Analysis and testing of the thermal design of the electrical package in the U.S. Army's Upgraded Logic Module (ULM)

The U.S. Army has developed an Upgraded Logic Module (ULM) for use in its Infantry Direct Fire Simulator System (IDFSS). It is designed to analyze data collected from associated instrumentation according to prescribed programming, to report results back to the system control via a telemetry interface, and it can be backpack mounted. The thermal environment existing at Ft. Hunter Liggett, Ca. (the primary operating environment for the ULM) during the summer will add an abnormal thermal load to the ULM operating environment in the backpack. A mock-up of the actual ULM was built to model the heat dissipation of all the components and tested in different environments using extreme power consumption rates. The actual ULM was tested with typical power consumption rates and various environmental temperatures, including solar loading. Under typical operating conditions, the ULM will remain within manufacturer's tolerances for individual component temperatures. However slight increases in power consumption rates will severely stress the reliability limits of certain components, and the reliability of the entire system cannot be predicted.http://archive.org/details/analysistestingo00keebCaptain, United States ArmyApproved for public release; distribution is unlimited

Telemedicine Security: Challenges and Solutions

The proliferation of telemedicine spurred by the COVID-19 pandemic has come with a variety of human factors challenges. Such challenges include mitigating potential risks associated with the quick transition to virtual care. We identify challenges and solutions related to telemedicine security, and analyze our results using Schlarman’s People, Policy, Technology framework (2001). Our systematic literature review synthe-sizes gray literature (white papers, news articles, and blog posts) in addition to formal (published) litera-ture. This methodology closes the gap between academic research and professional practice and aids in providing timely, practical insights related to cybersecurity and safety in virtual care environments. As the transition from traditional care continues to develop, we seek to better understand emerging vulnerabilities, identify crucial cyber hygiene practices, and provide insights on how to improve the safety of paitent data in virtiual care. Telemedicine is here to stay, and lessons learned from the pandemic are likely to remain useful

Validation of the GUESS-18: A Short Version of the Game User Experience Satisfaction Scale (GUESS)

The Game User Experience Satisfaction Scale (GUESS) is a 55-item tool assessing nine constructs describing video game satisfaction. While the development of the GUESS followed best practices and resulted in a versatile, comprehensive tool for assessing video game user experience, responding to 55 items can be cumbersome in situations where repeated assessments are necessary. The aim of this research was to develop a shorter version of the scale for use in iterative game design, testing, and research. Two studies were conducted: the first one to create a configural model of the GUESS that was then truncated to an 18-item short scale to establish an initial level of validity and a second study with a new sample to demonstrate cross-sample validity of the 18- item GUESS scale. Results from a confirmatory factor analysis of the 18-item scale demonstrated excellent fit and construct validity to the original nine construct instrument. Use of the GUESS-18 is encouraged as a brief, practical, yet comprehensive measure of video game satisfaction for practitioners and researchers

Unlocking the Methodology Of Escape Rooms: Considerations For Conducting Applied Escape Rooms in Research

Background. Teams are the foundation of modern organizations. Many organizations are interested in interventions to bolster the effectiveness of their workforce. One viable intervention is an escape room. Escape rooms are engaging, team based activities that require individuals to work together to complete multiple tasks in a limited amount of time. Purpose. The purpose of this article is to provide ten considerations that are relevant to leveraging escape rooms as a means for data collection. Specifically, we offer guidance regarding pilot testing, equipment set-up, participant recruitment, briefing participants, progress monitoring, hints, room maintenance, data maintenance and analysis, and revising the room and study. Conclusion. The considerations provided in this article can assist researchers when attempting to employ an escape room as a mechanism to collect data

Advancing Team Cohesion: Using an Escape Room as a Novel Approach

Objective: An escape room was used to study teamwork and its determinants, which have been found to relate to the quality and safety of patient care delivery. This pilot study aimed to explore the value of an escape room as a mechanism for improving cohesion among interdisciplinary healthcare teams. Methods: This research was conducted at a nonprofit medical center in Southern California. All participants who work on a team were invited to participate. Authors employed an interrupted within-subjects design, with two pre- and post- escape room questionnaires related to two facets of group cohesion: (belonging – (PGC-B) and morale (PGC-M)). Participants rated their perceptions of group cohesion before, after, and one-month after the escape room. The main outcome measures included PGC-B/M. Results: Sixty-two teams participated (n 280 participants) of which 31 teams (50%) successfully “escaped” in the allotted 45 minutes. There was a statistically significant difference in PGC between the three time periods, F(4, 254) 24.10, p \u3c .001; Wilks’ K .725; partial g2 .275. Results indicated significantly higher scores for PGC immediately after the escape room and at the one-month follow-up compared to baseline. Conclusions: This work offers insights into the utility of using an escape room as a team building intervention in interprofessional healthcare teams. Considering the modifiability of escape rooms, they may function as valuable team building mechanisms in healthcare. More work is needed to determine how escape rooms compare to more traditional team building curriculums

