Multiple resources and mental workload

Attentional management of cognitive-motor interference in adults during walking: Insights from an EEG study

Dual-task paradigms, which involve performing cognitive and motor tasks simultaneously, are commonly used to study how attentional resources are allocated and managed under varying task demands. This study aimed to investigate cognitive-motor interferences (CMI) under different levels of cognitive and motor task difficulty without instruction on task prioritization. 17 healthy young adults performed an auditory oddball task with increasing cognitive and motor (walking vs. sitting) difficulty. Cognitive and motor performances, along with P3 (P3a and P3b) brainwave components, were analysed. Increasing cognitive difficulty resulted in more errors and increased P3a amplitude, reflecting enhanced attentional demand, while P3b remained unaffected. This suggests a threshold effect on attentional resources. Motor complexity lengthened P3a and P3b latencies without affecting amplitude, indicating delayed attentional resource recruitment. Additionally, walking with the most difficult cognitive task increased cognitive error, suggesting attentional resource limits. With increased motor and cognitive complexity, CMI emerged, leading to cognitive error increase and improved gait stability without amplitude changes in P3a and P3b. Two hypotheses were proposed: motor prioritization and motor facilitation. Our study suggests managing attentional resources to balance cognitive and motor tasks rather than linearly increasing task complexity. Viewing dual tasks as a new, integrated task is proposed, supported by previous neural network integration studies. Thus, understanding how the brain organizes tasks in response to constraints is crucial for comprehending complex task execution.

Neurocognitive and Neuromuscular Rehabilitation Techniques after ACL Injury, Part 1: Optimizing Recovery in the Acute Post-Operative Phase- A Clinical Commentary

Anterior cruciate ligament (ACL) injury rates are on the rise, despite improved surgical techniques and prevention programs. While traditional rehabilitation emphasizes the restoration of motion, strength, and physical performance, emerging research highlights the importance of addressing neurocognitive deficits that can persist after injury. These deficits, including altered proprioception, impaired motor control and muscle recruitment, as well as heightened reliance on visual feedback, can significantly increase the risk of re-injury and impede return to sport. The purpose of this clinical commentary is to outline a proposed comprehensive approach to rehabilitation that challenges the neurocognitive system to optimize rehabilitation outcomes and reduce reinjury risk. Thus, this clinical commentary discusses the rationale for integrating neurocognitive training into all phases of ACLR rehabilitation, from initial injury to eight weeks post-surgery. It details the neurophysiological changes caused by ACL injury and presents evidence supporting the use of exercises that challenge visual attention, decision-making, and motor planning. A comprehensive rehabilitation framework incorporating both physical and neurocognitive components is proposed, aiming to improve long-term outcomes and reduce re-injury risk. Level of Evidence: 5.

Obstacle negotiation while dual-tasking in children with Developmental Coordination Disorder (DCD): An augmented-reality approach

BACKGROUND

Children with Developmental Coordination Disorder (DCD) exhibit deficits in predictive motor control, balance, and aspects of cognitive control, which are important for safely negotiating obstacles while walking. As concurrent performance of cognitive and motor tasks (dual-tasking) may exacerbate these deficits, we examined motor and cognitive dual-tasking differences between children with DCD and their typically developing (TD) peers during obstacle negotiation.

METHODS

34 children aged 6-12 years (16 TD, 18 DCD) walked along a 12 m path, stepping over an obstacle (30 % or 50 % of leg length) at its mid-point. On dual-task trials, participants completed a simple or complex (cognitive) visual discrimination task presented via an augmented reality headset. Proportional dual-task costs (pDTCs) were measured on cognitive and gait outcomes over three phases: pre-obstacle, obstacle step-over, and post-obstacle.

RESULTS

During the obstacle step-over phase, both groups increased their leading leg clearance when dual-tasking, while the DCD group had larger pDTC than TD for the high obstacle under simple stimulus conditions (viz simple-high combination). The complex cognitive task produced larger pDTCs than the simple one on leading leg clearance and post-obstacle gait variability.

CONCLUSIONS

In general, both DCD and TD groups showed similar pDTCs under complex conditions, while the specific deficit in DCD under the simple-high combination suggests a (default) compensatory strategy during step-over when attention is diverted to a secondary task. Competing cognitive and motor demands during obstacle negotiation present a potential safety risk for children.

Frontal midline theta power during the cue-target-interval reflects increased cognitive effort in rewarded task-switching

Cognitive performance largely depends on how much effort is invested during task-execution. This also means that we rarely perform as good as we could. Cognitive effort is adjusted to the expected outcome of performance, meaning that it is driven by motivation. The results from recent studies suggest that the expenditure of cognitive control is particularly prone to being affected by modulations of cognitive effort. Although recent EEG studies investigated the neural underpinnings of the interaction of effort and control, reports on how cognitive effort is reflected by oscillatory activity of the EEG are quite sparse. It is the goal of the present study to bridge this gap by performing an exploratory analysis of high-density EEG data from a switching-task using manipulations of monetary incentives. A beamformer approach is used to localize the sensor-level effects in source-space. The results indicate that the manipulation of cognitive effort was successful. The participants reported significantly higher motivation and cognitive effort in high versus low reward trials. Performance was also significantly increased. The analysis of the EEG data revealed that the increase of cognitive effort was reflected by an increased mid-frontal theta activity during the cue-target interval, suggesting an increased use of proactive control. This interpretation is supported by the result from a regression analysis performed on single-trial data, showing higher mid-frontal theta power prior to target-onset being associated with faster responses. Alpha-desynchronization throughout the trial was also more pronounced in high reward trials, signaling a bias of attention towards the processing of external stimuli. Source reconstruction suggests that these effects are located in areas related to cognitive control, and visual processing.

Effects of a Passive Back-Support Exosuit on Postural Control and Cognitive Performance During a Fatigue-Inducing Posture Maintenance Task

OBJECTIVE

To evaluate the effectiveness of passive back-support exosuit on postural control and cognitive performance during a fatigue-inducing posture maintenance task.

BACKGROUND

Wearable support systems (exoskeletons/exosuits) reduce physical demands but may also influence postural control and cognitive performance by reducing muscular fatigue.

METHOD

Eighteen participants visited on two different days to test an exosuit system and performed dual-task cognitive assessments based on human information processing (information acquisition, information integration, and action implementation) while maintaining a 35° trunk flexion posture for 16 minutes. Center-of-pressure (CoP), cognitive performance, and perceived workload were recorded, while erector spinae muscle activity was captured to quantify muscle fatigue.

RESULTS

The exosuit was effective in reducing erector spinae muscle fatigue during the static posture maintenance task (61% less in Δmedian frequency: -9.5 Hz (EXO-Off) versus -3.7 Hz (EXO-On)). The fatigue-inducing task increased CoP velocity as a function of time (29% greater: 9.3 mm/sec (pre) versus 12.0 mm/sec (post)), and exosuit use decreased CoP velocity (23% less: 12.1 mm/sec (EXO-Off) versus 9.4 mm/sec (EXO-On)). The exosuit was also effective at mitigating cognitive degradation, as evidenced by a higher hit-to-signal ratio (8% greater: 81.3 (EXO-Off) versus 87.9 (EXO-On)) in the information integration task and reducing perceived workload in all stages of human information processing.

CONCLUSION

Exosuit provided benefits of postural control and information integration processing during a 16-min static posture maintenance task.

APPLICATION

Torso exoskeletons/suits can have positive implications for occupations with concurrent physical and cognitive demands.

Investigating mental workload across task modalities: a multimodal analysis using pupillometry

Understanding mental workload is challenging due to its multidimensional nature and varying sensitivities of its primary measures: task performance, perceived workload, and physiological responses. This study investigates the effects of task load on performance, perceived workload, and pupil measures across different information modalities. A within-subjects experiment involving three tasks (digit span, matrix span, and dual n-back) was conducted with three task load levels. Workload measures included accuracy/sensitivity, reaction time, NASA-TLX, peak pupil diameter, and peak pupil latency. Consistent patterns of associations between task load and these workload measures were found across the three modalities. Workload measures revealed a nuanced interplay between task modality and task load. Robustness of peak pupil latency, accuracy, and NASA-TLX was highlighted across verbal and visual modalities, while peak pupil diameter showed a weaker impact with differences between modalities. The findings encourage multivariate assessment of mental workload to account for different task modalities.

