M Thomas

Investigation of the Effects of Coffee on Alertness and Performance during the Day and Night

An experiment was carried out to examine the effects of coffee on performance and alertness in the day and at night. The results showed that caffeinated coffee had a beneficial effect on alertness and improved performance on a variety of tasks in both day and night sessions. The effects were often very large. For example, at night, consumption of caffeinated coffee produced comparable alertness ratings to the day-time ratings given when juice was drunk. In contrast to the effects of caffeinated coffee, the difference between the decaffeinated coffee and juice were small and variable. Overall, these results clearly demonstrate the beneficial effects of consuming caffeinated coffee, and show that this effect is comparable in the day and night.

Effect of influenza B virus infection on human performance

Anecdotal evidence suggests that influenza reduces peoples safety and efficiency in their workplace. Studies of experimentally induced influenza B in volunteers at the Medical Research Council Common Cold Unit showed that infection increased reaction times to stimuli occurring at varying intervals but that hand-eye coordination was unimpaired. We report the results of two studies to determine whether natural influenza B similarly prolongs human reaction times and whether other performance indicators are affected.

What are the highest priorities for research in emergency prehospital care

The recent UK Department of Health publication “ Taking Healthcare to the Patient: Transforming NHS Ambulance Services ”1 recommended that the Department of Health should commission a programme of work to build the evidence base for the delivery of emergency and unscheduled prehospital care. As a starting point, the Department of Health commissioned the 999 EMS Research Forum to review the evidence base for the delivery of emergency prehospital care; to identify gaps in the evidence base; and to prioritise topics for future research. The 999 EMS Research Forum is a partnership of academics, clinicians and prehospital care practitioners and managers formed in 1999, whose aim is to encourage, promote and disseminate research and evidence-based policy and practice in 999 health care. Prioritisation of research topics is a key part of the process of commissioning of research, although methods may differ.2 3 The desirability of including a wide range of stakeholders in a structured approach has been stressed, in order to achieve a credible result that may be more likely to produce research that informs policy and practice.4–6 This emergency prehospital care research prioritisation exercise included …

Self-reported mood, general health, wellbeing and employment status in adults with suspected DCD

Developmental Coordination Disorder (DCD) affects around 2-6% of the population and is diagnosed on the basis of poor motor coordination in the absence of other neurological disorders. Its psychosocial impact has been delineated in childhood but until recently there has been little understanding of the implications of the disorder beyond this. This study aims to focus on the longer term impact of having DCD in adulthood and, in particular, considers the effect of employment on this group in relation to psychosocial health and wellbeing. Self-reported levels of life satisfaction, general health and symptoms of anxiety and depression were investigated in a group of adults with a diagnosis of DCD and those with suspected DCD using a number of published self-report questionnaire measures. A comparison between those in and out of employment was undertaken. As a group, the unemployed adults with DCD reported significantly lower levels of life satisfaction. Whilst there was no significant difference between those who were employed and unemployed on General Health Questionnaire scores; both groups reported numbers of health related issues reflective of general health problems in DCD irrespective of employment status. While both groups reported high levels of depressive symptoms and rated their satisfaction with life quite poorly, the unemployed group reported significantly more depressive symptoms and less satisfaction. Additionally, the results identified high levels of self-reported anxiety in both groups, with the majority sitting outside of the normal range using the Hospital Anxiety and Depression Scale. These findings add to the small but increasing body of literature on physical and mental health and wellbeing in adults with DCD. Furthermore, they are the first to provide insight into the possible mediating effects of employment status in adults with DCD.

EFFECTS OF THE COMMON COLD ON MOOD AND PERFORMANCE

Abstract Previous research has shown that both experimentally-induced and naturally occurring upper respiratory tract illnesses (URTIs) influence mood and mental functioning. None of the previous studies of naturally occurring colds has conducted appropriate virological assays to determine the nature of the infecting agent. This is an essential methodological step in studies of malaise associated with URTIs. The aim of this research was to investigate the effects of naturally occurring colds on mood and objective measures of performance. This was done by first conducting a cross-sectional comparison of 37 healthy people and 158 volunteers with colds and then a longitudinal study in which 100 volunteers developed colds and 87 remained healthy. Virological techniques were used to identify infecting agents and comparisons made across the different groups. The results showed that having a cold was associated with reduced alertness and slowed reaction times. These effects were observed both for colds where the infecting virus was identified and those where it was not. Similar effects were obtained for both rhinovirus and coronavirus colds. One may conclude that upper respiratory tract illnesses lead to a reduction in subjective alertness and impaired psychomotor functioning. This was true for both illnesses where the infecting agent was identified and for those clinical illnesses where no virus was detected. It is now important to identify the mechanisms linking infection and illness with the behavioural changes. Similarly, the impact of these effects on real-life activities such as driving needs examining. Finally, methods of treatment need to be developed which not only treat the local symptoms of the illnesses but remove the negative mood and the performance impairments.

