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alert fatigue

Catherine de Blacam, Sean Tierney, Odhran Shelley
BACKGROUND: Surgical training requires exposure to clinical decision-making and operative experience in a supervised environment. It is recognised that learning ability is compromised when fatigued. The European Working Time Directive requires a decrease in working hours, but compliance reduces trainees' clinical exposure, which has profound implications for plastic surgery training. The aim of this study was to evaluate plastic surgery registrars' experience of an EWTD-compliant rota, and to examine its impact on patient care, education, and logbook activity...
October 20, 2016: Journal of Plastic Surgery and Hand Surgery
Katharina A Schindlbeck, Janek Becker, Felix Berger, Arne Mehl, Charlotte Rewitzer, Sarah Geffe, Peter M Koch, Jan C Preiß, Britta Siegmund, Jochen Maul, Frank Marzinzik
PURPOSE: Inflammatory bowel disease has been associated with neurological symptoms including restless legs syndrome. Here, we investigated the impact of restless legs syndrome in patients with inflammatory bowel disease on sleep, fatigue, mood, cognition, and quality of life. METHODS: Two groups of inflammatory bowel disease patients, with and without restless legs syndrome, were prospectively evaluated for sleep disorders, fatigue, daytime sleepiness, depression, anxiety, and health-related quality of life...
October 18, 2016: International Journal of Colorectal Disease
Anne Press, Sundas Khan, Lauren McCullagh, Andy Schachter, Salvatore Pardo, Nina Kohn, Thomas McGinn
No abstract text is available yet for this article.
September 23, 2016: Evidence-based Medicine
Micha Mm Wilhelmus, Justin L Hay, Rob Gja Zuiker, Pieter Okkerse, Christelle Perdrieu, Julien Sauser, Maurice Beaumont, Jeroen Schmitt, Joop Ma van Gerven, Beata Y Silber
Caffeine induces positive effects on sustained attention, although studies assessing the acute effects of low caffeine dose (<75 mg) on sustained attention are limited and use short-term tests. Therefore, we investigated the acute effects of a 60 mg dose of caffeine on sustained attention in tests lasting up to 45 minutes using 82 low or non-caffeine-consuming healthy male (n=41) and female (n=41) adults aged between 40 and 60 years. Vigilance was measured using Mackworth Clock test, Rapid Visual Information Processing Test, adaptive tracking test, saccadic eye movement and attention switch test...
September 20, 2016: Journal of Psychopharmacology
Rachel T Clarke, Ann Van den Bruel, Clare Bankhead, Christopher D Mitchell, Bob Phillips, Matthew J Thompson
OBJECTIVE: Leukaemia is the most common cancer of childhood, accounting for a third of cases. In order to assist clinicians in its early detection, we systematically reviewed all existing data on its clinical presentation and estimated the frequency of signs and symptoms presenting at or prior to diagnosis. DESIGN: We searched MEDLINE and EMBASE for all studies describing presenting features of leukaemia in children (0-18 years) without date or language restriction, and, when appropriate, meta-analysed data from the included studies...
October 2016: Archives of Disease in Childhood
Jaques Reifman, Kamal Kumar, Nancy J Wesensten, Nikolaos A Tountas, Thomas J Balkin, Sridhar Ramakrishnan
STUDY OBJECTIVES: Computational tools that predict the effects of daily sleep/wake amounts on neurobehavioral performance are critical components of fatigue management systems, allowing for the identification of periods during which individuals are at increased risk for performance errors. However, none of the existing computational tools is publicly available, and the commercially available tools do not account for the beneficial effects of caffeine on performance, limiting their practical utility...
September 9, 2016: Sleep
Teresa Cotrim, José Carvalhais, Catarina Neto, Júlia Teles, Paulo Noriega, Francisco Rebelo
In the last two decades the control of the Portuguese railway network has become much more centralized in three centres, there integrating the functions of route flow management, electrical control and signalling. This study aimed to investigate the influence of work and individual determinants in sleepiness among railway control workers, namely socio-demographic factors, work ability, psychosocial factors, shiftwork characteristics, fatigue perception, and sleep. Sleepiness by shift was associated with quality of sleep, job satisfaction, fatigue perception, quantitative demands, and age...
