Wednesday, October 18, 2017

Fatigue and You

Disclaimer! This is NOT an opinion piece, but rather a collection of various readings and clippings which serve to spur further exploration in the topic. These are not full articles but simply excerpts from the bulk of reading material that is available.  As much citation and references were taken with regards to the topic. Legitimacy and accuracy of the clippings are read at your own discretion.
Fatigue and You

Night-time departures, early morning arrivals, and adjusting to several time zones in a matter of days can rattle circadian rhythms, compromise attention and challenge vigilance. And yet, these are the very conditions many pilots face as they contend with a technically challenging job in which potentially hundreds of lives are at stake.

From the standpoint of performance, as fatigue increases, accuracy and timing degrade, lower standards of performance are accepted, the ability to integrate information from individual flight instruments into a meaningful overall pattern declines, and attention narrows (Caldwell & Caldwell, 2003). 

Severely fatigued pilots may even experience perceptual illusions because of brief, involuntary lapses into sleep. As sleepiness increases, performance becomes less consistent, especially at night, when there is often a five fold increase in lapses in vigilance (Dinges, 1990). Since 1990 the US National Transportation Safety Board has placed pilot fatigue on the Most Wanted List of safety related priorities.

In one study, F-117 pilots were deprived of one night of sleep and then were tested on precision instruments. Not only did pilot errors on those instruments double after one night of sleep loss, pilots reported feeling depressed and confused.

Within 24 hours of continuous wakefulness, levels of self-rated depression, confusion, and fatigue increased, and there were substantial elevations in slow-wave EEG activity (of the type usually associated with Sleep Deprivation and Aviation Performance 87 extreme drowsiness).

On a secondary task in between simulator flights, there was a 20 percent lengthening of reaction time, a 100 percent increase in incorrect responses to warning signals, and a 60 percent reduction in basic psycho motor tracking ability.

A report from an NTSB study of major accidents in domestic air carriers stated that “crews comprising captains and first officers whose time since awakening was above the median
for their crew position made more errors overall, and significantly more procedural and tactical decision errors” (National Transportation Safety Board, 1994, p. 75). A Navy Safety Center study cited fatigue as the second-most problematic factor, after spatial disorientation, in aeromedically related mishaps and hazard reports (Command Flight Surgeon, 2005).
Conservative estimates are that fatigue is responsible for 4 to 7% of civil aviation mishaps (Lyman & Orlady, 1981), 4% of Army aviation accidents, 12% of the Navy’s most serious aviation mishaps, and almost 8% of the Air Force’s Class A (most severe) aviation mishaps (Caldwell et al., 2009).
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Clearly fatigue is fundamentally the result of insufficient sleep, but for pilots the important issue is the consequences of that sleep loss when they are sitting at the control panel.
The author suggests that “fatigue related risks increase substantially when
(a) the waking period is longer than 16 hours,
(b) the pre-duty sleep period is shorter than 6 hours, or
(c) the work period occurs during the pilot’s usual sleep hours
.



The two most important variables for alertness are recent sleep and the body’s natural circadian rhythm” What that means is that when a pilot reports for duty, he or she should have had from seven to nine hours of good sleep within a reasonable period of time before work and that as often as possible, the work schedule is in some harmony with the pilot’s natural daily rhythm.

Fortunately, new Federal Aviation Administration regulations better account for the true physiological nature of fatigue, but additional fatigue-management strategies are needed.

Caldwell acknowledges that the very nature of airline travel predisposes pilots to disrupted sleep schedules, but he points out several approaches that can both predict a truly impaired pilot and mitigate the consequences of a lack of sleep.

Controlled Rest and getting the most out of it
“A controlled nap can improve performance significantly,” says Mark Rosekind, a member of the NTSB and a long-time expert on the dangers of fatigue. Rosekind told reporters Monday that a 1995 NASA study found that “a 26-minute nap improved performance 34% and alertness 54%.”

The NASA study compared alertness among trans-Pacific airline pilots. It “allowed one group of pilots flying across the Pacific to take a 25-minute nap while their co-pilots flew the planes, while a control group was required to stay awake for the entire flight.

Those without the naps nodded off five times as much
– including while on the approach to the airport – as those who got some sleep,” reported the AP in 2009.

Some foreign carriers have adopted the conclusions and now allow pilots to take short naps on long flights while co-pilots remain awake. But the FAA and US carriers have resisted the changes.

Pilots in the rest group typically fell asleep quickly, slept “efficiently” for an average of 26 minutes and, after awakening, displayed “improved physiological alertness and performance,” compared with colleagues in the no-rest group, according to the researchers’ report.

“The benefits of the nap were observed through the critical descent and landing phases of flight,” the report said. “The nap did not affect layover sleep or the cumulative sleep debt displayed by the majority of crew members. The nap procedures were implemented with minimal disruption to usual flight operations, and there were no reported or identified concerns regarding safety.