Augmented action observation: Theory and practical applications in sensorimotor rehabilitation

Sensory feedback is a fundamental aspect of effective motor learning in sport and clinical contexts. One way to provide this is through sensory augmentation, where extrinsic sensory information are associated with, and modulated by, movement. Traditionally, sensory augmentation has been used as an online strategy, where feedback is provided during physical execution of an action. In this article, we argue that action observation can be an additional effective channel to provide augmented feedback, which would be complementary to other, more traditional, motor learning and sensory augmentation strategies. Given these similarities between observing and executing an action, action observation could be used when physical training is difficult or not feasible, for example during immobilization or during the initial stages of a rehabilitation protocol when peripheral fatigue is a common issue. We review the benefits of observational learning and preliminary evidence for the effectiveness of using augmented action observation to improve learning. We also highlight current knowledge gaps which make the transition from laboratory to practical contexts difficult. Finally, we highlight the key areas of focus for future research.

A performance-based mental workload identification method for special vehicle crews

Detecting the mental workload state of armored vehicle crews is of great significance for monitoring the driving state of the crew and improving comprehensive combat effectiveness. In this manuscript, we propose a performance-based mental workload identification method and carry out experimental validation to improve the accuracy of crew mental workload identification and realize the effective classification of mental workload. Based on the virtual simulation system of the special vehicle crew task, this manuscript selects 20 subjects for the mental workload experiment of special vehicle crews. The experiment collected NASA-TLX scale, EEG, eye-tracking data, and performance data. The results show that the mental workload of the crews fluctuates in the segmented tasks of complex operations in typical scenes of special vehicles. The method of determining mental workload using NASA-TLX generates label noise in classification, which is not suitable for special vehicle tasks. Performance-based mental workload identification method is able to recognize fluctuations in the crew's mental workload during segmented tasks. Performance-based and NASA-TXL-based methods were classified using linear discriminant analysis. The results show that the accuracy of the method based on performance is improved by 15.72 %. This manuscript found the NASA-TXL scale is not suitable for the complex tasks of special vehicles, and proposed a performance-based identification method that can help to categorize the mental workload states of special vehicle crews.

Exploring Embodied Cognition and Brain Dynamics Under Multi-Tasks Target Detection in Immerse Projector-Based Augmented Reality (IPAR) Scenarios

Embodied cognition explores the intricate interaction between the brain, body, and the surrounding environment. The advancement of mobile devices, such as immersive interactive computing and wireless electroencephalogram (EEG) devices, has presented new challenges and opportunities for studying embodied cognition. To address how mobile technology within immersive hybrid settings affects embodied cognition, we propose a target detection multitask incorporating mixed body movement interference and an environmental distraction light signal. We aim to investigate human embodied cognition in immersive projector-based augmented reality (IPAR) scenarios using wireless EEG technology. We recruited and engaged fifteen participants in four multitasking conditions: standing without distraction (SND), walking without distraction (WND), standing with distraction (SD), and walking with distraction (WD). We pre-processed the EEG data using Independent Component Analysis (ICA) to isolate brain sources and K-means clustering to categorize Independent Components (ICs). Following that, we conducted time-frequency and correlation analyses to identify neural dynamics changes associated with multitasking. Our findings reveal a decline in behavioral performance during multitasking activities. We also observed decreases in alpha and beta power in the frontal and motor cortex during standing target search tasks, decreases in theta power, and increases in alpha power in the occipital lobe during multitasking. We also noted perturbations in theta band power during distraction tasks. Notably, physical movement induced more significant fluctuations in the frontal and motor cortex than distractions from social environment light signals. Particularly in scenarios involving walking and multitasking, there was a noticeable reduction in beta suppression. Our study underscores the importance of brain-body collaboration in multitasking scenarios, where the simultaneous engagement of the body and brain in complex tasks highlights the dynamic nature of cognitive processes within the framework of embodied cognition. Furthermore, integrating immersive augmented reality technology into embodied cognition research enhances our understanding of the interplay between the body, environment, and cognitive functions, with profound implications for advancing human-computer interaction and elucidating cognitive dynamics in multitasking.

Assessing advanced driver assistance systems in police vehicles under demanding conditions

Advanced driver-assistance systems (ADAS) are technologies that can enhance drivers' safety by relieving them from some driving related activities. However, police driving conditions and demands are different from those of civilian drivers. The objective of this study was to assess the impact of ADAS such as forward collision warning (FCW), automatic emergency braking (AEB), and blind spot monitoring (BSM) on police officers' driving performance, workload, and trust in vehicle safety to provide personalised solutions for police vehicles. A driving simulation study was conducted with 18 police officers. ADAS use was assessed under various driving conditions and while officers were engaged in non-driving related tasks. Findings suggested that the FCW and AEB systems improved officers' driving performance, while the BSM system had limited effectiveness due to low salience. ADAS were beneficial under normal driving conditions and when officers were using in-vehicle technology; however, they did not help officers in pursuit conditions.

Audiovisual messages may improve the processing of traffic information and driver attention during partially automated driving: An EEG study

Partially autonomous vehicles can help minimize human errors. However, being free from some driving subtasks can result in a low vigilance state, which can affect the driver's attention towards the road. The present study first tested whether drivers of partially autonomous vehicles would benefit from the addition of auditory versions of the messages presented in variable message signs (VMS), particularly, when they find themselves in a monotonous driving situation. A second aim was to test whether the addition of auditory messages would also produce an indirect effect on the driver's vigilance, improving performance on other driving subtasks not related to the message processing. Forty-three volunteers participated in a driving simulator study. They completed two tasks: (a) a VMS task, where they had to regain manual control of the car if the VMS message was critical, and (b) a car-following task, where they had to pay attention to the preceding car to respond to occasional brake events. Behavioral and EEG data were registered. Overall, results indicated that the addition of audio messages helped drivers process VMS information more effectively and maintain a higher level of vigilance throughout the driving time. These findings would provide useful information for the development of partially automated vehicles, as their design must guarantee that the driver remains attentive enough to assume control when necessary.

Effects of word presentation during treadmill walking on episodic memory and gait

Entrainment emerges when oscillatory movements synchronize with environmental stimuli processing. The purpose of this experiment was to assess how cognitive-motor entrainment during a dual-task would influence the quality of gait and affect episodic long-term memory. Twenty-one participants (22.56 y/o; 64 % F) walked at preferred paces while listening to 40-item word lists. In separate sessions, unique word lists were presented predictably on every fourth stride, unpredictably related to stepping, or predictably while standing. Memory tests administered 24-hr after encoding revealed that predictable word presentation led to better free-recall performance than unpredicted (p = .044); recognition memory was not impacted. Gait phase parameters during the predicted condition were more stable than the unpredicted condition or baseline assessments. Cognitive-motor entrainment may alleviate dual-task costs and enhance memory retention.

Cognitive workload classification of law enforcement officers using physiological responses

Motor vehicle crashes (MVCs) are a leading cause of death for law enforcement officers (LEOs) in the U.S. LEOs and more specifically novice LEOs (nLEOs) are susceptible to high cognitive workload while driving which can lead to fatal MVCs. The objective of this study was to develop a machine learning algorithm (MLA) that can estimate cognitive workload of LEOs while performing secondary tasks in a patrol vehicle. A ride-along study was conducted with 24 nLEOs. Participants performed their normal patrol operations while their physiological responses such as heartrate, eye movement, and galvanic skin response were recorded using unobtrusive devices. Findings suggested that the random forest algorithm could predict cognitive workload with relatively high accuracy (>70%) given that it was entirely reliant on physiological signals. The developed MLA can be used to develop adaptive in-vehicle technology based on real-time estimation of cognitive workload, which can reduce the risk of MVCs in police operations.

Assessing driver distraction from in-vehicle information system: an on-road study exploring the effects of input modalities and secondary task types

In-vehicle information system (IVIS) use is prevalent among young adults. However, their interaction with IVIS needs to be better understood. Therefore, an on-road study aims to explore the effects of input modalities and secondary task types on young drivers' secondary task performance, driving performance, and visual glance behavior. A 2 × 4 within-subject design was undertaken. The independent variables are input modalities (auditory-speech and visual-manual) and secondary task types (calls, music, navigation, and radio). The dependent variables include secondary task performance (task completion time, number of errors, and SUS), driving performance (average speed, number of lane departure warnings, and NASA-TLX), and visual glance behavior (average glance duration, number of glances, total glance duration, and number of glances over 1.6 s). The statistical analysis result showed that the main effect of input modalities is significant, with more distraction during visual-manual than auditory-speech. The main impact of secondary task types was also substantial across most metrics, aside from average speed and average glance duration. Navigation and music were the most distracting, followed by calls, and radio came in last. The distracting effect of input modalities is relatively stable and generally not moderated by the secondary task types, except radio tasks. The findings practically benefit the driver-friendly human-machine interface design, preventing IVIS-related distraction.

