the role of self-regulation and shift schedule in countering the slow violence … role of...
TRANSCRIPT
![Page 1: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/1.jpg)
The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence of Shiftwork: Notes from the
Front Line
Ruhi Snyder, RPSGT, CCSH Sleep Disorders Lab
Kingston Health Sciences Centre, Kingston, Canada [email protected]
![Page 2: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/2.jpg)
Structure of the Talk:
• AbriefintroductiontoCircadianRhythms• ImportantHormones• Chronotypes• ShiftWorkTolerance
• ConsequencesofCircadianDisruption• Metabolic• Cognitive
• RoleofSelfRegulationandShiftSchedule–MyCaseStudy• Results• Conclusion• ClosingStatement
![Page 3: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/3.jpg)
What is shift work?
• Atypicalworkschedulesthatextendbeyonda9-5workday,suchas• Earlyworkstarts• Compressedworkweeks• Eveningwork• Nightwork
![Page 4: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/4.jpg)
… observed the harmfulness of shift work, in particular night work: such as bakers who work at night, so when others sleep
they stay awake, while trying to sleep during the day like animals who escape the light: hence in the same town, there
are men living an antithetic life in comparison with others
BernadinoRamazzini.DeMorbisArtificumDiatriba.1713.
![Page 5: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/5.jpg)
“Slow Violence” is the term coined by Rob Nixon to describe the catastrophic effects of
environmental deterioration and its invisible trauma on human beings.
As shift-workers, we commit
the slow violence against ourselves.
Nixon,Rob.SlowViolenceandtheEnvironmentalismofPoor(2011).HarvardUniversityPress.
![Page 6: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/6.jpg)
The Slow Violence of Shift Work
• CircadianRhythmDisorders• MetabolicDisorders• SleepDisorders• MoodDisorders• Cognitivedysfunction• Cancer
![Page 7: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/7.jpg)
Normal circadian rhythm
• Theapproximately24hourbiologicalclock–keepstherhythmandsynchronicityofvariousphysiologicalaspectsincluding:
• Hormones• Bloodsugar• Sleep/wake• Metabolism
• It’ssynchronicityisfundamentaltovariousaspectsofwellbeing.• Itallowsorganismstoadjusttheirphysiologybyanticipatingdailyenvironmentalchanges,ratherthanmerelyrespondingtotheminareactivemanner.
Krygeretal.PriniciplesandPractiseofSleepMedicine5thedition.
![Page 8: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/8.jpg)
The Master Clock
ImagefromGoogleImagesonMasterClock
![Page 9: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/9.jpg)
The Human Circadian Clock
• Hasaninherentrhythmthatislongerthan24hours
• Itrequiresresettingorentraining.
• Themostpowerfulcueorsynchronizerislight(465nm).
Appleman,K.SleepMedicine2013(14)456-461
![Page 10: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/10.jpg)
Regulation of the Central Pacemaker
Int.J.Mol.Sci.2014,15,23448-23500.J.PinealRes.2012;52:1-11
![Page 11: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/11.jpg)
Melatonin - Darkness Hormone
• Oneofthemostwellknowncircadianoutputsignal,othersbeingthecentralnervoussystemandthecorebodytemperature
• Consideredtobegoldstandard• Suppressedbylightduringthedaytime.
