Development and Implementation of a Situation Awareness Workshop to Advance Safe Practice in Novice Nurses.

The current study evaluated the effectiveness of a workshop designed to provide nurses (n = 6) with the means to improve their situation awareness. The nurses participated in a full-day workshop in which their situation awareness performance was measured before and after using the Situation Awareness Global Assessment Technique. Following the workshop, nurses demonstrated improvement in their perception of relevant cues, comprehension of what the combination of cues means, and projection of the patient's future status. The implications of situation awareness education for health-care professionals are discussed.

Effectiveness of auditory and tactile crossmodal cues in a dual-task visual and auditory scenario.

In this study, we examined how spatially informative auditory and tactile cues affected participants' performance on a visual search task while they simultaneously performed a secondary auditory task. Visual search task performance was assessed via reaction time and accuracy. Tactile and auditory cues provided the approximate location of the visual target within the search display. The inclusion of tactile and auditory cues improved performance in comparison to the no-cue baseline conditions. In comparison to the no-cue conditions, both tactile and auditory cues resulted in faster response times in the visual search only (single task) and visual-auditory (dual-task) conditions. However, the effectiveness of auditory and tactile cueing for visual task accuracy was shown to be dependent on task-type condition. Crossmodal cueing remains a viable strategy for improving task performance without increasing attentional load within a singular sensory modality. Practitioner Summary: Crossmodal cueing with dual-task performance has not been widely explored, yet has practical applications. We examined the effects of auditory and tactile crossmodal cues on visual search performance, with and without a secondary auditory task. Tactile cues aided visual search accuracy when also engaged in a secondary auditory task, whereas auditory cues did not.

Military Occupations Most Affected by Head/Sensory Injuries and the Potential Job Impact of Those Injuries.

OBJECTIVE: Identifying Department of Defense (DoD) occupations affected by injuries to the head and sensory systems. METHODS: We explored the Defense Medical Epidemiology Database to identify occupations with the highest incidence of injured personnel, then ranked how frequently they occurred in a top 10 list for each of four injury categories (head/brain, visual, auditory, vestibular) encompassing 25 injury codes. Across all four categories, the most affected occupations were identified, among which we chose three Army combat-related military occupational specialties (MOSs) for detailed study. We identified skills needed to perform these MOSs and explored whether MOS-critical deficits could be expected following the injuries. RESULTS: Some DoD occupations are more likely to suffer from these injuries, including Infantry, Combat Operations Control, Artillery/Gunnery, Motor Vehicle Operator, Combat Engineering, and Armor/Amphibious. Within these DoD occupations, we explored three Army combatant MOSs: Infantry (11B), Cavalry Scout (19D), and Artillery (13B), confirming that these jobs are likely to be disrupted by injuries within the four categories. CONCLUSIONS: Head and sensory injuries disproportionately affect certain military occupations. Relatively few injuries disrupt combat-related abilities that are job critical (e.g., firearms operation) and job specific (e.g., Artillery gunnery problems); these should be the focus of efforts to improve rehabilitation and RTD outcomes.

Comparison of interstimulus intervals on change detection in nondriving and driving scenarios.

Change detection across disruptions of visual scenes is typically studied using brief durations of the interstimulus interval (ISI) (i.e., up to 300 ms). We investigated change detection across durations that approximate longer, voluntary glances away from a visual scene (i.e., 500-2,000 ms), which are often actualized in driving situations. Experiment 1 found that in nondriving scenarios, change detection performance, as measured by accuracy and response time, decreased as ISI increased. Experiment 2 found that in driving scenarios, change detection for plausible changes also decreased as the ISI increased, but there was no similar decrease in performance for implausible changes. Both Experiments 1 and 2 showed that the necessary number of exposures to the change decreased as ISIs approximated voluntary glances, suggesting that change detection strategies may be modified at longer ISI durations.

Efficacy and safety of Sleeping Beauty transposon-mediated gene transfer in preclinical animal studies.

Sleeping Beauty (SB) transposons have been effective in delivering therapeutic genes to treat certain diseases in mice. Hydrodynamic gene delivery of integrating transposons to 5-20% of the hepatocytes in a mouse results in persistent elevated expression of the therapeutic polypeptides that can be secreted into the blood for activity throughout the animal. An alternative route of delivery is ex vivo transformation with SB transposons of hematopoietic cells, which then can be reintroduced into the animal for treatment of cancer. We discuss issues associated with the scale-up of hydrodynamic delivery to the liver of larger animals as well as ex vivo delivery. Based on our and others' experience with inefficient delivery to larger animals, we hypothesize that impulse, rather than pressure, is a critical determinant of the effectiveness of hydrodynamic delivery. Accordingly, we propose some alterations in delivery strategies that may yield efficacious levels of gene delivery in dogs and swine that will be applicable to humans. To ready hydrodynamic delivery for human application we address a second issue facing transposons used for gene delivery regarding their potential to "re-hop" from one site to another and thereby destabilize the genome. The ability to correct genetic diseases through the infusion of DNA plasmids remains an appealing goal.