Directly Comparing Handoff Protocols for Pediatric Hospitalists

BACKGROUND AND OBJECTIVES: Handoff protocols are often developed by brainstorming and consensus, and few are directly compared. We hypothesized that a handoff protocol (Flex 11) developed using a rigorous methodology would be more favorable in terms of clinicians’ attitudes, behaviors, cognitions, or time-on-task when performing handoffs compared with a prevalent protocol (Situation Background Assessment Recommendation [SBAR]). METHODS: Using a between-groups, randomized control trial design (Flex 11 versus SBAR) during a pilot study in a simulated environment, 20 clinicians (13 attending physicians and 7 residents) received 3 patient handoffs from a standardized physician, managed the patients, and handed off the patients to the same standardized physician. Participants completed surveys assessing their attitudes and cognitions, and behaviors and handoff duration were assessed through observations. RESULTS: All data were analyzed using independent samples t tests. For attitudes, “ease of use” ratings were lower for SBAR participants than Flex 11 participants (P , .01), and “being helpful” ratings were lower for SBAR participants than Flex 11 participants (P 5 .02). For behaviors, results indicate no significant difference in the information acquired between the SBAR and Flex 11 protocols. However, SBAR participants gave significantly less information than Flex 11 participants (P , .01). For cognitions, SBAR and Flex 11 participants reported similar workload except for frustration. For handoff duration, there were no significant differences between the protocols (P 5 .36). CONCLUSIONS: The results suggest that Flex 11 is an efficient, beneficial tool in a simulated environment with pediatric clinicians. Future studies should evaluate this protocol in the inpatient setting

Telerounding: A Scoping Review and Implications for Future Healthcare Practice

Telerounding is slated to become an important avenue for future healthcare practice. As utilization of telerounding is increasing, a review of the literature is necessary to distill themes and identify critical considerations for the implementation of telerounding. We provide evidence of the utility of telerounding and considerations to support its implementation in future healthcare practice based on a scoping review. Method: We collected articles from nine scientific databases from the earliest dated available articles to August 2020. We identified whether each article centered on telerounding policies, regulations, or practice. We also organized information from each article and sorted themes into four categories: sample characteristics, technology utilized, study constructs, and research outcomes. Results: We identified 21 articles related to telerounding that fit our criteria. All articles emphasized telerounding practice. Most articles reported data collected from surgical wards, had adult samples, and utilized robotic telerounding systems. Most articles reported null effects or positive effects on their measured variables. Discussion: Providers and patients can benefit from the effective implementation of telerounding. Telerounding can support patient care by reducing travel expenses and opportunities for infection. Evidence suggests that telerounding can reduce patient length of stay. Patients and providers are willing to utilize telerounding, but patient willingness is influenced by age and education. Telerounding does not appear to negatively impact satisfaction or patient care. Organizations seeking to implement telerounding systems must consider education for their providers, logistics associated with hardware and software, scheduling, and characteristics of the organizational context that can support telerounding. Considerations provided in this article can mitigate difficulties associated with the implementation of telerounding

Reflecting the real value of health care resources in modelling and cost-effectiveness studies-The example of viral load informed differentiated care

BACKGROUND: The WHO HIV Treatment Guidelines suggest routine viral-load monitoring can be used to differentiate antiretroviral therapy (ART) delivery and reduce the frequency of clinic visits for patients stable on ART. This recommendation was informed by economic analysis that showed the approach is very likely to be cost-effective, even in the most resource constrained of settings. The health benefits were shown to be modest but the costs of introducing and scaling up viral load monitoring can be offset by anticipated reductions in the costs of clinic visits, due to these being less frequent for many patients. KEY ISSUES FOR ECONOMIC EVALUATION: The cost-effectiveness of introducing viral-load informed differentiated care depends upon whether cost reductions are possible if the number of clinic visits is reduced and/or how freed clinic capacity is used for alternative priorities. Where freed resources, either physical or financial, generate large health gains (e.g. if committed to patients failing ART or to other high value health care interventions), the benefits of differentiated care are expected to be high; if however these freed physical resources are already under-utilized or financial resources are used less efficiently and would not be put to as beneficial an alternative use, the policy may not be cost-effective. The implication is that the use of conventional unit costs to value resources may not well reflect the latter's value in contributing to health improvement. Analyses intended to inform resource allocated decisions in a number of settings may therefore have to be interpreted with due consideration to local context. In this paper we present methods of how economic analyses can reflect the real value of health care resources rather than simply applying their unit costs. The analyses informing the WHO Guidelines are re-estimated by implementing scenarios using this framework, informing how differentiated care can be prioritized to generate greatest gains in population health. IMPLICATIONS: The findings have important implications for how economic analyses should be undertaken and reported in HIV and other disease areas. Results provide guidance on conditions under which viral load informed differentiated care will more likely prove to be cost effective when implemented