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At least 649 records · Page 36Linked to original sources

PubMed1999

Is residual impairment after alcohol an effect of repeated performance?

BACKGROUND: The study examines the residual impairment of performance due to alcohol on the descending limb of the blood alcohol curve. The occurrence of residual impairment at low or zero levels of blood alcohol is well established but its cause is uncertain. It is hypothesized that residual impairment may be due in part to the methodological procedure of repeated performance testing in the post-ingestion period. METHODS: There were 80 volunteers randomly allocated to one of four treatment conditions: a) alcohol and repeated performance (A-R) where psychomotor tasks were performed at 20-min interval for 2 h post ingestion; b) alcohol and double performance (A-D) where tasks were performed only at 1 h and 2 h from ingestion; c) placebo and repeated performance (P-R); and d) placebo and double performance (P-D). Alcohol was administered as vodka to achieve a peak blood-alcohol concentration (BAC) of approximately 80 mg per 100 ml. Performance effects were assessed by a dual task of primary pursuit tracking and secondary visual reaction time, and a visual sustained attention task. RESULTS: Alcohol caused significant impairment of secondary reaction time, the effect being greatest at peak BAC. Sustained attention was also impaired by alcohol but the effect just missed significance. Repeated performance conditions were associated with significantly greater impairment of secondary reaction time and sustained attention when compared with double performance conditions. The factor of performance condition did not, however, interact with that of alcohol. CONCLUSIONS: The monotony and boredom that may be associated with repeated performance do not contribute to residual alcohol impairment.

Adolescent↗

PubMed2004

Validation of a sensitivity performance index test protocol and evaluation of colour Doppler sensitivity for a range of ultrasound scanners.

The ability to detect flow is the most crucial aspect of an ultrasound (US) system because, if flow cannot be detected, no other aspect of performance matters. The objectives of this study were to validate a Doppler "sensitivity performance index," a figure of merit, and to determine if it could be used to differentiate colour Doppler sensitivity performance in scanners of varying complexity. The sensitivity performance index was developed to give a combined measure of related aspects of sensitivity, such as the lowest detectable velocity, the vessel size and the penetration depth. The colour Doppler sensitivity was evaluated objectively as the lowest detectable velocity signal from the deepest achievable point within the Doppler sensitivity phantom free from extraneous noise in a small diameter vessel (3.2 mm inner diameter). The effect of vessel size and mean velocity on the sensitivity performance index were investigated and it was found that the index was not proportional to vessel size, but this may be accounted for by considering the effect of the acoustic properties of the vessel material, the clutter filter and beam shape. The results obtained using flow phantoms with vessel sizes different from those used in this study are, therefore, not directly comparable to the results found in this study; however, a similar trend should be found in the results for the effect of control settings and a similar range of US scanners. It was found that the Doppler sensitivity performance index was a robust challenging test because none of the US scanners evaluated was capable of achieving the highest sensitivity performance index score, which would be limited by the lowest pump velocity and the deepest point of the vessel within the flow phantom. Therefore, this suggests that this method of determining Doppler sensitivity performance is valuable in the absence of other suitable methods, despite the fact that the relationship between the sensitivity performance index and vessel size is not proportional. Furthermore, use of the Doppler sensitivity performance index for the evaluation of a range of scanners demonstrated that curvilinear transducers have higher sensitivity performance indices than higher-frequency linear transducers, due to the higher achievable penetration depth. The effect of instrument settings was assessed for two transducers, the 4C3 curvilinear general-purpose transducer (Aspen) and the PVM375AT curvilinear general-purpose transducer (Nemio). The colour Doppler sensitivity performance was found to be significantly dependent on the clutter filter setting and the output power setting for both transducers tested. Users need to be aware of the effect of these settings on the colour Doppler sensitivity performance of their US scanner when interpreting the clinical significance of the colour Doppler information.

Blood Flow Velocity↗

PubMed1999

Assessing the performance of NHS hospital trusts: the role of 'hard' and 'soft' information.

