Medical devices alert. Subject: Transmission of blood-borne pathogens via spring-loaded lancet devices.
Explore the source record for details and available documents.
Blood Specimen Collection↗
SEARCH · PubMed Health
Results for “subjective alertness”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Circadian rhythms in subjective alertness and core body temperature.
Explore the source record for details and available documents.
Adult↗
Subjective alertness and sleep quality in connection with permanent 12-hour day and night shifts.
OBJECTIVES: The aim of this study was to compare permanent 12-hour day and night shifts (shift change over times at 0500 and 1700) in a shift system with 3 work periods followed by 4 free days. METHODS: Sleep diaries were collected after main periods of sleep, and sleepiness ratings [Karolinska sleepiness scale (KSS)] were obtained 4 times during the last free day and also during the following 3 workshifts. Eighteen to twenty night workers and 8-10 day workers (depending on the instrument) participated. RESULTS: The day workers were significantly sleepier during their workdays. Times for going to bed and for rising differed between the groups. The amount of sleep per week did not differ between groups, but the pattern across days did in that the day workers had a short sleep (5 hours) before the first day and 6 hours of sleep after the other two. Night workers slept long (9 hours) before the first shift and had 6.5-hour sleep periods after the other shifts. During free time the day workers slept around 9 hours and the night workers around 8 hours. Sleep quality and ease of awakening showed no group differences in overall levels, but the day workers had difficulties awakening before their shifts. The night workers had little variation in sleep quality or difficulties awakening. CONCLUSIONS: The suggested explanation for the greater sleepiness and difficulties awakening among the day workers was the early start of the shift and the difficulties the workers had with phase advancing their sleep-wake rhythm.
Adult↗
Awareness affects the response of human subjects exposed to a single whiplash-like perturbation.
STUDY DESIGN: Human subjects were exposed experimentally to a single whiplash-like perturbation. OBJECTIVE: To determine how awareness of the presence and timing of a whiplash-like perturbation affects the onset and amplitude of the neck muscle response and the peak magnitude of head and neck kinematics. SUMMARY OF BACKGROUND DATA: Although most whiplash injuries are sustained in rear-end collisions, which occur without warning, most studies of whiplash injury have used subjects aware of the imminent perturbation. METHODS: Seated subjects (35 women and 31 men) underwent a single forward horizontal perturbation (peak acceleration, 1.5 g). Surface electromyography measured the sternocleidomastoid and cervical paraspinal muscle activity. Three awareness conditions were tested: a countdown for subjects alerted to their perturbation, a perturbation without an alert for subjects who expected it within 60 seconds, and an unexpected perturbation for surprised subjects who were deceived. RESULTS: The muscle and kinematic responses of aware (alerted and unalerted) subjects were not significantly different. Sternocleidomastoid activation occurred 7 ms later in surprised subjects than in aware subjects (P < 0.0002). Cervical paraspinal amplitudes were 260% larger and angular head accelerations in flexion were 180% larger in surprised male subjects than in alerted male subjects. Surprised female subjects exhibited a 25% larger head retraction and a 30% lower forward acceleration of the mastoid process than aware female subjects. CONCLUSIONS: The larger retractions observed in surprised females likely produce larger tissue strains and may increase injury potential. Aware human subjects may not replicate the muscle response, kinematic response, or whiplash injury potential of unprepared occupants in real collisions.
Acceleration↗
Risk-taking behavior: effects of ethanol, caffeine, and basal sleepiness.
