wheel Applications

    NASA Astrophysics Data System (ADS)

    Dicecco, Sante; Altenhof, William; Hu, Henry; Banting, Richard

    2017-04-01

    In an effort to better understand the impact of material degradation on the fatigue life of mining wheels made of a high-strength low alloy carbon steel (Q345), this study seeks to evaluate the effect of surface corrosion on the high-cycle fatigue behavior of the Q345 alloy. The fatigue behavior of the polished and corroded alloy was investigated. Following exposure to a 3.5 wt.% NaCl saltwater solution, polished and corroded fatigue specimens were tested using an R.R. Moore rotating-bending fatigue apparatus. Microstructural analyses via both optical microscopy and scanning electron microscopy (SEM) revealed that one major phase, α-iron phase, ferrite, and one minor phase, colony pearlite, existed in the extracted Q345 alloy. The results of the fatigue testing showed that the polished and corroded specimens had an endurance strength of approximately 295 and 222 MPa, respectively, at 5,000,000 cycles. The corroded surface condition resulted in a decrease in the fatigue strength of the Q345 alloy by 24.6%. Scanning electron microscope fractography indicated that failure modes for polished and corroded fatigue specimens were consistent in the high-cycle low loading fatigue regime. Conversely, SEM fractography of low-cycle high-loading fatigue specimens found considerable differences in fracture surfaces between the corroded and polished fatigue specimens.

  11. Fatigue Properties of the Ultra-High Strength Steel TM210A

    PubMed Central

    Kang, Xia; Zhao, Gui-ping

    2017-01-01

    This paper presents the results of an experiment to investigate the high cycle fatigue properties of the ultra-high strength steel TM210A. A constant amplitude rotating bending fatigue experiment was performed at room temperature at stress ratio R = −1. In order to evaluate the notch effect, the fatigue experiment was carried out upon two sets of specimens, smooth and notched, respectively. In the experiment, the rotating bending fatigue life was tested using the group method, and the rotating bending fatigue limit was tested using the staircase method at 1 × 107 cycles. A double weighted least square method was then used to fit the stress-life (S–N) curve. The S–N curves of the two sets of specimens were obtained and the morphologies of the fractures of the two sets of specimens were observed with scanning electron microscopy (SEM). The results showed that the fatigue limit of the smooth specimen for rotating bending fatigue was 615 MPa; the ratio of the fatigue limit to tensile strength was 0.29, and the cracks initiated at the surface of the smooth specimen; while the fatigue limit of the notched specimen for rotating bending fatigue was 363 MPa, and the cracks initiated at the edge of the notch. The fatigue notch sensitivity index of the ultra-high strength maraging steel TM210A was 0.69. PMID:28891934

  12. Fatigue Following Traumatic Brain Injury in Children and Adolescents: A Longitudinal Follow-Up 6 to 12 Months After Injury.

    PubMed

    Crichton, Alison; Anderson, Vicki; Oakley, Ed; Greenham, Mardee; Hearps, Stephen; Delzoppo, Carmel; Beauchamp, Miriam H; Hutchison, James S; Guerguerian, Anne-Marie; Boutis, Kathy; Babl, Franz E

    Longitudinal fatigue data in children suffering from traumatic brain injury (TBI) are lacking. To examine the effects of time postinjury (6-12 months) and injury severity on fatigue after childhood TBI. Secondarily, we compared fatigue 12 months postinjury against published control data. Three tertiary children's hospitals across Australia (n = 1) and Canada (n = 2). Parents (n = 109) of children (mean [M] = 9.9 years at injury; range, 1.0-16.9 years) admitted to one of 3 participating hospitals with mild (n = 69) or moderate/severe (n = 37) TBI. Longitudinal prospective study. Primary: Pediatric Quality of Life Multidimensional Fatigue Scale (total, general, sleep/rest, and cognitive), rated by parents 6 and 12 months postinjury. Secondary: Pediatric Injury Functional Outcome Scale (fatigue and sleep items, rated on recruitment and 6 and 12 months postinjury). Demographic and children data were collected at recruitment. Mixed-models analysis demonstrated nonsignificant effects of time (6 vs 12 months postinjury) on multidimensional fatigue scores. Cognitive fatigue worsened over time. Moderate/severe TBI was associated with worse fatigue 12 months postinjury (general, P = .03; cognitive, P = .02). Across all severities, fatigue 12 months postinjury was significantly worse compared with control data (total fatigue, P < .001; all domains, all Ps < .025). Fatigue remains significant at 12 months since injury, particularly for those with moderate/severe TBI.

  13. Influence of stress systems and physical activity on different dimensions of fatigue in female fibromyalgia patients.

    PubMed

    Doerr, Johanna M; Fischer, Susanne; Nater, Urs M; Strahler, Jana

    2017-02-01

    Fatigue is a defining characteristic and one of the most debilitating features of fibromyalgia syndrome (FMS). The mechanisms underlying different dimensions of fatigue in FMS remain unclear. The aim of the current study was to test whether stress-related biological processes and physical activity modulate fatigue experience. Using an ambulatory assessment design, 26 female FMS patients reported general, mental, and physical fatigue levels at six time points per day for 14 consecutive days. Salivary cortisol and alpha-amylase were analyzed as markers of neuroendocrine functioning. Participants wore wrist actigraphs for the assessment of physical activity. Lower increases in cortisol after awakening predicted higher mean daily general and physical fatigue levels. Additionally, mean daily physical activity positively predicted next-day mean general fatigue. Levels of physical fatigue at a specific time point were positively associated with momentary cortisol levels. The increase in cortisol after awakening did not mediate the physical activity - fatigue relationship. There were no associations between alpha-amylase and fatigue. Our findings imply that both changes in hypothalamic-pituitary-adrenal axis activity and physical activity contribute to variance in fatigue in the daily lives of patients with FMS. This study helps to paint a clearer picture of the biological and behavioral underpinnings of fatigue in FMS and highlight the necessity of interdisciplinary treatment approaches targeting biological, behavioral and psychological aspects of FMS. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. What paramedics think about when they think about fatigue: contributing factors.

    PubMed

    Paterson, Jessica L; Sofianopoulos, Sarah; Williams, Brett

    2014-04-01

    Paramedic fatigue is associated with burnout, attrition, sick leave, work disability, physical and mental health complaints and impaired performance. However, no studies have addressed how fatigue is understood by paramedics. The present study addresses this shortcoming by exploring factors paramedics recognise as contributors to fatigue. Forty-nine (12F; 38 years ± 9.7 years) Australian paramedics completed a survey on perceived causes of performance impairing fatigue. A total of 107 responses were systematically coded following principles common to qualitative data analysis: data immersion, coding, categorisation and theme generation. Six themes emerged: working time, sleep, workload, health and well-being, work-life balance and environment. Consistent with a scientific understanding of fatigue, prior sleep and wake, time of day and task-related factors were often identified as contributing to fatigue. In other cases, paramedics' attributions deviated from a scientific understanding of direct causes of fatigue. These findings demonstrate that paramedics have a broad understanding of fatigue. It is critical to take this into account when discussing fatigue with paramedics, particularly in the case of fatigue education or wellness programmes. These data highlight areas for intervention and education to minimise the experience of paramedic fatigue and the negative health and safety outcomes for paramedics and patients as a result. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  15. Donepezil for cancer fatigue: a double-blind, randomized, placebo-controlled trial.

    PubMed

    Bruera, Eduardo; El Osta, Badi; Valero, Vicente; Driver, Larry C; Pei, Be-Lian; Shen, Loren; Poulter, Valerie A; Palmer, J Lynn

    2007-08-10

    To evaluate the effectiveness of donepezil compared with placebo in cancer patients with fatigue as measured by the Functional Assessment for Chronic Illness Therapy-Fatigue (FACIT-F). Patients with fatigue score >or= 4 on a scale of 0 to 10 (0 = no fatigue, 10 = worst possible fatigue) for more than 1 week were included. Patients were randomly assigned to receive donepezil 5 mg or placebo orally every morning for 7 days. A research nurse contacted the patients by telephone daily to assess toxicity and fatigue level. All patients were offered open-label donepezil during the second week. FACIT-F and/or the Edmonton Symptom Assessment System (ESAS) were assessed at baseline, and days 8, 11, and 15. The FACIT-F fatigue subscale score on day 8 was considered the primary end point. Of 142 patients randomly assigned to treatment, 47 patients in the donepezil group and 56 in the placebo group were assessable for final analysis. Fatigue intensity improved significantly on day 8 in both donepezil and placebo groups. However, there was no significant difference in fatigue improvement by FACIT-F (P = .57) or ESAS (P = .18) between groups. In the open-label phase, fatigue intensity continued to be low as compared with baseline. No significant toxicities were observed. Donepezil was not significantly superior to placebo in the treatment of cancer-related fatigue.

  16. Experiences and management of fatigue in everyday life among adult patients living with heart failure: a systematic review of qualitative evidence.

    PubMed

    Schjoedt, Inge; Sommer, Irene; Bjerrum, Merete Bender

    2016-03-01

    Fatigue, a common and distressing symptom of heart failure, is a non-specific, invisible and subjective experience, which is difficult to describe and for which there are no effective interventions. Fatigue negatively impacts on patients' everyday life, prognosis and quality of life, therefore it is important that patients can manage, monitor and respond to changes in fatigue. To cope with fatigue patients may need or seek advice on self-management strategies. To synthesize the best available evidence on the experiences and management of fatigue in everyday life among adult patients with stable heart failure. Adults with confirmed and stable heart failure. Studies exploring the experiences and management of fatigue in everyday life among adults with heart failure. Qualitative studies focusing on qualitative data, including, but not limited to, designs within phenomenology, grounded theory or ethnography. A three-step search strategy was used to identify published and unpublished qualitative studies from 1995 to 2014. Studies that met the inclusion criteria were assessed by two independent reviewers for methodological validity using the standardized critical appraisal tools of the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data was extracted from the five included studies using JBI-QARI. Findings were identified and arranged according to the three research questions: patients' experiences of fatigue, impact of fatigue on everyday life and how patients' managed fatigue and its consequences in everyday life. Findings were pooled using JBI-QARI. From the five included studies, 108 findings were derived and subsequently aggregated into 24 categories, which were finally meta-synthesized into five syntheses: "A pervasive and unignorable bodily experience" captured the patients' descriptions of fatigue experiences; "Limited performance of daily living and social activities" and "Loss of self-esteem, identity and intellectual function" aggregated the impact of fatigue on patients' everyday life; "Using protecting and restoring strategies according to the body barometer" and "A dynamic balance between accepting and struggling against fatigue" captured how patients managed fatigue and its consequences. Three different types of bodily fatigue challenge patients with heart failure. Decreased physical capacity, unpredictability and fluctuating intensity are dominant features of fatigue experiences, which cause limitations in performing daily and social activities, increased dependency of others, and loss of self-esteem, identity and intellectual function. Patients' management of fatigue and its consequences is an ongoing process involving use of protective and restorative activities to handle the specific bodily fatigue. However it also relates to living constructively with fatigue by striking a balance between adjusting to and struggling against fatigue. Healthcare providers should be accountable to their patients, recognizing and taking into consideration patients' fatigue experiences and the meaning of fatigue, in order to provide optimal and individual care to their patients. Further qualitative research is needed to consider cultural factors of importance for managing fatigue in everyday life among patients with heart failure. Furthermore research should explore and test different kinds of physical and mind-body activities on the patients' functional capacity and wellbeing.

  17. 38 CFR 4.88a - Chronic fatigue syndrome.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Chronic fatigue syndrome... Deficiencies § 4.88a Chronic fatigue syndrome. (a) For VA purposes, the diagnosis of chronic fatigue syndrome requires: (1) new onset of debilitating fatigue severe enough to reduce daily activity to less than 50...

  18. 38 CFR 4.88a - Chronic fatigue syndrome.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Chronic fatigue syndrome... Deficiencies § 4.88a Chronic fatigue syndrome. (a) For VA purposes, the diagnosis of chronic fatigue syndrome requires: (1) new onset of debilitating fatigue severe enough to reduce daily activity to less than 50...

  19. 38 CFR 4.88a - Chronic fatigue syndrome.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Chronic fatigue syndrome... Deficiencies § 4.88a Chronic fatigue syndrome. (a) For VA purposes, the diagnosis of chronic fatigue syndrome requires: (1) new onset of debilitating fatigue severe enough to reduce daily activity to less than 50...

  20. Fatigue and gynecologic cancer.

    PubMed

    Olt, George J

    2003-02-01

    Fatigue is common in women with gynecologic cancers and is thought to be multifactorial. Anemia, cachexia, pain, and depression are frequently associated with cancer and treatment-related fatigue and should be evaluated and treated. The National Comprehensive Cancer Network Fatigue Practice Guidelines are helpful in the assessment and treatment of women with gynecologic cancer-related fatigue.

  1. Is Fatigue a Common Crohn's Disease Symptom? What Can Be Done about It?

    MedlinePlus

    ... to fatigue — either directly or by interfering with sleep. Seek psychological therapy. Consider talking to a doctor or a counselor about ways to manage fatigue and other psychological factors that can impact fatigue, ... foods and get adequate sleep. Be sure to share your concerns about fatigue ...

  2. Microstructure-Sensitive Modeling of High Cycle Fatigue (Preprint)

    DTIC Science & Technology

    2009-03-01

    SUBJECT TERMS microplasticity , microstructure-sensitive modeling, high cycle fatigue, fatigue variability 16. SECURITY CLASSIFICATION OF: 17...3Air Force Research Laboratory Wright Patterson Air Force Base, Ohio 45433 Keywords: Microplasticity , microstructure-sensitive modeling, high cycle...cyclic microplasticity ) plays a key role in modeling fatigue resistance. Unlike effective properties such as elastic stiffness, fatigue is

  3. Experimental study on visual detection for fatigue of fixed-position staff.

    PubMed

    Nie, Baisheng; Huang, Xin; Chen, Yang; Li, Anjin; Zhang, Ruming; Huang, Jinxin

    2017-11-01

    Fatigue can lead to decreased work performance and poorer safety and health condition. Fatigue is ubiquitous in production and in life, while the research on it is mainly concentrated in the automotive driving, aircraft piloting and other fields, and it is insufficient to study on the fatigue of fixed-position staff. This paper puts forward a non-contact visual image method, which can monitor the extent of fatigue of fixed-position staff. Fatigue threshold used in judgment is obtained by processing the recorded data of visual images of the experimental subjects when fatiguing and by analyzing eye closure time, percentage of eyelid closure (PERCLOS) value, frequency and number of blinks. The results show that there is significant difference among the four indicators before and after experiment subjects undergo fatigue. The fatigue of experimental subjects is obvious when eye closure time is 3.5 s/min, PERCLOS value 6%, and blink frequency 0.4 times/s. This provides a reference for a wider range of detection of fatigue and a method for avoiding mistakes and accidents. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Experimental and modeling results of creep fatigue life of Inconel 617 and Haynes 230 at 850 C

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chen, Xiang; Sokolov, Mikhail A; Sham, Sam

    Creep fatigue testing of Ni-based superalloy Inconel 617 and Haynes 230 were conducted in the air at 850 C. Tests were performed with fully reversed axial strain control at a total strain range of 0.5%, 1.0% or 1.5% and hold time at maximum tensile strain for 3, 10 or 30 min. In addition, two creep fatigue life prediction methods, i.e. linear damage summation and frequency-modified tensile hysteresis energy modeling, were evaluated and compared with experimental results. Under all creep fatigue tests, Haynes 230 performed better than Inconel 617. Compared to the low cycle fatigue life, the cycles to failure formore » both materials decreased under creep fatigue test conditions. Longer hold time at maximum tensile strain would cause a further reduction in both material creep fatigue life. The linear damage summation could predict the creep fatigue life of Inconel 617 for limited test conditions, but considerably underestimated the creep fatigue life of Haynes 230. In contrast, frequency-modified tensile hysteresis energy modeling showed promising creep fatigue life prediction results for both materials.« less

  5. Experimental Study on Fatigue Performance of Foamed Lightweight Soil

    NASA Astrophysics Data System (ADS)

    Qiu, Youqiang; Yang, Ping; Li, Yongliang; Zhang, Liujun

    2017-12-01

    In order to study fatigue performance of foamed lightweight soil and forecast its fatigue life in the supporting project, on the base of preliminary tests, beam fatigue tests on foamed lightweight soil is conducted by using UTM-100 test system. Based on Weibull distribution and lognormal distribution, using the mathematical statistics method, fatigue equations of foamed lightweight soil are obtained. At the same time, according to the traffic load on real road surface of the supporting project, fatigue life of formed lightweight soil is analyzed and compared with the cumulative equivalent axle loads during the design period of the pavement. The results show that even the fatigue life of foamed lightweight soil has discrete property, the linear relationship between logarithmic fatigue life and stress ratio still performs well. Especially, the fatigue life of Weibull distribution is more close to that derived from the lognormal distribution, in the instance of 50% guarantee ratio. In addition, the results demonstrated that foamed lightweight soil as subgrade filler has good anti-fatigue performance, which can be further adopted by other projects in the similar research domain.

  6. Risk factors for fatigue in patients with epilepsy.

    PubMed

    Yan, Song; Wu, Yuanbin; Deng, Yanchun; Liu, Yonghong; Zhao, Jingjing; Ma, Lei

    2016-11-01

    Fatigue is highly prevalent in patients with epilepsy and has a major impact on quality of life, but little data is available on its effects and management in epilepsy. To identify the incidence and risk factors of fatigue in patients with epilepsy, 105 epilepsy patients (45 women and 60 men) were enrolled in our study. Demographic and clinical data were collected and psychological variables including fatigue, sleep quality, excess daytime sleepiness, anxiety, and depression were measured by Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale, respectively. Of 105 patients, 29.5% exhibited fatigue (FSS score ⩾4). We found no correlation between the occurrence of fatigue and any of our demographic or clinical variables. Fatigue is correlated with low sleep quality, anxiety, and depression, but not with excess daytime sleepiness. Thus, we concluded that fatigue is highly prevalent in patients with epilepsy, and that low sleep quality, anxiety, and depression are significantly correlated with fatigue in epileptics, while excess daytime sleepiness not. Copyright © 2016. Published by Elsevier Ltd.

  7. Evaluation of fatigue life of CRM-reinforced SMA and its relationship to dynamic stiffness.

    PubMed

    Mashaan, Nuha Salim; Karim, Mohamed Rehan; Abdel Aziz, Mahrez; Ibrahim, Mohd Rasdan; Katman, Herda Yati; Koting, Suhana

    2014-01-01

    Fatigue cracking is an essential problem of asphalt concrete that contributes to pavement damage. Although stone matrix asphalt (SMA) has significantly provided resistance to rutting failure, its resistance to fatigue failure is yet to be fully addressed. The aim of this study is to evaluate the effect of crumb rubber modifier (CRM) on stiffness and fatigue properties of SMA mixtures at optimum binder content, using four different modification levels, namely, 6%, 8%, 10%, and 12% CRM by weight of the bitumen. The testing undertaken on the asphalt mix comprises the dynamic stiffness (indirect tensile test), dynamic creep (repeated load creep), and fatigue test (indirect tensile fatigue test) at temperature of 25°C. The indirect tensile fatigue test was conducted at three different stress levels (200, 300, and 400 kPa). Experimental results indicate that CRM-reinforced SMA mixtures exhibit significantly higher fatigue life compared to the mixtures without CRM. Further, higher correlation coefficient was obtained between the fatigue life and resilient modulus as compared to permanent strain; thus resilient modulus might be a more reliable indicator in evaluating the fatigue life of asphalt mixture.

  8. Fatigue behavior of a 2XXX series aluminum alloy reinforced with 15 vol Pct SiCp

    NASA Astrophysics Data System (ADS)

    Bonnen, J. J.; Allison, J. E.; Jones, J. W.

    1991-05-01

    The fatigue behavior of a naturally aged powder metallurgy 2xxx series aluminum alloy (Alcoa MB85) and a composite made of this alloy with 15 vol pct SiCp, has been investigated. Fatigue lives were determined using load-controlled axial testing of unnotched cylindrical samples. The influence of mean stress was determined at stress ratios of -1, 0.1, and 0.7. Mean stress had a significant influence on fatigue life, and this influence was consistent with that normally observed in metals. At each stress ratio, the incorporation of SiC reinforcement led to an increase in fatigue life at low and intermediate stresses. When considered on a strain-life basis, however, the composite materials had a somewhat inferior resistance to fatigue. Fatigue cracks initiated from several different microstructural features or defect types, but fatigue life did not vary significantly with the specific initiation site. As the fatigue crack advanced away from the fatigue crack initiation site, increasing numbers of SiC particles were fractured, in agreement with crack-tip process zone models.

  9. Fatigue in Intensive Care Nurses and Related Factors.

    PubMed

    Çelik, Sevim; Taşdemir, Nurten; Kurt, Aylin; İlgezdi, Ebru; Kubalas, Özge

    2017-10-01

    Fatigue negatively affects the performance of intensive care nurses. Factors contributing to the fatigue experienced by nurses include lifestyle, psychological status, work organization and sleep problems. To determine the level of fatigue among nurses working in intensive care units and the related factors. This descriptive study was conducted with 102 nurses working in intensive care units in the West Black Sea Region of Turkey. Data were collected between February and May 2014 using a personal information form, the Visual Analogue Scale for Fatigue (VAS-F), the Hospital Anxiety and Depression Scale and the Pittsburg Sleep Quality Index. The intensive care nurses in the study were found to be experiencing fatigue. Significant correlations were observed between scores on the VAS-F Fatigue and anxiety (p=0.01), depression (p=0.002), and sleep quality (p<0.001). Anxiety, depression and quality of sleep were significantly affected by the intensive care nurses' levels of fatigue. These results can be of benefit in taking measures which may be used to reduce fatigue in nurses, especially the fatigue related to work organization and social life.

  10. Fatigue crack initiation of magnesium alloys under elastic stress amplitudes: A review

    NASA Astrophysics Data System (ADS)

    Wang, B. J.; Xu, D. K.; Wang, S. D.; Han, E. H.

    2017-12-01

    The most advantageous property of magnesium (Mg) alloys is their density, which is lower compared with traditional metallic materials. Mg alloys, considered the lightest metallic structural material among others, have great potential for applications as secondary load components in the transportation and aerospace industries. The fatigue evaluation of Mg alloys under elastic stress amplitudes is very important in ensuring their service safety and reliability. Given their hexagonal close packed structure, the fatigue crack initiation of Mg and its alloys is closely related to the deformation mechanisms of twinning and basal slips. However, for Mg alloys with shrinkage porosities and inclusions, fatigue cracks will preferentially initiate at these defects, remarkably reducing the fatigue lifetime. In this paper, some fundamental aspects about the fatigue crack initiation mechanisms of Mg alloys are reviewed, including the 3 followings: 1) Fatigue crack initiation of as-cast Mg alloys, 2) influence of microstructure on fatigue crack initiation of wrought Mg alloys, and 3) the effect of heat treatment on fatigue initiation mechanisms. Moreover, some unresolved issues and future target on the fatigue crack initiation mechanism of Mg alloys are also described.

  11. The meaning and measurement of work fatigue: Development and evaluation of the Three-Dimensional Work Fatigue Inventory (3D-WFI).

    PubMed

    Frone, Michael R; Tidwell, Marie-Cecile O

    2015-07-01

    Although work fatigue represents an important construct in several substantive areas, prior conceptual definitions and measures have been inadequate in a number of ways. The goals of the present study were to develop a conceptual definition and outline the desirable characteristics of a work fatigue measure, briefly examine several prior measures of work fatigue-related constructs, and develop and evaluate a new measure of work fatigue. The Three-Dimensional Work Fatigue Inventory (3D-WFI) provides separate and commensurate assessments of physical, mental, and emotional work fatigue. Results from a pilot study (n = 207) and a broader evaluative study of U.S. wage and salary workers (n = 2,477) suggest that the 3D-WFI is psychometrically sound and evinces a meaningful pattern of relations with variables that comprise the nomological network of work fatigue. As with all new measures, additional research is required to evaluate fully the utility of the 3D-WFI in research on work fatigue. (c) 2015 APA, all rights reserved).

  12. The numerical high cycle fatigue damage model of fillet weld joint under weld-induced residual stresses

    NASA Astrophysics Data System (ADS)

    Nguyen Van Do, Vuong

    2018-04-01

    In this study, a development of nonlinear continuum damage mechanics (CDM) model for multiaxial high cycle fatigue is proposed in which the cyclic plasticity constitutive model has been incorporated in the finite element (FE) framework. T-joint FE simulation of fillet welding is implemented to characterize sequentially coupled three-dimensional (3-D) of thermo-mechanical FE formulation and simulate the welding residual stresses. The high cycle fatigue damage model is then taken account into the fillet weld joints under the various cyclic fatigue load types to calculate the fatigue life considering the residual stresses. The fatigue crack initiation and the propagation in the present model estimated for the total fatigue is compared with the experimental results. The FE results illustrated that the proposed high cycle fatigue damage model in this study could become a powerful tool to effectively predict the fatigue life of the welds. Parametric studies in this work are also demonstrated that the welding residual stresses cannot be ignored in the computation of the fatigue life of welded structures.

  13. Bithermal fatigue: A simplified alternative to thermomechanical fatigue

    NASA Technical Reports Server (NTRS)

    Verrilli, Michael J.

    1988-01-01

    A bithermal fatigue test technique was proposed as a simplified alternative to the thermomechanical fatigue test. Both the thermomechanical cycle and the bithermal technique can be used to study nonisothermal fatigue behavior. The difference between the two cycles is that in a conventional thermomechanical fatigue cycle the temperature is continuously varied concurrently with the applied mechanical strains, but in the bithermal fatigue cycle the specimen is held at zero load during the temperature excursions and all the loads are applied at the two extreme temperatures of the cycle. Experimentally, the bithermal fatigue test technique offers advantages such as ease in synchronizing the temperature and mechanical strain waveforms, in minimizing temperature gradients in the specimen gauge length, and in reducing and interpreting thermal fatigue such as the influence of alternate high and low temperatures on the cyclic stress-strain response characteristics, the effects of thermal state, and the possibility of introducing high- and low-temperature deformation mechanisms within the same cycle. The bithermal technique was used to study nonisothermal fatigue behavior of alloys such as single-crystal PWA 1480, single-crystal Rene N4, cast B1900+Hf, and wrought Haynes 188.

  14. Experimental and modeling results of creep-fatigue life of Inconel 617 and Haynes 230 at 850 °C

    NASA Astrophysics Data System (ADS)

    Chen, Xiang; Sokolov, Mikhail A.; Sham, Sam; Erdman, Donald L., III; Busby, Jeremy T.; Mo, Kun; Stubbins, James F.

    2013-01-01

    Creep-fatigue testing of Ni-based superalloy Inconel 617 and Haynes 230 were conducted in the air at 850 °C. Tests were performed with fully reversed axial strain control at a total strain range of 0.5%, 1.0% or 1.5% and hold time at maximum tensile strain for 3, 10 or 30 min. In addition, two creep-fatigue life prediction methods, i.e. linear damage summation and frequency-modified tensile hysteresis energy modeling, were evaluated and compared with experimental results. Under all creep-fatigue tests, Haynes 230 performed better than Inconel 617. Compared to the low cycle fatigue life, the cycles to failure for both materials decreased under creep-fatigue test conditions. Longer hold time at maximum tensile strain would cause a further reduction in both material creep-fatigue life. The linear damage summation could predict the creep-fatigue life of Inconel 617 for limited test conditions, but considerably underestimated the creep-fatigue life of Haynes 230. In contrast, frequency-modified tensile hysteresis energy modeling showed promising creep-fatigue life prediction results for both materials.

  15. Side Effects: Fatigue

    Cancer.gov

    Fatigue is a common side effect of many cancer treatments such as chemotherapy, radiation therapy, immunotherapy, and surgery. Anemia and pain can also cause fatigue. Learn about symptoms and way to manage fatigue.

  16. Adrenal Fatigue

    MedlinePlus

    ... unlikely to cover the costs. What is the theory behind adrenal fatigue? Supporters of adrenal fatigue believe ... by producing hormones like cortisol. According to the theory of adrenal fatigue, when people are faced with ...

  17. Are stamina and fatigue polar opposites? A case study.

    PubMed

    So, Suzanna; Evans, Meredyth; Jason, Leonard A; Brown, Abigail

    2015-01-01

    Most individuals with Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS) (Carruthers et al., 2003 ), Myalgic Encephalomyelitis (ME) (Carruthers et al., 2011 ), and chronic fatigue syndrome (CFS) (Fukuda et al., 1994 ) indicate that they experience fatigue and sharp decreases in energy levels, which hinder the ability to engage in physical activities (Friedberg & Jason, 1998 ). However, there are some individuals who reduce activity engagement in order to avoid a worsening of symptoms; thus these individuals may endorse lower levels of fatigue. Accordingly, those with low levels of fatigue but low endurance/stamina might be inadvertently excluded from some criteria based on the fatigue requirement. The current study serves as an exploration of the relationship between fatigue and stamina and the effects of these constructs on illness symptomology and their implications for assessment and diagnosis.

  18. Are Stamina and Fatigue Polar Opposites? A Case Study

    PubMed Central

    So, Suzanna; Evans, Meredyth; Jason, Leonard A.; Brown, Abigail

    2014-01-01

    Most individuals with Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS) (Carruthers et al., 2003), Myalgic Encephalomyelitis (ME) (Carruthers et al., 2011), and chronic fatigue syndrome (CFS) (Fukuda et al., 1994) indicate that they experience fatigue and sharp decreases in energy levels, which hinder the ability to engage in physical activities (Friedberg & Jason, 1998). However, there are some individuals who reduce activity engagement in order to avoid a worsening of symptoms; thus these individuals may endorse lower levels of fatigue. Accordingly, those with low levels of fatigue but low endurance/stamina might be inadvertently excluded from some criteria based on the fatigue requirement. The current study serves as an exploration of the relationship between fatigue and stamina and the effects of these constructs on illness symptomology and their implications for assessment and diagnosis. PMID:25584526

  19. A Pilot Study to Examine the Relationship Between Napping and Fatigue in Nurses Practicing on the Night Shift.

    PubMed

    Neville, Kathleen; Velmer, Gillian; Brown, Shari; Robol, Nancy

    2017-11-01

    The aim of this study is to explore the relationship of night-shift napping on fatigue. Nurses' fatigue, especially at night, interferes with quality of life and job performance and impacts safety and health. Night-shift nurses completed the Brief Fatigue Inventory and a demographic information sheet to determine differences in fatigue between nurses who napped during their night shift as compared with nurses who did not nap. No statistically significant differences in global fatigue were found; differences in rotating shift, age, and, gender were identified. Rotating shifts, a 2nd job, and caring for family predicted fatigue. Based on this pilot study, further investigations of fatigue among night-shift nurses are needed as well as evidence-based support to promote sleep.

  20. Effect of Light Water Reactor Water Environments on the Fatigue Life of Reactor Materials

    DOE PAGES

    Chopra, O. K.; Stevens, G. L.; Tregoning, R.; ...

    2017-10-06

    The American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code (Code) provides rules for the design of Class 1 components of nuclear power plants. Figures I-9.1 through I-9.6 of Appendix I to Section III of the Code specify fatigue design curves for applicable structural materials. However, the Code design curves do not explicitly address the effects of light water reactor (LWR) water environments. Existing fatigue strain-vs.-life (ε-N) laboratory data illustrate potentially significant effects of LWR water environments on the fatigue resistance of pressure vessel and piping steels. Extensive studies have been conducted at Argonne National Laboratory and elsewheremore » since 1990 to investigate the effects of LWR environments on the fatigue life of piping and pressure vessel steels. This article summarizes the results of these studies. Existing fatigue ε-N data were evaluated to identify the various material, environmental, and loading conditions that influence fatigue crack initiation; a methodology for estimating fatigue lives as a function of these parameters was developed. The effects were incorporated into the ASME Code Section III fatigue evaluations in terms of an environmental correction factor, F en, which is defined as the ratio of fatigue life in air at room temperature to the fatigue life in the LWR water environment at reactor operating temperatures. Available fatigue data were used to develop fatigue design curves for carbon and low-alloy steels, austenitic stainless steels, and nickel-chromium-iron (NiCr-Fe) alloys and their weld metals in air at room temperature. A review of the Code Section III fatigue adjustment factors of 2 on strain and 20 on life is also presented and the possible conservatism inherent in the choice of these adjustment factors is evaluated. A brief description of potential effects of neutron irradiation on fatigue crack initiation for these structural materials is also presented.« less

  1. Effect of Light Water Reactor Water Environments on the Fatigue Life of Reactor Materials

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chopra, O. K.; Stevens, G. L.; Tregoning, R.

    The American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code (Code) provides rules for the design of Class 1 components of nuclear power plants. Figures I-9.1 through I-9.6 of Appendix I to Section III of the Code specify fatigue design curves for applicable structural materials. However, the Code design curves do not explicitly address the effects of light water reactor (LWR) water environments. Existing fatigue strain-vs.-life (ε-N) laboratory data illustrate potentially significant effects of LWR water environments on the fatigue resistance of pressure vessel and piping steels. Extensive studies have been conducted at Argonne National Laboratory and elsewheremore » since 1990 to investigate the effects of LWR environments on the fatigue life of piping and pressure vessel steels. This article summarizes the results of these studies. Existing fatigue ε-N data were evaluated to identify the various material, environmental, and loading conditions that influence fatigue crack initiation; a methodology for estimating fatigue lives as a function of these parameters was developed. The effects were incorporated into the ASME Code Section III fatigue evaluations in terms of an environmental correction factor, F en, which is defined as the ratio of fatigue life in air at room temperature to the fatigue life in the LWR water environment at reactor operating temperatures. Available fatigue data were used to develop fatigue design curves for carbon and low-alloy steels, austenitic stainless steels, and nickel-chromium-iron (NiCr-Fe) alloys and their weld metals in air at room temperature. A review of the Code Section III fatigue adjustment factors of 2 on strain and 20 on life is also presented and the possible conservatism inherent in the choice of these adjustment factors is evaluated. A brief description of potential effects of neutron irradiation on fatigue crack initiation for these structural materials is also presented.« less

  2. Fatigue in children with cancer at the end of life.

    PubMed

    Ullrich, Christina K; Dussel, Veronica; Hilden, Joanne M; Sheaffer, Jan W; Moore, Caron L; Berde, Charles B; Wolfe, Joanne

    2010-10-01

    Fatigue is a prevalent source of suffering in children with advanced cancer; yet, little is known about it. This study aimed to describe fatigue experienced by children with advanced cancer and to identify the factors associated with suffering from fatigue and its treatment. A retrospective cross-sectional study of 141 parents of children who died of cancer (response rate: 64%) was conducted in two tertiary-level U.S. pediatric hospitals. By parent report, 96% of children experienced fatigue in the last month of life. Nearly 50% experienced significant suffering from fatigue; this was associated with suffering from pain, dyspnea, anorexia, nausea/vomiting, diarrhea, anxiety, sadness, or fear (P<0.05), and with side effects from pain or dyspnea treatment (P<0.05). In multivariate analysis of symptom-related factors, suffering from nausea/vomiting (odds ratio [OR]=3.93, 95% confidence interval [CI]=1.23-12.61, P=0.02); anorexia (OR=7.52, 95% CI=1.87-30.25, P=0.005); and fear (OR=5.13, 95% CI=2.03-12.96, P ≤ 0.001) remained independently associated with fatigue. Children suffering from fatigue had primary oncologists with fewer years' experience than children who did not suffer from fatigue (mean=7.7 years, standard deviation [SD]=4.9 vs. mean of 9.9 years, SD=6.0, P=0.02). Among children with fatigue, 17 of 129 (13%) received fatigue-directed treatment, which was successful in 3 of 12 (25%). Children experiencing side effects from dyspnea or pain treatment were more likely to be treated for fatigue (relative risk=1.25, 95% CI=1.06-1.47, P=0.009). Fatigue is a common source of suffering in children with cancer at the end of life. Palliation of this symptom is rarely successful. Increased attention to factors associated with fatigue and effective interventions to ameliorate fatigue are needed. Copyright © 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  3. Fatigue shifts and scatters heart rate variability in elite endurance athletes.

    PubMed

    Schmitt, Laurent; Regnard, Jacques; Desmarets, Maxime; Mauny, Fréderic; Mourot, Laurent; Fouillot, Jean-Pierre; Coulmy, Nicolas; Millet, Grégoire

    2013-01-01

    This longitudinal study aimed at comparing heart rate variability (HRV) in elite athletes identified either in 'fatigue' or in 'no-fatigue' state in 'real life' conditions. 57 elite Nordic-skiers were surveyed over 4 years. R-R intervals were recorded supine (SU) and standing (ST). A fatigue state was quoted with a validated questionnaire. A multilevel linear regression model was used to analyze relationships between heart rate (HR) and HRV descriptors [total spectral power (TP), power in low (LF) and high frequency (HF) ranges expressed in ms(2) and normalized units (nu)] and the status without and with fatigue. The variables not distributed normally were transformed by taking their common logarithm (log10). 172 trials were identified as in a 'fatigue' and 891 as in 'no-fatigue' state. All supine HR and HRV parameters (Beta±SE) were significantly different (P<0.0001) between 'fatigue' and 'no-fatigue': HRSU (+6.27±0.61 bpm), logTPSU (-0.36±0.04), logLFSU (-0.27±0.04), logHFSU (-0.46±0.05), logLF/HFSU (+0.19±0.03), HFSU(nu) (-9.55±1.33). Differences were also significant (P<0.0001) in standing: HRST (+8.83±0.89), logTPST (-0.28±0.03), logLFST (-0.29±0.03), logHFST (-0.32±0.04). Also, intra-individual variance of HRV parameters was larger (P<0.05) in the 'fatigue' state (logTPSU: 0.26 vs. 0.07, logLFSU: 0.28 vs. 0.11, logHFSU: 0.32 vs. 0.08, logTPST: 0.13 vs. 0.07, logLFST: 0.16 vs. 0.07, logHFST: 0.25 vs. 0.14). HRV was significantly lower in 'fatigue' vs. 'no-fatigue' but accompanied with larger intra-individual variance of HRV parameters in 'fatigue'. The broader intra-individual variance of HRV parameters might encompass different changes from no-fatigue state, possibly reflecting different fatigue-induced alterations of HRV pattern.

  4. Clinical Indicators of Psychosocial Distress Predict for Acute Radiation-Induced Fatigue in Patients Receiving Adjuvant Radiation Therapy for Breast Cancer: An Analysis of Patient-Reported Outcomes

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kishan, Amar U.; Wang, Pin-Chieh; Sharif, Jamal

    Purpose: To assess the magnitude and predictors of patient-reported fatigue among breast cancer patients receiving radiation therapy (RT). Methods and Materials: Patients receiving breast RT completed a survey querying fatigue at each weekly on-treatment visit. Patient-reported fatigue severity and interference was assessed on an ordinal scale of 0 to 4, using a validated scoring system. Baseline anxiety and depression scores were also obtained. The kinetics of mean fatigue scores per week and the maximum fatigue scores over the course of the entire treatment were assessed, and clinical predictors were identified by univariate and multivariate regression. Results: The average fatigue severitymore » and interference scores were 0.6 and 0.46. The average fatigue scores increased to an equivalent extent from week to week, with expected increases of 0.99 in fatigue severity and 0.85 in interference over 7 weeks. Patients treated with hypofractionated RT (HF-RT) versus conventionally fractionated RT (CF-RT) had significantly fewer maximum fatigue severity or interference scores that were >2 (ie, severe or very severe; 29% vs 10% for severity, and 26% vs 8% for interference, P<.01). Age ≤45 years, presence of psychiatric/pain-related comorbidities, and baseline sadness and anxiety severity were predictive of average and maximum fatigue scores (P<.05), but variables related to treatment intensity (eg, mastectomy vs lumpectomy, chemotherapy use, radiation target volumes) and other host factors (working, children, marital status, proximity to RT facility) were not. Conclusion: Patient-reported fatigue modestly increases over RT courses, with less maximum fatigue reported with HF-RT. Younger age and baseline sadness, anxiety, and psychiatric/pain-related comorbidities are powerful predictors of fatigue, whereas other factors, such as treatment intensity, are not. Future studies will investigate interventions for patients at high risk for fatigue.« less

  5. The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures.

    PubMed

    Whitehead, Lisa

    2009-01-01

    Fatigue is a common symptom associated with a wide range of chronic diseases. A large number of instruments have been developed to measure fatigue. An assessment regarding the reliability, validity, and utility of fatigue measures is time-consuming for the clinician and researcher, and few reviews exist on which to draw such information. The aim of this article is to present a critical review of fatigue measures, the populations in which the scales have been used, and the extent to which the psychometric properties of each instrument have been evaluated to provide clinicians and researchers with information on which to base decisions. Seven databases were searched for all articles that measured fatigue and offered an insight into the psychometric properties of the scales used over the period 1980-2007. Criteria for judging the "ideal" measure were developed to encompass scale usability, clinical/research utility, and the robustness of psychometric properties. Twenty-two fatigue measures met the inclusion criteria and were evaluated. A further 17 measures met some of the criteria, but have not been tested beyond initial development, and are reviewed briefly at the end of the article. The review did not identify any instrument that met all the criteria of an ideal instrument. However, a small number of short instruments demonstrated good psychometric properties (Fatigue Severity Scale [FSS], Fatigue Impact Scale [FIS], and Brief Fatigue Inventory [BFI]), and three comprehensive instruments demonstrated the same (Fatigue Symptom Inventory [FSI], Multidimensional Assessment of Fatigue [MAF], and Multidimensional Fatigue Symptom Inventory [MFSI]). Only four measures (BFI, FSS, FSI, and MAF) demonstrated the ability to detect change over time. The clinician and researcher also should consider the populations in which the scale has been used previously to assess its validity with their own patient group, and assess the content of a scale to ensure that the key qualitative aspects of fatigue of the population of interest are covered.

