| 1. |
- Jarvela-Reijonen, Elina, et al.
(författare)
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The Effects of Acceptance and Commitment Therapy (ACT) Intervention on Inflammation and Stress Biomarkers : a Randomized Controlled Trial
- 2020
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 27:5, s. 539-555
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Tidskriftsartikel (refereegranskat)abstract
- Background Psychological processes can be manifested in physiological health. We investigated whether acceptance and commitment therapy (ACT), targeted on psychological flexibility (PF), influences inflammation and stress biomarkers among working-age adults with psychological distress and overweight/obesity. Method Participants were randomized into three parallel groups: (1) ACT-based face-to-face (n = 65; six group sessions led by a psychologist), (2) ACT-based mobile (n = 73; one group session and mobile app), and (3) control (n = 66; only the measurements). Systemic inflammation and stress markers were analyzed at baseline, at 10 weeks after the baseline (post-intervention), and at 36 weeks after the baseline (follow-up). General PF and weight-related PF were measured with questionnaires (Acceptance and Action Questionnaire, Acceptance and Action Questionnaire for Weight-Related Difficulties). Results A group x time interaction (p = .012) was detected in the high-sensitivity C-reactive protein (hsCRP) level but not in other inflammation and stress biomarkers. hsCRP decreased significantly in the face-to-face group from week 0 to week 36, and at week 36, hsCRP was lower among the participants in the face-to-face group than in the mobile group (p = .035, post hoc test). Age and sex were stronger predictors of biomarker levels at follow-up than the post-intervention PF. Conclusion The results suggest that ACT delivered in group sessions may exert beneficial effects on low-grade systemic inflammation. More research is needed on how to best apply psychological interventions for the health of both mind and body among people with overweight/obesity and psychological distress.
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| 2. |
- Järvelä-Reijonen, Elina, et al.
(författare)
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High perceived stress is associated with unfavorable eating behavior in overweight and obese Finns of working age.
- 2016
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Ingår i: Appetite. - : Elsevier. - 0195-6663 .- 1095-8304. ; 103, s. 249-258
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Tidskriftsartikel (refereegranskat)abstract
- Stress-related eating may be a potential factor in the obesity epidemic. Rather little is known about how stress associates with eating behavior and food intake in overweight individuals in a free-living situation. Thus, the present study aims to investigate this question in psychologically distressed overweight and obese working-aged Finns. The study is a cross-sectional baseline analysis of a randomized controlled trial. Of the 339 study participants, those with all the needed data available (n = 297, 84% females) were included. The mean age was 48.9 y (SD = 7.6) and mean body mass index 31.3 kg/m(2) (SD = 3.0). Perceived stress and eating behavior were assessed by self-reported questionnaires Perceived Stress Scale (PSS), Intuitive Eating Scale, the Three-Factor Eating Questionnaire, Health and Taste Attitude Scales and ecSatter Inventory. Diet and alcohol consumption were assessed by 48-h dietary recall, Index of Diet Quality, and AUDIT-C. Individuals reporting most perceived stress (i.e. in the highest PSS tertile) had less intuitive eating, more uncontrolled eating, and more emotional eating compared to those reporting less perceived stress (p < 0.05). Moreover, individuals in the highest PSS tertile reported less cognitive restraint and less eating competence than those in the lowest tertile (p < 0.05). Intake of whole grain products was the lowest among those in the highest PSS tertile (p < 0.05). Otherwise the quality of diet and alcohol consumption did not differ among the PSS tertiles. In conclusion, high perceived stress was associated with the features of eating behavior that could in turn contribute to difficulties in weight management. Stress-related way of eating could thus form a potential risk factor for obesity. More research is needed to develop efficient methods for clinicians to assist in handling stress-related eating in the treatment of obese people.
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| 3. |
- Järvelä-Reijonen, Elina, et al.
