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Effects of alternating 8- and 12-hour shifts on sleep, sleepiness, physical effort and performance.

OBJECTIVES: The aim of the present study was to compare 12-hour shifts during weekends with 8-hour shifts during weekdays with respect to sleep, sleepiness, physical effort, and performance. METHODS: Thirty-one subjects at a power plant participated. Sleep, sleepiness, and physical effort were measured with a diary. About half of the subjects carried out a reaction-time test during both 8- and 12-hour morning and night shifts. The remaining subjects carried out a vigilance task. RESULTS: Sleepiness was higher and physical effort lower on the 12-hour night shift than on the 8-hour night shift. However, the subjects who had the same level of physical effort on 8- and 12-hour night shifts did not differ with respect to sleepiness. During the 12-hour morning shift, sleepiness was lower and the sleep length was longer than on the 8-h morning shift. The subjects who had the same amount of sleep for 8- and 12-hour morning shifts showed no difference in sleepiness. Sleep did not differ between 8- and 12-hour night shifts. There was no difference between 8- and 12-hour shifts with respect to performance. CONCLUSIONS: It was suggested that the difference in sleepiness between 8- and 12-hour shifts is related to differences in sleep length for the morning shift, and to differences in physical effort for the night shift, rather than to shift duration. Thus the most likely conclusion is that 12-hour shifts do not cause increased sleepiness or impaired performance or disturbed sleep.

Adult↗

A multidimensional evaluation of fire fighter training for hazardous materials response: first results from the IAFF Program.

The International Association of Fire Fighters (IAFF) course on hazardous materials training for first responders is described together with an evaluation plan that includes multiple levels of assessment. Trainee appraisals of the course, shifts in their ratings of task competencies, gains in knowledge quiz scores, and self-reports on actions reflecting lessons learned from the course are among the measures used. Evaluations of courses given in several city fire departments found more than 60% of trainee judgments of course quality and utility to be highly favorable, along with significant post-course improvements in their competency ratings and quiz scores. Follow-up interviews with samples of trainees also suggested more self-protective behaviors and preventive actions being taken with regard to alarms and risks of hazardous materials exposures. However, cross-comparing the results for the various evaluation measures gave only limited support to a popular evaluation model that hypothesized that they would be interdependent. Limitations in appreciating technical course subjects, the value of add-on or refresher instruction, and variable risk experiences are noted in explaining differences in some training results.

Analysis of Variance↗

Executive cognitive deficits in primary dystonia.

Primary dystonia is a disorder of movement for which no consistent pathophysiology has been identified; in the absence of evidence to the contrary, it is assumed to be cognitively benign. We have studied a clinically heterogeneous group of 14 patients with primary dystonia on a battery of neuropsychological tests. Despite well-preserved speed of information processing, language, spatial, memory and general intellectual skills relative to normal controls, we have identified a constellation of attentional-executive cognitive deficits on the Cambridge Neuropsychological Test Automated Battery (CANTAB). Specifically, patients demonstrated significant difficulties negotiating the extra-dimensional set-shifting phase of the IED task. The implications of these findings for the pathophysiology of primary dystonia are discussed. This is, to the best of our knowledge, the first report of a significant cognitive deficit in patients with primary dystonia.

Adult↗

Attentional bias associated with alcohol cues: differences between heavy and occasional social drinkers.

RATIONALE: Previous research has shown an attentional bias toward drug-related stimuli in opiate addicts and toward emotionally threatening words in anxiety patients. OBJECTIVE: The primary aim of this study was to investigate whether non-dependent heavy social drinkers would differ in their selective attention towards alcohol-related stimuli in comparison with a group of occasional social drinkers. METHODS: Attentional bias was assessed using alcohol-related pictures and words in a dot probe detection task. Picture and word pairs were visually presented, followed by a dot probe that replaced one of the items. Attentional bias was determined from latencies in responding to the dot probe. Questionnaires were used to examine the relationships among attention, outcome expectancies after alcohol consumption, and personality traits. Higher-order executive function was also measured with two cognitive tasks, recognition memory and attentional shift. RESULTS: The heavy social drinkers showed an attentional bias towards the alcohol-related stimuli when compared to the occasional social drinkers. The heavy social drinkers also scored more highly on expectancy factors of sociability and sexuality and lower on the personality traits of self-directedness and persistence. CONCLUSION: The results support cognitive theories of addictive behaviour in which the ability of drug-related stimuli to capture attention is suggested to play a part in drug dependence, craving and relapse.

Adolescent↗

A developmental study of covert orienting to peripheral visual cues.

