Subjective and predicted sleepiness while driving in young adults

Sleepiness is a significant contributor to car crashes and sleepiness related crashes have higher mortality and morbidity than other crashes. Young adult drivers are at particular risk for sleepiness related car crashes. It has been suggested that this is because young adults are typically sleepier than older adults because of chronic sleep loss, and more often drive at times of increased risk of acute sleepiness. This prospective study aimed to determine the relationship between predicted and perceived sleepiness while driving in 47 young-adult drivers over a 4-week period. Sleepiness levels were predicted by a model incorporating known circadian and sleep factors influencing alertness, and compared to subjective ratings of sleepiness during 25 18 driving episodes. Results suggested that young drivers frequently drive while at risk of crashing, at times of predicted sleepiness (>7% of episodes) and at times they felt themselves to be sleepy (>23% of episodes). A significant relationship was found between perceived and predicted estimates of sleepiness. However, the participants nonetheless drove at these times. The results of this study may help preventative programs to specifically target factors leading to increased sleepiness when driving (particularly time of day), and to focus interventions to stop young adults from driving when they feel sleepy. (c) 2005 Elsevier Ltd. All rights reserved.

Effects of visual occlusion and fatigue on motor performance in water

The purpose of this study was to test the effects of visual occlusion and fatigue on the motor performance of vertical skills in synchronized swimming. Experienced synchronized swimmers (n = 12) were randomly assigned to either an exercise or nonexercise (control) activity group. Subjective ratings of fatigue were obtained from the swimmers who then each performed four vertical skills under alternating conditions of vision and visual occlusion before and after either a swimming (designed to induce fatigue) or nonphysical activity. A main effect of activity (p < .03) was found for two measures of performance accuracy (lateral and anterior total distance traveled) but not for lateral and anterior maximum deviation from vertical, indicating that fatigue played a role in executing the skills. The data also indicate that the maintenance of a stationary position is a skill of greater difficulty than maintaining a true vertical. In contrast with previous research findings on synchronized swimmers, a significant effect of vision in all conditions was found, with performance decrements in the conditions of visual occlusion showing that vision provided important sensory input for the swimmers.

When differences matter: Intergroup distinctiveness and the evaluation of impostors

The present study examined the effect of intergroup distinctiveness and group membership on evaluations of impostors. We predicted that ingroup members would be harsher than outgroup members on an impostor and that perceptions of intergroup distinctiveness would further moderate these evaluations. Specifically, we tested the social identity theory prediction that low intergroup distinctiveness would lead to greater derogation of the impostor (the 'reactive distinctiveness' hypothesis) against the self-categorization hypothesis that high intergroup distinctiveness would instigate more derogation of an impostor (the 'reflective distinctiveness' hypothesis). In this study, vegetarians (ingroup members) and meat eaters (outgroup members) were presented with a target claiming to be vegetarian, but caught indulging in a meat dish. We found that ingroup members derogated the impostor more and felt less pleased about discovering the impostor behaviour than did outgroup members. In line with the reflective distinctiveness hypothesis, the heightened derogation displayed by ingroup members only emerged when intergroup distinctiveness was high, an effect that was mediated by ratings of group identification. The discussion focuses on the different responses intergroup distinctiveness may evoke. Copyright (c) 2005 John Wiley & Sons, Ltd.

The development of an observation tool for use with parents with psychiatric disability and their preschool children

Community-based treatment and care of people with psychiatric disabilities has meant that they are now more likely to engage in the parenting role. This has led to the development of programs designed to enhance the parenting skills of people with psychiatric disabilities. Evaluation of these programs has been hampered by a paucity of evaluation tools. This study's aim was to develop and trial a tool that examined the parent-child interaction within a group setting, was functional and easy to use, required minimum training and equipment, and had acceptable levels of reliability and validity. The revised tool yielded a single scale with acceptable reliability. It had discriminative validity and concurrent validity with non-independent global ratings of parenting. Sensitivity to change was not investigated. The findings suggest that this method of evaluating parenting is likely to have both clinical and research utility and further investigation of the psychometric properties of the tool is warranted.