30mins or less Power Naps & Sleep Inertia
The NASA sleep researchers and others believe that properly planned napping strategies can be effective against fatigue, preventing many of the attention lapses and micro sleeps periods of sleep that last only several seconds and often are not recognized encountered during long-range flight operations.

In addition to its benefits, napping also has a negative aspect. “Practically everyone,” Caldwell said, “experiences post-nap grogginess.” This grogginess also is referred to as “sleep inertia,” which manifests itself in degraded vigilance, increased drowsiness and diminished performance for one to 35 minutes after awakening.

Sleep inertia is an important consideration in the scheduling of cockpit naps, sleep researchers have said.

ALPA’s Prater agreed, adding, “Trying to come up out of a nap to make a snap decision is difficult.” Those who favor in-seat napping agree that planning must take into consideration several factors.

As MA’s recommendations call for no more than 40 minutes to be set aside for an on-duty, in-seat nap. The time limit was derived from the NASA studies and other sleep research that has shown that a sleep period of less than 30 minutes is less likely to be followed by excessive sleep inertia.


Coffee Power Naps. Paradoxical?
Though it sounds paradoxical, scientific evidence suggests that consuming caffeine just before taking a short siesta does a better job of restoring your alertness than does simply having a cup of coffee or tea or taking a nap without a caffeine appetizer.
What explains the power of the coffee nap? It all boils down to body chemistry specifically, to the competing effects of caffeine and adenosine, a drowsiness-inducing chemical compound that accumulates in your brain when you’re awake and dissipates as you sleep.

If you want to try it yourself, have a coffee beforehand – espresso is a good, quick fix – so that it takes effect towards the end of your nap, or controlled recovery period (CRP). Don’t sip your coffee too slowly, as you might find it’s already taking effect as you begin your CRP, and be aware of the amount of caffeine you have already consumed. 

Caffeine’s alertness-boosting effect typically peaks about 30 minutes after the stimulant is consumed. So by sleeping for 20 or so minutes of those 30, you can reduce the amount of adenosine the caffeine has to compete with. And voila, the caffeine has a greater effect.

If you can fall asleep in your nap before caffeine does that, when it’s time to wake up, you’re getting the benefits of the caffeine perfectly timed with the nap sleep benefit,” sleep researcher Dr. David Dinges, a professor in the department of psychiatry at the University of Pennsylvania, told The Huffington Post.

Dinges recalled a 2001 study in which 28 men and women were given either a low-dose caffeine pill or a placebo during the latter stages of an 88-hour period during which the sleep they got came only in the form of seven two-hour naps. In that experiment, the caffeine was successful in overcoming so-called sleep inertia. That’s a term scientists use to describe the grogginess you feel immediately after waking up.

That’s not the only evidence of the curious relationship between caffeine and napping. In a series of studies conducted in the 1990s, researchers at Lough borough University in England found that drinking a cup of coffee and then immediately taking a 15-minute nap was better at curbing drowsiness in motorists than simply having a cup of coffee or taking a short nap (the motorists’ alertness was measured not on the road but in a driving simulator).
Sources:
Crew Schedules, Sleep Deprivation, and Aviation Performance (PDF Download Available). Available from: https://www.researchgate.net/publication/254081761_Crew_Schedules_Sleep_Deprivation_and_Aviation_Performance [accessed Oct 17 2017].
https://www.researchgate.net/publication/254081761_Crew_Schedules_Sleep_Deprivation_and_Aviation_Performance
https://www.psychologicalscience.org/news/releases/crew-schedules-sleep-deprivation-and-aviation-performance.html
J. A. Caldwell. Crew Schedules, Sleep Deprivation, and Aviation Performance. Current Directions in Psychological Science, 2012; 21 (2): 85 DOI: 10.1177/0963721411435842

http://www.dtic.mil/dtic/tr/fulltext/u2/a519631.pdf
https://www.huffingtonpost.com/2014/09/03/coffee-sleep-power-naps-science_n_5753360.html
https://www.theguardian.com/lifeandstyle/2016/oct/23/the-secret-of-power-napping
https://flightsafety.org/wp-content/uploads/2016/11/asw_dec09-jan10_p38-42.pdf
Image Sources
https://i.ytimg.com/vi/aQSDZOZ0cJ0/hqdefault.jpg 
https://blog.bulletproof.com/coffee-naps-bulletproof-power-nap/ 
http://www.jetpix.com/airspacestealth/
https://www.flightdeckfriend.com/
http://www.collective-evolution.com/2016/05/30/naps-why-theyre-important-how-long-they-should-be-for-the-biggest-brain-boosting-benefits/

Monday, October 16, 2017

Singapore - To Eat 15Oct2017 (Hotel Jen J65)

Singapore - To Stay
Singapore - To Eat
Singapore - To Do

Singapore - To Eat
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J65
Hotel Jen
located 1.1km from Orchard MRT station
J65’s all you can eat seafood buffet on the weekend is priced at $75++ (Fri, Sat, Sun) per head. Located on the ground floor of Hotel Jen, located at the start of Orchard Road, its a great starter/finisher to walk down the famous shopping street of Singapore.
Click here for ABBA location of J65, 1A Cuscaden Rd, Level 1, 249716
The stars here are most defiantly the oysters and the cold cut Boston lobsters. We must have cleared at least three whole lobsters each!