Effect of Takeover Request Time and Warning Modality on Trust in L3 Automated Driving

OBJECTIVE

This study investigated the effects of four takeover request (TOR) times and seven warning modalities on performance and trust in automated driving on a mildly congested urban road scenario, as well as the relationship between takeover performance and trust.

BACKGROUND

Takeover is crucial in L3 automated driving, where human-machine codriving is employed. Establishing trust in takeover scenarios among drivers can enhance the acceptance of autonomous vehicles, thereby promoting their widespread adoption.

METHOD

Using a driving simulator, data from 28 participants, including collision counts, takeover time (ToT), electrodermal activity (EDA) data, and self-reported trust scores, were collected and analyzed primarily using Generalized Linear Mixed Models (GLMM).

RESULTS

Collisions during the takeover undermined participants' trust in the autonomous driving system. As TOR time increased, participants' trust improved, and the longer TOR time did not lead to participant confusion. There was no significant relationship between warning modality and trust. Furthermore, the combination of three warning modalities did not exhibit a notable advantage over the combination of two modalities.

CONCLUSION

The study examined the effects of TOR time and warning modality on trust, as well as preliminarily explored the potential association between takeover performance, including collisions and ToT, and trust in autonomous driving takeovers.

APPLICATION

Researchers and designers of automotive interactions were given referenceable TOR time and warning modality by this study, which extended the autonomous driving takeover scenarios. These findings contributed to boosting drivers' confidence in transferring control to the automated system.

Design and validation of a simulated multitasking environment for assessing the cognitive load on the infantry squad leader

The increasing cognitive load on infantry squad leaders is a common challenge in modern military operations. As this can increase health and safety risks, there is a need to study the factors responsible for the increase in cognitive load. Ecological situations inherently lack strong experimental controls; therefore, microworlds that simulate real tasks are the usual alternative to field studies. However, to the best of our knowledge, there are currently no microworlds that reproduce the main tasks of the squad leader during operations. This article adresses this gap by describing the design and validation of a new microworld: the Simulated Multitasking Environment for the Squad leader (SMES). Qualitative research was firstly conducted to highlight several squad leader's generic tasks (i.e., common to many situations in the field) that guided the design of the SMES. Psychometric validation of the SMES was then based on two experiments: (i) the first evaluated the microworld's psychometric qualities when tasks were performed individually; and (ii) the second explored concurrent tasks, reflecting real-world complexity. The results showed that the parameters manipulated for each task were relevant for inducing cognitive load, measured using a secondary detection response task and the NASA-TLX questionnaire. The SMES demonstrated satisfactory convergent and content validity in multitasking but not in single-task conditions. Performance in multitasking situations therefore does not seem to depend on task-specific skills, suggesting the existence of an independent factor-multitasking ability. Theoretical and practical implications of the SMES validation are discussed.

Balance Performance in Young Adults With Hearing Aids: How Can It Be Affected by the Visual Cognitive Task?

OBJECTIVE

The aim of this study was to investigate the effect of a visual cognitive additional task on balance performance in young adults with hearing aids (HAs).

METHOD

Twenty young adult HA users and 20 controls were recruited for the study. Participants were asked to stand on a force plate using computerized dynamic posturography and perform a Sensory Organization Test (SOT) as a balance task under single-task (ST) and dual-task (DT) conditions. The DT condition involved performing a visual cognitive task (Backward Digit Recall) while maintaining balance. Balance performance was measured using equilibrium scores under four different conditions.

RESULTS

The results showed that SOT scores of HA users decreased significantly in the DT compared to the ST (p of Condition 1: < .001; p of Condition 4: < .001; p of Condition 6: = .001). HA users' SOT scores in the DT condition were statistically significantly lower than controls (p of Condition 1: < .003; p of Condition 4: < .009; p of Condition 6: = .004). This suggests that the presence of a visual cognitive additional task has a negative impact on balance performance in young adults with HAs.

CONCLUSIONS

These findings highlight the importance of considering the impact of cognitive tasks on balance performance in young adults with HAs. Further studies should investigate the specific needs of hearing loss patients in multitasking conditions, including age, degree of hearing loss, and cognitive ability, to develop effective interventions to reduce the risk of falls.

Flipping the script: Action-plan modification during single- and multiple-action control

In this paper, we tested the idea that local changes in action demands (e.g., due to an invalid cue or trial-by-trial) result in frugal modifications of existing action plans via action-plan-modification operations. We implemented an experimental procedure making use of a cue that indicates the action requirements for an upcoming signal with a certain degree of reliability. Crucially, incongruent cue-stimulus pairs either require action-plan modification or "resetting" the prepared action plan and reselecting a new response from scratch. We systematically varied the proportion of valid cues over four experiments. There were four most basic response conditions: left button press, right button press, dual button presses, no action. Results support the concept of action-plan modification rather than reset-reselect: switching between a left and a right response was faster and less error-prone than any other type of switch, both between trials and between cue and signal. Thus, it appears that given two responses that can be conceived of as polar opposites (within the same single-action category), there is an action-plan-modification operation ("invert") that transforms one into the other at a comparatively low cost. Furthermore, we observed a mixed pattern of dual-action costs and benefits. This indicates that participants represented dual actions holistically, that is, not based on a conjunction of single-action plans as building blocks. In addition, switching from null actions to overt actions appeared to require very similar action-plan-modification operations as other types of switches - thus, null actions are apparently not coded as empty sets, but rather represent actions in their own right. Finally, we observed strikingly similar patterns of results for trial-by-trial changes in action demands and intra-trial cue-signal incongruency. This implies that the mere cue-based formulation of an action plan - which is not actually executed - is sufficient to produce action-switching-like effects.

Predicting driver's takeover time based on individual characteristics, external environment, and situation awareness

The driver's takeover time is crucial to ensure a safe takeover transition in conditional automated driving. The study aimed to construct a prediction model of driver's takeover time based on individual characteristics, external environment, and situation awareness variables. A total of 18 takeover events were designed with scenarios, non-driving-related tasks, takeover request time, and traffic flow as variables. High-fidelity driving simulation experiments were carried out, through which the driver's takeover data was obtained. Fifteen basic factors and three dynamic factors were extracted from individual characteristics, external environment, and situation awareness. In this experiment, these 18 factors were selected as input variables, and XGBoost and Shapely were used as prediction methods. A takeover time prediction model (BM + SA model) was then constructed. Moreover, we analyzed the main effect of input variables on takeover time, and the interactive contribution made by the variables. And in this experiment, the 15 basic factors were selected as input variables, and the basic takeover time prediction model (BM model) was constructed. In addition, this study compared the performance of the two models and analyzed the contribution of input variables to takeover time. The results showed that the goodness of fit of the BM + SA model (Adjusted_R2) was 0.7746. The XGBoost model performs better than other models (support vector machine, random forest, CatBoost, and LightBoost models). The relative importance degree of situation awareness variables, individual characteristic variables, and external environment variables to takeover time gradually reduced. Takeover time increased with the scan and gaze durations and decreased with pupil area and self-reported situation awareness scores. There was also an interaction effect between the variables to affect takeover time. Overall, the performance of the BM + SA model was better than that of the BM model. This study can provide support for predicting driver's takeover time and analyzing the mechanism of influence on takeover time. This study can provide support for the development of real-time driver's takeover ability prediction systems and optimization of human-machine interaction design in automated vehicles, as well as for the management department to evaluate and improve the driver's takeover performance in a targeted manner.

Evaluation of physiological responses to mental workload in n-back and arithmetic tasks

Working memory tasks, such as n-back and arithmetic tasks, are frequently used in studying mental workload. The present study investigated and compared the sensitivity of several physiological measures at three levels of difficulty of n-back and arithmetic tasks. The results showed significant differences in fixation duration and pupil diameter among three task difficulty levels for both n-back and arithmetic tasks. Pupil diameters increase with increasing mental workload, whereas fixation duration decreases. Blink duration and heart rate (HR) were significantly increased as task difficulty increased in the n-back task, while root mean square of successive differences (RMSSD) and standard deviation of R-R intervals (SDNN) were significantly decreased in the arithmetic task. On the other hand, blink rate and Galvanic Skin Response (GSR) were not sensitive enough to assess the differences in task difficulty for both tasks. All significant physiological measures yielded significant differences between low and high task difficulty except for SDNN.Practitioner summary: This study aimed to assess the sensitivity levels of several physiological measures of mental workload in n-back and arithmetic tasks. It showed that pupil diameter was the most sensitive in both tasks. This study also found that most physiological indices are sensitive to an extreme change in task difficulty levels.