January 2017: Applied Ergonomics
Jean-François Brunet, Dominique Dagenais, Marc Therrien, Daniel Gartenberg, Geneviève Forest
Despite its high sensitivity and validity in the context of sleep loss, the Psychomotor Vigilance Test (PVT) could be improved. The aim of the present study was to validate a new smartphone PVT-type application called sleep-2-Peak (s2P) by determining its ability to assess fatigue-related changes in alertness in a context of extended wakefulness. Short 3-min versions of s2P and of the classic PVT were administered at every even hour during a 35-h total sleep deprivation protocol. In addition, subjective measures of sleepiness were collected...
September 8, 2016: Behavior Research Methods
Rachael Sv Parker, P Parker
BACKGROUND: Fatigue in military operations leads to safety and operational problems due to a decrease in alertness and performance. The primary method of counteracting the effects of sleep deprivation is to increase nightly sleep time, which in operational situations is not always feasible. History has taught us that surgeons and surgical teams are finite resources that cannot operate on patients indefinitely. METHODS: A systematic review was conducted using the search terms 'sleep' and 'deprivation' examining the impact of sleep deprivation on cognitive performance in military surgical teams...
September 13, 2016: Journal of the Royal Army Medical Corps
Maurizio Bossola, Gilda Pepe, Carlo Vulpio
Fatigue is still present in approximately 40%-50% of kidney transplant recipients (KTR), rates comparable to that of the hemodialysis population. Correlates of fatigue include inflammation, symptoms of depression, sleep disorders, and obesity. Fatigue in KTR determines a significant severe functional impairment, either when globally considered or when analyzed at the level of the single domains such as sleep and rest, homemaking, mobility, social interaction, ambulation, leisure activities, alertness behavior, and work limitations...
September 13, 2016: Clinical Transplantation
Haogao Gu, Ross Ka-Kit Leung, Qinlong Jing, Wangjian Zhang, Zhicong Yang, Jiahai Lu, Yuantao Hao, Dingmei Zhang
Dengue fever (DF) is endemic in Guangzhou and has been circulating for decades, causing significant economic loss. DF prevention mainly relies on mosquito control and change in lifestyle. However, alert fatigue may partially limit the success of these countermeasures. This study investigated the delayed effect of meteorological factors, as well as the relationships between five climatic variables and the risk for DF by boosted regression trees (BRT) over the period of 2005-2011, to determine the best timing and strategy for adapting such preventive measures...
2016: International Journal of Environmental Research and Public Health
P Brenner, F Piehl
Multiple sclerosis (MS) is a neuroinflammatory condition with a prominent progressive neurodegenerative facet that typically affects young- or middle-aged adults. Although physical disabilities have been in the foreground by being easier to assess, there is an increasing interest in mental disabilities and psychiatric co-morbidities, which have a disproportionally high impact on important outcome measures such as quality of life and occupational disability. In particular, cognitive impairment, depression and mental fatigue, which mutually interact with each other, seem to be of importance in this context...
September 2016: Acta Neurologica Scandinavica
Lauren Chong, Nathan J Jamieson, Deepak Gill, Davinder Singh-Grewal, Jonathan C Craig, Angela Ju, Camilla S Hanson, Allison Tong
CONTEXT: Epilepsy is a common and severe neurologic disease associated with increased mortality, seizure-related injury, and adverse psychological and quality-of-life outcomes. OBJECTIVE: To describe the perspectives of children and adolescents with epilepsy. DATA SOURCES: Medline, Embase, PsycINFO, and CINAHL from inception to August 2015. STUDY SELECTION: Qualitative studies on children's experiences of epilepsy. DATA EXTRACTION: Results from primary studies...