(författare)
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Sleep-time physiological recovery is associated with eating habits in distressed working-age Finns with overweight : Secondary analysis of a randomised controlled trial
- 2021
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Ingår i: Journal of Occupational Medicine and Toxicology. - : BioMed Central (BMC). - 1745-6673. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Association of physiological recovery with nutrition has scarcely been studied. We investigated whether physiological recovery during sleep relates to eating habits, i.e., eating behaviour and diet quality. Methods: Cross-sectional baseline analysis of psychologically distressed adults with overweight (N = 252) participating in a lifestyle intervention study in three Finnish cities. Recovery measures were based on sleep-time heart rate variability (HRV) measured for 3 consecutive nights. Measures derived from HRV were 1) RMSSD (Root Mean Square of the Successive Differences) indicating the parasympathetic activation of the autonomic nervous system and 2) Stress Balance (SB) indicating the temporal ratio of recovery to stress. Eating behaviour was measured with questionnaires (Intuitive Eating Scale, Three-Factor Eating Questionnaire, Health and Taste Attitude Scales, ecSatter Inventory (TM)). Diet quality was quantified using questionnaires (Index of Diet Quality, Alcohol Use Disorders Identification Test Consumption) and 48-h dietary recall. Results: Participants with best RMSSD reported less intuitive eating (p = 0.019) and less eating for physical rather than emotional reasons (p = 0.010) compared to those with poorest RMSSD; participants with good SB reported less unconditional permission to eat (p = 0.008), higher fibre intake (p = 0.028), higher diet quality (p = 0.001), and lower alcohol consumption (p < 0.001) compared to those with poor SB, although effect sizes were small. In subgroup analyses among participants who reported working regular daytime hours (n = 216), only the associations of SB with diet quality and alcohol consumption remained significant. Conclusions: Better nocturnal recovery showed associations with better diet quality, lower alcohol consumption and possibly lower intuitive eating. In future lifestyle interventions and clinical practice, it is important to acknowledge sleep-time recovery as one possible factor linked with eating habits.
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| 4. |
- Lappalainen, Raimo, et al.
(författare)
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The effectiveness and applicability of different lifestyle interventions for enhancing wellbeing : the study design for a randomized controlled trial for persons with metabolic syndrome risk factors and psychological distress.
- 2014
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Obesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on self-management. This randomized controlled trial examines the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress. The offered interventions are based on cognitive behavioral approaches, and are designed for enhancing general well-being and supporting personalized lifestyle changes.METHODS/DESIGN: 339 obese individuals reporting stress symptoms were recruited and randomized to either (1) a minimal contact web-guided Cognitive Behavioral Therapy-based (CBT) intervention including an approach of health assessment and coaching methods, (2) a mobile-guided intervention comprising of mindfulness, acceptance and value-based exercises, (3) a face-to-face group intervention using mindfulness, acceptance and value-based approach, or (4) a control group. The participants were measured three times during the study (pre = week 0, post = week 10, and follow-up = week 36). Psychological well-being, lifestyles and habits, eating behaviors, and user experiences were measured using online surveys. Laboratory measurements for physical well-being and general health were performed including e.g. liver function, thyroid glands, kidney function, blood lipids and glucose levels and body composition analysis. In addition, a 3-day ambulatory heart rate and 7-day movement data were collected for analyzing stress, recovery, physical activity, and sleep patterns. Food intake data were collected with a 48 -hour diet recall interview via telephone. Differences in the effects of the interventions would be examined using multiple-group modeling techniques, and effect-size calculations.DISCUSSION: This study will provide additional knowledge about the effects of three low intensity interventions for improving general well-being among individuals with obesity and stress symptoms. The study will show effects of two technology guided self-help interventions as well as effect of an acceptance and value-based brief group intervention. Those who might benefit from the aforesaid interventions will increase knowledge base to better understand what mechanisms facilitate effects of the interventions.TRIAL REGISTRATION: Current Clinical Trials NCT01738256, Registered 17 August, 2012.
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| 5. |
- Sallinen, Mikael, et al.
(författare)
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Are long-haul truck drivers unusually alert? : A comparison with long-haul airline pilots
- 2020
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Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575 .- 1879-2057. ; 137
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recent studies suggest heavy vehicle drivers self-estimate their sleepiness unexpectedly low during night duties. The present study compared sleepiness ratings of long-haul truck drivers with those of long-haul airline pilots during night and non-night duties. In addition, the correspondence between self-rated manifest and predicted latent sleepiness was examined in the two groups. Methods: Twenty-two drivers and 33 pilots participated. Their working hours, sleep, on-duty sleepiness, and use of sleepiness countermeasures were measured in naturalistic conditions. Predictions of latent sleepiness were based on the measurements of working hours and sleep using the Sleep/Wake Predictor modelling tool. Results: Drivers rated lower levels of sleepiness than pilots during both duty types, though predicted latent sleepiness levels were very similar among the two groups. Neither the results of sleep nor those of sleepiness countermeasures explained the difference in self-rated sleepiness. Discussion: The results raise the possibility that long-haul truck drivers are actually sleepier than they report, and thus are at an increased risk for not responding to sleepiness in a timely manner. A potential explanation for this behavior is lack of education and training on sleepiness among truck drivers as compared with airline pilots. Alternatively, long-haul truck drivers may be exceptionally tolerant to soporific working conditions. The first reported results do not, however, support this hypothesis.
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| 6. |
- Sallinen, Mikael, et al.