Observers aged 6, 8, and 20 years participated in a speeded classification task designed to measure covert shifts of visual attention. On each trial observers responded to a target which appeared in one of three locations arrayed horizontally across the display. Three prestimulus cues were employed: neutral (the cue was present in all three possible target locations), unpredictable (the cue was present in the target location on a random basis), and predictable (the cue was present in the target location on 80% of the trials). There were four developmental findings: (1) Observers of all ages oriented attention automatically to the cued locations, (2) children processed targets in non-cued locations more slowly than adults, (3) only adults took advantage of the predictability of the cue, and (4) all age groups provided evidence that strategic orienting competes with response priming for cognitive resources. The implications of these findings for theories of attentional development are discussed.

Adult↗

Evoked potential indices of selective hemispheric engagement in affective and phonetic tasks.

Evoked potentials (EPs) to a probe click stimulus were recorded from left and right temporal areas of dextral adults engaged in phonetic and prosodic processing of an emotionally charged tape recorded conversation. Attenuation of the probe EP amplitudes was significantly greater in the left and right hemispheres during the phonetic and prosodic tasks, respectively, indicating lateral dominance shifts depending on selective processing of linguistic vs affective cues conveyed by the same speech signals.

Adult↗

Long-term effects of antidepressants on balance, equilibrium, and postural reflexes.

To assess the long-term effects of antidepressant medication on balance, equilibrium, and postural reflexes, we studied 30 patients, ages 20-76 years, who had a diagnosis of depressive disorder (as defined by DSM-III-R criteria) and had been treated with tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) for > or = 1 year. They were assessed by a Balance Master System. The assessment included three tasks: static balance, rhythmic weight shift, and limits of stability. When compared with 30 nonhospitalized healthy controls (of comparable age and the same sex), patients who took TCAs showed impaired balance function in all main indices. The results suggest that the impairment of balance function includes motor coordination, fine-motor control, postural reflexes, maintaining equilibrium, and reaction time. No obvious impairment of balance function was observed in patients who took SSRIs.

Adult↗

Learning impairment caused by a toxin produced by Pfiesteria piscicida infused into the hippocampus of rats.

Pfiesteria piscicida, an estuarine dinoflagellate, which has been shown to kill fish, has also been associated with neurocognitive deficits in humans. With a rat model, we have demonstrated the cause-and-effect relationship between Pfiesteria exposure and learning impairment. In several studies, we have replicated the finding in Sprague-Dawley rats that exposure to fixed acute doses of Pfiesteria cells or filtrates caused radial-arm maze learning impairment. Recently, this finding of Pfiesteria-induced learning impairment in rats has been independently replicated in another laboratory as well. We have demonstrated significant Pfiesteria-induced learning impairment in both the win-shift and repeated-acquisition tasks in the radial-arm maze and in reversal learning in a visual operant signal detection task. These learning impairments have been seen as long as 10 weeks after a single acute exposure to Pfiesteria. In the current study, we used a hydrophilic toxin isolated from clonal P. piscicida cultures (PfTx) and tested its effect when applied locally to the ventral hippocampus on repeated acquisition of rats in the radial-arm maze. Toxin exposure impaired choice accuracy in the radial-arm maze repeated acquisition procedure. The PfTx-induced impairment was seen at the beginning of the session and the early learning deficit was persistent across 6 weeks of testing after a single administration of the toxin. Eventually, with enough practice, in each session, the PfTx-exposed rats did learn that session's problem as did control rats. This model has demonstrated the cause-and-effect relationship between exposure to a hydrophilic toxin produced by P. piscicida and learning impairment, and specifically that the ventral hippocampus was critically involved.

Animals↗

The relationship between employment and neuropsychological impairment in HIV infection.

The relationship between neurocognitive impairment and employment in a cohort of 130 predominantly symptomatic individuals with HIV-1 infection was examined. Participants were classified as employed (full or part-time for pay) or unemployed (N = 64) and administered a neuropsychological test battery. When covarying for CD4 count, age, and physical limitations, the results revealed that unemployed men performed below that of employed participants on tasks of memory, set shifting-cognitive flexibility, and psychomotor speed. The results are discussed within the context of similar findings in other illnesses.

Adult↗

Adaptive decision processes in perceptual comparisons: effects of changes in the global difficulty context.

Adaptive decision processes were investigated in experiments involving an unexpected change in the global ease or difficulty of the task. Under accuracy stress, a shift from an easy to a difficult context induced a marked increase in decision time, but a shift from a difficult to an easy context did not. Under speed stress, a shift to a more difficult context induced lower accuracy and rated confidence, depending on the difficulty of the decisions. A view of caution developed in D. Vickers's (1979) accumulator theory--whereby one seeks to base decisions on more information--is compared with a view based on slow and fast guessing theory (W. M. Petrusic, 1992; W. M. Petrusic & J. V. Baranski, 1989a)--whereby one seeks to base decisions on more diagnostic information. On balance, the findings support the latter view.

