Abstract This paper proposes a study to determine whether a mechanism exists that links C-1 esterase inhibitor deficiency with Chronic Fatigue syndrome (CFS). FS is a clinically defined condition which is characterized by severe and disabling fatigue. It examines the problems faced by health care professionals in treating CFS patients since the etiology of the illness is not known. It attempts to determine whether CFS patients are characterized by a C-1 esterase inhibitor deficiency and whether replacement therapy for C-1 esterase inhibitor deficiency leads to improvements in patients? CFS status. It also looks at the significance of the study to nursing since advanced practice nurses play an important role in the delivery of care to CFS patients.
Outline
Introductory Statement
Statement of the Problem
Research Questions
Significance of the Study to Nursing
Background Information
Review of Literature
C-1 Esterase Inhibitor Deficiency: Related Research
Chronic Fatigue Syndrome (CFS)
Conclusions Relevant to the Study Problem
From the Paper "The role of the advanced practice nurse practitioner continues to expand. In the contemporary period, some of the more prominent of the roles performed by the advanced practice nurse practitioner are as follows: the role of the nurse practitioner as a care provider; the role of the nurse practitioner as a manager; the role of the nurse practitioner as a patient health educator; the role of the nurse practitioner as a consultant; the role of the nurse practitioner as a researcher; and the role of the nurse practitioner in relation to psychiatric and metal health nursing."
Abstract This paper examines chronic fatigue syndrome (CFS) its diagnosis, and the ways in which healthcare providers are learning to better manage its symptoms. The paper gives a brief history of the disease, citing when it was first noted as a condition. Today's definition of CFS is also given. The author then suggests various causes of the condition, although there are no definitive answers. The various treatment options are presented, although this is also controversial. The paper includes a review of several recent studies on CFS. The author concludes that CFS will continue to present challenges to both healthcare providers and sufferers since the disease is one example of the large range of medically unexplained syndromes today.
From the Paper "Today, CDC defines the illness as: "a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity." Individuals having CFS most often function at a substantially lower level of activity than capable of prior to the illness. In addition to these key defining characteristics, patients also report a number of nonspecific symptoms, such as weakness, muscle pain, impaired memory and/or mental concentration, insomnia, and post-exertional fatigue lasting more than 24 hours. Mental health professionals also recognize that CFS often relates to depression. In some cases, CFS can persist for years (CDC, 2006). "
Abstract This paper discusses various aspects of pilot fatigue, the causes of such fatigue and the associated dangers. The paper also discusses aviation accidents where pilot fatigue was proved to have been the cause. The paper further discusses ways in which pilot fatigue can be avoided.
Outline:
Introduction
Accidents Associated With Fatigue Causes and Results of Pilot Fatigue Past, Present and Future Responses to Pilot Fatigue Conclusion
From the Paper "There are of coarse more recent examples that 1999 and as the attention of the aviation industry, the flying public and of coarse the media have become more attuned to these sorts of situations the accounts are more likely to list pilot fatigue as a major cause of an accident but ultimately the responsibility is often laid upon the individual flight crews as to their obvious inability to self advocate in situations where their physical and mental state is impaired by fatigue. The commercial industry often does not associate their own responsibility, regarding the over scheduling of pilots or the random and physically and mentally disruptive nature of changing time zones, sleep deprivation or limited downtime in a increasingly competitive and demanding environment where cost cutting is necessary and individuals are often lost in the shuffle of the schedule with longer lists of flights and generally lower cost flights that provide a lower return on the investment."
This paper is an extensive literature review of research tests and experiments relating to the relationship of physical and psychological fatigue and aviation accidents.
Abstract This paper explains that fatigue is a factor that is being increasingly seen as a threat and a problem in the aviation industry and the Air Force. It has been estimated that problems caused by fatigue costs American industry more than $18 billion a year in terms of lost productivity. The author points out that fatigue is characterized by (1) a decreased capacity for work, known as work decrement; (2) modifications in the physiological state of the individual; and (3) a feeling of weariness, which may be accompanied by irritability, anxiety, excessive worry and a disturbed emotional state. The paper relates that reports indicate that fatigue, as a result of sleep deprivation, is not always a critical factor and that there are various factors that are interrelated and can effect the assessments of fatigue of aviation issues. Many quotations. Graph.
Table of Contents
Introduction
Method
Results
Discussion
Conclusion
From the Paper "Researchers also point out that the varying results obtained from studies are related to and dependent on the type of experiments and the situations in which the testing takes place. They note that the best data and sources of information on the true effects of fatigue are often taken from actual combat situations and conditions; while many state that the results from simulations and laboratory experiments do not produce an accurate picture of the reality of fatigue and fatigue-induced errors in aviation."
