Using real-time fMRI neurofeedback to modulate M1-cerebellum connectivity

Objective. The potential of neurofeedback to alter the M1-cerebellum connectivity was explored using motor imagery-based rt-fMRI. These regions were chosen due to their importance in motor performance and motor rehabilitation. Methods. Four right-handed individuals were recruited to examine the potential to change the M1-cerebellum neurofeedback link. The University of Glasgow Cognitive Neuroimaging Centre used a 3T MRI scanner from January 2019 to January 2020 to conduct this prospective study. Everyone participated in each fMRI session, which included six NF training runs. Participants were instructed to imagine complicated hand motions during the NF training to raise a thermometer bar’s height. To contrast the correlation coefficients between the initial and last NF runs, a t-test was performed post hoc. Results. The neurofeedback connection between M1 and the cerebellum was strengthened in each participant. Motor imagery strategy was a significant task in training M1-cerebellum connectivity as participants used it successfully to enhance the activation level between these regions during M1-cerebellum modulation using real-time fMRI. The t-test and linear regression, on the other hand, showed this increase to be insignificant. Conclusion. A novel technique to manipulate M1-cerebellum connectivity was discovered using real-time fMRI NF. This study showed that each participant’s neurofeedback connectivity between M1 and cerebellum was enhanced. This increase, on the other hand, was insignificant statistically. The results showed that the connectivity between both areas increased positively. Through the integration of fMRI and neurofeedback, M1-cerebellum connectivity can be positively affected

The influence of social support on sleep and fatigue level among patients receiving hemodialysis in Saudi Arabia: a cross-sectional correlational design

Background: Patients on hemodialysis (HD) are more likely to experience sleep problems and fatigue that may affect their health outcomes. Management of these patients with social support may improve their sleep quality and fatigue as well as their health. Aim: This study aimed to assess the influence of social support on sleep quality and fatigue levels among HD patients. Methods: A cross-correlational study was conducted among 260 conveniently sampled HD patients from four dialysis centers in Hail and Al-Qassim cities of Saudi Arabia from Jun 2022 to January 2023. Besides sociodemographic data, the Pittsburgh Sleep Quality Index (PSQI), the Multidimensional Assessment of Fatigue (MAF) and the Oslo Social Support Scale (OSSS-3) were used to assess sleep quality, fatigue levels and social support, respectively. Chi-square test was used to determine the association between categorical variables, while Pearson’s correlation coefficient was used to test the correlation between sleep quality, fatigue, and social support. Results: Poor sleep and high fatigue were significantly higher in older patients compared to younger patients (p <0.001), while strong social support was significantly lower in older patients than younger and middle-aged ones (p = 0.001). On the other hand, poor sleep and high fatigue were significantly higher in males than females (p = 0.022 and p <0.001, respectively), while strong social support was significantly higher in females than males (p <0.001). Married patients showed significantly poorer sleep than single ones (p = 0.019), but single patients received significantly stronger social support. Retired patients showed significantly poorer sleep, higher fatigue and weaker social support than other groups (p <0.001). There was a significant negative correlation between fatigue and sleep quality among HD patients, where patients with more fatigue had poorer sleep (r = −0.510, p <0.001). A significant positive correlation was found between social support and sleep quality, where patients with stronger social support had more normal sleep (r = 0.415, p <0.001). However, a significant negative correlation was found between social support and fatigue, where patients with stronger social support had lower levels of fatigue (r = −0.479, p <0.001). Conclusion: Saudi patients on HD who have stronger social support have better sleep quality and reduced fatigue levels than those with less social support. There is a need to design and implement intervention studies with structured social support programs, and to evaluate their effectiveness on improving sleep and reducing fatigue among HD patients

Exposure to secondary traumatic stress and its related factors among emergency nurses in Saudi Arabia: a mixed method study