STUDY OBJECTIVES: This study examined the effects of ethanol, caffeine, and basal sleepiness on a laboratory measure of risk-taking behavior, the Stop Light Task. The aims were to determine whether sleepiness and ethanol degrade psychomotor speed and risky choice and whether caffeine attenuates these effects. DESIGN: Mixed design with participants chosen for basal level of sleepiness and each assessed under 4 conditions presented in a Latin-square crossover design. PARTICIPANTS: Thirteen healthy adult volunteers aged 21 to 35 years. INTERVENTIONS: Participants received ethanol 0.5 g/kg and caffeine placebo, ethanol 0.5 g/kg and caffeine 150 mg, ethanol 0.5 g/kg and caffeine 300 mg, or a dual (ethanol-caffeine) placebo between 9:00 am and 9:30 am. MEASUREMENTS: The Multiple Sleep Latency Test (MSLT) was used to determine basal level of sleepiness. Subjects completed the Stop Light Task about 60 to 90 minutes after drug administration to assess psychomotor speed and risky choices. RESULTS: Seven subjects were classified as Alert (MSLT = 12.6 +/- 2.0 minutes) and 6 Sleepy (MSLT = 8.1 +/- 1.0 minutes). Sleepy compared to Alert subjects did not differ in psychomotor speed overall. Ethanol significantly slowed psychomotor speed relative to placebo, and ethanol-caffeine combinations attenuated this effect. Consistent with previous studies using the Stop Light Task, higher response requirements (FR15-FR50) and higher point loss probability (12.5%, 37.5%, 100%) significantly decreased risky choice, across sleepiness and treatment conditions. Alert subjects made "go" (primary measure of risk-taking) choices more often at lower response requirements and less often at higher response requirements, relative to Sleepy subjects. Ethanol did not significantly affect "go" choices but did produce changes in "go" choices as a function of response requirement. Given their more optimal pattern of choice behavior, Alert subjects gained significantly more money than Sleepy subjects; ethanol and caffeine combinations did not significantly affect money earned. CONCLUSIONS: These data suggest that sleepiness moderates risky choice such that Alert subjects have improved choice "acuity." Also, under conditions where risk-taking depends on responding rapidly (like the Stop Light Task), ethanol may also impair responding and caffeine may attenuate this effect.
Adult↗
Circadian rhythms in healthy aging--effects downstream from the pacemaker.
Using both previously published findings and entirely new data, we present evidence in support of the argument that the circadian dysfunction of advancing age in the healthy human is primarily one of failing to transduce the circadian signal from the circadian timing system (CTS) to rhythms "downstream" from the pacemaker rather than one of failing to generate the circadian signal itself. Two downstream rhythms are considered: subjective alertness and objective performance. For subjective alertness, we show that in both normal nychthemeral (24 h routine, sleeping at night) and unmasking (36 h of constant wakeful bed rest) conditions, advancing age, especially in men, leads to flattening of subjective alertness rhythms, even when circadian temperature rhythms are relatively robust. For objective performance, an unmasking experiment involving manual dexterity, visual search, and visual vigilance tasks was used to demonstrate that the relationship between temperature and performance is strong in the young, but not in older subjects (and especially not in older men).
Adult↗
A pilot study of subjective daytime alertness and mood in primary insomnia participants using ecological momentary assessment.
This pilot study compared daytime symptom ratings in primary insomniacs (n = 7) and age-matched controls (n = 8). Participants completed sleep diaries and rated their daytime symptoms using a Daytime Symptom Diary (DSD) 4 times per day for 1 week. DSD responses were collapsed into 4 domains: mood, subjective alertness, energy, and concentration. The level and variability of DSD domains, and correlations between the domains and sleep diary characteristics, were examined. Significant Group x Time of Day interactions were observed in values for each DSD domain, with the most consistent group differences occurring in the morning. Coefficients of variation for DSD domains were greater in the insomnia group. Frequent measures of daytime symptoms may be useful outcomes in insomnia studies.
Adult↗
A 14-h night-shift in the control room of a fire brigade.
All 29 operators in the control room of a fire brigade performed test sessions during work and leisure time at 2-h intervals on a day with a 14-h night-shift, a day off and a day with a 10-h morning shift. The test sessions consisted of a visual search choice reaction time test and two Sternberg memory search tests (1 or 5 letters had to be memorized). Furthermore, the operators recorded their oral temperature and their subjective alertness before each test session. The subject also kept a diary of work and sleep times for 14 days. The circadian rhythm of body temperature was hardly changed by a single night-shift. Parallel to the body temperature, the subjective alertness fell significantly during the night-shift reaching a minimum value at 06:00 h. The mean reaction times increased non-significantly at the end of the night-shift and the results of the two Sternberg memory search tests showed no significant trends. The sleep of the operators after the night-shift was on average reduced to 5 hs 34 min. The results of subjective rating of alertness and reaction time test are interpreted as effects of the combined influences of circadian rhythmicity, sleep loss and time on professional task. Most results support the conclusion that a 14-h night-shift without extensive breaks is not acceptable.