Abstract This paper is a research proposal to assess the effects on Chronic Fatigue Syndrome patients of increases in the serum levels of C-1 esterace inhibitor within the context of the concept of complement dis-regulation. This paper states that Chronic Fatigue Syndrome (CFS) is a clinically defined condition that is characterized by severe and disabling fatigue, but there is no validated diagnosis or treatment that will lead to a cure for CFS. The author will use Beck Depression Inventory (BDI) Kohlman Evaluation of Living Skills (KELS) and The Fatigue Inventory as the psychological measurements.
From the Paper "Clinical anxiety is defined within the context of feelings experienced by a person. At one level, anxiety is defined as a feeling of mingled dread and apprehension about a person's future where no specific cause for such dread and apprehension is present. At another level, anxiety is defined as a chronic feeling of fear by a person. This feeling may be mild in intensity or the feeling fear may be overwhelming for the person so affected. Anxiety also may be a secondary drive involving an acquired avoidance response. In this latter context, when in the presence of the conditioning stimulus, a person will display behavior that may be interpreted as evidence of the presence of anxiety. "
Abstract In this article, the writer points out that when pilots become tired, they are more likely to make mistakes or even to fall asleep - both of which are unacceptable for anyone seeking to pilot an aircraft safely. This study examines how pilots are affected by fatigue in aviation and how this can lead to accidents. The research shows that pilot fatigue can be caused by some other, less readily identifiable, sources as well. To this end, the paper presents a review of the peer-reviewed, scholarly and popular literature concerning pilot fatigue followed by a summary of the research and important findings in the conclusion. The writer concludes that until the day comes when aircraft are completely autonomous and do not require human control, the issue of pilot fatigue will remain relevant and important to the flying public, pilots and policymakers alike. The paper
includes a figure and research log.
Outline:
Review and Discussion
Conclusion
From the Paper "When many people think of becoming fatigued, the cause usually relates to simply becoming physically tired for whatever reason, but the research quickly shows that pilots are subjected to a wide range of conditions that are unique to the profession. For example, according to Garland and his colleagues, pilot experiences during World War II suggest that noise and even vibrations can contribute to pilot fatigue. Likewise, Ward points out that pilots during World War II could become fatigued because of the very nature of their jobs and the types of aircraft involved .. "
Abstract This paper notes that the cause of muscle fatigue has long been a physiological curiosity, with textbooks often ignoring the problem completely, and discusses an article by G. Kolata entitled "Finding May Solve Riddle of Fatigue in Muscles." According to Kolata, all animals with muscles experience this fatigue; however, until now, scientists have been unable to explain why, especially with the theory of lactic-acid build up recently being discredited. A new study by scientists at Columbia, searching for better ways to treat patients with congestive heart failure, may not only answer this question, but also provide a method for solving muscle fatigue.
Outline:
Abstract
Introduction
Context
Analysis
Relation to Profession
Future
Conclusion
From the Paper "Instead of lactic-acid, this latest study blames muscle fatigue on calcium flow inside the muscle cells. This ebb and flow of calcium is what controls muscle contractions. As muscles tire, tiny channels begin to leak calcium and this calcium leakage then not only weakens the contractions but also stimulates an enzyme that eats away at muscle fibers, which further exacerbates fatigue. Utilizing a drug meant to prevent calcium leaks in the heart muscle, lead researcher Dr. Marks, applied the drug to the skeletal muscles. With this drug, it was found the mice could run 10 to 20 percent longer."
Tags: molecular chronic epinephrine norephinephrine, life expectancy, cardiac
Abstract The paper looks at a personal and informal account of chronic fatigue syndrome (CFS) and of fibromyalgia (FM). The paper discusses how CFS and FM are similar conditions since both involve pain and fatigue and also result in misunderstanding from outsiders. The paper shows how the individual's account of her and her husband's illness agrees with the literature.
Outline:
Introduction
Discussion of CFS
Critical Analysis
Conclusion
From the Paper "Based on Zona's account, CFS means total exhaustion and complete lack of energy. She can accomplish just a little at a time and must be careful of her limits. She experiences many aches and pains as well as spasms which cause insomnia. She has numerous allergies especially to medications. Food also is a problem for allergies. She feels as though her brain is fogged and she is difficulties concentrating. She also has problems with vision and refocusing. Dry throat and acid burn are other problems. She does not experience the same set of symptoms each day. Sometimes her symptoms are similar to a panic attack."
Abstract This paper seeks to explore the crack growth fracture mechanics with a focus on the factors that influence the fatigue crack growth rate and how the Paris-Erdogan equation can be used to predict fatigue crack growth as well as in the calculation of crack growth rate. The paper also presents research on modes of mechanical failure.