Combined Effects of Moderate Hypoxia and Sleep Restriction on Mental Workload

Aircraft pilots face a high mental workload (MW) under environmental constraints induced by high altitude and sometimes sleep restriction (SR). Our aim was to assess the combined effects of hypoxia and sleep restriction on cognitive and physiological responses to different MW levels using the Multi-Attribute Test Battery (MATB)-II with an additional auditory Oddball-like task. Seventeen healthy subjects were subjected in random order to three 12-min periods of increased MW level (low, medium, and high): sleep restriction (SR, <3 h of total sleep time (TST)) vs. habitual sleep (HS, >6 h TST), hypoxia (HY, 2 h, FIO2 = 13.6%, ~3500 m vs. normoxia, NO, FIO2 = 21%). Following each MW level, participants completed the NASA-TLX subjective MW scale. Increasing MW decreases performance on the MATB-II Tracking task (p = 0.001, MW difficulty main effect) and increases NASA-TLX (p = 0.001). In the combined HY/SR condition, MATB-II performance was lower, and the NASA-TLX score was higher compared with the NO/HS condition, while no effect of hypoxia alone was observed. In the accuracy of the auditory task, there is a significant interaction between hypoxia and MW difficulty (F(2-176) = 3.14, p = 0.04), with lower values at high MW under hypoxic conditions. Breathing rate, pupil size, and amplitude of pupil dilation response (PDR) to auditory stimuli are associated with increased MW. These parameters are the best predictors of increased MW, independently of physiological constraints. Adding ECG, SpO2, or electrodermal conductance does not improve model performance. In conclusion, hypoxia and sleep restriction have an additive effect on MW. Physiological and electrophysiological responses must be taken into account when designing a MW predictive model and cross-validation.

Dual-task costs in speed tasks: a comparison between elite ice hockey, open-skill and closed-skill sports athletes

Introduction

Ice hockey is a high pace sports game that requires players to integrate multiple skills. Players face perceptive, cognitive, and motor tasks concurrently; hence, players are regularly exposed to dual- or multi-task demands. Dual-tasking has been shown to lead to decreased performance in one or both performed tasks. The degree of performance reductions might be modulated by the exhaustion of cognitive resources. Literature on dual-task paradigms that combine sport-relevant elements is scarce. Therefore, a novel paradigm combining cyclical speed of the lower extremities and concurrent visuo-verbal speed reading was tested and validated. Additionally, to understand the nature of dual-task costs, the relationship between these costs and cognitive performance was assessed. We hypothesized occurrence of dual-task costs in all athletes without relationship to single task performance. Differences in dual-task cost were expected between open-skill and closed-skill sports, as well as differing expertise levels. Level of cognitive function was expected to explain some variance in dual-task cost.

Methods

A total of 322 elite athletes (120 ice hockey, 165 other team sports, 37 closed-skill sports) participated in this study. Each athlete performed a tapping task, a visuo-verbal speed-reading task, and both tasks simultaneously. All ice hockey athletes performed additional cognitive tests assessing processing speed, spatial working memory, sustained attention, two choice reaction time, and motor inhibition.

Results

The results of paired-sample t-tests confirmed significant dual-task costs for all sport groups (p < 0.001). Single-task performance and dual-task costs correlated weakly in a positive direction. A one-way ANOVA revealed significantly greater costs in closed-skill sports athletes than in ice hockey and other sports athletes. No significant differences in dual-task costs were found between teams of differing expertise levels. Lastly, no significant regression model was found to predict dual-task costs from cognitive test performance.

Discussion

Our study suggests that this novel dual-task paradigm was successful in inducing dual-task costs for all elite athletes. Since it distinguishes between closed-skill and open-skill sports athletes, it might be a valuable diagnostic tool for performance and for talent development of open-skill athletes. Dual-task costs could not be relevantly predicted via cognitive performance measures, questioning cognitive resource theories as an explanation for dual-task costs.

Enhancing human-AI collaboration: The case of colonoscopy

Diagnostic errors impact patient health and healthcare costs. Artificial Intelligence (AI) shows promise in mitigating this burden by supporting Medical Doctors in decision-making. However, the mere display of excellent or even superhuman performance by AI in specific tasks does not guarantee a positive impact on medical practice. Effective AI assistance should target the primary causes of human errors and foster effective collaborative decision-making with human experts who remain the ultimate decision-makers. In this narrative review, we apply these principles to the specific scenario of AI assistance during colonoscopy. By unraveling the neurocognitive foundations of the colonoscopy procedure, we identify multiple bottlenecks in perception, attention, and decision-making that contribute to diagnostic errors, shedding light on potential interventions to mitigate them. Furthermore, we explored how existing AI devices fare in clinical practice and whether they achieved an optimal integration with the human decision-maker. We argue that to foster optimal Human-AI collaboration, future research should expand our knowledge of factors influencing AI's impact, establish evidence-based cognitive models, and develop training programs based on them. These efforts will enhance human-AI collaboration, ultimately improving diagnostic accuracy and patient outcomes. The principles illuminated in this review hold more general value, extending their relevance to a wide array of medical procedures and beyond.

Voluntary task switching is affected by modality compatibility and preparation

Cognitive task control can be examined in task-switching studies. Performance costs in task switches are usually smaller with compatible stimulus-response modality mappings (visual-manual and auditory-vocal) than with incompatible mappings (visual-vocal and auditory-manual). Modality compatibility describes the modality match of sensory input and of the anticipated response effect (e.g., vocal responses produce auditory effects, so that auditory stimuli are modality-compatible with vocal responses). Fintor et al. (Psychological Research, 84(2), 380-388, 2020) found that modality compatibility also biased task choice rates in voluntary task switching (VTS). In that study, in each trial participants were presented with a visual or auditory spatial stimulus and were free to choose the response modality (manual vs. vocal). In this free-choice task, participants showed a bias to create more modality-compatible than -incompatible mappings. In the present study, we assessed the generality of Fintor et al.'s (2020) findings, using verbal rather than spatial stimuli, and more complex tasks, featuring an increased number of stimulus-response alternatives. Experiment 1 replicated the task-choice bias to preferentially create modality-compatible mappings. We also found a bias to repeat the response modality just performed, and a bias to repeat entire stimulus-response modality mappings. In Experiment 2, we manipulated the response-stimulus interval (RSI) to examine whether more time for proactive cognitive control would help resolve modality-specific crosstalk in this free-choice paradigm. Long RSIs led to a decreased response-modality repetition bias and mapping repetition bias, but the modality-compatibility bias was unaffected. Together, the findings suggest that modality-specific priming of response modality influences task choice.

When Do Humans Heed AI Agents' Advice? When Should They?

OBJECTIVE

We manipulate the presence, skill, and display of artificial intelligence (AI) recommendations in a strategy game to measure their effect on users' performance.

BACKGROUND

Many applications of AI require humans and AI agents to make decisions collaboratively. Success depends on how appropriately humans rely on the AI agent. We demonstrate an evaluation method for a platform that uses neural network agents of varying skill levels for the simple strategic game of Connect Four.

METHODS

We report results from a 2 × 3 between-subjects factorial experiment that varies the format of AI recommendations (categorical or probabilistic) and the AI agent's amount of training (low, medium, or high). On each round of 10 games, participants proposed a move, saw the AI agent's recommendations, and then moved.

RESULTS

Participants' performance improved with a highly skilled agent, but quickly plateaued, as they relied uncritically on the agent. Participants relied too little on lower skilled agents. The display format had no effect on users' skill or choices.

CONCLUSIONS

The value of these AI agents depended on their skill level and users' ability to extract lessons from their advice.

APPLICATION

Organizations employing AI decision support systems must consider behavioral aspects of the human-agent team. We demonstrate an approach to evaluating competing designs and assessing their performance.

The role of visual conditions and aircraft type on different aspects of pilot workload

OBJECTIVE

The objective of our work was to assess the impact of flight conditions by aircraft type on the workload estimated using NASA-Task Load Index (NASA-TLX).

