Multitask Conditions Research Articles

Agility training to integratively promote neuromuscular, cardiorespiratory and cognitive function in healthy older adults: a one-year randomized-controlled trial

BackgroundExercise training recommendations for seniors include the targeted training of strength, balance, endurance and flexibility domains. Agility training (AT) is conceptualized as a multi-component and time-efficient training framework for older adults to improve physical, functional and cognitive health domains that are relevant for maintaining activities of daily living. The aim of this one-year trial was to comparatively evaluate the effects of agility training on physical and cognitive function.MethodsSeventy-nine healthy older adults (AT: 61.5% female, 70.8 ± 4.8 years, 27.7 ± 4.2 kg/m2; CG: 60.5% female, 69.6 ± 4.7 years, 27.5 ± 4.4 kg/m2) took part in this one-year randomized controlled intervention and were either assigned to the agility training group (AT) with two weekly 60 min AT sessions or to the control group (CG), receiving no treatment. Participants were assessed pre, intermediate and post intervention for strength and power, balance, gait speed under multi-task conditions, aerobic capacity as well as cognitive performance. Linear mixed effects models were used to analyze the effect of treatment over time.ResultsFifty-four participants (AG: 25, CG: 29) were analyzed, most drop-outs attributed to COVID-19 (17/30 dropouts). Adherence was good (75%) of 90 offered sessions. Notable effects in favor of AT were found for gait parameters in single (d = 0.355, Δ = 4.3%), dual (d = 0.375, Δ = 6.1%) and triple (d = 0.376, Δ = 6.4%) task conditions, counter movement jump performance (strength and power) (d = 0.203, Δ = 6.9%), static one leg balance (d = 0.256, Δ = 12.33%) and n-back reaction time (cognitive performance) (d = 0.204, Δ = 3.8%). No effects were found for the remaining outcomes (d < 0.175).ConclusionAT might serve as an integrative training approach for older adults particularly improving gait and lower limb power parameters. It seems suitable to improve a broad range of seniors’ health domains and should replace isolated training of these domains. However, individual variation and progression of exercises should be considered when programming agility training providing adequate challenges throughout a long-term intervention for all participants.Trial registrationDRKS, DRKS00017469. Registered 19 June 2019—Retrospectively registered.

A Study on the Effect of Traditional Chinese Exercise Combined With Rhythm Training on the Intervention of Older Adults With Mild Cognitive Impairment.

To examine the effect of combination exercise program on cognitive function of older adults with mild cognitive impairment (MCI), and identify biomarkers associated with improvement of cognitive functions. Subjects were 42 older adults (ages, 60-80years) with MCI. The subjects were randomly classified to traditional Chinese exercise combined with rhythm training group (TCE + RTG, n = 14), walking group (WG, n = 14), and control group (CG, n = 14), according to their level of MMSE scores. These groups exercised for 60minutes at 1 session, 3 sessions a week for 12weeks. The intervention program was conducted under multitask conditions to stimulate attention and memory, and the control group attended 3 education classes. Measurements were administered before, after the 6-week, and after the 12-week intervention period; Measurements: The Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Symbol Digit Modalities Test (SDMT), Activities of Daily Living Scale (ADL), and the 17-item Hamilton Depression Scale (HAMD-17), along with the brain-derived neurotrophic factor (BDNF). A repeated-measures analysis of variance was used to examine differences among the 3 groups and between the 3 testing times (pre-test vs middle-test vs post-test). (1) The TCE + RTG showed significant improvement in the MMSE, MoCA, SDMT, and ADL scale test results (P < .01) and HAMD-17 scale test results (P < .05). The WG also showed significant improvement in the MMSE, MoCA, and HAMD-17 scale test results (P < .05) and the ADL scale test results (P < .01). While there was no significant change in the CG after the intervention. (2) The TCE + RTG and WG showed positive improvement in peripheral blood BDNF levels, while the CG showed a decrease in these test results. There were significant differences between the TCE + RTG and CG before and after the intervention. The results suggested that a TCE + RT is beneficial for improving memory and maintaining general cognitive function and peripheral blood BDNF levels in older adults with MCI. Peripheral blood BDNF levels may predict improvement of cognitive functions in older adults with MCI. Further studies are required to determine the positive effects of TCE + RT on cognitive function in older adults with MCI. Trial Registration: ChiCTR2200058545, Registered 10 April 2022.

