Effects of C5/C6 Intervertebral Space Distraction Height on Pressure on the Adjacent Intervertebral Disks and Articular Processes and Cervical Vertebrae Range of Motion.

PubMed

Lu, Tingsheng; Luo, Chunshan; Ouyang, Beiping; Chen, Qiling; Deng, Zhongliang

2018-04-25

BACKGROUND This study aimed to investigate the association between range of motion of the cervical vertebrae and various C5/C6 intervertebral space distraction heights. MATERIAL AND METHODS The cervical vertebrae from 6 fresh adult human cadavers were used to prepare the models. Changes in C4/C5 and C6/C7 intervertebral disk pressures, articular process pressure, and range of motion of the cervical vertebrae before and after the distraction of the C5/C6 intervertebral space at benchmark heights of 100%, 120%, 140%, and 160% were tested under different exercise loads. RESULTS The pressure on the adjacent intervertebral disks was highest with the standing upright position before distraction, varied with different positions of the specimens and distraction heights after distraction, and was closest to that before distraction at a distraction height of 120% (P<0.05). The pressure of the adjacent articular processes was highest with left and right rotations before distraction, varied with different positions of the specimens and distraction heights after distraction, and was lowest under the same exercise load with different positions at a distraction height of 120% (P<0.05). The ranges of motion of the cervical vertebrae and intervertebral disks were largest without distraction and at a distraction height of 120% after distraction, respectively (P<0.05). CONCLUSIONS When removing the C5/C6 intervertebral disk and implanting an intervertebral bone graft, a benchmark height of 120% had little influence on the pressure of the adjacent intervertebral disks and articular processes and range of motion of the cervical vertebrae and is therefore an appropriate intervertebral space distraction height.

Effects of C5/C6 Intervertebral Space Distraction Height on Pressure on the Adjacent Intervertebral Disks and Articular Processes and Cervical Vertebrae Range of Motion

PubMed Central

Lu, Tingsheng; Luo, Chunshan; Ouyang, Beiping; Chen, Qiling

2018-01-01

Background This study aimed to investigate the association between range of motion of the cervical vertebrae and various C5/C6 intervertebral space distraction heights. Material/Methods The cervical vertebrae from 6 fresh adult human cadavers were used to prepare the models. Changes in C4/C5 and C6/C7 intervertebral disk pressures, articular process pressure, and range of motion of the cervical vertebrae before and after the distraction of the C5/C6 intervertebral space at benchmark heights of 100%, 120%, 140%, and 160% were tested under different exercise loads. Results The pressure on the adjacent intervertebral disks was highest with the standing upright position before distraction, varied with different positions of the specimens and distraction heights after distraction, and was closest to that before distraction at a distraction height of 120% (P<0.05). The pressure of the adjacent articular processes was highest with left and right rotations before distraction, varied with different positions of the specimens and distraction heights after distraction, and was lowest under the same exercise load with different positions at a distraction height of 120% (P<0.05). The ranges of motion of the cervical vertebrae and intervertebral disks were largest without distraction and at a distraction height of 120% after distraction, respectively (P<0.05). Conclusions When removing the C5/C6 intervertebral disk and implanting an intervertebral bone graft, a benchmark height of 120% had little influence on the pressure of the adjacent intervertebral disks and articular processes and range of motion of the cervical vertebrae and is therefore an appropriate intervertebral space distraction height. PMID:29693646

Videogame distraction using virtual reality technology for children experiencing cold pressor pain: the role of cognitive processing.

PubMed

Law, Emily F; Dahlquist, Lynnda M; Sil, Soumitri; Weiss, Karen E; Herbert, Linda Jones; Wohlheiter, Karen; Horn, Susan Berrin

2011-01-01

This study examined whether increasing the demand for central cognitive processing involved in a distraction task, by involving the child in ongoing, effortful interaction with the distraction stimulus, would increase children's tolerance for cold pressor pain. Seventy-nine children ages 6-15 years underwent a baseline cold pressor trial followed by two cold pressor trials in which they received interactive distraction (i.e., used voice commands to play a videogame) or passive distraction (in which they merely watched the output from the same videogame segment) in counterbalanced order. Both distraction conditions were presented via a virtual reality-type helmet. As expected, children demonstrated significant improvement in pain tolerance during distraction relative to baseline. Children showed the greatest improvement during the interactive distraction task. The effects of distraction on children's cold pressor pain tolerance are significantly enhanced when the distraction task also includes greater demands for central cognitive processing.

Interactive versus passive distraction for acute pain management in young children: the role of selective attention and development.

PubMed

Wohlheiter, Karen A; Dahlquist, Lynnda M

2013-03-01

To examine whether age and developmental differences in selective attention influence young children's differential responses to interactive and passive distraction. 65 3- to 6-year-old children underwent three cold-pressor trials while receiving no intervention, playing a video game (interactive distraction), or watching a video game (passive distraction). In addition, children completed a test of selective attention, and parents completed ratings of attention. Consistent with neurocognitive models of pain, children benefited more from interactive distraction than from passive distraction. Although older children demonstrated superior pain tolerance overall, age and selective attention skills did not moderate children's responses to the distraction intervention. These findings suggest that younger preschoolers can benefit from interactive distraction to manage acute pain, provided that the distraction activity is developmentally appropriate. Research is needed to determine whether developmental issues are more important moderators of children's responses to distraction when faced with more challenging task demands.

Evaluating Robotic Surgical Skills Performance Under Distractive Environment Using Objective and Subjective Measures.

PubMed

Suh, Irene H; LaGrange, Chad A; Oleynikov, Dmitry; Siu, Ka-Chun

2016-02-01

Distractions are recognized as a significant factor affecting performance in safety critical domains. Although operating rooms are generally full of distractions, the effect of distractions on robot-assisted surgical (RAS) performance is unclear. Our aim was to investigate the effect of distractions on RAS performance using both objective and subjective measures. Fifteen participants performed a knot-tying task using the da Vinci Surgical System and were exposed to 3 distractions: (1) passive distraction entailed listening to noise with a constant heart rate, (2) active distraction included listening to noise and acknowledging a change of random heart rate from 60 to 120 bpm, and (3) interactive distraction consisted of answering math questions. The objective kinematics of the surgical instrument tips were used to evaluate performance. Electromyography (EMG) of the forearm and hand muscles of the participants were collected. The median EMG frequency (EMG(fmed)) and the EMG envelope (EMG(env)) were analyzed. NASA Task Load Index and Fundamentals of Laparoscopic Surgery score were used to evaluate the subjective performance. One-way repeated analysis of variance was applied to examine the effects of distraction on skills performance. Spearman's correlations were conducted to compare objective and subjective measures. Significant distraction effect was found for all objective kinematics measures (P < .05). There were significant distraction effects for EMG measures (EMG(env), P < .004; EMG(fmed), P = .031). Significant distraction effects were also found for subjective measurements. Distraction impairs surgical skills performance and increases muscle work. Understanding how the surgeons cope with distractions is important in developing surgical education. © The Author(s) 2015.

Dynamics of Driver Distraction: The process of engaging and disengaging

PubMed Central

Lee, John D.

2014-01-01

Driver distraction research has a long history, spanning nearly 50 years, but intensifying over the last decade. The dominant paradigm guiding this research defines distraction in terms of excessive workload and limited attentional resources. This approach largely ignores how drivers come to engage in these tasks and under what conditions they engage and disengage from driving—the dynamics of distraction. The dynamics of distraction identifies breakdowns of interruption management as an important contributor to distraction, leading to describe distraction in terms of failures of task timing, switching, and prioritization. The dynamics of distraction also identifies disengagement in driving (e.g., mind wandering) as a substantial challenge that secondary tasks might exacerbate or mitigate. Increasing vehicle automation accentuates the need to consider these dynamics of distraction. Automation offers drivers more opportunity to engage in distractions and disengage from driving, and can surprise drivers by unexpectedly requiring drivers to quickly re-engage in driving—placing greater importance of interruption management expertise. This review describes distraction in terms of breakdowns in interruption management and problems of engagement, and summarizes how contingency, conditioning, and consequence traps lead to problems of engaging and disengaging in driving and distractions. PMID:24776224

Gender differences in the content of cognitive distraction during sex.

PubMed

Meana, Marta; Nunnink, Sarah E

2006-02-01

This study compared 220 college men and 237 college women on two types of self-reported cognitive distraction during sex, performance- and appearance-based. Affect, psychological distress, sexual knowledge, attitudes, fantasies, experiences, body image, satisfaction, and sexual function were assessed with the Derogatis Sexual Functioning Inventory and the Sexual History Form to determine associations with distraction. Between-gender analyses revealed that women reported higher levels of overall and appearance-based distraction than did men, but similar levels of performance-based distraction. Within-gender analyses revealed that women reported as much of one type of distraction as the other, while men reported more performance- than appearance-based distraction. In women, appearance-based distraction was predicted by negative body image, psychological distress, and not being in a relationship, while performance-based distraction was predicted by negative body image, psychological distress, and sexual dissatisfaction. In men, appearance-based distraction was predicted by negative body image, sexual dissatisfaction and not being in a relationship, while performance-based distraction was predicted by negative body image and sexual dissatisfaction. Investigating the content of cognitive distraction may be useful in understanding gender differences in sexual experience and in refining cognitive components of sex therapy.

Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis

PubMed Central

Saltzman, Charles L.; Hillis, Stephen L.; Stolley, Mary P.; Anderson, Donald D.; Amendola, Annunziato

2012-01-01

Background: Initial reports have shown the efficacy of fixed distraction for the treatment of ankle osteoarthritis. We hypothesized that allowing ankle motion during distraction would result in significant improvements in outcomes compared with distraction without ankle motion. Methods: We conducted a prospective randomized controlled trial comparing the outcomes for patients with advanced ankle osteoarthritis who were managed with anterior osteophyte removal and either (1) fixed ankle distraction or (2) ankle distraction permitting joint motion. Thirty-six patients were randomized to treatment with either fixed distraction or distraction with motion. The patients were followed for twenty-four months after frame removal. The Ankle Osteoarthritis Scale (AOS) was the main outcome variable. Results: Two years after frame removal, subjects in both groups showed significant improvement compared with the status before treatment (p < 0.02 for both groups). The motion-distraction group had significantly better AOS scores than the fixed-distraction group at twenty-six, fifty-two, and 104 weeks after frame removal (p < 0.01 at each time point). At 104 weeks, the motion-distraction group had an overall mean improvement of 56.6% in the AOS score, whereas the fixed-distraction group had a mean improvement of 22.9% (p < 0.01). Conclusion: Distraction improved the patient-reported outcomes of treatment of ankle osteoarthritis. Adding ankle motion to distraction showed an early and sustained beneficial effect on outcome. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. PMID:22637202

Reflections of Distraction in Memory: Transfer of Previous Distraction Improves Recall in Younger and Older Adults

PubMed Central

Thomas, Ruthann C.; Hasher, Lynn

2012-01-01

Three studies explored whether younger and older adults’ free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting words. When the memory task was indirect in its use of distraction (Study 1), only older adults showed transfer, with better recall of previously distracting compared with new words, which increased their recall to match that of younger adults. However, younger adults showed transfer when cued about the relevance of previous distraction both before studying the words (Study 2) and before recalling the words (Study 3) in the memory test. Results suggest that both younger and older adults encode distraction, but younger adults require explicit cueing to use their knowledge of distraction. In contrast, older adults transfer knowledge of distraction in both explicitly cued and indirect memory tasks. Results are discussed in terms of age differences in inhibition and source-constrained retrieval. PMID:21843024

Reflections of distraction in memory: transfer of previous distraction improves recall in younger and older adults.

PubMed

Thomas, Ruthann C; Hasher, Lynn

2012-01-01

Three studies explored whether younger and older adults' free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting words. When the memory task was indirect in its use of distraction (Study 1), only older adults showed transfer, with better recall of previously distracting compared with new words, which increased their recall to match that of younger adults. However, younger adults showed transfer when cued about the relevance of previous distraction both before studying the words (Study 2) and before recalling the words (Study 3) in the memory test. Results suggest that both younger and older adults encode distraction, but younger adults require explicit cueing to use their knowledge of distraction. In contrast, older adults transfer knowledge of distraction in both explicitly cued and indirect memory tasks. Results are discussed in terms of age differences in inhibition and source-constrained retrieval.

Effects of mobile phone distraction on pedestrians' crossing behavior and visual attention allocation at a signalized intersection: An outdoor experimental study.

PubMed

Jiang, Kang; Ling, Feiyang; Feng, Zhongxiang; Ma, Changxi; Kumfer, Wesley; Shao, Chen; Wang, Kun

2018-06-01

With the rapid growth in mobile phone use worldwide, traffic safety experts have begun to consider the impact of mobile phone distractions on pedestrian crossing safety. This study sought to investigate how mobile phone distractions (music distraction, phone conversation distraction and text distraction) affect the behavior of pedestrians while they are crossing the street. An outdoor-environment experiment was conducted among 28 college student pedestrians. Two HD videos and an eye tracker were employed to record and analyze crossing behavior and visual attention allocation. The results of the research showed that the three mobile phone distractions cause different levels of impairment to pedestrians' crossing performance, with the greatest effect from text distraction, followed by phone conversation distraction and music distraction. Pedestrians distracted by music initiate crossing later, have increased pupil diameter, and reduce their scanning frequency, fixation points and fixation times toward traffic signal area priorities. In addition to the above effects, pedestrians distracted by phone conversation cross the street more slowly, direct fewer fixation points to the right traffic area, and spend less fixation time and lower average fixation duration on the left traffic area. Moreover, pedestrians distracted by texting look left and right less often and switch, distribute and maintain less visual attention on the traffic environment. These findings may inform researchers, policy makers, and pedestrians. Copyright © 2018 Elsevier Ltd. All rights reserved.

Mindless Feeding: Is Maternal Distraction During Bottle-Feeding Associated with Overfeeding?

PubMed Central

Golen, Rebecca B.; Ventura, Alison K.

2015-01-01

Mindless eating, or eating while distracted by surrounding stimuli, leads to overeating. The present study explored whether “mindless feeding,” or maternal distraction during bottle-feeding, is associated with greater infant formula/milk intakes and lower maternal sensitivity to infant cues. Mothers and their ≤24-week-old bottle-feeding infants (N=28) visited our laboratory for a video-recorded feeding observation. Infant intake was assessed by weighing bottles before and after the feedings. Maternal sensitivity to infant cues was objectively assessed by behavioral coding of video-records using the Nursing Child Assessment Feeding Scale. Maternal distraction was defined as looking away from the infant >75% of the feeding; using a mobile device; conversing with another adult; or sleeping. Twenty-nine percent (n=8) of mothers were distracted. While differences in intakes for infants of distracted vs. not distracted mothers did not reach significance (p=0.24), the association between distraction and infant intake was modified by two dimensions of temperament: orienting/regulation capacity (p=0.03) and surgency/extraversion (p=0.04). For infants with low orienting/regulation capacity, infants of distracted mothers consumed more (177.1 ± 33.8 ml) than those of not distracted mothers (92.4 ± 13.8 ml). Similar findings were noted for infants with low surgency/extraversion (distracted: 140.6 ± 22.5 ml; not distracted: 78.4 ± 14.3 ml). No association between distraction and intake was seen for infants with high orienting/regulation capacity or surgency/extraversion. A significantly greater proportion of distracted mothers showed low sensitivity to infant cues compared to not distracted mothers (p=0.04). In sum, mindless feeding may interact with infant characteristics to influence feeding outcomes; further experimental and longitudinal studies are needed. PMID:25953601

Effects of distraction on memory and cognition: a commentary.

PubMed

Craik, Fergus I M

2014-01-01

This commentary is a review of the findings and ideas reported in the preceding nine articles on the effects of distraction on aspects of cognitive performance. The articles themselves deal with the disruptive effects of distraction on recall of words, objects and events, also on visual processing, category formation and other cognitive tasks. The commentary assesses the part played by "domain-general" suppression of distracting information and the "domain-specific" competition arising when tasks and distraction involve very similar material. Some forms of distraction are meaningfully relevant to the ongoing task, and Treisman's (1964) model of selective attention is invoked to provide an account of findings in this area. Finally, individual differences to vulnerability to distraction are discussed; older adults are particularly affected by distracting stimuli although the failure to repress distraction can sometimes prove beneficial to later cognitive performance.

Videogame Distraction using Virtual Reality Technology for Children Experiencing Cold Pressor Pain: The Role of Cognitive Processing

PubMed Central

Law, Emily F.; Sil, Soumitri; Weiss, Karen E.; Herbert, Linda Jones; Wohlheiter, Karen; Horn, Susan Berrin

2011-01-01

Objective This study examined whether increasing the demand for central cognitive processing involved in a distraction task, by involving the child in ongoing, effortful interaction with the distraction stimulus, would increase children's tolerance for cold pressor pain. Methods Seventy-nine children ages 6–15 years underwent a baseline cold pressor trial followed by two cold pressor trials in which they received interactive distraction (i.e., used voice commands to play a videogame) or passive distraction (in which they merely watched the output from the same videogame segment) in counterbalanced order. Both distraction conditions were presented via a virtual reality-type helmet. Results As expected, children demonstrated significant improvement in pain tolerance during distraction relative to baseline. Children showed the greatest improvement during the interactive distraction task. Conclusion The effects of distraction on children's cold pressor pain tolerance are significantly enhanced when the distraction task also includes greater demands for central cognitive processing. PMID:20656761

Effect of maxillary distraction osteogenesis on velopharyngeal function: a pilot study.

PubMed

Harada, Kiyoshi; Ishii, Yoshimasa; Ishii, Masatoshi; Imaizumi, Humiko; Mibu, Michiko; Omura, Ken

2002-05-01

The purpose of this study was to examine preoperative and postoperative changes of velopharyngeal function in cleft patients who underwent maxillary distraction osteogenesis using the Rigid External Distraction System. Six cleft patients followed for a minimum of 12 months after maxillary distraction were examined. Plain and contrast lateral-cephalograms were obtained preoperatively and postoperatively, and speech evaluation was performed by the same authorized speech therapist at the same time points. The mean distraction amount at the anterior nasal spine was 11.7 mm (range, 7.4 mm - 15.0 mm). Both the nasopharyngeal depth and velar length increased after maxillary distraction, but the need ratio (nasopharyngeal depth/velar length) also increased after distraction. Although scores for velopharyngeal closure dropped a few points after maxillary distraction, the rating for hypernasality remained unchanged in all patients but the patient whose distraction amount was 15.0 mm. These results suggest that maxillary distraction of less than 15 mm may not markedly affect velopharyngeal function in cleft patients.

Mechanisms behind distracted driving behavior: The role of age and executive function in the engagement of distracted driving

PubMed Central

Pope, Caitlin Northcutt; Bell, Tyler Reed; Stavrinos, Despina

2016-01-01

Performing secondary tasks, such as texting while driving, is associated with an increased risk of motor vehicle collisions (MVCs). While cognitive processes, such as executive function, are involved in driving, little is known about the relationship between executive control and willingness to engage in distracted driving. This study investigated the relationship between age, behavioral manifestations of executive function, and self-reported distracted driving behaviors. Executive difficulty (assessed with the BRIEF-A) as well as demographics (age and gender) was considered as possible predictors of engagement in distracted driving behaviors. Fifty-nine young, middle, and older adults self-reported executive difficulty and weekly engagement in distracted driving behaviors. Results revealed that while partially accounted for by age, global executive difficulty was uniquely related to engagement in distracted driving behaviors. Older age was associated with fewer weekly self-reported distracted driving behaviors while higher self-reported executive difficulty was associated with more frequent weekly engagement in distracted behavior. No significant differences were found between young and middle-aged adults on distracted driving behaviors. Findings conclude that distracted driving is a ubiquitous phenomenon evident in drivers of all ages. Possible mechanisms underlying distracted driving behavior could potentially be related to deficits in executive function. PMID:27716494

Mechanisms behind distracted driving behavior: The role of age and executive function in the engagement of distracted driving.

PubMed

Pope, Caitlin Northcutt; Bell, Tyler Reed; Stavrinos, Despina

2017-01-01

Performing secondary tasks, such as texting while driving, is associated with an increased risk of motor vehicle collisions (MVCs). While cognitive processes, such as executive function, are involved in driving, little is known about the relationship between executive control and willingness to engage in distracted driving. This study investigated the relationship between age, behavioral manifestations of executive function, and self-reported distracted driving behaviors. Executive difficulty (assessed with the BRIEF-A) as well as demographics (age and gender) was considered as possible predictors of engagement in distracted driving behaviors. Fifty-nine young, middle, and older adults self-reported executive difficulty and weekly engagement in distracted driving behaviors. Results revealed that while partially accounted for by age, global executive difficulty was uniquely related to engagement in distracted driving behaviors. Older age was associated with fewer weekly self-reported distracted driving behaviors while higher self-reported executive difficulty was associated with more frequent weekly engagement in distracted behavior. No significant differences were found between young and middle-aged adults on distracted driving behaviors. Findings conclude that distracted driving is a ubiquitous phenomenon evident in drivers of all ages. Possible mechanisms underlying distracted driving behavior could potentially be related to deficits in executive function. Copyright © 2016 Elsevier Ltd. All rights reserved.

A low-cost method of craniofacial distraction osteogenesis.

PubMed

Greyvensteyn, Gerhardus A; Madaree, Anil

2016-03-01

Distraction osteogenesis is an effective treatment modality for the correction of craniofacial deformities. The cost of these devices is significant and may preclude routine use of these distractors in developing countries. Hence, distraction osteogenesis was performed using medical equipment that was readily available in any hospital at minimal cost. From 2008 to 2013, a retrospective study was performed on infants and neonates who underwent primary distraction for craniofacial abnormalities. Midface or mandibular distraction was performed because of respiratory impairment and/or globe exposure. The apparatus used included Steinmann pins, stainless steel wires, attachment bolts, orthopaedic pulleys, string and intravenous bags for weights. For midface distraction, a transzygomatic pin was inserted, and a transmandibular pin or a cerclage wire was inserted into the mandible through the symphysis or body of the mandible and connected to the pulley system. Distraction osteogenesis was performed on five patients - three mandibular distractions (Pierre Robin sequence) and two transfacial distractions (Apert syndrome/Pfeiffer syndrome type III). The mean age, duration of distraction and duration of consolidation at the time of distraction was 60.5 days, 18.6 days and 16.4 days, respectively. The mean length of distraction achieved was 12 mm. Common complications observed were pin loosening, pressure necrosis of the skin and uneven pull. A major disadvantage was the longer hospital stay required. The African method of distraction is effective, easy and cost effective and could be used in third-world hospitals where surgical expertise or expensive distraction sets are not freely available. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Young and Older Adults' Reading of Distracters

ERIC Educational Resources Information Center

Kemper, Susan; Mcdowd, Joan; Metcalf, Kim; Liu, Chiung-Ju

2008-01-01

Eye-tracking technology was employed to examine young and older adults' performance in the reading with distraction paradigm. Distracters of 1, 2, and 4 words that formed meaningful phrases were used. There were marked age differences in fixation patterns. Young adults' fixations to the distracters and targets increased with distracter length.…

Long-term follow-up after maxillary distraction osteogenesis in growing children with cleft lip and palate.

PubMed

Huang, Chiung-Shing; Harikrishnan, Pandurangan; Liao, Yu-Fang; Ko, Ellen W C; Liou, Eric J W; Chen, Philip K T

2007-05-01

To evaluate the changes in maxillary position after maxillary distraction osteogenesis in six growing children with cleft lip and palate. Retrospective, longitudinal study on maxillary changes at A point, anterior nasal spine, posterior nasal spine, central incisor, and first molar. The University Hospital Craniofacial Center. Cephalometric radiographs were used to measure the maxillary position immediately after distraction, at 6 months, and more than 1 year after distraction. After maxillary distraction with a rigid external distraction device, the maxilla (A point) on average moved forward 9.7 mm and downward 3.5 mm immediately after distraction, moved backward 0.9 mm and upward 2.0 mm after 6 months postoperatively, and then moved further backward 2.3 mm and downward 6.8 mm after more than 1 year from the predistraction position. In most cases, maxilla moved forward at distraction and started to move backward until 1 year after distraction, but remained forward, as compared with predistraction position. Maxilla also moved downward during distraction and upward in 6 months, but started descending in 1 year. There also was no further forward growth of the maxilla after distraction in growing children with clefts.

Impact of intraoperative distractions on patient safety: a prospective descriptive study using validated instruments.

PubMed

Sevdalis, Nick; Undre, Shabnam; McDermott, James; Giddie, Jasdeep; Diner, Lila; Smith, Gillian

2014-04-01

There is emerging evidence indicating that distractions in the operating room (OR) are prevalent. Studies have shown a negative impact of distractions, but they have been conducted mostly with residents in simulated environments. We tested the hypothesis that intraoperative distractions are associated with deterioration in patient safety checks in the OR. We assessed 24 elective urologic procedures. Blinded trained assessors (two surgeons, one psychologist) used validated instruments to prospectively assess in vivo frequency and severity of distractions (related to communication, phones/pagers, equipment/provisions, OR environment, other hospital departments, or a member of the OR team) and completion of safety-related tasks (related to the patient, equipment, and communication). Descriptive and correlational analyses were conducted. Mean case duration was 70 min (mean intraoperative time 31 min). A mean of 4.0 communication distractions (range 0-9) and 2.48 other distractions (range 0-5) were recorded per case (distraction rate of one per 10 min). Distractions from external visitors (addressed to the entire team or the surgeon) and distractions due to lack of coordination between hospital departments were most disruptive. Regarding safety checks, patient tasks were completed most often (85-100 %) followed by equipment tasks (75-100 %) and communication tasks (55-90 %). Correlational analyses showed that more frequent/severe communication distractions were linked to lower completion of patient checks intraoperatively (median rho -0.56, p < 0.05). Distractions are prevalent in ORs and in this study were linked to deterioration in intraoperative patient safety checks. Surgeons should be mindful of their tolerance to distractions. Surgical leadership can help control distractions and reduce their potential impact on patient safety and performance.

Does attention capacity moderate the effect of driver distraction in older drivers?

PubMed

Cuenen, Ariane; Jongen, Ellen M M; Brijs, Tom; Brijs, Kris; Lutin, Mark; Van Vlierden, Karin; Wets, Geert

2015-04-01

With age, a decline in attention capacity may occur and this may impact driving performance especially while distracted. Although the effect of distraction on driving performance of older drivers has been investigated, the moderating effect of attention capacity on driving performance during distraction has not been investigated yet. Therefore, the aim was to investigate whether attention capacity has a moderating effect on older drivers' driving performance during visual distraction (experiment 1) and cognitive distraction (experiment 2). In a fixed-based driving simulator, older drivers completed a driving task without and with visual distraction (experiment 1, N=17, mean age 78 years) or cognitive distraction (experiment 2, N=35, mean age 76 years). Several specific driving measures of varying complexity (i.e., speed, lane keeping, following distance, braking behavior, and crashes) were investigated. In addition to these objective driving measures, subjective measures of workload and driving performance were also included. In experiment 1, crash occurrence increased with visual distraction and was negatively related to attention capacity. In experiment 2, complete stops at stop signs decreased, initiation of braking at pedestrian crossings was later, and crash occurrence increased with cognitive distraction. Interestingly, for a measure of lane keeping (i.e., standard deviation of lateral lane position (SDLP)), effects of both types of distraction were moderated by attention capacity. Despite the decrease of driving performance with distraction, participants estimated their driving performance during distraction as good. These results imply that attention capacity is important for driving. Driver assessment and training programs might therefore focus on attention capacity. Nonetheless, it is crucial to eliminate driver distraction as much as possible given the deterioration of performance on several driving measures in those with low and high attention capacity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Biomechanical influence of pin placement and elbow angle on joint distraction and hinge alignment for an arthrodiatasis elbow-pin-fixator construct.

PubMed

Lee, Wei-Shiun; Linz, Shang-Chih; Shih, Kao-Shang; Chao, Ching-Kong; Chen, Yeung-Jen; Fan, Chang-Yuan

2012-10-01

Stiffness and contracture of the periarticular tissues are common complications of a post-traumatic elbow. Arthrodiatasis is a surgical technique that uses an external fixator for initial immobilization and subsequent distraction. The two prerequisites for an ideal arthrodiatasis are concentric distraction (avoiding bony contact) and hinge alignment (reducing internal stress). This study used the finite element (FE) method to clarify the relationship between these two prerequisites and the initial conditions (pin placement, elbow angle, and distraction mode). A total of 12 variations of the initial conditions were symmetrically arranged to evaluate their biomechanical influence on concentric distraction and hinge alignment. The humeroulnar surface was hypothesized to be ideally distracted orthogonal to the line joining the tips of the olecranon and the coronoid. The eccentric separation of the humeroulnar surfaces is a response to the non-orthogonality of the distracting force and joining line. Pin placement significantly affects the effective moment arm of the fixing pins to distract the bridged elbow. Both elbow angle and distraction mode directly alter the direction of the distracting force at the elbow center. In general, the hinges misalignment occurs in a direction opposite to the distraction-activated site. After joint distraction, the elastic deflection of the fixing pins inevitably makes both elbow and fixator hinges to misalign. This indicates that both joint distraction and hinge alignment are the interactive mechanisms. The humeroulnar separation is more concentric in the situation of the 120 degrees humeral distraction by using stiffer pins with convergent placement. Even so, the eccentric displacement of the elbow hinge is a crucial consideration in the initial placement of the guiding pin to compensate for hinge misalignment.

Interactive versus Passive Distraction and Parent Psychoeducation as Pain Management Techniques during Paediatric Venepuncture - A Randomized Controlled Trial.

PubMed

Newell, Anna; Keane, Jennifer; McGuire, Brian E; Heary, Caroline; McDarby, Vincent; Dudley, Bernie; Moran, Josh; Francis, Kady; Caes, Line

2018-05-10

The aim of the current research was to compare the relative efficacy of interactive and passive distraction, with or without parental psychoeducation, on child pain and distress during a venepuncture. We also compared the effect of parental psychoeducation on parental distress, knowledge of distraction strategies and engagement in distraction. This cross-sectional study included 213 children scheduled for a venepuncture, and one of their parents, who were randomly allocated to one of four conditions; interactive distraction, passive distraction, interactive distraction with parent psychoeducation and passive distraction with parent psychoeducation. ANCOVA's were used to investigate the impact of distraction type and the use of parent psychoeducation on child and parent pain related outcome variables. Statistical analyses revealed no significant differences between groups for child-reported pain and distress. The parents of children who received interactive distraction reported significantly higher levels of distress than the parents of children who received passive distraction. Parents who received parent psychoeducation had a significantly higher level of knowledge than parents who did not receive psychoeducation, but did not engage in more effective pain management behaviour. The results indicated that distraction type did not have a significantly different influence on child pain-related outcome variables. In addition, while psychoeducation was demonstrated to be effective in increasing parental knowledge, it was not sufficient to change parental behaviour.

Impaired laparoscopic performance of novice surgeons due to phone call distraction: a single-centre, prospective study.

PubMed

Yang, Cui; Heinze, Julia; Helmert, Jens; Weitz, Juergen; Reissfelder, Christoph; Mees, Soeren Torge

2017-12-01

Distractions such as phone calls during laparoscopic surgery play an important role in many operating rooms. The aim of this single-centre, prospective study was to assess if laparoscopic performance is impaired by intraoperative phone calls in novice surgeons. From October 2015 to June 2016, 30 novice surgeons (medical students) underwent a laparoscopic surgery training curriculum including two validated tasks (peg transfer, precision cutting) until achieving a defined level of proficiency. For testing, participants were required to perform these tasks under three conditions: no distraction (control) and two standardised distractions in terms of phone calls requiring response (mild and strong distraction). Task performance was evaluated by analysing time and accuracy of the tasks and response of the phone call. In peg transfer (easy task), mild distraction did not worsen the performance significantly, while strong distraction was linked to error and inefficiency with significantly deteriorated performance (P < 0.05). Precision cutting (difficult task) was not slowed down by mild distraction, but surgical and cognitive errors were significantly increased when participants were distracted (P < 0.05). Compared to mild distraction, participants reported a more severe subjective disturbance when they were diverted by strong distraction (P < 0.05). Our data reveals that phone call distractions result in impaired laparoscopic performance under certain circumstances. To ensure patient safety, phone calls should be avoided as far as possible in operating rooms.

Stress in Lumbar Intervertebral Discs during Distraction

PubMed Central

Gay, Ralph E.; Ilharreborde, Brice; Zhao, Kristin D.; Berglund, Lawrence J.; Bronfort, Gert; An, Kai-Nan

2008-01-01

BACKGROUND CONTEXT The intervertebral disc is a common source of low back pain. Prospective studies suggest that treatments that intermittently distract the disc might be beneficial for chronic low back pain. Although the potential exists for distraction therapies to affect the disc biomechanically their effect on intradiscal stress is debated. PURPOSE To determine if distraction alone, distraction combined with flexion or distraction combined with extension can reduce nucleus pulposus pressure and posterior anulus compressive stress in cadaveric lumbar discs compared to simulated standing or lying. STUDY DESIGN Laboratory study using single cadaveric motion segments. OUTCOME MEASURES Strain gauge measures of nucleus pulposus pressure and compressive stress in the anterior and posterior annulus fibrosus METHODS Intradiscal stress profilometry was performed on 15 motion segments during 5 simulated conditions: standing, lying, and 3 distracted conditions. Disc degeneration was graded by inspection from 1 (normal) to 4 (severe degeneration). RESULTS All distraction conditions markedly reduced nucleus pressure compared to either simulated standing or lying. There was no difference between distraction with flexion and distraction with extension in regard to posterior annulus compressive stress. Discs with little or no degeneration appeared to distributed compressive stress differently than those with moderate or severe degeneration. CONCLUSIONS Distraction appears to predictably reduce nucleus pulposus pressure. The effect of distraction therapy on the distribution of compressive stress may be dependent in part on the health of the disc. PMID:17981092

Combination therapy with intra-articular injection of mesenchymal stem cells and articulated joint distraction for repair of a chronic osteochondral defect in the rabbit.

PubMed

Harada, Yohei; Nakasa, Tomoyuki; Mahmoud, Elhussein Elbadry; Kamei, Goki; Adachi, Nobuo; Deie, Masataka; Ochi, Mitsuo

2015-10-01

The present study investigated intra-articular injection of bone-marrow-derived mesenchymal stem cells (MSCs) combined with articulated joint distraction as treatment for osteochondral defects. Large osteochondral defects were created in the weight-bearing area of the medial femoral condyle in rabbit knees. Four weeks after defect creation, rabbits were divided into six groups: control group, MSC group, distraction group, distraction + MSC group, temporary distraction group, and temporary distraction + MSC group. Groups with MSC received intra-articular injection of MSCs. Groups with distraction underwent articulated distraction arthroplasty. Groups with temporary distraction discontinued the distraction after 4 weeks. The rabbits were euthanized at 4, 8, and 12 weeks after treatment except temporary distraction groups which were euthanized at only 12 weeks. Histological scores in the distraction + MSC group were significantly better than in the control, MSC group or distraction group at 4 and 8 weeks, but showed no further improvement. At 12 weeks, the temporary distraction + MSC group showed the best results, demonstrating hyaline cartilage repair with regeneration of the osteochondral junction. In conclusion, joint distraction with intra-articular injection of MSCs promotes early cartilage repair, and compressive loading of the repair tissue after temporary distraction stimulates articular cartilage regeneration. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Distracted by Your Mind? Individual Differences in Distractibility Predict Mind Wandering

ERIC Educational Resources Information Center

Forster, Sophie; Lavie, Nilli

2014-01-01

Attention may be distracted from its intended focus both by stimuli in the external environment and by internally generated task-unrelated thoughts during mind wandering. However, previous attention research has focused almost exclusively on distraction by external stimuli, and the extent to which mind wandering relates to external distraction is…

The role of driver distraction in crashes: an analysis of 1995-1999 Crashworthiness Data System Data.

PubMed

Stutts, J C; Reinfurt, D W; Rodgman, E A

2001-01-01

Five years (1995-1999) of national Crashworthiness Data System (CDS) data are analyzed to determine the role of driver distraction in traffic crashes and the specific sources of this distraction. Results show that 8.3 percent of the drivers were distracted at the time of their crash; after adjustment for the large percentage of drivers with unknown distraction status, the percentage rose to 12.9 percent. The most frequently cited sources of driver distraction were persons, objects or events outside the vehicle (29.4% of distracted drivers), adjusting the radio, tape or CD player (11.4%), and other occupants in the vehicle (10.9%). Other specific distractions (moving objects in vehicle, other objects brought into vehicle, adjusting vehicle or climate controls, eating and drinking, cell phones, and smoking) were each cited in only one to four percent of the cases. The likelihood of being distracted and the source of distraction varied by driver age but not by gender. Results are discussed in light of the limitations inherent in the CDS and other crash data, and the need for expanded data collection initiatives.

Rigid external maxillary distraction and rhinoplasty for pyknodysostosis.

PubMed

Varol, Altan; Sabuncuoglu, Fidan Alakus; Sencimen, Metin; Akcam, Timur; Olmez, Hüseyin; Basa, Selçuk

2011-05-01

This article reports the treatment of an 33-year-old female patient with pyknodysostosis by rigid external distraction II midface distraction system. The patient with pyknodysostosis described in this report had severe midfacial hypoplasia. Correction of this by use of routine orthognathic surgery would require osteosynthesis and bone grafting. Risk of infection and/or nonunion after such a surgical procedure was considered too great, and therefore the possibility of treatment by distraction osteogenesis of the maxilla was evaluated. The rigid external distraction II midface distraction system was used to relocate the hypoplastic maxilla at anterior-inferior projection. Distraction osteogenesis should be considered as the primary reconstructive method for maxillofacial deformities in patients with sclerosing bone dysplasias, since this is the second reported case treated successfully with rigid external distraction.

Distracted Biking: An Observational Study.

PubMed

Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J

2016-01-01

Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured.

Distracted Biking: An Observational Study

PubMed Central

Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J.

2016-01-01

Commuting via bicycle is a very popular mode of transportation in the Northeastern United States (US). Boston, MA has seen a rapid increase in bicycle ridership over the past decade which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at four high traffic intersections in Boston during various peak commuting hours for two types of distractions: auditory (ear buds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%, 95% CI: 29%-33%) were distracted. Of those observed, auditory distractions were the most common (N= 349 [17.7%, 95% CI: 16%-19%], p=0.0003) followed by visual/tactile distractions (N= 266 [13.5%, 95% CI: 12%-15%]). The highest proportion (40.7%, 95% CI: 35%-46%) of distracted bicyclists was observed during the midday commute (between 13:30-15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost one-third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured. PMID:26953533

Normalizing memory recall in fibromyalgia with rehearsal: a distraction-counteracting effect.

PubMed

Leavitt, Frank; Katz, Robert S

2009-06-15

To examine the impact of distraction on the retention of rehearsed information in patients with fibromyalgia syndrome (FMS). Data refer to the neurocognitive examination of 134 patients (91 with FMS and 43 control subjects) presenting with memory loss. Four neurocognitive measures free of distraction, along with 2 measures with added distraction, were completed. Differences in the retention of rehearsed and unrehearsed information with a source of distraction present were calculated. Patients with FMS showed normal cognitive functioning on verbal memory tests free of distraction. Adding a source of distraction caused unrefreshed information to be lost at a disproportionate rate in patients with FMS. Over 87% of patients with FMS scored in the impaired range on a task of unrehearsed verbal memory. Adding a source of distraction to well-rehearsed information produced a normal rate of recall in FMS. Rehearsal mechanisms are intact in patients with FMS and play beneficial roles in managing interference from a source of distraction. In the absence of rehearsal, a source of distraction added to unrefreshed information signals a remarkable level of cognitive deficit in FMS that goes undetected by conventionally relied-upon neurocognitive measures. We present a theory to promote understanding of the cognitive deficit of people with FMS based on reduced speed of lexical activation and poor recall after distraction.

Systematic Review and Meta-Analysis of Distraction and Hypnosis for Needle-Related Pain and Distress in Children and Adolescents

PubMed Central

Noel, Melanie; Parker, Jennifer A.; Chambers, Christine T.; Uman, Lindsay S.; Kisely, Steve R.; McGrath, Patrick J.

2014-01-01

Objective To systematically review the evidence (and quality) for distraction and hypnosis for needle-related pain and distress in children and adolescents. To explore the effects of distraction characteristics (e.g., adult involvement, type of distracter), child age, and study risk of bias on treatment efficacy. Methods 26 distraction and 7 hypnosis trials were included and self-report, observer-report, and behavioral pain intensity and distress examined. Distraction studies were coded for 4 intervention characteristics, and all studies coded for child age and study risk of bias. Results Findings showed strong support for distraction and hypnosis for reducing pain and distress from needle procedures. The quality of available evidence was low, however. Characteristics of distraction interventions, child age, and study risk of bias showed some influence on treatment efficacy. Conclusions Distraction and hypnosis are efficacious in reducing needle-related pain and distress in children. The quality of trials in this area needs to be improved. PMID:24891439

75 FR 45696 - Pipeline Safety: Personal Electronic Device Related Distractions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... of PEDs. Such distractions may also hinder their prompt recognition and reaction to abnormal... distractions caused by the use of PEDs. Such distractions may also hinder their prompt recognition and reaction...

Sharing the responsibility for driver distraction across road transport systems: a systems approach to the management of distracted driving.

PubMed

Young, Kristie L; Salmon, Paul M

2015-01-01

Distracted driving is acknowledged universally as a large and growing road safety problem. Compounding the problem is that distracted driving is a complex, multifaceted issue influenced by a multitude of factors, organisations and individuals. As such, management of the problem is not straightforward. Numerous countermeasures have been developed and implemented across the globe. The vast majority of these measures have derived from the traditional reductionist, driver-centric approach to distraction and have failed to fully reflect the complex mix of actors and components that give rise to drivers becoming distracted. An alternative approach that is gaining momentum in road safety is the systems approach, which considers all components of the system and their interactions as an integrated whole. In this paper, we review the current knowledge base on driver distraction and argue that the systems approach is not currently being realised in practice. Adopting a more holistic, systems approach to distracted driving will not only improve existing knowledge and interventions from the traditional approach, but will enhance our understanding and management of distraction by considering the complex relationships and interactions of the multiple actors and the myriad sources, enablers and interventions that make up the distracted driving system. It is only by recognising and understanding how all of the system components work together to enable distraction to occur, that we can start to work on solutions to help mitigate the occurrence and consequences of distracted driving. Copyright © 2014 Elsevier Ltd. All rights reserved.

Promoted new bone formation in maxillary distraction osteogenesis using a tissue-engineered osteogenic material.

PubMed

Kinoshita, Kazuhiko; Hibi, Hideharu; Yamada, Yoichi; Ueda, Minoru

2008-01-01

Bilateral maxillary distraction was performed at a higher rate in rabbits to determine whether locally applied tissue-engineered osteogenic material (TEOM) enhances bone regeneration. The material was an injectable gel composed of autologous mesenchymal stem cells, which were cultured then induced to be osteogenic in character, and platelet-rich plasma (PRP). After a 5-day latency period, distraction devices were activated at a rate of 2.0 mm once daily for 4 days. Twelve rabbits were divided into 2 groups. At the end of distraction, the experimental group of rabbits received an injection of TEOM into the distracted tissue on one side, whereas, saline solution was injected into the distracted tissue on the contralateral side as the internal control. An additional control group received an injection of PRP or saline solution into the distracted tissue in the same way as the experimental group. The distraction regenerates were assessed by radiological and histomorphometric analyses. The radiodensity of the distraction gap injected with TEOM was significantly higher than that injected with PRP or saline solution at 2, 3, and 4 weeks postdistraction. The histomorphometric analysis also showed that both new bone zone and bony content in the distraction gap injected with TEOM were significantly increased when compared with PRP or saline solution. Our results demonstrated that the distraction gap injected with TEOM showed significant new bone formation. Therefore, injections of TEOM may be able to compensate for insufficient distraction gaps.

Management of post midface distraction occlusal discrepancy using temporary anchorage devices in a cleft patient

PubMed Central

Koteswara Prasad, N. K.; Hussain, Syed Altaf; Chitharanjan, Arun B.; Murthy, Jyotsna

2015-01-01

Open bite deformity following a successful midface advancement by distraction osteogenesis is a common complication. Temporary anchorage devices can be deployed during the distraction and post-distraction settling phases for restoring the occlusion even in severe cases. The following report describes the management of severe anterior open bite following maxillary distraction. PMID:25991895

Disposed to distraction: Genetic variation in the cholinergic system influences distractibility but not time-on-task effects

PubMed Central

Berry, Anne S.; Demeter, Elise; Sabhapathy, Surya; English, Brett A.; Blakely, Randy D.; Sarter, Martin; Lustig, Cindy

2015-01-01

Both the passage of time and external distraction make it difficult to keep attention on the task at hand. We tested the hypothesis that time-on-task and external distraction pose independent challenges to attention, and that the brain’s cholinergic system selectively modulates our ability to resist distraction. Participants with a polymorphism limiting cholinergic capacity (Ile89Val variant (rs1013940) of the choline transporter gene SLC5A7) and matched controls completed self-report measures of attention and a laboratory task that measured decrements in sustained attention with and without distraction. We found evidence that distraction and time-on-task effects are independent and that the cholinergic system is strongly linked to greater vulnerability to distraction. Ile89Val participants reported more distraction during everyday life than controls, and their task performance was more severely impacted by the presence of an ecologically valid video distractor (similar to a television playing in the background). These results are the first to demonstrate a specific impairment in cognitive control associated with the Ile89Val polymorphism, and add to behavioral and cognitive neuroscience studies indicating the cholinergic system’s critical role in overcoming distraction. PMID:24666128

The role of alcohol use on recent trends in distracted driving.

PubMed

Wilson, Fernando A; Stimpson, Jim P; Tibbits, Melissa K

2013-11-01

Distracted driving is now an increasingly deadly threat to road safety. We provide evidence that intoxicated driving is increasingly responsible for recent increases in fatalities from distracted driving crashes. This study describes trends in deaths on U.S. public roads caused by alcohol-involved and distracted drivers using the Fatality Analysis Reporting System (FARS)-a census of fatal crashes on U.S. public roads. Fatality rates per vehicle-miles traveled are calculated using data from the Federal Highway Administration. Alcohol-involved drivers who are simultaneously distracted were responsible for 1750 deaths in 2009, an increase of more than 63% from 2005 when there were 1072 deaths. Alcohol use while driving is increasingly responsible for a growing number of fatalities from distracted driving, accounting for 32% of deaths from distracted driving in 2009 versus 24% in 2005. The fatality rate from these crashes increased from 35.9 to 59.2 deaths per 100 billion vehicle-miles traveled after 2005. Alcohol use is quickly increasing as an important factor behind distracted driving fatalities. This has implications for policies combating distracted driving that do not address the role of alcohol use in distracted driving. Copyright © 2013 Elsevier Ltd. All rights reserved.

Arthroscopic Talar Dome Access Using a Standard Versus Wire-Based Traction Method for Ankle Joint Distraction.

PubMed

Barg, Alexej; Saltzman, Charles L; Beals, Timothy C; Bachus, Kent N; Blankenhorn, Brad D; Nickisch, Florian

2016-07-01

To evaluate the accessibility of the talar dome through anterior and posterior portals for ankle arthroscopy with the standard noninvasive distraction versus wire-based longitudinal distraction using a tensioned wire placed transversely through the calcaneal tuberosity. Seven matched pairs of thigh-to-foot specimens underwent ankle arthroscopy with 1 of 2 methods of distraction: a standard noninvasive strapping technique or a calcaneal tuberosity wire-based technique. The order of the arthroscopic approach and use of a distraction method was randomly determined. The areas accessed from both 2-portal anterior and 2-portal posterior approaches were determined by using a molded translucent grid. The mean talar surface accessible by anterior ankle arthroscopy was comparable with noninvasive versus calcaneal wire distraction with 57.8% ± 17.2% (range, 32.9% to 75.7%) versus 61.5% ± 15.2% (range, 38.5% to 79.1%) of the talar dome, respectively (P = .590). The use of calcaneal wire distraction significantly improved posterior talar dome accessibility compared with noninvasive distraction, with 56.4% ± 20.0% (range, 14.4% to 78.0%) versus 39.8% ± 14.9% (range, 20.0% to 57.6%) of the talar dome, respectively (P = .031). Under the conditions studied, our cadaveric model showed equivalent talar dome access with 2-portal anterior arthroscopy of calcaneal wire-based distraction versus noninvasive strap distraction, but improved access for 2-portal posterior arthroscopy with calcaneal wire-based distraction versus noninvasive strap distraction. The posterior 40% of the talar dome is difficult to access via anterior ankle arthroscopy. Posterior calcaneal tuberosity wire-based longitudinal distraction improved arthroscopic access to the centro-posterior talar dome with a posterior arthroscopic approach. Published by Elsevier Inc.

A simple mechanism for measuring and adjusting distraction forces during maxillary advancement.

PubMed

Suzuki, Eduardo Yugo; Suzuki, Boonsiva

2009-10-01

Direct measurement of distraction forces on the craniofacial skeleton has never been reported. The present report describes the development of a method of assessing and adjusting traction forces applied through maxillary distraction osteogenesis. A simple mechanism to measure and adjust tension force during maxillary distraction osteogenesis was developed and connected bilaterally to the traction screws of a rigid external distraction device. Measurements were carried out before and after activation using a Shimpo (Nidec-Shimpo America Corporation, Itasca, IL) force gauge in 4 patients (2 with unilateral cleft lip and/or palate, 1 with bilateral cleft lip and palate, and 1 with noncleft) during the distraction process. Activation was performed twice a day at a rate of 1 mm/day. The average maximum force applied throughout the distraction period was 42.5 N (range 16.4 to 65.3 N), with increments, after activation, averaging 10.5 N (range 7.9 to 15.7 N). In patients with unilateral cleft lip and/or palate, distraction forces on the larger segment were 65.1% higher than on the lesser segment. A differential pattern of forces was also observed in the patients with asymmetric noncleft. However, the differential forces between lateral segments were not observed in the patient with bilateral cleft lip and palate. During the activation period, distraction forces progressively increased, whereas the amount of maxillary movement decreased. Pain and discomfort were reported with high forces. Through this mechanism, direct measurement and adjustment of distraction forces during maxillary advancement was possible. The unbalanced pattern of forces observed in patients with cleft suggests the necessity of individual adjustments for controlling pain and clinical symptoms. Accordingly, assessment of distraction forces during maxillary distraction osteogenesis is extremely helpful in understanding the biomechanics of the distraction process.

Potential distractions and unsafe driving behaviors among drivers of 1- to 12-year-old children.

PubMed

Macy, Michelle L; Carter, Patrick M; Bingham, C Raymond; Cunningham, Rebecca M; Freed, Gary L

2014-01-01

Driver distraction has been identified as a threat to individual drivers and public health. Motor vehicle collisions remain a leading cause of death for children, yet little is known about distractions among drivers of children. This study sought to characterize potential distractions among drivers of children. A 2-site, cross-sectional, computerized survey of child passenger safety practices was conducted among adult drivers of 1- to 12-year-old children who presented for emergency care between October 2011 to May 2012. Drivers indicated the frequency with which they engaged in 10 potential distractions in the past month while driving with their child. Distractions were grouped in 4 categories: (1) nondriving, (2) cellular phone, (3) child, and (4) directions. Information about other unsafe driving behaviors and sociodemographic characteristics was collected. Nearly 90% of eligible parents participated. Analysis included 570 drivers (92.2%). Non-driving-related and cellular phone-related distractions were disclosed by >75% of participants. Fewer participants disclosed child (71.2%) and directions-related distractions (51.9%). Child age was associated with each distraction category. Cellular phone-related distractions were associated with the child riding daily in the family car, non-Hispanic white, and higher education. Parents admitting to drowsy driving and being pulled over for speeding had over 2 times higher odds of disclosing distractions from each category. Distracted driving activities are common among drivers of child passengers and are associated with other unsafe driving behaviors. Child passenger safety may be improved by preventing crash events through the reduction or elimination of distractions among drivers of child passengers. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Potential Distractions and Unsafe Driving Behaviors Among Drivers of 1- to 12-year-old Children

PubMed Central

Macy, Michelle L.; Carter, Patrick M.; Bingham, C. Raymond; Cunningham, Rebecca M.; Freed, Gary L.

2014-01-01

Objective Driver distraction has been identified as a threat to individual drivers and public health. Motor vehicle collisions remain a leading cause of death for children yet little is known about distractions among drivers of children. This study sought to characterize potential distractions among drivers of children. Methods A two-site, cross-sectional, computerized survey of child passenger safety practices was conducted among adult drivers of 1- to 12-year-old children who presented for emergency care between October 2011-May 2012. Drivers indicated the frequency with which they engaged in ten potential distractions in the past month while driving with their child. Distractions were grouped in four categories: 1) non-driving, 2) cellular phone, 3) child, 4) directions. Information about other unsafe driving behaviors and sociodemographic characteristics was collected. Results Nearly 90% of eligible parents participated. Analysis included 570 (92.2%) drivers. Non-driving and cellular phone-related distractions were disclosed by >75% of participants. Fewer participants disclosed child (71.2%) and directions-related distractions (51.9%). Child age was associated with each distraction category. Cellular phone-related distractions were associated with the child riding daily in the family car, non-Hispanic white and other race/ethnicity, and higher education. Parents admitting to drowsy driving and being pulled over for speeding had over two-times higher odds of disclosing distractions from each category. Conclusions Distracted driving activities are common among drivers of child passengers and associated with other unsafe driving behaviors. Child passenger safety may be improved by preventing crash events through the reduction or elimination of distractions among drivers of child passengers. PMID:24767781

'Sorry, I meant the patient's left side': impact of distraction on left-right discrimination.

PubMed

McKinley, John; Dempster, Martin; Gormley, Gerard J

2015-04-01

Medical students can have difficulty in distinguishing left from right. Many infamous medical errors have occurred when a procedure has been performed on the wrong side, such as in the removal of the wrong kidney. Clinicians encounter many distractions during their work. There is limited information on how these affect performance. Using a neuropsychological paradigm, we aim to elucidate the impacts of different types of distraction on left-right (LR) discrimination ability. Medical students were recruited to a study with four arms: (i) control arm (no distraction); (ii) auditory distraction arm (continuous ambient ward noise); (iii) cognitive distraction arm (interruptions with clinical cognitive tasks), and (iv) auditory and cognitive distraction arm. Participants' LR discrimination ability was measured using the validated Bergen Left-Right Discrimination Test (BLRDT). Multivariate analysis of variance was used to analyse the impacts of the different forms of distraction on participants' performance on the BLRDT. Additional analyses looked at effects of demographics on performance and correlated participants' self-perceived LR discrimination ability and their actual performance. A total of 234 students were recruited. Cognitive distraction had a greater negative impact on BLRDT performance than auditory distraction. Combined auditory and cognitive distraction had a negative impact on performance, but only in the most difficult LR task was this negative impact found to be significantly greater than that of cognitive distraction alone. There was a significant medium-sized correlation between perceived LR discrimination ability and actual overall BLRDT performance. Distraction has a significant impact on performance and multifaceted approaches are required to reduce LR errors. Educationally, greater emphasis on the linking of theory and clinical application is required to support patient safety and human factor training in medical school curricula. Distraction has the potential to impair an individual's ability to make accurate LR decisions and students should be trained from undergraduate level to be mindful of this. © 2015 John Wiley & Sons Ltd.

The impact of distraction mitigation strategies on driving performance.

PubMed

Donmez, Birsen; Boyle, Linda Ng; Lee, John D

2006-01-01

An experiment was conducted to assess the effects of distraction mitigation strategies on drivers' performance and productivity while engaged in an in-vehicle information system task. Previous studies show that in-vehicle tasks undermine driver safety and there is a need to mitigate driver distraction. An advising strategy that alerts drivers to potential dangers and a locking strategy that prevents the driver from continuing the distracting task were presented to 16 middle-aged and 12 older drivers in a driving simulator in two modes (auditory, visual) and two road conditions (curves, braking events). Distraction was a problem for both age groups. Visual distractions were more detrimental than auditory ones for curve negotiation, as depicted by more erratic steering, F (6, 155) = 26.76, p < .05. Drivers did brake more abruptly under auditory distractions, but this effect was mitigated by both the advising, t (155) = 8.37, p < .05, and locking strategies, t (155) = 8.49, p < .05. The locking strategy also resulted in longer minimum time to collision for middle-aged drivers engaged in visual distractions, F (6, 138) = 2.43, p < .05. Adaptive interfaces can reduce abrupt braking on curve entries resulting from auditory distractions and can also improve the braking response for distracted drivers. These strategies can be incorporated into existing in-vehicle systems, thus mitigating the effects of distraction and improving driver performance.

Temporary Segmental Distraction in a Dog with Degenerative Lumbosacral Stenosis.

PubMed

Willems, Nicole; Kersten, Roel F M R; van Gaalen, Steven M; Öner, F Cumhur; Strijkers, Gustav J; Veraa, Stefanie; Beukers, Martijn; Tryfonidou, Marianna A; Meij, Björn P

2018-06-02

 Degenerative lumbosacral stenosis (DLSS) is characterized by intervertebral disc degeneration and causes lower back pain in dogs. Temporary distraction in rabbit models with induced intervertebral disc degeneration showed signs of intervertebral disc repair. In the present study, we assessed safety and efficacy of temporary segmental distraction in a dog with clinical signs of DLSS.  Distraction of the lumbosacral junction by pedicle screw-rod fixation was applied in a 5-year-old Greyhound with DLSS and evaluated by radiography, magnetic resonance imaging, and force plate analysis before and after distraction.  Safe distraction of the lumbosacral junction was demonstrated, with improvement of clinical signs after removal of the distraction device. Signal intensity of the intervertebral disc showed no changes over time. T2 value was highest directly after removal of the distraction device but decreased by 10% of the preoperative value at 9 months of follow-up. Disc height decreased (8%) immediately after removal of the distraction device, but recovered to the initial value. A decrease in the pelvic/thoracic propulsive force during pedicle screw-rod fixation and distraction was demonstrated, which slowly increased by 4% compared with the initial value.  Temporary pedicle screw-rod fixation in combination with distraction in a dog with DLSS was safe, improved clinical signs and retained disc height at 9 months of follow-up. Schattauer GmbH Stuttgart.

Attention and working memory in elderly: the influence of a distracting environment.

PubMed

Rodrigues, Pedro F S; Pandeirada, Josefa N S

2015-02-01

The present work investigated the effect of a distracting environment in the performance of attentional and working memory (WM) tasks in elderly participants. To this end, forty elderly performed two attentional tasks (simple reaction time and go/no-go tasks), and three WM tasks (arithmetic, memory for digits and sequences of letters and numbers). Each participant performed the tasks in a distracting and a non-distracting environment, with an interval of 14-21 days between sessions. The results revealed better performance in the attentional tasks when these were done in the non-distracting environment, as compared to when they were done in the distracting environment. Specifically, participants provided more accurate responses, fewer false alarms and omissions when responding in the non-distracting environment than when responding in the distracting environment. Participants were also faster at providing correct responses in the go/no-go task when it was performed in the non-distracting environment. As for the memory tasks, the effect of type of environment was significant only in the memory for digits in a forward direction task. Our data suggest the need to consider the potential damaging consequences of distracting environments when the elderly have to perform tasks that demand their attention. Specific examples of such situations are presented in the discussion (e.g., distracting effect of environment on medical and on psychological evaluations).

The effects of coping style on virtual reality enhanced videogame distraction in children undergoing cold pressor pain.

PubMed

Sil, Soumitri; Dahlquist, Lynnda M; Thompson, Caitlin; Hahn, Amy; Herbert, Linda; Wohlheiter, Karen; Horn, Susan

2014-02-01

This study sought to evaluate the effectiveness of virtual reality (VR) enhanced interactive videogame distraction for children undergoing experimentally induced cold pressor pain and examined the role of avoidant and approach coping style as a moderator of VR distraction effectiveness. Sixty-two children (6-13 years old) underwent a baseline cold pressor trial followed by two cold pressor trials in which interactive videogame distraction was delivered both with and without a VR helmet in counterbalanced order. As predicted, children demonstrated significant improvement in pain tolerance during both interactive videogame distraction conditions. However, a differential response to videogame distraction with or without the enhancement of VR technology was not found. Children's coping style did not moderate their response to distraction. Rather, interactive videogame distraction with and without VR technology was equally effective for children who utilized avoidant or approach coping styles.

Divided attention reduces resistance to distraction at encoding but not retrieval.

PubMed

Weeks, Jennifer C; Hasher, Lynn

2017-08-01

Older adults show implicit memory for previously seen distraction, an effect attributed to poor attentional control. It is unclear whether this effect results from lack of control over encoding during the distraction task, lack of retrieval constraint during the test task, or both. In the present study, we simulated poor distraction control in young adults using divided attention at encoding, at retrieval, at both times, or not at all. The encoding task was a 1-back task on pictures with distracting superimposed letter strings, some of which were words. The retrieval task was a word fragment completion task testing implicit memory for the distracting words. Attention was divided using an auditory odd digit detection task. Dividing attention at encoding, but not at retrieval, resulted in significant priming for distraction, which suggests that control over encoding processes is a primary determinant of distraction transfer in populations with low inhibitory control (e.g. older adults).

Active and passive distraction using a head-mounted display helmet: effects on cold pressor pain in children.

PubMed

Dahlquist, Lynnda M; McKenna, Kristine D; Jones, Katia K; Dillinger, Lindsay; Weiss, Karen E; Ackerman, Claire Sonntag

2007-11-01

The current study tested the effectiveness of interactive versus passive distraction that was delivered via a virtual reality type head-mounted display helmet for children experiencing cold pressor pain. Forty children, aged 5 to 13 years, underwent 1 or 2 baseline cold pressor trials followed by interactive distraction and passive distraction trials in counterbalanced order. Pain threshold and pain tolerance. Children who experienced either passive or interactive distraction demonstrated significant improvements in both pain tolerance and pain threshold relative to their baseline scores. In contrast, children who underwent a second cold pressor trial without distraction showed no significant improvements in pain tolerance or threshold. Although both distraction conditions were effective, the interactive distraction condition was significantly more effective. Implications for the treatment of children's distress during painful medical procedures are discussed. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Eye closure helps memory by reducing cognitive load and enhancing visualisation.

PubMed

Vredeveldt, Annelies; Hitch, Graham J; Baddeley, Alan D

2011-10-01

Closing the eyes helps memory. We investigated the mechanisms underlying the eyeclosure effect by exposing 80 eyewitnesses to different types of distraction during the witness interview: blank screen (control), eyes closed, visual distraction, and auditory distraction. We examined the cognitive load hypothesis by comparing any type of distraction (visual or auditory) with minimal distraction (blank screen or eyes closed). We found recall to be significantly better when distraction was minimal, providing evidence that eyeclosure reduces cognitive load. We examined the modality-specific interference hypothesis by comparing the effects of visual and auditory distraction on recall of visual and auditory information. Visual and auditory distraction selectively impaired memory for information presented in the same modality, supporting the role of visualisation in the eyeclosure effect. Analysis of recall in terms of grain size revealed that recall of basic information about the event was robust, whereas recall of specific details was prone to both general and modality-specific disruptions.

Do as I say, not as I do: Distracted driving behavior of teens and their parents.

PubMed

Raymond Bingham, C; Zakrajsek, Jennifer S; Almani, Farideh; Shope, Jean T; Sayer, Tina B

2015-12-01

Driver distraction is an important contributor to crash risk. Teenage driver distraction can be influenced by the attitudes and behaviors of parents. This study examined teens' and their parents' engagement in distracting behavior while driving. Survey data were collected from a national sample of 403 parent-teen dyads using random-digit dialing telephone interviews. Results demonstrated few parent or teen sex differences in distracting behavior engagement while driving, or in their perceptions of each others' behavior. Parents and teens' frequencies of distracting behavior engagement were positively correlated. Parents' and teens' perceptions of each others' distracting behavior engagement while driving exceeded their own selfreports. Finally, the likelihood that teens reported engaging in distracting behavior while driving was more strongly associated with their perceptions of their parents' distracting behavior than by parents' self reports of their own behavior. These results suggest that parents' examples of driving behavior are an important influence on teen driving behavior, but potentially more important are teens' perceptions of their parents' behaviors. Published by Elsevier Ltd.

“I wasn’t texting; I was just reading an email …”: a qualitative study of distracted driving enforcement in Washington State

PubMed Central

Nevin, Paul E; Blanar, Laura; Kirk, Annie Phare; Freedheim, Amy; Kaufman, Robert; Hitchcock, Laura; Maeser, Jennifer D; Ebel, Beth E

2018-01-01

Background In response to the rise of distracted driving, many countries and most US states have adopted laws to restrict the use of handheld phones for drivers. Specific provisions of each law and the overall social mores of distracted driving influence enforceability and impact. Objectives Identify multilevel interdependent factors that influence distracted driving enforcement through the perspective of police officers. Design/methods We conducted focus group discussions with active duty law enforcement officers from three large Washington State counties. Our thematic analysis used descriptive and pattern coding that placed our findings within a social ecological framework to facilitate targeted intervention development. Results Participants reported that the distracted driving law posed challenges for consistent and effective enforcement. They emphasised the need to change social norms around distracted driving, similar to the shifts seen around impaired driving. Many participants were themselves distracted drivers, and their individual knowledge, attitude and beliefs influenced enforcement. Participants suggested that law enforcement leaders and policymakers should develop and implement policies and strategies to prioritise and motivate increased distracted driving enforcement. Conclusions Individual, interpersonal, organisational and societal factors influence enforcement of distracted driving laws. Targeted interventions should be developed to address distracted driving and sustain effective enforcement. PMID:27634839

Midface distraction osteogenesis: internal vs. external devices.

PubMed

Meling, T R; Høgevold, H-E; Due-Tønnessen, B J; Skjelbred, P

2011-02-01

This study compares internal and external distraction devices in the treatment of midface retrusion. 20 patients were treated with midface distraction (12 Crouzon, 4 Apert, 4 others); 12 with internal distraction (MID device), 8 with external distraction (Red or Blue device). The two groups were compared regarding operation time, peroperative blood loss and complications. The groups were comparable regarding patient age, sex, weight and diagnosis. In the MID-group, 7 of 12 patients (58%) underwent Le Fort III, 5 underwent 12 monobloc (32%). In the Blue device group, three of eight patients underwent Le Fort II (38%), three of eight underwent Le Fort III (38%), and two of eight underwent monobloc (25%). Operation time was shorter in the Blue device (mean 298 min) than in the MID group (mean 354 min). Peroperative blood loss and complication rates were similar. The internal distraction device is the 'gold standard' for treating midface retrusion. The use of an external distraction device in midface distraction osteogenesis is associated with a shorter operation time; peroperative blood loss and complications were similar. An external device affords better 3-dimensional control during the distraction process, so external distraction is preferable in patients who will tolerate this treatment. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Speech-Language Dissociations, Distractibility, and Childhood Stuttering

PubMed Central

Conture, Edward G.; Walden, Tedra A.; Lambert, Warren E.

2015-01-01

Purpose This study investigated the relation among speech-language dissociations, attentional distractibility, and childhood stuttering. Method Participants were 82 preschool-age children who stutter (CWS) and 120 who do not stutter (CWNS). Correlation-based statistics (Bates, Appelbaum, Salcedo, Saygin, & Pizzamiglio, 2003) identified dissociations across 5 norm-based speech-language subtests. The Behavioral Style Questionnaire Distractibility subscale measured attentional distractibility. Analyses addressed (a) between-groups differences in the number of children exhibiting speech-language dissociations; (b) between-groups distractibility differences; (c) the relation between distractibility and speech-language dissociations; and (d) whether interactions between distractibility and dissociations predicted the frequency of total, stuttered, and nonstuttered disfluencies. Results More preschool-age CWS exhibited speech-language dissociations compared with CWNS, and more boys exhibited dissociations compared with girls. In addition, male CWS were less distractible than female CWS and female CWNS. For CWS, but not CWNS, less distractibility (i.e., greater attention) was associated with more speech-language dissociations. Last, interactions between distractibility and dissociations did not predict speech disfluencies in CWS or CWNS. Conclusions The present findings suggest that for preschool-age CWS, attentional processes are associated with speech-language dissociations. Future investigations are warranted to better understand the directionality of effect of this association (e.g., inefficient attentional processes → speech-language dissociations vs. inefficient attentional processes ← speech-language dissociations). PMID:26126203

A Osteogenesis Distraction Device Enabling Control of Vertical Direction for Syndromic Craniosynostosis

PubMed Central

Fukawa, Toshihiko; Hirakawa, Takashi; Maegawa, Jiro

2014-01-01

Background: We have developed a hybrid facial osteogenesis distraction system that combines the advantages of external and internal distraction devices to enable control of both the distraction distance and vector. However, when the advanced maxilla has excessive clockwise rotation and shifts more downward vertically than planned, it might be impossible to pull it up to correct it. We invented devices attached to external distraction systems that can control the vertical vector of distraction to resolve this problem. The purpose of this article is to describe the result of utilizing the distraction system for syndromic craniosynostosis. Methods: In addition to a previously reported hybrid facial distraction system, the devices for controlling the vertical direction of the advanced maxilla were attached to the external distraction device. The vertical direction of the advanced maxilla can be controlled by adjustment of the spindle units. This system was used for 2 patients with Crouzon and Apert syndrome. Results: The system enabled control of the vertical distance, with no complications during the procedures. As a result, the maxilla could be advanced into the planned position including overcorrection without excessive clockwise rotation of distraction. Conclusion: Our system can alter the cases and bring them into the planned position, by controlling the vertical vector of distraction. We believe that this system might be effective in infants with syndromic craniosynostosis as it involves 2 osteotomies and horizontal and vertical direction of elongation can be controlled. PMID:25289307

A new distraction arthroplasty device using magnetic force; a cadaveric study.

PubMed

Kamei, Goki; Ochi, Mitsuo; Okuhara, Atsushi; Fujimiya, Mineko; Deie, Masataka; Adachi, Nobuo; Nakamae, Atsuo; Nakasa, Tomoyuki; Ohkawa, Shingo; Takazawa, Kobun; Eguchi, Akio; Katou, Tomohiro; Takada, Tsuyoshi; Usman, Muhammad Andry

2013-04-01

It is difficult for an articular cartilage injury to repair spontaneously. There are many procedures for treating cartilage injury, however there is no standard procedure for middle-aged patients who have diffuse knee osteoarthritis, especially of the lateral compartment. Therefore, Ochi developed a new distraction device that uses magnetic power to enlarge a joint space and promote cartilage regeneration with microfracture. The purpose of this study is to evaluate this new distraction arthroplasty system by using the cadaveric knee. This study used ten knees from six cadavers that were embalmed by Thiel's methods. The medial and lateral joint space was measured by AP radiographic view before and after distraction, and after weight-bearing to evaluate the joint distraction. The contact pressure of the medial and lateral compartments at the knee extension position by using a prescale film system was measured before and after weight-bearing with a 15 or 30-kg weight-bearing load to evaluate the effectiveness of this device. The lateral joint space significantly increased from the pre-distraction to the post-distraction; however, it did not change significantly between post-distraction and post-weight-bearing. With a 15 or 30-kg weight-bearing load, the contact pressure of the lateral compartment significantly decreased from the pre-distraction to the post-distraction. The most important advantage of this device is that it maintains a continuous distraction tension and enables almost the full range of motion of the knee. We believe that joint distraction by using magnetic force can be a promising option for cartilage injury in middle-aged patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

Neural signatures of the response to emotional distraction: a review of evidence from brain imaging investigations

PubMed Central

Iordan, A. D.; Dolcos, S.; Dolcos, F.

2013-01-01

Prompt responses to emotional, potentially threatening, stimuli are supported by neural mechanisms that allow for privileged access of emotional information to processing resources. The existence of these mechanisms can also make emotional stimuli potent distracters, particularly when task-irrelevant. The ability to deploy cognitive control in order to cope with emotional distraction is essential for adaptive behavior, while reduced control may lead to enhanced emotional distractibility, which is often a hallmark of affective disorders. Evidence suggests that increased susceptibility to emotional distraction is linked to changes in the processing of emotional information that affect both the basic response to and coping with emotional distraction, but the neural correlates of these phenomena are not clear. The present review discusses emerging evidence from brain imaging studies addressing these issues, and highlights the following three aspects. First, the response to emotional distraction is associated with opposing patterns of activity in a ventral “hot” affective system (HotEmo, showing increased activity) and a dorsal “cold” executive system (ColdEx, showing decreased activity). Second, coping with emotional distraction involves top–down control in order to counteract the bottom-up influence of emotional distraction, and involves interactions between the amygdala and the prefrontal cortex. Third, both the response to and coping with emotional distraction are influenced by individual differences affecting emotional sensitivity and distractibility, which are linked to alterations of both HotEmo and ColdEx neural systems. Collectively, the available evidence identifies specific neural signatures of the response to emotional challenge, which are fundamental to understanding the mechanisms of emotion-cognition interactions in healthy functioning, and the changes linked to individual variation in emotional distractibility and susceptibility to affective disorders. PMID:23761741

Students distracted by electronic devices perform at the same level as those who are focused on the lecture.