BACKGROUND

Learning about subjective workload is important for assessing the impact of a pilot's work environment on their performance in the cockpit. This is an important element of flight safety and includes the prevention of aviation accidents.

METHODS

The study included 146 military pilots that fly the following aircrafts: flying fast-jet (21), fixed-wing (24), and rotary-wing (101). The NASA-TLX questionnaire was used to assess workload and pilots were asked to determine the level of workload resulting from flying under the following conditions: daytime flight (VFR), night-vision flight performed under Night Visual Flight Rules (NVFR), and night-vision flight using night-vision goggles (NVGs).

RESULTS

The highest level of workload was consistently attributed to flights performed under NVG conditions. NVFR conditions were rated as the most burdensome, while VFR conditions were rated as the least burdensome. Fast-jet pilots rated their mental performance and effort workload as significantly higher than pilots of other aircrafts.

CONCLUSION

Pilots' perceived workload is influenced by both flight conditions and the type of aircraft they fly. Workload knowledge is important for flight safety and should be taken into account during training and flight-task planning.

APPLICATION

The results of our study can be useful both in flight training and in work on the effectiveness of the human-machine interface. Awareness of one's own limitations due to the work environment can help improve flight safety.

Modeling distracted driving behavior considering cognitive processes

The modeling of distracted driving behavior has been studied for many years, however, there remain many distraction phenomena that can not be fully modeled. This study proposes a new method that establishes the model using the queuing network model human processor (QN-MHP) framework. Unlike previous models that only consider distracted-driving-related human factors from a mathematical perspective, the proposed method reflects the information processing in the human brain, and simulates the distracted driver's cognitive processes based on a model structure supported by physiological and cognitive research evidence. Firstly, a cumulative activation effect model for external stimuli is adopted to mimic the phenomenon that a driver responds only to stimuli above a certain threshold. Then, dual-task queuing and switching mechanisms are modeled to reflect the cognitive resource allocation under distraction. Finally, the driver's action is modeled by the Intelligent Driver Model (IDM). The model is developed for visual distraction auditory distraction separately. 773 distracted car-following events from the Shanghai Naturalistic Driving Study data were used to calibrate and verify the model. Results show that the model parameters are more uniform and reasonable. Meanwhile, the model accuracy has improved by 57% and 66% compared to the two baseline models respectively. Moreover, the model demonstrates its ability to generate critical pre-crash scenarios and estimate the crash rate of distracted driving. The proposed model is expected to contribute to safety research regarding new vehicle technologies and traffic safety analysis.

Skillful and strategic navigation in soccer - a motor-cognitive dual-task approach for the evaluation of a dribbling task under different cognitive load conditions

Soccer is a competitive sport that relies on distinct motor skills and cognitive processes. However, cognitive aspects are often overlooked, with a focus mainly on motor skills. Limited research has explored screening tests within motor-cognitive navigation dual-task (DT) paradigms. This study aims to validate a sensitive approach for assessing soccer-specific dribbling by evaluating the Trail-Dribbling Test (TDT) as a method to differentiate high-performance (HP) from low-performance (LP) players. Two hundred and seventy-five participants (41 females) aged between 12 and 34 completed the Trail-Making Test (TMT), the Trail-Walking Test (TWT), and the soccer-specific TDT under three levels of cognitive load. Results indicated shorter TDT durations for HP compared to LP players, with increased cognitive load accentuating differences (TDT-M: p = 0.044, d = 0.260; TDT-A: p < 0.001, d = 0.449; TDT-B: p < 0.001, d = 0.653). The TDT effectively discriminated between HP and LP players in the 14-15 (AUC = 0.712-0.820) and 16-17 age groups (AUC = 0.634-0.839). In conclusion, the ecologically valid TDT demonstrates the potential for quantifying soccer-specific dribbling, offering insights into motor and cognitive aspects of dribbling performance, especially among soccer players aged 14-17.

Measuring aviator workload using EEG: an individualized approach to workload manipulation

Introduction

Measuring an operator's physiological state and using that data to predict future performance decrements has been an ongoing goal in many areas of transportation. Regarding Army aviation, the realization of such an endeavor could lead to the development of an adaptive automation system which adapts to the needs of the operator. However, reaching this end state requires the use of experimental scenarios similar to real-life settings in order to induce the state of interest that are able to account for individual differences in experience, exposure, and perception to workload manipulations. In the present study, we used an individualized approach to manipulating workload in order to account for individual differences in response to workload manipulations, while still providing an operationally relevant flight experience.

Methods

Eight Army aviators participated in the study, where they completed two visits to the laboratory. The first visit served the purpose of identifying individual workload thresholds, with the second visit resulting in flights with individualized workload manipulations. EEG data was collected throughout both flights, along with subjective ratings of workload and flight performance.

Results

Both EEG data and workload ratings suggested a high workload. Subjective ratings were higher during the high workload flight compared to the low workload flight (p < 0.001). Regarding EEG, frontal alpha (p = 0.04) and theta (p = 0.01) values were lower and a ratio of beta/(alpha+theta) (p = 0.02) were higher in the baseline flight scenario compared to the high workload scenario. Furthermore, the data were compared to that collected in previous studies which used a group-based approach to manipulating workload.

Discussion

The individualized method demonstrated higher effect sizes in both EEG and subjective ratings, suggesting the use of this method may provide a more reliable way of producing high workload in aviators.

Task-Relevant Smartphone Messages Within Work Zones: A Driving Simulation Study

OBJECTIVE

This study explored the impact of in-vehicle messages relative to roadside messages to alert drivers to events within a simulated work zone, in order to determine if these messages can improve driving performance within the work zone.

BACKGROUND

Safety risks in work zones are usually mitigated by design standards and clear signage to communicate work zone information to drivers. Due to distraction and other driving task demands, these signs are not always noticed by motorists, nor are they always followed when they are noticed.

METHOD

The driving simulation tested drivers in two different types of work zones, shoulder work, and lane closure. Participants drove through these work zones three times, each with different messaging interfaces to communicate hazardous events to the driver. The interfaces included a roadside, portable changeable message sign, a smartphone presenting only auditory messages, and a smartphone presenting audio-visual messages.

RESULTS

There was significantly better driving performance on key metrics including lane deviation for the in-vehicle message conditions relative to the roadside signs. Furthermore, drivers directed visual attention toward the roadway for the in-vehicle message conditions relative to the roadside sign condition.

CONCLUSION

The results indicate that in-vehicle messaging could provide benefits to primary task performance in driving if the message content is appropriately designed.

APPLICATION

The findings provide support for a design framework to support in-vehicle communication to drivers approaching work zones and other environments to safely alert them to hazards.

Attention capture by own name decreases with speech compression

Auditory stimuli that are relevant to a listener have the potential to capture focal attention even when unattended, the listener's own name being a particularly effective stimulus. We report two experiments to test the attention-capturing potential of the listener's own name in normal speech and time-compressed speech. In Experiment 1, 39 participants were tested with a visual word categorization task with uncompressed spoken names as background auditory distractors. Participants' word categorization performance was slower when hearing their own name rather than other names, and in a final test, they were faster at detecting their own name than other names. Experiment 2 used the same task paradigm, but the auditory distractors were time-compressed names. Three compression levels were tested with 25 participants in each condition. Participants' word categorization performance was again slower when hearing their own name than when hearing other names; the slowing was strongest with slight compression and weakest with intense compression. Personally relevant time-compressed speech has the potential to capture attention, but the degree of capture depends on the level of compression. Attention capture by time-compressed speech has practical significance and provides partial evidence for the duplex-mechanism account of auditory distraction.

The Relevance of Attention Control, Not Working Memory, in Human Factors

OBJECTIVE

Discuss the human factors relevance of attention control (AC), a domain-general ability to regulate information processing functions in the service of goal-directed behavior.

BACKGROUND

Working memory (WM) measures appear as predictors in various applied psychology studies. However, measures of WM reflect a mixture of memory storage and controlled attention making it difficult to interpret the meaning of significant WM-task relations for human factors. In light of new research, complex task performance may be better predicted or explained with new measures of attention control rather than WM.

METHOD

We briefly review the topic of individual differences in abilities in Human Factors. Next, we focus on WM, how it is measured, and what can be inferred from significant WM-task relations.

RESULTS

The theoretical underpinnings of attention control as a high-level factor that affects complex thought and behavior make it useful in human factors, which often study performance in complex and dynamic task environments. To facilitate research on attention control in applied settings, we discuss a validated measure of attention control that predicts more variance in complex task performance than WM. In contrast to existing measures of WM or AC, our measures of attention control only require 3 minutes each (10 minutes total) and may be less culture-bound making them suitable for use in applied settings.

