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OBJECTIVES: To investigate whether chronotype is a moderator variable that also interacts with shift type and whether they jointly influence the attention performance of nurses working in acute and critical care units. METHODS: We adopted a longitudinal research design focusing on nurses working rotating shifts in the emergency room and intensive care units at a medical center. A total of 40 complete samples were obtained. Data analysis was conducted using the generalized estimating equations in SAS 9.4. RESULTS: The mean (SD) age of the participants was 26.35 (2.12) years. After controlling for age, gender, and sleep duration, an interaction effect was discovered between a specific chronotype and shift type; that is, the interaction effect between chronotype and shift type was only significant when comparing late-types working the night shift with early- and intermediate-types working the night shift (B = -18.81, P = .011). The least squares means of the mean reaction time of the interaction effects between the 2 chronotype groups and the 3 shift types found that the mean reaction time of late-types working the night shift was 11.31 ms (P = .044) slower compared with working the day shift. CONCLUSIONS: The chronotype is a moderator variable between shift type and mean reaction time, such that matching the chronotype of nurses in acute and critical care units with the appropriate shift type improved their mean reaction time. It is hoped that the results of this study could serve as a reference for acute and critical care nurses when scheduling their shifts.

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Sleep deprivation (SD) negatively affects several aspects of cognitive performance, and one of the most widely-used tools to evaluate these effects is the Psychomotor Vigilance Test (PVT). The present study investigated the possibility of predicting changes induced by SD in vigilant attention performance by evaluating the baseline electroencephalographic (EEG) activity immediately preceding the PVT stimuli onset. All participants (n = 10) underwent EEG recordings during 10 min of PVT before and after a night of SD. For each participant, the root mean square (RMS) of the baseline EEG signal was evaluated for each 1 s time window, and the respective average value was computed. After SD, participants showed slower (and less accurate) performance in the PVT task. Moreover, a close relationship between the changes in the baseline activity with those in cognitive performance was identified at several electrodes (Fp2, F7, F8, P3, T6, O1, Oz, O2), with the highest predictive power at the occipital derivations. These results indicate that vigilant attention impairments induced by SD can be predicted by the pre-stimulus baseline activity changes.

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Gross anatomy is located in a three-dimensional space. Visualizing aspects of structures in gross anatomy education should aim to provide information that best resembles their original spatial proportions. Stereoscopic three-dimensional imagery might offer possibilities to implement this aim, though some research has revealed potential impairments that may result from observing stereoscopic visualizations, such as discomfort. However, possible impairments of working memory such as decreased visual attention performance due to applying this technology in gross anatomy education have not yet been investigated. Similarly, in gross anatomy education the impact of stereoscopic imagery on learners' recognition of anatomical-spatial relationships and the impact of different presentation formats have only been investigated in a small number of studies. In this study, the performance of 171 teacher trainees working on the anatomy of hearing was examined, either with non-stereoscopic or stereoscopic imagery. Static and dynamic picture presentations were applied. Overall, benefits for stereoscopic imagery on estimating anatomical-spatial relations were found. The performance on a visual attention test indicates that the impact of stereoscopic visualizations on the human cognitive system varies more from person to person compared to non-stereoscopic visualizations. In addition, combinations of temporarily moving pictures and stereoscopic imagery lead to decreased visual attention performance compared to combinations of moving pictures and non-stereoscopic imagery. Anat Sci Educ 11: 15-24. © 2017 American Association of Anatomists.

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OBJECTIVE: Neurophysiologic monitoring parameters related to cognition in Multiple Sclerosis (MS) are sparse. Previous work reported an association between magnetoencephalographic (MEG) alpha-1 activity and information processing speed. While this remains to be replicated by more available electroencephalographic (EEG) methods, also other established EEG markers, e.g. the slow-wave/fast-wave ratio (theta/beta ratio), remain to be explored in this context. METHODS: Performance on standard tests addressing information processing speed and attention (Symbol-Digit Modalities Test, SDMT; Test of Attention Performance, TAP) was examined in relation to resting-state EEG alpha-1 and alpha-2 activity and the theta/beta ratio in 25MS patients. RESULTS: Increased global alpha-1 and alpha-2 activity and an increased frontal theta/beta ratio (pronounced slow-wave relative to fast-wave activity) were associated with lower SDMT processing speed. In an exploratory analysis, clinically impaired attention was associated with a significantly increased frontal theta/beta ratio whereas alpha power did not show sensitivity to clinical impairment. CONCLUSIONS: EEG global alpha power and the frontal theta/beta ratio were both associated with attention. The theta/beta ratio involved potential clinical sensitivity. SIGNIFICANCE: Resting-state EEG recordings can be obtained during the routine clinical process. The examined resting-state measures may represent feasible monitoring parameters in MS. This notion should be explored in future intervention studies.