Physiological Metrics of Surgical Difficulty and Multi-Task Requirement during Robotic Surgery Skills.

Previous studies in robotic-assisted surgery (RAS) have studied cognitive workload by modulating surgical task difficulty, and many of these studies have relied on self-reported workload measurements. However, contributors to and their effects on cognitive workload are complex and may not be sufficiently summarized by changes in task difficulty alone. This study aims to understand how multi-task requirement contributes to the prediction of cognitive load in RAS under different task difficulties. Multimodal physiological signals (EEG, eye-tracking, HRV) were collected as university students performed simulated RAS tasks consisting of two types of surgical task difficulty under three different multi-task requirement levels. EEG spectral analysis was sensitive enough to distinguish the degree of cognitive workload under both surgical conditions (surgical task difficulty/multi-task requirement). In addition, eye-tracking measurements showed differences under both conditions, but significant differences of HRV were observed in only multi-task requirement conditions. Multimodal-based neural network models have achieved up to 79% accuracy for both surgical conditions.

The association of executive functions and physical fitness with cognitive-motor multitasking in a street crossing scenario

Age-related decline in cognitive-motor multitasking performance has been attributed to declines in executive functions and physical fitness (motor coordinative fitness and cardiovascular fitness). It has been suggested that those cognitive and physical resources strongly depend on lifestyle factors such as long-term regular physical activity and cognitive engagement. Although research suggests that there is covariation between components of executive functions and physical fitness, the interdependence between these components for cognitive-motor multitasking performance is not yet clear. The aim of the study was to examine the contribution and interrelationship between executive functions, motor coordinative fitness, and cardiovascular fitness on street crossing while multitasking. We used the more ecologically valid scenario to obtain results that might be directly transferable to daily life situation. Data from 50 healthy older adults (65–75 years, 17 females, recruited in two different cities in Germany) were analyzed. Participants’ executive functions (composite score including six tests), motor coordinative fitness (composite score including five tests), and cardiovascular fitness (spiroergometry), as well as their street crossing performance while multitasking were assessed. Street crossing was tested under single-task (crossing a two-line road), and multitask conditions (crossing a two-line road while typing numbers on a keypad as simulation of mobile phone use). Street crossing performance was assessed by use of cognitive outcomes (typing, crossing failures) and motor outcomes (stay time, crossing speed). Linear mixed-effects models showed beneficial main effects of executive functions for typing (p = 0.004) and crossing failures (p = 0.023), and a beneficial main effect of motor coordinative fitness for stay time (p = 0.043). Commonality analysis revealed that the proportion of variance commonly explained by executive functions, motor coordinative fitness, and cardiovascular fitness was small for all street crossing outcomes. For typing and crossing failures (cognitive outcomes), the results further showed a higher relative contribution of executive functions compared to motor coordinative fitness and cardiovascular fitness. For stay time (motor outcome), the results correspondingly revealed a higher relative contribution of motor coordinative fitness compared to executive functions and cardiovascular fitness. The findings suggest that during cognitive-motor multitasking in everyday life, task performance is determined by the components of executive functions and physical fitness related to the specific task demands. Since multitasking in everyday life includes cognitive and motor tasks, it seems to be important to maintain both executive functions and physical fitness for independent living up to old age.

Reexamining the Environmental Kuznets Curve in Chinese Cities: Does Intergovernmental Competition Matter?