CONCLUSION

Explaining or predicting task performance relations with attention control rather than WM may have dramatically different implications for designing more specific, equitable task interfaces, or training.

APPLICATION

A highly efficient ability predictor can help researchers and practitioners better understand task requirements for human factors interventions or performance prediction.

The Differential Effects of Multisensory Attentional Cues on Task Performance in VR Depending on the Level of Cognitive Load and Cognitive Capacity

As the utilization of VR is expanding across diverse fields, research on devising attentional cues that could optimize users' task performance in VR has become crucial. Since the cognitive load imposed by the context and the individual's cognitive capacity are representative factors that are known to determine task performance, we aimed to examine how the effects of multisensory attentional cues on task performance are modulated by the two factors. For this purpose, we designed a new experimental paradigm in which participants engaged in dual (N-back, visual search) tasks under different levels of cognitive load while an attentional cue (visual, tactile, or visuotactile) was presented to facilitate search performance. The results showed that multi-sensory attentional cues are generally more effective than uni-sensory cues in enhancing task performance, but the benefit of multi-sensory cues changes according to the level of cognitive load and the individual's cognitive capacity; the amount of benefit increases as the cognitive load is higher and the cognitive capacity is lower. The findings of this study provide practical implications for designing attentional cues to enhance VR task performance, considering both the complexity of the VR context and users' internal characteristics.

Implementation of Health IT for Cancer Screening in US Primary Care: Scoping Review

BACKGROUND

A substantial percentage of the US population is not up to date on guideline-recommended cancer screenings. Identifying interventions that effectively improve screening rates would enhance the delivery of such screening. Interventions involving health IT (HIT) show promise, but much remains unknown about how HIT is optimized to support cancer screening in primary care.

OBJECTIVE

This scoping review aims to identify (1) HIT-based interventions that effectively support guideline concordance in breast, cervical, and colorectal cancer screening provision and follow-up in the primary care setting and (2) barriers or facilitators to the implementation of effective HIT in this setting.

METHODS

Following scoping review guidelines, we searched MEDLINE, CINAHL Plus, Web of Science, and IEEE Xplore databases for US-based studies from 2015 to 2021 that featured HIT targeting breast, colorectal, and cervical cancer screening in primary care. Studies were dual screened using a review criteria checklist. Data extraction was guided by the following implementation science frameworks: the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework; the Expert Recommendations for Implementing Change taxonomy; and implementation strategy reporting domains. It was also guided by the Integrated Technology Implementation Model that incorporates theories of both implementation science and technology adoption. Reporting was guided by PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews).

RESULTS

A total of 101 studies met the inclusion criteria. Most studies (85/101, 84.2%) involved electronic health record-based HIT interventions. The most common HIT function was clinical decision support, primarily used for panel management or at the point of care. Most studies related to HIT targeting colorectal cancer screening (83/101, 82.2%), followed by studies related to breast cancer screening (28/101, 27.7%), and cervical cancer screening (19/101, 18.8%). Improvements in cancer screening were associated with HIT-based interventions in most studies (36/54, 67% of colorectal cancer-relevant studies; 9/14, 64% of breast cancer-relevant studies; and 7/10, 70% of cervical cancer-relevant studies). Most studies (79/101, 78.2%) reported on the reach of certain interventions, while 17.8% (18/101) of the included studies reported on the adoption or maintenance. Reported barriers and facilitators to HIT adoption primarily related to inner context factors of primary care settings (eg, staffing and organizational policies that support or hinder HIT adoption). Implementation strategies for HIT adoption were reported in 23.8% (24/101) of the included studies.

CONCLUSIONS

There are substantial evidence gaps regarding the effectiveness of HIT-based interventions, especially those targeting guideline-concordant breast and colorectal cancer screening in primary care. Even less is known about how to enhance the adoption of technologies that have been proven effective in supporting breast, colorectal, or cervical cancer screening. Research is needed to ensure that the potential benefits of effective HIT-based interventions equitably reach diverse primary care populations.

The mental workload of ICU nurses performing human-machine tasks and associated factors: A cross-sectional questionnaire survey

AIMS

To assess the level of mental workload (MWL) of intensive care unit (ICU) nurses in performing different human-machine tasks and examine the predictors of the MWL.

DESIGN

A cross-sectional questionnaire study.

METHODS

Between January and February 2021, data were collected from ICU nurses (n = 427) at nine tertiary hospitals selected from five (east, west, south, north, central) regions in China through an electronic questionnaire, including sociodemographic questions, the National Aeronautics and Space Administration Task Load Index, General Self-Efficacy Scale, Difficulty-assessing Index System of Nursing Operation Technique, and System Usability Scale. Descriptive statistics, t-tests, one-way ANOVA and multiple linear regression models were used.

RESULTS

ICU nurses experienced a medium level of MWL (score 52.04 on a scale of 0-100) while performing human-machine tasks. ICU nurses' MWL was notably higher in conducting first aid and life support tasks (using defibrillators or ventilators). Predictors of MWL were task difficulty, system usability, professional title, age, self-efficacy, ICU category, and willingness to study emerging technology actively. Task difficulty and system usability were the strongest predictors of nearly all typical tasks.

CONCLUSION

ICU nurses experience a medium MWL while performing human-machine tasks, but higher mental, temporal, and effort are perceived compared to physical demands. The MWL varied significantly across different human-machine tasks, among which are significantly higher: first aid and life support and information-based human-machine tasks. Task difficulty and system availability are decisive predictors of MWL.

IMPACT

This is the first study to investigate the level of MWL of ICU nurses performing different representative human-machine tasks and to explore its predictors, which provides a reference for future research. These findings suggest that healthcare organizations should pay attention to the MWL of ICU nurses and develop customized management strategies based on task characteristics to maintain a moderate level of MWL, thus enabling ICU nurses to perform human-machine tasks better.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The Impact of Various Cockpit Display Interfaces on Novice Pilots' Mental Workload and Situational Awareness: A Comparative Study

Future airspace is expected to become more congested with additional in-service cargo and commercial flights. Pilots will face additional burdens in such an environment, given the increasing number of factors that they must simultaneously consider while completing their work activities. Therefore, care and attention must be paid to the mental workload (MWL) experienced by operating pilots. If left unaddressed, a state of mental overload could affect the pilot's ability to complete his or her work activities in a safe and correct manner. This study examines the impact of two different cockpit display interfaces (CDIs), the Steam Gauge panel and the G1000 Glass panel, on novice pilots' MWL and situational awareness (SA) in a flight simulator-based setting. A combination of objective (EEG and HRV) and subjective (NASA-TLX) assessments is used to assess novice pilots' cognitive states during this study. Our results indicate that the gauge design of the CDI affects novice pilots' SA and MWL, with the G1000 Glass panel being more effective in reducing the MWL and improving SA compared with the Steam Gauge panel. The results of this study have implications for the design of future flight deck interfaces and the training of future pilots.

Understanding Symptom Self-Monitoring Needs Among Postpartum Black Patients: Qualitative Interview Study

BACKGROUND

Pregnancy-related death is on the rise in the United States, and there are significant disparities in outcomes for Black patients. Most solutions that address pregnancy-related death are hospital based, which rely on patients recognizing symptoms and seeking care from a health system, an area where many Black patients have reported experiencing bias. There is a need for patient-centered solutions that support and encourage postpartum people to seek care for severe symptoms.

OBJECTIVE

We aimed to determine the design needs for a mobile health (mHealth) patient-reported outcomes and decision-support system to assist Black patients in assessing when to seek medical care for severe postpartum symptoms. These findings may also support different perinatal populations and minoritized groups in other clinical settings.

METHODS

We conducted semistructured interviews with 36 participants-15 (42%) obstetric health professionals, 10 (28%) mental health professionals, and 11 (31%) postpartum Black patients. The interview questions included the following: current practices for symptom monitoring, barriers to and facilitators of effective monitoring, and design requirements for an mHealth system that supports monitoring for severe symptoms. Interviews were audio recorded and transcribed. We analyzed transcripts using directed content analysis and the constant comparative process. We adopted a thematic analysis approach, eliciting themes deductively using conceptual frameworks from health behavior and human information processing, while also allowing new themes to inductively arise from the data. Our team involved multiple coders to promote reliability through a consensus process.