The spread over at Hotel Jen was diverse, just the right selection and a decent variety featuring the local flavors. There’s just about enough  there that you can go one complete round and probably squeeze in a bit more for seconds.
Ordered On:
Sunday Seafood Mania Buffet at SGD75/pax
15Oct0217
SGD75++/pax

*Boston lobsters were fantastic and would be appreciated if they offered a cook variety as well. Alas that'd be reserved for their lobsters Wednesdays and Thursday's Lobster Rock and Roll. The prawns were sweet and fresh as were the oysters. (Taste of the sea). Perhaps the oysters were strategically placed at the back to pace out diners.*Whole Baked Salmon
*The baked salmon was surprisingly very well done. Not at all over cooked, succulent and flavorful. The sweetish tomato sauce worked really well together with the fish and worth going back for seconds and for the brave, replicating at home.*
DIY Kueh Pie Tee

*The DIY stations were nice but maybe a little complicated for tourist. There's no really how to section for tourist. The kueh pai te was to a surprisingly good standard. Both in filling and condiments!*
Local Fare

*The Chilli crab was prepared a little different from the usual varieties had around Singapore. It would have been great if they served fried man tao (fried chinese soft buns) along side. The local, Indian and Chinese (so-so Laksa, pretty decent satay, chicken, crispy pork roast, fried rice) sections were probably there just to round off the buffet experience. There's also the typical western roast section of Pork and Beef which were pretty okay/average. Nothing really to scream over.*

*The desserts section was quite pleasant and featured a wider spread of local fare. The durian paste was a pleasant surprise. Nice but it maybe a little overworked, with not much durian fibers to give it a little more texture. Good but have had better else where.*
Pros:
Pretty respectable quality seafood selection.
Nice selection of local fare featuring both sweets and savory.
Very fair asking price for the selection especially with the Boston Lobsters, and the oysters.
Cons:
Vegetable selection is hugely lacking.
The Lobster available one way maybe a bit boring.
The rest of dishes are pretty average.
Fed3 At SGD264.85
A very fair pricing especially if you are a fan of their seafood. The lobsters and oysters especially. The rest of the items kinda rounded up the buffet experience. Their local dessert section and after meal coffee/hot tea stations was a welcoming delight. Service was pretty all right. It did get a little slowed down mid way through but they kept the buffet table stocked.

Fair valued with a not too over the top spread to charge you an arm or a leg. The lobsters special on Wed and Thursdays are worth for consideration to come back and give a try at an additional SGD10++ per pax. Look out for any credit card deal that may give a great deal!

Thursday, October 12, 2017

Hydration on Flight. How much should you drink?

Disclaimer! This is NOT an opinion piece, but rather a collection of various readings and clippings which serve to spur further exploration in the topic. These are not full articles but simply excerpts from the bulk of reading material that is available.  As much citation and references were taken with regards to the topic. Legitimacy and accuracy of the clippings are read at your own discretion.
Hydration on Flight
the importance of staying hydrated

Base Line of 8 Glasses of Water
As rule of thumb from various sources, to stay properly hydrated under normal conditions, you need to drink eight glasses, containing eight ounces of water or other non-caffeinated drinks per day. That equates to about 2 liters per day.
Your body loses about 2 liters or 66 ounces of water per day via your urine, sweat, breathing and bowel movements. Your most basic water requirements involve drinking to replace these water losses. This is where the eight glasses of water per day rule is based, which helps you replace lost water. However, some people need more or less water. Keep in mind that you also take in water through the foods you eat. Soups and fruits like watermelon have high water content that also can contribute to hydration.

The Aircraft Environment
High and as Dry as the Sahara
- Marie Claire
Dehydration is a major issue when traveling by airplane,’ Yasmin tells us. ‘The problem arises due to spending long periods of time in a climate-controlled environment where the relative humidity can be as low as 10-15%, which is three times drier than the Sahara desert!

‘In an average 10 hour flight, men can lose approximately two litres of water and women around 1.6 litres. This means that on a London to Sydney flight a passenger could lose up to 4 litres and 8% of their bodily water.’
And since research shows that spending six hours in a climate simulator that mimics conditions on a plane, leads to a significant decrease in hydration status, with around 2% loss in total body water content over this time, despite them drinking 400ml of water, it’s safe to say, flying is bad for hydration levels.

