Biomedical subjects

S Streufert

Publications and source records attributed to S Streufert.

At least 19 recordsLinked to original sources

PubMed2004

Improvements in simulated real-world relevant performance for patients with seasonal allergic rhinitis: impact of desloratadine.

BACKGROUND: Seasonal allergic rhinitis (SAR) diminishes task performance and decreases quality of life. Antihistamines are frequently used to treat the symptoms of SAR. First generation antihistamines often have their own detrimental effects upon human functioning while second generation antihistamines appear to have fewer or no undesirable side-effects. OBJECTIVE: This study evaluated the impact of desloratadine on simulated real-world performance demands in individuals suffering from SAR. METHODS: This was a randomized, double-blind, cross-over study where asymptomatic participants were treated with placebo and symptomatic participants were treated with desloratadine or placebo. They then participated in a real-world equivalent task performance simulation that assessed information processing capacity at multiple levels of task difficulty ranging from easy to difficult decision-making tasks. RESULTS: Desloratadine either completely restored performance to the level of the asymptomatic placebo control or improved performance in six of the nine performance categories, where it had been diminished by the presence of SAR. CONCLUSIONS: These findings suggest that treatment with desloratadine has considerable beneficial effects on work place performance when individuals suffer from SAR.

Adolescent↗

PubMed2002

Value of a cognitive simulation in medicine: towards optimizing decision making performance of healthcare personnel.

Medical errors can be reduced or avoided by training in both factual knowledge and in optimal information processing. The latter is of special importance when task settings are complex, when information about a patient's condition is ambiguous and uncertain, and when rapid changes can occur. Simulations can contribute to effective training in these areas of functioning without putting patients at risk. The strategic management simulation (SMS) has been used worldwide with many high level professionals. Its application to assessing and training medical decision makers is discussed.

Cognition↗

PubMed2001

Strategic management simulations is a novel way to measure resident competencies.

BACKGROUND: The Strategic Management Simulation (SMS) has been used extensively to test and train higher cognitive functions in persons who occupy professional and leadership positions (i.e., skills like those needed by a surgeon). METHODS: The SMS was used to predict surgical residents' competency in decision making. Skills required for integrative surgical decision making including critical thinking, crisis management, flexibility, factual knowledge, and team building were assessed. Surgical residents with at least 2 years of experience participated. In additional, attending faculty familiar with the residents' work evaluated each resident with a standard comprehensive rating scale. Simulation performance on multiple measures was compared with faculty ratings. RESULTS: A number of measures obtained on simulation performance (eg, activity level, response speed, initiative, adequate usage of and appropriate search for relevant information) generated high correlations with comprehensive faculty assessment (eg, measures of crisis management, team interactions, flexibility of approach). CONCLUSION: The simulation technique is able to accurately assess performance of surgical residents (on a number of parameters) in a relatively brief time period. Simulation data were highly similar to faculty ratings that were based on at least 2 years of experience with the resident.

Clinical Competence↗

PubMed1997

Excess coffee consumption in simulated complex work settings: detriment or facilitation of performance?

Twenty-four managers who normally consume between 400 and 1,000 mg of caffeine per day participated in all-day quasi-experimental simulations. In a crossover, doubleblind design, they made complex managerial decisions either on treatment with their typical daily dose of caffeine or on treatment with 400 mg of caffeine in excess of daily consumption. The effect of caffeine treatment on various validated performance indicators was investigated. The impact of excess caffeine consumption was mild. Increased caffeine facilitated speed of response to incoming information but decreased utilization of opportunity. No significance was obtained for other measures of managerial effectiveness (such as activity, breadth, strategy, and emergency response).

Adult↗

PubMed1995

Effects of caffeine deprivation on complex human functioning.

Twenty-five managers who reported an average daily caffeine consumption of 575 mg participated in two complex simulations. A double-blind cross-over design was employed to assess the effects of normal caffeine consumption versus caffeine deprivation upon seven validated measures of managerial effectiveness. Data from a Caffeine Withdrawal Questionnaire indicated discomfort upon deprivation. Systolic blood pressure increased during "normal" caffeine consumption levels but fell quickly and remained lower during deprivation. Several measures of managerial performance indicated decreased effectiveness upon caffeine deprivation. In contrast to prior research from simpler task settings, cognitive effectiveness (during complex task performance) was diminished. However, a measure of strategic performance which requires a relatively high level of cognitive effort showed no impact of caffeine deprivation.

Adult↗

PubMed1995

Alcohol hangover and managerial effectiveness.

Twenty-one male managers who normally drink moderate amounts of alcohol participated in a placebo-controlled, double-blind, cross-over experiment. Subjects consumed either placebo or alcoholic drinks to attain a breath alcohol level of 0.10 during the evening before participation in Strategic Management Simulations. By the time of arrival at the simultaion laboratory on the following morning, breath alcohol levels were measured at 0.00. Questionnaire responses indicated considerable hangover discomfort. Responses to semantic differential evaluative scales suggested that research participants evaluated their own managerial performance in the simulation setting as impaired. However, multiple (validated) measures of decision-making performance obtained in the simulation task did not show any deterioration of functioning. Previous research had shown considerable performance decrements in the same task setting, while blood/breath alcohol levels ranged from 0.05 through 0.10%. Apparently, complex decision-making competence by persons who normally consume moderate amounts of alcohol may not be impaired by hangover caused by intoxication during the previous evening that remains at or below a blood alcohol level of 0.10.

