Work-related self-assessed fatigue and recovery among nurses

In diary studies, people provide frequent reports on the events and experiences of their daily lives. These reports capture the particulars of experience in a way that is not possible using traditional designs. We review the types of research questions that diary methods are best equipped to answer, the main designs that can be used, current technology for obtaining diary reports, and appropriate data analysis strategies. Major recent developments include the use of electronic forms of data collection and multilevel models in data analysis. We identify several areas of research opportunities: 1. in technology, combining electronic diary reports with collateral measures such as ambulatory heart rate; 2. in measurement, switching from measures based on between-person differences to those based on within-person changes; and 3. in research questions, using diaries to (a) explain why people differ in variability rather than mean level, (b) study change processes during major events and transitions, and (c) study interpersonal processes using dyadic and group diary methods.

Sleep has a critical role in promoting health. Research over the past decade has documented that sleep disturbance has a powerful influence on the risk of infectious disease, the occurrence and progression of several major medical illnesses including cardiovascular disease and cancer, and the incidence of depression. Increasingly, the field has focused on identifying the biological mechanisms underlying these effects. This review highlights the impact of sleep on adaptive and innate immunity, with consideration of the dynamics of sleep disturbance, sleep restriction, and insomnia on (a) antiviral immune responses with consequences for vaccine responses and infectious disease risk and (b) proinflammatory immune responses with implications for cardiovascular disease, cancer, and depression. This review also discusses the neuroendocrine and autonomic neural underpinnings linking sleep disturbance and immunity and the reciprocal links between sleep and inflammatory biology. Finally, interventions are discussed as effective strategies to improve sleep, and potential opportunities are identified to promote sleep health for therapeutic control of chronic infectious, inflammatory, and neuropsychiatric diseases.

This paper presents a cognitive-energetical framework for the analysis of effects of stress and high workload on human performance. Following Kahneman's (1973) model, regulation of goals and actions is assumed to require the operation of a compensatory control mechanism, which allocates resources dynamically. A two-level compensatory control model provides the basis for a mechanism of resource allocation through an effort monitor, sensitive to changes in the level of regulatory activity, coupled with a supervisory controller which can implement different modes of performance-cost trade-off. Performance may be protected under stress by the recruitment of further resources, but only at the expense of increased subjective effort, and behavioural and physiological costs. Alternatively, stability can be achieved by reducing performance goals, without further costs. Predictions about patterns of latent decrement under performance protection are evaluated in relation to the human performance literature. Even where no primary task decrements may be detected, performance may show disruption of subsidiary activities or the use of less efficient strategies, as well as increased psychophysiological activation, strain, and fatigue after-effects. Finally, the paper discusses implications of the model for the assessment of work strain, with a focus on individual-level patterns of regulatory activity and coping.