  6. Body temperature is elevated and linked to fatigue in relapsing-remitting multiple sclerosis, even without heat exposure.

    PubMed

    Sumowski, James F; Leavitt, Victoria M

    2014-07-01

    To investigate whether (1) resting body temperature is elevated in patients with relapsing-remitting multiple sclerosis (RRMS) relative to healthy individuals and patients with secondary progressive multiple sclerosis (SPMS), and (2) warmer body temperature is linked to worse fatigue in patients with RRMS. Cross-sectional study. Climate-controlled laboratory (∼22°C) within a nonprofit medical rehabilitation research center. Patients with RRMS (n=50), matched healthy controls (n=40), and patients with SPMS (n=22). Not applicable. Body temperature was measured with an aural infrared thermometer (normative body temperature for this thermometer, 36.75°C), and differences were compared across patients with RRMS and SPMS and healthy persons. Patients with RRMS completed measures of general fatigue (Fatigue Severity Scale [FSS]), as well as physical and cognitive fatigue (Modified Fatigue Impact Scale [MFIS]). There was a large effect of group (P<.001, ηp(2)=.132) whereby body temperature was higher in patients with RRMS (37.04°±.27°C) relative to healthy controls (36.83°±.33°C; P=.009) and patients with SPMS (36.75°±.39°C; P=.001). Warmer body temperature in patients with RRMS was associated with worse general fatigue (FSS; rp=.315, P=.028) and physical fatigue (physical fatigue subscale of the MFIS; rp=.318, P=.026), but not cognitive fatigue (cognitive fatigue subscale of the MIFS; rp=-.017, P=.909). These are the first-ever demonstrations that body temperature is elevated endogenously in patients with RRMS and linked to worse fatigue. We discuss these findings in the context of failed treatments for fatigue in RRMS, including several failed randomized controlled trials (RCTs) of stimulants (modafinil). In contrast, our findings may help explain how RCTs of cooling garments and antipyretics (aspirin) have effectively reduced MS fatigue, and encourage further research on cooling/antipyretic treatments of fatigue in RRMS. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Functional assessment of chronic illness therapy—the fatigue scale exhibits stronger associations with clinical parameters in chronic dialysis patients compared to other fatigue-assessing instruments

    PubMed Central

    Chao, Chia-Ter; Huang, Jenq-Wen

    2016-01-01

    Background. Patients with end-stage renal disease (ESRD) have a high symptom burden, among which fatigue is highly prevalent. Many fatigue-assessing instruments exist, but comparisons among instruments in this patient population have yet to be investigated. Methods. ESRD patients under chronic hemodialysis were prospectively enrolled and seven types of fatigue instruments were administered: Brief Fatigue Inventory (BFI), Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), Fatigue Severity Scale (FSS), Lee Fatigue Scale (LFS), Fatigue Questionnaire (FQ), Fatigue Symptom Inventory (FSI), and Short-Form 36-Vitality (SF36-V). Using these instruments, we investigated the correlation between fatigue severity and clinical/biochemical parameters, including demographic/comorbidity profile, dialysis-related complications, and frailty severity. We used regression analysis with serum albumin and frailty severity as the dependent variables to investigate the independent correlations. Results. A total of 46 ESRD patients were enrolled (average age of 67 ± 11.6 years), and 50% of them had type 2 diabetes mellitus. Results from the seven tested instruments showed high correlation with each other. We found that the fatigue severity by FACIT-F was significantly associated with age (p = 0.03), serum albumin (p = 0.003) and creatinine (p = 0.02) levels, while SF36-V scores were also significantly associated with age (p = 0.02) and serum creatinine levels (p = 0.04). However, the fatigue severity measured by the FSS, FSI, FQ, BFI, and LFS did not exhibit these associations. Moreover, regression analysis showed that only FACIT-F scores were independently associated with serum albumin levels and frailty severity in ESRD patients. Conclusion. Among the seven fatigue-assessing instruments, only the FACIT-F yielded results that demonstrated significant and independent associations with important outcome-related features in ESRD patients. PMID:26998414

  8. Course and Predictors of Postdeployment Fatigue: A Prospective Cohort Study in the Dutch Armed Forces.

    PubMed

    Wiborg, Jan F; Rademaker, Arthur R; Geuze, Elbert; Twisk, Jos W R; Vermetten, Eric; Knoop, Hans

    2016-08-01

    The purpose of this study was to examine course and predictors of fatigue in military personnel deployed to Afghanistan. A total of 906 soldiers in the Dutch Armed Forces who participated in a 4-month mission to Afghanistan were included in this study. Assessment took place prior to and 1, 6, 12, and 24 months after deployment. Data were collected between 2005 and 2011. The fatigue severity subscale of the Checklist Individual Strength was used to indicate the level of fatigue during the previous 2 weeks. Mixed models and logistic regression analysis were used to predict course and prevalence of fatigue after deployment. Predictors of postdeployment fatigue were assessed prior to deployment. The mean level of fatigue increased significantly following deployment (B = 0.58, P = .007). In total, 274 soldiers (30.2%) were severely fatigued at least once after deployment and 130 (14.3%) soldiers had recurrent levels of severe fatigue. Only a minority of the veterans with severe fatigue could be classified as having posttraumatic stress disorder (PTSD, per DSM-IV-TR criteria) or potential medical problems. Significant predeployment predictors of less favorable courses of fatigue after deployment were higher levels of fatigue (B = 0.46, P ≤ .001), emotional abuse during childhood (B = 0.99, P ≤ .001), and harm avoidance (B = 0.27, P = .012). These predeployment factors also predicted severe fatigue after deployment. Severe fatigue is a substantial problem in Afghanistan War veterans that does not seem to resolve over time. In a majority of cases, the symptoms cannot be attributed to medical problems or PTSD, whereas predeployment differences in psychosocial factors partially explain course and prevalence of postdeployment fatigue. These findings support assumptions that a complex interplay of various factors might be responsible for the symptoms. © Copyright 2016 Physicians Postgraduate Press, Inc.

  9. Hope and fatigue in chronic illness: The role of perceived stress.

    PubMed

    Hirsch, Jameson K; Sirois, Fuschia M

    2016-04-01

    Fatigue is a debilitating symptom of chronic illness that is deleteriously affected by perceived stress, a process particularly relevant to inflammatory disease. Hopefulness, a goal-based motivational construct, may beneficially influence stress and fatigue, yet little research has examined these associations. We assessed the relation between hope and fatigue, and the mediating effect of stress, in individuals with fibromyalgia, arthritis, and inflammatory bowel disease. Covarying age, sex, and pain, stress partially mediated the association between hope and fatigue; those with greater hope reported less stress and consequent fatigue. Therapeutically, bolstering hope may allow proactive management of stressors, resulting in less fatigue. © The Author(s) 2014.

  10. An Abnormal Increase of Fatigue Life with Dwell Time during Creep-Fatigue Deformation for Directionally Solidified Ni-Based Superalloy DZ445

    NASA Astrophysics Data System (ADS)

    Ding, Biao; Ren, Weili; Deng, Kang; Li, Haitao; Liang, Yongchun

    2018-03-01

    The paper investigated the creep-fatigue behavior for directionally solidified nickel-based superalloy DZ445 at 900 °C. It is found that the fatigue life shows an abnormal increase when the dwell time exceeds a critical value during creep-fatigue deformation. The area of hysteresis loop and fractograph explain the phenomenon quite well. The shortest life corresponds to the maximal area of hysteresis loop, i. e. the maximum energy to be consumed during the creep-fatigue cycle. The fractographic observation of failed samples further supports the abnormal behavior of fatigue life.

  11. Evaluating Interactive Fatigue Management Workshops for Occupational Health Professionals in the United Kingdom

    PubMed Central

    Ali, Sheila; Chalder, Trudie; Madan, Ira

    2014-01-01

    Background Disabling fatigue is common in the working age population. It is essential that occupational health (OH) professionals are up-to-date with the management of fatigue in order to reduce the impact of fatigue on workplace productivity. Our aim was to evaluate the impact of one-day workshops on OH professionals' knowledge of fatigue and chronic fatigue syndrome (CFS), and their confidence in diagnosing and managing these in a working population. Methods Five interactive problem-based workshops were held in the United Kingdom. These workshops were developed and delivered by experts in the field. Questionnaires were self-administered immediately prior to, immediately after, and 4 months following each workshop. Questionnaires included measures of satisfaction, knowledge of fatigue and CFS, and confidence in diagnosing and managing fatigue. Open-ended questions were used to elicit feedback about the workshops. Results General knowledge of fatigue increased significantly after training (with a 25% increase in the median score). Participants showed significantly higher levels of confidence in diagnosing and managing CFS (with a 62.5% increase in the median score), and high scores were maintained 4 months after the workshops. OH physicians scored higher on knowledge and confidence than nurses. Similarly, thematic analysis revealed that participants had increased knowledge and confidence after attending the workshops. Conclusion Fatigue can lead to severe functional impairment with adverse workplace outcomes. One-day workshops can be effective in training OH professionals in how to diagnose and manage fatigue and CFS. Training may increase general knowledge of fatigue and confidence in fatigue management in an OH setting. PMID:25516811

  12. Fatigue in patients with Juvenile Idiopathic Arthritis: relationship to perceived health, physical health, self-efficacy, and participation.

    PubMed

    Armbrust, Wineke; Lelieveld, Otto H T M; Tuinstra, Jolanda; Wulffraat, Nico M; Bos, G J F Joyce; Cappon, Jeannette; van Rossum, Marion A J; Sauer, Pieter J J; Hagedoorn, Mariët

    2016-12-06

    Fatigue is common in patients with JIA and affects daily life negatively. We assessed the presence and severity of fatigue in patients with JIA, including factors presumed associated with fatigue (e.g., disease activity, disability, pain, physical activity, exercise capacity, and self-efficacy), and whether fatigue is related to participation in physical education classes, school attendance, and sports frequency. The current study used baseline data of 80 patients with JIA (age 8-13) who participated in an intervention aimed at promoting physical activity. Primary outcome measurements were fatigue, assessed using the Pediatric-Quality-of-Life-Inventory (PedsQl)-Fatigue-scale and energy level assessed using a VAS scale. Other outcome measurements were disease activity (VAS Physician Global Assessment Scale), disability (Childhood Health Assessment Questionnaire), physical activity (accelerometer), exercise capacity (Bruce treadmill test), self-efficacy (Childhood Arthritis Self-Efficacy Scale), and participation (self-report). Sixty percent of patients with JIA suffered from daily low-energy levels; 27% suffered from very low-energy levels more than half the week. Low energy levels were best predicted by disability and low physical activity. Fatigue measured with the PEDsQL was higher compared to the control-population. Disability and low self-efficacy were main predictors of fatigue. Self-efficacy was a predictor of fatigue but did not act as moderator. Fatigue was a predictor for sports frequency but not for school attendance. Fatigue is a significant problem for JIA patients. Interventions aimed at reducing perceived disability, stimulating physical activity, and enhancing self-efficacy might reduce fatigue and thereby enhance participation. Trial number ISRCTN92733069.

  13. Lack of Energy: An Important and Distinct Component of HIV-Related Fatigue and Daytime Function

    PubMed Central

    Aouizerat, Bradley E.; Gay, Caryl L.; Lerdal, Anners; Portillo, Carmen J.; Lee, Kathryn A.

    2012-01-01

    Context Fatigue is a prevalent symptom among adults living with human immunodeficiency virus (HIV). There is increasing evidence that fatigue and energy are related, yet distinct constructs. Although HIV-related fatigue has been well studied, little is known about perceived energy and how it relates to fatigue, individual characteristics, and other symptoms. Objectives To describe the experience of perceived energy in adults with HIV and evaluate its relationship to demographic and clinical characteristics as well as symptoms of fatigue, sleep disturbance, anxiety, depression, and daytime function. Methods The design was descriptive, comparative, and correlational. The sample of 318 adults with HIV completed a demographic questionnaire, the Memorial Symptom Assessment Scale, and measures of fatigue, sleep disturbance, anxiety, depressive symptoms, and daytime function. Medical records were reviewed for disease and treatment data. Participants who reported a lack of energy were compared with those who did not on demographic, clinical, and symptom variables. Regression models of perceived energy and its interference with daytime function also were evaluated. Results Perceived lack of energy was highly prevalent (65%) and more strongly related to interference with daytime function than more general measures of fatigue severity, even when controlling for other characteristics and symptoms. Like other aspects of fatigue, lack of energy was associated with sleep disturbance, anxiety, and depressive symptoms. Lack of energy was more strongly related to morning fatigue than to evening fatigue. Conclusion Lack of energy interferes with daytime function and is not just the inverse of fatigue but a distinct perception that differs from fatigue. PMID:22917712

  14. Exploring the Relationship of Task Performance and Physical and Cognitive Fatigue During a Daylong Light Precision Task.

    PubMed

    Yung, Marcus; Manji, Rahim; Wells, Richard P

    2017-11-01

    Our aim was to explore the relationship between fatigue and operation system performance during a simulated light precision task over an 8-hr period using a battery of physical (central and peripheral) and cognitive measures. Fatigue may play an important role in the relationship between poor ergonomics and deficits in quality and productivity. However, well-controlled laboratory studies in this area have several limitations, including the lack of work relevance of fatigue exposures and lack of both physical and cognitive measures. There remains a need to understand the relationship between physical and cognitive fatigue and task performance at exposure levels relevant to realistic production or light precision work. Errors and fatigue measures were tracked over the course of a micropipetting task. Fatigue responses from 10 measures and errors in pipetting technique, precision, and targeting were submitted to principal component analysis to descriptively analyze features and patterns. Fatigue responses and error rates contributed to three principal components (PCs), accounting for 50.9% of total variance. Fatigue responses grouped within the three PCs reflected central and peripheral upper extremity fatigue, postural sway, and changes in oculomotor behavior. In an 8-hr light precision task, error rates shared similar patterns to both physical and cognitive fatigue responses, and/or increases in arousal level. The findings provide insight toward the relationship between fatigue and operation system performance (e.g., errors). This study contributes to a body of literature documenting task errors and fatigue, reflecting physical (both central and peripheral) and cognitive processes.

  15. Translating Fatigue to Human Performance.

    PubMed

    Enoka, Roger M; Duchateau, Jacques

    2016-11-01

    Despite flourishing interest in the topic of fatigue-as indicated by the many presentations on fatigue at the 2015 Annual Meeting of the American College of Sports Medicine-surprisingly little is known about its effect on human performance. There are two main reasons for this dilemma: 1) the inability of current terminology to accommodate the scope of the conditions ascribed to fatigue, and 2) a paucity of validated experimental models. In contrast to current practice, a case is made for a unified definition of fatigue to facilitate its management in health and disease. On the basis of the classic two-domain concept of Mosso, fatigue is defined as a disabling symptom in which physical and cognitive function is limited by interactions between performance fatigability and perceived fatigability. As a symptom, fatigue can only be measured by self-report, quantified as either a trait characteristic or a state variable. One consequence of such a definition is that the word fatigue should not be preceded by an adjective (e.g., central, mental, muscle, peripheral, and supraspinal) to suggest the locus of the changes responsible for an observed level of fatigue. Rather, mechanistic studies should be performed with validated experimental models to identify the changes responsible for the reported fatigue. As indicated by three examples (walking endurance in old adults, time trials by endurance athletes, and fatigue in persons with multiple sclerosis) discussed in the review, however, it has proven challenging to develop valid experimental models of fatigue. The proposed framework provides a foundation to address the many gaps in knowledge of how laboratory measures of fatigue and fatigability affect real-world performance.

  16. Giardia-specific cellular immune responses in post-giardiasis chronic fatigue syndrome.

    PubMed

    Hanevik, Kurt; Kristoffersen, Einar; Mørch, Kristine; Rye, Kristin Paulsen; Sørnes, Steinar; Svärd, Staffan; Bruserud, Øystein; Langeland, Nina

    2017-01-28

    The role of pathogen specific cellular immune responses against the eliciting pathogen in development of post-infectious chronic fatigue syndrome (PI-CFS) is not known and such studies are difficult to perform. The aim of this study was to evaluate specific anti-Giardia cellular immunity in cases that developed CFS after Giardia infection compared to cases that recovered well. Patients reporting chronic fatigue in a questionnaire study three years after a Giardia outbreak were clinically evaluated five years after the outbreak and grouped according to Fukuda criteria for CFS and idiopathic chronic fatigue. Giardia specific immune responses were evaluated in 39 of these patients by proliferation assay, T cell activation and cytokine release analysis. 20 Giardia exposed non-fatigued individuals and 10 healthy unexposed individuals were recruited as controls. Patients were clinically classified into CFS (n = 15), idiopathic chronic fatigue (n = 5), fatigue from other causes (n = 9) and recovered from fatigue (n = 10). There were statistically significant antigen specific differences between these Giardia exposed groups and unexposed controls. However, we did not find differences between the Giardia exposed fatigue classification groups with regard to CD4 T cell activation, proliferation or cytokine levels in 6 days cultured PBMCs. Interestingly, sCD40L was increased in patients with PI-CFS and other persons with fatigue after Giardia infection compared to the non-fatigued group, and correlated well with fatigue levels at the time of sampling. Our data show antigen specific cellular immune responses in the groups previously exposed to Giardia and increased sCD40L in fatigued patients.

  17. Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial

    PubMed Central

    Heine, Martin; Verschuren, Olaf; Hoogervorst, Erwin LJ; van Munster, Erik; Hacking, Hub GA; Visser-Meily, Anne; Twisk, Jos WR; Beckerman, Heleen; de Groot, Vincent; Kwakkel, Gert

    2017-01-01

    Background: Evidence supporting the effectiveness of aerobic training, specific for fatigue, in severely fatigued patients with multiple sclerosis (MS) is lacking. Objective: To estimate the effectiveness of aerobic training on MS-related fatigue and societal participation in ambulant patients with severe MS-related fatigue. Methods: Patients (N = 90) with severe MS-related fatigue were allocated to 16-week aerobic training or control intervention. Primary outcomes were perceived fatigue (Checklist Individual Strength (CIS20r) fatigue subscale) and societal participation. An improvement of ⩾8 points on the CIS20r fatigue subscale was considered clinically relevant. Outcomes were assessed by a blinded observer at baseline, 2, 4, 6 and 12 months. Results: Of the 89 patients that started treatment (median Expanded Disability Status Scale (interquartile range), 3.0 (2.0–3.6); mean CIS20r fatigue subscale (standard deviation (SD)), 42.6 (8.0)), 43 received aerobic training and 46 received the control intervention. A significant post-intervention between-group mean difference (MD) on the CIS20r fatigue subscale of 4.708 (95% confidence interval (CI) = 1.003–8.412; p = 0.014) points was found in favour of aerobic training that, however, was not sustained during follow-up. No effect was found on societal participation. Conclusion: Aerobic training in MS patients with severe fatigue does not lead to a clinically meaningful reduction in fatigue or societal participation when compared to a low-intensity control intervention. PMID:28528566

  18. A pilot mixed-methods evaluation of MS INFoRm: a self-directed fatigue management resource for individuals with multiple sclerosis.

    PubMed

    Akbar, Nadine; Turpin, Karen; Petrin, Julie; Smyth, Penny; Finlayson, Marcia

    2018-06-01

    Fatigue management interventions for individuals with multiple sclerosis (MS) often feature structured programmes requiring repeated, in-person attendance that is not possible for all individuals. We sought to determine whether MS INFoRm, a self-directed fatigue management resource for individuals with MS, was worth further, more rigorous evaluation. Our indicators of worthiness were actual use of the resource by participants over 3 months, reductions in fatigue impact and increases in self-efficacy, and participant reports of changes in fatigue management knowledge and behaviours. This was a single-group, mixed-methods, before-after pilot study in individuals with MS reporting mild to moderate fatigue. Thirty-five participants were provided with MS INFoRm by a USB flash drive to use at home for 3 months, on their own volition. Twenty-three participants completed all standardized questionnaires, semi-structured interviews and study process measures. Participants reported actively using MS INFoRm over the 3-month study period (median total time spent using MS INFoRm=315 min) as well as significantly lower overall fatigue impact (Modified Fatigue Impact Scale: t=2.6, P=0.01), increased knowledge of MS fatigue (z=-2.8, P=0.01) and greater confidence in managing MS fatigue (z=-3.3, P=0.001). Individuals with significant reductions in fatigue impact also reported behavioural changes including tracking fatigue, better communication with others, greater awareness, improved quality of life and being more proactive. This study provides evidence that further rigorous evaluation of MS INFoRm, a self-directed resource for managing fatigue, is worth pursuing.

  19. Bidirectional Relationships Between Fatigue and Everyday Experiences in Persons Living With HIV.

    PubMed

    Cook, Paul F; Hartson, Kimberly R; Schmiege, Sarah J; Jankowski, Catherine; Starr, Whitney; Meek, Paula

    2016-06-01

    Fatigue symptoms are very common among persons living with HIV (PLWH). Fatigue is related to functional and psychological problems and to treatment nonadherence. Using secondary data from ecological momentary assessment, we examined fatigue as a predictor of PLWH everyday experiences. In bidirectional analyses based on the shape shifters model, we also examined these experiences as predictors of fatigue. Data were examined from 67 PLWH who completed daily surveys on a handheld computer. Brief validated scales were used to assess participants' control beliefs, mood, stress, coping, social support, experience of stigma, and motivation. At the beginning and end of the study, fatigue was measured with two CES-D items that have been used in past HIV symptom research. Multilevel models and logistic regression were used to test reciprocal predictive relationships between variables. Moderate to severe fatigue affected 45% of PLWH in the study. Initial fatigue predicted PLWH subsequent overall level of control beliefs, mood, stress, coping, and social support, all p < .05. These state variables remained relatively constant over time, regardless of participants' initial fatigue. In tests for reciprocal relationships with 33 PLWH, average daily stress, OR = 4.74, and stigma, OR = 4.86, also predicted later fatigue. Fatigue predicted several daily survey variables including stress and social support. Stress and support in turn predicted fatigue at a later time, suggesting a self-perpetuating cycle but also a possible avenue for intervention. Future studies should examine daily variation in fatigue among PLWH and its relation to other everyday experiences and behaviors. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. Exploring the patient perspective of fatigue in adults with visual impairment: a qualitative study

    PubMed Central

    Bode, Christina; van der Aa, Hilde P A; Hulshof, Carel T J; Bosmans, Judith E; van Rens, Gerardus H M B; van Nispen, Ruth M A

    2017-01-01

    Objectives Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies. Setting Two large Dutch low vision multidisciplinary rehabilitation organisations. Participants 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling. Methods A qualitative study involving semistructured interviews. A total of four first-level codes were top–down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding. Results Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue. Conclusions Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss. PMID:28775181

  1. Damage Evolution and Life Prediction of Cross-Ply C/SiC Ceramic-Matrix Composite under Cyclic Fatigue Loading at Room Temperature and 800 °C in Air

    PubMed Central

    Li, Longbiao

    2015-01-01

    The damage evolution and life prediction of cross-ply C/SiC ceramic-matrix composite (CMC) under cyclic-fatigue loading at room temperature and 800 °C in air have been investigated using damage parameters derived from fatigue hysteresis loops, i.e., fatigue hysteresis modulus and fatigue hysteresis loss energy. The experimental fatigue hysteresis modulus and fatigue hysteresis loss energy degrade with increasing applied cycles attributed to transverse cracks in the 90° plies, matrix cracks and fiber/matrix interface debonding in the 0° plies, interface wear at room temperature, and interface and carbon fibers oxidation at 800 °C in air. The relationships between fatigue hysteresis loops, fatigue hysteresis modulus and fatigue hysteresis loss energy have been established. Comparing experimental fatigue hysteresis loss energy with theoretical computational values, the fiber/matrix interface shear stress corresponding to different cycle numbers has been estimated. It was found that the degradation rate at 800 °C in air is much faster than that at room temperature due to serious oxidation in the pyrolytic carbon (PyC) interphase and carbon fibers. Combining the fiber fracture model with the interface shear stress degradation model and the fibers strength degradation model, the fraction of broken fibers versus the cycle number can be determined for different fatigue peak stresses. The fatigue life S-N curves of cross-ply C/SiC composite at room temperature and 800 °C in air have been predicted. PMID:28793728

  2. Damage Evolution and Life Prediction of Cross-Ply C/SiC Ceramic-Matrix Composite under Cyclic Fatigue Loading at Room Temperature and 800 °C in Air.

    PubMed

    Li, Longbiao

    2015-12-09

    The damage evolution and life prediction of cross-ply C/SiC ceramic-matrix composite (CMC) under cyclic-fatigue loading at room temperature and 800 °C in air have been investigated using damage parameters derived from fatigue hysteresis loops, i.e. , fatigue hysteresis modulus and fatigue hysteresis loss energy. The experimental fatigue hysteresis modulus and fatigue hysteresis loss energy degrade with increasing applied cycles attributed to transverse cracks in the 90° plies, matrix cracks and fiber/matrix interface debonding in the 0° plies, interface wear at room temperature, and interface and carbon fibers oxidation at 800 °C in air. The relationships between fatigue hysteresis loops, fatigue hysteresis modulus and fatigue hysteresis loss energy have been established. Comparing experimental fatigue hysteresis loss energy with theoretical computational values, the fiber/matrix interface shear stress corresponding to different cycle numbers has been estimated. It was found that the degradation rate at 800 °C in air is much faster than that at room temperature due to serious oxidation in the pyrolytic carbon (PyC) interphase and carbon fibers. Combining the fiber fracture model with the interface shear stress degradation model and the fibers strength degradation model, the fraction of broken fibers versus the cycle number can be determined for different fatigue peak stresses. The fatigue life S-N curves of cross-ply C/SiC composite at room temperature and 800 °C in air have been predicted.

  3. Handgrip fatiguing exercise can provide objective assessment of cancer-related fatigue: a pilot study.

    PubMed

    Veni, T; Boyas, S; Beaune, B; Bourgeois, H; Rahmani, A; Landry, S; Bochereau, A; Durand, S; Morel, B

    2018-06-24

    As a subjective symptom, cancer-related fatigue is assessed via patient-reported outcomes. Due to the inherent bias of such evaluation, screening and treatment for cancer-related fatigue remains suboptimal. The purpose is to evaluate whether objective cancer patients' hand muscle mechanical parameters (maximal force, critical force, force variability) extracted from a fatiguing handgrip exercise may be correlated to the different dimensions (physical, emotional, and cognitive) of cancer-related fatigue. Fourteen women with advanced breast cancer, still under or having previously received chemotherapy within the preceding 3 months, and 11 healthy women participated to the present study. Cancer-related fatigue was first assessed through the EORTC QLQ-30 and its fatigue module. Fatigability was then measured during 60 maximal repeated handgrip contractions. The maximum force, critical force (asymptote of the force-time evolution), and force variability (root mean square of the successive differences) were extracted. Multiple regression models were performed to investigate the influence of the force parameters on cancer-related fatigue's dimensions. The multiple linear regression analysis evidenced that physical fatigue was best explained by maximum force and critical force (r = 0.81; p = 0.029). The emotional fatigue was best explained by maximum force, critical force, and force variability (r = 0.83; p = 0.008). The cognitive fatigue was best explained by critical force and force variability (r = 0.62; p = 0.035). The handgrip maximal force, critical force, and force variability may offer objective measures of the different dimensions of cancer-related fatigue and could provide a complementary approach to the patient reported outcomes.

  4. The reciprocal relationship between daily fatigue and catastrophizing following cancer treatment: Affect and physical activity as potential mediators.

    PubMed

    Müller, Fabiola; Stephenson, Ellen; DeLongis, Anita; Smink, Ans; Van Ginkel, Robert J; Tuinman, Marrit A; Hagedoorn, Mariët

    2018-03-01

    Fatigue is a distressing symptom many cancer patients experience even after completion of treatment. Although theory and empirical evidence indicate that negative cognitions perpetuate fatigue after completion of treatment, insight into how this process unfolds in daily life is limited. This study used an intensive longitudinal design to investigate the reciprocal relationship between catastrophizing and fatigue in daily life and whether affective and behavioral processes mediate these relationships. Post-treatment colorectal cancer patients (n = 101) completed daily diaries (14 days, 3 times daily) regarding their fatigue, catastrophizing, positive and negative affect, and physical activity. Multilevel modeling was applied to investigate within-person associations within days. Analyses revealed a positive reciprocal relationship between fatigue and catastrophizing throughout the day. That is, high levels of catastrophizing were associated with increases in fatigue within patients. In turn, but to a lesser extent, high levels of fatigue predicted increases in catastrophizing at the next assessment. Low positive affect and high negative affect mediated the effect of catastrophizing on increases in fatigue. Only negative affect mediated the reverse relationship. Physical activity did not mediate either relationship. This study provides evidence for a mutually reinforcing relationship between catastrophizing and fatigue in daily life, which might explain the perpetuation of fatigue after completion of cancer treatment. Fatigue-specific cognitive behavior therapy could be improved by educating patients about this daily reciprocal relationship, train them to quickly replace catastrophizing thoughts in daily life, and help them to cope with affective changes induced by fatigue. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Fatigue In Continuous-Fiber/Metal-Matrix Composites

    NASA Technical Reports Server (NTRS)

    Johnson, William S.

    1992-01-01

    Report describes experimental approaches to quantification of fatigue damage in metal-matrix composites (MMC's). Discusses number of examples of development of damage and failure along with associated analytical models of behavior of MMC. Objectives of report are twofold. First, present experimental procedures and techniques for conducting meaningful fatigue tests to detect and quantify fatigue damage in MMC's. Second, present examples of how fatigue damage initiated and grows in various MMC's. Report furnishes some insight into what type of fatigue damage occurs and how damage quantified.

  6. Considerations concerning fatigue life of metal matrix composites

    NASA Technical Reports Server (NTRS)

    Radhakrishnan, V. M.; Bartolotta, Paul A.

    1993-01-01

    Since metal matrix composites (MMC) are composed from two very distinct materials each having their own physical and mechanical properties, it is feasible that the fatigue resistance depends on the strength of the weaker constituent. Based on this assumption, isothermal fatigue lives of several MMC's were analyzed utilizing a fatigue life diagram approach. For each MMC, the fatigue life diagram was quantified using the mechanical properties of its constituents. The fatigue life regions controlled by fiber fracture and matrix were also quantitatively defined.

  7. Fatigue Behavior of an Advanced SiC/SiC Composite at Elevated Temperature in Air and in Steam

    DTIC Science & Technology

    2009-12-01

    specimens tested in salt fog achieved fatigue run-out. However, a significant decrease in fatigue life was observed for fatigue stresses ≥ 100 MPa...fatigue stress level approached the proportional limit. The reduction is fatigue life was attributed to the increased matrix cracking near the...oxidation of any free silicon remaining after production using methods such as melt infiltration, and the SiC itself as temperatures near 1000 ºC. These

  8. The Dopamine Imbalance Hypothesis of Fatigue in Multiple Sclerosis and Other Neurological Disorders

    PubMed Central

    Dobryakova, Ekaterina; Genova, Helen M.; DeLuca, John; Wylie, Glenn R.

    2015-01-01

    Fatigue is one of the most pervasive symptoms of multiple sclerosis (MS), and has engendered hundreds of investigations on the topic. While there is a growing literature using various methods to study fatigue, a unified theory of fatigue in MS is yet to emerge. In the current review, we synthesize findings from neuroimaging, pharmacological, neuropsychological, and immunological studies of fatigue in MS, which point to a specific hypothesis of fatigue in MS: the dopamine imbalance hypothesis. The communication between the striatum and prefrontal cortex is reliant on dopamine, a modulatory neurotransmitter. Neuroimaging findings suggest that fatigue results from the disruption of communication between these regions. Supporting the dopamine imbalance hypothesis, structural and functional neuroimaging studies show abnormalities in the frontal and striatal regions that are heavily innervated by dopamine neurons. Further, dopaminergic psychostimulant medication has been shown to alleviate fatigue in individuals with traumatic brain injury, chronic fatigue syndrome, and in cancer patients, also indicating that dopamine might play an important role in fatigue perception. This paper reviews the structural and functional neuroimaging evidence as well as pharmacological studies that suggest that dopamine plays a critical role in the phenomenon of fatigue. We conclude with how specific aspects of the dopamine imbalance hypothesis can be tested in future research. PMID:25814977

  9. Taltirelin alleviates fatigue-like behavior in mouse models of cancer-related fatigue.

    PubMed

    Dougherty, John P; Wolff, Brian S; Cullen, Mary J; Saligan, Leorey N; Gershengorn, Marvin C

    2017-10-01

    Fatigue affects most cancer patients and has numerous potential causes, including cancer itself and cancer treatment. Cancer-related fatigue (CRF) is not relieved by rest, can decrease quality of life, and has no FDA-approved therapy. Thyrotropin-releasing hormone (TRH) has been proposed as a potential novel treatment for CRF, but its efficacy against CRF remains largely untested. Thus, we tested the TRH analog, taltirelin (TAL), in mouse models of CRF. To model fatigue, we used a mouse model of chemotherapy, a mouse model of radiation therapy, and mice bearing colon 26 carcinoma tumors. We used the treadmill fatigue test to assess fatigue-like behavior after treatment with TAL. Additionally, we used wild-type and TRH receptor knockout mice to determine which TRH receptor was necessary for the actions of TAL. Tumor-bearing mice displayed muscle wasting and all models caused fatigue-like behavior, with mice running a shorter distance in the treadmill fatigue test than controls. TAL reversed fatigue-like behavior in all three models and the mouse TRH 1 receptor was necessary for the effects of TAL. These data suggest that TAL may be useful in alleviating fatigue in all cancer patients and provide further support for evaluating TAL as a potential therapy for CRF in humans. Published by Elsevier Ltd.

  10. Distinct Evening Fatigue Profiles in Oncology Outpatients Receiving Chemotherapy

    PubMed Central

    Wright, Fay; Cooper, Bruce A.; Conley, Yvette P.; Hammer, Marilyn J.; Chen, Lee-May; Paul, Steven M.; Levine, Jon D.; Miaskowski, Christine; Kober, Kord M.

    2018-01-01

    Background Fatigue is the most common and debilitating symptom experienced by oncology patients during chemotherapy (CTX). Fatigue severity demonstrates a large amount of inter-individual and diurnal variability. Purpose Study purposes were to evaluate for subgroups of patients with distinct evening fatigue profiles and evaluate how these subgroups differed on demographic, clinical, and symptom characteristics. Methods Outpatients with breast, gastrointestinal, gynecological, or lung cancer (n=1332) completed questionnaires six times over two cycles of CTX. Lee Fatigue Scale (LFS) evaluated evening fatigue severity. Latent profile analysis was used to identify distinct evening fatigue profiles. Results Four distinct evening fatigue classes (i.e., Low (14.0%), Moderate (17.2%), High (36.0%), Very High (32.8%)) were identified. Compared to the Low class, patients in the Very High evening fatigue class were: younger, female, had childcare responsibilities, had more years of education, had a lower functional status, had a higher comorbidity burden, and were diagnosed with breast cancer. Patients in the Very High class reported higher levels of depressive symptoms, sleep disturbance, and evening fatigue at enrollment. Conclusions Findings provide new insights into modifiable risk factors for higher levels of evening fatigue. Clinicians can use this information to identify higher risk patients and plan appropriate interventions. PMID:29725554

  11. Comparison of the effect of selected muscle groups fatigue on postural control during bipedal stance in healthy young women.

    PubMed

    Shirazi, Zahra Rojhani; Jahromi, Fatemeh Nikhalat

    2013-09-01

    The maintenance of balance is an essential requirement for the performance of daily tasks and sporting activities and muscular fatigue is a factor to impair postural control, so this study was done to compare the effect of selected muscle groups fatigue on postural control during bipedal stance in healthy subjects. Fifteen healthy female students (24.3 ± 2.6 years) completed three testing session with a break period of at least 2 days. During each session, postural control was assessed during two 30-s trials of bipedal stance with eyes close before and after the fatigue protocol. Fatigue protocols were performed by 60% of their unfatigued Maximum Voluntary Contraction of unilateral ankle plantar flexors, bilateral lumbar extensors and bilateral neck extensors. One of the three fatigue protocols was performed on each session. The result showed that fatigue had a significant effect on COP velocity and it increase COP velocity but there was not found any difference in postural sway between muscle groups. Localized muscle fatigue caused deficits in postural control regardless of the location of fatigue. Authors suggest the possibility of the contributions of central mechanisms to postural deficits due to fatigue and it seems that difference was not between muscle groups due to central fatigue.

  12. Effects of acupressure on fatigue and depression in hepatocellular carcinoma patients treated with transcatheter arterial chemoembolization: a quasi-experimental study.

    PubMed

    Lan, Su-Chen; Lin, Yueh-E; Chen, Shu-Ching; Lin, Yu-Fang; Wang, Yu-Jen

    2015-01-01

    This study was to examine the effects of acupressure on fatigue and depression in HCC patients undergoing TACE. A quasiexperimental study design was used. Patients were evaluated at five time points: before treatment (T1) and 2, 3, 4, and 5 days after treating TACE (T2, T3, T4, and T5). Fatigue and depression were assessed by a VAS fatigue scale and a VAS depression scale at each time point. TFRS and BDI were administered at T1 and T5. Patients' fatigue and depression were significantly higher at T5 than at T1 in two groups. Fatigue and depression increased in both the experimental and control groups' patients over the five days of hospitalization during which TACE and chemotherapy were administered. The experimental group had significantly less fatigue than the control group, with lower subscale scores on physical, psychosocial, daily, and overall fatigue. There were no differences between the groups on depression. At posttest, the experimental group experienced lower physical, psychosocial, daily, and overall fatigue than the control group. Acupressure can improve fatigue in HCC patients during treatment with TACE but did not alleviate depression. Discharge planning should include home care for management of fatigue and depression.

  13. Electromyogram and perceived fatigue changes in the trapezius muscle during typewriting and recovery.

    PubMed

    Kimura, Mitsutoshi; Sato, Hirotaka; Ochi, Mamoru; Hosoya, Satoshi; Sadoyama, Tsugutake

    2007-05-01

    The purpose of the present study was to investigate the development and recovery of muscle fatigue in the upper trapezius muscle by analyzing electromyographic signals. Six male subjects performed a simulated typewriting task for four 25-min sessions. During fatigue and the following rest periods, subjective fatigue and surface electromyography (EMG) from the trapezius muscle during isometric contraction at 30% maximum voluntary contraction (MVC) were periodically measured in the interval. We detected a significant decrease in muscle fiber conduction velocity (MFCV) (P = 0.008) and median frequency (MDF) (P = 0.026) as well as an increase in root mean square (RMS) (P = 0.039) and subjective fatigue (P = 0.0004) during the fatigue period. During the recovery period, subjective fatigue decreased drastically and significantly (P = 0.0004), however, the EMG parameters did not recover completely. Thus, physiological muscle fatigue in the trapezius developed in accordance with subjective muscle fatigue during typewriting. On the other hand, differences between the physiological and subjective parameters were found during recovery. Further studies should be necessary to reveal the discrepancy could be a major factor of a transition from temporal phenomena to serious chronic muscle fatigue and to identify the necessity of some guidelines to prevent VDT work-related chronic muscle fatigue in the trapezius.

  14. Development and characterization of fatigue resistant Aramid reinforced aluminium laminates (ARALL) for fatigue Critical aircraft components

    NASA Astrophysics Data System (ADS)

    Qaiser, M. H.; Umar, S.; Nauman, S.

    2014-06-01

    The structural weight of an aircraft has always been a controlling parameter that governs its fuel efficiency and transport capacity. In pursuit of achieving light-weight aircraft structures, high design stress levels have to be adopted and materials with high specific strength such as Aluminum etc. are to be deployed. However, an extensive spectrum of fatigue load exists at the aircraft wings and other aerodynamic components that may cause initiation and propagation of fatigue cracks and concludes in a catastrophic rupture. Fatigue is therefore the limiting design parameter in such cases and materials with high fatigue resistance are then required. A major improvement in the fatigue behavior was observed by laminating Kevlar fibers with Aluminum using epoxy. ARALL (Aramid Reinforced ALuminum Laminates) is a fatigue resistant hybrid composite that consists of layers of thin high strength aluminum alloy sheets surface bonded with aramid fibers. The intact aramid fibers tie up the fatigue cracks, thus reducing the stress intensity factor at the crack tip as a result of which the fatigue properties of can be enhanced with orders of magnitude as compared to monolithic high strength Aluminum alloy sheets. Significant amount of weight savings can be achieved in fatigue critical components in comparison with the traditional materials used in aircraft.