RESULTS

Our findings revealed considerations related to relevant symptom inputs for postpartum support, the drivers that may affect symptom processing, and the design needs for symptom self-monitoring and patient decision-support interventions. First, participants viewed both somatic and psychological symptom inputs as important to capture. Second, self-perception; previous experience; sociocultural, financial, environmental, and health systems-level factors were all perceived to impact how patients processed, made decisions about, and acted upon their symptoms. Third, participants provided recommendations for system design that involved allowing for user control and freedom. They also stressed the importance of careful wording of decision-support messages, such that messages that recommend them to seek care convey urgency but do not provoke anxiety. Alternatively, messages that recommend they may not need care should make the patient feel heard and reassured.

CONCLUSIONS

Future solutions for postpartum symptom monitoring should include both somatic and psychological symptoms, which may require combining existing measures to elicit symptoms in a nuanced manner. Solutions should allow for varied, safe interactions to suit individual needs. While mHealth or other apps may not be able to address all the social or financial needs of a person, they may at least provide information, so that patients can easily access other supportive resources.

Swimming with a head-mounted display: dual-task costs

Head-up displays (HUDs) have the potential to change work in operation environments by providing hands-free information to wearers. However, these benefits may be accompanied by trade-offs, primarily by increasing cognitive load due to dividing attention. Previous studies have attempted to understand the trade-offs of HUD usage; however, all of which were focused on land-based tasks. A gap in understanding exists when examining HUD use in aquatic environments as immersion introduces unique environmental and physiological factors that could affect multitasking. In this study, we investigated multitasking performance associated with swimming with a HUD. Eighteen participants completed three tasks: swimming only, a HUD-administered word recall task, and a dual-task combining both tasks. Results revealed significant dual-task interference in both tasks, though possibly less pronounced than in land-based tasks. These findings enhance not only help characterise dual-task performance, but also offer valuable insights for HUD design for aquatic settings.

Impact of Distractors on Sustained Attention and Inhibition in Children With ADHD

OBJECTIVE

This study examines the impact of visual and auditory distractors on attention and inhibition in children with and without ADHD.

METHOD

The study used the MOXO d-CPT child version. The sample consisted of 208 children aged 8 to 12 years, including 64 with ADHD and 144 controls.

RESULTS

Children with ADHD and controls differed in their reaction to distracting stimuli; visual distractors cause a higher decrease in sustained attention and inhibitory control in the ADHD group. Moreover, auditory distractors generate improved performance in the control group but not in the ADHD group. In addition, age-related effects were found in both sustained attention and inhibitory control in all children, regardless of whether the ADHD condition was present.

CONCLUSIONS

The findings indicate that children with ADHD performed poorer compared to controls, and that distractors differently affected the performance of the two groups.

What's that on Your Phone? Effects of Mobile Device Task Type on Pedestrian Performance

BACKGROUND

The number of accidents due to distracted pedestrian is on the rise and many governments and institutions are enacting public policies which restrict texting while walking. However, pedestrians do more than just texting when they use their mobile devices on the go.

OBJECTIVE

Exploring pedestrian multitasking, this paper aims to examine the effects of mobile device task type on pedestrian performance outcomes.

METHOD

We performed two studies in lab simulations where 78 participants were asked to perform different tasks on a mobile device (playing a game, reading, writing an email, texting one person, group texting) while performing a pedestrian visual discrimination task while either standing or walking on a treadmill. Behavioral performance as well as neurophysiological data are collected.

RESULTS

Results show that compared to a no-phone control, multitasking with any of the tasks on a mobile device leads to poor performance on a pedestrian visual discrimination task. Playing a game is the most cognitively demanding task and leads to the greatest performance degradation.

CONCLUSION

Our studies show that multitasking with a mobile device has the potential to negatively impact pedestrian safety, regardless of task type. However, the impacts of different mobile device tasks are not all equivalent. More research is needed to tease out the different effects of these various tasks and to design mobile applications which effectively and safely capture pedestrians' attention.

APPLICATION

Public policy, infrastructure, and smart technologies can be used to mitigate the negative effects of mobile multitasking. A more thorough understanding of mobile device task-specific factors at play can help tailor these counter-measures to better aid distracted pedestrians.

Free Cognitive Capacity Assessed by the P300 Method During Manual Docking Training in Space

INTRODUCTION: The classical P300 brain potential method was used to assess the cognitive capacity during training of manual docking in space. The aim of the study was to enhance the safety of this operation during a mission.METHODS: To examine this, N = 8 cosmonauts had to perform the manually controlled docking task simultaneously with an acoustic monitoring task. The P300 component was evoked by the acoustic stimuli of the secondary task. The docking task had to be executed at three difficulty levels: low (station not turning); medium (station turning around one axis); and difficult (station turning around three axes). In the secondary task, subjects had to discriminate between a low and a high tone, which occurred with a probability of 90% and 10%, respectively. Subjects had to count the high tones. After the 10th high tone, they had to inspect the power supply by giving an oral command.RESULTS: A methodology for event-related potentials was successfully demonstrated under space conditions. The P300 amplitude was largest and the latency shortest during the medium difficult task.DISCUSSION: The results suggest that P300 can be recorded during the complex manual docking task in space and could be used to assess individual available cognitive capacity of cosmonauts during a space mission.Bubeev JA, Johannes B, Kotrovska TI, Schastlivtseva D, Bronnikov S, Hoermann H-J, Gaillard AWK. Free cognitive capacity assessed by the P300 method during manual docking training in space. Aerosp Med Hum Perform. 2024; 95(4):187-193.

Dual-Task and Single-Task Practice Does Not Influence the Attentional Demands of Movement Sequence Representations

This study examined the attentional demands of movement sequence representations at different temporal points after single- or dual-task practice. The visual-spatial representation encodes the movement based on visual-spatial coordinates such as the target locations. The motor representation encodes the movement in motor coordinates including joint angles and muscle activation patterns. Participants were randomly assigned to a single-task or dual-task practice group. Following acquisition, participants performed two retention tests and inter-manual transfer tests, both under dual-task and single-task. The transfer tests consisted of a mirror and non-mirror test and examined motor and visual-spatial representation development. The main finding is that attentional demands of the sequence representations were not affected by the practice condition. However, movement initiation requires more attention than the end of the movement in both representations.

Locomotor-cognitive dual-tasking in children with developmental coordination disorder

Introduction

Children with Developmental Coordination Disorder (DCD) demonstrate deficits in predictive motor control and aspects of cognitive control compared with their typically developing (TD) peers. Adjustment to dynamic environments depends on both aspects of control and the deficits for children with DCD may constrain their ability to perform daily actions that involve dual-tasking. Under the assumption that motor-cognitive integration is compromised in children with DCD, we examined proportional dual-task costs using a novel locomotor-cognitive dual-task paradigm that enlisted augmented reality. We expect proportional dual-task performance costs to be greater for children with DCD compared to their TD peers.

Methods

Participants were 34 children aged 6-12 years (16 TD, 18 DCD) who walked along a straight 12 m path under single- and dual-task conditions, the cognitive task being visual discrimination under simple or complex stimulus conditions presented via augmented reality. Dual-task performance was measured in two ways: first, proportional dual-task costs (pDTC) were computed for cognitive and gait outcomes and, second, within-trial costs (p-WTC) were measured as the difference on gait outcomes between pre- and post-stimulus presentation.

Results

On measures of pDTC, TD children increased their double-limb support time when walking in response to a dual-task, while the children with DCD increased their locomotor velocity. On p-WTC, both groups increased their gait variability (step length and step width) when walking in response to a dual-task, of which the TD group had a larger proportional change than the DCD group. Greater pDTCs on motor rather than cognitive outcomes were consistent across groups and method of dual-task performance measurement.

Discussion

Contrary to predictions, our results failed to support dramatic differences in locomotor-cognitive dual-task performance between children with DCD and TD, with both groups tending to priorities the cognitive over the motor task. Inclusion of a within-trial calculation of dual-task interference revealed an expectancy effect for both groups in relation to an impending visual stimulus. It is recommended that dual-task paradigms in the future continue to use augmented reality to present the cognitive task and consider motor tasks of sufficient complexity to probe the limits of performance in children with DCD.