PubMed

Nalliah, Romesh P; Allareddy, Veerasathpurush

2014-01-01

Background. Little is known about the characteristics of internet distractions that students may engage in during lecture. The objective of this pilot study is to identify some of the internet-based distractions students engage in during in-person lectures. The findings will help identify what activities most commonly cause students to be distracted from the lecture and if these activities impact student learning. Methods. This study is a quasi-experimental pilot study of 26 students from a single institution. In the current study, one class of third-year students were surveyed after a lecture on special needs dentistry. The survey identified self-reported utilization patterns of "smart" devices during the lecture. Additionally, twelve quiz-type questions were given to assess the students' recall of important points in the lecture material that had just been covered. Results. The sample was comprised of 26 students. Of these, 17 were distracted in some form (either checking email, sending email, checking Facebook, or sending texts). The overall mean score on the test was 9.85 (9.53 for distracted students and 10.44 for non-distracted students). There were no significant differences in test scores between distracted and non-distracted students (p = 0.652). Gender and types of distractions were not significantly associated with test scores (p > 0.05). All students believed that they understood all the important points from the lecture. Conclusions. Every class member felt that they acquired the important learning points during the lecture. Those who were distracted by electronic devices during the lecture performed similarly to those who were not. However, results should be interpreted with caution as this study was a small quasi-experimental design and further research should examine the influence of different types of distraction on different types of learning.

Distraction systems for ankle arthroscopy.

PubMed

Palladino, S J

1994-07-01

It is clear that for most of the routine pathology addressed with ankle arthroscopy, including most talar dome transchondral fractures, manual distraction (or none at all) is all that is necessary to successfully complete the procedure. There is little need to add the expense and potential complications associated with some distraction systems. However, some cases involve pathology or surgical techniques that either would be better addressed with distraction or absolutely demand distraction. It is recommended that invasive ankle distraction be reserved for (1) cases in which noninvasive distraction has not yielded adequate field visualization or instrument maneuvering room, (2) cases of preoperatively documented pathology involving the posterior talar dome (including some medial talar dome fractures) or inferior tibial surface, or (3) arthroscopic ankle fusion. Consideration should be given to providing 6 to 12 weeks of protected function of the extremity to avoid delayed fracture presentation. In general, the invasive distraction system should be reserved for those cases that would not ordinarily be managed with aggressive rehabilitation and early return to activities. For those cases where the benefits of distraction are desired (some dome fractures, meniscoid lesions, gutter pathology, and adhesive capsulitis) and aggressive rehabilitation with early return to activities may be planned, noninvasive distraction systems are now available that offer a sustainable joint separation of good magnitude. With the growing availability and effectiveness of the commercial noninvasive ankle distractors, I do not disagree with Stone and Guhl98 when they advocate the use of noninvasive distraction for routine arthroscopic procedures, with conversion to invasive distraction should there be insufficient joint separation. In summary, providing optimal field visualization and maneuvering room for instrumentation is essential for the successful performance of arthroscopic ankle surgery. This article has discussed options available to the arthroscopist that can assist in achieving these objectives. The exact method of distraction selected for a given case may be determined by the arthroscopist by weighing the issues discussed in this article.

Does Guided Bone Regeneration Prevent Unfavorable Bone Shapes in Distraction Gap?

PubMed

Demetoglu, Umut; Alkan, Alper; Kiliç, Erdem; Ozturk, Mustafa; Bilge, Suheyb

2018-03-01

Complications related to distraction osteogenesis can cause degradation of newly regenerated bone. Additionally, an unfavorable shape of the regenerated bone at the distraction gap can reduce the quantity of regenerated bone. The aim of the present study was to report on the prevention of unfavorable shapes of regenerated bone using guided bone regeneration during distraction. Bilateral alveolar distraction was performed in 10 beagle dog mandibles. One side of the mandible formed the experimental group and the other side served as the control group. In the experimental group, guided bone regeneration was performed simultaneously with distraction osteogenesis. In the control group, only alveolar distraction was applied. At the end of a 1-week latent period, all mandibles were distracted 10 mm (1 mm/day). After the distraction period, 3 months were allowed for consolidation. After consolidation, all the dogs were euthanized, and the shape of the regenerated bone was determined to be either favorable or unfavorable. Densitometric evaluation and area measurements were performed using computed tomography scans. Statistical evaluation was performed using the independent t test, with a significance level of P < .05. In the experimental group, no unfavorable bone shape developed in the distraction gap, and the new bone had a surface and volume similar to those of the segments. In contrast, in the control group, 4 mandibles had an unfavorable bone shape in the distraction gap and 4 showed favorable bone healing with no defect. The surface area of the regenerating bone in the experimental group was significantly greater than that in the control group. Also, the surface area differed significantly between the experimental and control groups (P < .05). However, the densitometric values did not differ between the 2 groups (P < .05). Concomitant use of guided bone regeneration with distraction osteogenesis could be an optimal method for generating a favorable bone shape within the distraction gap. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Maternal Distraction During Breast- and Bottle Feeding Among WIC and non-WIC Mothers.

PubMed

Ventura, Alison K; Teitelbaum, Simone

To explore the prevalence and correlates of maternal distraction during infant feeding within a sample of mothers enrolled or not in the Special Supplemental Nutrition Program for Woman, Infants, and Children (WIC). Mothers kept diaries of their infants' feeding patterns. Mothers (n = 75) with infants aged ≤6 months. Within the diaries, mothers recorded what else, if anything, they did during the feeding. Mothers also completed questionnaires on demographics, feeding styles, and infant temperament and eating behaviors. Mothers' responses were coded into thematic categories. Feedings were classified as distracted when the mothers reported doing something other than feeding and/or interacting with the infant. Logistic regression was used to explore whether mothers exhibited different levels of distraction when breastfeeding (BF) vs bottle feeding. The researchers used multiple stepwise regression to explore associations between distracted feeding and characteristics of mothers and infants. Distractions were reported during 43% of feedings; 26% involved technological distractors. Mothers who were multiparous and perceived that their infants had greater appetites reported greater levels of any distraction during feeding. Mothers who were of racial/ethnic minorities, adhered to laissez faire feeding style, had younger infants, and perceived their infants to have lower food responsiveness and greater appetite reported greater levels of technological distraction. Being enrolled in WIC was not associated with mothers' levels of distracted feeding. Mothers reported a wide variety of distractions during both BF and bottle feeding; higher levels of distraction were associated with characteristics of both mothers and infants. Further research is needed to understand whether and how maternal distraction affects feeding outcomes. Awareness of such distractions and their potential impact would be useful to practitioners working with pregnant and postpartum women. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Short-term retention of pictures and words as a function of type of distraction and length of delay interval.

PubMed

Pellegrino, J W; Siegel, A W; Dhawan, M

1976-01-01

Picture and word triads were tested in a Brown-Peterson short-term retention task at varying delay intervals (3, 10, or 30 sec) and under acoustic and simultaneous acoustic and visual distraction. Pictures were superior to words at all delay intervals under single acoustic distraction. Dual distraction consistently reduced picture retention while simultaneously facilitating word retention. The results were interpreted in terms of the dual coding hypothesis with modality-specific interference effects in the visual and acoustic processing systems. The differential effects of dual distraction were related to the introduction of visual interference and differential levels of functional acoustic interference across dual and single distraction tasks. The latter was supported by a constant 2/1 ratio in the backward counting rates of the acoustic vs. dual distraction tasks. The results further suggest that retention may not depend on total processing load of the distraction task, per se, but rather that processing load operates within modalities.

Investigating saccade programming in the praying mantis Tenodera aridifolia using distracter interference paradigms.

PubMed

Yamawaki, Yoshifumi

2006-10-01

To investigate the saccadic system in the mantis, I applied distracter interference paradigms. These involved presenting the mantis with a fixation target and one or several distracters supposed to affect saccades towards the target. When a single target was presented, a medium-sized target located in its lower visual field elicited higher rates of saccade response. This preference for target size and position was also observed when a target and a distracter were presented simultaneously. That is, the mantis chose and fixated the target rather than a distracter that was much smaller or larger than the target, or was located above the target. Furthermore, the mantis' preference was not affected by increasing the number of distracters. However, the presence of the distracter decreased the occurrence rate of saccade and increased the response time to saccade. I conclude that distracter interference paradigms are an effective way of investigating the visual processing underlying saccade generation in the mantis. Possible mechanisms of saccade generation in the mantis are discussed.

A multimodal dataset for various forms of distracted driving

PubMed Central

Taamneh, Salah; Tsiamyrtzis, Panagiotis; Dcosta, Malcolm; Buddharaju, Pradeep; Khatri, Ashik; Manser, Michael; Ferris, Thomas; Wunderlich, Robert; Pavlidis, Ioannis

2017-01-01

We describe a multimodal dataset acquired in a controlled experiment on a driving simulator. The set includes data for n=68 volunteers that drove the same highway under four different conditions: No distraction, cognitive distraction, emotional distraction, and sensorimotor distraction. The experiment closed with a special driving session, where all subjects experienced a startle stimulus in the form of unintended acceleration—half of them under a mixed distraction, and the other half in the absence of a distraction. During the experimental drives key response variables and several explanatory variables were continuously recorded. The response variables included speed, acceleration, brake force, steering, and lane position signals, while the explanatory variables included perinasal electrodermal activity (EDA), palm EDA, heart rate, breathing rate, and facial expression signals; biographical and psychometric covariates as well as eye tracking data were also obtained. This dataset enables research into driving behaviors under neatly abstracted distracting stressors, which account for many car crashes. The set can also be used in physiological channel benchmarking and multispectral face recognition. PMID:28809848

[Mandibular-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia with rapid prototyping technology].

PubMed

Gao, Quan-Wen; Song, Hui-Feng; Xu, Ming-Huo; Liu, Chun-Ming; Chai, Jia-Ke

2013-11-01

To explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology. The patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation. The distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved. Rapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

Unfavourable results with distraction in craniofacial skeleton

PubMed Central

Agarwal, Rajiv

2013-01-01

Distraction osteogenesis has revolutionised the management of craniofacial abnormalities. The technique however requires precise planning, patient selection, execution and follow-up to achieve consistent and positive results and to avoid unfavourable results. The unfavourable results with craniofacial distraction stem from many factors ranging from improper patient selection, planning and use of inappropriate distraction device and vector. The present study analyses the current standards and techniques of distraction and details in depth the various errors and complications that may occur due to this technique. The commonly observed complications of distraction have been detailed along with measures and suggestions to avoid them in clinical practice. PMID:24501455

Brain Activity and Network Interactions in the Impact of Internal Emotional Distraction.

PubMed

Iordan, A D; Dolcos, S; Dolcos, F

2018-06-14

Emotional distraction may come from the external world and from our mind, as internal distraction. Although external emotional distraction has been extensively investigated, less is known about the mechanisms associated with the impact of internal emotional distraction on cognitive performance, and those involved in coping with such distraction. These issues were investigated using a working memory task with emotional distraction, where recollected unpleasant autobiographical memories served as internal emotional distraction. Emotion regulation was manipulated by instructing participants to focus their attention either on or away from the emotional aspects of their memories. Behaviorally, focusing away from emotion was associated with better working memory performance than focusing on the recollected emotions. Functional MRI data showed reduced response in brain regions associated with the salience network, coupled with greater recruitment of executive prefrontal and memory-related temporoparietal regions, and with increased frontoparietal connectivity, when subjects focused on nonemotional contextual details of their memories. Finally, temporal dissociations were also identified between regions involved in self-referential (showing faster responses) versus context-related processing (showing delayed responses). These findings demonstrate that focused attention is an effective regulation strategy in coping with internal distraction, and are relevant for understanding clinical conditions where coping with distressing memories is dysfunctional.

Systematic review and meta-analysis of distraction and hypnosis for needle-related pain and distress in children and adolescents.

PubMed

Birnie, Kathryn A; Noel, Melanie; Parker, Jennifer A; Chambers, Christine T; Uman, Lindsay S; Kisely, Steve R; McGrath, Patrick J

2014-09-01

To systematically review the evidence (and quality) for distraction and hypnosis for needle-related pain and distress in children and adolescents. To explore the effects of distraction characteristics (e.g., adult involvement, type of distracter), child age, and study risk of bias on treatment efficacy.  26 distraction and 7 hypnosis trials were included and self-report, observer-report, and behavioral pain intensity and distress examined. Distraction studies were coded for 4 intervention characteristics, and all studies coded for child age and study risk of bias.  Findings showed strong support for distraction and hypnosis for reducing pain and distress from needle procedures. The quality of available evidence was low, however. Characteristics of distraction interventions, child age, and study risk of bias showed some influence on treatment efficacy. Distraction and hypnosis are efficacious in reducing needle-related pain and distress in children. The quality of trials in this area needs to be improved. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects of joint position on the distraction distance during grade III glenohumeral joint distraction in healthy individuals

PubMed Central

Park, Sam-Sik; Kim, Bo-Kyung; Moon, Ok-Kon; Choi, Wan-Suk

2015-01-01

[Purpose] The study investigated the effects of joint position on the distraction distance during Grade III glenohumeral joint distraction in healthy individuals. [Subjects and Methods] Twenty adults in their forties without shoulder disease were randomly divided into neutral position group (NPG; n = 7), resting position group (RPG; n = 7), and end range position group (ERPG; n = 6). After Kaltenborn Grade III distraction for 40s, the distance between glenoid fossa and humeral head was measured by ultrasound. [Results] The average distances between the humeral head and glenoid fossa before distraction were 2.86 ± 0.81, 3.21 ± 0.47, and 3.55 ± 0.59 mm for the NP, RP, and ERP groups. The distances after applying distraction were 3.12 ± 0.51, 3.86 ± 0.55, and 4.35 ± 0.32 mm. Between-group comparison after applying distraction revealed no significant differences between the NP and RP groups, while there was a statistically significant difference between the NP and RP groups, as well as between the NP and ERP groups. [Conclusion] Joint space was largest in ERP individuals when performing manual distraction. PMID:26644692

[Utility of nickel-titanium shape memory alloys of vertebral body reduction fixator with assisted distraction bar].

PubMed

Man, Yi; Zheng, Yue-huan; Cao, Peng; Chen, Bo; Zheng, Tao; Sun, Chang-hui; Lu, Jiong

2011-06-07

To test the nickel-titanium (Ni-Ti) shape memory alloys of vertebral body reduction fixator with assisted distraction bar for the treatment of traumatic and osteoporotic vertebral body fracture. A Ni-Ti shape memory alloys of vertebral body reduction fixator with assisted distraction bar was implanted into the compressed fracture specimens through vertebral pedicle with the radiographic monitoring to reduce the collapsed endplate as well as distract the compressed vertebral fracture. Radiographic film and computed tomographic reconstruction technique were employed to evaluate the effects of reduction and distraction. A biomechanic test machine was used to measure the fatigue and the stability of deformation of fixation segments. Relying on the effect of temperature shape memory, such an assembly could basically reduce the collapsed endplate as well as distract the compressed vertebral fracture. And when unsatisfied results of reduction and distraction occurred, its super flexibility could provide additional distraction strength. A Ni-Ti shape memory alloys of vertebral body reduction fixator with assisted distraction bar may provide effective endplate reduction, restore the vertebral height and the immediate biomechanic spinal stability. So the above assembly is indicated for the treatment of traumatic and osteoporotic vertebral body fracture.

Susceptibility to distraction during reading in young, young-old, and old-old adults.

PubMed

McGinnis, Debra

2012-01-01

BACKGROUND/STUDY CONTEXT: Susceptibility to distraction during reading may increase with age, resulting in comprehension errors. Neurological integrity and cognitive reserve are possible covariates of age-related distraction susceptibility. The current study investigated distraction susceptibility in three age groups (young, young-old, and old-old), and examined the covariation patterns of variable sets associated with neurological integrity and cognitive reserve. Participants responded to comprehension questions after reading stories that included semantically related or semantically unrelated distractors. Neurological integrity measures consisted of Mini-Mental State Examination, Selective Reminding, and Category Fluency. Cognitive reserve measures consisted of education and vocabulary. Old-old adults were more likely than young and young-old adults to select distractors when responding to comprehension questions (24.02%, 11.95%, 3.68%, respectively). Age-related distraction variance significantly overlapped neurological variance, and became more transparent after cognitive reserve variance was controlled. This study augments previous age-related distraction research by highlighting (a) the increase in distraction susceptibility in adults over 79, particularly when distractors are semantically related; (b) the influence of age-related neurological integrity on distraction; and (c) the possibility that education and verbal experience may decrease distraction susceptibility, consistent with cognitive reserve frameworks.

Clinical clearance of the cervical spine in patients with distracting injuries: It is time to dispel the myth.

PubMed

Rose, Melanie K; Rosal, Lindy M; Gonzalez, Richard P; Rostas, Jack W; Baker, Jeremy A; Simmons, Jon D; Frotan, Mohammed A; Brevard, Sydney B

2012-08-01

The purpose of this study was to prospectively assess the sensitivity and efficacy of clinical examination for screening of cervical spine (c-spine) injury in awake and alert blunt trauma patients with concomitant "distracting injuries." During the 24-month period from December 2009 to December 2011, all blunt trauma patients older than 13 years were prospectively evaluated with a standard cervical spine examination protocol by the trauma surgery team at a Level 1 trauma center. Awake and alert patients with a Glasgow Coma Score (GCS) ≥14 underwent clinical examination of the cervical spine. Clinical examination was performed regardless of "distracting injuries." Patients without complaints of pain or tenderness on physical exam had their cervical collar removed, and the c-spine was considered clinically cleared of injury. All awake and alert patients with "distracting injuries," including those clinically cleared and those with complaints of c-spine pain or tenderness underwent computerized tomographic (CT) scanning of the entire c-spine. "Distracting injuries" were categorized into three anatomic regions: head injuries, torso injuries and long bone fractures. Patients with minor distracting injuries were not considered to have a "distracting injury." During the 24-month study period, 761 blunt trauma patients with GCS ≥14 and at least one "distracting injury" had been entered into the study protocol. Two-hundred ninety-six (39%) of the patients with "distracting injuries" had a positive c-spine clinical examination, 85 (29%) of whom were diagnosed with c-spine injury. Four hundred sixty-four (61%) of the patients with "distracting injuries"’ were initially clinically cleared, with one patient (0.2%) diagnosed with a c-spine injury. This yielded an overall sensitivity of 99% (85/86) and negative predictive value greater than 99% (463/464) for cervical spine clinical examination in awake and alert blunt trauma patients with "distracting injuries." In the awake and alert blunt trauma patient with "distracting injuries," clinical examination is a sensitive screening method for cervical spine injury. Radiological assessment is unnecessary for safe clearance of the asymptomatic cervical spine in awake and alert blunt trauma patients with "distracting injuries." These findings suggest the concept of "distracting injury" in the context of cervical spine clinical examination is invalid. Expanding the utility of cervical spine clinical examination to patients with "distracting injuries" allows for significant reduction of both healthcare cost and radiation exposure.

Distraction rate and latency: factors in the outcome of paediatric maxillary distraction.

PubMed

Higuera, Stephen; Cole, Patrick; Stephenson, J B; Hollier, Larry

2009-12-01

Over 50 years ago, current tenets of distraction osteogenesis were developed through work on the lower extremity; however, the application of these tenets in the paediatric craniofacial skeleton remains questionable. Prompted by recent concern that traditional aspects of distraction may be either outdated or wholly inapplicable to the paediatric maxilla, we retrospectively evaluated maxillary distraction protocol using a 24-h latency period in conjunction with a distraction rate of 2mm/day. Following maxillary advancement via a distraction protocol consisting of a 24-h latency period and a distraction rate of 2mm/day, seven consecutive paediatric cases were evaluated. Standard profile photos and cephalometric films taken preoperatively, at device removal and at 1-year follow-up were compared. With the sella as the point of registration, pre- and post-distraction films were superimposed on the sella-nasion plane. Sella-nasion-subspinale, the angle of convexity, the distance from incisal edges to the y-axis, and angulation of the upper incisor to the sella-nasion plane were analysed to evaluate hard-tissue changes. Patient age ranged from 3 to 14 years (mean=7.43 years). Maxillary distraction length averaged 11 mm (range=10-12 mm). Interval from device application to removal averaged 98 days (range=75-180 days). The interval of the active distraction ranged from 11 to 65 days (mean=24 days). From distraction completion to device removal averaged 85 days (range=60-150). Follow-up intervals ranged from 52 to 24 months (mean=34 months). All patients demonstrated substantial clinical advancement of the maxilla with correction of midfacial deficiencies. A single patient developed mild cellulitis at one skin-device interface; no other complications were noted. Cephalometric and clinical evaluations at 1 year post-distraction demonstrated stable results, and parental satisfaction was qualitatively high. The surgical dogma of lower-extremity distraction osteogenesis is not absolute and may not be optimal for use in the paediatric maxilla. Our results demonstrate effective maxillary correction following application of a 24-h latency period coupled with rapid distraction at 2mm/day. Our success with a short latency period and more rapid device expanse may be a product of the significant vascularity and improved healing potential of the paediatric maxilla.

On an efficient and effective intelligent transportation system (ITS) safety and traffic efficiency application with corresponding driver behavior

NASA Astrophysics Data System (ADS)

Ekedebe, Nnanna; Yu, Wei; Lu, Chao

2015-06-01

Driver distraction could result in safety compromises attributable to distractions from in-vehicle equipment usage [1]. The effective design of driver-vehicle interfaces (DVIs) and other human-machine interfaces (HMIs) together with their usability, and accessibility while driving become important [2]. Driving distractions can be classified as: visual distractions (any activity that takes your eyes away from the road), cognitive distraction (any activity that takes your mind away from the course of driving), and manual distractions (any activity that takes your hands away from the steering wheel [2]). Besides, multitasking during driving is a distractive activity that can increase the risks of vehicular accidents. To study the driver's behaviors on the safety of transportation system, using an in-vehicle driver notification application, we examined the effects of increasing driver distraction levels on the evaluation metrics of traffic efficiency and safety by using two types of driver models: young drivers (ages 16-25 years) and middle-age drivers (ages 30-45 years). Our evaluation data demonstrates that as a drivers distraction level is increased, less heed is given to change route directives from the in-vehicle on-board unit (OBU) using textual, visual, audio, and haptic notifications. Interestingly, middle-age drivers proved more effective/resilient in mitigating the negative effects of driver distraction over young drivers [2].

Le Fort III Distraction With Internal vs External Distractors: A Cephalometric Analysis.

PubMed

Robertson, Kevin J; Mendez, Bernardino M; Bruce, William J; McDonnell, Brendan D; Chiodo, Michael V; Patel, Parit A

2018-05-01

This study compares the change in midface position following Le Fort III advancement using either rigid external distraction (group 1) or internal distraction (group 2). We hypothesized that, with reference to right-facing cephalometry, internal distraction would result in increased clockwise rotation and inferior displacement of the midface. Le Fort III osteotomies and standardized distraction protocols were performed on 10 cadaveric specimens per group. Right-facing lateral cephalograms were traced and compared across time points to determine change in position at points orbitale, anterior nasal spine (ANS), A-point, and angle ANB. Institutional. Twenty cadaveric head specimens. Standard subcranial Le Fort III osteotomies were performed from a coronal approach and adequately mobilized. The specified distraction mechanism was applied and advanced by 15 mm. Changes of position were calculated at various skeletal landmarks: orbitale, ANS, A-point, and ANB. Group 1 demonstrated relatively uniform x-axis advancement with minimal inferior repositioning at the A-point, ANS, and orbitale. Group 2 demonstrated marked variation in x-axis advancement among the 3 points, along with a significant inferior repositioning and clockwise rotation of the midface ( P < .0001). External distraction resulted in more uniform advancement of the midface, whereas internal distraction resulted in greater clockwise rotation and inferior displacement. External distraction appears to provide increased vector control of the midface, which is important in creating a customized distraction plan based on the patient's individual occlusal and skeletal needs.

The effect of ankle distraction on arthroscopic evaluation of syndesmotic instability: A cadaveric study.

PubMed

Lubberts, Bart; Guss, Daniel; Vopat, Bryan G; Wolf, Jonathon C; Moon, Daniel K; DiGiovanni, Christopher W

2017-12-01

To assist with visualization, orthopaedic surgeons often apply ankle distraction during arthroscopic procedures. The study aimed to investigate whether ankle distraction suppresses fibular motion in cadaveric specimens with an unstable syndesmotic injury. Fourteen fresh-frozen above knee specimens underwent arthroscopic assessment with 1) intact ligaments, 2) after sectioning of the anterior inferior tibiofibular ligament, the interosseous ligament, and the posterior inferior tibiofibular ligament, and 3) after sectioning of the deep and superficial deltoid ligament. In all scenarios, the lateral hook test, anterior-posterior hook test, and posterior-anterior hook test were applied. Each test was performed with and without ankle distraction. Coronal plane anterior and posterior tibiofibular diastasis as well as sagittal plane tibiofibular translation due to the applied load were arthroscopically measured. Tibiofibular diastasis in the coronal plane, as measured at both the anterior and posterior third of the incisura, was found to be significantly less when ankle distraction was applied, as compared to arthroscopic evaluation in the absence of distraction. In contrast, measurement of sagittal plane tibiofibular translation was not affected by ankle distraction. Since arthroscopic findings of syndesmotic instability are subtle the differential values of the syndesmotic measurements taken on and off distraction are clinically relevant. To optimally assess syndesmotic instability one should evaluate the syndesmosis without distraction or focus on fibular motion in the sagittal plane when distraction is required. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predicting Visual Distraction Using Driving Performance Data

PubMed Central

Kircher, Katja; Ahlstrom, Christer

2010-01-01

Behavioral variables are often used as performance indicators (PIs) of visual or internal distraction induced by secondary tasks. The objective of this study is to investigate whether visual distraction can be predicted by driving performance PIs in a naturalistic setting. Visual distraction is here defined by a gaze based real-time distraction detection algorithm called AttenD. Seven drivers used an instrumented vehicle for one month each in a small scale field operational test. For each of the visual distraction events detected by AttenD, seven PIs such as steering wheel reversal rate and throttle hold were calculated. Corresponding data were also calculated for time periods during which the drivers were classified as attentive. For each PI, means between distracted and attentive states were calculated using t-tests for different time-window sizes (2 – 40 s), and the window width with the smallest resulting p-value was selected as optimal. Based on the optimized PIs, logistic regression was used to predict whether the drivers were attentive or distracted. The logistic regression resulted in predictions which were 76 % correct (sensitivity = 77 % and specificity = 76 %). The conclusion is that there is a relationship between behavioral variables and visual distraction, but the relationship is not strong enough to accurately predict visual driver distraction. Instead, behavioral PIs are probably best suited as complementary to eye tracking based algorithms in order to make them more accurate and robust. PMID:21050615

A roadside study of observable driver distractions.

PubMed

Sullman, Mark J M; Prat, Francesc; Tasci, Duygu Kuzu

2015-01-01

This study investigated the prevalence of observable distractions while driving and the effect of drivers' characteristics and time-related variables on their prevalence. Using roadside observation, 2 independent observers collected data at 4 randomly selected locations in St. Albans, UK. Of the 10,984 drivers observed, 16.8% were engaged in a secondary task, with talking to passengers being the most common distraction (8.8%), followed by smoking (1.9%) and talking on a hands-free mobile phone (1.7%). An additional 1.0% were observed talking on a handheld phone, and the rest of the distractions (e.g., texting, drinking) were recorded in less than 1% of the drivers observed. Gender-related differences were found for a number of different distractions (i.e., talking to passengers, drinking, and handheld mobile phone conversations), but age emerged as a significant predictor for most secondary tasks, including talking to passengers, smoking, hands-free mobile phone use, handheld mobile phone use, texting/keying numbers, drinking, and engagement in any type of distraction (all distractions combined). The overall pattern for age was that middle-aged and older drivers were less likely to be distracted than younger drivers. This work provides further evidence of the relatively high rate of distracted driving in the UK. The findings clearly indicate that younger drivers are more likely to drive distracted, which probably contributes to their higher crash rates.

Transantral distraction devices in correction of severe maxillary deformity in cleft patients.

PubMed

Shokirov, Shokhruh; Wangerin, Konrad

2011-01-01

Maxillary advancement by Le Fort I osteotomy in cleft patients has an average relapse of about 40-60 percent. With extraoral distraction devices it is possible to obtain an almost unlimited advancement of the upper jaw. Due to the social problems the retention period is normally reduced to some monthes. A relapse of 10-25 % can be seen in these cases. Le Fort I internal distraction osteogenesis offers an alternative to one-step orthognathic advancement, with advantages of gradual lengthening through scar and earlier treatment in growing patients. The objective of this study was to present our experience in the treatment of maxillary deficiency in cleft patients using transantral internal distraction devices. The distraction procedure was successfully accomplished in seventeen patients. For all the seventeen patients maxillary distraction device designed by Konrad Wangerin was used. The distraction distances were 8 to 24 mm. Preoperative, postoperative, and follow-up (12 and 24 months) lateral cephalogram measurements were compared including angular and linear changes. A good new bone was found that was formed in distraction pitch between lines of osteotomy. After distraction of median facial zone, occlusion and profile of soft tissues were considerably improved. All patients after postoperative time required final orthodontic treatment and their final occlusal relationships were satisfactory. The transantral distraction device is a new option for the treatment of severe maxillary hypoplasia in cleft patients.

"I wasn't texting; I was just reading an email …": a qualitative study of distracted driving enforcement in Washington State.

PubMed

Nevin, Paul E; Blanar, Laura; Kirk, Annie Phare; Freedheim, Amy; Kaufman, Robert; Hitchcock, Laura; Maeser, Jennifer D; Ebel, Beth E

2017-06-01

In response to the rise of distracted driving, many countries and most US states have adopted laws to restrict the use of handheld phones for drivers. Specific provisions of each law and the overall social mores of distracted driving influence enforceability and impact. Identify multilevel interdependent factors that influence distracted driving enforcement through the perspective of police officers. We conducted focus group discussions with active duty law enforcement officers from three large Washington State counties. Our thematic analysis used descriptive and pattern coding that placed our findings within a social ecological framework to facilitate targeted intervention development. Participants reported that the distracted driving law posed challenges for consistent and effective enforcement. They emphasised the need to change social norms around distracted driving, similar to the shifts seen around impaired driving. Many participants were themselves distracted drivers, and their individual knowledge, attitude and beliefs influenced enforcement. Participants suggested that law enforcement leaders and policymakers should develop and implement policies and strategies to prioritise and motivate increased distracted driving enforcement. Individual, interpersonal, organisational and societal factors influence enforcement of distracted driving laws. Targeted interventions should be developed to address distracted driving and sustain effective enforcement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The hip fluid seal--Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip stability to distraction.

PubMed

Nepple, Jeffrey J; Philippon, Marc J; Campbell, Kevin J; Dornan, Grant J; Jansson, Kyle S; LaPrade, Robert F; Wijdicks, Coen A

2014-04-01

The acetabular labrum is theorized to be important to normal hip function by providing stability to distraction forces through the suction effect of the hip fluid seal. The purpose of this study was to determine the relative contributions of the hip capsule and labrum to the distractive stability of the hip, and to characterize hip stability to distraction forces in six labral conditions: intact labrum, labral tear, labral repair (looped vs. through sutures), partial resection, labral reconstruction with iliotibial band, and complete resection. Eight cadaveric hips with a mean age of 47.8 years (SD 4.3, range 41-51 years) were included. For each condition, the hip seal was broken by distracting the hip at a rate of 0.33 mm/s while the required force, energy, and negative intra-articular pressure were measured. For comparisons between labral conditions, measurements were normalized to the intact labral state (percent of intact). The relative contribution of the labrum to distractive stability was greatest at 1 and 2 mm of displacement, where it was significantly greater than the role of the capsule and accounted for 77 % (SD 27 %, p = 0.006) and 70 % (SD 7 %, p = 0.009) of total distractive stability, respectively. The relative contribution of the capsule to distractive stability increased with progressive displacement, providing 41 % (SD 49 %) and 52 % (SD 53 %) of distractive stability at 3 and 5 mm of distraction, respectively. The maximal distraction force required to break the hip seal in the intact labral state (capsule removed) varied from 124 to 150 N. Labral tear, partial resection, and complete resection resulted in average maximal distraction forces of 76 % (SD 34 %), 29 % (SD 26 %), and 27 % (SD 22 %), respectively, compared to the intact state. Through type labral repairs resulted in significantly greater improvements (from the labral tear state) in maximal negative pressure generated, compared to looped type repairs (median increase; +32 vs. -9 %, p = 0.029). Labral reconstruction resulted in a mean maximal distraction force of 66 % (SD 35 %), with a significant improvement of 37 % compared to partial labral resection (p < 0.001). The acetabular labrum was the primary hip stabilizer to distraction forces at small displacements (1-2 mm). Partial labral resection significantly decreased the distractive strength of the hip fluid seal. Labral reconstruction significantly improved distractive stability, compared to partial labral resection. The results of this study may provide insight into the relative importance of the capsule and labrum to distractive stability of the hip and may help to explain hip microinstability in the setting of labral disease.

Case study: videogame distraction reduces behavioral distress in a preschool-aged child undergoing repeated burn dressing changes: a single-subject design.

PubMed

Sil, Soumitri; Dahlquist, Lynnda M; Burns, Andrew J

2013-04-01

This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes. A 4-year-old girl underwent 3 baseline and 10 videogame distraction sessions (5 passive and 5 interactive) using a restricted alternating treatments design. Observed behavioral distress was coded, and parents and nurses rated the child's distress and cooperative behavior. Relative to baseline, behavioral distress decreased and cooperative behavior increased immediately after the onset of videogame distraction. Single Case Randomization Tests revealed significantly lower behavioral distress and greater cooperation during interactive videogame distraction relative to passive videogame distraction. Interactive videogame distraction appears to be a feasible and effective pain management strategy for a preschool-aged child undergoing repeated painful medical procedures.

Sex differences in the response to emotional distraction: an event-related fMRI investigation.

PubMed

Iordan, Alexandru D; Dolcos, Sanda; Denkova, Ekaterina; Dolcos, Florin

2013-03-01

Evidence has suggested that women have greater emotional reactivity than men. However, it is unclear whether these differences in basic emotional responses are also associated with differences in emotional distractibility, and what the neural mechanisms that implement differences in emotional distractibility between women and men are. Functional MRI recording was used in conjunction with a working memory (WM) task, with emotional distraction (angry faces) presented during the interval between the memoranda and the probes. First, we found an increased impact of emotional distraction among women in trials associated with high-confidence responses, in the context of overall similar WM performance in women and men. Second, women showed increased sensitivity to emotional distraction in brain areas associated with "hot" emotional processing, whereas men showed increased sensitivity in areas associated with "cold" executive processing, in the context of overall similar patterns of response to emotional distraction in women and men. Third, a sex-related dorsal-ventral hemispheric dissociation emerged in the lateral PFC related to coping with emotional distraction, with women showing a positive correlation with WM performance in left ventral PFC, and men showing similar effects in the right dorsal PFC. In addition to extending to men results that have previously been reported in women, by showing that both sexes engage mechanisms that are similar overall in response to emotional distraction, the present study identifies sex differences in both the response to and coping with emotional distraction. These results have implications for understanding sex differences in the susceptibility to affective disorders, in which basic emotional responses, emotional distractibility, and coping abilities are altered.

Causal evidence for frontal involvement in memory target maintenance by posterior brain areas during distracter interference of visual working memory

PubMed Central

Feredoes, Eva; Heinen, Klaartje; Weiskopf, Nikolaus; Ruff, Christian; Driver, Jon

2011-01-01

Dorsolateral prefrontal cortex (DLPFC) is recruited during visual working memory (WM) when relevant information must be maintained in the presence of distracting information. The mechanism by which DLPFC might ensure successful maintenance of the contents of WM is, however, unclear; it might enhance neural maintenance of memory targets or suppress processing of distracters. To adjudicate between these possibilities, we applied time-locked transcranial magnetic stimulation (TMS) during functional MRI, an approach that permits causal assessment of a stimulated brain region's influence on connected brain regions, and evaluated how this influence may change under different task conditions. Participants performed a visual WM task requiring retention of visual stimuli (faces or houses) across a delay during which visual distracters could be present or absent. When distracters were present, they were always from the opposite stimulus category, so that targets and distracters were represented in distinct posterior cortical areas. We then measured whether DLPFC-TMS, administered in the delay at the time point when distracters could appear, would modulate posterior regions representing memory targets or distracters. We found that DLPFC-TMS influenced posterior areas only when distracters were present and, critically, that this influence consisted of increased activity in regions representing the current memory targets. DLPFC-TMS did not affect regions representing current distracters. These results provide a new line of causal evidence for a top-down DLPFC-based control mechanism that promotes successful maintenance of relevant information in WM in the presence of distraction. PMID:21987824

Lengthening by distraction osteogenesis in congenital shortening of metacarpals.

PubMed

Bulut, Mehmet; Uçar, Bekir Yavuz; Azboy, Ibrahim; Belhan, Oktay; Yilmaz, Erhan; Karakurt, Lokman

2013-01-01

The aim of this study was to present the results of seven cases of metacarpal lengthening by distraction osteogenesis and to discuss the ideal daily rate of distraction. Metacarpal lengthening was performed by distraction osteogenesis in the seven metacarpals of four patients (3 females, 1 male; mean age: 14.9 years). A unilateral external fixator was used for lengthening. Lengthening was initiated with a distraction rate of 2x0.5 mm/day in the patient with bilateral involvement of the middle and ring metacarpals. On the tenth day of lengthening, distraction was discontinued due to pain and contracture. Then, distraction was continued with a rate of 2x0.25 mm/day. In all other cases, the distraction rate was 0.5 mm/day. Pre- and postoperative range of motion was measured with a goniometer. Patient satisfaction was evaluated with visual analog scale. The mean pre- and postoperative metacarpal lengths were 34.6 mm (range: 33 to 37) and 49.7 mm (range: 47 to 52), respectively. The mean lengthening achieved was 15.1 mm (range: 14 to 17), while the mean distraction rate was 0.55 mm/day (range: 0.48 to 0.63). No functional loss was observed in the fingers at the final check-up. The patients were happy with the functional and cosmetic results. Distraction osteogenesis is a safe method providing acceptable cosmetic and functional results in patients with congenital metacarpal shortness. The length of metacarpals and muscles that will be affected from lengthening should be considered when determining the daily rate of distraction.

The use of internal maxillary distraction for maxillary hypoplasia: a preliminary report.

PubMed

Van Sickels, Joseph E; Madsen, Mathew J; Cunningham, Larry L; Bird, Douglas

2006-12-01

Distraction osteogenesis is a useful alternative to advance the maxilla in complicated cases of maxillary hypoplasia. The purpose of this article is to review the workup, experience, and preliminary results with the use of internal distraction osteogenesis for maxillary hypoplasia at one teaching institution. Over a 5-year period, more than 300 patients with craniofacial and dentofacial defects have undergone oral and maxillofacial surgery at our center to correct their skeletal discrepancies. Of these, 10 have had maxillary distraction osteogenesis done with internal distractors. Follow-up of 6 months or more was available for 8 patients. Stereolithographic models were used to bend distractors prior to surgery in 6 patients. Latency prior to the start of distraction was 3 to 7 days and varied with the age of the patient. Distraction occurred at approximately 1 mm per day with an average distraction length of 8.5 mm (range, 6-10 mm). Excellent occlusal results were obtained in 5 patients. Major complications including nonunion and failure to achieve acceptable occlusal results were observed in 3 patients. Minor complications including pain and loosening of the distracter devices were observed in 2 patients, but did not appear to affect the esthetic and functional results. Distraction osteogenesis is a useful alternative to traditional orthognathic surgery to treat maxillary hypoplasia. Internal distractions are attractive to patients, but are more difficult to place and can cause discomfort to patients when trying to achieve an ideal primary vector of distraction. Stereolithographic models can help with placement of the device. Changes in design of distractors may help with patient discomfort.

Computer tablet distraction reduces pain and anxiety in pediatric burn patients undergoing hydrotherapy: A randomized trial.

PubMed

Burns-Nader, Sherwood; Joe, Lindsay; Pinion, Kelly

2017-09-01

Distraction is often used in conjunction with analgesics to minimize pain in pediatric burn patients during treatment procedures. Computer tablets provide many options for distraction items in one tool and are often used during medical procedures. Few studies have examined the effectiveness of tablet distraction in improving the care of pediatric burn patients. This study examines the effectiveness of tablet distraction provided by a child life specialist to minimize pain and anxiety in pediatric burn patients undergoing hydrotherapy. Thirty pediatric patients (4-12) undergoing hydrotherapy for the treatment of burns participated in this randomized clinical trial. The tablet distraction group received tablet distraction provided by a child life specialist while those in the control group received standard care. Pain was assessed through self-reports and observation reports. Anxiety was assessed through behavioral observations. Length of procedure was also recorded. Nurses reported significantly less pain for the tablet distraction group compared to the control group. There was no significant difference between groups on self-reported pain. The tablet distraction group displayed significantly less anxiety during the procedure compared to the control group. Also, the tablet distraction group returned to baseline after the procedure while those in the control group displayed higher anxiety post-procedure. There was no difference in the length of the procedure between groups. These findings suggest tablet distraction provided by a child life specialist may be an effective method for improving pain and anxiety in children undergoing hydrotherapy treatment for burns. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Cognitive Distraction and African American Women's Endorsement of Gender Role Stereotypes

ERIC Educational Resources Information Center

Smith, Kalynda; Craig-Henderson, Kellina

2010-01-01

The present study investigated the effect of cognitive distraction on the endorsement of gender role stereotypes in one sample of African American female participants. Participants' awareness and endorsement of gender role stereotypes for male and females was assessed. Following random assignment to distraction or no distraction conditions, they…

Homework Distraction Scale: Confirming the Factor Structure With Middle School Students

ERIC Educational Resources Information Center

Xu, Jianzhong; Fan, Xitao; Du, Jianxia

2016-01-01

The goal of the current investigation was to evaluate psychometric properties of the Homework Distraction Scale (HDS) using 796 middle school students. Results from confirmatory factor analyses (CFAs) supported the presence of two distinct yet related subscales for the HDS: Conventional Distraction and Tech-Related Distraction. Results of…

Vector alignment in maxillary distraction osteogenesis.

PubMed

Uckan, Sina; Arman, Ayca; Bayram, Burak; Celik, Erkan

2006-09-01

Maxillary distraction osteogenesis is an alternative treatment of cleft patients with severe maxillary hypoplasia. The aim of this paper is to present the combined surgical/orthodontic treatment of a cleft lip and palate patient and to evaluate the maxillary distraction procedure and the distraction vector in high Le Fort I osteotomy.

Case Study: Videogame Distraction Reduces Behavioral Distress in a Preschool-Aged Child Undergoing Repeated Burn Dressing Changes: A Single-Subject Design

PubMed Central

Sil, Soumitri; Burns, Andrew J.

2013-01-01

Objective This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes. Method A 4-year-old girl underwent 3 baseline and 10 videogame distraction sessions (5 passive and 5 interactive) using a restricted alternating treatments design. Observed behavioral distress was coded, and parents and nurses rated the child’s distress and cooperative behavior. Results Relative to baseline, behavioral distress decreased and cooperative behavior increased immediately after the onset of videogame distraction. Single Case Randomization Tests revealed significantly lower behavioral distress and greater cooperation during interactive videogame distraction relative to passive videogame distraction. Conclusions Interactive videogame distraction appears to be a feasible and effective pain management strategy for a preschool-aged child undergoing repeated painful medical procedures. PMID:23248343

[Stimulation and evaluation on maxillary distraction osteogenesis using CASSOS 2001].

PubMed

Zhu, Min; Qiu, Wei-liu; Tang, You-sheng; Li, Qing-yun

2002-09-01

To simulate maxillary distraction osteogenesis and evaluate the change of soft and hard tissue before and after treatment, using Computer-Assisted Simulation System for Orthognathic Surgery( CASSOS 2001). A fourteen-year-old boy with severe maxillary hypoplasia, due to unilateral cleft lip and palate, was analysed by cephalometric analysis. The simulations of maxillary distraction osteogenesis (Le Fort I osteotomy and Le Fort II osteotomy) were re-analysed. After the treatment, cephalometric analysis was preformed again. The data were compared. The maxillary hypoplasia was well treated using maxillary distraction osteogenesis; Compared with Le fort I osteotomy, more satisfactory results can be obtained by Le fort I distraction osteogenesis. Maxillary distraction osteogenesis is a better way to treat severe maxillary hypoplasia with operated CLP than maxillary osteotomy. CASSOS 2001 can help surgeons and patients on simulation and evaluation of maxillary distraction osteogenesis, and on decision of treatment plan.

Safety climate and the distracted driving experiences of truck drivers.

PubMed

Swedler, David I; Pollack, Keshia M; Agnew, Jacqueline

2015-07-01

For truck drivers, distracted driving is a workplace behavior that increases occupational injury risk. We propose safety climate as an appropriate lens through which researchers can examine occupational distracted driving. Using a mixed methods study design, we surveyed truck drivers using the Safety Climate Questionnaire (SCQ) complemented by semi-structured interviews of experts on distracted driving and truck safety. Safety climate was assessed by using the entire SCQ as an overall climate score, followed by factor analysis that identified the following safety climate factors: Communications and Procedures; Management Commitment; and Work Pressure. In multivariate regression, the overall safety climate scale was associated with having ever experienced a crash and/or distraction-involved swerving. Interview participants described how these SCQ constructs could affect occupational distracted driving. To reduce distraction-related crashes in their organizations, management can adhere to safe policies and procedures, invest in engineering controls, and develop safer communication procedures. © 2015 Wiley Periodicals, Inc.

A Source of Distractions in the Classroom: The Teacher.

ERIC Educational Resources Information Center

Wong, Lily Y. S.

This paper identifies distracting factors which take away pupils' attention from the lesson and focus it on the teacher. Distracting factors include teachers' irritating habits, improper attire, and mannerisms. Examples of distracting features of both males and females are listed in eight categories: (1) attire; (2) hair; (3) make-up; (4) personal…

The Effects of Distraction on Cognitive Task Performance during Toddlerhood

ERIC Educational Resources Information Center

Wyss, Nancy M.; Kannass, Kathleen N.; Haden, Catherine A.

2013-01-01

We investigated the effects of distraction on attention and task performance during toddlerhood. Thirty toddlers (24- to 26-month-olds) completed different tasks (2 of each: categorization, problem solving, memory, free play) in one of two conditions: No Distraction or Distraction. The results revealed that the distractor had varying effects on…

The Color-Word Interference Test and Its Relation to Performance Impairment under Auditory Distraction.

ERIC Educational Resources Information Center

Thackray, Richard I.; And Others

The ability to resist distraction is an important requirement for air traffic controllers. The study examined the relationship between performance on the Stroop color-word interference test (a suggested measure of distraction susceptibility) and impairment under auditory distraction on a task requiring the subject to generate random sequences of…

Non-erotic cognitive distractions during sexual activity in sexual minority and heterosexual young adults.

PubMed

Lacefield, Katharine; Negy, Charles

2012-04-01

The present study examined 100 lesbian and gay college students and 100 heterosexual students to determine whether group differences exist in frequency of a range of non-erotic cognitive distractions during sexual activity. Non-erotic cognitive distraction is a descriptive term for both self-evaluative cognitions related to physical performance and body image concerns, as well as additional cognitive distractions (e.g., contracting an STI or emotional concerns) during sexual activity. Participants were matched on gender (96 males and 104 females), age, and ethnicity, and completed questionnaires assessing frequency of non-erotic cognitive distractions during sexual activity, as well as measures of additional variables (trait and body image anxiety, attitudes toward sexual minorities, self-esteem, and religiosity). Results indicated that sexual minorities experienced significantly more cognitive distractions related to body image, physical performance, and STIs during sexual activity than heterosexuals. Regarding gender, men reported more distractions related to STIs than women. Interaction effects were observed between sexual orientation and gender for body image-, disease-, and external/emotional-based distractions. Implications of these findings are discussed.

Development and evolution of distraction devices: Use of indigenous appliances for Distraction Osteogenesis-An overview

PubMed Central

Andrade, Neelam; Gandhewar, Trupti; Kalra, Rinku

2011-01-01

An attempt has been made to review various devices as well as the outstanding studies done in the past for understanding the methodology of distraction for regeneration of bone. Lengthening of underdeveloped bones inclusive of the maxillofacial complex has been obtained by distraction osteogenesis by many authors. This could be achieved by the use of various extraoral or intraoral devices. Devices used for distraction osteogenesis must have a minimum of 2 important characteristics – they should be able to transfer distraction forces directly to the bone and secondly, should offer adequate rigidity for osseous consolidation to occur. With advanced technology and biomechanical engineering, preformed intraoral distraction devices are now available worldwide. The introduction of these intraoral bone-bourne devices have eliminated the need for bulky, cumbersome extraoral distraction devices which had problems such as external scars, pin tract infections, nerve or tooth bud injuries and poor patient compliance. The design of completely internalized custom made appliance has opened new vistas in the field of Oral and Maxillofacial Surgery. Indigenous internal devices are also economical and locally available. PMID:23482829

Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions: “Just Hang Up and Drive”

PubMed Central

Kahn, Christopher A.; Cisneros, Victor; Lotfipour, Shahram; Imani, Ghasem; Chakravarthy, Bharath

2015-01-01

For years, public health experts have been concerned about the effect of cell phone use on motor vehicle collisions, part of a phenomenon known as “distracted driving.” The Morbidity and Mortality Weekly Report (MMWR) article “Mobile Device Use While Driving - United States and Seven European Countries 2011” highlights the international nature of these concerns. Recent (2011) estimates from the National Highway Traffic Safety Administration are that 10% of fatal crashes and 17% of injury crashes were reported as distraction-affected. Of 3,331 people killed in 2011 on roadways in the U.S. as a result of driver distraction, 385 died in a crash where at least one driver was using a cell phone. For drivers 15–19 years old involved in a fatal crash, 21% of the distracted drivers were distracted by the use of cell phones. Efforts to reduce cell phone use while driving could reduce the prevalence of automobile crashes related to distracted driving. The MMWR report shows that there is much ground to cover with distracted driving. Emergency physicians frequently see the devastating effects of distracted driving on a daily basis and should take a more active role on sharing the information with patients, administrators, legislators, friends and family. PMID:26759649

Distracted Driving, A Major Preventable Cause of Motor Vehicle Collisions: "Just Hang Up and Drive".

PubMed

Kahn, Christopher A; Cisneros, Victor; Lotfipour, Shahram; Imani, Ghasem; Chakravarthy, Bharath

2015-12-01

For years, public health experts have been concerned about the effect of cell phone use on motor vehicle collisions, part of a phenomenon known as "distracted driving." The Morbidity and Mortality Weekly Report (MMWR) article "Mobile Device Use While Driving - United States and Seven European Countries 2011" highlights the international nature of these concerns. Recent (2011) estimates from the National Highway Traffic Safety Administration are that 10% of fatal crashes and 17% of injury crashes were reported as distraction-affected. Of 3,331 people killed in 2011 on roadways in the U.S. as a result of driver distraction, 385 died in a crash where at least one driver was using a cell phone. For drivers 15-19 years old involved in a fatal crash, 21% of the distracted drivers were distracted by the use of cell phones. Efforts to reduce cell phone use while driving could reduce the prevalence of automobile crashes related to distracted driving. The MMWR report shows that there is much ground to cover with distracted driving. Emergency physicians frequently see the devastating effects of distracted driving on a daily basis and should take a more active role on sharing the information with patients, administrators, legislators, friends and family.

Mandibular distraction osteogenesis with newly designed electromechanical distractor.

PubMed

Aykan, Andac; Ugurlutan, Rifat; Zor, Fatih; Ozturk, Serdar

2014-07-01

The purposes of this study were to design a fully automatic electromechanical distractor for continuous mandibular distraction osteogenesis and to investigate the efficacy of this newly developed distractor on sheep mandible model. Five sheep underwent unilateral mandibular osteotomy, and the mechanical component of electromechanical distractor was fixed on both sides of the osteotomy site using pins. After a 5-day latency period, the electromechanical distractor was activated at a rate of 0.30 mm per 8 hours using an electronic control unit. The bone was lengthened for 20 days without any intervention to the electromechanical distractor. The animals were killed on the sixth week of the consolidation period, and 5 distracted mandibles were examined through macroscopic observation and computed tomography. Distracted bone length was measured through computed tomography on sagittal slices. The device was tolerated by the distraction process without complications in all animals. New callus formation was observed on the distraction gap. Radiologic evaluation showed new callus formation in the distraction gap. New callus length was found to be, in average, 18.28 mm. In this preliminary study, a newly designed electromechanical distractor was successfully used for mandible distraction, which mainly provided a continuous lengthening during activation period spontaneously without any intervention. We think that the clinical application of this electromechanic distractor may provide patient comfort during distraction. Moreover, electromechanical distractor has the potential for high-resolution movement capacity when compared with annual distraction. The promising results from this prototype are encouraging to further investigations for human applications.

Influence of Threat and Serotonin Transporter Genotype on Interference Effects

PubMed Central

Jasinska, Agnes J.; Ho, S. Shaun; Taylor, Stephan F.; Burmeister, Margit; Villafuerte, Sandra; Polk, Thad A.

2012-01-01

Emotion-cognition interactions are critical in goal-directed behavior and may be disrupted in psychopathology. Growing evidence also suggests that emotion-cognition interactions are modulated by genetic variation, including genetic variation in the serotonin system. The goal of the current study was to examine the impact of threat-related distracters and serotonin transporter promoter polymorphism (5-HTTLPR/rs25531) on cognitive task performance in healthy females. Using a novel threat-distracter version of the Multi-Source Interference Task specifically designed to probe emotion-cognition interactions, we demonstrate a robust and temporally dynamic modulation of cognitive interference effects by threat-related distracters relative to other distracter types and relative to no-distracter condition. We further show that threat-related distracters have dissociable and opposite effects on cognitive task performance in easy and difficult task conditions, operationalized as the level of response interference that has to be surmounted to produce a correct response. Finally, we present evidence that the 5-HTTLPR/rs25531 genotype in females modulates susceptibility to cognitive interference in a global fashion, across all distracter conditions, and irrespective of the emotional salience of distracters, rather than specifically in the presence of threat-related distracters. Taken together, these results add to our understanding of the processes through which threat-related distracters affect cognitive processing, and have implications for our understanding of disorders in which threat signals have a detrimental effect on cognition, including depression and anxiety disorders. PMID:22590463

Distraction osteogenesis in the surgical management of syndromic craniosynostosis: a comprehensive review of published papers.

PubMed

Al-Namnam, N M N; Hariri, F; Rahman, Z A A

2018-04-13

Our aim was to summarise current published evidence about the prognosis of various techniques of craniofacial distraction osteogenesis, particularly its indications, protocols, and complications. Published papers were acquired from online sources using the keywords "distraction osteogenesis", "Le Fort III", "monobloc", and "syndromic craniosynostosis" in combination with other keywords, such as "craniofacial deformity" and "midface". The search was confined to publications in English, and we followed the guidelines of the PRISMA statement. We found that deformity of the skull resulted mainly from Crouzon syndrome. Recently craniofacial distraction has been achieved by monobloc distraction osteogenesis using an external distraction device during childhood, while Le Fort III distraction osteogenesis was used in maturity. Craniofacial distraction was indicated primarily to correct increased intracranial pressure, exorbitism, and obstructive sleep apnoea in childhood, while midface hypoplasia was the main indication in maturity. Overall the most commonly reported complications were minor inflammatory reactions around the pins, and anticlockwise rotation when using external distraction systems. The mean amount of bony advancement was 12.3mm for an external device, 18.6mm for an internal device and 18.7mm when both external and internal devices were used. Treatment by craniofacial distraction must be validated by long-term studies as there adequate data are lacking, particularly about structural relapse and the assessment of function. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

ALCOHOL AND DISTRACTION INTERACT TO IMPAIR DRIVING PERFORMANCE

PubMed Central

Harrison, Emily L. R.; Fillmore, Mark T.

2011-01-01

Background Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. Methods The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol + divided attention; placebo; and placebo + divided attention. Results As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Conclusions Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. PMID:21277119

Alcohol and distraction interact to impair driving performance.

PubMed

Harrison, Emily L R; Fillmore, Mark T

2011-08-01

Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol+divided attention; placebo; and placebo+divided attention. As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Measurement of Distraction Force in Cleft Lip and Palate Patients During Le Fort I Maxillary Advancement With Rigid External Distraction.

PubMed

Sawada, Hiromi; Ogawa, Takuya; Kataoka, Keiichi; Baba, Yoshiyuki; Moriyama, Keiji

2017-03-01

Maxillary distraction osteogenesis (DO) is a mainstream surgical technique for patients who have severe maxillary hypoplasia associated with craniofacial syndromes and cleft-related deformities. However, limited information about the biomechanical aspects of maxillary DO is available limiting broad utilization and improvements to the procedure. The objective of this study was to analyze force levels during the active distraction process and to investigate the relationship between distraction force and maxillary movement during Le Fort I maxillary DO using a rigid external distraction (RED) system. Microtension gauges were integrated into the distraction wires on each side of the RED system. Six patients with cleft lip and palate aged 12.8 to 23.5 years underwent strain gauge measurements during maxillary advancement with DO using an RED system. Lateral cephalograms were taken to measure maxillary horizontal, vertical, and linear movements after DO. The average linear maxillary movement was 11.2 mm (range 8.5-15.9 mm). The applied forces ranged from 13.4 to 26.8 N. The distance of maxillary movement was proportional to the distraction force. The measurement of distraction forces during DO provides important information with which to establish appropriate protocols. Patients requiring more advancement may require more distraction force. However, other factors such as scarring, patient anatomy, surgical freedom of the osteotomized maxilla, and the like, may affect the required force during DO with the RED system.

Regional Brain Differences in the Effect of Distraction During the Delay Interval of a Working Memory Task

PubMed Central

Dolcos, Florin; Miller, Brian; Kragel, Philip; Jha, Amishi; McCarthy, Gregory

2012-01-01

Working memory (WM) comprises operations whose coordinated action contributes to our ability to maintain focus on goal-relevant information in the presence of distraction. The present study investigated the nature of distraction upon the neural correlates of WM maintenance operations by presenting task-irrelevant distracters during the interval between the memoranda and probes of a delayed-response WM task. The study used a region of interest (ROIs) approach to investigate the role of anterior (e.g., lateral and medial prefrontal cortex - PFC) and posterior (e.g., parietal and fusiform cortices) brain regions that have been previously associated with WM operations. Behavioral results showed that distracters that were confusable with the memorandum impaired WM performance, compared to either the presence of non-confusable distracters or to the absence of distracters. These different levels of distraction led to differences in the regional patterns of delay interval activity measured with event-related functional magnetic resonance imaging (fMRI). In the anterior ROIs, dorsolateral PFC activation was associated with WM encoding and maintenance, and in maintaining a preparatory state, and ventrolateral PFC activation was associated with the inhibition of distraction. In the posterior ROIs, activation of the posterior parietal and fusiform cortices was associated with WM and perceptual processing, respectively. These findings provide novel evidence concerning the neural systems mediating the cognitive and behavioral responses during distraction, and places frontal cortex at the top of the hierarchy of the neural systems responsible for cognitive control. PMID:17459348

Evaluation of bone healing in femurs lengthened via the gradual distraction method.

PubMed

Jochymek, Jiri; Gal, Petr

2007-06-01

Treatment of leg length inequality via lengthening of the shorter extremity is an infrequent orthopedic procedure due to the requirement of special distraction devices and possible serious complications. Essential qualitative changes in operative technique development are associated with the name of G. A. Ilizarov, who paved the way for the autoregenerate gradual distraction method in the 1950s. In the years 1990 through 2006 a total of 57 patients underwent femur lengthening via gradual distraction using various types of external fixators at the Department of Pediatric Surgery, Orthopedics, and Traumatology, Faculty Hospital in Brno. The quality of bone healing was monitored and a number of parameters followed and statistically evaluated using regularly scheduled X-ray examinations. In 11 cases we had to remove the external fixator following the distraction phase, perform an osteosynthesis via a splint and fill the distraction gap via spongioplasty. The bone healing was satisfactory in the remaining 46 patients and the lengthened bone required no other fixation method. The analysis showed statistically significant deceleration in bone healing following distraction in female patients over 12 years of age, and in boys over 14 years of age. Lack of periosteal callus five weeks after surgery always signified serious problems in further healing. Severe complications were recorded in 11 cases during the distraction phase, and in 9 cases after the removal of the distraction apparatus. The aim of this report was to present the results of our study of distraction gap bone healing using the gradual lengthening approach.

Constructing a publically available distracted driving database and research tool.

PubMed

Atchley, Paul; Tran, Ashleigh V; Salehinejad, Mohammad Ali

2017-02-01

The goal of the current work was to create a publicly available visualization tool of distracted driving research, the purpose of which is to allow the public and other stakeholders to empirically inform questions of their choice that may bear on policy discussions. Fifty years of distracted driving research was used to design a comprehensive database of studies that evaluated the effects of distraction on driving performance. Distraction sources (e.g., texting, talking, visual distraction) and performance measures were defined, and the sample of studies were evaluated and categorized by their measures. The final product yielded 342 studies using various methodologies. Across all measures, 1297 found distractions degraded driving performance, 54 found distraction improved driving performance, and 257 found distraction had no effect on driving performance. An analysis of the most common phone distractions (texting and talking) showed that texting almost always results in degraded performance. Aggregate data reveal no difference in performance decrements for hand-held or hands-free phones even though single studies of those variables vary in their outcomes. This project illustrates how scientific research can be made publically available for use by a diverse audience of stakeholders. An important result of this project is that data aggregated along a simple set of characteristics such as whether or not performance is decreased, improved or not affected, can reveal trends in the data that are less clear from any individual study. Copyright © 2016 Elsevier Ltd. All rights reserved.

Exploring inattention and distraction in the SafetyNet Accident Causation Database.

PubMed

Talbot, Rachel; Fagerlind, Helen; Morris, Andrew

2013-11-01

Distraction and inattention are considered to be very important and prevalent factors in the causation of road accidents. There have been many recent research studies which have attempted to understand the circumstances under which a driver becomes distracted or inattentive and how distraction/inattention can be prevented. Both factors are thought to have become more important in recent times partly due to the evolution of in-vehicle information and communication technology. This study describes a methodology that was developed to understand when factors such as distraction and inattention may have been contributors to crashes and also describes some of the consequences of distraction and inattention in terms of subsequent driver actions. The study uses data relating to distraction and inattention from the SafetyNet Accident Causation Database. This database was formulated as part of the SafetyNet project to address the lack of representative in-depth accident causation data within the European Union. Data were collected in 6 European countries using 'on-scene' and 'nearly on-scene' crash investigation methodologies. 32% of crashes recorded in the database, involved at least one driver, rider or pedestrian, who was determined to be 'Inattentive' or 'Distracted'. 212 of the drivers were assigned 'Distraction' and 140 drivers were given the code 'Inattention'. It was found that both distraction and inattention often lead to missed observations within the driving task and consequently 'Timing' or 'Direction' become critical events in the aetiology of crashes. In addition, the crash types and outcomes may differ according to the type and nature of the distraction and inattention as determined by the in-depth investigations. The development of accident coding methodology is described in this study as is its evolution into the Driver Reliability and Error Analysis Model (DREAM) version 3.0. Copyright © 2012 Elsevier Ltd. All rights reserved.

The role of executive functioning in children's attentional pain control: an experimental analysis.

PubMed

Verhoeven, Katrien; Dick, Bruce; Eccleston, Christopher; Goubert, Liesbet; Crombez, Geert

2014-02-01

Directing attention away from pain is often used in children's pain treatment programs to control pain. However, empirical evidence concerning its effectiveness is inconclusive. We therefore sought to understand other influencing factors, including executive function and its role in the pain experience. This study investigates the role of executive functioning in the effectiveness of distraction. School children (n=164) completed executive functioning tasks (inhibition, switching, and working memory) and performed a cold-pressor task. One half of the children simultaneously performed a distracting tone-detection task; the other half did not. Results showed that participants in the distraction group were engaged in the distraction task and were reported to pay significantly less attention to pain than controls. Executive functioning influenced distraction task engagement. More specifically, participants with good inhibition and working memory abilities performed the distraction task better; participants with good switching abilities reported having paid more attention to the distraction task. Furthermore, distraction was found to be ineffective in reducing pain intensity and affect. Executive functioning did not influence the effectiveness of distraction. However, a relationship was found between executive functioning and pain affect, indicating that participants with good inhibition and working memory abilities experienced the cold-pressor task as less stressful and unpleasant. Our findings suggest that distraction as a process for managing pain is complex. While it appears that executive function may play a role in adult distraction, in this study it did not direct attention away from pain. It may instead be involved in the overall pain experience. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Maxillary segmental distraction in children with unilateral clefts of lip, palate, and alveolus.

PubMed

Zemann, Wolfgang; Pichelmayer, Margit

2011-06-01

Alveolar clefts are commonly closed by a bone grafting procedure. In cases of wide clefts the deficiency of soft tissue in the cleft area may lead to wound dehiscence and loss of the bony graft. Segmental maxillary bony transfer has been mentioned to be useful in such cases. Standard distraction devices allow unidirectional movement of the transported segment. Ideally the distraction should strictly follow the dental arch. The aim of this study was to analyze distraction devices that were adapted to the individual clinical situation of the patients. The goal was to achieve a distraction strictly parallel to the dental arch. Six children with unilateral clefts of lip, palate, and alveolus between 12 and 13 years of age were included in the study. The width of the cleft was between 7 and 19 mm. Dental cast models were used to manufacture individual distraction devices that should allow a segmental bony transport strictly parallel to the dental arch. Segmental osteotomy was performed under general anesthesia. Distraction was started 5 days after surgery. All distracters were tooth fixed but supported by palatal inserted orthodontic miniscrews. In all patients, a closure of the alveolar cleft was achieved. Two patients required additional bone grafting after the distraction procedure. The distraction was strictly parallel to the dental arch in all cases. In 1 case a slight cranial displacement of the transported maxillary segment could be noticed, leading to minor modifications of the following distractors. Distraction osteogenesis is a proper method to close wide alveolar clefts. Linear segmental transport is required in the posterior part of the dental arch, whereas in the frontal part the bony transport should run strictly parallel to the dental arch. An exact guided segmental transport may reduce the postoperative orthodontic complexity. Copyright © 2011 Mosby, Inc. All rights reserved.

Treatment of severe radial club hand by distraction using an articulated mini-rail fixator and transfixing pins.

PubMed

Romana, C; Ciais, G; Fitoussi, F

2015-06-01

Treatment of severe radial club hand is difficult. Several authors have emphasized the importance of preliminary soft-tissue distraction before centralization. Treatment of severe radial club hand by articulated mini-rail allowing prior soft-tissue distraction improves results. Thirteen patients were treated sequentially, with an initial step of distraction and a second step of centralization. The first step consisted in fitting 2 mini-fixators, one in the concavity and the other in the convexity of the deformity. Four transfixing wires through the ulna and metacarpal bone connected the 2 fixators. After this preliminary distraction, the fixator was removed and a centralization wire was introduced percutaneously, with ulnar osteotomy if necessary. Sagittal and coronal correction was measured on the angle between forearm and hand. Mean age at treatment was 37.5 months (range, 9-120 months). Mean distraction time was 53.2 days (26-90 days). Ulnar osteotomy was required in 8 cases (61%). There were no major complications requiring interruption of distraction. Sagittal and coronal correction after centralization reduced mean residual forearm/hand angulation to<12°. Soft-tissue distraction in the concavity ahead of centralization is essential to good correction, avoiding extensive soft-tissue release and hyperpressure on the distal ulnar growth plate. There have been several studies of distraction; the present technique, associating 2 mini-fixators connected by threaded K-wires, provided sufficient distraction in the concavity of the deformity to allow satisfactory correction in all cases. Subsequent complications (breakage or displacement of the centralization wires) testify to the complexity of long-term management. The present study confirms the interest of a preliminary soft-tissue distraction step in treating severe radial club hand. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Audiovisual distraction for pain relief in paediatric inpatients: A crossover study.

PubMed

Oliveira, N C A C; Santos, J L F; Linhares, M B M

2017-01-01

Pain is a stressful experience that can have a negative impact on child development. The aim of this crossover study was to examine the efficacy of audiovisual distraction for acute pain relief in paediatric inpatients. The sample comprised 40 inpatients (6-11 years) who underwent painful puncture procedures. The participants were randomized into two groups, and all children received the intervention and served as their own controls. Stress and pain-catastrophizing assessments were initially performed using the Child Stress Scale and Pain Catastrophizing Scale for Children, with the aim of controlling these variables. The pain assessment was performed using a Visual Analog Scale and the Faces Pain Scale-Revised after the painful procedures. Group 1 received audiovisual distraction before and during the puncture procedure, which was performed again without intervention on another day. The procedure was reversed in Group 2. Audiovisual distraction used animated short films. A 2 × 2 × 2 analysis of variance for 2 × 2 crossover study was performed, with a 5% level of statistical significance. The two groups had similar baseline measures of stress and pain catastrophizing. A significant difference was found between periods with and without distraction in both groups, in which scores on both pain scales were lower during distraction compared with no intervention. The sequence of exposure to the distraction intervention in both groups and first versus second painful procedure during which the distraction was performed also significantly influenced the efficacy of the distraction intervention. Audiovisual distraction effectively reduced the intensity of pain perception in paediatric inpatients. The crossover study design provides a better understanding of the power effects of distraction for acute pain management. Audiovisual distraction was a powerful and effective non-pharmacological intervention for pain relief in paediatric inpatients. The effects were detected in subsequent acute painful procedures. © 2016 European Pain Federation - EFIC®.

Experiential Exposure to Texting and Walking in Virtual Reality: A Randomized Trial to Reduce Distracted Pedestrian Behavior

PubMed Central

Schwebel, David C.; McClure, Leslie A.; Porter, Bryan E.

2017-01-01

Background Distracted pedestrian behavior is a significant public health concern, as research suggests distracted pedestrians have significantly higher risk of injury compared to fully attentive pedestrians. Despite this, efforts to reduce distracted pedestrian behavior are scant. Objective Using a repeated measures experimental research design, we implemented a behavioral intervention to reduce distracted pedestrian behavior in the high-risk environment of an urban college campus and simultaneously monitored behavior on a control urban college campus not exposed to the intervention. We had two primary aims: reduce perceived vulnerability to injury among individual pedestrians and reduce distracted pedestrian behavior in the environment through a change in community-based norms. Methods The hallmark of the behavioral intervention was a week-long opportunity for community members to experience personally the risks of distracted pedestrian behavior by attempting to cross a virtual pedestrian environment street while text-messaging. This was supplemented by traditional and social marketing and publicity through various campus partners. A sample of 219 individuals completed self-report surveys about perceived vulnerability to distracted pedestrian injury before experiencing the distracted virtual street-crossing and again after 2 weeks and 5 months. Observational assessment of distracted pedestrian behavior was conducted at a busy intersection on the campus as well as at a control campus not exposed to the intervention at baseline, post-intervention, 10 weeks, and 6 months. Results The intervention achieved mixed results. Individuals exposed to texting within a simulated pedestrian environment reported changes in their intentions to cross streets while distracted and in perceived vulnerability to risk while crossing streets, but we did not witness evidence of changed community norms based on observed rates of distracted pedestrian behavior before and after the intervention compared to a control campus not exposed to the intervention. Discussion The intervention created some change in self-reported intentions and thoughts but did not create significant behavior change on the campus exposed to it. Further efforts to develop interventions that will yield a reduction in distracted pedestrian behavior are needed. PMID:28279843

Experiential exposure to texting and walking in virtual reality: A randomized trial to reduce distracted pedestrian behavior.

PubMed

Schwebel, David C; McClure, Leslie A; Porter, Bryan E

2017-05-01

Distracted pedestrian behavior is a significant public health concern, as research suggests distracted pedestrians have significantly higher risk of injury compared to fully attentive pedestrians. Despite this, efforts to reduce distracted pedestrian behavior are scant. Using a repeated measures experimental research design, we implemented a behavioral intervention to reduce distracted pedestrian behavior in the high-risk environment of an urban college campus and simultaneously monitored behavior on a control urban college campus not exposed to the intervention. We had two primary aims: reduce perceived vulnerability to injury among individual pedestrians and reduce distracted pedestrian behavior in the environment through a change in community-based norms. The hallmark of the behavioral intervention was a week-long opportunity for community members to experience personally the risks of distracted pedestrian behavior by attempting to cross a virtual pedestrian environment street while text-messaging. This was supplemented by traditional and social marketing and publicity through various campus partners. A sample of 219 individuals completed self-report surveys about perceived vulnerability to distracted pedestrian injury before experiencing the distracted virtual street-crossing and again after 2 weeks and 5 months. Observational assessment of distracted pedestrian behavior was conducted at a busy intersection on the campus as well as at a control campus not exposed to the intervention at baseline, post-intervention, 10 weeks, and 6 months. The intervention achieved mixed results. Individuals exposed to texting within a simulated pedestrian environment reported changes in their intentions to cross streets while distracted and in perceived vulnerability to risk while crossing streets, but we did not witness evidence of changed community norms based on observed rates of distracted pedestrian behavior before and after the intervention compared to a control campus not exposed to the intervention. The intervention created some change in self-reported intentions and thoughts but did not create significant behavior change on the campus exposed to it. Further efforts to develop interventions that will yield a reduction in distracted pedestrian behavior are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effects of an oral distraction on cattle during a painful procedure

PubMed Central

Aitken, Brooke L.; Stookey, Joseph M.; Noble, Scott; Watts, Jon; Finlay, Don

2013-01-01

An oral distraction was investigated as a way to reduce struggle and heart rate of beef cattle undergoing freeze branding. Oral distraction reduced the struggle of steers, regardless of branding treatment. No effect on heart rate was found. Distractions may provide a way to reduce struggle by animals during restraint. PMID:24155450

Direct hip joint distraction during acetabular fracture surgery using the AO universal manipulator.

PubMed

Calafi, L Afshin; Routt, M L Chip

2010-02-01

Certain acetabular fractures may necessitate distraction of the hip joint for removal of intra-articular debris and assessment of reduction. Distraction can be accomplished by manual traction, using a traction table or an AO universal manipulator (UM). The UM is a relatively simple and an inexpensive device that can provide focal distraction in a controlled manner without the risks associated with the use of a traction table. We describe a technique using the UM for hip joint distraction during acetabular fracture surgery through a Kocher-Langenbeck surgical exposure.

