Usability of augmented reality technology in tele-mentorship for managing clinical scenarios - A study protocol

BackgroundTele-mentorship is considered to offer a solution to training and providing professional assistance at a distance. Tele-mentoring is a method in which a mentor interactively guides a mentee at a different geographic location in real time using a technological communication device. During a healthcare procedure, tele-mentoring can support a medical expert, remote from the treatment site, to guide a less-experienced practitioner at a different geographic location. Augmented Reality (AR) technology has been incorporated in tele-mentoring systems in healthcare environments globally. However, evidence is absent about the usability of AR technology in tele-mentoring clinical healthcare professionals in managing clinical scenarios.AimThis study aims to evaluate the usability of Augmented Reality (AR) technology in tele-mentorship for managing clinical scenarios.MethodsThis study uses a quasi-experimental design. Four experienced health professionals and a minimum of twelve novice health practitioners will be recruited for the roles of mentors and mentees, respectively. In the experiment, each mentee wearing the AR headset performs a maximum of four different clinical scenarios in a simulated learning environment. A mentor who stays in a separate room and uses a laptop will provide the mentee remote instruction and guidance following the standard protocols for the treatment proposed for each scenario. The scenarios of Acute Coronary Syndrome, Acute Myocardial Infarction, Pneumonia Severe Reaction to Antibiotics, and Hypoglycaemic Emergency are selected, and the corresponding clinical management protocols developed. Outcome measures include the mentors and mentees’ perception of the AR’s usability, mentorship effectiveness, and the mentees’ self-confidence and skill performance.EthicsThe protocol was approved by the Tasmania Health and Medical Human Research Ethics Committee (Project ID: 23343). The complete pre-registration of our study can be found at https://osf.io/q8c3u/

Angles in Fuzzy Disc and Angular Noncommutative Solitons

The fuzzy disc, introduced by the authors of Ref.[1], is a disc-shaped region in a noncommutative plane, and is a fuzzy approximation of a commutative disc. In this paper we show that one can introduce a concept of angles to the fuzzy disc, by using the phase operator and phase states known in quantum optics. We gave a description of a fuzzy disc in terms of operators and their commutation relations, and studied properties of angular projection operators. A similar construction for a fuzzy annulus is also given. As an application, we constructed fan-shaped soliton solutions of a scalar field theory on a fuzzy disc, which corresponds to a fan-shaped D-brane. We also applied this concept to the theory of noncommutative gravity that we proposed in Ref.[2]. In addition, possible connections to black hole microstates, holography and an experimental test of noncommutativity by laser physics are suggested.Comment: 24 pages, 12 figures; v2: minor mistake corrected in Eq.(3.21), and discussion adapted accordingly; v3: a further discussion on the algebra of the fuzzy disc added in subsection 3.2; v4: discussions improved and typos correcte

Quantum nature of laser light

All compositions of a mixed-state density operator are equivalent for the prediction of the probabilities of future outcomes of measurements. For retrodiction, however, this is not the case. The retrodictive formalism of quantum mechanics provides a criterion for deciding that some compositions are fictional. Fictional compositions do not contain preparation device operators, that is operators corresponding to states that could have been prepared. We apply this to Molmer's controversial conjecture that optical coherences in laser light are a fiction and find agreement with his conjecture. We generalise Molmer's derivation of the interference between two lasers to avoid the use of any fictional states. We also examine another possible method for discriminating between conerent states and photon number states in laser light and find that it does not work, with the equivalence for prediction saved by entanglement

Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness

<b>Background</b> In this article we outline Burden of Treatment Theory, a new model of the relationship between sick people, their social networks, and healthcare services. Health services face the challenge of growing populations with long-term and life-limiting conditions, they have responded to this by delegating to sick people and their networks routine work aimed at managing symptoms, and at retarding - and sometimes preventing - disease progression. This is the new proactive work of patient-hood for which patients are increasingly accountable: founded on ideas about self-care, self-empowerment, and self-actualization, and on new technologies and treatment modalities which can be shifted from the clinic into the community. These place new demands on sick people, which they may experience as burdens of treatment.<p></p> <b>Discussion</b> As the burdens accumulate some patients are overwhelmed, and the consequences are likely to be poor healthcare outcomes for individual patients, increasing strain on caregivers, and rising demand and costs of healthcare services. In the face of these challenges we need to better understand the resources that patients draw upon as they respond to the demands of both burdens of illness and burdens of treatment, and the ways that resources interact with healthcare utilization.<p></p> <b>Summary</b> Burden of Treatment Theory is oriented to understanding how capacity for action interacts with the work that stems from healthcare. Burden of Treatment Theory is a structural model that focuses on the work that patients and their networks do. It thus helps us understand variations in healthcare utilization and adherence in different healthcare settings and clinical contexts