Formal performance measurement systems have become a prominent feature throughout most of the public sector. The NHS is no exception and the government is developing and expanding on existing performance data to produce a new national framework which is to be at the heart of the 'performance-led' NHS. The success of formal performance measurement systems depends in part on the degree to which they can capture adequately relevant information within a quantitative framework. In this paper, we explore the use of formal, quantitative 'hard' information and informal, subjective 'soft' information in the assessment of the performance of NHS hospital Trusts by external organisations. Our empirical work is summarised into 3 main themes: (i) the use of 'soft' information as a complement to 'hard' information; (ii) the use of 'soft' information as a substitute for 'hard' information; and (iii) the use of 'hard' information as a safety net in the assessment of performance. We argue that 'soft' information plays a valuable role in the assessment of performance of NHS Trusts and note that this is also reflected in current practice in the private sector. We argue that one of the main functions of 'hard' information in performance assessment is to act as a safety net in order to identify laggards by highlighting poor performance. Rarely is it used as a means to encourage good performance or to identify best practice. Whilst the safety net function may indeed be useful, if the new national performance framework is to achieve its aim of promoting good performance, the limitations of formal systems will have to be taken into account. We argue that the advantages of 'soft' information in the NHS should be acknowledged, rather than trying to force it into a formal framework where the benefits may be nullified. However, we also warn against excessive reliance on 'soft' information and suggest that a balanced system which allows both 'hard' and 'soft' information to flourish is the optimal solution to performance assessment in the NHS.

Efficiency, Organizational↗

PubMed2001

Self-efficacy and OSCE performance among second year medical students.

Competent performance requires not only requisite knowledge and skills but also beliefs of personal efficacy to use both effectively. This study examined the confidence of second-year medical students regarding their OSCE performance. Students completed an OSCE at the end of their second year of medical school; their performance was rated using checklists containing key items. Ten minutes prior to the OSCE, students completed a brief survey, which included 31 items sampling confidence in performing various clinical skills required in the OSCE. In addition, students assessed their preparedness and their anxiety, and reported the number of hours they studied in preparation for the OSCE. A total of 82 identifiable surveys (73 %) were used in this analysis. Students with high self-efficacy were more likely to score above the mean OSCE performance compared to low self-rated students (71% versus 51%), however self-efficacy was not significantly correlated to OSCE performance. A causal path model was constructed to predict OSCE performance. Performance in the clinical skills and biomedical science curricula both were related to perceived anxiety, which was related to self-efficacy. Preparedness was predicated on self-efficacy and itself predicted performance. Knowledge also had a strong direct link to performance. Performance is more than having the requisite abilities. Performance was found to be the product of complex relationships between skills and knowledge, mediated by perceptions of anxiety, self-confidence and preparedness. The model illustrates the importance of realistic self-appraisal for competent performance.

Clinical Competence↗

PubMed2004

Leg extensor power, cognition, and functional performance in independent and marginally dependent older adults.

BACKGROUND: physical and cognitive function must be integrated and optimised in performance of daily activities. Age-related loss of physical function can result in poor performance of necessary daily activities and possibly lead to increased dependency and a change of living status. OBJECTIVES: (1) to evaluate average differences in physiological, cognitive, and functional performance of older adults from two different levels of independence, (2) to examine contributions of leg power, cognition, and functional performance to level of independence. DESIGN: cross-sectional study of self-reported 'independent' versus 'marginally dependent' older adults. SUBJECTS: 35 older adults (77.2 +/- 6 years) were placed into independent (n = 18) or marginally dependent (n = 17) groups based upon the Medical Outcomes Study SF36 physical function scores (independent: SF36PF > or = 85, marginally dependent: SF36PF < 85) and living status. METHODS: assessment of physical function includes the dependent variable, SF36PF. Assessment of physical, cognitive, and functional performance include the independent variables of leg extensor power, reaction time, processing speed, memory, attention, and functional performance. Functional performance is assessed by the Continuous Scale Physical Functional Performance Test. RESULTS: independent older adults have greater performance on leg power, reaction time, processing speed, memory, and functional performance than marginally dependent older adults. Functional performance is an independent predictor of level of independence. Leg power and cognition were separate small but significant predictors of independence. CONCLUSIONS: independent older adults have greater physiological, cognitive and functional performance than marginally dependent older adults. Individuals with greater functional performance tend to remain independent.