‘Around 50% of this decrease is due to ‘insensible water loss’, mostly due to respiration. Insensible water loss is due to a combination of the mildly hypoxic environment which increases breathing rate and the dry cabin air and is difficult to prevent or reduce this type of water loss.’

‘A 1-2% decrease in hydration has significant impact on the health and mood of passengers and can affect cognition, attention, memory and critical thinking, as well as leading to feelings of tiredness, fatigue and irritability.’

Oh, and if that’s not enough, because your mucosal membranes become dehydrated while flying, their ability to trap bacteria or viruses becomes less efficient and effective so you’re more likely to catch an illness.

Pass us the big bottles of water, we say!


 
According to The Airliner Cabin Environment and the Health of Passengers and Crew
Humidity Levels in an Aircraft Environment

- At cruise altitudes, the outside air contains very little moisture, and the main sources of humidity in the cabin air are respiration and evaporation from the skin of occupants. The steady supply of dry outside air is more than sufficient to flush the human-generated moisture from the cabin and maintain a low moisture content in the air, typically 10–20% relative humidity at cruise altitudes. Such values of relative humidity are below comfort guidelines (American Society of Heating, Refrigerating, and Air-Conditioning Engineers. 1992).

- Theoretically, at least, cabin air could be humidified to comfortable values. But a number of problems are associated with such humidification, including the weight penalty associated with the water that would need to be carried, the biological growth that is often associated with humidifiers, and the maintenance requirements of humidification systems.

- The humidity required for passenger comfort might exceed that which generates some of the safety concerns for the aircraft operations described previously. Whole-cabin humidification systems are therefore not normally included on aircraft. Air supplied to the cockpit is humidified on a small fraction of the current aircraft fleet, but on most aircraft the cockpit is normally drier than the passenger cabin air because of the higher ventilation rates in the cockpit.


- With that amount of moisture generation and the FAA minimal design flow rate of outside air of 0.042 kg/s, the water vapor concentration in the cabin air will be 0.0050, or 0.5%; this corresponds to a relative humidity of about 18% at typical cabin air temperatures.
That value might be a slight underestimate of the humidity because some occupants, particularly the cabin crew, will be more active than others.

From Google*The relative humidity in the Sahara Desert is 25 percentThe annual averages for relative humidity in Singapore range throughout the day from a maximum of 96 percent to a minimum of 64 percent. Humidity levels are fairly steady in Singapore, year round. Overall, December is the city's most humid month.*


 ------------------------------------------------------------------------------
Hydration and Safety
According to FAA (Federal Aviation Administration) From: Pilotfriend.com/Plane and Pilot.com (Nina Anderson is a Hawker pilot, FAA Wings Program human factors seminar leader and ISSA Specialist in Performance Nutrition.)

There is scant attention given to it. Most pilots overlook it. Some shrug it off, while others simply don’t know about its effects in the cockpit. The problem?

Pilot dehydration. Most pilots are unaware of its devastating effects and symptoms, which can increase the risk of aircraft incidents and accidents, even during a mildly warm day.

In order to heighten general aviation’s awareness of this often overlooked condition, the Federal Aviation Administration (FAA) has recently added pilot dehydration—its symptoms, causes, effects and corrective actions—to its latest Practical Test Standards list of physiological conditions. The FAA believes that educating pilots about dehydration will not only decrease aircraft incidents, but also save pilots’ lives one day.

Most pilots associate dehydration with thirst and assume that they can drink any type of liquid. This isn’t always the case. A pilot’s dehydration condition is caused by a lack of water within the body cavity due to high body temperatures, a dry aircraft environment, excess caffeine, antihistamines and inappropriate fluid intake. Many soft drinks, teas and juice drinks don’t constitute adequate hydration substitutes, as they contain caffeine and sugar that may compromise absorption of the water content.
Hot cockpits and flight lines also cause dehydration.

What about the 72-degree/22degree C cockpit? Pilots should concern themselves in that environment, too, since average humidity in the cockpit is low, causing a dramatic increase in fluid loss. 


Everyone must be aware that un-replaced water losses equal two percent of body weight and will impact your body’s ability to regulate heat.

- 3% water loss of Body Weight There is a decrease in muscle cell contraction times.
- 4% water loos of Body Weight there is a five to 10 percent drop in overall performance, which can last up to four hours.
The symptoms of dehydration go beyond thirst. In an effort to respond to the brain’s need for fluid, the kidneys reabsorb water through the urine, creating fluid retention and frequent urges to visit the bathroom.

Dry skin is also an indicator of dehydration, as the skin gets most of its moisture subdermally. The brain is 75 percent water and, when it needs to replace lost fluid, it can manifest certain symptoms, such as headaches, light-headedness and fatigue.
Dehydration also contributes to:
- fuzzy thinking
- poor decision-making
- dizziness
- muscle fatigue.
Long-term effects
- wrinkled skin
- impaired memory function

- dry hair
- brittle nails
- constipation
- susceptibility to colds
- because of extremely dry nasal passages, sinus infections. 