The role of perceptual load in object recognition.

PubMed

Lavie, Nilli; Lin, Zhicheng; Zokaei, Nahid; Thoma, Volker

2009-10-01

Predictions from perceptual load theory (Lavie, 1995, 2005) regarding object recognition across the same or different viewpoints were tested. Results showed that high perceptual load reduces distracter recognition levels despite always presenting distracter objects from the same view. They also showed that the levels of distracter recognition were unaffected by a change in the distracter object view under conditions of low perceptual load. These results were found both with repetition priming measures of distracter recognition and with performance on a surprise recognition memory test. The results support load theory proposals that distracter recognition critically depends on the level of perceptual load. The implications for the role of attention in object recognition theories are discussed. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Clinical Use of Deferoxamine in Distraction Osteogenesis of Irradiated Bone

PubMed Central

Momeni, Arash; Rapp, Scott; Donneys, Alexis; Buchman, Steven R.; Wan, Derrick C.

2016-01-01

The deleterious effects of radiotherapy, including hypovascularity and hypocellularity, have made distraction of irradiated bones challenging. Animal studies, however, have demonstrated adjunctive measures such as the administration of deferoxamine to significantly improve bone regeneration across irradiated distraction gaps. In this report, we demonstrate, for the first time, enhanced bone formation following deferoxamine application in a patient following distraction of a previously irradiated maxilla. CT imaging of the pterygomaxillary buttress on the side of administration revealed significantly increased bone area and density relative to the contralateral buttress. This is the first presentation of clinical deferoxamine use to promote bone formation following irradiated bone distraction and highlights the promise for this adjunctive measure to make outcomes after distraction of irradiated bone more reliable. PMID:27171947

Effect of cell phone distraction on pediatric pedestrian injury risk.

PubMed

Stavrinos, Despina; Byington, Katherine W; Schwebel, David C

2009-02-01

Early adolescents are using cell phones with increasing frequency. Cell phones are known to distract motor vehicle drivers to the point that their safety is jeopardized, but it is unclear if cell phones might also distract child pedestrians. This study was designed to examine the influence of talking on a cell phone for pediatric pedestrian injury risk. Seventy-seven children aged 10 to 11 years old completed simulated road crossings in an immersive, interactive virtual pedestrian environment. In a within-subjects design, children crossed the virtual street 6 times while undistracted and 6 times while distracted by a cell phone conversation with an unfamiliar research assistant. Participants also completed several other experimental tasks hypothesized to predict the impact of distraction while crossing the street and talking on a cell phone. Children's pedestrian safety was compromised when distracted by a cell phone conversation. While distracted, children were less attentive to traffic; left less safe time between their crossing and the next arriving vehicle; experienced more collisions and close calls with oncoming traffic; and waited longer before beginning to cross the street. Analyses testing experience using a cell phone and experience as a pedestrian yielded few significant results, suggesting that distraction on the cell phone might affect children's pedestrian safety no matter what their experience level. There was some indication that younger children and children who are less attentive and more oppositional may be slightly more susceptible to distraction while talking on the cell phone than older, more attentive, and less oppositional children. Our results suggest that cell phones distract preadolescent children while crossing streets.

Technical feasibility of personalized articulating knee joint distraction for treatment of tibiofemoral osteoarthritis.

PubMed

Struik, T; Jaspers, J E N; Besselink, N J; van Roermund, P M; Plomp, S; Rudert, M J; Lafeber, F P J G; Mastbergen, S C

2017-11-01

Knee osteoarthritis is a highly prevalent degenerative joint disorder characterized by joint tissue damage and pain. Knee joint distraction has been introduced as a joint preserving surgical procedure to postpone knee arthroplasty. An often used standard externally fixation device for distraction poses a burden to patients due to the absence of joint flexion during the 6weeks treatment. Therefore, a personalized articulating distraction device was developed. The aim of this study was to test technical feasibility of this device. Based on an often applied rigid device, using equal bone pin positions and connectors, a hinge mechanism was developed consisting of a cam-following system for reproducing the complex joint-specific knee kinematics. In support, a device was developed for capturing the joint-specific sagittal plane articulation. The obtained kinematic data were translated into joint-specific cam shapes that were installed bilaterally in the hinge mechanism of the distraction device, as such providing personalized knee motion. Distraction of 5mm was performed within a range of motion of 30deg. joint flexion. Pre-clinical evaluation of the working principle was performed on human cadaveric legs and system stiffness characteristics were biomechanically evaluated. The desired range of motion was obtained and distraction was maintained under physiologically representative loading. Moreover, the joint-specific approach demonstrated tolerance of deviations from anatomical and alignment origin during initial placement of the developed distraction device. Articulation during knee distraction is considered technically feasible and has potential to decrease burden and improve acceptance of distraction therapy. Testing of clinical feasibility is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preliminary soft-tissue distraction versus checkrein ligament release after fasciectomy in the treatment of dupuytren proximal interphalangeal joint contractures.

PubMed

Craft, Randall O; Smith, Anthony A; Coakley, Brandon; Casey, William J; Rebecca, Alanna M; Duncan, Scott F M

2011-11-01

Checkrein ligament release for treatment of proximal interphalangeal joint Dupuytren contractures does not address the shortened arteries or deficient skin. The Digit Widget uses soft-tissue distraction to overcome these issues. This study compares checkrein ligament release after fasciectomy versus preliminary soft-tissue distraction, followed by operative release, for treatment of proximal interphalangeal joint Dupuytren contractures. The authors compared operative and postoperative characteristics of patients treated with either fasciectomy plus checkrein ligament release or Digit Widget distraction between 2001 and 2008. Seventeen patients (20 digits) underwent ligament release (mean contracture, 55.9 degrees); six of these 20 were reoperations. Thirteen patients (17 digits) underwent distraction (mean contracture, 67.6 degrees); 10 of 17 were reoperations. The 20 digits treated with fasciectomy plus ligament release had an average extension improvement of 31.4 degrees (range, -4 to 70 degrees). Digits treated with distraction had an average extension improvement of 53.4 degrees (range, 30 to 75 degrees) (p<0.001 versus ligament release). Three digits treated with distraction improved to full proximal interphalangeal extension. Initial contractures of 60 degrees or less treated by ligament release (n=12) or distraction (n=7) improved by means of 28.8 degrees and 47.7 degrees, respectively (p=0.048). Contractures greater than 60 degrees treated by ligament release (n=8) or distraction (n=10) improved by means of 35.3 degrees and 57.3 degrees, respectively (p=0.02). Soft-tissue distraction followed by operative release showed greater correction than Dupuytren fasciectomy plus checkrein ligament release. Therapeutic, III.

Correction of rabbit model with mandibular ramus shortening by distraction osteogenesis at condylar neck.

PubMed

Meng, Qinggong; Yang, Xuewen; Long, Xing; Li, Jian; Cai, Hengxing

2012-04-01

The rabbit model has been established to mimic the effect of temporomandibular joint (TMJ) arthroplasty of ankylosis, and distraction at the level of the condylar neck is used to elongate the ascending ramus. The histomorphologic changes of TMJ and distraction gap were investigated. The unilateral condyles and articular discs were extirpated, and the experimental mandibular rami were shortened by 5 mm. An embedded distracter was used to restore the height of the mandibular ramus by unilateral condylar neck distraction (0.8 mm daily for 7 days). A total of 12 adult white rabbits were used, 8 in the experimental group and 4 in the control group. Of the 8 rabbits in the experimental group, 4 each were killed at 4 and 8 weeks after completion of distraction. The TMJ and distracted calluses were harvested and processed for radiographic and histologic examination. An open bite was seen in all rabbits postoperatively that had diminished at the end of distraction. The newly formed condyles radiologically showed remodeling, flattening, and sclerosis. The bony transport disc had gradually remodeled to a new condyle that was similar to the original condyle in appearance and structure. The surface of the transport disc was covered with a fibrous tissue. Moreover, the bony regeneration was perfect in the distraction gap. These results suggest that distraction osteogenesis at the condylar neck using the traditional preauricular approach of TMJ surgery, without the additional incision, can be performed concurrently with arthroplasty of TMJ ankylosis at the same region. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Stem cells rejuvenate radiation-impaired vasculogenesis in murine distraction osteogenesis.

PubMed

Deshpande, Sagar S; Gallagher, Kathleen K; Donneys, Alexis; Nelson, Noah S; Guys, Nicholas P; Felice, Peter A; Page, Erin E; Sun, Hongli; Krebsbach, Paul H; Buchman, Steven R

2015-03-01

Radiotherapy is known to be detrimental to bone and soft-tissue repair. Bone marrow stromal cells have been shown to enhance bone regeneration during distraction osteogenesis following radiation therapy. The authors posit that transplanted bone marrow stromal cells will significantly augment the mandibular vascularity devastated by radiation therapy. Nineteen male Lewis rats were split randomly into three groups: distraction osteogenesis only (n = 5), radiation therapy plus distraction osteogenesis (n = 7), and radiation therapy plus distraction osteogenesis with intraoperative placement of 2 million bone marrow stromal cells (n = 7). A mandibular osteotomy was performed, and an external fixator device was installed. From postoperative days 4 through 12, rats underwent a gradual 5.1-mm distraction followed by a 28-day consolidation period. On postoperative day 40, Microfil was perfused into the vasculature and imaging commenced. Vascular radiomorphometric values were calculated for regions of interest. An analysis of variance with post hoc Tukey or Games-Howell tests was used, dependent on data homogeneity. Stereologic analysis indicated significant remediation in vasculature in the bone marrow stromal cell group compared with the radiation therapy/distraction osteogenesis group. Each of five metrics idicated significant improvements from radiation therapy/distraction osteogenesis to the bone marrow stromal cell group, with no difference between the bone marrow stromal cell group and the distraction osteogenesis group. Bone marrow stromal cells used together with distraction osteogenesis can rejuvenate radiation-impaired vasculogenesis in the mandible, reversing radiation therapy-induced isotropy and creating a robust vascular network. Bone marrow stromal cells may offer clinicians an alternative reconstructive modality that could improve the lifestyle of patients with hypovascular bone.

Examining drivers' eye glance patterns during distracted driving: Insights from scanning randomness and glance transition matrix.

PubMed

Wang, Yuan; Bao, Shan; Du, Wenjun; Ye, Zhirui; Sayer, James R

2017-12-01

Visual attention to the driving environment is of great importance for road safety. Eye glance behavior has been used as an indicator of distracted driving. This study examined and quantified drivers' glance patterns and features during distracted driving. Data from an existing naturalistic driving study were used. Entropy rate was calculated and used to assess the randomness associated with drivers' scanning patterns. A glance-transition proportion matrix was defined to quantity visual search patterns transitioning among four main eye glance locations while driving (i.e., forward on-road, phone, mirrors and others). All measurements were calculated within a 5s time window under both cell phone and non-cell phone use conditions. Results of the glance data analyses showed different patterns between distracted and non-distracted driving, featured by a higher entropy rate value and highly biased attention transferring between forward and phone locations during distracted driving. Drivers in general had higher number of glance transitions, and their on-road glance duration was significantly shorter during distracted driving when compared to non-distracted driving. Results suggest that drivers have a higher scanning randomness/disorder level and shift their main attention from surrounding areas towards phone area when engaging in visual-manual tasks. Drivers' visual search patterns during visual-manual distraction with a high scanning randomness and a high proportion of eye glance transitions towards the location of the phone provide insight into driver distraction detection. This will help to inform the design of in-vehicle human-machine interface/systems. Copyright © 2017. Published by Elsevier Ltd.

Psychometrics of Multiple Choice Questions with Non-Functioning Distracters: Implications to Medical Education.

PubMed

Deepak, Kishore K; Al-Umran, Khalid Umran; AI-Sheikh, Mona H; Dkoli, B V; Al-Rubaish, Abdullah

2015-01-01

The functionality of distracters in a multiple choice question plays a very important role. We examined the frequency and impact of functioning and non-functioning distracters on psychometric properties of 5-option items in clinical disciplines. We analyzed item statistics of 1115 multiple choice questions from 15 summative assessments of undergraduate medical students and classified the items into five groups by their number of non-functioning distracters. We analyzed the effect of varying degree of non-functionality ranging from 0 to 4, on test reliability, difficulty index, discrimination index and point biserial correlation. The non-functionality of distracters inversely affected the test reliability and quality of items in a predictable manner. The non-functioning distracters made the items easier and lowered the discrimination index significantly. Three non-functional distracters in a 5-option MCQ significantly affected all psychometric properties (p < 0.5). The corrected point biserial correlation revealed that the items with 3 functional options were psychometrically as effective as 5-option items. Our study reveals that a multiple choice question with 3 functional options provides lower most limit of item format that has adequate psychometric property. The test containing items with less number of functioning options have significantly lower reliability. The distracter function analysis and revision of nonfunctioning distracters can serve as important methods to improve the psychometrics and reliability of assessment.

Response of ramus following vertical lengthening with distraction osteogenesis.

PubMed

Tuzuner-Oncul, Aysegul Mine; Kisnisci, Reha S

2011-09-01

Vertical lengthening of the mandibular ramus is considered to be one of the least stable surgical procedures in the management of musculoskeletal maxillofacial deformities. The aim of this study was to evaluate the response of the mandibular ramus following vertical lengthening by means of distraction osteogenesis. This study included eight non-syndromic adult patients with temporomandibular joint ankylosis. The vertical height deficiency of the mandibular ramus and the ramus/condyle unit on the affected side were simultaneously reconstructed by transportation of a bone segment using distraction osteogenesis following gap arthroplasty. Lateral and posteroanterior (PA) cephalograms taken postoperatively before active distraction, at the completion of distraction and 6, 12, 24 months after distraction, were compared to evaluate the changes of the ramus height. In all cases the vertical ramus and ramus/condyle unit height loss were successfully reconstructed by distraction osteogenesis. There was no relapse in the amount of height gained by distraction osteogenesis at the 24 months follow-up review (p>0.05). Acute one stage vertical lengthening of the mandibular ramus is considered to be one of the least stable musculoskeletal procedures with relapse being a significant adverse outcome. In this clinical study gradual vertical lengthening of the ramus through ramus/condyle unit distraction osteogenesis has maintained the initial vertical ramus height gained for 24 months. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Differential Impact of Personality Traits on Distracted Driving Behaviors in Teens and Older Adults

PubMed Central

Parr, Morgan N.; Ross, Lesley A.; McManus, Benjamin; Bishop, Haley J.; Wittig, Shannon M. O.; Stavrinos, Despina

2016-01-01

Objective To determine the impact of personality on distracted driving behaviors. Method Participants included 120 drivers (48 teens, 72 older adults) who completed the 45-item Big Five Personality questionnaire assessing self-reported personality factors and the Questionnaire Assessing Distracted Driving (QUADD) assessing the frequency of distracted driving behaviors. Associations for all five personality traits with each outcome (e.g. number of times texting on the phone, talking on the phone, and interacting with the phone while driving) were analyzed separately for teens and older adults using negative binomial or Poisson regressions that controlled for age, gender and education. Results In teens, higher levels of openness and conscientiousness were predictive of greater reported texting frequency and interacting with a phone while driving, while lower levels of agreeableness was predictive of fewer reported instances of texting and interacting with a phone while driving. In older adults, greater extraversion was predictive of greater reported talking on and interacting with a phone while driving. Other personality factors were not significantly associated with distracted driving behaviors. Conclusions Personality traits may be important predictors of distracted driving behaviors, though specific traits associated with distracted driving may vary across age groups. The relationship between personality and distracted driving behaviors provides a unique opportunity to target drivers who are more likely to engage in distracted driving behavior, thereby increasing the effectiveness of educational campaigns and improving driving safety. PMID:27054484

Corrected Cephalometric Analysis to Determine the Distance and Vector of Distraction Osteogenesis for Syndromic Craniosynostosis

PubMed Central

Fukawa, Toshihiko; Hirakawa, Takashi; Satake, Toshihiko; Maegawa, Jiro

2017-01-01

Background: The purpose of this study was to confirm the utility of a corrected cephalometric analysis to facilitate the planning of distraction osteogenesis with Le Fort III osteotomy for syndromic craniosynostosis. Methods: This prospective study involved 4 male and 2 female patients (mean patient age, 8 years 9 months; age range, 4 years 6 months to 13 years 2 months) with Crouzon syndrome who were treated with Le Fort III maxillary distraction using our previously described system of analysis of a corrected cephalogram and who underwent clinical follow-up. Lateral cephalograms were obtained immediately after device removal. Results: Distraction of orbitale moved the vector downward to the adult profile, but there was slightly less elongation than the adult profile for the distraction distance. The desired and real mean angles after distraction of point A were 29.2 ± 7.9° and 6.1 ± 8.5°, respectively, and the desired and the real mean distances after distraction of point A were 30.6 ± 12.7 mm and 29.4 ± 4.1 mm, respectively. Conclusions: Using the corrected cephalometric analysis, the distance and vector of distraction osteogenesis with Le Fort III osteotomy could be determined in patients with syndromic craniosynostosis. The distraction system brought the patients' facial bones to the planned position using controlling devices. PMID:29062650

Le Fort I distraction using internal devices for maxillary hypoplasia in patients with cleft lip, palate, and alveolus: complications and their prevention and management.

PubMed

Mitsukawa, Nobuyuki; Satoh, Kaneshige; Morishita, Tadashi

2010-09-01

In recent years, advancement has been made in distraction osteogenesis in the facial area. It has been applied actively to treat maxillary hypoplasia in patients with cleft lip, palate, and alveolus. Le Fort I distraction using internal devices does not lead to disability in daily living, including during the retention period, and has low surgical invasiveness, facile management, and superior aesthetics. Thus, there have been occasional reports on this procedure in recent years. Because an internal device is unidirectional, the greatest disadvantage is the inability to adjust the direction of distraction after its placement. However, past reports have emphasized its advantages, and its complications have rarely been discussed. We performed Le Fort I distraction using internal devices on 15 young patients. Our results showed notable complications in a few cases. When serial cephalometric analysis was performed after maxillary distraction, it demonstrated that the maxilla assumes various three-dimensional distraction morphologies. In particular, cases with insufficient bone grafting of alveolar clefts developed collapse mainly in the alveolar cleft region during postoperative distraction. Mobility and deviation of the maxillary bone fragment occurred. We implemented preventative measures against complications such as using modifications to place the devices parallel on the left and right sides and using a bite splint for distraction. These measures produced improved outcomes, and we describe here the details.

Changes in nasorespiratory function in association with maxillary distraction osteogenesis in subjects with cleft lip and palate.

PubMed

Saito, Kiyo; Ono, Takashi; Mochida, Masumi; Ohyama, Kimie

2006-01-01

The current study aimed to determine how nasorespiratory function changes in association with maxillary distraction osteogenesis (DO). Furthermore, with regard to impaired nasorespiratory function, the possibility of a relationship between the cleft side and laterality and any effect of maxillary distraction osteogenesis was investigated. In this descriptive, prospective clinical report, subjective and objective data regarding nasorespiratory function before and after maxillary distraction osteogenesis were compared. Data from 13 subjects with cleft lip and palate were used. Subjects had a severe maxillary deficiency and underwent distraction osteogenesis using a rigid external device system. The subjective measure was the score on a questionnaire regarding nasorespiratory function using a visual analog scale. The objective measure was nasal resistance. The visual analog scale score for two items significantly decreased just after distraction osteogenesis. Nasal resistance also significantly decreased 1 year after distraction osteogenesis. Moreover, nasal resistance on the cleft side was significantly greater than that on the noncleft side just before and 1 year after distraction osteogenesis. There was a significant positive correlation between changes in the visual analog scale score and nasal resistance. These results suggest that nasorespiratory function changes in association with maxillary distraction osteogenesis in subjects with cleft lip and palate. Moreover, it appears that nasal obstruction on the cleft side does not change in subjects with unilateral cleft lip and palate.

Reflections of Distraction in Memory: Transfer of Previous Distraction Improves Recall in Younger and Older Adults

ERIC Educational Resources Information Center

Thomas, Ruthann C.; Hasher, Lynn

2012-01-01

Three studies explored whether younger and older adults' free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting…

Backward distraction osteogenesis in a patient with severe mandibular micrognathia.

PubMed

Mitsukawa, Nobuyuki; Morishita, Tadashi; Saiga, Atsuomi; Akita, Shinsuke; Kubota, Yoshitaka; Satoh, Kaneshige

2013-09-01

Maxillary skeletal prognathism can involve severe mandibular micrognathia with marked mandibular retrognathism or hypoplasia. For patients with such a condition, a conventional treatment is mandibular advancement by sagittal split ramus osteotomy (SSRO). This procedure has problems such as insufficient advancement, instability of jaw position, and postoperative relapse. Thus, in recent years, mandibular distraction osteogenesis has been used in some patients. Mandibular distraction has many advantages, but an ideal occlusion is difficult to achieve using this procedure. That is, 3-dimensional control cannot be attained using an internal device that is unidirectional. This report describes a case of severe mandibular micrognathia in a 14-year-old girl treated using backward distraction osteogenesis. This procedure was first reported by Ishii et al (Jpn J Jaw Deform 2004; 14:49) and involves a combination of SSRO and ramus distraction osteogenesis. In the present study, intermaxillary fixation in centric occlusion was performed after osteotomy, and proximal bone segments were distracted in a posterosuperior direction. This procedure is a superior surgical technique that avoids the drawbacks of SSRO and conventional mandibular distraction. However, it applies a large load to the temporomandibular joints and requires thorough management. Thus, careful evaluation needs to be made of the indication for backward distraction osteogenesis.

Attention, working memory, and grammaticality judgment in typical young adults.

PubMed

Smith, Pamela A

2011-06-01

To examine resource allocation and sentence processing, this study examined the effects of auditory distraction on grammaticality judgment (GJ) of sentences varied by semantics (reversibility) and short-term memory requirements. Experiment 1: Typical young adult females (N = 60) completed a whole-sentence GJ task in distraction (Quiet, Noise, or Talk). Participants judged grammaticality of Passive sentences varied by sentence (length), grammaticality, and reversibility. Reaction time (RT) data were analyzed using a mixed analysis of variance. Experiment 2: A similar group completed a self-paced reading GJ task using the similar materials. Experiment 1: Participants responded faster to Bad and to Nonreversible sentences, and in the Talk distraction. The slowest RTs were noted for Good-Reversible-Padded sentences in the Quiet condition. Experiment 2: Distraction did not differentially affect RTs for sentence components. Verb RTs were slower for Reversible sentences. Results suggest that narrative distraction affected GJ, but by speeding responses, not slowing them. Sentence variables of memory and reversibility slowed RTs, but narrative distraction resulted in faster processing times regardless of individual sentence variables. More explicit, deliberate tasks (self-paced reading) resulted in less effect from distraction. Results are discussed in terms of recent theories about auditory distraction.

[An adjustable distractor for transverse maxillary distraction osteogenesis].

PubMed

Leyder, P; Wycisk, G; Quilichini, J

2013-06-01

The posterior skeletal widening in conventional distractions (Surgical Assisted Rapid Maxillary Expansion) is often modest, in contrast with a predominant anterior expansion. Until recently, it was not possible to consider transverse palatal distraction osteogenesis and Le Fort I impaction or advancement in the same procedure, as the osteosynthesis plates impeded maxillary anterior opening. We developed new sliding osteosynthesis plates allowing to perform an advancement or impaction Le Fort I osteotomy associated with a low-resistance bipartite palatal distraction osteogenesis. We had for aim to describe the device and to determine its clinical applications. This new palatal distractor is made up of two independent stainless steel jacks allowing for an adjustable distraction in the anterior or posterior area as needed. Bone-borne and tooth-borne versions are available. This new distractor can be adjusted sagittally. The distraction can be angular or parallel, and the distraction mode can be modified during post-operative distraction. This device should be adapted to all clinical presentations. It can be used in combination with sliding osteosynthesis to perform a Le Fort 1 osteotomy and at the same time a complete correction of vertical, horizontal, and sagittal deficiencies. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Transpalatal distraction--state of the art for the individual management of transverse maxillary deficiency--a review of 50 consecutive cases.

PubMed

Adolphs, Nicolai; Ernst, Nicole; Menneking, Horst; Hoffmeister, Bodo

2014-12-01

Transpalatal distraction has been established as a technique for surgical assisted rapid palatal/maxillary expansion (SARPE/SARME) in order to correct transverse maxillary deficiency. From 2007 until 2013 bone borne transpalatal distraction devices have been inserted in 50 patients affected by transverse maxillary deficiency and transpalatal distraction has been performed by the same surgical team. Patient records were retrospectively evaluated after ending of the active distraction phase with respect to indication, achieved expansion, additional procedures and side effects. In all cases the existing transverse maxillary deficiency was corrected by means of transpalatal distraction according to the individual needs. No complications were observed that interfered with that therapeutic aim. Evaluation of the records showed a wide variance of parameters which impedes evidence based statements. According to that series transpalatal distraction is a safe, powerful and reliable procedure and can be recommended as a state of the art procedure for the individually adapted correction of transverse maxillary deficiency if well known parameters of distraction are respected. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Incomplete mobilization of the maxilla resulting in failed maxillary distraction: a case report.

PubMed

Alkan, Alper; Inal, Samet; Baş, Burcu; Ozer, Mete

2007-12-01

Maxillary distraction osteogenesis has become an accepted alternative method in the treatment of patients with severe maxillary hypoplasia in craniofacial syndromes and cleft-related deformities. Insufficient distraction, undesirable soft tissue changes, and occurrence of defective distraction vectors are among the potential complications of intraoral maxillary distraction osteogenesis. A 2-stage procedure combining maxillary advancement by distraction technique with genioplasty and mandibular setback surgery was planned to correct jaw deformities in a 22-year-old patient with severe maxillary retrusion, mandibular prognathism, and excessive lower facial height. In the first stage, osteotomies were performed and maxilla was lightly mobilized after down-fracture. Distractors were placed to the maxilla intraorally. During activation period, the maxilla rotated in a clockwise direction, producing a discrepancy between the planned and the actual vectors. Complete distraction was unsatisfactory and the complication was due to surgical technique. This case report presents the failure of maxillary distraction due to incomplete mobilization of the maxilla. Treatment of the case was achieved by the conventional osteotomy techniques at final operation. The maxilla was successfully advanced to the desired position producing good occlusion and an improved facial profile.

Motivation enhances control of positive and negative emotional distractions.

PubMed

Walsh, Amy T; Carmel, David; Harper, David; Grimshaw, Gina M

2018-01-03

Using cognitive control to ignore distractions is essential for successfully achieving our goals. In emotionally-neutral contexts, motivation can reduce interference from irrelevant stimuli by enhancing cognitive control. However, attention is commonly biased towards emotional stimuli, making them potent distractors. Can motivation aid control of emotional distractions, and does it do so similarly for positive and negative stimuli? Here, we examined how task motivation influences control of distraction from positive, negative, and neutral scenes. Participants completed a simple perceptual task while attempting to ignore task-irrelevant images. One group received monetary reward for fast and accurate task performance; another (control) group did not. Overall, both negative (mutilation) and positive (erotic) images caused greater slowing of responses than neutral images of people, but emotional distraction was reduced with reward. Crucially, despite the different motivational directions associated with negative and positive stimuli, reward reduced negative and positive distraction equally. Our findings suggest that motivation may encourage the use of a sustained proactive control strategy that can effectively reduce the impact of emotional distraction.

Distraction and mind-wandering under load.

PubMed

Forster, Sophie

2013-01-01

Attention research over the last several decades has provided rich insights into the determinants of distraction, including distractor characteristics, task features, and individual differences. Load Theory represented a particularly important breakthrough, highlighting the critical role of the level and nature of task-load in determining both the efficiency of distractor rejection and the stage of processing at which this occurs. However, until recently studies of distraction were restricted to those measuring rather specific forms of distraction by external stimuli which I argue that, although intended to be irrelevant, were in fact task-relevant. In daily life, attention may be distracted by a wide range of stimuli, which may often be entirely unrelated to any task being performed, and may include not only external stimuli but also internally generated stimuli such as task-unrelated thoughts. This review outlines recent research examining these more general, entirely task-irrelevant, forms of distraction within the framework of Load Theory. I discuss the relation between different forms of distraction, and the universality of load effects across different distractor types and individuals.

The neural bases of distracter-resistant working memory

PubMed Central

Wager, Tor D.; Spicer, Julie; Insler, Rachel; Smith, Edward E.

2014-01-01

A major difference between humans and other animals is our capacity to maintain information in working memory (WM) while performing secondary tasks, which enables sustained, complex cognition. A common assumption is that the lateral prefrontal cortex (PFC) is critical for WM performance in the presence of distracters, but direct evidence is scarce. We assessed the relationship between fMRI activity and WM performance within-subjects, with performance matched across Distracter and No-distracter conditions. Activity in ventrolateral PFC during WM encoding and maintenance positively predicted performance in both conditions, whereas activity in the pre-supplementary motor area (pre-SMA) predicted performance only under distraction. Other parts of dorsolateral and ventrolateral PFC predicted performance only in the No-distracter condition. These findings challenge a lateral PFC-centered view of distracter-resistance, and suggest that the lateral PFC supports a type of WM representation that is efficient for dealing with task-irrelevant input but is nonetheless easily disrupted by dual-task demands. PMID:24366656

Does distraction facilitate problem-focused coping with job stress? A 1 year longitudinal study.

PubMed

Shimazu, Akihito; Schaufeli, Wilmar B

2007-10-01

This study examined the sole and combined effects of problem-focused coping and distraction on employee well-being (i.e., stress responses and job performance) using two-wave panel survey data with a 1-year time lag. Participants were 488 male employees, who worked for a construction machinery company in western Japan. Hierarchical multiple regression analyses were conducted to examine whether distraction moderates the relationship of problem-focused coping with well-being. More use of problem-focused coping was negatively related to subsequent stress responses among those high in distraction. The combination of high problem-focused coping and high distraction was positively related to subsequent job performance, although it was limited only to the high job stress situation. Results suggest that the combination of high problem-focused coping and high distraction may lead to lower stress responses and better performance (but only in high job stress situations for performance) than the combination of high problem-focused coping and low distraction, at least for male blue-collar workers.

The role of computer-aided 3D surgery and stereolithographic modelling for vector orientation in premaxillary and trans-sinusoidal maxillary distraction osteogenesis.

PubMed

Varol, Altan; Basa, Selçuk

2009-06-01

Maxillary distraction osteogenesis is a challenging procedure when it is performed with internal submerged distractors due to obligation of setting accurate distraction vectors. Five patients with severe maxillary retrognathy were planned with Mimics 10.01 CMF and Simplant 10.01 software. Distraction vectors and rods of distractors were arranged in 3D environment and on STL models. All patients were operated under general anaesthesia and complete Le Fort I downfracture was performed. All distractions were performed according to orientated vectors. All patients achieved stable occlusion and satisfactory aesthetic outcome at the end of the treatment period. Preoperative bending of internal maxillary distractors prevents significant loss of operation time. 3D computer-aided surgical simulation and model surgery provide accurate orientation of distraction vectors for premaxillary and internal trans-sinusoidal maxillary distraction. Combination of virtual surgical simulation and stereolithographic models surgery can be validated as an effective method of preoperative planning for complicated maxillofacial surgery cases.

A simplified modification of a reconstruction plate into a mandibular transport distraction device: A technical note.

PubMed

Mohanty, Sujata; Dabas, Jitender; Gupta, Rekha

2015-01-01

Transport distraction is nowadays gaining enormous popularity and is becoming a promising option for reconstruction of mandibular defects. However, the vast number of distraction device designs create huge confusion in the clinician's mind to choose the right one. Considering these complex and costly designs, the authors decided to find a simplified way of combining a modified conventional reconstruction plate and monofocal distraction device that can act as a transport distraction device for bridging of bony defects. A case performed by this technique and device has been presented along with the description of device design.

Management of Cleft Maxillary Hypoplasia with Anterior Maxillary Distraction: Our Experience.

PubMed

Chacko, Tojan; Vinod, Sankar; Mani, Varghese; George, Arun; Sivaprasad, K K

2014-12-01

Maxillary hypoplasia is a common developmental problem in cleft lip and palate deformities. Since 1970s these deformities have traditionally been corrected by means of orthognathic surgery. Management of skeletal deformities in the maxillofacial region has been an important challenge for maxillofacial surgeons and orthodontists. Distraction osteogenesis is a surgical technique that uses body's own repairing mechanisms for optimal reconstruction of the tissues. We present four cases of anterior maxillary distraction osteogenesis with tooth borne distraction device-Hyrax, which were analyzed retrospectively for the efficacy of the tooth borne device-Hyrax and skeletal stability of distracted anterior maxillary segment.

Pedicle distraction increases intervertebral and spinal canal area in a cadaver and bone model

PubMed Central

Hughes, Matthew; Papadakos, Nikolaos; Bishop, Tim; Bernard, Jason

2018-01-01

Introduction: Lumbar spinal stenosis is degenerative narrowing of the spinal canal and/or intervertebral foramen causing compression of the spinal cord and nerve roots. Traditional decompression techniques can often cause significant trauma and vertebral instability. This paper evaluates a method of increasing pedicle length to decompress the spinal and intervertebral foramen, which could be done minimally invasive. Methods: Three Sawbone (Sawbones Europe, Sweden) and 1 cadaveric lumbar spine underwent bilateral pedicle distraction at L4. A pedicle channel was drilled between the superior articular process and transverse process into the vertebral body. The pedicles underwent osteotomy at the midpoint. Screws were inserted bilaterally and fixated distraction of 0 mm, 2 mm, 4 mm and 6 mm. CT images were taken at each level of distraction. Foramen area was measured in the sagittal plane at L3/4. Spinal canal area was measured at L4 in the axial images. The cadaver was used to evaluate safety of osteotomy and soft tissue interactions preventing distraction. Statistical analysis was by student paired t-test and Pearson rank test. Results: Increasing distraction led to greater Spinal canal area. From 4.27 cm2 to 5.72 cm2 (p = 0.002) with 6 mm distraction. A Maximal increase of 34.1%. Vertebral foramen area also increased with increasing pedicle distraction. From 2.43 cm2 to 3.22 cm2 (p = 0.022) with 6 mm distraction. A maximal increase of 32.3%. The cadaver spinal canal increased in area by 21.7%. The vertebral foramen increased in area by 36.2% (left) and 22.6% (right). Discussion: For each increase in pedicle distraction the area of the spinal and vertebral foramen increases. Pedicle distraction could potentially be used to alleviate spinal stenosis and root impingement. A potential osteotomy plane could be at the midpoint of the pedicle with minimal risk to nerve roots and soft tissue restrictions to prevent distraction. PMID:29727270

Pedicle distraction increases intervertebral and spinal canal area in a cadaver and bone model.

PubMed

Hughes, Matthew; Papadakos, Nikolaos; Bishop, Tim; Bernard, Jason

2018-01-01

Lumbar spinal stenosis is degenerative narrowing of the spinal canal and/or intervertebral foramen causing compression of the spinal cord and nerve roots. Traditional decompression techniques can often cause significant trauma and vertebral instability. This paper evaluates a method of increasing pedicle length to decompress the spinal and intervertebral foramen, which could be done minimally invasive. Three Sawbone (Sawbones Europe, Sweden) and 1 cadaveric lumbar spine underwent bilateral pedicle distraction at L4. A pedicle channel was drilled between the superior articular process and transverse process into the vertebral body. The pedicles underwent osteotomy at the midpoint. Screws were inserted bilaterally and fixated distraction of 0 mm, 2 mm, 4 mm and 6 mm. CT images were taken at each level of distraction. Foramen area was measured in the sagittal plane at L3/4. Spinal canal area was measured at L4 in the axial images. The cadaver was used to evaluate safety of osteotomy and soft tissue interactions preventing distraction. Statistical analysis was by student paired t-test and Pearson rank test. Increasing distraction led to greater Spinal canal area. From 4.27 cm 2 to 5.72 cm 2 (p = 0.002) with 6 mm distraction. A Maximal increase of 34.1%. Vertebral foramen area also increased with increasing pedicle distraction. From 2.43 cm 2 to 3.22 cm 2 (p = 0.022) with 6 mm distraction. A maximal increase of 32.3%. The cadaver spinal canal increased in area by 21.7%. The vertebral foramen increased in area by 36.2% (left) and 22.6% (right). For each increase in pedicle distraction the area of the spinal and vertebral foramen increases. Pedicle distraction could potentially be used to alleviate spinal stenosis and root impingement. A potential osteotomy plane could be at the midpoint of the pedicle with minimal risk to nerve roots and soft tissue restrictions to prevent distraction. © The Authors, published by EDP Sciences, 2018.

“Maybe I Will Just Send a Quick Text…” – An Examination of Drivers’ Distractions, Causes, and Potential Interventions

PubMed Central

Johansson, Ole J.; Fyhri, Aslak

2017-01-01

Many people use cars all over the world. This is, however, not done without risk, as traffic accidents are one of the most common causes of death for adolescents worldwide. The number of deaths has steadily decreased, both worldwide and in Norway. Many of these accidents involve passenger cars and distracted driving. While there are many campaigns to improve safety in traffic, little research has looked at distractions. A recent report has investigated the occurrence of and damage caused by distraction, and one article has looked at what predicts baseline differences in levels of distracted driving. However, no one has tested an intervention to decrease distracted behavior in traffic. Motivational variables suggested by the Theory of Planned Behavior, personality traits, and demographic variables show utility in similar contexts and are all tested in this project. Data from two samples were collected to investigate the nature of distractions in traffic, what factors predict baseline levels of distractions, and to test an intervention to reduce distractions. Both samples feature randomly assigned intervention and control groups. The first sample (n = 1100 total; n = 208 was licensed to drive) consisted of high school students from all over Norway as a part of a larger attitudinal campaign, while the second sample (n = 414) was more general. The second tested a digital version of implementation intentions designed as volitional help sheets. The results from both samples suggest that there are some robust differences between people in how much they are distracted in everyday life, while some variables need further research. The second study failed to uncover any effects of the intervention. Reasons for this are discussed, along with points on the efficacy of digital interventions, the design of the volitional help sheets, and the design of the study in general. Notwithstanding the ineffectual interventions, this study contains novel information about baseline differences in distractive behavior that may further impact future behavior change interventions and guide future research. PMID:29204129

"Maybe I Will Just Send a Quick Text…" - An Examination of Drivers' Distractions, Causes, and Potential Interventions.

PubMed

Johansson, Ole J; Fyhri, Aslak

2017-01-01

Many people use cars all over the world. This is, however, not done without risk, as traffic accidents are one of the most common causes of death for adolescents worldwide. The number of deaths has steadily decreased, both worldwide and in Norway. Many of these accidents involve passenger cars and distracted driving. While there are many campaigns to improve safety in traffic, little research has looked at distractions. A recent report has investigated the occurrence of and damage caused by distraction, and one article has looked at what predicts baseline differences in levels of distracted driving. However, no one has tested an intervention to decrease distracted behavior in traffic. Motivational variables suggested by the Theory of Planned Behavior, personality traits, and demographic variables show utility in similar contexts and are all tested in this project. Data from two samples were collected to investigate the nature of distractions in traffic, what factors predict baseline levels of distractions, and to test an intervention to reduce distractions. Both samples feature randomly assigned intervention and control groups. The first sample ( n = 1100 total; n = 208 was licensed to drive) consisted of high school students from all over Norway as a part of a larger attitudinal campaign, while the second sample ( n = 414) was more general. The second tested a digital version of implementation intentions designed as volitional help sheets. The results from both samples suggest that there are some robust differences between people in how much they are distracted in everyday life, while some variables need further research. The second study failed to uncover any effects of the intervention. Reasons for this are discussed, along with points on the efficacy of digital interventions, the design of the volitional help sheets, and the design of the study in general. Notwithstanding the ineffectual interventions, this study contains novel information about baseline differences in distractive behavior that may further impact future behavior change interventions and guide future research.

[Analysis of the results of bone healing in femurs lengthened by the gradual distraction method in children and adolescents].

PubMed

Jochymek, J; Skvaril, J; Ondrus, S

2009-10-01

Treatment of leg length inequality via lengthening of the shorter extremity is an infrequent orthopedic procedure due to the requirement of special distraction devices and possible serious complications. Essential qualitative changes in operative technique development are associated with the name of G. A. Ilizarov, who paved the way for the autoregenerate gradual distraction method in the 1950s. In the years 1990 through 2007 a total of 67 patients underwent femur lengthening via gradual distraction using various types of external fixators at the Department of Pediatric Surgery, Orthopedics, and Traumatology, Faculty Hospital in Brno. The quality of bone healing was monitored and a number of parameters followed and statistically evaluated using regularly scheduled X-ray examinations. In 13 cases we had to remove the external fixator following the distraction phase, perform an osteosynthesis via a splint and fill the distraction gap via spongioplasty. The bone healing was satisfactory in the remaining 54 patients and the lengthened bone required no other fixation method. The analysis showed statistically significant deceleration in bone healing following distraction in female patients over 12 years of age, and in boys over 14 years of age. Lack of periosteal callus five weeks after surgery always signified serious problems in further healing. Severe complications were recorded in 11 cases during the distraction phase, and in 12 cases after the removal of the distraction apparatus. Our results fully correspond with the data and experience of others cited authors. In addition our study showed deceleration in bone healing in girls over 12 years and in boys over 14 years of age and serious problem in healing when is lack of periostal callus five weeks after surgery. The aim of this report was to present the results of our study of distraction gap bone healing using the gradual lengthening approach. Key words: leg lengthening, gradual distraction, external fixation, leg discrepancy, complication.

Driver Distraction Using Visual-Based Sensors and Algorithms.

PubMed

Fernández, Alberto; Usamentiaga, Rubén; Carús, Juan Luis; Casado, Rubén

2016-10-28

Driver distraction, defined as the diversion of attention away from activities critical for safe driving toward a competing activity, is increasingly recognized as a significant source of injuries and fatalities on the roadway. Additionally, the trend towards increasing the use of in-vehicle information systems is critical because they induce visual, biomechanical and cognitive distraction and may affect driving performance in qualitatively different ways. Non-intrusive methods are strongly preferred for monitoring distraction, and vision-based systems have appeared to be attractive for both drivers and researchers. Biomechanical, visual and cognitive distractions are the most commonly detected types in video-based algorithms. Many distraction detection systems only use a single visual cue and therefore, they may be easily disturbed when occlusion or illumination changes appear. Moreover, the combination of these visual cues is a key and challenging aspect in the development of robust distraction detection systems. These visual cues can be extracted mainly by using face monitoring systems but they should be completed with more visual cues (e.g., hands or body information) or even, distraction detection from specific actions (e.g., phone usage). Additionally, these algorithms should be included in an embedded device or system inside a car. This is not a trivial task and several requirements must be taken into account: reliability, real-time performance, low cost, small size, low power consumption, flexibility and short time-to-market. The key points for the development and implementation of sensors to carry out the detection of distraction will also be reviewed. This paper shows a review of the role of computer vision technology applied to the development of monitoring systems to detect distraction. Some key points considered as both future work and challenges ahead yet to be solved will also be addressed.

Anterior ankle arthroscopy, distraction or dorsiflexion?

PubMed

de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek

2010-05-01

Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.

Ankylosis of temporomandibular joints after mandibular distraction osteogenesis in patients with Nager syndrome: Report of two cases and literature review.

PubMed

Wu, Cheng Chun; Sakahara, Daisuke; Imai, Keisuke

2017-10-01

Nager syndrome, also known as Nager acrofacial dysostosis, was first described by Nager and de Reynier in 1948. The patients commonly present with micrognathia, and a preventive tracheostomy is necessary when there are symptoms of upper airway obstruction. Mandibular distraction osteogenesis is considered as an effective procedure, which not only improves micrognathia but also minimizes the chances of tracheostomy. However, mandibular distraction osteogenesis has some complications such as relapse, teeth injury, infection, and injury of the temporomandibular joints (TMJs). In this study, the author reported two patients with Nager syndrome who suffered from ankylosis of TMJs after mandibular distraction osteogenesis. In addition, a comprehensive literature review of post-distraction ankylosis of TMJs in patients with Nager syndrome was performed. Few studies demonstrated the condition of TMJs after mandibular distraction osteogenesis, and three studies were identified from the review. One study reported ankylosis of bilateral coronoid processes, in which coronoidectomies were necessary. Another study reported the use of prostheses to replace the ankylosed joints in a patient who had undergone many surgeries of the joints, such as gap arthroplasties, reconstructions with costochondral grafts, etc. One other study raised the concept of unloading the condyles during the mandibular distraction to prevent subsequent ankylosis. It seems that multiple factors are related to the ankylosis of TMJs after mandibular distraction osteogenesis in patients with Nager syndrome. Prevention of post-distraction ankylosis of the joints is important because the treatment is difficult and not always effective. We should conduct more studies about protection of the joints during mandibular distraction in the future. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Anterior ankle arthroscopy, distraction or dorsiflexion?

PubMed Central

Golanó, Pau; Clavero, Joan A.; van Dijk, C. Niek

2010-01-01

Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7–1.5) and 0.7 cm (range 0.5–0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy. PMID:20217392

Circumplex Model of Affect: A Measure of Pleasure and Arousal During Virtual Reality Distraction Analgesia.

PubMed

Sharar, Sam R; Alamdari, Ava; Hoffer, Christine; Hoffman, Hunter G; Jensen, Mark P; Patterson, David R

2016-06-01

Immersive virtual reality (VR) distraction provides clinically effective pain relief and increases subjective reports of "fun" in medical settings of procedural pain. The goal of this study was to better describe the variable of "fun" associated with VR distraction analgesia using the circumplex model (pleasure/arousal) of affect. Seventy-four healthy volunteers (mean age, 29 years; 37 females) received a standardized, 18-minute, multimodal pain sequence (alternating thermal heat and electrical stimulation to distal extremities) while receiving immersive, interactive VR distraction. Subjects rated both their subjective pain intensity and fun using 0-10 Graphic Rating Scales, as well as the pleasantness of their emotional valence and their state of arousal on 9-point scales. Compared with pain stimulation in the control (baseline, no VR) condition, immersive VR distraction significantly reduced subjective pain intensity (P < 0.001). During VR distraction, compared with those reporting negative affect, subjects reporting positive affect did so more frequently (41 percent versus 9 percent), as well as reporting both greater pain reduction (22 percent versus 1 percent) and fun scores (7.0 ± 1.9 versus 2.4 ± 1.4). Several factors-lower anxiety, greater fun, greater presence in the VR environment, and positive emotional valence-were associated with subjective analgesia during VR distraction. Immersive VR distraction reduces subjective pain intensity induced by multimodal experimental nociception. Subjects who report less anxiety, more fun, more VR presence, and more positive emotional valence during VR distraction are more likely to report subjective pain reduction. These findings indicate VR distraction analgesia may be mediated through anxiolytic, attentional, and/or affective mechanisms.

Circumplex Model of Affect: A Measure of Pleasure and Arousal During Virtual Reality Distraction Analgesia

PubMed Central

Alamdari, Ava; Hoffer, Christine; Hoffman, Hunter G.; Jensen, Mark P.; Patterson, David R.

2016-01-01

Abstract Objective: Immersive virtual reality (VR) distraction provides clinically effective pain relief and increases subjective reports of “fun” in medical settings of procedural pain. The goal of this study was to better describe the variable of “fun” associated with VR distraction analgesia using the circumplex model (pleasure/arousal) of affect. Materials and Methods: Seventy-four healthy volunteers (mean age, 29 years; 37 females) received a standardized, 18-minute, multimodal pain sequence (alternating thermal heat and electrical stimulation to distal extremities) while receiving immersive, interactive VR distraction. Subjects rated both their subjective pain intensity and fun using 0–10 Graphic Rating Scales, as well as the pleasantness of their emotional valence and their state of arousal on 9-point scales. Results: Compared with pain stimulation in the control (baseline, no VR) condition, immersive VR distraction significantly reduced subjective pain intensity (P < 0.001). During VR distraction, compared with those reporting negative affect, subjects reporting positive affect did so more frequently (41 percent versus 9 percent), as well as reporting both greater pain reduction (22 percent versus 1 percent) and fun scores (7.0 ± 1.9 versus 2.4 ± 1.4). Several factors—lower anxiety, greater fun, greater presence in the VR environment, and positive emotional valence—were associated with subjective analgesia during VR distraction. Conclusions: Immersive VR distraction reduces subjective pain intensity induced by multimodal experimental nociception. Subjects who report less anxiety, more fun, more VR presence, and more positive emotional valence during VR distraction are more likely to report subjective pain reduction. These findings indicate VR distraction analgesia may be mediated through anxiolytic, attentional, and/or affective mechanisms. PMID:27171578

Driver Distraction Using Visual-Based Sensors and Algorithms

PubMed Central

Fernández, Alberto; Usamentiaga, Rubén; Carús, Juan Luis; Casado, Rubén

2016-01-01

Driver distraction, defined as the diversion of attention away from activities critical for safe driving toward a competing activity, is increasingly recognized as a significant source of injuries and fatalities on the roadway. Additionally, the trend towards increasing the use of in-vehicle information systems is critical because they induce visual, biomechanical and cognitive distraction and may affect driving performance in qualitatively different ways. Non-intrusive methods are strongly preferred for monitoring distraction, and vision-based systems have appeared to be attractive for both drivers and researchers. Biomechanical, visual and cognitive distractions are the most commonly detected types in video-based algorithms. Many distraction detection systems only use a single visual cue and therefore, they may be easily disturbed when occlusion or illumination changes appear. Moreover, the combination of these visual cues is a key and challenging aspect in the development of robust distraction detection systems. These visual cues can be extracted mainly by using face monitoring systems but they should be completed with more visual cues (e.g., hands or body information) or even, distraction detection from specific actions (e.g., phone usage). Additionally, these algorithms should be included in an embedded device or system inside a car. This is not a trivial task and several requirements must be taken into account: reliability, real-time performance, low cost, small size, low power consumption, flexibility and short time-to-market. The key points for the development and implementation of sensors to carry out the detection of distraction will also be reviewed. This paper shows a review of the role of computer vision technology applied to the development of monitoring systems to detect distraction. Some key points considered as both future work and challenges ahead yet to be solved will also be addressed. PMID:27801822

Internal maxillary distraction with a new bimalar device.

PubMed

Kahn, David M; Broujerdi, Joseph; Schendel, Stephen A

2008-04-01

Distraction osteogenesis of the Le Fort I segment is advocated for patients who require significant advancement of the maxilla or who have a soft tissue envelope compromised by scar tissue. We present a technique for maxillary distraction using an interconnecting intraoral device anchored to the malar prominences above the osteotomy and either the maxilla and/or the dentition below the level of the osteotomy. Ten patients with nonsyndromic cleft lip and palate, mean age of 18, underwent Le Fort I maxillary distraction osteogenesis for management of maxillary hypoplasia. A Le Fort I osteotomy is performed and a Spectrum Intraoral Midface Multi-Vector Distractor (OsteoMed, Addison, TX) is placed leaving a 1 mm to 2 mm distraction gap. After a 2 to 4 day latency period, distraction begins at a rate of 1 mm a day. Once the desired occlusion is achieved the device is left in place for a minimum of 2 months for consolidation. Preoperative Sella-Nasion-A point measurements from lateral cephalograms averaged 74 degrees (range, 70-76 degrees). Postoperative Sella-Nasion-A point averaged 81 degrees (range, 75-89 degrees). Preoperative overjet averaged -7.4 mm (range, -3 to -13 mm). Postoperative overjet averaged 2.6 mm (range, 1-3 mm). Average distraction was 9 mm (range, 6-16 mm). The average vertical movement was 7.2 mm in an inferior direction (range, 0-15 mm). The results remained stable at a follow-up of 30 months. We report on distraction of the Le Fort I segment using an internal device. The device design allows the forces of distraction to be shared across a larger surface area delivering a uniform and reliable vector of distraction with increased stability.

Relaxation and Distraction in Experimental Desensitization.

ERIC Educational Resources Information Center

Weir, R. O.; Marshall, W. L.

1980-01-01

Compared experimental desensitization with a procedure that replaced relaxation with a distraction task and with an approach that combined both relaxation and distraction. Desensitization generally was more effective than the other two procedures. (Author)

Soft tissue balance changes depending on joint distraction force in total knee arthroplasty.

PubMed

Nagai, Kanto; Muratsu, Hirotsugu; Matsumoto, Tomoyuki; Miya, Hidetoshi; Kuroda, Ryosuke; Kurosaka, Masahiro

2014-03-01

The influence of joint distraction force on intraoperative soft tissue balance was evaluated using Offset Repo-Tensor® for 78 knees that underwent primary posterior-stabilized total knee arthroplasty. The joint center gap and varus ligament balance were measured between osteotomized surfaces using 20, 40 and 60 lbs of joint distraction force. These values were significantly increased at extension and flexion as the distraction force increased. Furthermore, lateral compartment stiffness was significantly lower than medial compartment stiffness. Thus, larger joint distraction forces led to larger varus ligament balance and joint center gap, because of the difference in soft tissue stiffness between lateral and medial compartments. These findings indicate the importance of the strength of joint distraction force in the assessment of soft tissue balance, especially when using gap-balancing technique. © 2014.

Differential impact of personality traits on distracted driving behaviors in teens and older adults.

PubMed

Parr, Morgan N; Ross, Lesley A; McManus, Benjamin; Bishop, Haley J; Wittig, Shannon M O; Stavrinos, Despina

2016-07-01

To determine the impact of personality on distracted driving behaviors. Participants included 120 drivers (48 teens, 72 older adults) who completed the 45-item Big Five Personality questionnaire assessing self-reported personality factors and the Questionnaire Assessing Distracted Driving (QUADD) assessing the frequency of distracted driving behaviors. Associations for all five personality traits with each outcome (e.g., number of times texting on the phone, talking on the phone, and interacting with the phone while driving) were analyzed separately for teens and older adults using negative binomial or Poisson regressions that controlled for age, gender and education. In teens, higher levels of openness and conscientiousness were predictive of greater reported texting frequency and interacting with a phone while driving, while lower levels of agreeableness was predictive of fewer reported instances of texting and interacting with a phone while driving. In older adults, greater extraversion was predictive of greater reported talking on and interacting with a phone while driving. Other personality factors were not significantly associated with distracted driving behaviors. Personality traits may be important predictors of distracted driving behaviors, though specific traits associated with distracted driving may vary across age groups. The relationship between personality and distracted driving behaviors provides a unique opportunity to target drivers who are more likely to engage in distracted driving behavior, thereby increasing the effectiveness of educational campaigns and improving driving safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

Perpendicular serial maxillary distraction osteogenesis in cleft lip and palate patients

PubMed Central

Ylikontiola, Leena P.; Sándor, George K.; Harila, Virpi

2015-01-01

Background: Cleft lip and palate patients often have a retruded maxilla with a severely narrowed deficient maxillary arch. This report aims to describe the management of severe maxillary retrusion and constriction in cleft lip and palate patients using distraction osteogenesis applied in serial sequence in two directions perpendicular to each other. Materials and Methods: Two adult male cleft lip and palate patients were treated with maxillary distraction osteogenesis in two stages. In the first stage, surgically assisted rapid palatal expansion with a tooth-borne device was performed to significantly expand the maxillary arch in the transverse dimension. After the teeth were orthodontically aligned, the horizontal distraction of the maxilla was made by two internal maxillary distraction devices. Results: In the first patient, the maxilla was initially widened by 11 mm and then distracted forward by 20 mm. Despite the breakage of the shaft of one of the two distractors at the end of distraction, a satisfactory occlusion was found at the time of distractor device removal. The maxillary position has remained stable through 8 years of follow-up. In the second patient, the palate was widened by 14 mm and the maxilla was distracted forward by 22 mm. The maxillary position has remained stable through 3 years of follow-up. Conclusion: Sequential serial distraction of maxilla in two planes perpendicular to each other is a safe and stable approach for the treatment of cleft lip and palate patients with severe transverse and anteroposterior discrepancies. PMID:26981462

Perpendicular serial maxillary distraction osteogenesis in cleft lip and palate patients.

PubMed

Ylikontiola, Leena P; Sándor, George K; Harila, Virpi

2015-01-01

Cleft lip and palate patients often have a retruded maxilla with a severely narrowed deficient maxillary arch. This report aims to describe the management of severe maxillary retrusion and constriction in cleft lip and palate patients using distraction osteogenesis applied in serial sequence in two directions perpendicular to each other. Two adult male cleft lip and palate patients were treated with maxillary distraction osteogenesis in two stages. In the first stage, surgically assisted rapid palatal expansion with a tooth-borne device was performed to significantly expand the maxillary arch in the transverse dimension. After the teeth were orthodontically aligned, the horizontal distraction of the maxilla was made by two internal maxillary distraction devices. In the first patient, the maxilla was initially widened by 11 mm and then distracted forward by 20 mm. Despite the breakage of the shaft of one of the two distractors at the end of distraction, a satisfactory occlusion was found at the time of distractor device removal. The maxillary position has remained stable through 8 years of follow-up. In the second patient, the palate was widened by 14 mm and the maxilla was distracted forward by 22 mm. The maxillary position has remained stable through 3 years of follow-up. Sequential serial distraction of maxilla in two planes perpendicular to each other is a safe and stable approach for the treatment of cleft lip and palate patients with severe transverse and anteroposterior discrepancies.

The role of age, working memory, and response inhibition in deviance distraction: A cross-sectional study.

PubMed

Leiva, Alicia; Andrés, Pilar; Servera, Mateu; Verbruggen, Frederick; Parmentier, Fabrice B R

2016-09-01

Sounds deviating from an otherwise repeated or structured sequence capture attention and affect performance in an ongoing visual task negatively, testament to the balance between selective attention and change detection. Although deviance distraction has been the object of much research, its modulation across the life span has been more scarcely addressed. Recent findings suggest possible connections with working memory and response inhibition. In this study we measured the performance of children and young and older adults in a cross-modal oddball task (deviance distraction), a working memory task (working memory capacity), and a response inhibition task (ability to voluntarily inhibit an already planned action) with the aim to establish the contribution of the latter 2 to the first. Older adults exhibited significantly more deviance distraction than children and young adults (who did not differ from each other). Working memory capacity mediated deviance distraction in children and older adults (though in opposite directions) but not in young adults. Response inhibition capacities did not mediate deviance distraction in any of the age groups. Altogether the results suggest that although the increase in deviance distraction observed in old age may partly reflect the relative impairment of working memory mechanisms, there is no straightforward and stable relation between working memory capacity and deviance distraction across the life span. Furthermore, our results indicate that deviance distraction is unlikely to reflect the temporary inhibition of responses. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Does distraction reduce the alcohol-aggression relation? A cognitive and behavioral test of the attention-allocation model.

PubMed

Gallagher, Kathryn E; Parrott, Dominic J

2011-06-01

This study provided the first direct test of the cognitive underpinnings of the attention-allocation model and attempted to replicate and extend past behavioral findings for this model as an explanation for alcohol-related aggression. A diverse community sample (55% African American) of men (N = 159) between 21 and 35 years of age (M = 25.80) were randomly assigned to 1 of 2 beverage conditions (i.e., alcohol, no-alcohol control) and 1 of 2 distraction conditions (i.e., distraction, no-distraction). Following beverage consumption, participants were provoked via reception of electric shocks and a verbal insult from a fictitious male opponent. Participants' attention allocation to aggression words (i.e., aggression bias) and physical aggression were measured using a dot probe task and a shock-based aggression task, respectively. Intoxicated men whose attention was distracted displayed significantly lower levels of aggression bias and enacted significantly less physical aggression than intoxicated men whose attention was not distracted. However, aggression bias did not account for the lower levels of alcohol-related aggression in the distraction, relative to the no-distraction, condition. These results replicated and extended past evidence that cognitive distraction is associated with lower levels of alcohol-related aggression in highly provoked males and provide the first known cognitive data to support the attentional processes posited by the attention-allocation model. Discussion focused on how these data inform intervention programming for alcohol-related aggression. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Does Distraction Reduce the Alcohol-Aggression Relation?: A Cognitive and Behavioral Test of the Attention-Allocation Model

PubMed Central

Gallagher, Kathryn E.; Parrott, Dominic J.

2011-01-01

Objective This study provided the first direct test of the cognitive underpinnings of the attention-allocation model and attempted to replicate and extend past behavioral findings for this model as an explanation for alcohol-related aggression. Method A diverse community sample (55% African-American) of males (N = 159) between 21 and 35 years of age (M = 25.80) were randomly assigned to one of two beverage conditions (i.e., alcohol, no-alcohol control) and one of two distraction conditions (i.e., distraction, no-distraction). Following beverage consumption, participants were provoked via reception of electric shocks and a verbal insult from a fictitious male opponent. Participants’ attention-allocation to aggression words (i.e., aggression bias) and physical aggression were measured using a dot probe task and a shock-based aggression task, respectively. Results Intoxicated men whose attention was distracted displayed significantly lower levels of aggression bias and enacted significantly less physical aggression than intoxicated men whose attention was not distracted. However, aggression bias did not account for the lower levels of alcohol-related aggression in the distraction, relative to the no-distraction, condition. Conclusions These results replicated and extended past evidence that cognitive distraction is associated with lower levels of alcohol-related aggression in highly provoked males and provide the first known cognitive data to support the attentional processes posited by the attention-allocation model. Discussion focused on how these data inform intervention programming for alcohol-related aggression. PMID:21500889

Driven to Distraction.

PubMed

Strayer, David L; Cooper, Joel M

2015-12-01

We address several themes that emerged in the commentaries related to our target article. First, we consider the relationship between cognitive distraction and crash risk. Second, we discuss the development of our cognitive distraction scale. Third, we weigh issues of self-regulation, appropriate baselines, and satisficing. Finally, we identify several areas where additional research is needed to refine our understanding of driver distraction and crash risk. © 2015, Human Factors and Ergonomics Society.

Big brown bats (Eptesicus fuscus) reveal diverse strategies for sonar target tracking in clutter.

PubMed

Mao, Beatrice; Aytekin, Murat; Wilkinson, Gerald S; Moss, Cynthia F

2016-09-01

Bats actively adjust the acoustic features of their sonar calls to control echo information specific to a given task and environment. A previous study investigated how bats adapted their echolocation behavior when tracking a moving target in the presence of a stationary distracter at different distances and angular offsets. The use of only one distracter, however, left open the possibility that a bat could reduce the interference of the distracter by turning its head. Here, bats tracked a moving target in the presence of one or two symmetrically placed distracters to investigate adaptive echolocation behavior in a situation where vocalizing off-axis would result in increased interference from distracter echoes. Both bats reduced bandwidth and duration but increased sweep rate in more challenging distracter conditions, and surprisingly, made more head turns in the two-distracter condition compared to one, but only when distracters were placed at large angular offsets. However, for most variables examined, subjects showed distinct strategies to reduce clutter interference, either by (1) changing spectral or temporal features of their calls, or (2) producing large numbers of sonar sound groups and consistent head-turning behavior. The results suggest that individual bats can use different strategies for target tracking in cluttered environments.

Letting go of yesterday: Effect of distraction on post-event processing and anticipatory anxiety in a socially anxious sample.

PubMed

Blackie, Rebecca A; Kocovski, Nancy L

2016-01-01

According to cognitive models, post-event processing (PEP) is a key factor in the maintenance of social anxiety. Given that decreasing PEP can be challenging for socially anxious individuals, it is important to identify potentially useful strategies. Although distraction may help to decrease PEP, the findings have been equivocal. The primary purpose of this study was to examine whether a brief distraction period immediately following a speech would lead to less PEP the next day. The secondary aim was to examine the effect of distraction following an initial speech on anticipatory anxiety for a second speech, via reductions in PEP. Participants (N = 77 undergraduates with elevated social anxiety; 67.53% female) delivered a speech and were randomly assigned to a distraction, rumination, or control condition. The following day, participants reported levels of PEP in relation to the first speech, as well as anxiety regarding a second, upcoming speech. As expected, those in the distraction condition reported less PEP than those in the rumination and control conditions. Additionally, distraction following the first speech was indirectly related to anticipatory anxiety for the second speech, via PEP. Distraction may represent a potentially useful strategy for reducing PEP and other maladaptive processes that may maintain social anxiety.

Sustained Efficacy of Virtual Reality Distraction

PubMed Central

Rutter, Charles E.; Dahlquist, Lynnda M.; Weiss, Karen E.

2011-01-01

The current study tested whether the effectiveness of distraction using virtual reality (VR) technology in reducing cold pressor pain would maintain over the course of eight weekly exposures. Twenty-eight adults, 18 to 23 years of age, underwent one baseline cold pressor trial and one VR distraction trial in randomized order each week. VR distraction led to significant increases in pain threshold and pain tolerance, and significant decreases in pain intensity, time spent thinking about pain, and self-reported anxiety, relative to baseline. Repeated exposure did not appear to affect the benefits of VR. Implications for the long-term use of VR distraction as a non-pharmacological analgesic are discussed. PMID:19231295

Impact of distracted driving on congestion.

DOT National Transportation Integrated Search

2011-03-01

Studies have documented a link between distracted driving and diminished safety; however, an association : between distracted driving and traffic congestion has not been investigated in depth. The present study : examined the behavior of teens and yo...

Distraction and Mind-Wandering Under Load

PubMed Central

Forster, Sophie

2013-01-01

Attention research over the last several decades has provided rich insights into the determinants of distraction, including distractor characteristics, task features, and individual differences. Load Theory represented a particularly important breakthrough, highlighting the critical role of the level and nature of task-load in determining both the efficiency of distractor rejection and the stage of processing at which this occurs. However, until recently studies of distraction were restricted to those measuring rather specific forms of distraction by external stimuli which I argue that, although intended to be irrelevant, were in fact task-relevant. In daily life, attention may be distracted by a wide range of stimuli, which may often be entirely unrelated to any task being performed, and may include not only external stimuli but also internally generated stimuli such as task-unrelated thoughts. This review outlines recent research examining these more general, entirely task-irrelevant, forms of distraction within the framework of Load Theory. I discuss the relation between different forms of distraction, and the universality of load effects across different distractor types and individuals. PMID:23734138

Neocondyle distraction osteogenesis in the management of temporomandibular joint ankylosis: Report of five cases with review of literature.

PubMed

Sharma, Ravi; Manikandhan, R; Sneha, P; Parameswaran, Anantanarayanan; Kumar, J Naveen; Sailer, Hermann F

2017-01-01

Management of temporomandibular joint (TMJ) ankylosis is a challenging and rather daunting task owing to complex abnormal anatomy and its sequel to craniofacial structures. Various autogenous grafts and alloplastic materials have been tried with variable success for creation of a near-normal joint. In recent years, neocondyle distraction has added a new dimension to the management of TMJ ankylosis. The aim of this paper is to describe the role of neocondyle distraction in TMJ ankylosis. Neocondyle distraction was carried out in five patients with TMJ ankylosis following gap arthroplasty. Computed tomogram scans were taken before surgery and 1-year postdistraction for surgical planning and postoperative assessment, respectively. The intraoral distractors (KLS Martin, Jacksonville, FL, USA) were used in this study. All five patients reported with adequate mouth opening and functional jaw movements. The procedure was well tolerated by all the patients. None of the patients underwent reankylosis following neocondyle distraction. With proper surgical planning and distraction protocol, neocondyle distraction is an effective and safe technique for TMJ reconstruction and preventing reankylosis.

Arthroscopic ankle arthrodesis with intra-articular distraction.

PubMed

Kim, Hyong Nyun; Jeon, June Young; Noh, Kyu Cheol; Kim, Hong Kyun; Dong, Quanyu; Park, Yong Wook

2014-01-01

Arthroscopic ankle arthrodesis has shown high rates of union comparable to those with open arthrodesis but with substantially less postoperative morbidity, shorter operative times, less blood loss, and shorter hospital stays. To easily perform arthroscopic resection of the articular cartilage, sufficient distraction of the joint is necessary to insert the arthroscope and instruments. However, sometimes, standard noninvasive ankle distraction will not be sufficient in post-traumatic ankle arthritis, with the development of arthrofibrosis and joint contracture after severe ankle trauma. In the present report, we describe a technique to distract the ankle joint by inserting a 4.6-mm stainless steel cannula with a blunt trocar inside the joint. The cannula allowed sufficient intra-articular distraction, and, at the same time, a 4.0-mm arthroscope can be inserted through the cannula to view the joint. Screws can be inserted to fix the joint under fluoroscopic guidance without changing the patient's position or removing the noninvasive distraction device and leg holder, which are often necessary during standard arthroscopic arthrodesis with noninvasive distraction. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Results of distraction callus osteogenesis in hand and foot in Iran: A 15-year experience

PubMed Central

Forootan, Kamal Seyed; Forootan, Nazila Seyed; Lebaschi, Amir Hussein

2015-01-01

Background: Distraction osteogenesis (DS) is currently an important technique for lengthening shortened bones of the hand and foot. Authors report their experience in applying DS for various conditions of the hand and foot using a distractor that the senior author has designed. Materials and Methods: Records of patients who underwent DS for hand and foot conditions in a private clinic were retrieved between January 2001 and January 2015. Data concerning distraction, outcome, and complications were recorded. Results: There were 17 patients, 7 males, and 10 females with a total 24 distractions. The mean length gained was 21.2 mm (1.69) and the mean total treatment time was 198.58 (15.88) days. Overall, complications occurred in 9 (37.5%) distractions. Major complications occurred in 2 (8.33%) of distractions. Minor complications occurred in 7 (29.2%) distractions. Conclusion: DS is an effective modality for lengthening bones of the hand and feet for both traumatic and congenital conditions. Joint stiffness/contracture is an important complication following DS of the metatarsals. PMID:26487873

Initial Experience With a New Intraoral Midface Distraction Device.

PubMed

Burstein, Fernando; Soldanska, Magdalena; Granger, Michael; Berhane, ChiChi; Schoemann, Mark

2015-06-01

Maxillary hypoplasia that necessitates surgical advancement affects approximately 25% of patients born with cleft lip and palate. Syndromic conditions such as Crouzon may also be accompanied by significant maxillary hypoplasia. Severe maxillary hypoplasia can result in airway obstruction, malocclusion, proptosis, and facial disfigurement. For optimal stability, severe hypoplasia is best addressed with maxillary distraction osteogenesis. Twenty-two patients (15 boys, 7 girls, ages 6-16 years, mean age 10 years) with severe midface hypoplasia underwent midface distraction with new internal maxillary distraction (IMD) device at our institution. Total distraction distances ranged from 15 to 30 mm. There were no major complications, and all of them had improvement in functional and aesthetic parameters. There were 2 minor complications and 2 patients failed to distract the full distance because of converging vectors. Early maxillary distraction in patients with severe midface hypoplasia is a useful technique to provide interval correction of severe maxillary hypoplasia before skeletal maturity and definitive orthognathic surgery is contemplated, and it is a good tool to improve occlusion, aesthetics, and self-perception in younger patients.

Initial Experience With a New Intraoral Midface Distraction Device

PubMed Central

Burstein, Fernando; Soldanska, Magdalena; Granger, Michael; Berhane, ChiChi; Schoemann, Mark

2015-01-01

Abstract Maxillary hypoplasia that necessitates surgical advancement affects approximately 25% of patients born with cleft lip and palate. Syndromic conditions such as Crouzon may also be accompanied by significant maxillary hypoplasia. Severe maxillary hypoplasia can result in airway obstruction, malocclusion, proptosis, and facial disfigurement. For optimal stability, severe hypoplasia is best addressed with maxillary distraction osteogenesis. Twenty-two patients (15 boys, 7 girls, ages 6–16 years, mean age 10 years) with severe midface hypoplasia underwent midface distraction with new internal maxillary distraction (IMD) device at our institution. Total distraction distances ranged from 15 to 30 mm. There were no major complications, and all of them had improvement in functional and aesthetic parameters. There were 2 minor complications and 2 patients failed to distract the full distance because of converging vectors. Early maxillary distraction in patients with severe midface hypoplasia is a useful technique to provide interval correction of severe maxillary hypoplasia before skeletal maturity and definitive orthognathic surgery is contemplated, and it is a good tool to improve occlusion, aesthetics, and self-perception in younger patients. PMID:26080162

Long-term stability of intra-oral maxillary distraction in unilateral cleft lip and palate: a case report.

PubMed

Nevzatoğlu, Sirin; Küçükkeleş, Nazan; Güzel, Zeki

2013-11-01

This case report presents short and long-term treatment results of a unilateral cleft lip and palate patient treated with a modified intra-oral tooth-bone borne distraction appliance. The chief complaints of a 16 year-old, unilateral cleft lip and palate patient were poor facial aesthetics, crowding and a fistula. Severe maxillary retrognathism was treated via distraction osteogenesis of the maxilla and performed using an intra-oral tooth-bone borne appliance. Treatment continued to completion with a multibracket system. At an eight-year review following the distraction procedure, the short and long-term results were determined cephalometrically. Following the distraction, A-point advanced 7 mm, 2 mm of which relapsed during fixed appliance treatment. At the end of the active treatment, the patient's skeletal and dental Class III relationship improved to Class I, which was preserved at the long-term review. The profile was markedly improved by the distraction osteogenesis. In cases of severe maxillary retrognathism as a result of a cleft lip and palate, maxillary distraction osteogenesis provides a viable alternative to orthognathic surgery.

77 FR 61048 - Distracted Driving Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

... DEPARTMENT OF TRANSPORTATION National Highway Traffic Safety Administration Distracted Driving Grant Program AGENCY: National Highway Traffic Safety Administration (NHTSA), Department of... distracted driving grants on August 24, 2012. In this notice, DOT is extending the application submission...

Advancement of the anterior maxilla by distraction (case report).