(författare)
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Self-reported reasons for on-duty sleepiness among commercial airline pilots
- 2021
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Ingår i: Chronobiology International. - : Informa UK Limited. - 0742-0528 .- 1525-6073. ; 38:9, s. 1308-1318
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Tidskriftsartikel (refereegranskat)abstract
- Experimental and epidemiological research has shown that human sleepiness is determined especially by the circadian and homeostatic processes. The present field study examined which work-related factors airline pilots perceive as causing on-duty sleepiness during short-haul and long-haul flights. In addition, the association between the perceived reasons for sleepiness and actual sleepiness levels was examined, as well as the association between reporting inadequate sleep causing sleepiness and actual sleep-wake history. The study sample consisted of 29 long-haul (LH) pilots, 28 short-haul (SH) pilots, and 29 mixed fleet pilots (flying both SH and LH flights), each of whom participated in a 2-month field measurement period, yielding a total of 765 SH and 494 LH flight duty periods (FDPs) for analyses (FDP, a period between the start of a duty and the end of the last flight of that duty). The self-reports of sleepiness inducers were collected at the end of each FDP by an electronic select menu. On-duty sleepiness was rated at each flight phase by the Karolinska Sleepiness Scale (KSS). The sleep-wake data was collected by a diary and actigraph. The results showed that “FDP timing” and “inadequate sleep” were the most frequently reported reasons for on-duty sleepiness out of the seven options provided, regardless of FDP type (SH, LH). Reporting these reasons significantly increased the odds of increased on-duty sleepiness (KSS ≥ 7), except for reporting “inadequate sleep” during LH FDPs. Reporting “inadequate sleep” was also associated with increased odds of a reduced sleep-wake ratio (total sleep time/amount of wakefulness ≤ 0.33). Both “FDP timing” and “inadequate sleep” were most frequently reported during early morning and night FDPs, whereas the other options showed no such phenomenon. The present study suggests that airline pilots’ perceptions of work-related factors that make them sleepy at work are in line with the previous experimental and epidemiological studies of sleepiness regulation.
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| 7. |
- Sallinen, Mikael, et al.
(författare)
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Sleep, alertness and alertness management among commercial airline pilots on short-haul and long-haul flights
- 2016
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Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575 .- 1879-2057. ; 98, s. 320-329
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Tidskriftsartikel (refereegranskat)abstract
- Airline pilots' sleep and on-duty alertness are important focus areas in commercial aviation. Until now, studies pertaining to this topic have mainly focused on specific characteristics of flights and thus a comprehensive picture of the matter is not well established. In addition, research knowledge of what airline pilots actually do to maintain their alertness while being on duty is scarce. To address these gaps in research knowledge, we conducted a field study on a representative sample of the airline pilots of a medium-sized airline. The sample consisted of 90 pilots, of whom 30 flew long-haul (LH) routes, 30 short-haul (SH) routes, and 30 flew both. A total of 86 pilots completed the measurements that lasted for almost two months per pilot. The measurements resulted in a total of 965 flight duty periods (FDPs) including SH flights and 627 FDPs including LH flights. During the measurement periods, sleep was measured by a diary and actigraphs, on-duty alertness by the Karolinska Sleepiness Scale (KSS) in all flight phases, and on-duty alertness management strategies by the diary. Results showed that SH and LH FDPs covering the whole domicile night (00:00-06:00 at home base) were most consistently associated with reduced sleep-wake ratio and subjective alertness. Approximately every 3rd FDP falling into this category involved a reduced sleep-wake ratio (1:3 or lower) and every 2nd a reduced level of subjective alertness (KSS rating 8-9 in at least one flight phase). The corresponding frequencies for the SH and LH FDPs that partly covered the domicile night were every 10th and every 5th FDP and for the pure non-night FDPs every 30th and every 36th FDP, respectively. The results also showed that the pilots tended to increase the use of effective on-duty alertness management strategies (consuming alertness-promoting products and taking strategic naps) in connection with the FDPs that overlapped the domicile night. Finally, the results showed that the frequency of flights involving reduced subjective alertness depended on how alertness was assessed. If it was assessed solely in the flight phase just before starting the landing procedures (top of descent) the phenomenon was less frequent than if the preceding cruise phase was also taken into account. Our results suggest that FDPs covering the whole domicile night should be prioritised over the other FDPs in fatigue management, regardless of whether an FDP is a short-haul or a long-haul. In addition, the identification of fatigue in flight operations requires one to assess pilots' alertness across all flight phases, not only at ToD. Due to limitations in our data, these conclusions can, however, be generalise to only LH FDPs during which pilots can be expected to be well acclimatised to the local time at their home base and SH night FDPs that include at least 3h of flying in the cruise phase.
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