Age differences in cognitive and psychomotor abilities and simulated driving.

The current study investigated the relationship between drivers' abilities in various cognitive and psychomotor domains and their driving performance. The goal was to identify test measures that could be used to develop a fitness-for-driving test battery, particularly for older drivers. Licensed drivers over 40 years of age (M=65.56 years, SD=13.02) were recruited from university leisure courses (n=18) and drivers under 40 (M=22.20 years, SD=3.79) were recruited from undergraduate and graduate courses (n=44). Participants were given a battery of standard neuropsychological tests used to assess ability in the domains of cognitive processing speed, psychomotor functioning, visuospatial performance, sustained attention, and executive functioning. Participants' driving ability was assessed in a simulator with data collected in three categories of driving performance: (a) driver control maintenance behaviors, (b) accidents and violations, and (c) attention and reaction time. Younger participants outperformed older participants in 4 out of the 5 domains of neuropsychological testing (all but sustained attention). Age differences were found in simulator driving accidents and violations and driving performance was significantly correlated with neuropsychological test performance. The results are discussed in terms of the potential to use these tests to assess older drivers seeking license renewal or for selecting professional drivers for the transportation industry.

Self-report measures of distractibility as correlates of simulated driving performance.

The present study investigated the relationship between self-reported measures pertaining to attention difficulties and simulated driving performance while distracted. Thirty-six licensed drivers participated in a simulator driving task while engaged in a cell phone conversation. The participants completed questionnaires assessing their tendency toward boredom, cognitive failures, and behaviors associated with attention deficit and hyperactivity. Scores on these measures were significantly correlated with various driving outcomes (e.g., speed, lane maintenance, reaction time). Significant relationships were also found between one aspect of boredom proneness (i.e., inability to generate interest or concentrate) and self-reports of past driving behavior (moving violations). The current study may aid in the understanding of how individual differences in driver distractibility may contribute to unsafe driving behaviors and accident involvement. Additionally, such measures may assist in the identification of individuals at risk for committing driving errors due to being easily distracted. The benefits and limitations of conducting and interpreting simulation research are discussed.

Cyclic variations in sustained human performance.

Biological rhythms play a prominent role in the modulation of human physiology and behavior. [Smith, K., Valentino, D., & Arruda, J. (2003). Rhythmic oscillations in the performance of a sustained attention task. Journal of Clinical and Experimental Neuropsychology, 25, 561-570] suggested that sustained human performance may systematically fluctuate in a cyclic manner with periods of 1.5 min and 5.2 min. The current series of investigations sought to manipulate those periodicities by altering task difficulty, administering caffeine, and testing on a more ecologically valid task. Strong evidence of a 1.5 min periodicity was found across studies. Most participants did not demonstrate the 5.2 min periodicity. Moreover, the 1.5 min periodicity was resistant to task manipulations and appeared in similar levels across conditions in all three experiments. These rhythms may be indicative of an endogenous system that modulates sustained attention in humans. Evidence supporting this idea and implications of the research are discussed.

Cognitive failures, driving errors and driving accidents.

INTRODUCTION: The impact of a driver's cognitive capability on traffic safety has not been adequately studied. This study examined the relationship between cognitive failures, driving errors and accident data. METHOD: Professional drivers from Iran (160 males, ages 18-65) participated in this study. The cognitive failures questionnaire (CFQ) and the driver error questionnaire were administered. The participants were also asked other questions about personal driving information. A principal component analysis with varimax rotation was performed to determine the factor structure of the CFQ. Poisson regression models were developed to predict driving errors and accidents from total CFQ scores and the extracted factors. RESULTS: Total CFQ scores were associated with driving error rates, but not with accidents. However, the 2 extracted factors suggested an increased effect on accidents and were strongly associated with driving errors. DISCUSSION: Although the CFQ was not able to predict driving accidents, it could be used to identify drivers susceptible to driving errors. Further development of a driving-oriented cognitive failure scale is recommended to help identify error prone drivers. Such a scale may be beneficial to licensing authorities or for developing driver selection and training procedures for organizations.

Engrossed in conversation: the impact of cell phones on simulated driving performance.

The current study examined the effects of cognitively distracting tasks on various measures of driving performance. Thirty-six college students with a median of 6 years of driving experience completed a driving history questionnaire and four simulated driving scenarios. The distraction tasks consisted of responding to a signal detection task and engaging in a simulated cell phone conversation. Driving performance was measured in terms of four categories of behavior: traffic violations (e.g., speeding, running stop signs), driving maintenance (e.g., standard deviation of lane position), attention lapses (e.g., stops at green lights, failure to visually scan for intersection traffic), and response time (e.g., time to step on brake in response to a pop-up event). Performance was significantly impacted in all four categories when drivers were concurrently talking on a hands-free phone. Performance on the signal detection task was poor and not significantly impacted by the phone task, suggesting that considerably less attention was paid to detecting these peripheral signals. However, the signal detection task did interact with the phone task on measures of average speed, speed variability, attention lapses, and reaction time. The findings lend further empirical support of the dangers of drivers being distracted by cell phone conversations.