Adult↗
Daytime alertness in subjective and objective insomnia: some preliminary findings.
Daytime performance and alertness were examined in two groups of patients with disorders of initiating and maintaining sleep (DIMS) and a control group of self-described good sleepers. Individuals complaining of disturbed sleep that was verified by polysomnographic indices (objective DIMS) and a group with complaints of disturbed sleep in the absence of objective findings (subjective DIMS) were compared with normal sleepers. Nocturnal polysomnographic recordings documented increased sleep latencies and decreased sleep efficiencies for the objective DIMS group and essentially normal sleep for the subjective DIMS group. However, the subjective DIMS group showed impaired daytime vigilance compared with both the objective DIMS and control groups. Additionally, the subjective DIMS group demonstrated an atypical daytime alertness and a tendency toward lowered arousal during vigilance task performance. Insomniacs without clear objective findings of disturbed sleep, therefore, showed decrements commonly seen following sleep loss or sleep disturbance, whereas insomniacs with evidence of disturbed nocturnal sleep did not differ from the control group in terms of waking function.
Adult↗
Daytime vigilance after morning bright light exposure in volunteers subjected to sleep restriction.
This study was designed to test the hypothesis that bright light (BL) can have a stimulating effect on vigilance even in the absence of suppression of melatonin secretion and that this effect can be detected when measured in subjects with low vigilance levels. Seven normal subjects were exposed to bright-white light (BL group) and seven to dim-red light (DL group) on 2 consecutive days, each following a night of 4-h sleep restriction. The light treatment was administered in the late morning, between 0900 and 1330 hours. Salivary melatonin measurements indicated that BL did not suppress melatonin secretion or induce circadian phase shifts. The effects of the two treatments were compared on validated measures of daytime vigilance: immediate effects were evaluated on subjective alertness during the light treatment, whereas short-term (0.5-10.5 h) and long-term (20.5-34.5 h) carryover effects were measured on subjective alertness, daytime sleep latencies (DSL), and psychomotor performance. After two nights of sleep restriction, subjective alertness and daytime sleep latencies decreased significantly, but there was no effect of the light treatment. BL treatment did not affect global performance, but there was an effect on the strategy used by the subjects, as shown by faster reaction times and increased percentage of errors in the BL group. It was concluded that daytime BL exposure did not have a stimulating effect on our measures of vigilance even in sleep-deprived subjects but that it may increase physiological arousal and affect the subjects' behavior in some specific performance tasks.
Adult↗
Mental and physical effort affect vigilance differently.
Both physical and mental effort are thought to affect vigilance. Mental effort is known for its vigilance declining effects, but the effects of physical effort are less clear. This study investigated whether these two forms of effort affect the EEG and subjective alertness differently. Participants performed a physical task and were subsequently presented with a mental task, or vice versa. Mental effort decreased subjective alertness and increased theta power in the EEG. Both results suggest a vigilance decline. Physical effort, however, increased subjective alertness and alpha and beta1 power in the EEG. These findings point towards an increase in vigilance. Beta2 power was reduced after physical effort, which may reflect a decrease in active cognitive processing. No transfer effects were found between the effort conditions, suggesting that the effects of mental and physical effort are distinct. It is concluded that mental effort decreases vigilance, whereas physical effort increases vigilance without improving subsequent task performance.
Adult↗
Arterial tonometry in the measurement of the effects of innocuous mechanical stimulation of the neck on heart rate and blood pressure.
Arterial tonometry was used to continuously monitor the effects on heart rate and blood pressure of a series of innocuous mechanical stimuli applied to the neck in conscious humans. The stimuli used were derived from procedures commonly employed in clinical examination and physical therapy of the neck. In alert subjects, the stimuli used generally caused small and sometimes statistically significant decreases in heart rate, systolic pressure and diastolic pressure. In alert subjects, statistically significant decreases in systolic and diastolic pressure were particularly associated with stimuli which involved full rotation of the neck. In the course of the prolonged series of stimuli, some subjects slept or reported being on the verge of sleep. In these subjects, the same stimuli produced mixed effects on heart rate and increases in systolic and diastolic pressure which were significantly different from the effects obtained in fully alert subjects.