• markerforcircadiansystem• Releasedbythepinealgland.• Hasantioxidativepropertiesthatcombatsfreeradicaldamage
J.PinealRes2012(52)1-11;AnnClinBiochem200643:344-353
![Page 12: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/12.jpg)
Long-term effects of Chronodisruption:
Circadianrhythmdisruption• Behavioralchanges,• Sleepdisorders,• Alteredhormoneandmetabolicdysregulation
Leadingto:
Krygeretal.PrincipleandpracticeofSleepMedicine5thed.2011Karatsoreosaetal.ProcNatAcadSciences.2011;108:1657–1662
• Mooddisorders• Cognitiveimpairment• Obesity• Diabetes
• Hypertension• Cardiovasculardisease• Cancer
![Page 13: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/13.jpg)
Chronotypes
• Twotypes:• Eveningtype“theowl”• Morningtype“thelark”
• Chronotypecanvarywithageandgender• Chronotypemodulatesshiftworker:
• Sleepduration• Sleepquality• Socialjetlag(internaldys-synchronization)
• MunichChronoTypeQuestionnaire(MCQTshift)
Judaetal.JBiolRhythms2013;28(2):141-51BiologicalRhythmsRes2010;(6):415-413
![Page 14: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/14.jpg)
Tolerance of shift work (SWT) studies
AIM:determineindividualdifferenceofshiftworktolerancebyevaluationofsleep,sleepiness,fatigue,socialfunctioning,physicalandmentalhealthAcohortof2,059Norwegiannurses(38%responserate)weresentquestionnaires,remindersFindings:• VariablesveryimportanttoSWT:well-beingandphysicalhealth• Shiftworktolerancedefinitionshouldnotonlyincludeinsomnia,fatigue,anxietyanddepression,butalsomentalhealthandsocialfunctioningvariables
.
IntArchOccupEnvironHealth2004;71,121-129BiologicalRhythmsResearch2015:46,No.257-264
Saksvik-lehouillieretal.IndustrialHealth2015;53:69-77
![Page 15: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/15.jpg)
Tolerance of shift work (SWT) studies
AnotherstudyonDutchPoliceofficersFindings:• SWTwasdirectlyrelatedtoqualityofsleep.• Womenweremoreintolerantbecauseofaddedresponsibilitiesoutsideofwork.• Ofteninshiftworkerssleepisshortenedto4.8–5.5hourswhichoftenleadstochronicsleepdeprivation.
IntArchOccupEnvironHealth2004;71,121-129BiologicalRhythmsResearch2015:46,No.257-264
Saksvik-lehouillieretal.IndustrialHealth2015;53:69-77
![Page 16: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/16.jpg)
Metabolic consequences of sleep loss
Sleepdeprivationisassociatedwith:• Neuroendocrineregulationofappetite-decreasedLEPTINlevelandincreasedGHRELIN
• Increasedenergyintakethroughhigh-caloriefood,snacks• Insulinresistanceleadingtodiabetes• Activationofgenesthatpromoteobesity
Sleepdebthassimilarimpactasagingonriskofchronicdisorders
Spiegeletal.JApplPhysiol2005;99(5):2008-2019.VanCauteretal.SleepMed.2008Sept;9(1):S23–S28.
Copinschietal.FrontHormRes2014;42:59-72.
![Page 17: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/17.jpg)
Chronic effect of shift work (SW) on cognition
Prospectivelongitudinalstudy• Cohortof3,232employees/retiredemployees:1,484shiftworkers• Clinicalexamsandquestionnairesatbaseline,5years,10years• Measuredtestsofspeedandmemory
Findings• Shiftworkassociatedwithchronicallyimpairedcognition• StrongerforexposuretoSW>10y• AfterstoppingSW,recoveryofcognitivefunctiontookatleast5years
Marquieetal.OccupEnvironMed2015;72:258-265.
![Page 18: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/18.jpg)
Verylittleresearchintohealthofshiftworkersthatcombinesinterventionsbaseduponlifestylefactors.
Asshiftworkers,• wedealwithmultiplevariables
• wehaveverylittlecontrolofourenvironmentandit’simpactonourphysiology
Case Study
Snyder,Ruhi(2015).
![Page 19: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/19.jpg)
Foundation of Case Study
• TimingandTypeofExercise
• TimingandTypeofDiet
• ShiftSchedules
• Intermittentfasting
• Meditation
• BlueBlockingSunglasses
![Page 20: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/20.jpg)
Methods
• Asleeptechnologistworking12-hournightskeptadetailedlogofshiftschedule,sickdays,burnoutdays,exerciseandfoodintakeduringnightshiftsanddaysoffworkandcreatedaselfregulationprogramthatevolvedoveraperiodofthreeyears.
• Aself-regulationprogramwasimplementedafterthefirstyearandinvolvedmodifying:
• thetimingandtypeofexercise,• timingandcompositionofdiet• Intermittentfastingandmeditation• shiftschedulesduringthenexttwoyearsand• Addedblueblockingglassesafterfinishingnightshiftasashieldfromthemorninglight.