*Best to drink cold 4.4Degree C Water*

So how do you avoid dehydration in the cockpit? You’ll need to permanently attach yourself to a water bottle and drink from it regularly. The Federal Air Surgeon Bulletin suggests drinking cool, 40-degree Fahrenheit 4.4degree C water before feeling thirsty. This will help you stay ahead of the game, keeping you hydrated before the “thirst mechanism” sets in. 


An alternative to water is to simply drink mineralized (electrolyte) water. Electrolyte drinks, more commonly known as sports drinks, are generally designed to replace the fluids (water) and electrolytes (sodium, potassium, chromium, manganese, etc.) lost during stress, body temperature regulation and exercise. Most contain sugars which may lower a pilots systemic blood-sugar levels and precipitate fatigue. 

The FAA also suggests staying away from coffee, sodas and teas—otherwise called diuretic drinks. These beverages contain caffeine, alcohol and carbonation, which causes excess urine production or decreased voluntary fluid intake—a sure sign of dehydration.

Coffee Diuretic effects

Coffee is basically the life-saver of most college students. It gives us that energy we need to get through the day filled with classes and other activities. Coffee has tons of health benefits like helping to lower your risk of getting type 2 diabetes, cancer and can help burn calories but is also gets a bad rep for being dehydrating because they are a diuretic (they make you pee!)


But is coffee actually dehydrating? And if so, how much water do we need to drink to offset the coffee we intake? If the old rule of eight glasses a day of water is true, then we might have to really start upping our water intake.
Luckily, it turns out coffee isn’t doing as much damage as we think. Our hydration levels because of coffee can actually differ in the short term and long term. In the short term, yes you probably need to be drinking more water. If you drink a lot of coffee in a short amount of time then you will need to pee more, thus losing hydration. This means that for every cup of coffee or two cups of black tea, you should drink one cup of water to make up for the diuretic effect.


However, in the long term you may not need to make up for coffee’s effects at all. After a while of drinking coffee your body actually adjusts and can actually become less dehydrating. But if you stop drinking coffee for a period of time and then start drinking it again, you lose that tolerance to coffee and you should drink water, in the 1 to 1 ratio, until your body adjusts again.


It is not always easy to tell if you are dehydrated but the pee check usually is a good indicator. If your pee is too dark yellow, then you definitely need to be drinking more water. Also, if you are feeling thirsty, sweating excessively, exposed to heat, weakness or dizzy you may be dehydrated.
However if it’s hot or you’re flying at higher altitudes, you will need to drink more to prevent dehydration, as these conditions tend to increase the rate of water loss from the body.

You’re best off to sip a little at a time. So bring a couple of water bottles into the cockpit and drink regularly while you’re flying, and keep safe!


Sources:
http://www.marieclaire.co.uk/life/travel-dehydration-509326
https://www.ncbi.nlm.nih.gov/books/NBK207472/ The Airliner Cabin Environment and the Health of Passengers and Crew

http://www.flyingmag.com/technique/tip-week/pilot-hydration
http://www.planeandpilotmag.com/article/flying-high-and-dry/#.Wdq3eDBx1PY
https://spoonuniversity.com/lifestyle/this-is-how-much-water-to-have-to-drink-to-offset-your-coffee-addiction


Image Sources
https://esnoticia.co/noticia-13552-8-glasses-of-water-a-day-a-myth

https://airlinegeeks.com/2015/04/14/where-airplanes-go-to-retire-the-dusty-mojave-desert-boneyard/
https://www.google.com.sg/imgres?imgurl=http%3A%2F%2Fichef.bbci.co.uk%2Fwwfeatures%2Fwm%2Flive%2F1280_640%2Fimages%2Flive%2Fp0%2F5h%2F41%2Fp05h41nr.jpg&imgrefurl=http%3A%2F%2Fwww.bbc.com%2Ffuture%2Fstory%2F20170919-how-flying-seriously-messes-with-your-mind&docid=oRZTdpSWD41oeM&tbnid=XxL_lgM1CLKqAM%3A&vet=10ahUKEwi00cGU2erWAhWFu48KHU1CBaYQMwhRKCIwIg..i&w=1280&h=640&client=firefox-b-ab&bih=701&biw=1536&q=dry%20airplane%20cabin%20environment&ved=0ahUKEwi00cGU2erWAhWFu48KHU1CBaYQMwhRKCIwIg&iact=mrc&uact=8
https://www.google.com.sg/imgres?imgurl=http%3A%2F%2Flostempireherbs.com%2Fwp-content%2Fuploads%2F2015%2F10%2Fdehydration.jpeg&imgrefurl=https%3A%2F%2Flostempireherbs.com%2Fcoffee-and-dehydration%2F&docid=zxc7GJb2E_xwBM&tbnid=Im67SvoNc2ARSM%3A&vet=10ahUKEwjP5ZGx2erWAhVC6Y8KHXTpBx0QMwhYKCkwKQ..i&w=750&h=545&bih=701&biw=1536&q=coffee%20diuretic%20effects&ved=0ahUKEwjP5ZGx2erWAhVC6Y8KHXTpBx0QMwhYKCkwKQ&iact=mrc&uact=8

