Workplace Cognitive Failure among Nurses during the COVID-19 Pandemic

Numerous studies provide evidence of the physical and emotional strain experienced by nurses during the COVID-19 pandemic. However, little is known regarding the impact of this occupational strain on nurses’ cognitive function at work. The aim of this study was to identify factors associated with workplace cognitive failure in a sample of U.S. nurses during the COVID-19 pandemic. An online questionnaire was administered in May 2020 to Michigan nurses statewide via three nursing organizations (n = 695 respondents). Path analysis was conducted to test the parallel effects of frequency of contact with COVID patients and personal protective equipment (PPE) supply on workplace cognitive failure scores. Mediation effects of stress, sleep quality, secondary trauma, and work-related exhaustion were examined for each exposure. Results revealed significant indirect effects of all mediators except sleep quality of contact with COVID patients (cumulative indirect effect = 1.30, z = 6.33, p < 0.001) and PPE (cumulative indirect effect = −2.10, z = −5.22, p < 0.001) on cognitive failure. However, 58% of the PPE effect was direct. To reduce the risk of cognitive failure, healthcare organizations need to provide nurses with protective equipment and work environments that allow nurses to strengthen their resilience to extreme working conditions.

Social Skills as Predictors of Cognitive Failure, Attention Deficits and Psychological Maladjustment in School Children

Poor social skills are linked with presence of cognitive and attention difficulties as well as poor social functioning and presence of cognition disturbances. Present research aimed to explore poor social skills as predictors of cognitive failure, attention deficits and psychological maladjustment in school children. Sampleincluded 200 students (100 girls & 100 boys) of class 4 & 5 with the meanage= 10.12(SD= 1.37).Social Skills Rating System, The Cognitive Failure Questionnaire, Attention Deficits Questionnaire (child version) and Personality Assessment Questionnaire were used to assess social skills, cognitive failure, attention deficits and psychological adjustment respectively.Results revealed significant inverse correlation of different social skills i.e., assertion, empathy, cooperation and self-control with cognitive failure, attention deficits and psychological maladjustment (p<0.01) Whereas cognitive failure, attention deficits had positive correlation with psychological maladjustment (p<0.01). Hierarchical regression analyses showed social skills deficits emerged as significant predictors of cognitive failures, attention deficits and psychological maladjustment in school children.

Background Feelings of Belonging and Psychological Trauma

Reports of not feeling understood are frequent in testimonies of psychological trauma. I argue that these feelings are not a matter of a cognitive failure but rather an expression of the absence of a more pervasive background feeling of belonging. Contemporary accounts of we-intentionality promise but ultimately fall short in explaining this sense of belonging. Gerda Walther offers an alternative account of communal experiences. Her notion of “habitual unification” can explain the background feelings of belonging that are woven through the individual’s everyday experience of being in a shared world. Having unified with another person, the world feels different. It is now experienced in light of a “we.” This is not only the case in actual, singular person-to-person encounters. Unification with others becomes habitual: it retreats into the background of the individual’s awareness, colouring their experience of the world. Thus sedimented, it forms a background sense of belonging to a shared world. Unification is enabled by experiencing others as being similar in a significant way, such as having the same experiences, values, or basic attitude: in Walther’s words, as being a “human, who also….” This, I shall argue, is impacted through traumatizing experiences. Trauma survivors struggle to experience others as “humans, who also…,” resulting in a failure of unification and thus impeding feelings of belonging. Trauma testimonies also suggest that actively seeking out recognition of similarities and shared aspects of experience may once again enable experiencing others as “humans, who also…,” thus enabling unification and re-establishing a sense of belonging.

