44 It’s All About That Trach! Using a Modified Delphi Approach to Developing Pediatric Tracheostomy Teaching Tools

Primary Subject area Medical Education Background Pediatric tracheostomy care is intimidating; regular and emergency care are critical skills. Tracheostomy care training is vital for pediatric patients who have multiple people involved in their care and are fully dependent on their tracheostomy tubes for breathing. An Alberta team is developing an informational tool, the “Tracheostomy Journey”, to help families and health care providers understand and communicate clearly about pediatric tracheostomy. A needs assessment identified consistent, universal, multimodal teaching and communication tools for families, trainees, and hospital and home care providers as a primary need. Consistency in training will also improve communication between caregivers and families. Objectives The main objective of this study was to develop shareable pediatric tracheostomy care and management teaching materials for health care professionals and families. The goals of such information are to ensure checks and balances, provide universal, consistent and cohesive teaching content to all caregivers, set expectations, and promote effective communication. Design/Methods A modified Delphi approach provided structured development of training modules using existing diverse teaching materials. Participants were asked to focus on safe, consistent pediatric tracheostomy care. Two components were to: 1) Update and consolidate basic hospital discharge checklists for families; 2) Formalize current unstructured emergency training while building new resources to teach families, staff, and trainees through goal-oriented simulations. Results We consolidated 7 Home Care tracheostomy care checklists and developed 24 simulations to teach specific care skills, incorporating input from multiple stakeholders to consolidate and unify content. Participants included primary care and subspecialty physicians (Respirology, Otolaryngology, Pediatric and Neonatal Intensive Care), home care, nursing, respiratory therapy, trainees, and families. The teaching materials emphasize inclusive, acceptable skill and confidence-building as well as mastery. Each module includes a scenario, preceptor script, and debriefing materials. Scripting is designed for future video adaptation, to allow review. Pilot evaluation with trainees included knowledge and confidence assessment before and after training, after training specifically addressed the question: “Do they address the goal?”. Conclusion Training materials were developed by an expert team via a modified Delphi process and met the intended goals of being accessible, acceptable, inclusive, and effective at teaching and consolidating the skills of those involved in pediatric tracheostomy care. These tools are ready to employ and are anticipated to improve teaching and communication for families and trainees caring for children with tracheostomy.

Semi-Supervised Image-to-Video Adaptation for Video Action Recognition

Given a sequence of images i.e. video, the task given a sequence of images i.e. video, the task of action recognition is to identify the most same action among the action sequences learned by the system. Such human action recognition is based on evidence gathered from videos. It has a lot of applications including surveillance, video indexing, biometrics, telehealth, and human-computer interaction. Vision-based human activity recognition is plagued by numerous challenges thanks to reading changes, occlusion, variation in execution rate, camera motion, and background clutter. In this survey, we provide an overview and report of the existing methods based on their ability to handle these challenges as well as how these methods can be generalized and their ability to detect abnormal actions. Such systematic classification can facilitate researchers to spot the acceptable ways on the market to deal with every one of the challenges visaged and their limitations. In addition to this, we also identify the public datasets and the challenges posed by them. From this survey, we have a tendency to draw conclusions relating to however well a challenge has been resolved, and that we determine potential analysis areas that need more work.

Estimation of Adaptation Parameters for Dynamic Video Adaptation in Wireless Network Using Experimental Method

A wireless network gives flexibility to the user in terms of mobility that attracts the user to use wireless communication more. The video communication in the wireless network experiences Quality of Services (QoS) and Quality of Experience (QoE) issues due to network dynamics. The parameters, such as node mobility, routing protocols, and distance between the nodes, play a major role in the quality of video communication. Scalable Video Coding (SVC) is an extension to H.264 Advanced Video Coding (AVC), allows partial removal of layers, and generates a valid adapted bit-stream. This adaptation feature enables the streaming of video data over a wireless network to meet the availability of the resources. The video adaptation is a dynamic process and requires prior knowledge to decide the adaptation parameter for extraction of the video levels. This research work aims at building the adaptation parameters that are required by the adaptation engines, such as Media Aware Network Elements (MANE), to perform adaptation on-the-fly. The prior knowledge improves the performances of the adaptation engines and gives the improved quality of the video communication. The unique feature of this work is that, here, we used an experimental evaluation method to identify the video levels that are suitable for a given network condition. In this paper, we estimated the adaptation parameters for streaming scalable video over the wireless network using the experimental method. The adaptation parameters are derived using node mobility, link bandwidth, and motion level of video sequences as deciding parameters. The experimentation is carried on the OMNeT++ tool, and Joint Scalable Video Module (JSVM) is used to encode and decode the scalable video data.

Écran et roman sur la scène. Réflexion croisée sur trois spectacles de Krystian Lupa

"Screen and Novel on Stage: a Cross Reflection on three Krystian Lupa’s Shows. Through the analysis of three shows – City of dream based on The Other Side by Alfred Kubin, Gargoyles and Cutting Timber based on Thomas Bernhard’s novels – this article aims at highlighting the specificity of on-stage video in Krystian Lupa’s work. Best known for his adaptations of long novels focusing on conscience and interiority, Lupa supersedes a basic use of video and uses it as a real means for the exploration of the characters’ psyche. More than a mere visual element facilitating the transition from novel to stage, video is for Krystian Lupa a way to interrogate the relationship between all the elements of theatre: indeed, it questions the actor’s relationship to the character he embodies, as well as the relationship between the spectator and what happens on stage. Keywords: Krystian Lupa, Alfred Kubin, Thomas Bernhard, video, adaptation of novel, character, actor."

Iterative Adaptation of a Maternal Nutrition Videos mHealth Intervention Across Countries Using Human-Centered Design: Qualitative Study

Background Mobile health (mHealth) video interventions are often transferred across settings. Although the outcomes of these transferred interventions are frequently published, the process of adapting such videos is less described, particularly within and across lower-income contexts. This study fills a gap in the literature by outlining experiences and priorities adapting a suite of South African maternal nutrition videos to the context of rural Burkina Faso. Objective The objective of this study was to determine the key components in adapting a suite of maternal nutrition mHealth videos across settings. Methods Guided by the principles of human-centered design, this qualitative study included 10 focus group discussions, 30 in-depth interviews, and 30 observations. We first used focus group discussions to capture insights on local nutrition and impressions of the original (South African) videos. After making rapid adjustments based on these focus group discussions, we used additional methods (focus group discussions, in-depth interviews, and observations) to identify challenges, essential video refinements, and preferences in terms of content delivery. All data were collected in French or Dioula, recorded, transcribed, and translated as necessary into French before being thematically coded by two authors. Results We propose a 3-pronged Video Adaptation Framework that places the aim of video adaptation at the center of a triangle framed by end recipients, health workers, and the environment. End recipients (here, pregnant or lactating mothers) directed us to (1) align the appearance, priorities, and practices of the video’s protagonist to those of Burkinabe women; (2) be mindful of local realities whether economic, health-related, or educational; and (3) identify and routinely reiterate key points throughout videos and via reminder cards. Health workers (here, Community Health Workers and Mentor Mothers delivering the videos) guided us to (1) improve technology training, (2) simplify language and images, and (3) increase the frequency of their engagements with end recipients. In terms of the environment, respondents guided us to localize climate, vegetation, diction, and how foods are depicted. Conclusions Design research provided valuable insights in terms of developing a framework for video adaptation across settings, which other interventionists and scholars can use to guide adaptations of similar interventions.