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OBJECTIVE: Cognitive impairment is associated with insomnia. However, there is a lack of evidence suggesting a link between insomnia and cognitive dysfunction in objective testing. The objectives of our current study were to assess the differences in components of attentional performance between primary insomnia patients and normal-sleeping controls and to examine potential predictors of attention impairment in patients with insomnia. METHODS: We studied 36 patients (age 40.39 ± 12.36 years; 57.1% male) with insomnia and 25 normal-sleeping controls (age 39.88 ± 12.50 years; 52.9% male) who underwent one-night polysomnography followed by Multiple Sleep Latency Test (MSLT) and Attention Network Task (ANT). ANT reflected three attentional networks termed the alerting, orienting, and executive control networks. RESULTS: After controlling for age, gender, body mass index, depression, anxiety, and education levels, patients with insomnia scored higher on the executive control variable of the ANT compared with normal-sleeping controls (96.75 ± 7.60 vs. 57.00 ± 10.49, p = 0.01). This higher score was independently associated with insufficiency of slow-wave sleep during nighttime sleep (ß = -0.38, p = 0.04). CONCLUSION: Our findings suggest that insomnia is associated with deficits in executive control of attention and that the underlying mechanism may be insufficiency of slow-wave sleep in chronic insomnia.

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BACKGROUND: In addition to demonstrating that human emotions improve work attention performance, numerous studies have also established that music alters human emotions. Given the pervasiveness of background music in the workplace, exactly how work attention, emotions and music listening are related is of priority concern in human resource management. OBJECTIVES: This preliminary study investigates the relationship between work attention performance and emotions arising from listening to music. PARTICIPANTS: Thirty one males and 34 females, ranging from 20-24 years old, participated in this study following written informed consent. METHODS: A randomized controlled trial (RCT) was performed in this study, which consisted of six steps and the use of the standard attention test and emotion questionnaire. RESULTS: Background music with lyrics adversely impacts attention performance more than that without lyrics. Analysis results also indicate that listeners self-reported feeling "loved" while music played that implied a higher score on their work-attention performance. Moreover, a greater ability of music to make listeners feel sad implied a lower score on their work-attention performance. CONCLUSIONS: Results of this preliminary study demonstrate that background music in the workplace should focus mainly on creating an environment in which listeners feel loved or taken care and avoiding music that causes individuals to feel stressed or sad. We recommend that future research increase the number of research participants to enhance the applicability and replicability of these findings.

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BACKGROUND: Prenatal exposure to polychlorinated biphenyls (PCBs) and lead are thought to be risk factors for attention-deficit hyperactivity disorder (ADHD), whereas the prenatal influence of polychlorinated dibenzo-p-dioxins and -furans (PCDD/Fs) on attention performance has been less studied. OBJECTIVES: Within the Duisburg Birth Cohort Study, we investigated low-level exposure to these compounds in relation to children's attention. METHODS: We measured blood levels of PCDD/Fs, PCBs and lead from pregnant mothers (32(nd) week of pregnancy) and PCDD/Fs and PCBs in breast milk (2 weeks after delivery). The attention of school-aged children (N=117) was investigated with a computer-based test battery of attention performance (KITAP) and a parent rating questionnaire of behaviors related to ADHD (FBB-ADHS). Influences of the exposure on attention were analyzed by multiple regression analyses. RESULTS: Increasing prenatal PCDD/F and PCB concentrations were significantly (p<0.05) associated with a higher number of omission errors in the subtest Divided Attention (47% and 42%; 95% confidence intervals (95%-CI): 1.08-2.00 and 1.07-1.89, respectively). Prenatal lead concentrations had few significant associations with attention performance (e.g., a 23% higher number of omission errors in the subtest Distractibility; 95%-CI: 1.00-1.51), whereas ADHD-related behavior (questionnaire based) was increased with increasing lead exposure (Overall-ADHD: 9%; 95%-CI: 1.01-1.17). ADHD-related behavior was negatively associated with prenatal PCDD/F or PCB exposures (e.g., for PCB exposure: -10%; 95%-CI: 0.82-0.99). CONCLUSIONS: Pre- and perinatal PCDD/F and PCB exposure may have subtle influences on attention performance in healthy children at low environmental levels, while behavior changes are negatively associated. Furthermore, we provide additional evidence for the impact of prenatal lead exposure on attention deficits.

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OBJECTIVE: To determine attention performance of medical students after sleep deprivation due to night shift work. METHODS: Prospective cohort design. All seventh, eighth and ninth semester students were invited to participate (n= 209). The effectiveness and concentration indices (d2 Test for attention, dependent variable) from 180 students at 3 evaluations during the semester were compared. Eighth and ninth semester students underwent their second evaluation after a night shift. The independent variables were nocturnal sleep measurements. RESULTS: No differences in nocturnal sleep hours during the previous week (p=0.966), sleep deprivation (p=0.703) or effectiveness in the d2 Test (p=0.428) were found between the groups at the beginning of the semester. At the beginning and the end of the semester, the d2 Test results were not different between groups (p=0.410, p=0.394) respectively. The second evaluation showed greater sleep deprivation in students with night shift work (p=0.001). The sleep deprived students had lower concentration indices (p=0.001).The differences were associated with the magnitude of sleep deprivation (p=0.008). Multivariate regression analysis showed that attention performance was explained by sleep deprivation due to night shift work, adjusting for age and gender. Students with sleep deprivation had worse concentration than those without. CONCLUSIONS: Sleep deprivation due to night shift work in medical students had a negative impact on their attention performance. Medical educators should address these potential negative learning and patient care consequences of sleep deprivation in medical students due to night shifts.

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