http://www.snopes.com/medical/graphics/coldwater.jpg

Wednesday, October 11, 2017

Speaking Up? - Silence that may kill

Disclaimer! This is NOT an opinion piece, but rather a collection of various readings and clippings which serve to spur further exploration in the topic. These are not full articles but simply excerpts from the bulk of reading material that is available.  As much citation and references were taken with regards to the topic. Legitimacy and accuracy of the clippings are read at your own discretion.
 Speaking up?
Silence that may kill



Statistics On Speaking Up in Aviation
Bienefeld and Grote (2012) conducted a study to determine the reasons why aircraft crew members sometimes choose to stay silent and not speak up to each other about safety critical information during flight.

Another objective of their study was to understand whether there are specific group differences as to why crew members aren’t speaking up, for example whether the barriers to speaking up are different between Captains and First Officers. The crew groups analyzed were Captain’s, Flight Attendant’s, Purser’s (Chief Flight Attendant) and Flight Attendant’s.

Sample
A total of 1,751 cockpit and cabin crew members of a European Airline participated in the study. Of these 1,751 participants there were 261 Captain's, 334 First Officer's, 307 Purser's and 849 Flight Attendant's studied.

Generalization potential
As this study focused on crew members from one European airline only, Benefeld and Grote note that future research should focus on whether similar results can be found in other airlines around the world with their different cultural contexts. Consequently further study is needed before this study can be generalized to other airlines and crew around the world.
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In their study, Bienefeld and Grote define speaking up as “as an upward voice directed from lower to higher status individuals within and across teams, that challenges the status quo, to avert or mitigate errors” (Bienefeld & Grote, 2012, p.1). As shown in table one, speaking up behavior changed significantly between crew member groups. Members were asked to rate from 0 (never speaking up) to 100 (always speaking up) in how often they spoke up regarding safety critical information.

Table One: Speaking Up Behavior Between Crew Groups

Mean SD Interpretation
Captain 86.93 19.17 Highest Speaking up
First Officer 30.95 22.71 3rd Highest Speaking Up
Purser (Chief Flight Attendant) 28.05 20.35 Lowest Speaking Up
Flight Attendant 57.66 15.17 2nd Highest Speaking Up
The results show that on average all crew members decide not to always speak up regarding issues that are safety related during flight. Interestingly, participant's spoke up only 52% of the time regarding safety critical information overall. The authors used a univariate general linear model to test if past speaking up behavior differed between groups, with each crew group being the independent variable and past speaking up behavior as the dependent variable. Participant's age, gender and and tenure were also included as co-variates. Results were that crew groups had a significant effect in past speaking up behavior (p < .001), however none of the co-variates showed any effects on past speaking up behavior.

When crew members were asked the reasons why they chose to be silent in a certain safety related situation that they remembered, specific group differences emerged as shown in table two.



Table Two: Reasons for Silence versus Frequency (percentage) per Group
Reasons For Silence Captain First Officer Purser Flight Attendant
1.Status Differences 0% 11% 20% 40% (4th)
2.Fear of Damaging Relationships 53% (1st) 43% (1st) 15% 42% (3rd)
3.Feelings of Futility 0% 33% (2nd) 23% (5th) 51% (2nd)
4.Lack of Experience in current position, job or aircraft type 14% (5th) 13% 3% 0%
5.Negative Impact on Others 24% (2nd) 24% (4th) 16% 36% (5th)
6.Poor Relationship with Supervisor 0% 20% 26% (4th) 35%
7.Fear of Punishment 0% 23% (5th) 67% (2nd) 81% (1st)
8.Fear of Negative Label 3% 29% (3rd) 21% 6%
9.Perceived conflict, efficiency vs safety 21% (3rd) 14% 70% (1st) 29%
10.Perceived Time Pressure 20% (4th) 11% 41% (3rd) 13%
Notes Percentages of Reasons add up to over 100% as most participants had more than one reason for being silent in the situation they remembered. Figures beside percentages indicate the top 5 reasons for each groups silence.
Captains' and First Officers' main reason for silence was the fear of damaging the relationship between one another in the cockpit, with 53% and 43% feeling this way respectively. Further to this, Captain's didn't want to speak up 24% of the time due to the embarrassment they thought the First Officer would feel.

The second highest reason for both First Officer's and Flight Attendant's staying silent was the feeling of futility if they were to speak up, highlighting the decision making positions Captain's and Purser's share.