Adult↗
Decreased human circadian pacemaker influence after 100 days in space: a case study.
OBJECTIVE: The objectives of this study were (1) to assess the circadian rhythms and sleep of a healthy, 42-year-old male astronaut experiencing microgravity (weightlessness) for nearly 5 months while living aboard Space Station Mir as it orbited Earth and (2) to determine the effects of prolonged space flight on the endogenous circadian pacemaker, as indicated by oral temperature and subjective alertness rhythms, and their ramifications for sleep, alertness, and performance. METHODS: For three 12- to 14-day blocks of time (spread throughout the mission), oral temperatures were taken and subjective alertness was self-rated five times per day. Sleep diaries and performance tests were also completed daily during each block. RESULTS: Examination of the subject's circadian alertness and oral temperature rhythms suggested that the endogenous circadian pacemaker seemed to function quite well up to 90 days in space. Thereafter (on days 110-122), the influence of the endogenous circadian pacemaker on oral temperature and subjective alertness circadian rhythms was considerably weakened, with consequent disruptions in sleep. CONCLUSIONS: Space missions lasting more than 3 months might result in diminished circadian pacemaker influence in astronauts, leading to eventual sleep problems.
Adult↗
Effects of the tranquillizer diazepam and the stimulant methylphenidate on alertness and memory.
Effects of alertness and memory of a single dose of diazepam (10 mg) and the central stimulant methylphenidate (20 mg) were studied in healthy volunteers. It was questioned whether opposite effects of diazepam and methylphenidate are not only observed with respect to alertness but also with respect to memory. It was also questioned whether the two drugs equally affect the first (primacy) and last (recency) items in both the immediate and delayed recall of newly learned words. The experiment was performed in a double-blind, placebo-controlled way. 12 subjects were exposed to a subjective alertness scale and a verbal memory test: a 15-word test. Subjective alertness was found to be decreased after diazepam and increased after methylphenidate. Anterograde amnesia was found after diazepam in the memory test. More specifically, the primacy but not the recency effect was reduced during the immediate recall and both were reduced in the delayed recall. methylphenidate had no effect on memory, however a ceiling effect might have obscured a putative drug effect. The results of a second experiment excluded this possibility. In all, the data demonstrate opposite effects of the two drugs on subjective alertness, suggesting opposite effects on vigilance. Opposite effects on memory were not established. This demonstrates that changes in alertness do not run in parallel with changes in memory. A scatter diagram, however, suggests a small effect of alertness on immediate recall. The effects of diazepam were also discussed in terms of the Atkinson and Shiffrin memory theory and it seems that diminished rehearsal processes are one of the key factors in explaining diazepam-induced amnesia.
Adult↗
Short-term memory, alertness and performance: a reappraisal of their relationship to body temperature.
Previous studies have led to the beliefs: (1) that short-term memory is best during the night when the body temperature is at its nadir, and (2) that the circadian rhythms of short-term memory and subjective alertness are driven by oscillators independent from each other and from the body temperature cycle. Unfortunately, these conclusions, which would have major implications for understanding the organization of the human circadian timing system, are largely based on field and laboratory studies, which in many cases sampled data infrequently and/or limited data collection to normal waking hours. In order to investigate these points further, we have monitored behavioural variables in two different protocols under controlled laboratory conditions: (1) during a period of 36-60 h of sustained wakefulness; and (2) during forced desynchrony between the body temperature and sleep/wake cycles, allowing testing of non-sleep-deprived subjects at all circadian phases. Contrary to earlier findings, we report here that the circadian rhythm of short-term memory varies in parallel with the circadian rhythms of subjective alertness, calculation performance, and core body temperature under both these experimental conditions. These results challenge the notion that short-term memory is inversely linked to the body temperature cycle and suggest that the human circadian pacemaker, which drives the body temperature cycle, is the primary determinant of endogenous circadian variations in subjective alertness and calculation performance as well as in the immediate recall of meaningful material.
Adolescent↗
Single dose human pharmacology of umespirone.