PubMed

Karakasis, Dimitri; Hadjipetrou, Loucia

2004-06-01

Several techniques of distraction osteogenesis have been applied for the correction of compromised midface in patients with clefts of the lip, alveolus and palate. This article presents a technique of callus distraction applied in a specific case of hypoplasia of a cleft maxilla with the sagittal advancement of the maxilla thus not affecting velopharyngeal function. The decision to apply distraction osteogenesis for advancement of the anterior maxillary segment in cleft patients offers many advantages.

Editorial Commentary: Ankle Arthroscopy: Correct Portals and Distraction Are the Keys to Success.

PubMed

Ferkel, Richard D

2016-07-01

Access to all areas of the ankle during arthroscopy is always problematic. The use of the correct portals and distraction increases access in both the supine and prone positions. Noninvasive distraction up to 30 pounds is safe and effective to perform arthroscopy in the supine position, and avoids the potential complications of pin distraction. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Effects of Videogame Distraction and a Virtual Reality Type Head-Mounted Display Helmet on Cold Pressor Pain in Young Elementary School-Aged Children

PubMed Central

Weiss, Karen E.; Law, Emily F.; Sil, Soumitri; Herbert, Linda Jones; Horn, Susan Berrin; Wohlheiter, Karen; Ackerman, Claire Sonntag

2010-01-01

Objective This study examined the effects of videogame distraction and a virtual reality (VR) type head-mounted display helmet for children undergoing cold pressor pain. Methods Fifty children between the ages of 6 and 10 years underwent a baseline cold pressor trial followed by two cold pressor trials in which interactive videogame distraction was delivered via a VR helmet or without a VR helmet in counterbalanced order. Results As expected, children demonstrated significant improvements in pain threshold and pain tolerance during both distraction conditions. However, the two distraction conditions did not differ in effectiveness. Conclusions Using the VR helmet did not result in improved pain tolerance over and above the effects of interactive videogame distraction without VR technology. Clinical implications and possible developmental differences in elementary school-aged children's ability to use VR technology are discussed. PMID:19786489

Repair of large full-thickness articular cartilage defects in the rabbit: the effects of joint distraction and autologous bone-marrow-derived mesenchymal cell transplantation.

PubMed

Yanai, T; Ishii, T; Chang, F; Ochiai, N

2005-05-01

We produced large full-thickness articular cartilage defects in 33 rabbits in order to evaluate the effect of joint distraction and autologous culture-expanded bone-marrow-derived mesenchymal cell transplantation (ACBMT) at 12 weeks. After fixing the knee on a hinged external fixator, we resected the entire surface of the tibial plateau. We studied three groups: 1) with and without joint distraction; 2) with joint distraction and collagen gel, and 3) with joint distraction and ACBMT and collagen gel. The histological scores were significantly higher in the groups with ACBMT collagen gel (p < 0.05). The area of regenerated soft tissue was smaller in the group allowed to bear weight (p < 0.05). These findings suggest that the repair of large defects of cartilage can be enhanced by joint distraction, collagen gel and ACBMT.

Understanding commercial truck drivers' decision-makin process concerning distracted driving.

PubMed

Swedler, David I; Pollack, Keshia M; Gielen, Andrea C

2015-05-01

A concurrent mixed methods design was used to explore personal and workplace factors, informed by the Theory of Planned Behavior, that affect truck drivers' decision-making about distracted driving on the job. Qualitative data were collected via semi-structured interviews with experts in truck safety and distracted driving, and quantitative data were collected via online survey of truck drivers in the United States. Findings from the interviews illustrated how drivers perceived distractions and the importance of supervisors enforcing organizational distracted driving policies. Survey results found that behavioral intentions were most important in regards to texting and crash and near-crash outcomes, while perceived norms from management best described the correlation between dispatch device use and negative crash-related outcomes. By using a mixed methods design, rather than two separate studies, these findings revealed nuanced differences into the influence of supervisors on distracted driving. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sustained efficacy of virtual reality distraction.

PubMed

Rutter, Charles E; Dahlquist, Lynnda M; Weiss, Karen E

2009-04-01

The current study tested whether the effectiveness of distraction using virtual reality (VR) technology in reducing cold pressor pain would maintain over the course of 8 weekly exposures. Twenty-eight adults, 18 to 23 years of age, underwent 1 baseline cold pressor trial and 1 VR distraction trial in randomized order each week. VR distraction led to significant increases in pain threshold and pain tolerance and significant decreases in pain intensity, time spent thinking about pain, and self-reported anxiety, relative to baseline. Repeated exposure did not appear to affect the benefits of VR. Implications for the long-term use of VR distraction as a nonpharmacological analgesic are discussed. This article addresses the concern that the efficacy of virtual reality-assisted distraction from pain could potentially decrease with repeated exposure. The current finding that efficacy did not diminish over several repeated exposures provides support for the use of virtual reality as an adjuvant treatment of pain.

Effects of videogame distraction and a virtual reality type head-mounted display helmet on cold pressor pain in young elementary school-aged children.

PubMed

Dahlquist, Lynnda M; Weiss, Karen E; Law, Emily F; Sil, Soumitri; Herbert, Linda Jones; Horn, Susan Berrin; Wohlheiter, Karen; Ackerman, Claire Sonntag

2010-07-01

This study examined the effects of videogame distraction and a virtual reality (VR) type head-mounted display helmet for children undergoing cold pressor pain. Fifty children between the ages of 6 and 10 years underwent a baseline cold pressor trial followed by two cold pressor trials in which interactive videogame distraction was delivered via a VR helmet or without a VR helmet in counterbalanced order. As expected, children demonstrated significant improvements in pain threshold and pain tolerance during both distraction conditions. However, the two distraction conditions did not differ in effectiveness. Using the VR helmet did not result in improved pain tolerance over and above the effects of interactive videogame distraction without VR technology. Clinical implications and possible developmental differences in elementary school-aged children's ability to use VR technology are discussed.

Cell Phone Calls in the Operating Theater and Staff Distractions: An Observational Study.

PubMed

Avidan, Alexander; Yacobi, Galel; Weissman, Charles; Levin, Phillip D

2017-01-09

Cell phones are the primary communication tool in our institution. There are no restrictions on their use in the operating rooms. The goal of this study was to evaluate the extent of cell phone use in the operating rooms during elective surgery and to evaluate whether they cause staff distractions. The following data on cell phone use were recorded anonymously: number of incoming and outgoing cell phone calls, duration of cell phone calls and their content (patient related, work related, private), who was distracted by the cell phone calls, and duration of distractions. We made observations during 52 surgeries. There were 205 cell phone calls, 197 (96.1%; median, 3 per surgery; interquartile range, 2-5) incoming and 8 (3.9%) outgoing. Incoming calls were answered on 110 (55.8%) of 197 (median, 2; interquartile range, 1-3) occasions. The mean duration of incoming calls (64 ± 40 seconds) was shorter than those of the outgoing calls (137 ± 242 seconds, P < 0.001). During 29 (14.7%) of 197 incoming calls, 30 staff distractions occurred. Distractions were caused mainly for surgeons talking on their cell phones (24/30, 80.0%). The mean duration of the distractions was 43.6 ± 22.3 seconds. During all 8 outgoing calls, no other staff members were distracted. The number of cell phone calls in the operating rooms during elective surgery was lower than expected and caused short-lived distractions mainly to the operating surgeons. We recommend that operating surgeons turn off their cell phones before surgery.

Transsutural distraction osteogenesis applied to maxillary complex with new internalized distraction device: analysis of the feasibility and long-term osteogenesis outcome.

PubMed

Tong, Haizhou; Gao, Feng; Yin, Jiapeng; Zhang, Xiangyu; Zhang, Chen; Yin, Ningbei; Zhao, Zhenmin

2015-03-01

The purposes of this study were to evaluate the effects of transsutural distraction osteogenesis applied to the maxillary complex with a new internalized distraction device and to analyze the long-term osteogenesis outcome. Three-month-old beagle dogs were treated with a self-designed internalized distractor. The feasibility was evaluated, and the effects of the maxillary growth were measured using radiography and computed tomography (CT). The regenerated bone was examined with micro-CT, biomechanical testing, and histology 1 year after the distraction. The experimental group showed significantly larger forward displacement of maxillary during the distraction. One year after the distraction, the micro-CT showed more incompact structure and bone volume/total volume was significantly less in the experimental group. Biomechanical testing also showed a significantly lower yield but with no difference in stiffness. Histologic staining found osteoclasts deposited in the region of the suture and osteoblasts on the bone surface. The immunohistochemical staining of osteoprotegrin and receptor activator of nuclear factor-κ B ligand showed evidence of expression in suture area components and osteocytes with no difference between the groups. Transsutural distraction osteogenesis using an internalized distractor with skull anchorage demonstrated feasibility. It is expected that this device may provide new thoughts in developing an appropriate appliance for clinical use in young patients with midfacial hypoplasia. Moreover, the long-term osteogenesis analysis findings suggest that the metabolism of sutural area still remained active, which enhanced our understanding of bone remodeling in the sutural area to manage maxillary relapse after transsutural distraction osteogenesis.

Identifying cognitive distraction using steering wheel reversal rates.

PubMed

Kountouriotis, Georgios K; Spyridakos, Panagiotis; Carsten, Oliver M J; Merat, Natasha

2016-11-01

The influence of driver distraction on driving performance is not yet well understood, but it can have detrimental effects on road safety. In this study, we examined the effects of visual and non-visual distractions during driving, using a high-fidelity driving simulator. The visual task was presented either at an offset angle on an in-vehicle screen, or on the back of a moving lead vehicle. Similar to results from previous studies in this area, non-visual (cognitive) distraction resulted in improved lane keeping performance and increased gaze concentration towards the centre of the road, compared to baseline driving, and further examination of the steering control metrics indicated an increase in steering wheel reversal rates, steering wheel acceleration, and steering entropy. We show, for the first time, that when the visual task is presented centrally, drivers' lane deviation reduces (similar to non-visual distraction), whilst measures of steering control, overall, indicated more steering activity, compared to baseline. When using a visual task that required the diversion of gaze to an in-vehicle display, but without a manual element, lane keeping performance was similar to baseline driving. Steering wheel reversal rates were found to adequately tease apart the effects of non-visual distraction (increase of 0.5° reversals) and visual distraction with offset gaze direction (increase of 2.5° reversals). These findings are discussed in terms of steering control during different types of in-vehicle distraction, and the possible role of manual interference by distracting secondary tasks. Copyright © 2016 Elsevier Ltd. All rights reserved.

Computer-Simulated Arthroscopic Knee Surgery: Effects of Distraction on Resident Performance.

PubMed

Cowan, James B; Seeley, Mark A; Irwin, Todd A; Caird, Michelle S

2016-01-01

Orthopedic surgeons cite "full focus" and "distraction control" as important factors for achieving excellent outcomes. Surgical simulation is a safe and cost-effective way for residents to practice surgical skills, and it is a suitable tool to study the effects of distraction on resident surgical performance. This study investigated the effects of distraction on arthroscopic knee simulator performance among residents at various levels of experience. The authors hypothesized that environmental distractions would negatively affect performance. Twenty-five orthopedic surgery residents performed a diagnostic knee arthroscopy computer simulation according to a checklist of structures to identify and tasks to complete. Participants were evaluated on arthroscopy time, number of chondral injuries, instances of looking down at their hands, and completion of checklist items. Residents repeated this task at least 2 weeks later while simultaneously answering distracting questions. During distracted simulation, the residents had significantly fewer completed checklist items (P<.02) compared with the initial simulation. Senior residents completed the initial simulation in less time (P<.001), with fewer chondral injuries (P<.005) and fewer instances of looking down at their hands (P<.012), compared with junior residents. Senior residents also completed 97% of the diagnostic checklist, whereas junior residents completed 89% (P<.019). During distracted simulation, senior residents continued to complete tasks more quickly (P<.006) and with fewer instances of looking down at their hands (P<.042). Residents at all levels appear to be susceptible to the detrimental effects of distraction when performing arthroscopic simulation. Addressing even straightforward questions intraoperatively may affect surgeon performance. Copyright 2016, SLACK Incorporated.

Processing of Emotional Distraction is both Automatic and Modulated by Attention: Evidence from an Event-Related fMRI Investigation

PubMed Central

Shafer, A.T.; Matveychuk, D.; Penney, T.; O’Hare, A.J.; Stokes, J.; Dolcos, F.

2015-01-01

Traditionally, emotional stimuli have been thought to be automatically processed via a bottom-up automatic “capture of attention” mechanism. Recently, this view has been challenged by evidence that emotion processing depends on the availability of attentional resources. Although these two views are not mutually exclusive, direct evidence reconciling them is lacking. One limitation of previous investigations supporting the traditional or competing views is that they have not systematically investigated the impact of emotional charge of task-irrelevant distraction in conjunction with manipulations of attentional demands. Using event-related fMRI, we investigated the nature of emotion-cognition interactions in a perceptual discrimination task with emotional distraction, by manipulating both the emotional charge of the distracting information and the demands of the main task. Findings suggest that emotion processing is both automatic and modulated by attention, but emotion and attention were only found to interact when finer assessments of emotional charge (comparison of most vs. least emotional conditions) were considered along with an effective manipulation of processing load (high vs. low). The study also identified brain regions reflecting the detrimental impact of emotional distraction on performance as well as regions involved in helping with such distraction. Activity in the dorsomedial prefrontal cortex (PFC) and ventrolateral PFC was linked to a detrimental impact of emotional distraction, whereas the dorsal anterior cingulate cortex and lateral occiptal cortex were involved in helping with emotional distraction. These findings demonstrate that task-irrelevant emotion processing is subjective to both the emotional content of distraction and the level of attentional demand. PMID:22332805

Attentional priorities and access to short-term memory: parietal interactions.

PubMed

Gillebert, Céline R; Dyrholm, Mads; Vangkilde, Signe; Kyllingsbæk, Søren; Peeters, Ronald; Vandenberghe, Rik

2012-09-01

The intraparietal sulcus (IPS) has been implicated in selective attention as well as visual short-term memory (VSTM). To contrast mechanisms of target selection, distracter filtering, and access to VSTM, we combined behavioral testing, computational modeling and functional magnetic resonance imaging. Sixteen healthy subjects participated in a change detection task in which we manipulated both target and distracter set sizes. We directly compared the IPS response as a function of the number of targets and distracters in the display and in VSTM. When distracters were not present, the posterior and middle segments of IPS showed the predicted asymptotic activity increase with an increasing target set size. When distracters were added to a single target, activity also increased as predicted. However, the addition of distracters to multiple targets suppressed both middle and posterior IPS activities, thereby displaying a significant interaction between the two factors. The interaction between target and distracter set size in IPS could not be accounted for by a simple explanation in terms of number of items accessing VSTM. Instead, it led us to a model where items accessing VSTM receive differential weights depending on their behavioral relevance, and secondly, a suppressive effect originates during the selection phase when multiple targets and multiple distracters are simultaneously present. The reverse interaction between target and distracter set size was significant in the right temporoparietal junction (TPJ), where activity was highest for a single target compared to any other condition. Our study reconciles the role of middle IPS in attentional selection and biased competition with its role in VSTM access. Copyright © 2012 Elsevier Inc. All rights reserved.

Comparative study of different osteotomy modalities in maxillary distraction osteogenesis for cleft lip and palate.

PubMed

Yu, Hongbo; Wang, Xudong; Fang, Bing; Shen, Steve Guofang

2012-11-01

Conventional maxillary distraction osteogenesis and anterior maxillary segmental distraction were applied in the treatment of severe maxillary hypoplasia secondary to cleft clip and palate. The aim of the present study was to compare the difference between these 2 osteotomy modalities used for rigid external distraction. Ten patients with severe maxillary hypoplasia secondary to CLP were enrolled in our study. They were randomly divided into 2 groups. Conventional maxillary distraction osteogenesis was performed in 5 patients and anterior maxillary segmental distraction in 5 patients. The preoperative and postoperative lateral cephalograms were compared, and cephalometric analysis was performed. The independent sample t test was used to evaluate the differences between the 2 groups. All patients healed uneventfully, and the maxillae moved forward satisfactorily. The sella-nasion-point A angles, nasion-point A-Frankfort horizontal plane angles, overjets, and 0-meridian to subnasale distances had increased significantly after distraction osteogenesis. Significant differences were found in the changes in palatal length between the 2 groups (P < .05). A mean increase of 7.50 mm in palatal length was found in the anterior maxillary segmental distraction group. No significant difference in the changes in palatopharyngeal depth or soft palatal length was found. With the ability of increasing the palatal and arch length, avoiding changes in palatopharyngeal depth, and preserving palatopharyngeal closure function, anterior maxillary segmental distraction has great value in the treatment of maxillary hypoplasia secondary to CLP. It is a promising and valuable technique in this potentially complicated procedure. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[Effects of hyperbaric oxygen treatment on healing of maxillary distraction osteogenesis in beagle dogs].

PubMed

Kudoh, Atsuo

2008-03-01

Distraction osteogenesis has been widely used even in the craniofacial region. A long fixation time during the consolidation period, however, is a major clinical disadvantage. Hyperbaric oxygen (HBO) has been used to improve healing in ischemic wounds. We have recently started applying hyperbaric oxygen to cleft palate patients after maxillary distraction, but there is little basic evidence. We hypothesized that hyperbaric oxygen would enhance the healing of distraction osteogenesis in the cleft palate model in dogs. A bony segment including a canine was transported proximally into an artificial bone defect in the left palate. Three dogs were treated with hyperbaric oxygen for 20 days just after the distraction and three other dogs underwent only the distraction process (control group). Blood flow of the canine pulp in the bone segment was monitored using a laser Doppler flowmeter throughout the experiment. All the dogs were sacrificed on day 100, and radiological analysis using peripheral quantitative CT and histomorphometric evaluations were performed. Blood flow in the HBO-treated group recovered to the original level about 30 days faster than in the control group (p<0.05). Cortical bone mineral density was significantly higher at the distraction site in the HBO-treated group than in the control group (p<0.05). The histomorphometric analysis revealed that the newly formed bone area was also larger in the HBO-treated group than in the control group (p<0.05). These results suggest that hyperbaric oxygen treatment could be useful for early removal of the distraction device in distraction osteogenesis.

Streamed video clips to reduce anxiety in children during inhaled induction of anesthesia.

PubMed

Mifflin, Katherine A; Hackmann, Thomas; Chorney, Jill Maclaren

2012-11-01

Anesthesia induction in children is frequently achieved by inhalation of nitrous oxide and sevoflurane. Pediatric anesthesiologists commonly use distraction techniques such as humor or nonprocedural talk to reduce anxiety and facilitate a smooth transition at this critical phase. There is a large body of successful distraction research that explores the use of video and television distraction methods for minor medical and dental procedures, but little research on the use of this method for ambulatory surgery. In this randomized control trial study we examined whether video distraction is effective in reducing the anxiety of children undergoing inhaled induction before ambulatory surgery. Children (control = 47, video = 42) between 2 and 10 years old undergoing ambulatory surgery were randomly assigned to a video distraction or control group. In the video distraction group a video clip of the child's preference was played during induction, and the control group received traditional distraction methods during induction. The modified Yale Preoperative Anxiety Scale was used to assess the children's anxiety before and during the process of receiving inhalation anesthetics. All subjects were similar in their age and anxiety scores before entering the operating rooms. Children in the video distraction group were significantly less anxious at induction and showed a significantly smaller change in anxiety from holding to induction than did children in the control group. Playing video clips during the inhaled induction of children undergoing ambulatory surgery is an effective method of reducing anxiety. Therefore, pediatric anesthesiologists may consider using video distraction as a useful, valid, alternative strategy for achieving a smooth transition to the anesthetized state.

The potential effect of technology and distractions on undergraduate students' concentration.

PubMed

Attia, Najya A; Baig, Lubna; Marzouk, Yousef I; Khan, Anwar

2017-01-01

In the present era, it is difficult to keep the concentration of college students at its maximum potential during the class time, as there are many distractions that negatively impact students' concentration and prevent optimal learning. Technologies such as laptops and cell phones have invaded the classroom, raising considerable concerns about their effects on college students' attention in the classroom. Despite these concerns, no research has been done in Saudi Arabia on the effects of technology and other types of classroom distractions on students' concentration. In the current study, we have attempted to identify students' perceptions of major distractions in the classroom based on seventeen internally (self-produced) and twenty-four externally produced classroom situations. The students participating in this study rated the degree to which each distraction interferes with their concentration on the class materials and their ability to learn. Data were collected through surveys of 265 students (66 and 199 students from medical and basic classes, respectively), including 97 females and 168 males 17-23 years of age from the academic years 2010 to 2014. A validated self-administered questionnaire was handed to the students in the classroom. The students were asked to report and rate the classroom distraction produced by 24 external internal distracters (Table-II), on a 5-point scale. The results revealed that ringing cell phones in the class were the most commonly reported electronic external distractor for 68% of students, and 21% of them reported being extremely distracted by this noise. Having an instructor who is difficult to understand was the most commonly reported external behavioral distractor for 75% of students, and 48% of them rated this as extremely distracting. Students talking in class were the most self-produced distractor for 72% of students; negatively impacting their concentration and ability to learn, and 42% of them rated it as an extreme distractor. Wearing clothing with unusual words, drinking and eating in the classroom were minimally distracting colleagues. Overall, distractions (internal and external) were more significant for fifth-year students than the other years at a p-value < 0.001. Students believed that laptop and cell phone use in the classroom can effect their concentration and ability to learn. The students also felt that inappropriate behavior is a major distraction for students as well, and thus necessitates monitoring and improvement.

The potential effect of technology and distractions on undergraduate students’ concentration

PubMed Central

Attia, Najya A.; Baig, Lubna; Marzouk, Yousef I.; Khan, Anwar

2017-01-01

Background and Objectives: In the present era, it is difficult to keep the concentration of college students at its maximum potential during the class time, as there are many distractions that negatively impact students’ concentration and prevent optimal learning. Technologies such as laptops and cell phones have invaded the classroom, raising considerable concerns about their effects on college students’ attention in the classroom. Despite these concerns, no research has been done in Saudi Arabia on the effects of technology and other types of classroom distractions on students’ concentration. In the current study, we have attempted to identify students’ perceptions of major distractions in the classroom based on seventeen internally (self-produced) and twenty-four externally produced classroom situations. Methods: The students participating in this study rated the degree to which each distraction interferes with their concentration on the class materials and their ability to learn. Data were collected through surveys of 265 students (66 and 199 students from medical and basic classes, respectively), including 97 females and 168 males 17–23 years of age from the academic years 2010 to 2014. A validated self-administered questionnaire was handed to the students in the classroom. The students were asked to report and rate the classroom distraction produced by 24 external internal distracters (Table-II), on a 5-point scale. Results: The results revealed that ringing cell phones in the class were the most commonly reported electronic external distractor for 68% of students, and 21% of them reported being extremely distracted by this noise. Having an instructor who is difficult to understand was the most commonly reported external behavioral distractor for 75% of students, and 48% of them rated this as extremely distracting. Students talking in class were the most self-produced distractor for 72% of students; negatively impacting their concentration and ability to learn, and 42% of them rated it as an extreme distractor. Wearing clothing with unusual words, drinking and eating in the classroom were minimally distracting colleagues. Overall, distractions (internal and external) were more significant for fifth-year students than the other years at a p-value < 0.001. Conclusion: Students believed that laptop and cell phone use in the classroom can effect their concentration and ability to learn. The students also felt that inappropriate behavior is a major distraction for students as well, and thus necessitates monitoring and improvement. PMID:29067054

Joint Distraction Treatments of Intra-Articular Fracture-Induced Posttraumatic Osteoarthritis in a Large Animal Model

DTIC Science & Technology

2016-10-01

acute joint distraction treatment suffered some complications and did not appear to improve cartilage health when applied at this acute phase. We have...immature animals from their herd as a result of PRRS (porcine respiratory and reproduction syndrome ). This forced purchase of animals from alternative more...joint distraction applied acutely after IAF are the focus of Aim 1, and the effects of joint distraction applied shortly after the bone has healed are

The impact of distracter-target similarity on contextual cueing effects of children and adults.

PubMed

Yang, Yingying; Merrill, Edward C

2014-05-01

Contextual cueing reflects a memory-based attentional guidance process that develops through repeated exposure to displays in which a target location has been consistently paired with a specific context. In two experiments, we compared 20 younger children's (6-7 years old), 20 older children's (9-10 years old), and 20 young adults' (18-21 years old) abilities to acquire contextual cueing effects from displays in which half of the distracters predicted the location of the target and half did not. Across experiments, we varied the similarity between the predictive and nonpredictive distracters and the target. In Experiment 1, the predictive distracters were visually similar to the target and dissimilar from the nonpredictive distracters. In Experiment 2, the nonpredictive distracters were also similar to the target and predictive distracters. All three age groups exhibited contextual cueing in Experiment 1, although the effect was not as strong for the younger children relative to older children and adults. All participants exhibited weaker contextual cueing effects in Experiment 2, with the younger children not exhibiting significant contextual cueing at all. Apparently, when search processes could not be guided to the predictive distracters on the basis of salient stimulus features, younger children in particular experienced difficulty in implicitly identifying and using aspects of the context to facilitate with the acquisition of contextual cueing effects. Copyright © 2013 Elsevier Inc. All rights reserved.

Single versus triple daily activation of the distractor: no significant effects of frequency of distraction on bone regenerate quantity and architecture.

PubMed

Djasim, Urville Mardijanto; Wolvius, Eppo Bonne; Van Neck, Johan Wilhelm; Van Wamel, Annemieke; Weinans, Harrie; Van Der Wal, Karel George Hendrik

2008-04-01

To study the effect of two different frequencies of distraction on the quantity and architecture of bone regenerate using micro-computed tomography, and to determine whether radiographic and ultrasonographic bone-fill scores provide reliable predictive value for the amount of new bone in the distraction area. Twenty-six skeletally mature rabbits underwent three full days of latency, after which midface distraction was started. Low-frequency group (n=12): a distraction rate of 0.9 mm/d achieved by one daily activation for 11 days to create a 10mm distraction gap. High-frequency group (n=12): idem, but three daily activations were used instead of one. Control group (n=2) underwent no distraction. After 21 days of consolidation, bone-fill in the distraction area was assessed by means of ultrasonography and radiography. Micro-computed tomography was used to quantify new bone formation and bone architecture. Relative bone volume (BV/TV) showed a tendency towards a difference (P=0.09) between the low and high-frequency groups. No significant differences were found for bone architecture. No significant correlation between BV/TV values and bone-fill scores was found. An increase in rhythm from one to three activations daily does not create significantly more bone. Bone-fill score values provided no reliable predictive value for the amount of new bone formation.

Distraction and Pedestrian Safety: How Talking on the Phone, Texting, and Listening to Music Impact Crossing the Street

PubMed Central

Schwebel, David C.; Stavrinos, Despina; Byington, Katherine W.; Davis, Tiffany; O’Neal, Elizabeth E.; de Jong, Desiree

2011-01-01

As use of handheld multimedia devices has exploded globally, safety experts have begun to consider the impact of distraction while talking, text-messaging, or listening to music on traffic safety. This study was designed to test how talking on the phone, texting, and listening to music may influence pedestrian safety. 138 college students crossed an interactive, semi-immersive virtual pedestrian street. They were randomly assigned to one of four groups: crossing while talking on the phone, crossing while texting, crossing while listening to a personal music device, or crossing while undistracted. Participants distracted by music or texting were more likely to be hit by a vehicle in the virtual pedestrian environment than were undistracted participants. Participants in all three distracted groups were more likely to look away from the street environment (and look toward other places, such as their telephone or music device) than were undistracted participants. Findings were maintained after controlling for demographics, walking frequency, and media use frequency. Distraction from multimedia devices has a small but meaningful impact on college students’ pedestrian safety. Future research should consider the cognitive demands of pedestrian safety, and how those processes may be impacted by distraction. Policymakers might consider ways to protect distracted pedestrians from harm and to reduce the number of individuals crossing streets while distracted. PMID:22269509

Comparative evaluation of the effectiveness of audio and audiovisual distraction aids in the management of anxious pediatric dental patients.

PubMed

Kaur, Rajwinder; Jindal, Ritu; Dua, Rohini; Mahajan, Sandeep; Sethi, Kunal; Garg, Sunny

2015-01-01

The aim of this study was to evaluate and compare audio and audiovisual distraction aids in management of anxious pediatric dental patients of different age groups and to study children's response to sequential dental visits with the use of distraction aids. This study was conducted on two age groups, that is, 4-6 years and 6-8 years with 30 patients in each age group on their first dental visit. The children of both the age groups were divided into 3 subgroups, the control group, audio distraction group, audiovisual distraction group with 10 patients in each subgroup. Each child in all the subgroups had gone through three dental visits. Child anxiety level at each visit was assessed by using a combination of anxiety measuring parameters. The data collected was tabulated and subjected to statistical analysis. Tukey honest significant difference post-hoc test at 0.05% level of significance revealed audiovisual group showed statistically highly significant difference from audio and control group, whereas audio group showed the statistically significant difference from the control group. Audiovisual distraction was found to be a more effective mode of distraction in the management of anxious children in both the age groups when compared to audio distraction. In both the age groups, a significant effect of the visit type was also observed.

Distraction of clinicians by smartphones in hospitals: a concept analysis.

PubMed

McBride, Deborah L

2015-09-01

To report an analysis of the concept of distraction of clinicians by smartphones and other mobile devices in hospitals. In the healthcare literature, the concept of distraction of clinicians by smartphones and other mobile devices in hospitals has no consistent definition. Concept analysis. Journal articles published from 2003-2014. Rodgers' Evolutionary Concept Analysis Method was used to analyse the concept of distraction of clinicians by smartphones and other mobile devices in hospitals. This analysis led to a definition of distraction of clinicians by smartphones as the interruption of a hospital clinician's primary task by the internally or externally initiated use of their smartphone or other mobile device. There are six attributes of distraction by smartphones and other mobile devices in hospitals. These attributes are: (1) an experience by a clinician; (2) an intrusion into a primary clinical task; (3) discontinuity of the clinical task; (4) externally or internally initiated; (5) situated in a healthcare setting; and (6) mediated by a smartphone or other mobile device. Use of the definition and the defining attributes of distraction of clinicians by smartphones will increase the validity and reliability of future studies. It will be extended to form a classification system of distractions within a framework of clinical practice, which will be used to unify and standardize future research studies. © 2015 John Wiley & Sons Ltd.

Patient characteristics as predictors of clinical outcome of distraction in treatment of severe ankle osteoarthritis.

PubMed

Marijnissen, A C A; Hoekstra, M C L; Pré, B C du; van Roermund, P M; van Melkebeek, J; Amendola, A; Maathuis, P; Lafeber, F P J G; Welsing, P M J

2014-01-01

Osteoarthritis (OA) is a slowly progressive joint disease. Joint distraction can be a treatment of choice in case of severe OA. Prediction of failure will facilitate implementation of joint distraction in clinical practice. Patients with severe ankle OA, who underwent joint distraction were included. Survival analysis was performed over 12 years (n = 25 after 12 years). Regression analyses were used to predict failures and clinical benefit at 2 years after joint distraction (n = 111). Survival analysis showed that 44% of the patients failed, 17% within 2 years and 37% within 5 years after joint distraction (n = 48 after 5 years). Survival analysis in subgroups showed that the percentage failure was only different in women (30% after 2 years) versus men (after 11 years still no 30% failure). In the multivariate analyses female gender was predictive for failure 2 years after joint distraction. Gender and functional disability at baseline predicted more pain. Functional disability and pain at baseline were associated with more functional disability. Joint distraction shows a long-term clinical beneficial outcome. However, failure rate is considerable over the years. Female patients have a higher chance of failure during follow-up. Unfortunately, not all potential predictors could be investigated and other clinically significant predictors were not found. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Virtual-Reality Distraction and Cold-Pressor Pain Tolerance: Does Avatar Point of View Matter?

PubMed Central

Herbert, Linda J.; Weiss, Karen E.; Jimeno, Monica

2010-01-01

Abstract This study tested the effects of distraction using virtual-reality (VR) technology on acute pain tolerance in young adults. Forty-one undergraduate students, aged 18–23 years, used a VR head-mounted display helmet, steering wheel, and foot pedal to play an auto racing video game while undergoing exposure to very cold water (cold pressor set at 1°C). Two different game views were tested that were hypothesized to affect the degree to which participants felt “present” in the virtual environment: a first-person view, in which the participant saw the virtual environment through the eyes of the game character being manipulated; and a third-person view, in which the participant viewed the game character from a distance. The length of time participants tolerated the cold-water exposure (pain tolerance) under each distraction condition was compared to a baseline (no distraction) trial. Subjects also rated the degree to which they felt “present” in the virtual environment after each distraction trial. Results demonstrated that participants had significantly higher pain tolerance during both VR-distraction conditions relative to baseline (no distraction) trials. Although participants reported a greater sense of presence during the first-person condition than the third-person condition, pain-tolerance scores associated with the two distraction conditions did not differ. The types of VR applications in which presence may be more or less important are discussed. PMID:20950186

Virtual-reality distraction and cold-pressor pain tolerance: does avatar point of view matter?

PubMed

Dahlquist, Lynnda M; Herbert, Linda J; Weiss, Karen E; Jimeno, Monica

2010-10-01

This study tested the effects of distraction using virtual-reality (VR) technology on acute pain tolerance in young adults. Forty-one undergraduate students, aged 18-23 years, used a VR head-mounted display helmet, steering wheel, and foot pedal to play an auto racing video game while undergoing exposure to very cold water (cold pressor set at 1 °C). Two different game views were tested that were hypothesized to affect the degree to which participants felt "present" in the virtual environment: a first-person view, in which the participant saw the virtual environment through the eyes of the game character being manipulated; and a third-person view, in which the participant viewed the game character from a distance. The length of time participants tolerated the cold-water exposure (pain tolerance) under each distraction condition was compared to a baseline (no distraction) trial. Subjects also rated the degree to which they felt "present" in the virtual environment after each distraction trial. Results demonstrated that participants had significantly higher pain tolerance during both VR-distraction conditions relative to baseline (no distraction) trials. Although participants reported a greater sense of presence during the first-person condition than the third-person condition, pain-tolerance scores associated with the two distraction conditions did not differ. The types of VR applications in which presence may be more or less important are discussed.

Distraction and pedestrian safety: how talking on the phone, texting, and listening to music impact crossing the street.

PubMed

Schwebel, David C; Stavrinos, Despina; Byington, Katherine W; Davis, Tiffany; O'Neal, Elizabeth E; de Jong, Desiree

2012-03-01

As use of handheld multimedia devices has exploded globally, safety experts have begun to consider the impact of distraction while talking, text-messaging, or listening to music on traffic safety. This study was designed to test how talking on the phone, texting, and listening to music may influence pedestrian safety. 138 college students crossed an interactive, semi-immersive virtual pedestrian street. They were randomly assigned to one of four groups: crossing while talking on the phone, crossing while texting, crossing while listening to a personal music device, or crossing while undistracted. Participants distracted by music or texting were more likely to be hit by a vehicle in the virtual pedestrian environment than were undistracted participants. Participants in all three distracted groups were more likely to look away from the street environment (and look toward other places, such as their telephone or music device) than were undistracted participants. Findings were maintained after controlling for demographics, walking frequency, and media use frequency. Distraction from multimedia devices has a small but meaningful impact on college students' pedestrian safety. Future research should consider the cognitive demands of pedestrian safety, and how those processes may be impacted by distraction. Policymakers might consider ways to protect distracted pedestrians from harm and to reduce the number of individuals crossing streets while distracted. Copyright © 2011 Elsevier Ltd. All rights reserved.

The efficacy of attentional distraction and sensory monitoring in chronic pain patients: A meta-analysis.

PubMed

Van Ryckeghem, Dimitri Ml; Van Damme, Stefaan; Eccleston, Christopher; Crombez, Geert

2018-02-01

Attentional strategies, such as distraction and sensory monitoring, are often offered to reduce pain and pain-related distress. However, evidence for their efficacy in chronic pain patients is equivocal. We report a meta-analysis on the efficacy of distraction and sensory monitoring in chronic pain patients, and explore possible methodological and theoretical moderators. The scientific literature was searched for relevant articles, which were coded for methodological quality and several theoretical and methodological moderator variables. Only 10 articles fulfilled the search criteria. Eight studies allowed us to compare distraction with a control condition, two studies to compare sensory monitoring with a control condition, and four studies to compare the effect of distraction with the effect of sensory monitoring. Overall, results indicate that distraction did not differ from control in altering pain experience (k=8; Hedges' g=0.10, ns) and distress (k=2; Hedges' g=0.549). Sensory monitoring did also not alter pain experience (k=2; Hedges' g=-0.21, ns) and distress (k=1; Hedges' g=-0.191, ns). We found no evidence to support the superiority of distraction or sensory monitoring in altering pain compared to control conditions. We offer guidance for future theory-driven research to investigate distraction and sensory monitoring in this largely unexplored field, albeit one replete with methodological difficulties. Copyright © 2017 Elsevier Ltd. All rights reserved.

Maxillary distraction osteogenesis in cleft lip and palate cases with midface hypoplasia using rigid external distractor: an alternative technique.

PubMed

Dua, Gaurav; Navin Kumar, Andrews; Roy, Indranil Deb; Roy, Supriyo Kumar

2014-05-01

Patients with operated cleft lip and palate present with a problem of midface hypoplasia, and such patients have been traditionally treated with orthognathic surgery. Such a procedure has its own limitations of relapse and hence a newer modality of distraction osteogenesis with histiogenesis can be chosen to overcome such limitations for midfacial advancement. The purpose of this study is to evaluate an alternative technique and its postoperative stability in maxillary distraction osteogenesis in patients of cleft lip and cleft palate using a rigid external device (RED). Nine patients with midface bone stock deficiency were selected for maxillary advancement. At the first surgery under general anesthesia, after Le Fort I osteotomy, RED system was used with the alternative technique. After distraction, evaluation was done for ease of the procedure, stability, and complications. Lateral cephalograms were evaluated at 3 stages: T1, pre-distraction; T2, post-distraction; and T3, 1 year post-distraction. A mean 13.4-mm midface advancement was shown with bone formation at the pterygomaxillary region without losing the vector and having a standby mode in case the wire broke during distraction The results were stable even at 1 year of follow-up. Maxillary position improved in relation to the cranial base. This study showed that the RED was versatile in midface advancement.

What drives technology-based distractions? A structural equation model on social-psychological factors of technology-based driver distraction engagement.

PubMed

Chen, Huei-Yen Winnie; Donmez, Birsen

2016-06-01

With the proliferation of new mobile and in-vehicle technologies, understanding the motivations behind a driver's voluntary engagement with such technologies is crucial from a safety perspective, yet is complex. Previous literature either surveyed a large number of distractions that may be diverse, or too focuses on one particular activity, such as cell phone use. Further, earlier studies about social-psychological factors underlying driver distraction tend to focus on one or two factors in-depth, and those that examine a more comprehensive set of factors are often limited in their analyses methods. The present work considers a wide array of social-psychological factors within a structural equation model to predict their influence on a focused set of technology-based distractions. A better understanding of these facilitators can enhance the design of distraction mitigation strategies. We analysed survey responses about three technology-based driver distractions: holding phone conversations, manually interacting with cell phones, and adjusting the settings of in-vehicle technology, as well as responses on five social-psychological factors: attitude, descriptive norm, injunctive norm, technology inclination, and a risk/sensation seeking personality. Using data collected from 525 drivers (ages: 18-80), a structural equation model was built to analyse these social-psychological factors as latent variables influencing self-reported engagement in these three technology-based distractions. Self-reported engagement in technology-based distractions was found to be largely influenced by attitudes about the distractions. Personality and social norms also played a significant role, but technology inclination did not. A closer look at two age groups (18-30 and 30+) showed that the effect of social norms, especially of injunctive norm (i.e., perceived approvals), was less prominent in the 30+ age group, while personality remained a significant predictor for the 30+ age group but marginally significant for the younger group. Findings from this work provide insights into the social-psychological factors behind intentional engagement in technology-based distractions and in particular suggesting that these factors may be sensitive to demographic differences. Copyright © 2016. Published by Elsevier Ltd.

An examination of driver distraction as recorded in NHTSA databases

DOT National Transportation Integrated Search

2009-09-01

The purpose of this research note is to provide fatality, injury, on-scene crash investigation, and survey data associated with distracted driving and to summarize recent data from NHTSA and other DOT modes pertaining to distracted-driving crashes.

The color-word interference test and its relation to performance impairment under auditory distraction.

DOT National Transportation Integrated Search

1972-03-01

The ability to resist distraction is an important requirement for air traffic controllers. The study examined the relationship between performance on the Stroop color-word interference test (a suggested measure of distraction susceptibility) and impa...

National survey on distracted driving attitudes and behaviors : 2012.

DOT National Transportation Integrated Search

2013-04-01

The 2012 National Survey on Distracted Driving Attitudes and Behaviors (NSDDAB) is the second in a series of : surveys on distracted driving that have provided data to help further the understanding of driving behavior and to : contribute to the deve...

National Survey on Distracted Driving Attitudes and Behaviors - 2015

DOT National Transportation Integrated Search

2018-03-01

The 2015 National Survey on Distracted Driving Attitudes and Behaviors (NSDDAB) is the third in a series of telephone surveys on distracted driving providing data to help further the understanding of driving behavior and to contribute to the developm...

Evaluating the effect of distractions in the operating room on clinical decision-making and patient safety.

PubMed

Murji, Ally; Luketic, Lea; Sobel, Mara L; Kulasegaram, Kulamakan Mahan; Leyland, Nicholas; Posner, Glenn

2016-10-01

Answering telephone calls and pagers is common distraction in the operating room. We sought to evaluate the impact of distractions on patient care by (1) assessing the accuracy and safety of responses to clinical questions posed to a surgeon while operating and (2) determining whether pager distractions affect simulation-based surgical performance. We conducted a randomized crossover study of obstetrics and gynecology residents. After studying a patient sign-out list, subjects performed a virtual salpingectomy. They were randomized to a distraction phase followed by quiet phase or vice versa. In the distraction phase, a pager beeped and subjects were asked questions based on the sign-out list. Accuracy of responses and the number of unsafe responses were recorded. In the quiet phase, trainees performed the task uninterrupted. Measures of surgical performance were successful task completion, time to task completion and operative blood loss. The mean score for correct responses to clinical questions during the distracted phase was 80 % (SD ±14 %). Nineteen residents (63 %) made at least 1 unsafe clinical decision while operating on the simulator (range 0-3). Subjects were more likely to successfully complete the surgical task in the allotted time under the quiet compared to distraction condition (OR 11.3, p = 0.03). There was no difference between the conditions in paired analysis for mean time (seconds) to task completion [426 (SD 133) vs. 440 (SD 186), p = 0.61] and mean operative blood loss (mL) [73.14 (SD 106) vs. 112.70 (SD 358), p = 0.47]. Distractions in the operating room may have a profound impact on patient safety on the wards. While multitasking in a simulated setting, the majority of residents made at least one unsafe clinical decision. Pager distractions also hindered surgical residents' ability to complete a simulated laparoscopic task in the allotted time without affecting other variables of surgical performance.

Knee joint distraction compared with high tibial osteotomy: a randomized controlled trial.

PubMed

van der Woude, J A D; Wiegant, K; van Heerwaarden, R J; Spruijt, S; van Roermund, P M; Custers, R J H; Mastbergen, S C; Lafeber, F P J G

2017-03-01

Both, knee joint distraction as a relatively new approach and valgus-producing opening-wedge high tibial osteotomy (HTO), are knee-preserving treatments for knee osteoarthritis (OA). The efficacy of knee joint distraction compared to HTO has not been reported. Sixty-nine patients with medial knee joint OA with a varus axis deviation of <10° were randomized to either knee joint distraction (n = 23) or HTO (n = 46). Questionnaires were assessed at baseline and 3, 6, and 12 months. Joint space width (JSW) as a surrogate measure for cartilage thickness was determined on standardized semi-flexed radiographs at baseline and 1-year follow-up. All patient-reported outcome measures (PROMS) improved significantly over 1 year (at 1 year p < 0.02) in both groups. At 1 year, the HTO group showed slightly greater improvement in 4 of the 16 PROMS (p < 0.05). The minimum medial compartment JSW increased 0.8 ± 1.0 mm in the knee joint distraction group (p = 0.001) and 0.4 ± 0.5 mm in the HTO group (p < 0.001), with minimum JSW improvement in favour of knee joint distraction (p = 0.05). The lateral compartment showed a small increase in the knee joint distraction group and a small decrease in the HTO group, leading to a significant increase in mean JSW for knee joint distraction only (p < 0.02). Cartilaginous repair activity, as indicated by JSW, and clinical outcome improvement occurred with both, knee joint distraction and HTO. These findings suggest that knee joint distraction may be an alternative therapy for medial compartmental OA with a limited mechanical leg malalignment. Randomized controlled trial, Level I.

Type IIIb Endoleak and Relining: A Mathematical Model of Distraction Forces.

PubMed

Swaelens, Charles; Poole, Robert J; Torella, Francesco; McWilliams, Richard G; England, Andrew; Fisher, Robert K

2016-04-01

To examine the changes in distraction force following relining of a conventional abdominal aortic stent-graft with a type IIIb endoleak using the Nellix endovascular sealing device compared to a unilateral stent-graft. Relining is often used to repair type IIIb endoleaks, but the consequences to graft stability are unknown. A mathematical model was constructed based on pressure and volume flow through the stent-grafts, incorporating recognized distraction force equations. Steady flow was presumed at peak systolic pressures to calculate the maximum distraction force, with gravity ignored. Distraction forces for 28- to 36-mm-diameter stent-graft bodies with 16-mm limbs were calculated and compared to forces following relining with single and double Nellix devices or the Renu unilateral device. Distraction forces for the 28-, 32-, and 36-mm stent-grafts prior to relining were 5.99, 10.21, and 14.99 N, respectively. Similar forces were reported after relining with bilateral Nellix devices (5.86, 10.08, and 14.86 N, respectively). However, use of a unilateral Nellix increased the distraction forces to 9.92, 14.14, and 18.92 N, respectively. These were comparable to the increase observed after relining with a Renu unilateral stent-graft (9.87, 14.09, and 18.86 N, respectively). The proportional increase in distraction force for a unilateral relining ranged from 26% to 66%, with the greatest increase noted in the smaller diameter main bodies. Relining a stent-graft with a type IIIb endoleak using bilateral Nellix devices does not increase the distraction force. However, a unilateral Nellix device or the Renu system could theoretically increase the distraction force by up to 66%, potentially risking migration and type Ia endoleak. In clinical practice, these results suggest that a relining with bilateral Nellix may have benefits over the Renu unilateral stent-graft. © The Author(s) 2016.

Effect of motion on speech recognition.

PubMed

Davis, Timothy J; Grantham, D Wesley; Gifford, René H

2016-07-01

The benefit of spatial separation for talkers in a multi-talker environment is well documented. However, few studies have examined the effect of talker motion on speech recognition. In the current study, we evaluated the effects of (1) motion of the target or distracters, (2) a priori information about the target and distracter spatial configurations, and (3) target and distracter location. In total, seventeen young adults with normal hearing were tested in a large anechoic chamber in two experiments. In Experiment 1, seven stimulus conditions were tested using the Coordinate Response Measure (Bolia et al., 2000) speech corpus, in which subjects were required to report the key words in a target sentence presented simultaneously with two distracter sentences. As in previous studies, there was a significant improvement in key word identification for conditions in which the target and distracters were spatially separated as compared to the co-located conditions. In addition, 1) motion of either talker or distracter resulted in improved performance compared to stationary presentation (talker motion yielded significantly better performance than distracter motion) 2) a priori information regarding stimulus configuration was not beneficial, and 3) performance was significantly better with key words at 0° azimuth as compared to -60° (on the listener's left). Experiment 2 included two additional conditions designed to assess whether the benefit of motion observed in Experiment 1 was due to the motion itself or to the fact that the motion conditions introduced small spatial separations in the target and distracter key words. Results showed that small spatial separations (on the order of 5-8°) resulted in improved performance (relative to co-located key words) whether the sentences were moving or stationary. These results suggest that in the presence of distracting messages, motion of either target or distracters and/or small spatial separation of the key words may be beneficial for sound source segregation and thus for improved speech recognition. Copyright © 2016 Elsevier B.V. All rights reserved.

The Impact of Anxiety-Inducing Distraction on Cognitive Performance: A Combined Brain Imaging and Personality Investigation

PubMed Central

Denkova, Ekaterina; Wong, Gloria; Dolcos, Sanda; Sung, Keen; Wang, Lihong; Coupland, Nicholas; Dolcos, Florin

2010-01-01

Background Previous investigations revealed that the impact of task-irrelevant emotional distraction on ongoing goal-oriented cognitive processing is linked to opposite patterns of activation in emotional and perceptual vs. cognitive control/executive brain regions. However, little is known about the role of individual variations in these responses. The present study investigated the effect of trait anxiety on the neural responses mediating the impact of transient anxiety-inducing task-irrelevant distraction on cognitive performance, and on the neural correlates of coping with such distraction. We investigated whether activity in the brain regions sensitive to emotional distraction would show dissociable patterns of co-variation with measures indexing individual variations in trait anxiety and cognitive performance. Methodology/Principal Findings Event-related fMRI data, recorded while healthy female participants performed a delayed-response working memory (WM) task with distraction, were investigated in conjunction with behavioural measures that assessed individual variations in both trait anxiety and WM performance. Consistent with increased sensitivity to emotional cues in high anxiety, specific perceptual areas (fusiform gyrus - FG) exhibited increased activity that was positively correlated with trait anxiety and negatively correlated with WM performance, whereas specific executive regions (right lateral prefrontal cortex - PFC) exhibited decreased activity that was negatively correlated with trait anxiety. The study also identified a role of the medial and left lateral PFC in coping with distraction, as opposed to reflecting a detrimental impact of emotional distraction. Conclusions These findings provide initial evidence concerning the neural mechanisms sensitive to individual variations in trait anxiety and WM performance, which dissociate the detrimental impact of emotion distraction and the engagement of mechanisms to cope with distracting emotions. Our study sheds light on the neural correlates of emotion-cognition interactions in normal behaviour, which has implications for understanding factors that may influence susceptibility to affective disorders, in general, and to anxiety disorders, in particular. PMID:21152391

Do absorption and realistic distraction influence performance of component task surgical procedure?

PubMed

Pluyter, Jon R; Buzink, Sonja N; Rutkowski, Anne-F; Jakimowicz, Jack J

2010-04-01

Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance. Twelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting conditions (exposure to music, conversation, and nonoptimal handling of the laparoscope) versus nondistracting conditions (control condition) as part of a 2 x 2 within-subject experimental design. Under distracting conditions, the medical interns showed a significant decline in task performance (overall task score, task errors, and operating time) and significantly increased levels of irritation toward both the assistant handling the laparoscope in a nonoptimal way and the sources of social distraction. Furthermore, individual differences in cognitive style (i.e., cognitive absorption and need for cognition) significantly influenced the levels of irritation experienced by the medical interns. The results suggest careful evaluation of the social and technological sources of distraction in the operation room to reduce irritation for the surgeon and provision of proper preclinical laparoscope navigation training to increase security for the patient.

Relative Effectiveness of Reappraisal and Distraction in Regulating Emotion in Late-Life Depression

PubMed Central

Smoski, Moria J.; LaBar, Kevin S.; Steffens, David C.

2013-01-01

Objectives The present study compares the effectiveness of two strategies, reappraisal and distraction, in reducing negative affect in older adults induced by focusing on personally relevant negative events and stressors. Participants included 30 adults with MDD and 40 never-depressed (ND) comparison participants ages 60 and over (mean age = 69.7 years). Design and Measurements Participants underwent three affect induction trials, each followed by a different emotion regulation strategy: distraction, reappraisal, and a no-instruction control condition. Self-reported affect was recorded pre- and post-affect induction, and at one-minute intervals during regulation. Results Across groups, participants reported greater reductions in negative affect with distraction than reappraisal or the no-instruction control condition. An interaction between group and regulation condition indicated that distraction was more effective in reducing negative affect in the MDD group than the ND group. Conclusions These results suggest that distraction is an especially effective strategy for reducing negative affect in older adults with MDD. Finding ways to incorporate distraction skills into psychotherapeutic interventions for late-life MDD may improve their effectiveness, especially for short-term improvement of affect following rumination. PMID:24021222

Bioresorbable distraction device for the treatment of airway problems for infants with Robin sequence.

PubMed

Breugem, Corstiaan; Paes, Emma; Kon, Moshe; Mink van der Molen, Aebele B; van der Molen, Aebele B Mink

2012-08-01

Pierre Robin sequence is a well known craniofacial entity. There are numerous ways to treat the respiratory insufficiency, but sometimes surgical intervention is needed. Tracheotomy could be associated with morbidity, and distraction osteogenesis has been established as a stable method to obtain a safe airway. Distraction osteogenesis has traditionally been performed with an external device. In this manuscript we describe the feasibility of an internal bioresorbable device. Retrospective descriptive study was performed in a tertiary academic children's hospital. After multidisciplinary team consultation, 12 consecutive patients with Robin sequence were treated with this internal distraction device. The mean age at surgery was 32 days, and the average amount of mandibular distraction was 18 mm. All patients were extubated after an average of 7.5 days after the surgery. The average length of stay in the hospital was 17 days after surgery. There were no major surgical complications. A tracheotomy was prevented in all our patients, and complications were limited. Long-term studies are needed to evaluate the influence that internal distraction has on the growth of the mandible and teeth. The internal distraction system seems safe for infants with micrognathia and has certain benefits when compared to the external distractor.

Distracting people from sources of discomfort in a simulated aircraft environment.

PubMed

Lewis, Laura; Patel, Harshada; Cobb, Sue; D'Cruz, Mirabelle; Bues, Matthias; Stefani, Oliver; Grobler, Tredeaux

2016-07-19

Comfort is an important factor in the acceptance of transport systems. In 2010 and 2011, the European Commission (EC) put forward its vision for air travel in the year 2050 which envisaged the use of in-flight virtual reality. This paper addressed the EC vision by investigating the effect of virtual environments on comfort. Research has shown that virtual environments can provide entertaining experiences and can be effective distracters from painful experiences. To determine the extent to which a virtual environment could distract people from sources of discomfort. Experiments which involved inducing discomfort commonly experienced in-flight (e.g. limited space, noise) in order to determine the extent to which viewing a virtual environment could distract people from discomfort. Virtual environments can fully or partially distract people from sources of discomfort, becoming more effective when they are interesting. They are also more effective at distracting people from discomfort caused by restricted space than noise disturbances. Virtual environments have the potential to enhance passenger comfort by providing positive distractions from sources of discomfort. Further research is required to understand more fully the reasons why the effect was stronger for one source of discomfort than the other.

Trends in Fatalities From Distracted Driving in the United States, 1999 to 2008

PubMed Central

Stimpson, Jim P.

2010-01-01

Objectives. We examined trends in distracted driving fatalities and their relation to cell phone use and texting volume. Methods. The Fatality Analysis Reporting System (FARS) records data on all road fatalities that occurred on public roads in the United States from 1999 to 2008. We studied trends in distracted driving fatalities, driver and crash characteristics, and trends in cell phone use and texting volume. We used multivariate regression analysis to estimate the relation between state-level distracted driving fatalities and texting volumes. Results. After declining from 1999 to 2005, fatalities from distracted driving increased 28% after 2005, rising from 4572 fatalities to 5870 in 2008. Crashes increasingly involved male drivers driving alone in collisions with roadside obstructions in urban areas. By use of multivariate analyses, we predicted that increasing texting volumes resulted in more than 16 000 additional road fatalities from 2001 to 2007. Conclusions. Distracted driving is a growing public safety hazard. Specifically, the dramatic rise in texting volume since 2005 appeared to be contributing to an alarming rise in distracted driving fatalities. Legislation enacting texting bans should be paired with effective enforcement to deter drivers from using cell phones while driving. PMID:20864709

Trends in fatalities from distracted driving in the United States, 1999 to 2008.

PubMed

Wilson, Fernando A; Stimpson, Jim P

2010-11-01

We examined trends in distracted driving fatalities and their relation to cell phone use and texting volume. The Fatality Analysis Reporting System (FARS) records data on all road fatalities that occurred on public roads in the United States from 1999 to 2008. We studied trends in distracted driving fatalities, driver and crash characteristics, and trends in cell phone use and texting volume. We used multivariate regression analysis to estimate the relation between state-level distracted driving fatalities and texting volumes. After declining from 1999 to 2005, fatalities from distracted driving increased 28% after 2005, rising from 4572 fatalities to 5870 in 2008. Crashes increasingly involved male drivers driving alone in collisions with roadside obstructions in urban areas. By use of multivariate analyses, we predicted that increasing texting volumes resulted in more than 16,000 additional road fatalities from 2001 to 2007. Distracted driving is a growing public safety hazard. Specifically, the dramatic rise in texting volume since 2005 appeared to be contributing to an alarming rise in distracted driving fatalities. Legislation enacting texting bans should be paired with effective enforcement to deter drivers from using cell phones while driving.

Identification of real-time diagnostic measures of visual distraction with an automatic eye-tracking system.

PubMed

Zhang, Harry; Smith, Matthew R H; Witt, Gerald J

2006-01-01

This study was conducted to identify eye glance measures that are diagnostic of visual distraction. Visual distraction degrades performance, but real-time diagnostic measures have not been identified. In a driving simulator, 14 participants responded to a lead vehicle braking at -2 or -2.7 m/s2 periodically while reading a varying number of words (6-15 words every 13 s) on peripheral displays (with diagonal eccentricities of 24 degrees, 43 degrees, and 75 degrees). As the number of words and display eccentricity increased, total glance duration and reaction time increased and driving performance suffered. Correlation coefficients between several glance measures and reaction time or performance variables were reliably high, indicating that these glance measures are diagnostic of visual distraction. It is predicted that for every 25% increase in total glance duration, reaction time is increased by 0.39 s and standard deviation of lane position is increased by 0.06 m. Potential applications of this research include assessing visual distraction in real time, delivering advisories to distracted drivers to reorient their attention to driving, and using distraction information to adapt forward collision and lane departure warning systems to enhance system effectiveness.

When Distraction Holds Relevance: A Prospective Memory Benefit for Older Adults.

PubMed

Lourenço, Joana S; Maylor, Elizabeth A

2015-06-09

Evidence is accumulating to show that age-related increases in susceptibility to distracting information can benefit older more than young adults in several cognitive tasks. Here we focus on prospective memory (i.e., remembering to carry out future intentions) and examine the effect of presenting distracting information that is intention-related as a function of age. Young and older adults performed an ongoing 1-back working memory task to a rapid stream of pictures superimposed with to-be-ignored letter strings. Participants were additionally instructed to respond to target pictures (namely, animals) and, for half of the participants, some strings prior to the targets were intention-related words (i.e., animals). Results showed that presenting intention-related distracting information during the ongoing task was particularly advantageous for target detection in older compared to young adults. Moreover, a prospective memory benefit was observed even for older adults who showed no explicit memory for the target distracter words. We speculate that intention-related distracter information enhanced the accessibility of the prospective memory task and suggest that when distracting information holds relevance to intentions it can serve a compensatory role in prospective remembering in older adults.

Changes in speech following maxillary distraction osteogenesis.

PubMed

Guyette, T W; Polley, J W; Figueroa, A; Smith, B E

2001-05-01

The purpose of this study was to describe changes in articulation and velopharyngeal function following maxillary distraction osteogenesis. This is a descriptive, post hoc clinical report comparing the performance of patients before and after maxillary distraction. The independent variable was maxillary distraction while the dependent variables were resonance, articulation errors, and velopharyngeal function. The data were collected at a tertiary health care center in Chicago. The data from pre- and postoperative evaluations of 18 maxillary distraction patients were used. The outcome measures were severity of hypernasality and hyponasality, velopharyngeal orifice size as estimated using the pressure-flow technique, and number and type of articulation errors. At the long-term follow-up, 16.7% exhibited a significant increase in hypernasality. Seventy-five percent of patients with preoperative hyponasality experienced improved nasal resonance. Articulation improved in 67% of patients by the 1-year follow-up. In a predominately cleft palate population, the risk for velopharyngeal insufficiency following maxillary distraction is similar to the risk observed in Le Fort I maxillary advancement. Patients being considered for maxillary distraction surgery should receive pre- and postoperative speech evaluations and be counseled about risks for changes in their speech.

Long-term skeletal and dental changes in patients with cleft lip and palate after maxillary distraction: a report of three cases treated with a rigid external distraction device.

PubMed

Harada, Kiyoshi; Sato, Masaru; Omura, Ken

2005-04-01

We examined long-term skeletal and dental changes in three patients with cleft lip and palate who underwent maxillary distraction using a rigid external distraction device. Two were children, and one was an adult. Changes in the overjet (OJ), overbite (OB), and positions of the anterior nasal spine (ANS), upper incisors (U1), pogonion (Pog), and lower incisors (L1) were measured on preoperative to 36 months postoperative lateral-cephalograms. In the adult, the positions of all examination points were relatively stable from 6 to 36 months postoperatively, and the OJ and OB were maintained at over 2 mm at 36 months. In the children, the positions of ANS and U1 changed inferiorly, Pog and L1 changed anteroinferiorly, and OJ and OB tended to decrease from 6 to 36 months postoperatively. Long-term skeletal and dental stability following maxillary distraction was relatively well maintained in the adult patient. In the children, the maxillomandibular growth was observed after maxillary distraction, but the mandibular overgrowth might have been inhibited by the correction of class III dentoskeletal deformity resulting from the maxillary distraction.

Trans-sinusal maxillary distraction for correction of midfacial hypoplasia: long-term clinical results.

PubMed

Nadjmi, N; Schutyser, F; Van Erum, R

2006-10-01

Maxillary distraction osteogenesis is indicated in severe angle class III malocclusions, and severe maxillary hypoplasia among some cleft patients and other craniofacial deformities. Twenty patients, aged 8-48 years (mean 17.8+/-10.5 SD) with maxillary and midfacial hypoplasia were treated. The follow-up period was 13-65 months (mean 35+/-16.3 SD). A trans-sinusal maxillary distractor was placed intraorally at each side of the maxilla. The distraction vector was predicted using specialist software, and was transferred to the patients using stereolithographic models and individual templates. A (high) Le Fort I type osteotomy was performed. The amount of activation varied from 8 to 17.5 mm (mean 13.1+/-2.9 SD). Soft and hard tissue formation resulted in complete healing across the distraction gaps. The distractors are almost completely submerged, and can be left in place as long as necessary to avoid relapse. Wit's appraisal was used to measure the stability of the long-term distraction results. Results up to 5 years after distraction showed considerable maxillary advancement with long-term stability. Ongoing growth of the facial skeleton must be considered when distraction osteogenesis is chosen in growing patients.

Distraction produces over-additive increases in the degree to which alcohol impairs driving performance.

PubMed

Van Dyke, Nicholas A; Fillmore, Mark T

2015-12-01

Research indicates that alcohol intoxication and increased demands on drivers' attention from distractions (e.g., passengers and cell phones) contribute to poor driving performance and increased rates of traffic accidents and fatalities. The present study examined the separate and combined effects of alcohol and distraction on simulated driving performance at blood alcohol concentrations (BrACs) below the legal driving limit in the USA (i.e., 0.08 %). Fifty healthy adult drivers (36 men and 14 women) were tested in a driving simulator following a 0.65-g/kg dose of alcohol and a placebo. Drivers completed two drive tests: a distracted drive, which included a two-choice detection task, and an undistracted control drive. Multiple indicators of driving performance, such as drive speed, within-lane deviation, steering rate, and lane exceedances were measured. Alcohol and distraction each impaired measures of driving performance. Moreover, the magnitude of alcohol impairment was increased by at least twofold when tested under the distracting versus the undistracted condition. The findings highlight the need for a clearer understanding of how common distractions impact intoxicated drivers, especially at BrACs that are currently legal for driving in the USA.

Reducing major rule violations in commuter rail operations : the role of distraction and attentional errors

DOT National Transportation Integrated Search

2012-10-22

Recent accidents in commuter rail operations and analyses of rule violations have highlighted the need for : better understanding of the contributory role of distraction and attentional errors. Distracted driving has : thoroughly been studied in rece...

Educating Idaho Teenage Drivers of the Dangers of Distracted Driving

DOT National Transportation Integrated Search

2017-08-01

The objective of this research project efforts are: 1) to develop an interactive driver-distracted presentation that can be used at different high schools in Idaho to educate teenage drivers about the danger of distracted driving, 2) to test the effe...

Educating teenage drivers in the Pacific Northwest regarding the dangers of distracted driving (phase I).

DOT National Transportation Integrated Search

2014-09-01

The goal of this outreach project was to examine driver distraction among teenagers in the Pacific Northwest. Specifically, to identify secondary tasks they consider distracting and determine their self-reported engagement in those same secondary tas...

Educating younger drivers in the Pacific Northwest regarding the dangers of distracted driving (phase II).

DOT National Transportation Integrated Search

2015-07-01

The goal of this outreach project was to examine driver distraction among high school and college students in the Pacific Northwest. : Specifically, to identify secondary tasks they consider distracting and determine their self-reported engagement in...

Evaluation of cranial bone transport distraction with and without adipose grafting.

PubMed

Koch, Felix P; Yuhasz, Mikell M; Travieso, Rob; Wong, Kenneth; Clune, James; Zhuang, Zhen W; Van Houten, Joshua; Steinbacher, Derek M

2014-05-01

Transport distraction osteogenesis (DO) can be used to autologously reconstitute calvarial defects. The purpose of this study is to histomorphologically interrogate osteogenic formation during cranial transport distraction using a novel device. We also evaluate the effect of fat grafting on the regenerate and soft-tissue stability during distraction. This study was approved by Yale IACUC. Ten male New Zealand white rabbits (3 mo; 3.5 kg) were used (8 treatment, 2 control). A 16 × 16 mm defect was created abutted by a 10 × 16 mm transport disc. The device was fixated anterioposteriorly. Four animals were fat-grafted using 2 mL of subdermal intrascapular fat deposited along the distraction site. Latency (1 d), active distraction (12-14 d) (1.5 mm/d), and consolidation (4 wk) followed. Calcein and xylene orange fluorochromes were injected subcutaneously during and post-distraction to mark sites of bone formation. Following sacrifice, osteogenesis was assessed using microCT, histology, and fluorescence. Treatment animals demonstrated regenerate bone between distracted segments on microCT. MicroCT analysis of non-fat-grafted and fat-grafted animals revealed a mean density of 2271.95 mgHA/ccm and 2254.27 mgHA/ccm (P = 0.967), respectively, and defect bone versus total volume (BV/TV) of 0.0999 and 0.0766 (P = 0.5979), respectively. Controls had minimal reossification. Histologically, mean densities measured 43.63% and 8.19%, respectively. Fluorescence revealed ossification from the callus as well as from dura and periosteum in the cranial defect. Transport distraction is effective to reconstruct critically sized rabbit calvarial defects. Regenerate bone arises predominantly from the callus with contribution from surrounding dura and periosteum. Adipose grafting is well tolerated but does not enhance osseous regeneration.

Fatalities of pedestrians, bicycle riders, and motorists due to distracted driving motor vehicle crashes in the U.S., 2005-2010.

PubMed

Stimpson, Jim P; Wilson, Fernando A; Muelleman, Robert L

2013-01-01

Distracted driving is an increasingly deadly threat to road safety. This study documents trends in and characteristics of pedestrian, bicycle rider, and other victim deaths caused by distracted drivers on U.S. public roads. We obtained data from the Fatality Analysis Reporting System database from 2005 to 2010 on every crash that resulted in at least one fatality within 30 days occurring on public roads in the U.S. Following the definition used by the National Highway Traffic Safety Administration, we identified distracted driving based on whether police investigators determined that a driver had been using a technological device, including a cell phone, onboard navigation system, computer, fax machine, two-way radio, or head-up display, or had been engaged in inattentive or careless activities. The rate of fatalities per 10 billion vehicle miles traveled increased from 116.1 in 2005 to 168.6 in 2010 for pedestrians and from 18.7 in 2005 to 24.6 in 2010 for bicyclists. Pedestrian victims of distracted driving crashes were disproportionately male, 25-64 years of age, and non-Hispanic white. They were also more likely to die at nighttime, be struck by a distracted driver outside of a marked crosswalk, and be in a metro location. Bicycling victims of distracted crashes were disproportionately male, non-Hispanic white, and struck by a distracted driver outside of a crosswalk. Compared with pedestrians, bicyclists were less likely to be hit in early morning. Distracted drivers are the cause of an increasing share of fatalities found among pedestrians and bicycle riders. Policies are needed to protect pedestrians and bicycle riders as they cross intersections or travel on roadways.

Acceptance, cognitive restructuring, and distraction as coping strategies for acute pain.

PubMed

Kohl, Annika; Rief, Winfried; Glombiewski, Julia Anna

2013-03-01

Little is known about treatment mechanisms underlying acceptance strategies. Acceptance is a strategy that is expected to increase pain tolerance more than distraction, while distraction should lead to lower pain intensity. The effect of cognitive restructuring on experimental pain has not yet been investigated. The present study aimed to explore differential short-term effects of acceptance, distraction, and cognitive restructuring on pain tolerance and intensity. Pain was induced in a sample of 109 female students using a thermode. We conducted analyses of covariance with instruction as the independent variable and posttest scores on pain variables as dependent variables, covarying for pretest scores. In addition, adherence to instructions and credibility of instructions were included as covariates. Acceptance led to a higher increase in pain tolerance than did cognitive restructuring of pain-related thoughts. No differences were detected between either acceptance and distraction or distraction and cognitive restructuring with respect to pain tolerance. Distraction led to lower pain intensity compared to acceptance. Cognitive restructuring did not differ from either acceptance or distraction with respect to pain intensity. As a short-term strategy, cognitive restructuring was not as useful as acceptance in increasing pain tolerance. Further studies should evaluate the preconditions under which different strategies are most effective. This study demonstrated that acceptance was superior to cognitive restructuring in increasing tolerance for experimentally induced pain, but was inferior to distraction with respect to decreasing pain intensity. Knowledge about the types of strategies that are useful in targeting diverse pain-related outcome measures is important for efforts to refine the treatment of chronic pain. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

Useful field of view predicts driving in the presence of distracters.

PubMed

Wood, Joanne M; Chaparro, Alex; Lacherez, Philippe; Hickson, Louise

2012-04-01

The Useful Field of View (UFOV) test has been shown to be highly effective in predicting crash risk among older adults. An important question which we examined in this study is whether this association is due to the ability of the UFOV to predict difficulties in attention-demanding driving situations that involve either visual or auditory distracters. Participants included 92 community-living adults (mean age 73.6 ± 5.4 years; range 65-88 years) who completed all three subtests of the UFOV involving assessment of visual processing speed (subtest 1), divided attention (subtest 2), and selective attention (subtest 3); driving safety risk was also classified using the UFOV scoring system. Driving performance was assessed separately on a closed-road circuit while driving under three conditions: no distracters, visual distracters, and auditory distracters. Driving outcome measures included road sign recognition, hazard detection, gap perception, time to complete the course, and performance on the distracter tasks. Those rated as safe on the UFOV (safety rating categories 1 and 2), as well as those responding faster than the recommended cut-off on the selective attention subtest (350 msec), performed significantly better in terms of overall driving performance and also experienced less interference from distracters. Of the three UFOV subtests, the selective attention subtest best predicted overall driving performance in the presence of distracters. Older adults who were rated as higher risk on the UFOV, particularly on the selective attention subtest, demonstrated poorest driving performance in the presence of distracters. This finding suggests that the selective attention subtest of the UFOV may be differentially more effective in predicting driving difficulties in situations of divided attention which are commonly associated with crashes.

Minimum distraction gap: how much ankle joint space is enough in ankle distraction arthroplasty?

PubMed

Fragomen, Austin T; McCoy, Thomas H; Meyers, Kathleen N; Rozbruch, S Robert

2014-02-01

The success of ankle distraction arthroplasty relies on the separation of the tibiotalar articular surfaces. The purpose of this study was to find the minimum distraction gap needed to ensure that the tibiotalar joint surfaces would not contact each other with full weight-bearing while under distraction. Circular external fixators were mounted to nine cadaver ankle specimens. Each specimen was then placed into a custom-designed load chamber. Loads of 0, 350, and 700N were applied to the specimen. Radiographic joint space was measured and joint contact pressure was monitored under each load. The external fixator was then sequentially distracted, and the radiographic joint space was measured under the three different loads. The experiment was stopped when there was no joint contact under 700N of load. The radiographic joint space was measured and the initial (undistracted) radiographic joint space was subtracted from it yielding the distraction gap. The minimum distraction gap (mDG) that would provide total unloading was calculated. The average mDG was 2.4 mm (range, 1.6 to 4.0 mm) at 700N of load, 4.4 mm (range, 3.7 to 5.8 mm) at 350N of load, and 4.9 mm (range, 3.7 to 7.0 mm) at 0N of load. These results suggest that if the radiographic joint space of on a standing X-ray of an ankle undergoing distraction arthroplasty shows a minimum of 5.8 mm of DG, then there will be no contact between joint surfaces during full weight-bearing. Therefore, 5 mm of radiographic joint space, as recommended historically, may not be adequate to prevent contact of the articular surfaces during weight-bearing.

The Impact of Operating Room Distractions on Stress, Workload, and Teamwork.