Adaptation, Physiological↗

Determination of language dominance: Wada test confirms functional transcranial Doppler sonography.

OBJECTIVE: To determine the efficacy of the invasive Wada test in determining language dominance, and to validate the functional transcranial Doppler sonography (fTCD) examination in patients. BACKGROUND: Previous work shows that simultaneous bilateral fTDC may identify cognitive hemispheric dominance in healthy individuals. METHOD: fTDC and the Wada test were performed prospectively in 14 patients with various diseases (tumors, cerebrovascular events, head injury, intractable epilepsy). fTDC hemispheric dominance was determined based on the hemispheric blood flow velocity shift for language and visuospatial tasks. RESULTS: fTDC was performed easily in patients. One patient could not be examined by fTDC because of absent temporal bone window for ultrasonic transmission. Two Wada tests were inconclusive due to patient somnolence. One of these patients suffered from right frontal tumor and had aphasia remitted under steroids when examined. fTDC indicated a bilateral language dominance. In the remaining 11 patients the correlation between fTDC and Wada language lateralization indices was 0.75 (p = 0.008). If a post hoc cutoff score was taken for the fTDC language lateralization index, in eight patients, both fTDC and Wada testing determined the left hemisphere to be dominant for language; in the other three patients, language function was bilateral in both examinations. CONCLUSION: Although the current results are preliminary and require replication in a larger sample, fTDC seems to be able to assess hemispheric language dominance not only in healthy individuals, but also in patients. It might become an alternative noninvasive or complementary tool to the Wada test, particularly in patients in whom the Wada test is impractical or gives inconclusive results.

Adolescent↗

[Reported morbidity and use of health services by working women, Brazil].

OBJECTIVE: Inclusion in the work force has become part of women's daily lives, and they have to cope with multiple tasks and manage double working shifts. A study was carried out to assess working women's morbidity and their use of health services. METHODS: By means of a household survey, chronic and acute morbidity (i.e. within 30 days of data collection) was reported by 1,157 women aged 10 to 49 years living in the southern area of the city of São Paulo, Brazil. Data were collected from January 1992 to January 1993. The relationship between employment and marital status, educational level and socioeconomic status was evaluated. RESULTS: Women who had a paid job were more likely to complain of acute or chronic morbidity. Also, these women tended to be less likely to seek medical services for their health problem. The most prevalent acute illnesses were: respiratory illnesses, especially influenza or colds (72/1,000), abdominal and pelvic pain (13.2/1,000), headaches (11.4/1,000), and hypertension (9.5/1,000). Regarding chronic complaints, hypertension (39.7/1,000), back pain (26.5/1,000), gastritis or inflammation of duodenum (24.6/1,000), and bronchitis (24.6/1,000) were the most prevalent conditions. CONCLUSIONS: Although employed women reported more health complaints than women who were not employed, their use of health services was equal to or less than that of women who were not employed for most health conditions studied.

Acute Disease↗

Relationship between discrimination tasks of the cantab and the corpus callosum morphology in Alzheimer's disease.

The relationship between performances on a simple discrimination task of the Attentional Set Shifting of the Cambridge Neuropsychological Test Auto mated Battery (CANTAB) and morphometry of the corpus callosum is examined in patients with Alzheimer's disease. Analysis showed patients with probable Alzheimer's disease are heterogeneous for the relationship between performances in the attentional test of the CANTAB and the anterior callosal atrophies. Interest in these results for clinical diagnosis of this mental disease is discussed.

Aged↗

Effects of an overnight fluid infusion on cognitive functions in preoperative patients.

The results of the present study show that subjects who received an overnight infusion of isotonic fluid did significantly less well at particular neuropsychological tests than controls who did not receive such an infusion. The relevant test parameters involved aspects of word list learning, and concept shifting on a complex speed task. Potentially biasing factors such as anxiety, disturbed sleep, education and age could be discarded. With respect to the physiological mechanism involved, the results suggest that a relatively expanded extracellular volume without dilutional hyponatremia might underlie the diminished performance. The experimental group did not lose weight overnight, and the hemoglobin and haematocrit level of the experimental group were significantly different from those of the control group; the blood pressure, plasma electrolytes and osmolality were not different. The present results provide evidence that disturbances in fluid homeostasis may affect cognitive performance.

Adult↗

The relationship between serum testosterone and visuomotor learning in hand skill in right-handed young women.

