Validation in the context of commercialization : the white rabbit effect

In this edition of Sleep Medicine, Sadeh and colleagues [1] explorethe use of on-line technologies to measure neurobehavioralperformance (NBP). The authors present a new online continuousperformance test (OCPT) that can, at least in theory, be used to assessNBP remotely and aggregate data from a wide range of collectionsites and clinical populations. The OCPT is a computerizedchoice response task and is described in detail in the paper [1]. Errorrates and response times are recorded and stored on an externalweb server

Dreams as gifts: A Maussian perspective

In The Gift, Mauss argues that people in many cultures have engaged in what appears to be a voluntary giving of gifts, but which in fact carries obligations at each point in the exchange-in the giving of, receiving of, and response to each gift. Moreover, these exchanges of gifts are an integral part of both building connections between individuals and groups and maintaining social hierarchies. Using the Mauss view of gifts as a framework for examining the social practice of sharing dreams, this article demonstrates the obligations present in the giving of, receiving of, and responding to dreams. It then identifies the implications of this understanding of dreams as gifts, for clients offering their dreams in psychotherapeutic settings. © 2019 American Psychological Association

The marginalisation of dreams in clinical psychological practice

The longstanding human interest in dreams has led to a significant body of psychological and philosophical discourse, including research. Recently, however, dreams have been relegated to the periphery of clinical psychological practice. This is potentially problematic as clients continue to bring dreams to therapy and many psychologists lack the confidence or competence to respond effectively to dream material. Building on the structural, professional and research cultures surrounding psychology using a cultural-historical activity theory framework, we argue the marginalisation of dreams is due to cultural-historical factors. These factors include the political and economic context in which psychology developed; psychology's early attempts to differentiate from psychoanalysis by identifying with behaviourism and the natural sciences; and a discipline-specific definition of what constitutes evidence-based practice. These factors led to professional discourses within which dreams are seen as of little clinical or therapeutic value, or that dream work is only for long-term therapy and requires extensive therapist training. However, there are diverse models of dream work consistent with most theoretical orientations within contemporary psychological practice. We conclude with recommendations on how to rebuild clinical confidence and competence in the use of dream material within the current professional environment. © 2018 Elsevier Lt

Fatigue management in practice – It's just good teamwork

An important review was published in this issue of the journal. The review by Banks et al. [1] is important for several reasons. Critically, it reviews a rapidly emerging area of sleep and fatigue science. Moreover, it emphasises the critical perspective that fatigue is much more than individual impairment. The review underlines the need to understand fatigue in a much broader context, that of individuals working as teams, and as part of larger organisational systems of work

A predictive model of work-related fatigue based on hours-of-work

RESEARCH over several decades has implicated shiftwork as a major cause of work-·related fatigue and decreased health and safety. However, discriminating between different rosters in terms of fatigue has been difficult. This is partially due to the large number of different rosters currently worked as well as the significant costs associated with laboratory-based roster assessments. Due to difficulties with traditional laboratory-based methods of modelling rosters, it is the authors' aim to develop a quantitative approach based only on the timing and duration of work periods. The potential applications of quantitative fatigue modelling in monitoring health and safety outcomes are also discussed. Specific examples are given for quantifying fatigue in road transport. In conclusion, this model provides a simple, straightforward approach to quantifying fatigue. It also enables organisations to model the relationship between hours of work and health and safety outcomes or to model the implications of proposed roster changes

Behavioural sleep interventions in infants: Plan B – combining models of responsiveness to increase parental choice