Activities of Daily Living↗

PubMedDate not supplied

Content and criterion validity evaluation of National Public Health Performance Standards measurement instruments.

OBJECTIVE: The Centers for Disease Control and Prevention's National Public Health Performance Standards Program (NPHPSP) has developed instruments to measure the performance of local and state public health departments on the 10 "Essential Services of Public Health," which have been tested in several states. This article is a report of the evaluation of the content and criterion validity of the local public health performance assessment instrument, and the content validity of the state public health performance assessment instrument. METHODS: Health department performance is measured using a set of indicators developed for the 10 Essential Services of Public Health and a model standard for each indicator. Content validity of each model standard in the local instrument was addressed by community partners along the following dimensions: the importance of each standard as a measure of the associated Essential Service, its completeness as a measure, and its reasonableness for achievement. All standards for each Essential Service were then judged in terms of their completeness in measuring performance in that service. Content validity of the state instrument was evaluated in a group interview of health department staff members from three states. Criterion validity of the local instrument was assessed for a sample of eight public health departments in Florida and six in New York by examining documentary evidence for selected responses. Criterion validity was also evaluated for a sample of Florida local public health departments and one Hawaii public health department by comparing state health department staffs' judgments of performance against the instrument score. RESULTS: Criterion validity was upheld for a summary performance score on the local instrument, but was not upheld for performance judgments on individual Essential Services. The NPHPSP standards based on the Essential Services have validity for measuring local public health system performance, according to community partners. The model standards are valid measures of state performance, according to state public health departments in three states. CONCLUSIONS: Within the scope of the validity evaluations completed, the NPHPSP state and local performance assessment instruments were found to be valid measures of public health performance.

Attitude of Health Personnel↗

PubMed1993

The empirical association between student and resident physician performances.

To further the understanding of the relationship between performances in a combined baccalaureate-MD degree program and in residency, the authors subjected their database of 298 study participants from the 1980-1983 entering classes of the University of Missouri-Kansas City School of Medicine to factor analysis and then to distribution-free statistical analyses. Distinct factors were identified among the performance measures from the combined-degree program; only one factor was identified among the measures of residency performance. Analysis of the relationship of performances in the combined-degree program and in residency indicated that almost half of the participants were in the same performance categories as students and as residents. The strongest association emerged between a clinical performance factor derived from performances in the combined-degree program and the residency clinical performance factor. However, the knowledge factor derived from performance measures in the combined-degree program was also associated with residency clinical performance. The associations were statistically significant but of limited strength; thus the present results resemble those of other investigators, despite the fact that they are based on distribution-free statistics and on purportedly cleaner and more homogeneous measures of performance. Various technical reasons may have caused this lack of strength, but it is also possible that empirical relationships between undergraduate and postgraduate performances are inherently limited because the performances expected of residents may not be mere extensions of those expected of medical students.

Achievement↗

PubMed2006

Medical students' self-reported experiences performing pelvic, breast, and male genital examinations and the influence of student gender and physician supervision.

PURPOSE: To survey third- and fourth-year medical students about their experiences performing gender-specific examinations. METHOD: In 2001, 402 third- and fourth-year medical students at the University of Washington School of Medicine were mailed a questionnaire that asked them to approximate the number of pelvic, breast, and male genital examinations they had performed and to estimate the percentage of these examinations that were observed and the percentage that were repeated by a supervising physician. They were also asked to rate their confidence performing these examinations. Chi-square analysis and stepwise multiple regression analysis were performed. RESULTS: A total of 194 (48%) students completed the questionnaire. Fourth-year female students performed significantly more pelvic (p < .01) and breast examinations (p < .01) than did fourth-year male students. The percentage of examinations that were repeated by a supervising physician was low. Only 86 (45%) of third- and fourth-year students had greater than 75% of their breast examinations repeated by a supervising physician. Male students were less confident in performing the pelvic exam (p < .01) and female students were less confident performing the male genital exam (p < .01). The only predictor of confidence in performing each of these examinations was the number of examinations performed (p < .001). Confidence did not correlate with the percentage of exams observed, percentage of examinations repeated by a supervising physician, or student gender. CONCLUSIONS: Student gender was a marker for suboptimal exposure for performing opposite-sex, gender-specific examinations. The only predictor of confidence in performing these examinations was the number of exams performed. Special efforts should be made to eliminate gender disparity in opportunities to perform gender-specific exams.

