A PDA-based system for online recording and analysis of concurrent events in complex behavioral processes

Male sexually coercive behaviour drives increased swimming efficiency in female guppies

Sexual coercion of females by males is widespread across sexually reproducing species. It stems from a conflict of interest over reproduction and exerts selective pressure on both sexes. For females, there is often a significant energetic cost of exposure to male sexually coercive behaviours.Our understanding of the efficiency of female resistance to male sexually coercive behaviour is key to understanding how sexual conflict contributes to population level dynamics and ultimately to the evolution of sexually antagonistic traits.Overlooked within this context are plastic physiological responses of traits within the lifetime of females that could moderate the energetic cost imposed by coercive males. Here, we examined whether conflict over the frequency and timing of mating between male and female guppies Poecilia reticulata can induce changes in swimming performance and aerobic capacity in females as they work to escape harassment by males.Females exposed to higher levels of harassment over a 5-month period used less oxygen to swim at a given speed, but displayed no difference in resting metabolic rate, maximal metabolic rate, maximal sustained swimming speed or aerobic scope compared to females receiving lower levels of harassment.The observed increase in swimming efficiency is at least partially related to differences in swimming mechanics, likely brought on by a training effect of increased activity, as highly harassed females spent less time performing pectoral fin-assisted swimming.Sexual conflict results in sexually antagonistic traits that impose a variety of costs, but our results show that females can reduce costs through phenotypic plasticity. It is also possible that phenotypic plasticity in swimming physiology or mechanics in response to sexual coercion can potentially give females more control over matings and affect which male traits are under selection.

Building the Evidence on Simulation Validity

Background:

Effective teamwork is important for patient safety, and verbal communication underpins many dimensions of teamwork. The validity of the simulated environment would be supported if it elicited similar verbal communications to the real setting. The authors hypothesized that anesthesiologists would exhibit similar verbal communication patterns in routine operating room (OR) cases and routine simulated cases. The authors further hypothesized that anesthesiologists would exhibit different communication patterns in routine cases (real or simulated) and simulated cases involving a crisis.

Methods:

Key communications relevant to teamwork were coded from video recordings of anesthesiologists in the OR, routine simulation and crisis simulation and percentages were compared.

Results:

The authors recorded comparable videos of 20 anesthesiologists in the two simulations, and 17 of these anesthesiologists in the OR, generating 400 coded events in the OR, 683 in the routine simulation, and 1,419 in the crisis simulation. The authors found no significant differences in communication patterns in the OR and the routine simulations. The authors did find significant differences in communication patterns between the crisis simulation and both the OR and the routine simulations. Participants rated team communication as realistic and considered their communications occurred with a similar frequency in the simulations as in comparable cases in the OR.

Conclusion:

The similarity of teamwork-related communications elicited from anesthesiologists in simulated cases and the real setting lends support for the ecological validity of the simulation environment and its value in teamwork training. Different communication patterns and frequencies under the challenge of a crisis support the use of simulation to assess crisis management skills.

Flight phases in the song of skylarks: impact on acoustic parameters and coding strategy

Skylarks inhabit open fields and perform an aerial song display which serves as a territorial signal. The particularly long and elaborate structure of this song flight raises questions about the impact of physical and energetic constraints acting on a communication signal. Song produced during the three distinct phases of the flight - ascending, level and descending phase could be subject to different constraints, serve different functions and encode different types of information. We compared song parameters during the ascending and the level phases. We found that the structure of the song varied with the phase of the flight. In particular, song had a higher tempo when skylarks were ascending which might be related to higher oxygen and energetic demands. We also explored which phase of the song flight might encode individuality. Earlier studies reported that skylarks reduced their territorial response to established neighbours if the neighbour song was broadcasted from the correct adjacent boundary, but reacted aggressively if the neighbour songs were broadcasted from an incorrect boundary (mimicking a displaced neighbour). Such differential response provides some evidence for individual recognition. Here, we exposed subjects to playback stimuli of neighbour song in which we had replaced either the song produced during the level or the ascending phase by the relevant song of the neighbour from the incorrect border. Singing response was higher towards stimuli in which the 'level phase song' was replaced, indicating that skylarks could be able to recognise their neighbours based on song of this phase. Thus, individuality seems to be primarily coded in the level phase of the flight song.

Team communication during patient handover from the operating room: more than facts and figures

OBJECTIVE

This study was aimed at examining team communication during postoperative handover and its relationship to clinicians' self-ratings of handover quality.