Flight Attendants' and Pursers' fear of punishment was a major reason for their silence, with 81% and 67% feeling this way respectively. This was contrasted to First Officer's who only gave this as a reason for silence 23% of the time.

Overall the reasons for silence varied greatly, with all groups top 3 reasons for not speaking up being different. (Jose I have emailed you a graph of the table two results).

The authors conducted 10 separate chi-square tests to test if crew groups were different in their reasons for being silent in the situation they remembered. This was achieved through comparing crew groups with their anticipated and viewed frequencies for each reason. All tests gave significant results (p < .001), confirming that a crew members group had a significant effect whether an individual reason for being silent was or was not chosen.

Secure and Insecure Authority
Beyond The Checklist: Suzzane Gordon, Patrick Mendenhall and Bonnie Blair O'Connor
The first officer is afraid to speak up because he doesn't want to make any waves. He doesn't want to get this captain pissed off at him. He's not gonna say anything even though he sees a potential mistake being made.

By Redefining this behavior as "Insecure authority," the aviation safety movement changed the subordinates' view of the behavior of the superior. If in the initial phases of the implementation of CRM this behavior could not be changed, it could still be de-legitimized.

What Johnson says he and his younger colleagues learned was that a good captain will demand that the first officer say something cause he realizes with some humility that everybody makes mistakes and isn't always perfect. The whole idea was for the captain to come on board and give a briefing and say look, if you see anything you don't like, if I'm screwing up, I want you to say something. It's called "Secure Authority"
In our actual training, just demanding participation from the rest of the crew whereas insecure authority is very aristocratic and tries to do everything himself.
 

An Upward Voice
Individual and Contextual Differences
From the Triad Institute Whether in the cockpit or the conference room, study after study shows that people are reluctant to share reservations, concerns, or candid views with their boss. What are they afraid of?
Amy Edmondson of Harvard
Business School calls this inhibited upward flow of information in organizations an absence of “upward voice.”
She says two kinds of factors
inhibit people’s willingness to speak their mind.

Individual Differences: personality factors like extroversion or pro-activity, communication skillfulness, and personal concerns about repercussions and job security

Contextual Differences: cues about the reaction you’ll get, such as leader behavior, the degree of hierarchy in the organization, and explicit channels for information, such as suggestion boxes, surveys, or regular meetings.

A matter of Cultural Differences
Power Distance Index
Geert Hofstede, a Dutch psychologist, developed the Power Distance Index (PDI) as part of his work to understand and measure certain cultural attributes. Power Distance is concerned with attitudes toward hierarchy – specifically with how much a particular culture values and respects authority.

The greater the PDI, the less likely an employee will disagree with their superior (or someone who has more power).

To determine the PDI, Hofstede conducted cultural surveys in nearly two dozen countries. He asked questions such as:
▪ How frequently, in your experience, does the following problem occur: employees being afraid to express disagreement with their managers or superiors?
▪ To what extent do the less powerful members of the organization accept and expect that power is distributed unequally?
▪ How much are older people respected or feared?
▪ Are power holders entitled to special privileges?

When Hofstede plotted the PDI associated with the pilot’s native country against their respective plane crash rates, he determined there was an association between these two factors. The pilots from countries with the highest Power Distance Index were over 2.5 times more likely to crash than the pilots from countries with the lowest PDI. 

Moreover, plane crashes are much more likely to happen when the captain is in the “flying seat”, even though they share the flying time about equally. Why?

The evidence suggests that the junior officer in the cockpit is reluctant to question the captain (who has more authority) when he or she sees something that may be an unsafe decision. The higher the PDI of the flight crew’s native country, the less likely the co-pilot will be to speak up when something does not seem right. This reticence is believed to be a significant contributor to the higher crash rate. Let’s consider these implications in the context of a non-aviation workplace.

The airline industry made changes to address the identified cultural communication gap. Crew resource management training is now standard in the industry. It is designed to teach junior crew members how to communicate clearly and assertively. There is a standard procedure for co-pilots to challenge the pilot if he/she thinks something has gone wrong or a poor decision is being made. It is a set of escalating statements:
1. “Captain, I’m concerned about…”
2. “Captain, I’m uncomfortable with…”
3. “Captain, I believe the situation is UNSAFE.”
(If the captain does not respond, the first officer is required to take over the aircraft).
Has this training worked?

South Korean people have a high Power Distance Index – and historically pilots from this country suffered a high plane crash rate. Since these changes in crew resource management training, South Korean commercial aviation crash rates are now in line with those countries with a low PDI (see the earlier graphic).

Note that South Korean culture still has a high PDI. But the pilots have been trained to behave quite differently once they enter the cockpit. They are now much more likely to speak up and question the captain if they see or hear something that could jeopardize the safety of the flight.