  15. Increased Th17/Treg Ratio in Poststroke Fatigue

    PubMed Central

    Liu, Xinjing; Kenkare, Komal; Li, Shanshan; Desai, Varsha; Wong, John; Luo, Xun; Wood, Lisa J.; Xu, Yuming; Wang, Qing Mei

    2015-01-01

    Fatigue is a major debilitating symptom after stroke. The biological mechanisms underlying poststroke fatigue (PFS) are unknown. We hypothesized that PSF is associated with an alteration in the balance between Th17 and Treg cells. To test this hypothesis we assessed fatigue in 30 stroke survivors using the Fatigue Scale for Motor and Cognitive Functions (FSMC). Peripheral blood was collected for assessment of Th17 and Treg cell populations and measurement of interleukin-10 (IL-10). Participants were dichotomized into severe fatigue (n = 14) and low-moderate fatigue (n = 16) groups by K-mean cluster analysis of FSMC scores. There were no group differences in age, gender, stroke type, stroke severity, or time since stroke. Stroke survivors in the severe fatigue group reported greater anxiety (p = 0.004) and depression (p = 0.001) than in the low-moderate fatigue group. The ratio of Th17 to Treg cells was significantly increased in the severe fatigue group relative to the mild-moderate fatigue group (p = 0.035). Serum levels of IL-10 negatively correlated withTh17/Treg ratio (r = −0.408,  p = 0.025). Our preliminary findings suggest that an imbalance in the Th17/Treg ratio is associated with the severity of PSF. PMID:26166952

  16. Ankle and knee biomechanics during normal walking following ankle plantarflexor fatigue.

    PubMed

    Hunt, Michael A; Hatfield, Gillian L

    2017-08-01

    The purpose of this study was to investigate the immediate effects of unilateral ankle plantarflexor fatigue on bilateral knee and ankle biomechanics during gait. Lower leg kinematics, kinetics, and muscle activation were assessed before and after an ankle plantarflexor fatiguing protocol in 31 healthy individuals. Fatigue (defined as >10% reduction in maximal isometric ankle plantarflexor torque production and a downward shift in the median power frequency of both heads of the gastrocnemius muscle of the fatigued limb) was achieved in 18 individuals, and only their data were used for analysis purposes. Compared to pre-fatigue walking trials, medial gastrocnemius activity was significantly reduced in the study (fatigued) limb. Other main changes following fatigue included significantly more knee flexion during loading, and an associated larger external knee flexion moment in the study limb. At the ankle joint, participants exhibited significantly less peak plantarflexion (occurring at toe-off) with fatigue. No significant differences were observed in the contralateral (non-fatigued) limb. Findings from this study indicate that fatigue of the ankle plantarflexor muscle does not produce widespread changes in gait biomechanics, suggesting that small to moderate changes in maximal ankle plantarflexor force production capacity (either an increase or decrease) will not have a substantial impact on normal lower limb functioning during gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Effects of Acupressure on Fatigue and Depression in Hepatocellular Carcinoma Patients Treated with Transcatheter Arterial Chemoembolization: A Quasi-Experimental Study

    PubMed Central

    Lan, Su-Chen; Lin, Yueh-E; Chen, Shu-Ching; Lin, Yu-Fang; Wang, Yu-Jen

    2015-01-01

    This study was to examine the effects of acupressure on fatigue and depression in HCC patients undergoing TACE. A quasiexperimental study design was used. Patients were evaluated at five time points: before treatment (T1) and 2, 3, 4, and 5 days after treating TACE (T2, T3, T4, and T5). Fatigue and depression were assessed by a VAS fatigue scale and a VAS depression scale at each time point. TFRS and BDI were administered at T1 and T5. Patients' fatigue and depression were significantly higher at T5 than at T1 in two groups. Fatigue and depression increased in both the experimental and control groups' patients over the five days of hospitalization during which TACE and chemotherapy were administered. The experimental group had significantly less fatigue than the control group, with lower subscale scores on physical, psychosocial, daily, and overall fatigue. There were no differences between the groups on depression. At posttest, the experimental group experienced lower physical, psychosocial, daily, and overall fatigue than the control group. Acupressure can improve fatigue in HCC patients during treatment with TACE but did not alleviate depression. Discharge planning should include home care for management of fatigue and depression. PMID:25802540

  18. Simple index of functional connectivity at rest in Multiple Sclerosis fatigue.

    PubMed

    Buyukturkoglu, Korhan; Porcaro, Camillo; Cottone, Carlo; Cancelli, Andrea; Inglese, Matilde; Tecchio, Franca

    2017-05-01

    To investigate the EEG-derived functional connectivity at rest (FCR) patterns of fatigued Multiple Sclerosis (MS) patients in order to find good parameters for a future EEG-Neurofeedback intervention to reduce their fatigue symptoms. We evaluated FCR between hemispheric homologous areas, via spectral coherence between pairs of corresponding left and right bipolar derivations, in the Theta, Alpha and Beta bands. We estimated FCR in 18MS patients with different levels of fatigue and minimal clinical severity and in 11 age and gender matched healthy controls. We used correlation analysis to assess the relationship between the fatigue scores and the FCR values differing between fatigued MS patients and controls. Among FCR values differing between fatigued MS patients and controls, fatigue symptoms increased with higher Beta temporo-parietal FCR (p=0.00004). Also, positive correlations were found between the fatigue levels and the fronto-frontal FCR in Beta and Theta bands (p=0.0002 and p=0.001 respectively). We propose that a future EEG-Neurofeedback system against MS fatigue would train patients to decrease voluntarily the beta coherence between the homologous temporo-parietal areas. We extracted a feature for building an EEG-Neurofeedback system against fatigue in MS. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  19. Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: A longitudinal study.

    PubMed

    Feldthusen, Caroline; Grimby-Ekman, Anna; Forsblad-d'Elia, Helena; Jacobsson, Lennart; Mannerkorpi, Kaisa

    2016-04-28

    To investigate the impact of disease-related aspects on long-term variations in fatigue in persons with rheumatoid arthritis. Observational longitudinal study. Sixty-five persons with rheumatoid arthritis, age range 20-65 years, were invited to a clinical examination at 4 time-points during the 4 seasons. Outcome measures were: general fatigue rated on visual analogue scale (0-100) and aspects of fatigue assessed by the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire. Disease-related variables were: disease activity (erythrocyte sedimentation rate), pain threshold (pressure algometer), physical capacity (six-minute walk test), pain (visual analogue scale (0-100)), depressive mood (Hospital Anxiety and Depression scale, depression subscale), personal factors (age, sex, body mass index) and season. Multivariable regression analysis, linear mixed effects models were applied. The strongest explanatory factors for all fatigue outcomes, when recorded at the same time-point as fatigue, were pain threshold and depressive mood. Self-reported pain was an explanatory factor for physical aspects of fatigue and body mass index contributed to explaining the consequences of fatigue on everyday living. For predicting later fatigue pain threshold and depressive mood were the strongest predictors. Pain threshold and depressive mood were the most important factors for fatigue in persons with rheumatoid arthritis.

  20. Fatigue Experiences Among OCD Outpatients.

    PubMed

    Pasquini, Massimo; Piacentino, Daria; Berardelli, Isabella; Roselli, Valentina; Maraone, Annalisa; Tarsitani, Lorenzo; Biondi, Massimo

    2015-12-01

    Patients with OCD are impaired in multiple domains of functioning and quality of life. While associated psychopathology complaints and neuropsychological deficits were reported, the subjective experience of general fatigue and mental fatigue was scarcely investigated. In this single-center case-control study we compared 50 non-depressed OCD outpatients consecutively recruited and 50 panic disorder (PD) outpatients, to determine whether they experienced fatigue differently. Assessment consisted of structured clinical interview for DSM-IV criteria by using the SCID-I and the SCID-II. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale, the Hamilton Anxiety Rating Scale, the Hamilton Depression Rating Scale, the Clinical Global Impressions Scale, severity and the Global Assessment of Functioning Scale. Fatigue was assessed by using the Multidimensional Fatigue Inventory (MFI). Regarding MFI physical fatigue, an OR of 0.196 (95 % CI 0.080-0.478) was found, suggesting that its presence is associated with lower odds of OCD compared to PD. The same can be said for MFI mental fatigue, as an OR of 0.138 (95 % CI 0.049-0.326) was found, suggesting that its presence is associated with lower odds of OCD. Notably, OCD patients with OCDP co-morbidity reported higher scores of mental fatigue. In this study fatigue, including mental fatigue, seems not to be a prominent experience among adult non-depressed OCD patients.

  1. You make me tired: An experimental test of the role of interpersonal operant conditioning in fatigue.

    PubMed

    Lenaert, Bert; Jansen, Rebecca; van Heugten, Caroline M

    2018-04-01

    Chronic fatigue is highly prevalent in the general population as well as in multiple chronic diseases and psychiatric disorders. Its etiology however remains poorly understood and cannot be explained by biological factors alone. Occurring in a psychosocial context, the experience and communication of fatigue may be shaped by social interactions. In particular, interpersonal operant conditioning may strengthen and perpetuate fatigue complaints. In this experiment, individuals (N = 44) repeatedly rated their currently experienced fatigue while engaging in cognitive effort (working memory task). Subtle social reward was given when fatigue increased relative to the previous rating; or disapproval when fatigue decreased. In the control condition, only neutral feedback was given. Although all participants became more fatigued during cognitive effort, interpersonal operant conditioning led to increased fatigue reporting relative to neutral feedback. This effect occurred independently of conscious awareness. Interestingly, the experimental condition also performed worse on the working memory task. Results suggest that fatigue complaints (and cognitive performance) may become controlled by their consequences such as social reward, and not exclusively by their antecedents such as effort. Results have implications for treatment development and suggest that interpersonal operant conditioning may contribute to fatigue becoming a chronic symptom. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Commentary: Listening Can Be Exhausting—Fatigue in Children and Adults With Hearing Loss

    PubMed Central

    Bess, Fred H.; Hornsby, Benjamin W. Y.

    2017-01-01

    Anecdotal reports of fatigue after sustained speech-processing demands are common among adults with hearing loss; however, systematic research examining hearing loss–related fatigue is limited, particularly with regard to fatigue among children with hearing loss (CHL). Many audiologists, educators, and parents have long suspected that CHL experience stress and fatigue as a result of the difficult listening demands they encounter throughout the day at school. Recent research in this area provides support for these intuitive suggestions. In this article, the authors provide a framework for understanding the construct of fatigue and its relation to hearing loss, particularly in children. Although empirical evidence is limited, preliminary data from recent studies suggest that some CHL experience significant fatigue—and such fatigue has the potential to compromise a child’s performance in the classroom. In this commentary, the authors discuss several aspects of fatigue including its importance, definitions, prevalence, consequences, and potential linkage to increased listening effort in persons with hearing loss. The authors also provide a brief synopsis of subjective and objective methods to quantify listening effort and fatigue. Finally, the authors suggest a common-sense approach for identification of fatigue in CHL; and, the authors briefly comment on the use of amplification as a management strategy for reducing hearing-related fatigue. PMID:25255399

  3. Knee Kinematics is Altered Post-Fatigue While Performing a Crossover Task

    PubMed Central

    Cortes, Nelson; Greska, Eric; Ambegaonkar, Jatin P.; Kollock, Roger O.; Caswell, Shane V.; Onate, James A.

    2013-01-01

    Purpose To examine the effect of a sequential fatigue protocol on lower extremity biomechanics during a crossover cutting task in female soccer players. Methods Eighteen female collegiate soccer players alternated between a fatigue protocol and two consecutive unanticipated crossover trials until fatigue was reached. Lower extremity biomechanics were evaluated during the crossover using a 3D motion capture system and two force plates. Repeated measures ANOVAs analyzed differences between three sequential stages of fatigue (pre, 50%, 100%) for each dependent variable (α=0.05). Results Knee flexion angles at initial contact (IC) for pre- (−32±9°) and 50% (−29±11°) were significantly higher than at 100% fatigue (−22±9°) (p<0.001 and p=0.015, respectively). Knee adduction angles at IC for pre- (9±5°) and 50% (8±4°) were significantly higher (p=0.006 and p=0.049, respectively) than at 100% fatigue (6±4°). Conclusions Fatigue altered sagittal and frontal knee kinematics after 50% fatigue whereupon participants had diminished knee control at initial contact. Interventions should attempt to reduce the negative effects of fatigue on lower extremity biomechanics by promotion appropriate frontal plane alignment, and increased knee flexion during fatigue status. PMID:24045915

  4. [Study on relationship between fatigue and work ability in chemistry workers].

    PubMed

    Wu, Si-Ying; Wang, Mian-Zhen; Wang, Zhi-Ming; Lan, Ya-Jia

    2005-01-01

    Explore the relationship between fatigue and work ability in 976 chemistry workers. A test of fatigue and work ability was carried out with fatigue scale and work ability index (WAI) for 976 workers, other influence factors of the work ability (such as work environment, labor load, job factors) were investigated with questionnaire. (1) The frequency of fatigue of the unmarried workers was significantly lower than that of the married workers and other marital status workers, while the score of WAI of the unmarried was significantly higher than that of those( P < 0.05); (2) the frequency of fatigue of the mental workers was significantly lower than that of the mixed physical and mental workers, while the score of WAI of the mental workers was significantly higher than that of physical workers and mixed physical and mental workers ( P < 0.05); (3) compared with the workers free of fatigue, the other workers had lower WAI scores; (4) the fatigue score correlated negatively to the WAI score (r = -0.499, P < 0.01); (5) Cumulative odds model analysis showed that after controlling the other risk factors, fatigue was an important risk factor of work ability (OR = 4.005). Fatigue has affected work ability in chemistry workers, the frequency of fatigue is higher, the score of WAI is lower.

  5. Sleep quality and correlates of poor sleep in patients with rheumatoid arthritis.

    PubMed

    Løppenthin, K; Esbensen, B A; Jennum, P; Østergaard, M; Tolver, A; Thomsen, T; Midtgaard, J

    2015-12-01

    The objective of this study is to examine sleep quality and correlates of poor sleep in patients with rheumatoid arthritis (RA). Five hundred patients with RA were recruited from a rheumatology outpatient clinic and included in this cross-sectional study. Sleep quality and disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI). Other instruments included the Multidimensional Fatigue Inventory, the Epworth Sleepiness Scale, and the Health Assessment Questionnaire. Disease activity was assessed according to disease activity score DAS28-CRP-based. Complete scores on PSQI were obtained from 384 patients (77 %). In those, the prevalence of poor sleep (PSQI >5) was 61 %, and the mean global PSQI score was 7.54 (SD 4.17). A linear association was found between poor sleep and mental fatigue, reduced activity related to fatigue, physical fatigue, and general fatigue. Mental fatigue and general fatigue were independently associated with sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction. However, in the linear multivariate analysis, only general fatigue 1.06 (95 % CI 1.03-1.09) and mental fatigue 1.03 (95 % CI 1.01-1.05) were found to be significant correlates for reporting poor sleep. This study shows that a majority of patients with RA experience poor sleep and that general fatigue and mental fatigue are associated with poor sleep.

  6. Saccadic eye movement metrics reflect surgical residents' fatigue.

    PubMed

    Di Stasi, Leandro L; McCamy, Michael B; Macknik, Stephen L; Mankin, James A; Hooft, Nicole; Catena, Andrés; Martinez-Conde, Susana

    2014-04-01

    Little is known about the effects of surgical residents' fatigue on patient safety. We monitored surgical residents' fatigue levels during their call day using (1) eye movement metrics, (2) objective measures of laparoscopic surgical performance, and (3) subjective reports based on standardized questionnaires. Prior attempts to investigate the effects of fatigue on surgical performance have suffered from methodological limitations, including inconsistent definitions and lack of objective measures of fatigue, and nonstandardized measures of surgical performance. Recent research has shown that fatigue can affect the characteristics of saccadic (fast ballistic) eye movements in nonsurgical scenarios. Here we asked whether fatigue induced by time-on-duty (~24 hours) might affect saccadic metrics in surgical residents. Because saccadic velocity is not under voluntary control, a fatigue index based on saccadic velocity has the potential to provide an accurate and unbiased measure of the resident's fatigue level. We measured the eye movements of members of the general surgery resident team at St. Joseph's Hospital and Medical Center (Phoenix, AZ) (6 males and 6 females), using a head-mounted video eye tracker (similar configuration to a surgical headlight), during the performance of 3 tasks: 2 simulated laparoscopic surgery tasks (peg transfer and precision cutting) and a guided saccade task, before and after their call day. Residents rated their perceived fatigue level every 3 hours throughout their 24-hour shift, using a standardized scale. Time-on-duty decreased saccadic velocity and increased subjective fatigue but did not affect laparoscopic performance. These results support the hypothesis that saccadic indices reflect graded changes in fatigue. They also indicate that fatigue due to prolonged time-on-duty does not result necessarily in medical error, highlighting the complicated relationship among continuity of care, patient safety, and fatigued providers. Our data show, for the first time, that saccadic velocity is a reliable indicator of the subjective fatigue of health care professionals during prolonged time-on-duty. These findings have potential impacts for the development of neuroergonomic tools to detect fatigue among health professionals and in the specifications of future guidelines regarding residents' duty hours.

  7. Fatigue, Creep-Fatigue, and Thermomechanical Fatigue Life Testing of Alloys

    NASA Technical Reports Server (NTRS)

    Halford, Gary R.; Lerch, Bradley A.; McGaw, Michael A.

    2000-01-01

    The fatigue crack initiation resistance of an alloy is determined by conducting a series of tests over a range of values of stress amplitude or strain range. The observed number of cycles to failure is plotted against the stress amplitude or strain range to obtain a fatigue curve. The fatigue properties quoted for an alloy are typically the constants used in the equation(s) that describe the fatigue curve. Fatigue lives of interest may be as low as 10(exp 2) or higher than 10(exp 9) cycles. Because of the enormous scatter associated with fatigue, dozens of tests may be needed to confidently establish a fatigue curve, and the cost may run into several thousands of dollars. To further establish the effects on fatigue life of the test temperature, environment, alloy condition, mean stress effects, creep-fatigue effects, thermomechanical cycling, etc. requires an extraordinarily large and usually very costly test matrix. The total effort required to establish the fatigue resistance of an alloy should not be taken lightly. Fatigue crack initiation tests are conducted on relatively small and presumed to be initially crack-free, samples of an alloy that are intended to be representative of the alloy's metallurgical and physical condition. Generally, samples are smooth and have uniformly polished surfaces within the test section. Some may have intentionally machined notches of well-controlled geometry, but the surface at the root of the notch is usually not polished. The purpose of polishing is to attain a reproducible surface finish. This is to eliminate surface finish as an uncontrolled variable. Representative test specimen geometries will be discussed later. Test specimens are cyclically loaded until macroscopically observable cracks initiate and eventually grow to failure. Normally, the fatigue failure life of a specimen is defined as the number of cycles to separation of the specimen into two pieces. Alternative definitions are becoming more common, particularly for low-cycle fatigue testing, wherein some prescribed indication of impending failure due to cracking is adopted. Specific criteria will be described later. As a rule, cracks that develop during testing are not measured nor are the test parameters intentionally altered owing to the presence of cracking.

  8. Improvement in multiple dimensions of fatigue in patients with fibromyalgia treated with duloxetine: secondary analysis of a randomized, placebo-controlled trial.

    PubMed

    Arnold, Lesley M; Wang, Fujun; Ahl, Jonna; Gaynor, Paula J; Wohlreich, Madelaine M

    2011-06-13

    Fatigue is one of the most disabling symptoms associated with fibromyalgia that greatly impacts quality of life. Fatigue was assessed as a secondary objective in a 2-phase, 24-week study in outpatients with American College of Rheumatology-defined fibromyalgia. Patients were randomized to duloxetine 60-120 mg/d (N = 263) or placebo (N = 267) for the 12-week acute phase. At Week 12, all placebo-treated patients were switched to double-blind treatment with duloxetine for the extension phase. Fatigue was assessed at baseline and every 4 weeks with the Multidimensional Fatigue Inventory (MFI) scales: General Fatigue, Physical Fatigue, Mental Fatigue, Reduced Activity, and Reduced Motivation. Other assessments that may be associated with fatigue included Brief Pain Inventory (BPI) average pain, numerical scales to rate anxiety, depressed mood, bothered by sleep difficulties, and musculoskeletal stiffness. Treatment-emergent fatigue-related events were also assessed. Changes from baseline to Week 12, and from Week 12 to Week 24, were analyzed by mixed-effects model repeated measures analysis. At Week 12, duloxetine versus placebo significantly (all p < .05) reduced ratings on each MFI scale, BPI pain, anxiety, depressed mood, and stiffness. Improvement in ratings of being bothered by sleep difficulties was significant only at Weeks 4 and 8. At Week 24, mean changes in all measures indicated improvement was maintained for patients who received duloxetine for all 24 weeks (n = 176). Placebo-treated patients switched to duloxetine (n = 187) had significant within-group improvement in Physical Fatigue (Weeks 16, 20, and 24); General Fatigue (Weeks 20 and 24); Mental Fatigue (Week 20); and Reduced Activity (Weeks 20 and 24). These patients also experienced significant within-group improvement in BPI pain, anxiety, depressed mood, bothered by sleep difficulties, and stiffness. Overall, the most common (> 5% incidence) fatigue-related treatment-emergent adverse events were fatigue, somnolence, and insomnia. Treatment with duloxetine significantly improved multiple dimensions of fatigue in patients with fibromyalgia, and improvement was maintained for up to 24 weeks. ClinicalTrials.gov registry NCT00673452.

  9. Sonic Fatigue Design Techniques for Advanced Composite Aircraft Structures

    DTIC Science & Technology

    1980-04-01

    AFWAL-TR-80.3019 AD A 090553 SONIC FATIGUE DESIGN TECHNIQUES FOR ADVANCED COMPOSITE AIRCRAFT STRUCTURES FINAL REPORT Ian Holehouse Rohr Industries...5 2. General Sonic Fatigue Theory .... ....... 7 3. Composite Laminate Analysis .. ....... ... 10 4. Preliminary Sonic Fatigue...overall sonic fatigue design guides. These existing desiyn methcds have been developed for metal structures. However, recent advanced composite

  10. Assessing Corrosion Damage and Corrosion Progression in Multistrand Anchor Systems in Use at Corps Projects

    DTIC Science & Technology

    2013-07-01

    14  4.8  Corrosion fatigue ...particularly vulnerable. ERDC TR-13-3 15 4.8 Corrosion fatigue Fatigue that takes place in a corrosive environment can reduce the number of...cycles generally considered acceptable before fatigue and fatigue -related failure occur. ERDC TR-13-3 16 5 Historical Perspective: Post-Tensioned

  11. Computational micromechanics of fatigue of microstructures in the HCF–VHCF regimes

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Castelluccio, Gustavo M.; Musinski, William D.; McDowell, David L.

    Advances in higher resolution experimental techniques have shown that metallic materials can develop fatigue cracks under cyclic loading levels significantly below the yield stress. Indeed, the traditional notion of a fatigue limit can be recast in terms of limits associated with nucleation and arrest of fatigue cracks at the microstructural scale. Though fatigue damage characteristically emerges from irreversible dislocation processes at sub-grain scales, the specific microstructure attributes, environment, and loading conditions can strongly affect the apparent failure mode and surface to subsurface transitions. This paper discusses multiple mechanisms that occur during fatigue loading in the high cycle fatigue (HCF) tomore » very high cycle fatigue (VHCF) regimes. We compare these regimes, focusing on strategies to bridge experimental and modeling approaches exercised at multiple length scales and discussing particular challenges to modeling and simulation regarding microstructure-sensitive fatigue driving forces and thresholds. Finally, we discuss some of the challenges in predicting the transition of failure mechanisms at different stress and strain amplitudes.« less

  12. Prediction of Mean and Design Fatigue Lives of Self Compacting Concrete Beams in Flexure

    NASA Astrophysics Data System (ADS)

    Goel, S.; Singh, S. P.; Singh, P.; Kaushik, S. K.

    2012-02-01

    In this paper, result of an investigation conducted to study the flexural fatigue characteristics of self compacting concrete (SCC) beams in flexure are presented. An experimental programme was planned in which approximately 60 SCC beam specimens of size 100 × 100 × 500 mm were tested under flexural fatigue loading. Approximately 45 static flexural tests were also conducted to facilitate fatigue testing. The flexural fatigue and static flexural strength tests were conducted on a 100 kN servo-controlled actuator. The fatigue life data thus obtained have been used to establish the probability distributions of fatigue life of SCC using two-parameter Weibull distribution. The parameters of the Weibull distribution have been obtained by different methods of analysis. Using the distribution parameters, the mean and design fatigue lives of SCC have been estimated and compared with Normally vibrated concrete (NVC), the data for which have been taken from literature. It has been observed that SCC exhibits higher mean and design fatigue lives compared to NVC.

  13. Atomistic origin of size effects in fatigue behavior of metallic glasses

    NASA Astrophysics Data System (ADS)

    Sha, Zhendong; Wong, Wei Hin; Pei, Qingxiang; Branicio, Paulo Sergio; Liu, Zishun; Wang, Tiejun; Guo, Tianfu; Gao, Huajian

    2017-07-01

    While many experiments and simulations on metallic glasses (MGs) have focused on their tensile ductility under monotonic loading, the fatigue mechanisms of MGs under cyclic loading still remain largely elusive. Here we perform molecular dynamics (MD) and finite element simulations of tension-compression fatigue tests in MGs to elucidate their fatigue mechanisms with focus on the sample size effect. Shear band (SB) thickening is found to be the inherent fatigue mechanism for nanoscale MGs. The difference in fatigue mechanisms between macroscopic and nanoscale MGs originates from whether the SB forms partially or fully through the cross-section of the specimen. Furthermore, a qualitative investigation of the sample size effect suggests that small sample size increases the fatigue life while large sample size promotes cyclic softening and necking. Our observations on the size-dependent fatigue behavior can be rationalized by the Gurson model and the concept of surface tension of the nanovoids. The present study sheds light on the fatigue mechanisms of MGs and can be useful in interpreting previous experimental results.

  14. Improvement on the Fatigue Performance of 2024-T4 Alloy by Synergistic Coating Technology

    PubMed Central

    Wang, Xi-Shu; Guo, Xing-Wu; Li, Xu-Dong; Ge, Dong-Yun

    2014-01-01

    In this paper, rotating bending fatigue tests of 2024-T4 Al alloy with different oxide coatings were carried out. Compared to the uncoated and previously reported oxide coatings of aluminum alloys, the fatigue strength is able to be enhanced by using a novel oxide coating with sealing pore technology. These results indicate that the better the coating surface quality is, the more excellent the fatigue performance under rotating bending fatigue loading is. The improvement on the fatigue performance is mainly because the fatigue crack initiation and the early stage of fatigue crack growth at the coating layer can be delayed after PEO coating with pore sealing. Therefore, it is a so-called synergistic coating technology for various uses, including welding thermal cracks and filling micro-pores. The effects of different oxide coatings on surface hardness, compressive residual stress, morphology and fatigue fracture morphology are discussed. A critical compressive residual stress of about 95–100 MPa is proposed. PMID:28788634

  15. Fatigue Behavior of Inconel 718 TIG Welds

    NASA Astrophysics Data System (ADS)

    Alexopoulos, Nikolaos D.; Argyriou, Nikolaos; Stergiou, Vasillis; Kourkoulis, Stavros K.

    2014-08-01

    Mechanical behavior of reference and TIG-welded Inconel 718 specimens was examined in the present work. Tensile, constant amplitude fatigue, and fracture toughness tests were performed in ambient temperature for both, reference and welded specimens. Microstructure revealed the presence of coarse and fine-grained heat-affected zones. It has been shown that without any post-weld heat treatment, welded specimens maintained their tensile strength properties while their ductility decreased by more than 40%. It was found that the welded specimens had lower fatigue life and this decrease was a function of the applied fatigue maximum stress. A 30% fatigue life decrease was noticed in the high cycle fatigue regime for the welded specimens while this decrease exceeded 50% in the low cycle fatigue regime. Cyclic stress-strain curves showed that Inconel 718 experiences a short period of hardening followed by softening for all fatigue lives. Cyclic fatigue response of welded specimens' exhibited cyclically stable behavior. Finally, a marginal decrease was noticed in the Mode I fracture toughness of the welded specimens.

  16. The impact of job and family demands on partner's fatigue: A study of Japanese dual-earner parents.

    PubMed

    Watanabe, Mayumi; Shimazu, Akihito; Bakker, Arnold B; Demerouti, Evangelia; Shimada, Kyoko; Kawakami, Norito

    2017-01-01

    This study of Japanese dual-earner couples examined the impact of family and job demands on one's own and one's partner's fatigue as well as gender differences in these effects. A total of 2,502 parents (1,251 couples) were surveyed using a self-administered questionnaire. A crossover model was tested using structural equation modeling. The results of structural equation modeling analyses showed that both job and family demands independently exacerbated fatigue. There was an indirect effect of job and family demands on partner fatigue through one's own fatigue only from husbands to wives. An indirect effect of job demands on partner fatigue through partner's family demands was identified only from wives to husbands. Furthermore, there were gender differences in the crossover of fatigue. This study shows that job and family demands influence family circumstances. When considering means to reduce employees' fatigue, gender differences in the mechanism of fatigue need to be taken into account.

  17. Computational micromechanics of fatigue of microstructures in the HCF–VHCF regimes

    DOE PAGES

    Castelluccio, Gustavo M.; Musinski, William D.; McDowell, David L.

    2016-05-19

    Advances in higher resolution experimental techniques have shown that metallic materials can develop fatigue cracks under cyclic loading levels significantly below the yield stress. Indeed, the traditional notion of a fatigue limit can be recast in terms of limits associated with nucleation and arrest of fatigue cracks at the microstructural scale. Though fatigue damage characteristically emerges from irreversible dislocation processes at sub-grain scales, the specific microstructure attributes, environment, and loading conditions can strongly affect the apparent failure mode and surface to subsurface transitions. This paper discusses multiple mechanisms that occur during fatigue loading in the high cycle fatigue (HCF) tomore » very high cycle fatigue (VHCF) regimes. We compare these regimes, focusing on strategies to bridge experimental and modeling approaches exercised at multiple length scales and discussing particular challenges to modeling and simulation regarding microstructure-sensitive fatigue driving forces and thresholds. Finally, we discuss some of the challenges in predicting the transition of failure mechanisms at different stress and strain amplitudes.« less

  18. A study of fatigue and fracture in 7075-T6 aluminum alloy in vacuum and air environments

    NASA Technical Reports Server (NTRS)

    Hudson, C. M.

    1973-01-01

    Axial load fatigue life, fatigue-crack propagation, and fracture toughness experiments were conducted on sheet specimens made of 7075-T6 aluminum alloy. These experiments were conducted at pressures ranging from atmospheric to 5 x 10 to the minus 8th torr. Analysis of the results from the fatigue life experiments indicated that for a given stress level, lower air pressures produced longer fatigue lives. At a pressure of 5 x 10 to the minus 8th torr fatigue lives were 15 or more times as long as at atmospheric pressure. Analysis of the results from the fatigue crack propagation experiments indicated that for small stress intensity factor ranges the fatigue crack propagation rates were up to twice as high at atmospheric pressure as in vacuum. The fracture toughness of 7075-T6 was unaffected by the vacuum environment. Fractographic examination showed that specimens tested in both vacuum and air developed fatigue striations. Considerably more striations developed on specimens tested at atmospheric pressure, however.

  19. Fatigue, Work Schedules, and Perceived Performance in Bedside Care Nurses.

    PubMed

    Sagherian, Knar; Clinton, Michael E; Abu-Saad Huijer, Huda; Geiger-Brown, Jeanne

    2017-07-01

    Hospital nurses are expected to maintain optimal work performance; yet, fatigue can threaten safe practice and result in unfavorable patient outcomes. This descriptive cross-sectional study explored the association between fatigue, work schedules, and perceived work performance among nurses. The study sample included 77 bedside nurses who were mostly female, single, and between 20 and 29 years of age. The majority worked 8-hour shifts and overtime. Nurses who worked during off days reported significantly higher chronic fatigue compared with those nurses who took time off. Nurses who reported feeling refreshed after sleep had significantly less chronic and acute fatigue and more intershift recovery. Nurses with acute and chronic fatigue perceived poorer physical performance. Also, nurses who reported chronic fatigue perceived they were less alert and less able to concentrate when providing patient care. Less effective communication was also associated with acute and chronic fatigue. In conclusion, fatigue has safety implications for nurses' practice that should be monitored by nursing management.

  20. Cancer-Related Fatigue, Version 2.2015

    PubMed Central

    Berger, Ann M.; Mooney, Kathi; Alvarez-Perez, Amy; Breitbart, William S.; Carpenter, Kristen M.; Cella, David; Cleeland, Charles; Dotan, Efrat; Eisenberger, Mario A.; Escalante, Carmen P.; Jacobsen, Paul B.; Jankowski, Catherine; LeBlanc, Thomas; Ligibel, Jennifer A.; Loggers, Elizabeth Trice; Mandrell, Belinda; Murphy, Barbara A.; Palesh, Oxana; Pirl, William F.; Plaxe, Steven C.; Riba, Michelle B.; Rugo, Hope S.; Salvador, Carolina; Wagner, Lynne I.; Wagner-Johnston, Nina D.; Zachariah, Finly J.; Bergman, Mary Anne; Smith, Courtney

    2017-01-01

    Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer. PMID:26285247

  1. Association of fatigue with emotional-eating behavior and the response to mental stress in food intake in a young adult population.

    PubMed

    Yoshikawa, Takahiro; Tanaka, Masaaki; Ishii, Akira; Watanabe, Yasuyoshi

    2014-01-01

    Fatigue is a common complaint among young adults. We investigated whether eating behaviors are associated with fatigue in this population. The participants consisted of 117 healthy students attending Osaka City University. They completed questionnaires assessing fatigue and eating behaviors. To identify the factors associated with the prevalence of fatigue, multivariate logistic regression analysis adjusted for gender was performed. The Emotional Eating subscale score of the Japanese version of Three-Factor Eating Questionnaire Revised 21-item and stress response in food intake (large decrease vs. no change) were positively associated with the prevalence of fatigue assessed by the Japanese version of the Chalder Fatigue Scale. The finding suggests that emotional eating and decrease in amount of food intake under mental stress were associated with fatigue in healthy young adults. Our findings may help to clarify the mechanisms underlying fatigue-eating coupling as well as the etiology of diseases related to abnormal eating behavior.

  2. Isothermal and thermal-mechanical fatigue of VVER-440 reactor pressure vessel steels

    NASA Astrophysics Data System (ADS)

    Fekete, Balazs; Trampus, Peter

    2015-09-01

    The fatigue life of the structural materials 15Ch2MFA (CrMoV-alloyed ferritic steel) and 08Ch18N10T (CrNi-alloyed austenitic steel) of VVER-440 reactor pressure vessel under completely reserved total strain controlled low cycle fatigue tests were investigated. An advanced test facility was developed for GLEEBLE-3800 physical simulator which was able to perform thermomechanical fatigue experiments under in-service conditions of VVER nuclear reactors. The low cycle fatigue results were evaluated with the plastic strain based Coffin-Manson law, and plastic strain energy based model as well. It was shown that both methods are able to predict the fatigue life of reactor pressure vessel steels accurately. Interrupted fatigue tests were also carried out to investigate the kinetic of the fatigue evolution of the materials. On these samples microstructural evaluation by TEM was performed. The investigated low cycle fatigue behavior can provide reference for remaining life assessment and lifetime extension analysis.

  3. Corrosion fatigue of high strength fastener materials in seawater. Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tipton, D.G.

    1983-12-01

    Environmental effects can significantly reduce the fatigue life of metals. As such, corrosion fatigue is a major concern in the engineering application of high strength fasteners in marine environments. The corrosion fatigue failure of an AISI 41L40 high strength steel blade-to-hub attachment bolt at the MOD-0A 200 kW wind turbine generator in Oahu, Hawaii prompted the current test program. Tests were undertaken to confirm the dramatic reduction of fatigue strength of AISI 41L40 in marine environments and to obtain similar corrosion fatigue data for candidate replacement materials. AISI 41L40, AISI 4140, PH 13-8Mo stainless steel, alloy 718 and alloy MP-35Nmore » were tested in axial fatigue at a frequency of 20 Hz in dry air and natural seawater. The fatigue data were fitted by regression equations to allow determination of fatigue strength for a given number of cycles to failure.« less

  4. Developing a fatigue questionnaire for Chinese civil aviation pilots.

    PubMed

    Dai, Jing; Luo, Min; Hu, Wendong; Ma, Jin; Wen, Zhihong

    2018-03-23

    To assess the fatigue risk is an important challenge in improving flight safety in aviation industry. The aim of this study was to develop a comprehensive fatigue risk management indicators system and a fatigue questionnaire for Chinese civil aviation pilots. Participants included 74 (all males) civil aviation pilots. They finished the questionnaire in 20 minutes before a flight mission. The estimation of internal consistency with Cronbach's α and Student's t test as well as Pearson's correlation analysis were the main statistical methods. The results revealed that the fatigue questionnaire had acceptable internal consistency reliability and construct validity; there were significant differences on fatigue scores between international and domestic flight pilots. And some international flight pilots, who had taken medications as a sleep aid, had worse sleep quality than those had not. The long-endurance flight across time zones caused significant differences in circadian rhythm. The fatigue questionnaire can be used to measure Chinese civil aviation pilots' fatigue, which provided a reference for fatigue risk management system to civil aviation pilots.

  5. Altered resting brain connectivity in persistent cancer related fatigue

    PubMed Central

    Hampson, Johnson P.; Zick, Suzanna M.; Khabir, Tohfa; Wright, Benjamin D.; Harris, Richard E.

    2015-01-01

    There is an estimated 3 million women in the US living as breast cancer survivors and persistent cancer related fatigue (PCRF) disrupts the lives of an estimated 30% of these women. PCRF is associated with decreased quality of life, decreased sleep quality, impaired cognition and depression. The mechanisms of cancer related fatigue are not well understood; however, preliminary findings indicate dysfunctional activity in the brain as a potential factor. Here we investigate the relationship between PCRF on intrinsic resting state connectivity in this population. Twenty-three age matched breast cancer survivors (15 fatigued and 8 non-fatigued) who completed all cancer-related treatments at least 12 weeks prior to the study, were recruited to undergo functional connectivity magnetic resonance imaging (fcMRI). Intrinsic resting state networks were examined with both seed based and independent component analysis methods. Comparisons of brain connectivity patterns between groups as well as correlations with self-reported fatigue symptoms were performed. Fatigued patients displayed greater left inferior parietal lobule to superior frontal gyrus connectivity as compared to non-fatigued patients (P < 0.05 FDR corrected). This enhanced connectivity was associated with increased physical fatigue (P = 0.04, r = 0.52) and poor sleep quality (P = 0.04, r = 0.52) in the fatigued group. In contrast greater connectivity in the non-fatigued group was found between the right precuneus to the periaqueductal gray as well as the left IPL to subgenual cortex (P < 0.05 FDR corrected). Mental fatigue scores were associated with greater default mode network (DMN) connectivity to the superior frontal gyrus (P = 0.05 FDR corrected) among fatigued subjects (r = 0.82) and less connectivity in the non-fatigued group (r = −0.88). These findings indicate that there is enhanced intrinsic DMN connectivity to the frontal gyrus in breast cancer survivors with persistent fatigue. As the DMN is a network involved in self-referential thinking we speculate that enhanced connectivity between the DMN and the frontal gyrus may be related to mental fatigue and poor sleep quality. In contrast, enhanced connectivity between the DMN and regions in the subgenual cingulate and brainstem may serve a protective function in the non-fatigued group. PMID:26106555

  6. Altered resting brain connectivity in persistent cancer related fatigue.

    PubMed

    Hampson, Johnson P; Zick, Suzanna M; Khabir, Tohfa; Wright, Benjamin D; Harris, Richard E

    2015-01-01

    There is an estimated 3 million women in the US living as breast cancer survivors and persistent cancer related fatigue (PCRF) disrupts the lives of an estimated 30% of these women. PCRF is associated with decreased quality of life, decreased sleep quality, impaired cognition and depression. The mechanisms of cancer related fatigue are not well understood; however, preliminary findings indicate dysfunctional activity in the brain as a potential factor. Here we investigate the relationship between PCRF on intrinsic resting state connectivity in this population. Twenty-three age matched breast cancer survivors (15 fatigued and 8 non-fatigued) who completed all cancer-related treatments at least 12 weeks prior to the study, were recruited to undergo functional connectivity magnetic resonance imaging (fcMRI). Intrinsic resting state networks were examined with both seed based and independent component analysis methods. Comparisons of brain connectivity patterns between groups as well as correlations with self-reported fatigue symptoms were performed. Fatigued patients displayed greater left inferior parietal lobule to superior frontal gyrus connectivity as compared to non-fatigued patients (P < 0.05 FDR corrected). This enhanced connectivity was associated with increased physical fatigue (P = 0.04, r = 0.52) and poor sleep quality (P = 0.04, r = 0.52) in the fatigued group. In contrast greater connectivity in the non-fatigued group was found between the right precuneus to the periaqueductal gray as well as the left IPL to subgenual cortex (P < 0.05 FDR corrected). Mental fatigue scores were associated with greater default mode network (DMN) connectivity to the superior frontal gyrus (P = 0.05 FDR corrected) among fatigued subjects (r = 0.82) and less connectivity in the non-fatigued group (r = -0.88). These findings indicate that there is enhanced intrinsic DMN connectivity to the frontal gyrus in breast cancer survivors with persistent fatigue. As the DMN is a network involved in self-referential thinking we speculate that enhanced connectivity between the DMN and the frontal gyrus may be related to mental fatigue and poor sleep quality. In contrast, enhanced connectivity between the DMN and regions in the subgenual cingulate and brainstem may serve a protective function in the non-fatigued group.