September 2016: Pediatrics
Maya Dewan, Heather Wolfe, Carola Young, Bimal Desai
BACKGROUND AND OBJECTIVES: A safety event drew attention to unsafe and inappropriate payer formulary alerts. These alerts display formulary, coverage, and eligibility data from the pharmacy benefits manager in response to an electronic prescription. They are intended to redirect prescribers to medications that are covered by insurance; however, these alerts were found to be inaccurate and contribute to potentially harmful alerts. Our objective was to reduce inappropriate payer formulary alerts by 30% within 1 year and to change the ePrescribing certification requirements to prevent future instances of harm...
September 2016: Hospital Pediatrics
Joshua Rolnick, N Lance Downing, John Shepard, Weihan Chu, Julia Tam, Alexander Wessels, Ron Li, Brian Dietrich, Michael Rudy, Leon Castaneda, Lisa Shieh
BACHGROUND: Increasing use of EHRs has generated interest in the potential of computerized clinical decision support to improve treatment of sepsis. Electronic sepsis alerts have had mixed results due to poor test characteristics, the inability to detect sepsis in a timely fashion and the use of outside software limiting widespread adoption. We describe the development, evaluation and validation of an accurate and timely severe sepsis alert with the potential to impact sepsis management...
2016: Applied Clinical Informatics
Nita Lewis Shattuck, Panagiotis Matsangas, John Moore, Laura Wegemann
OBJECTIVES: We assessed the prevalence of, and association among, musculoskeletal (MSK) symptoms, reported sleep, daytime alertness, fatigue, and consumption of caffeinated beverages. METHODS: Crewmembers of a U.S. Navy aircraft carrier (N = 767) completed a survey pertaining to demographics, exercise frequency, sleep duration, caffeinated beverages consumption, daytime sleepiness, fatigue, and MSK symptoms occurrence. RESULTS: Participants reported 6...
July 2016: Military Medicine
George W Williams, Christy A George, Brian C Harvey, Jenny E Freeman
BACKGROUND: Current respiratory monitoring technologies such as pulse oximetry and capnography have been insufficient to identify early signs of respiratory compromise in nonintubated patients. Pulse oximetry, when used appropriately, will alert the caregiver to an episode of dangerous hypoxemia. However, desaturation lags significantly behind hypoventilation and alarm fatigue due to false alarms poses an additional problem. Capnography, which measures end-tidal CO2 (EtCO2) and respiratory rate (RR), has not been universally used for nonintubated patients for multiple reasons, including the inability to reliably relate EtCO2 to the level of impending respiratory compromise and lack of patient compliance...
July 5, 2016: Anesthesia and Analgesia
Mohamed Khalifa, Ibrahim Zabani
Clinical decision support systems (CDSS) are designed to help making clinical decisions regarding the management of patients. CDS alerts can save lives but frequent insignificant ones might cause alert fatigue. Studies discuss that 33% to 96% of clinical alerts are ignored. We categorized best evidence based strategies, to reduce alert fatigue and improve CDSS utilization, into five major areas. Classify alerts in to three main levels; severe, moderate and minor then develop a core set of critical drug to drug interactions...
2016: Studies in Health Technology and Informatics
Stephen J Gleich, Kim Strupp, Robert T Wilder, Daryl J Kor, Randall Flick
BACKGROUND: Malignant hyperthermia (MH) is a rare anesthetic pharmacogenetic disorder that can be difficult to detect in its earliest phases. Prompt treatment is known to improve outcomes. The modern anesthesia information management systems (AIMS) collect enormous amounts of data. However, data lack context and are not able to provide real-time guidance. Utilizing our AIMS, we developed the capacity to incorporate decision support. AIMS: We describe the creation and evaluation of a real-time detection tool for MH...
September 2016: Paediatric Anaesthesia
Halim I Baquapuri, Ali Wajdan, Ekaterina Kutafina, Berno Misgeld, Stephan M Jonas
In recent years the need for informal home care in European countries is growing quickly due to increased life expectancy and demographic change. Informal caregivers have to overcome many obstacles ranging from a lack of adequate training to misjudging their physical and psychological abilities. The aim of this project is to create a low cost wearable device, which unobtrusively measures the physical stress load on caregivers. Two parameters with the most impact on performance and well-being of the caregiver have been identified: (i) fatigue and (ii) back-stress...
2016: Studies in Health Technology and Informatics
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