We could take a page from the crew resource training manual and apply it to an industrial setting. Why not give employees the skills to speak up, using a standard protocol? For example, the procedure for anyone to challenge a co-worker when he/she thinks that person is taking an unnecessary risk could be the following:
1. “_________, I’m concerned about…”
2. “__________, I’m uncomfortable with…”
3. “__________, I believe the situation is unsafe.”
If __________does not respond, the task is stopped.

The Power of One
Just because we educate employees on how to escalate a concern, it does not mean they will have the courage to do so.  We need to appreciate the powerful force of social influence. In this video, David Maxfield and Joseph Grenny explain the power of having just one person in a group speak up in dissent.  They suggest that we express our disagreement using polite doubt.

Leading Change

How can we get employees to speak up when they see risky behavior?  Here are some actions we can take to reduce an organization’s Power Distance Index:

  1. Set a clear expectation that everyone (even the most junior employee) is empowered to speak up whenever something doesn’t seem right.
  2. Look for opportunities to positively reinforce this behavior when it is observed. Communicate the importance of doing this by citing examples or telling stories of others who spoke up – thus preventing a decision or action that otherwise would have resulted in a negative outcome.
  3. Be a role model for how to receive feedback. Publicly praise anyone who voices a concern.  This is especially critical if this person questions a decision or expresses an opinion that is counter to the majority view.
  4. Provide training on how to raise and quickly escalate a concern, à la the crew resource training method used by the airline industry.  Standardize the way employees can respectively disagree or pose a question when there is a hierarchy that may inhibit the behavior to speak up. Teach the concept of disagreeing through polite doubt.
  5. Enlist opinion leaders in the effort to make “speaking up” an accepted and expected behavior.  These are people who are “respected and connected” in the organization. However, they may not have any formal authority. If you can get this group to speak up, it sends a signal to others that it is an acceptable norm.
  6. Facilitate a discussion about this topic in natural work groups.  Have them commit to one another that (a) they will speak up and (b) they will listen when anyone questions a decision or believes that situation is not safe.
We cannot achieve a zero event work place unless we create an environment where employees are watching out for one another.  But simply watching is not enough.  We need everyone to be comfortable enough to take action and speak up when they see anyone taking an unnecessary risk – every time!

Sources:

- Geert Hofstede. Culture’s Consequences: Comparing Values, Behaviors, Institutions, and Organizations Across Nations.  Sage Publications. Thousand Oaks, CA. 2001
Robert L. Helmreich and Ashleigh Merritt. “Culture in the Cockpit:  Do Hofstede’s Dimensions Replicate?” Journal of Cross-Cultural Psychology 31, no.3 (May 2000): 283-301.
“Culture May Play Role In Flight Safety — Boeing Study Finds Higher Aviation Accident Rates Among Nations Where Individualism Not The Norm”. Don Phillips. The Washington Post. August 22, 1994.
Ute Fischer and Judith Orasanu.  “Cultural Diversity and Crew Communication.” Astronautical Congress.  Amsterdam. October 1999.
One Simple Skill to Overcome Peer Pressure. https://youtu.be/1-U6QTRTZSc
http://ehstoday.com/safety-leadership/control-or-caring-what-your-motive-safety-conversation

- https://books.google.com.sg/books?id=8aadDgAAQBAJ&pg=PA170&lpg=PA170&dq=beyond+the+checklist+insecure+authority&source=bl&ots=ddaSg74Ok8&sig=cpPmJgLNtwEQenoqKmc4s9eFbBA&hl=en&sa=X&ved=0ahUKEwj60ej6ouLWAhWLK48KHWTqDeAQ6AEIJjAA#v=onepage&q=beyond%20the%20checklist%20insecure%20authority&f=false
 - http://triadconsultinggroup.com/sites/default/files/Whitepaper%204%20-%20Talking%20Up.pdf


- http://wikiofscience.wikidot.com/data:silence-that-may-kill-when-aircrew-members-dont-speak-u
- http://continuousmile.com/employees-speak-up-risky-behavior/
1. Bienefeld, Nadine, and Gudela Grote. "Silence that may kill: When aircrew members don’t speak up and why." Aviation Psychology and Applied Human Factors 2.1 (2012): 1.

2. Milliken, F. J., Morrison, E. W., & Hewlin, P. F. (2003). An exploratory study of employee silence: Issues that employees don’t communicate upward and why. Journal of Manage- ment Studies, 40(6), 1453–1476

2. Detert, J. R., & Burris, E. R. (2007). Leadership behavior and employee voice: Is the door really open? Academy of Management Journal, 50, 869–884
Images from:
https://isys6621.com/2014/11/13/why-we-behave-differently-in-social-media/
https://www.timeshighereducation.com/opinion/speaking-up-for-the-public-phd-viva
http://yashimdauji.blogspot.sg/2012/11/test-pilots.html