  7. Fatigue

    MedlinePlus

    ... to help you find out what's causing your fatigue and recommend ways to relieve it. Fatigue itself is not a disease. Medical problems, treatments, and personal habits can add to fatigue. These include Taking certain medicines, such as antidepressants, ...

  8. Reviews on factors affecting fatigue behavior of high-Mn steels

    NASA Astrophysics Data System (ADS)

    Kim, Sangshik; Jeong, Daeho; Sung, Hyokyung

    2018-01-01

    A variety of factors affect the fatigue behavior of high-Mn steels, which include both extrinsic (i.e., loading type, R ratio, specimen type, surface condition, temperature, and environment) and intrinsic (i.e., chemical composition, grain size, microstructure, stacking fault energy) factors. Very often, the influence of extrinsic factors on the fatigue behavior is even greater than that of intrinsic factors, misleading the interpretation of fatigue data. The metallurgical factors influence the initiation and propagation behaviors of fatigue by altering the characteristics of slip that is prerequisite for fatigue damage accumulation. It is however not easy to separate the effect of each factor since they affect the fatigue behavior of high-Mn steels in complex and synergistic way. In this review, the fatigue data of high-Mn steels are summarized and the factors complicating the interpretation are discussed.

  9. Research on the Fatigue Flexural Performance of RC Beams Attacked by Salt Spray

    NASA Astrophysics Data System (ADS)

    Mao, Jiang-hong; Xu, Fang-yuan; Jin, Wei-liang; Zhang, Jun; Wu, Xi-xi; Chen, Cai-sheng

    2018-04-01

    The fatigue flexural performance of RC beams attacked by salt spray was studied. A testing method involving electro osmosis, electrical accelerated corrosion and salt spray was proposed. This corrosion process method effectively simulates real-world salt spray and fatigue loading exerted by RC components on sea bridges. Four RC beams that have different stress amplitudes were tested. It is found that deterioration by corrosion and fatigue loading reduces the fatigue life of the RC and decreases the ability of deformation. The fatigue life and deflection ability could be reduced by increasing the stress amplitude and the corrosion duration time. The test result demonstrates that this experimental method can couple corrosion deterioration and fatigue loading reasonably. This procedure may be applied to evaluate the fatigue life and concrete durability of RC components located in a natural salt spray environment.

  10. Post-stroke fatigue and return to work: a 2-year follow-up.

    PubMed

    Andersen, G; Christensen, D; Kirkevold, M; Johnsen, S P

    2012-04-01

    Post-stroke fatigue may affect the ability to return to work but quantitative studies are lacking. We included 83 first-ever stroke patients <60 years and employed either full-time (n = 77) or part-time (n = 6) at baseline. The patients were recruited from stroke units at Aarhus University Hospital between 2003 and 2005 and were followed for 2 years. Fatigue was assessed by the Multidimensional Fatigue Inventory. Pathological fatigue was defined as a score ≥12 on the General Fatigue dimension. Return to paid work was defined as working at least 10 h per week. Data were analyzed using multivariable logistic regression. A total of 58% of patients had returned to paid work after 2 years. The adjusted Odds Ratio (OR) for returning to paid work was 0.39 (95% confidence interval (CI) 0.16-1.08) for patients with a General Fatigue score ≥12 at baseline. Persisting pathological fatigue after 2 years of follow-up was associated with a lower chance of returning to paid work [adjusted OR 0.29 (95% CI 0.11-0.74)]. Higher scores of General Fatigue at follow-up also correlated negatively with the chance of returning to paid work when analyzing fatigue on a continuous scale (adjusted OR 0.87, 95% CI 0.80-0.94 for each point increase in General Fatigue). Post-stroke fatigue appears to be an independent determinant of not being able to resume paid work following stroke. © 2011 John Wiley & Sons A/S.

  11. Physical activity is Associated with Reduced Fatigue in Adults Living with HIV/AIDS

    PubMed Central

    Perazzo, Joe; Decker, Michael; Horvat-Davey, Christine; Sattar, Abdus; Voss, Joachim

    2016-01-01

    Aims To describe the relationships among home-based physical activity, fatigue, sleep, gender and quality of life in people living with HIV/AIDS Background Fatigue is a common and distressing symptom among people living with HIV/AIDS. Few interventions exist that effectively reduce fatigue in this population. Physical activity has shown promise to reduce fatigue in other populations, but its impact on fatigue in HIV/AIDS has not yet been explored. Design This study was conducted using a prospective, descriptive cohort design. Methods Overall, 90 adults living with HIV/AIDS completed cross-sectional measures. Home-based physical activity was measured using a seven-day self-report diary. Fatigue was measured using the self-reported HIV-Related Fatigue Scale. Sleep was assessed using wrist actigraphy and quality of life was assessed using the HIV-Associated Quality of Life Scale. Data were collected from December 2012 – April 2013 and analyzed using correlations and multiple linear regression. Results The number of minutes of home-based physical activity was significantly associated with reduced fatigue among people living with HIV/AIDS. Additionally, increased fatigue was associated with decreased quality of life. No associations were found among fatigue, sleep or gender. Conclusions Our study demonstrates that physical activity in the home setting is an effective strategy to reduce fatigue among people living with HIV/AIDS. Future work developing and testing interventions to improve home-based physical activity in this population is needed. PMID:27485463

  12. Fatigue in HIV illness: relationship to depression, physical limitations, and disability.

    PubMed

    Ferrando, S; Evans, S; Goggin, K; Sewell, M; Fishman, B; Rabkin, J

    1998-01-01

    This study was conducted to investigate the prevalence of clinical fatigue reported by gay/bisexual men at all HIV illness stages, and whether fatigue, while associated with depression, independently contributes to limitations in physical function and disability. HIV- men, HIV+ men with CD4 counts >500, HIV+ men with CD4 counts 200 to 500, and men with AIDS were compared on prevalence of clinical fatigue, as defined by a standardized instrument. Among HIV+ men, the relationships among fatigue, depressed mood, major depressive disorder, HIV illness markers (including CD4 count and HIV RNA viral load), physical limitations, and disability were assessed at baseline and after 1 year. The prevalence of clinical fatigue in men with CD4 counts <500 was 14%, significantly higher than HIV- men and HIV+ men with CD4 counts >500. However, fatigue was not directly correlated with CD4 count or HIV RNA. Fatigue was a chronic symptom that was associated with depressed mood, major depressive disorder, physical limitations, and disability. After 1 year, an increase in depressive symptoms predicted a small amount of variance in fatigue; however, depressive symptoms were not associated with physical limitations or disability after controlling for fatigue. Fatigue is a chronic symptom that is more prevalent in advanced HIV illness, and which, although associated with depression, does not seem to be merely a symptom of depression. Because fatigue contributes independently to physical limitations and disability, it should be assessed and treated.

  13. Gene Expression Profiling of Evening Fatigue in Women Undergoing Chemotherapy for Breast Cancer

    PubMed Central

    Kober, Kord M.; Dunn, Laura; Mastick, Judy; Cooper, Bruce; Langford, Dale; Melisko, Michelle; Venook, Alan; Chen, Lee-May; Wright, Fay; Hammer, Marilyn J.; Schmidt, Brian L.; Levine, Jon; Miaskowski, Christine; Aouizerat, Bradley E.

    2017-01-01

    Moderate to severe fatigue occurs in 14% to 96% of oncology patients undergoing active treatment. Current interventions for fatigue are not efficacious. A major impediment to the development of effective treatments is a lack of understanding of the fundamental mechanisms underlying fatigue. In the current study, differences in phenotypic characteristics and gene expression profiles were evaluated in a sample of breast cancer patients undergoing chemotherapy (CTX) who reported low (n=19) and high (n=25) levels of evening fatigue. Compared to the low group, patients in the high evening fatigue group reported lower functional status scores, higher comorbidity scores, and fewer prior cancer treatments. One gene was identified as up-regulated and eleven genes were identified to be down-regulated in the high evening fatigue group. Gene set analysis found 24 down-regulated and 94 simultaneously up and down perturbed pathways between the two fatigue groups. Transcript Origin Analysis found that differential expression originated primarily from monocytes and dendritic cell types. Query of public data sources found 18 gene expression experiments with similar differential expression profiles. Our analyses revealed that inflammation, neurotransmitter regulation, and energy metabolism are likely mechanisms associated with evening fatigue severity; that CTX may contribute to fatigue seen in oncology patients; and that the patterns of gene expression may be shared with other models of fatigue (e.g., physical exercise, pathogen-induced sickness behavior). These results suggest that the mechanisms that underlie fatigue in oncology patients are multi-factorial. PMID:26957308

  14. A study on fatigue strength reduction factor for small diameter socket welded pipe joints

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Higuchi, Makoto; Nakagawa, Akira; Hayashi, Makoto

    1996-12-01

    Factors that may exert influence on the fatigue strength of small diameter socket welded joints of nominal diameter in the 20--50 mm range have been investigated by the fully reversed four-point bending fatigue test with the material, diameter, pipe schedule, throat depth, bead shape, slip-on gap, and root defect as the testing parameters. The fatigue strength of socket joints depended acutely on the diameter. When the diameter is large, the fatigue strength tended to be low and the fracture is of the root-failure mode; when it is small, on the other hand, the fatigue strength is high and the fracturemore » is of the toe-failure mode. Stainless steel proved to be superior to carbon steel; it gave rise to 1.37 times the fatigue strength of the latter for socket joints of nominal diameter 50 mm; the fatigue strength reduction factor determined at 10{sup 7} cycles with respect to the fatigue strength of smooth base metal in the fully reversed fatigue was about 4 for stainless steel and about 5 for carbon steel. The fatigue strength was higher, the larger the Sche number (i.e., the thicker the pipe wall); it was improved markedly by placing one final refinement pass on the toe or by eliminating the slip-on gap. An empirical formula relating the size of the root defect to the fatigue strength reduction has been proposed.« less

  15. Mediators of the effects on fatigue of pragmatic rehabilitation for chronic fatigue syndrome.

    PubMed

    Wearden, Alison J; Emsley, Richard

    2013-10-01

    To examine potential mediators of the effect of pragmatic rehabilitation on improvements in fatigue following a randomized controlled trial for patients with chronic fatigue syndrome (CFS/ME) in primary care (IRCTN 74156610). Patients fulfilled the Oxford criteria for CFS. Ninety-five patients were randomized to pragmatic rehabilitation and 100 to general practitioner (GP) treatment as usual. The outcome was the Chalder fatigue scale score (0123 scoring) at end of treatment (20 weeks) and 1-year follow up (70 weeks). First, the effect of treatment on potential mediators was assessed. Then fatigue was regressed on significant mediators, treatment allocation, and baseline measures of fatigue and significant mediators. Reduction in limiting activities at 20 weeks mediated the positive effect of pragmatic rehabilitation on fatigue at 70 weeks (mediated effect size = -2.64, SE = 0.81, p = .001, proportion of effect mediated = 82.0%). Reduction in catastrophizing at 20 weeks mediated the positive effect of pragmatic rehabilitation on fatigue at 70 weeks (mediated effect size = -1.39, SE = 0.61, p = .023, proportion of effect mediated = 43.2%). Reductions in 70-week measures of fear avoidance, embarrassment avoidance, limiting activities, and all-or-nothing behavior all mediated improvement in fatigue at 70 weeks, although the causal direction of these cross-sectional effects cannot be determined. There were no between-group differences on measures of exercise capacity (a timed step test). Improvements in fatigue following pragmatic rehabilitation are related to changes in behavioral responses to and beliefs about fatigue.

  16. Effect of outdoor exposure at ambient and elevated temperatures on fatigue life of Ti-6Al-4V titanium alloy sheet in the annealed and the solution treated and aged condition

    NASA Technical Reports Server (NTRS)

    Phillips, E. P.

    1974-01-01

    Specimens of Ti-6Al-4V titanium alloy sheet in the annealed and the solution-treated and aged heat-treatment condition were exposed outdoors at ambient and 560 K (550 F) temperatures to determine the effect of outdoor exposure on fatigue life. Effects of exposure were determined by comparing fatigue lives of exposed specimens to those of unexpected specimens. Two procedures for fatigue testing the exposed specimens were evaluated: (1) fatigue tests conducted outdoors by applying 1200 load cycles per week until failure occurred and (2) conventional fatigue tests (continuous cycling until failure occurred) conducted indoors after outdoor exposure under static load. The exposure period ranged from 9 to 28 months for the outdoor fatigue-test group and was 24 months for the static-load group. All fatigue tests were constant-amplitude bending of specimens containing a drilled hole (stress concentration factor of 1.6). The results of the tests indicate that the fatigue lives of solution-treated and aged specimens were significantly reduced by the outdoor exposure at 560 K but not by the exposure at ambient temperature. Fatigue lives of the annealed specimens were essentially unaffected by the outdoor exposure at either temperature. The two test procedures - outdoor fatigue test and indoor fatigue test after outdoor exposure - led to the same conclusions about exposure effects.

  17. Evaluation of the psychometric properties of the PROMIS Cancer Fatigue Short Form with cancer patients.

    PubMed

    Cessna, Julie M; Jim, Heather S L; Sutton, Steven K; Asvat, Yasmin; Small, Brent J; Salsman, John M; Zachariah, Babu; Fishman, Mayer; Field, Teresa; Fernandez, Hugo; Perez, Lia; Jacobsen, Paul B

    2016-02-01

    Fatigue is common among cancer patients and adversely impacts quality of life. As such, it is important to measure fatigue accurately in a way that is not burdensome to patients. The 7-item Patient Reported Outcome Measurement Information System (PROMIS) Cancer Fatigue Short Form scale was recently developed using item response theory (IRT). The current study evaluated the psychometric properties of this scale in two samples of cancer patients using classical test theory (CTT). Two samples were used: 121 men with prostate cancer and 136 patients scheduled to undergo hematopoietic cell transplantation (HCT) for hematologic cancer. All participants completed the PROMIS Cancer Fatigue Short Form as well as validated measures of fatigue, vitality, and depression. HCT patients also completed measures of anxiety, perceived stress, and a clinical interview designed to identify cases of cancer-related fatigue. PROMIS Cancer Fatigue Short Form items loaded on a single factor (CFI=0.948) and the scale demonstrated good internal consistency reliability in both samples (Cronbach's alphas>0.86). Correlations with psychosocial measures were significant (p values<.0001) and in the expected direction, offering evidence for convergent and concurrent validity. PROMIS Fatigue scores were significantly higher in patients who met case definition criteria for cancer-related fatigue (p<.0001), demonstrating criterion validity. The current study provides evidence that the PROMIS Cancer Fatigue Short Form is a reliable and valid measure of fatigue in cancer patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Fatigue: a distressing symptom for patients with irritable bowel syndrome.

    PubMed

    Frändemark, Å; Jakobsson Ung, E; Törnblom, H; Simrén, M; Jakobsson, S

    2017-01-01

    Fatigue is a frequent symptom in patients with irritable bowel syndrome (IBS), and is associated with poor quality of life. However, few studies have evaluated its impact on daily life or the perceived distress it can cause. Using a multi-methods approach, this study describes the impact and manifestations of fatigue in patients with IBS and investigates the relationship between fatigue severity and illness-related and health-promoting factors. A total of 160 patients with IBS completed self-reported questionnaires assessing fatigue, gastrointestinal symptoms, psychological distress, and sense of coherence. Fatigue was assessed with the Fatigue Impact Scale, which also includes structured and open-ended questions which were analyzed with a deductive qualitative analysis. Patients were classified as having severe, moderate, or mild fatigue based on frequency, distress and impact on daily life. The open-ended questions revealed a multidimensional impact on life. Fatigue mainly interfered with the ability to perform physical activities, work, and domestic work, and the ability to interact socially. Decreased stamina was evident, along with strategies to limit the bodily consequences of tiredness. Severe fatigue was accompanied by more severe IBS symptoms, anxiety and depression and lower sense of coherence. Fatigue is a distressing symptom which occurs in a sizeable proportion of patients with IBS. It affects life in a multidimensional way, with poor bodily stamina being the most prominent feature. Fatigue, along with sense of coherence, depression and anxiety, needs to be assessed, confirmed and targeted for interventions. © 2016 John Wiley & Sons Ltd.

  19. The role of psychological factors in fatigue among end-stage kidney disease patients: a critical review

    PubMed Central

    Moss-Morris, Rona; Macdougall, Iain C.; Chilcot, Joseph

    2017-01-01

    Fatigue is a common and debilitating symptom, affecting 42–89% of end-stage kidney disease patients, persisting even in pre–dialysis care and stable kidney transplantation, with huge repercussions on functioning, quality of life and patient outcomes. This paper presents a critical review of current evidence for the role of psychological factors in renal fatigue. To date, research has concentrated primarily on the contribution of depression, anxiety and subjective sleep quality to the experience of fatigue. These factors display consistent and strong associations with fatigue, above and beyond the role of demographic and clinical factors. Considerably less research is available on other psychological factors, such as social support, stress, self-efficacy, illness and fatigue-specific beliefs and behaviours, and among transplant recipients and patients in pre-dialysis care. Promising evidence is available on the contribution of illness beliefs and behaviours to the experience of fatigue and there is some indication that these factors may vary according to treatment modality, reflecting the differential burdens and coping necessities associated with each treatment modality. However, the use of generic fatigue scales casts doubt on what specifically is being measured among dialysis patients, illness-related fatigue or post-dialysis-specific fatigue. Therefore, it is important to corroborate the available evidence and further explore, qualitatively and quantitatively, the differences in fatigues and fatigue-specific beliefs and behaviours according to renal replacement therapy, to ensure that any model and subsequent intervention is relevant and grounded in the experiences of patients. PMID:28638608

  20. Factors associated with intern fatigue.

    PubMed

    Friesen, Lindsay D; Vidyarthi, Arpana R; Baron, Robert B; Katz, Patricia P

    2008-12-01

    Prior data suggest that fatigue adversely affects patient safety and resident well-being. ACGME duty hour limitations were intended, in part, to reduce resident fatigue, but the factors that affect intern fatigue are unknown. To identify factors associated with intern fatigue following implementation of duty hour limitations. Cross-sectional confidential survey of validated questions related to fatigue, sleep, and stress, as well as author-developed teamwork questions. Interns in cognitive specialties at the University of California, San Francisco. Univariate statistics characterized the distribution of responses. Pearson correlations elucidated bivariate relationships between fatigue and other variables. Multivariate linear regression models identified factors independently associated with fatigue, sleep, and stress. Of 111 eligible interns, 66 responded (59%). In a regression analysis including gender, hours worked in the previous week, sleep quality, perceived stress, and teamwork, only poorer quality of sleep and greater perceived stress were significantly associated with fatigue (p < 0.001 and p = 0.02, respectively). To identify factors that may affect sleep, specifically duty hours and stress, a secondary model was constructed. Only greater perceived stress was significantly associated with diminished sleep quality (p = 0.04), and only poorer teamwork was significantly associated with perceived stress (p < 0.001). Working >80 h was not significantly associated with perceived stress, quality of sleep, or fatigue. Simply decreasing the number of duty hours may be insufficient to reduce intern fatigue. Residency programs may need to incorporate programmatic changes to reduce stress, improve sleep quality, and foster teamwork in order to decrease intern fatigue and its deleterious consequences.

  1. Evaluation of the Psychometric Properties of the PROMIS Cancer Fatigue Short Form with Cancer Patients

    PubMed Central

    Cessna, Julie M.; Jim, Heather S.L.; Sutton, Steven K.; Asvat, Yasmin; Small, Brent J.; Salsman, John M.; Zachariah, Babu; Fishman, Mayer; Field, Teresa; Fernandez, Hugo; Perez, Lia; Jacobsen, Paul B.

    2016-01-01

    Objective Fatigue is common among cancer patients and adversely impacts quality of life. As such, it is important to measure fatigue accurately in a way that is not burdensome to patients. The 7-item Patient Reported Outcome Measurement Information System (PROMIS) Cancer Fatigue Short Form scale was recently developed using item response theory (IRT). The current study evaluated the psychometric properties of this scale in two samples of cancer patients using classical test theory (CTT). Methods Two samples were used: 121 men with prostate cancer and 136 patients scheduled to undergo hematopoietic cell transplantation (HCT) for hematologic cancer. All participants completed the PROMIS Cancer Fatigue Short Form as well as validated measures of fatigue, vitality, and depression. HCT patients also completed measures of anxiety, perceived stress, and a clinical interview designed to identify cases of cancer -related fatigue. Results PROMIS Cancer Fatigue Short Form items loaded on a single factor (CFI = 0.948) and the scale demonstrated good internal consistency reliability in both samples (Cronbach’s alphas > 0.86). Correlations with psychosocial measures were significant (p-values < .0001) and in the expected direction, offering evidence for convergent and concurrent validity. PROMIS Fatigue scores were significantly higher in patients who met case definition criteria for cancer-related fatigue (p < .0001), demonstrating criterion validity. Conclusion The current study provides evidence that the PROMIS Cancer Fatigue Short Form is a reliable and valid measure of fatigue in cancer patients. PMID:26800633

  2. Cancer-related fatigue: Mechanisms, risk factors, and treatments

    PubMed Central

    Bower, Julienne E.

    2015-01-01

    Fatigue is one of the most common and distressing side effects of cancer and its treatment, and may persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and may be a risk factor for reduced survival. The prevalence and course of fatigue in cancer patients has been well characterized, and there is growing understanding of underlying biological mechanisms. Inflammation has emerged as a key biological pathway for cancer-related fatigue, with studies documenting links between markers of inflammation and fatigue before, during, and particularly after treatment. There is considerable variability in the experience of cancer-related fatigue that is not explained by disease- or treatment-related characteristics, suggesting that host factors may play an important role in the development and persistence of this symptom. Indeed, longitudinal studies have begun to identify genetic, biological, psychosocial, and behavioral risk factors for cancer-related fatigue. Given the multi-factorial nature of cancer-related fatigue, a variety of intervention approaches have been examined in randomized controlled trials, including physical activity, psychosocial, mind-body, and pharmacological treatments. Although there is currently no gold standard for treating fatigue, several of these approaches have shown beneficial effects and can be recommended to patients. This report provides a state of the science review of mechanisms, risk factors, and interventions for cancer-related fatigue, with a focus on recent longitudinal studies and randomized trials that have targeted fatigued patients. PMID:25113839

  3. The effect of fatigue driving on injury severity considering the endogeneity.

    PubMed

    Li, Yanyan; Yamamoto, Toshiyuki; Zhang, Guangnan

    2018-02-01

    Fatigue driving is one of the most risky driving-related behaviors and represented a significant social and economic cost to the community. Several studies have already examined the relationship between fatigue driving behavior and traffic injury severity from different aspects. However, fatigue driving and injury severity in traffic crash may share some common influential factors. Ignoring the impact of these common factors will lead to endogeneity problem and result in biased parameter estimation. Based on 38,564 crash records during 2006-2011 in Guangdong province, China, we apply a bivariate endogenous binary-ordered probit model to examine the relationship between fatigue driving and injury severity considering endogeneity of fatigue driving. We also explore the difference of influential factors between commercial and non-commercial vehicle drivers. This study identifies several common observed influential factors of fatigue driving propensity and fatal injury propensity and reveals a substantial and significant negative correlation of unobserved factors between them. The influence of fatigue driving on injury severity is significantly underestimated if the endogeneity of fatigue driving on fatal injury propensity is ignored. Factors such as vehicle insurance and road types not only affect fatal injury propensity, but also fatigue driving propensity. The findings in this study can help better understand how those factors affect fatigue driving and injury severity, and contributes to more efficient policy for preventing the harmfulness of fatigue-related crashes. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

  4. Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism.

    PubMed

    Louwerens, Marloes; Appelhof, Bente C; Verloop, Herman; Medici, Marco; Peeters, Robin P; Visser, Theo J; Boelen, Anita; Fliers, Eric; Smit, Johannes W A; Dekkers, Olaf M

    2012-12-01

    Research on determinants of well-being in patients on thyroid hormone replacement therapy is warranted, as persistent fatigue-related complaints are common in this population. In this study, we evaluated the impact of different states of hypothyroidism on fatigue and fatigue-related symptoms. Furthermore, the relationship between fatigue and the TSH receptor (TSHR)-Asp727Glu polymorphism, a common genetic variant of the TSHR, was analyzed. A cross-sectional study was performed in 278 patients (140 patients treated for differentiated thyroid carcinoma (DTC) and 138 with autoimmune hypothyroidism (AIH)) genotyped for the TSHR-Asp727Glu polymorphism. The multidimensional fatigue inventory (MFI-20) was used to assess fatigue, with higher MFI-20 scores indicating more fatigue-related complaints. MFI-20 scores were related to disease status and Asp727Glu polymorphism status. AIH patients scored significantly higher than DTC patients on all five MFI-20 subscales (P<0.001), independent of clinical and thyroid hormone parameters. The frequency of the TSHR-Glu727 allele was 7.2%. Heterozygous DTC patients had more favorable MFI-20 scores than wild-type DTC patients on four of five subscales. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue was found in DTC patients only. AIH patients had significantly higher levels of fatigue compared with DTC patients, which could not be attributed to clinical or thyroid hormone parameters. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue in DTC patients should be confirmed in other cohorts.

  5. Fatigue Life Methodology for Bonded Composite Skin/Stringer Configurations

    NASA Technical Reports Server (NTRS)

    Krueger, Ronald; Paris, Isabelle L.; OBrien, T. Kevin; Minguet, Pierre J.

    2001-01-01

    A methodology is presented for determining the fatigue life of composite structures based on fatigue characterization data and geometric nonlinear finite element (FE) analyses. To demonstrate the approach, predicted results were compared to fatigue tests performed on specimens which represented a tapered composite flange bonded onto a composite skin. In a first step, tension tests were performed to evaluate the debonding mechanisms between the flange and the skin. In a second step, a 2D FE model was developed to analyze the tests. To predict matrix cracking onset, the relationship between the tension load and the maximum principal stresses transverse to the fiber direction was determined through FE analysis. Transverse tension fatigue life data were used to -enerate an onset fatigue life P-N curve for matrix cracking. The resulting prediction was in good agreement with data from the fatigue tests. In a third step, a fracture mechanics approach based on FE analysis was used to determine the relationship between the tension load and the critical energy release rate. Mixed mode energy release rate fatigue life data were used to create a fatigue life onset G-N curve for delamination. The resulting prediction was in good agreement with data from the fatigue tests. Further, the prediction curve for cumulative life to failure was generated from the previous onset fatigue life curves. The results showed that the methodology offers a significant potential to Predict cumulative fatigue life of composite structures.

  6. Fatigue in Patients With Advanced Terminal Cancer Correlates With Inflammation, Poor Quality of Life and Sleep, and Anxiety/Depression.

    PubMed

    Rodrigues, Alex Rua; Trufelli, Damila Cristina; Fonseca, Fernando; de Paula, Larissa Carvalho; Giglio, Auro Del

    2016-12-01

    To assess which laboratory and clinical factors are associated with fatigue in patients with terminal cancer. We evaluated 51 patients with advanced incurable solid tumors using the Chalder Fatigue Questionnaire (CFQ) and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale for fatigue; the Pittsburgh Sleep Quality Index (PSQI-BR) for sleep quality; the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression; the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire, Version 3.0 (QLQ C-30); and Functional Assessment of Cancer Therapy (FACT) for quality of life. We also analyzed several inflammatory markers and the modified Glasgow prognostic score (mGPS). We observed severe fatigue in 19 (38%) patients (FACIT-F score >36). There was a significant correlation between fatigue as evaluated by the CFQ and quality of sleep and between the CFQ mental fatigue subscale scores and TNF-α level. When fatigue was evaluated using the FACIT-F scale, we observed a significant association between fatigue and anxiety/depression, quality of sleep, mGPS, and hemoglobin levels. Fatigue measured both with the CFQ and FACIT-F scale correlated with poor quality of life according to the EORTC QLQ C-30. In patients with advanced cancer, fatigue is a common symptom associated with the presence of inflammation, poor quality of sleep, depression/anxiety, and poor quality of life. © The Author(s) 2015.

  7. Cognitive and affective mechanisms of pain and fatigue in multiple sclerosis.

    PubMed

    Arewasikporn, Anne; Turner, Aaron P; Alschuler, Kevin N; Hughes, Abbey J; Ehde, Dawn M

    2018-06-01

    To examine the extent to which pain catastrophizing, fatigue catastrophizing, positive affect, and negative affect simultaneously mediated the associations between common symptoms of multiple sclerosis (MS; i.e., pain, fatigue) and impact on daily life, depressive symptoms, and resilience. Participants were community-dwelling adults with MS (N = 163) reporting chronic pain, fatigue, and/or moderate depressive symptoms. Multiple mediation path analysis was used to model potential mediators of pain and fatigue separately, using baseline data from a randomized controlled trial comparing two symptom self-management interventions. In the pain model, pain catastrophizing was a mediator of pain intensity with pain interference and depression. Negative affect was a mediator of pain intensity with depression and resilience. In the fatigue model, fatigue catastrophizing was a mediator of fatigue intensity with fatigue impact and depression. Positive affect was a mediator of fatigue intensity with depression and resilience. These findings provide preliminary support for the presence of differential effects of cognitive-affective mediators and suggest potential targets for psychological interventions based on an individual's clinical presentation. The differential mediating effects also support the inclusion of both positive and negative aspects of psychological health in models of pain and fatigue, which would not be otherwise apparent if negative constructs were examined in isolation. To our knowledge, this is the first study to utilize a multivariate path analysis approach to examine cognitive-affective mediators of pain and fatigue in MS, while also examining positive and negative constructs concurrently. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  8. Patient-Reported Outcomes and Fatigue in Patients with Chronic Hepatitis C Infection.

    PubMed

    Golabi, Pegah; Sayiner, Mehmet; Bush, Haley; Gerber, Lynn H; Younossi, Zobair M

    2017-08-01

    Fatigue is a common symptom. Diagnosis is difficult. Fatigue is often a complex symptom. In the recent years, fatigue has gained considerable amount of attention. It has 2 major types, central and peripheral, which may occur together or alone. Although fatigue has many strong relations with depression and sleep disorders, it is a separate entity. For the diagnosis of fatigue, self-reports and patient-reported outcomes are highly valuable tools because these methods can reflect patients' perceptions. Treating the underlying disease with newly developed direct-acting antivirals often improves the perceived fatigue. Healthy lifestyle changes are the cornerstone of the treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Fatigue Behavior of Steel Fiber Reinforced High-Strength Concrete under Different Stress Levels

    NASA Astrophysics Data System (ADS)

    Zhang, Chong; Gao, Danying; Gu, Zhiqiang

    2017-12-01

    The investigation was conducted to study the fatigue behavior of steel fiber reinforced high-strength concrete (SFRHSC) beams. A series of 5 SFRHSC beams was conducted flexural fatigue tests at different stress level S of 0.5, 0.55, 0.6, 0.7 and 0.8 respectively. Static test was conducted to determine the ultimate static capacity prior to fatigue tests. Fatigue modes and S-N curves were analyzed. Besides, two fatige life prediction model were analyzed and compared. It was found that stress level S significantly influenced the fatigue life of SFRHSC beams and the fatigue behavior of SFRHSC beams was mainly determined by the tensile reinforcement.

  10. Tension and fatigue behavior of 316LVM 1x7 multi-strand cables used as implantable electrodes.

    PubMed

    Lewandowski, John J; Varadarajan, Ravikumar; Smith, Brian; Tuma, Chris; Shazly, Mostafa; Vatamanu, Luciano O

    2008-07-15

    The mechanical behavior of 316LVM 1x7 cables were evaluated in uniaxial tension, and in cyclic strain-controlled fatigue with the use of a Flex tester operated to provide fully reversed bending fatigue. The magnitude of cyclic strains imparted to each cable tested was controlled via the use of different diameter mandrels. Smaller diameter mandrels produced higher values of cyclic strain and lower fatigue life. Multiple samples were tested and analyzed via scanning electron microscopy. The fatigue results were analyzed via a Coffin-Manson-Basquin approach and compared to fatigue data obtained from the literature where testing was conducted on similar materials, but under rotating bending fatigue conditions.

  11. Fracture mechanics and corrosion fatigue.

    NASA Technical Reports Server (NTRS)

    Mcevily, A. J.; Wei, R. P.

    1972-01-01

    Review of the current state-of-the-art in fracture mechanics, particularly in relation to the study of problems in environment-enhanced fatigue crack growth. The usefulness of this approach in developing understanding of the mechanisms for environmental embrittlement and its engineering utility are discussed. After a brief review of the evolution of the fracture mechanics approach and the study of environmental effects on the fatigue behavior of materials, a study is made of the response of materials to fatigue and corrosion fatigue, the modeling of the mechanisms of the fatigue process is considered, and the application of knowledge of fatigue crack growth to the prediction of the high cycle life of unnotched specimens is illustrated.

  12. Fatigue Lives Of Laser-Cut Metals

    NASA Technical Reports Server (NTRS)

    Martin, Michael R.

    1988-01-01

    Fatigue lives made to approach those attainable by traditional grinding methods. Fatigue-test specimens prepared from four metallic alloys, and material removed from specimens by manual grinding, by Nd:glass laser, and by Nd:YAG laser. Results of fatigue tests of all specimens indicated reduction of fatigue strengths of laser-fired specimens. Laser machining holds promise for improved balancing of components of gas turbines.

  13. Predicting Fatigue Lives Of Metal-Matrix/Fiber Composites

    NASA Technical Reports Server (NTRS)

    Bartolotta, Paul A.

    1994-01-01

    Method of prediction of fatigue lives of intermetallic-matrix/fiber composite parts at high temperatures styled after method of universal slopes. It suffices to perform relatively small numbers of fatigue tests. Data from fatigue tests correlated with tensile-test data by fitting universal-slopes equation to both sets of data. Thereafter, universal-slopes equation used to predict fatigue lives from tensile properties.

  14. Trauma, stressful life events and depression predict HIV-related fatigue

    PubMed Central

    Leserman, J.; Barroso, J.; Pence, B.W.; Salahuddin, N.; Harmon, J.L.

    2008-01-01

    Despite the fact that fatigue is a common and debilitating symptom among HIV-infected persons, we know little about the predictors of fatigue in this population. The goal of this cross-sectional study was to examine the effects of early childhood trauma, recent stressful life events and depression on intensity and impairment of fatigue in HIV, over and above demographic factors and clinical characteristics. We studied 128 HIV-infected men and women from one southern state. The median number of childhood traumatic events was two and participants tended to have at least one moderate recent stressful event. Multiple regression findings showed that patients with less income, more childhood trauma, more recent stressful events and more depressive symptoms had greater fatigue intensity and fatigue-related impairment in daily functioning. Recent stresses were a more powerful predictor of fatigue than childhood trauma. None of the disease-related measures (e.g. CD4, viral load, antiretroviral medication) predicted fatigue. Although stress and trauma have been related to fatigue in other populations, this is the first study to examine the effects of traumatic and recent stressful life events on fatigue in an HIV-infected sample. PMID:18608079

  15. Consolidation of fatigue and fatigue-crack-propagation data for design use

    NASA Technical Reports Server (NTRS)

    Rice, R. C.; Davies, K. B.; Jaske, C. E.; Feddersen, C. E.

    1975-01-01

    Analytical methods developed for consolidation of fatigue and fatigue-crack-propagation data for use in design of metallic aerospace structural components are evaluated. A comprehensive file of data on 2024 and 7075 aluminums, Ti-6Al-4V alloy, and 300M steel was established by obtaining information from both published literature and reports furnished by aerospace companies. Analyses are restricted to information obtained from constant-amplitude load or strain cycling of specimens in air at room temperature. Both fatigue and fatigue-crack-propagation data are analyzed on a statistical basis using a least-squares regression approach. For fatigue, an equivalent strain parameter is used to account for mean stress or stress ratio effects and is treated as the independent variable; cyclic fatigue life is considered to be the dependent variable. An effective stress-intensity factor is used to account for the effect of load ratio on fatigue-crack-propagation and treated as the independent variable. In this latter case, crack-growth rate is considered to be the dependent variable. A two term power function is used to relate equivalent strain to fatigue life, and an arc-hyperbolic-tangent function is used to relate effective stress intensity to crack-growth rate.

  16. Fatigue Risk Management: A Maritime Framework

    PubMed Central

    Grech, Michelle Rita

    2016-01-01

    It is evident that despite efforts directed at mitigating the risk of fatigue through the adoption of hours of work and rest regulations and development of codes and guidelines, fatigue still remains a concern in shipping. Lack of fatigue management has been identified as a contributory factor in a number of recent accidents. This is further substantiated through research reports with shortfalls highlighted in current fatigue management approaches. These approaches mainly focus on prescriptive hours of work and rest and include an individualistic approach to managing fatigue. The expectation is that seafarers are responsible to manage and tolerate fatigue as part of their working life at sea. This attitude is an accepted part of a seafarer’s role. Poor compliance is one manifest of this problem with shipboard demands making it hard for seafarers to follow hours of work and rest regulations, forcing them into this “poor compliance” trap. This makes current fatigue management approaches ineffective. This paper proposes a risk based approach and way forward for the implementation of a fatigue risk management framework for shipping, aiming to support the hours of work and rest requirements. This forms part of the work currently underway to review and update the International Maritime Organization, Guidelines on Fatigue. PMID:26840326

  17. Symptoms of fatigue and coping strategies in maritime pilotage.

    PubMed

    Chambers, Timothy P; Main, Luana C

    2015-01-01

    Little is known regarding the symptoms of fatigue that maritime pilots experience during shift work. Moreover, the strategies these individuals use to cope with the onset of fatigue are also unknown. The current study explored the symptoms of fatigue and coping strategies experienced by maritime pilots when on-shift. Fifty maritime pilots were recruited via an advertisement in the national association's quarterly newsletter (Mage = 51.42; SD = 9.81). Participants responded to a modified version of the questionnaire used with aviation pilots that assessed overall fatigue, and the symptoms pilots associated with fatigue on duty. Methods pilots used to cope with fatigue before shift and when on the bridge were also assessed. There were significant effects for pilot vitality on 4 categories of fatigue: cognitive dysfunction; emotional disturbance; mean physical effects; and sleepiness. There were no significant effects for vitality on any of the self-reported coping strategy factors. The findings indicated that maritime pilots experience a variety of physical, behavioural, and cognitive fatigue symptoms when on shift. Some of these symptoms are similar to those reported by aviation pilots. However, unlike aviation pilots, maritime pilots reported utilising self-sufficient coping strategies to deal with the experience of fatigue.

  18. Mild traumatic brain injury and fatigue: a prospective longitudinal study.

    PubMed

    Norrie, Joan; Heitger, Marcus; Leathem, Janet; Anderson, Tim; Jones, Richard; Flett, Ross

    2010-01-01

    To examine fatigue prevalence, severity, predictors and co-variates over 6 months post-mild traumatic brain injury (MTBI). Longitudinal prospective study including 263 adults with MTBI. Participants completed the Fatigue Severity Scale (FSS), Rivermead Post-concussion Symptoms Questionnaire (RPSQ), Hospital Anxiety and Depression Scale (HADS) and the Short Form 36 Health Survey-Version 2 (SF-36v2). Complete data were available for 159 participants. Key measures; prevalence--RPSQ Item 6: severity--FSS. The effect of time on fatigue prevalence and severity was examined using ANOVA. Multiple regression analysis identified statistically significant covariates. Post-MTBI fatigue prevalence was 68%, 38% and 34% at 1 week, 3 and 6 months, respectively. There was a strong effect for time over the first 3 months and moderate-to-high correlations between fatigue prevalence and severity. Early fatigue strongly predicted later fatigue; depression, but not anxiety was a predictor. Fatigue was seen as laziness by family or friends in 30% of cases. Post-MTBI fatigue is a persistent post-concussion symptom, exacerbated by depression but not anxiety. It diminishes in the first 3 months and then becomes relatively stable, suggesting the optimum intervention placement is at 3 months or more post-MTBI.

  19. A wireless body measurement system to study fatigue in multiple sclerosis.

    PubMed

    Yu, Fei; Bilberg, Arne; Stenager, Egon; Rabotti, Chiara; Zhang, Bin; Mischi, Massimo

    2012-12-01

    Fatigue is reported as the most common symptom by patients with multiple sclerosis (MS). The physiological and functional parameters related to fatigue in MS patients are currently not well established. A new wearable wireless body measurement system, named Fatigue Monitoring System (FAMOS), was developed to study fatigue in MS. It can continuously measure electrocardiogram, body-skin temperature, electromyogram and motions of feet. The goal of this study is to test the ability of distinguishing fatigued MS patients from healthy subjects by the use of FAMOS. This paper presents the realization of the measurement system including the design of both hardware and dedicated signal processing algorithms. Twenty-six participants including 17 MS patients with fatigue and 9 sex- and age-matched healthy controls were included in the study for continuous 24 h monitoring. The preliminary results show significant differences between fatigued MS patients and healthy controls. In conclusion, the FAMOS enables continuous data acquisition and estimation of multiple physiological and functional parameters. It provides a new, flexible and objective approach to study fatigue in MS, which can distinguish between fatigued MS patients and healthy controls. The usability and reliability of the FAMOS should however be further improved and validated through larger clinical trials.