PubMed

Wheelock, Ana; Suliman, Amna; Wharton, Rupert; Babu, E D; Hull, Louise; Vincent, Charles; Sevdalis, Nick; Arora, Sonal

2015-06-01

To investigate whether distractions in the operating room (OR) are associated with higher mental workload and stress, and poorer teamwork among OR personnel. Engaging in multiple tasks can affect performance. There is little research on the effect of distractions on surgical team members' behavior and cognitive processes. Ninety general surgery cases were observed in real time. Cases were assessed by a surgeon and a behavioral scientist using 4 validated tools: OR Distractions Assessment Form, the Observational Teamwork Assessment for Surgery tool, NASA-Task Load Index, and short form of the State Trait Anxiety Inventory. Analysis of variance was performed to evaluate significant differences between teamwork, workload, and stress level among team members. Correlations (Pearson r) were computed to evaluate associations between variables. The most prevalent distractions were those initiated by external staff, followed by case-irrelevant conversations. Case-irrelevant conversations were associated with poorer team performance. Irrelevant conversations initiated by surgeons were associated with lower teamwork in surgeons (across team skills: r = -0.44 to -0.58, P < 0.05 to 0.01) and anesthesiologists (r = -0.38 and r = -0.40, for coordination and leadership; P < 0.05). Equipment-related distractions correlated with higher stress (r = 0.48, P < 0.05) and lower teamwork (across team skills: r = -0.42 to -0.50, P < 0.05) in nurses. Acoustic distractions correlated with higher stress in surgeons (r = 0.32, P < 0.05) and higher workload in anesthesiologists (r = 0.30, P < 0.05). Although some distractions may be inevitable in the OR, they can also be detrimental to the team. A deeper understanding of the effect of distractions on teams and their outcomes can lead to targeted quality improvement.

Biomechanical comparison of two intraoperative mobilization techniques for maxillary distraction osteogenesis: Down-fracture versus non-down-fracture.

PubMed

Yang, Lili; Suzuki, Eduardo Yugo; Suzuki, Boonsiva

2014-01-01

The purpose of this study was to compare the distraction forces and the biomechanical effects between two different intraoperative surgical procedures (down-fracture [DF] and non-DF [NDF]) for maxillary distraction osteogenesis. Eight patients were assigned into two groups according to the surgical procedure: DF, n = 6 versus NDF, n = 2. Lateral cephalograms taken preoperatively (T1), immediately after removal of the distraction device (T2), and after at least a 6 months follow-up period (T3) were analyzed. Assessment of distraction forces was performed during the distraction period. The Mann-Whitney U-test was used to compare the difference in the amount of advancement, the maximum distraction force and the amount of relapse. Although a significantly greater amount of maxillary movement was observed in the DF group (median 9.5 mm; minimum-maximum 7.9-14.1 mm) than in the NDF group (median 5.9 mm; minimum-maximum 4.4-7.6 mm), significantly lower maximum distraction forces were observed in the DF (median 16.4 N; minimum-maximum 15.1-24.6 N) than in the NDF (median 32.9 N; minimum-maximum 27.6-38.2 N) group. A significantly greater amount of dental anchorage loss was observed in the NDF group. Moreover, the amount of relapse observed in the NDF group was approximately 3.5 times greater than in the DF group. In this study, it seemed that, the use of the NDF procedure resulted in lower levels of maxillary mobility at the time of the maxillary distraction, consequently requiring greater amounts of force to advance the maxillary bone. Moreover, it also resulted in a reduced amount of maxillary movement, a greater amount of dental anchorage loss and poor treatment stability.

Skeletal and dental stability after maxillary distraction with a rigid external device in adult cleft lip and palate patients.

PubMed

Aksu, Muge; Saglam-Aydinatay, Banu; Akcan, Cenk Ahmet; El, Hakan; Taner, Tulin; Kocadereli, Ilken; Tuncbilek, Gokhan; Mavili, Mehmet Emin

2010-02-01

To evaluate skeletal and dental stability in adult cleft lip and palate patients treated with a rigid external distraction system at the end of distraction and during the postdistraction period. Lateral cephalograms of 7 patients were obtained before distraction, at the end of distraction, and during the postdistraction period. The mean age before distraction was 21.56 +/- 4.73 years. The mean follow-up was 37.3 +/- 12.4 months. The assessment of findings showed that skeletal maxillary sagittal movement was achieved in a superoanterior direction. The maxillary depth angle and effective maxillary length increased significantly (2 degrees and 9 mm, respectively) after distraction, whereas the palatal plane angle increased by 8 degrees , resulting in an anterior movement of the maxilla with a counterclockwise rotation. The lower facial height showed no significant changes after distraction. The sagittal movement of the upper incisors and the angulation of the upper first molars increased significantly (4.5 mm and 5.5 degrees , respectively). During the postdistraction period, the maxilla showed a slight relapse (22%). The effective maxillary length decreased by 2 mm. The palatal plane angle almost returned to its original position, showing 7 degrees of clockwise rotation. The lower facial height remained stable. The upper incisors moved anteriorly and the upper first molars showed a significant mesioangular change during follow-up. After distraction, significant maxillary advancement was achieved with a counterclockwise rotation. The upper incisors moved labially, and the upper first molars angulated mesially. After 3 years, a 22% relapse rate was seen in the maxilla. The counterclockwise rotation of the maxilla was returned to its original position. The upper incisors moved more anteriorly. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Texting while driving: A study of 1211 U.S. adults with the Distracted Driving Survey.

PubMed

Gliklich, Emily; Guo, Rong; Bergmark, Regan W

2016-12-01

Texting and other cell-phone related distracted driving is estimated to account for thousands of motor vehicle collisions each year but studies examining the specific cell phone reading and writing activities of drivers are limited. The objective of this study was to describe the frequency of cell-phone related distracted driving behaviors. A national, representative, anonymous panel of 1211 United States drivers was recruited in 2015 to complete the Distracted Driving Survey (DDS), an 11-item validated questionnaire examining cell phone reading and writing activities and at what speeds they occur. Higher DDS scores reflect more distraction. DDS scores were analyzed by demographic data and self-reported crash rate. Nearly 60% of respondents reported a cell phone reading or writing activity within the prior 30 days, with reading texts (48%), writing texts (33%) and viewing maps (43%) most frequently reported. Only 4.9% of respondents had enrolled in a program aimed at reducing cell phone related distracted driving. DDS scores were significantly correlated to crash rate (p < 0.0001), with every one point increase associated with an additional 7% risk of a crash (p < 0.0001). DDS scores were inversely correlated to age (p < 0.0001). The DDS demonstrated high internal consistency (Cronbach's alpha = 0.94). High rates of cell phone-related distraction are reported here in a national sample. Distraction is associated with crash rates and occurs across all age groups, but is highest in younger drivers. The DDS can be used to evaluate the impact of public health programs aimed at reducing cell-phone related distracted driving.

Parathyroid hormone therapy mollifies radiation-induced biomechanical degradation in murine distraction osteogenesis.

PubMed

Deshpande, Sagar S; Gallagher, Katherine K; Donneys, Alexis; Tchanque-Fossuo, Catherine N; Sarhaddi, Deniz; Nelson, Noah S; Chepeha, Douglas B; Buchman, Steven R

2013-07-01

Descriptions of mandibular distraction osteogenesis for tissue replacement after oncologic resection or for defects caused by osteoradionecrosis have been limited. Previous work demonstrated radiation decreases union formation, cellularity and mineral density in mandibular distraction osteogenesis. The authors posit that intermittent systemic administration of parathyroid hormone will serve as a stimulant to cellular function, reversing radiation-induced damage and enhancing bone regeneration. Twenty male Lewis rats were randomly assigned to three groups: group 1 (radiation and distraction osteogenesis, n = 7) and group 2 (radiation, distraction osteogenesis, and parathyroid hormone, n = 5) received a human-equivalent dose of 35 Gy of radiation (human bioequivalent, 70 Gy) fractionated over 5 days. All groups, including group 3 (distraction osteogenesis, n = 8), underwent a left unilateral mandibular osteotomy with bilateral external fixator placement. Distraction osteogenesis was performed at a rate of 0.3 mm every 12 hours to reach a gap of 5.1 mm. Group 2 was injected with parathyroid hormone (60 µg/kg) subcutaneously daily for 3 weeks after the start of distraction osteogenesis. On postoperative day 40, all left hemimandibles were harvested. Biomechanical response parameters were generated. Statistical significance was considered at p ≤ 0.05. Parathyroid hormone-treated mandibles had significantly higher failure load and higher yield than did untreated mandibles. However, these values were still significantly lower than those of nonirradiated mandibles. The authors have successfully demonstrated the therapeutic efficacy of parathyroid hormone to stimulate and enhance bone regeneration in their irradiated murine mandibular model of distraction osteogenesis. Anabolic regimens of parathyroid hormone, a U.S. Food and Drug Administration-approved drug on formulary, significantly improve outcomes in a model of postoncologic craniofacial reconstruction.

Parathyroid Hormone Therapy Mollifies Radiation-Induced Biomechanical Degradation in Murine Distraction Osteogenesis

PubMed Central

Deshpande, Sagar S.; Gallagher, Katherine K.; Donneys, Alexis; Tchanque-Fossuo, Catherine N.; Sarhaddi, Deniz; Nelson, Noah S.; Chepeha, Douglas B.; Buchman, Steven R.

2015-01-01

Objective Descriptions of mandibular distraction osteogenesis for tissue replacement after oncologic resection or for defects caused by osteoradionecrosis have been limited. Previous work demonstrated radiation decreases union formation, cellularity and mineral density in mandibular distraction osteogenesis. The authors posit that intermittent systemic administration of parathyroid hormone will serve as a stimulant to cellular function, reversing radiation-induced damage and enhancing bone regeneration. Methods Twenty male Lewis rats were randomly assigned to three groups: group 1 (radiation and distraction osteogenesis, n = 7) and group 2 (radiation, distraction osteogenesis, and parathyroid hormone, n = 5) received a human-equivalent dose of 35 Gy of radiation (human bioequivalent, 70 Gy) fractionated over 5 days. All groups, including group 3 (distraction osteogenesis, n = 8), underwent a left unilateral mandibular osteotomy with bilateral external fixator placement. Distraction osteogenesis was performed at a rate of 0.3 mm every 12 hours to reach a gap of 5.1 mm. Group 2 was injected with parathyroid hormone (60 μg/kg) subcutaneously daily for 3 weeks after the start of distraction osteogenesis. On postoperative day 40, all left hemimandibles were harvested. Biomechanical response parameters were generated. Statistical significance was considered at p ≤ 0.05. Results Parathyroid hormone–treated mandibles had significantly higher failure load and higher yield than did untreated mandibles. However, these values were still significantly lower than those of nonirradiated mandibles. Conclusions The authors have successfully demonstrated the therapeutic efficacy of parathyroid hormone to stimulate and enhance bone regeneration in their irradiated murine mandibular model of distraction osteogenesis. Anabolic regimens of parathyroid hormone, a U.S. Food and Drug Administration–approved drug on formulary, significantly improve outcomes in a model of postoncologic craniofacial reconstruction. PMID:23806959

Using driver simulators to measure the impact of distracted driving on commercial motor vehicle operators : [research brief].

DOT National Transportation Integrated Search

2015-06-01

This study addresses the impact of various distractions on commercial motor vehicle (CMV) operators. Using state-of-the-art driving simulators in realistic traffic, this project focused on CMV operator performance as drivers experienced distractions ...

Using driver simulators to measure the impact of distracted driving on commercial motor vehicle operators.

DOT National Transportation Integrated Search

2015-06-01

Driver distraction is at the forefront of public discussion concerning safety on Americas roads and highways. Understanding the risks of distracted driving and finding ways to prevent it has been the goal of Federal, State, and private organizatio...

Predictors of Cell Phone Use in Distracted Driving: Extending the Theory of Planned Behavior.

PubMed

Tian, Yan; Robinson, James D

2017-09-01

This study examines the predictors of six distracted driving behaviors, and the survey data partially support Ajzen's (1991) Theory of Planned Behavior (TPB). The data suggest that the attitude variable predicted intention to engage in all six distracted driving behaviors (reading and sending text messages, making and answering cell phone calls, reading/viewing social media, and posting on social media while driving). Extending the model to include past experience and the variable perceived safety of technology yielded an improvement in the prediction of the distraction variables. Specifically, past experience predicted all six distracted driving behaviors, and the variable perceived safety of technology predicted intentions to read/view social media and intention to post on social media while driving. The study provides evidence for the importance of incorporating expanded variables into the original TPB model to predict cell phone use behaviors while driving, and it suggests that it is essential to tailor campaign materials for each specific cell phone use behavior to reduce distracted driving.

A dual contribution to the involuntary semantic processing of unexpected spoken words.

PubMed

Parmentier, Fabrice B R; Turner, Jacqueline; Perez, Laura

2014-02-01

Sounds are a major cause of distraction. Unexpected to-be-ignored auditory stimuli presented in the context of an otherwise repetitive acoustic background ineluctably break through selective attention and distract people from an unrelated visual task (deviance distraction). This involuntary capture of attention by deviant sounds has been hypothesized to trigger their semantic appraisal and, in some circumstances, interfere with ongoing performance, but it remains unclear how such processing compares with the automatic processing of distractors in classic interference tasks (e.g., Stroop, flanker, Simon tasks). Using a cross-modal oddball task, we assessed the involuntary semantic processing of deviant sounds in the presence and absence of deviance distraction. The results revealed that some involuntary semantic analysis of spoken distractors occurs in the absence of deviance distraction but that this processing is significantly greater in its presence. We conclude that the automatic processing of spoken distractors reflects 2 contributions, one that is contingent upon deviance distraction and one that is independent from it.

[Three-dimensional modeling of mandibular distraction].

PubMed

Morgon, L A; Trunde, F; Coudert, J L; Disant, F

2003-12-01

Facial hemi-atrophy affects 1 in 4000 or 5000 children. We propose treating this deformation of the 1st branchial arch with the "bone distraction" lengthening technique first described by Ilizarov in the 1950s, which has already been employed with the mandible. We have modelled mandibular distraction in facial hemi-atrophy patients and discuss the benefits of such pre-surgical planning encompassing the assistance of pre- and post-operative as well as surgically coordinated orthodontic therapy. Using X scanner views of a 5 year-old girl patient, we have developed a distraction-simulation software, which makes the pathological side harmonious with the healthy side along the medial sagittal plane. In order to obtain facial symmetry, put bones in balance, and orient the occlusal plane horizontally, essential requisites of occlusal stability, it is necessary: to employ a 2 or 3-dimensional distractor, to pre-plan the distraction and screw positioning, to set up a fixed orthodontic treatment plan prior to beginning distraction therapy.

Age differences in the neural response to emotional distraction during working memory encoding.

PubMed

Ziaei, Maryam; Samrani, George; Persson, Jonas

2018-06-11

Age-related declines in attention and working memory (WM) are well documented and may be worsened by the occurrence of distracting information. Emotionally valenced stimuli may have particularly strong distracting effects on cognition. We investigated age-related differences in emotional distraction using task-fMRI. WM performance in older adults was lower for emotional compared with neutral distractors, suggesting a disproportional impairment elicited by emotional task-irrelevant information. Critically, older adults were particularly distracted by task-irrelevant positive information, whereas the opposite pattern was found for younger adults. Age groups differed markedly in the brain response to emotional distractors; younger adults activated posterior cortical regions and the striatum, and older adults activated frontal regions. Also, an age by valence interaction was found for IFG and ACC, suggesting differential modulation of attention to task-relevant emotional information. These results provide new insights into age-related changes in emotional processing and the ability to resolve interference from emotional distraction.

Preventing distraction: Assessing stimulus-specific and general effects of the predictive cueing of deviant auditory events

PubMed Central

Horváth, János; Sussman, Elyse; Winkler, István; Schröger, Erich

2011-01-01

Rare irregular sounds (deviants) embedded into a regular sound sequence have large potential to draw attention to themselves (distraction). It has been previously shown that distraction, as manifested by behavioral response delay, and the P3a and reorienting negativity (RON) event-related potentials, could be reduced when the forthcoming deviant was signaled by visual cues preceding the sounds. In the present study, we investigated the type of information used in the prevention of distraction by manipulating the information content of the visual cues preceding the sounds. Cues could signal the specific variant of the forthcoming deviant, or they could just signal that the next tone was a deviant. We found that stimulus-specific cue information was used in reducing distraction. The results also suggest that early P3a and RON index processes related to the specific deviating stimulus feature, whereas late P3a reflects a general distraction-related process. PMID:21310210

Carpal tunnel volume changes of the wrist under distraction.

PubMed

Cho, M S; Means, K R; Shrout, J A; Segalman, K A

2008-10-01

This study attempts to determine changes in carpal canal volume with distraction across the wrist. Uniform longitudinal distraction was maintained with two external fixators on the radial and ulnar aspects of the forearm axis of five cadaver specimens. After CT scanning, volume determinations were made at 5 mm increments beginning at the lunocapitate joint to a point 1.5 cm distal to the middle finger carpometacarpal joint. There was a statistically significant decrease of the mean total carpal canal volume from 0 to 4.54 kg of distraction, with no statistically significant decrease from 0 to 2.27 kg or 2.27 to 4.54 kg. The largest decrease occurred at 15 and 20 mm distal to the proximal edge of the transverse carpal ligament corresponding to the level of the hamate hook. Reduction in mean carpal canal volume was 10.2% and 7.5% at these distances, respectively, from 0 to 4.54 kg of distraction. Progressive distraction across the wrist causes a decrease in total carpal canal volume.

Evaluation of traction stirrup distraction technique to increase the joint space of the shoulder joint in the dog: A cadaveric study.

PubMed

Devesa, V; Rovesti, G L; Urrutia, P G; Sanroman, F; Rodriguez-Quiros, J

2015-06-01

The objective of this study was to evaluate technical feasibility and efficacy of a joint distraction technique by traction stirrup to facilitate shoulder arthroscopy and assess potential soft tissue damage. Twenty shoulders were evaluated radiographically before distraction. Distraction was applied with loads from 40 N up to 200 N, in 40 N increments, and the joint space was recorded at each step by radiographic images. The effects of joint flexion and intra-articular air injection at maximum load were evaluated. Radiographic evaluation was performed after distraction to evaluate ensuing joint laxity. Joint distraction by traction stirrup technique produces a significant increase in the joint space; an increase in joint laxity could not be inferred by standard and stress radiographs. However, further clinical studies are required to evaluate potential neurovascular complications. A wider joint space may be useful to facilitate arthroscopy, reducing the likelihood for iatrogenic damage to intra-articular structures. Copyright © 2015 Elsevier Ltd. All rights reserved.

A new noninvasive controlled intra-articular ankle distraction technique on a cadaver model.

PubMed

Aydin, Ahmet T; Ozcanli, Haluk; Soyuncu, Yetkin; Dabak, Tayyar K

2006-08-01

Effective joint distraction is crucial in arthroscopic ankle surgery. We describe an effective and controlled intra-articular ankle distraction technique that we have studied by means of a fresh-frozen cadaver model. Using a kyphoplasty balloon, which is currently used in spine surgery, we tried to achieve a controlled distraction. After the fixation of the cadaver model, standard anteromedial and anterolateral portals were used for ankle arthroscopy. From the same portals, the kyphoplasty balloon was inserted and placed in an appropriate position intra-articularly. The necessary amount of distraction was achieved by inflating the kyphoplasty balloon with a pressure regulation pump. All anatomic sites of the ankle joint were easily visualized with the arthroscope during surgery by changing the pressure and the intra-articular position of the kyphoplasty balloon. Ankle distraction was clearly seen on the arthroscopic and image intensifier view. The kyphoplasty balloon is simple to place through the standard portals and the advantage is that it allows easy manipulation of the arthroscopic instruments from the same portal.

Joint Preservation of the Wrist Using Articulated Distraction Arthroplasty: A Case Report of a Novel Technique

PubMed Central

Fletcher, Matt D. A.

2015-01-01

Distraction arthroplasty of the ankle, elbow, and hip has become widely accepted and used within the orthopaedic community with excellent initial results which appear sustained. To date it has not been applied to the wrist in the same manner. A novel technique, drawn upon past success of articulated ankle distraction and static wrist distraction, was devised and evaluated by application of articulated wrist distraction performed over a 12-week period in a patient with poor functional outcome following limited wrist fusion. Posttreatment results showed improvement in range of motion (100-degree arc), subjective pain, and functional outcome measures (DASH 21.7, Mayo Wrist Score 80) comparable or better than either limited wrist fusion or proximal row carpectomy. Articulated wrist distraction initially appears to be a promising therapeutic option for the management of the stiff and painful wrist to maintain maximal function for which formal wrist arthrodesis may be the only alternative. PMID:25767728

Long-term follow-up of early cleft maxillary distraction.

PubMed

Park, Young-Wook; Kwon, Kwang-Jun; Kim, Min-Keun

2016-12-01

Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.

Investigating Deviance Distraction and the Impact of the Modality of the To-Be-Ignored Stimuli.

PubMed

Marsja, Erik; Neely, Gregory; Ljungberg, Jessica K

2018-03-01

It has been suggested that deviance distraction is caused by unexpected sensory events in the to-be-ignored stimuli violating the cognitive system's predictions of incoming stimuli. The majority of research has used methods where the to-be-ignored expected (standards) and the unexpected (deviants) stimuli are presented within the same modality. Less is known about the behavioral impact of deviance distraction when the to-be-ignored stimuli are presented in different modalities (e.g., standard and deviants presented in different modalities). In three experiments using cross-modal oddball tasks with mixed-modality to-be-ignored stimuli, we examined the distractive role of unexpected auditory deviants presented in a continuous stream of expected standard vibrations. The results showed that deviance distraction seems to be dependent upon the to-be-ignored stimuli being presented within the same modality, and that the simplest omission of something expected; in this case, a standard vibration may be enough to capture attention and distract performance.

Distraction osteogenesis of costochondral bone grafts in the mandible.

PubMed

Stelnicki, Eric J; Hollier, Larry; Lee, Catherine; Lin, Wen-Yuan; Grayson, Barry; McCarthy, Joseph G

2002-03-01

Costochondral grafting for reconstruction of the Pruzansky type III mandible has given variable results. Lengthening of the rib graft by means of distraction had been advocated when subsequent growth of the grafted mandible is inadequate. This retrospective study reviews a series of patients with mandibular costochondral grafts who underwent subsequent distraction osteogenesis of the graft. A retrospective review identified two patient groups: group 1 consisted of individuals (n = 9) who underwent costochondral rib grafting of the mandible followed by distraction osteogenesis several months later at a rate of 1 mm/day. Group 2 consisted of patients with Pruzansky type II mandibles who had distraction osteogenesis without prior rib grafting (n = 9). The biomechanical parameters, orthodontic treatment regimens, and complications were examined versus patient age and quality of the rib graft. Distraction osteogenesis was successfully performed in six of the rib graft patients (group 1) and in all of the group 2 individuals. On the basis of the Haminishi scale, the computed tomographic scan appearance of the regenerate was classified as "standard or external" in six of the group 1 patients and as either "agenetic" or "pillar" (fibrous union) in the remaining three patients. In group 1, the average device was expanded 23 mm (range, 20 to 30 mm). Group 2 mandibular distraction results were all classified as either standard or external, and there was an average device expansion of 22.4 mm (range, 16 to 30 mm). The length of consolidation averaged 12.6 weeks in group 1, compared with 8.5 weeks in the traditional mandibular distraction patients (group 2). The mean shift of the dental midline to the contralateral side was 2.5 mm in group 1 versus 4.0 mm in group 2. Complex multiplanar and transport distractions were successfully performed on grafts of adequate bony volume. All four patients in group 1 with tracheostomies were successfully decannulated after consolidation. Rib graft distraction complications included pin tract infections in two patients, hardware failure with premature pin pullout in one patient, and evidence of fibrous nonunions in three young patients with single, diminutive rib grafts. In group 2, there were no distraction failures. Distraction osteogenesis can be successfully performed on costochondral rib grafts of the mandible; however, the complication rate is higher than in non-rib-graft patients. Performing the technique on older, more cooperative individuals seems to reduce this risk. In addition, placement of a double rib graft or an iliac bone graft of sufficient volume to create a neomandible with greater bone stock is an absolute requirement to decrease the risk of fibrous nonunion and provide a bone base of sufficient size for retention of the distraction device and manipulation of the regenerate.

The Effect of Capsulotomy and Capsular Repair on Hip Distraction: A Cadaveric Investigation.

PubMed

Khair, M Michael; Grzybowski, Jeffrey S; Kuhns, Benjamin D; Wuerz, Thomas H; Shewman, Elizabeth; Nho, Shane J

2017-03-01

To quantify how increasing interportal capsulotomy size affects the force required to distract the hip and to biomechanically compare simple side-to-side suture repair to acetabular-based suture anchors as capsular repair techniques. Twelve fresh-frozen cadaveric hip specimens were dissected to the capsuloligamentous complex of the hip joint and fixed in a material testing system, such that a pure axial distraction of the iliofemoral ligament could be achieved. After each hip in was tested an intact state, sequential distraction was tested with 2, 4, 6, and 8 cm capsulotomies. Specimens were assigned randomly to be repaired with either 4 side-to-side suture repair (n = 6) or 2 double-loaded all-suture anchors (n = 6). The distraction force as well as the relative distraction force percentage normalized to the intact capsule were compared between suture repair and suture anchor repair groups. Increasing the size of the capsulotomy resulted in less force required to distract the hip to 6 mm. The force decreased as the capsulotomy was extended with statistical significance in distraction force seen between the intact state and the 4 cm (P = .003), 6 cm (P < .001), and 8 cm (P ≤ .001) capsulotomy but not for the intact state compared to the 2 cm capsulotomy (P = .28). Statistical significance in relative distraction force was seen for each of the capsulotomy conditions (P < .001 for all conditions compared with the intact state). The side-to-side suture repair construct (104.3% of intact force) required greater force to distraction to 6 mm compared with the suture anchor repair (87.1% of intact force) (P = .008). An interportal capsulotomy significantly affected the force required to distract the hip in a cadaveric model, with the larger the size of capsulotomy resulting in less force required to distract the hip. When we performed an interportal capsulotomy, the iliofemoral ligament strength was altered significantly but capsular repair with either side-to-side sutures or suture anchor-based repair was able to restore the capsular strength to a native intact hip. We found, however, that the side-to-side suture repair was better able to restore the distraction force compared with suture anchor repair. Capsular management during hip arthroscopy remains a debated topic, with multiple techniques involving both capsulotomy and capsular closure published in the literature. This study provides insight into capsular stability against axial stress under capsulotomy and capsular repair conditions. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Age differences in the frontoparietal cognitive control network: Implications for distractibility

PubMed Central

Campbell, Karen L.; Grady, Cheryl L.; Ng, Charisa; Hasher, Lynn

2016-01-01

Current evidence suggests that older adults have reduced suppression of, and greater implicit memory for, distracting stimuli, due to age-related declines in frontal-based control mechanisms. In this study, we used fMRI to examine age differences in the neural underpinnings of attentional control and their relationship to differences in distractibility and subsequent memory for distraction. Older and younger adults were shown a rapid stream of words or nonwords superimposed on objects and performed a 1-back task on either the letters or the objects, while ignoring the other modality. Older adults were more distracted than younger adults by the overlapping words during the 1-back task, and they subsequently showed more priming for these words on an implicit memory task. A multivariate analysis of the imaging data revealed a set of regions, including the rostral PFC and inferior parietal cortex, that younger adults activated to a greater extent than older adults during the ignore-words condition, and activity in this set of regions was negatively correlated with priming for the distracting words. Functional connectivity analyses using right and left rostral PFC seeds revealed a network of putative control regions, including bilateral parietal cortex, connected to the frontal seeds at rest. Older adults showed reduced functional connectivity within this frontoparietal network, suggesting that their greater distractibility may be due to decreased activity and coherence within a cognitive control network that normally acts to reduce interference from distraction. PMID:22659108

Get the Message: A Teen Distracted Driving Program.

PubMed

Adeola, Ruth; Omorogbe, Ashleigh; Johnson, Abree

Elimination of distracted driving is becoming a public health priority. Each day, an average of 8 people are killed due to a distracted driver in the United Sates. Although all drivers are at risk, research has indicated that teenage drivers are overrepresented in motor vehicle crashes due to distracted driving. Teenage drivers are hindered by limited driving experience, and the illusion of invincibility is a common phase in social and cognitive adolescent development. "Get the Message: A Teenage Distracted Driving Program" was established at the R Adams Cowley Shock Trauma Center to identify, define, and measure the factors that contribute to distracted driving in teens. A convenience sample of 1,238 teenagers in this study represented all 50 states in the United States, the District of Columbia, Puerto Rico, Canada, and 21 other countries. At the beginning of each program, a presurvey is administered to assess baseline behavior, attitude, and knowledge regarding distracted driving. After completing the program, teens complete a postsurvey to measure proposed changes in driving behaviors, attitude, and knowledge. The program employs the use of a slide presentation, hospital tour, video, and survivor's testimony to influence teen driving behaviors and increase knowledge. Research has indicated that an increase in the Health Belief Model constructs may enhance engagement in health-promoting behaviors, such as safe driving practices in teens. Based on the postsurvey results, the reduction in projected phone use while driving in this teen population indicates the effectiveness of this hospital-based teen distracted driving program.

Distraction osteogenesis for management of obstructive sleep apnoea in temporomandibular joint ankylosis patients before the release of joint.

PubMed

Yadav, Rahul; Bhutia, Ongkila; Shukla, Garima; Roychoudhury, Ajoy

2014-07-01

To evaluate the effects of distraction osteogenesis in management of obstructive sleep apnoea patients secondary to temporomandibular joints ankylosis. Fifteen patients were included in study. Preoperatively the patients were worked up for polysomnography and CT scans. Only those patients with Apnoea-hypopnoea index >15 events/h denoting moderate to severe obstructive sleep apnoea were included in the study. Distraction osteogenesis was followed with 5 days latency period in adult patients and 0 days for children. Rate of distraction was 1 mm/day for adults and 2 mm/day for children till the mandibular incisors were in reverse overjet. After 3 months post distraction assessment was done using polysomnography and CT scan. TMJ ankylosis was released by doing gap arthroplasty after distraction osteogenesis. Post distraction improvement was seen in clinical features of OSA like daytime sleepiness and snoring. Epworth sleepiness scale improved from a mean of 10.25 to 2.25. Polysomnographic analysis also showed improvement in all cases with apnoea-hypopnoea index from 57.03 to 6.67 per hour. Lowest oxygen saturation improved from 64.47% to 81.20% and average minimum oxygen saturation improved from 92.17% to 98.19%. Body mass index improved from a mean of 18.26 to 21.39 kg/m2. Distraction osteogenesis is a stable and beneficial treatment option for temporomandibular joint ankylosis patients with obstructive sleep apnoea. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Two-stage distraction lengthening of the forearm.

PubMed

Taghinia, Amir H; Al-Sheikh, Ayman A; Panossian, Andre E; Upton, Joseph

2013-01-01

Single-stage lengthening of the forearm using callus distraction is well described; however, forearm lengthening using a 2-stage technique of distraction followed by bone grafting has received less attention. A 2-staged technique can be a better alternative in cases where the surgeon desires extensive lengthening. A retrospective review was undertaken of eleven 2-stage forearm lengthening procedures performed by 1 surgeon over a 15-year period. Indications were radial longitudinal deficiency (8 patients), neonatal ischemic contractures (2 patients), and septic growth arrest (1 patient). Average follow-up was 2.8 years. Distraction was performed on patients an average of 82 mm over an average duration of 24 weeks. Average time to union from the time of distractor removal and grafting was 87 days. Average healing index was 32.1 d/cm. Distraction problems were common and related to the length of time that the distractor was in place; they included pain, pin-related infections, and multiple mechanical device difficulties. Three patients had nonunion, and another had delayed union; however, additional procedures resulted in ultimate bony union in all patients. Demineralized bone matrix and autologous corticocancellous bone grafts yielded predictable healing and good functional results in short-distance distractions. For longer distractions, free vascularized fibula transfer produced the best outcomes. Intercalary cortical allografts did not heal well. Patients with neonatal Volkmann contractures had the most difficulty with distraction and healing, ultimately obtaining little to no lengthening and poor functional outcomes.

Simultaneous maxillary distraction osteogenesis using a twin-track distraction device combined with alveolar bone grafting in cleft patients: preliminary report of a technique.

PubMed

Suzuki, Eduardo Yugo; Watanabe, Masayo; Buranastidporn, Boonsiva; Baba, Yoshiyuki; Ohyama, Kimie; Ishii, Masatoshi

2006-01-01

The simultaneous use of cleft reduction and maxillary advancement by distraction osteogenesis has not been applied routinely because of the difficulty in three-dimensional control and stabilization of the transported segments. This report describes a new approach of simultaneous bilateral alveolar cleft reduction and maxillary advancement by distraction osteogenesis combined with autogenous bone grafting. A custom-made Twin-Track device was used to allow bilateral alveolar cleft closure combined with simultaneous maxillary advancement, using distraction osteogenesis and a rigid external distraction system in a bilateral cleft lip and palate patient. After a maxillary Le Fort I osteotomy, autogenous iliac bone graft was placed in the cleft spaces before suturing. A latency period of six days was observed before activation. The rate of activation was one mm/d for the maxillary advancement and 0.5 mm/d for the segmental transport. Accordingly, the concave facial appearance was improved with acceptable occlusion, and complete bilateral cleft closure was attained. No adjustments were necessary to the vector of the transported segments during the activation and no complications were observed. The proposed Twin-Track device, based on the concept of track-guided bone transport, permitted three-dimensional control over the distraction processes allowing simultaneous cleft closure, maxillary distraction, and autogenous bone grafting. The combined simultaneous approach is extremely advantageous in correcting severe deformities, reducing the number of surgical interventions and, consequently, the total treatment time.

Distractions in the School Science Laboratory

ERIC Educational Resources Information Center

Hamza, Karim M.

2013-01-01

In this article, I make a case for the potential educative worth of distractions for learning science in the school laboratory. Distractions are operationalized as experiences lying outside the main purpose of the laboratory activity, thereby diverting students' attention from that purpose. Through a practical epistemology analysis, I…

Note-Taking and Memory in Different Media Environments

ERIC Educational Resources Information Center

Lin, Lin; Bigenho, Chris

2011-01-01

Through this study the authors investigated undergraduate students' memory recall in three media environments with three note-taking options, following an A x B design with nine experiments. The three environments included no-distraction, auditory-distraction, and auditory-visual-distraction; while the three note-taking options included…

Effects of Auditory Distraction on Cognitive Processing of Young Adults

ERIC Educational Resources Information Center

LaPointe, Leonard L.; Heald, Gary R.; Stierwalt, Julie A. G.; Kemker, Brett E.; Maurice, Trisha

2007-01-01

Objective: The effects of interference, competition, and distraction on cognitive processing are unclearly understood, particularly regarding type and intensity of auditory distraction across a variety of cognitive processing tasks. Method: The purpose of this investigation was to report two experiments that sought to explore the effects of types…

Neuronal Effects of Auditory Distraction on Visual Attention

ERIC Educational Resources Information Center

Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.

2013-01-01

Selective attention in the presence of distraction is a key aspect of healthy cognition. The underlying neurobiological processes, have not, however, been functionally well characterized. In the present study, we used functional magnetic resonance imaging to determine how ecologically relevant distracting noise affects cortical activity in 27…

Neural Basis of Visual Distraction

ERIC Educational Resources Information Center

Kim, So-Yeon; Hopfinger, Joseph B.

2010-01-01

The ability to maintain focus and avoid distraction by goal-irrelevant stimuli is critical for performing many tasks and may be a key deficit in attention-related problems. Recent studies have demonstrated that irrelevant stimuli that are consciously perceived may be filtered out on a neural level and not cause the distraction triggered by…

The Role of Perceptual Load in Object Recognition

ERIC Educational Resources Information Center

Lavie, Nilli; Lin, Zhicheng; Zokaei, Nahid; Thoma, Volker

2009-01-01

Predictions from perceptual load theory (Lavie, 1995, 2005) regarding object recognition across the same or different viewpoints were tested. Results showed that high perceptual load reduces distracter recognition levels despite always presenting distracter objects from the same view. They also showed that the levels of distracter recognition were…

Animation as a Distractor to Learning.

ERIC Educational Resources Information Center

Rieber, Lloyd P.

1996-01-01

A study of 364 fifth graders investigated distractibility of animated graphics in a computer-based tutorial about Newton's Laws of Motion. Found no difference in post-test performance for those with high, medium, or no distraction graphics. Students in the two distraction conditions took less time to process instructional frames than students in…

Why Does Working Memory Capacity Predict RAPM Performance? A Possible Role of Distraction

ERIC Educational Resources Information Center

Jarosz, Andrew F.; Wiley, Jennifer

2012-01-01

Current theories concerning individual differences in working memory capacity (WMC) suggest that WMC reflects the ability to control the focus of attention and resist interference and distraction. The current set of experiments tested whether susceptibility to distraction is partially responsible for the established relationship between…

[Callus distraction].

PubMed

Giebel, G

1995-09-01

Fibroblast networks that form collagen and connect the two ends of bone develop in the haematoma after corticotomy. This regenerative tissue is vascularized and distracted. Even during the lengthening, mineralization starts. This starts at the ends created by the osteotomy, in the form of conical bony columns 200 microns thick, which grows towards each other in a manner reminiscent of stalagmites and stalactites, until the central, fibrous inner zone (growth zone) formed during distraction is completely mineralized. Connective tissue and bony bars are arranged lengthwise. As a rule, intramembranous callus formation takes place during distraction osteogenesis with no intermediate cartilaginous step.

Ultrasound control of magnet growing rod distraction in early onset scoliosis.

PubMed

Pérez Cervera, T; Lirola Criado, J F; Farrington Rueda, D M

2016-01-01

The growing rod technique is currently one of the most common procedures used in the management of early onset scoliosis. However, in order to preserve spine growth and control the deformity it requires frequent surgeries to distract the rods. Magnetically driven growing rods have recently been introduced with same treatment goal, but without the inconvenience of repeated surgical distractions. One of the limitations of this technical advance is an increase in radiation exposure due to the increase in distraction frequency compared to conventional growing rods. An improvement of the original technique is presented, proposing a solution to the inconvenience of multiple radiation exposure using ultrasound technology to control the distraction process of magnetically driven growing rods. Copyright © 2014 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Driver distraction: a perennial but preventable public health threat to adolescents.

PubMed

Bingham, C Raymond

2014-05-01

Although public health efforts have made some progress in reducing risk of adolescent motor vehicle crashes over the last three decades, new technologies and evolving behavior patterns have focused attention on the risk of distracted driving. For many of the same reasons that alcohol-impaired driving represents a distinct risk for adolescents, distracted driving has an elevated impact on this age group. Similarly, many of the strategies used to reduce alcohol-impaired driving among adolescents might be applied to driver distraction, including adults serving as role models with high standards of behavior. The unique challenge posed by the proliferation of new technological distractions may accelerate this risk behavior and may lend itself to innovative prevention efforts. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Anterior Segmental Distraction Osteogenesis in the Hypoplastic Cleft Maxilla

PubMed Central

Rao (Janardhan), Sruthi; Kotrashetti, S. M.; Lingaraj, J. B.; Pinto, P. X.; Keluskar, K. M.; Jain, Siddharth; Sone, Piyush; Rao, Santhosh

2013-01-01

Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP). Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding. We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. A custom-made tooth-borne distraction device with a hyrax screw positioned anteroposteriorly was used. The evaluation comprised of hard and soft tissue analysis and speech assessment. A stable occlusion with positive overjet and correction of dental-crowding without extraction was achieved at one year post-distraction. Facial profile and lip support improved. There was no deterioration in speech. PMID:23984033

Resisting distraction and response inhibition trigger similar enhancements of future performance.

PubMed

Bissett, Patrick G; Grant, Lauren D; Weissman, Daniel H

2017-10-01

Resisting distraction and response inhibition are crucial aspects of cognitive control. Interestingly, each of these abilities transiently improves just after it is utilized. Competing views differ, however, as to whether utilizing either of these abilities (e.g., resisting distraction) enhances future performance involving the other ability (e.g., response inhibition). To distinguish between these views, we combined a Stroop-like task that requires resisting distraction with a restraint variant of the stop-signal task that requires response inhibition. We observed similar sequential-trial effects (i.e., performance enhancements) following trials in which participants (a) resisted distraction (i.e., incongruent go trials) and (b) inhibited a response (i.e., congruent stop trials). First, the congruency effect in go trials, which indexes overall distractibility, was smaller after both incongruent go trials and congruent stop trials than it was after congruent go trials. Second, stop failures were less frequent after both incongruent go trials and congruent stop trials than after congruent go trials. A control experiment ruled out the possibility that perceptual conflict or surprise engendered by occasional stop signals triggers sequential-trial effects independent of stopping. Thus, our findings support a novel, integrated view in which resisting distraction and response inhibition trigger similar sequential enhancements of future performance. Copyright © 2017 Elsevier B.V. All rights reserved.

Design and characterization of a new bioreactor for continuous ultra-slow uniaxial distraction of a three-dimensional scaffold-free stem cell culture.

PubMed

Weiss, S; Henle, P; Roth, W; Bock, R; Boeuf, S; Richter, W

2011-01-01

A computer controlled dynamic bioreactor for continuous ultra-slow uniaxial distraction of a scaffold-free three-dimensional (3D) mesenchymal stem cell pellet culture was designed to investigate the influence of stepless tensile strain on behavior of distinct primary cells like osteoblasts, chondroblasts, or stem cells without the influence of an artificial culture matrix. The main advantages of this device include the following capabilities: (1) Application of uniaxial ultra-slow stepless distraction within a range of 0.5-250 μm/h and real-time control of the distraction distance with high accuracy (mean error -3.4%); (2) tension strain can be applied on a 3D cell culture within a standard CO(2) -incubator without use of an artificial culture matrix; (3) possibility of histological investigation without loss of distraction; (4) feasibility of molecular analysis on RNA and protein level. This is the first report on a distraction device capable of applying continuous tensile strain to a scaffold-free 3D cell culture within physiological ranges of motion comparable to distraction ostegenesis in vivo. We expect the newly designed microdistraction device to increase our understanding on the regulatory mechanisms of mechanical strains on the metabolism of stem cells. Copyright © 2010 American Institute of Chemical Engineers (AIChE).

Distraction produces over-additive increases in the degree to which alcohol impairs driving performance

PubMed Central

Van Dyke, Nicholas A.; Fillmore, Mark T.

2015-01-01

Rationale Research indicates that alcohol intoxication and increased demands on drivers’ attention from distractions (e.g. passengers and cell phones) contribute to poor driving performance and increased rates of traffic accidents and fatalities. Objectives The present study examined the separate and combined effects of alcohol and distraction on simulated driving performance at blood alcohol concentrations (BrACs) below the legal driving limit in the United States (i.e. 0.08%). Methods Fifty healthy adult drivers (36 men and 14 women) were tested in a driving simulator following a 0.65 g/kg dose of alcohol and a placebo. Drivers completed two drive tests; a distracted drive, which included a two-choice detection task, and an undistracted control drive. Multiple indicators of driving performance, such as drive speed, within-lane deviation, steering rate, and lane exceedances were measured. Results Alcohol and distraction each impaired measures of driving performance. Moreover, the magnitude of alcohol impairment was increased by at least two-fold when tested under the distracting versus the undistracted condition. Conclusions The findings highlight the need for a clearer understanding of how common distractions impact intoxicated drivers, especially at BrACs that are currently legal for driving in the United States. PMID:26349918

Top-down dimensional weight set determines the capture of visual attention: evidence from the PCN component.

PubMed

Töllner, Thomas; Müller, Hermann J; Zehetleitner, Michael

2012-07-01

Visual search for feature singletons is slowed when a task-irrelevant, but more salient distracter singleton is concurrently presented. While there is a consensus that this distracter interference effect can be influenced by internal system settings, it remains controversial at what stage of processing this influence starts to affect visual coding. Advocates of the "stimulus-driven" view maintain that the initial sweep of visual processing is entirely driven by physical stimulus attributes and that top-down settings can bias visual processing only after selection of the most salient item. By contrast, opponents argue that top-down expectancies can alter the initial selection priority, so that focal attention is "not automatically" shifted to the location exhibiting the highest feature contrast. To precisely trace the allocation of focal attention, we analyzed the Posterior-Contralateral-Negativity (PCN) in a task in which the likelihood (expectancy) with which a distracter occurred was systematically varied. Our results show that both high (vs. low) distracter expectancy and experiencing a distracter on the previous trial speed up the timing of the target-elicited PCN. Importantly, there was no distracter-elicited PCN, indicating that participants did not shift attention to the distracter before selecting the target. This pattern unambiguously demonstrates that preattentive vision is top-down modifiable.

Distract or reappraise? Age-related differences in emotion-regulation choice.

PubMed

Scheibe, Susanne; Sheppes, Gal; Staudinger, Ursula M

2015-12-01

Does aging impact strategy choice with regard to regulating negative emotions? Based on the assumption that older adults are highly motivated to quickly defuse negative states, we predicted that older adults, relative to young adults, would show an increased preference for distraction (a cognitive disengagement strategy) over reappraisal (a cognitive engagement strategy) in the face of negative material. A stronger preference for distraction, in turn, should be associated with higher affective well-being at older ages, as it helps to avoid high physiological arousal. Young (19-28 years, n = 38) and older (65-75 years, n = 39) adults completed a laboratory task of emotion-regulation choice in which they viewed negative pictures of high and low intensity and chose between distraction and reappraisal to regulate their emotional response. Confirming predictions, age was associated with an increased preference to choose distraction over reappraisal. Among older but not young adults, the relative preference for distraction to reappraisal predicted higher state-affective well-being. In addition, across age groups, the preference for distraction over reappraisal was positively predicted by stimulus intensity and negatively by cognitive resources. Findings support the notion of an age-related shift toward disengagement strategies to regulate negative emotions, which maps onto older adults' prohedonic orientation and holds affective benefits. (c) 2015 APA, all rights reserved).

Body Image in Dyadic and Solitary Sexual Desire: The Role of Encoding Style and Distracting Thoughts.

PubMed

Dosch, Alessandra; Ghisletta, Paolo; Van der Linden, Martial

2016-01-01

This study explored the link between body image and desire to engage in sexual activity (dyadic and solitary desire) in adult women living in a long-term couple relationship. Moreover, it considered two psychological factors that may underlie such a link: the occurrence of body-related distracting thoughts during sexual activity and encoding style (i.e., the tendency to rely on preexisting internal schemata versus external information at encoding). A total of 53 women (29 to 47 years old) in heterosexual relationships completed questionnaires assessing sexual desire (dyadic, solitary), body image, body-related distracting thoughts during sexual activity, and encoding style. Results showed that poor body image was associated with low dyadic and solitary sexual desire. Body-related distracting thoughts during sexual activity mediated the link between body image and solitary (but not dyadic) sexual desire. Finally, the mediation of body-related distracting thoughts between body image and solitary sexual desire was moderated by encoding style. A negative body image promoted the occurrence of body-related distracting thoughts during sexual activity, especially in internal encoders. Our study highlights the importance of body image, distracting thoughts, and encoding style in women's solitary sexuality and suggests possible factors that may reduce the impact of those body-related factors in dyadic sexual desire.

Informational masking of speech in children: Effects of ipsilateral and contralateral distracters

NASA Astrophysics Data System (ADS)

Wightman, Frederic L.; Kistler, Doris J.

2005-11-01

Using a closed-set speech recognition paradigm thought to be heavily influenced by informational masking, auditory selective attention was measured in 38 children (ages 4-16 years) and 8 adults (ages 20-30 years). The task required attention to a monaural target speech message that was presented with a time-synchronized distracter message in the same ear. In some conditions a second distracter message or a speech-shaped noise was presented to the other ear. Compared to adults, children required higher target/distracter ratios to reach comparable performance levels, reflecting more informational masking in these listeners. Informational masking in most conditions was confirmed by the fact that a large proportion of the errors made by the listeners were contained in the distracter message(s). There was a monotonic age effect, such that even the children in the oldest age group (13.6-16 years) demonstrated poorer performance than adults. For both children and adults, presentation of an additional distracter in the contralateral ear significantly reduced performance, even when the distracter messages were produced by a talker of different sex than the target talker. The results are consistent with earlier reports from pure-tone masking studies that informational masking effects are much larger in children than in adults.

A new palatal distractor device for bodily movement of maxillary bones by rigid self-locking miniplates and screws system.

PubMed

Cortese, Antonio; Savastano, Mauro; Cantone, Antonio; Claudio, Pier Paolo

2013-07-01

A new palatal distractor device for bodily movement of the maxillary bones after complete segmented Le Fort I osteotomy for 1-stage transversal distraction and tridimensional repositioning on 1 patient is presented. The new distractor has an intrinsic tridimensional rigidity also in the fixation system by self-locking miniplates and screws for better control of the 2 maxillary fragments during distraction. Le Fort I distraction and repositioning procedure in association with a bilateral sagittal split osteotomy were performed on 1 patient with complete solution of the cross-bite and class III malocclusion. Results of dental and cephalometric analysis performed before surgery (T1), after surgery and distraction time (T2), and 18 months after surgery and orthodontic appliance removal (T3) are reported. No complications were encountered using the new distractor device. Advantages of this device and technique are presented including improved rigidity of both distraction (jackscrew) and fixation (4 self-locking miniplates and screws) systems resulting in complete control of the position of the 2 maxillary fragments during distraction and surgery. In addition, this new device allows resuming palatal distraction in the event of cross-bite relapse without causing dental-related problems or the risks of screw slackening.

Does linear separability really matter? Complex visual search is explained by simple search

PubMed Central

Vighneshvel, T.; Arun, S. P.

2013-01-01

Visual search in real life involves complex displays with a target among multiple types of distracters, but in the laboratory, it is often tested using simple displays with identical distracters. Can complex search be understood in terms of simple searches? This link may not be straightforward if complex search has emergent properties. One such property is linear separability, whereby search is hard when a target cannot be separated from its distracters using a single linear boundary. However, evidence in favor of linear separability is based on testing stimulus configurations in an external parametric space that need not be related to their true perceptual representation. We therefore set out to assess whether linear separability influences complex search at all. Our null hypothesis was that complex search performance depends only on classical factors such as target-distracter similarity and distracter homogeneity, which we measured using simple searches. Across three experiments involving a variety of artificial and natural objects, differences between linearly separable and nonseparable searches were explained using target-distracter similarity and distracter heterogeneity. Further, simple searches accurately predicted complex search regardless of linear separability (r = 0.91). Our results show that complex search is explained by simple search, refuting the widely held belief that linear separability influences visual search. PMID:24029822

The Molecular and Cellular Events That Take Place during Craniofacial Distraction Osteogenesis

PubMed Central

Rachmiel, Adi

2014-01-01

Summary: Gradual bone lengthening using distraction osteogenesis principles is the gold standard for the treatment of hypoplastic facial bones. However, the long treatment time is a major disadvantage of the lengthening procedures. The aim of this study is to review the current literature and summarize the cellular and molecular events occurring during membranous craniofacial distraction osteogenesis. Mechanical stimulation by distraction induces biological responses of skeletal regeneration that is accomplished by a cascade of biological processes that may include differentiation of pluripotential tissue, angiogenesis, osteogenesis, mineralization, and remodeling. There are complex interactions between bone-forming osteoblasts and other cells present within the bone microenvironment, particularly vascular endothelial cells that may be pivotal members of a complex interactive communication network in bone. Studies have implicated number of cytokines that are intimately involved in the regulation of bone synthesis and turnover. The gene regulation of numerous cytokines (transforming growth factor-β, bone morphogenetic proteins, insulin-like growth factor-1, and fibroblast growth factor-2) and extracellular matrix proteins (osteonectin, osteopontin) during distraction osteogenesis has been best characterized and discussed. Understanding the biomolecular mechanisms that mediate membranous distraction osteogenesis may guide the development of targeted strategies designed to improve distraction osteogenesis and accelerate bone regeneration that may lead to shorten the treatment duration. PMID:25289295

Effect of visual distraction and auditory feedback on patient effort during robot-assisted movement training after stroke

PubMed Central

2011-01-01

Background Practicing arm and gait movements with robotic assistance after neurologic injury can help patients improve their movement ability, but patients sometimes reduce their effort during training in response to the assistance. Reduced effort has been hypothesized to diminish clinical outcomes of robotic training. To better understand patient slacking, we studied the role of visual distraction and auditory feedback in modulating patient effort during a common robot-assisted tracking task. Methods Fourteen participants with chronic left hemiparesis from stroke, five control participants with chronic right hemiparesis and fourteen non-impaired healthy control participants, tracked a visual target with their arms while receiving adaptive assistance from a robotic arm exoskeleton. We compared four practice conditions: the baseline tracking task alone; tracking while also performing a visual distracter task; tracking with the visual distracter and sound feedback; and tracking with sound feedback. For the distracter task, symbols were randomly displayed in the corners of the computer screen, and the participants were instructed to click a mouse button when a target symbol appeared. The sound feedback consisted of a repeating beep, with the frequency of repetition made to increase with increasing tracking error. Results Participants with stroke halved their effort and doubled their tracking error when performing the visual distracter task with their left hemiparetic arm. With sound feedback, however, these participants increased their effort and decreased their tracking error close to their baseline levels, while also performing the distracter task successfully. These effects were significantly smaller for the participants who used their non-paretic arm and for the participants without stroke. Conclusions Visual distraction decreased participants effort during a standard robot-assisted movement training task. This effect was greater for the hemiparetic arm, suggesting that the increased demands associated with controlling an affected arm make the motor system more prone to slack when distracted. Providing an alternate sensory channel for feedback, i.e., auditory feedback of tracking error, enabled the participants to simultaneously perform the tracking task and distracter task effectively. Thus, incorporating real-time auditory feedback of performance errors might improve clinical outcomes of robotic therapy systems. PMID:21513561

Patient-specific Distraction Regimen to Avoid Growth-rod Failure.

PubMed

Agarwal, Aakash; Jayaswal, Arvind; Goel, Vijay K; Agarwal, Anand K

2018-02-15

A finite element study to establish the relationship between patient's curve flexibility (determined using curve correction under gravity) in juvenile idiopathic scoliosis and the required distraction frequency to avoid growth rod fracture, as a function of time. To perform a parametric analysis using a juvenile scoliotic spine model (single mid-thoracic curve with the apex at the eighth thoracic vertebra) and establish the relationship between curve flexibility (determined using curve correction under gravity) and the distraction interval that allows a higher factor of safety for the growth rods. Previous studies have shown that frequent distraction with smaller magnitude of distractions are less likely to result in rod failure. However there has not been any methodology or a chart provided to apply this knowledge on to the individual patients that undergo the treatment. This study aims to fill in that gap. The parametric study was performed by varying the material properties of the disc, hence altering the axial stiffness of the scoliotic spine model. The stresses on the rod were found to increase with increased axial stiffness of the spine, and this resulted in the increase of required optimal frequency to achieve a factor of safety of two for growth rods. A relationship between the percentage correction in Cobb's angle due to gravity alone, and the required distraction interval for limiting the maximum von Mises stress to 255 MPa on the growth rods was established. The distraction interval required to limit the stresses to the selected nominal value reduces with increase in stiffness of the spine. Furthermore, the appropriate distraction interval reduces for each model as the spine becomes stiffer with time (autofusion). This points to the fact the optimal distraction frequency is a time-dependent variable that must be achieved to keep the maximum von Mises stress under the specified factor of safety. The current study demonstrates the possibility of translating fundamental information from finite element modeling to the clinical arena, for mitigating the occurrence of growth rod fracture, that is, establishing a relationship between optimal distraction interval and curve flexibility (determined using curve correction under gravity). N/A.

Conformational Changes in the Carpus During Finger Traps Distraction

PubMed Central

Leventhal, Evan L.; Moore, Douglas C.; Akelman, Edward; Wolfe, Scott W.; Crisco, Joseph J.

2010-01-01

Introduction Wrist distraction is a common treatment maneuver used clinically for the reduction of distal radial fractures and mid-carpal dislocations. Wrist distraction is also required during wrist arthroscopy to access the radiocarpal joint and has been used as a test for scapholunate ligament injury. However, the effect of a distraction load on the normal wrist has not been well studied. The purpose of this study was to measure the 3-D conformational changes of the carpal bones in the normal wrist as a result of a static distractive load. Methods The dominant wrists of 14 healthy volunteers were scanned using computed tomography at rest and during application of 98N of distraction. Load was applied using finger traps and volunteers were encouraged to relax their forearm muscles and to allow distraction of the wrist. The motions of the bones in the wrist were tracked between the unloaded and loaded trial using markerless bone registration. The average displacement vector of each bone was calculated relative to the radius as well as the interbone distances for 20 bone-bone interactions. Joint separation was estimated at the radiocarpal, midcarpal and carpal-metacarpal joints in the direction of loading using the radius, lunate, capitate and 3rd metacarpal. Results With loading, the distance between the radius and 3rd metacarpal increased an average of 3.3±3.1mm in the direction of loading. This separation was primarily located in the axial direction at the radiocarpal (1.0±1.0mm) and midcarpal (2.0±1.7mm) joints. There were minimal changes in the transverse direction within the distal row, although the proximal row narrowed by 0.98±0.7mm. Distraction between the radius and scaphoid (2.5±2.2mm) was 2.4 times greater than between the radius and lunate (1.0±1.0mm). Conclusions Carpal distraction has a significant effect on the conformation of the carpus, especially at the radiocarpal and midcarpal joints. In the normal wrist, external traction causes twice as much distraction at the lunocapitate joint than at the radiolunate joint. PMID:20141894

Conformational changes in the carpus during finger trap distraction.

PubMed

Leventhal, Evan L; Moore, Douglas C; Akelman, Edward; Wolfe, Scott W; Crisco, Joseph J

2010-02-01

Wrist distraction is a common treatment maneuver used clinically for the reduction of distal radial fractures and midcarpal dislocations. Wrist distraction is also required during wrist arthroscopy to access the radiocarpal joint and has been used as a test for scapholunate ligament injury. However, the effect of a distraction load on the normal wrist has not been well studied. The purpose of this study was to measure the three-dimensional conformational changes of the carpal bones in the normal wrist as a result of a static distractive load. Using computed tomography, the dominant wrists of 14 healthy volunteers were scanned at rest and during application of 98 N of distraction. Load was applied using finger traps, and volunteers were encouraged to relax their forearm muscles and to allow distraction of the wrist. The motions of the bones in the wrist were tracked between the unloaded and loaded trial using markerless bone registration. The average displacement vector of each bone relative to the radius was calculated, as were the interbone distances for 20 bone-bone interactions. Joint separation was estimated at the radiocarpal, midcarpal, and carpometacarpal joints in the direction of loading using the radius, lunate, capitate, and third metacarpal. With loading, the distance between the radius and third metacarpal increased an average of 3.3 mm +/- 3.1 in the direction of loading. This separation was primarily in the axial direction at the radiocarpal (1.0 mm +/- 1.0) and midcarpal (2.0 mm +/- 1.7) joints. There were minimal changes in the transverse direction within the distal row, although the proximal row narrowed by 0.98 mm +/- 0.7. Distraction between the radius and scaphoid (2.5 mm +/- 2.2) was 2.4 times greater than that between the radius and lunate (1.0 mm +/- 1.0). Carpal distraction has a significant (p < .01) effect on the conformation of the carpus, especially at the radiocarpal and midcarpal joints. In the normal wrist, external traction causes twice as much distraction at the lunocapitate joint than at the radiolunate joint. Copyright 2010. Published by Elsevier Inc.

Social media interruption affects the acquisition of visually, not aurally, acquired information during a pathophysiology lecture.

PubMed

Marone, Jane R; Thakkar, Shivam C; Suliman, Neveen; O'Neill, Shannon I; Doubleday, Alison F

2018-06-01

Poor academic performance from extensive social media usage appears to be due to students' inability to multitask between distractions and academic work. However, the degree to which visually distracted students can acquire lecture information presented aurally is unknown. This study examined the ability of students visually distracted by social media to acquire information presented during a voice-over PowerPoint lecture, and to compare performance on examination questions derived from information presented aurally vs. that presented visually. Students ( n = 20) listened to a 42-min cardiovascular pathophysiology lecture containing embedded cartoons while taking notes. The experimental group ( n = 10) was visually, but not aurally, distracted by social media during times when cartoon information was presented, ~40% of total lecture time. Overall performance among distracted students on a follow-up, open-note quiz was 30% poorer than that for controls ( P < 0.001). When the modality of presentation (visual vs. aural) was compared, performance decreased on examination questions from information presented visually. However, performance on questions from information presented aurally was similar to that of controls. Our findings suggest the ability to acquire information during lecture may vary, depending on the degree of competition between the modalities of the distraction and the lecture presentation. Within the context of current literature, our findings also suggest that timing of the distraction relative to delivery of material examined affects performance more than total distraction time. Therefore, when delivering lectures, instructors should incorporate organizational cues and active learning strategies that assist students in maintaining focus and acquiring relevant information.

Combined micro computed tomography and histology study of bone augmentation and distraction osteogenesis

NASA Astrophysics Data System (ADS)

Ilgenstein, Bernd; Deyhle, Hans; Jaquiery, Claude; Kunz, Christoph; Stalder, Anja; Stübinger, Stefan; Jundt, Gernot; Beckmann, Felix; Müller, Bert; Hieber, Simone E.

2012-10-01

Bone augmentation is a vital part of surgical interventions of the oral and maxillofacial area including dental implantology. Prior to implant placement, sufficient bone volume is needed to reduce the risk of peri-implantitis. While augmentation using harvested autologous bone is still considered as gold standard, many surgeons prefer bone substitutes to reduce operation time and to avoid donor site morbidity. To assess the osteogenic efficacy of commercially available augmentation materials we analyzed drill cores extracted before implant insertion. In younger patients, distraction osteogenesis is successfully applied to correct craniofacial deformities through targeted bone formation. To study the influence of mesenchymal stem cells on bone regeneration during distraction osteogenesis, human mesenchymal stem cells were injected into the distraction gap of nude rat mandibles immediately after osteotomy. The distraction was performed over eleven days to reach a distraction gap of 6 mm. Both the rat mandibles and the drill cores were scanned using synchrotron radiation-based micro computed tomography. The three-dimensional data were manually registered and compared with corresponding two-dimensional histological sections to assess bone regeneration and its morphology. The analysis of the rat mandibles indicates that bone formation is enhanced by mesenchymal stem cells injected before distraction. The bone substitutes yielded a wide range of bone volume and degree of resorption. The volume fraction of the newly formed bone was determined to 34.4% in the computed tomography dataset for the augmentation material Geistlich Bio-Oss®. The combination of computed tomography and histology allowed a complementary assessment for both bone augmentation and distraction osteogenesis.

Effect of audiovisual distraction with 3D video glasses on dental anxiety of children experiencing administration of local analgesia: a randomised clinical trial.

PubMed

Nuvvula, S; Alahari, S; Kamatham, R; Challa, R R

2015-02-01

To determine the effect of three-dimensional (3D) audiovisual (AV) distraction in reducing dental anxiety of children. A randomised clinical trial with a parallel design carried out on 90 children (49 boys and 41 girls) aged between 7 and 10 years (mean age of 8.4 years) to ascertain the comparative efficacy of audio (music) and AV (3D video glasses) distraction in reducing the dental anxiety of children during local analgesia (LA) administration. Ninety children were randomly divided into three groups; control (basic behaviour guidance techniques without distraction), audio (basic techniques plus music) and AV (basic techniques plus 3D AV) distraction groups. All the children experienced LA administration with/without distraction and the anxiety was assessed using a combination of measures: MCDAS(f) (self-report), pulse rate (physiological), behaviour (using Wright's modification of Frankl behaviour rating scale and Houpt scale) and preferences of children. All 90 children completed the study. A highly significant reduction in the anxiety of audiovisual group as reported by the MCDAS(f) values (p<0.001) and Houpt scale (p=0.003); whereas pulse rate showed statistically significant increase (p<0.001) in all the three groups irrespective of distraction. The child preferences also affirmed the usage of 3D video glasses. LA administration with music or 3D video glasses distraction had an added advantage in a majority of children with 3D video glasses being superior to music. High levels of satisfaction from children who experienced treatment with 3D video glasses were also observed.

Effects of a computer-based training module on drivers' willingness to engage in distracting activities.

PubMed

Horrey, William J; Lesch, Mary F; Kramer, Arthur F; Melton, David F

2009-08-01

This study examines the effect of a computer-based training module on drivers' attitudes and behaviors with respect to in-vehicle distraction. Research findings on the negative performance implications of distraction call for the need to mitigate these adverse effects. Forty drivers (ages 18 to 20 yrs) were divided into two groups: a training group that completed the module and a control group that viewed an unrelated video. The training promoted enhanced metacognitive skills (e.g., planning, monitoring) and strategies to deal with distraction. Measures of willingness to perform in-vehicle activities while driving (involving the use of short videos) were assessed before and after the intervention. Drivers also performed in-vehicle tasks while driving an instrumented vehicle on a closed test track. Following the training, drivers in the training group showed a decline in their ratings of willingness to engage in distracting activities along with a corresponding increase in perceived risk. In contrast, ratings from drivers in the control group did not change on any measures. Drivers in the training group were also more likely to perform in-vehicle tasks while the vehicle was parked compared with the control group-an obvious safety benefit. However, there was no observable benefit of training for drivers who performed the distracting tasks while the vehicle was in motion. There may be some promise to such a training approach. The implications for distraction and training are discussed. Training general skills in dealing with potentially distracting in-vehicle tasks may help offset some of the negative outcomes associated with their use.

Automated Continuous Distraction Osteogenesis May Allow Faster Distraction Rates: A Preliminary Study

PubMed Central

Peacock, Zachary S.; Tricomi, Brad; Murphy, Brian; Magill, John; Kaban, Leonard B.; Troulis, Maria

2013-01-01

Purpose To determine if automated continuous distraction osteogenesis at rates > 1mm/day would result in clinical and radiographic bone formation in a minipig model. Materials and Methods An automated, continuous, curvilinear distraction device was placed across a mandibular osteotomy in 10 minipigs. After 12 mm of distraction and 24 days fixation, animals were sacrificed and bone healing evaluated. The continuous distraction rates were 1.5 (n=5) and 3 mm/day (n=5). A semiquantitative scale was used to assess ex-vivo clinical appearance of the distraction gap (3= osteotomy not visible; 2= <50%; 1= >50%; 0= 100% visible); stability (3 = no mobility; 2 and 1 = mobility in 2 or 1 plane respectively; 0= mobility in 3 planes); radiographic density (4 = 100% gap opaque, 3= >75%, 2 = 50% – 75%, 1= <50%, or 0 = radiolucent). Groups of 4 minipigs distracted discontinuously at 1, 2, and 4 mm/day served as controls. Results The continuous DO 1.5 mm/day group had significantly higher scores for appearance and radiographic density compared to the discontinuous 4 mm/day group. The continuous DO 3mm/day group had significantly higher scores for appearance and radiographic density compared to the discontinuous 4 mm/day group, and higher stability compared to the discontinuous 2 and 4 mm/day groups. Conclusions Results of this preliminary study indicate that continuous DO at rates of 1.5 and 3.0 mm/day produces better bone formation when compared to discontinuous DO at rates faster than 1mm/day. PMID:23499159

Skeletal and soft tissue changes and stability in cleft lip and palate patients after distraction osteogenesis using a new intraoral maxillary device.

PubMed

Ansari, Edward; Tomat, Catherine; Kadlub, Natacha; Diner, Patrick A; Bellocq, Thomas; Vazquez, Marie-Paule; Picard, Arnaud

2015-04-01

The authors have recently reported on the use of an internal maxillary distraction device. In this study, we report on the hard and soft tissue movements achieved with this intraoral distraction device, and the stability changes after distraction osteogenesis for maxillary hypoplasia in patients with cleft lip and palate. Ten male patients with severe hypoplasia of the maxilla, with complete uni- or bilateral cleft lip and palate were included. The mean age of the patients at the time of operation was 11.91 years (±3.41). To evaluate the distraction process and stability, superimpositions on the preoperative lateral cephalograms were performed. The mean follow-up (FU) was 15.42 months (±3.94). Cephalometric measurements at all of the maxillary hard and soft tissue points improved significantly. Maxillary point A was advanced by 8.25 mm (±3.17; P < 0.001). After distraction soft tissue point A' had advanced 7.10 mm (±2.69; P < 0.001). The soft tissue to hard tissue ratio at point A was 0.86:1 after distraction. Maxillary horizontal relapse at point A was 14.1% at FU. Vertical relapse was not significant. This rigid intraoral distraction device can be successfully used in the correction of severe maxillary hypoplasia. The marked aesthetic improvement and low psychological encumbrance make this device viable for the treatment of cleft-related hypoplasia of the maxilla. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Harnessing the Wandering Mind: The Role of Perceptual Load

ERIC Educational Resources Information Center

Forster, Sophie; Lavie, Nilli

2009-01-01

Perceptual load is a key determinant of distraction by task-irrelevant stimuli (e.g., Lavie, N. (2005). "Distracted and confused?: Selective attention under load." "Trends in Cognitive Sciences," 9, 75-82). Here we establish the role of perceptual load in determining an internal form of distraction by task-unrelated thoughts (TUTs or…

Object-Based Attention Overrides Perceptual Load to Modulate Visual Distraction

ERIC Educational Resources Information Center

Cosman, Joshua D.; Vecera, Shaun P.

2012-01-01

The ability to ignore task-irrelevant information and overcome distraction is central to our ability to efficiently carry out a number of tasks. One factor shown to strongly influence distraction is the perceptual load of the task being performed; as the perceptual load of task-relevant information processing increases, the likelihood that…

The use of commercial advertising on large scale electronic billboards for highways and their relation to driver safety and driver distraction, literature review.

DOT National Transportation Integrated Search

2008-07-01

The potential for driver distraction on highways is a major safety concern for state : departments of transportation (DOTs). In the current technological climate, drivers have : the potential to be distracted by cell phones, mp3 players and other med...

Some Effects of Distractions in Nonverbal Mathematical Problems

ERIC Educational Resources Information Center

Bana, J. P.; Nelson, D.

1977-01-01

The central purpose of this study was to investigate the effects of distractions in nonverbal problems on the problem solving behavior and performance of young children (grades 1-3) in 6 schools (N=360). Results indicated 66 percent of the subjects were distracted by irrelevant spatial-numerical or color attribute uses. (JC)

Neuronal effects of auditory distraction on visual attention

PubMed Central

Smucny, Jason; Rojas, Donald C.; Eichman, Lindsay C.; Tregellas, Jason R.

2013-01-01

Selective attention in the presence of distraction is a key aspect of healthy cognition. The underlying neurobiological processes, have not, however, been functionally well characterized. In the present study, we used functional magnetic resonance imaging to determine how ecologically relevant distracting noise affects cortical activity in 27 healthy adults during two versions of the visual sustained attention to response task (SART) that differ in difficulty (and thus attentional load). A significant condition (noise or silence) by task (easy or difficult) interaction was observed in several areas, including dorsolateral prefrontal cortex (DLPFC), fusiform gyrus (FG), posterior cingulate (PCC), and pre-supplementary motor area (PreSMA). Post-hoc analyses of interaction effects revealed deactivation of DLPFC, PCC, and PreSMA during distracting noise under conditions of low attentional load, and activation of FG and PCC during distracting noise under conditions of high attentional load. These results suggest that distracting noise may help alert subjects to task goals and reduce demands on cortical resources during tasks of low difficulty and attentional load. Under conditions of higher load, however, additional cognitive resources may be required in the presence of noise. PMID:23291265

Synchronization with competing visual and auditory rhythms: bouncing ball meets metronome.

PubMed

Hove, Michael J; Iversen, John R; Zhang, Allen; Repp, Bruno H

2013-07-01

Synchronization of finger taps with periodically flashing visual stimuli is known to be much more variable than synchronization with an auditory metronome. When one of these rhythms is the synchronization target and the other serves as a distracter at various temporal offsets, strong auditory dominance is observed. However, it has recently been shown that visuomotor synchronization improves substantially with moving stimuli such as a continuously bouncing ball. The present study pitted a bouncing ball against an auditory metronome in a target-distracter synchronization paradigm, with the participants being auditory experts (musicians) and visual experts (video gamers and ball players). Synchronization was still less variable with auditory than with visual target stimuli in both groups. For musicians, auditory stimuli tended to be more distracting than visual stimuli, whereas the opposite was the case for the visual experts. Overall, there was no main effect of distracter modality. Thus, a distracting spatiotemporal visual rhythm can be as effective as a distracting auditory rhythm in its capacity to perturb synchronous movement, but its effectiveness also depends on modality-specific expertise.

Happiness increases distraction by auditory deviant stimuli.

PubMed

Pacheco-Unguetti, Antonia Pilar; Parmentier, Fabrice B R

2016-08-01

Rare and unexpected changes (deviants) in an otherwise repeated stream of task-irrelevant auditory distractors (standards) capture attention and impair behavioural performance in an ongoing visual task. Recent evidence indicates that this effect is increased by sadness in a task involving neutral stimuli. We tested the hypothesis that such effect may not be limited to negative emotions but reflect a general depletion of attentional resources by examining whether a positive emotion (happiness) would increase deviance distraction too. Prior to performing an auditory-visual oddball task, happiness or a neutral mood was induced in participants by means of the exposure to music and the recollection of an autobiographical event. Results from the oddball task showed significantly larger deviance distraction following the induction of happiness. Interestingly, the small amount of distraction typically observed on the standard trial following a deviant trial (post-deviance distraction) was not increased by happiness. We speculate that happiness might interfere with the disengagement of attention from the deviant sound back towards the target stimulus (through the depletion of cognitive resources and/or mind wandering) but help subsequent cognitive control to recover from distraction. © 2015 The British Psychological Society.

The use of VR distraction to decrease pain after laparoscopic bariatric surgery: a case study.

