scholarly journals The Use of Stereoscopy in a Neurosurgery Training Virtual Environment

2016 ◽  
Vol 25 (4) ◽  
pp. 289-298 ◽  
Author(s):  
Nigel W. John ◽  
Nicholas I. Phillips ◽  
Llyr ap Cenydd ◽  
Serban R. Pop ◽  
David Coope ◽  
...  
Keyword(s):  
Virtual Environment ◽  
Easy Access ◽  
Control Group ◽  
High Fidelity ◽  
Stereoscopic Display ◽  
Apparent Contradiction ◽  
Training Tool ◽  
Stereo Display ◽  
Lay People ◽  
The Uk

We have previously investigated the effectiveness of a custom-built virtual environment in assisting training of a ventriculostomy procedure, which is a commonly performed procedure by a neurosurgeon and a core task for trainee surgeons. The training tool (called VCath) was initially developed as a low-fidelity app for a tablet platform to provide easy access and availability to trainees. Subsequently, we have developed a high-fidelity version of VCath that uses a stereoscopic display to immerse the trainee in the virtual environment. This article reports on two studies that have been carried out to compare the low- and high-fidelity versions of VCath, particularly to assess the value of stereoscopy. Study 1 was conducted at the second annual boot camp organized for all year-one trainees in neurosurgery in the UK. Study 2 was performed on lay people, with no surgical experience. Our hypothesis was that using stereoscopy in the training task would be beneficial. Results from Study 1 demonstrated that performance improved for both the control group and the group trained with the tablet version of VCath. The group trained on the high-fidelity version of VCath with a stereoscopic display showed no performance improvement. The indication is that our hypothesis is false. In Study 2, six different conditions were investigated that covered the use of training with VCath on a tablet, a mono display at two different sizes, a stereo display at two different sizes, and a control group who received no training. Results from this study with lay people show that stereoscopy can make a significant improvement to the accuracy of needle placement. The possible reasons for these results and the apparent contradiction between the two studies are discussed.

scholarly journals A Tablet-Based Virtual Environment for Neurosurgery Training

2015 ◽  
Vol 24 (2) ◽  
pp. 155-162 ◽  
Author(s):  
Nigel W. John ◽  
Nicholas I. Phillips ◽  
Llyr ap Cenydd ◽  
David Coope ◽  
Nick Carleton-Bland ◽  
...  
Keyword(s):  
Virtual Environment ◽  
Improve Patient Safety ◽  
Cognitive Task ◽  
Training Group ◽  
Entry Point ◽  
Easy Access ◽  
Control Group ◽  
Anatomical Landmarks ◽  
Training Tool ◽  
The Uk

The requirement for training surgical procedures without exposing the patient to additional risk is well accepted and is part of a national drive in the UK and internationally. Computer-based simulations are important in this context, including neurosurgical resident training. The objective of this study is to evaluate the effectiveness of a custom-built virtual environment in assisting training of a ventriculostomy procedure. The training tool (called VCath) has been developed as an app for a tablet platform to provide easy access and availability to trainees. The study was conducted at the first boot camp organized for all year-one trainees in neurosurgery in the UK. The attendees were randomly distributed between the VCath training group and the control group. Efficacy of performing ventriculostomy for both groups was assessed at the beginning and end of the study using a simulated insertion task. Statistically significant changes in performance of selecting the burr hole entry point, the trajectory length and duration metrics for the VCath group, together with a good indicator of improved normalized jerk (representing the speed and smoothness of arm motion), all suggest that there has been a higher-level cognitive benefit to using VCath. The app is successful as it is focused on the cognitive task of ventriculostomy, encouraging the trainee to rehearse the entry point and use anatomical landmarks to create a trajectory to the target. In straight-line trajectory procedures such as ventriculostomy, cognitive task-based education is a useful adjunct to traditional methods and may reduce the learning curve and ultimately improve patient safety.

scholarly journals Evaluating Programs to Counter Violent Extremism: The Example of Case-Managed Interventions

Proceedings ◽  
2021 ◽  
Vol 77 (1) ◽  
pp. 20
Author(s):  
Adrian Cherney
Keyword(s):  
New South ◽  
New South Wales ◽  
Linear Process ◽  
Case Note ◽  
Control Group ◽  
Client Participation ◽  
South Wales ◽  
Client Change ◽  
Violent Extremism ◽  
The Uk

