Update: factors influencing heart rate variability–a narrative review

ObjectiveHeart rate variability (HRV) is an important non-invasive marker for the assessment of an organism’s autonomic physiological regulatory pathways. Lower HRV has been shown to correlate with increased mortality. HRV is influenced by various factors or diseases. The aim of this narrative review is to describe the current state of knowledge on factors influencing HRV and their significance for interpretation.MethodsThe narrative review only included reviews, meta-analyses, and cohort studies which were published until 2021. HRV confounders were grouped into four categories (non-influenceable physiological factors, diseases, influenceable lifestyle factors and external factors).ResultsThe review found that HRV was decreased not only in non-influenceable physiological factors (e.g., age, gender, ethnicity) but also in connection with various number of acute and chronic diseases (e.g., psychiatric diseases, myocardial infarction, heart failure), influenceable lifestyle factors (e.g., alcohol abuse, overweight, physical activity), and external factors (e.g., heat, noise, shift work, harmful- and hazardous substances).ConclusionIn order to improve the quality of HRV studies and to ensure accurate interpretation, it is recommended that confounders be taken into account in future diagnostic measurements or measurements in the workplace (e.g., as part of health promotion measures) in order to counteract data bias

Well-being of veterinarians in rural and urban areas

IntroductionThe field of veterinary medicine is characterized by a variety of challenging working conditions. The alarmingly low mental well-being of veterinarians has been examined from various perspectives. However, the influence of work location on the well-being of veterinary professionals has scarcely been investigated. The aim of the study was therefore to analyze the well-being of German veterinarians and to determine whether there is a correlation between well-being and work location.MethodsAs part of a cross-sectional study, 999 veterinary professionals answered questions regarding their work location (self-designed questions) and well-being (WHO-Five Well-being Index, WHO-5). A differentiation was made according to work location: urban cities (population > 100,000), medium/small cities (population < 100,000 inhabitants), and rural areas.ResultsOverall, the surveyed veterinarians had low well-being (ranging from 56.8% in rural areas to 61.3% in medium/small towns). The results of the general linear model indicated a significant difference in the WHO total score among veterinarians from different work locations (p < 0.001). However, when sex, age, type of employment, and field of specialization were included in the analysis, no significant between-subject effects were found.ConclusionAccording to the results, work location does not seem to have a significant influence on the well-being of veterinarians and therefore may be of lower priority in the development and implementation of interventions. However, further investigation of work-related predictors of the mental health of veterinarians is recommended, as the results indicate a low well-being among these professionals

Mental Health and Work-Related Behaviors in Management of Work Requirements of University Lecturers in Ukraine—An Age Group Comparison

Background: There are only a few national and international studies on the health of third-level professor lecturers at universities and colleges. Work-related diseases are important and relevant for occupational medicine. The aim of the study was to examine the mental health and work-related behavior and experience patterns of Ukrainian university lecturers in age group comparisons. Methods: Data were collected from 81 Ukrainian university lecturers (General Health Questionnaire (GHQ-12), Questionnaire on Work-Related Behavior and Experience Patterns (AVEM)). The university lecturers were split into 4 age groups. Results: 9.9% of higher education lecturers reported impaired mental health (GHQ-12). In all, 64.8% of the total sample showed AVEM risk patterns. There were differences in age groups (third age group scoring lower than the first age group on the GHQ total score). The first age group had significantly lower opinions of the subjective importance of work on their personal lives compared to the third and fourth age group, while the second age group had significantly lower opinions compared to the fourth age group. All individuals with impaired mental health in GHQ-12 had AVEM risk patterns. Conclusions: These results offer novel insights into the health of Ukrainian university lecturers. Occupational healthcare practitioners should take them into consideration in order to initiate appropriate interventions

Kältearbeit

<jats:title>Zusammenfassung</jats:title><jats:p>Zur Kältearbeit zählen Arbeiten in technisch gekühlten Räumen (z. B. Kühl- und Tiefkühlhäuser) oder Tätigkeiten im Freien bei niedrigen Temperaturen. Der Mensch kann den Auswirkungen ungünstiger Umgebungsbedingungen lediglich in Grenzen durch autonome Regulationsmechanismen entgegenwirken. Daher sind zusätzliche Schutzmaßnahmen, wie bspw. geeignete Kälteschutzkleidung und abgestimmte Arbeitszeit-Pausenzeit-Regime zwingend erforderlich, um kurz- oder langfristige Folgen für die Gesundheit des Arbeitnehmers abzuwenden. Hierzu gehören Unterkühlungen bis hin zu Erfrierungen, aber auch chronische Erkrankungen können durch wiederkehrende Kälteexpositionen verstärkt werden. Die durch Kälte bedingte Abnahme der Beweglichkeit, insbesondere der Hände, kann zudem das Unfallrisiko erhöhen. Durch diese Risiken ergibt sich neben verbindlichen Regelungen zur Kälteschutzkleidung und zu den Arbeits- und Pausenzeiten auch die Notwendigkeit besonderer arbeitsmedizinischer Vorsorgemaßnahmen, die allerdings für viele Kältearbeiter kaum greifen. Dieser Beitrag liefert einen Überblick über die physiologischen Grundlagen zur Kältearbeit, Arbeits- und Pausenzeiten, Kälteschutzkleidung, arbeitsmedizinischen Vorsorgeuntersuchungen und Handlungsempfehlungen in Notfallsituationen.</jats:p&gt