  20. Trauma, stressful life events and depression predict HIV-related fatigue.

    PubMed

    Leserman, J; Barroso, J; Pence, B W; Salahuddin, N; Harmon, J L

    2008-11-01

    Despite the fact that fatigue is a common and debilitating symptom among HIV-infected persons, we know little about the predictors of fatigue in this population. The goal of this cross-sectional study was to examine the effects of early childhood trauma, recent stressful life events and depression on intensity and impairment of fatigue in HIV, over and above demographic factors and clinical characteristics. We studied 128 HIV-infected men and women from one southern state. The median number of childhood traumatic events was two and participants tended to have at least one moderate recent stressful event. Multiple regression findings showed that patients with less income, more childhood trauma, more recent stressful events and more depressive symptoms had greater fatigue intensity and fatigue-related impairment in daily functioning. Recent stresses were a more powerful predictor of fatigue than childhood trauma. None of the disease-related measures (e.g. CD4, viral load, antiretroviral medication) predicted fatigue. Although stress and trauma have been related to fatigue in other populations, this is the first study to examine the effects of traumatic and recent stressful life events on fatigue in an HIV-infected sample.

  1. The fatigue experience for women with human immunodeficiency virus.

    PubMed

    Lee, K A; Portillo, C J; Miramontes, H

    1999-01-01

    To examine fatigue as a symptom experienced by women with human immunodeficiency virus (HIV). A convenience sample of 100 women with HIV. Independent sample t-tests were used to test for mean differences in fatigue related to variables in the women's sociocultural and home environment (ethnicity, employment, marital status, and parenting). Pearson product moment correlations were used to examine significant relationships between fatigue and physiologic variables (age, CD4 cell count, and sleep). Lower CD4 cell counts were related to more daytime sleep, higher evening fatigue, and higher morning fatigue. Morning fatigue was related to duration of wake episodes during the night, napping, and perception of sleep disturbance during the past week. The number of awakenings during the first night predicted the severity of fatigue the next evening. To understand the fatigue experienced by women with HIV, researchers and clinicians must focus on the relative contributions of sociocultural, home, and physiologic environments within which these women live. Additional research is ongoing to identify the strategies these women use to manage daily activities such that gender-relevant and culturally relevant interventions for alleviating fatigue can be tested in women with a variety of chronic illnesses, including HIV and acquired immune deficiency syndrome.

  2. Evaluation of fatigue properties of EN31 steel heat treated using biodegradable gingili oil

    NASA Astrophysics Data System (ADS)

    Harichandra, B. P.; Prashanth, Mrudula; Prakash, S. V.

    2016-09-01

    Rotating bending fatigue is the most commonly encountered loading in most machines and machine tools. At the same time, modern literature in this area is very little. EN31 steel is a steel which is commonly used in load bearing applications which encounters fatigue loading. Further, studies on heat treated EN31 steel to improve fatigue strength is hardly reported. This paper takes this rare issue further ahead by using bio-degradable gingili oil to heat treat EN31 steel for fatigue applications. This paper reports the results of rotating bending fatigue study of EN31 steel. Fatigue tests were conducted for three conditions a) Untreated, b) Heat treated with water, and c) Heat treated with gingili oil, with cantilever loads ranging from 30% to 90% using double sided rotating bending fatigue testing machine. It is seen that EN31 steel heat treated using gingili oil has far superior fatigue properties than water treated and untreated ones, with gingili oil quenched specimen have ∼10 times more fatigue life than water quenched specimen and ∼100 times more than unquenched specimens when lower bending stresses are involved.

  3. The influence of lumbar extensor muscle fatigue on lumbar-pelvic coordination during weightlifting.

    PubMed

    Hu, Boyi; Ning, Xiaopeng

    2015-01-01

    Lumbar muscle fatigue is a potential risk factor for the development of low back pain. In this study, we investigated the influence of lumbar extensor muscle fatigue on lumbar-pelvic coordination patterns during weightlifting. Each of the 15 male subjects performed five repetitions of weightlifting tasks both before and after a lumbar extensor muscle fatiguing protocol. Lumbar muscle electromyography was collected to assess fatigue. Trunk kinematics was recorded to calculate lumbar-pelvic continuous relative phase (CRP) and CRP variability. Results showed that fatigue significantly reduced the average lumbar-pelvic CRP value (from 0.33 to 0.29 rad) during weightlifting. The average CRP variability reduced from 0.17 to 0.15 rad, yet this change ws statistically not significant. Further analyses also discovered elevated spinal loading during weightlifting after the development of lumbar extensor muscle fatigue. Our results suggest that frequently experienced lumbar extensor muscle fatigue should be avoided in an occupational environment. Lumbar extensor muscle fatigue generates more in-phase lumbar-pelvic coordination patterns and elevated spinal loading during lifting. Such increase in spinal loading may indicate higher risk of back injury. Our results suggest that frequently experienced lumbar muscle fatigue should be avoided to reduce the risk of LBP.

  4. Cancer-related fatigue--mechanisms, risk factors, and treatments.

    PubMed

    Bower, Julienne E

    2014-10-01

    Fatigue is one of the most common adverse effects of cancer that might persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and might be a risk factor of reduced survival. The prevalence and course of fatigue in patients with cancer have been well characterized and there is growing understanding of the underlying biological mechanisms. Inflammation seems to have a key role in fatigue before, during, and after cancer-treatment. However, there is a considerable variability in the presentation of cancer-related fatigue, much of which is not explained by disease-related or treatment-related characteristics, suggesting that host factors might be important in the development and persistence of this symptom. Indeed, longitudinal studies have identified genetic, biological, psychosocial, and behavioural risk factors associated with cancer-related fatigue. Although no current gold-standard treatment for fatigue is available, a variety of intervention approaches have shown beneficial effects in randomized controlled trials, including physical activity, psychosocial, mind-body, and pharmacological treatments. This Review describes the mechanisms, risk factors, and possible interventions for cancer-related fatigue, focusing on recent longitudinal studies and randomized trials that have targeted fatigued patients.

  5. Tendon fatigue in response to mechanical loading

    PubMed Central

    Andarawis-Puri, N.; Flatow, E. L.

    2015-01-01

    Tendinopathies are commonly attributable to accumulation of sub-rupture fatigue damage from repetitive use. Data is limited to late stage disease from patients undergoing surgery, motivating development of animal models, such as ones utilizing treadmill running or repetitive reaching, to investigate the progression of tendinopathies. We developed an in vivo model using the rat patellar tendon that allows control of the loading directly applied to the tendon. This manuscript discusses the response of tendons to fatigue loading and applications of our model. Briefly, the fatigue life of the tendon was used to define low, moderate and high levels of fatigue loading. Morphological assessment showed a progression from mild kinks to fiber disruption, for low to high level fatigue loading. Collagen expression, 1 and 3 days post loading, showed more modest changes for low and moderate than high level fatigue loading. Protein and mRNA expression of Ineterleukin-1β and MMP-13 were upregulated for moderate but not low level fatigue loading. Moderate level (7200 cycles) and 100 cycles of fatigue loading resulted in a catabolic and anabolic molecular profile respectively, at both 1 and 7 days post loading. Results suggest unique mechanisms for different levels of fatigue loading that are distinct from laceration. PMID:21625047

  6. Influence of Prior Fatigue Cycling on Creep Behavior of Reduced Activation Ferritic-Martensitic Steel

    NASA Astrophysics Data System (ADS)

    Sarkar, Aritra; Vijayanand, V. D.; Parameswaran, P.; Shankar, Vani; Sandhya, R.; Laha, K.; Mathew, M. D.; Jayakumar, T.; Rajendra Kumar, E.

    2014-06-01

    Creep tests were carried out at 823 K (550 °C) and 210 MPa on Reduced Activation Ferritic-Martensitic (RAFM) steel which was subjected to different extents of prior fatigue exposure at 823 K at a strain amplitude of ±0.6 pct to assess the effect of prior fatigue exposure on creep behavior. Extensive cyclic softening that characterized the fatigue damage was found to be immensely deleterious for creep strength of the tempered martensitic steel. Creep rupture life was reduced to 60 pct of that of the virgin steel when the steel was exposed to as low as 1 pct of fatigue life. However, creep life saturated after fatigue exposure of 40 pct. Increase in minimum creep rate and decrease in creep rupture ductility with a saturating trend were observed with prior fatigue exposures. To substantiate these findings, detailed transmission electron microscopy studies were carried out on the steel. With fatigue exposures, extensive recovery of martensitic-lath structure was distinctly observed which supported the cyclic softening behavior that was introduced due to prior fatigue. Consequently, prior fatigue exposures were considered responsible for decrease in creep ductility and associated reduction in the creep rupture strength.

  7. An evaluation of fatigue limit of notched specimen of a C/C composite

    NASA Astrophysics Data System (ADS)

    Makabe, C.; Fujikawa, M.; Ferdous, M. S.

    2018-06-01

    The fatigue strengths in notched specimens of carbon fiber reinforced carbon composites (C/C composites) were investigated. The fatigue limit was measured by S-N curves and load increase tests. The value of fatigue limit obtained by those methods was almost the same. Slits of several sizes were cut on both sides of a test section, and different sizes of slit length were chosen. Also, specimens with blunt-notches were used to compare the fatigue strength. The weakest fatigue limit was obtained in the case of specimens with blunt-notches. However, the stress concentration factor of those is smaller than that of slit specimens. The relationships between fatigue strengths and specimen shapes were analyzed by stress distribution. The effect of slit configuration on fatigue strength was then discussed regarding the experimental consequences. Consequently, it was discussed that the fatigue strength of the present specimens was determined depending on the damage conditions in the vicinity of the notch and on the crack initiation behavior. It is expected that the tendency of the S-N curve and fatigue limit was related to the shear damage and shear mode of the crack growth.

  8. A probabilistic fatigue analysis of multiple site damage

    NASA Technical Reports Server (NTRS)

    Rohrbaugh, S. M.; Ruff, D.; Hillberry, B. M.; Mccabe, G.; Grandt, A. F., Jr.

    1994-01-01

    The variability in initial crack size and fatigue crack growth is incorporated in a probabilistic model that is used to predict the fatigue lives for unstiffened aluminum alloy panels containing multiple site damage (MSD). The uncertainty of the damage in the MSD panel is represented by a distribution of fatigue crack lengths that are analytically derived from equivalent initial flaw sizes. The variability in fatigue crack growth rate is characterized by stochastic descriptions of crack growth parameters for a modified Paris crack growth law. A Monte-Carlo simulation explicitly describes the MSD panel by randomly selecting values from the stochastic variables and then grows the MSD cracks with a deterministic fatigue model until the panel fails. Different simulations investigate the influences of the fatigue variability on the distributions of remaining fatigue lives. Six cases that consider fixed and variable conditions of initial crack size and fatigue crack growth rate are examined. The crack size distribution exhibited a dominant effect on the remaining fatigue life distribution, and the variable crack growth rate exhibited a lesser effect on the distribution. In addition, the probabilistic model predicted that only a small percentage of the life remains after a lead crack develops in the MSD panel.

  9. [Evaluating fatigue resistance effect of health food by near-infrared tissue oximeter].

    PubMed

    Wu, Jian; Ding, Hai-shu; Ye, Da-tian

    2009-09-01

    Currently, chronic fatigue syndrome (CFS) seriously affects people's normal living and work. In the present paper, the physiological parameters, such as tissue oxygenation saturation and heart rate, were used to evaluate the subjects' fatigue degree, and the fatigue resistance capsule and coffee were taken as a measure to adjust the fatigue. Human tissue oxygen saturation (rSO2) can be monitored noninvasively and in real time by near infrared spectroscopy (NIRS) based on spatially-resolved spectroscopy. Aiming at those brainworkers who need to work in an office for a long time; two static experiments were designed to evaluate the fatigue degree of the subjects who either take the fatigue resistance capsules/coffee or not. The rSO2 and heart rate (HR) of the subjects in the experiment group and contrast group were measured respectively for fatigue evaluation. This work particularly analyzed the changes in rSO2 in these two groups. The results show that the rSO2 of subjects in the experiment group evidently increased compared to that in the contrast group when the subjects took the fatigue resistance capsule or coffee, thereby show that the health food can reduce the fatigue to a certain extent.

  10. Effects of Distress and Eustress on Changes in Fatigue from Waking to Working.

    PubMed

    Parker, Kelsey N; Ragsdale, Jennifer M

    2015-11-01

    As a potential indicator of strain, fatigue is an important outcome in occupational health research. The current study examined the influence of positive (eustress) and negative (distress) work experiences on changes in fatigue from morning to at-work. It was expected that within-person changes in fatigue from waking to working would be moderated by employees' experiences of stress, pain, happiness, and meaningfulness at work. Data on 1,195 full-time working adults were collected through the Bureau of Labor Statistics' 2010 American Time Use Study (ATUS) using a day reconstruction method to assess fatigue at two time points (morning and during work) and employees' eustress and distress experiences during work. Multilevel modeling showed that the indicators of distress, stress and pain, predicted higher morning fatigue and stronger increases in fatigue during the workday. The indicators of eustress, happiness and meaningfulness, predicted lower fatigue at both time points but not temporal changes. These results contribute to understanding changes in employees' fatigue and suggest that the differential effects of distress and eustress experiences at work may be important to consider in fatigue management interventions. © 2015 The International Association of Applied Psychology.

  11. A survey of the prevalence of fatigue, its precursors and individual coping mechanisms among U.S. manufacturing workers.

    PubMed

    Lu, Lin; Megahed, Fadel M; Sesek, Richard F; Cavuoto, Lora A

    2017-11-01

    Advanced manufacturing has resulted in significant changes on the shop-floor, influencing work demands and the working environment. The corresponding safety-related effects, including fatigue, have not been captured on an industry-wide scale. This paper presents results of a survey of U.S. manufacturing workers for the: prevalence of fatigue, its root causes and significant factors, and adopted individual fatigue coping methods. The responses from 451 manufacturing employees were analyzed using descriptive data analysis, bivariate analysis and Market Basket Analysis. 57.9% of respondents indicated that they were somewhat fatigued during the past week. They reported the ankles/feet, lower back and eyes were frequently affected body parts and a lack of sleep, work stress and shift schedule were top selected root causes for fatigue. In order to respond to fatigue when it is present, respondents reported coping by drinking caffeinated drinks, stretching/doing exercises and talking with coworkers. Frequent combinations of fatigue causes and individual coping methods were identified. These results may inform the design of fatigue monitoring and mitigation strategies and future research related to fatigue development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Fatigue in HIV-Infected People: A Three-Year Observational Study

    PubMed Central

    Barroso, Julie; Leserman, Jane; Harmon, James L.; Hammill, Bradley; Pence, Brian W.

    2015-01-01

    Context HIV-related fatigue remains the most frequent complaint of seropositive patients. Objectives To describe the natural course of fatigue in HIV infection, in a sample (n=128) followed for a three-year period. Methods A longitudinal prospective design was used to determine what factors influenced changes in fatigue intensity and fatigue-related impairment of functioning in a community-dwelling sample of HIV-infected individuals. Participants were followed every six months for a three-year period. At each study visit, we collected data on a large number of physiological and psychosocial markers that have been shown to be related to fatigue in HIV-infected people. At three-month intervals between study visits, we collected data on fatigue via mailed questionnaires. Results Fatigue in HIV infection is largely a result of stressful life events, and is closely tied to the anxiety and depression that accompany such events. Fatigue did not remit spontaneously over the course of the study, indicating the need for interventions to ameliorate this debilitating symptom. Conclusion Intervening to help people who are suffering from HIV-related fatigue to deal with stressful life events may help to ameliorate this debilitating symptom. PMID:25701691

  13. Evaluation of Fatigue Life of CRM-Reinforced SMA and Its Relationship to Dynamic Stiffness

    PubMed Central

    Mashaan, Nuha Salim; Karim, Mohamed Rehan; Abdel Aziz, Mahrez; Ibrahim, Mohd Rasdan; Katman, Herda Yati

    2014-01-01

    Fatigue cracking is an essential problem of asphalt concrete that contributes to pavement damage. Although stone matrix asphalt (SMA) has significantly provided resistance to rutting failure, its resistance to fatigue failure is yet to be fully addressed. The aim of this study is to evaluate the effect of crumb rubber modifier (CRM) on stiffness and fatigue properties of SMA mixtures at optimum binder content, using four different modification levels, namely, 6%, 8%, 10%, and 12% CRM by weight of the bitumen. The testing undertaken on the asphalt mix comprises the dynamic stiffness (indirect tensile test), dynamic creep (repeated load creep), and fatigue test (indirect tensile fatigue test) at temperature of 25°C. The indirect tensile fatigue test was conducted at three different stress levels (200, 300, and 400 kPa). Experimental results indicate that CRM-reinforced SMA mixtures exhibit significantly higher fatigue life compared to the mixtures without CRM. Further, higher correlation coefficient was obtained between the fatigue life and resilient modulus as compared to permanent strain; thus resilient modulus might be a more reliable indicator in evaluating the fatigue life of asphalt mixture. PMID:25050406

  14. Driver fatigue and highway driving: a simulator study.

    PubMed

    Ting, Ping-Huang; Hwang, Jiun-Ren; Doong, Ji-Liang; Jeng, Ming-Chang

    2008-06-09

    Long duration of driving is a significant cause of fatigue-related accidents on motorways or major roadways. The fatigue caused by driving for extended periods acutely impairs driver alertness and performance and can compromise transportation safety. This study quantitatively measured the progression of driver fatigue and identified the conservative safe duration of continuous highway driving. Thirty young male subjects were analyzed during 90 min of laboratory-simulated highway driving. Sleepiness ratings (SSS) and reaction time (RT) tests were used to assess impairment of driver alertness and vigilance. Additionally, various measures of driving performance recorded throughout the experiment were used to measure temporal deterioration of driver performance from alert to fatigued using principal component analysis (PCA). The analytical results revealed that SSS scores, reaction times (RTs) and unstable driving performance significantly increased over time, indicating that excessive driving time is a significant fatigue factor and potential cause of fatigue-related accidents. Moreover, the analytical results indicated that 80 min was the safe limit for monotonous highway driving. Based on the experimental findings of this study, public awareness of the adverse affects of driver fatigue during long-distance driving should be enhanced. This study provides explicit information of fatigue development that can be used to prevent fatigue-related accidents.

  15. Mental fatigue detection based on the functional near infrared spectroscopy

    NASA Astrophysics Data System (ADS)

    Zhang, Zhen; Xu, Fenggang; Yang, Hanjun; Jiang, Jin; Cao, Yong; Jiao, Xuejun

    2017-02-01

    Mental fatigue can be induced by long time mental work, mental fatigue caused worse performance and accidents. As a non-invasive technique, functional near-infrared spectroscopy (fNIRS) can measure blood oxygen activity in the cerebral cortex which reflect the cognitive function of brain indirectly. Aiming at investigating whether fNIRS can measure the mental fatigue and study the spatial pattern of hemodynamic response for mental fatigue, we used three sessions of verbal 2-back working memory task for a total of 120 minutes to induce mental fatigue, 15 healthy subjects were recruited and 30 channels including prefrontal cortex (PFC) and motor cortex (MC) were measured by fNIRS. The mean oxyhemoglobin feature for 20s was extracted as well as subjective fatigue level and performance. The results showed significant increase of subjected fatigue level as well as significant decrease performance from session one to three task. With the increased level of fatigue, oxyhemoglobin in PFC increase significantly and the spatial pattern of hemodynamic response in the all 30 channels varied with task duration as well. These findings indicated the potential of fNIRS measured hemodynamic as a mental fatigue indicator.

  16. Fatigue Risk Management: A Maritime Framework.

    PubMed

    Grech, Michelle Rita

    2016-01-29

    It is evident that despite efforts directed at mitigating the risk of fatigue through the adoption of hours of work and rest regulations and development of codes and guidelines, fatigue still remains a concern in shipping. Lack of fatigue management has been identified as a contributory factor in a number of recent accidents. This is further substantiated through research reports with shortfalls highlighted in current fatigue management approaches. These approaches mainly focus on prescriptive hours of work and rest and include an individualistic approach to managing fatigue. The expectation is that seafarers are responsible to manage and tolerate fatigue as part of their working life at sea. This attitude is an accepted part of a seafarer's role. Poor compliance is one manifest of this problem with shipboard demands making it hard for seafarers to follow hours of work and rest regulations, forcing them into this "poor compliance" trap. This makes current fatigue management approaches ineffective. This paper proposes a risk based approach and way forward for the implementation of a fatigue risk management framework for shipping, aiming to support the hours of work and rest requirements. This forms part of the work currently underway to review and update the International Maritime Organization, Guidelines on Fatigue.

  17. Fatigue as a cause, not a consequence of depression and daytime sleepiness: a cross-lagged analysis.

    PubMed

    Schönberger, Michael; Herrberg, Marlene; Ponsford, Jennie

    2014-01-01

    To examine the temporal relation between fatigue, depression, and daytime sleepiness after traumatic brain injury. Fatigue is a frequent and disabling consequence of traumatic brain injury (TBI). However, it is unclear whether fatigue is a primary consequence of the structural brain injury or a secondary consequence of injury-related sequelae such as depression and daytime sleepiness. Eighty-eight adults with complicated mild-severe TBI (69% male). Fatigue Severity Scale; depression subscale of the Hospital Anxiety and Depression Scale; Epworth Sleepiness scale at baseline and 6-month follow-up. A cross-lagged path analysis computed within a structural equation modeling framework revealed that fatigue was predictive of depression (β = .20, P < .05) and sleepiness (β = .25, P < .05). However, depression and sleepiness did not predict fatigue (P > .05). The results support the view of fatigue after TBI as "primary fatigue"-that is, a consequence of the structural brain injury rather than a secondary consequence of depression or daytime sleepiness. A rehabilitation approach that assists individuals with brain injury in learning to cope with their neuropsychological and physical limitations in everyday life might attenuate their experience with fatigue.

  18. Measuring fatigue in people living with HIV/AIDS: psychometric characteristics of the HIV-Related Fatigue Scale

    PubMed Central

    BW, Pence; Barroso, J.; Leserman, J.; Harmon, J.L.; Salahuddin, N.

    2008-01-01

    In the era of life-prolonging antiretroviral therapy, chronic fatigue is one of the most prevalent and disabling symptoms of people living with HIV/AIDS, yet its measurement remains challenging. No instruments have been developed specifically to describe HIV-related fatigue. We assessed the reliability and construct validity of the HIV-Related Fatigue Scale (HRFS), a 56-item self-report instrument developed through formative qualitative research and designed to measure the intensity and consequences of fatigue as well as the circumstances surrounding fatigue in people living with HIV. The HRFS has three main scales, which measure fatigue intensity, the responsiveness of fatigue to circumstances and fatigue-related impairment of functioning. The functioning scale can be further divided into subscales measuring impairment of activities of daily living, impairment of mental functioning and impairment of social functioning. Each scale demonstrated high internal consistency (Cronbach’s alpha=0.93, 0.91 and 0.97 for the intensity, responsiveness and functioning scales, respectively). The HRFS scales also demonstrated satisfactory convergent validity when compared to other fatigue measures. HIV-Related Fatigue Scales were moderately correlated with quality of nighttime sleep (rho = 0.46, 0.47 and 0.35) but showed only weak correlations with daytime sleepiness (rho = 0.20, 0.33 and 0.18). The scales were also moderately correlated with general mental and physical health as measured by the SF-36 Health Survey (rho ranged from 0.30 to 0.68 across the 8 SF-36 subscales with most >0.40). The HRFS is a promising tool to help facilitate research on the prevalence, etiology and consequences of fatigue in people living with HIV. PMID:18608084

  19. Investigating the effects of maximal anaerobic fatigue on dynamic postural control using the Y-Balance Test.

    PubMed

    Johnston, William; Dolan, Kara; Reid, Niamh; Coughlan, Garrett F; Caulfield, Brian

    2018-01-01

    The Y Balance Test is one of the most commonly used dynamic balance assessments, providing an insight into the integration of the sensorimotor subsystems. In recent times, there has been an increase in interest surrounding it's use in various clinical populations demonstrating alterations in motor function. Therefore, it is important to examine the effect physiological influences such as fatigue play in dynamic postural control, and establish a timeframe for its recovery. Descriptive laboratory study. Twenty male and female (age 23.75±4.79years, height 174.12±8.45cm, mass 69.32±8.76kg) partaking in competitive sport, completed the Y Balance Test protocol at 0, 10 and 20min, prior to a modified 60s Wingate fatiguing protocol. Post-fatigue assessments were then completed at 0, 10 and 20 min post-fatiguing intervention. Intraclass correlation coefficients demonstrated excellent intra-session reliability (0.976-0.982) across the three pre-fatigue YBT tests. Post-hoc paired sample t-tests demonstrated that all three reach directions demonstrated statistically significant differences between pre-fatigue and the first post-fatigue measurement (anterior; p=0.019, posteromedial; p=0.019 & posterolateral; p=0.003). The anterior reach direction returned to pre-fatigue levels within 10min (p=0.632). The posteromedial reach direction returned to pre-fatigue levels within 20min (p=0.236), while the posterolateral direction maintained a statistically significant difference at 20min (p=0.023). Maximal anaerobic fatigue has a negative effect on normalised Y balance test scores in all three directions. Following the fatiguing protocol, dynamic postural control returns to pre-fatigue levels for the anterior (<10min), posteromedial (<20min) and posterolateral (>20min). Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. An Exploratory Study of Fatigue and Physical Activity in Canadian Thyroid Cancer Patients.

    PubMed

    Alhashemi, Ahmad; Jones, Jennifer M; Goldstein, David P; Mina, Daniel Santa; Thabane, Lehana; Sabiston, Catherine M; Chang, Eugene K; Brierley, James D; Sawka, Anna M

    2017-09-01

    Fatigue is common among cancer survivors, but fatigue in thyroid cancer (TC) survivors may be under-appreciated. This study investigated the severity and prevalence of moderate and severe fatigue in TC survivors. Potential predictive factors, including physical activity, were explored. A cross-sectional, written, self-administered TC patient survey and retrospective chart review were performed in an outpatient academic Endocrinology clinic in Toronto, Canada. The primary outcome measure was the global fatigue score measured by the Brief Fatigue Inventory (BFI). Physical activity was evaluated using the International Physical Activity Questionnaire-7 day (IPAQ-7). Predictors of BFI global fatigue score were explored in univariate analyses and a multivariable linear regression model. The response rate was 63.1% (205/325). Three-quarters of the respondents were women (152/205). The mean age was 52.5 years, and the mean time since first TC surgery was 6.8 years. The mean global BFI score was 3.5 (standard deviation 2.4) out of 10 (10 is worst). The prevalence of moderate-severe fatigue (global BFI score 4.1-10 out of 10) was 41.4% (84/203). Individuals who were unemployed or unable to work due to disability reported significantly higher levels of fatigue compared to the rest of the study population, in uni-and multivariable analyses. Furthermore, increased physical activity was associated with reduced fatigue in uni- and multivariable analyses. Other socio-demographic, disease, or biochemical variables were not significantly associated with fatigue in the multivariable model. Moderate or severe fatigue was reported in about 4/10 TC survivors. Independent predictors of worse fatigue included unemployment and reduced physical activity.

  1. Measuring fatigue in people living with HIV/AIDS: psychometric characteristics of the HIV-related fatigue scale.

    PubMed

    Pence, B W; Barroso, J; Leserman, J; Harmon, J L; Salahuddin, N

    2008-08-01

    In the era of life-prolonging antiretroviral therapy, chronic fatigue is one of the most prevalent and disabling symptoms of people living with HIV/AIDS, yet its measurement remains challenging. No instruments have been developed specifically to describe HIV-related fatigue. We assessed the reliability and construct validity of the HIV-Related Fatigue Scale (HRFS), a 56-item self-report instrument developed through formative qualitative research and designed to measure the intensity and consequences of fatigue as well as the circumstances surrounding fatigue in people living with HIV. The HRFS has three main scales, which measure fatigue intensity, the responsiveness of fatigue to circumstances and fatigue-related impairment of functioning. The functioning scale can be further divided into subscales measuring impairment of activities of daily living, impairment of mental functioning and impairment of social functioning. Each scale demonstrated high internal consistency (Cronbach's alpha=0.93, 0.91 and 0.97 for the intensity, responsiveness and functioning scales, respectively). The HRFS scales also demonstrated satisfactory convergent validity when compared to other fatigue measures. HIV-Related Fatigue Scales were moderately correlated with quality of nighttime sleep (rho=0.46, 0.47 and 0.35) but showed only weak correlations with daytime sleepiness (rho=0.20, 0.33 and 0.18). The scales were also moderately correlated with general mental and physical health as measured by the SF-36 Health Survey (rho ranged from 0.30 to 0.68 across the 8 SF-36 subscales with most >0.40). The HRFS is a promising tool to help facilitate research on the prevalence, etiology and consequences of fatigue in people living with HIV.

  2. Work factors as predictors of persistent fatigue: a prospective study of nurses' aides.

    PubMed

    Eriksen, W

    2006-06-01

    To identify work factors that predict persistent fatigue in nurses' aides. The sample comprised 5547 Norwegian nurses' aides, not on leave when they completed a mailed questionnaire in 1999. Of these, 4645 (83.7%) completed a second questionnaire 15 months later. The outcome measure was the occurrence of persistent fatigue, defined as having felt "usually fatigued" or "always fatigued" in daytime during the previous 14 days. In respondents without persistent fatigue at baseline, medium and high work demands, heavy smoking, being single, and having long term health problems were associated with increased risk of persistent fatigue at follow up. Medium and high rewards for well done work, medium levels of leadership fairness, and regular physical exercise were associated with reduced risk of persistent fatigue at follow up. In respondents with persistent fatigue at baseline, medium and high levels of positive challenges at work, high support from immediate superior, medium feedback about quality of one's work, and changes of work or work tasks that resulted in less heavy work or lower work pace were associated with increased odds of recovery (no persistent fatigue at follow up). Working in a nursing home and being intensely bothered by long term health problems were associated with reduced odds of recovery. High demands and lack of rewards at work may cause persistent fatigue in nurses' aides. Reduction of demands, adequate feedback, and mental stimulation in the form of support and positive challenges may facilitate recovery in those who have persistent fatigue. Leaders in the health services may be in a position to regulate factors that influence the level of fatigue in nurses' aides.

  3. The impact of depression on fatigue in patients with haemodialysis: a correlational study.

    PubMed

    Bai, Yu-Ling; Lai, Liu-Yuan; Lee, Bih-O; Chang, Yong-Yuan; Chiou, Chou-Ping

    2015-07-01

    To investigate the fatigue levels and important fatigue predictors for patients undergoing haemodialysis. Fatigue is a common symptom for haemodialysis patients. With its debilitating and distressing effects, it impacts patients in terms of their quality of life while also increasing their mortality rate. A descriptive correlational study. Convenience sampling was conducted at six chosen haemodialysis centres in Southern Taiwan. Data were collected via a structured questionnaire from 193 haemodialysis patients. The scales involved in this study were socio-demographic details, the Center for Epidemiologic Studies Depression Scale, and the Fatigue Scale for haemodialysis patients. Data analysis included percentages, means, standard deviations and hierarchical multiple regression analysis. The fatigue level for haemodialysis patients was in the moderate range. Results from the hierarchical multiple regression analysis indicated that age, employment status, types of medications, physical activity and depression were significant. Of those variables, depression had the greatest impact on the patients' fatigue level, accounting for up to 30·6% of the explanatory power. The total explanatory power of the regression model was 64·2%. This study determined that for haemodialysis patients, unemployment, increased age, taking more medications or lower exercise frequencies resulted in more severe depression, which translated in turn to higher levels of fatigue. Among all these factors, depression had the greatest impact on the patients' fatigue levels. Not only is this finding beneficial to future studies on fatigue as a source of reference, it is also helpful in our understanding of important predictors relating to fatigue in the everyday lives of haemodialysis patients. It is recommended that when caring for fatigued patients, more care should be dedicated to their psychological states, and assistance should be provided in a timely way so as to reduce the amount of fatigue suffered. © 2015 John Wiley & Sons Ltd.

  4. Sleep quality moderates the association between physical activity frequency and feelings of energy and fatigue in adolescents.

    PubMed

    Herring, Matthew P; Monroe, Derek C; Kline, Christopher E; O'Connor, Patrick J; MacDonncha, Ciaran

    2018-03-05

    Physical activity (PA) can improve sleep quality, low energy, and fatigue. Though poor sleep quality may induce feelings of low energy and fatigue, the potential moderating effect of sleep quality on associations between PA and feelings of energy and fatigue among adolescents is unknown. Thus, this study examined the moderating effect of sleep quality on associations between PA frequency and feelings of energy and fatigue among adolescents in Ireland. Adolescents (N = 481; 281 males, 200 females) aged 15.1 ± 1.7 years self-reported PA frequency, feelings of energy and fatigue, and sleep quality (September to December 2015). Two-way ANCOVAs examined variation in feelings of energy and fatigue according to the interaction of PA and sleep quality. Standardized mean difference (d) quantified the magnitude of differences. Poor sleepers with low PA reported greater feelings of fatigue compared to normal sleepers with low PA (d = 1.02; 95% CI 0.60, 1.44), and poor sleepers with moderate PA reported greater feelings of fatigue compared to normal sleepers with moderate PA (d = 0.50; 0.17, 0.82). Poor sleepers with low PA reported greater feelings of fatigue compared to both poor sleepers with moderate PA (d = 0.44; 0.05, 0.83) and poor sleepers with high PA (d = 0.87; 0.46, 1.28). Poor sleepers with moderate PA reported greater feelings of fatigue compared to poor sleepers with high PA (d = 0.52; 0.14, 0.91). Poor sleep did not moderate the association between PA and feelings of energy. Sleep quality moderates the association between PA frequency and feelings of fatigue. Fatigue symptoms improve as PA frequency increases among adolescents with poor sleep quality.

  5. Comprehensively understanding fatigue in patients with myeloproliferative neoplasms.

    PubMed

    Scherber, Robyn M; Kosiorek, Heidi E; Senyak, Zhenya; Dueck, Amylou C; Clark, Matthew M; Boxer, Michael A; Geyer, Holly L; McCallister, Archie; Cotter, Mary; Van Husen, Barbara; Harrison, Claire N; Mesa, Ruben A

    2016-02-01

    Patients with myeloproliferative neoplasms (MPNs) experience a high persistence, prevalence, and severity of fatigue. There is currently only limited information regarding factors that contribute to fatigue in patients with MPNs. A 70-item, Internet-based survey regarding fatigue was developed by MPN investigators and patients/advocates and hosted by the Mayo Clinic Survey Research Center. Fatigue was found to be prevalent and severe among international survey respondents (1788 respondents). Higher body mass index (P<.001), current use of alcohol (P<.001), and current tobacco use (P = .0025) were found to be significantly associated with greater fatigue. Moderate/severe fatigue was present more frequently in those individuals who did not exercise compared with those who reported exercising at least once per week (P<.001). Medical comorbidities found to be significantly associated with greater fatigue included restless leg syndrome (P = .006), diabetes mellitus (P = .045), fibromyalgia (P < 0.001), chronic fatigue syndrome (P = .006), and chronic kidney disease (P = .02). Current use of antidepressants (P<.001), antihistamines (P = .0276), antianxiety medications (P = .0357), and prescription pain medications (P<.001) were found to be associated with worsened fatigue. Nearly 25% of respondents scored > 2 on the Patient Health Questionnaire, indicating a high probability of depression. Higher Brief Fatigue Inventory score, Myeloproliferative Neoplasm Total Symptom Score, and individual symptom items were all associated with a higher likelihood of depressive symptoms (P<.0001). The management of fatigue should be multifactorial, with a comprehensive assessment and treatment plan to address all modifiable fatigue etiologies. Patients with MPNs likely have a higher prevalence of mood disturbances compared with the general population, suggesting the need to assess and intervene in this domain. © 2015 American Cancer Society.

  6. Fatigue, not self-rated motor symptom severity, affects quality of life in functional motor disorders.

    PubMed

    Gelauff, J M; Kingma, E M; Kalkman, J S; Bezemer, R; van Engelen, B G M; Stone, J; Tijssen, M A J; Rosmalen, J G M

    2018-06-02

    While fatigue is found to be an impairing symptom in functional motor disorders (FMD) in clinical practice, scientific evidence is lacking. We investigated fatigue severity and subtypes in FMD compared to organic neurological disease. Furthermore, the role of fatigue within FMD and its impact on quality of life and self-rated health were investigated. Data from 181 patients participating in the self-help on the internet for functional motor disorders, randomised Trial were included. Data from 217 neurological controls with neuromuscular disorders (NMD) originated from a historical cohort. Fatigue was measured using the checklist individual strength (CIS). Motor symptom severity, depression and anxiety were correlated to fatigue. For multivariable regression analyses, physical functioning and pain were additionally taken into account. Severe fatigue was, respectively, present in 78 and 53% of FMD and NMD patients (p < 0.001). FMD patients scored higher than NMD patients on all fatigue subdomains (p < 0.001). In the FMD group, fatigue subdomains were correlated to depression, anxiety and partly to motor symptom severity. Quality of life was negatively associated with fatigue [OR 0.93 (0.90-0.96), p < 0.001] and depression [OR 0.87 (0.81-0.93), p < 0.001], but not self-rated motor symptom severity. Self-rated health was negatively associated with fatigue [OR 0.92 (0.88-0.96), p < 0.001] and pain [OR 0.98 (0.97-0.99), p < 0.001]. Fatigue was found to be a prevalent problem in FMD, more so than in organic neurological disease. It significantly affected quality of life and self-rated health, while other factors such as motor symptom severity did not. Fatigue should be taken into account in clinical practice and treatment trials.

  7. The course of fatigue after acute spinal cord injury.

    PubMed

    Anton, H A; Miller, W C; Townson, A F; Imam, B; Silverberg, N; Forwell, S

    2017-01-01

    Prospective cohort study. To determine the prevalence and course of fatigue following acute spinal cord injury (SCI) during rehabilitation and after discharge. Tertiary spinal cord rehabilitation facility. Fifty-two patients with traumatic SCI were assessed after admission to rehabilitation and followed until 6-months post discharge into the community. Fatigue was measured using the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale for Spinal Cord Injury (MFIS-SCI) at admission, discharge and 6 months after discharge. Clinically significant fatigue was defined as FSS scores ⩾4 or MFIS-SCI scores ⩾24.5. The mean (s.d.) age of our mainly male (78.8%) sample was 46.3 (17.8) years of age. Half had cervical and 61.6% had complete injuries. Mean (s.d.) FSS scores were 3.7 (1.6) at baseline, 3.4 (1.5) at discharge and 3.7 (1.7) post discharge. Mean (s.d.) MFIS-SCI scores were 24.4 (16.1) at baseline, 23.4 (16.3) at discharge and 27.8 (17.5) post discharge. Fatigue on the FSS was present in 51.9% at baseline, 38.3% at discharge and 48.1% post discharge. Fatigue on the MFIS-SCI was present in 44.2% at baseline, 44.7% at discharge and 51.9% post discharge. There was no relationship between fatigue and injury level or completeness. Fatigue is common in SCI patients admitted to rehabilitation. Fatigue remained stable during rehabilitation and after discharge into the community. Clinicians should consider early screening for fatigue and interventions to reduce the consequences of fatigue in people with SCI. The British Columbia Medical Services Foundation funded our study.

  8. A possible genetic association with chronic fatigue in primary Sjögren's syndrome: a candidate gene study.

    PubMed

    Norheim, Katrine Brække; Le Hellard, Stephanie; Nordmark, Gunnel; Harboe, Erna; Gøransson, Lasse; Brun, Johan G; Wahren-Herlenius, Marie; Jonsson, Roland; Omdal, Roald

    2014-02-01

    Fatigue is prevalent and disabling in primary Sjögren's syndrome (pSS). Results from studies in chronic fatigue syndrome (CFS) indicate that genetic variation may influence fatigue. The aim of this study was to investigate single nucleotide polymorphism (SNP) variations in pSS patients with high and low fatigue. A panel of 85 SNPs in 12 genes was selected based on previous studies in CFS. A total of 207 pSS patients and 376 healthy controls were genotyped. One-hundred and ninety-three patients and 70 SNPs in 11 genes were available for analysis after quality control. Patients were dichotomized based on fatigue visual analogue scale (VAS) scores, with VAS <50 denominated "low fatigue" (n = 53) and VAS ≥50 denominated "high fatigue" (n = 140). We detected signals of association with pSS for one SNP in SLC25A40 (unadjusted p = 0.007) and two SNPs in PKN1 (both p = 0.03) in our pSS case versus control analysis. The association with SLC25A40 was stronger when only pSS high fatigue patients were analysed versus controls (p = 0.002). One SNP in PKN1 displayed an association in the case-only analysis of pSS high fatigue versus pSS low fatigue (p = 0.005). This candidate gene study in pSS did reveal a trend for associations between genetic variation in candidate genes and fatigue. The results will need to be replicated. More research on genetic associations with fatigue is warranted, and future trials should include larger cohorts and multicentre collaborations with sharing of genetic material to increase the statistical power.