Breast Diseases↗

PubMed2006

Cancer Care Ontario and integrated cancer programs: portrait of a performance management system and lessons learned.

PURPOSE: A performance management system has been implemented by Cancer Care Ontario (CCO). This system allows for the monitoring and management of 11 integrated cancer programs (ICPs) across the Province of Ontario. The system comprises of four elements: reporting frequency, reporting requirements, review meetings and accountability and continuous improvement activities. CCO and the ICPs have recently completed quarterly performance review exercises for the last two quarters of the fiscal year 2004-2005. The purpose of this paper is to address some of the key lessons learned. DESIGN/METHODOLOGY/APPROACH: The paper provides an outline of the CCO performance management system. FINDINGS: These lessons included: data must be valid and reliable; performance management requires commitments from both parties in the performance review exercises; streamlining performance reporting is beneficial; technology infrastructure which allows for cohesive management of data is vital for a sustainable performance management system; performance indicators need to stand up to scrutiny by both parties; and providing comparative data across the province is valuable. Critical success factors which would help to ensure a successful performance management system include: corporate engagement from various parts of an organization in the review exercises; desire to focus on performance improvement and avoidance of blaming; and strong data management systems. PRACTICAL IMPLICATIONS: The performance management system is a practical and sustainable system that allows for performance improvement of cancer care services. It can be a vital tool to enhance accountability within the health care system. ORIGINALITY/VALUE: The paper demonstrates that the performance management system supports accountability in the cancer care system for Ontario, and reflects the principles of the provincial governments commitment to continuous improvement of healthcare.

Delivery of Health Care, Integrated↗

PubMed1975

Immediate effects on human performance of a 1,5-genzodiazepine (clobazam) compared with the 1,4-benzodiazepines, chlordiazepoxide hydrochloride and diazepam.

1 The immediate effects on human performance of the 1,5-benzodiazepine, clobazam (20 mg), and the 1,4-benzodiazepines, chlordiazepoxide hydrochloride (20 mg) and diazepam (10 mg), were studied by adaptive tracking and measurement of reaction time. Each drug was ingested at 09.00 h and performance was measured at 09 h 30 min (0.5 h), 11 h 30 min (2.5 h), 14 h 30 min (5.5 h) and 18 h 30 min (9.5 h after ingestion). 2 With diazepam decrements in performance on adaptive tracking were observed at 0.5 h and 2.5 h and performance was enhanced at 9.5 h after ingestion. With clobazam performance at individual times did not differ significantly from control, but there was evidence of an improvement in performance during the day. There was no evidence of impaired performance on adaptive tracking after chlordiazepoxide hydrochloride. 3 Reaction time was slowed at 0.5 h and 2.5 h after diazepam and chlordiazepoxide hydrochloride. A decrease in reaction time was observed at 9.5 h after diazepam. No changes in reaction time were observed after clobazam. 4 The subjects as a group differentiated correctly between performance decrements on adaptive tracking after diazepam and the absence of performance decrements after clobazam and chlordiazepoxide hydrochloride. The persistence of the decrement in performance after diazepam was accurately assessed. 5 It is evident that the nature and persistence of impaired performance and the ability to appreciate impaired performance vary considerably between the benzodiazepines, and that the choice of a benzodiazepine should include careful consideration of performance sequelae.