Quantifying the Risk of Localised Animal Movement Bans for Foot-and-Mouth Disease

The maintenance of disease-free status from Foot-and-Mouth Disease is of significant socio-economic importance to countries such as the UK. The imposition of bans on the movement of susceptible livestock following the discovery of an outbreak is deemed necessary to prevent the spread of what is a highly contagious disease, but has a significant economic impact on the agricultural community in itself. Here we consider the risk of applying movement restrictions only in localised zones around outbreaks in order to help evaluate how quickly nation-wide restrictions could be lifted after notification. We show, with reference to the 2001 and 2007 UK outbreaks, that it would be practical to implement such a policy provided the basic reproduction ratio of known infected premises can be estimated. It is ultimately up to policy makers and stakeholders to determine the acceptable level of risk, involving a cost benefit analysis of the potential outcomes, but quantifying the risk of spread from different sized zones is a prerequisite for this. The approach outlined is relevant to the determination of control zones and vaccination policies and has the potential to be applied to future outbreaks of other diseases

Dopamine Beta Hydroxylase Genotype Identifies Individuals Less Susceptible to Bias in Computer-Assisted Decision Making

Computerized aiding systems can assist human decision makers in complex tasks but can impair performance when they provide incorrect advice that humans erroneously follow, a phenomenon known as “automation bias.” The extent to which people exhibit automation bias varies significantly and may reflect inter-individual variation in the capacity of working memory and the efficiency of executive function, both of which are highly heritable and under dopaminergic and noradrenergic control in prefrontal cortex. The dopamine beta hydroxylase (DBH) gene is thought to regulate the differential availability of dopamine and norepinephrine in prefrontal cortex. We therefore examined decision-making performance under imperfect computer aiding in 100 participants performing a simulated command and control task. Based on two single nucleotide polymorphism (SNPs) of the DBH gene, −1041 C/T (rs1611115) and 444 G/A (rs1108580), participants were divided into groups of low and high DBH enzyme activity, where low enzyme activity is associated with greater dopamine relative to norepinephrine levels in cortex. Compared to those in the high DBH enzyme activity group, individuals in the low DBH enzyme activity group were more accurate and speedier in their decisions when incorrect advice was given and verified automation recommendations more frequently. These results indicate that a gene that regulates relative prefrontal cortex dopamine availability, DBH, can identify those individuals who are less susceptible to bias in using computerized decision-aiding systems

Interface of culture, insecurity and HIV and AIDS: Lessons from displaced communities in Pader District, Northern Uganda

<p>Abstract</p> <p>Background</p> <p>Northern Uganda unlike other rural regions has registered high HIV prevalence rates comparable to those of urbanized Kampala and the central region. This could be due to the linkages of culture, insecurity and HIV. We explored community perceptions of HIV and AIDS as a problem and its inter-linkage with culture and insecurity in Pader District.</p> <p>Methods</p> <p>A cross sectional qualitative study was conducted in four sub-counties of Pader District, Uganda between May and June 2008. Data for the study were collected through 12 focus group discussions (FGDs) held separately; 2 FGDs with men, 6 FGDs with women, and 4 FGDs with the youth (2 for each sex). In addition we conducted 15 key informant interviews with; 3 health workers, 4 community leaders at village and parish levels, 3 persons living with HIV and 5 district officials. Data were analysed using the content thematic approach. This process involved identification of the study themes and sub-themes following multiple reading of interview and discussion transcripts. Relevant quotations per thematic area were identified and have been used in the presentation of study findings.</p> <p>Results</p> <p>The struggles to meet the basic and survival needs by individuals and households overshadowed HIV as a major community problem. Conflict and risky sexual related cultural practices were perceived by communities as major drivers of HIV and AIDS in the district. Insecurity had led to congestion in the camps leading to moral decadence, rape and defilement, prostitution and poverty which increased vulnerability to HIV infection. The cultural drivers of HIV and AIDS were; widow inheritance, polygamy, early marriages, family expectations, silence about sex and alcoholism.</p> <p>Conclusions</p> <p>Development partners including civil society organisations, central government, district administration, religious and cultural leaders as well as other stakeholders should mainstream HIV in all community development and livelihood interventions in the post conflict Pader district to curtail the likely escalation of the HIV epidemic. A comprehensive behaviour change communication strategy is urgently needed to address the negative cultural practices. Real progress in the region lies in advocacy and negotiation to realise lasting peace.</p