Since China's central authority began enforcing the environmental target responsibility system and introduced environmental indicators to the official ranking tournament in 2007, an ecological transformation has emerged in the intergovernmental competition (IGC) among localities. Because the extant literature on the environmental Kuznets curve (EKC) remains unclear regarding how that ecological IGC transformation changes the EKC economy-pollution correlation, this research investigates the degree to which the transformed IGC changes the form of the EKC, and how that altered EKC varies for different pollutants (i.e., SO2 and CO2) and in different regions (i.e., the eastern, central, and western regions). The results demonstrate a consistently inverted U-shaped relationship between income and SO2 emissions in all three regions, whereas when CO2 emissions are taken as the pollution indicator, the EKC hypothesis holds only in the eastern and central cities, and a positive linear income-CO2 nexus is found in the western region. Spatial analysis reveals that whereas the IGC flattens the inverted U-shaped curves between income and SO2 emissions, it has led to a higher economic cost, corresponding to the turning point of the EKC for CO2 emissions. The findings indicate that the ecological transformation of the IGC has facilitated a positive up-down yardstick competition in the strategic interactions of sustainable development across local Chinese governments, which can lead to a kind of balance between centralization and decentralization by inspiring local officials' adaptability and activity in reducing pollutant emissions and strengthening the officials' responsiveness to performance rankings. This study elucidates the environmental impacts of IGC in China and provides an institutional explanation for the strategic interactions among local governments when they are tackling the environment-economy nexus under multitask conditions.

The impact of a multicomponent-functional training with postural correction on functional balance in the elderly with a history of falling

PurposeGood posture plays a significant role for the elderly in achieving optimal quality of life. This study aimed to evaluate the impact of multicomponent functional training with postural correction on functional balance in the elderly with a history of falling.MethodsThis study was a randomized controlled, single-blind study. Subjects (n = 28, mean age = 70 years) with a history of falling were selected and randomly allocated to either a multicomponent functional training (n = 14) or a control group (n = 14). The experimental group exercised for 8 weeks, three days per week for 60 min per day. The training program with strength, endurance, and balance parts was conducted in the multi-task conditions to stimulate the physical and cognitive abilities focusing on the attentional-correct posture. The control group received conventional care. The Berg balance and short physical performance battery tests were used in the pre-test and post-test. The adjusted post-test means of experimental and control groups were analyzed using the ANCOVA test to eliminate any pretest effects.ResultsThis study found a significant effect of training on Berg balance test (P = 0.001), Timed Up and Go with D-T (P = 0.01), Timed Up and Go (P = 0.002), and Short Physical Performance Battery (P = 0.001).ConclusionsEight weeks of multicomponent exercise training has beneficial effects on balance and physical function and results in improved equilibrium and a decreasing probability of falling. Therefore, practitioners can use this 8-week training program for older adults.

The Effects of Different Types of Dual Tasking on Balance in Healthy Older Adults.

Numerous of our daily activities are performed within multitask or dual task conditions. These conditions involve the interaction of perceptual and motor processes involved in postural control. Age-related changes may negatively impact cognition and balance control. Studies identifying changes related to dual-task actions in older people are need. This study aimed to determine the effects of different types of dual-tasking on the balance control of healthy older adults. The sample included 36 community-living older adults, performing two tests—a sway test and a timed up-and-go test—in three conditions: (a) single motor task; (b) dual motor task; and (c) dual motor task with cognitive demands. Cognitive processes (dual-task and cognition) affected static balance, increasing amplitude (p < 0.001) and frequency (p < 0.001) of the center of mass displacements. Dynamic balance revealed significant differences between the single motor condition and the other two conditions during gait phases (p < 0.001). The effect of dual-tasking in older adults suggests that cognitive processes are a main cause of increased variability in balance and gait when under an automatic control. During sit-to-stand, turning, and turn-to-sit movements under dual-tasking, the perceptive information becomes the most important focus of attention, while any cognitive task becomes secondary.