Evaluation of a headphones-fitted EEG system for the recording of auditory evoked potentials and mental workload assessment

Advancements in portable neuroimaging technologies open up new opportunities to gain insight into the neural dynamics and cognitive processes underlying day-to-day behaviors. In this study, we evaluated the relevance of a headphone- mounted electroencephalogram (EEG) system for monitoring mental workload. The participants (N = 12) were instructed to pay attention to auditory alarms presented sporadically while performing the Multi-Attribute Task Battery (MATB) whose difficulty was staged across three conditions to manipulate mental workload. The P300 Event-Related Potentials (ERP) elicited by the presentation of auditory alarms were used as probes of attentional resources available. The amplitude and latency of P300 ERPs were compared across experimental conditions. Our findings indicate that the P300 ERP component can be captured using a headphone-mounted EEG system. Moreover, neural responses to alarm could be used to classify mental workload with high accuracy (over 80%) at a single-trial level. Our analyses indicated that the signal-to-noise ratio acquired by the sponge-based sensors remained stable throughout the recordings. These results highlight the potential of portable neuroimaging technology for the development of neuroassistive applications while underscoring the current limitations and challenges associated with the integration of EEG sensors in everyday-life wearable technologies. Overall, our study contributes to the growing body of research exploring the feasibility and validity of wearable neuroimaging technologies for the study of human cognition and behavior in real-world settings.

A Combined Assessment Tool of Teamwork, Communication, and Workload in Hospital Procedural Units

Teamwork, communication, and workload issues continue to contribute to patient safety events. The authors developed a diagnostic mixed methods toolkit combining a behavior observation tool, semistructured interview guide, and surveys to proactively identify relevant gaps. Applied across 14 units at three hospitals, this toolkit yielded 344 findings with 156 associated recommendations and took, on average, four days of observation. On a scale from 1 (not at all helpful) to 6 (substantially helpful), leaders indicated that the assessment and its recommendations were very helpful (median 5, interquartile range 5-6, 34 survey respondents, 47.9% individual-level response rate, 85.7% unit-level response rate). Integrating this tool into a broader safety strategy can help inform organizational improvement efforts.

Recognition and evaluation of mental workload in different stages of perceptual and cognitive information processing using a multimodal approach

This study explores the effects of different perceptual and cognitive information processing stages on mental workload by assessing multimodal indicators of mental workload such as the NASA-TLX, task performance, ERPs and eye movements. Repeated measures ANOVA of the data showed that among ERP indicators, P1, N1 and N2 amplitudes were sensitive to perceptual load (P-load), P3 amplitude was sensitive to P-load only in the prefrontal region during high cognitive load (C-load) states, and P3 amplitude in the occipital and parietal regions was sensitive to C-load. Among the eye movement indicators, blink frequency was sensitive to P-load in all C-load states, but to C-load in only low P-load states; pupil diameter and blink duration were sensitive to both P-load and C-load. Based on the above indicators, the k-nearest neighbours (KNN) algorithm was used to propose a classification method for the four different mental workload states with an accuracy of 97.89%.Practitioner summary: Based on the results of this study, it is possible to implement the monitoring of mental workload states and optimise brain task allocation in operations involving high mental workload, such as human-computer interaction.

Granular estimation of user cognitive workload using multi-modal physiological sensors

Mental workload (MWL) is a crucial area of study due to its significant influence on task performance and potential for significant operator error. However, measuring MWL presents challenges, as it is a multi-dimensional construct. Previous research on MWL models has focused on differentiating between two to three levels. Nonetheless, tasks can vary widely in their complexity, and little is known about how subtle variations in task difficulty influence workload indicators. To address this, we conducted an experiment inducing MWL in up to 5 levels, hypothesizing that our multi-modal metrics would be able to distinguish between each MWL stage. We measured the induced workload using task performance, subjective assessment, and physiological metrics. Our simulated task was designed to induce diverse MWL degrees, including five different math and three different verbal tiers. Our findings indicate that all investigated metrics successfully differentiated between various MWL levels induced by different tiers of math problems. Notably, performance metrics emerged as the most effective assessment, being the only metric capable of distinguishing all the levels. Some limitations were observed in the granularity of subjective and physiological metrics. Specifically, the subjective overall mental workload couldn't distinguish lower levels of workload, while all physiological metrics could detect a shift from lower to higher levels, but did not distinguish between workload tiers at the higher or lower ends of the scale (e.g., between the easy and the easy-medium tiers). Despite these limitations, each pair of levels was effectively differentiated by one or more metrics. This suggests a promising avenue for future research, exploring the integration or combination of multiple metrics. The findings suggest that subtle differences in workload levels may be distinguishable using combinations of subjective and physiological metrics.

"It's okay because I'm just driving": an exploration of self-reported mobile phone use among Mexican drivers

Introduction

Technological advancements have the potential to enhance people's quality of life, but their misuse can have a detrimental impact on safety. A notable example is the escalating issue of distracted driving resulting from the use of mobile phones behind the wheel, leading to severe crashes and injuries. Despite these concerns, both drivers' usage patterns and their risk-related associations remain scarcely documented in Mexico. Therefore, this descriptive study aimed to examine the mobile phone usage of Mexican drivers, its relationships to risk awareness and near-miss/crash involvement, and the self-reported underlying reasons for this behavior.

Methods

This cross-sectional study utilized a sample of 1,353 licensed Mexican drivers who took part in a nationwide series of interviews regarding their onboard phone use settings.

Results

A significant percentage of drivers (96.8%) recognize using a mobile phone while driving as high-risk behavior. However, only 7.4% reported completely avoiding its use while driving, with 22.4% identified as high-frequency users. Frequency was also found positively associated with the self-reported rate of near-misses and crashes. Furthermore, qualitative data analysis highlights the emergence of a 'sense of urgency' to attend to phone-related tasks in response to daily demands and life dynamics, offering a potential explanation for this behavior.

Conclusion

The results of this study suggest common patterns of onboard mobile use among Mexican drivers concerning driving situations and associated risks. This underscores the need for increased efforts to discourage onboard phone use in the country.

Assessment of Drivers' Mental Workload by Multimodal Measures during Auditory-Based Dual-Task Driving Scenarios

Assessing drivers' mental workload is crucial for reducing road accidents. This study examined drivers' mental workload in a simulated auditory-based dual-task driving scenario, with driving tasks as the main task, and auditory-based N-back tasks as the secondary task. A total of three levels of mental workload (i.e., low, medium, high) were manipulated by varying the difficulty levels of the secondary task (i.e., no presence of secondary task, 1-back, 2-back). Multimodal measures, including a set of subjective measures, physiological measures, and behavioral performance measures, were collected during the experiment. The results showed that an increase in task difficulty led to increased subjective ratings of mental workload and a decrease in task performance for the secondary N-back tasks. Significant differences were observed across the different levels of mental workload in multimodal physiological measures, such as delta waves in EEG signals, fixation distance in eye movement signals, time- and frequency-domain measures in ECG signals, and skin conductance in EDA signals. In addition, four driving performance measures related to vehicle velocity and the deviation of pedal input and vehicle position also showed sensitivity to the changes in drivers' mental workload. The findings from this study can contribute to a comprehensive understanding of effective measures for mental workload assessment in driving scenarios and to the development of smart driving systems for the accurate recognition of drivers' mental states.

Modality Changes in Vigilance Displays: Further Evidence of Supramodal Resource Depletion in Vigilance

OBJECTIVE

This study was designed to evaluate the effects of a modality change on vigilance performance to determine whether depletion of modality-specific resources contributes to the vigilance decrement.

BACKGROUND

Resource theory accounts for the vigilance decrement by arguing that the demands of vigilance deplete limited information processing resources. Research indicates that both supramodal and modality-specific resources are involved in vigilance, but it is unclear whether the vigilance decrement is due to depletion of supramodal resources, modality-specific resources, or both. If depletion of modality-specific resources contributes to the decrement, changing the modality of a vigilance display should improve vigilance performance after a decrement.

METHOD

Participants completed a 50-min vigilance task beginning in either the visual modality or the auditory modality. After 40-min, half of the participants experienced a sudden transition to the other modality; the remaining participants did not experience a modality change.

RESULTS

Performance declined over time and was generally superior in the auditory modality. Changing modality from visual to auditory increased correct detections, whereas changing from auditory to visual decreased correct detections. Both types of modality change were associated with an increase in false alarms, and neither had an effect on workload or stress.

CONCLUSION

Supramodal resource depletion, rather than modality-specific resource depletion, is the most likely explanation for the vigilance decrement that can be derived from resource theory.

APPLICATION

Modality changes are not likely to counteract the vigilance decrement and may actually increase false alarm errors. Countermeasure development should involve identification of depleted supramodal resources.