![Page 21: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/21.jpg)
Exercise Related Benefits
• Exerciseimproves:• Sleep• Mood• Stresslevel• executivefunction• Cognition• Neuroplasticity• regulatesmetabolism• Increasesmusclemass
VanReethetal.AmPhysiolSoc1994;E964-74Spark:TheRevolutionaryNewScienceofExerciseandCognition2008
JournalofScienceandMedicineinSport2014;(17)51-55
![Page 22: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/22.jpg)
Benefits of Nocturnal Exercise
• Onlyahandfulofstudieshavebeenconductedoneffectsofnocturnalexercise• NocturnalExercise(HighIntensityIntervalTraining)phasedelaysCircadianRhythmsofMelatonin
• Regularexercisecancreatesubstantialphasedelays• Acceleratesre-entrainmentofthehumansleep-wakecycle
EuropeanJofAppliedPhysio(2007)99:331-341
J.PinealRes.(2012)52:1-11JournalOfCircadianRhythms201614(1):2,1-8
![Page 23: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/23.jpg)
Sample Journal Entry- 2012 2weeksoffworkApproximatelysleptfor11-12hours.Inbedby1:30amWokeupfirstaround10:30amandwentbacktobedat11:00amandthenwokeupagainat1:00pm.Hadabagelcreamcheeseforbreakfastandasingleshotlattewithacupofmilk.Mildheadacheandtook1Advil(200mg).Hadpastawithcheese,peasandcornat6:30followedbyathirdlatte.Arrivedatworkafterbeingofffor12days.
Mood:fairlygood.Attitude:goodExercise:at11:30Stretching:2minutesStairs:1:54Rest:0.1Pushupsandabs:1:29@20eachStairs:2:22Pushupsandabs:.30Stretching:7minutesHadadifficulttimeduringthesecondsetofstairclimbing-pacerelativelyslowgoingdownandatthelowestafterclimbing50stairs.Continuedtorunupatarelativelylowpaceforthenext50stairs.
Levelofenergy:highFocus:highAttitude:positiveConcentration:goodAnalyzed1studyandconducted3diagnosticstudies.Moreenergyandwanttodomorephysicalactivity-recordedat2:18am.anothersetofpullupsat12:30amMeal@1:00amcontainingbeefandabeansoup.Teaat2:00am.Energylevelat4:00-moderate,yawningpresent.Physicallyalert.Mentally-mildlyfoggy.
![Page 24: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/24.jpg)
Case study – exercise and shift schedule Year ExerciseOnNights ExerciseonDaysoff ShiftSchedule
2011-2012 Variabletiming-Running,yoga,cardio11:30pm-4:00am
Variabletiming-Running,yoga,cardioNoon-7:30pm
4nights/wk3nights/wkIntermittentdayshift
2012-2013 Variabletiming–highintensitytraining12–2:30am
Controlled–martialarts7-9pm2x/wk12-1:301x/wk
4nights/wk3nights/wkIntermittentdayshift
2013-2014 Controlledtiming-highintensitytraining,yogaandmeditation2:00-2:45am
Highlycontrolled12-1:302x/wk–martialartsAfternoon–runningPostexercise-meditation
3nights/wkto3nights/wkandadayshift(fixeddays)
2014-2015 Controlledtiming-highintensitytraining,yogaandmeditation2:00-2:45am
Controlledandflexible12-1:301x/wk–martialartsAfternoon2x/wk–running,hiking,andrecoveryperiods.Postexercise–yogaandmeditation
2nights/weekor2nightsaweekwithaflexibledayshiftFixedschedule
![Page 25: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/25.jpg)
Year DietonNights DietonDaysOff
2011-2012 VariableandunrestrictedAllfoodgroups,somesweets,caffeineanytime,occasionalalcohol
VariableAllfoodgroups,somesweets,caffeineanytime,occasionalalcohol
2012-2013 Eveningmeal6pm-Halfaportionofmealcontainingleanprotein,carbs,two-threevegetablesandasaladSnacks11pm-12ampmfruitsmoothieswithproteinpowder,nutsandvarious1hourpriortoworkout:fruits/vegetablesPostworkoutmealtheotherhalfoftheeveningmeal
BLS-bigmeal7-9:30pmafterworkoutifapplicableSnacks–fruits,nuts,smoothies
2013-2014 Stricttimingofintakeofmealsandcoffee,noprocessedfoodorsugarMeal1hourpriortoshiftMeal1-1/2hourpostworkoutduringtheshiftPreworkout-fruit,wholegraincrackersandnutsNocaffeineafter1pmNofoodintakeafter4am.