Background: Emergency department (ED) nurses are exposed to the risk of secondary traumatic stress (STS), which poses a threat not only to nurses’ health and psychological well-being but also adversely affects the execution of their professional duties. The quality and outcome of their nursing services are negatively affected by STS. Purpose: The purpose of this study is to comprehensively investigate the prevalence and intensity of Secondary Traumatic Stress (STS) among Emergency Department (ED) nurses. It aims to identify and analyze the socio-demographic, occupational, and psychological factors that influence the severity and variation of STS experienced by these nurses. Methods: The study utilized a sequential explanatory mixed methods approach, including two phases. Phase 1 employed a cross-sectional study design, utilizing a convenience sample of 181 nurses to explore the levels of STS and the factors associated with it. Following this, Phase 2 was structured as a qualitative descriptive study, which involved conducting semi-structured interviews with a purposefully selected group of ten ED nurses. Data collection took place at three major hospitals in Saudi Arabia during the period from January to June 2022. Results: A total of 181 participants were included in the study. The mean STSS score reported by the nurses was 51 (SD = 13.23) out of the maximum possible score of 85, indicating severe STS among ED nurses. Factors associated with an increase in the levels of STS among ED nurses included being female, older in age, married, possessing higher education and experience, having a positive relationship with colleagues, receiving organisational support, and dealing with a higher number of trauma cases. Several themes emerged from the qualitative interviews including: ED Characteristics: Dual Impact on STS, Emotional Resonance and Vulnerability, Personal Life Stressors, The Ability to Cope, and Social Support. Conclusion and implications for practice: Future strategies and interventions targeting STS should be prioritized to effectively manage its impact on ED nurses. It is crucial to develop targeted interventions that address the specific factors contributing to STS, as identified in this study. Additionally, these findings aim to enhance awareness among nursing administrators, managers, and supervisors about the critical factors associated with STS. This awareness is essential for accurately assessing and developing interventions that mitigate STS among nursing staff

Functional localizers for motor areas of the brain using fMRI

Neuroimaging researchers increasingly take advantage of the known functional properties of brain regions to localize motor regions in the brain and investigate changes in their activity under various conditions. Using this noninvasive functional MRI (fMRI) method makes it possible to identify and localize brain activation. There are many localizers that can be used to identify brain areas, namely, motor areas such as functional localizer, anatomical localizer, or Atlas mask. Eighteen right-handed participants were recruited for this research to test the reliability of five localizers for primary motor cortex (M1), supplementary motor area (SMA), premotor cortex (PMC), motor cerebellum, and motor thalamus. Motor execution task, namely, hand clenching was used to activate M1, SMA, and motor cerebellum. A combined action observation and motor imagery (AOMI) task was used to functionally activate PMC. Finally, a mask based on Talairach coordinates Atlas was created and used to identify the motor thalamus. Our results show that all localizers were successfully activated in the desired regions of interest. Motor execution successfully activated M1, SMA, and motor cerebellum. A novel localizer based on AOMI was successfully activated in PMC, and the motor thalamus mask obtained from the thalamus mask was successfully implemented on each participant. In conclusion, all five localizers tested in this research were reliable and can be used for rt-fMRI neurofeedback research to define the regions of interest

Investigation of the Level and Factors Influencing Emergency Department Nurses Fatigue: A Case Study of the Saudi Arabian Context

Background: Work-related fatigue is a common health problem among nurses which can affect their performance and decision making. Significance and Aim: The study explores the levels of fatigue and its associated factors among emergency department (ED) nurses in Saudi Arabia. Methods: The study was developed through a cross-sectional quantitative study design. This included the collection of primary quantitative data with a questionnaire prepared and published on REDCap. The study questionnaire was adapted from two tools, namely the OFER 15 and the Copenhagen II tools, respectively. Results: The study established that the Saudi Arabian ED nurses have high acute fatigue (OFER 15 score = 81.11), moderate-high chronic fatigue (OFER 15 score = 74.17), and a high inter-shift recovery index (OFER 15 score = 78.01). In terms of the predictor factors, the study established that for the demographic factors, gender has an impact on chronic and acute fatigue, while work experience impacted acute fatigue and the number of dependents impacted on inter-shift recovery index. On the psycho-social factors, chronic fatigue is influenced by emotional demand (which is a variable used to evaluate the levels to which the nurse is invested, gaining education/skills thus increases job satisfaction) (&minus;0.289), influence at work (&minus;0.310), commitment at the workplace (0.376), rewards (&minus;0.187), stress (0.420), and burnout (0.293), respectively. Acute fatigue is influenced by the emotional demands (0.336), role clarity (&minus;0.128), and the nurses&rsquo; well-being and health (&minus;0.034). Finally, the inter-shift recovery index is influenced by the ED nurses&rsquo; burnout levels (&minus;0.877). Conclusions: The study indicates a high level of nursing fatigue among the Saudi Arabian ED nurses