Adaptive Coordinated Control Strategy of Multi Manipulator System based on Multi-Agent

With people's increasing awareness of life and the increasing complexity of exploration in unknown environment, a single robot can not meet the increasing demand, including the price, flexibility and efficiency of robots. As a common mechanical control system in industrial production instead of human production, multi manipulator system can be applied in complex environment, multi task and other conditions. In order to settle the coordinated control fault of multi manipulator system, we study adaptive coordinated control strategy with the help of multi-agent research method in this paper, which can simplify the complexity of the problem and design an efficient and feasible system control protocol. The complex items in the multi manipulator system are treated as non affine systems. Using the design idea of non affine algorithm, combined with implicit function theorem and median theorem, the non affine system is transformed into affine systems, the controller is separated, and a distributed adaptive control strategy is designed. The results indicate that manipulator systems can effectively track the active manipulator system in finite time and the significance of the algorithm is proven by MATLAB simulation analysis.

Cognitive Load Impairs Time to Initiate and Complete Shooting Tasks in ROTC Members.

Multitasking typically requires an individual to simultaneously process cognitive information while performing a motor task. Cognitive motor interference (CMi) is encountered when cognitive challenges negatively impact motor task performance. Military personnel encounter cognitively taxing situations, especially during combat or other tactical performance scenarios, which may lead to injury or motor performance deficits (i.e., shooting inaccuracy, delayed stimulus-response time, and slowed movement speed). The purpose of the current study was to develop four cognitive motor shooting paradigms to determine the effects of cognitive load on shooting performance in healthy Reserve Officers' Training Corps (ROTC) cadets. Thirty-two healthy collegiate ROTC members (24 male and 8 female; 20.47 ± 1.24 years, 174.95 ± 10.58 cm, and 77.99 ± 13.90 kg) were recruited to complete four simulated shooting tasks with additional "motor" challenge (180° turn, gait, weighted, and unweighted landing) and with and without a "cognitive" decision-making challenge requiring response selection and inhibition to both auditory and visual stimuli, totaling eight multi-task cognitive motor shooting conditions. The current study was approved by the university's Institutional Review Board. Task initiation (seconds), task completion (seconds), and number of misses were calculated to determine marksmanship efficiency and accuracy. For each task, a multivariate repeated-measures analysis of variance (ANOVA) was conducted for the combined dependent variables. If the overall multivariate repeated-measures ANOVA was significant, follow-up univariate ANOVAs were conducted for each dependent variable. Alpha was set at α = 0.05 for all analyses. Task initiation increased for the cognitive condition for the 180° turn (4.29 ± 1.22 seconds baseline, 5.09 ± 1.39 seconds cognitive; P < .05), gait (2.76 ± .60 seconds baseline, 3.93 ± .62 seconds cognitive; P < .05), unweighted (1.27 ± .57 seconds baseline, 3.39 ± .63 seconds cognitive; P < .05), and weighted landing (1.46 ± .72 seconds baseline, 3.35 ± .60 seconds cognitive; P < .05). Task completion time increased for the cognitive condition for the 180° turn (3.48 ± 1.53 seconds baseline, 4.85 ± 1.24 seconds cognitive; P < .05), gait (7.84 ± 2.07 seconds baseline, 9.23 ± 1.76 seconds cognitive; P < .05), unweighted (5.98 ± 1.55 seconds baseline, 7.45 ± 1.51 seconds cognitive; P < .05), and weighted landing (6.09 ± 1.42 seconds baseline, 7.25 ± 1.79 seconds cognitive; P < .05). There were no statistically significant differences in the number of misses for any of the tasks between conditions (P > .05). The addition of a cognitive load increased both task initiation and task completion times during cognitive motor simulated shooting. Adding cognitive loads to tactical performance tasks can result in CMi and negatively impact tactical performance. Thus, consideration for additional cognitive challenges into training may be warranted to reduce the potential CMi effect on tactical performance.

Cognitive-Postural Multitasking Training in Older Adults - Effects of Input-Output Modality Mappings on Cognitive Performance and Postural Control.