Leg muscle recruitment in highly trained cyclists

In this study, we examined patterns of leg muscle recruitment and co-activation, and the relationship between muscle recruitment and cadence, in highly trained cyclists. Electromyographic (EMG) activity of the tibialis anterior, tibialis posterior, peroneus longus, gastrocnemius lateralis and soleus was recorded using intramuscular electrodes, at individual preferred cadence, 57.5, 77.5 and 92.5 rev.min(-1). The influence of electrode type and location on recorded EMG was also investigated using surface and dual intramuscular recordings. Muscle recruitment patterns varied from those previously reported, but there was little variation in muscle recruitment between these highly trained cyclists. The tibialis posterior, peroneus longus and soleus were recruited in a single, short burst of activity during the downstroke. The tibialis anterior and gastrocnemius lateralis were recruited in a biphasic and alternating manner. Contrary to existing hypotheses, our results indicate little co-activation between the tibialis posterior and peroneus longus. Peak EMG amplitude increased linearly with cadence and did not decrease at individual preferred cadence. There was little variation in patterns of muscle recruitment or co-activation with changes in cadence. Intramuscular electrode location had little influence on recorded EMG. There were significant differences between surface and intramuscular recordings from the tibialis anterior and gastrocnemius lateralis, which may explain differences between our findings and those of previous studies.

Controlled trial of multidisciplinary care teams for acutely ill medical inpatients: enhanced multidisciplinary care

Background: Acute hospital general medicine services care for ageing complex patients, using the skills of a range of health-care providers. Evidence suggests that comprehensive early assessment and discharge planning may improve efficiency and outcomes of care in older medical patients. Aim: To enhance assessment, communication, care and discharge planning by restructuring consistent, patient-centred multidisciplinary teams in a general medicine service. Methods: Prospective controlled trial enrolling 1538 consecutive medical inpatients. Intervention units with additional allied health staff formed consistent multidisciplinary teams aligned with inpatient admitting units rather than wards; implemented improved communication processes for early information collection and sharing between disciplines; and specified shared explicit discharge goals. Control units continued traditional, referral-based multidisciplinary models with existing staffing levels. Results: Access to allied health services was significantly enhanced. There was a trend to reduced index length of stay in the intervention units (7.3 days vs 7.8 days in control units, P = 0.18), with no change in 6-month readmissions. in-hospital mortality was reduced from 6.4 to 3.9% (P = 0.03); less patients experienced functional decline in hospital (P = 0.04) and patients' ratings of health status improved (P = 0.02). Additional staffing costs were balanced by potential bed-day savings. Conclusion: This model of enhanced multidisciplinary inpatient care has provided sustainable efficiency gains for the hospital and improved patient outcomes.

Adolescents' reactions to universal and indicated prevention programs for depression: Perceived stigma and consumer satisfaction

There is a common view that one of the major considerations in selecting between universal and indicated interventions is the marked stigma produced by the latter. However, to date there has been no empirical examination of this assumption. The current study examined reported stigma and program satisfaction following two school-based interventions aimed at preventing depression in 532 middle adolescents. The interventions were conducted either across entire classes by classroom teachers (universal delivery) or in small high risk groups by mental health professionals (indicated delivery). The indicated delivery was associated with significantly greater levels of perceived stigma, but effect sizes were small and neither program was associated with marked stigma in absolute terms. Perceived stigma was more strongly associated with aspects of the individual including being male and showing greater externalizing symptomatology. In contrast, the indicated program was evaluated more positively by both participants and program leaders and effect sizes for these measures of satisfaction were moderate to large. The results point to the need for further empirical evaluation of both perceived stigma and program satisfaction in providing balanced considerations of the value of indicated and universal programs.

