One night CPAP withdrawal impairs performance at a driving simulator task faster than sleep restriction to 5 hours with treatment in OSA patients

Introduction Sleep restriction and missing 1 night’s continuous positive air pressure (CPAP) treatment are scenarios faced by obstructive sleep apnoea (OSA) patients, who must then assess their own fitness to drive. This study aims to assess the impact of this on driving performance. Method 11 CPAP treated participants (50–75 yrs), drove an interactive car simulator under monotonous motorway conditions for 2 hours on 3 afternoons, following;(i)normal night’s sleep (average 8.2 h) with CPAP (ii) sleep restriction (5 h), with CPAP (iii)normal length of sleep, without CPAP. Driving incidents were noted if the car came out of the designated driving lane. EEG was recorded continually and KSS reported every 200 seconds. Results Driving incidents: Incidents were more prevalent following CPAP withdrawal during hour 1, demonstrating a significant condition time interaction [F(6,60) = 3.40, p = 0.006]. KSS: At the start of driving participants felt sleepiest following CPAP withdrawal, by the end of the task KSS levels were similar following CPAP withdrawal and sleep restriction, demonstrating a significant condition, time interaction [F(3.94,39.41) = 3.39, p = 0.018]. EEG: There was a non significant trend for combined alpha and theta activity to be highest throughout the drive following CPAP withdrawal. Discussion CPAP withdrawal impairs driving simulator performance sooner than restricting sleep to 5 h with CPAP. Participants had insight into this increased sleepiness reflected by the higher KSS reported following CPAP withdrawal. In the practical terms of driving any one incident could be fatal. The earlier impairment reported here demonstrates the potential danger of missing CPAP treatment and highlights the benefit of CPAP treatment even when sleep time is short.

The poor penetration of topical burn agent through burn eschar on a porcine burn model [Letter to the Editor]

We read with great interest the article entitled “Enhancing drugs absorption through third-degree burn wound eschar” by Manafi et al. [1]. The authors addressed the concern of poor penetration of topically applied anti-microbials through burn eschar and detailed the improvement of this penetration by penetration enhancers. Here, we would like to report the poor penetration of a topical agent into the viable deep dermal layer under burn eschar on a porcine burn model [2]. In burn treatment, a common practice is the topical application of either anti-microbial products or wound enhancing agents. While the activity of anti-microbial products is designed to fight against microbes on the wound surface but with the least toxicity to viable tissue, wound enhancing agents need to reach the viable tissue layer under the burn eschar. Many studies have reported the accelerated healing of superficial burn wounds and skin graft donor sites by the topical application of exogeneous growth factors [3]. It is well known that the efficacy of the penetration of a topical agent on intact skin mostly depends on the molecular size of the product [4] and [5]. While burn injury destroys this epidermal physiological barrier, the coagulated burn tissue layer on the burn wound surface makes it difficult for topical agents to reach viable tissue....

Fetuin-A : a major fetal serum protein that promotes "wound closure" and scarless healing [Letter to the Editor]

Burn-wound healing is a dynamic, interactive process involving a number of cellular and molecular events and is characterized by inflammation, granulation tissue formation, re-epithelialization, and tissue remodeling (Greenhalgh, 2002; Linares, 2002). Unlike incisional-wound healing, it also requires extensive re-epithelialization due to a predominant horizontal loss of tissue and often heals with abnormal scarring when burns involve deep dermis. The early mammalian fetus has the remarkable ability to regenerate normal epidermis and dermis and to heal dermal incisional wounds with no signs of scarring. Extensive research has indicated that scarless healing appears to be intrinsic to fetal skin (McCallion and Ferguson, 1996; Ferguson and O’Kane, 2004). Previously, we reported a fetal burn model, in which 80-day-old ovine fetuses (gestation¼ 145–153 days) healed deep dermal partial thickness burns without scars, whereas postnatal lambs healed equal depth burns with significant scarring (Cuttle et al., 2005; Fraser et al., 2005). This burn model provided early evidence that fetal skin has the capacity to repair and restore dermal horizontal loss, not just vertical injuries.

Acticoat™ : A cost-effective and evidence-based dressing strategy [Letter to the Editor]

We thank Dr. Burd et al. for taking an interest in our paper [1]. The retrospective cohort study was performed and published for two reasons. Firstly, we wished to compare and contrast the use of Acticoat™ and Silvazine™, and secondly we wished to demonstrate how one's practice can be dramatically altered by a change in dressing used. We found that Acticoat™ was safe and easy to use, caused less trauma to patients, required less frequent dressing changes and enabled treatment to be conducted on an outpatient, rather than an inpatient basis. During the period of Acticoat™ treatment we also saw a dramatic reduction in grafting requirements and also in the need for long-term scar management. Burd et al. correctly state that silver-based dressings are now more widely available, however many burn centres in the world continue to use silver sulphadiazine with daily baths. We therefore feel that a comparison is very relevant and useful. Prospective, randomised clinical trials of a range of silver-based dressings would indeed be useful, and hopefully Dr. Burd and colleagues will take up their own suggestion and perform these studies...