Older adults exhibit impaired cognitive and balance performance, particularly under multi-task conditions, which can be improved through training. Compatibility of modality mappings in cognitive tasks (i.e., match between stimulus modality and anticipated sensory effects of motor responses), modulates physical and cognitive dual-task costs. However, the effects of modality specific training programs have not been evaluated yet. Here, we tested the effects of cognitive-postural multi-tasking training on the ability to coordinate task mappings under high postural demands in healthy older adults. Twenty-one adults aged 65–85 years were assigned to one of two groups. While group 1 performed cognitive-postural triple-task training with compatible modality mappings (i.e., visual-manual and auditory-vocal dual n-back tasks), group 2 performed the same tasks with incompatible modality mappings (i.e., visual-vocal and auditory-manual n-back tasks). Throughout the 6-weeks balance training intervention, working-memory load was gradually increased while base-of-support was reduced. Before training (T0), after a 6-week passive control period (T1), and immediately after the intervention (T2), participants performed spatial dual one-back tasks in semi-tandem stance position. Our results indicate improved working-memory performance and reduced dual-task costs for both groups after the passive control period, but no training-specific performance gains. Furthermore, balance performance did not improve in response to training. Notably, the cohort demonstrated meaningful interindividual variability in training responses. Our findings raise questions about practice effects and age-related heterogeneity of training responses following cognitive-motor training. Following multi-modal balance training, neither compatible nor incompatible modality mappings had an impact on the observed outcomes.

Effects of Cognitive and Physical Loads on Dynamic and Static Balance Performance of Healthy Older Adults Under Single-, Dual-, and Multi-task Conditions.

The aim of this study is to examine the effects of cognitive and physical loads on dynamic and static balance performance of healthy older adults under single-, dual-, and multi-task conditions. Previous studies on postural control in older adults have generally used dual-task methodology, whereas less attention has been paid to multi-task performance, despite its importance in many daily and occupational activities. The effects of single versus combined (dual-task and multi-task) cognitive (to speak out the name of the weekdays in a reverse order) and physical (with three levels including handling weights of 1, 2, and 3 kg in each hand) loads on dynamic and static balance performance of 42 older adults (21 males and 21 females) aged ≥60 years were examined. Dynamic and static balance measures were evaluated using the Timed Up and Go (TUG) and stabilometer (sway index) tests, respectively. The TUG speed of female participants was generally slower than that of male participants. Age had no effect on balance performance measures. Under dual-task conditions, cognitive load decreased the dynamic balance performance, while the physical task levels had no effect. The dual-task conditions had no impact on the static balance performance. The effects of cognitive and physical loads on dynamic balance performance varied under dual- and multi-task conditions. The findings highlight differences between dual- and multi-task protocols and add to the understanding of balance performance in older adults under cognitive and physical loads. The present study highlights differences between dual- and multi-task methodologies that need to be considered in future studies of balance and control in older adults.

Interaction between proprioceptive sensitivity and the attentional demand for dynamic postural control in sedentary seniors: A pilot study

Introduction Postural instabilities and falls among seniors have been attributed to both a decline in proprioceptive function as well as an inability to efficiently allocate attention to balance in multi-task conditions. This study aims to explore the interaction between proprioceptive sensitivity and attentional demand for dynamic postural control in seniors. Material and methods Old and young sedentary adults performed a postural stability limit task in five experimental conditions that varied the availability of vision and the presence of a secondary attentional task: – attentional task; – postural task with eyes open; – postural task with eyes closed; – postural task with eyes open and secondary attentional task; – postural task with eyes closed and secondary attentional task. Ground reaction force data was collected at 200 Hz using an AMTI force platform and center of foot pressure (COP) was analysed. The functional limits of stability were quantified as the maximum center of pressure excursion during voluntary leaning in each direction. We hypothesized that the greatest age-related differences in performing this stability limit task would seen under the dual-task condition because of limitations in attentional resources available for concurrently coping with high proprioceptive and cognitive demands. Results The findings demonstrate the impact of removing visual-information is more important when older adults are required to perform the attentional task simultaneously with the postural stability limit task. Discussion This suggests that increasing the demand for proprioceptive processing increases the attentional cost of postural control, consistent with a significant interaction between proprioception and attention in the postural control of seniors.