  9. Fatigue of Chinese railway employees and its influential factors: Structural equation modelling.

    PubMed

    Tsao, Liuxing; Chang, Jing; Ma, Liang

    2017-07-01

    Fatigue is an identifiable and preventable cause of accidents in transport operations. Regarding the railway sector, incident logs and simulation studies show that employee fatigue leads to lack of alertness, impaired performance, and occurrence of incidents. China has one of the largest rail systems in the world, and Chinese railway employees work under high fatigue risks; therefore, it is important to assess their fatigue level and find the major factors leading to fatigue. We designed a questionnaire that uses Multidimensional Fatigue Instrument (MFI-20), NASA-TLX and subjective rating of work overtime feelings to assess employee fatigue. The contribution of each influential factor of fatigue was analysed using structural equation modelling. In total, 297 employees from the rail maintenance department and 227 employees from the locomotive department returned valid responses. The average scores and standard deviations for the five subscales of MFI-20, namely General Fatigue, Physical Fatigue, Reduced Activity, Reduced Motivation, and Mental Fatigue, were 2.9 (0.8), 2.8 (0.8), 2.5 (0.8), 2.5 (0.7), and 2.4 (0.8) among the rail maintenance employees and 3.5 (0.8), 3.5 (0.7), 3.3 (0.7), 3.0 (0.6), and 3.1 (0.7), respectively, among the locomotive employees. The fatigue of the locomotive employees was influenced by feelings related to working overtime (standardized r = 0.22) and workload (standardized r = 0.27). The work overtime control and physical working environment significantly influenced subjective feelings (standardized r = -0.25 and 0.47, respectively), while improper work/rest rhythms and an adverse physical working environment significantly increased the workload (standardized r = 0.48 and 0.33, respectively). Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Factors Associated with Fatigue among Men Aged 45 and Older: A Cross-Sectional Study

    PubMed Central

    Lin, Wei-Quan; Jing, Meng-Juan; Tang, Jie; Wang, Jia-Ji; Zhang, Hui-Shan; Yuan, Le-Xin; Wang, Pei-Xi

    2015-01-01

    Background and Purpose: Fatigue is one of the most common symptoms reported in several studies; but few studies have concentrated on the male population, especially for the middle-aged and older men who are exposed to greater fatigue risk. The purpose of this study was to explore the prevalence of fatigue and identify the risk factors of fatigue among men aged 45 and older in China. Methods: This study was part of a cross-sectional study on community health in Shunde (Guangdong Province, China). A total sample of 1158 men aged 45 and older were included. Sociodemographic characteristics, health and lifestyle factors and the Chalder Fatigue Scale (CFS) were measured by structured questionnaires through face-to-face interviews. Multivariate logistic regression was applied to determine the risk factors of fatigue. Results: Approximately 30% of participants experienced fatigue. Older age (≥75 years: adjusted OR 3.88, 95% CI 2.09–7.18), single marital status (1.94, 1.04–3.62), unemployed status (1.68, 1.16–2.43), number of self-reported chronic diseases (≥2 chronic diseases: 2.83, 1.86–4.31), number of individuals’ children (≥4 children: 2.35, 1.33–4.15), hospitalization in the last year (1.61, 1.03–2.52) were all significantly associated with increased risk of fatigue, while regular exercise (0.46, 0.32–0.65) was a protective factor against fatigue. Conclusions: Fatigue was usual in males and several factors were associated with the fatigue. These findings may have implication in risk assessment of fatigue and help in developing and implementing targeted interventions in middle-aged and elderly males. PMID:26404346

  11. Subjective but Not Actigraphy-Defined Sleep Predicts Next-Day Fatigue in Chronic Fatigue Syndrome: A Prospective Daily Diary Study

    PubMed Central

    Russell, Charlotte; Wearden, Alison J.; Fairclough, Gillian; Emsley, Richard A.; Kyle, Simon D.

    2016-01-01

    Study Objectives: This study aimed to (1) examine the relationship between subjective and actigraphy-defined sleep, and next-day fatigue in chronic fatigue syndrome (CFS); and (2) investigate the potential mediating role of negative mood on this relationship. We also sought to examine the effect of presleep arousal on perceptions of sleep. Methods: Twenty-seven adults meeting the Oxford criteria for CFS and self-identifying as experiencing sleep difficulties were recruited to take part in a prospective daily diary study, enabling symptom capture in real time over a 6-day period. A paper diary was used to record nightly subjective sleep and presleep arousal. Mood and fatigue symptoms were rated four times each day. Actigraphy was employed to provide objective estimations of sleep duration and continuity. Results: Multilevel modelling revealed that subjective sleep variables, namely sleep quality, efficiency, and perceiving sleep to be unrefreshing, predicted following-day fatigue levels, with poorer subjective sleep related to increased fatigue. Lower subjective sleep efficiency and perceiving sleep as unrefreshing predicted reduced variance in fatigue across the following day. Negative mood on waking partially mediated these relationships. Increased presleep cognitive and somatic arousal predicted self-reported poor sleep. Actigraphy-defined sleep, however, was not found to predict following-day fatigue. Conclusions: For the first time we show that nightly subjective sleep predicts next-day fatigue in CFS and identify important factors driving this relationship. Our data suggest that sleep specific interventions, targeting presleep arousal, perceptions of sleep and negative mood on waking, may improve fatigue in CFS. Citation: Russell C, Wearden AJ, Fairclough G, Emsley RA, Kyle SD. Subjective but not actigraphy-defined sleep predicts next-day fatigue in chronic fatigue syndrome: a prospective daily diary study. SLEEP 2016;39(4):937–944. PMID:26715232

  12. Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome

    PubMed Central

    Lattie, Emily G.; Antoni, Michael H.; Fletcher, Mary Ann; Penedo, Frank; Czaja, Sara; Lopez, Corina; Perdomo, Dolores; Sala, Andreina; Nair, Sankaran; Fu, Shih Hua; Klimas, Nancy

    2012-01-01

    Objectives Stressors and emotional distress responses impact chronic fatigue syndrome (CFS) symptoms, including fatigue. Having better stress management skills might mitigate fatigue by decreasing emotional distress. Because CFS patients comprise a heterogeneous population, we hypothesized that the role of stress management skills in decreasing fatigue may be most pronounced in the subgroup manifesting the greatest neuroimmune dysfunction. Methods In total, 117 individuals with CFS provided blood and saliva samples, and self-report measures of emotional distress, perceived stress management skills (PSMS), and fatigue. Plasma interleukin-1-beta (IL-1β, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), and diurnal salivary cortisol were analyzed. We examined relations among PSMS, emotional distress, and fatigue in CFS patients who did and did not evidence neuroimmune abnormalities. Results Having greater PSMS related to less fatigue (p = .019) and emotional distress (p < .001), greater diurnal cortisol slope (p = .023) and lower IL-2 levels (p = .043). PSMS and emotional distress related to fatigue levels most strongly in CFS patients in the top tercile of IL-6, and emotional distress mediated the relationship between PSMS and fatigue most strongly in patients with the greatest circulating levels of IL-6 and a greater inflammatory (IL-6):anti-inflammatory (IL-10) cytokine ratio. Discussion CFS patients having greater PSMS show less emotional distress and fatigue, and the influence of stress management skills on distress and fatigue appear greatest among patients who have elevated IL-6 levels. These findings support the need for research examining the impact of stress management interventions in subgroups of CFS patients showing neuroimmune dysfunction. PMID:22417946

  13. Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome.

    PubMed

    Lattie, Emily G; Antoni, Michael H; Fletcher, Mary Ann; Penedo, Frank; Czaja, Sara; Lopez, Corina; Perdomo, Dolores; Sala, Andreina; Nair, Sankaran; Fu, Shih Hua; Klimas, Nancy

    2012-08-01

    Stressors and emotional distress responses impact chronic fatigue syndrome (CFS) symptoms, including fatigue. Having better stress management skills might mitigate fatigue by decreasing emotional distress. Because CFS patients comprise a heterogeneous population, we hypothesized that the role of stress management skills in decreasing fatigue may be most pronounced in the subgroup manifesting the greatest neuroimmune dysfunction. In total, 117 individuals with CFS provided blood and saliva samples, and self-report measures of emotional distress, perceived stress management skills (PSMS), and fatigue. Plasma interleukin-1-beta (IL-1β, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), and diurnal salivary cortisol were analyzed. We examined relations among PSMS, emotional distress, and fatigue in CFS patients who did and did not evidence neuroimmune abnormalities. Having greater PSMS related to less fatigue (p=.019) and emotional distress (p<.001), greater diurnal cortisol slope (p=.023) and lower IL-2 levels (p=.043). PSMS and emotional distress related to fatigue levels most strongly in CFS patients in the top tercile of IL-6, and emotional distress mediated the relationship between PSMS and fatigue most strongly in patients with the greatest circulating levels of IL-6 and a greater inflammatory (IL-6):anti-inflammatory (IL-10) cytokine ratio. CFS patients having greater PSMS show less emotional distress and fatigue, and the influence of stress management skills on distress and fatigue appear greatest among patients who have elevated IL-6 levels. These findings support the need for research examining the impact of stress management interventions in subgroups of CFS patients showing neuroimmune dysfunction. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Effect of micromorphology at the fatigue crack tip on the crack growth in electron beam welded Ti-6Al-4V joint

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tao, Junhui; Hu, Shubing, E-mail: 187352581@qq.com

    In this paper, we describe experiments on welded joints of Ti-6Al-4V alloy specimens exhibiting fatigue characteristics in the base metal (BM), hot affected zone (HAZ) and fuse zone (FZ). The effect of micromorphology on crack propagation at the tip of the fatigue crack in joints formed by electron beam welding was investigated using an optical microscope, transmission electron microscope and other methodologies. The results demonstrated that the fatigue crack originated in and propagated along α/β boundaries in the BM. In the HAZ, the fatigue crack occurred at the boundary between martensite laths, and propagated through most irregular-equiaxed α phases andmore » a few martensite laths. In the FZ, the fatigue crack originated at the boundaries between the fine crushing phases among martensite laths, and propagated along a majority of α/β boundaries and several narrow martensite laths. The electron beam welded joint of Ti-6Al-4V alloy showed instances of zigzag fatigue cracks that increased in degree from lowest in the HAZ, moderate in the FZ to greatest in the BM. Conversely, fatigue crack growth rate (FCGR) was greatest in the HAZ, less in the FZ and slowest in the BM. - Highlights: •Ti-6Al-4V welded joint exhibits different fatigue characteristics. •The fatigue crack propagates along α/β boundaries in the BM. •The fatigue crack propagates through α phases and martensite laths in the HAZ. •The fatigue crack propagates along α/β boundaries and martensite laths in the FZ. •Fatigue crack growth rate is fastest in the HAZ, less in the FZ, slowest in the BM.« less

  15. The Effect of Fatigue and Fatigue Intensity on Exercise Tolerance in Moderate COPD.

    PubMed

    Al-Shair, Khaled; Kolsum, Umme; Singh, Dave; Vestbo, Jørgen

    2016-12-01

    Fatigue is one of the most disabling symptoms in COPD, but little is known about the impact of fatigue on functional disability. We explored the impact of fatigue and fatigue intensity on exercise tolerance after adjusting for other factors using multivariate analysis and compared it to that of dyspnoea. A total of 119 patients with mainly moderate-severe stable COPD (38 % women, mean age 66 years) were enrolled. We used the Medical Research Council dyspnoea scores (MRC), Manchester COPD fatigue scale (MCFS) and its three dimensions, Borg scales for fatigue and dyspnoea, six-minute walk distance (6MWD), St George's Respiratory Questionnaire, the BODE index, and the Centre for Epidemiological Study on Depression scale (CES-D), and we measured spirometry, blood gases, systemic inflammatory markers and fat-free mass index (FFMI). Fatigue measured using the MCFS was associated with 6MWD and explained 22 % of the variability in 6MWD (p < 0.001). Fatigue remained associated with 6MWD after adjusting for MRC dyspnoea, FFMI and FEV 1 , FVC, PaO 2 , PaCO 2 , CES-D, TNF-alpha, smoking status, age and gender. We found that 33, 50 and 23 % of patients reported an increase by 2 scores on Borg scales for fatigue, dyspnoea or both at the end of the 6MWT. Fatigue scores (both before and after the 6MWT) were negatively correlated with 6MWD after adjusting for FEV 1 , FFMI, CES-D score and age (p = 0.007 and 0.001, respectively). In moderate stable COPD, fatigue may be a central driver of functional disability, to the same extent as dyspnoea.

  16. Exploring the patient perspective of fatigue in adults with visual impairment: a qualitative study.

    PubMed

    Schakel, Wouter; Bode, Christina; van der Aa, Hilde P A; Hulshof, Carel T J; Bosmans, Judith E; van Rens, Gerardus H M B; van Nispen, Ruth M A

    2017-08-03

    Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies. Two large Dutch low vision multidisciplinary rehabilitation organisations. 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling. A qualitative study involving semistructured interviews. A total of four first-level codes were top-down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding. Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue. Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Psychological profiles in patients with Sjögren's syndrome related to fatigue: a cluster analysis.

    PubMed

    van Leeuwen, Ninke; Bossema, Ercolie R; Knoop, Hans; Kruize, Aike A; Bootsma, Hendrika; Bijlsma, Johannes W J; Geenen, Rinie

    2015-05-01

    Fatigue is a highly prevalent and debilitating symptom in the autoimmune disease SS. Although the disease process plays a role in fatigue, psychological factors may influence fatigue and the ability to deal with its consequences. Profiles of co-occurring psychological factors may suggest potential targets for the treatment of fatigue. The aim of this study was to identify psychological profiles in patients with SS and the accompanying levels of fatigue. Three hundred patients with primary SS (mean age 57 years, 93% female) completed questionnaires on fatigue (multidimensional fatigue inventory), physical activity cognitions (TAMPA-SK), illness cognitions, cognitive regulation, emotion processing and regulation [Toronto Alexithymia Scale 20, Emotion Regulation Questionnaire (ERQ), Berkeley Expressivity Questionnaire], coping strategies (Brief COPE) and social support. Principal axis factor analysis (oblimin rotation) yielded six psychological factors: social support, negative thinking, positive thinking, emotional expressivity, avoidance and alexithymia (i.e. the inability to differentiate emotions). Using cluster analyses, these factors were grouped in four psychological profiles: functional (39%), alexithymic (27%), self-reliant (23%) and dysfunctional (11%). Irrespective of the psychological profile, the level of fatigue was substantially higher in patients than in the general population. Patients with a dysfunctional or an alexithymic profile reported more fatigue than those with a self-reliant profile. Our study in SS yielded four psychological profiles that were differentially associated with fatigue. These profiles can be used to examine determinants and prognosis of fatigue as well as the possibility of customizing cognitive behavioural interventions for chronic fatigue. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. The association of sociodemographic and objectively-assessed disease variables with fatigue in systemic sclerosis: an analysis of 785 Canadian Scleroderma Research Group Registry patients.

    PubMed

    Levis, Brooke; Kwakkenbos, Linda; Hudson, Marie; Baron, Murray; Thombs, Brett D

    2017-02-01

    Fatigue is prevalent among patients with systemic sclerosis (SSc). To date, studies investigating fatigue in SSc have been hampered by the instruments used to measure fatigue in SSc and have included patient-reported rather than objectively-rated measures of disease. The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale is a validated measure for assessing fatigue in SSc that, compared to other instruments, provides good coverage of the full range of the fatigue spectrum. The objective of this study was to assess sociodemographic and objectively-rated disease-related associates of fatigue, as measured by the FACIT-F, in a large sample of patients with SSc. Fatigue was assessed using the FACIT-F scale. Disease severity was assessed using Medsger's severity scale. Multivariable linear regression was performed to assess the independent associations between sociodemographic and medical variables and fatigue. Among 785 patients, the mean FACIT-F score was 32.2 (SD = 12.1). Being age 40-49 (reference = 60+; standardized regression coefficient (β) = -0.11), less than post-secondary education (β = 0.07), having more medical comorbidities (β = -0.11) and more severe muscle (β = -0.10), gastrointestinal (β = -0.15), lung (β = -0.13), and general system disease severity (β = -0.13) were independently associated with more fatigue (p < 0.05). Fatigue in SSc was independently associated with more severe disease. These data contribute to a better understanding of fatigue in SSc and help inform patient-centered research in SSc.

  19. Fatigue in Advanced Cancer Patients: Congruence Between Patients and Their Informal Caregivers About Patients' Fatigue Severity During Cancer Treatment With Palliative Intent and Predictors of Agreement.

    PubMed

    Poort, Hanneke; Peters, Marlies E W J; Gielissen, Marieke F M; Verhagen, Constans A H H V M; Bleijenberg, Gijs; van der Graaf, Winette T A; Wearden, Alison J; Knoop, Hans

    2016-09-01

    Informal caregivers (ICs) are increasingly involved in the monitoring of symptoms during advanced cancer patients' treatment with palliative intent. A common but subjective symptom during this extended treatment phase is fatigue. This exploratory longitudinal study aimed to determine agreement between patients and ICs about patients' fatigue severity. In addition, predictors of agreement over time were studied. A sample of 107 patients with advanced cancer (life expectancy ≥ six months) and their ICs completed the subscale fatigue severity of the Checklist Individual Strength based on the patient's status at baseline and six months later. This eight-item subscale has a validated cutoff to determine the presence of clinically relevant levels of fatigue. ICs' own fatigue severity, strain, self-esteem, and relationship satisfaction were examined as predictors of agreement. A total of 107 dyads completed measures at baseline and 69 dyads six months later. At baseline, ICs' significantly overestimated patients' fatigue severity (P < 0.001) with a moderate amount of bias (Cohen's d = 0.48). In 81 of the 107 dyads (76%), there was congruence about the presence or absence of severe fatigue. On a group level, congruence did not significantly change over time. On a dyad level, there was a tendency to either remain congruent or reach congruence. Next to baseline congruence, ICs' fatigue severity and strain predicted ICs' fatigue ratings (R(2) = 0.22). Most ICs accurately predict presence or absence of clinically relevant levels of patients' fatigue. ICs' own fatigue severity and strain should be taken into account as they influence agreement. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  20. Longitudinal risk factors for persistent fatigue in adolescents.

    PubMed

    Viner, Russell M; Clark, Charlotte; Taylor, Stephanie J C; Bhui, Kam; Klineberg, Emily; Head, Jenny; Booy, Robert; Stansfeld, Stephen A

    2008-05-01

    To examine whether sedentary behavior, obesity, smoking, and depression are risk factors for persistent fatigue in adolescents. Longitudinal population-based survey. Twenty-eight randomly selected schools in east London, England, in 2001 and 2003. A total of 1880 adolescents (49% male; 81% nonwhite British) aged 11 to 12 years and 13 to 14 years in 2000. Confidential questionnaires completed in class. Persistent fatigue (extreme tiredness twice weekly or more often in the previous month at both surveys), sedentary behavior, physical activity, depressive symptoms, body mass index, and smoking. Severe fatigue was reported in 11% of participants aged 11 to 14 years and 17% of participants aged 13 to 16 years. Eighty-four participants (4%) reported persistent fatigue. Across both surveys, only 3 pupils reported chronic fatigue syndrome. In multivariate logistic regression, risk of persistent fatigue was independently associated with being sedentary for more than 4 hours per day (odds ratio = 1.6; 95% confidence interval, 1.1-2.3; P = .01), being physically active (odds ratio = 1.5; 95% confidence interval, 1.1-2.3; P = .004), and depressive symptoms (odds ratio = 2.0; 95% confidence interval, 1.5-2.7; P < .001) in the first survey, after adjustment for age, sex, and socioeconomic status. Obesity and smoking were not associated with fatigue. Persistent fatigue is common. Being highly sedentary or highly active independently increased the risk of persistent fatigue, suggesting that divergence in either direction from healthy levels of activity increases the risk for persistent fatigue. Mental health is important in the etiology of persistent fatigue. To help define effective preventive strategies, further work is needed on the mechanisms by which these factors contribute to fatigue.

  1. Influence of blood flow occlusion on the development of peripheral and central fatigue during small muscle mass handgrip exercise

    PubMed Central

    Broxterman, R M; Craig, J C; Smith, J R; Wilcox, S L; Jia, C; Warren, S; Barstow, T J

    2015-01-01

    Abstract The influence of the muscle metabolic milieu on peripheral and central fatigue is currently unclear. Moreover, the relationships between peripheral and central fatigue and the curvature constant (W ′) have not been investigated. Six men (age: 25 ± 4 years, body mass: 82 ± 10 kg, height: 179 ± 4 cm) completed four constant power handgrip tests to exhaustion under conditions of control exercise (Con), blood flow occlusion exercise (Occ), Con with 5 min post-exercise blood flow occlusion (Con + Occ), and Occ with 5 min post-exercise blood flow occlusion (Occ + Occ). Neuromuscular fatigue measurements and W ′ were obtained for each subject. Each trial resulted in significant peripheral and central fatigue. Significantly greater peripheral (79.7 ± 5.1% vs. 22.7 ± 6.0%) and central (42.6 ± 3.9% vs. 4.9 ± 2.0%) fatigue occurred for Occ than for Con. In addition, significantly greater peripheral (83.0 ± 4.2% vs. 69.0 ± 6.2%) and central (65.5 ± 14.6% vs. 18.6 ± 4.1%) fatigue occurred for Occ + Occ than for Con + Occ. W ′ was significantly related to the magnitude of global (r = 0.91) and peripheral (r = 0.83) fatigue. The current findings demonstrate that blood flow occlusion exacerbated the development of both peripheral and central fatigue and that post-exercise blood flow occlusion prevented the recovery of both peripheral and central fatigue. Moreover, the current findings suggest that W ′ may be determined by the magnitude of fatigue accrued during exercise. Key points Critical power represents an important threshold for neuromuscular fatigue development and may, therefore, dictate intensities for which exercise tolerance is determined by the magnitude of fatigue accrued. Peripheral fatigue appears to be constant across O2 delivery conditions for large muscle mass exercise, but this consistency is equivocal for smaller muscle mass exercise. We sought to determine the influence of blood flow occlusion during handgrip exercise on neuromuscular fatigue development and to examine the relationship between neuromuscular fatigue development and W ′. Blood flow occlusion influenced the development of both peripheral and central fatigue, thus providing further evidence that the magnitude of peripheral fatigue is not constant across O2 delivery conditions for small muscle mass exercise. W ′ appears to be related to the magnitude of fatigue accrued during exercise, which may explain the reported consistency of intramuscular metabolic perturbations and work performed for severe-intensity exercise. PMID:26104881

  2. What is the best term in Spanish to express the concept of cancer-related fatigue?

    PubMed

    Centeno, Carlos; Portela Tejedor, María Angustias; Carvajal, Ana; San Miguel, Maria Teresa; Urdiroz, Julia; Ramos, Luis; De Santiago, Ana

    2009-05-01

    Fatigue is one of the most frequent symptoms in patients with cancer. No adequate term in Spanish has been defined to describe the English concept of fatigue. To identify the most suitable Spanish words that define the concept of fatigue and to check psychometric characteristics. Consensus with professional experts on Spanish words that best suit the English concept of fatigue. A prospective study on oncologic patients was also undertaken, which included an evaluation of the intensity of fatigue through visual numeric scales (VNS) where the words had been previously selected. The fatigue subscale of the Functional Assessment of Cancer Therapy-Fatigue (FACT-F) questionnaire was taken as a reference. The experts highlighted the words cansancio, agotamiento, and debilidad (tiredness, exhaustion, and weakness) as the terms that best defined the concept of fatigue. In the psychometric assessment study, 100 patients were included, of which 61 (61%) presented diagnostic values for cancer-related fatigue in the FACT-F fatigue subscale (score 34/52 or lower). The VNS for the chosen terms obtained a high correlation with the FACT-F fatigue subscale results: cansancio (tiredness) r = -0.71, agotamiento (exhaustion) r = -0.74, debilidad (weakness) r = -0.74, with no statistical differences between them. For the detection of fatigue by means of the VNS, tiredness (cutoff point > or =4/10) gave sensitivity (S) 0.90 and specificity (E) 0.72; exhaustion (cutoff point > or =3/10) S 0.95 and E 0.90 and weakness (cutoff point > or =4/10) S 0.92 and E 0.72. The ROC curve was 0.88 for tiredness, 0.94 for exhaustion, and 0.92 for weakness, with no significant difference between the areas mentioned. The terms cansancio, agotamiento, and debilidad (tiredness, exhaustion, and weakness) are suitable for defining the English concept of fatigue in Spanish, and should be the preferred option for inclusion in evaluation tools.

  3. Prevalence and Correlates of Fatigue in CKD and ESRD: Are Sleep Disorders a Key to Understanding Fatigue?

    PubMed Central

    Jhamb, Manisha; Liang, Kelly; Yabes, Jonathan; Steel, Jennifer L; Dew, Mary Amanda; Shah, Nirav; Unruh, Mark

    2014-01-01

    Background Fatigue is an important symptom to patients with advanced CKD. The aim of this study is to examine the prevalence and severity of fatigue among non-dialysis dependent CKD and ESRD patients; examine association of fatigue with subjective and objective sleep quality; identify other modifiable factors associated with fatigue. Methods Cross-sectional survey of 87 non-dialysis dependent CKD (eGFR ≤45 ml/min/1.73 m2) and 86 ESRD patients was done using Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F) and SF-36 vitality scale. Higher FACIT-F score denoted less fatigue. Objective sleep was assessed using in-home polysomnography. Predictors of fatigue were determined using linear regression model. Results Mean FACIT-F score among all participants was 34.5±11.0. Mean scores were similar among CKD and ESRD groups (34.25±11.28 versus 34.73±10.86; p=0.73). On univariate analyses, patients with higher levels of fatigue were more likely to have cardiovascular disease, benzodiazepine use, depressive symptoms, slightly lower hemoglobin and serum albumin levels. There was no significant association between severity of sleep apnea and level of fatigue (Apnea Hypopnea Index 20.1±27.6 versus 20.3±22.0; p=0.69). Presence of cardiovascular disease, low serum albumin, depressive symptoms, poor subjective sleep quality, excessive daytime sleepiness and restless legs syndrome (RLS) were independently associated with greater fatigue in multivariable regression models. The FACIT-F score correlated closely with the SF-36 vitality score (r =0.81, p<0.0001). Conclusions Patients with advanced CKD and ESRD experience profound fatigue. Depressive symptoms, RLS, excessive daytime sleepiness, and low albumin levels may provide targets for interventions to improve fatigue in patients with advanced CKD. PMID:24335380

  4. Body temperature is elevated and linked to fatigue in relapsing-remitting multiple sclerosis, even without heat exposure

    PubMed Central

    Sumowski, James F.; Leavitt, Victoria M.

    2014-01-01

    Objective To investigate whether resting body temperature is elevated and linked to fatigue in patients with relapsing-remitting multiple sclerosis (RRMS). Design Cross-sectional study investigating (a) differences in resting body temperature across RRMS, SPMS, and healthy groups, and (b) the relationship between body temperature and fatigue in RRMS patients. Setting Climate-controlled laboratory (~22°C) within a non-profit medical rehabilitation research center. Participants Fifty patients with RRMS, 40 matched healthy controls, and 22 patients with secondary-progressive MS (SPMS). Intervention None. Main Outcome Measure(s) Body temperature was measured with an aural infrared thermometer (normal body temperature for this thermometer is 36.75°C), and differences were compared across RRMS, SPMS, and healthy persons. RRMS patients completed measures of general fatigue (Fatigue Severity Scale; FSS), as well as physical and cognitive fatigue (Modified Fatigue Impact Scale; MFIS). Results There was a large effect of group (p<.001, ηp2=.132) whereby body temperature was higher in RRMS patients (37.04°C±0.27) relative to healthy controls (36.83 ± 0.33; p = .009) and SPMS patients (36.75°C±0.39; p=.001). Warmer body temperature in RRMS patients was associated with worse general fatigue (FSS; rp=.315, p=.028) and physical fatigue (pMFIS; rp=.318, p=.026), but not cognitive fatigue (cMIFS; rp=−.017, p=.909). Conclusions These are the first-ever demonstrations that body temperature is elevated endogenously in RRMS patients, and linked to worse fatigue. We discuss these findings in the context of failed treatments for fatigue in RRMS, including several failed randomized controlled trials (RCTs) of stimulants (modafinil). In contrast, our findings may help explain how RCTs of cooling garments and antipyretics (aspirin) have effectively reduced MS fatigue, and encourage further research on cooling/antipyretic treatments of fatigue in RRMS. PMID:24561056

  5. Patterns of Morning and Evening Fatigue Among Adults with HIV/AIDS

    PubMed Central

    Lerdal, Anners; Gay, Caryl L.; Aouizerat, Bradley E.; Portillo, Carmen J.; Lee, Kathryn A.

    2011-01-01

    Aims and objectives Describe patterns of morning and evening fatigue in adults with HIV and examine their relationship to demographic and clinical factors and other symptoms. Background Most studies of HIV-related fatigue assess average levels of fatigue and do not address its diurnal fluctuations. Patterns of fatigue over the course of the day may have important implications for assessment and treatment. Design A cross-sectional, correlational design was used with six repeated measures over 72 hours. Method A convenience sample of 318 HIV-infected adults was recruited in San Francisco. Socio-demographic, clinical and symptom data were collected with questionnaires. CD4+ T-cell count and viral load were obtained from medical records. Participants completed a four-item version of the Lee Fatigue Scale each morning and evening for three consecutive days. Participants were grouped based on their diurnal pattern of fatigue (high evening only, high morning only, high morning and evening and low morning and evening). Group comparisons and logistic regression were used to determine the unique predictors of each fatigue pattern. Results The high evening fatigue pattern was associated with anxiety and the high morning pattern was associated with anxiety and depression. The morning fatigue pattern showed very little fluctuation between morning and evening, the evening pattern showed the largest fluctuation. The high morning and evening pattern was associated with anxiety, depression and sleep disturbance and this group reported the most fatigue-related distress and interference in functioning. Conclusions These results provide initial evidence for the importance of assessing the patient’s daily pattern of fatigue fluctuation, as different patterns were associated with different symptom experiences and perhaps different etiologies. Relevance to clinical practice Different fatigue patterns may benefit from tailored intervention strategies. Management of depressive symptoms could be tested in patients who experience high levels of morning fatigue. PMID:21752119

  6. Fatigue and quality of life in women treated for various types of gynaecological cancers: a cross-sectional study

    PubMed Central

    Sekse, Ragnhild Johanne Tveit; Hufthammer, Karl Ove; Vika, Margrethe Elin

    2015-01-01

    Aims and objectives To examine the prevalence of cancer-related fatigue in women treated for various types of gynaecological cancers and, for these cancers, to assess fatigue in relation to distress, health-related quality of life, demography and treatment characteristics. Background Advances in treatment of cancer have improved the likelihood of survival. Consequently, there are a growing number of patients who become survivors after cancer and who face side effects even years after treatment. One of the most frequently reported side effects across all types and stages of the disease is cancer-related fatigue. Design A descriptive cross-sectional study. Methods One hundred and twenty women treated for gynaecological cancers who were participants in an intervention study were included. Fatigue, psychological distress, health-related QoL and demographics were assessed by questionnaires. Disease and treatment characteristics were extracted from medical records. Results Cancer-related fatigue was reported in 53% of the women treated for gynaecological cancers, with a higher proportion in the group of cervical cancer, followed by ovarian cancer. Younger participants reported fatigue more frequently than older participants. When adjusting for age, the type of cancer a woman experiences was shown to have little impact on her risk of experiencing fatigue. The participants with fatigue reported higher levels of anxiety and depression than participants without fatigue. There was a relationship between fatigue and quality of life as measured by SF-36 domains. Conclusion The findings underscore the importance of screening for fatigue, patient education and symptom management. This should be included in a standard procedure during treatment and follow-up. Both somatic and psychological aspects of fatigue should be emphasised. Relevance to clinical practice The findings imply the need for health personnel to have focus on fatigue during the entire cancer trajectory of women after gynaecological cancers, as well as the need for screening, information, guidance and symptom management. PMID:25040957

  7. Self-management of fatigue in rheumatoid arthritis: a randomised controlled trial of group cognitive-behavioural therapy

    PubMed Central

    Hewlett, Sarah; Ambler, Nick; Almeida, Celia; Cliss, Alena; Hammond, Alison; Kitchen, Karen; Knops, Bev; Pope, Denise; Spears, Melissa; Swinkels, Annette; Pollock, Jon

    2011-01-01

    Objectives To investigate the effect of group cognitive behavioural therapy (CBT) for fatigue self-management, compared with groups receiving fatigue information alone, on fatigue impact among people with rheumatoid arthritis (RA). Methods Two-arm, parallel randomised controlled trial in adults with RA, fatigue ≥6/10 (Visual Analogue Scale (VAS) 0–10, high bad) and no recent change in RA medication. Group CBT for fatigue self-management comprised six (weekly) 2 h sessions, and consolidation session (week 14). Control participants received fatigue self-management information in a 1 h didactic group session. Primary outcome at 18 weeks was the impact of fatigue measured using two methods (Multi-dimensional Assessment of Fatigue (MAF) 0–50; VAS 0–10), analysed using intention-to-treat analysis of covariance with multivariable regression models. Results Of 168 participants randomised, 41 withdrew before entry and 127 participated. There were no major baseline differences between the 65 CBT and 62 control participants. At 18 weeks CBT participants reported better scores than control participants for fatigue impact: MAF 28.99 versus 23.99 (adjusted difference −5.48, 95% CI −9.50 to −1.46, p=0.008); VAS 5.99 versus 4.26 (adjusted difference −1.95, 95% CI −2.99 to −0.90, p<0.001). Standardised effect sizes for fatigue impact were MAF 0.59 (95% CI 0.15 to 1.03) and VAS 0.77 (95% CI 0.33 to 1.21), both in favour of CBT. Secondary outcomes of perceived fatigue severity, coping, disability, depression, helplessness, self-efficacy and sleep were also better in CBT participants. Conclusions Group CBT for fatigue self-management in RA improves fatigue impact, coping and perceived severity, and well-being. Trial registration: ISRCTN 32195100 PMID:21540202

  8. Stimulated peripheral production of interferon-gamma is related to fatigue and depression in multiple sclerosis.

    PubMed

    Pokryszko-Dragan, A; Frydecka, I; Kosmaczewska, A; Ciszak, L; Bilińska, M; Gruszka, E; Podemski, R; Frydecka, D

    2012-10-01

    The aim of the study was to evaluate the stimulated production of interferon-gamma (IFNγ) by peripheral CD3+CD4+ T lymphocytes in patients with multiple sclerosis (MS) with regard to the degree of fatigue, and to investigate relationships between immunological parameters, level of depression and clinical variables. Forty MS patients (30 women, 10 men, aged 22-60 years): 20 fatigued and 20 non-fatigued were involved in the study. Fatigue was evaluated using the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS), depression level - using Beck Depression Inventory (BDI). Production of IFNγ by stimulated peripheral blood CD3+CD4+ T lymphocytes, assessed using flow cytometry, was compared between MS patients with different levels of fatigue and controls. Correlations were searched out between immunological findings and BDI, age, duration and course of MS, relapse rate, disability (assessed in Expanded Disability Status Scale - EDSS) and its progression. Stimulated production of IFNγ by CD3+CD4+ T lymphocytes was higher in severely fatigued patients in comparison with non-fatigued ones and controls, tended to correlate with FSS and MFIS, and correlated with BDI. No relationships were found between immunological findings and disease-related variables. Stimulated production of IFNγ by peripheral CD3+CD4+ T lymphocytes is related to fatigue and depression in MS patients. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Effect of mental fatigue on the central nervous system: an electroencephalography study

    PubMed Central

    2012-01-01

    Background Fatigue can be classified as mental and physical depending on its cause, and each type of fatigue has a multi-factorial nature. We examined the effect of mental fatigue on the central nervous system using electroencephalography (EEG) in eighteen healthy male volunteers. Methods After enrollment, subjects were randomly assigned to two groups in a single-blinded, crossover fashion to perform two types of mental fatigue-inducing experiments. Each experiment consisted of four 30-min fatigue-inducing 0- or 2-back test sessions and two evaluation sessions performed just before and after the fatigue-inducing sessions. During the evaluation session, the participants were assessed using EEG. Eleven electrodes were attached to the head skin, from positions F3, Fz, F4, C3, Cz, C4, P3, Pz, P4, O1, and O2. Results In the 2-back test, the beta power density on the Pz electrode and the alpha power densities on the P3 and O2 electrodes were decreased, and the theta power density on the Cz electrode was increased after the fatigue-inducing mental task sessions. In the 0-back test, no electrodes were altered after the fatigue-inducing sessions. Conclusions Different types of mental fatigue produced different kinds of alterations of the spontaneous EEG variables. Our findings provide new perspectives on the neural mechanisms underlying mental fatigue. PMID:22954020

  10. Factors on working conditions and prolonged fatigue among physicians in Japan.

    PubMed

    Wada, Koji; Arimatsu, Mayuri; Yoshikawa, Toru; Oda, Susumu; Taniguchi, Hatsumi; Higashi, Toshiaki; Aizawa, Yoshiharu

    2008-10-01

    Fatigue among physicians could affect patients' safety and physicians' health. Fatigue could be caused by unfavorable working conditions. However, there have been no studies on the working conditions and fatigue among physicians in Japan. The objective of this study was to determine the factors on working conditions associated with prolonged fatigue among physicians in Japan. A questionnaire was mailed to physicians who graduated from one of the medical schools in Japan and who have had more than 3 years of experience in clinical practice. They were asked to assess 10 different aspects of their working conditions using a 5-point Likert scale. Prolonged fatigue was measured using the checklist of individual strength questionnaire. Multiple regression analysis was used to examine the multivariate relationship between the variables and prolonged fatigue. Data from 377 men and 101 women were analyzed in this study. For both male and female physicians, a harder workload was positively associated and better career satisfaction was negatively associated with prolonged fatigue. Prolonged fatigue was negatively associated with better relationships with other physicians and staff for male physicians and less personal time for female physicians. The adjusted variance in prolonged fatigue related to exposure variables was 26 and 29% in men and in women, respectively. The result of this study suggested that it is desirable to take these factors into consideration in the management of prolonged fatigue among physicians in Japan.

  11. The impact of subjective cognitive fatigue and depression on cognitive function in patients with multiple sclerosis.

    PubMed

    Golan, Daniel; Doniger, Glen M; Wissemann, Karl; Zarif, Myassar; Bumstead, Barbara; Buhse, Marijean; Fafard, Lori; Lavi, Idit; Wilken, Jeffrey; Gudesblatt, Mark

    2018-02-01

    The association between subjective cognitive fatigue and objective cognitive dysfunction in patients with multiple sclerosis (PwMS) has been studied, with conflicting results. To explore the impact of fatigue on cognitive function, while controlling for the influence of depression, disability, comorbidities, and psychotropic medications. PwMS completed a computerized cognitive testing battery with age- and education-adjusted cognitive domain scores. Disability (Expanded Disability Status Scale (EDSS)), cognitive fatigue, and depression were concurrently evaluated. In all, 699 PwMS were included. Both cognitive fatigue and depression were significantly and negatively correlated with the same cognitive domains: information processing speed, executive function, attention, motor function, and memory (-0.15 ⩽ r ⩽ -0.14 for cognitive fatigue; -0.24 ⩽ r ⩽ -0.19 for depression). Multivariate analysis revealed significant but small independent correlations only between depression and neuropsychological test results, while cognitive fatigue had no independent correlation with objective cognitive function except for a trend toward impaired motor function in highly fatigued PwMS. Depression and cognitive fatigue accounted for no more than 6% of the variance in objective cognitive domain scores. Cognitive fatigue is not independently related to objective cognitive impairment. Depression may influence cognitive function of PwMS primarily when it is severe. Cognitive impairment in PwMS should not be ascribed to fatigue or mild depression.

  12. Associations between fatigue, physical activity, and QoL in patients with myeloproliferative neoplasms.

    PubMed

    Tolstrup Larsen, Rasmus; Tang, Lars H; Brochmann, Nana; Meulengracht Flachs, Esben; Illemann Christensen, Anne; Hasselbalch, Hans C; Zwisler, Ann-Dorthe

    2018-06-01

    Patients with Philadelphia chromosome-negative Myeloproliferative Neoplasms (MPNs) report fatigue as the most common symptom and contributing significantly to reduction in their quality of life (QoL). Targeted non-pharmacological intervention to increase levels of physical activity is suggested as a fatigue-reducing and QoL-enhancing intervention in MPN patients. The interrelationship between physical activity, fatigue, and QoL has, to our knowledge, never been reported. We analyzed data from 1807 MPN patients. The primary analysis included a multiple regression model allowing fatigue to mediate the relationship between physical activity and QoL. We herein report the first and the largest study of patients with MPNs, in whom we have investigated the interrelationship between fatigue, physical activity, and QoL. Sedentary patients were more likely to report fatigue compared to highly active patients. There was a negative association between fatigue and QoL, and there was a positive association between physical activity and QoL. There was no interaction between fatigue and physical activity in the association with QoL. We found positive associations between level of physical activity and QoL, independently of fatigue being present. More research is needed before physical activity can be introduced as a targeted intervention to reduce fatigue and increase QoL in the management of patients. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Prevalence and determinants of fatigue in patients with moderate to severe chronic GvHD.