Task constraints

Newell (1985, 1986) identified the importance of interacting constraints on the emergent behaviours of learners or performers in sport as they assemble functional states of movement organisation in achieving task goals. Constraints, related to the person, task and environment, were defined as ‘boundaries or features that limit motion of the entity under consideration at any moment in time’ (Newell, 1986, p.347). Personal (or organismic) constraints include factors such as individual anthropometrics (height, weight, and limb lengths), fitness (e.g., strength, speed, aerobic capacity, and flexibility), mental skills (e.g. concentration, confidence, emotional control and motivation), perceptual and decisionmaking skills (e.g., recognising patterns of play, anticipation by reading the movements of opponents) and personality factors (e.g., risk taking or conservative behaviours). Newell (1986, p.350) distinguished between general environmental constraints, such as gravity, ambient temperature, natural light and altitude and task constraints, which are task specific and concerned with the goals of a specific activity. More recently, socio-cultural constraints (e.g., family support, cultural expectations and access to facilities) have also been considered as environmental constraints. Application of the constraints framework to the study of sport performance has led to task constraints being defined to include factors such as rules of games, equipment used, boundary playing areas and markings, nets and goals, the number of...

Revisiting sub-topic retrieval in the ImageCLEF 2009 photo retrieval task

Ranking documents according to the Probability Ranking Principle has been theoretically shown to guarantee optimal retrieval effectiveness in tasks such as ad hoc document retrieval. This ranking strategy assumes independence among document relevance assessments. This assumption, however, often does not hold, for example in the scenarios where redundancy in retrieved documents is of major concern, as it is the case in the sub–topic retrieval task. In this chapter, we propose a new ranking strategy for sub–topic retrieval that builds upon the interdependent document relevance and topic–oriented models. With respect to the topic– oriented model, we investigate both static and dynamic clustering techniques, aiming to group topically similar documents. Evidence from clusters is then combined with information about document dependencies to form a new document ranking. We compare and contrast the proposed method against state–of–the–art approaches, such as Maximal Marginal Relevance, Portfolio Theory for Information Retrieval, and standard cluster–based diversification strategies. The empirical investigation is performed on the ImageCLEF 2009 Photo Retrieval collection, where images are assessed with respect to sub–topics of a more general query topic. The experimental results show that our approaches outperform the state–of–the–art strategies with respect to a number of diversity measures.

ShARe/CLEF eHealth Evaluation Lab 2013, Task 3: Information retrieval to address patients' questions when reading clinical reports

This paper presents the results of task 3 of the ShARe/CLEF eHealth Evaluation Lab 2013. This evaluation lab focuses on improving access to medical information on the web. The task objective was to investigate the effect of using additional information such as the discharge summaries and external resources such as medical ontologies on the IR effectiveness. The participants were allowed to submit up to seven runs, one mandatory run using no additional information or external resources, and three each using or not using discharge summaries.

Task modeling for collaborative authoring

Motivation ?Task analysis for designing modern collaborative work needs a more fine grained approach. Especially in a complex task domain, like collaborative scientific authoring, when there is a single overall goal that can only be accomplished only by collaboration between multiple roles, each requiring its own expertise. We analyzed and re-considered roles, activities, and objects for design for complex collaboration contexts. Our main focus is on a generic approach to design for multiple roles and subtasks in a domain with a shared overall goal, which requires a detailed approach. Collaborative authoring is our current example. This research is incremental: an existing task analysis approach (GTA) is reconsidered by applying it to a case of complex collaboration. Our analysis shows that designing for collaboration indeed requires a refined approach to task modeling: GTA, in future, will need to consider tasks at the lowest level that can be delegated or mandates. These tasks need to be analyzed and redesigned in more in detail, along with the relevant task object.