Adult↗

PubMed2000

Humanism: is its evaluation captured in commonly used performance measures?

BACKGROUND: There is an increased awareness of the importance of humanistic behavior and its education in the medical school curriculum. Relatively little is known about correlations between humanism and other performance measures. PURPOSES: To determine the correlation between humanism and other commonly used performance measures, and to determine if more humanistic students perform better, the same, or worse than less humanistic students. METHODS: During the Family Medicine clerkship, standardized patients (SPs) used the Physician Humanism Scale to assess 428 students for humanism. Clinical preceptors, SPs, written assignments, and a national knowledge examination also assessed student performance. The humanism scores were correlated with the SP and non-SP performance measures. RESULTS: Humanism scores were significantly and positively correlated to all of the performance measures, but the correlation coefficients were low, ranging from .12 to .31. Students in the lowest quartile for humanism consistently scored lower for all of the performance measures, including both local and national exams (two-tailed significance < .018). Students with very low humanism scores still passed other performance evaluations. CONCLUSIONS: The correlation between humanism and other performance measures is quite low, indicating that a separate measure for humanism provides different and additional information that current performance measures do not include. More humanistic students perform better than their less humanistic peers, but current performance measures do not identify students with the lowest scores on humanistic behavior. This study supports the inclusion of humanism as an additional, independent performance measure.

Clinical Clerkship↗

PubMed1994

Patient-carried card prompts vs computer-generated prompts to remind private practice physicians to perform health maintenance measures.

BACKGROUND: We compared the efficacy of a computer-generated prompt sheet placed on the front of patients' charts with a patient-carried prompt card to remind physicians to perform selected health maintenance items. METHODS: A randomized prospective single-blind study was performed in private practice offices in rural eastern North Carolina, with 28 family practitioners and nine general internists participating. Twenty-two physicians were randomized to the computer prompt group and 22 to the card prompt group. Four physicians in the computer group did not complete the study because of computer software problems, and three physicians did not complete the study because their limited staff was unable to enter patient data into the computer. Before the intervention, 20 patient charts (10 males and 10 females) from each physician were audited for the performance of influenza vaccinations, stool for occult blood, pap smears, breast examinations performed by the physicians, and mammograms. One year after the intervention was instituted, chart audits for the above five items were done again on 20 different patient charts for each physician. RESULTS: There was a 7% increase in the performance of influenza vaccinations in the card group (17% vs 24%) compared with a 6% increase in the computer group (20% vs 26%). There was a 5% decrease in the performance of stool for occult blood in the card group (28% vs 23%) compared with a 1% increase in the computer group (30% vs 31%). There was an 11% decrease in the performance of pap smears in the card group (26% vs 15%) compared with a 3% increase in the computer group (23% vs 26%). There was a 2% decrease in the performance of breast examinations by the physician in the card group (35% vs 33%) compared with a 3% increase in the computer group (30% vs 33%). Finally, there was a 3% increase in the performance of mammograms in the card group (22% vs 25%) compared with an 11% increase in the computer group (15% vs 26%). CONCLUSIONS: Our data show a greater increase in performance of health maintenance items in the computer-prompted group. The performance of stool for occult blood, pap smears, breast examinations performed by the physician, and mammograms were increased more in the computer-prompted group than in the card group. However, there was not a statistically significant difference after intervention for any of the audited health maintenance items for either the computer group or the card group. Overall, health maintenance measures were performed in only a minority of appropriate patients.

Adult↗

PubMed1999

Relationship between visual motor integration skill and academic performance in kindergarten through third grade.