In recent years, there has been a proliferation of programs aimed at preventing radicalization and disengaging known violent extremists. Some programs have targeted individuals through the use of case management approaches and the development of individual intervention plans (e.g., the Desistance and Disengagement Program and the Channel program in the UK; the Australian New South Wales Corrections Proactive Integrated Support Model—PRISM—and state-based division initiatives in Australia). There is a broad consensus in the literature that the evaluation of such initiatives has been neglected. However, the evaluation of case-managed interventions to counter violent extremism (CVE) is challenging. They can have small caseloads which makes it difficult to have any comparison or control group. Client participation can vary over time, with no single intervention plan being alike. This can make it hard to untangle the relative influence of different components of the intervention on indicators of radicalization and disengagement. In this presentation, results from primary research that set out to evaluate case-managed CVE interventions in Australia and develop evaluation metrics are presented. This research involves the examination of interventions implemented by New South Wales corrections and state police. The effectiveness of these interventions was assessed against a five-point metric of client change. Client change overtime was analyzed using case note information collected by the various interventions on client participation. Results show that client change is not a linear process and that the longer an individual is engaged in a case-managed intervention, the more likely they are to demonstrate change relating to disengagement. Specific case studies are used to illustrate trajectories and turning points related to radicalization and to highlight the role of case-managed interventions in facilitating disengagement. Key elements of effective interventions include the provision of ongoing informal support. Investment in capturing case note information should be a priority of intervention providers. Different challenges confronted by case-managed CVE interventions are highlighted.

scholarly journals Referrals to Urgent Dental Centres During the COVID-19 Pandemic: A Multi-Site Analysis Research Project

2021 ◽  
Vol 10 (1) ◽  
pp. 40-45
Author(s):  
Adam Shathur ◽  
Samuel Reeves ◽  
Faizal Sameja ◽  
Vishal Patel ◽  
Allan Jones
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Easy Access ◽  
Dental Services ◽  
Care Services ◽  
Dental Practitioners ◽  
Consultation And Referral ◽  
Care Systems ◽  
Access To Primary Care ◽  
The Uk

Introduction: The COVID-19 pandemic enforced the cessation of routine dentistry and the creation of local urgent dental care systems in the UK. General dental practices are obligated by NHS guidance to remain open and provide remote consultation and referral where appropriate to patients having pain or problems. Aims: To compare two urgent dental centres with different triage and referral systems with regard to quality and appropriateness of referrals, and patient management outcomes. Methods: 110 consecutive referrals received by a primary care urgent dental centre and a secondary care urgent dental centre were assessed. It was considered whether the patients referred had access to remote primary care dental services, fulfilled the criteria required to be deemed a dental emergency as mandated by NHS guidance, and what the outcomes of referrals were. Results: At the primary care centre, 100% of patients were referred by general dental practitioners and had access to remote primary care dental services. 95.5% of referrals were deemed appropriate and were seen for treatment. At the secondary care site, 94.5% of referrals were direct from the patient by contacting NHS 111. 40% had received triaging to include ‘advice, analgesia and antimicrobial’ from a general dental practitioner, and 25.5% were deemed appropriate and resulted in treatment. Conclusion: Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.

Peritonsillar abscess drainage: using oropharyngeal endoscopy as a therapeutic adjunct and training tool

2021 ◽  
Vol 135 (2) ◽  
pp. 176-178 ◽  
Author(s):  
A Sawhney ◽  
R Bidaye ◽  
A Khanna
Keyword(s):  
Peritonsillar Abscess ◽  
Therapeutic Procedure ◽  
Deep Tissue ◽  
Abscess Drainage ◽  
Incision And Drainage ◽  
Training Tool ◽  
Poor Access ◽  
The Uk ◽  
And Training ◽  
Poor Lighting

AbstractBackgroundPeritonsillar abscess, or quinsy, is one of the most common emergency presentations to ENT departments, and is the most common deep tissue infection of the head and neck. In the UK, junior members of the ENT team are regularly required to independently assess, diagnose and treat patients with peritonsillar aspiration or incision and drainage.IssueInexperienced practitioners can stumble at several obstacles: poor access due to trismus; poor lighting; difficulty in learning the therapeutic procedure; and difficulty in accurately documenting findings and treatment.SolutionTo counter these and other difficulties, the authors describe the routine use of video endoscopy as a training tool and therapeutic adjunct in the management of quinsy.