Evidence for retarded extinction of aversive learning in anxious children

The habituation to intense acoustic stimuli and the acquisition of differentially conditioned fear were assessed in 53 clinically anxious and 30 non-anxious control children and young adolescents. Anxious children tended to show larger electrodermal responses during habituation, but did not differ in blink startle latency or magnitude. After acquisition training, non-anxious children rated the CS + as more fear provoking and arousing than the CS- whereas the ratings of anxious children did not differ. However, anxious children rated the CS + as more fear provoking after extinction, a difference that was absent in non-anxious children. During extinction training, anxious children displayed larger blink magnitude facilitation during CS + and a trend towards larger electrodermal responses, a tendency not seen in nonanxious children. These data suggest that extinction of fear learning is retarded in anxious children. (c) 2005 Elsevier Ltd. All rights reserved.

Long-term outcomes of an Australian universal prevention trial of anxiety and depression symptoms in children and youth: An evaluation of the friends program

This study evaluated the long-term effectiveness of the FRIENDS Program in reducing anxiety and depression in a sample of children from Grade 6 and Grade 9 in comparison to a control condition. Longitudinal data for Lock and Barrett's (2003) universal prevention trial is presented, along with data from 12-month follow-up to 24- and 36-month follow-up. Results of this study indicate that intervention reductions in anxiety reported in Lock and Barrett were maintained for students in Grade 6, with the intervention group reporting significantly lower ratings of anxiety at long-term follow-up. A significant Time times Intervention Group times Gender Effect on Anxiety was found, with girls in the intervention group reporting significantly lower anxiety at 12-month and 24-month follow-up but not at 36-month follow-up in comparison to the control condition. Results demonstrated a prevention effect with significantly fewer high-risk students at 36-month follow-up in the intervention condition than in the control condition. Results are discussed within the context of prevention research.

Multiparametric evaluation of dysphonic severity

In recent years, the multiparametric approach for evaluating perceptual rating of voice quality has been advocated. This study evaluates the accuracy of predicting perceived overall severity of voice quality with a minimal set of aerodynamic, voice range profile (phonetogram), and acoustic perturbation measures. One hundred and twelve dysphonic persons (93 women and 19 men) with laryngeal pathologies and 41 normal controls (35 women and six men) with normal voices participated in this study. Perceptual severity judgement was carried out by four listeners rating the G (overall grade) parameter of the GRBAS scale.(1) The minimal set of instrumental measures was selected based on the ability of the measure to discriminate between dysphonic and normal voices, and to attain at least a moderate correlation with perceived overall severity. Results indicated that perceived overall severity was best described by maximum phonation time of sustained /a/, peak intraoral pressure of the consonant-vowel /pi/ strings production, voice range profile area, and acoustic jitter. Direct-entry discriminant function analysis revealed that these four voice measures in combination correctly predicted 67.3% of perceived overall severity levels.

Pattern and correlates of inpatient admission during the initial acute phase of first-episode psychosis

Objectives: The first aim of this study was to examine the rate, pattern and correlates of inpatient admission during the first 3 months of treatment for first-episode psychosis (FEP). The second aim was to determine whether the pattern of inpatient admission during this period was associated with remission of psychotic symptoms or inpatient service use at 15-month follow-up. Method: One hundred and four consecutive patients with FEP at a specialist treatment service were approached to participate in a follow-up study. Patients were grouped on the basis of the pattern of inpatient admission (none, one, or multiple) during the first 3 months of treatment. Clinical ratings at baseline and 3-month follow-up, and ratings of remission of psychotic symptoms at 3 and 15-month follow-up, were available for two-thirds of the patients. Inpatient data for the 15-month follow-up period were derived from an electronic database for most patients (n = 98). Results: Eighty (76.9%) of the 104 patients were admitted to an inpatient unit during the first 3 months of treatment. Fifty-nine (56.7%) patients had a single admission and 21 (20.2%) had multiple admissions. At baseline, inpatient admission was associated with a diagnosis of affective psychosis and more severe behavioural and functional disturbance but not positive psychotic symptoms. Multiple admissions were associated with risks to self or others at baseline and 3-month follow-up, and lack of remission of positive symptoms at 3 and 15-month follow-up. There was no association between the pattern of inpatient admission during the initial 3-month period and inpatient service use during the following 12-month period. Conclusions: The substantial proportion of young patients with FEP admitted to hospital emphasizes the need for youth-friendly treatment environments and practices. Although patients with multiple admissions during the initial treatment period are less likely to achieve remission, these patients are no more likely to establish a pattern of revolving-door hospitalizations compared with other patients.