PURPOSE: The objective of this study was to examine the relationship between visual motor integration skill and academic performance in kindergarten through third grade. METHODS: One hundred ninety-one (N = 191) children in kindergarten through third grade (mean age = 7.78 years; 52% male) from an upper-middle class, suburban, primarily Caucasian, elementary school near Cleveland, Ohio were included in this investigation. Visual analysis and visual motor integration skill were assessed with the Beery Developmental Test of Visual Motor Integration (VMI) long form because it is a commonly used test in both optometric and educational practice and has a detailed scoring system. The relationship between performance on the VMI and teachers' ratings of academic achievement was analyzed because teachers' grades are a primary means of assessing school performance. The children's regular classroom teachers rated the children with respect to reading, math, and writing ability. Second and third grade children (N = 98) were also rated on spelling ability. Only experienced teachers were included in the investigation and the validity of the teachers' ratings was substantiated by significant correlations with standardized test scores. Teachers were masked to performance on the VMI until the rating was completed. The Stanford Diagnostic Reading test, 4th edition, was also used as a measure of reading ability in the first graders and the Otis-Lennon School Ability test (OLSAT), 6th edition, was also used as a measure of school-related cognitive ability in the second graders. RESULTS: Performance on the VMI was found to be significantly related to teachers' ratings of the children's reading (p = 0.0001), math (p = 0.0001), writing (p = 0.0001) and spelling (p = 0.0118) ability. An analysis by age group revealed that performance on the VMI was significantly correlated with reading achievement ratings in the 7- and 8- year-olds (p<0.001 and p = 0.002, respectively), with math and writing achievement ratings in the 7-, 8-, and 9-year-olds (math: p<0.001, p = 0.004, and p = 0.003, respectively; writing: p<0.001, p = 0.008, and p = 0.016, respectively), and with spelling achievement ratings in the 8- and 9-year-olds (p = 0.040 and p = 0.007, respectively). VMI scores were also significantly related to performance on the Stanford Reading test in the first graders (p = 0.003) and to performance on the OLSAT in the second graders (verbal score: p = 0.005, nonverbal score: p = 0.002, and total score: p<0.001). In order to partially control for mathematical ability, an additional analysis was performed with children who were identified by the OLSAT as having either below average, average, or above average verbal reasoning scores ability (the verbal reasoning score consists of aural and arithmetic reasoning). This analysis again revealed a significant correlation between the VMI and teachers' achievement ratings in math (p = 0.007 among second grade students with average ability). Finally, in order to partially control for cognitive ability related to writing, an additional analysis was performed with children who were identified by the OLSAT as having either below average, average, or above average nonverbal cluster OLSAT scores. (The nonverbal cluster consists of pictorial and figural reasoning.) This analysis again revealed a significant correlation between the VMI and teachers' achievement ratings in writing (p = 0.001 among average second grade students). CONCLUSION: Performance on a visual analysis and visual motor integration task is significantly related to academic performance in 7-, 8- and 9-year-olds.

Child↗

PubMedDate not supplied

Impact of cardiac symptoms on self-reported household task performance in women with coronary artery disease.

PURPOSE: Household tasks are highly salient physical activities for women. Inability to perform household tasks may serve as an important marker of limitations imposed by cardiac symptoms. The purpose of this study was to examine the impact of cardiac symptoms on perceived ability to perform household tasks in women with coronary artery disease and to examine relationships among age, whether the woman lived alone, ability to perform household tasks, and cardiac-related quality of life. METHODS: Forty-one women with confirmed diagnosis of coronary artery disease and a mean age of 66 years (SD 12 years) were interviewed about the impact of their cardiac symptoms and perceived ability to perform household tasks (Household Activities Scale) and cardiac-related quality of life (Seattle Angina Questionnaire). The women were primarily white (89.4%) and retired (65.9%). Forty-six percent were married, and 26.8% lived alone. RESULTS: "Washing dishes" (51.3%) was the only task a majority of the sample could perform without limitation. Household tasks most commonly reported as no longer performed included carrying laundry (24.4%), vacuuming (30.0%), and scrubbing the floor (51.2%). The task most commonly modified because of cardiac symptoms was changing bed linens (60%). Of the 14 household tasks, women performed a mean of 3.39 (SD 3.36) activities without difficulty. Total number of household activities performed without difficulty was associated with better quality of life in the area of exertional capacity (r = 0.50, P = 0.001). Women who lived alone reported greater perceived ability to perform household tasks than women who did not live alone (r = 0.31, P = 0.05). Age was not significantly associated with perceived household task performance (r = -0.22, P = 0.17). CONCLUSION: Women with coronary artery disease (CAD) perceived cardiac symptoms as disrupting their ability to perform household tasks. Future research is needed to determine the independent impact of cardiac symptoms on functional limitations, especially in older women with heart disease, and whether changes in ability to perform household tasks could be a marker for coronary artery disease progression in women.