Distinguishing between task and contextual performance for nurses : development of a job performance scale

Aim. This paper is a report of a development and validation of a new job performance scale based on an established job performance model. Background. Previous measures of nursing quality are atheoretical and fail to incorporate the complete range of behaviours performed. Thus, an up-to-date measure of job performance is required for assessing nursing quality. Methods. Test construction involved systematic generation of test items using focus groups, a literature review, and an expert review of test items. A pilot study was conducted to determine the multidimensional nature of the taxonomy and its psychometric properties. All data were collected in 2005. Findings. The final version of the nursing performance taxonomy included 41 behaviours across eight dimensions of job performance. Results from preliminary psychometric investigations suggest that the nursing performance scale has good internal consistency, good convergent validity and good criterion validity. Conclusion. The findings give preliminary support for a new job performance scale as a reliable and valid tool for assessing nursing quality. However, further research using a larger sample and nurses from a broader geographical region is required to cross-validate the measure. This scale may be used to guide hospital managers regarding the quality of nursing care within units and to guide future research in the area.

The stress-buffering effects of control on task satisfaction and perceived goal attainment : an experimental study of the moderating influence of desire for control

The purpose of the present study was to examine the extent to which Desire for Control (DFC) interacts with experimental manipulations of demand and control, and the consequences of these interactions on task satisfaction and perceived goal attainment (i.e. task performance and task mastery). It was expected that the proposed stress-buffering effects of control would be evident only for individuals high in DFC. Moreover, it was anticipated that control may have a stress-exacerbating effect for those low in DFC. These hypotheses were tested on a sample of 137 first year psychology students who participated in an in-basket activity under low and high conditions of demand and control. Results revealed that the proposed stress-buffering effect of control was found only for those high in DFC and a stress-exacerbating effect of increased control was evident for those low in DFC on task performance and task mastery perceptions. Future research directions and the implications of these findings to applied settings are discussed.

Task-relationship-self : a framework for understanding service encounter behaviors

Research conducted over past decades has investigated selected service encounter behaviors from either a customer or service provider perspective. However, a comprehensive, dual-perspective framework is lacking. Such a framework is needed to organize knowledge of these behaviors, and thereby provide structure, clarity, and parsimony to the field. This paper describes a three-tier framework of service encounter behavior that was developed by applying grounded theory principles to interviews with customers, service employees, and other stakeholders. These informants described many ways in which they behave when executing service exchanges, dealing with service difficulties, and managing themselves in the process. Using an iterative inductive approach, a conceptual framework was developed in which specific (Tier 1) behaviors were placed within broader (Tier 2) categories, and these lower classification levels were, in turn, interpreted within a conceptual space defined by the (Tier 3) dimensions of task, relationship, and self. This framework was then elaborated and refined by reference to the psychology and marketing literature, a set of 157 audio-recorded service interactions, and an expert panel study. The paper includes comparisons between the framework and those previously proposed, propositions regarding service encounter processes and outcomes, and implications for future research and practice.

General self-efficacy influences affective task reactions during a work simulation : the temporal effects of changes in workload at different levels of control

This study investigated the effects of workload, control, and general self-efficacy on affective task reactions (i.e., demands-ability fit, active coping, and anxiety) during a work simulation. The main goals were: (1) to determine the extent general self-efficacy moderates the effects of demand and control on affective task reactions, and; (2) to determine if this varies as a function of changes in workload. Participants (N=141) completed an inbox activity under conditions of low or high control and within low and high workload conditions. The order of trials varied so that workload increased or decreased. Results revealed individuals with high general self-efficacy reported better demands-abilities fit and active coping as well as less anxiety. Three interactive effects were found. First, it was found that high control increased demands-abilities fit from trial 1 to trial 2, but only when workload decreased. Second, it was found that low efficacious individuals active coping increased in trial 2, but only under high control. Third, it was found that high control helped high efficacious individuals manage anxiety when workload decreased. However, for individuals with low general self-efficacy, neither high nor low control alleviated anxiety (i.e., whether workload increased or decreased over time).

Automatic inference of driving task demand from visual cues of emotion and attention

Sensing the mental, physical and emotional demand of a driving task is of primary importance in road safety research and for effectively designing in-vehicle information systems (IVIS). Particularly, the need of cars capable of sensing and reacting to the emotional state of the driver has been repeatedly advocated in the literature. Algorithms and sensors to identify patterns of human behavior, such as gestures, speech, eye gaze and facial expression, are becoming available by using low cost hardware: This paper presents a new system which uses surrogate measures such as facial expression (emotion) and head pose and movements (intention) to infer task difficulty in a driving situation. 11 drivers were recruited and observed in a simulated driving task that involved several pre-programmed events aimed at eliciting emotive reactions, such as being stuck behind slower vehicles, intersections and roundabouts, and potentially dangerous situations. The resulting system, combining face expressions and head pose classification, is capable of recognizing dangerous events (such as crashes and near misses) and stressful situations (e.g. intersections and way giving) that occur during the simulated drive.