When group members admit to being conformist: The role of relative intragroup status in conformity self-reports

Five studies examined the hypothesis that people will strategically portray the self as being more g-roup influenced the more junior they feel within the group. Among social psychologists (Study 1), ratings of self-conformity by g-roup members were greater when the status of the participant was low than when it was high. These effects were replicated in Studies 2, 3, and 4 in which relative intragroup status was manipulated. In Study 3, the authors found junior group members described themselves as more conformist than senior members when they were addressing an ingroup audience, but when they were addressing an outgroup audience the effect disappeared. Furthermore, junior members (but not senior members) rated themselves as more conformist when they were led to believe their responses were public than when responses were private (Study 5). The discussion focuses on the strategic processes underlying low-status group members' self-reports of group influence and the functional role of conformity in groups.

Intergroup processes in intragroup contexts: The roles of group status, group identification and communication in diverse work teams

The present research examines employee identification and communication in organisations. In Study 1, 2229 soldiers from a military organisation completed measures of perceived status and strength of identification with their unit, employment category and their brigade. As predicted, the status of a key organisational group influenced reactions to different organisational groups: full-time soldiers evaluated their work unit and the organisation as being lower in status and identified less strongly with both of these groups than part-time soldiers. The second study extended these findings to a different research context: a large psychiatric hospital undergoing downsizing and restructuring. Surprisingly, there were no differences in survivors' and victims' levels of identification with organisational groups. Instead, and consistent with Study 1, there was evidence to suggest that employees adjusted their patterns of identification and perceptions of group status through a compensatory mechanism that maximised opportunities for selfenhancement and positive distinctiveness. In the third study, employees from a public hospital (N = 142) rated communication from double ingroup members (same work unit/same occupational group) more favourably than communication from partial group members (same work unit/different occupational group). These results are considered in terms of their practical implications for identity management in organisations.

Disruptive vocalization and depression in older nursing home residents

Screaming and other types of disruptive vocalization are commonly observed among nursing home residents. Depressive symptoms are also frequently seen in this group, although the relationship between disruptive vocalization and depressive symptoms is unclear. Accordingly, we sought to examine this relationship in older nursing home residents. We undertook a controlled comparison of 41 vocally disruptive nursing home residents and 43 non-vocally-disruptive nursing home residents. All participants were selected to have Mini-Mental State Examination (MMSE) scores of at least 10. Participants had a mean age of 81.0 years (range 63-97 years) and had a mean MMSE score of 17.8 (range 10-29). Nurse ratings of disruptive vocalization according to a semioperationalized definition were validated against the noisy behavior subscale of the Cohen-Mansfield Agitation Inventory. Subjects were independently rated for depressive symptoms by a psychiatrist using the Dementia Mood Assessment Scale, the Cornell Scale for Depression in Dementia, and the Depressive Signs Scale. Vocally disruptive nursing home residents scored significantly higher than controls on each of these three depression-in-dementia scales. These differences remained significant when the effects of possible confounding variables of cognitive impairment, age, and sex were removed. We conclude that depressive symptoms are associated with disruptive vocalization and may have an etiological role in the generation of disruptive vocalization behaviors in elderly nursing home residents.

Spatial bias and temporal lag in tactile space perception

Constructing a veridical spatial map by touch poses at least two problems for a perceptual system. First, as the hand is moved through space, the locations of features may be displaced if there is an uncorrected lag between the moment the hand encounters a feature and the time that feature is encoded on a spatial map. Second, due to the sequential nature of the process, some form of memory, which itself may be subject to spatial distortions, is required for integration of spatial samples. We investigated these issues using a task involving active haptic exploration with a stylus swept back and forth in the horizontal plane at the wrist. Remembered locations of tactile targets were shifted towards the medial axis of the forearm, suggesting a central tendency in haptic spatial memory, while evidence for a displacement of perceived locations in the direction of sweep motion was consistent with processing delays.