PubMed

Hoyus, Kattia Cabas; Cardenas-López, Georgina; Maldonado, Jose Gutierrez; Ruiz-Esquivel, Ma Fernanda; Torres-Villalobos, Gonzalo

2012-01-01

One of the advantages of laparoscopic bariatric surgery is the reduced level of postoperative pain. In some cases, however, the pain level may be high. This is a challenge for specialists. This case study explores the use of VR distraction in an 18 year-old patient who had undergone laparoscopic bariatric surgery and who reported pain during the postoperative period. The study was conducted in a Level III Private Hospital in Mexico City where the patient was hospitalized. The patient was administered standard analgesic during VR distraction, which lasted a total of 40 minutes divided into two sessions. The scores of three visual analogue scales and catastrophism were the dependent variables of this study. The scales were administered before and after the VR distraction intervention. The patient reported lower pain levels after VR distraction and reductions in some components of catastrophism. This study proves that VR distraction can be effective not only in reducing the physical component of pain (a notion that is already well established) but also the cognitive/affective component. More controlled studies of the issue are required.

[Biomechanical study of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate].

PubMed

Hou, Min; Shi, Guang-Yu; Pu, Li-Chen; Song, Da-Li; Zhang, Xi-Zhong; Liu, Chun-Ming

2009-09-01

To investigate the biomechanical changes of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate (CLP). 3-D finite element (FEM) analysis was used. 3-D models of Le Fort I, II, III osteotomy and soft tissue were established. Based on the new pattern of internal midface distractor, the distraction of maxillary complex was simulated to advance 10 mm anteriorly. The mechanical change was studied. The maxillary complex in CLP were advanced after distraction. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. The maxillary complex was moved anteriorly en bloc after Le Fort III osteotomy, but some degree of rotation of maxillary complex was observed during the distraction after Le Fort I and II osteotomy. In vertical direction, the maxillary complex had more counterclockwise rotation after Le Fort II osteotomy. 3-D FEM analysis can be used for the study of internal distraction. It can reflect the maxillary movement and provide the theory basis for preoperative design.

Long-term maxillomandibular skeletal and dental changes in children with cleft lip and palate after maxillary distraction.

PubMed

Harada, Kiyoshi; Sato, Masaru; Omura, Ken

2006-09-01

Long-term skeletal and dental changes were examined in 8 children with cleft lip and palate who underwent maxillary distraction to allow the maxilla to catch up to their mandibular growth at the treatment point. Changes in the overjet (OJ), overbite (OB), and positions of the anterior nasal spine (ANS), upper incisors (U1), pogonion (Pog), and lower incisors (L1) were measured on preoperative to 36 months postoperative lateral-cephalograms. In most of the children, the long-term changes after the maxillary distraction resulted in an inferior growth of the maxilla and anteroinferior growth of the mandible. This seems to suggest that maxillary distraction performed during childhood needs considerable overcorrection. However, if the maxilla is distracted to an adult position during childhood, the masticatory functions of the children will markedly deteriorate until their jaws grow. Therefore, we believe that one goal of maxillary distraction during childhood can be to allow the maxilla to catch up to the mandibular growth of the children at the treatment point.

Postdictive modulation of visual orientation.

PubMed

Kawabe, Takahiro

2012-01-01

The present study investigated how visual orientation is modulated by subsequent orientation inputs. Observers were presented a near-vertical Gabor patch as a target, followed by a left- or right-tilted second Gabor patch as a distracter in the spatial vicinity of the target. The task of the observers was to judge whether the target was right- or left-tilted (Experiment 1) or whether the target was vertical or not (Supplementary experiment). The judgment was biased toward the orientation of the distracter (the postdictive modulation of visual orientation). The judgment bias peaked when the target and distracter were temporally separated by 100 ms, indicating a specific temporal mechanism for this phenomenon. However, when the visibility of the distracter was reduced via backward masking, the judgment bias disappeared. On the other hand, the low-visibility distracter could still cause a simultaneous orientation contrast, indicating that the distracter orientation is still processed in the visual system (Experiment 2). Our results suggest that the postdictive modulation of visual orientation stems from spatiotemporal integration of visual orientation on the basis of a slow feature matching process.

Biomechanical analysis of cervical distraction.

PubMed

Miller, L S; Cotler, H B; De Lucia, F A; Cotler, J M; Hume, E L

1987-11-01

A biomechanical analysis of cervical distraction is presented, and a model comparing closed reduction of cervical spine dislocations to spring mechanics is developed. Behavior of a spring may be described as F = k delta x where F = distraction force; delta x = elongation of the spring; and k = spring constant. The records and roentgenograms of 24 cervical spine dislocations were reviewed retrospectively. Evaluation of cervical distraction vs traction weight indicates that Ftraction = kneck delta x; where F = traction weight and x = distraction at the injured level. The constant, kneck, is different for bilateral and unilateral dislocations (P less than .001) and is a function of magnitude of injury and neck morphology. As determined in this study, traction weight needed for reduction of facet dislocations may be estimated using the formulae: Ftx = 107.1 lbs/cm (x) unilateral, and Ftx = 76.4 lbs/cm (x) bilateral.

Angioplasty balloon catheters used for distraction of the ankle joint.

PubMed

Sartoretti, C; Sartoretti-Schefer, S; Duff, C; Buchmann, P

1996-02-01

Arthroscopy of the ankle joint is now routinely performed in diagnostic and therapeutic interventions but is still a demanding and difficult operative procedure in this very small and tight joint. Arthroscopy can be facilitated by a sufficient distraction that gives a better overview of the joint space. However, it is still a matter of debate how to obtain the adequate distraction. Distention by manual strength as well as by the help of a technical device have been proposed. We report our experience with distraction of the ankle joint by the help of one or two intraarticularily located and secondarily insufflated angioplasty balloon catheters that are routinely used in interventional radiology. These special catheters allow a careful and controlled distention of the joint with a fixed space of distraction and, according to our limited experience, without any morbidity.

Does Personality Have a Different Impact on Self-Rated Distraction, Job Satisfaction, and Job Performance in Different Office Types?

PubMed

Seddigh, Aram; Berntson, Erik; Platts, Loretta G; Westerlund, Hugo

2016-01-01

This study investigates the joint effect of office type (cell, shared room, open-plan, and flex) and personality, measured by the Big Five personality traits, on self-rated measures of distraction, job satisfaction, and job performance (measured by professional efficacy). Regression analyses with interactions between personality and office type were conducted on 1205 participants working in 5 organizations from both the private and public sectors. While few interactions were observed in the cases of professional efficacy and job satisfaction, several were observed between personality traits and office type on the level of distraction reported. Specifically, more emotionally stable participants reported lower distraction, particularly those working in flex offices. Both agreeableness and openness to experience were associated with higher levels of distraction among participants in open-plan compared to cell offices.

Does Personality Have a Different Impact on Self-Rated Distraction, Job Satisfaction, and Job Performance in Different Office Types?

PubMed Central

Seddigh, Aram; Berntson, Erik; Platts, Loretta G.; Westerlund, Hugo

2016-01-01

This study investigates the joint effect of office type (cell, shared room, open-plan, and flex) and personality, measured by the Big Five personality traits, on self-rated measures of distraction, job satisfaction, and job performance (measured by professional efficacy). Regression analyses with interactions between personality and office type were conducted on 1205 participants working in 5 organizations from both the private and public sectors. While few interactions were observed in the cases of professional efficacy and job satisfaction, several were observed between personality traits and office type on the level of distraction reported. Specifically, more emotionally stable participants reported lower distraction, particularly those working in flex offices. Both agreeableness and openness to experience were associated with higher levels of distraction among participants in open-plan compared to cell offices. PMID:27223898

Designing feedback to mitigate teen distracted driving: A social norms approach.

PubMed

Merrikhpour, Maryam; Donmez, Birsen

2017-07-01

The purpose of this research is to investigate teens' perceived social norms and whether providing normative information can reduce distracted driving behaviors among them. Parents are among the most important social referents for teens; they have significant influences on teens' driving behaviors, including distracted driving which significantly contributes to teens' crash risks. Social norms interventions have been successfully applied in various domains including driving; however, this approach is yet to be explored for mitigating driver distraction among teens. Forty teens completed a driving simulator experiment while performing a self-paced visual-manual secondary task in four between-subject conditions: a) social norms feedback that provided a report at the end of each drive on teens' distracted driving behavior, comparing their distraction engagement to their parent's, b) post-drive feedback that provided just the report on teens' distracted driving behavior without information on their parents, c) real-time feedback in the form of auditory warnings based on eyes of road-time, and d) no feedback as control. Questionnaires were administered to collect data on these teens' and their parents' self-reported engagement in driver distractions and the associated social norms. Social norms and real-time feedback conditions resulted in significantly smaller average off-road glance duration, rate of long (>2s) off-road glances, and standard deviation of lane position compared to no feedback. Further, social norms feedback decreased brake response time and percentage of time not looking at the road compared to no feedback. No major effect was observed for post-drive feedback. Questionnaire results suggest that teens appeared to overestimate parental norms, but no effect of feedback was found on their perceptions. Feedback systems that leverage social norms can help mitigate driver distraction among teens. Overall, both social norms and real-time feedback induced positive driving behaviors, with social norms feedback outperforming real-time feedback. Copyright © 2017 Elsevier Ltd. All rights reserved.

Partially Biodegradable Distraction Implant to Replace Conventional Implants in Alveolar Bone of Insufficient Height: A Preliminary Study in Dogs.

PubMed

Li, Tao; Zhang, Yongqiang; Shao, Bo; Gao, Yuan; Zhang, Chen; Cao, Qiang; Kong, Liang

2015-12-01

Dental implants have been widely used in the last few decades. However, patients with insufficient bone height need reconstructive surgeries before implant insertion. The distraction implant (DI) has been invented to simplify the treatment procedure, but the shortcomings of DIs have limited their clinical use. We incorporated biodegradable polyester into a novel DI called the partially biodegradable distraction implant (PBDI). The purpose of this study was to assess the radiological, histological, and biomechanical properties of the PBDI in animal models. PBDIs were manufactured and inserted into the atrophied mandibles of nine dogs. Box-shaped alveolar bones were segmented and distracted. The dogs were randomly divided into three groups that were sacrificed 1, 2, and 3 months after the implant insertion. Actual augmentation height (AAH) of the bone segments was measured to evaluate the effect of distraction. X-ray examination and micro-CT reconstruction and analysis were used to evaluate the regenerated bone in the distraction gap and bone around the functional element. Histological sections were used to evaluate the osseointegration and absorption of the PBDI. Fatigue tests were used to evaluate the biomechanical properties of the PBDI. Little change was found in AAH among the three groups. X-ray examination and micro-CT reconstruction showed good growth of regenerated bone in the distraction gap. Alveolar bone volume around the functional element increased steadily. No obvious bone absorption occurred in the alveolar crest around PBDI. Three months after distraction, the functional element achieved osseointegration, and the support element began to be absorbed. All PBDIs survived the fatigue test. The PBDI is a novel and reliable dental implant. It becomes a conventional implant after the absorption of the support element and the removal of the distraction screw. It is a promising replacement for conventional implants in patients with insufficient alveolar bone height. © 2014 Wiley Periodicals, Inc.

Bone-lengthening for symbrachydactyly of the hand with the technique of callus distraction.

PubMed

Miyawaki, Takeshi; Masuzawa, Genzo; Hirakawa, Masahiko; Kurihara, Kunihiro

2002-06-01

Bone-lengthening in the hand and foot is a relatively new application for distraction osteogenesis. We present the operative treatment and postoperative outcome for four patients with M ller type-D symbrachydactyly of the hand who underwent metacarpal lengthening with use of a distraction device to establish pinch function. Four patients who underwent distraction osteogenesis for the treatment of congenital symbrachydactyly of the hand were evaluated over a thirteen-year period. The nondominant right hand was treated in two patients, and the nondominant left hand was treated in the other two. The patients included three boys and one girl; all patients had the operation between the ages of five and eleven years. Distraction osteogenesis was performed on the fifth metacarpal in one patient and on the fourth and fifth metacarpals in the remaining three, in whom both bones were lengthened simultaneously with use of a single device. Postoperative bone elongation was analyzed with radiographs made at the time of removal of the distractor. The sensory function of the treated fingers and any growth disturbance of the distracted bones were evaluated. The mean duration of distraction was 37.3 days (range, thirty-two to forty-nine days), and the distractor was removed at a mean of eighty-four days after surgery. The bones were lengthened by a mean of 22.3 mm (81.6% of their original length) at a rate of 0.6 mm/day. Pinch function was improved in all patients. On the basis of our limited experience, we found that distraction osteogenesis of the metacarpals was an effective technique for the establishment of pinch function. We also found that an intramedullary Kirschner wire could maintain the alignment of the osteotomized bone. Although distraction requires a longer treatment period, it is apparently more effective than bone-grafting in terms of achieving adequate bone length. Simultaneous lengthening of two metacarpals also was found to be an effective technique.

The effect of soft tissue distraction on deformity recurrence after centralization for radial longitudinal deficiency.

PubMed

Manske, M Claire; Wall, Lindley B; Steffen, Jennifer A; Goldfarb, Charles A

2014-05-01

To assess recurrence and complications in children with radial longitudinal deficiency treated with or without external fixator soft tissue distraction prior to centralization. Thirteen upper extremities treated with centralization alone were compared with 13 treated with ring fixator distraction followed by centralization. Resting wrist position between the 2 groups was compared before surgery, approximately 2 years after surgery (midterm), and at final follow-up, which was at a mean of 10 years for the centralization-alone group and 6 years for the distraction group. Radiographs were reviewed for hand-forearm angle, hand-forearm position, volar carpal subluxation, ulnar length, and physeal integrity. The clinical resting wrist position was improved significantly after surgery and at final follow-up in both groups, but recurrence was worse at final follow-up in the distraction group patients. Radiographically, in the centralization alone group, the hand-forearm angle improved from 53° before surgery to 13° at midterm but worsened to 27° at final follow-up. In the distraction group, the hand-forearm angle improved from 53° before surgery to 21° at midterm but worsened to 36° at final follow-up. The hand-forearm position improved between preoperative and final assessment in both groups, but at final follow-up, the centralization-alone group had a significantly better position. Volar subluxation was 4 mm improved in the centralization alone group and 2 mm worse in the distraction group at final follow-up. Centralization, with or without distraction with an external fixator, resulted in improved alignment of the wrist. Distraction facilitated centralization, but it did not prevent deformity recurrence and was associated with a worse final radial deviation and volar subluxation position compared with wrists treated with centralization alone. Therapeutic III. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Biomechanical comparison of two intraoperative mobilization techniques for maxillary distraction osteogenesis: Down-fracture versus non-down-fracture

PubMed Central

Yang, Lili; Suzuki, Eduardo Yugo; Suzuki, Boonsiva

2014-01-01

Purposes: The purpose of this study was to compare the distraction forces and the biomechanical effects between two different intraoperative surgical procedures (down-fracture [DF] and non-DF [NDF]) for maxillary distraction osteogenesis. Materials and Methods: Eight patients were assigned into two groups according to the surgical procedure: DF, n = 6 versus NDF, n = 2. Lateral cephalograms taken preoperatively (T1), immediately after removal of the distraction device (T2), and after at least a 6 months follow-up period (T3) were analyzed. Assessment of distraction forces was performed during the distraction period. The Mann–Whitney U-test was used to compare the difference in the amount of advancement, the maximum distraction force and the amount of relapse. Results: Although a significantly greater amount of maxillary movement was observed in the DF group (median 9.5 mm; minimum-maximum 7.9-14.1 mm) than in the NDF group (median 5.9 mm; minimum-maximum 4.4-7.6 mm), significantly lower maximum distraction forces were observed in the DF (median 16.4 N; minimum-maximum 15.1-24.6 N) than in the NDF (median 32.9 N; minimum-maximum 27.6-38.2 N) group. A significantly greater amount of dental anchorage loss was observed in the NDF group. Moreover, the amount of relapse observed in the NDF group was approximately 3.5 times greater than in the DF group. Conclusions: In this study, it seemed that, the use of the NDF procedure resulted in lower levels of maxillary mobility at the time of the maxillary distraction, consequently requiring greater amounts of force to advance the maxillary bone. Moreover, it also resulted in a reduced amount of maxillary movement, a greater amount of dental anchorage loss and poor treatment stability. PMID:25593865

Age-related changes in working memory and the ability to ignore distraction.

PubMed

McNab, Fiona; Zeidman, Peter; Rutledge, Robb B; Smittenaar, Peter; Brown, Harriet R; Adams, Rick A; Dolan, Raymond J

2015-05-19

A weakened ability to effectively resist distraction is a potential basis for reduced working memory capacity (WMC) associated with healthy aging. Exploiting data from 29,631 users of a smartphone game, we show that, as age increases, working memory (WM) performance is compromised more by distractors presented during WM maintenance than distractors presented during encoding. However, with increasing age, the ability to exclude distraction at encoding is a better predictor of WMC in the absence of distraction. A significantly greater contribution of distractor filtering at encoding represents a potential compensation for reduced WMC in older age.

Short-term retention of pictures and words: evidence for dual coding systems.

PubMed

Pellegrino, J W; Siegel, A W; Dhawan, M

1975-03-01

The recall of picture and word triads was examined in three experiments that manipulated the type of distraction in a Brown-Peterson short-term retention task. In all three experiments recall of pictures was superior to words under auditory distraction conditions. Visual distraction produced high performance levels with both types of stimuli, whereas combined auditory and visual distraction significantly reduced picture recall without further affecting word recall. The results were interpreted in terms of the dual coding hypothesis and indicated that pictures are encoded into separate visual and acoustic processing systems while words are primarily acoustically encoded.

Clinical and experimental study of TMJ distraction: preliminary results.

PubMed

Festa, F; Galluccio, G

1998-01-01

A physiotherapeutic approach, with manual maneuvers and/or distraction appliances, is indicated in the treatment of temporomandibular joint disorders (TMDs) to prevent the progressive fibrosis of the muscle fibers. In this article, the authors report preliminary results of experimental and clinical studies conducted to assess the real effect of distraction in temporomandibular joint disorders. The experimental invivo studies confirmed the structural alteration due to compression and distraction on the capsular and condylar tissues. Clinical cases are reported to show the increase of the intraarticular vertical dimension, with a forward and downward movement of the condyles in a more physiologic condition.

Maxillary advancement using distraction osteogenesis with intraoral device.

PubMed

Takigawa, Yoko; Uematsu, Setsuko; Takada, Kenji

2010-11-01

This article describes the surgical orthodontic treatment of maxillary hypoplasia in a patient with cleft lip and palate using maxillary distraction osteogenesis with internal maxillary distractors. Maxillary advancement was performed to correct the retrusive maxillary facial profile and Class III malocclusion. Rotational movement of the distraction segment was made to correct the upper dental midline. Although maxillary advancement was insufficient because of unexpected breakage of the intraoral distractor after completion of the distraction, skeletal traction with a face mask compensated for the shortage. Successful esthetic improvement and posttreatment occlusal stability were achieved with no discernible relapse after 2 years of retention.

Does audiovisual distraction reduce dental anxiety in children under local anesthesia? A systematic review and meta-analysis.

PubMed

Zhang, Cai; Qin, Dan; Shen, Lu; Ji, Ping; Wang, Jinhua

2018-03-02

To perform a systematic review and meta-analysis on the effects of audiovisual distraction on reducing dental anxiety in children during dental treatment under local anesthesia. The authors identified eligible reports published through August 2017 by searching PubMed, EMBASE, and Cochrane Central Register of Controlled Trials. Clinical trials that reported the effects of audiovisual distraction on children's physiological measures, self-reports and behavior rating scales during dental treatment met the minimum inclusion requirements. The authors extracted data and performed a meta-analysis of appropriate articles. Nine eligible trials were included and qualitatively analyzed; some of these trials were also quantitatively analyzed. Among the physiological measures, heart rate or pulse rate was significantly lower (p=0.01) in children subjected to audiovisual distraction during dental treatment under local anesthesia than in those who were not; a significant difference in oxygen saturation was not observed. The majority of the studies using self-reports and behavior rating scales suggested that audiovisual distraction was beneficial in reducing anxiety perception and improving children's cooperation during dental treatment. The audiovisual distraction approach effectively reduces dental anxiety among children. Therefore, we suggest the use of audiovisual distraction when children need dental treatment under local anesthesia. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Distracted driving in elderly and middle-aged drivers.

PubMed

Thompson, Kelsey R; Johnson, Amy M; Emerson, Jamie L; Dawson, Jeffrey D; Boer, Erwin R; Rizzo, Matthew

2012-03-01

Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention. This study examined distracted driving performance in an instrumented vehicle (IV) in 86 elderly (mean=72.5 years, SD=5.0 years) and 51 middle-aged drivers (mean=53.7 years, SD=9.3 year) under a concurrent auditory-verbal processing load created by the Paced Auditory Serial Addition Task (PASAT). Compared to baseline (no-task) driving performance, distraction was associated with reduced steering control in both groups, with middle-aged drivers showing a greater increase in steering variability. The elderly drove slower and showed decreased speed variability during distraction compared to middle-aged drivers. They also tended to "freeze up", spending significantly more time holding the gas pedal steady, another tactic that may mitigate time pressured integration and control of information, thereby freeing mental resources to maintain situation awareness. While 39% of elderly and 43% of middle-aged drivers committed significantly more driving safety errors during distraction, 28% and 18%, respectively, actually improved, compatible with allocation of attention resources to safety critical tasks under a cognitive load. Copyright © 2011 Elsevier Ltd. All rights reserved.

Distracted Driving in Elderly and Middle-Aged Drivers

PubMed Central

Thompson, Kelsey R.; Johnson, Amy M.; Emerson, Jamie L.; Dawson, Jeffrey D.; Boer, Erwin R.

2011-01-01

Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention. This study examined distracted driving performance in an instrumented vehicle (IV) in 86 elderly (mean = 72.5 years, SD = 5.0 years) and 51 middle-aged drivers (mean = 53.7 years, SD = 9.3 year) under a concurrent auditory-verbal processing load created by the Paced Auditory Serial Addition Task (PASAT). Compared to baseline (no-task) driving performance, distraction was associated with reduced steering control in both groups, with middle-aged drivers showing a greater increase in steering variability. The elderly drove slower and showed decreased speed variability during distraction compared to middle-aged drivers. They also tended to “freeze up”, spending significantly more time holding the gas pedal steady, another tactic that may mitigate time pressured integration and control of information, thereby freeing mental resources to maintain situation awareness. While 39% of elderly and 43% of middle-aged drivers committed significantly more driving safety errors during distraction, 28% and 18%, respectively, actually improved, compatible with allocation of attention resources to safety critical tasks under a cognitive load. PMID:22269561

Curvilinear relationship between phonological working memory load and social-emotional modulation

PubMed Central

Mano, Quintino R.; Brown, Gregory G.; Bolden, Khalima; Aupperle, Robin; Sullivan, Sarah; Paulus, Martin P.; Stein, Murray B.

2015-01-01

Accumulating evidence suggests that working memory load is an important factor for the interplay between cognitive and facial-affective processing. However, it is unclear how distraction caused by perception of faces interacts with load-related performance. We developed a modified version of the delayed match-to-sample task wherein task-irrelevant facial distracters were presented early in the rehearsal of pseudoword memoranda that varied incrementally in load size (1-syllable, 2-syllables, or 3-syllables). Facial distracters displayed happy, sad, or neutral expressions in Experiment 1 (N=60) and happy, fearful, or neutral expressions in Experiment 2 (N=29). Facial distracters significantly disrupted task performance in the intermediate load condition (2-syllable) but not in the low or high load conditions (1- and 3-syllables, respectively), an interaction replicated and generalised in Experiment 2. All facial distracters disrupted working memory in the intermediate load condition irrespective of valence, suggesting a primary and general effect of distraction caused by faces. However, sad and fearful faces tended to be less disruptive than happy faces, suggesting a secondary and specific valence effect. Working memory appears to be most vulnerable to social-emotional information at intermediate loads. At low loads, spare capacity is capable of accommodating the combinatorial load (1-syllable plus facial distracter), whereas high loads maximised capacity and deprived facial stimuli from occupying working memory slots to cause disruption. PMID:22928750

Memory load modulates graded changes in distracter filtering

PubMed Central

Shimi, Andria; Woolrich, Mark W.; Mantini, Dante; Astle, Duncan E.

2015-01-01

Our ability to maintain small amounts of information in mind is critical for successful performance on a wide range of tasks. However, it remains unclear exactly how this maintenance is achieved. One possibility is that it is brought about using mechanisms that overlap with those used for attentional control. That is, the same mechanisms that we use to regulate and optimize our sensory processing may be recruited when we maintain information in visual short-term memory (VSTM). We aimed to test this hypothesis by exploring how distracter filtering is modified by concurrent VSTM load. We presented participants with sequences of target items, the order and location of which had to be maintained in VSTM. We also presented distracter items alongside the targets, and these distracters were graded such that they could be either very similar or dissimilar to the targets. We analyzed scalp potentials using a novel multiple regression approach, which enabled us to explore the neural mechanisms by which the participants accommodated these variable distracters on a trial-to-trial basis. Critically, the effect of distracter filtering interacted with VSTM load; the same graded changes in perceptual similarity exerted effects of a different magnitude depending upon how many items participants were already maintaining in VSTM. These data provide compelling evidence that maintaining information in VSTM recruits an overlapping set of attentional control mechanisms that are otherwise used for distracter filtering. PMID:25610387

Exploring Factors That Influence Technology-Based Distractions in Bring Your Own Device Classrooms

ERIC Educational Resources Information Center

Kay, Robin; Benzimra, Daniel; Li, Jia

2017-01-01

Previous research on distractions and the use of mobile devices (personal digital assistants, tablet personal computers, or laptops) have been conducted almost exclusively in higher education. The purpose of the current study was to examine the frequency and influence of distracting behaviors in Bring Your Own Device secondary school classrooms.…

Distracted driving: a neglected epidemic.

PubMed

Dildy, Dale W

2012-10-01

In 2009, the National Highway Traffic Safety Administration (NHTSA) estimated nearly 6,000 distracted driver fatalities and 515,000 injuries in the United States alone. Distracted driving is a worldwide problem that needs to be addressed. Software is available to disable cell phone usage while driving, but using the advanced technology may require legislation along with a renewed sense of driver responsibility.

Social Media Interruption Affects the Acquisition of Visually, Not Aurally, Acquired Information during a Pathophysiology Lecture

ERIC Educational Resources Information Center

Marone, Jane R.; Thakkar, Shivam C.; Suliman, Neveen; O'Neill, Shannon I.; Doubleday, Alison F.

2018-01-01

Poor academic performance from extensive social media usage appears to be due to students' inability to multitask between distractions and academic work. However, the degree to which visually distracted students can acquire lecture information presented aurally is unknown. This study examined the ability of students visually distracted by social…

Differences between Students with and without ADHD on Task Vigilance under Conditions of Distraction

ERIC Educational Resources Information Center

Ross, Peter; Randolph, Justus

2016-01-01

Distraction is a typical component of any classroom environment. For effective instruction and learning to take place, it is critical for students to eventually return to task and maintain task vigilance (i.e., returning to the task at hand) when a distraction occurs. Students with attention deficit hyperactivity disorder (ADHD), by definition,…

Comparison of Hypnosis and Distraction in Severely Ill Children Undergoing Painful Medical Procedures.

ERIC Educational Resources Information Center

Smith, Julien T.; And Others

1996-01-01

An ethnically diverse sample of high and low hypnotizable children (N=27) suffering from cancer or blood disorders were trained along with their parents to use both distraction and hypnosis to reduce pain and anxiety. Distraction produced significant positive effects for observer-rated distress scores for the low hypnotizable children. Discusses…

Crash-Resistant Crewseat Limit-Load Optimization through Dynamic Testing with Cadavers

DTIC Science & Technology

1986-01-01

10 2.4.3 Hyperflexion with Distraction ..... ......... 11 2.4.4 Rotational Injuries ............. 11 2.4.5 Hyperextension Injuries ............. 11...characteristic wedging ......... .................. 19 10 The Chance fracture: a flexion- distraction injury ..... ... 19 11 Rotational lateral wedge...involving hyperflexlon with distraction 0 Rotational injuries * Hyperextension injuries. Such a classification is, of course, arbitrary to some degree. In

The Use of Choice-Based Distraction to Decrease the Distress of Children at the Dentist

ERIC Educational Resources Information Center

Filcheck, Holly A.; Allen, Keith D.; Ogren, Hilary; Darby, James Brandt; Holstein, Brian; Hupp, Steve

2005-01-01

This research was conducted to examine whether choice-based distraction provides an effective means of reducing the distress of children undergoing routine dental treatment. Sixty children between the ages of 5-12 who required restorative dental treatment were assigned randomly to either a Control group or a Distraction group in which the…

Complications of the Intramedullary Skeletal Kinetic Distractor (ISKD) in distraction osteogenesis.

PubMed

Lee, Dong Hoon; Ryu, Keun Jung; Song, Hae Ryong; Han, Soo-Hong

2014-12-01

The Intramedullary Skeletal Kinetic Distractor (ISKD) (Orthofix Inc, Lewisville, TX, USA) is an intramedullary device designed for more comfortable limb lengthening than that with external fixators; lengthening is achieved with this nail using rotational oscillation between two telescoping sections. However, the degree to which this device achieves this goal and its complication rate have not been fully documented. We determined (1) the frequency with which distraction was not achieved at the desired rate, (2) whether pain differed between patients with normally and abnormally distracting nails, (3) risk factors for abnormal nails, and (4) other complications. We analyzed 35 lengthening segments (26 femurs, nine tibias) in 19 patients. Mean length achieved was 47 mm. Femoral nails were categorized into four groups according to distraction rate: normal, runaway (unintentionally faster rate [> 1.5 mm/day]), difficult-to-distract (slower rate [< 0.8 mm/day] requiring manual manipulation but not requiring general anesthesia), and nondistracting (slower rate [< 0.8 mm/day] requiring manual manipulation under general anesthesia or reosteotomy). Possible risk factors, including age, BMI, preoperative thigh circumferences, degree of intramedullary overreaming, and length of the thicker portion of the nail within the distal fragment, were compared among groups. VAS pain scores were compared among groups under three conditions: rest, physiotherapy, and distraction motion. Complications were also analyzed. Minimum followup was 15 months (mean, 26 months; range, 15-38 months) after first-stage surgery. Abnormal distraction rate was observed in 21 of 35 segments (60%; 17 femurs, four tibias). VAS pain scores showed no differences among groups during rest or physiotherapy but were higher (p = 0.02) in the problematic nails (7-8 points) versus normal nails (3 points) during distraction. Only mean length of the thicker portion of the nail within the distal fragment differed between normally and abnormally distracting nails (95 mm versus 100 mm; p = 0.03), although this was unlikely to be clinically important. Complications occurred in 10 patients (53%), including five with decreased ankle ROM during distraction, four with delayed bone healing, and one with mechanical device failure during distraction. Rate control was difficult to achieve with the ISKD nail for femoral and tibial lengthenings, complications were relatively common, and among patients in whom rate control was not achieved, pain levels were high. Based on our findings, we believe that surgeons should avoid use of this nail. Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Not Merely Experiential: Unconscious Thought Can Be Rational

PubMed Central

Garrison, Katie E.; Handley, Ian M.

2017-01-01

Individuals often form more reasonable judgments from complex information after a period of distraction vs. deliberation. This phenomenon has been attributed to sophisticated unconscious thought during the distraction period that integrates and organizes the information (Unconscious Thought Theory; Dijksterhuis and Nordgren, 2006). Yet, other research suggests that experiential processes are strengthened during the distraction (relative to deliberation) period, accounting for the judgment and decision benefit. We tested between these possibilities, hypothesizing that unconscious thought is distinct from experiential processes, and independently contributes to judgments and decisions during a distraction period. Using an established paradigm, Experiment 1 (N = 319) randomly induced participants into an experiential or rational mindset, after which participants received complex information describing three roommates to then consider consciously (i.e., deliberation) or unconsciously (i.e., distraction). Results revealed superior roommate judgments (but not choices) following distraction vs. deliberation, consistent with Unconscious Thought Theory. Mindset did not have an influence on roommate judgments. However, planned tests revealed a significant advantage of distraction only within the rational-mindset condition, which is contrary to the idea that experiential processing alone facilitates complex decision-making during periods of distraction. In a second experiment (N = 136), we tested whether effects of unconscious thought manifest for a complex analytical reasoning task for which experiential processing would offer no advantage. As predicted, participants in an unconscious thought condition outperformed participants in a control condition, suggesting that unconscious thought can be analytical. In sum, the current results support the existence of unconscious thinking processes that are distinct from experiential processes, and can be rational. Thus, the experiential vs. rational nature of a process might not cleanly delineate conscious and unconscious thought. PMID:28729844

Analysis of naturalistic driving videos of fleet services drivers to estimate driver error and potentially distracting behaviors as risk factors for rear-end versus angle crashes.

PubMed

Harland, Karisa K; Carney, Cher; McGehee, Daniel

2016-07-03

The objective of this study was to estimate the prevalence and odds of fleet driver errors and potentially distracting behaviors just prior to rear-end versus angle crashes. Analysis of naturalistic driving videos among fleet services drivers for errors and potentially distracting behaviors occurring in the 6 s before crash impact. Categorical variables were examined using the Pearson's chi-square test, and continuous variables, such as eyes-off-road time, were compared using the Student's t-test. Multivariable logistic regression was used to estimate the odds of a driver error or potentially distracting behavior being present in the seconds before rear-end versus angle crashes. Of the 229 crashes analyzed, 101 (44%) were rear-end and 128 (56%) were angle crashes. Driver age, gender, and presence of passengers did not differ significantly by crash type. Over 95% of rear-end crashes involved inadequate surveillance compared to only 52% of angle crashes (P < .0001). Almost 65% of rear-end crashes involved a potentially distracting driver behavior, whereas less than 40% of angle crashes involved these behaviors (P < .01). On average, drivers spent 4.4 s with their eyes off the road while operating or manipulating their cell phone. Drivers in rear-end crashes were at 3.06 (95% confidence interval [CI], 1.73-5.44) times adjusted higher odds of being potentially distracted than those in angle crashes. Fleet driver driving errors and potentially distracting behaviors are frequent. This analysis provides data to inform safe driving interventions for fleet services drivers. Further research is needed in effective interventions to reduce the likelihood of drivers' distracting behaviors and errors that may potentially reducing crashes.

Not Merely Experiential: Unconscious Thought Can Be Rational.

PubMed

Garrison, Katie E; Handley, Ian M

2017-01-01

Individuals often form more reasonable judgments from complex information after a period of distraction vs. deliberation. This phenomenon has been attributed to sophisticated unconscious thought during the distraction period that integrates and organizes the information (Unconscious Thought Theory; Dijksterhuis and Nordgren, 2006). Yet, other research suggests that experiential processes are strengthened during the distraction (relative to deliberation) period, accounting for the judgment and decision benefit. We tested between these possibilities, hypothesizing that unconscious thought is distinct from experiential processes, and independently contributes to judgments and decisions during a distraction period. Using an established paradigm, Experiment 1 ( N = 319) randomly induced participants into an experiential or rational mindset, after which participants received complex information describing three roommates to then consider consciously (i.e., deliberation) or unconsciously (i.e., distraction). Results revealed superior roommate judgments (but not choices) following distraction vs. deliberation, consistent with Unconscious Thought Theory. Mindset did not have an influence on roommate judgments. However, planned tests revealed a significant advantage of distraction only within the rational-mindset condition, which is contrary to the idea that experiential processing alone facilitates complex decision-making during periods of distraction. In a second experiment ( N = 136), we tested whether effects of unconscious thought manifest for a complex analytical reasoning task for which experiential processing would offer no advantage. As predicted, participants in an unconscious thought condition outperformed participants in a control condition, suggesting that unconscious thought can be analytical. In sum, the current results support the existence of unconscious thinking processes that are distinct from experiential processes, and can be rational. Thus, the experiential vs. rational nature of a process might not cleanly delineate conscious and unconscious thought.

Evidence of cartilage repair by joint distraction in a canine model of osteoarthritis.

PubMed

Wiegant, Karen; Intema, Femke; van Roermund, Peter M; Barten-van Rijbroek, Angelique D; Doornebal, Arie; Hazewinkel, Herman A W; Lafeber, Floris P J G; Mastbergen, Simon C

2015-02-01

Knee osteoarthritis (OA) is a degenerative joint disorder characterized by cartilage, bone, and synovial tissue changes that lead to pain and functional impairment. Joint distraction is a treatment that provides long-term improvement in pain and function accompanied by cartilage repair, as evaluated indirectly by imaging studies and measurement of biochemical markers. The purpose of this study was to evaluate cartilage tissue repair directly by histologic and biochemical assessments after joint distraction treatment. In 27 dogs, OA was induced in the right knee joint (groove model; surgical damage to the femoral cartilage). After 10 weeks of OA development, the animals were randomized to 1 of 3 groups. Two groups were fitted with an external fixator, which they wore for a subsequent 10 weeks (one group with and one without joint distraction), and the third group had no external fixation (OA control group). Pain/function was studied by force plate analysis. Cartilage integrity and chondrocyte activity of the surgically untouched tibial plateaus were analyzed 25 weeks after removal of the fixator. Changes in force plate analysis values between the different treatment groups were not conclusive. Features of OA were present in the OA control group, in contrast to the generally less severe damage after joint distraction. Those treated with joint distraction had lower macroscopic and histologic damage scores, higher proteoglycan content, better retention of newly formed proteoglycans, and less collagen damage. In the fixator group without distraction, similarly diminished joint damage was found, although it was less pronounced. Joint distraction as a treatment of experimentally induced OA results in cartilage repair activity, which corroborates the structural observations of cartilage repair indicated by surrogate markers in humans. Copyright © 2015 by the American College of Rheumatology.

A minipig model of maxillary distraction osteogenesis.

PubMed

Papadaki, Maria E; Troulis, Maria J; Glowacki, Julie; Kaban, Leonard B

2010-11-01

To establish a porcine model for maxillary distraction osteogenesis and to document the sequence of bone formation in the zone of advancement. Female Yucatan minipigs (n = 9) in the mixed dentition stage underwent modified Le Fort I osteotomy through a vestibular incision under general anesthesia. A unidirectional, semiburied Le Fort I distraction device was fixed across the osteotomy. The distraction protocol was 0-day latency, 1-mm/d rate for 12 days, and 24 days of fixation. Maxillary specimens (n = 9) were harvested and divided in half at the end of distraction (n = 6 sides), midfixation (n = 6), and the end of fixation (n = 6). Clinical stability, volume, and radiographic density across the zone of advancement were graded on semiquantitative scales. Specimens were stained with hematoxylin and eosin and examined with light microscopy. Animals tolerated the operation, the distraction and fixation periods. There were no infections and no devices failed. At the end of the distraction period, bone trabeculae were present at the periphery and fibrous tissues, and vessels, preosteoblasts, and osteoblasts were present in the center of the zone of advancement. Islands of chondrocyte-like cells appeared in 1 specimen each at midfixation and the end of fixation. At the end of fixation, clinical stability and radiographic density were graded 3/3 and bone formation was complete across the advancement zone in all specimens. A model for Le Fort I distraction osteogenesis was established. Intramembranous bone formation was the predominant mechanism of healing in the zone of advancement. Latency was not necessary for bone formation in this minipig model. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The role of auditory transient and deviance processing in distraction of task performance: a combined behavioral and event-related brain potential study

PubMed Central

Berti, Stefan

2013-01-01

Distraction of goal-oriented performance by a sudden change in the auditory environment is an everyday life experience. Different types of changes can be distracting, including a sudden onset of a transient sound and a slight deviation of otherwise regular auditory background stimulation. With regard to deviance detection, it is assumed that slight changes in a continuous sequence of auditory stimuli are detected by a predictive coding mechanisms and it has been demonstrated that this mechanism is capable of distracting ongoing task performance. In contrast, it is open whether transient detection—which does not rely on predictive coding mechanisms—can trigger behavioral distraction, too. In the present study, the effect of rare auditory changes on visual task performance is tested in an auditory-visual cross-modal distraction paradigm. The rare changes are either embedded within a continuous standard stimulation (triggering deviance detection) or are presented within an otherwise silent situation (triggering transient detection). In the event-related brain potentials, deviants elicited the mismatch negativity (MMN) while transients elicited an enhanced N1 component, mirroring pre-attentive change detection in both conditions but on the basis of different neuro-cognitive processes. These sensory components are followed by attention related ERP components including the P3a and the reorienting negativity (RON). This demonstrates that both types of changes trigger switches of attention. Finally, distraction of task performance is observable, too, but the impact of deviants is higher compared to transients. These findings suggest different routes of distraction allowing for the automatic processing of a wide range of potentially relevant changes in the environment as a pre-requisite for adaptive behavior. PMID:23874278

Age differences in emotion regulation effort: Pupil response distinguishes reappraisal and distraction for older but not younger adults.

PubMed

Martins, Bruna; Florjanczyk, Jan; Jackson, Nicholas J; Gatz, Margaret; Mather, Mara

2018-03-01

In previous research, older adults show greater emotional benefits from distracting themselves than from reappraising an event when strategically regulating emotion. Older adults also demonstrate an attentional preference to avoid, while younger adults show a bias toward approaching negative stimuli. This suggests a possible age-related differentiation of cognitive effort across approach and avoidance of negative stimuli during emotion regulation. In this study, we tracked cognitive effort via pupil dilation during the use of distraction (avoidance) and reappraisal (approach) strategies across age. Forty-eight younger adults (M = 20.94, SD = 1.78; 19 men) and 48 older adults (M = 68.82, SD = 5.40; 15 men) viewed a slideshow of negative images and were instructed to distract, reappraise, or passively view each image. Older adults showed greater pupil dilation during reappraisal than distraction, but younger adults displayed no difference between conditions-an effect that survived when controlling for gaze patterns. Gaze findings revealed that older adults looked less within images during active emotion regulation compared with passive viewing (no difference between distraction and reappraisal), and younger adults showed no difference across strategies. Younger adults gazed less within the most emotional image areas during distraction, but this did not significantly contribute to pupil response. Our findings support that distraction is less cognitively effortful than reinterpreting negative information in later life. These findings could be explained by older adults' motivational bias to disengage from negative information because of the age-related positivity effect, or compensation for decreased working memory resources across the life span. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Distraction, not hunger, is associated with lower mood and lower perceived work performance on fast compared to non-fast days during intermittent fasting.

PubMed

Appleton, Katherine M; Baker, Stephanie

2015-06-01

Using a repeated measures design, 16 females recorded hunger, distraction, mood and perceived work performance on two consecutive fast days, on two earlier and on two subsequent consecutive non-fast days, during intermittent fasting. Using regression analyses, low positive mood was associated with higher distraction (β = -0.38, p < 0.01), and lower perceived work performance was associated with higher distraction (β = -0.50, p < 0.01) and lower positive mood (β = 0.59, p = 0.01). No associations were found with hunger (largest β = -0.11, p = 0.15). Associations between mood, perceived work performance and distraction but not hunger mirror those found in traditional dieting and suggest no benefit for attention from intermittent fasting-type regimes. © The Author(s) 2015.

Effects of videogame distraction using a virtual reality type head-mounted display helmet on cold pressor pain in children.

PubMed

Dahlquist, Lynnda M; Weiss, Karen E; Clendaniel, Lindsay Dillinger; Law, Emily F; Ackerman, Claire Sonntag; McKenna, Kristine D

2009-06-01

To test whether a head-mounted display helmet enhances the effectiveness of videogame distraction for children experiencing cold pressor pain. Forty-one children, aged 6-14 years, underwent one or two baseline cold pressor trials followed by two distraction trials in which they played the same videogame with and without the helmet in counterbalanced order. Pain threshold (elapsed time until the child reported pain) and pain tolerance (total time the child kept the hand submerged in the cold water) were measured for each cold pressor trial. Both distraction conditions resulted in improved pain tolerance relative to baseline. Older children appeared to experience additional benefits from using the helmet, whereas younger children benefited equally from both conditions. The findings suggest that virtual reality technology can enhance the effects of distraction for some children. Research is needed to identify the characteristics of children for whom this technology is best suited.

Evaluative pressure overcomes perceptual load effects.

PubMed

Normand, Alice; Autin, Frédérique; Croizet, Jean-Claude

2015-06-01

Perceptual load has been found to be a powerful bottom-up determinant of distractibility, with high perceptual load preventing distraction by any irrelevant information. However, when under evaluative pressure, individuals exert top-down attentional control by giving greater weight to task-relevant features, making them more distractible from task-relevant distractors. One study tested whether the top-down modulation of attention under evaluative pressure overcomes the beneficial bottom-up effect of high perceptual load on distraction. Using a response-competition task, we replicated previous findings that high levels of perceptual load suppress task-relevant distractor response interference, but only for participants in a control condition. Participants under evaluative pressure (i.e., who believed their intelligence was assessed) showed interference from task-relevant distractor at all levels of perceptual load. This research challenges the assumptions of the perceptual load theory and sheds light on a neglected determinant of distractibility: the self-relevance of the performance situation in which attentional control is solicited.

Cognitive defusion versus thought distraction: a clinical rationale, training, and experiential exercise in altering psychological impacts of negative self-referential thoughts.

PubMed

Masuda, Akihiko; Feinstein, Amanda B; Wendell, Johanna W; Sheehan, Shawn T

2010-11-01

Using two modes of intervention delivery, the present study compared the effects of a cognitive defusion strategy with a thought distraction strategy on the emotional discomfort and believability of negative self-referential thoughts. One mode of intervention delivery consisted of a clinical rationale and training (i.e., Partial condition). The other mode contained a condition-specific experiential exercise with the negative self-referential thought in addition to the clinical rationale and training (i.e., Full condition). Nonclinical undergraduates were randomly assigned to one of five protocols: Partial-Defusion, Full-Defusion, Partial-Distraction, Full-Distraction, and a distraction-based experimental control task. The Full-Defusion condition reduced the emotional discomfort and believability of negative self-referential thoughts significantly more than other comparison conditions. The positive results of the Full-Defusion condition were also found among participants with elevated depressive symptoms.

Five years experience with a new intraoral maxillary distraction device (RID).

PubMed

Picard, Arnaud; Diner, Patrick A; Galliani, Eva; Tomat, Catherine; Vazquez, Ma rie Paule; Carls, Friedrich P

2011-10-01

Maxillary distraction osteogenesis is well established for the treatment of severe retromaxilla. We report our experience since 2004 of the treatment of 19 patients using a new intraoral maxillary distraction device. Maxillary advancement was successful in all patients with mean advancement of 9.6mm (range 4-17) measured at a point in lateral cephalograms. The new device limited surgical exposure and the amount of materials implanted, and improved control in every phase of the distraction. It was psychologically accepted by patients and was more comfortable than existing devices. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Asymmetric Anterior Distraction for Transversely Distorted Maxilla and Midfacial Anteroposterior Deficiency in a Patient With Cleft Lip/Palate: Two-Stage Surgical Approach.

PubMed

Hirata, Kae; Tanikawa, Chihiro; Aikawa, Tomonao; Ishihama, Kohji; Kogo, Mikihiko; Iida, Seiji; Yamashiro, Takashi

2016-07-01

The present report describes a male patient with a unilateral cleft lip and palate who presented with midfacial anteroposterior and transverse deficiency. Correction involved a two-stage surgical-orthodontic approach: asymmetric anterior distraction of the segmented maxilla followed by two-jaw surgery (LeFort I and bilateral sagittal splitting ramus osteotomies). The present case demonstrates that the asymmetric elongation of the maxilla with anterior distraction is an effective way to correct a transversely distorted alveolar form and midfacial anteroposterior deficiency. Furthermore, successful tooth movement was demonstrated in the new bone created by distraction.

Influences shaping nurses' use of distraction for children's procedural pain.

PubMed

Olmstead, Deborah L; Scott, Shannon D; Mayan, Maria; Koop, Priscilla M; Reid, Kathy

2014-04-01

This study explored pediatric nurses' choices to use distraction for managing painful procedures. Using interpretive description approaches, interviews with pediatric nurses provided descriptions of choices to manage procedural pain. Nurses' distress influenced distraction use to mitigate the suffering of children and themselves. Newer nurses described task mastery as influencing distraction choices. Nurses' accounts of performing painful procedures on children mirrored children's descriptions of pain from the literature. Nurses' distress and competency performing painful procedures on children influenced practice. Future qualitative studies could extend understanding of pain management choices by pediatric nurses and the impact on undermanaged pain. © 2014, Wiley Periodicals, Inc.

Determining skill transferability of action games as a method to reduce in-vehicle phone distractions.

PubMed

Rupp, M; McConnell, D S; Smither, J A

2012-01-01

Distracted driving has been shown to be a safety issue in numerous studies. To combat this problem, in-vehicle technology, legislation, media interventions, and other methods have been proposed and attempted. However research indicates that the drivers themselves may circumvent, ignore, or not be able to react in time for these interventions to be effective. Therefore research into training programs for drivers may improve reaction time under distraction. Research indicates that action game players have faster reaction times and more attentional resources than non-players on paper-based tests. However, transferability to driving has not been studied yet. This paper outlines a study to determine if action game players perform better at a driving task based on frequency of game-play. Participants will be placed into two groups of play (high vs. low) and tested against two levels of distraction (none vs. phone conversation). It is expected that participants who play higher frequency of action games will perform better under distraction than lower frequency players. Driver performance, conversation recall, frequency and durations of eye fixations will be analyzed based on previous research which has validated those variables as a measure of distraction and higher workload.

Age-related similarities in contextual cueing in the presence of unpredictive distracters.

PubMed

Yang, Yingying; Merrill, Edward C

2015-01-01

Contextual cueing effects of 6-8-year-old children, 10-12-year-old-children, and college students were compared under conditions in which some of the distracters in the search displays predicted the location of the target and other distracters did not. More specifically, the percent of distracters that predicted the location of the target varied across three conditions (100%, 67%, and 33%). Previous research had indicated that children are impacted more than adults when the percent of predictive distracters is relatively low. However, that research included new displays as well as repeated displays as participants were implicitly learning the association between the predictive distracters and the target. This re-evaluation did not introduce new display until a separate test phase. Results suggested that all three age groups demonstrated significant and comparable contextual cueing effects across all three signal-to-noise ratio conditions. Hence, children appear to possess the general ability to extract and remember information associated with spatial regularities in the presence of considerable spatial noise. In addition, contextual cueing effects were linked to improvements in search efficiency for all groups in this study, providing another degree of similarity across variations in age.

A cocktail-party listening experiment with children

NASA Astrophysics Data System (ADS)

Wightman, Frederic; Callahan, Michael; Kistler, Doris

2003-04-01

In an experiment modeled after one reported recently by Brungart and Simpson [J. Acoust. Soc. Am. 112, 2985-2995 (2002)], 38 children (ages 4-16) and 10 adults responded to a monaural target speech signal in the presence of one or two distracter speech signals. The target speaker was a male and the distracter speakers were females. When two distracters were present they were in different ears. Performance at several different target ear S/N was measured and psychometric functions were fitted to estimate threshold, or the 50% performance level. The youngest children required approximately 20 dB higher S/N than adults to achieve threshold with a single distracter. This difference disappeared by age 16. The impact of adding the contralateral distracter, which is thought to contribute only informational masking, was roughly constant across age, however. Adult thresholds increased about 11 dB and the thresholds for the youngest children increased about 10 dB. This was surprising given previous experiments that showed much larger informational masking effects in young children. Also inconsistent with previous results is the lack of individual differences. Nearly all listeners showed almost the same contralateral distracter effect. [Work supported by NICHD.

Emotion-focused coping and distraction: sex differences in the influence of anxiety sensitivity during noxious heat stimulation.

PubMed

Thompson, T; Keogh, E; Chen, M J-L; French, C C

2012-03-01

While previous research has indicated that the relative efficacy of attentional strategies on pain may be influenced by anxiety sensitivity (AS) and sex, no study appears to have examined this within the context of an emotion-focus versus distraction paradigm. The present study compared the effect of attentional emotion-focus and distraction instructions on pain response with noxious heat stimulation in 114 healthy adults (62 women and 52 men) varying in levels of AS. Results indicated that men reported a significantly higher mean tolerance time than women. Moderated regression analysis also revealed a significant strategy × anxiety sensitivity × sex interaction on pain tolerance. For those low in AS, relative efficacy was dependent upon sex, with distraction superior to emotion-focusing in women, but with strategies equivalent in men. For those high in AS, however, distraction resulted in uniformly greater pain tolerance than attentional emotion-focusing. These results indicate that AS and sex may be influential in determining the relative effectiveness of distraction and emotion-based attentional strategies for pain management. © 2011 European Federation of International Association for the Study of Pain Chapters.

Technology-related distracted walking behaviours in Manhattan's most dangerous intersections.

PubMed

Basch, Corey H; Ethan, Danna; Rajan, Sonali; Basch, Charles E

2014-10-01

Use of mobile devices has been cited as a distraction while driving, and more recently, among pedestrians crossing urban streets. In 2010, over half of New York City traffic fatalities were pedestrians. The aim of this study was to estimate the prevalence of distracted walking due to pedestrians' use of headphones, mobile phones, or both. Data were gathered by direct observations at the 10 intersections in Manhattan with the highest frequency of pedestrian-motor vehicle collisions. More than 1 in 4 of the >3500 pedestrians observed were distracted by mobile electronic devices while crossing during the 'walk' (28.8%) and 'don't walk' (26.3%) signals. Poisson regression analyses established there was a significant difference in individuals talking on a mobile device during the 'walk' signal versus the 'don't walk' signal; however, no other significant differences in other distracted walking behaviours were observed. This study contributes to the emerging literature on distracted walking behaviour by pedestrians in busy urban areas and can help to inform pedestrian-focused safety efforts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Rumination and Cognitive Distraction in Major Depressive Disorder: An Examination of Respiratory Sinus Arrhythmia

PubMed Central

LeMoult, Joelle; Yoon, K. Lira; Joormann, Jutta

2015-01-01

Difficulty regulating emotions following stressful events is a hallmark of Major Depressive Disorder (MDD). Although individuals’ ability to regulate their emotions is believed to have direct consequences for both emotional and physical wellbeing, few studies have examined the cardiovascular effects of different emotion regulation strategies in MDD. To the best of our knowledge, the current study is the first to examine the effects of two emotion regulation strategies, cognitive distraction and rumination, on both self-reported sadness and respiratory sinus arrhythmia (RSA) in individuals with MDD and healthy controls (CTLs). Following a forced-failure stressor, participants were randomly assigned to a rumination or cognitive distraction condition. As expected, rumination increased sadness and triggered RSA withdrawal for both MDDs and CTLs. Interestingly, although cognitive distraction reduced sadness, it also triggered RSA withdrawal. Moreover, cognitive distraction was associated with greater RSA withdrawal for MDDs than CTLs. Thus, although depressed individuals are able to use cognitive distraction to emotionally recover from stress, it may be associated with greater cognitive effort. Adding low-cost physiological measures such as RSA into assessments has the potential to offer new and important information about the effects of emotion regulation on mental and physiological health. PMID:27199505

Mitigating driver distraction with retrospective and concurrent feedback.

PubMed

Donmez, Birsen; Boyle, Linda Ng; Lee, John D

2008-03-01

An experiment was conducted to assess the effects of retrospective and combined retrospective and concurrent feedback on driver performance and engagement in distracting activities. A previous study conducted by the authors showed that concurrent (or real time) feedback can help drivers better modulate their distracting activities. However, research also shows that concurrent feedback can pose additional distractions due to the limited time and resources available during driving. Retrospective feedback, which is presented at the end of a trip (i.e., post-drive), can include additional information on safety critical situations during a trip and help the driver learn safe driving habits. A driving simulator study was conducted with 48 participants and 3 conditions: retrospective feedback, combined feedback (both retrospective and concurrent), and no feedback (baseline case). The feedback conditions (retrospective and combined) resulted in faster response to lead vehicle braking events as depicted by shorter accelerator release times. Moreover, combined feedback also resulted in longer glances to the road. The results suggest that both feedback types have potential to improve immediate driving performance and driver engagement in distractions. Combined feedback holds the most promise for mitigating the effects of distraction from in-vehicle information systems.

Safety implications of providing real-time feedback to distracted drivers.

PubMed

Donmez, Birsen; Boyle, Linda Ng; Lee, John D

2007-05-01

A driving simulator study was conducted to assess whether real-time feedback on a driver's state can influence the driver's interaction with in-vehicle information systems (IVIS). Previous studies have shown that IVIS tasks can undermine driver safety by increasing driver distraction. Thus, mitigating driver distraction using a feedback mechanism appears promising. This study was designed to test real-time feedback that alerts drivers based on their off-road eye glances. Feedback was displayed in two display locations (vehicle-centered, and IVIS-centered) to 16 young and 13 middle-aged drivers. Distraction was observed as problematic for both age groups with delayed responses to a lead vehicle-braking event as indicated by delayed accelerator releases. Significant benefits were not observed for braking and steering behavior for this experiment, but there was a significant change in drivers' interaction with IVIS. When given feedback on their distracted state, drivers looked at the in-vehicle display less frequently regardless of where feedback was displayed in the vehicle. This indicates that real-time feedback based on the driver state can positively alter driver's engagement in distracting activities, helping them attend better to the roadway.

[Application and research progress of subtalar distraction bone block arthrodesis in treatment of calcaneus fracture malunion].

PubMed

Wang, Shanxi; Li, Jun; Huang, Fuguo; Liu, Lei

2017-05-01

To review the application and research progress of subtalar distraction bone block arth-rodesis in the treatment of calcaneus fracture malunion. The recent literature concerning the history, surgical technique, postoperative complication, indications, and curative effect of subtalar distraction arthrodesis with bone graft block interposition in the treatment of calcaneus fracture malunion was summarized and analyzed. Subtalar distraction bone block arthrodesis is one of the main ways to treat calcaneus fracture malunion, including a combined surgery with subtalar arthrodesis and realignment surgery for hindfoot deformity using bone block graft. The advantage is on the base of subtalar joint fusion, through one-time retracting subtalar joint, the posterior articular surface of subtalar joint implants bone block can partially restore calcaneal height, thus improving the function of the foot. Compared with other calcaneal malunion treatments, subtalar distraction arthrodesis is effective to correct complications caused by calcaneus fracture malunion, and it can restore the height of talus and calcaneus, correct loss of talocalcaneal angle, and ease pain. Subtalar distraction bone block arthrodesis has made remarkable progress in the treatment of calcaneus fracture malunion, but it has the disadvantages of postoperative nonunion and absorption of bone block, so further study is needed.

Distraction to treat knee osteoarthritis.

PubMed

Flouzat-Lachaniette, Charles-Henri; Roubineau, François; Heyberger, Clémence; Bouthors, Charlie

2017-03-01

The objective of this article is to review data on joint distraction used to treat knee osteoarthritis. Joint distraction is a surgical procedure in which the two bony ends of the joint are gradually pulled apart then kept separated for 2 months in an external fixation frame. Weight bearing is continued to ensure variations in hydrostatic pressure within the joint. In published studies, joint distraction provided substantial clinical and structural improvements in patients with knee osteoarthritis, delaying joint replacement surgery for at least 2 years. Animal studies showed that joint distraction was associated with decrease in the secondary inflammatory response, cartilage breakdown, and subchondral bone remodeling. In vitro, the intermittent application of hydrostatic pressure stimulated the production of extracellular matrix, particularly in joints with osteoarthritis. Nevertheless, several considerations invite caution when considering the more widespread use of joint distraction. Published studies have short follow-ups and small sample sizes. In addition, the high frequency of pin tract infection is of concern, since most patients eventually require knee replacement surgery. These two considerations indicate a need for longer-term prospective studies of patient cohorts. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Beliefs About Appearance, Cognitive Distraction and Sexual Functioning in Men and Women: A Mediation Model Based on Cognitive Theory.

PubMed

Silva, Elizabet; Pascoal, Patrícia M; Nobre, Pedro

2016-09-01

Dysfunctional beliefs about body appearance and cognitive distraction from body appearance during sexual activity have been associated with sexual problems, particularly in women. However, there are no studies examining the interplay between these dimensions and the mechanisms by which they affect sexual functioning. To examine the mediating role of cognitive distraction with body appearance on the relation between beliefs about appearance and sexual functioning. The study sample consisted of 426 heterosexual participants (129 men and 297 women) involved in an exclusive dyadic committed relationship who answered an online questionnaire. The Body Appearance Cognitive Distraction Scale, the Beliefs About Appearance Scale, the International Index of Erectile Function, and the Female Sexual Function Index. The findings indicated that cognitive distraction with body appearance fully mediated the relation between beliefs about appearance and sexual functioning in men and women. The results support the role of beliefs about appearance and cognitive distraction based on body appearance in predicting sexual functioning, reaffirming the role of cognitive models in explaining sexual functioning in men and women. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Distraction osteogenesis and orthognathic surgery for a patient with unilateral cleft lip and palate.

PubMed

Kim, Ji Hyun; Lee, Il Hong; Lee, Sang Min; Yang, Byoung Eun; Park, In Young

2015-03-01

Maxillary deficiency is a common feature in patients with repaired cleft lip and palate. Orthognathic surgery has been the conventional approach for the management of cleft-related maxillary hypoplasia. However, for patients with a severe maxillary deficiency, orthognathic surgery alone has many disadvantages, such as high relapse rates of 25% to 40%, instability, limited amount of advancement, and a highly invasive surgical technique. As an alternative treatment method, distraction osteogenesis has been used successfully in the distraction of the mandible, the maxilla, the entire midface, and the orbits as well as the cranial bones, with stable outcomes. The type of distraction device, either external or internal, can be chosen based on the surgical goals set for the patient. In this study, we report on the use of a rigid external distraction device for maxillary advancement in a 22-year-old woman with a repaired unilateral cleft lip and palate and severe maxillary hypoplasia. After the distraction osteogenesis, 2-jaw surgery was performed to correct the maxillary yaw deviation and the mandibular prognathism. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Transpalatal distraction for the management of maxillary constriction in pediatric patients.

PubMed

Adolphs, Nicolai; Ernst, Nicole; Hoffmeister, Bodo; Raguse, Jan-Dirk

2015-01-01

The management of severe maxillary constriction can be challenging. For that purpose surgically assisted maxillary expansion by transpalatal distraction (TPD) can typically be recommended after skeletal maturity. However in selected cases bone borne transpalatal distraction devices can contribute to improve maxillary constriction considerably earlier already during mixed dentition. To assess the possibility of bone borne transpalatal distraction in pediatric patients. Clinical paper. Since 2010 TPD has been applied to six pediatric patients during mixed dentition when severe maxillary constriction was present and conventional orthodontic widening has already failed. Individually selected devices (Surgitec, Belgium) were inserted in general anaesthesia and distraction was performed according to well known parameters. Maxillary constriction could be improved in all six patients without any drawbacks by bone borne devices during mixed dentition. Skeletal conditions were obviously improved for subsequent orthodontic or orthognathic therapy without functional impairment. Follow-up is up to 36 months after device removal. Transpalatal Distraction is recommendable in selected pediatric patients if massive growth disturbance is present or has to be expected. TPD allows for individually adapted maxillary expansion by selection and positioning of appropriate devices in combination with intraoperative testing of maxillary movements and controlled bone removal.

Brain activation for response inhibition under gaming cue distraction in internet gaming disorder.

PubMed

Liu, Gin-Chung; Yen, Ju-Yu; Chen, Chiao-Yun; Yen, Cheng-Fang; Chen, Cheng-Sheng; Lin, Wei-Chen; Ko, Chih-Hung

2014-01-01

We evaluated neural substrates related to the loss of control in college students with internet gaming disorder (IGD). We hypothesized that deficit in response inhibition under gaming cue distraction was the possible mechanism for the loss of control internet use. Eleven cases of IGD and 11 controls performed Go/NoGo tasks with/without gaming distraction in the functional magnetic resonance imaging scanner. When the gaming picture was shown as background while individuals were performing Go/NoGo tasks, the IGD group committed more commission errors. The control group increased their brain activations more over the right dorsolateral prefrontal cortex (DLPFC) and superior parietal lobe under gaming cue distraction in comparison with the IGD group. Furthermore, brain activation of the right DLPFC and superior parietal lobe were negatively associated with performance of response inhibition among the IGD group. The results suggest that the function of response inhibition was impaired under gaming distraction among the IGD group, and individuals with IGD could not activate right DLPFC and superior parietal lobe to keep cognitive control and attention allocation for response inhibition under gaming cue distraction. This mechanism should be addressed in any intervention for IGD. Copyright © 2013. Published by Elsevier B.V.

Identification of common features of vehicle motion under drowsy/distracted driving: A case study in Wuhan, China.

PubMed

Chen, Zhijun; Wu, Chaozhong; Zhong, Ming; Lyu, Nengchao; Huang, Zhen

2015-08-01

Drowsy/distracted driving has become one of the leading causes of traffic crash. Only certain particular drowsy/distracted driving behaviors have been studied by previous studies, which are mainly based on dedicated sensor devices such as bio and visual sensors. The objective of this study is to extract the common features for identifying drowsy/distracted driving through a set of common vehicle motion parameters. An intelligent vehicle was used to collect vehicle motion parameters. Fifty licensed drivers (37 males and 13 females, M=32.5 years, SD=6.2) were recruited to carry out road experiments in Wuhan, China and collecting vehicle motion data under four driving scenarios including talking, watching roadside, drinking and under the influence of drowsiness. For the first scenario, the drivers were exposed to a set of questions and asked to repeat a few sentences that had been proved valid in inducing driving distraction. Watching roadside, drinking and driving under drowsiness were assessed by an observer and self-reporting from the drivers. The common features of vehicle motions under four types of drowsy/distracted driving were analyzed using descriptive statistics and then Wilcoxon rank sum test. The results indicated that there was a significant difference of lateral acceleration rates and yaw rate acceleration between "normal driving" and drowsy/distracted driving. Study results also shown that, under drowsy/distracted driving, the lateral acceleration rates and yaw rate acceleration were significantly larger from the normal driving. The lateral acceleration rates were shown to suddenly increase or decrease by more than 2.0m/s(3) and the yaw rate acceleration by more than 2.5°/s(2). The standard deviation of acceleration rate (SDA) and standard deviation of yaw rate acceleration (SDY) were identified to as the common features of vehicle motion for distinguishing the drowsy/distracted driving from the normal driving. In order to identify a time window for effectively extracting the two common features, a double-window method was used and the optimized "Parent Window" and "Child Window" were found to be 55s and 6s, respectively. The study results can be used to develop a driving assistant system, which can warn drivers when any one of the four types of drowsy/distracted driving is detected. Copyright © 2015. Published by Elsevier Ltd.

Internal Distraction Osteogenesis With Piezosurgery Oblique Osteotomy of Supraorbital Margin of Frontal Bone for the Treatment of Unilateral Coronal Synostosis.

PubMed

Shen, Weimin; Cui, Jie; Chen, Jianbing; Ji, Yi; Kong, Liangliang

2017-05-01

To assess the utility of internal distraction osteogenesis with Piezosurgery oblique osteotomy of supraorbital margin of frontal bone for the treatment of unilateral coronal synostosis and to study the outcome and complications of this procedure. Oblique osteotomy allows for entry into the cranial cavity, and along with parallel cut to the roof of the orbit, avoids the need to cut into the orbit which forms the frontal flap. Oblique osteotomy was performed along the supraorbital rim to do a frontal suture of the glabella (ages of patients were less than 1 year) or on the opposite side of the supraorbital rim (ages of patients were older than 1 year) after performing a suturectomy of the effected coronal suture. Two internal distraction devices were subsequently placed across the osteotomized, fused coronal suture. Finally, the cranium pieces were divided in the middle and placed in the middle of the frontal bone using biological glue. Five days after the operation, a 0.6-mm distraction was done twice daily. The distraction was removed 6 months after reaching 2 to 3 cm. Internal distraction osteogenesis with supraorbital oblique osteotomy was performed in 9 patients suffering from unilateral coronal synostosis. Eight patients had no postoperative infections around the shaft puncture wounds. One patient had infection in the rods around the distraction during the period of fixed, but was cured with antibiotic treatment. During a mean follow-up period of 12 months (5-26 months), all patients were satisfied with the cosmetic and functional results. No complications, including fixed screw displacement, penetration of the cranium and dura mater or retraction of distraction devices, occurred. The devices were exposed in 1 patient, resulting in a postoperative scar. Despite these complications, the cranium was successfully expanded in all patients. Use of this procedure avoids the need for frontal osteotomy to move the orbit forward. Adding 2 cranium strips can be used to reconstruct the frontal nodule to make up for inadequacy of the frontal nodules highlighting to distract operation. Retracting a separated cranium is not easy after it has been fixed for 6 months. Thus, the management of unilateral coronal synostosis using internal distraction osteogenesis with supraorbital oblique osteotomy is safe and effective.

The regulation of emotions in adolescents: Age differences and emotion-specific patterns

PubMed Central

Theurel, Anne

2018-01-01

Two experiments addressed the issue of age-related differences and emotion-specific patterns in emotion regulation during adolescence. Experiment 1 examined emotion-specific patterns in the effectiveness of reappraisal and distraction strategies in 14-year-old adolescents (N = 50). Adolescents were instructed to answer spontaneously or to downregulate their responses by using either distraction or cognitive reappraisal strategies before viewing negative pictures and were asked to rate their emotional state after picture presentation. Results showed that reappraisal effectiveness was modulated by emotional content but distraction was not. Reappraisal was more effective than distraction at regulating fear or anxiety (threat-related pictures) but was similar to distraction regarding other emotions. Using the same paradigm, Experiment 2 examined in 12-year-old (N = 56), 13-year-old (N = 49) and 15-year-old adolescents (N = 54) the age-related differences a) in the effectiveness of reappraisal and distraction when implemented and b) in the everyday use of regulation strategies using the Cognitive Emotion Regulation Questionnaire. Results revealed that regulation effectiveness was equivalent for both strategies in 12-year-olds, whereas a large improvement in reappraisal effectiveness was observed in 13- and 15-year-olds. No age differences were observed in the reported use of reappraisal, but older adolescents less frequently reported using distraction and more frequently reported using the rumination strategy. Taken together, these experiments provide new findings regarding the use and the effectiveness of cognitive regulation strategies during adolescence in terms of age differences and emotion specificity. PMID:29879165

The Effect of Virtual Reality Distraction on Pain Relief During Dressing Changes in Children with Chronic Wounds on Lower Limbs.

PubMed

Hua, Yun; Qiu, Rong; Yao, Wen-Yan; Zhang, Qin; Chen, Xiao-Li

2015-10-01

It has been demonstrated that patients with chronic wounds experience the most pain during dressing changes. Currently, researchers focus mostly on analgesics and appropriate dressing materials to relieve pain during dressing changes of chronic wounds. However, the effect of nonpharmacologic interventions, such as virtual reality distraction, on pain management during dressing changes of pediatric chronic wounds remains poorly understood. To investigate the effect of virtual reality distraction on alleviating pain during dressing changes in children with chronic wounds on their lower limbs. A prospective randomized study. A pediatric center in a tertiary hospital. Sixty-five children, aged from 4 to 16 years, with chronic wounds on their lower limbs. Pain and anxiety scores during dressing changes were recorded by using the Wong-Baker Faces picture scale, visual analogue scale, and pain behavior scale, as well as physiological measurements including pulse rate and oxygen saturation. Time length of dressing change was recorded. Virtual reality distraction significantly relieved pain and anxiety scores during dressing changes and reduced the time length for dressing changes as compared to standard distraction methods. The use of virtual reality as a distraction tool in a pediatric ward offered superior pain reduction to children as compared to standard distractions. This device can potentially improve clinical efficiency by reducing length time for dressing changes. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

A Novel Spinal Implant for Fusionless Scoliosis Correction: A Biomechanical Analysis of the Motion Preserving Properties of a Posterior Periapical Concave Distraction Device.

PubMed

Holewijn, Roderick M; de Kleuver, Marinus; van der Veen, Albert J; Emanuel, Kaj S; Bisschop, Arno; Stadhouder, Agnita; van Royen, Barend J; Kingma, Idsart

2017-08-01

Biomechanical study. Recently, a posterior concave periapical distraction device for fusionless scoliosis correction was introduced. The goal of this study was to quantify the effect of the periapical distraction device on spinal range of motion (ROM) in comparison with traditional rigid pedicle screw-rod instrumentation. Using a spinal motion simulator, 6 human spines were loaded with 4 N m and 6 porcine spines with 2 N m to induce flexion-extension (FE), lateral bending (LB), and axial rotation (AR). ROM was measured in 3 conditions: untreated, periapical distraction device, and rigid pedicle screw-rod instrumentation. The periapical distraction device caused a significant ( P < .05) decrease in ROM of FE (human, -40.0% and porcine, -55.9%) and LB (human, -18.2% and porcine, -17.9%) as compared to the untreated spine, while ROM of AR remained unaffected. In comparison, rigid instrumentation caused a significantly ( P < .05) larger decrease in ROM of FE (human, -80.9% and porcine, -94.0%), LB (human, -75.0% and porcine, -92.2%), and AR (human, -71.3% and porcine, -86.9%). Although no destructive forces were applied, no device failures were observed. Spinal ROM was significantly less constrained by the periapical distraction device compared to rigid pedicle screw-rod instrumentation. Therefore, provided that scoliosis correction is achieved, a more physiological spinal motion is expected after scoliosis correction with the posterior concave periapical distraction device.

Influence of positive distractions on children in two clinic waiting areas.

PubMed

Pati, Debajyoti; Nanda, Upali

2011-01-01

To examine the influence of positive distraction on the behavior and activity of children in two clinic waiting areas. People spend a considerable proportion of time waiting in hospitals. Studies show that the quality of waiting environments influences the perception of quality of care and caregivers, that perception of waiting time is a better indicator of patient satisfaction than actual waiting time, and that the waiting environment contributes to the perception of wait time. In fact, the attractiveness of the physical environment in waiting areas has been shown to be significantly associated with higher perceived quality of care, less anxiety, and higher reported positive interaction with staff. Can positive distractions in waiting areas improve the waiting experience, as indicated by the behavior and activities of children waiting for treatment? Five distraction conditions were randomly introduced in the waiting area of the dental and cardiac clinics of a major pediatric tertiary care center through a single plasma screen intervention. The attention, behavior, and activities of waiting children were recorded. Data on 158 pediatric patients were collected over 12 days during December 2008 and January 2009. Data analysis shows that the introduction of distraction conditions was associated with more calm behavior and less fine and gross movement, suggesting significant calming effects associated with the distraction conditions. Data also suggest that positive distraction conditions are significant attention grabbers and could be an important contributor to improving the waiting experience for children in hospitals by improving environmental attractiveness.