A Prospective Phase II Randomized Trial of Proton Radiotherapy vs. Intensity Modulated Radiotherapy for Patients with Newly Diagnosed Glioblastoma

Background To determine if proton radiotherapy (PT), compared to intensity modulated radiotherapy (IMRT), delayed time to cognitive failure in patients with newly diagnosed glioblastoma. Methods Eligible patients were randomized unblinded to PT vs. IMRT. The primary endpoint was time to cognitive failure. Secondary endpoints included overall survival (OS), intracranial progression-free survival (PFS), toxicity, and patient-reported outcomes. Results A total of 90 patients were enrolled and 67 were evaluable with median follow-up of 48.7 months (range 7.1-66.7). There was no significant difference in time to cognitive failure between treatment arms (HR, 0.88; 95% CI, 0.45 to 1.75; P=0.74). PT was associated with a lower rate of fatigue (24% vs. 58%, P=0.05), but otherwise there were no significant differences in patient-reported outcomes at 6 months. There was no difference in PFS (HR, 0.74; 95% CI, 0.44 to 1.23; P=0.24) or OS (HR, 0.86; 95% CI, 0.49 to 1.50; P=0.60). However, PT significantly reduced the radiation dose for nearly all structures analyzed. The average number of grade 2 or higher toxicities was significantly higher in patients who received IMRT (mean 1.15, range 0-6) compared to PT (mean 0.35, range 0-3; P=0.02). Conclusions In this signal seeking phase II trial, PT was not associated with a delay in time to cognitive failure but did reduce toxicity and patient reported fatigue. Larger randomized trials are needed to determine the potential of PT such as dose escalation for glioblastoma and cognitive preservation in patients with lower grade gliomas with a longer survival time.

The Role of Mitochondrial Impairment in Alzheimer´s Disease Neurodegeneration: The Tau Connection

: Accumulative evidence has shown that mitochondrial dysfunction plays a pivotal role in the pathogenesis of Alzheimer's disease (AD). Mitochondrial impairment actively contributes to the synaptic and cognitive failure that characterizes AD. The presence of soluble pathological forms of tau like hyperphosphorylated at Ser396 and Ser404 and cleaved at Asp421 by caspase 3, negatively impacts mitochondrial bioenergetics, transport, and morphology in neurons. These adverse effects against mitochondria health will contribute to the synaptic impairment and cognitive decline in AD. Current studies suggest that mitochondrial failure induced by pathological tau forms is likely the result of the opening of the mitochondrial permeability transition pore (mPTP). mPTP is a mitochondrial mega-channel that is activated by increases in calcium and is associated with mitochondrial stress and apoptosis. This structure is composed of different proteins, where Ciclophilin D (CypD) is considered to be the primary mediator of mPTP activation. Also, new studies suggest that mPTP contributes to Aβ pathology and oxidative stress in AD. : Further, inhibition of mPTP through the reduction of CypD expression prevents cognitive and synaptic impairment in AD mouse models. More importantly, tau protein contributes to the physiological regulation of mitochondria through the opening/interaction with mPTP in hippocampal neurons. Therefore, in this paper, we will discuss evidence that suggests an important role of pathological forms of tau against mitochondrial health. Also, we will discuss the possible role of mPTP in the mitochondrial impairment produced by the presence of tau pathology and its impact on synaptic function present in AD.

The Monday Effect Revisited: A Diary and Sleep Actigraphy Study

Purpose Accidents are more likely to occur during the morning hours of Mondays (Monday effect). This might be due to a higher level of cognitive failure on Monday morning at work. Methods In a pilot actigraphy study across one working week, we explored this Monday effect and regressed daily self-reported workplace cognitive failure on weekdays (Monday versus other days), background social stressors at work, delayed sleep onset and sleep duration. Diary data were gathered from 40 full-time employees. Results Confirming our assumptions, results revealed work-related cognitive failure and sleep-onset latency on the previous night to be higher on Mondays compared to other workdays. Work-related cognitive failure correlated positively with delayed sleep-onset latency and background social stressors. In multilevel regression analysis, Monday significantly explained variations in workplace cognitive failure. The addition of background social stressors at work and sleep-onset latency to the regression model showed unique contributions to the prediction of workplace cognitive failure. No significant two-way or three-way interactions between working days, sleep-onset latency or sleep duration, and background social stressors were found. Conclusion Peak levels of cognitive failure on Monday morning and the association of cognitive failure with social stressors at work contribute to understanding the mechanisms involved in the increased prevalence of occupational accidents on Monday morning. Occupational safety interventions should address both social stressors at work and individual sleep hygiene.