Wholegrainsonly;eliminatedalcoholandprocessedsugarS-6:30-8pmStarted12hourfasting
2014-2015 Continuesame Continuesame;occasionalalcohol
Case study – diet type and timing
![Page 26: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/26.jpg)
Results
• AfterimplementationoftheSelfRegulationProgramandchangestoshiftschedule,thefollowingqualitativeandquantitativeobservationsweremade:
• Mental-improvementofmood,tolerance,patience,self-efficacy,senseofempowerment
• Physical-improvementinstrength,endurance,sleepqualityandenergylevel;lesspronetoinjuryandfatigue
• Sick–significantreductioninsickdaysandtimeoffforburnout(eg.preSRP:8sickdays/year;SRP:0sickdayspastyear)
• Productivity–improvementinfocus;increasedworkoutput;improvedinteractionswithpatientandimprovementinwork-lifeintegration.
![Page 27: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/27.jpg)
Shift Schedule
Ruhi Snyder ©2018
![Page 28: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/28.jpg)
Ruhi Snyder ©2018
Shift Schedule
![Page 29: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/29.jpg)
Ruhi Snyder ©2018
Shift Schedule
![Page 30: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/30.jpg)
Ruhi Snyder ©2018
Evolution of Self-Regulation and Impact on Work
![Page 31: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/31.jpg)
Conclusion
• Theauthor’sself-regulationprograminvolvinglifestylefactorshadnumerouspersonalandemployeebenefits
• Regularconsecutivenightshiftsfollowedbyatleast4daysoffandaflexibledayshiftonatwoweekcycle,reinforcedwithselfregulationasperdailytimedexerciseandmeals,anda12hourfast,meditation,wearingblueblockingsunglasses…ledto,bettermentalandphysicalhealth,reducedsickdays,andincreasedproductivityandimprovedworklifeintegration.
![Page 32: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/32.jpg)
Closing statement
Thecasestudyiscomplexasitisembeddedinreal-lifewithmultiplevariablesthatshiftedconstantly.It,therefore,requiredamulti-layered,constantly-evolvingapproach.Itrequiredaprocessofselfawarenessofmyownrhythms,awillingnesstochangeandaltercoursewhenneeded,anopendialoguewithmyorganizationandacompletecollaborationandunderstandingfrommyfamily.Italsorequiredanunderstandingofpersonaleconomy(goingfromfulltimewithbenefitstopermanentparttimewithnobenefits).Asa24-hoursociety,shiftworkisarealityformany(Bluecollarorwhitecollar)andasareit’simplicationsonone’swell-beingandoncommunityandthesociety.Weneedamorecollaborativeandreallifeapproachtoshiftworkforthereisnoonemodelfitsallsolution,forhumanbeingsaredynamicandconstantlychangingsystemswithvariablesthatarechangingfrommomenttomoment.
RuhiSnyder2018
![Page 33: The Role of Self-Regulation and Shift Schedule in Countering the Slow Violence … Role of Self... · 2020-03-24 · “Slow Violence” is the term coined by Rob Nixon to describe](https://reader035.vdocuments.site/reader035/viewer/2022070810/5f08d42a7e708231d423ebb9/html5/thumbnails/33.jpg)
Acknowledgements:
KimSnyder,LucasSnyder,SaruGill-Bajwa,ArzoiBajwa,Dr.HelenDriver,ShelaghFreedman,Dr.KarenSchultz,LaurieAnderson,CynthiaDawson,TabathaKnight,KatherineQuarterman,KrisMarks,Dr.MichaelFitzpatrick,GillianBlekkenhorst,JenniferSnyder,Dr.NicolleDomnik,Dr.MalaJoneja,Dr.ManojDias-Abbey,TallackMartialArts,BenRobinson