A confirmatory approach to the factor structure of the Boredom Proneness Scale: evidence for a two-factor short form.

We analyzed previous exploratory factor analytic structures on the Boredom Proneness Scale (BPS; Farmer & Sundberg, 1986) using confirmatory factor analysis in structural equation modeling in LISREL 8 (Jöreskog & Sörbom, 1993). These analyses indicated that 2 factors were generally consistent across 6 exploratory models. Items that had significant loadings on these two factors (N = 12; 6 for each factor) indicated a lack of Internal Stimulation and External Stimulation. In further analysis on these 12 items using LISREL, we found a much improved fit and provided support for a short form version of the original BPS. We also found the shortened version to be invariant across gender. We discuss implications for the more precise measurement of boredom proneness and the use of the scale in applied settings.

Internet use and misuse. Preliminary findings from a new assessment instrument.

The internet is an affordable and easily accessible technology that has many potential applications to psychology. Interactive technologies engage users psychologically and may facilitate adaptive and maladaptive behaviors. This research explored the Internet-use patterns, psychological characteristics, and negative consequences associated with online activities of 393 college students using the Internet Use Survey (IUS), a self-report instrument designed to administer online. Results indicated that participants spent an average of 3.3 total hours per day on the Internet during the past 12 months and used the medium for multiple purposes. Although participants reported the occurrence of some potentially negative consequences related to Internet use, the prevalence rates for most problematic behaviors were generally low. Exploratory principal component analysis of the IUS subscale that attempts to measure Internet-related impairment revealed four factors: absorption, negative consequences, disrupted sleep, and deception. All of these factors were then significantly related to a measure of boredom proneness. This research supports the necessity for multidimensional assessment (e.g., frequency and context) of Internet usage to enhance our understanding of how this new technology interfaces with users psychologically and behaviorally.

Boredom proneness and sleep disorders as predictors of adult attention deficit scores.

This study examined the extent to which boredom proneness and sleep disturbances were related to attention deficit scores in college-aged adults. In a sample of 148 college students, Attention scores on the Adult Behavior Checklist were best predicted by Boredom Proneness (BP) subscale scores, which assess one's inability to maintain internal stimulation and feelings of constraint, and scores on the Epworth Daytime Sleepiness Scale and Athens Insomnia Scale (R2 = .57). Hyperactivity scores were best predicted by the BP subscales, which assess one's need for a stimulating environment, the perception of time passing slowly, and feelings of constraint, and the Epworth Scale (R2 = .51). The findings contribute to the understanding of the symptomatology of attention deficit in adults and provide further evidence of the validity of this measure.

The cognitive failures questionnaire revisited: dimensions and correlates.

The authors reexamined the factor structure of the Cognitive Failures Questionnaire (D. E. Broadbent, P. F. Cooper, P. Fitzgerald, & K. R. Parkes, 1982) and its correlates. The Cognitive Failures Questionnaire was designed to assess a person's likelihood of committing an error in the completion of an everyday task. A principal components factor analysis with varimax rotation yielded 4 internally consistent, interpretable factors. These factors were labeled Memory, Distractibility, Blunders, and (memory for) Names. This study lends partial support for the factor analytic solution proposed by L. K. Pollina, A. L. Greene, R. H. Tunick, and J. M. Puckett (1992). In addition, it extends previous findings by providing initial evidence for the construct validity of the factors established by correlating factor scores with measures of other related constructs (i.e., boredom proneness, attention deficit/hyperactivity disorder, Type A behavior pattern).

Behavioral and pharmacologic treatment of transformed migraine with analgesic overuse: outcome at 3 years.

OBJECTIVE: To determine whether combined treatment using medication and biofeedback would be more effective than drug treatment alone for treating transformed migraine complicated by analgesic overuse. BACKGROUND: Headaches that are chronic, daily, and aggravated by medication overuse are particularly difficult to treat. METHODS: Sixty-one consecutive patients with transformed migraine and analgesic overuse were treated with inpatient pharmacologic therapy alone or with inpatient pharmacologic therapy combined with biofeedback-assisted relaxation. All patients then were followed prospectively for 3 years. RESULTS: Both treatment groups exhibited similar levels of improvement immediately following treatment and for 1 year thereafter. At year 3, participants receiving combined treatment showed greater sustained improvement on two of three outcome measures assessed (ie, fewer days of headache and reduced consumption of analgesic medication). In addition, a greater number of patients assigned to pharmacologic treatment alone relapsed (ie, resumed overuse of analgesics) compared to patients receiving combined treatment. CONCLUSIONS: These results suggest that a combination of pharmacologic and behavioral treatment is more effective than drug therapy alone in the long-term management of transformed migraine with analgesic overuse. Confirmation of these findings, as well as extension to other forms of behavioral and cognitive-behavioral treatment, is required.