ELFIN, the United Kingdom preterm lactoferrin trial: interpretation and future questions

2020 ◽  
Author(s):  
Janet Elizabeth Berrington ◽  
William McGuire ◽  
NIcholas David Embleton
Keyword(s):  
United Kingdom ◽  
Preterm Infants ◽  
Late Onset ◽  
Disease Onset ◽  
Intervention Group ◽  
Control Group ◽  
Bovine Lactoferrin ◽  
The United Kingdom ◽  
Late Onset Sepsis ◽  
The Uk

Previous studies suggested that supplemental bovine lactoferrin (BLF) given to preterm infants (<32 weeks gestation) may reduce late onset sepsis (LOS) and necrotising enterocolitis (NEC), but have been underpowered. The Enteral Lactoferrin in Neonates (ELFIN) study, performed in the United Kingdom (UK), aimed to further address this issue with a well powered double blinded placebo controlled trial of >2200 preterm infants. ELFIN did not demonstrate a reduction in LOS or NEC, or several other clinically important measures. 316 (29%) of 1093 infants in the intervention group developed late-onset sepsis versus 334 (31%) of 1089 in the control group with an adjusted risk ratio of 0·95 (95% CI 0·86–1·04; p=0· 233). Reasons for the differences in ELFIN trial results and other studies may include population differences, the routine use of antifungals in the UK, timing of administration of the lactoferrin in relation to disease onset, or specific properties of the lactoferrin used in different trials. Further exploration is being undertaken in the UK NIHR funded Mechanisms Affecting the Guts of Preterm Infants in Enteral feeding trials (MAGPIE) study, for which results should be available soon.

scholarly journals Stress of nursing students in clinical simulation: a randomized clinical trial

2018 ◽  
Vol 71 (3) ◽  
pp. 967-974 ◽  
Author(s):  
Radamés Boostel ◽  
Jorge Vinícius Cestari Felix ◽  
Carina Bortolato-Major ◽  
Edivane Pedrolo ◽  
Stela Adami Vayego ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Nursing Students ◽  
Randomized Clinical Trial ◽  
Interpersonal Relationships ◽  
Control Group ◽  
High Fidelity ◽  
Clinical Simulation ◽  
Skill Laboratory ◽  
Before And After ◽  
Experimental Group

ABSTRACT Objective: To evaluate and compare the perception of stressors by nursing students before and after a high-fidelity clinical simulation or conventional laboratory practice class. Method: This is a randomized clinical trial conducted with 52 nursing students. Both groups had theoretical classes about cardiothoracic physical examination, followed by practice class in skill laboratory. In addition, the experimental group took part in a high-fidelity simulation scenario. Stressors were evaluated before and after class, with the application of KEZKAK questionnaire. Results: The experimental group was significantly more worried about six factors related to lack of competence and to interpersonal relationships (p < 0.05), while the control group was significantly more worried about being in contact with suffering (p = 0.0315). Conclusion: The simulation affects students’ perception of stressors and promotes their self-evaluation and critical thinking regarding the responsibility that comes with their learning.

scholarly journals PLAYING ACTIVE VIDEO GAMES WHILE IN A TENNIS TRAINING PROCESS: A NEW TRAINING TOOL OR A HANDICAP FOR CHILDREN?

2019 ◽  
Vol 9 (2) ◽  
pp. 75-88
Author(s):  
Luka Šlosar ◽  
Matej Plevnik ◽  
Uroš Marušič
Keyword(s):  
Video Games ◽  
Control Group ◽  
Kinetic Chain ◽  
Tennis Players ◽  
Training Tool ◽  
Active Video Games ◽  
Active Video ◽  
Post Test ◽  
Game Intervention ◽  
Experimental Group

Aim: The purpose of this pilot study was to quantify the effect of a continued active video games (AVG) playing on the tennis forehand and backhand technique development. Methods: Altogether 24 tennis players (7 – 9 year olds) were randomly divided in two different groups, both involved in a 12-week tennis training program (twice a week for an hour). The participants in the experimental group received an additional twice a week (20-minute) AVG Virtua Tennis 4 game intervention at the end of each regular tennis training hour, while the participants in the control group received no additional intervention. Pre- and post-AVG intervention, the Tennis Rating Score for Children scale (TRSC) was applied to detect tennis training-related changes that occur in each specific stroke. Results: Our results at the post-test show that participants in the experimental group did not significantly improved in one element (TRSC12; p = 0,317) in the forehand stroke and two (TRSC10; p = 0,157 and TRSC12 p = 0,157) in the backhand. The control group significantly improved in all the fifteen evaluated elements in both the forehand and backhand stroke. The experimental group had a higher effect size in all the kinetic chain section in both the forehand and backhand stroke compared to the control. The same happens for the TRSC7 (point of contact – height). Conclusion: Prolonged AVG playing seems to improve visual attentions skills (perception of a moving object) in young tennis players, giving them the opportunity to be able to prepare themselves for the oncoming ball sooner as compared to their control counterparts. From the other perspective, AVG were shown to negatively affect correct players positioning, especially at the beginning and at the end of a stroke. Keywords: exergames, tennis technique, visual attention skills