    PubMed

    Im, A; Mitchell, S A; Steinberg, S M; Curtis, L; Berger, A; Baird, K; Kuzmina, Z; Joe, G; Comis, L E; Juckett, M; Avila, D; Baruffaldi, J; Masuch, L; Pirsl, F; Pavletic, S Z

    2016-05-01

    Although fatigue is common after allogeneic hematopoietic cell transplantation, little is known about fatigue in patients with chronic GvHD (cGvHD). The aim of this study was to explore factors associated with fatigue in cGvHD. Data were drawn from a sequentially recruited, cross-sectional study of adults with moderate or severe cGvHD (n=263). Respondents were classified as fatigued or not fatigued based on their response to a single item regarding loss of energy from the Lee cGvHD Symptom Scale. In univariate analysis, factors significantly associated with fatigue included performance status, number of prior cGvHD therapies, cGvHD symptom bother, self-assessed physical and mental health, nutritional status, walk velocity and self-reported physical activity. There were no significant associations between fatigue and disease-related cGvHD variables. Multivariable logistic regression demonstrated that being less active and having pulmonary and/or muscle/joint symptoms were independently associated with fatigue. In conclusion, clinically significant fatigue was prevalent in more than one-third of subjects with cGvHD, and was disabling. Absence of association with measures of cGvHD severity underscores the need to elucidate the pathogenesis of fatigue and its relationship with inflammatory activity. Pulmonary and muscle/joint symptoms and physical inactivity represent potential targets for intervention in clinical studies.

  14. Feasibility, Validity, and Reliability of the Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale for Adults in Inpatients with Severe Obesity

    PubMed Central

    Manzoni, Gian Mauro; Rossi, Alessandro; Marazzi, Nicoletta; Agosti, Fiorenza; De Col, Alessandra; Pietrabissa, Giada; Castelnuovo, Gianluca; Molinari, Enrico; Sartorio, Allessandro

    2018-01-01

    Objective This study was aimed to examine the feasibility, validity, and reliability of the Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL™ MFS) for adult inpatients with severe obesity. Methods 200 inpatients (81% females) with severe obesity (BMI ≥ 35 kg/m2) completed the PedsQL MFS (General Fatigue, Sleep/Rest Fatigue and Cognitive Fatigue domains), the Fatigue Severity Scale, and the Center for Epidemiologic Studies Depression Scale immediately after admission to a 3-week residential body weight reduction program. A randomized subsample of 48 patients re-completed the PedsQL MFS after 3 days. Results Confirmatory factor analysis showed that a modified hierarchical model with two items moved from the Sleep/Rest Fatigue domain to the General Fatigue domain and a second-order latent factor best fitted the data. Internal consistency and test-retest reliabilities were acceptable to high in all scales, and small to high statistically significant correlations were found with all convergent measures, with the exception of BMI. Significant floor effects were found in two scales (Cognitive Fatigue and Sleep/Rest Fatigue). Conclusion The Italian modified PedsQL MFS for adults showed to be a valid and reliable tool for the assessment of fatigue in inpatients with severe obesity. Future studies should assess its discriminant validity as well as its responsiveness to weight reduction. PMID:29402854

  15. Gender differences in fatigue: biopsychosocial factors relating to fatigue in men and women.

    PubMed

    Bensing, J M; Hulsman, R L; Schreurs, K M

    1999-10-01

    Fatigue is a common problem, which is found more frequently among women than men. To date, neither the etiology of fatigue nor the factors that explain the gender difference in its incidence are still fully understood. In a sample of men (n = 4,681) and women (n = 4,698) (age range, 15-64 years) in the Dutch National Survey of Morbidity and Interventions in General Practice, the gender differences in the underlying biological, psychological, and social factors of fatigue were analyzed. Both general and gender-specific factors were recognized. Men and women who experience complaints of fatigue appeared to be younger and more highly educated. They had more acute health complaints and more psychosocial problems and also showed a lower level of perceived health. Among women, only gender-specific biological complaints and psychosocial problems were related to fatigue. In addition, relevant sociodemographic variables included taking care of young children and being employed. Among men, fatigue was particularly related to having handicaps and severe chronic complaints. Taking care of young children did not make a difference in the male sample. Fatigue can only be adequately understood in a multicausal model with biomedical and psychosocial factors. Complaints of fatigue are too often ignored in general practice. By adopting a patient-centered style of communication, physicians can acquire a more complete picture of the patients' fatigue.

  16. Psychiatric disorders and medical care utilization among people in the general population who report fatigue.

    PubMed

    Walker, E A; Katon, W J; Jemelka, R P

    1993-08-01

    To study the prevalence of fatigue in the general population and its association with psychiatric disorders, somatization, and medical utilization. The public-use data tape from the 1984 National Institute of Mental Health Epidemiologic Catchment Area Study. Household sample of 18,571 subjects. Structured psychiatric interviews were reviewed to study the prevalence of complaints of current and lifetime fatigue and their relationship to selected psychiatric disorders. Fatigue has high current (6.7%) and lifetime (24.4%) prevalences in the general population. Medically unexplained fatigue also has high current (6.0%) and lifetime (15.5%) prevalences. When compared with those reporting no current fatigue, subjects who reported current (one-month) fatigue were significantly more likely to have experienced current and lifetime episodes of major depression, dysthymic disorder, panic disorder, and somatization disorder. They also had significantly higher mean numbers of lifetime and current DSM-III psychiatric diagnoses, medically unexplained physical symptoms (not just fatigue-related symptoms), and visits to health care providers than did patients without current episodes of fatigue. The high prevalence of fatigue in the general population appears to be significantly associated with increased lifetime and current risk for affective, anxiety, and somatoform disorders, as well as increased utilization of medical services. These data suggest that assessment of both medical and psychological health may be essential for the proper care of patients with fatigue.

  17. Probabilistic fatigue methodology for six nines reliability

    NASA Technical Reports Server (NTRS)

    Everett, R. A., Jr.; Bartlett, F. D., Jr.; Elber, Wolf

    1990-01-01

    Fleet readiness and flight safety strongly depend on the degree of reliability that can be designed into rotorcraft flight critical components. The current U.S. Army fatigue life specification for new rotorcraft is the so-called six nines reliability, or a probability of failure of one in a million. The progress of a round robin which was established by the American Helicopter Society (AHS) Subcommittee for Fatigue and Damage Tolerance is reviewed to investigate reliability-based fatigue methodology. The participants in this cooperative effort are in the U.S. Army Aviation Systems Command (AVSCOM) and the rotorcraft industry. One phase of the joint activity examined fatigue reliability under uniquely defined conditions for which only one answer was correct. The other phases were set up to learn how the different industry methods in defining fatigue strength affected the mean fatigue life and reliability calculations. Hence, constant amplitude and spectrum fatigue test data were provided so that each participant could perform their standard fatigue life analysis. As a result of this round robin, the probabilistic logic which includes both fatigue strength and spectrum loading variability in developing a consistant reliability analysis was established. In this first study, the reliability analysis was limited to the linear cumulative damage approach. However, it is expected that superior fatigue life prediction methods will ultimately be developed through this open AHS forum. To that end, these preliminary results were useful in identifying some topics for additional study.

  18. Comparison of the effects of fatigue on kinematics and muscle activation between men and women after anterior cruciate ligament reconstruction.

    PubMed

    Lessi, Giovanna Camparis; Silva, Rodrigo Scattone; Serrão, Fábio Viadanna

    2018-05-01

    Studies comparing the effects of fatigue between men and women after anterior cruciate ligament (ACL) reconstruction are lacking. The purpose of this study was to compare the effects of muscle fatigue on trunk, pelvis and lower limb kinematics and on lower limb muscle activation between male and female athletes who underwent ACL reconstruction. Cross-sectional study. Laboratory setting. Fourteen recreational athletes (7 males and 7 females) with unilateral ACL reconstruction participated of this study. Trunk, pelvis and lower limb kinematics and muscle activation of the vastus lateralis, gluteus medius and gluteus maximus were evaluated during a single-leg drop vertical jump landing before and after a fatigue protocol. Females had greater peak knee abduction after fatigue in relation to before fatigue (P = 0.008), and in relation to men after fatigue (P = 0.011). Also, in females, peak knee abduction was greater in the reconstructed limb in relation to the non-reconstructed limb after fatigue (P = 0.029). Males showed a greater mean amplitude of activation of the vastus lateralis muscle after fatigue in relation to before fatigue (P < 0.001). Muscle fatigue produced kinematic alterations that have been shown to increase the risk for a second ACL injury in female athletes. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Smoking impact on grip strength and fatigue resistance: implications for exercise and hand therapy practice.

    PubMed

    Al-Obaidi, Saud; Al-Sayegh, Nowall; Nadar, Mohammed

    2014-07-01

    Grip strength assessment reflects on overall health of the musculoskeletal system and is a predictor of functional prognosis and mortality. The purpose of this study was: examine whether grip-strength and fatigue resistance are impaired in smokers, determine if smoking-related impairments (fatigue-index) can be predicted by demographic data, duration of smoking, packets smoked-per-day, and physical activity. Maximum isometric grip strength (MIGS) of male smokers (n = 111) and nonsmokers (n = 66) was measured before/after induced fatigue using Jamar dynamometer at 5-handle positions. Fatigue index was calculated based on percentage change in MIGS initially and after induced fatigue. Number of repetitions to squeeze the soft rubber ball to induce fatigue was significantly lower in smokers compared with nonsmokers (t = 10.6, P < .001 dominant hand; t = 13.9, P < .001 nondominant), demonstrating a significantly higher fatigue-index for smokers than nonsmokers (t = -8.7, P < .001 dominant hand; t = -6.0, P < .001 nondominant). The effect of smoking status on MIGS scores was significantly different between smokers and nonsmokers after induced fatigue (β = -3.98, standard error = 0.59, P < .001) where smokers experienced on average a reduction of nearly 4 MIGS less than nonsmokers before fatigue. Smoking status was the strongest significant independent predictor of the fatigue-index. Smokers demonstrated reduced grip strength and fast fatigability in comparison with nonsmokers.

  20. Factors Influencing Dwell Fatigue Cracking in Notches of Powder Metallurgy Superalloys

    NASA Technical Reports Server (NTRS)

    Gabb, T. P.; Telesman, J.; Ghosn, L.; Garg, A.; Gayda, J.

    2011-01-01

    The influences of heat treatment and cyclic dwells on the notch fatigue resistance of powder metallurgy disk superalloys were investigated for low solvus high refractory (LSHR) and ME3 disk alloys. Disks were processed to produce material conditions with varied microstructures and associated mechanical properties. Notched specimens were first subjected to baseline dwell fatigue cycles having a dwell at maximum load, as well as tensile, stress relaxation, creep rupture, and dwell fatigue crack growth tests at 704 C. Several material heat treatments displayed a bimodal distribution of fatigue life with the lives varying by two orders-of-magnitude, while others had more consistent fatigue lives. This response was compared to other mechanical properties, in search of correlations. The wide scatter in baseline dwell fatigue life was observed only for material conditions resistant to stress relaxation. For selected materials and conditions, additional tests were then performed with the dwells shifted in part or in total to minimum tensile load. The tests performed with dwells at minimum load exhibited lower fatigue lives than max dwell tests, and also exhibited early crack initiation and a substantial increase in the number of initiation sites. These results could be explained in part by modeling evolution of peak stresses in the notch with continued dwell fatigue cycling. Fatigue-environment interactions were determined to limit life for the fatigue cycles with dwells.

  1. Compassion fatigue and compassion satisfaction among family physicians in the Republic of Srpska, Bosnia and Herzegovina.

    PubMed

    Račić, Maja; Virijević, Aleksandra; Ivković, Nedeljka; Joksimović, Bojan N; Joksimović, Vedrana R; Mijovic, Biljana

    2018-03-19

    The aim of this study was to examine self-perceived compassion fatigue and compassion satisfaction among family physicians in Bosnia and Herzegovina and describe potential contributing factors. The cross-sectional study enrolled 120 family physicians. Professional quality of life compassion satisfaction and fatigue version 5 (ProQOL5) was used to assess compassion satisfaction and two components of compassion fatigue, secondary traumatic stress and burnout. The symptoms of chronic fatigue were evaluated using the Chalder fatigue scale. The majority of family physicians had moderate levels of compassion satisfaction (70%), burnout (75%) and secondary traumatic stress (55.8%). Family physicians with higher levels of secondary traumatic stress reported chronic fatigue (p = 0.001), longer length of service (p = 0.024) and residency training (p = 0.041). Chronic fatigue (p = 0.001), living in a rural environment (p = 0.033), larger size of practice (p = 0.006) and high number of patients with chronic disease (p = 0.001) were associated with a higher risk of burnout. Family physicians with large practices, long years of experience, a high number of chronically ill patients and experiencing chronic fatigue are at risk of developing compassion fatigue. A systematic exploration of compassion fatigue in relation to working conditions might provide an appropriate starting point for the development of preventive interventions.

  2. Does fatigue have any impact on satisfaction of search?

    NASA Astrophysics Data System (ADS)

    Krupinski, Elizabeth A.; Schartz, Kevin; Caldwell, Robert; Madsen, Mark; Berbaum, Kevin S.

    2017-03-01

    Previous studies have demonstrated that fatigue impacts diagnostic accuracy, especially for those in training. We continued this line of investigation to determine if fatigue has any impact on a common source of errors - satisfaction of search (SOS). SOS requires subjects to participate in 2 sessions (SOS and non-SOS) and so does fatigue (fatigued and not fatigued) so we ran subjets in only the fatigued condition and used a previous non-fatigued study as the comparison. We used 64 chest computed radiographs half demonstrating various ``test'' abnormalities were read twice by 20 radiologists, once with and once without the addition of a simulated pulmonary nodule. Receiver-operating characteristic detection accuracy and decision thresholds were analyzed to study the effects of adding the nodule on detecting the test abnormalities. Adding nodules did not influence detection accuracy (ROC AUC SOS = 0.667; non-SOS = 0.679), but did induce a reluctance to report them. Adding nodules did not affect inspection time so the reluctance to report was not associated with reduced search. Fatigue did not appear to exacerbate the SOS effect. A second study with fractures revealed the same shift in performance but did reduce viewing times when fatigued. The results of these two studies suggest that the impact of fatigue on SOS is more complicated than expected and thus may require more investigation to fully understand its impact in the clinic.

  3. Crack tip field and fatigue crack growth in general yielding and low cycle fatigue

    NASA Technical Reports Server (NTRS)

    Minzhong, Z.; Liu, H. W.

    1984-01-01

    Fatigue life consists of crack nucleation and crack propagation periods. Fatigue crack nucleation period is shorter relative to the propagation period at higher stresses. Crack nucleation period of low cycle fatigue might even be shortened by material and fabrication defects and by environmental attack. In these cases, fatigue life is largely crack propagation period. The characteristic crack tip field was studied by the finite element method, and the crack tip field is related to the far field parameters: the deformation work density, and the product of applied stress and applied strain. The cyclic carck growth rates in specimens in general yielding as measured by Solomon are analyzed in terms of J-integral. A generalized crack behavior in terms of delta is developed. The relations between J and the far field parameters and the relation for the general cyclic crack growth behavior are used to analyze fatigue lives of specimens under general-yielding cyclic-load. Fatigue life is related to the applied stress and strain ranges, the deformation work density, crack nucleus size, fracture toughness, fatigue crack growth threshold, Young's modulus, and the cyclic yield stress and strain. The fatigue lives of two aluminum alloys correlate well with the deformation work density as depicted by the derived theory. The general relation is reduced to Coffin-Manson low cycle fatigue law in the high strain region.

  4. Healing of Fatigue Crack in 1045 Steel by Using Eddy Current Treatment

    PubMed Central

    Yang, Chuan; Xu, Wenchen; Guo, Bin; Shan, Debin; Zhang, Jian

    2016-01-01

    In order to investigate the methods to heal fatigue cracks in metals, tubular specimens of 1045 steel with axial and radial fatigue cracks were treated under the eddy current. The optical microscope was employed to examine the change of fatigue cracks of specimens before and after the eddy current treatment. The results show that the fatigue cracks along the axial direction of the specimen could be healed effectively in the fatigue crack initiation zone and the crack tip zone under the eddy current treatment, and the healing could occur within a very short time. The voltage breakdown and the transient thermal compressive stress caused by the detouring of eddy current around the fatigue crack were the main factors contributing to the healing in the fatigue crack initiation zone and the crack tip zone, respectively. Eddy current treatment may be a novel and effective method for crack healing. PMID:28773761

  5. Testosterone as a treatment for fatigue in HIV+ men.

    PubMed

    Wagner, G J; Rabkin, J G; Rabkin, R

    1998-07-01

    This study assessed correlates of fatigue and the efficacy of testosterone therapy as a treatment for fatigue in men with symptomatic HIV and clinical hypogonadism. We conducted a 12-week open trial of testosterone for HIV+ men with clinical hypogonadism (low libido plus at least one of the associated symptoms of depressed mood, fatigue, and weight loss), CD4 count below 400 cells/cu.mm, and serum testosterone level below 500 ng/dl. 108 men entered the trial; 50% were nonwhite and 72% had an AIDS diagnosis. Baseline correlates of fatigue, as measured by the self-report Chalder Fatigue Scale (CFS), included elevated laboratory values (hematocrit, hemoglobin), lower overall physical functioning, greater psychological distress, and reduced quality of life. Sixty-six of 72 men who presented with fatigue completed the trial, with 52 (79%) rated as responders (much improved energy level) by the study doctor. Fatigue declined significantly among responders, but not nonresponders.

  6. Inflammatory fatigue and sickness behaviour - lessons for the diagnosis and management of chronic fatigue syndrome.

    PubMed

    Arnett, S V; Clark, I A

    2012-12-10

    Persistent and severe fatigue is a common part of the presentation of a diverse range of disease processes. There is a growing body of evidence indicating a common inflammatory pathophysiology underlying many conditions where fatigue is a primary patient concern, including chronic fatigue syndrome. This review explores current models of how inflammatory mediators act on the central nervous system to produce fatigue and sickness behaviour, and the commonality of these processes in conditions as diverse as surgical trauma, infection, various cancers, inflammatory bowel disease, connective tissue diseases and autoimmune diseases. We also discuss evidence indicating chronic fatigue syndrome may have important pathophysiological similarities with cytokine mediated sickness behaviour, and what lessons can be applied from sickness behaviour to chronic fatigue syndrome with regards to the diagnosis and management. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. What Is Orofacial Fatigue and How Does It Affect Function for Swallowing and Speech?

    PubMed Central

    Solomon, Nancy Pearl

    2012-01-01

    Speech-language pathologists are likely to encounter patients who report symptoms of fatigue, but there are few clinical procedures to assess this phenomenon. Furthermore, it is difficult to determine whether fatigue contributes to a patient's dysphagia or dysarthria. This article reviews orofacial muscles, including the muscles of the tongue, lips, and cheeks, highlighting in particular their role in swallowing and speaking. It provides definitions of fatigue and describes assessment procedures. The author's research has focused on assessing fatigue, especially of the tongue, and elucidating the effects of exercising the tongue on speech and nonspeech tasks. Most of this work involves people who have Parkinson's disease and neurologically normal adults; results generally support heightened fatigue in Parkinson's disease. However, the effect of fatigue on functional activities remains unclear. Literature regarding the effects of orofacial fatigue on swallowing and speaking is notably sparse, but preliminary evidence indicates that these functions are rather robust. PMID:17117353

  8. High-Cycle, Push-Pull Fatigue Fracture Behavior of High-C, Si-Al-Rich Nanostructured Bainite Steel.

    PubMed

    Zhao, Jing; Ji, Honghong; Wang, Tiansheng

    2017-12-29

    The high-cycle, push-pull fatigue fracture behavior of high-C, Si-Al-rich nanostructured bainitic steel was studied through the measurement of fatigue limits, a morphology examination and phase composition analysis of the fatigue fracture surface, as well as fractography of the fatigue crack propagation. The results demonstrated that the push-pull fatigue limits at 10⁷ cycles were estimated as 710-889 MPa, for the samples isothermally transformed at the temperature range of 220-260 °C through data extrapolation, measured under the maximum cycle number of 10⁵. Both the interior inclusion and the sample surface constituted the fatigue crack origins. During the fatigue crack propagation, a high amount of secondary cracks were formed in almost parallel arrangements. The apparent plastic deformation occurred in the fracture surface layer, which induced approximately all retained austenite to transform into martensite.

  9. High-Cycle, Push–Pull Fatigue Fracture Behavior of High-C, Si–Al-Rich Nanostructured Bainite Steel

    PubMed Central

    Zhao, Jing; Ji, Honghong

    2017-01-01

    The high-cycle, push–pull fatigue fracture behavior of high-C, Si–Al-rich nanostructured bainitic steel was studied through the measurement of fatigue limits, a morphology examination and phase composition analysis of the fatigue fracture surface, as well as fractography of the fatigue crack propagation. The results demonstrated that the push–pull fatigue limits at 107 cycles were estimated as 710–889 MPa, for the samples isothermally transformed at the temperature range of 220–260 °C through data extrapolation, measured under the maximum cycle number of 105. Both the interior inclusion and the sample surface constituted the fatigue crack origins. During the fatigue crack propagation, a high amount of secondary cracks were formed in almost parallel arrangements. The apparent plastic deformation occurred in the fracture surface layer, which induced approximately all retained austenite to transform into martensite. PMID:29286325

  10. Generation of synthetic surface electromyography signals under fatigue conditions for varying force inputs using feedback control algorithm.

    PubMed

    Venugopal, G; Deepak, P; Ghosh, Diptasree M; Ramakrishnan, S

    2017-11-01

    Surface electromyography is a non-invasive technique used for recording the electrical activity of neuromuscular systems. These signals are random, complex and multi-component. There are several techniques to extract information about the force exerted by muscles during any activity. This work attempts to generate surface electromyography signals for various magnitudes of force under isometric non-fatigue and fatigue conditions using a feedback model. The model is based on existing current distribution, volume conductor relations, the feedback control algorithm for rate coding and generation of firing pattern. The result shows that synthetic surface electromyography signals are highly complex in both non-fatigue and fatigue conditions. Furthermore, surface electromyography signals have higher amplitude and lower frequency under fatigue condition. This model can be used to study the influence of various signal parameters under fatigue and non-fatigue conditions.

  11. Sleep-deprivation effect on human performance: a meta-analysis approach

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Candice D. Griffith; Candice D. Griffith; Sankaran Mahadevan

    Human fatigue is hard to define since there is no direct measure of fatigue, much like stress. Instead fatigue must be inferred from measures that are affected by fatigue. One such measurable output affected by fatigue is reaction time. In this study the relationship of reaction time to sleep deprivation is studied. These variables were selected because reaction time and hours of sleep deprivation are straightforward characteristics of fatigue to begin the investigation of fatigue effects on performance. Meta-analysis, a widely used procedure in medical and psychological studies, is applied to the variety of fatigue literature collected from various fieldsmore » in this study. Meta-analysis establishes a procedure for coding and analyzing information from various studies to compute an effect size. In this research the effect size reported is the difference between standardized means, and is found to be -0.6341, implying a strong relationship between sleep deprivation and performance degradation.« less

  12. A Review of the Fatigue Properties of Additively Manufactured Ti-6Al-4V

    NASA Astrophysics Data System (ADS)

    Cao, Fei; Zhang, Tiantian; Ryder, Matthew A.; Lados, Diana A.

    2018-03-01

    Various additive manufacturing (AM) technologies have been used to fabricate Ti-6Al-4V. The fatigue performance of Ti-6Al-4V varies from process to process. In this review, fatigue properties of Ti-6Al-4V alloys made by different AM technologies and post-fabrication treatments were compiled and discussed to correlate with the materials' characteristic features, primarily surface roughness and porosity. Microstructure anisotropy and porosity effects on fatigue crack growth and fatigue life are also presented and discussed. A modified Kitagawa-Takahashi diagram developed from current available fatigue data was used to quantify the influence of defects on fatigue strength. This review aims to assist in selecting/optimizing AM processes to achieve high fatigue resistance in Ti-6Al-4V, as well as provide a better understanding of the advantages and limitations of current AM techniques in producing titanium alloys.

  13. Stuy on Fatigue Life of Aluminum Alloy Considering Fretting

    NASA Astrophysics Data System (ADS)

    Yang, Maosheng; Zhao, Hongqiang; Wang, Yunxiang; Chen, Xiaofei; Fan, Jiali

    2018-01-01

    To study the influence of fretting on Aluminum Alloy, a global finite element model considering fretting was performed using the commercial code ABAQUS. With which a new model for predicting fretting fatigue life has been presented based on friction work. The rationality and effectiveness of the model were validated according to the contrast of experiment life and predicting life. At last influence factor on fretting fatigue life of aerial aluminum alloy was investigated with the model. The results revealed that fretting fatigue life decreased monotonously with the increasing of normal load and then became constant at higher pressures. At low normal load, fretting fatigue life was found to increase with increase in the pad radius. At high normal load, however, the fretting fatigue life remained almost unchanged with changes in the fretting pad radius. The bulk stress amplitude had the dominant effect on fretting fatigue life. The fretting fatigue life diminished as the bulk stress amplitude increased.

  14. Stress and coping styles are associated with severe fatigue in medical students.

    PubMed

    Tanaka, Masaaki; Fukuda, Sanae; Mizuno, Kei; Kuratsune, Hirohiko; Watanabe, Yasuyoshi

    2009-01-01

    Fatigue is a common complaint among medical students and researchers consider it to be related to poor academic outcomes. The authors' goal in the present study was to determine whether stress and coping strategies were associated with fatigue in medical students. The study group consisted of 73 second-year healthy students attending the Osaka City University Graduate School of Medicine. Participants completed a questionnaire about fatigue (Japanese version of Chalder Fatigue Scale), stress, stress coping (Japanese version of the Coping Inventory for Stressful Situations), overwork, and nocturnal sleeping hours. On univariate and multivariate logistic regression analyses adjusted for age and gender, stress was positively associated with fatigue. In addition, after adjustment for age, gender, and emotion- and task-oriented stress coping activities, avoidance-oriented stress coping activity was associated with fatigue. The results suggest that stress and the coping style are correlated with fatigue in medical students.

  15. Is there a cognitive signature for MS-related fatigue?

    PubMed

    Hanken, Katrin; Eling, Paul; Hildebrandt, Helmut

    2015-04-01

    The compensatory approach of fatigue argues that it is a state caused by task load. The neuropsychiatric approach argues that fatigue is a trait (like depression), unrelated to environmental challenges. We propose that fatigue is an internal state that can be measured behaviorally only by applying specific cognitive tasks. PubMed was searched for articles concerning the relation between fatigue and cognitive performance or brain atrophy or functional MRI, distinguishing between the following cognitive domains: learning/memory, cognitive speed/selective attention, language, visuospatial processing, working memory, alerting/vigilance. Only tasks assessing alerting/vigilance are strongly related to fatigue. Areas with brain atrophy in fatigue patients overlap with brain regions activated in healthy controls performing alerting/vigilance tasks. Fatigue is not a compensatory state, nor a psychogenic trait. It is a feeling with behavioral effects that seems to be caused by brain atrophy or a neurochemical dysfunction of the alerting/vigilance system. © The Author(s), 2014.

  16. Driver fatigue during extended rail operations.

    PubMed

    Jay, Sarah M; Dawson, Drew; Ferguson, Sally A; Lamond, Nicole

    2008-09-01

    Relay is an effective mode of freight transportation within Australia. Relay requires two crews to drive the train continuously from one specified destination to another and return with crews working in alternating shifts. The aim of the current investigation was to assess fatigue levels during extended relay operations. Nine drivers participated and data were collected from 16 four-day trips. Fatigue was assessed objectively and subjectively prior to and following each trip and before and after each 8h shift. Analyses revealed a trend for elevated fatigue at the end of each shift. Designated 8h rest periods appeared sufficient to reduce fatigue to levels recorded prior to departure and prevent accumulation of fatigue across the trip. Drivers seemed to cope well with the 8h rotating sleep/wake regime. While fatigue did not observably accumulate, it is possible that operational measures may better reflect fatigue experienced over the course of each trip.

  17. Evaluation of corrosion fatigue and life prediction of lower arm for automotive suspension component

    NASA Astrophysics Data System (ADS)

    Kim, Yong-Sang; Kim, Jung-Gu

    2017-01-01

    Lower arm is one of the suspension components of automobile. It is suffered from driving vibration and corrosive environment, namely corrosion fatigue. In this study, corrosion fatigue property of lower arm was investigated, and a modified model based on Palmgren-Miner rule was developed to predict the lifetimes of corrosion fatigue. The corrosion fatigue life of lower arm was about 1/6 times shorter than fatigue life. Based on the results of corrosion fatigue tests and meteorological data in Seoul and Halifax, the corrosion fatigue life of lower arm was predicted. The satisfaction of 10-year and 300,000 km warranty was dominated by the climate of automobile driving. This prediction indicates that the weather condition or driving condition influences the life of automotive parts. Therefore, to determine the warranty of automotive parts, the driving condition has to be carefully considered.

  18. Ultrasonic Corrosion Fatigue Behavior of High Strength Austenitic Stainless Steels

    NASA Astrophysics Data System (ADS)

    Ebara, R.; Yamaguchi, Y.; Kanei, D.; Yamamoto, Y.

    Ultrasonic corrosion fatigue tests were conducted for high strength austenitic stainless steels such as YUS270 and SUS304N2 in 3%NaCl aqueous solution. The reduction of giga-cycle corrosion fatigue strength of YUS270 and SUS304N2 was not observed at all, while the reduction of corrosion fatigue life was observed at higher stress amplitude. Corrosion pit was observed on corrosion fatigue crack initiation area. Striation was predominantly observed on crack propagation area in air and in 3% NaCl aqueous solution. The reduction of corrosion fatigue strength of high strength austenitic stainless steels such as YUS270 and SUS304N2 is due to the corrosion pit formation at corrosion fatigue crack initiation area. It can be concluded that the higher the ultimate tensile strength of austenitic stainless steels the higher the giga-cycle corrosion fatigue strength in 3%NaCl aqueous solution is.

  19. Healing of Fatigue Crack in 1045 Steel by Using Eddy Current Treatment.

    PubMed

    Yang, Chuan; Xu, Wenchen; Guo, Bin; Shan, Debin; Zhang, Jian

    2016-07-29

    In order to investigate the methods to heal fatigue cracks in metals, tubular specimens of 1045 steel with axial and radial fatigue cracks were treated under the eddy current. The optical microscope was employed to examine the change of fatigue cracks of specimens before and after the eddy current treatment. The results show that the fatigue cracks along the axial direction of the specimen could be healed effectively in the fatigue crack initiation zone and the crack tip zone under the eddy current treatment, and the healing could occur within a very short time. The voltage breakdown and the transient thermal compressive stress caused by the detouring of eddy current around the fatigue crack were the main factors contributing to the healing in the fatigue crack initiation zone and the crack tip zone, respectively. Eddy current treatment may be a novel and effective method for crack healing.

  20. Quantitative assessment of motor fatigue: normative values and comparison with prior-polio patients.

    PubMed

    Meldrum, Dara; Cahalane, Eibhlis; Conroy, Ronan; Guthrie, Richard; Hardiman, Orla

    2007-06-01

    Motor fatigue is a common complaint of polio survivors and has a negative impact on activities of daily living. The aim of this study was to establish a normative database for hand grip strength and fatigue and to investigate differences between prior-polio subjects and normal controls. Static and dynamic hand grip fatigue and maximum voluntary isometric contraction (MVIC) of hand grip were measured in subjects with a prior history of polio (n = 44) and healthy controls (n = 494). A normative database of fatigue was developed using four indices of analysis. Compared with healthy controls, subjects with prior polio had significantly reduced hand grip strength but developed greater hand grip fatigue in only one fatigue index. Quantitative measurement of fatigue in the prior-polio population may be useful in order to detect change over time and to evaluate treatment strategies.

  1. Corrosion Fatigue of Anodized Aluminum 7075-T73 in Salt Ladened Humid Air.

    DTIC Science & Technology

    1981-01-01

    relative humidity and coating thickness on the fatigue of anodized 2024-T351 aluminum in reversed torsion . They also found no effect of coating ... fatigue resistance. Most of the previous corrosion fatigue work has been on the effect of relative humidity on the fatigue life of coated aluminum ...alloys. Eeles and 1hurston Iwere some of the early investigators

  2. Biomarkers of Fatigue: Ranking Mental Fatigue Susceptibility

    DTIC Science & Technology

    2010-12-10

    expected declines in performance during the 36-hour, 15-minute period of sleep deprivation without caffeine. The simple change from baseline results...rankings for fatigue resistance were then determined via a percent- change rule similar to that used in Chaiken, Harville, Harrison, Fischer, Fisher...and Whitmore (2008). This rule ranks subjects on percent change of cognitive performance from a baseline performance (before fatigue) to a fatigue

  3. "A Group of Me's": Adult Learning through Group Process: The Experiences of Participants in a Teleconference Delivered Multiple Sclerosis Fatigue Management Program

    ERIC Educational Resources Information Center

    Preissner, Katharine L.

    2013-01-01

    Multiple sclerosis (MS) is a chronic, progressive neurological disorder that affects approximately 2.1 million people worldwide. Fatigue is one of the most common and most disabling symptoms of MS. One well-established approach to address fatigue is fatigue management education provided by an occupational therapist. Fatigue management education is…

  4. Review of Corrosion Fatigue.

    DTIC Science & Technology

    1981-11-16

    other is not always well defined. 3.0 CORROSIM FATIGUE VARIABLES AND THEIR EFFECTS Corrosion fatigue behavior is pverned, y Ir of variables- environmental...on near threshold fatigue crack growth behavior is primarily a function of environmental reaction in this steel . 3.2 Mechanical Effects Among the...Gallagher""’ and Pao studied the corrosion fatigue behavior of 4340 steel at various * Ifrequencies in distilled water and water vapor, respectively

  5. Factors associated with fatigue in acquired immunodeficiency syndrome patients with antiretroviral drug adverse reactions: a retrospective study.

    PubMed

    Liu, Zhibin; Yang, Jiping; Liu, Huijuan; Jin, Yantao

    2013-06-01

    To retrospectively study the prevalence of fatigue and factors associated with fatigue among acquired immunodeficiency syndrome (AIDS) patients with antiretroviral drug adverse reactions. Data were collected from case report forms (CRFs) for a project funded by the 11th National 5-year Special Science and Technology Program on Major Infectious Diseases. Fatigue was defined by patient self-report. The outcomes were the prevalence of fatigue and the potential risk factors of fatigue. Univariate and multivariate logistic regression analyses were conducted to identify the factors associated with fatigue. Among the 228 subjects, the prevalence of fatigue was 86.8%. In univariate analysis, the significant differences in demographic characteristics between patients with and without fatigue were: gender [OR = 2.29; 95% CI (1.05-4.98)], education level [OR = 0.40; 95% CI (0.18-0.85)], anemia [OR = 3.80; 95% CI (1.27-11.31)], time of HIV diagnosis [OR = 0.29; 95% CI (0.13-0.65)], and route of infection [OR = 0.14; 95% CI (0.06-0.32)]. Abnormal taste and rapid pulse were more commonly seen in patients with fatigue (P < 0.05), while abdominal distension and lumbar soreness were encountered less often in patients with fatigue (P < 0.05). Multivariate analysis showed that the four main factors associated with fatigue were anemia [OR = 3.50; 95% CI (1.01-12.15)], route of infection [OR = 3.40; 95% CI (1.21-9.58); P = 0.02 < 0.05], lumbar soreness [OR = 0.06; 95% CI (0.02-0.18); P = 0.000 < 0.05], and rapid pulse [OR = 10.58; 95% CI (2.16-51.75); P = 0.004 < 0.05]. This study demonstrated that fatigue is common (86.8% prevalence) in AIDS patients with antiretroviral drug adverse reactions, and that anemia, route of infection (i.e., non-commercial blood donation) and rapid pulse were risk factors, while lumbar soreness was a protective factor related to fatigue. More attention should be paid to fatigue and more efforts should be made to find ways to prevent, control and eliminate this symptom in AIDS patients with antiretroviral drug adverse reactions.

  6. Implementing the Fatigue Guidelines at One NCCN Member Institution: Process and Outcomes

    PubMed Central

    Borneman, Tami; Piper, Barbara F.; Sun, Virginia Chih-Yi; Koczywas, Marianna; Uman, Gwen; Ferrell, Betty

    2008-01-01

    Fatigue, despite being the most common and distressing symptom in cancer, is often unrelieved because of numerous patient provider, and system barriers. The overall purpose of this 5-year prospective clinical trial is to translate the NCCN Cancer-Related Fatigue Clinical Practice Guidelines in Oncology and NCCN Adult Cancer Pain Clinical Practice Guidelines in Oncology into practice and develop a translational interventional model that can be replicated across settings. This article focuses on one NCCN member institution’s experience related to the first phase of the NCCN Cancer-Related Fatigue Guidelines implementation, describing usual care compared with evidence-based guidelines. Phase 1 of this 3-phased clinical trial compared the usual care of fatigue with that administered according to the NCCN guidelines. Eligibility criteria included age 18 years or older; English-speaking; diagnosed with breast, lung, colon, or prostate cancer; and fatigue and/or pain ratings of 4 or more on a 0 to 10 screening scale. Research nurses screened all available subjects in a cancer center medical oncology clinic to identify those meeting these criteria. Instruments included the Piper Fatigue Scale, a Fatigue Barriers Scale, a Fatigue Knowledge Scale, and a Fatigue Chart Audit Tool. Descriptive and inferential statistics were used in data analysis. At baseline, 45 patients had fatigue only (≥4) and 24 had both fatigue and pain (≥4). This combined sample (N = 69) was predominantly Caucasian (65%), female (63%), an average of 60 years old, diagnosed with stage 3 or 4 breast cancer, and undergoing treatment (82%). The most common barriers noted were patients’ belief that physicians would introduce the subject of fatigue if it was important (patient barrier); lack of fatigue documentation (professional barrier); and lack of supportive care referrals (system barrier). Findings showed several patient, professional, and system barriers that distinguish usual care from that recommended by the NCCN Cancer-Related Fatigue Guidelines. Phase 2, the intervention model, is designed to decrease these barriers and improve patient outcomes overtime, and is in progress. PMID:18053431

  7. Effects of chicken essence on recovery from mental fatigue in healthy males

    PubMed Central

    Yamano, Emi; Tanaka, Masaaki; Ishii, Akira; Tsuruoka, Nobuo; Abe, Keiichi; Watanabe, Yasuyoshi

    2013-01-01

    Background Fatigue is a common symptom in modern society. There has been a recent resurgence of interest in traditional remedies for fatigue. Chicken essence, which is rich in anserine and carnosine, has been widely taken in Asian countries as a traditional remedy with various aims, including attenuation of physical and mental fatigue. However, the evidence for its efficacy specifically for mental fatigue remains unclear. We examined the effect of essence of chicken on mental fatigue in humans, using our established fatigue-inducing task and evaluation methods. Material/Methods In this placebo-controlled crossover study, 20 healthy male volunteers were randomized to receive daily oral administration of essence of chicken or placebo drink provided by Cerebos Pacific Ltd. via Suntory holdings Ltd. for 4 weeks. The participants performed 2-back test trials as a fatigue-inducing mental task and then had a rest session. Just before and after each session, they completed cognitive task trials focusing on selective attention to evaluate the level of mental fatigue. Results After essence of chicken intake for 1 and 4 weeks, the reaction times on the cognitive task trials after the rest session were significantly shorter than those at baseline, and significant changes were not observed with placebo intake. The reaction times before and after the fatigue-inducing session were not altered by either essence of chicken or placebo intake. Conclusions We showed that daily intake of essence of chicken could be effective for the recovery from mental fatigue and is a promising candidate for use as an anti-fatigue food. PMID:23831862

  8. The effects of load carriage and muscle fatigue on lower-extremity joint mechanics.

    PubMed

    Wang, He; Frame, Jeff; Ozimek, Elicia; Leib, Daniel; Dugan, Eric L

    2013-09-01

    Military personnel are commonly afflicted by lower-extremity overuse injuries. Load carriage and muscular fatigue are major stressors during military basic training. To examine effects of load carriage and muscular fatigue on lower-extremity joint mechanics during walking. Eighteen men performed the following tasks: unloaded walking, walking with a 32-kg load, fatigued walking with a 32-kg load, and fatigued walking. After the second walking task, muscle fatigue was elicited through a fatiguing protocol consisting of metered step-ups and heel raises with a 16-kg load. Each walking task was performed at 1.67 m x s(-1) for 5 min. Walking movement was tracked by a VICON motion capture system at 120 Hz. Ground reaction forces were collected by a tandem force instrumented treadmill (AMTI) at 2,400 Hz. Lower-extremity joint mechanics were calculated in Visual 3D. There was no interaction between load carriage and fatigue on lower-extremity joint mechanics (p > .05). Both load carriage and fatigue led to pronounced alterations of lower-extremity joint mechanics (p < .05). Load carriage resulted in increases of pelvis anterior tilt, hip and knee flexion at heel contact, and increases of hip, knee, and ankle joint moments and powers during weight acceptance. Muscle fatigue led to decreases of ankle dorsiflexion at heel contact, dorsiflexor moment, and joint power at weight acceptance. In addition, muscle fatigue increased demand for hip extensor moment and power at weight acceptance. Statistically significant changes in lower-extremity joint mechanics during loaded and fatigued walking may expose military personnel to increased risk for overuse injuries.