We have compared the cognitive, EEG, and neuroendocrine effects of single doses of umespirone (20 mg and 80 mg) with those of buspirone (30 mg) and placebo in double-blind, cross-over studies in 44 healthy men. The pattern and time-course of the cognitive effects with umespirone and buspirone were dissimilar. Peak effects of buspirone were seen shortly after dosing and then receded, whilst the effects of umespirone persisted for up to 23 h. Although both drugs objectively impaired attention, buspirone reduced subjective alertness, calmness, and contentedness, whilst umespirone increased subjective alertness and contentedness and showed potential to improve secondary verbal memory. The EEG effects of umespirone were different from those seen with buspirone; they included a decrease of power in the alpha 1 band and the beta bands in the frontocentral area and an increase in the delta and theta bands in the occipitotemporal area. Umespirone had a later onset of action than buspirone but its effects lasted longer. Similar transient increases in serum prolactin and growth hormone concentrations were seen with buspirone and 80 mg umespirone; umespirone 20 mg had no effect. Plasma concentrations of ACTH and adrenaline and serum concentrations of cortisol were unaffected by either dose of umespirone. There was some evidence that buspirone increased ACTH and cortisol concentrations in some cases, and that umespirone increased noradrenaline concentrations. The frequency of adverse events was higher with buspirone than with 80 mg of umespirone. At the lower dose of umespirone, the frequency was similar to that with placebo.
Adult↗
Time course of sleep inertia dissipation in human performance and alertness.
Alertness and performance on a wide variety of tasks are impaired immediately upon waking from sleep due to sleep inertia, which has been found to dissipate in an asymptotic manner following waketime. It has been suggested that behavioural or environmental factors, as well as sleep stage at awakening, may affect the severity of sleep inertia. In order to determine the time course of sleep inertia dissipation under normal entrained conditions, subjective alertness and cognitive throughput were measured during the first 4 h after habitual waketime from a full 8-h sleep episode on 3 consecutive days. We investigated whether this time course was affected by either sleep stage at awakening or behavioural/environmental factors. Sleep inertia dissipated in an asymptotic manner and took 2-4 h to near the asymptote. Saturating exponential functions fitted the sleep inertia data well, with time constants of 0.67 h for subjective alertness and 1.17 h for cognitive performance. Most awakenings occurred out of stage rapid eye movement (REM), 2 or 1 sleep, and no effect of sleep stage at awakening on either the severity of sleep inertia or the time course of its dissipation could be detected. Subjective alertness and cognitive throughput were significantly impaired upon awakening regardless of whether subjects got out of bed, ate breakfast, showered and were exposed to ordinary indoor room light (approximately 150 lux) or whether subjects participated in a constant routine (CR) protocol in which they remained in bed, ate small hourly snacks and were exposed to very dim light (10-15 lux). These findings allow for the refinement of models of alertness and performance, and have important implications for the scheduling of work immediately upon awakening in many occupational settings.
Adult↗
Intensive and sustained air operations: potential use of the stimulant, pemoline.
BACKGROUND: Intensive and sustained military operations involve long periods of overnight work and the occasional use of a stimulant to maintain performance may be beneficial. In this context a dose response study was carried out to investigate the effects of pemoline, a dopamimetic agent, on overnight work and to assess potential residual effects on subsequent sleep. METHODS: Six healthy volunteers participated in a placebo-controlled, double-blind, cross-over trial involving a 12-h period of work during which subjective alertness and performance on a range of tasks were assessed at 1.5 h intervals following ingestion at 2000 hours of pemoline (10, 20, 30 and 40 mg) and, on two occasions, placebo. The work period was preceded by a 6-h sleep period with temazepam 20 mg, and followed by a 4-h recovery sleep with no medication. All sleep periods were recorded electroencephalographically. RESULTS: There was no difference between sleep periods preceding the work period. Subjective alertness and performance on all tasks deteriorated significantly during the work period, with the earliest impairments in performance observed at 0200 hours. Pemoline increased subjective alertness and performance on all but two tasks, compared with placebo. The onset of activity was seen 4.5 h after drug ingestion and alerting effects of 30 and 40 mg pemoline persisted beyond the work period, disturbing morning recovery sleep. Doses of 10 and 20 mg pemoline had no effect on recovery sleep. CONCLUSION: The present studies indicate that a 20 mg dose of pemoline may be suitable for maintaining nocturnal performance without having adverse effects on recovery sleep.
Adult↗