Adult↗

PubMed2006

Determinants of real-world functional performance in schizophrenia subjects: correlations with cognition, functional capacity, and symptoms.

OBJECTIVE: Impairments in adaptive life skills are a major source of disability in patients with schizophrenia. The relationship between adaptive life skills in real-world settings and performance on neuropsychological tests may be complicated by other factors that interfere with deployment of skills. Assessment of the ability to perform life skills under optimal conditions (i.e., assessment of functional capacity) has been proposed as a means to clarify these relationships. METHOD: The authors examined cross-sectional data from a study of the course of neuropsychological and adaptive life skills of older (age 50-85) schizophrenia patients (N=78). Functional capacity was examined with a performance-based measure (UCSD Performance-Based Skills Assessment), and case managers rated real-world adaptive functions (i.e., interpersonal skills, work skills, and community activities). Neuropsychological performance was assessed with a comprehensive battery, while symptoms were assessed with patient self-report and clinical ratings. RESULTS: Confirmatory path analyses were used to evaluate the effects of neuropsychological performance, functional capacity, and symptoms on the various domains of real-world functioning. Neuropsychological performance predicted functional capacity, which predicted all three domains of real-world functioning. Depression predicted interpersonal and work skills, while negative symptoms affected interpersonal skills independently of other predictors. CONCLUSIONS: Real-world adaptive life skills are predicted by neuropsychological performance, symptoms, and functional capacity. Neuropsychological performance contributes little to the prediction of real-world performance after accounting for functional capacity. In some domains, negative and depressive symptoms influenced real-world performance while not relating to functional capacity or neuropsychological performance.

Activities of Daily Living↗

PubMed1996

Circadian variation in sports performance.

Chronobiology is the science concerned with investigations of time-dependent changes in physiological variables. Circadian rhythms refer to variations that recur every 24 hours. Many physiological circadian rhythms at rest are endogenously controlled, and persist when an individual is isolated from environmental fluctuations. Unlike physiological variables, human performance cannot be monitored continuously in order to describe circadian rhythmicity. Experimental studies of the effect of circadian rhythms on performance need to be carefully designed in order to control for serial fatigue effects and to minimise disturbances in sleep. The detection of rhythmicity in performance variables is also highly influenced by the degree of test-retest repeatability of the measuring equipment. The majority of components of sports performance, e.g. flexibility, muscle strength, short term high power output, vary with time of day in a sinusoidal manner and peak in the early evening close to the daily maximum in body temperature. Psychological tests of short term memory, heart rate-based tests of physical fitness, and prolonged submaximal exercise performance carried out in hot conditions show peak times in the morning. Heart rate-based tests of work capacity appear to peak in the morning because the heart rate responses to exercise are minimal at this time of day. Post-lunch declines are evident with performance variables such as muscle strength, especially if measured frequently enough and sequentially within a 24-hour period to cause fatigue in individuals. More research work is needed to ascertain whether performance in tasks demanding fine motor control varies with time of day. Metabolic and respiratory rhythms are flattened when exercise becomes strenuous whilst the body temperature rhythm persists during maximal exercise. Higher work-rates are selected spontaneously in the early evening. At present, it is not known whether time of day influences the responses of a set training regimen (one in which the training stimulus does not vary with time of day) for endurance, strength, or the learning of motor skills. The normal circadian rhythms can be desynchronised following a flight across several time zones or a transfer to nocturnal work shifts. Although athletes show all the symptoms of 'jet lag' (increased fatigue, disturbed sleep and circadian rhythms), more research work is needed to identify the effects of transmeridian travel on the actual performances of elite sports competitors. Such investigations would need to be chronobiological, i.e. monitor performance at several times on several post-flight days, and take into account direction of travel, time of day of competition and the various performance components involved in a particular sport. Shiftwork interferes with participation in competitive sport, although there may be greater opportunities for shiftworkers to train in the hours of daylight for individual sports such as cycling and swimming. Studies should be conducted to ascertain whether shiftwork-mediated rhythm disturbances affect sports performance. Individual differences in performance rhythms are small but significant. Circadian rhythms are larger in amplitude in physically fit individuals than sedentary individuals. Athletes over 50 years of age tend to be higher in 'morningness', habitually scheduling relatively more training in the morning and selecting relatively higher work-rates during exercise compared with young athletes. These differences should be recognised by practitioners concerned with organising the habitual regimens of athletes.