The relationship between serum testosterone level and motor learning in hand skill was studied in right-handed young women. Hand skill was assessed by a peg moving task. Subjects were required to shift 25 pegs from one of two parallel rows to the corresponding holes as fast as possible, first with right and then with left hand. One trial consisted of the time elapsed to move 25 pegs with one hand. Ten trials were performed by each hand. Peg moving times for the right and left hands linearly decreased at each successive trial (visuomotor learning). Subjects were divided into two subgroups as those having serum testosterone concentrations below and above the mean. The right hand skill and its motor learning was found to be better in subjects with low testosterone than those with high testosterone. The left hand skill was better in subjects with low testosterone than those with high testosterone; there was no significant difference in the left-hand learning in subjects with low and high testosterone (parallel regression lines). Motor learning linearly decreased with testosterone for the right hand, not for the left hand. These results seem to be in accord with the testosterone theory of cerebral lateralization (Geschwind & Behan, 1982).

Adolescent↗

Inhibition of attended processing during saccadic eye movements.

People are unable to perform some, but not all, cognitive tasks while moving their eyes. A possible common denominator among disrupted processes is the use of attention. The present research proposes and tests an attentional suppression hypothesis to evaluate this claim. This hypothesis states that because attention is obligatorily allocated to a to-be-fixated location prior to the onset of a saccade, during saccadic events attentional resources are unavailable to direct processing associated with higher order cognitive tasks. Subjects were engaged in a task that combined saccades and shifts of attention across global and local levels of hierarchical figures. When the eyes did not move, this shift took place between stimulus presentations. When saccades intervened between the stimuli, the global-local shifts of attention were interrupted, suggesting that saccades suppress cognitive processes requiring attention.

Attention↗

The effects of single-dose fexofenadine, diphenhydramine, and placebo on cognitive performance in flight personnel.

BACKGROUND: Sedation and functional impairments are side effects associated with the use of first-generation antihistamines that preclude their use in aviation. Selected second-generation antihistamines do not have such side effects and have been proposed for use in aircrew. METHODS: Forty-two healthy naval aviation personnel served as subjects in this double-blind, randomized, placebo-controlled crossover study. Subjective drowsiness, cognitive performance, and vigilance were measured under three conditions: 180 mg fexofenadine (F), 50 mg diphenhydramine (D) as a positive control, or placebo (P). RESULTS: Subjects receiving F vs. D tended to have a faster mean hit reaction time (adjusted mean difference +/- SE, -10.5 +/- 6.8 ms, p = 0.127). Subjects performed faster and better with F vs. D on measures of omission errors and commission errors (p < 0.05). Variable symbol digit coding delayed recall accuracy was better for F vs. D (p = 0.023), and approached significance for shifting attention and divided attention tasks (p = 0.062 and p = 0.057, respectively). Subjects reported significantly more drowsiness (p < 0.005) with D than F. CONCLUSIONS: Diphenhydramine administration resulted in significant psychomotor decrements compared with fexofenadine, while the effects of fexofenadine were similar to placebo. These results provide additional support for the safe use of fexofenadine by aviation personnel.

Administration, Oral↗

Identification of static and dynamic postural instability following traumatic brain injury.

OBJECTIVE: Quantitative evaluation of static and dynamic aspects of postural instability as a long-term consequence of traumatic brain injury (TBI). DESIGN: Experimental two-group design. SETTING: Outpatient rehabilitation department. PATIENTS AND OTHER PARTICIPANTS: From a consecutive sample of TBI patients at least 6 months after trauma, 20 subjects were selected who complained of reduced gross motor skills but showed no sensorimotor impairments in a standard neurological examination (11 men, 9 women; mean age 36.2 +/- 10.7 years). Thirteen patients had sustained mild, 2 moderate, and 5 severe TBI. Twenty healthy controls were matched for age and gender. INTERVENTION: None. MAIN OUTCOME MEASURES: A dual-plate force platform recorded the amplitude and velocity of the center-of-pressure fluctuations in the anteroposterior (AP) and lateral (LAT) sway directions during quiet standing. Also, the speed and fluency of weight shifting using visual feedback was registered. Both balance tasks were combined with an arithmetic task, whereas quiet standing was also tested with visual deprivation. RESULTS: Compared to controls, TBI patients showed an increase of over 50% in AP and LAT sway, and a weight-shifting speed 20% lower. Dual-task interference was never significant. Visual deprivation was most detrimental for the TBI patients, particularly for LAT sway control. CONCLUSION: A long-term overall reduction in both static and dynamic control of posture can be present after TBI, even in patients without clear neurological deficits. Force-plate recordings can identify such (latent) balance problems. Visual deprivation during quiet standing appears a simple, sensitive test for postural instability related to sensory integration deficits.

Adolescent↗