In families with infants between the ages of 6 and 18 months, sleep disruption can be significant, often putting parents at risk of a range of negative psychological and psychosocial consequences. Commonly prescribed sleep interventions typically involve ‘extinction’ methods, which require parents to completely or periodically ignore their infant's overnight cries. These methods can be effective in many, but not all cases. For over 40 years 30–40% of parents have consistently reported difficulty ignoring their child. For this group, ignoring their child is behaviourally and/or ideologically difficult with attrition often leading to a perceived sense of failure. For these parents the treatment may be worse than the problem. On the other hand, there is emerging evidence to support the use of more responsive methods for those who find extinction approaches behaviourally or ideologically challenging. In this paper we propose an integrated, less polarised approach to infant behavioural sleep interventions that better caters to those who have difficulty with extinction methods – our so-called ‘Plan B’. This approach potentially resolves the often opposing ideological and theoretical perspectives of extinction versus responsiveness into a practical, complementary and pragmatic treatment framework. Recommendations on how best to implement Plan B are also presented. In our view, Plan B could provide practitioners with a logically integrated well-targeted suite of clinical interventions that could potentially improve compliance, reduce attrition and ultimately benefit the sleep and well-being of all infants and their parents, especially those who struggle with traditional extinction methodologies. © 2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians

Fatigue management in healthcare: It is a risky business

In this issue, McClelland et al. provide data on self-reported fatigue in a large cohort (n = 3847) of anaesthetic consultants and paediatric intensivists in the UK and Republic of Ireland [1]. Although much has been written on fatigue in junior doctors and trainees, this is one of the first studies to report systematically on working time arrangements and self-reported fatigue and well-being in senior medical staff

A predictive model of work-related fatigue based on hours-of-work

RESEARCH over several decades has implicated shiftwork as a major cause of work-·related fatigue and decreased health and safety. However, discriminating between different rosters in terms of fatigue has been difficult. This is partially due to the large number of different rosters currently worked as well as the significant costs associated with laboratory-based roster assessments. Due to difficulties with traditional laboratory-based methods of modelling rosters, it is the authors' aim to develop a quantitative approach based only on the timing and duration of work periods. The potential applications of quantitative fatigue modelling in monitoring health and safety outcomes are also discussed. Specific examples are given for quantifying fatigue in road transport. In conclusion, this model provides a simple, straightforward approach to quantifying fatigue. It also enables organisations to model the relationship between hours of work and health and safety outcomes or to model the implications of proposed roster changes

12-h or 8-h shifts? It depends

Since 12-h shifts were first implemented, the question has been asked - are ‘twelves’ better than ‘eights’? People trying to answer this question invariably refer to the limited literature at their disposal, often piecemeal, small-scale studies comparing 8-h versus 12-h shifts in isolated groups of workers in which many other factors vary concurrently. The narrow perspective and sometimes ‘vested interests’ of the organizations, researchers, publishers and individual workers can influence both the choice of measures, the analysis of results and their interpretation. The current review suggests that it is not sufficient to evaluate a shift pattern on the basis of a single dimension of a working time arrangement, such as shift length. Numerous factors associated with the work practice influence the outcome of a shift pattern including start times, pattern of shifts and amount of overtime. Moreover, the type of work being done and the demographics or characteristics of the workforce are additional mediating factors. Finally, and perhaps most critically, the relative importance assigned to different outcome measures is an important consideration. There are situations where total sleep time might increase following a change to 12-h shifts, whereas domestic life for some workers may deteriorate. Additionally, safety measures may show improvements on 8-h shifts but physical or psychological health outcomes may be worse. The myriad combinations of work pattern, work task, worker and outcome measure under investigation mean that the best way to take account of these complexities may be to use an approach that manages ‘system’ risk. Given the non-linearities in the system, and the fact that current approaches either ignore, or privilege a subset of outcomes, it is perhaps more appropriate to conceptualize working time arrangements as an ‘ecosystem’ and to address the risks in the overall system as opposed to a single dimension such as shift length

Fatigue proofing

Since World \Var II we have seen an increasing focus on fatigue as a source of error and a threat to operational safety in a variety of industries, including transport, emergency services, health care, and others. There is a significant extant literature documenting both the causes and effects of fatigue. In brief, prior sleep-wake behavior, time-of-day, and workload are key factors determining the level of fatigue experienced by the individual worker. Slowed cognitive processing and impaired attentional and emotional control all c:ombine to increase the likelihood of task-related errors and thereby compromise judgement, decision making, and ultimately workplace safety