Relaxation and strain among emergency medical service personnel and emergency control center dispatchers during the first two waves of the SARS-CoV-2 pandemic

Background Workloads of emergency medical service personnel (EMP) and emergency control center dispatchers (CCDs) were manifold. The SARS-CoV-2 pandemic presented new challenges for the prehospital emergency medical service. The purpose of this study was to compare the status of stress/strain and recovery of Recovery-Stress Questionnaire among EMP and CCDs in Germany during the first 2 waves of the SARS-CoV-2 pandemic both between occupational groups and over time. Material and Methods A total of 2426 emergency medical service personnel and control center dispatchers were questioned with the Recovery-Stress Questionnaire based on Kallus. The results from the first 2 waves of the pandemic (June–August 2020 and January–February 2021) were compared. Results During the first and second wave of SARS-CoV-2 pandemic, the subjectively perceived stress of emergency medical service personnel and control center dispatchers increased, but recovery decreased. The CCDs showed more unfavorable values compared to EMP. Conclusions Health promotion interventions are necessary to counteract possible career changes or mental or other diseases due to insufficient management

Heart rate variability as a strain indicator for psychological stress for emergency physicians during work and alert intervention: a systematic review

Background!#!The workloads of emergency physicians are severe. The prevalence of burnout among emergency physicians is higher than with other physicians or compared to the general population. The analysis of heart rate variability (HRV) is a valid method for objective monitoring of workload. The aim of this paper is to systematically evaluate the literature on heart rate variability as an objective indicator for mental stress of emergency physicians.!##!Methods!#!A systematic literature review examining heart rate variability of emergency physicians in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting systematic reviews was performed. PubMed, Ovid, Cochrane Libary, Scopus, and Web of Science electronic databases were used. The methodological quality was evaluated by using a modified STARD for HRV.!##!Results!#!Two studies matched the inclusion criteria by using HRV between alert intervention and two other studies were considered that used HRV in other question areas. It showed an adaptation of HRV under stress. The studies were not comparable.!##!Conclusions!#!There is a need for occupational health studies that examine strains and stress of emergency physicians. The well-established parasympathetic mediated HRV parameters seem to be suitable parameters to objectify the stress

Selbsteinschätzung des persönlichen Verhaltens und Erlebens bei traumatisierten und nichttraumatisierten Personen

<jats:title>Zusammenfassung</jats:title><jats:sec> <jats:title>Hintergrund</jats:title> <jats:p>Potenziell traumatisierende Erlebnisse sind vielfältig, und deren Chronifizierung sollte vermieden werden. Ziel der Arbeit war es, zu untersuchen, ob die Personen, die traumatische Situationen erlebt haben, andere Persönlichkeitsmerkmale, d. h. anderes Verhalten und Erleben in Situationen, zeigen.</jats:p> </jats:sec><jats:sec> <jats:title>Material und Methoden</jats:title> <jats:p>Es wurden 96 Bankangestellte (Alter: 42,6 ± 9,56 Jahre) befragt. Die Gruppeneinteilung erfolgte anhand des Fragebogens Impact of Event Scale: potenziell traumatisches Ereignis erlebt (Gruppe T) oder nicht (Gruppe kT). Mittels des Inventars zur Persönlichkeitsdiagnostik in Situationen (IPS) wurde die Selbsteinschätzung des persönlichen Verhaltens und Erlebens in beiden Gruppen untersucht.</jats:p> </jats:sec><jats:sec> <jats:title>Ergebnisse</jats:title> <jats:p>Insgesamt 28 (29,2 %) Befragten gaben subjektiv ein potenziell traumatisches Ereignis an. Die geschätzte PTBS-Prävalenz lag bei 3,1 %. Statistische Unterschiede fanden sich nur im Leistungsverhalten (Lebensbereich Zufriedenheit) zwischen Gruppe T und Gruppe kT. Die Probanden, die eine traumatische Situation erlebt haben, hatten jedoch mehr interventionsbedürftige IPS-Profile. Beide Gruppen wiesen ein eher gering ausgeprägtes Erholungsverhalten auf.</jats:p> </jats:sec><jats:sec> <jats:title>Diskussion</jats:title> <jats:p>Die gewonnenen Erkenntnisse zur Selbsteinschätzung der Bankangestellten der Situationen zeigen die Notwendigkeit der frühzeitigen Prävention psychischer Erkrankungen infolge traumatischer Ereignisse. Selbsteinschätzung des Erlebens bei der Auseinandersetzung mit potenziell traumatisierten Situation kann dabei eine Rolle in der Entstehung der PTBS spielen. Die interdisziplinären Angebote und Kooperationen erscheinen sehr wichtig zu sein und sollten im Rahmen von Präventionsteams genutzt werden.</jats:p> </jats:sec&gt