Circadian Rhythm↗

PubMed2006

The effect of conformation on orthopaedic health and performance in a cohort of National Hunt racehorses: preliminary results.

REASONS FOR PERFORMING STUDY: There is a lack of scientific data and studies on the effect of conformation on performance or on orthopaedic health. OBJECTIVES: To investigate the relationship between conformation, injury and performance in racehorses used for racing over fences. METHODS: Over 2 years, 108 National Hunt racehorses were followed and their medical and performance data recorded. Conformation was measured in 3D with a computerised motion analysis system. Linear multiple regression models were used to evaluate the effect of conformation on measures of race performance and stepwise forward logistic regression models to assess the effect on risk of injury. RESULTS: An increase in intermandibular width, flexor angle of the shoulder joint and coxal angle (the angle between the ilium and ischium) was demonstrated to have a positive effect on performance. Performance decreased with increasing girth, length of the hind digit and valgus conformation of the metacarpophalangeal joint. The risk of suffering from superficial digital flexor tendon injury increased with increasing metacarpophalangeal joint angle and with carpus valgus conformation. The risk of pelvic fracture increased with valgus conformation of the tarsus and decreased with an increasing coxal angle. CONCLUSION: Valgus deformation was demonstrated to be detrimental to performance or increased risk of injury, perhaps resulting in higher loads on musculoskeletal structures. The coxal angle was the only parameter to have an effect on both risk of injury and performance. An alignment of the muscles with the axis of the pelvis may be beneficial for force transmission and decrease the bending moment of the muscles on the bones. The statistical power of this study is limited, however it provides preliminary data necessary for the planning of a larger scale study on the effect of conformation on performance and risk of injury. CLINICAL RELEVANCE: Studies of the effects of conformation on performance and risk of injury may aid in identifying individuals likely to perform well on the racecourse and avoid risks of injury.

Animals↗

PubMed1999

Emotions, heart rate and performance in archery. A case study.

BACKGROUND: A case study of an elite female archer was conducted to gain insight into individual psychophysical reactions accompanying an athletic event, and to test predictions of pre-performance emotions effects upon performance. Good performance was expected when the actual pre-performance emotions resembled the recalled optimal emotion pattern. Conversely, poor performance was expected when the actual pre-performance emotions paralleled the recalled ineffective emotion pattern. METHODS EXPERIMENTAL DESIGN: the investigation comprised individual emotion profiling, emotions and heart rate monitoring, final interview and performance evaluation. SETTING: The research was accomplished during the 1996 European Archery Championships, one of the most important international archery competitions. PARTICIPANT: An 18-year-old female athlete of the Italian archery national team. INTERVENTIONS: Because of the exploratory nature of the study, no intervention was implemented. MEASURES: Emotion profiling was carried out using an idiographic approach based on recalled optimal and poor performances, according to the Individual Zones of Optimal Functioning (IZOF) model. Emotions, heart rate, and performance were monitored across the five days of practice and competition. RESULTS: Individual pre-performance optimal emotion pattern, heart rate deceleration during shooting, consistent shooting scores were revealed throughout practice and competition. CONCLUSIONS: The good performance predicted on the basis of pre-performance emotion assessments was met and was confirmed by the archer's interpretation.

Adolescent↗