BACKGROUND

Adverse events can often be traced back to inadequate communication during patient handover. Research and improvement efforts have mostly focused on the information transfer function of patient handover. However, the specific mechanisms between handover communication processes among teams of transferring and receiving clinicians and handover quality are poorly understood.

METHOD

We conducted a prospective, cross-sectional observation study using a taxonomy for handover behaviors developed on the basis of established approaches for analyzing teamwork in health care. Immediately after the observation, transferring and receiving clinicians rated the quality of the handover using a structured tool for handover quality assessment. Handover communication during 117 handovers in three postoperative settings and its relationship to clinicians' self-ratings of handover quality were analyzed with the use of correlation analyses and analyses of variance.

RESULTS

We identified significantly different patterns of handover communication between clinical settings and across handover roles. Assessments provided during handover were related to higher ratings of handover quality overall and to all four dimensions of handover quality identified in this study. If assessment was lacking, we observed compensatory information seeking by the receiving team.

CONCLUSION

Handover quality is more than the correct, complete transmission of patient information. Assessments, including predictions or anticipated problems, are critical to the quality of postoperative handover.

APPLICATION

The identification of communication behaviors related to high-quality handovers is necessary to effectively support the design and evaluation of handover improvement efforts.

Skin exposure to epoxy in the pipe relining trade - an observational study

BACKGROUND

Epoxy resin systems (ERSs) are frequent causes of occupational allergic contact dermatitis. Epoxy pipe relining has become a widely used alternative to replacing old and worn drain pipes in housing, and involves a high risk of skin exposure to ERSs.

OBJECTIVES

To map out work methods, protective measures and skin and surface contamination among workers involved in epoxy pipe relining, as a basis for prevention of occupational skin disease.

METHODS

Twenty-one employees in eight relining companies in Stockholm County were observed. Contact and contamination with ERSs and the use of personal protective equipment during relining work were noted.

RESULTS

Contamination by uncured ERSs on gloves, personal and shared tools and work areas was identified during mixing, wetting, installation, and cleaning. The gloves used were often inadequate for handling ERSs.

CONCLUSIONS

Relining pipes poses an extensive risk of uncured ERS exposure, and contamination was identified during the whole work process. Shared and personal tools and work areas were extensively contaminated. Changes in work routines and logistics for handling ERSs are essential, and knowledge among both employers and employees regarding the risks caused by ERS exposure is vital to create a safe work environment and prevent contact allergies.

An observation support system with an adaptive ontology-driven user interface for the modeling of complex behaviors during surgical interventions

The field of surgical interventions emphasizes knowledge and experience; explicit and detailed models of surgical processes are hard to obtain by observation or measurement. However, in medical engineering and related developments, such models are highly valuable. Surgical process modeling deals with the generation of complex process descriptions by observation. This places high demands on the observers, who have to use a sizable terminology to denominate surgical actions, instruments, and patient anatomies, and to describe processes unambiguously. Here, we present a novel method, employing an ontology-based user interface that adapts to the actual situation and describe the principles of the system. A validation study showed that this method enables observers with little recording experience to reach a recording accuracy of >90%. Furthermore, this method can be used for live and video observation. We conclude that the method of ontology-supported recording for complex behaviors can be advantageously employed when surgical processes are modeled.

A wireless portable physiology recorder for psychophysiology research based on a personal digital assistant

Psychophysiology research is increasingly relying on portable instruments that can assess physiological responses during real-life situations at locations outside of research labs, such as at school, home, work, and outdoors. In this article, I report on the feasibility of a personal digital assistant-based portable physiology recording system with online signal graphing and wireless digital telemetry for psychophysiology research. I demonstrate that such a system can measure electrocardiogram and electrodermal activity and send this data over a wireless communication link to a PC. It enables users to inspect the integrity of the acquired signals on the portable device and on a PC base station, and it allows users to place time markers for online data analysis.

Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians

BACKGROUND

Hospital physicians' time is a critical resource in medical care. Two aspects are of interest. First, the time spent in direct patient contact - a key principle of effective medical care. Second, simultaneous task performance ('multitasking') which may contribute to medical error, impaired safety behaviour, and stress. There is a call for instruments to assess these aspects. A preliminary study to gain insight into activity patterns, time allocation and simultaneous activities of hospital physicians was carried out. Therefore an observation instrument for time-motion-studies in hospital settings was developed and tested.