Hybrid Waters: On Water,Nature, and Society

2004 ◽  
Author(s):  
Erik Swyngedouw
Keyword(s):  
Water Management ◽  
Water Supply ◽  
Global Environmental Change ◽  
Easy Access ◽  
Clean Water ◽  
Water Control ◽  
Popular Resistance ◽  
Global North ◽  
The Uk ◽  
Nature And Society

In recent years, we have become increasingly aware of the importance of water as a critical good, and questions of water supply, access, and management, both in quantitative and qualitative terms, have become key issues (Gleick 1993; Postel 1992; Stauffer 1998). The proliferating commodification and privatization of water management systems; the combination of Global Environmental Change with increased demands from cities, agriculture, and industry for reasonably clean water; the inadequate access of almost a billion people on the planet to clean water (over half of whom live in large urban centres); the proliferating geopolitical struggle over the control of river basins; the popular resistance against the construction of new megadams; the political struggles around water privatization projects; and many other issues; have brought water politics to the foreground of national and international agendas (Shiklomanov 1990; 1997; Herrington 1996; Roy 2001). In the twentieth century, water scarcity was seen as a problem primarily affecting developing societies (Anton 1993). However, at the turn of the new century, water problems are becoming increasingly globalized. In Europe, the area bordering the Mediterranean, notably Spain, southern Italy, and Greece, is arguably the location in which the water crisis has become most acute, both in quantitative and qualitative terms (Batisse and Gernon 1989; Margat 1992; Swyngedouw 1996a). However, northern European countries, such as the UK, Belgium, and France, have also seen increasing problems with water supply, water management, and water control (Haughton 1996), while transitional societies in eastern Europe are faced with mounting water supply problems (Thomas and Howlett 1993). The Yorkshire drought in England, for example, or the Walloon/Flemish dispute over water rights are illuminating examples of the intensifying conflict that surrounds water issues (Bakker 1999). Cities in the global South and the global North alike are suffering from a deterioration in their water supply infrastructure and in their environmental and social conditions in general (Lorrain 1995; Brockerhoff and Brennan 1998). Up to 50% of urban residents in the developing world’s megacities have no easy access to reasonably clean and affordable water. The myriad socioenvironmental problems associated with deficient water supply conditions threaten urban sustainability, social cohesion, and, most disturbingly, the livelihoods of millions of people (Niemczynowicz 1991).

scholarly journals Feasibility of testing the medium-term impact of inulin on phenolic acids bioavailability in healthy overweight individuals

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Wenjuan Cong ◽  
Cara Swailes ◽  
Mircea Martiniuc ◽  
Wardah Talib ◽  
William Mullen ◽  
...  
Keyword(s):  
Phenolic Acids ◽  
Acid Reflux ◽  
Control Group ◽  
Flavonoid Content ◽  
Opt Out ◽  
Gastrointestinal Distress ◽  
Faecal Samples ◽  
Diet Control ◽  
Cardiometabolic Markers ◽  
The Uk