Positive reinforcement modulates fronto-limbic systems subserving emotional interference in adolescents.

PubMed

Ladouceur, Cecile D; Schlund, Michael W; Segreti, Anna-Maria

2018-02-15

Fronto-limbic systems play an important role in supporting resistance to emotional distraction to promote goal-directed behavior. Despite evidence that alterations in the functioning of these systems are implicated in developmental trajectories of psychopathology, most studies have been conducted in adults. This study examined the functioning of fronto-limbic systems subserving emotional interference in adolescents and whether differential reinforcement of correct responding can modulate these neural systems in ways that could promote resistance to emotional distraction. Fourteen healthy adolescents (ages 9-15) completed an emotional delayed working memory task during fMRI with emotional distracters (none, neutral, negative) while positive reinforcement (i.e., monetary reward) was provided for correct responses under some conditions. Adolescents showed slightly reduced behavioral performance and greater activation in amygdala and prefrontal cortical regions (ventrolateral, ventromedial, dorsolateral) on correct trials with negative distracters compared to those with no or neutral distracters. Positive reinforcement yielded an overall improvement in accuracy and reaction times and counteracted the effects of negative distracters as evidenced by significant reductions in activation in key fronto-limbic regions. The present findings extend results on emotional interference from adults to adolescents and suggest that positive reinforcement could be used to potentially promote insulation from emotional distraction. A challenge for the future will be to build upon these findings for constructing reinforcement-based attention training programs that could be used to reduce emotional attention biases in anxious youth. Copyright © 2017 Elsevier B.V. All rights reserved.

Six weeks of continuous joint distraction appears sufficient for clinical benefit and cartilaginous tissue repair in the treatment of knee osteoarthritis.

PubMed

van der Woude, J A D; van Heerwaarden, R J; Spruijt, S; Eckstein, F; Maschek, S; van Roermund, P M; Custers, R J H; van Spil, W E; Mastbergen, S C; Lafeber, F P J G

2016-10-01

Knee joint distraction (KJD) is a surgical joint-preserving treatment in which the knee joint is temporarily distracted by an external frame. It is associated with joint tissue repair and clinical improvement. Initially, patients were submitted to an eight-week distraction period, and currently patients are submitted to a six-week distraction period. This study evaluates whether a shorter distraction period influences the outcome. Both groups consisted of 20 patients. Clinical outcome was assessed by WOMAC questionnaires and VAS-pain. Cartilaginous tissue repair was assessed by radiographic joint space width (JSW) and MRI-observed cartilage thickness. Baseline data between both groups were comparable. Both groups showed an increase in total WOMAC score; 24±4 in the six-week group and 32±5 in the eight-week group (both p<0.001). Mean JSW increased 0.9±0.3mm in the six-week group and 1.1±0.3mm in the eight-week group (p=0.729 between groups). The increase in mean cartilage thickness on MRI was 0.6±0.2mm in the eight-week group and 0.4±0.1mm in the six-week group (p=0.277). A shorter distraction period does not influence short-term clinical and structural outcomes statistically significantly, although effect sizes tend to be smaller in six week KJD as compared to eight week KJD. Copyright © 2016 Elsevier B.V. All rights reserved.

Muscle response to leg lengthening during distraction osteogenesis.

PubMed

Thorey, Fritz; Bruenger, Jens; Windhagen, Henning; Witte, Frank

2009-04-01

Continuous lengthening of intact muscles during distraction osteogenesis leads to an increase of sarcomeres and enhances the regeneration of tendons and blood vessels. A high distraction rate leads to an excessive leg and muscle lengthening and might cause damages of muscle fibers with fibrosis, necrosis, and muscle weakness. Complications like muscle contractures or atrophy after postoperative immobilization emphazize the importance of muscles and their function in the clinical outcome. In an animal model of distraction osteogenesis, 18 sheep were operated with an external fixator followed by 4 days latency, 21 days distraction (1.25 mm per day) and 51 days consolidation. The anatomical location (gastrocnemius, peroneus tertius, and first flexor digitorum longus muscle), dimension and occurrence of muscular defects were characterized histologically. The callus formation and leg axis was monitored by weekly X-rays. Additionally, serum creatine kinase was analyzed during a distraction and consolidation period. Significant signs of muscle lesions in all three observed muscles can be found postoperatively, whereas normal callus formation and regular leg axis was observed radiologically. The peroneus tertius and first flexor digitorum longus muscles were found to have significantly more signs of fibrosis, inflammatory, and necrosis. Creatine kinase showed two peaks: 4 and 39 days postoperative as an indication of muscle damage and regeneration. The study implicates that muscle damages should be considered when a long-distance distraction osteogenesis is planned. The surgeon should consider these muscle responses and individually discuss a two-stage treatment or additional muscle tendon releases to minimize the risk of muscle damages.

Maxillary-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia.

PubMed

Nakajima, Hideo; Sakamoto, Yoshiaki; Tamada, Ikkei; Ogata, Hisao; Kishi, Kazuo; Sakamoto, Teruo

2011-12-01

We treat hemifacial microsomia with a combination of surgery and orthodontic treatment during the growth period, resulting in early improvement in facial asymmetry and the induction of normal growth. We previously used gradual distraction of the mandibular ramus for Pruzansky's type II classification (Pruzansky, 1969). In type II cases, the maxilla should also be treated actively as, using this technique, improvement of the occlusal plane is difficult to achieve, resulting in a cross bite and difficulties in post-operative orthodontic treatment-especially in older patients. Morphologically, the mandibular angle region of the operative side is flat, and the angle of the mouth remains elevated. We performed mandibular-driven simultaneous maxillo-mandibular distraction while the occlusion was maintained using intermaxillary anchorage. However, mandibular-driven distraction tended to elongate the face because the mandible only elongated downwards and the mandibular ramus did not reach the glenoid. Furthermore, external distraction devices produce significant distress for patients until removal of the device and cause scars on the face. We developed a new internal distraction device with a variable angle and performed maxillary-driven simultaneous maxillo-mandibular distraction using this device. The result was morphologically satisfactory and solved the above problems. Because the patient was in the growth period, careful follow-up and induction to normal growth were important while the inferior growth of the affected side was monitored. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery

PubMed Central

Rachmiel, Adi; Even-Almos, Michal; Aizenbud, Dror

2012-01-01

Purpose: The purpose of this paper is to compare the treatment of hypoplastic, retruded maxillary cleft palate using distraction osteogenesis vs. orthognathic surgery in terms of stability and relapse, growth after distraction and soft tissue profile changes. Materials and Methods: The cleft patients showed anteroposterior maxillary hypoplasia with class III malocclusion and negative overjet resulting in a concave profile according to preoperative cephalometric measurements, dental relationship, and soft tissue analysis. The patients were divided in two groups of treatment : S0 eventeen were treated by orthognathic Le Fort I osteotomy fixed with four mini plates and 2 mm screws, and 19 were treated by maxillary distraction osteogenesis with rigid extraoral devices (RED) connected after a Le Fort I osteotomy. The rate of distraction was 1 mm per day to achieve Class I occlusion with slight overcorrection and to create facial profile convexity. Following a 10 week latency period the distraction devices were removed. Results: In the RED group the maxilla was advanced an average of 15.80 mm. The occlusion changed from class III to class I. The profile of the face changed from concave to convex. At a 1-year follow up the results were stable. The mean orthognathic movement was 8.4 mm. Conclusion: In mild maxillary deficiency a one stage orthognathic surgery is preferable. However, in patients requiring moderate to large advancements with significant structural deficiencies of the maxilla or in growing patients the distraction technique is preferred. PMID:23483803

Rapid maxillary distraction protocol utilizing the halo distraction system and rigid internal fixation.

PubMed

Baker, Stephen B; Reid, Russell R; Burkey, Brooke; Bartlett, Scott P

2007-09-01

To shorten head frame wear time associated with external halo distraction (HD), we have adapted a protocol for maxillary distraction with the halo system that integrates plate fixation. All patients had a history of cleft lip and/or palate and maxillary retrusion > or = 8 mm. Five patients treated with this protocol and followed for at least 1 year were included in this study. The protocol included a 3-day latency period, variable maxillary distraction, and removal of the halo device with simultaneous rigid internal fixation. Two patients had a variable period of maxillomandibular fixation (MMF), which maintained the maxillary advancement and idealized intercuspal position while permitting further callus maturation. Cephalographs were obtained preoperatively, immediately following distractor removal, and 1 year after rigid internal fixation. The mean age at time of surgery was 18.7 years. The maxillary deficiency ranged from 8 to 15 mm (mean = 10.6 mm). All five patients demonstrated excellent occlusion. Cephalometric analysis 1-year post rigid internal fixation revealed minimal (<1 mm) skeletal relapse. Rapid maxillary distraction followed by MMF to maintain maxillary advancement may reduce halo device wear to 1 to 2 weeks. MMF optimizes occlusion by forcing the maxillary teeth into maximal intercuspal position. Rigid fixation is not only associated with less long-term relapse compared to nonrigid forms of fixation, but also minimizes the incidence of nonunion. This treatment protocol provides the advancement possible with distraction osteogenesis and the accuracy of orthognathic surgery, thereby minimizing external head frame wear.

A Mobile App Offering Distractions and Tips to Cope With Cigarette Craving: A Qualitative Study

PubMed Central

Smith, Wally; Pearce, Jon; Borland, Ron

2014-01-01

Background Despite considerable effort, most smokers relapse within a few months after quitting due to cigarette craving. The widespread adoption of mobile phones presents new opportunities to provide support during attempts to quit. Objective To design and pilot a mobile app "DistractMe" to enable quitters to access and share distractions and tips to cope with cigarette cravings. Methods A qualitative study with 14 smokers who used DistractMe on their mobiles during the first weeks of their quit attempt. Based on interviews, diaries, and log data, we examined how the app supported quitting strategies. Results Three distinct techniques of coping when using DistractMe were identified: diversion, avoidance, and displacement. We further identified three forms of engagement with tips for coping: preparation, fortification, and confrontation. Overall, strategies to prevent cravings and their effects (avoidance, displacement, preparation, and fortification) were more common than immediate coping strategies (diversion and confrontation). Tips for coping were more commonly used than distractions to cope with cravings, because they helped to fortify the quit attempt and provided opportunities to connect with other users of the application. However, distractions were important to attract new users and to facilitate content sharing. Conclusions Based on the qualitative results, we recommend that mobile phone-based interventions focus on tips shared by peers and frequent content updates. Apps also require testing with larger groups of users to assess whether they can be self-sustaining. PMID:25099632

Long-term skeletodental stability of mandibular symphyseal distraction osteogenesis: Tooth-borne vs hybrid distraction appliances.

PubMed

Durham, Julia N; King, John W; Robinson, Quinton C; Trojan, Terry M

2017-03-01

To evaluate and compare the long-term skeletodental stability of mandibular symphyseal distraction osteogenesis (MSDO) achieved with the use of tooth-borne vs. hybrid distraction appliances. Posttreatment and follow-up orthodontic records were collected for 33 patients. The 14 patients who underwent distraction with a tooth-borne appliance had a mean follow-up of 5.08 years. The 19 patients who underwent distraction with a hybrid appliance had a mean follow-up of 6.07 years. Records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Total changes of 16 measurements were analyzed to compare patients who underwent the tooth-borne vs. the hybrid distraction. Both groups shared several similar and significant (P < .05) changes from posttreatment to follow-up records. Cast analysis showed a decrease in intercanine width and arch length and an increase in irregularity index. The postero-anterior cephalometric radiograph showed an increase in the width of the interincisal apices. The lateral cephalometric radiograph showed a decrease in the MP-L1 angle. The only statistically significant difference between the two appliances was the intercentral incisor contact point. Changes found are consistent with those found in untreated and orthodontically treated individuals over time. The long-term changes in the current patient sample can be determined to be expected and acceptable. MSDO is a viable treatment option with the use of either a hybrid or tooth-borne appliance.

Effects of vertebral column distraction on transcranial electrical stimulation-motor evoked potential and histology of the spinal cord in a porcine model.

PubMed

Yang, Jae Hyuk; Suh, Seung Woo; Modi, Hitesh N; Ramani, Easwar T; Hong, Jae Young; Hwang, Jin Ho; Jung, Woon Yong

2013-05-01

Spinal cord injury can occur following surgical procedures for correction of scoliosis and kyphosis, as these procedures produce lengthening of the vertebral column. The objective of this study was to cause spinal cord injury by vertebral column distraction and evaluate the histological changes in the spinal cord in relationship to the pattern of recovery from the spinal cord injury. Global osteotomy of all three spinal columns was performed on the ninth thoracic vertebra of sixteen pigs. The osteotomized vertebra was distracted until transcranial electrical stimulation-motor evoked potential (TES-MEP) signals disappeared or decreased by >80% compared with the baseline amplitude; this was defined as spinal cord injury. The distraction distance at which spinal cord injury occurred was measured, the distraction was released, and the TES-MEP recovery pattern was observed. A wake-up test was performed, two days of observations were made, and histological changes were evaluated in relationship to the recovery pattern. Spinal cord injury developed at a distraction distance of 20.2 ± 4.7 mm, equivalent to 3.6% of the thoracolumbar spinal length, and the distraction distance was correlated with the thoracolumbar spinal length (r = 0.632, p = 0.009). No animals exhibited complete recovery according to TES-MEP testing, eleven exhibited incomplete recovery, and five exhibited no recovery. During the two days of observation, all eleven animals with incomplete recovery showed positive responses to sensory and motor tests, whereas none of the five animals with no recovery had positive responses. On histological evaluation, three animals that exhibited no recovery all showed complete severance of nerve fibers (axotomy), whereas six animals that exhibited incomplete recovery all showed partial white-matter injury. Parallel distraction of approximately 3.6% of the thoracolumbar length after global osteotomy resulted in spinal cord injury and histological evidence of spinal cord damage. The pattern of recovery from the spinal cord injury after release of the distraction was consistent with the degree of axonal damage. Axotomy was observed in animals that exhibited no recovery on TES-MEP, and only hemorrhagic changes in the white matter were observed in animals that exhibited incomplete recovery.

Callus Distraction Versus Single-Stage Lengthening With Bone Graft for Treatment of Brachymetatarsia: A Systematic Review.

PubMed

Jones, Marc D; Pinegar, David M; Rincker, Sarah A

2015-01-01

Brachymetatarsia deformity is a cosmetically displeasing anomaly that can become physically symptomatic. The surgical techniques most commonly used to repair the anomaly include single-stage lengthening with a bone graft, callus distraction, or a combination of bone grafting and callus distraction. A systematic review of the published data was performed to compare the outcomes of these 3 surgical procedures. A total of 61 studies reporting the use of callus distraction or single-stage lengthening, or both, for the treatment of brachymetatarsia were included in the present review. The incidence of major postoperative complications after callus distraction, single-stage lengthening, and the combination procedure was 49 (12.62%), 13 (3.72%), and 3 (33.33%), respectively. The number of minor complications with callus distraction, single-stage lengthening, and the combination procedure was 152 (39.18%), 55 (15.76%), and 1 (11.11%); the mean percentage of the original length achieved was 37.36%, 25.98% and 36.00%; and the mean length achieved was 17.5, 13.2, and 14.0 mm, respectively. The healing index (mo/cm) and healing time was 2.31 and 16.04 weeks, 1.90 and 9.35 weeks, and 3.93 and 14.62 weeks for callus distraction, single-stage lengthening, and the combination procedure, respectively. Our findings indicate that the callus distraction technique is associated with greater length gained but results in greater complication rates and requires almost twice the time to heal. Single-stage lengthening with a bone graft was associated with fewer complications and faster healing times than callus distraction but with lesser gains in length. From the information reported in the studies we reviewed, the prevalence of bilateral brachymetatarsia was 44.52%, and the female/male ratio was 13.7:1. Both of these findings seem to contradict the usual data given (72% for bilateral brachymetatarsia and a female/male ratio of 25:1). Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Ilizarov distraction-lengthening in congenital anomalies of the upper limb.

PubMed

Hülsbergen-Krüger, S; Preisser, P; Partecke, B D

1998-04-01

Nine patients underwent Ilizarov distraction-lengthening for congenital anomalies. All were late cases and had undergone other procedures. In five radial club hand patients with very short forearms, we achieved an average 5.8 cm increase in length with each distraction cycle. In two patients with symbrachydactyly of the cleft hand type, we achieved pinch grip between a radial and an ulnar digit by lengthening the short ray. Another case of the monodactyly type in which we tried to lengthen three transplanted proximal toe phalanges ended in failure. A soft tissue distraction was attempted in a case of camptodactyly but failed. We report the problems we encountered and suggest some solutions.

Le Fort I Maxillary Advancement Using Distraction Osteogenesis

PubMed Central

Combs, Patrick D.; Harshbarger, Raymond J.

2014-01-01

Treatment of maxillary hypoplasia has traditionally involved conventional Le Fort I osteotomies and advancement. Advancements of greater than 10 mm risk significant relapse. This risk is greater in the cleft lip and palate population, whose anatomy and soft tissue scarring from prior procedures contributes to instability of conventional maxillary advancement. Le Fort I advancement with distraction osteogenesis has emerged as viable, stable treatment modality correction of severe maxillary hypoplasia in cleft, syndromic, and noncleft patients. In this article, the authors provide a review of current data and recommendations concerning Le Fort I advancement with distraction osteogenesis. In addition, they outline their technique for treating severe maxillary hypoplasia with distraction osteogenesis using internal devices. PMID:25383054

Effects of Videogame Distraction using a Virtual Reality Type Head-Mounted Display Helmet on Cold Pressor Pain in Children

PubMed Central

Weiss, Karen E.; Dillinger Clendaniel, Lindsay; Law, Emily F.; Ackerman, Claire Sonntag; McKenna, Kristine D.

2009-01-01

Objective To test whether a head-mounted display helmet enhances the effectiveness of videogame distraction for children experiencing cold pressor pain. Method Forty-one children, aged 6–14 years, underwent one or two baseline cold pressor trials followed by two distraction trials in which they played the same videogame with and without the helmet in counterbalanced order. Pain threshold (elapsed time until the child reported pain) and pain tolerance (total time the child kept the hand submerged in the cold water) were measured for each cold pressor trial. Results Both distraction conditions resulted in improved pain tolerance relative to baseline. Older children appeared to experience additional benefits from using the helmet, whereas younger children benefited equally from both conditions. The findings suggest that virtual reality technology can enhance the effects of distraction for some children. Research is needed to identify the characteristics of children for whom this technology is best suited. PMID:18367495

Is positive thinking in anticipation of a performance situation better than distraction? An experimental study in preadolescents.

PubMed

Vassilopoulos, Stephanos P; Brouzos, Andreas; Tsorbatzoudis, Haralambos; Tziouma, Olga

2017-04-01

The current study compares the effects of experimentally induced positive anticipatory thinking and distraction in preadolescents aged 12-13. Eighty-seven participants were instructed to either engage in positive anticipatory thoughts or perform a distraction task while preparing to perform a sporting activity in front of their peers. Results revealed that trait social anxiety was associated with more negative estimates of sport performance and catastrophic thoughts relating to the impending sport activity. Additionally, compared to children who distracted, children in the positive anticipation condition showed significantly increased anxiety levels, more catastrophic thoughts and more negative predictions of sport performance and appearance, although these effects did not appear to interact with trait social anxiety. Finally, no significant manipulation effect on participants' observable behavior was found. The findings further highlight the utility of distracting from an impending, anxiety-provoking situation to keep anxious feelings to a low level. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study.

PubMed

Singh, Divya; Samadi, Firoza; Jaiswal, Jn; Tripathi, Abhay Mani

2014-01-01

The purpose of the present study was to evaluate the eff-cacy of 'audio distraction' in anxious pediatric dental patients. Sixty children were randomly selected and equally divided into two groups of thirty each. The first group was control group (group A) and the second group was music group (group B). The dental procedure employed was extraction for both the groups. The children included in music group were allowed to hear audio presentation throughout the treatment procedure. Anxiety was measured by using Venham's picture test, pulse rate, blood pressure and oxygen saturation. 'Audio distraction' was found efficacious in alleviating anxiety of pediatric dental patients. 'Audio distraction' did decrease the anxiety in pediatric patients to a significant extent. How to cite this article: Singh D, Samadi F, Jaiswal JN, Tripathi AM. Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study. Int J Clin Pediatr Dent 2014;7(3):149-152.

The use of mandibular body distraction in hemifacial microsomia

PubMed Central

Sakamoto, Yoshiaki; Nakajima, Hideo; Ogata, Hisao; Kishi, Kazuo

2013-01-01

Objective: The goals of treatment for hemifacial microsomia include horizontalization of occlusal plane and acquisition of facial symmetry. Although horizontalization of occlusal plane can be easily achieved, facial symmetry, particularly in relation to mandibular contour, can be difficult to attain. Soft tissue is generally reconstructed to correct facial asymmetry, and no studies have described correction of facial asymmetry through skeletal reconstruction. Case: A 12-year-old girl presented with grade IIb right-sided hemifacial microsomia. She was treated using Nakajima's angle-variable internal distraction (NAVID) system for mandibular body distraction. Results: Following treatment, appropriate facial symmetry was achieved, and the patient was extremely satisfied with the results. Conclusions: Thus, we successfully treated the present patient by our novel method involving distraction osteogenesis. This method was effective and useful for several reasons including; the changes were not accompanied by postoperative tissue absorption, donor sites were not involved, and the treatment outcome could be reevaluated by adjusting distraction while the patient's appearance was being remodeled. PMID:24205479

Independence between implicit and explicit processing as revealed by the Simon effect.

PubMed

Lo, Shih-Yu; Yeh, Su-Ling

2011-09-01

Studies showing human behavior influenced by subliminal stimuli mainly focus on implicit processing per se, and little is known about its interaction with explicit processing. We examined this by using the Simon effect, wherein a task-irrelevant spatial distracter interferes with lateralized response. Lo and Yeh (2008) found that the visual Simon effect, although it occurred when participants were aware of the visual distracters, did not occur with subliminal visual distracters. We used the same paradigm and examined whether subliminal and supra-threshold stimuli are processed independently by adding a supra-threshold auditory distracter to ascertain whether it would interact with the subliminal visual distracter. Results showed auditory Simon effect, but there was still no visual Simon effect, indicating that supra-threshold and subliminal stimuli are processed separately in independent streams. In contrast to the traditional view that implicit processing precedes explicit processing, our results suggest that they operate independently in a parallel fashion. Copyright © 2010 Elsevier Inc. All rights reserved.

Visual attention distracter insertion for improved EEG rapid serial visual presentation (RSVP) target stimuli detection

NASA Astrophysics Data System (ADS)

Khosla, Deepak; Huber, David J.; Martin, Kevin

2017-05-01

This paper† describes a technique in which we improve upon the prior performance of the Rapid Serial Visual Presentation (RSVP) EEG paradigm for image classification though the insertion of visual attention distracters and overall sequence reordering based upon the expected ratio of rare to common "events" in the environment and operational context. Inserting distracter images maintains the ratio of common events to rare events at an ideal level, maximizing the rare event detection via P300 EEG response to the RSVP stimuli. The method has two steps: first, we compute the optimal number of distracters needed for an RSVP stimuli based on the desired sequence length and expected number of targets and insert the distracters into the RSVP sequence, and then we reorder the RSVP sequence to maximize P300 detection. We show that by reducing the ratio of target events to nontarget events using this method, we can allow RSVP sequences with more targets without sacrificing area under the ROC curve (azimuth).

Building a computer program to support children, parents, and distraction during healthcare procedures.

PubMed

Hanrahan, Kirsten; McCarthy, Ann Marie; Kleiber, Charmaine; Ataman, Kaan; Street, W Nick; Zimmerman, M Bridget; Ersig, Anne L

2012-10-01

This secondary data analysis used data mining methods to develop predictive models of child risk for distress during a healthcare procedure. Data used came from a study that predicted factors associated with children's responses to an intravenous catheter insertion while parents provided distraction coaching. From the 255 items used in the primary study, 44 predictive items were identified through automatic feature selection and used to build support vector machine regression models. Models were validated using multiple cross-validation tests and by comparing variables identified as explanatory in the traditional versus support vector machine regression. Rule-based approaches were applied to the model outputs to identify overall risk for distress. A decision tree was then applied to evidence-based instructions for tailoring distraction to characteristics and preferences of the parent and child. The resulting decision support computer application, titled Children, Parents and Distraction, is being used in research. Future use will support practitioners in deciding the level and type of distraction intervention needed by a child undergoing a healthcare procedure.

Effect of mandibular distraction osteogenesis on the temporomandibular joint: a systematic review of animal experimental studies.

PubMed

Andersen, Kristian; Pedersen, Thomas Klit; Hauge, Ellen Margrethe; Schou, Søren; Nørholt, Sven Erik

2014-04-01

The present systematic review aimed to test the hypothesis of no effect of mandibular distraction osteogenesis on the temporomandibular joint. Animal experimental studies from January 1985 to August 2013 were included. Studies were searched in PubMed, Embase, Scopus, and the Cochrane Library. A total of 289 articles were identified, and 17 were included. Included studies were characterized by a high risk of bias and by inhomogeneity related to animal species, experimental procedures, and evaluation methods. Mandibular distraction osteogenesis within physiologic limits may be followed by adaptive changes in bone, disk, and cartilage. Increased daily rates and total activation length may influence the severity of the adaptive changes. Animal experimental studies indicate that mandibular distraction osteogenesis may induce adaptive changes in the temporomandibular joint. Adaptive changes may be influenced by increased daily rates and total length of distraction osteogenesis. Well-designed studies are needed before final conclusions can be drawn. Copyright © 2014 Elsevier Inc. All rights reserved.

The effectiveness of virtual reality distraction for pain reduction: a systematic review.

PubMed

Malloy, Kevin M; Milling, Leonard S

2010-12-01

Virtual reality technology enables people to become immersed in a computer-simulated, three-dimensional environment. This article provides a comprehensive review of controlled research on the effectiveness of virtual reality (VR) distraction for reducing pain. To be included in the review, studies were required to use a between-subjects or mixed model design in which VR distraction was compared with a control condition or an alternative intervention in relieving pain. An exhaustive search identified 11 studies satisfying these criteria. VR distraction was shown to be effective for reducing experimental pain, as well as the discomfort associated with burn injury care. Studies of needle-related pain provided less consistent findings. Use of more sophisticated virtual reality technology capable of fully immersing the individual in a virtual environment was associated with greater relief. Overall, controlled research suggests that VR distraction may be a useful tool for clinicians who work with a variety of pain problems. Copyright © 2010 Elsevier Ltd. All rights reserved.

Special Considerations in Distracted Driving with Teens

PubMed Central

Durbin, Dennis R; McGehee, Daniel V; Fisher, Donald; McCartt, Anne

2014-01-01

Novice teen drivers have long been known to have an increased risk of crashing, as well as increased tendencies toward unsafe and risky driving behaviors. Teens are unique as drivers for several reasons, many of which have implications specifically in the area of distracted driving. This paper reviews several of these features, including the widespread prevalence of mobile device use by teens, their lack of driving experience, the influence of peer passengers as a source of distraction, the role of parents in influencing teens’ attitudes and behaviors relevant to distracted driving and the impact of laws designed to prevent mobile device use by teen drivers. Recommendations for future research include understanding how engagement in a variety of secondary tasks by teen drivers affects their driving performance or crash risk; understanding the respective roles of parents, peers and technology in influencing teen driver behavior; and evaluating the impact of public policy on mitigating teen crash risk related to driver distraction. PMID:24776228

The effect of stress induction on working memory in patients with psychogenic nonepileptic seizures.

PubMed

Bakvis, Patricia; Spinhoven, Philip; Putman, Peter; Zitman, Frans G; Roelofs, Karin

2010-11-01

Although psychogenic nonepileptic seizures (PNES) are considered a stress-induced paroxysmal disintegration of cognitive functions, it remains unknown whether stress indeed impairs cognitive integrative functions, such as working memory (WM), in patients with PNES. An N-back task with emotional distracters (angry, happy, and neutral faces) was administered at baseline and after stress induction (Cold Pressor Test) to 19 patients with PNES and 20 matched healthy controls. At baseline, patients displayed increased WM interference for the facial distracters. After stress induction, group differences generalized to the no-distracter condition. Within patients, high cortisol stress responses were associated with larger stress-induced WM impairments in the no-distracter condition. These findings demonstrate that patients' cognitive integrative functions are impaired by social distracters and stress induction. Moreover, the stress- and cortisol-related generalization of the relative WM impairments offers a promising experimental model for the characteristic paroxysmal disintegration of attentional and mnemonic functions in patients with PNES associated with stress. Copyright © 2010 Elsevier Inc. All rights reserved.

Distraction of the temporomandibular joint condyle in patients with unilateral non-reducing disc displacement: Fact or fiction?

PubMed

Yıldız, Melih; Çağatay Dayan, Süleyman; Şakar, Olcay; Sülün, Tonguç

2017-07-24

This study investigated the distractive effect of a unilateral pivot splint on patients with unilateral disc displacement without reduction. The study group was comprised of 18 patients who had no history of treatment with removable prosthetic restorations of molars, premolars, or canine teeth, and no previous treatment for temporomandibular disorder. Joint spaces measurements made on magnetic resonance images indicated the affected side to be narrower than the healthy side. Unilateral distraction splints were made for all patients. An ultrasonic motion analyzer was used to measure the vertical shift occurring on the affected side as patients closed their mouths with maximal force with the splint in their mouths. Closing with maximal force on the unilateral distraction splint led to a noticeable downward movement of the affected condyle. The findings of this study indicate that the TMJ condyle of patients with unilateral disc displacement without reduction may be unilaterally distracted if the articular space is narrowed.

Perioperative incidents associated with internal maxillary distraction osteogenesis: a retrospective study of 20 patients.

PubMed

Kristian, Andersen; Erik, Nørholt Sven; Annelise, Küseler; John, Jensen; Klit, Pedersen Thomas

2012-12-01

This retrospective study aimed to assess the frequency and distribution of incidents encountered during the perioperative period of maxillary distraction with internal devices. The perioperative period was defined as the period between device placement and removal. Records of 20 patients treated during 2004-2011 with internal maxillary distraction osteogenesis were examined. Incidents were registered in terms of severity and need of intervention. Eighty percent of the patients experienced minor incidents, of which the most frequent were pain during activation and infections; 80% of these experienced ≥1 hard and soft tissue-related incidents, and 20% ≥1 device-related incidents. All incidents were solved with minimal or no intervention. Maxillary distraction using internal devices is a safe treatment with only minor incidents in the perioperative period. Preoperative planning and good cooperation are essential for preventing postoperative incidents. Prophylactic antibiotic treatment during the distraction period may be indicated. Copyright © 2012 Elsevier Inc. All rights reserved.

Maxillary distraction osteogenesis using Le Fort I osteotomy without intraoperative down-fracture.

PubMed

Yamauchi, K; Mitsugi, M; Takahashi, T

2006-06-01

The aim of this study is to present a technique for maxillary distraction osteogenesis using Le Fort I osteotomy without down-fracture. Six cleft-related patients suffering from severe midfacial deficiency were treated with maxillary distraction osteogenesis. The RED II system was chosen as the extraoral device and the Leipzig retention plate system to anchor the maxillary segment. Maxillary distraction osteogenesis was successful in all cases. Cephalometric and clinical evaluation after an average follow-up period of 1 year showed stable results with respect to skeletal and dental relationships. The SNA angle increased from 72.3 degrees to 81.4 degrees and the ANB angle increased by 11.0 degrees immediately after removing the distraction device. After 1 year, the sagittal bone gain remained and the SNA angle had decreased by 0.8 degrees . This technique seems to minimize the risk of the surgical procedure and shorten the operation time. It may become an alternative method for the treatment of patients with severe midfacial hypoplasia.

Articulated distraction.

PubMed

Hosny, Gamal Ahmed

2011-07-01

Articular hip distraction can be applied either by using a monolateral articulated distractor or a circular fixator. The fixator should be aligned such that its axis is aligned with the transverse axis of the hip joint. Following distraction, the range of motion is maintained with regular physiotherapy. It is a useful salvage procedure in older children with hip stiffness, when other methods of containment are not applicable. Copyright © 2011 Elsevier Inc. All rights reserved.

The Evoked Potential. An Experimental Method for Biomechanical Analysis of Brain and Spinal Injury

DTIC Science & Technology

1980-01-01

Newtons produced marked changes in blood pressure, heart rate and distraction of the cervical spinal column with minimal ligamentous disruption...pathologic distraction and pathologic flexion of the thoracic ver- tebral column (8). Cerebral responses were lost within two minutes aftex complete...However, the immediate flexion and distraction responses were not altered. These findings suggest that mechanical trauma alters the spinal cord evoked

The role of gist and verbatim memory in complex decision making: Explaining the unconscious-thought effect.

PubMed

Abadie, Marlène; Waroquier, Laurent; Terrier, Patrice

2017-05-01

Previous research showed that the unconscious-thought effect , which refers to an improvement in complex decision making following a distraction period, was moderated by the presentation format of pieces of information about different options. The aim of the current study was to replicate this finding and further examine the memory representations underlying decision making following a distraction or a deliberation period. Results showed that, when the information was presented blocked per option, participants were better able to differentiate the best option from the others after a distraction period than immediately after the information presentation or after a deliberation period. In addition, distracted participants retrieved more gist representations of the options when the information was presented per option. By contrast, participants were better able to differentiate the best option from the others after a deliberation period when the information was presented per attribute. Participants who deliberated also retrieved more verbatim representations when the information was presented per attribute. Finally, mediation analyses indicated that the accuracy of the evaluations of the options depends on gist memory when distracted but on verbatim memory when deliberating. These findings suggest that the effectiveness of distraction or deliberation depends on the memory representations of the different options. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Spatial and temporal EEG dynamics of dual-task driving performance

PubMed Central

2011-01-01

Background Driver distraction is a significant cause of traffic accidents. The aim of this study is to investigate Electroencephalography (EEG) dynamics in relation to distraction during driving. To study human cognition under a specific driving task, simulated real driving using virtual reality (VR)-based simulation and designed dual-task events are built, which include unexpected car deviations and mathematics questions. Methods We designed five cases with different stimulus onset asynchrony (SOA) to investigate the distraction effects between the deviations and equations. The EEG channel signals are first converted into separated brain sources by independent component analysis (ICA). Then, event-related spectral perturbation (ERSP) changes of the EEG power spectrum are used to evaluate brain dynamics in time-frequency domains. Results Power increases in the theta and beta bands are observed in relation with distraction effects in the frontal cortex. In the motor area, alpha and beta power suppressions are also observed. All of the above results are consistently observed across 15 subjects. Additionally, further analysis demonstrates that response time and multiple cortical EEG power both changed significantly with different SOA. Conclusions This study suggests that theta power increases in the frontal area is related to driver distraction and represents the strength of distraction in real-life situations. PMID:21332977

Atlantoaxial Joint Distraction with a New Expandable Device for the Treatment of Basilar Invagination with Preservation of the C2 Nerve Root: A Cadaveric Anatomical Study.

PubMed

Polli, Filippo Maria; Trungu, Sokol; Miscusi, Massimo; Forcato, Stefano; Visocchi, Massimiliano; Raco, Antonino

2017-01-01

Atlantoaxial joint distraction has been advocated for the decompression of the brain stem in patients affected by basilar invagination, avoiding direct transoral decompression. This technique requires C2 ganglion resection and it is often impossible to perform due to the peculiar bony anatomy. We describe a cadaveric anatomical study supporting the feasibility of C1-C2 distraction performed with an expandable device, allowing easier insertion of the tool and preservation of the C2 nerve root. In five adult cadaveric specimens, posterior atlantoaxial surgical exposure was performed and an expandable system was inserted within the C1-C2 joint. The expansion of the device, leading to active distraction of the joint space, together with all the surgical steps of the technique was recorded with anatomical pictures and the final results were checked with a computed tomography (CT) scan. Insertion of the device was easily performed in all cases without anatomical conflict with the C2 ganglion; CT scans confirmed the distraction of the C1-C2 joint. This cadaveric anatomical study confirms the feasibility of the introduction of an expandable and flexible device within the C1-C2 joint, allowing it's distraction and preservation of the C2 ganglion.

Time course of emotion-related responding during distraction and reappraisal

PubMed Central

Schönfelder, Sandra; Kanske, Philipp; Heissler, Janine

2014-01-01

Theoretical accounts of emotion regulation (ER) discriminate various cognitive strategies to voluntarily modify emotional states. Amongst these, attentional deployment (i.e. distraction) and cognitive change (i.e. reappraisal), have been shown to successfully down-regulate emotions. Neuroimaging studies found that both strategies differentially engage neural structures associated with selective attention, working memory and cognitive control. The aim of this study was to further delineate similarities and differences between the ER strategies reappraisal and distraction by investigating their temporal brain dynamics using event-related potentials (ERPs) and their patterns of facial expressive behavior. Twenty-one participants completed an ER experiment in which they had to either passively view positive, neutral and negative pictures, reinterpret them to down-regulate affective responses (reappraisal), or solve a concurrently presented mathematical equation (distraction). Results demonstrate the efficacy of both strategies in the subjective control of emotion, accompanied by reductions of facial expressive activity (Corrugator supercilii and Zygomaticus major). ERP results indicated that distraction, compared with reappraisal, yielded a stronger and earlier attenuation of the late positive potential (LPP) magnitude for negative pictures. For positive pictures, only distraction but not reappraisal had significant effect on LPP attenuation. The results support the process model of ER, separating subtypes of cognitive strategies based on their specific time course. PMID:23988760

Emotional intensity influences pre-implementation and implementation of distraction and reappraisal

PubMed Central

Shafir, Roni; Schwartz, Naama; Blechert, Jens

2015-01-01

Although emotional intensity powerfully challenges regulatory strategies, its influence remains largely unexplored in affective-neuroscience. Accordingly, the present study addressed the moderating role of emotional intensity in two regulatory stages—implementation (during regulation) and pre-implementation (prior to regulation), of two major cognitive regulatory strategies—distraction and reappraisal. According to our framework, because distraction implementation involves early attentional disengagement from emotional information before it gathers force, in high-intensity it should be more effective in the short-term, relative to reappraisal, which modulates emotional processing only at a late semantic meaning phase. Supporting findings showed that in high (but not low) intensity, distraction implementation resulted in stronger modulation of negative experience, reduced neural emotional processing (centro-parietal late positive potential, LPP), with suggestive evidence for less cognitive effort (frontal-LPP), relative to reappraisal. Related pre-implementation findings confirmed that anticipating regulation of high-intensity stimuli resulted in distraction (over reappraisal) preference. In contrast, anticipating regulation of low-intensity stimuli resulted in reappraisal (over distraction) preference, which is most beneficial for long-term adaptation. Furthermore, anticipating cognitively demanding regulation, either in cases of regulating counter to these preferences or via the more effortful strategy of reappraisal, enhanced neural attentional resource allocation (Stimulus Preceding Negativity). Broad implications are discussed. PMID:25700568

Anterior maxillary segmental distraction for correction of maxillary hypoplasia and dental crowding in cleft palate patients: a preliminary report.

PubMed

Wang, X-X; Wang, X; Li, Z-L; Yi, B; Liang, C; Jia, Y-L; Zou, B-S

2009-12-01

To evaluate the feasibility of anterior maxillary segmental distraction (AMSD) to correct maxillary hypoplasia and severe dental crowding in cleft lip and palate (CLP) patients, 7 patients (average age 16.4 years) with maxillary hypoplasia, shortened maxillary dental arch length and severe anterior dental crowding secondary to CLP were selected for this study. After anterior maxillary segmental osteotomy, 3 patients were treated using bilateral internal distraction devices, and 4 patients were treated using rigid external distraction devices. Photographs and radiographs were taken to review the improvement in facial profile and occlusion after distraction. An average 10.25 mm anterior maxillary advancement was obtained in all patients after 10-23 days of distraction and 9-16 weeks of consolidation. The sella-nasion-point A (SNA) angle increased from 69.5 degrees to 79.6 degrees. Midface convexity was greatly improved and velopharyngeal competence was preserved. The maxillary dental arch length was greatly increased by 10.1 mm (P<0.01). Dental crowding and malocclusion were corrected by orthodontic treatment. These results show that AMSD can effectively correct the hypoplastic maxilla and severe dental crowding associated with CLP by increasing the midface convexity and dental arch length while preserving velopharyngeal function, and dental crowding can be corrected without requiring tooth extraction.

Velopharyngeal changes after maxillary distraction in cleft patients using a rigid external distraction device: A retrospective study.

PubMed

Taha, Mahasen; Elsheikh, Yasser M

2016-11-01

 To evaluate early and late velopharyngeal changes in cleft lip and palate (CLP) patients after use of the Rigid External Distractor (RED) device and to correlate these changes to the amount of maxillary advancement.  Thirty Class III CLP patients were included in the study. Maxillary advancement was performed using the RED device in combination with titanium miniplates and screws for anchorage. Lateral cephalograms, nasometer, and nasopharyngoscope records were taken before distraction, immediately after distraction, and 1 year after distraction. A paired t-test was used to detect differences at P < .05.  SNA angle and A point and ANS to Y axis were significantly increased after maxillary distraction (P  =  .0001). Statistically significant increases in nasopharyngeal and oropharyngeal depths, velar angle, and need ratio were also found (P  =  .0001). Nasalance scores showed a significant increase (P  =  .008 for nasal text and .044 for oral text). A significant positive correlation was observed between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality (P  =  .012 and .026, respectively).  Nasopharyngeal function was deteriorated after maxillary advancement in CLP patients. There was a significant positive correlation between the amount of maxillary advancement and the increase in nasopharyngeal depth and hypernasality.

Long-term results of maxillary distraction osteogenesis in nongrowing cleft: 5-years experience using internal device.

PubMed

Hirjak, D; Reyneke, J P; Janec, J; Beno, M; Kupcova, I

2016-01-01

Patients with cleft lip and palate (CLP) related deformities frequently have maxillary hypoplasia in all dimensions. These patients usually present with class III malocclusions, retruded midfaces and narrow hard palates. The skeletal problems can be treated by means of Le Fort I maxillary procedures. Surgical and orthodontic correction of severe maxillary hypoplasia, as often seen in CLP patients, has however proved to be challenging. The magnitude of the advancement is often hampered and the post operative stability significantly affected by palatal soft tissue scarring. The slow distraction of bone and the histogenic abilities of distraction osteogenesis (DO) have made it an atractive alternative treatment option for the management of maxillary hypoplasia in these patients. This paper presents the treatment results of 15 nongrowing CLP patients with severe maxillary hypoplasia treated by means of intra oral distraction. The mean anterior distraction of the maxillas was 12.7 mm (9-15.0 mm). The long-term cephalometric and clinical evaluation after a minimum of 60 months (mean follow-up 71 months) proved to be stable. The treatment results revealed, that distraction osteogenesis in nongrowing CLP patients with severe maxillary hypoplasia proved to be a predictable and stable option (Tab. 2, Fig. 3, Ref. 26).

Maxillary movement in distraction osteogenesis using internal devices in cleft palate patients.

PubMed

Tomita, Daisuke; Omura, Susumu; Ozaki, Shusaku; Shimazaki, Kazuo; Fukuyama, Eiji; Tohnai, Iwai; Torikai, Katsuyuki

2011-03-01

The purpose of this cephalometric study was to compare the actual movement with the planned movement of the maxilla by using internal maxillary distraction in cleft lip and palate patients. Twelve patients, including eight with unilateral and four with bilateral cleft lip and palate, underwent maxillary advancement with internal maxillary distractors. Lateral cephalometric radiographs obtained preoperatively, predistraction, and postdistraction were used for analysis. The movement of the maxilla, angular change of the internal devices and rotation of the mandible were measured at each stage, and the planned vector of advancement predicted from the placement vector of the distractors was compared with the actual vector. Internal maxillary distractors were rotated in a clockwise direction during the distraction period. The angular change of the distractors was 7.7°. The amount of actual advancement at anterior nasal spine with distraction was 6.3 mm, which represented about 70% of the distance of activation of distraction. The actual advanced vector at anterior nasal spine was 9.7° smaller than the planned vector. The mandible underwent a clockwise rotation of 3.5°. In the internal distraction technique, the maxilla was advanced inferiorly to the planned vector and with a slight clockwise rotation. These results are useful for surgical planning when using internal distractors.

Removable splint with locking attachments for maxillary distraction osteogenesis with the RED system.

PubMed

Suzuki, E Y; Suzuki, B

2007-12-01

The external traction hooks of the intraoral splint used to control traction forces applied to the maxilla with the rigid external distraction system represent a major barrier to surgical procedures. The purpose of this article is to introduce a removable intraoral splint with locking attachments that can be placed post-surgically immediately before distraction, facilitating surgery and consequently reducing the operative time. Fifteen cleft lip and palate patients underwent maxillary distraction osteogenesis using a rigid external distraction device in combination with the proposed removable splint that was fixed onto the maxillary teeth to provide anchorage. Initial records showed severe maxillary hypoplasia and negative overjet. The removable splint was fabricated using 1.5-mm diameter stainless-steel rigid orthodontic wires soldered to the locking attachments (Y&B Products LP, Chiang Mai, Thailand), making possible its placement post-surgically. Stable splint fixation was achieved prior to the distraction procedure and the desired treatment goals were reached. No complications inserting or removing the splint post-surgically, including pain or discomfort, were observed. The use of the removable splint with locking attachments has proved to be a highly effective fixation approach to manage the severely hypoplastic maxilla, eliminating lip constraints resulting from scarring, and allowing for easier, more deliberate and careful dissection.

Experimentally induced distraction impacts cognitive but not emotional processes in think-aloud cognitive assessment

PubMed Central

Hsu, Kean J.; Babeva, Kalina N.; Feng, Michelle C.; Hummer, Justin F.; Davison, Gerald C.

2014-01-01

Studies have examined the impact of distraction on basic task performance (e.g., working memory, motor responses), yet research is lacking regarding its impact in the domain of think-aloud cognitive assessment, where the threat to assessment validity is high. The Articulated Thoughts in Simulated Situations think-aloud cognitive assessment paradigm was employed to address this issue. Participants listened to scenarios under three conditions (i.e., while answering trivia questions, playing a visual puzzle game, or with no experimental distractor). Their articulated thoughts were then content-analyzed both by the Linguistic Inquiry and Word Count (LIWC) program and by content analysis of emotion and cognitive processes conducted by trained coders. Distraction did not impact indices of emotion but did affect cognitive processes. Specifically, with the LIWC system, the trivia questions distraction condition resulted in significantly higher proportions of insight and causal words, and higher frequencies of non-fluencies (e.g., “uh” or “umm”) and filler words (e.g., “like” or “you know”). Coder-rated content analysis found more disengagement and more misunderstanding particularly in the trivia questions distraction condition. A better understanding of how distraction disrupts the amount and type of cognitive engagement holds important implications for future studies employing cognitive assessment methods. PMID:24904488

Effects of music therapy and distraction cards on pain relief during phlebotomy in children.

PubMed

Aydin, Diler; Sahiner, Nejla Canbulat

2017-02-01

To investigate three different distraction methods (distraction cards, listening to music, and distraction cards + music) on pain and anxiety relief in children during phlebotomy. This study was a prospective, randomized, controlled trial. The sample consisted of children aged 7 to 12years who required blood tests. The children were randomized into four groups, distraction cards, music, distraction cards + music, and controls. Data were obtained through face-to-face interviews with the children, their parents, and the observer before and after the procedure. The children's pain levels were assessed and reported by the parents and observers, and the children themselves who self-reported using Wong-Baker FACES. The children's anxiety levels were also assessed using the Children's Fear Scale. Two hundred children (mean age: 9.01±2.35years) were included. No difference was found between the groups in the self, parent, and observer reported procedural pain levels (p=0.72, p=0.23, p=0.15, respectively). Furthermore, no significant differences were observed between groups in procedural child anxiety levels according to the parents and observer (p=0.092, p=0.096, respectively). Pain and anxiety relief was seen in all three methods during phlebotomy; however, no statistically significant difference was observed. Copyright © 2016 Elsevier Inc. All rights reserved.

The effects of chlorpromazine and lorazepam on abnormal antisaccade and no-saccade distractibility.

PubMed

Green, J F; King, D J

1998-10-15

Abnormally high levels of saccadic distractibility have been demonstrated to occur in patients with schizophrenia. Converging evidence implicates frontal cortical dysfunction as a mechanism; however, much of the neuropharmacology of saccadic distractibility has not yet been established. We measured antisaccade, no-saccade, and visually guided saccade components in healthy subjects following single doses of lorazepam 2 mg, chlorpromazine 50-100 mg, and placebo. Visual analogue rating scales (VARS) provided a subjective measure of sedation. Lorazepam, but not chlorpromazine, was shown to cause an increase in saccadic distractibility in both the antisaccade and no-saccade tasks. Peak visually guided saccade velocity was decreased by lorazepam and chlorpromazine in a dose-dependent manner, with corresponding changes seen in VARS. Lorazepam, unexpectedly, did not affect peak antisaccade velocity. The background level of antisaccade directional errors was 6.43%, which is relatively low compared to control groups in patient studies. These results support the view that abnormal saccadic distractibility in patients with schizophrenia is not due to an acute effect of antipsychotic medication. The use of benzodiazepines and the level of task practice are highlighted as possible confounding variables in patient studies. The implications of these results for the current neuropathological theories of abnormal saccadic distractibility are discussed.

An evidence-based review: distracted driver.

PubMed

Llerena, Luis E; Aronow, Kathy V; Macleod, Jana; Bard, Michael; Salzman, Steven; Greene, Wendy; Haider, Adil; Schupper, Alex

2015-01-01

Cell phone use and texting are prevalent within society and have thus pervaded the driving population. This technology is a growing concern within the confines of distracted driving, as all diversions from attention to the road have been shown to increase the risk of crashes. Adolescent, inexperienced drivers, who have the greatest prevalence of texting while driving, are at a particularly higher risk of crashes because of distraction. Members of the Injury Control Violence Prevention Committee of the Eastern Association for the Surgery of Trauma performed a PubMed search of articles related to distracted driving and cell phone use as a distractor of driving between 2000 and 2013. A total of 19 articles were found to merit inclusion as evidence in the evidence-based review. These articles provided evidence regarding the relationship between distracted driving and crashes, cell phone use contributing to automobile accidents, and/or the relationship between driver experience and automobile accidents. (Adjust methods/results sections to the number of articles that correctly corresponds to the number of references, as well as the methodology for reference inclusion.) Based on the evidence reviewed, we can recommend the following. All drivers should minimize all in-vehicle distractions while on the road. All drivers should not text or use any touch messaging system (including the use of social media sites such as Facebook and Twitter) while driving. Younger, inexperienced drivers should especially not use cell phones, texting, or any touch messaging system while driving because they pose an increased risk for death and injury caused by distractions while driving.

A Prospective Randomized Controlled Trial of Nonpharmacological Pain Management During Intravenous Cannulation in a Pediatric Emergency Department.

PubMed

Miller, Kate; Tan, Xianghong; Hobson, Andrew Dillon; Khan, Asaduzzaman; Ziviani, Jenny; OʼBrien, Eavan; Barua, Kim; McBride, Craig A; Kimble, Roy M

2016-07-01

Intravenous (IV) cannulation is commonly performed in pediatric emergency departments (EDs). The busy ED environment is often not conducive to conventional nonpharmacological pain management. This study assessed the use of Ditto (Diversionary Therapy Technologies, Brisbane, Australia), a handheld electronic device which provides procedural preparation and distraction, as a means of managing pain and distress during IV cannulation performed in the pediatric ED. A randomized controlled trial with 98 participants, aged 3 to 12 years, was conducted in a pediatric ED. Participants were recruited and randomized into 5 intervention groups as follows: (1) Standard Distraction, (2) PlayStation Portable Distraction, (3) Ditto Distraction, (4) Ditto Procedural Preparation, and (5) Ditto Preparation and Distraction. Children's pain and distress levels were assessed via self-reports and observational reports by caregivers and nursing staff across the following 3 time points: (1) before, (2) during, and (3) after IV cannulation. Caregivers and nursing staff reported significantly reduced pain and distress levels in children accessing the combined preparation and distraction Ditto protocol, as compared to standard distraction (P ≤ 0.01). This intervention also saw the greatest reduction in pain and distress as reported by the child. Caregiver reports indicate that using the combined Ditto protocol was most effective in reducing children's pain experiences while undergoing IV cannulation in the ED. The use of Ditto offers a promising opportunity to negotiate barriers to the provision of nonpharmacological approaches encountered in the busy ED environment, and provide nonpharmacological pain-management interventions in pediatric EDs.

Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review.

PubMed

Indovina, Paola; Barone, Daniela; Gallo, Luigi; Chirico, Andrea; De Pietro, Giuseppe; Antonio, Giordano

2018-02-26

This review aims to provide a framework for evaluating the utility of virtual reality (VR) as a distraction intervention to alleviate pain and distress during medical procedures. We firstly describe the theoretical bases underlying the VR analgesic and anxiolytic effects and define the main factors contributing to its efficacy, which largely emerged from studies on healthy volunteers. Then, we provide a comprehensive overview of the clinical trials using VR distraction during different medical procedures, such as burn injury treatments, chemotherapy, surgery, dental treatment, and other diagnostic and therapeutic procedures. A broad literature search was performed using as main terms "virtual reality", "distraction" and "pain". No date limit was applied and all the retrieved studies on immersive VR distraction during medical procedures were selected. VR has proven to be effective in reducing procedural pain, as almost invariably observed even in patients subjected to extremely painful procedures, such as patients with burn injuries undergoing wound care and physical therapy. Moreover, VR seemed to decrease cancer-related symptoms in different settings, including during chemotherapy. Only mild and infrequent side effects were observed. Despite these promising results, future long-term randomized controlled trials with larger sample sizes and evaluating not only self-report measures but also physiological variables are needed. Further studies are also required both to establish predictive factors to select patients who can benefit from VR distraction and to design hardware/software systems tailored to the specific needs of different patients and able to provide the greatest distraction at the lowest cost.

A Novel Spinal Implant for Fusionless Scoliosis Correction: A Biomechanical Analysis of the Motion Preserving Properties of a Posterior Periapical Concave Distraction Device

PubMed Central

Holewijn, Roderick M.; de Kleuver, Marinus; van der Veen, Albert J.; Emanuel, Kaj S.; Bisschop, Arno; Stadhouder, Agnita; van Royen, Barend J.

2017-01-01

Study Design: Biomechanical study. Objective: Recently, a posterior concave periapical distraction device for fusionless scoliosis correction was introduced. The goal of this study was to quantify the effect of the periapical distraction device on spinal range of motion (ROM) in comparison with traditional rigid pedicle screw-rod instrumentation. Methods: Using a spinal motion simulator, 6 human spines were loaded with 4 N m and 6 porcine spines with 2 N m to induce flexion-extension (FE), lateral bending (LB), and axial rotation (AR). ROM was measured in 3 conditions: untreated, periapical distraction device, and rigid pedicle screw-rod instrumentation. Results: The periapical distraction device caused a significant (P < .05) decrease in ROM of FE (human, −40.0% and porcine, −55.9%) and LB (human, −18.2% and porcine, −17.9%) as compared to the untreated spine, while ROM of AR remained unaffected. In comparison, rigid instrumentation caused a significantly (P < .05) larger decrease in ROM of FE (human, −80.9% and porcine, −94.0%), LB (human, −75.0% and porcine, −92.2%), and AR (human, −71.3% and porcine, −86.9%). Conclusions: Although no destructive forces were applied, no device failures were observed. Spinal ROM was significantly less constrained by the periapical distraction device compared to rigid pedicle screw-rod instrumentation. Therefore, provided that scoliosis correction is achieved, a more physiological spinal motion is expected after scoliosis correction with the posterior concave periapical distraction device. PMID:28811983

[Clinical application of transport distraction osteogenesis arthroplasty in the treatment of temporomandibular joint bony ankylosis].

PubMed

Liang, Cheng; Wang, Xing; Yi, Biao; Li, Zi-li; Wang, Xiao-xia

2013-03-12

To explore the clinical application of transport distraction osteogenesis arthroplasty (TDOAP) in the treatment of temporomandibular joint (TMJ) bony ankylosis. From December 1999 to December 2011, a total of 73 patients (89 sides of TMJ) underwent TDOAP were included. There were 39 males and 34 females with a mean age of 19.6 years (range: 3 - 60). Among them, 27 patients were recurrence cases and 30 cases were accompanied with micrognathia and obstructive sleep apnea-hypopnea syndrome (OSAHS). The mean preoperative degree of mouth opening was 6.6 mm (range: 1 - 20). After a release of ankylosis, a transport disc was performed and fixed to ramus with a distractor. Distraction began at Days 4 - 8 postoperation. The distraction rhythm and rate were 0.25 mm four times daily. Distraction stopped when planning distance was achieved. And a distractor was maintained in place for 3-6 months after completion of distraction and then removed. Active postoperative training of mouth opening was implemented. The mean distance of distraction was 15.3 mm (range: 12 - 23). The range of mouth opening of 65 patients increased to normal and bone formation in gaps were perfect. The mean follow-up period was 44.8 months (range: 18 - 102). Eight cases were recurrent. And 1/37 over 15 years old and 7/36 under 15 years old had recurrence. TDOAP is an effective treatment for TMJ ankylosis. A pediatric patient, especially recurrent, should be operated after adolescence to decrease recurrence. Micrognathia and OSAHS should be also considered during the treatment of ankylosis.

Regenerate Healing Outcomes in Unilateral Mandibular Distraction Osteogenesis Using Quantitative Histomorphometry

PubMed Central

Schwarz, Daniel A.; Arman, Krikor G.; Kakwan, Mehreen S.; Jamali, Ameen M.; Elmeligy, Ayman A.; Buchman, Steven R.

2015-01-01

Background The authors’ goal was to ascertain regenerate bone-healing metrics using quantitative histomorphometry at a single consolidation period. Methods Rats underwent either mandibular distraction osteogenesis (n=7) or partially reduced fractures (n=7); their contralateral mandibles were used as controls (n=11). External fixators were secured and unilateral osteotomies performed, followed by either mandibular distraction osteogenesis (4 days’ latency, then 0.3 mm every 12 hours for 8 days; 5.1 mm) or partially reduced fractures (fixed immediately postoperatively; 2.1 mm); both groups underwent 4 weeks of consolidation. After tissue processing, bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, and osteocyte count per high-power field were analyzed by means of quantitative histomorphometry. Results Contralateral mandibles had statistically greater bone volume/tissue volume ratio and osteocyte count per high-power field compared with both mandibular distraction osteogenesis and partially reduced fractures by almost 50 percent, whereas osteoid volume/tissue volume ratio was statistically greater in both mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles. No statistical difference in bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, or osteocyte count per high-power field was found between mandibular distraction osteogenesis specimens and partially reduced fractures. Conclusions The authors’ findings demonstrate significantly decreased bone quantity and maturity in mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles using the clinically analogous protocols. If these results are extrapolated clinically, treatment strategies may require modification to ensure reliable, predictable, and improved outcomes. PMID:20463629

Mitigating the effects of in-vehicle distractions through use of the Psychological Refractory Period paradigm.

PubMed

Hibberd, Daryl L; Jamson, Samantha L; Carsten, Oliver M J

2013-01-01

Modern driving involves frequent and potentially detrimental interactions with distracting in-vehicle tasks. Distraction has been shown to slow brake reaction time and decrease lateral and longitudinal vehicle control. It is likely that these negative effects will become more prevalent in the future as advances are made in the functionality, availability, and number of in-vehicle systems. This paper addresses this problem by considering ways to manage in-vehicle task presentation to mitigate their distracting effects. A driving simulator experiment using 48 participants was performed to investigate the existence of the Psychological Refractory Period in the driving context and its effect on braking performance. Drivers were exposed to lead vehicle braking events in isolation (single-task) and with a preceding surrogate in-vehicle task (dual-task). In dual-task scenarios, the time interval between the in-vehicle and braking tasks was manipulated. Brake reaction time increased when drivers were distracted. The in-vehicle task interfered with the performance of the braking task in a manner that was dependent on the interval between the two tasks, with slower reactions following a shorter inter-task interval. This is the Psychological Refractory Period effect. These results have implications for driver safety during in-vehicle distraction. The findings are used to develop recommendations regarding the timing of in-vehicle task presentation so as to reduce their potentially damaging effects on braking performance. In future, these guidelines could be incorporated into a driver workload management system to minimise the opportunity for a driver to be distracted from the ongoing driving task. Copyright © 2012 Elsevier Ltd. All rights reserved.

Benefits of Ilizarov automated bone distraction for nerves and articular cartilage in experimental leg lengthening.

PubMed

Shchudlo, Nathalia; Varsegova, Tatyana; Stupina, Tatyana; Shchudlo, Michael; Saifutdinov, Marat; Yemanov, Andrey

2017-09-18

To determine peculiarities of tissue responses to manual and automated Ilizarov bone distraction in nerves and articular cartilage. Twenty-nine dogs were divided in two experimental groups: Group M - leg lengthening with manual distraction (1 mm/d in 4 steps), Group A - automated distraction (1 mm/d in 60 steps) and intact group. Animals were euthanized at the end of distraction, at 30 th day of fixation in apparatus and 30 d after the fixator removal. M-responses in gastrocnemius and tibialis anterior muscles were recorded, numerical histology of peroneal and tibialis nerves and knee cartilage semi-thin sections, scanning electron microscopy and X-ray electron probe microanalysis were performed. Better restoration of M-response amplitudes in leg muscles was noted in A-group. Fibrosis of epineurium with adipocytes loss in peroneal nerve, subperineurial edema and fibrosis of endoneurium in some fascicles of both nerves were noted only in M-group, shares of nerve fibers with atrophic and degenerative changes were bigger in M-group than in A-group. At the end of experiment morphometric parameters of nerve fibers in peroneal nerve were comparable with intact nerve only in A-group. Quantitative parameters of articular cartilage (thickness, volumetric densities of chondrocytes, percentages of isogenic clusters and empty cellular lacunas, contents of sulfur and calcium) were badly changed in M-group and less changed in A-group. Automated Ilizarov distraction is more safe method of orthopedic leg lengthening than manual distraction in points of nervous fibers survival and articular cartilage arthrotic changes.

Protection of the temporomandibular joint during syndromic neonatal mandibular distraction using condylar unloading.

PubMed

Fan, Kenneth; Andrews, Brian T; Liao, Eileen; Allam, Karam; Raposo Amaral, Cesar Augusto; Bradley, James P

2012-05-01

Neonatal distraction in severe micrognathia patients may alleviate the need for tracheostomy. The authors' objectives in evaluating syndromic neonatal distraction cases were to: (1) document preoperative temporomandibular joint pathology, (2) compare the incidence of postoperative temporomandibular joint ankylosis, and (3) determine whether "unloading" the condyle tended to prevent temporomandibular joint pathology. Syndromic versus nonsyndromic micrognathic (and normal) patient temporomandibular joint abnormalities were compared preoperatively based on computed tomography scans and incisor opening (n = 110). Patient temporomandibular joint outcomes after neonatal mandibular distraction were compared with regard to ankylosis (n = 59). Condylar-loaded versus condylar-unloaded (with class II intermaxillary elastics) temporomandibular joint outcomes were compared based on imaging and the need for joint reconstruction (n = 25). Preoperative abnormalities of neonatal temporomandibular joint pathology on computed tomography scans were not significant: syndromic, 15 percent; nonsyndromic, 5.9 percent; and normal joints, 4.2 percent. Syndromic patients had a significantly greater interincisor distance decrease postoperatively (48 percent; p < 0.05) and at 1-year follow-up (28 percent; p < 0.05) compared with nonsyndromic patients. Also, computed tomography scans revealed that 28 percent of syndromic patients developed temporomandibular joint abnormalities, whereas nonsyndromic patients were unchanged. Condylar-loaded patients had worse clinical outcomes compared with condylar-unloaded patients (80 percent versus 7 percent) and required temporomandibular joint reconstruction for bony ankylosis (40 percent versus 0 percent) after distraction. Neonatal syndromic, micrognathia patients have increased temporomandibular joint pathology preoperatively and bony ankylosis after distraction but are protected with partial unloading of the condyle during distraction. Risk, II; Therapeutic, III.

Benefits of Ilizarov automated bone distraction for nerves and articular cartilage in experimental leg lengthening

PubMed Central

Shchudlo, Nathalia; Varsegova, Tatyana; Stupina, Tatyana; Shchudlo, Michael; Saifutdinov, Marat; Yemanov, Andrey

2017-01-01

AIM To determine peculiarities of tissue responses to manual and automated Ilizarov bone distraction in nerves and articular cartilage. METHODS Twenty-nine dogs were divided in two experimental groups: Group M - leg lengthening with manual distraction (1 mm/d in 4 steps), Group A - automated distraction (1 mm/d in 60 steps) and intact group. Animals were euthanized at the end of distraction, at 30th day of fixation in apparatus and 30 d after the fixator removal. M-responses in gastrocnemius and tibialis anterior muscles were recorded, numerical histology of peroneal and tibialis nerves and knee cartilage semi-thin sections, scanning electron microscopy and X-ray electron probe microanalysis were performed. RESULTS Better restoration of M-response amplitudes in leg muscles was noted in A-group. Fibrosis of epineurium with adipocytes loss in peroneal nerve, subperineurial edema and fibrosis of endoneurium in some fascicles of both nerves were noted only in M-group, shares of nerve fibers with atrophic and degenerative changes were bigger in M-group than in A-group. At the end of experiment morphometric parameters of nerve fibers in peroneal nerve were comparable with intact nerve only in A-group. Quantitative parameters of articular cartilage (thickness, volumetric densities of chondrocytes, percentages of isogenic clusters and empty cellular lacunas, contents of sulfur and calcium) were badly changed in M-group and less changed in A-group. CONCLUSION Automated Ilizarov distraction is more safe method of orthopedic leg lengthening than manual distraction in points of nervous fibers survival and articular cartilage arthrotic changes. PMID:28979852

When loading working memory reduces distraction: behavioral and electrophysiological evidence from an auditory-visual distraction paradigm.

PubMed

SanMiguel, Iria; Corral, María-José; Escera, Carles

2008-07-01

The sensitivity of involuntary attention to top-down modulation was tested using an auditory-visual distraction task and a working memory (WM) load manipulation in subjects performing a simple visual classification task while ignoring contingent auditory stimulation. The sounds were repetitive standard tones (80%) and environmental novel sounds (20%). Distraction caused by the novel sounds was compared across a 1-back WM condition and a no-memory control condition, both involving the comparison of two digits. Event-related brain potentials (ERPs) to the sounds were recorded, and the N1/MMN (mismatch negativity), novelty-P3, and RON components were identified in the novel minus standard difference waveforms. Distraction was reduced in the WM condition, both behaviorally and as indexed by an attenuation of the late phase of the novelty-P3. The transient/change detection mechanism indexed by MMN was not affected by the WM manipulation. Sustained slow frontal and parietal waveforms related to WM processes were found on the standard ERPs. The present results indicate that distraction caused by irrelevant novel sounds is reduced when a WM component is involved in the task, and that this modulation by WM load takes place at a late state of the orienting response, all in all confirming that involuntary attention is under the control of top-down mechanisms. Moreover, as these results contradict predictions of the load theory of selective attention and cognitive control, it is suggested that the WM load effects on distraction depend on the nature of the distractor-target relationships.

Effects of cell-phone and text-message distractions on true and false recognition.

PubMed

Smith, Theodore S; Isaak, Matthew I; Senette, Christian G; Abadie, Brenton G

2011-06-01

This study examined the effects of electronic communication distractions, including cell-phone and texting demands, on true and false recognition, specifically semantically related words presented and not presented on a computer screen. Participants were presented with 24 Deese-Roediger-McDermott (DRM) lists while manipulating the concurrent presence or absence of cell-phone and text-message distractions during study. In the DRM paradigm, participants study lists of semantically related words (e.g., mother, crib, and diaper) linked to a non-presented critical lure (e.g., baby). After studying the lists of words, participants are then requested to recall or recognize previously presented words. Participants often not only demonstrate high remembrance for presented words (true memory: crib), but also recollection for non-presented words (false memory: baby). In the present study, true memory was highest when participants were not presented with any distraction tasks during study of DRM words, but poorer when they were required to complete a cell-phone conversation or text-message task during study. False recognition measures did not statistically vary across distraction conditions. Signal detection analyses showed that participants better discriminated true targets (list items presented during study) from true target controls (items presented during study only) when cell-phone or text-message distractions were absent than when they were present. Response bias did not vary significantly across distraction conditions, as there were no differences in the likelihood that a participant would claim an item as "old" (previously presented) rather than "new" (not previously presented). Results of this study are examined with respect to both activation monitoring and fuzzy trace theories.

Maxillary distraction osteogenesis in the adolescent cleft patient: three-dimensional computed tomography analysis of linear and volumetric changes over five years.

PubMed

Chen, Philip Kuo-Ting; Por, Yong-Chen; Liou, Eric Jein-Wein; Chang, Frank Chun-Shin

2011-07-01

To assess the results of maxillary distraction osteogenesis with the Rigid External Distraction System using three-dimensional computed tomography scan volume-rendered images with respect to stability and facial growth at three time frames: preoperative (T0), 1-year postoperative (T1), and 5-years postoperative (T2). Retrospective analysis. Tertiary. A total of 12 patients with severe cleft maxillary hypoplasia were treated between June 30, 1997, and July 15, 1998. The mean age at surgery was 11 years 1 month. Le Fort I maxillary distraction osteogenesis. Distraction was started 2 to 5 days postsurgery at a rate of 1 mm per day. The consolidation period was 3 months. No face mask was used. A paired t test was used for statistical analysis. Overjet, ANB, and SNA and maxillary, pterygoid, and mandibular volumes. From T0 to T1, there were statistically significant increments of overjet, ANB, and SNA and maxillary, pterygoid, and mandibular volumes. The T1 to T2 period demonstrated a reduction of overjet (30.07%) and ANB (54.42%). The maxilla showed a stable SNA and a small but statistically significant advancement of the ANS point. There was a significant increase in the mandibular volume. However, there was no significant change in the maxillary and pterygoid volumes. Maxillary distraction osteogenesis demonstrated linear and volumetric maxillary growth during the distraction phase without clinically significant continued growth thereafter. Overcorrection is required to take into account recurrence of midface retrusion over the long term.

Tooth-borne distraction osteogenesis versus conventional Le Fort I in maxillary advancement of cleft lip and palate patients.

PubMed

Jamilian, Abdolreza; Showkatbakhsh, Rahman; Behnaz, Mohammad; Ghassemi, Alireza; Kamalee, Zinat; Perillo, Letizia

2018-01-31

Distraction osteogenesis (DO) is rapidly becoming a mainstream surgical technique for correction of maxillary deficiency. The aim of this study was to compare the effectiveness of a newly designed tooth-borne osteogenic distraction device with conventional LeFort 1 osteotomy in maxillary advancement of cleft lip and palate patients. The DO group consisted of 10 subjects (7 males, 3 females) with a mean age of 21.2 (SD 4.2) years. In these patients, the newly designed distraction device which exerted force anteroposteriorly was cemented after mobilization of the maxilla. After a latency period of 7 days, the distractor was activated twice daily by a total amount of 0.5 mm per day. The activation was continued for 3 weeks. After an 8-week consolidation period, the distraction appliance was removed. Cephalograms of DO patients were obtained at the start of distraction and at the end of consolidation. The LeFort 1 group consisted of 11 subjects (6 males, 5 females) with a mean age of 22.3 (SD 3.7) years. Pre and post-surgery lateral cephalograms were obtained. T-Test and paired T-test were used to evaluate the data. At the end of treatment, the SNA angle of LeFort 1 patients increased by 5.5° (SD 2.3) (P<0.001) and the SNA angle of DO patients increased by 3.4° (SD 2) (P<0.001). Current evidence suggests that both conventional LeFort 1 and tooth-borne osteogenic distraction device can effectively advance the maxilla forward in patients with cleft lip.

Teens' distracted driving behavior: Prevalence and predictors.

PubMed

Gershon, Pnina; Zhu, Chunming; Klauer, Sheila G; Dingus, Tom; Simons-Morton, Bruce

2017-12-01

Teen drivers' over-involvement in crashes has been attributed to a variety of factors, including distracted driving. With the rapid development of in-vehicle systems and portable electronic devices, the burden associated with distracted driving is expected to increase. The current study identifies predictors of secondary task engagement among teenage drivers and provides basis for interventions to reduce distracted driving behavior. We described the prevalence of secondary tasks by type and driving conditions and evaluated the associations between the prevalence of secondary task engagement, driving conditions, and selected psychosocial factors. The private vehicles of 83 newly-licensed teenage drivers were equipped with Data Acquisition Systems (DAS), which documented driving performance measures, including secondary task engagement and driving environment characteristics. Surveys administered at licensure provided psychosocial measures. Overall, teens engaged in a potentially distracting secondary task in 58% of sampled road clips. The most prevalent types of secondary tasks were interaction with a passenger, talking/singing (no passenger), external distraction, and texting/dialing the cell phone. Secondary task engagement was more prevalent among those with primary vehicle access and when driving alone. Social norms, friends' risky driving behaviors, and parental limitations were significantly associated with secondary task prevalence. In contrast, environmental attributes, including lighting and road surface conditions, were not associated with teens' engagement in secondary tasks. Our findings indicated that teens engaged in secondary tasks frequently and poorly regulate their driving behavior relative to environmental conditions. Practical applications: Peer and parent influences on secondary task engagement provide valuable objectives for countermeasures to reduce distracted driving among teenage drivers. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Multi-modal distraction. Using technology to combat pain in young children with burn injuries.