From the Paper "According to Hancock, G. J. (2003, p.125), fracture mechanics is used to predict the effect of cracks on the durability and integrity of structures and components. It helps in detecting cracks in structure before a crack grows to significant length as a result of sustained stress cycles. During fatigue, crack growth rate can be calculated by the Paris-Erdogan equation given by da/dn = C (Δk)n where a represents the crack length, n represents the number of fatigue cycles, Δk represents the applied stress intensity factor range while c and m are considered to be constants of a material. Δk increases with time as a load is applied due to the growth of the crack. For a crack of length a, the rate of crack growth given by da/dn per cycle varies with Δk. Where c and m are constant with m between 2 and 4. The upper limit of a crack growth rate curve represents the fracture toughness of the material while the lower limit is the threshold. There is characterization of sub-critical crack growth using linear plastic fracture mechanics parameters and acoustic emission data to predict crack propagation rates. This determines the number of cycles required for an existing crack to attain a substantial size. (Reuter, W. G, Robert, S. P. 2002, p.458)Acoustic emissions are elastic stress waves generated by a rapid release of energy from a localized source within a stressed material. Fatigue crack growth rate is influenced by many factors some of which include: notch radius where research indicates presence of higher fatigue crack growth rate in a blunt notch. This is because of accumulation of fatigue damage at the tip of the notch initiating the crack a head of the notch. Material strength, initial crack tip condition, mean stress, overload as well as non-proportional load determine the crack growth rate. Research has also shown that ferroelectric ceramics experience cracking and mechanical degradation when subjected to large alternating electric fields. (Anderson, T.L., 2005, p.455)"
Abstract This paper researches and describes the effects of fatigue on cognitive performance, including the effects noted on persons in the aviation arena
Abstract This study looks at many of the issues women of advanced maternal age face, but focuses primarily on fatigue and depression, as these seem to be two of the main complaints that are expressed by this group of women. Why these complaints are so prevalent is discussed, as well as the purpose behind this study and the theoretical framework that it deals with.
From the Paper "The concern over women of advanced maternal age (over 35) giving birth has had a long history. There are many that think it is dangerous, and not just for the physical health of the mother, but for her mental and emotional health as well. Much of this has to do with the fact that there are many risks that come with having a baby, and the older the mother is when she has her first child the harder it often is for her. This is especially true of women who are over the age of 35, but some women have babies when they are in the late thirties or their forties with no apparent ill effects. Nevertheless, the concerns are very real and should not be ignored by women over 35 who are considering having their first child."
Abstract This paper examines the disorder of chronic fatigue syndrome (CFS). It particularly emphasizes disease management. The paper reviews the disorder, symptoms and prognosis. It then provides a more detailed examination of the problematic aspects in managing day-to-day activities, such as work, family and social obligations, due to the illness. The paper looks at how patient lifestyle modifications and adaptive measures can influence the outcome of CFS.
Table of Contents:
Abstract
Managing the Disorder
From the Paper "CFS is a complex and demanding disorder that significantly alters one's lifestyle and affects more than just the patient. Comprehensive understanding of the disorder and how each patient is affected are essential in order to help the patient manage their disorder effectively and avoid further depressive, frustration and anger based emotional complications that normally plague an individual with a chronic disorder. For the patient with CFS, such a reaction creates a negative cyclical spiral. A positive approach and helping the patient to accept their situation, focusing on what they can do rather than on their limitations will promote a sense of well-being rather than disability."
Abstract This paper presents an overview of the past and present situation with regard to flight attendant fatigue. It also attempts to discuss the role that unions and associations have had in gaining the required attention from the authorities about this issue. In addition, the paper suggests the possible reasons for the extreme delay in the publication of relevant research studies on the topic.
Outline:
Introduction
Overview
Towards Recommendations and Solutions
Conclusion
From the Paper "It should also be noted that the concern expressed by the AFA and other flight attendant bodies was not only directed at the personal health and welfare of the flight attendants but was also part of a larger concern related to national safety and security. The issue of flight attendant fatigue has a profound impact on issues such as safety regulations and the flight attendant's response to an emergency. It was felt that flight fatigue could have dramatic and far-reaching consequences in terms of emergency and evacuation duties. This aspect was particularly pertinent in the light of the threat of terrorism in the post 9/11 environment in the country. Simply stated, "In an era of heightened security, with the need for constant vigilance, we cannot afford to be exhausted on the job" (Flight Attendants Union Launches Fatigue Survey)"
Abstract This extensive paper explores the psychological phenomenon known as secondary traumatic stress disorder, which occurs with those working with victims of trauma. The paper highlights the symptoms of this disorder, and further emphasizes the importance of work with trauma victims in the new century. The author argues in favor of services being established in this emerging field that has been brought on by recent terrorism and natural disasters. The paper also includes a definition of a successful critical incident stress debriefing (CISD), a structured group-process firmly based on crisis-intervention and educational principles and techniques. The paper also includes two models that explain burnout and compassion fatigue. The author concludes by encouraging therapists to be aware of the possibility of secondary traumatic stress disorder and empathy fatigue in order to remain effective professionals.
From the Paper "People who work with victims of trauma often develop emotional and physical symptoms themselves. Common symptoms include anxiety, depression, irritability, digestive problems, fatigue and sleeplessness. Excessive demands on the practitioner's mental or physical resources can cause stress, resulting in a general disruption of the functions of the body and mind, putting both at risk. (Rand, 2003, p. 41)"