Work-related behavior and experience patterns of music educators – a basis for intervention

Objectives Music educators are subjected to many physical and psychological stresses encountered in the workplace. These stresses could be counteracted by certain work-related behavior and experience patterns as personal resources to reduce the negative consequences of stress. The aim of the study was to determine the existing work-related behavioral and experiential patterns and the characteristics of the Work-Related Behavior and Experience Patterns (Arbeitsbezogenes Verhaltens- und Erlebensmuster – AVEM) questionnaire dimensions in the professional group of music educators according to age group. Material and Methods A total of 205 music educators (66.3% female) from various music schools in Germany participated in the online survey. The subjects were divided into 3 age groups (AG): AG I: ≤35 years, AG II: 36–45 years, AG III: ≥46 years. In addition to sociodemographic and occupational data, the standardized AVEM questionnaire was used according to Schaarschmidt and Fischer. The age and occupation-related data were evaluated in a correlation analysis with the expression of AVEM dimensions. Results A total of 71.4% of the music educators were ≥46 years old group. Another 12.8% belonged to AG II, and 15.8% belonged to AG III. The sex distribution in the 3 age groups was comparable (p = 0.261). The expression of all AVEM dimensions was within the reference range. The most pronounced dimension, with a stanine value of M±SD 5.2±2.15, was the willingness to spend. There was also no significant difference in the assignment to the 4 patterns in the 3 age groups (p = 0.669). Age showed a negative correlation with the experience of social support (ρ = –0.354). Conclusions The age-independent and high intervention-requiring expressions of the AVEM risk patterns A and B led to the recommendation of workplace prevention and health promotion measures. Therefore, it seems reasonable to promote appropriate stress management measures and resilience during studies

Subjective and objective demands on different types of differential stress inventory

Purpose To validate the differential stress inventory (DSI) by evaluating the objective and subjective stress differences in the five DSI types in the occupational setting. Methods A total of 119 German participants working as medical assistants (n = 40) or in a bank (n = 79) were recruited. They completed the Maslach Burnout Inventory–General Survey, the DSI, and wore ECG measuring devices for 24 h to measure heart rate variability. The DSI was used to group people into one of five types according to how they perceived and coped with stress: normal, overstressed, stress-resistant, low stress/high coping, or high stress/high coping. Results The overstressed type had significantly more burnout symptoms than the other types. The high stress/high coping type also had more symptoms of emotional exhaustion and total burnout compared to the other types, while the low stress/high coping and the stress-resistant types generally had the lowest levels of burnout. There were no differences on the HRV parameters among the DSI types. Conclusion Categorising people into types like in the DSI can help make workers aware of unhealthy stress and coping patterns before they turn into more severe pathology. Proper application and targeted preventive measures can save the individual’s health and the company’s budget. While the DSI picked up on differences in burnout symptoms as a long-term consequence of stress, there is evidence that it cannot pick up on short-term stress or physical stress as measured by HRV from the 24 h recording

Effects of different exercise interventions on cardiac autonomic control and secondary health factors in middle-aged adults : a systematic review

This systematic review was conducted in accordance with the PRISMA guidelines to summarize the existing literature on the effects of different exercise interventions on cardiac autonomic control and secondary health factors. Resting heart rate variability (HRV) was used as indicator of cardiac autonomic control. Secondary factors were related to factors that contribute to cardiovascular health. Studies examining the effects of endurance, resistance, multimodal, or coordinative training interventions in healthy participants aged between 45 and 60 years old on average were considered. The methodological quality of the studies was examined using two assessment scales (TESTEX and STARDHRV). PROSPERO registration number: CRD42020206606. The literature review retrieved eight studies fulfilling all inclusion criteria. Cardiac autonomic control and cardiovascular health improved after endurance and multimodal interventions. Resistance training had no significant impact on HRV or any secondary health factor. Coordinative exercise interventions showed inconclusive results regarding HRV but showed significant improvements in secondary health factors. The quality assessment tools revealed some methodological and reporting deficits. Despite the small number of studies, we suggest endurance and multimodal interventions including aerobic exercises for the enhancement of cardiac autonomic control and the reduction of cardiovascular risk in middle-aged adults. Further studies need to be conducted to examine the long-term effects of exercise in the midlife period.OVGU-Publikationsfonds 202