  9. Mental versus physical fatigue after subarachnoid hemorrhage: differential associations with outcome.

    PubMed

    Buunk, Anne M; Groen, Rob J M; Wijbenga, Rianne A; Ziengs, Aaltje L; Metzemaekers, Jan D M; van Dijk, J Marc C; Spikman, Jacoba M

    2018-06-20

    Fatigue is a major consequence of subarachnoid hemorrhage (SAH), but the specific characteristics are unclear. Our objective was to investigate the nature of post-SAH fatigue (mental or physical) and to determine the relationship with functional outcome in the chronic stage. Also, the possible influence of mood disorders and acute SAH-related factors (SAH type and external cerebrospinal fluid (CSF) drainage) on the presence of fatigue was investigated. Patients with an aneurysmal SAH (aSAH) or angiographically negative SAH (anSAH) were assessed 3 to 10 years post-SAH (N = 221). Questionnaires were used to investigate mental and physical fatigue and mood. Functional outcome was examined with the Glasgow Outcome Scale Extended (GOSE). Between-group comparisons and binary logistic regression analysis were performed. Frequencies of mental and physical fatigue were 48.4% and 38.5% respectively, with prevalence of mental fatigue being significantly higher. A two-way ANOVA with SAH type and external CSF drainage as independent variables and mental fatigue as dependent variable, showed a significant main effect of CSF drainage only (p < 0.001). Only mental fatigue explained a significant part of the variance in long-term functional outcome (Model χ 2 = 52.99, p < 0.001; Nagelkerke R² = 0.32). Mental fatigue after SAH is a serious burden to the patient and is associated with impaired long-term functional outcome. Distinguishing different aspects of fatigue is relevant as mental post-SAH fatigue might be a target for treatment aimed to improve long-term outcome. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome.

    PubMed

    Keech, Andrew; Sandler, Carolina X; Vollmer-Conna, Ute; Cvejic, Erin; Lloyd, Andrew R; Barry, Benjamin K

    2015-12-01

    To design and validate an instrument to capture the characteristic post-exertional exacerbation of fatigue in patients with chronic fatigue syndrome (CFS). Firstly, patients with CFS (N=19) participated in five focus group discussions to jointly explore the nature of fatigue and dynamic changes after activity, and inform development of a self-report instrument - the Fatigue and Energy Scale (FES). The psychometric properties of the FES were then examined in two case-control challenge studies: a physically-demanding challenge (moderate-intensity aerobic exercise; N=10 patients), and a cognitively-demanding challenge (simulated driving; N=11 patients). Finally, ecological validity was evaluated by recording in association with tasks of daily living (N=9). Common descriptors for fatigue included 'exhaustion', 'tiredness', 'drained of energy', 'heaviness in the limbs', and 'foggy in the head'. Based on the qualitative data, fatigue was conceptualised as consisting of 'physical' and 'cognitive' dimensions. Analysis of the psychometric properties of the FES showed good sensitivity to the changing symptoms during a post-exertional exacerbation of fatigue following both physical exercise and driving simulation challenges, as well as tasks of daily living. The 'fatigue' experienced by patients with CFS covers both physical and cognitive components. The FES captured the phenomenon of a post-exertional exacerbation of fatigue commonly reported by patients with CFS. The characteristics of the symptom response to physical and cognitive challenges were similar. Both the FES and the challenge paradigms offer key tools to reliably investigate biological correlates of the dynamic changes in fatigue. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Trajectories of Evening Fatigue in Oncology Outpatients Receiving Chemotherapy

    PubMed Central

    Wright, Fay; Melkus, Gail D’Eramo; Hammer, Marilyn; Schmidt, Brian L.; Knobf, M. Tish; Paul, Steven M.; Cartwright, Frances; Mastick, Judy; Cooper, Bruce A.; Chen, Lee-May; Melisko, Michelle; Levine, Jon D.; Kober, Kord; Aouizerat, Bradley E.; Miaskowski, Christine

    2015-01-01

    Context Fatigue is a distressing, persistent sense of physical tiredness that is not proportional to a person’s recent activity. Fatigue impacts patients’ treatment decisions and can limit their self-care activities. While significant interindividual variability in fatigue severity has been noted, little is known about predictors of interindividual variability in initial levels and trajectories of evening fatigue severity in oncology patients receiving chemotherapy (CTX). Objectives To determine whether demographic, clinical, and symptom characteristics were associated with initial levels as well as the trajectories of evening fatigue. Methods A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (N=586) completed demographic and symptom questionnaires a total of six times over two cycles of CTX. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling (HLM) was used to answer the study objectives. Results A large amount of interindividual variability was found in the evening fatigue trajectories. A piecewise model fit the data best. Patients who were White, diagnosed with breast, gynecological, or lung cancer, and who had more years of education, child care responsibilities, lower functional status, and higher levels of sleep disturbance and depression reported higher levels of evening fatigue at enrollment. Conclusion This study identified both non-modifiable (e.g., ethnicity) and modifiable (e.g., child care responsibilities, depressive symptoms, sleep disturbance) risk factors for more severe evening fatigue. Using this information, clinicians can identify patients at higher risk for more severe evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors. PMID:25828560

  12. Reduced Radial Displacement of the Gastrocnemius Medialis Muscle After Electrically Elicited Fatigue.

    PubMed

    Macgregor, Lewis J; Ditroilo, Massimiliano; Smith, Iain J; Fairweather, Malcolm M; Hunter, Angus M

    2016-08-01

    Assessments of skeletal-muscle functional capacity often necessitate maximal contractile effort, which exacerbates muscle fatigue or injury. Tensiomyography (TMG) has been investigated as a means to assess muscle contractile function after fatigue; however, observations have not been contextualized by concurrent physiological measures. To measure peripheral-fatigue-induced alterations in mechanical and contractile properties of the plantar-flexor muscles through noninvasive TMG concurrently with maximal voluntary contraction (MVC) and passive muscle tension (PMT) to validate TMG as a gauge of peripheral fatigue. Pre- and posttest intervention with control. University laboratory. 21 healthy male volunteers. Subjects' plantar flexors were tested for TMG parameters, along with MVC and PMT, before and after either a 5-min rest period (control) or a 5-min electrical-stimulation intervention (fatigue). Temporal (contraction velocity) and spatial (radial displacement) contractile parameters of the gastrocnemius medialis were recorded through TMG. MVC was measured as an indicator of muscle fatigue, and PMT was measured to assess muscle stiffness. Radial displacement demonstrated a fatigue-associated reduction (3.3 ± 1.2 vs 4.0 ± 1.4 mm, P = .031), while contraction velocity remained unaltered. In addition, MVC significantly declined by 122.6 ± 104 N (P < .001) after stimulation (fatigue). PMT was significantly increased after fatigue (139.8 ± 54.3 vs 111.3 ± 44.6 N, P = .007). TMG successfully detected fatigue, evident from reduced MVC, by displaying impaired muscle displacement accompanied by elevated PMT. TMG could be useful in establishing skeletal-muscle fatigue status without exacerbating the functional decrement of the muscle.

  13. Fatigue-enhanced hyperalgesia in response to muscle insult: induction and development occur in a sex-dependent manner

    PubMed Central

    Gregory, N. S.; Gibson-Corley, K.; Frey-Law, L.; Sluka, K. A.

    2014-01-01

    Chronic muscle pain affects 20–50% of the population, is more common in women than men, and is associated with increased pain during physical activity and exercise. Muscle fatigue is common in people with chronic muscle pain, occurs in response to exercise and is associated with release of fatigue metabolites. Fatigue metabolites can sensitize muscle nociceptors which could enhance pain with exercise. Using a mouse model we tested whether fatigue of a single muscle, induced by electrical stimulation, resulted in enhanced muscle hyperalgesia and if the enhanced hyperalgesia was more pronounced in female mice. Muscle fatigue was induced in combination with a sub-threshold muscle insult (2 injections of pH 5.0 saline) in male and female mice. We show that male and female mice, fatigued immediately prior to muscle insult in the same muscle, develop similar muscle hyperalgesia 24h later. However, female mice also develop hyperalgesia when muscle fatigue and muscle insult occur in different muscles, and when muscle insult is administered 24 hours after fatigue in the same muscle. Further, hyperalgesia lasts significantly longer in females. Finally, muscle insult with or without muscle fatigue results in minimal inflammatory changes in the muscle itself, and sex differences are not related to estradiol (ovariectomy) or changes in brainstem activity (pNR1). Thus, the current model mimics muscle fatigue-induced enhancement of pain observed in chronic muscle pain conditions in the human population. Interactions between fatigue and muscle insult may underlie the development of chronic widespread pain with an associated female predominance observed in human subjects. PMID:23906552

  14. The PedsQL Multidimensional Fatigue Scale in young adults: feasibility, reliability and validity in a University student population.

    PubMed

    Varni, James W; Limbers, Christine A

    2008-02-01

    The PedsQL (Pediatric Quality of Life Inventory) is a modular instrument designed to measure health-related quality of life (HRQOL) and disease-specific symptoms in children and adolescents ages 2-18. The PedsQL Multidimensional Fatigue Scale was designed as a generic symptom-specific instrument to measure fatigue in pediatric patients ages 2-18. Since a sizeable number of pediatric patients prefer to remain with their pediatric providers after age 18, the objective of the present study was to determine the feasibility, reliability, and validity of the PedsQL Multidimensional Fatigue Scale in young adults. The 18-item PedsQL Multidimensional Fatigue Scale (General Fatigue, Sleep/Rest Fatigue, and Cognitive Fatigue domains), the PedsQL 4.0 Generic Core Scales Young Adult Version, and the SF-8 Health Survey were completed by 423 university students ages 18-25. The PedsQL Multidimensional Fatigue Scale evidenced minimal missing responses, achieved excellent reliability for the Total Scale Score (alpha = 0.90), distinguished between healthy young adults and young adults with chronic health conditions, was significantly correlated with the relevant PedsQL 4.0 Generic Core Scales and the SF-8 standardized scores, and demonstrated a factor-derived structure largely consistent with the a priori conceptual model. The results demonstrate the measurement properties of the PedsQL Multidimensional Fatigue Scale in a convenience sample of young adult university students. The findings suggest that the PedsQL Multidimensional Fatigue Scale may be utilized in the evaluation of fatigue for a broad age range.

  15. Randomized pilot trial of yoga versus strengthening exercises in breast cancer survivors with cancer-related fatigue.

    PubMed

    Stan, Daniela L; Croghan, Katrina A; Croghan, Ivana T; Jenkins, Sarah M; Sutherland, Stephanie J; Cheville, Andrea L; Pruthi, Sandhya

    2016-09-01

    Fatigue is one of the most common and bothersome refractory symptoms experienced by cancer survivors. Mindful exercise interventions such as yoga improve cancer-related fatigue; however, studies of yoga have included heterogeneous survivorship populations, and the effect of yoga on fatigued survivors remains unclear. We randomly assigned 34 early-stage breast cancer survivors with cancer-related fatigue (≥4 on a Likert scale from 1-10) within 1 year from diagnosis to a 12-week intervention of home-based yoga versus strengthening exercises, both presented on a DVD. The primary endpoints were feasibility and changes in fatigue, as measured by the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Secondary endpoint was quality of life, assessed by the Functional Assessment of Cancer Therapies-Breast (FACT-B). We invited 401 women to participate in the study; 78 responded, and we enrolled 34. Both groups had significant within-group improvement in multiple domains of the fatigue and quality of life scores from baseline to post-intervention, and these benefits were maintained at 3 months post-intervention. However, there was no significant difference between groups in fatigue or quality of life at any assessment time. Similarly, there was no difference between groups in adherence to the exercise intervention. Both DVD-based yoga and strengthening exercises designed for cancer survivors may be good options to address fatigue in breast cancer survivors. Both have reasonable uptake, are convenient and reproducible, and may be helpful in decreasing fatigue and improving quality of life in the first year post-diagnosis in breast cancer patients with cancer-related fatigue.

  16. Relationship of Mitochondrial Enzymes to Fatigue Intensity in Men With Prostate Cancer Receiving External Beam Radiation Therapy

    PubMed Central

    Filler, Kristin; Lyon, Debra; McCain, Nancy; Bennett, James; Fernández-Martínez, Juan Luis; deAndrés-Galiana, Enrique Juan; Elswick, R. K.; Lukkahatai, Nada; Saligan, Leorey

    2015-01-01

    Purpose: Mitochondrial dysfunction is a plausible biological mechanism for cancer-related fatigue. Specific aims of this study were to (1) describe the levels of mitochondrial oxidative phosphorylation complex (MOPC) enzymes, fatigue, and health-related quality of life (HRQOL) before and at completion of external beam radiation therapy (EBRT) in men with nonmetastatic prostate cancer (PC); (2) examine relationships over time among levels of MOPC enzymes, fatigue, and HRQOL; and (3) compare levels of MOPC enzymes in men with clinically significant and nonsignificant fatigue intensification during EBRT. Methods: Fatigue was measured by the revised Piper Fatigue Scale and the Functional Assessment of Cancer Therapy–Fatigue subscale (FACT-F). MOPC enzymes (Complexes I–V) and mitochondrial antioxidant superoxide dismutase 2 were measured in peripheral blood using enzyme-linked immunosorbent assay at baseline and completion of EBRT. Participants were categorized into high or low fatigue (HF vs. LF) intensification groups based on amount of change in FACT-F scores during EBRT. Results: Fatigue reported by the 22 participants with PC significantly worsened and HRQOL significantly declined from baseline to EBRT completion. The HF group comprised 12 men with clinically significant change in fatigue (HF) during EBRT. Although no significant changes were observed in MOPC enzymes from baseline to EBRT completion, there were important differences in the patterns in the levels of MOPC enzymes between HF and LF groups. Conclusion: Distinct patterns of changes in the absorbance of MOPC enzymes delineated fatigue intensification among participants. Further investigation using a larger sample is warranted. PMID:26584846

  17. Translating Fatigue to Human Performance

    PubMed Central

    Enoka, Roger M.; Duchateau, Jacques

    2016-01-01

    Despite flourishing interest in the topic of fatigue—as indicated by the many presentations on fatigue at the 2015 annual meeting of the American College of Sports Medicine—surprisingly little is known about its impact on human performance. There are two main reasons for this dilemma: (1) the inability of current terminology to accommodate the scope of the conditions ascribed to fatigue, and (2) a paucity of validated experimental models. In contrast to current practice, a case is made for a unified definition of fatigue to facilitate its management in health and disease. Based on the classic two-domain concept of Mosso, fatigue is defined as a disabling symptom in which physical and cognitive function is limited by interactions between performance fatigability and perceived fatigability. As a symptom, fatigue can only be measured by self-report, quantified as either a trait characteristic or a state variable. One consequence of such a definition is that the word fatigue should not be preceded by an adjective (e.g., central, mental, muscle, peripheral, and supraspinal) to suggest the locus of the changes responsible for an observed level of fatigue. Rather, mechanistic studies should be performed with validated experimental models to identify the changes responsible for the reported fatigue. As indicated by three examples (walking endurance in old adults, time trials by endurance athletes, and fatigue in persons with multiple sclerosis) discussed in the review, however, it has proven challenging to develop valid experimental models of fatigue. The proposed framework provides a foundation to address the many gaps in knowledge of how laboratory measures of fatigue and fatigability impact real-world performance. PMID:27015386

  18. Protocol for the "four steps to control your fatigue (4-STEPS)" randomised controlled trial: a self-regulation based physical activity intervention for patients with unexplained chronic fatigue

    PubMed Central

    2012-01-01

    Background Unexplained Chronic Fatigue is a medical condition characterized by the presence of persistent, severe and debilitating medically unexplained fatigue, leading to impaired functioning and lower quality of life. Research suggests that physical activity can contribute to the reduction of fatigue and other somatic symptoms and can thus significantly improve physical functioning and quality of life in these patients. Based on the self-regulation (SR) theory of behaviour change, we developed a brief physical activity program for patients suffering from unexplained chronic fatigue which focuses on the training of self-regulation skills, the "4-STEPS to control your fatigue" program. Methods/Design This is a multi-centre, randomised controlled trial (RCT) that will be carried out in local primary care centres and at the Portuguese Fibromyalgia and Chronic Fatigue Syndrome Patients Association. Patients aged between 18 and 65 and fulfilling operationalized criteria for Idiopathic Chronic Fatigue (ICF) and Chronic Fatigue Syndrome (CFS) will be recruited and randomly allocated to standard care (SC) or standard care plus a self-regulation based physical activity program (4-STEPS). Patients will be assessed at baseline, after the intervention (3 months) and at 12 months follow-up. The primary outcome is fatigue severity. Discussion The results of the RCT will provide information about the effectiveness of a brief self-regulation intervention for promoting physical activity in patients with unexplained chronic fatigue. If the program proves to be effective, it may be considered as an adjunctive treatment for these patients. Trial Registration ISRCTN: ISRCTN70763996 PMID:22429404

  19. Factors Associated with Intern Fatigue

    PubMed Central

    Vidyarthi, Arpana R.; Baron, Robert B.; Katz, Patricia P.

    2008-01-01

    ABSTRACT BACKGROUND Prior data suggest that fatigue adversely affects patient safety and resident well-being. ACGME duty hour limitations were intended, in part, to reduce resident fatigue, but the factors that affect intern fatigue are unknown. OBJECTIVE To identify factors associated with intern fatigue following implementation of duty hour limitations. DESIGN Cross-sectional confidential survey of validated questions related to fatigue, sleep, and stress, as well as author-developed teamwork questions. SUBJECTS Interns in cognitive specialties at the University of California, San Francisco. MEASUREMENTS Univariate statistics characterized the distribution of responses. Pearson correlations elucidated bivariate relationships between fatigue and other variables. Multivariate linear regression models identified factors independently associated with fatigue, sleep, and stress. RESULTS Of 111 eligible interns, 66 responded (59%). In a regression analysis including gender, hours worked in the previous week, sleep quality, perceived stress, and teamwork, only poorer quality of sleep and greater perceived stress were significantly associated with fatigue (p < 0.001 and p = 0.02, respectively). To identify factors that may affect sleep, specifically duty hours and stress, a secondary model was constructed. Only greater perceived stress was significantly associated with diminished sleep quality (p = 0.04), and only poorer teamwork was significantly associated with perceived stress (p < 0.001). Working >80 h was not significantly associated with perceived stress, quality of sleep, or fatigue. CONCLUSIONS Simply decreasing the number of duty hours may be insufficient to reduce intern fatigue. Residency programs may need to incorporate programmatic changes to reduce stress, improve sleep quality, and foster teamwork in order to decrease intern fatigue and its deleterious consequences. PMID:18807096

  20. Illness perceptions of fatigue and the association with sense of coherence and stress in patients one year after myocardial infarction.

    PubMed

    Alsén, Pia; Eriksson, Monica

    2016-02-01

    To explore the associations between illness perceptions of fatigue, sense of coherence and stress in patients one year after myocardial infarction. Post-myocardial infarction fatigue is a stressful symptom that is difficult to cope with. Patients' illness perceptions of fatigue guide professionals in predicting how individuals will respond emotionally and cognitively to symptoms. Individuals' sense of coherence can be seen as a coping resource in managing stressors. A cross-sectional study design was used. One year post-myocardial infarction, a total of 74 patients still experiencing fatigue completed four questionnaires: the Multidimensional Fatigue Scale Inventory-20, the Brief Illness Perception Questionnaire, the Sense of Coherence scale (sense of coherence-13) and a single-item measure of stress symptoms. Descriptive statistics, correlations and stepwise regression analysis were carried out. Strong negative associations were found between illness perceptions of fatigue, sense of coherence and stress. Sense of coherence has an impact on illness perceptions of fatigue. Of the dimensions of sense of coherence, comprehensibility seemed to play the greatest role in explaining illness perceptions of fatigue one year after myocardial infarction. To strengthen patients' coping resources, health-care professionals should create opportunities for patients to gain individual-level knowledge that allows them to distinguish between common fatigue symptoms and warning signs for myocardial infarction. There is a need to improve strategies for coping with fatigue. It is also essential to identify patients with fatigue after myocardial infarction, as they need explanations for their symptoms and extra support. © 2016 John Wiley & Sons Ltd.

  1. Parental fatigue and parenting practices during early childhood: an Australian community survey.

    PubMed

    Cooklin, A R; Giallo, R; Rose, N

    2012-09-01

    Parenting behaviours are influenced by a range of factors, including parental functioning. Although common, the influence of parental fatigue on parenting practices is not known. The first aim of this study was to investigate the relationship between fatigue and parenting practices. The second aim was to identify parental psychosocial factors significantly associated with fatigue. A sample of 1276 Australian parents, of at least one child aged 0-5 years, completed a survey. Demographic, psychosocial (social support, coping responses) and parental sleep and self-care information was collected. Hierarchical regression was performed to assess the contribution of fatigue (modified Fatigue Assessment Scale) to parental practices (warmth, irritability and involvement), and parenting experiences (Parenting Stress Index, Parenting Sense of Competence Scale). Hierarchical multiple regression assessed the contribution of a range of parental sleep, psychosocial (social support, coping responses) and self-care variables to fatigue when demographic characteristics were held constant. Higher fatigue was significantly associated with lower parental competence (β=-0.17, P < 0.005), greater parenting stress (β= 0.21, P < 0.005) and more irritability in parent-child interactions (β= 0.11, P < 0.005). Several psychosocial characteristics were associated with higher parental fatigue, including inadequate social support, poorer diet, poorer sleep quality and ineffective coping styles including self-blame and behaviour disengagement. Fatigue is common, and results suggest that fatigue contributes to adverse parental practices and experiences. However, possible risk factors for higher fatigue were identified in this study, indicating opportunities for intervention, management and support for parents. © 2011 Blackwell Publishing Ltd.

  2. Fatigue crack tip deformation and fatigue crack propagation

    NASA Technical Reports Server (NTRS)

    Kang, T. S.; Liu, H. W.

    1972-01-01

    The effects of stress ratio, prestress cycling and plate thickness on the fatigue crack propagation rate are studied on 2024-T351 aluminum alloy. Fatigue crack propagation rate increases with the plate thickness and the stress ratio. Prestress cycling below the static yield strength has no noticeable effect on the fatigue crack propagation rate. However, prestress cycling above the static yield strength causes the material to strain harden and increases the fatigue crack propagation rate. Crack tip deformation is used to study the fatigue crack propagation. The crack tip strains and the crack opening displacements were measured from moire fringe patterns. The moire fringe patterns were obtained by a double exposure technique, using a very high density master grille (13,400 lines per inch).

  3. Fatigue Behavior of a Box-Type Welded Structure of Hydraulic Support Used in Coal Mine

    PubMed Central

    Zhao, Xiaohui; Li, Fuyong; Liu, Yu; Fan, Yanjun

    2015-01-01

    Hydraulic support is the main supporting equipment of the coal mining systems, and they are usually subjected to fatigue failure under the high dynamic load. The fracture positions are generally at welded joints where there is a serious stress concentration. In order to investigate and further improve the fatigue strength of hydraulic support, the present work first located the possible position where fatigue failure occurs through finite element analysis, and then fatigue tests were carried out on the different forms of welded joints for the dangerous parts. Finally, Fatigue strength-life (S-N) curves and fracture mechanism were studied. This research will provide a theoretical reference for the fatigue design of welded structures for hydraulic support. PMID:28793586

  4. Experimental Study on Fatigue Behaviour of Shot-Peened Open-Hole Steel Plates

    PubMed Central

    Wang, Zhi-Yu; Wang, Qing-Yuan; Cao, Mengqin

    2017-01-01

    This paper presents an experimental study on the fatigue behaviour of shot-peened open-hole plates with Q345 steel. The beneficial effects induced by shot peening on the fatigue life improvement are highlighted. The characteristic fatigue crack initiation and propagation modes of open-hole details under fatigue loading are revealed. The surface hardening effect brought by the shot peening is analyzed from the aspects of in-depth micro-hardness and compressive residual stress. The fatigue life results are evaluated and related design suggestions are made as a comparison with codified detail categories. In particular, a fracture mechanics theory-based method is proposed and demonstrated its validity in predicting the fatigue life of studied shot-peened open-hole details. PMID:28841160

  5. The perceptual features of vocal fatigue as self-reported by a group of actors and singers.

    PubMed

    Kitch, J A; Oates, J

    1994-09-01

    Performers (10 actors/10 singers) rated via a self-report questionnaire the severity of their voice-related changes when vocally fatigued. Similar frequency patterns and perceptual features of vocal fatigue were found across subjects. Actors rated "power" aspects (e.g., voice projection) and singers rated vocal dynamic aspects (e.g., pitch range) of their voices as most affected when vocally fatigued. Vocal fatigue was evidenced by changes in kinesthetic/proprioceptive sensations and vocal dynamics. The causes and context of vocal fatigue were vocal misuse, being "run down," high performance demands, and using high pitch/volume levels. Further research is needed to delineate the perceptual features of "normal" levels of vocal fatigue and its possible causes.

  6. Grain boundary oxidation and its effects on high temperature fatigue life

    NASA Technical Reports Server (NTRS)

    Liu, H. W.; Oshida, Yoshiki

    1986-01-01

    Fatigue lives at elevated temperatures are often shortened by creep and/or oxidation. Creep causes grain boundary void nucleation and grain boundary cavitation. Grain boundary voids and cavities will accelerate fatigue crack nucleation and propagation, and thereby shorten fatigue life. The functional relationships between the damage rate of fatigue crack nucleation and propagation and the kinetic process of oxygen diffusion depend on the detailed physical processes. The kinetics of grain boundary oxidation penetration was investigated. The statistical distribution of grain boundary penetration depth was analyzed. Its effect on high temperature fatigue life are discussed. A model of intermittent micro-ruptures of grain boundary oxide was proposed for high temperature fatigue crack growth. The details of these studies are reported.

  7. A novel evaluation strategy for fatigue reliability of flexible nanoscale films

    NASA Astrophysics Data System (ADS)

    Zheng, Si-Xue; Luo, Xue-Mei; Wang, Dong; Zhang, Guang-Ping

    2018-03-01

    In order to evaluate fatigue reliability of nanoscale metal films on flexible substrates, here we proposed an effective evaluation way to obtain critical fatigue cracking strain based on the direct observation of fatigue damage sites through conventional dynamic bending testing technique. By this method, fatigue properties and damage behaviors of 930 nm-thick Au films and 600 nm-thick Mo-W multilayers with individual layer thickness 100 nm on flexible polyimide substrates were investigated. Coffin-Manson relationship between the fatigue life and the applied strain range was obtained for the Au films and Mo-W multilayers. The characterization of fatigue damage behaviors verifies the feasibility of this method, which seems easier and more effective comparing with the other testing methods.

  8. Fatigue Analysis of Overhead Sign and Signal Structures

    DOT National Transportation Integrated Search

    1994-05-01

    This report documents methods of fatigue analysis for overhead sign and signal structures. The main purpose of this report is to combine pertinent wind loading and vibration theory, fatigue damage theory, and experimental data into a useable fatigue ...

  9. Hydraulic Fatigue-Testing Machine

    NASA Technical Reports Server (NTRS)

    Hodo, James D.; Moore, Dennis R.; Morris, Thomas F.; Tiller, Newton G.

    1987-01-01

    Fatigue-testing machine applies fluctuating tension to number of specimens at same time. When sample breaks, machine continues to test remaining specimens. Series of tensile tests needed to determine fatigue properties of materials performed more rapidly than in conventional fatigue-testing machine.

  10. Fatigue risks in the connections of sign support structures : [technical brief].

    DOT National Transportation Integrated Search

    2013-07-01

    The latest edition of the AASHTO design specifications (AASHTO 2001) introduced provisions for fatigue design. However, many structures presently in service were designed before fatigue provisions were part of the design specifications. The fatigue d...

  11. Validity and reliability of the Traditional Chinese version of the Multidimensional Fatigue Inventory in general population.

    PubMed

    Chuang, Li-Ling; Chuang, Yu-Fen; Hsu, Miao-Ju; Huang, Ying-Zu; Wong, Alice M K; Chang, Ya-Ju

    2018-01-01

    Fatigue is a common symptom in the general population and has a substantial effect on individuals' quality of life. The Multidimensional Fatigue Inventory (MFI) has been widely used to quantify the impact of fatigue, but no Traditional Chinese translation has yet been validated. The goal of this study was to translate the MFI from English into Traditional Chinese ('the MFI-TC') and subsequently to examine its validity and reliability. The study recruited a convenience sample of 123 people from various age groups in Taiwan. The MFI was examined using a two-step process: (1) translation and back-translation of the instrument; and (2) examination of construct validity, convergent validity, internal consistency, test-retest reliability, and measurement error. The validity and reliability of the MFI-TC were assessed by factor analysis, Spearman rho correlation coefficient, Cronbach's alpha coefficient, intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. All participants completed the Short-Form-36 Health Survey Taiwan Form (SF-36-T) and the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) concurrently to test the convergent validity of the MFI-TC. Test-retest reliability was assessed by readministration of the MFI-TC after a 1-week interval. Factor analysis confirmed the four dimensions of fatigue: general/physical fatigue, reduced activity, reduced motivation, and mental fatigue. A four-factor model was extracted, combining general fatigue and physical fatigue as one factor. The results demonstrated moderate convergent validity when correlating fatigue (MFI-TC) with quality of life (SF-36-T) and sleep disturbances (PSQI) (Spearman's rho = 0.68 and 0.47, respectively). Cronbach's alpha for the MFI-TC total scale and subscales ranged from 0.73 (mental fatigue subscale) to 0.92 (MFI-TC total scale). ICCs ranged from 0.85 (reduced motivation) to 0.94 (MFI-TC total scale), and the MDC ranged from 2.33 points (mental fatigue) to 9.5 points (MFI-TC total scale). The Bland-Altman analyses showed no significant systematic bias between the repeated assessments. The results support the use of the Traditional Chinese version of the MFI as a comprehensive instrument for measuring specific aspects of fatigue. Clinicians and researchers should consider interpreting general fatigue and physical fatigue as one subscale when measuring fatigue in Traditional Chinese-speaking populations.

  12. Validity and reliability of the Traditional Chinese version of the Multidimensional Fatigue Inventory in general population

    PubMed Central

    Chuang, Li-Ling; Chuang, Yu-Fen; Hsu, Miao-Ju; Huang, Ying-Zu; Wong, Alice M. K.

    2018-01-01

    Background Fatigue is a common symptom in the general population and has a substantial effect on individuals’ quality of life. The Multidimensional Fatigue Inventory (MFI) has been widely used to quantify the impact of fatigue, but no Traditional Chinese translation has yet been validated. The goal of this study was to translate the MFI from English into Traditional Chinese (‘the MFI-TC’) and subsequently to examine its validity and reliability. Methods The study recruited a convenience sample of 123 people from various age groups in Taiwan. The MFI was examined using a two-step process: (1) translation and back-translation of the instrument; and (2) examination of construct validity, convergent validity, internal consistency, test-retest reliability, and measurement error. The validity and reliability of the MFI-TC were assessed by factor analysis, Spearman rho correlation coefficient, Cronbach’s alpha coefficient, intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. All participants completed the Short-Form-36 Health Survey Taiwan Form (SF-36-T) and the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) concurrently to test the convergent validity of the MFI-TC. Test-retest reliability was assessed by readministration of the MFI-TC after a 1-week interval. Results Factor analysis confirmed the four dimensions of fatigue: general/physical fatigue, reduced activity, reduced motivation, and mental fatigue. A four-factor model was extracted, combining general fatigue and physical fatigue as one factor. The results demonstrated moderate convergent validity when correlating fatigue (MFI-TC) with quality of life (SF-36-T) and sleep disturbances (PSQI) (Spearman's rho = 0.68 and 0.47, respectively). Cronbach’s alpha for the MFI-TC total scale and subscales ranged from 0.73 (mental fatigue subscale) to 0.92 (MFI-TC total scale). ICCs ranged from 0.85 (reduced motivation) to 0.94 (MFI-TC total scale), and the MDC ranged from 2.33 points (mental fatigue) to 9.5 points (MFI-TC total scale). The Bland-Altman analyses showed no significant systematic bias between the repeated assessments. Conclusions The results support the use of the Traditional Chinese version of the MFI as a comprehensive instrument for measuring specific aspects of fatigue. Clinicians and researchers should consider interpreting general fatigue and physical fatigue as one subscale when measuring fatigue in Traditional Chinese-speaking populations. PMID:29746466

  13. Fatigue and related factors among hotel workers: the effects of emotional labor and non-standard working hours.

    PubMed

    Lee, Ju Jong; Moon, Hyun Jey; Lee, Kyung-Jae; Kim, Joo Ja

    2014-01-01

    This study assessed fatigue and its association with emotional labor and non-standard working hours among hotel workers. A structured self-administered questionnaire was distributed to 1,320 employees of five hotels located in Seoul. The questionnaire survey included questions concerning the participants' sociodemographics, health-related behaviors, job-related factors, emotional labor, and fatigue. Fatigue was assessed using the Multidimensional Fatigue Scale (MFS). Multiple logistic regression modeling was used to determine the associations between fatigue and emotional labor. Among male workers, there was a significant association between fatigue and both emotional disharmony (OR=5.52, 95% CI=2.35-12.97) and emotional effort (OR=3.48, 95% CI=1.54-7.86). These same associations were seen among the female workers (emotional disharmony: OR=6.91, 95% CI=2.93-16.33; emotional effort: OR=2.28, 95% CI=1.00-5.16). These results indicate that fatigue is associated with emotional labor and, especially, emotional disharmony among hotel workers. Therefore, emotional disharmony management would prove helpful for the prevention of fatigue.

  14. The impact of job and family demands on partner’s fatigue: A study of Japanese dual-earner parents

    PubMed Central

    Shimazu, Akihito; Bakker, Arnold B.; Demerouti, Evangelia; Shimada, Kyoko; Kawakami, Norito

    2017-01-01

    Objectives This study of Japanese dual-earner couples examined the impact of family and job demands on one’s own and one’s partner’s fatigue as well as gender differences in these effects. Methods A total of 2,502 parents (1,251 couples) were surveyed using a self-administered questionnaire. A crossover model was tested using structural equation modeling. Results The results of structural equation modeling analyses showed that both job and family demands independently exacerbated fatigue. There was an indirect effect of job and family demands on partner fatigue through one’s own fatigue only from husbands to wives. An indirect effect of job demands on partner fatigue through partner’s family demands was identified only from wives to husbands. Furthermore, there were gender differences in the crossover of fatigue. Conclusions This study shows that job and family demands influence family circumstances. When considering means to reduce employees’ fatigue, gender differences in the mechanism of fatigue need to be taken into account. PMID:28235008

  15. Predicting non-isometric fatigue induced by electrical stimulation pulse trains as a function of pulse duration

    PubMed Central

    2013-01-01

    Background Our previous model of the non-isometric muscle fatigue that occurs during repetitive functional electrical stimulation included models of force, motion, and fatigue and accounted for applied load but not stimulation pulse duration. Our objectives were to: 1) further develop, 2) validate, and 3) present outcome measures for a non-isometric fatigue model that can predict the effect of a range of pulse durations on muscle fatigue. Methods A computer-controlled stimulator sent electrical pulses to electrodes on the thighs of 25 able-bodied human subjects. Isometric and non-isometric non-fatiguing and fatiguing knee torques and/or angles were measured. Pulse duration (170–600 μs) was the independent variable. Measurements were divided into parameter identification and model validation subsets. Results The fatigue model was simplified by removing two of three non-isometric parameters. The third remained a function of other model parameters. Between 66% and 77% of the variability in the angle measurements was explained by the new model. Conclusion Muscle fatigue in response to different stimulation pulse durations can be predicted during non-isometric repetitive contractions. PMID:23374142

  16. Fatigue-Induced Changes in Movement Pattern and Muscle Activity During Ballet Releve on Demi-Pointe.

    PubMed

    Lin, Cheng-Feng; Lee, Wan-Chin; Chen, Yi-An; Hsue, Bih-Jen

    2016-08-01

    Fatigue in ballet dancers may lead to injury, particularly in the lower extremities. However, few studies have investigated the effects of fatigue on ballet dancers' performance and movement patterns. Thus, the current study examines the effect of fatigue on the balance, movement pattern, and muscle activities of the lower extremities in ballet dancers. Twenty healthy, female ballet dancers performed releve on demi-pointe before and after fatigue. The trajectory of the whole body movement and the muscle activities of the major lower extremity muscles were recorded continuously during task performance. The results show that fatigue increases the medial-lateral center of mass (COM) displacement and hip and trunk motion, but decreases the COM velocity and ankle motion. Moreover, fatigue reduces the activities of the hamstrings and tibialis anterior, but increases that of the soleus. Finally, greater proximal hip and trunk motions are applied to compensate for the effects of fatigue, leading to a greater COM movement. Overall, the present findings show that fatigue results in impaired movement control and may therefore increase the risk of dance injury.

  17. The multiaxial fatigue response of cylindrical geometry under proportional loading subject to fluctuating tractions

    NASA Astrophysics Data System (ADS)

    Martinez, Rudy D.

    A multiaxial fatigue model is proposed, as it would apply to cylindrical geometry in the form of industrial sized pressure vessels. The main focus of the multiaxial fatigue model will be based on using energy methods with the loading states confined to fluctuating tractions under proportional loading. The proposed fatigue model is an effort to support and enhance existing fatigue life predicting methods for pressure vessel design, beyond the ASME Boiler and Pressure Vessel codes, ASME Section VIII Division 2 and 3, which is currently used in industrial engineering practice for pressure vessel design. Both uniaxial and biaxial low alloy pearlittic-ferritic steel cylindrical cyclic test data are utilized to substantiate the proposed fatigue model. Approximate material hardening and softening aspects from applied load cycling states and the Bauschinger effect are accounted for by adjusting strain control generated hysteresis loops and the cyclic stress strain curve. The proposed fatigue energy model and the current ASME fatigue model are then compared with regards to the accuracy of predicting fatigue life cycle consistencies.

  18. Fatigue Behavior of a Third Generation PM Disk Superalloy

    NASA Technical Reports Server (NTRS)

    Gayda, John; Gabb, Timothy P.

    2008-01-01

    The fatigue behavior of a 3rd generation PM disk alloy, LSHR, was studied at 1300 F. Tensile, creep, and fatigue tests were run on smooth and notched (Kt = 2) bars under a variety of conditions. Analysis of smooth bar fatigue data, run under strain and load control with R ratios of 0 and -1, showed that a stress based Smith-Watson-Topper approach could collapse the data set. While the tensile and creep data showed substantial notch strengthening at 1300 F, the fatigue data showed a life deficit for the notch specimens. A viscoplastic finite element model, which accounted for stress relaxation at the notch tip, provided the best correlation between the notched and smooth bar behavior, although the fatigue data was not fully rationalized based on this simplified viscoplastic model of the stresses at the notch tip.Inclusion of a 90 sec dwell at peak load was found to dramatically decrease notch fatigue life. This result was shown to be consistent with a simple linear creep-fatigue damage rule, where creep damage dominated at low stresses and fatigue damage was more prevalent at higher stresses.

  19. Long-term efficacy of cognitive-behavioral therapy by general practitioners for fatigue: a 4-year follow-up study.

    PubMed

    Leone, Stephanie S; Huibers, Marcus J H; Kant, Ijmert; van Amelsvoort, Ludovic G P M; van Schayck, Constant P; Bleijenberg, Gijs; Knottnerus, J André

    2006-11-01

    In an earlier study, we found that cognitive-behavioral therapy (CBT) delivered by general practitioners (GPs) for fatigue among employees on sick leave was not effective after 12 months. In this study we aim to assess the long-term efficacy of CBT by GPs for fatigue. It was hypothesized that the intervention could prevent deterioration as well as relapse of fatigue complaints and relapse into absenteeism in the long term. Patients who participated in the original randomized controlled trial were followed up 4 years later. Fatigue and absenteeism were the main outcomes. Fatigue and absenteeism were high in the intervention and control groups at the 4-year follow-up. There was no significant difference between the intervention group and the control group on fatigue and absenteeism. The intervention group however tended toward less-favorable outcomes as compared with the control group. Like that of chronic fatigue syndrome, the prognosis of less-advanced fatigue is rather poor. CBT delivered by GPs is not effective in the long term.

  20. Fatigue Characterization of Alloy 10: a 1300F Disk Alloy for Small Gas Turbine Engines

    NASA Technical Reports Server (NTRS)

    Gayda, John

    2000-01-01

    A detailed fatigue characterization of Alloy 10, a high strength nickel-based disk alloy, was conducted on test coupons machined from a 'pancake' forging. Smooth bar, strain controlled fatigue testing at various R-ratios was run at representative bore, 750 F, and rim, 1300 F, temperatures. This was followed by notch fatigue testing (Kt=2) run under load control. Analysis of the fatigue data using a Smith-Watson-Topper approach and finite element analysis of the notch root was employed to understand material behavior in these tests. Smooth bar fatigue data showed a significant R-ratio dependence at either test temperature which could be accounted for using a Smith-Watson-Topper parameter (SWT). In general, fatigue life was longer at 750 F than 1300 F for a given SWT. For notch fatigue tests, life was longer at 750 F than 1300 F but only at higher stresses. This was attributed to differences in alloy strength. At lower stresses, finite element analysis suggested that convergence of fatigue life at both temperatures resulted from relaxation of stresses at the notch root in the 1300 F tests.

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