Adult↗

PubMed1994

Alcohol and managerial performance.

Effects of alcohol intoxication at .05 and .10 breath alcohol concentration upon a number of validated indicators of managerial performance were investigated in a double-blind crossover placebo-controlled simulation design. Managers (N = 48) spent 2 days handling quasi-experimental (partially event-controlled) tasks that permitted realistic managerial decision making under both "normal" and "emergency" conditions. The data showed that speed and frequency of managerial action were affected by alcohol at the .10 but not the .05 level. Strategy and planning deteriorated at both levels. Limited improvement of performance was observed for one simpler component of managerial functioning at the lower intoxication level, possibly due to myopia and/or a motivated "strain" toward better performance induced by the perception of impairment.

Adult↗

PubMed1992

Effects of alcohol intoxication on risk taking, strategy, and error rate in visuomotor performance.

Adult men (N = 44) participated for 2 days (alcohol vs. placebo treatment) in a double-blind, crossover experiment. Performance on the Digit Symbol Substitution Task (DSST) and a visuomotor (VM) task was measured 4 times each day. On the alcohol-treatment day, data were obtained once during ascending breath alcohol levels (BALs), once during maximal BALs (0.05 or 0.10), and twice during descending BALs. Data were collected at the same time points on the placebo-treatment day. Limited evidence for acute tolerance was obtained with the DSST, but error rates on the VM task were higher during maximal and descending BALs. Error rates remained near placebo values, and participants displayed slightly greater caution, while BALs were ascending. Strategy scores on the VM task exceeded placebo scores during maximal intoxication. Data interpretation is focused on individuals in higher level (e.g., professional) positions.

Adult↗

PubMed1990

Age and management team performance.

One hundred eighty male managers participated as age-homogeneous 4-person teams in a validated all-day decision-making simulation. Fifteen teams consisted of 28- to 35-year-old participants (young), 15 teams were in the 45-55 age range (middle-aged), and 15 teams consisted of 65- to 75-year-old (older) persons. More than 40 objective performance measures (loading on 12-15 factors) were calculated on the basis of team decision making, planning, and other indicators. Performance by young and middle-aged teams was generally similar. Older teams made fewer decisions and were less strategic and less responsive to incoming information. Their overview of the task was less broad; action diversity and information search was reduced. However, older teams used opportunities and handled a simulated emergency as effectively as their younger and middle-aged counterparts. Alternative explanations for the obtained differences are presented.

Adult↗

PubMed1989

Effects of beta blockade with metoprolol on simple and complex task performance.

The effect of treatment with the beta-blocker metoprolol on several indicants of task performance was investigated. Twenty-five male hypertensives were treated for 2 weeks each with drug and placebo in a double-blind crossover design. Comparisons to 25 matched untreated normotensives were made. Participants responded twice to a Mood Adjective Check List (MACL) and the Stroop Color-Word Test. In addition, they participated in two parallel decision-making simulations. Normotensives and hypertensives on drug or placebo did not differ on MACL and Stroop scores. Comparisons on 12 validated simulation measures showed that drug treatment with metoprolol aided complex task performance. Drug treatment improved strategic capacity and the ability to deal effectively with emergencies. Preliminary evidence that treatment with metoprolol might help restore performance capacity that may have been lost due to hypertensive disease was also obtained.

Adult↗

PubMed1988

Impact of beta-blockade on complex cognitive functioning.

Fifty adult men with mild to moderate hypertension were recruited to participate in a double-blind crossover study. Each subject received 14 days of drug treatment and 14 days of placebo treatment (random order). Half the subjects were assigned to a metoprolol (150 mg/day) vs placebo treatment regimen and half to an atenolol (100 mg/day) vs placebo regimen. Blood pressure levels as well as measures of simple (proofreading), intermediate (visual-motor task), and complex (management simulation) task performance were obtained at the end of the drug and placebo treatment periods. Metoprolol treatment generated better scores than did placebo or atenolol treatment for proofreading, visual-motor performance, and several measures of complex managerial competence. Atenolol treatment generally resulted in performance levels that did not differ from those observed with placebo. However, atenolol-treated subjects made more errors than did placebo-treated subjects in the visual-motor task and also showed some deterioration on one measure of complex managerial functioning.

Adrenergic beta-Antagonists↗

PubMed1985

Effects of load stressors, cognitive complexity and type A coronary prone behavior on visual-motor task performance.

In two separate experiments, 25 and 42 adult working males participated in a visual-motor task modeled on a video game. The game was designed to permit measurement of strategy, risk taking, errors committed, and overall task performance. Predictions of complexity theory for task performance were supported. In the second experiment, participants were divided into four subgroups on the basis of Type A versus Type B coronary-prone behavior (measured on the structured interview) and on the basis of unidimensional versus multidimensional responding (measured by a complexity interview with stems of the sentence completion test). Type A coronary-prone behavior did not contribute to differences in visual-motor performance. More multidimensional persons exceeded their unidimensional counterparts, especially in the application of strategy. The extension of complexity theory approaches to simpler tasks is discussed. It is noted that the frequently voiced assumptions of Type A individuals-that their behavior style tends to lead to higher performance levels-is not supported.

Adult↗

PubMed1983