Caffeine and the common cold

An experiment was carried out to determine whether caffeinated and decaffeinated coffee removed the malaise (reduced alertness, slower psychomotor performance) associated with having a common cold. One hundred volunteers were tested when healthy and 46 returned to the laboratory when they developed colds. Those subjects who remained healthy were then recalled as a control group. On the second visit subjects carried out two sessions, one pre-drink and another an hour after the drink. Subjects were randomly assigned to one of the following three conditions, caffeinated coffee (1.5 mg/kg caffeine/body weight), decaffeinated coffee or fruit juice. Subjects with colds reported decreased alertness and were slower at performing psychomotor tasks. Caffeine increased the alertness and performance of the colds subjects to the same level as the healthy group and decaffeinated coffee also led to an improvement. These results suggest that drugs which increase alertness can remove the malaise associated with the common cold, and that increased stimulation of the sensory afferent nerves may also be beneficial.

Effects of caffeine and noise on mood, performance and cardiovascular functioning

An experiment was conducted to examine the effects of caffeine and noise on mood, mental performance and cardiovascular function. One hundred and six young adults (mean age 21·2 years) took part in the study. Subjects were assigned to one of six groups formed by combining noise/quiet and drink (caffeinated coffee, decaffeinated coffee and fruit juice) conditions. Subjects were familiarized with the tasks and then completed a pre‐drink baseline session (conducted in the quiet). Subjects were then given either caffeinated coffee (1·5 mg/kg caffeine), decaffeinated coffee or fruit juice. Following consumption of the drink subjects were re‐tested 1 h later, either in noise (75 dBA conglomerate noise, consisting of speech, music and machinery noise) or in quiet. The subjects exposed to noise felt more anxious and showed an increase in blood pressure. Their performance of a cognitive vigilance task also declined over time. There were no significant main effects of caffeine, although simple reaction time was quickest in the caffeinated coffee group. Caffeine did not modify the effects of noise on mood, cardiovascular functioning or sustained attention. Indeed, the only interaction between drinks and noise was found in recall and recognition memory tasks, with the caffeine/noise group having better memory performance than the decaffeinated/noise subjects. Overall, the results show that low levels of caffeine do not increase the behavioural and physiological changes observed in a stressful situation.

An Investigation into the Cognitive Deficits Associated with Chronic Fatigue Syndrome

This study addresses, among other things, the debate as to whether cognitive deficits do occur with a diagnosis of Chronic Fatigue Syndrome (CFS). Previous studies have indicated a potential mismatch between subjective patient ratings of impairment and clinical assessment. In an attempt to tackle some of the methodological problems faced by previous research in this field, this study recruited a large sample of CFS patients where adequate diagnosis had been made and administered an extensive battery of measures. In doing so this study was able to replicate previous published evidence of clear cognitive impairment in this group and demonstrate also that these deficits occurred independent of psychopathology. The conclusion drawn is that cognitive impairments can be identified if appropriate measures are used. Furthermore, the authors have shown that performance changes in these measures have been used to assess both efficacy of a treatment regime and rates of recovery.

Involving service users in trials: developing a standard operating procedure

BackgroundMany funding bodies require researchers to actively involve service users in research to improve relevance, accountability and quality. Current guidance to researchers mainly discusses general principles. Formal guidance about how to involve service users operationally in the conduct of trials is lacking. We aimed to develop a standard operating procedure (SOP) to support researchers to involve service users in trials and rigorous studies.MethodsResearchers with experience of involving service users and service users who were contributing to trials collaborated with the West Wales Organisation for Rigorous Trials in Health, a registered clinical trials unit, to develop the SOP. Drafts were prepared in a Task and Finish Group, reviewed by all co-authors and amendments made.ResultsWe articulated core principles, which defined equality of service users with all other research team members and collaborative processes underpinning the SOP, plus guidance on how to achieve these. We developed a framework for involving service users in research that defined minimum levels of collaboration plus additional consultation and decision-making opportunities. We recommended service users be involved throughout the life of a trial, including planning and development, data collection, analysis and dissemination, and listed tasks for collaboration. We listed people responsible for involving service users in studies and promoting an inclusive culture. We advocate actively involving service users as early as possible in the research process, with a minimum of two on all formal trial groups and committees. We propose that researchers protect at least 1% of their total research budget as a minimum resource to involve service users and allow enough time to facilitate active involvement.ConclusionsThis SOP provides guidance to researchers to involve service users successfully in developing and conducting clinical trials and creating a culture of actively involving service users in research at all stages. The UK Clinical Research Collaboration should encourage clinical trials units actively to involve service users and research funders should provide sufficient funds and time for this in research grants.

Primary healthcare provision and Chronic Fatigue Syndrome: a survey of patients' and General Practitioners' beliefs

BackgroundThe current study was conducted as part of a research project into the evaluation and assessment of healthcare provision and education in Chronic Fatigue Syndrome (CFS). One aim of the study was the development of informative and educational literature for both General Practitioners (GP) and sufferers. Issues such as diagnosis, management and treatment of the syndrome should be included in information booklets written by healthcare professionals. It was important to begin the process by assessing the level of specialist knowledge that existed in typical GP surgeries. This data would then be compared to data from CFS patients.Method197 survey booklets were sent to CFS sufferers from an existing research panel. The patients approached for the purpose of the study had been recruited onto the panel following diagnosis of their illness at a specialised CFS outpatient clinic in South Wales. A further 120 booklets were sent to GP surgeries in the Gwent Health Authority region in Wales.ResultsResults from the study indicate that the level of specialist knowledge of CFS in primary care remains low. Only half the GP respondents believed that the condition actually exists.ConclusionSteps are recommended to increase the knowledge base by compiling helpful and informative material for GPs and patient groups.