Uncovering treatment burden as a key concept for stroke care: a systematic review of qualitative research

&lt;b&gt;Background&lt;/b&gt; Patients with chronic disease may experience complicated management plans requiring significant personal investment. This has been termed ‘treatment burden’ and has been associated with unfavourable outcomes. The aim of this systematic review is to examine the qualitative literature on treatment burden in stroke from the patient perspective.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods and findings&lt;/b&gt; The search strategy centred on: stroke, treatment burden, patient experience, and qualitative methods. We searched: Scopus, CINAHL, Embase, Medline, and PsycINFO. We tracked references, footnotes, and citations. Restrictions included: English language, date of publication January 2000 until February 2013. Two reviewers independently carried out the following: paper screening, data extraction, and data analysis. Data were analysed using framework synthesis, as informed by Normalization Process Theory. Sixty-nine papers were included. Treatment burden includes: (1) making sense of stroke management and planning care, (2) interacting with others, (3) enacting management strategies, and (4) reflecting on management. Health care is fragmented, with poor communication between patient and health care providers. Patients report inadequate information provision. Inpatient care is unsatisfactory, with a perceived lack of empathy from professionals and a shortage of stimulating activities on the ward. Discharge services are poorly coordinated, and accessing health and social care in the community is difficult. The study has potential limitations because it was restricted to studies published in English only and data from low-income countries were scarce.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; Stroke management is extremely demanding for patients, and treatment burden is influenced by micro and macro organisation of health services. Knowledge deficits mean patients are ill equipped to organise their care and develop coping strategies, making adherence less likely. There is a need to transform the approach to care provision so that services are configured to prioritise patient needs rather than those of health care systems

Changes in health-related behaviours and mental health in a UK public sample during the first set of COVID-19 public health restrictions

Public health restrictions, in response to the COVID-19 pandemic, have had potentially wide-ranging, unintended effects on health-related behaviours such as diet and physical activity and also affected mental health due to reduced social interactions. This study explored how health-related behaviours and mental health were impacted in a sample of the UK public during the COVID-19 pandemic. Two online surveys were administered in the UK, one within the first three months of the restrictions (Timepoints 1 (involving pre-pandemic recall) and 2) and another ten weeks later (Timepoint 3). Moderate-vigorous physical activity (MVPA), sitting time, screen time and sexual activity were self-reported. Diet was assessed using the Dietary Instrument for Nutri-tion Education questionnaire. Mental health was measured using the short-form Warwick-Edinburgh Mental Well-being Scale and Becks’ Anxiety and Depression Inventories. Differences between timepoints were explored using the Friedman, Wilcoxon signed-rank, McNemar and McNemar-Bowker tests. 296 adults (74% under 65 years old; 65% female) provided data across all timepoints. Between T1 and T2, MVPA, time outdoors and sexual activity decreased while sitting and screen time increased (p<0.05). Between T2 and T3, saturated fat intake, MVPA, time out-doors, and mental wellbeing increased while sitting, screen time and anxiety symptoms decreased (p<0.05). This study found that depending on the level of COVID-19 public health restrictions in place, there appeared to be a varying impact on different health-related behaviours and mental health. As countries emerge from restrictions, it will be prudent to direct necessary resources to address these important public health issues