AbstractIntroductionInteractions between polyphenols and non-digestible carbohydrates (NDC) can impact on polyphenolic metabolites bioavailability, including phenolic acids. The BLEND2 trial (NCT03840746) aims to study longer-term interactions of a flavonoid-rich food with/without NDC on microbiota metabolites and cardiometabolic markers. Trial feasibility using a bespoke food was tested.Material and MethodsThe soup was developed locally containing cherry tomatoes, tomato puree, red onion, fresh lovage, with/without the NDC inulin (10g), but improved and processed with Campden BRI, Chipping Campden, UK. The final product (~400g/ tin) was evaluated with VAS scales (0–10) for appearance, smell, taste and overall palatability, and flavonoid content evaluated using liquid chromatography-mass spectrometry. The 3-arm parallel randomised blinded design (control soup, soup + inulin, habitual diet control) recruited self-reported healthy participants (BMI > 25, 40–70y) with urine, blood, faecal samples collected at baseline, 3-week, 6-weeks.ResultsBoth soups scored similarly (n = 8 testers) for visual appeal (with inulin 5.1 ± 2.1; without 4.5 ± 2.0); smell (with 5.9 ± 1.7; without 5.4 ± 0.8); taste (with 6.6 ± 2.0; without 5.5 ± 2.3), aftertaste (with 6.3 ± 2.9; without 5.4 ± 2.3) and overall palatability (with 7.0 ± 1.9; without 6.1 ± 2.1).The soups (A&B), 1 tin/day, provide 68.5 ± 10.9 mg total flavonoids (soup A n = 3, quercetin equivalents) and 74.0 ± 16.1 mg (soup B, n = 3): quercetin (A 1.2 ± 0.1 mg; B 1.3 ± 0.6 mg), quercetin-4-glucoside (A 3.9 ± 1.0 mg; B 4.1 ± 1.9 mg), quercetin-3-rutinoside (A 23.0 ± 3.2 mg; B 20.5 ± 1.0 mg), quercetin 3,4-diglucosides (A 40.5 ± 6.9 mg; B 48.2 ± 14.9 mg).Following notes of interest (n = 415), n = 111 attended screening, n = 34 did not proceed (medications, opt-out; 31%). Participants (n = 77) are mostly British (79%), median age 56y (IQR 49-62) with a median BMI of 31 (IQR 28-35). Dropout was low (12%) and early in the study (personal issues, n = 2; gastrointestinal issues, n = 2; failure to comply with protocol, n = 2; acid reflux symptoms, n = 1; dislike of test food, n = 1). Adverse events included acid reflux/heartburn (n = 4), gastrointestinal distress (n = 3) accounting for 3 drop-outs.To date, urine, blood and faecal samples (study day or day + 1) were collected at all timepoints, for all participants. Participation (soup arms) has not led to body weight or blood lipids changes compared to control group.DiscussionThe protocol for this 6-week trial has proved feasible with lower dropout than expected. Soup flavonoid content representing ~16% of average European flavonoid intakes, with inulin (10g) half the UK daily fibre intake. The soup was well accepted with few reports of adverse issues. Recruitment in this population is challenging, due to high levels of medication and ill health.

A NATIONAL SURVEY TO IDENTIFY HOW DISPLACEMENT VALUE INFORMATION IS USED AND PRESENTED TO CLINICAL STAFF IN NHS HOSPITALS

2016 ◽  
Vol 101 (9) ◽  
pp. e2.75-e2
Author(s):  
Nanna Christiansen ◽  
Zinab Kehk ◽  
Susan Keeling ◽  
Bryony Dean
Keyword(s):  
Hospital Setting ◽  
Visual Presentation ◽  
National Standard ◽  
Survey Study ◽  
Easy Access ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Paediatric Hospital ◽  
Method Of Calculation ◽  
The Uk

AimThe use of displacement values (DVs) when preparing intravenous (IV) medication for children enables accurate doses to be given1 and is assumed to be common paediatric practice. This survey aimed to assess views of UK paediatric pharmacists on DVs in practice to explore:▸ How prevalent is DV use in the paediatric hospital setting▸ Which type of IV administration guidelines were being used▸ Which form of DV presentation is perceived to be most practical▸ Which method of calculation is preferredMethodA national cross-sectional survey study was undertaken. The questionnaire comprised of 13 closed and open questions as well as samples of how DVs are currently displayed on the Medusa Injectable Medicines Guide2. After piloting the questionnaire the survey was sent to 365 paediatric pharmacists across 120 UK hospitals utilising Qualtrics Survey Software.ResultsFifty-five completed questionnaires covering 52 (43%) United Kingdom (UK) hospital trusts were received. Of 55 respondents, 52 (95%) reported the clinical significance of DVs in paediatric care. This was reflected in the fact that all local guides provided information on DVs. The majority (32;59%) used locally produced guides, while 15 (27%) of respondents used Medusa as a resource. All respondents commented on methods of presentation and calculation of DV information. Of four methods presented, the method involving presentation of reconstitution information in a brand-specific table was ranked as most practical (46;84% respondents). This method was viewed as being clear and concise. Respondents also expressed the importance of having this tabulated method visually embedded in the monograph to allow easy access to information on the wards. This concurs with suggested information presentation to aid error reduction in the literature.3 National standardisation of DV information was viewed as ‘very useful' or ‘preferred' by 52 (95%) of respondents; reasons for this preference were risk reduction due to errors or misinterpretation.ConclusionThe use of DVs in paediatrics is commonplace in the UK; this is reflected in local IV guides used by the majority of centres. Improving visual presentation of DVs is important and tabulated expression of DVs is preferred by pharmacists and a national standard presentation of DVs is encouraged. The results from the survey will inform the monograph layout for the Medusa. Prior to implementation nurse feedback should also be sought.

Sign in / Sign up

Export Citation Format

Share Document