Ambient intelligence and simulation in health care virtual scenarios

The success of change depends greatly on the ability to respond to human needs and to bridge the gap between humans and machines, and understanding the environment. With such experience, in addition to extensive practice in managing change, knowledge sharing and innovation, it would be interesting in offering a contribution by facilitating a dialogue, knowledge café (i.e. bringing in knowledge) on these issues, and how to apply them to new and altering scenarios. On the other hand, when one comes into the area of health care, one major limitation felt by those institutions, is in the selection process of physicians to undertake a specific task, where there is a lack of objective, of validated measures of human performance. Indeed, objective measures are necessary if simulators are to be used to evaluate the skills and training of medical practitioners and teams or to evaluate the impact of new processes or equipment design on the overall system performance. Therefore, in this paper it will be presented a logical theory of Situation Awareness (SA) and discusses the methods required for developing an objective measure of SA within the context of a simulated medical environment, as the one referred to above. Analysis and interpretation of SA data for both individual and team performance in health care are presented

Fluconazole and Voriconazole Multidisk Testing of Candida Species for Disk Test Calibration and MIC Estimation

Fluconazole and voriconazole MICs were determined for 114 clinical Candida isolates, including isolates of Candida albicans, Candida glabrata, Candida krusei, Candida lusitaniae, Candida parapsilosis, and Candida tropicalis. All strains were susceptible to voriconazole, and most strains were also susceptible to fluconazole, with the exception of C. glabrata and C. krusei, the latter being fully fluconazole resistant. Single-strain regression analysis (SRA) was applied to 54 strains, including American Type Culture Collection reference strains. The regression lines obtained were markedly different for the different Candida species. Using an MIC limit of susceptibility to fluconazole of ≤8 μg/ml, according to NCCLS standards, the zone breakpoint for susceptibility for the 25-μg fluconazole disk was calculated to be ≥18 mm for C. albicans and ≥22 mm for C. glabrata and C. krusei. SRA results for voriconazole were used to estimate an optimal disk content according to rational criteria. A 5-μg disk content of voriconazole gave measurable zones for a tentative resistance limit of 4 μg/ml, whereas a 2.5-μg disk gave zones at the same MIC level for only three of the species. A novel SRA modification, multidisk testing, was also applied to the two major species, C. albicans and C. glabrata, and the MIC estimates were compared with the true MICs for the isolates. There was a significant correlation between the two measurements. Our results show that disk diffusion methods might be useful for azole testing of Candida isolates. The method can be calibrated using SRA. Multidisk testing gives direct estimations of the MICs for the isolates