Modeling Driver Take-Over Reaction Time and Emergency Response Time using an Integrated Cognitive Architecture

Drivers’ take-over reaction time in partially automated vehicles is a fundamental component of automated vehicle design requirements, and take-over reaction time is affected by many factors such as distraction and drivers’ secondary tasks. This study built cognitive architecture models to simulate drivers’ take-over reaction time in different secondary task conditions. Models were built using the queueing network-adaptive control of thought rational (QN-ACTR) cognitive architecture. Drivers’ task-specific skills and knowledge were programmed as production rules. A driving simulator program was connected to the models to produce prediction of reaction time. Model results were compared with human results in both single-task and multi-task conditions. The models were built without adjusting any parameter to fit the human data. The models could produce simulation results of take-over reaction time similar to the human results in take-over conditions with visual or auditory concurrent tasks, as well as emergency response time in a manual driving condition. Overall, R square was 0.96, root mean square error (RMSE) was 0.5 s, and mean absolute percentage error (MAPE) was 9%. The models could produce simulation results of reaction time similar to the human results from different task conditions. The production rules are plausible representations of drivers’ strategies and skills. The models provide a useful tool for the evaluation of take-over alert design and the prediction of driver performance.

Effective Strategy of the Multicomponent Exercise Program for Older Individuals in a Depopulated Rural Region

The aim of this study was to examine whether the multicomponent exercise program based on an independent home-training can become effective strategy for Japanese older people in a depopulated rural region. Twenty participants over 65 years old without cognitive impairment exercised for 90-min a day, once per 2 weeks for 6 months, according to education regarding an independent home-exercise. The exercise program was conducted under multitask conditions to cognition, including an aerobic exercise. Physical and cognitive measurements were carried out at baseline and after the 6-month intervention. The physical measurement consisted of four domains, and the cognitive evaluation included four domains. 12 older adults (age mean: 76.9 years, % female: 91.6%) completed the 6-month follow-up. According to statistical analyses, the walking speed was significantly faster, and the executive function also had significantly increased after the intervention. Our findings suggest that the multicomponent exercise program based on home-training can be effective for enhancements of the gait ability and the executive function for older individuals in a depopulated rural region.

Investigating an errorless learning approach for developing dental operative technique skills: A pilot study.

Explicit instruction (conscious knowledge/rules) is generally used for learning dental operative skills; however, recent work has demonstrated advantages of learning skills implicitly with minimal accrual of conscious knowledge and reduced attentional demands. Therefore, this study examined the effects of learning handpiece manipulation skills explicitly (errorful) and implicitly (errorless: limited error detection/correction) under conditions of increased attentional demands (ie multitasking and additional instructions). Non-dental university students were randomly assigned to errorless (n=11) or errorful (n=8) groups. They used pencil lead instead of a bur, with errorless learners shading shapes from simple (small circle) to complex (cross), while errorful learners shaded the shapes in reverse. During testing, they completed simulated cavities in baseline, additional instructions and multitask conditions. Learning performance was calculated as per cent of the shape shaded successfully. Test performance was computed as error in cavity length/depth and was compared with dental students who had completed their operative technique course (n=14). Errorless learners were more accurate than errorful learners especially when shading difficult shapes (P=0.042). With additional instructions, errorless and errorful learners did not differ in cavity depth (P=0.057) or length (P=0.540). When multitasking, errorless learners prepared the cavity length (P=0.048) but not depth (P=0.920) more accurately than errorful learners. Overall, performance of errorless learners was comparable to dental students. These preliminary findings suggest handpiece skills can be acquired implicitly via errorless learning, and it is less attentionally demanding than errorful learning, as evident by maintenance of preparation performance when processing additional relevant instructions and multitasking.