PubMed

Miller, Kate; Rodger, Sylvia; Bucolo, Sam; Greer, Ristan; Kimble, Roy M

2010-08-01

The use of non-pharmacological pain management remains adhoc within acute paediatric burns pain management protocols despite ongoing acknowledgement of its role. Advancements in adult based pain services including the integration of virtual reality has been adapted to meet the needs of children in pain, as exemplified by the development of multi-modal distraction (MMD). This easy to use, hand held interactive device uses customized programs designed to inform the child about the procedure he/she is about to experience and to distract the child during dressing changes. (1) To investigate if either MMD procedural preparation (MMD-PP) or distraction (MMD-D) has a greater impact on child pain reduction compared to standard distraction (SD) or hand held video game distraction (VG), (2) to understand the impact of MMD-PP and MMD-D on clinic efficiency by measuring length of treatment across groups, and lastly, (3) to assess the efficacy of distraction techniques over three dressing change procedures. A prospective randomised control trial was completed in a paediatric tertiary hospital Burns Outpatient Clinic. Eighty participants were recruited and studied over their first three dressing changes. Pain was assessed using validated child report, caregiver report, nursing observation and physiological measures. MMD-D and MMD-PP were both shown to significantly relieve reported pain (p

Associations of distraction involvement and age with driver injury severities.

PubMed

Donmez, Birsen; Liu, Zishu

2015-02-01

This paper investigates the associations between the severity of injuries sustained by a driver who is involved in a two-vehicle crash, the existence and type of driver distraction as well as driver's age. Few studies investigated distraction as it relates to injury severity. Moreover, these studies did not consider driver age which is a significant factor related to driving behavior and the ability to respond in a crash situation. An ordered logit model was built to predict injury severity sustained by drivers using data from the U.S. National Automotive Sampling System's General Estimates System (2003 to 2008). Various factors (e.g., weather, gender, and speeding) were statistically controlled for, but the main focus was on the interaction of driver age and distraction type. The trends observed for young and mid-age drivers were similar. For these age groups, dialing or texting on the cell phone, passengers, and in-vehicle sources resulted in an increase in a likelihood of more severe injuries. Talking on the cell phone had a similar effect for younger drivers but was not significant for mid-age drivers. Inattention and distractions outside the vehicle decreased the odds of severe injuries. For older drivers, the highest odds of severe injuries were observed with dialing or texting on a cell phone, followed by in-vehicle sources and talking on the cell phone. All these sources were associated with an increased likelihood of injury severity. Similar to young and mid-age drivers, distractions outside the vehicle decreased the odds of severe injuries. Other distraction types did not have a significant effect for the older age group. The results support previous literature and extend our understanding of crash injury severity. The findings have implications for policy making and the design of distraction mitigation systems. Copyright © 2014 National Safety Council and Elsevier Ltd. All rights reserved.

Impact of Distracted Driving on Safety and Traffic Flow

PubMed Central

Stavrinos, Despina; Jones, Jennifer L.; Garner, Annie A.; Griffin, Russell; Franklin, Crystal A.; Ball, David; Welburn, Sharon C.; Ball, Karlene K.; Sisiopiku, Virginia P.; Fine, Philip R.

2015-01-01

Studies have documented a link between distracted driving and diminished safety; however, an association between distracted driving and traffic congestion has not been investigated in depth. The present study examined the behavior of teens and young adults operating a driving simulator while engaged in various distractions (i.e., cell phone, texting, and undistracted) and driving conditions (i.e., free flow, stable flow, and oversaturation). Seventy five participants 16 to 25 years of age (split into 2 groups: novice drivers and young adults) drove a STISIM simulator three times, each time with one of three randomly presented distractions. Each drive was designed to represent daytime scenery on a 4 lane divided roadway and included three equal roadway portions representing Levels of Service (LOS) A, C, and E as defined in the 2000 Highway Capacity Manual. Participants also completed questionnaires documenting demographics and driving history. Both safety and traffic flow related driving outcomes were considered. A Repeated Measures Multivariate Analysis of Variance was employed to analyze continuous outcome variables and a Generalized Estimate Equation (GEE) poisson model was used to analyze count variables. Results revealed that, in general more lane deviations and crashes occurred during texting. Distraction (in most cases, text messaging) had a significantly negative impact on traffic flow, such that participants exhibited greater fluctuation in speed, changed lanes significantly fewer times, and took longer to complete the scenario. In turn, more simulated vehicles passed the participant drivers while they were texting or talking on a cell phone than while undistracted. The results indicate that distracted driving, particularly texting, may lead to reduced safety and traffic flow, thus having a negative impact on traffic operations. No significant differences were detected between age groups, suggesting that all drivers, regardless of age, may drive in a manner that impacts safety and traffic flow negatively when distracted. PMID:23465745

Impact of distracted driving on safety and traffic flow.

PubMed

Stavrinos, Despina; Jones, Jennifer L; Garner, Annie A; Griffin, Russell; Franklin, Crystal A; Ball, David; Welburn, Sharon C; Ball, Karlene K; Sisiopiku, Virginia P; Fine, Philip R

2013-12-01

Studies have documented a link between distracted driving and diminished safety; however, an association between distracted driving and traffic congestion has not been investigated in depth. The present study examined the behavior of teens and young adults operating a driving simulator while engaged in various distractions (i.e., cell phone, texting, and undistracted) and driving conditions (i.e., free flow, stable flow, and oversaturation). Seventy five participants 16-25 years of age (split into 2 groups: novice drivers and young adults) drove a STISIM simulator three times, each time with one of three randomly presented distractions. Each drive was designed to represent daytime scenery on a 4 lane divided roadway and included three equal roadway portions representing Levels of Service (LOS) A, C, and E as defined in the 2000 Highway Capacity Manual. Participants also completed questionnaires documenting demographics and driving history. Both safety and traffic flow related driving outcomes were considered. A Repeated Measures Multivariate Analysis of Variance was employed to analyze continuous outcome variables and a Generalized Estimate Equation (GEE) Poisson model was used to analyze count variables. Results revealed that, in general more lane deviations and crashes occurred during texting. Distraction (in most cases, text messaging) had a significantly negative impact on traffic flow, such that participants exhibited greater fluctuation in speed, changed lanes significantly fewer times, and took longer to complete the scenario. In turn, more simulated vehicles passed the participant drivers while they were texting or talking on a cell phone than while undistracted. The results indicate that distracted driving, particularly texting, may lead to reduced safety and traffic flow, thus having a negative impact on traffic operations. No significant differences were detected between age groups, suggesting that all drivers, regardless of age, may drive in a manner that impacts safety and traffic flow negatively when distracted. Copyright © 2013 Elsevier Ltd. All rights reserved.

The presence of nonthoracic distracting injuries does not affect the initial clinical examination of the cervical spine in evaluable blunt trauma patients: a prospective observational study.

PubMed

Konstantinidis, Agathoklis; Plurad, David; Barmparas, Galinos; Inaba, Kenji; Lam, Lydia; Bukur, Marko; Branco, Bernardino C; Demetriades, Demetrios

2011-09-01

A distracting injury mandates cervical spine (c-spine) imaging in the evaluable blunt trauma patient who demonstrates no pain or tenderness over the c-spine. The purpose of this study was to examine which distracting injuries can negatively affect the sensitivity of the standard clinical examination of the c-spine. This is a prospective observational study conducted at a Level I Trauma Center from January 1, 2008, to December 31, 2009. After institutional review board approval, all evaluable (Glasgow Coma Scale score ≥13) blunt trauma patients older than 16 years sustaining a c-spine injury were enrolled. A distracting injury was defined as any immediately evident bony or soft tissue injury or a complaint of non-c-spine pain whether or not an actual injury was subsequently diagnosed. Information regarding the initial clinical examination and the presence of a distracting injury was collected from the senior resident or attending trauma surgeon involved in the initial management. During the study period, 101 evaluable patients sustained a c-spine injury. Distracting injuries were present in 88 patients (87.1%). The most common was rib fracture (21.6%), followed by lower extremity fracture (20.5%) and upper extremity fracture (12.5%). Only four (4.0%) patients had no pain or tenderness on the initial examination of the c-spine. All four patients had bruising and tenderness to the upper anterior chest. None of these four patients developed neurologic sequelae or required a surgical stabilization or immobilization. C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. Further definition of distracting injuries is mandated to avoid unnecessary utilization of resources and to reduce the imaging burden associated with the evaluation of the c-spine.

Reconstruction of juxta-articular huge defects of distal femur with vascularized fibular bone graft and Ilizarov's distraction osteogenesis.

PubMed

Lai, Davy; Chen, Chuan-Mu; Chiu, Fang-Yao; Chang, Ming-Chau; Chen, Tain-Hsiung

2007-01-01

We evaluate the effect of reconstructing huge defects (mean, 15.8 cm) of the distal femur with Ilizarov's distraction osteogenesis and free twin-barreled vascularized fibular bone graft (TVFG). We retrospectively reviewed a consecutive series of five patients who had cases of distal femoral fractures with huge defects and infection that were treated by the Ilizarov's distraction osteogenesis. After radical debridement, two of the five cases had free TVFG and monolocal distraction osteogenesis, and another two cases had multilocal distraction osteogenesis with knee fusion because of loss of the joint congruity. The other case with floating knee injury had bilocal distraction osteogenesis and a preserved knee joint. The mean defect of distal femur was 15.8 cm (range, 14-18 cm) in length. The mean length of distraction osteogenesis by Ilizarov's apparatus was 8.2 cm. The mean length of TVFG was 8 cm. The average duration from application of Ilizarov's apparatus to achievement of bony union was 10.2 months (range, 8-13 months). At the end of the follow-up, ranges of motion of three knees were 0 to 45 degrees, 0 to 60 degrees, and 0 to 90 degrees. Two cases had knee arthrodesis with bony fusion because of loss of the joint congruity. There were no leg length discrepancies in all five patients. In addition, three patients had pin tract infections and one case had a 10 degree varus deformity of the femur. Juxta-articular huge defect (>10 cm) of distal femur remains a challenge to orthopedic surgeons. Ilizarov's technique provides the capability to maintain stability, eradicate infection, restore leg length, and to perform adjuvant reconstructive procedure easily. In this study, we found that combining Ilizarov's distraction osteogenesis with TVFG results in improved patient outcome for patients with injuries such as supracondylar or intercondylar infected fractures or nonunion of distal femur with huge bone defect.

Condylar cartilaginous changes after mandibular distraction osteogenesis in rabbits.

PubMed

Ahn, Sin-Young; Kim, Su-Gwan

2011-10-01

The purpose of this study was to evaluate histologic and immunohistochemical changes in the condylar articular surface in response to distraction osteogenesis (DO) of the mandibular body in rabbits. A unilateral osteotomy of the mandible at the premolar area was performed in 16 rabbits. The animals were divided into 4 groups based on different distraction parameters (rate and rhythm). After a 5-day latency, the mandible was lengthened by 0.5 mm daily for 6 days (group 1); 0.5 mm twice daily for 3 days (group 2); 0.5 mm once daily for 10 days (group 3); or 0.5 mm twice daily for 5 days (group 4). All 4 groups underwent a 14-day consolidation period. Four rabbits were included in the control group. The specimens were stained with hematoxylin-eosin for histologic examination. Immunohistochemical analysis was performed to evaluate the expression of growth factors. None of the groups demonstrated any degenerative changes in the temporomandibular joint (TMJ). On the distraction side in all groups, the histopathological examination revealed a hypertrophic thickening of the cartilage zone. Prominent endochondral ossification and high active osteoblasts were observed in groups 3 and 4. On the nondistraction side, no major changes were observed excluding the appearance of osteoclasts in groups 3 and 4. The immunohistochemical analysis revealed tenascin immunoreactivity in bone marrow mesenchymal cells on the distraction side in group 4. Connexin immunoreactivity did not display a marked change in any of the groups. Osteocalcin was observed on the distraction side in group 2, which suggested that bone formation is increased. Nitric oxide synthase 2 immunoreactivity was observed on the distraction side in group 2, which is associated with stress and inflammation. The results indicated that the hypertrophy of the cartilage zone and endochondral ossification became more pronounced as the extent and rate of distraction increased. Copyright © 2011 Mosby, Inc. All rights reserved.

Blinded by taboo words in L1 but not L2.

PubMed

Colbeck, Katie L; Bowers, Jeffrey S

2012-04-01

The present study compares the emotionality of English taboo words in native English speakers and native Chinese speakers who learned English as a second language. Neutral and taboo/sexual words were included in a Rapid Serial Visual Presentation (RSVP) task as to-be-ignored distracters in a short- and long-lag condition. Compared with neutral distracters, taboo/sexual distracters impaired the performance in the short-lag condition only. Of critical note, however, is that the performance of Chinese speakers was less impaired by taboo/sexual distracters. This supports the view that a first language is more emotional than a second language, even when words are processed quickly and automatically. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Effects of distraction on negative behaviors and salivary α-amylase under mildly stressful medical procedures for brief inpatient children.

PubMed

Tsumura, Hideki; Shimada, Hironori; Morimoto, Hiroshi; Hinuma, Chihiro; Kawano, Yoshiko

2014-08-01

Inconsistent results have been reported on the effects of distraction on negative emotions during medical procedures in infants. These differing results may be attributable to the fact that the effects are apparent under a mildly stressful medical procedure. A total of 17 infants, 18 preschoolers, and 15 school-aged children who were hospitalized were administered, monitoring for vital signs, a mildly stressful medical procedure, by a nurse in a uniform with attractive character designs as a distractor. Consistent with the hypothesis, participating infants showed fewer negative behaviors and lower salivary α-amylase levels when distracted. The results support the efficacy of distraction in infants under a mildly stressful medical procedure. © The Author(s) 2013.

Nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly.

PubMed

Patterson, Ryan W; Seitz, William H

2010-04-01

Symbrachydactyly describes a spectrum of congenital hand differences consisting of digital loss resulting in fused short fingers. As the principles for distraction lengthening have evolved, the technique of nonvascularized toe phalangeal transfer to the hand with shortened digits has provided patients with improved outcomes. Nonvascularized toe phalanx to hand transplant with distraction lengthening restores functional length to a skeletally deficient, poorly functioning hand while maintaining an overlying layer of vascular and sensate tissue. The primary goal is improvement of digital length to enhance mechanical advantage and prehension. We describe the technique of nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly, including the following steps: nonvascularized proximal toe phalanx harvest, toe phalanx transfer to hand, pin placement, osteotomy, and closure.

Bilateral Distraction Osteogenesis of Vascularized Iliac Crest Free Flaps Used in Mandibular Reconstruction

PubMed Central

Subramaniam, Shiva S.; Vujcich, Nathan J.; Nastri, Alf L.

2016-01-01

Summary: Vascularized free flaps have become the gold standard in reconstructing large segmental mandibular defects; however, even when bony union and soft-tissue coverage is achieved, insufficient bone stock and altered facial contour can create functional and cosmetic problems for the patient. There have been limited case reports on the use of secondary distraction osteogenesis to address these issues. The authors report a case of bilateral mandibular distraction of deep circumflex iliac artery free flaps, used for mandibular reconstruction after total mandibulectomy for treatment of osteosarcoma. Performed for reasons of retrognathia and facilitation of dental prosthetic rehabilitation, this is the first case of bilateral horizontal distraction osteogenesis of deep circumflex iliac artery free flaps reported in the literature. PMID:27257565

Effects of advertising billboards during simulated driving.

PubMed

Edquist, Jessica; Horberry, Tim; Hosking, Simon; Johnston, Ian

2011-05-01

There is currently a great deal of interest in the problem of driver distraction. Most research focuses on distractions from inside the vehicle, but drivers can also be distracted by objects outside the vehicle. Major roads are increasingly becoming sites for advertising billboards, and there is little research on the potential effects of this advertising on driving performance. The driving simulator experiment presented here examines the effects of billboards on drivers, including older and inexperienced drivers who may be more vulnerable to distractions. The presence of billboards changed drivers' patterns of visual attention, increased the amount of time needed for drivers to respond to road signs, and increased the number of errors in this driving task. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Reconstruction of a Post Traumatic Anterior Maxillary Defect by Transport Distraction Osteogenesis.

PubMed

Rajkumar, K; Neelakandan, R S; Devadoss, Pradeep; Bandyopadhyay, T K

2017-03-01

Rehabilitation of segmental defects of maxilla presents a reconstructive challenge to obtain an ideal osseous form and height with adequate soft tissue investment. Though variety of prosthetic and surgical reconstructive options like the use of vascularized and non vascularized bone grafts are available they produce less than optimal results. Bone transport distraction is a reliable procedure in various maxillofacial bony defect reconstruction techniques. We describe herein a technique of maxillary bone transport distraction using an indigenously designed, custom made trifocal transport distractor performed in a post traumatic avulsive defect of the anterior maxilla. Transport distraction was successful for anterior maxillary alveolar bony regeneration, with excellent soft tissue cover and vestibular depth, which also helped close an oroantral/oronasal fistula.

Effects of road infrastructure and traffic complexity in speed adaptation behaviour of distracted drivers.

PubMed

Oviedo-Trespalacios, Oscar; Haque, Md Mazharul; King, Mark; Washington, Simon

2017-04-01

The use of mobile phones while driving remains a major human factors issue in the transport system. A significant safety concern is that driving while distracted by a mobile phone potentially modifies the driving speed leading to conflicts with other road users and consequently increases crash risk. However, the lack of systematic knowledge of the mechanisms involved in speed adaptation of distracted drivers constrains the explanation and modelling of the extent of this phenomenon. The objective of this study was to investigate speed adaptation of distracted drivers under varying road infrastructure and traffic complexity conditions. The CARRS-Q Advanced Driving Simulator was used to test participants on a simulated road with different traffic conditions, such as free flow traffic along straight roads, driving in urbanized areas, and driving in heavy traffic along suburban roads. Thirty-two licensed young drivers drove the simulator under three phone conditions: baseline (no phone conversation), hands-free and handheld phone conversations. To understand the relationships between distraction, road infrastructure and traffic complexity, speed adaptation calculated as the deviation of driving speed from the posted speed limit was modelled using a decision tree. The identified groups of road infrastructure and traffic characteristics from the decision tree were then modelled with a Generalized Linear Mixed Model (GLMM) with repeated measures to develop inferences about speed adaptation behaviour of distracted drivers. The GLMM also included driver characteristics and secondary task demands as predictors of speed adaptation. Results indicated that complex road environments like urbanization, car-following situations along suburban roads, and curved road alignment significantly influenced speed adaptation behaviour. Distracted drivers selected a lower speed while driving along a curved road or during car-following situations, but speed adaptation was negligible in the presence of high visual cutter, indicating the prioritization of the driving task over the secondary task. Additionally, drivers who scored high on self-reported safe attitudes towards mobile phone usage, and who reported prior involvement in a road traffic crash, selected a lower driving speed in the distracted condition than in the baseline. The results aid in understanding how driving task demands influence speed adaptation of distracted drivers under various road infrastructure and traffic complexity conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Temporal changes in cortical activation during distraction from pain: a comparative LORETA study with conditioned pain modulation.

PubMed

Moont, Ruth; Crispel, Yonatan; Lev, Rina; Pud, Dorit; Yarnitsky, David

2012-01-30

Methods to cognitively distract subjects from pain and experimental paradigms to induce conditioned pain modulation (CPM; formerly termed diffuse noxious inhibitory controls or DNIC) have each highlighted activity changes in closely overlapping cortical areas. This is the first study, to our knowledge, to compare cortical activation changes during these 2 manipulations in the same experimental set-up. Our study sample included thirty healthy young right handed males capable of expressing CPM. We investigated brief consecutive time windows using 32-channel EEG-based sLORETA, to determine dynamic changes in localized cortical potentials evoked by phasic noxious heat stimuli to the left volar forearm. This was performed under visual cognitive distraction tasks and conditioning hot-water pain to the right hand (CPM), both individually and simultaneously. Previously we have shown that for CPM, there is increased activity in frontal cortical regions followed by reduced activation of the somatosensory areas, suggesting a pain inhibitory role for these frontal regions. We now observed that distraction caused a different extent of cortical activation; greater early activation of frontal areas (DLPFC, OFC and caudal ACC at 250-350 ms post-stimulus), yet lesser reduction in the somatosensory cortices, ACC, PCC and SMA after 350 ms post-stimulus, compared to CPM. Both CPM and distraction reduced subjective pain scores to a similar extent. Combining CPM and distraction further reduced pain ratings compared to CPM and distraction alone, supporting the dissimilarity of the mechanisms of pain modulation under these 2 manipulations. The results are discussed in terms of the differential functional roles of the prefrontal cortex. Copyright © 2011 Elsevier B.V. All rights reserved.

Preventing distracted driving among college students: Addressing smartphone use.

PubMed

Hassani, Sahar; Kelly, Erin H; Smith, Jennifer; Thorpe, Sara; Sozzer, Fatima H; Atchley, Paul; Sullivan, Elroy; Larson, Dean; Vogel, Lawrence C

2017-02-01

Based on the National Highway Traffic Safety Association's (NHTSA) Report, fatalities due to distracted driving are on the rise and the highest proportion of fatalities by age group is the 20-29 year old category. To date little has been done to educate college students about the dangers of distracted driving and engage these students in promoting a safe driving culture. Intervening among college students has the potential for making real-time behavior change, can foster a lifetime of safe driving habits among these students, and can help contribute to a culture of safe driving that can be created and sustained through positive messages from peers. The goals of this study were to develop, implement and evaluate a distracted driving presentation for college students to change knowledge, attitude and behavior on distracted driving. A 30-min, multi-media presentation on distracted driving was presented to 19 colleges and universities, totaling 444 college students (mean age 23.7±7.0 years of age, 61% females, 39% males). Students completed three surveys: prior to the workshop (interview 1), immediately after the workshop (interview 2), and 3 months following the workshop (interview 3). We assessed changes between interview 1 and interview 2 and found 15 of the 15 attitude-knowledge based questions significantly improved after the course. In addition, we assessed changes from interviews 1 and 3, and found 11 of the 15 attitude-knowledge based questions maintained their significance. Responses to behavior related questions at three months were also compared to baseline, and significant improvements were found for 12 of the 14 questions. While this study was successful in improving the short-term attitude-knowledge and behaviors on distracted driving, work is needed to sustain (and evaluate) long-term effects. Copyright © 2016 Elsevier Ltd. All rights reserved.

Creating the environment for driver distraction: A thematic framework of sociotechnical factors.

PubMed

Parnell, Katie J; Stanton, Neville A; Plant, Katherine L

2018-04-01

As modern society becomes more reliant on technology, its use within the vehicle is becoming a concern for road safety due to both portable and built-in devices offering sources of distraction. While the effects of distracting technologies are well documented, little is known about the causal factors that lead to the drivers' engagement with technological devices. The relevance of the sociotechnical system within which the behaviour occurs requires further research. This paper presents two experiments, the first aims to assess the drivers self-reported decision to engage with technological tasks while driving and their reasoning for doing so with respect to the wider sociotechnical system. This utilised a semi-structured interview method, conducted with 30 drivers to initiate a discussion on their likelihood of engaging with 22 different tasks across 7 different road types. Inductive thematic analysis provided a hierarchical thematic framework that detailed the self-reported causal factors that influence the drivers' use of technology whilst driving. The second experiment assessed the relevance of the hierarchical framework to a model of distraction that was established from within the literature on the drivers use of distracting technologies while driving. The findings provide validation for some relationships studied in the literature, as well as providing insights into relationships that require further study. The role of the sociotechnical system in the engagement of distractions while driving is highlighted, with the causal factors reported by drivers suggesting the importance of considering the wider system within which the behaviour is occurring and how it may be creating the conditions for distraction to occur. This supports previous claims made within the literature based model. Recommendations are proposed that encourage a movement away from individual focused countermeasures towards systemic actors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neural Correlates of Opposing Effects of Emotional Distraction on Perception and Episodic Memory: An Event-Related fMRI Investigation

PubMed Central

Shafer, Andrea T.; Dolcos, Florin

2012-01-01

A main question in emotion and memory literature concerns the relationship between the immediate impact of emotional distraction on perception and the long-term impact of emotion on memory. While previous research shows both automatic and resource-mediated mechanisms to be involved in initial emotion processing and memory, it remains unclear what the exact relationship between the immediate and long-term effects is, and how this relationship may change as a function of manipulations at perception favoring the engagement of either more automatic or mediated mechanisms. Using event-related functional magnetic resonance imaging, we varied the degree of resource availability for processing task-irrelevant emotional information, to determine how the initial (impairing) impact of emotional distraction related to the long-term (enhancing) impact of emotion on memory. Results showed that a direct relationship between emotional distraction and memory was dependent on automatic mechanisms, as this was found only under conditions of limited resource availability and engagement of amygdala (AMY)-hippocampal (HC) mechanisms to both impairing and enhancing effects. A hemispheric disassociation was also identified in AMY-HC, where while both sides were associated with emotional distraction and left AMY and anterior HC were linked to emotional memory, functional asymmetry was only identified in the posterior HC, with only the left side contributing to emotional memory. Finally, areas dissociating between the two opposing effects included the medial frontal, precentral, superior temporal, and middle occipital gyri (linked to emotional distraction), and the superior parietal cortex (linked to emotional memory). These findings demonstrate the relationship between emotional distraction and memory is context dependent and that specific brain regions may be more or less susceptible to the direction of emotional modulation (increased or decreased), depending on the task manipulation, and processes investigated. PMID:23049502

Interaction between object-based attention and pertinence values shapes the attentional priority map of a multielement display.

PubMed

Gillebert, Celine R; Petersen, Anders; Van Meel, Chayenne; Müller, Tanja; McIntyre, Alexandra; Wagemans, Johan; Humphreys, Glyn W

2016-06-01

Previous studies have shown that the perceptual organization of the visual scene constrains the deployment of attention. Here we investigated how the organization of multiple elements into larger configurations alters their attentional weight, depending on the "pertinence" or behavioral importance of the elements' features. We assessed object-based effects on distinct aspects of the attentional priority map: top-down control, reflecting the tendency to encode targets rather than distracters, and the spatial distribution of attention weights across the visual scene, reflecting the tendency to report elements belonging to the same rather than different objects. In 2 experiments participants had to report the letters in briefly presented displays containing 8 letters and digits, in which pairs of characters could be connected with a line. Quantitative estimates of top-down control were obtained using Bundesen's Theory of Visual Attention (1990). The spatial distribution of attention weights was assessed using the "paired response index" (PRI), indicating responses for within-object pairs of letters. In Experiment 1, grouping along the task-relevant dimension (targets with targets and distracters with distracters) increased top-down control and enhanced the PRI; in contrast, task-irrelevant grouping (targets with distracters) did not affect performance. In Experiment 2, we disentangled the effect of target-target and distracter-distracter grouping: Pairwise grouping of distracters enhanced top-down control whereas pairwise grouping of targets changed the PRI. We conclude that object-based perceptual representations interact with pertinence values (of the elements' features and location) in the computation of attention weights, thereby creating a widespread pattern of attentional facilitation across the visual scene. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Impact of social and technological distraction on pedestrian crossing behaviour: an observational study

PubMed Central

Thompson, Leah L; Rivara, Frederick P; Ayyagari, Rajiv C; Ebel, Beth E

2013-01-01

Objectives The objective of the present work was to study the impact of technological and social distraction on cautionary behaviours and crossing times in pedestrians. Methods Pedestrians were observed at 20 high-risk intersections during 1 of 3 randomly assigned time windows in 2012. Observers recorded demographic and behavioural information, including use of a mobile device (talking on the phone, text messaging, or listening to music). We examined the association between distraction and crossing behaviours, adjusting for age and gender. All multivariate analyses were conducted with random effect logistic regression (binary outcomes) and random effect linear regression (continuous outcomes), accounting for clustering by site. Results Observers recorded crossing behaviours for 1102 pedestrians. Nearly one-third (29.8%) of all pedestrians performed a distracting activity while crossing. Distractions included listening to music (11.2%), text messaging (7.3%) and using a handheld phone (6.2%). Text messaging, mobile phone use and talking with a companion increased crossing time. Texting pedestrians took 1.87 additional seconds (18.0%) to cross the average intersection (3.4 lanes), compared to undistracted pedestrians. Texting pedestrians were 3.9 times more likely than undistracted pedestrians to display at least 1 unsafe crossing behaviour (disobeying the lights, crossing mid-intersection, or failing to look both ways). Pedestrians listening to music walked more than half a second (0.54) faster across the average intersection than undistracted pedestrians. Conclusions Distracting activity is common among pedestrians, even while crossing intersections. Technological and social distractions increase crossing times, with text messaging associated with the highest risk. Our findings suggest the need for intervention studies to reduce risk of pedestrian injury. PMID:23243104

Using event-triggered naturalistic data to examine the prevalence of teen driver distractions in rear-end crashes.

PubMed

Carney, Cher; Harland, Karisa K; McGehee, Daniel V

2016-06-01

While teen driver distraction is cited as a leading cause of crashes, especially rear-end crashes, little information is available regarding its true prevalence. The majority of distraction studies rely on data derived from police reports, which provide limited information regarding driver distraction. This study examined over 400 teen driver rear-end crashes captured by in-vehicle event recorders. A secondary data analysis was conducted, paying specific attention to driver behaviors, eyes-off-road time, and response times to lead-vehicle braking. Among teens in moderate to severe rear-end crashes, over 75% of drivers were observed engaging in a potentially distracting behavior. The most frequently seen driver behaviors were cell phone use, attending to a location outside the vehicle, and attending to passengers. Drivers using a cell phone had a significantly longer response time than drivers not engaged in any behaviors, while those attending to passengers did not. Additionally, in about 50% of the rear-end crashes where the driver was operating/looking at a phone (e.g., texting), the driver showed no driver response (i.e., braking or steering input) before impact, compared to 10% of crashes where the driver was attending to a passenger. The high frequency of attending to passengers and use of a cell phone leading up to a crash, compounded with the associated risks, underlines the importance of continued investigation in these areas. Parents and teens must be educated regarding the frequency of and the potential effects of distractions. Additional enforcement may be necessary if Graduated Driver Licensing (GDL) programs are to be effective. Systems that alert distracted teens could also be especially helpful in reducing rear-end collisions. Copyright © 2016 Elsevier Ltd and National Safety Council. All rights reserved.

Posterior distraction reduction and occipitocervical fixation for the treatment of basilar invagination and atlantoaxial dislocation.

PubMed

Meng, Yang; Chen, Hua; Lou, Jigang; Rong, Xin; Wang, Beiyu; Deng, Yuxiao; Ding, Chen; Hong, Ying; Liu, Hao

2016-01-01

To introduce a novel distraction technique for the treatment of basilar invagination (BI) and atlantoaxial dislocation (AAD) via a posterior-only approach. Twenty-one consecutive patients with BI and AAD who underwent posterior distraction reduction and occipitocervical fixation between January 2009 and June 2013 were enrolled in the present study. This novel distraction technique included two steps. First, the distraction between the occipitocervical junction of the rod (OCJR) and the occipital screws was performed to achieve horizontal and partial vertical reduction. Secondly, the distraction was performed between the C2 screws and OCJR to achieve complete vertical reduction. The pre- and postoperative JOA score, the extent of reduction, the fusion status, and the complications were recorded and analyzed. The mean follow-up was 18.3 months with a range of 10-32 months. No patient incurred neurovascular injury during surgery. The mean JOA score at the last follow-up (15.4) showed significant improvement (P<0.01) compared with the pre-operative parameters (11.2). Complete horizontal reduction was achieved in 18 patients (85.7%), and complete vertical reduction was achieved in 17 patients (80.9%). The rest patients are all received greater than 50% horizontal and vertical reduction. Solid fusion was achieved in 20 patients (95.2%). Mild dysphagia was observed in two patients. One patient suffered from postoperative fever and pulmonary infection. This novel distraction technique may provide satisfactory reduction via a posterior-only approach without exposure of the C1/2 facet joint. Therefore, it is a safe and effective method for the treatment of BI with AAD. Copyright © 2015 Elsevier B.V. All rights reserved.

Joint distraction attenuates osteoarthritis by reducing secondary inflammation, cartilage degeneration and subchondral bone aberrant change.

PubMed

Chen, Y; Sun, Y; Pan, X; Ho, K; Li, G

2015-10-01

Osteoarthritis (OA) is a progressive joint disorder. To date, there is not effective medical therapy. Joint distraction has given us hope for slowing down the OA progression. In this study, we investigated the benefits of joint distraction in OA rat model and the probable underlying mechanisms. OA was induced in the right knee joint of rats through anterior cruciate ligament transaction (ACLT) plus medial meniscus resection. The animals were randomized into three groups: two groups were treated with an external fixator for a subsequent 3 weeks, one with and one without joint distraction; and one group without external fixator as OA control. Serum interleukin-1β level was evaluated by ELISA; cartilage quality was assessed by histology examinations (gross appearance, Safranin-O/Fast green stain) and immunohistochemistry examinations (MMP13, Col X); subchondral bone aberrant changes was analyzed by micro-CT and immunohistochemistry (Nestin, Osterix) examinations. Characters of OA were present in the OA group, contrary to in general less severe damage after distraction treatment: firstly, IL-1β level was significantly decreased; secondly, cartilage degeneration was attenuated with lower histologic damage scores and the lower percentage of MMP13 or Col X positive chondrocytes; finally, subchondral bone abnormal change was attenuated, with reduced bone mineral density (BMD) and bone volume/total tissue volume (BV/TV) and the number of Nestin or Osterix positive cells in the subchondral bone. In the present study, we demonstrated that joint distraction reduced the level of secondary inflammation, cartilage degeneration and subchondral bone aberrant change, joint distraction may be a strategy for slowing OA progression. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Airway and Feeding Outcomes of Mandibular Distraction, Tongue-Lip Adhesion, and Conservative Management in Pierre Robin Sequence: A Prospective Study.

PubMed

Khansa, Ibrahim; Hall, Courtney; Madhoun, Lauren L; Splaingard, Mark; Baylis, Adriane; Kirschner, Richard E; Pearson, Gregory D

2017-04-01

Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospectively evaluate the airway and feeding outcomes of their comprehensive approach to Pierre Robin sequence, which includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion. A longitudinal study of newborns with Pierre Robin sequence treated at a pediatric academic medical center between 2010 and 2015 was performed. Baseline feeding and respiratory data were collected. Patients underwent conservative management if they demonstrated sustainable weight gain without tube feeds, and if their airway was stable with positioning alone. Patients who required surgery underwent tongue-lip adhesion or mandibular distraction osteogenesis based on family and surgeon preference. Postoperative airway and feeding data were collected. Twenty-eight patients with Pierre Robin sequence were followed prospectively. Thirty-two percent had a syndrome. Ten underwent mandibular distraction osteogenesis, eight underwent tongue-lip adhesion, and 10 were treated conservatively. There were no differences in days to extubation or discharge, change in weight percentile, requirement for gastrostomy tube, or residual obstructive sleep apnea between the three groups. No patients required tracheostomy. The greatest reduction in apnea-hypopnea index occurred with mandibular distraction osteogenesis, followed by tongue-lip adhesion and conservative management. Careful selection of which patients with Pierre Robin sequence need surgery, and of the most appropriate surgical procedure for each patient, can minimize the need for postprocedure tracheostomy. A comprehensive approach to Pierre Robin sequence that includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion can result in excellent airway and feeding outcomes. Therapeutic, II.

Soft-tissue volumetric changes following monobloc distraction procedure: analysis using digital three-dimensional photogrammetry system (3dMD).

PubMed

Chan, Fuan Chiang; Kawamoto, Henry K; Federico, Christina; Bradley, James P

2013-03-01

We have previously reported that monobloc advancement by distraction osteogenesis resulted in decreased morbidity and greater advancement with less relapse compared with acute monobloc advancement with bone grafting. In this study, we examine the three-dimensional (3D) volumetric soft-tissue changes in monobloc distraction.Patients with syndromic craniosynostosis who underwent monobloc distraction from 2002 to 2010 at University of California-Los Angeles Craniofacial Center were studied (n = 12). We recorded diagnosis, indications for the surgery, and volumetric changes for skeletal and soft-tissue midface structures (preoperative/postoperative [6 weeks]/follow-up [>1 year]). Computed tomography scans and a digital 3D photogrammetry system were used for image analysis.Patients ranged from 6 to 14 years of age (mean, 10.1 years) at the time of the operation (follow-up 2-11 years); mean distraction advancement was 19.4 mm (range, 14-25 mm). There was a mean increase in the 3D volumetric soft-tissue changes: 99.5 ± 4.0 cm(3) (P < 0.05) at 6 weeks and 94.9 ± 3.6 cm(3) (P < 0.05) at 1-year follow-up. When comparing soft-tissue changes at 6 weeks postoperative to 1-year follow-up, there were minimal relapse changes. The overall mean 3D skeletal change was 108.9 ± 4.2 cm. For every 1 cm of skeletal gain, there was 0.78 cm(3) of soft-tissue gain.Monobloc advancement by distraction osteogenesis using internal devices resulted in increased volumetric soft-tissue changes, which remained stable at 1 year. The positive linear correlation between soft-tissue increments and bony advancement can be incorporated during the planning of osteotomies to achieve optimum surgical outcomes with monobloc distraction.

The biomechanical effects of limb lengthening and botulinum toxin type A on rabbit tendon.

PubMed

Olabisi, Ronke M; Best, Thomas M; Hurschler, Christof; Vanderby, Ray; Noonan, Kenneth J

2010-12-01

Numerous studies have examined the effects of distraction osteogenesis (DO) on bone, but relatively fewer have explored muscle adaptation, and even less have addressed the concomitant alterations that occur in the tendon. The purpose herein was to characterize the biomechanical properties of normal and elongated rabbit (N = 20) tendons with and without prophylactic botulinum toxin type A (BTX-A) treatment. Elastic and viscoelastic properties of Achilles and Tibialis anterior (TA) tendons were evaluated through pull to failure and stress relaxation tests. All TA tendons displayed nonlinear viscoelastic responses that were strain dependent. A power law formulation was used to model tendon viscoelastic responses and tendon elastic responses were fit with a microstructural model. Distraction-elongated tendons displayed increases in compliance and stress relaxation rates over undistracted tendons; BTX-A administration offset this result. The elastic moduli of distraction-lengthened TA tendons were diminished (p = 0.010) when distraction was combined with gastrocnemius (GA) BTX-A administration, elastic moduli were further decreased (p = 0.004) and distraction following TA BTX-A administration resulted in TA tendons with moduli not different from contralateral control (p > 0.05). Compared to contralateral control, distraction and GA BTX-A administration displayed shortened toe regions, (p = 0.031 and 0.038, respectively), while tendons receiving BTX-A in the TA had no differences in the toe region (p > 0.05). Ultimate tensile stress was unaltered by DO, but stress at the transition from the toe to the linear region of the stress-stretch curve was diminished in all distraction-elongated TA tendons (p < 0.05). The data suggest that prophylactic BTX-A treatment to the TA protects some tendon biomechanical properties. Copyright © 2010 Elsevier Ltd. All rights reserved.

Psychological Interventions for Vaccine Injections in Young Children 0 to 3 Years

PubMed Central

Pillai Riddell, Rebecca; Taddio, Anna; McMurtry, C. Meghan; Chambers, Christine; Shah, Vibhuti; Noel, Melanie

2015-01-01

Background: This systematic review evaluated the effectiveness of distraction for reducing infant distress during vaccinations in young children aged 0 to 3 years. Design/Methods: Database searches identified relevant randomized and quasi-randomized controlled trials. Three separate clinical questions related to variants of the psychological strategy of distraction (directed video; directed toy; nondirected toy) were pursued. Distress was identified as the critical outcome to assess the benefits of distraction and extracted from relevant trials. Distress was analyzed by phase of procedure (distress preprocedure; distress acute; distress recovery; idiosyncratic phases based on some or all of the 3 aforementioned phases). Results: Ten studies were included in the review. Significant results are presented herein. For directed video distraction, moderate quality evidence suggested that distress was lowered in the treatment group standardized mean difference (SMD −0.68 lower [95% confidence interval (CI), −1.04 to −0.32]) for the acute+recovery phase as well as the preprocedure phase (SMD −0.49 lower [95% CI, −7.6 to −0.22]). For directed toy distraction, the analysis of low-quality evidence for a combined preprocedure+acute+recovery phase of distress (analysis n=81), suggested that distress was lowered in the treatment group (SMD −0.47 lower [95% CI, −0.91 to −0.02]). An effect for nondirected toy distraction was also seen, analyzing very–low-quality evidence, for the acute distress phase (n=290; SMD −0.93 lower [95% CI, −1.86 to 0.00]). Conclusion: Generally low-quality to very–low-quality evidence suggests that there may be an effect of directed (toy and video) and nondirected toy distraction for children aged 0 to 3 years, for certain phases of the vaccination. PMID:26201014

Effects of audiovisual distraction on children’s behaviour during dental treatment: a randomized controlled clinical trial

PubMed Central

Al-Khotani, Amal; Bello, Lanre A'aziz; Christidis, Nikolaos

2016-01-01

Abstract Aim: Dental anxiety leads to undesirable distresses such as avoidance of dental treatment and increase stress among caregivers that consequently affect the treatment quality. The aim of this study was therefore to evaluate the effectiveness of viewing videotaped cartoons using an eyeglass system (i-theatre™) as an audiovisual (AV) distraction technique on behaviour and anxiety in children receiving dental restorative treatment. Methods: Fifty-six consecutive children patients who presented for treatment and met inclusion criteria were included and randomly divided into two groups; a control group without distraction (CTR-group) and a distraction-group (AV-group). Three dental treatment visits were provided for each patient. Anxiety and cooperative behaviour were assessed with the Facial Image Scale (FIS) and the Modified Venham’s clinical ratings of anxiety and cooperative behaviour scale (MVARS). The vital signs, blood pressure and pulse were also taken. Results: The AV-group showed significantly lower MVARS scores than the CTR-group (p = 0.029), and the scores decreased significantly during treatment in the AV-group (p = 0.04). Further, the pulse rate was significantly increased in the CTR-group during injection with local anaesthesia (p = 0.02), but not in the AV-group. Conclusion: AV distraction seems to be an effective method in reducing fear and anxiety in children during dental treatment. Further, children who used eyeglass goggle display as a distraction tool during dental treatment reported not only less anxiety than control groups but also showed more positive responses after injection with local anaesthesia. Hence, AV-distraction seems to be a useful tool to decrease the distress and dental anxiety during dental treatment. PMID:27409593

Causes of peroneal neuropathy associated with orthopaedic leg lengthening in different canine models.

PubMed

Shchudlo, Natalia A; Varsegova, Tatyana N; Shchudlo, Mikhail M; Stepanov, Mikhail A; Yemanov, Andrey A

2018-05-25

Peroneal neuropathy is one of the complications of orthopaedic leg lengthening. Methods of treatment include slowing of distraction and decompression both of which may lead to additional complications. The purpose of this study was to analyse the changes in histologic peroneal nerve structure during experimental orthopaedic lengthening using various modes of manual or automatic distraction. The obtained data provide the basis for better understanding of peroneal neuropathy pathogenesis and refinement of prophylaxis and preventive treatment protocols. Four experimental models of canine leg lengthening using the Ilizarov fixator were studied: 1 (n = 10)-manual distraction-1 mm/day divided into four increments; 2 (n = 12)-automatic distraction-1 mm/day in 60 increments, 3 (n = 9) and 4 (n = 9)-increased rate of high frequency automatic distraction: 3 mm/day in 120 and 180 increments, respectively. In peroneal nerves semi-thin sections cross-sectional fascicular areas, content of adipocytes in epineurium, endoneurial vascularisation, morphometric parameters of nerve fibres were assessed by computerised analysis at the end of distraction and of consolidation periods and 30 days after fixator removal. In Groups 1-2 massive nerve fibre degeneration along with epineural vessels obliteration was revealed in two cases from 22, whereas in Groups 3-4 there were 10 from 18 (p < 0.01). Injuries of perineurium and endoneurial vessels were noted in Group 3, and long-lasting thinning of nerve fascicles in Group 4. The decrease in epineurial fat tissue was revealed in all groups, more drastic in 3. Modifications and injuries of nerve sheaths and blood vessels depending on distraction rate and frequency contribute to peroneal neuropathy. Its mechanical, circulatory and metabolic causes are discussed.

RESPONSE STYLE AND VULNERABILITY TO ANGER-INDUCED EATING IN OBESE ADULTS

PubMed Central

Appelhans, Bradley M.; Whited, Matthew C.; Schneider, Kristin L.; Oleski, Jessica; Pagoto, Sherry L.

2010-01-01

Emotional eating appears to contribute to weight gain, but the characteristics that make one vulnerable to emotional eating remain unclear. The present study examined whether two negative affect response styles, rumination and distraction, influenced palatable food intake following an anger mood induction in normal weight and obese adults. We hypothesized that higher rumination and lower distraction would be associated with greater vulnerability to anger-induced eating, particularly among obese individuals. Sixty-one participants (74% female, mean age = 34.6) underwent neutral and anger mood inductions in counterbalanced order. Directly following each mood induction, participants were provided with 2,400 kcals of highly palatable snack foods in the context of a laboratory taste test. Results revealed that distraction influenced energy intake following the mood induction for obese but not normal weight individuals. Obese participants who reported greater use of distraction strategies consumed fewer calories than those reporting less use of distraction strategies. These findings were independent of subjective hunger levels, individual differences in mood responses and trait anger, and other factors. Rumination did not account for changes in energy intake among obese or normal weight participants. Among obese individuals, the tendency to utilize fewer negative affect distraction strategies appears to be associated with vulnerability to eating in response to anger. Future research should determine whether coping skills training can reduce emotional eating tendencies. PMID:21184967

Is gaze following purely reflexive or goal-directed instead? Revisiting the automaticity of orienting attention by gaze cues.

PubMed

Ricciardelli, Paola; Carcagno, Samuele; Vallar, Giuseppe; Bricolo, Emanuela

2013-01-01

Distracting gaze has been shown to elicit automatic gaze following. However, it is still debated whether the effects of perceived gaze are a simple automatic spatial orienting response or are instead sensitive to the context (i.e. goals and task demands). In three experiments, we investigated the conditions under which gaze following occurs. Participants were instructed to saccade towards one of two lateral targets. A face distracter, always present in the background, could gaze towards: (a) a task-relevant target--("matching" goal-directed gaze shift)--congruent or incongruent with the instructed direction, (b) a task-irrelevant target, orthogonal to the one instructed ("non-matching" goal-directed gaze shift), or (c) an empty spatial location (no-goal-directed gaze shift). Eye movement recordings showed faster saccadic latencies in correct trials in congruent conditions especially when the distracting gaze shift occurred before the instruction to make a saccade. Interestingly, while participants made a higher proportion of gaze-following errors (i.e. errors in the direction of the distracting gaze) in the incongruent conditions when the distracter's gaze shift preceded the instruction onset indicating an automatic gaze following, they never followed the distracting gaze when it was directed towards an empty location or a stimulus that was never the target. Taken together, these findings suggest that gaze following is likely to be a product of both automatic and goal-driven orienting mechanisms.

Stimulus-dependent modulation of visual neglect in a touch-screen cancellation task.

PubMed

Keller, Ingo; Volkening, Katharina; Garbacenkaite, Ruta

2015-05-01

Patients with left-sided neglect frequently show omissions and repetitive behavior on cancellation tests. Using a touch-screen-based cancellation task, we tested how visual feedback and distracters influence the number of omissions and perseverations. Eighteen patients with left-sided visual neglect and 18 healthy controls performed four different cancellation tasks on an iPad touch screen: no feedback (the display did not change during the task), visual feedback (touched targets changed their color from black to green), visual feedback with distracters (20 distracters were evenly embedded in the display; detected targets changed their color from black to green), vanishing targets (touched targets disappeared from the screen). Except for the condition with vanishing targets, neglect patients had significantly more omissions and perseverations than healthy controls in the remaining three subtests. Both conditions providing feedback by changing the target color showed the highest number of omissions. Erasure of targets nearly diminished omissions completely. The highest rate of perseverations was observed in the no-feedback condition. The implementation of distracters led to a moderate number of perseverations. Visual feedback without distracters and vanishing targets abolished perseverations nearly completely. Visual feedback and the presence of distracters aggravated hemispatial neglect. This finding is compatible with impaired disengagement from the ipsilesional side as an important factor of visual neglect. Improvement of cancellation behavior with vanishing targets could have therapeutic implications. (c) 2015 APA, all rights reserved).

Mechanisms underlying selecting objects for action

PubMed Central

Wulff, Melanie; Laverick, Rosanna; Humphreys, Glyn W.; Wing, Alan M.; Rotshtein, Pia

2015-01-01

We assessed the factors which affect the selection of objects for action, focusing on the role of action knowledge and its modulation by distracters. Fourteen neuropsychological patients and 10 healthy aged-matched controls selected pairs of objects commonly used together among distracters in two contexts: with real objects and with pictures of the same objects presented sequentially on a computer screen. Across both tasks, semantically related distracters led to slower responses and more errors than unrelated distracters and the object actively used for action was selected prior to the object that would be passively held during the action. We identified a sub-group of patients (N = 6) whose accuracy was 2SDs below the controls performances in the real object task. Interestingly, these impaired patients were more affected by the presence of unrelated distracters during both tasks than intact patients and healthy controls. Note that the impaired patients had lesions to left parietal, right anterior temporal and bilateral pre-motor regions. We conclude that: (1) motor procedures guide object selection for action, (2) semantic knowledge affects action-based selection, (3) impaired action decision making is associated with the inability to ignore distracting information and (4) lesions to either the dorsal or ventral visual stream can lead to deficits in making action decisions. Overall, the data indicate that impairments in everyday tasks can be evaluated using a simulated computer task. The implications for rehabilitation are discussed. PMID:25954177

Experimentally induced chocolate craving leads to an attentional bias in increased distraction but not in speeded detection.

PubMed

Smeets, Elke; Roefs, Anne; Jansen, Anita

2009-12-01

In the present study, the causal influence of chocolate craving on attentional bias for chocolate-related information was examined by experimentally inducing chocolate craving in a sample of high trait chocolate cravers vs. low trait chocolate cravers. A sample of 35 high trait chocoholics and 33 low trait chocolate cravers were randomly assigned to either the exposure condition in which craving was manipulated or the non-exposure condition. To measure attentional bias, a pictorial version of the visual search paradigm [Smeets, E., Roefs, A., van Furth, E., & Jansen, A. (2008). Attentional bias for body and food in eating disorders: increased distraction, speeded detection, or both? Behaviour Research and Therapy, 46, 229-238] was used, assessing two components: distraction and detection. It was found that experimentally induced chocolate craving led to increased distraction by chocolate pictures in the high trait chocolate cravers, in comparison to the low trait chocolate cravers. Moreover, this measure of distraction correlated strongly with self-reported craving, but only in the chocoholics and in the exposure condition. In the non-exposure condition, high trait chocolate cravers showed speeded detection of chocolate pictures relative to non-chocoholics, but this component did not correlate with self-reported craving. It is concluded that experimentally induced craving for chocolate causes a bias in, specifically the increased distraction component of attention in high trait chocolate cravers.

Plugging the attention deficit: perceptual load counters increased distraction in ADHD.

PubMed

Forster, Sophie; Robertson, David J; Jennings, Alistair; Asherson, Philip; Lavie, Nilli

2014-01-01

Increased vulnerability to extraneous distraction is a key symptom of Attention-Deficit Hyperactivity Disorder (ADHD), which may have particularly disruptive consequences. Here we apply Load Theory of attention to increase understanding of this symptom, and to explore a potential method for ameliorating it. Previous research in nonclinical populations has highlighted increased perceptual load as a means of improving the ability to focus attention and avoid distraction. The present study examines whether adults with ADHD can also benefit from conditions of high perceptual load to improve their focused attention abilities. We tested adults with ADHD and age- and IQ-matched controls on a novel measure of irrelevant distraction under load, designed to parallel the form of distraction that is symptomatic of ADHD. During a letter search task, in which perceptual load was varied through search set size, participants were required to ignore salient yet entirely irrelevant distractors (colorful images of cartoon characters) presented infrequently (10% of trials). The presence of these distractors produced a significantly greater interference effect on the search RTs for the adults with ADHD compared with controls, p = .005, ηp² = .231. Perceptual load, however, significantly reduced distractor interference for the ADHD group and was as effective in reducing the elevated distractor interference in ADHD as it was for controls. These findings clarify the nature of the attention deficit underlying increased distraction in ADHD, and demonstrate a tangible method for overcoming it.

Time course of emotion-related responding during distraction and reappraisal.

PubMed

Schönfelder, Sandra; Kanske, Philipp; Heissler, Janine; Wessa, Michèle

2014-09-01

Theoretical accounts of emotion regulation (ER) discriminate various cognitive strategies to voluntarily modify emotional states. Amongst these, attentional deployment (i.e. distraction) and cognitive change (i.e. reappraisal), have been shown to successfully down-regulate emotions. Neuroimaging studies found that both strategies differentially engage neural structures associated with selective attention, working memory and cognitive control. The aim of this study was to further delineate similarities and differences between the ER strategies reappraisal and distraction by investigating their temporal brain dynamics using event-related potentials (ERPs) and their patterns of facial expressive behavior. Twenty-one participants completed an ER experiment in which they had to either passively view positive, neutral and negative pictures, reinterpret them to down-regulate affective responses (reappraisal), or solve a concurrently presented mathematical equation (distraction). Results demonstrate the efficacy of both strategies in the subjective control of emotion, accompanied by reductions of facial expressive activity (Corrugator supercilii and Zygomaticus major). ERP results indicated that distraction, compared with reappraisal, yielded a stronger and earlier attenuation of the late positive potential (LPP) magnitude for negative pictures. For positive pictures, only distraction but not reappraisal had significant effect on LPP attenuation. The results support the process model of ER, separating subtypes of cognitive strategies based on their specific time course. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Interfering with free recall of words: Detrimental effects of phonological competition.

PubMed

Fernandes, Myra A; Wammes, Jeffrey D; Priselac, Sandra; Moscovitch, Morris

2016-09-01

We examined the effect of different distracting tasks, performed concurrently during memory retrieval, on recall of a list of words. By manipulating the type of material and processing (semantic, orthographic, and phonological) required in the distracting task, and comparing the magnitude of memory interference produced, we aimed to infer the kind of representation upon which retrieval of words depends. In Experiment 1, identifying odd digits concurrently during free recall disrupted memory, relative to a full attention condition, when the numbers were presented orthographically (e.g. nineteen), but not numerically (e.g. 19). In Experiment 2, a distracting task that required phonological-based decisions to either word or picture material produced large, but equivalent effects on recall of words. In Experiment 3, phonological-based decisions to pictures in a distracting task disrupted recall more than when the same pictures required semantically-based size estimations. In Experiment 4, a distracting task that required syllable decisions to line drawings interfered significantly with recall, while an equally difficult semantically-based color-decision task about the same line drawings, did not. Together, these experiments demonstrate that the degree of memory interference experienced during recall of words depends primarily on whether the distracting task competes for phonological representations or processes, and less on competition for semantic or orthographic or material-specific representations or processes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Anterior maxillary segmental distraction in the treatment of severe maxillary hypoplasia secondary to cleft lip and palate.

PubMed

Li, Hongliang; Dai, Jiewen; Si, Jiawen; Zhang, Jianfei; Wang, Minjiao; Shen, Steve Guofang; Yu, Hongbo

2015-01-01

Anterior maxillary segmental distraction (AMSD) is an effective surgical procedure in the treatment of maxillary hypoplasia secondary to cleft lip and palate. Its unique advantage of preserving velopharyngeal function makes this procedure widely applied. In this study, the application of AMSD was described and its long-term stability was explored. Eight patients with severe maxillary hypoplasia secondary to CLP were included in this study. They were treated with AMSD using rigid external distraction (RED) device. Cephalometric analysis was performed twice at three time points for evaluation: before surgery (T1), after distraction (T2), and 2 years after treatment (T3). One-way analysis of variance was used to assess the differences statistically. All the distractions completed smoothly, and maxilla was distracted efficiently. The value of SNA, NA-FH, Ptm-A, U1-PP, overjet and PP (ANS-PNS) increased significantly after the AMSD procedure (P < 0.05), with the mean overjet increased by 14.28 mm. However, comparison of cephalometric analysis between T2 and T3 showed no significant difference (P > 0.05). Changes of palatopharyngeal depth and soft palatal length were insignificant. AMSD with RED device provided an effective way to correct maxillary hypoplasia secondary to CLP, extended the palatal and arch length, avoided damage on velopharyngeal closure function and reduced the relapse rate. It is a promising and valuable technique in this potentially complicated procedure.

Maxillary distraction osteogenesis in cleft lip and palate patients with skeletal anchorage.

PubMed

Minami, Katsuhiro; Mori, Yoshihide; Tae-Geon, Kwon; Shimizu, Hidetaka; Ohtani, Miyuki; Yura, Yoshiaki

2007-03-01

Maxillary distraction osteogenesis with the rigid external distraction (RED) system has been used to treat cleft lip and palate (CLP) patients with severe maxillary hypoplasia. We introduce maxillary distraction osteogenesis for CLP patients with skeletal anchorage adapted on a stereolithographic model. Six maxillary deficiency CLP patients treated according to our CLP treatment protocol had undergone maxillary distraction osteogenesis. In all patients, computed tomography (CT) images were recorded preoperatively, and the data were transferred to a workstation. Three-dimensional skeletal structures were reconstructed with CT data sets, and a stereolithographic model was produced. On the stereolithographic model, miniplates were adapted to the surface of maxilla beside aperture piriforms. The operation performed involved a high Le Fort I osteotomy with pterygomaxillary disjunction. Miniplates were fixed to the maxillary segment with three or four screws and used for anchorage of the RED system. Retraction of the maxillary segment was initiated after 1 week. The accuracy of the stereolithographic models was enough to adapt the miniplates so that there was no need to readjust the plates during surgery. Postoperative cephalometric analysis showed that the direction of the retraction was almost parallel to the palatal plane, and dental compensation did not occur. We performed maxillary distraction osteogenesis with skeletal anchorage adapted on the stereolithographic models. Excellent esthetic outcome and skeletal advancement were achieved without dentoalveolar compensations.

One-step transversal palatal distraction and maxillary repositioning: technical considerations, advantages, and long-term stability.

PubMed

Cortese, Antonio; Savastano, Mauro; Savastano, Germano; Claudio, Pier Paolo

2011-09-01

Transversal maxillary hypoplasia in adolescence is a frequently seen pathology, which can be treated with a combination of surgery and orthodontic treatment to widen the maxilla in skeletally matured patients.We evaluated the advantages of a new surgical technique: Le Fort I distraction osteogenesis using a bone-borne device. Because relapse is one of the main problems in surgical maxillary expansion, long-term stability of this new technique was evaluated. Data from 4 adult patients with maxillary restriction, class III malocclusion, or maxillary malposition were collected preoperatively, 4 months after distraction, and 5 years after distraction. Measurements were recorded on dental models to detect palatal expansion at dental level; cephalograms by lateral and posteroanterior plane were analyzed to detect maxillary movements. Maxillary measurements were substantially stable 5 years after distractions. Only minor dental movements occurred at the dental analysis after 5 years related to a lack of orthodontic contention without any compromise of the dental result (no crossbite relapse and class I stability). Le Fort I with down-fracture for expansion and repositioning by bone-borne distractor device can [corrected] be used to simultaneously widen, advance, and vertically reposition the maxilla without causing healing problems, particularly using a rigid distraction device. Long-term stability can be achieved; however, further studies with a larger number of patients will be necessary for better evaluation.

Association Between Cognitive Complaints and Vulnerability to Environmental Distraction in Multiple Sclerosis.

PubMed

Randolph, John J; Randolph, Jennifer S; Wishart, Heather A

2017-02-01

Individuals with multiple sclerosis (MS) often report cognitive dysfunction, although neuropsychological evaluation findings may not correlate with subjective concerns. One factor that may explain this lack of correspondence is the controlled testing environment, which differs from busier settings where cognitive lapses are noted to occur. This study used a novel environmental manipulation to determine whether individuals with MS who report cognitive dysfunction are more vulnerable to the effects of auditory distraction during neuropsychological testing. Twenty-four individuals with clinically definite MS or clinically isolated syndrome were administered a cognitive battery during two counterbalanced auditory conditions: quiet/standard condition, and distraction condition with random office background noise. Participants were divided into high versus low cognitive complaint groups using a median split analysis of Perceived Deficits Questionnaire responses. Participants with more cognitive complaints showed a decrement in performance on the oral Symbol Digit Modalities Test during the distraction condition while those with fewer cognitive complaints demonstrated stable performance across conditions. These findings remained significant after controlling for education, premorbid intellect, fatigue, and depressed mood. These results suggest that individuals with MS with more cognitive complaints are vulnerable to environmental distraction, particularly regarding processing speed. Incorporating random environmental noise or other distraction conditions during selected measures may enhance the ecological validity of neuropsychological evaluation results in MS. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Rumination but not distraction increases eating-related symptoms in anorexia and bulimia nervosa.

PubMed

Naumann, Eva; Tuschen-Caffier, Brunna; Voderholzer, Ulrich; Caffier, Detlef; Svaldi, Jennifer

2015-05-01

Recent models of eating disorders emphasize the importance of ruminative thinking in the occurrence of unhealthy eating behavior. Hence, the aim of the current study was to examine the influence of induced rumination and distraction on the desire to engage in eating-related symptoms in anorexia (AN) and bulimia nervosa (BN). After a sadness induction, either a ruminative or distractive emotion regulation style was encouraged in women with AN (n = 38), BN (n = 37), and non-eating disordered controls (CG; n = 36). At baseline and after the emotion regulation induction feelings of sadness, desire to abstain from eating (DTA) and desire to binge (DTB) were assessed. Main results reveal that rumination led to a significant increase of DTA in the AN group and of DTB in patients with BN. In the CG, DTA significantly decreased after distraction. Although there were significant increases in subjective sadness in the rumination condition, no changes were found in the distraction condition. The results suggest that rumination in response to sadness has a detrimental effect on eating-related symptoms in eating disorders. (c) 2015 APA, all rights reserved).

[Long-term effects and influence on facial structure of palatal distraction].

PubMed

Liang, Li-min; Liu, Chun-ming; Xiong, Jun; Hou, Min

2003-11-01

The purpose of this study was to evaluate a new palatoplasty with persistent elastic distraction osteogenesis. Twenty mongrel dog aged in 6 month were divided into two groups: the control (n = 10) and the experimental group (n = 10). The cleft palate model was made surgically in experimental dogs. The hard palate clefts were repaired with persistent elastic distraction osteogenesis. Then the animals were observed for an additional 12 weeks before sacrifice. Direct measurements was taken on dry skulls of the dogs and the data were analyzed statistically. For all experimental dogs, the clefts were closed after gradual distraction. No relapse and airway blocking occurred in observational period. There were no significant differences in the variables of facial length, height and width between the two groups (P > 0.05). The length of horizontal portion of hard palate in experimental group was significantly longer than that in the control (P < 0.01). There was no complication and disturbance on maxillofacial structure in repairing cleft palate with persistent elastic distraction osteogenesis. It is an effective and safe technique for repairing cleft palate in animal model.

Breakage of internal maxillary distractor: considerable complication of maxillary distraction osteogenesis.

PubMed

Aikawa, Tomonao; Iida, Seiji; Isomura, Emiko T; Namikawa, Mari; Matsuoka, Yudai; Yamada, Chiaki; Yamamoto, Taku; Takigawa, Yoko

2008-07-01

Maxillary distraction osteogenesis using intraoral distractors is now one of the standard treatments of maxillary retrusion. This report shows 2 cases of breakage of this internal maxillary distractor in patients with cleft lip and palate; one was observed during the distraction period and the other was during the retention period. The first case required a rotational movement of the distraction segment, and this movement caused the laterally dislocation of the posterior part of the distractor, where the distractor suffered some mechanical forces by mouth opening. In the latter case, breakage of distractor was observed on the radiographs taken 3 months after distraction and this complication may have been caused by mechanical force by occlusion and mastication. Both breakages were found at the joint of the anchorage plate and the extension rod, which has some flexibility for adjusting the plate to the bone surface. Therefore, surgeons should pay special attention for this mechanical weak area in this distractor not only during the advancement period, but also during the retention period and should avoid unnecessary frequent bending for adopting the bone surface, which directly weakens the joint.

Building a Computer Program to Support Children, Parents, and Distraction during Healthcare Procedures

PubMed Central

McCarthy, Ann Marie; Kleiber, Charmaine; Ataman, Kaan; Street, W. Nick; Zimmerman, M. Bridget; Ersig, Anne L.

2012-01-01

This secondary data analysis used data mining methods to develop predictive models of child risk for distress during a healthcare procedure. Data used came from a study that predicted factors associated with children’s responses to an intravenous catheter insertion while parents provided distraction coaching. From the 255 items used in the primary study, 44 predictive items were identified through automatic feature selection and used to build support vector machine regression models. Models were validated using multiple cross-validation tests and by comparing variables identified as explanatory in the traditional versus support vector machine regression. Rule-based approaches were applied to the model outputs to identify overall risk for distress. A decision tree was then applied to evidence-based instructions for tailoring distraction to characteristics and preferences of the parent and child. The resulting decision support computer application, the Children, Parents and Distraction (CPaD), is being used in research. Future use will support practitioners in deciding the level and type of distraction intervention needed by a child undergoing a healthcare procedure. PMID:22805121

The neurobiology of focus and distraction: The case for incorporating mindfulness into leadership.

PubMed

Mohapel, Paul

2018-05-01

Increasingly health leaders are experiencing greater demands and pressures, which require the need for better focus while limiting unwarranted distractions. This article offers a neurobiological explanation of how the brain focuses and becomes distracted, in order to help health leaders gain insight into their own effectiveness. Two main neural circuits are contrasted: the mind-wandering default mode circuit and the attentional central executive system. These two systems act in an antagonistic pairing, where the degree of toggling between systems is associated with the degree a person can sustain focus and filter out unwarranted distractions. Excessive multitasking appears to compromise the neural switch of these two systems, thereby diminishing our focus and concentration. In contrast, mindfulness practice is shown to have the opposite effect by enhancing the neural switch, thereby enhancing leadership focus that can lead to greater flexibility, foresight, regulation, and creativity. To conclude, leaders who are excessively distracted, such as with multitasking, may be compromising cognitive brain functioning, while engaging in mindfulness may replenish the brain and thereby enhance leaders' ability to sustain focus and tap into higher cognitive functioning.

Effects of non-surgical joint distraction in the treatment of severe knee osteoarthritis.

PubMed

Khademi-Kalantari, Khosro; Mahmoodi Aghdam, Somayeh; Akbarzadeh Baghban, Alireza; Rezayi, Mehdi; Rahimi, Abbas; Naimee, Sedighesadat

2014-10-01

The aim of this study was to evaluate the clinical results of non surgical knee distraction in patients with severe knee osteoarthritis. forty female patients with severe knee osteoarthritis were randomly divided in two groups. A standard physiotherapy treatment was applied to both groups and in one group it was accompanied with 20 min knee joint distraction. The patients were treated for 10 sessions. Clinical examination consisted of functional examination, completion of a quality of life questionnaire, pain scale, and assessment of joint mobility and joint edema. The standard physiotherapy treatment accompanied by knee distraction resulted in significantly higher improvement in pain (P = 0.004), functional ability (P = 0.02), quality of life (P = 0.002) and knee flexion range of motion (p = 0.02) compared to the standard physiotherapy treatment alone post treatment and after 1 month follow up. Adding knee distraction to standard physiotherapy treatment can result in further improvement in pain relief, increased functional ability and better quality of life in patients with severe knee osteoarthritis. Copyright © 2013 Elsevier Ltd. All rights reserved.

Management of Late Onset Perthes: Evaluation of Distraction by External Fixator—5-Year Follow-Up

PubMed Central

Srivastava, Rajeshwar N.; Shukla, Prashant; Pushkar, Amit; Ali, Sabir

2014-01-01

Background. Hip distraction in Perthes' disease unloads the joint, which negates the harmful effect of the stresses on the articular surfaces, which may promote the sound healing of the area of necrosis. We have examined the effect of arthrodiastasis on the preservation of the femoral head in older children with Perthes' disease. Methods and Materials. Twelve children with age more than 8 years with Perthes' disease of less than one year were treated with hip distraction by a hinged monolateral external fixator. Observation and Results. Mean duration of distraction was 13.9 days. These children were evaluated by clinicoradiological parameters for a mean period of 32.4 months. There was a significant improvement in the range of movements and mean epiphyseal index, but the change in the percentage of uncovered head femur was insignificant. There was significant improvement in Harris Hip score. Conclusions. Hip distraction by hinged monolateral external fixator seems to be a valid treatment option in cases with Perthes' disease in the selected group of patients, where poor results are expected from conventional treatment. PMID:25580302

What's the law got to do with it? Legislation regarding in-vehicle technology use and its impact on driver distraction.

PubMed

Parnell, Katie J; Stanton, Neville A; Plant, Katherine L

2017-03-01

Legislation in the road transport domain aims to control safety on the roads. Despite this, a critical issue affecting road safety is that of driver distraction. Although poorly defined, distraction is a significant road safety issue which, in part, is caused by the prevalence of technology within vehicles. Legislation surrounding the use of in-vehicle technologies are explored in this paper from a socio-technical system perspective. This reveals the wider context of the road transport system operating under the current laws using an Accimap analysis. A distinction in the law between the use of hand-held mobile phones, a device that is typically banned for use by drivers worldwide, and the use of other technological devices that are covered by more general laws against 'careless' and/or 'dangerous' driving was found. Historically, individual drivers' have been blamed for distraction, whereas the systems approach shows how current legislation may have created the conditions necessary for driver distraction. Copyright © 2016 Elsevier Ltd. All rights reserved.

Age Differences in Emotion Regulation Choice: Older Adults Use Distraction Less Than Younger Adults in High-Intensity Positive Contexts.

PubMed

Martins, Bruna; Sheppes, Gal; Gross, James J; Mather, Mara

2018-04-16

Previous research demonstrates that younger and older adults prefer distraction over engagement (reappraisal) when regulating high-intensity negative emotion. Older adults also demonstrate a greater bias for positive over negative information in attention and memory compared with younger adults. In this study, we investigated whether emotion regulation choice preferences may differ as a function of stimulus valence with age. The effect of stimulus intensity on negative and positive emotion regulation strategy preferences was investigated in younger and older men. Participants indicated whether they favored distraction or reappraisal to attenuate emotional reactions to negative and positive images that varied in intensity. Men in both age-groups preferred distraction over reappraisal when regulating high-intensity emotion. As no age-related strategic differences were found in negative emotion regulation preferences, older men chose to distract less from high-intensity positive images than did younger men. Older men demonstrated greater engagement with highly positive emotional contexts than did younger men. Thus, age differences in emotion regulation goals when faced with intense emotional stimuli depend on the valence of the emotional stimuli.

Low-Cost Intra-Articular Distraction Technique Using Kirschner Wires and a Toothed Lamina Spreader.

PubMed

Shymon, Stephen Joseph; Harris, Thomas Gregory

We describe a low-cost (instrument cost) technique for joint distraction using 2 Kirschner wires and a toothed lamina spreader in lieu of a Hintermann distractor. The described technique allows for temporary intra-articular distraction and visualization and preservation of the articular surface with extra-articular instrumentation. The technique can also allow for closed reduction and percutaneous treatment in cases of soft tissue compromise. Additionally, the technique uses common orthopedic surgical instruments, leading to a minimal learning curve for novice surgeons. We have found this distraction technique to be most effective for intra-articular preparation of hindfoot and midfoot arthrodeses and for navicular fracture reduction. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Segmental maxillary distraction with a novel device for closure of a wide alveolar cleft

PubMed Central

Bousdras, Vasilios A.; Liyanage, Chandra; Mars, Michael; Ayliffe, Peter R

2014-01-01

Treatment of a wide alveolar cleft with initial application of segmental distraction osteogenesis is reported, in order to minimise cleft size prior to secondary alveolar bone grafting. The lesser maxillary segment was mobilised with osteotomy at Le Fort I level and, a novel distractor, facilitated horizontal movement of the dental/alveolar segment along the curvature of the maxillary dental arch. Following a latency period of 4 days distraction was applied for 7 days at a rate of 0.5 mm twice daily. Radiographic, ultrasonographic and clinical assessment revealed new bone and soft tissue formation 8 weeks after completion of the distraction phase. Overall the maxillary segment did move minimising the width of the cleft, which allowed successful closure with a secondary alveolar bone graft. PMID:24987601

Segmental maxillary distraction with a novel device for closure of a wide alveolar cleft.

PubMed

Bousdras, Vasilios A; Liyanage, Chandra; Mars, Michael; Ayliffe, Peter R

2014-01-01

Treatment of a wide alveolar cleft with initial application of segmental distraction osteogenesis is reported, in order to minimise cleft size prior to secondary alveolar bone grafting. The lesser maxillary segment was mobilised with osteotomy at Le Fort I level and, a novel distractor, facilitated horizontal movement of the dental/alveolar segment along the curvature of the maxillary dental arch. Following a latency period of 4 days distraction was applied for 7 days at a rate of 0.5 mm twice daily. Radiographic, ultrasonographic and clinical assessment revealed new bone and soft tissue formation 8 weeks after completion of the distraction phase. Overall the maxillary segment did move minimising the width of the cleft, which allowed successful closure with a secondary alveolar bone graft.