The purpose of this research was to identify the factors which people with rheumatoid arthritis (RA) believed contributed to their fatigue. A second purpose was to examine the relationships among identified factors and the sensation of fatigue. One hundred people with RA were asked to identify verbally factors which they believed contributed to their fatigue. The three most frequently identified factors included RA disease activity, disturbed sleep and increased physical effort. These factors were operationalized and measured as joint pain using the Modified McGill Pain Inventory, fragmented sleep through overnight electroencephalographic (EEG) sleep studies, and reduced physical ability using walking time and grip strength measures. Fifteen of the original subjects with RA and 12 age and gender matched control subjects completed the second phase of the research. Five of the RA subjects were experiencing a disease flare while the remaining 10 were either in remission or their disease was midly active. Those subjects in flare had significantly (P less than 0.01) more joint pain, significantly (P less than 0.05) more fragmented sleep, and significantly reduced functional capacity as measured through walking time (P less than 0.05) and grip strength (P less than 0.05) when compared to non-flare and control subjects. Fatigue levels of the subjects in flare were positively correlated with joint pain (r = 0.62), fragmented sleep (r = 0.42) and grip strength of the right hand (r = 0.52) and left hand (r = 0.88). Fatigue levels of non-flare and control subjects were negatively correlated with the majority of measured variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Power spectral analysis (PSA) was used to evaluate the longitudinal overnight electroencephalographic (EEG) sleep recordings of eight subjects, between the ages of 15 and 19 years, who had sustained a minor head injury (MHI). Recordings occurred within 72 h, 6 weeks, and 12 weeks following MHI. A conditioning night preceded the first study night during which EEG electrodes were in place and subjects slept at least 7.5 h with a mean sleep efficiency of 91%. PSA was performed on four channels of EEG data recorded from fronto-temporal (F3-T3, F4-T4), and temporal (T3-T5, T4-T6) electrodes. The three waveforms associated with sleep, Delta, Theta, and Alpha-1 were all significantly elevated within 72 h post-MHI. Over time all wave forms decreased in mean log power. Theta in rapid eye movement (REM) sleep Cycle 1 decreased significantly within 6 weeks postinjury. The greatest number of significant changes, over the 12-week period were recorded during the non-REM (NREM) sleep. Changes included (1) significant decreases in mean log power of Theta and Alpha-1 in Cycle 1 from fronto-temporal leads; (2) significant decreases in Delta, Theta, and Alpha-1 in Cycle 2 from fronto-temporal leads, and (3) significant decreases in Delta and Theta for consistency during Cycle 2 from temporal leads. The intrusion of Theta into the first REM cycle within 6 weeks and its subsequent decrease within 6 weeks suggested the initiation of recovery toward baseline values. This was followed by decreased levels of Theta power during NREM Cycles 1 and 2, and Delta power in Cycle 2, both of which approached their lowest levels within 12 wks. The decrease in Alpha-1 power occurred last. Alpha-1 remained elevated through both Cycles 1 and 2 of the 6th week and then showed a precipitous decrease between the sixth and twelfth week. These findings suggested that following MHI, the brain has a specific sequence of recovery as illustrated by Delta, Theta, and Alpha-1 powers requiring different time frames to reach their lowest levels.

The purpose of this study was to determine the relationship between stress factors, emotional stress and rheumatoid arthritis (RA) disease activity. Subjects (n = 101) confirmed to have RA completed the Daily Hassles Scale (DHS) to identify daily stress factors and the State/Trait Anxiety Inventory (STAI) as well as a visual analogue (VA) to measure emotional stress levels. The investigator evaluated RA disease activity (RADA) and erythrocyte sedimentation rate (ESR). Pearson product-moment correlation was used for statistical evaluation. A statistically significant, positive correlation was found between RADA and both measures of emotional stress; STAI r2 = 0.16, VA r2 = 0.25, P less than 0.01. Utilizing a psychophysiological feedback loop model, it was hypothesized that emotional stress levels and RA disease activity each served as a driving force and a consequence, i.e. as emotional stress levels increased, RA symptoms intensified and, likewise, as RA symptoms intensified, emotional stress levels increased. Nursing interventions were identified which possibly would reduce emotional stress levels, and thus, perhaps, decrease the incidence and/or severity of RA disease activity.

1984 represents a pivotal year for nursing and nursing education in part as a result of future legislation of the Nurse Training Act (NTA). In the face of lost federal funds secondary to the recession, and/or the current administration's attitude toward funding for higher education as well as a decreasing number of college‐age students, nursing must be prepared to launch a united effort to recapture lost funds and/or prevent future losses. This must be a deliberate, pragmatic, and well‐organized effort. It must be goal‐oriented, not merely reactive. To assess how nursing deans and/or chairpersons are planning to confront the financial and demographic realities of the1980s and 1990s a national survey was conducted among 227 nursing education administrators. These administrators responded to a four‐page questionnaire providing quantitative and qualitative data. Areas covered in the questionnaire included previous use of NTA funds, priorities for future nurse training legislation and funding, enrollment trends of undergraduate and graduate nursing students and lastly, master plans and future goals designed to cope with reduced federal funding. Categories that were most important in the establishment, maintenance, or expansion of their programs were capitation, graduate and undergraduate student assistance, and special projects. The respondents indicated that future priorities for nurse training funding would include direct student assistance, piogram and institutional support, and individual needs of specific schools and/or regions. The respondents claimed that over the last five years 30% of schools had experienced a decline in enrollment of undergraduates, and 27% had experienced a decline in graduate enrollment. Lost federal funds contributed to 74 % of the undergraduate decline and 74% of the graduate decline. Future goals and master plans designed to cope with reduced federal funding have been characterized as developmental programatic approaches and/or a combined developmental/programatic approach. However, a startling 16% of the total respondents did not indicate future plans or goals. This survey further indicated that the priorities of those surveyed have changed from program concerns to student concerns and that their assessed needs are dramatically different from those of the Reagan administration. Of the deans and/ or chairpersons surveyed, 74% indicated that they were generating creative plans to cope with lost federal funds.

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