An experimental paradigm for the assessment of realistic human multitasking

Human multitasking has been evaluated with paradigms that administered two—rarely three—concurrent tasks. In everyday life, however, we usually face an ever-changing sequence of distinct concurrent tasks. Available studies therefore provided valuable insights into our ability for dual tasking, but they did not address the natural interplay of dual tasking and task switching. The present study was undertaken to explore the feasibility of two new paradigms which replicate that interplay in virtual reality. We used car driving simulator software to implement a virtual car-driving task as well as a virtual street-crossing task. Either task was administered alone, as well as concurrently with a battery of loading tasks that mimicked activities of everyday life. The loading tasks used different sensory modalities, different cognitive processes, and different output channels and were presented in an ever-changing sequence. Cronbach’s alpha scores of key registered variables were high, which indicates that our approach is reliable. Driving and street-crossing performance deteriorated under multitask conditions, which indicates that our approach is sensitive to multitasking. This is the first study to demonstrate the feasibility of an experimental paradigm for the assessment of natural multitasking, i.e., of combined dual tasking and task switching. This paradigm could be of interest for basic science as well as for prevention and rehabilitation settings.

Influence evaluation of multi-task conditions on walking balance via hip acceleration variation

Influence evaluation of multi-task conditions on walking balance via hip acceleration variation

The perceptions of patient safety culture: A difference between physicians and nurses in Taiwan

AimsIn order to pursue a better patient safety culture and provide a superior medical service for patients, this study aims to respectively investigate the perceptions of patient safety from the viewpoints of physicians and nurses in Taiwan. BackgroundLittle knowledge has clearly identified the difference of perceptions between physicians and nurses in patient safety culture. Understanding physicians and nurses' attitudes toward patient safety is a critical issue for healthcare organizations to improve medical quality. MethodsConfirmatory factor analysis (CFA) is used to verify the structure of data (e.g. reliability and validity), and Pearson's correlation analysis is conducted to demonstrate the relationships among seven patient safety culture dimensions. ResultsResearch results illustrate that more teamwork is exhibited among team members, the more safety of a patient is committed. Perceptions of management and emotional exhaustion are important components that contribute to a better patient safety. More importantly, working conditions and stress recognition are found to be negatively related from the perceptions of nurses. Compared to physicians, nurses reported higher stress and challenges which result from multi-task working conditions in the hospital. ConclusionsThis study focused on the contribution of a better patient safety culture from different viewpoints of physicians and nurses for healthcare organizations in Taiwan. A different attitudes toward patient safety is found between physicians and nurses. The results enable the hospital management to realize and design appropriate implications for hospital staffs to establish a better patient safety culture.

The Status of the Strategic Task Overload Model (STOM) for Predicting Multi-Task Management

A model for task switching which focuses on the decision making of operators in overloaded multitask conditions is reviewed and new research presented. The STOM model is an ongoing effort and as such, work is now accumulating, which serves to validate the model as a useful predictive method, but also is uncovering uncertainties that require further investigation. Here we summarize the origins of the model, which was informed by past modeling efforts, a literature review and a meta-analysis. We then describe in detail the basic parameters of STOM and the current status of each, before discussing future directions and six uncertainties uncovered when building our understanding of task switching choice.

A Bayesian Assessment of Real-World Behavior During Multitasking

Multitasking is common in everyday life, but its effect on activities of daily living is not well understood. Critical appraisal of performance for both healthy individuals and patients is required. Motor activities during meal preparation were monitored in healthy individuals with a wearable sensor network during single and multitask conditions. Motor performance was quantified by the median frequencies (fm) of hand trajectories and wrist accelerations. The probability that multitasking occurred based on the obtained motor information was estimated using a Naïve Bayes Model, with a specific focus on the single and triple loading conditions. The Bayesian probability estimator showed task distinction for the wrist accelerometer data at the high and low value ranges. The likelihood of encountering a certain motor performance during well-established everyday activities, such as preparing a simple meal, changed when additional (cognitive) tasks were performed. Within a healthy population, the probability of lower acceleration frequency patterns increases when people are asked to multitask. Cognitive decline due to aging or disease might yield even greater differences.