METHODS

35 participant observations of internists and surgeons of a German municipal 300-bed hospital were conducted. Complete day shifts of hospital physicians on wards, emergency ward, intensive care unit, and operating room were continuously observed. Assessed variables of interest were time allocation, share of direct patient contact, and simultaneous activities. Inter-rater agreement of Kappa = .71 points to good reliability of the instrument.

RESULTS

Hospital physicians spent 25.5% of their time at work in direct contact with patients. Most time was allocated to documentation and conversation with colleagues and nursing staff. Physicians performed parallel simultaneous activities for 17-20% of their work time. Communication with patients, documentation, and conversation with colleagues and nursing staff were the most frequently observed simultaneous activities. Applying logit-linear analyses, specific primary activities increase the probability of particular simultaneous activities.

CONCLUSION

Patient-related working time in hospitals is limited. The potential detrimental effects of frequently observed simultaneous activities on performance outcomes need further consideration.

Coordination patterns related to high clinical performance in a simulated anesthetic crisis

BACKGROUND

Teamwork is an integral component in the delivery of safe patient care. Several studies highlight the importance of effective teamwork and the need for teams to respond dynamically to changing task requirements, for example, during crisis situations. In this study, we address one of the many facets of "effective teamwork" in medical teams by investigating coordination patterns related to high performance in the management of a simulated malignant hyperthermia (MH) scenario. We hypothesized that (a) anesthesia crews dynamically adapt their work and coordination patterns to the occurrence of a simulated MH crisis and that (b) crews with higher clinical performance scores (based on a time-based scoring system for critical MH treatment steps) exhibit different coordination patterns.

METHODS

This observational study investigated differences in work and coordination patterns of 24 two-person anesthesia crews in a simulated MH scenario. Clinical and coordination behavior were coded using a structured observation system consisting of 36 mutually exclusive observation categories for clinical activities, coordination activities, teaching, and other communication. Clinical performance scores for treating the simulated episode of MH were calculated using a time-based scoring system for critical treatment steps. Coordination patterns in response to the occurrence of a crisis situation were analyzed using multivariate analysis of variance and the relationship between coordination patterns and clinical performance was investigated using hierarchical regression analyses. Qualitative analyses of the three highest and lowest performing crews were conducted to complement the quantitative analysis.

RESULTS

First, a multivariate analysis of variance revealed statistically significant changes in the proportion of time spent on clinical and coordination activities once the MH crisis was declared (F [5,19] = 162.81, P < 0.001, eta(p)(2) = 0.98). Second, hierarchical regression analyses controlling for the effects of cognitive aid use showed that higher performing anesthesia crews exhibit statistically significant less task distribution (beta = -0.539, P < 0.01) and significantly more situation assessment (beta = 0.569, P < 0.05). Additional qualitative video analysis revealed, for example, that lower scoring crews were more likely to split into subcrews (i.e., both anesthesiologists worked with other members of the perioperative team without maintaining a shared plan among the two-person anesthesia crew).

CONCLUSIONS

Our results of the relationship of coordination patterns and clinical performance will inform future research on adaptive coordination in medical teams and support the development of specific training to improve team coordination and performance.

Male harassment drives females to alter habitat use and leads to segregation of the sexes

Sexual conflict is ubiquitous across taxa. It often results in male harassment of females for mating opportunities that are costly for females, in some cases reducing reproductive success and increasing mortality. One strategy that females may employ to avoid sexual harassment is to segregate spatially from males. In fact, we do find sexual segregation in habitat use in species that have high levels of sexual conflict; however, the role of sexual harassment in driving such segregation remains poorly understood. Here, we demonstrate experimentally in a population of wild Trinidadian guppies Poecilia reticulata that male sexual harassment drives females into habitats that they otherwise do not prefer to occupy. In support of the social factors hypothesis for sexual segregation, which states that social factors such as harassment drive sexual segregation, this female behaviour leads to segregation of the sexes. In the presence of males, females actively select areas of high predation risk, but low male presence, and thus trade off increased predation risk against reduced sexual harassment.

The model anti-androgen flutamide suppresses the expression of typical male stickleback reproductive behaviour

Over the past 15 years considerable attention has been given to the presence in the environment of endocrine disrupting chemicals (EDCs) that may have harmful effects on organisms. Specific test guidelines for the detection of EDCs used for short-term fish screening assays have been developed by the Organisation for Economic Cooperation and Development (OECD). Compared to the core species used in the OECD guidelines, the three-spined stickleback (Gasterosteus aculeatus) has an additional and unique endpoint for (anti-)androgenic substances through the androgen-dependent glue protein (spiggin) used in the nest building. Here we describe a specific behavioural assay that was developed in parallel to the OECD protocol, utilising unique behavioural features of sticklebacks. In the assay, a photoperiod of 16L:8D (light:dark) and a temperature of 17+/-1 degrees C was used to induce breeding in quiescent male sticklebacks that were simultaneously exposed for a 21-day period to the mammalian anti-androgen flutamide (FL) at 100, 500 and 1000 microg/l (plus a water control). Spiggin production and the reproductive behaviour (nest building and courtship) of male sticklebacks were the main measured endpoints. The control fish entered an active breeding cycle including nest building and courtship behaviours as expected due to the stimulating temperature and photoperiodic conditions. The FL-exposed males showed significantly lower spiggin levels at 500 and 1000 microg/l. In addition, there was a significant decrease in the number of nests built by the FL-treated males at 100 microg/l with no nest built at 500 and 1000 microg/l. Finally, FL affected the courtship behaviour of the males with a significant reduction of the number of zigzags towards the female. When the breeding status of the stickleback males is controlled, the behavioural assay developed here is a suitable tool for the detection of androgen antagonists.

Adaptive coordination in cardiac anaesthesia: a study of situational changes in coordination patterns using a new observation system

Patient care in hospital settings requires coordinated team performance. Studies in other industries show that successful teams adapt their coordination processes to the situational task requirements. This prospective field study aimed to test a new observation system and investigate patterns of adaptive coordination within operating room teams. A trained observer recorded coordination activities during 24 cardiac surgery procedures. The study tested whether different patterns occur during different phases of and between different types of surgical procedures (two-way multivariate ANOVA with repeated measure). A statistically significant increase was found in clinical and coordination activities in phases of the operation with high task interdependence. The highest level of 'coordination via the work environment' (i.e. an implicit coordination mechanism) was recorded during the actual procedure on the beating heart. These findings prove the sensitivity of the observation system developed and evaluated in this study and provide insight into patterns of adaptive coordination in cardiac anaesthesia. This study furthers our understanding of adaptive coordination as a cornerstone of effective team performance in complex work environments. Using a new observation system, it describes patterns employed by health care professionals in response to changing task demands in an acute patient care setting.

Skin exposure in geriatric care ? a comparison between observation and self-assessment of exposure

The aim of this study was to compare observation and self-assessment of skin exposure to irritants during a working day in nursing in geriatric care. The study group consisted of 40 volunteers, 13 nurses, and 27 assistant nurses. Before the start of a working day, the participants completed a questionnaire regarding skin exposure to water, gloves, hand disinfection, and moisturizers. Observers subsequently used a hand-held computer to register the time and frequency of each exposure. The total mean skin exposure time was 96 min per working day, including glove use. The mean exposure time to water was 9 min per working day. A tendency to overestimate was found for all exposures. A strong correlation between self-reports and observations was found for hand disinfection and moisturizers, while a moderate correlation was found for gloves and number of water exposures and a weak correlation for total time of water exposure. Despite the differences between self-assessment and observation of the exposure, we consider the questionnaire to be useful for surveying skin exposure in nursing. Furthermore, the observations in this study suggest that nursing work in geriatric care may comprise limited exposure to water.

Self-reported skin exposure--validation of questions by observation

The aim of this study was to validate questions regarding skin exposure using observation. The study group consisted of 40 individuals in 5 different occupations: nurse in an intensive care unit, car mechanic, hairdresser, kitchen worker, and office worker. The participants completed a questionnaire before the start of a working day. The questionnaire covered total skin exposure times to water, foodstuffs, chemicals, and occlusive gloves and also covered the frequency of hand-washing during a working day. Observers subsequently used a hand-held computer to register the time and the frequency of each exposure. A strong correlation between self-reports and observations was found for questions regarding exposure times to water, foodstuffs, and occlusive gloves and also a moderate correlation for questions regarding frequency of hand-washing. The present observation method was insufficient for estimating total exposure times to chemicals as the true exposure time is influenced by, e.g. the use of contaminated protective gloves and the efficacy with which the chemicals were removed. The inter-observer reliability showed a very strong correlation. We consider the questions regarding skin exposure to water, foodstuffs, protective gloves, and hand-washing to be useful for future studies. The observation method seems to be reliable, useful, and easy to apply.