New Role, New Country: introducing US physician assistants to Scotland

This paper draws from research commissioned by the Scottish Executive Health Department (SEHD). It provides a case study in the introduction of a new health care worker role into an already well established and "mature" workforce configuration It assesses the role of US style physician assistants (PAs), as a precursor to planned "piloting" of the PA role within the National Health Service (NHS) in Scotland

Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety

Objective: Computerised therapies play an integral role in efforts to improve access to psychological treatment for patients with depression and anxiety. However, despite recognised problems with uptake, there has been a lack of investigation into the barriers and facilitators of engagement. We aimed to systematically review and synthesise findings from qualitative studies of computerised therapies, in order to identify factors impacting on engagement. Method: Systematic review and meta-synthesis of qualitative studies of user experiences of computer delivered therapy for depression and/or anxiety. Results: 8 studies were included in the review. All except one were of desktop based cognitive behavioural treatments. Black and minority ethnic and older participants were underrepresented, and only one study addressed users with a comorbid physical health problem. Through synthesis, we identified two key overarching concepts, regarding the need for treatments to be sensitive to the individual, and the dialectal nature of user experience, with different degrees of support and anonymity experienced as both positive and negative. We propose that these factors can be conceptually understood as the ‘non-specific’ or ‘common’ factors of computerised therapy, analogous to but distinct from the common factors of traditional face-to-face therapies. Conclusion: Experience of computerised therapy could be improved through personalisation and sensitisation of content to individual users, recognising the need for users to experience a sense of ‘self’ in the treatment which is currently absent. Exploiting the common factors of computerised therapy, through enhancing perceived connection and collaboration, could offer a way of reconciling tensions due to the dialectal nature of user experience. Future research should explore whether the findings are generalisable to other patient groups, to other delivery formats (such as mobile technology) and other treatment modalities beyond cognitive behaviour therapy. The proposed model could aid the development of enhancements to current packages to improve uptake and support engagement

Virtual Blindness - A Choice Blindness Experiment with a Virtual Experimenter

How are people facing a virtual agent affected by the vividness and graphical fidelity of the agent and its environment? A choice blindness (CB) experiment - measuring detection rate of hidden manipulations - was conducted presenting a high versus low immersion virtual environment. The hypothesis was that the lower quality virtual environment (low immersion) would increase the detection rate for the CB manipulations. 38 subjects participated in the experiment and were randomized into two groups (high and low immersion). Both conditions presented a virtual agent conducting the CB experiment. During the experiment, 16 pairs of portraits were shown two at a time for the participants who were then asked to choose which portrait they found most attractive. For eight of the pairs, participants were asked to justify their choice while in four cases their choice had been secretly switched to the portrait they had not chosen. If a participant stated that the chosen portrait had been switched, it was annotated as a concurrent detection. The results revealed an increase in detection and earlier detection rate for the low immersion implementation compared to the high immersion implementation. Future research may involve experiments with higher degree of both immersion and presence, using for example head mounted display systems

Augmented reality in a Remote Tower Environment based on VS/IR Fusion and optical tracking

Over the past years, several augmented reality features have been developed to make Remote Tower Operations more cost-efficient and user-friendly. In the context of a national research project (The paper reports results gained in the project INVIDEON (FKZ 20 V1505A) sponsored by the Luftfahrtforschungsprogramm (LuFo) of the Federal Ministry of Transport and Digital Infrastructure Germany.), augmented reality based on visual spectrum (VS) and infrared (IR) fusion and as well as on optical tracking is a study objective. Having both VS and IR information available at any time is expected to enable more efficient air traffic control, even at restricted visibility conditions. Integrating VS and IR in one video panorama should also decrease head-down times and therefore increase situation awareness and reduce workload. The integration of two different sensors will be realized by overlaying VS/IR combined with adapted input devices and optical tracking methods. Developing a good concept for the integration of VS/IR and testing it in an exploratory manner can only be achieved with the help of system experts and rapid prototyping methods in simulation environments. During three workshops, human factors specialists, project partners and seven air traffic controllers worked out a prototype that was gradually improved over time and helped to generate a first concept. Firstly, this paper addresses the challenges of VS/IR fusion, manual PTZ following (as a precursor for optical tracking) and adapted input devices. Secondly, it presents the construction process of a prototype in an explorative manner, based on a user-centered approach and implemented in a simulation environment. Finally, it summarizes and presents the results from the workshops and throughout the construction process

The contribution of physician assistants in primary care: a systematic review

The research evidence of the contribution of PAs to primary care was mixed and limited. However, the continued growth in employment of PAs in American primary care suggests that this professional group is judged to be of value by increasing numbers of employers. Further specific studies are needed to fill in the gaps in our knowledge about the effectiveness of PAs' contribution to the international primary care workforce

Overfishing of small pelagic fishes increases trophic overlap between immature and mature striped dolphins in the Mediterranean Sea

The interactions among diet, ecology, physiology, and biochemistry affect N and C stable isotope signatures in animal tissues. Here, we examined if ecological segregation among animals in relation to sex and age existed by analyzing the signatures of δ15N and δ13C in the muscle of Western Mediterranean striped dolphins. Moreover, we used a Bayesian mixing model to study diet composition and investigated potential dietary changes over the last two decades in this population. For this, we compared isotope signatures in samples of stranded dolphins obtained during two epizootic events occurring in 1990 and 2007–2008. Mean δ13C values for females and males were not significantly different, but age-related variation indicated δ13C enrichment in both sexes, suggesting that females and males most likely fed in the same general areas, increasing their consumption of benthic prey with age. Enrichment of δ15N was only observed in females, suggesting a preference for larger or higher trophic level prey than males, which could reflect different nutritional requirements. δ13C values showed no temporal variation, although the mean δ15N signature decreased from 1990 to 2007–2008, which could indicate a dietary shift in the striped dolphin over the last two decades. The results of SIAR indicated that in 1990, hake and sardine together contributed to 60% on the diet of immature striped dolphins, and close to 90% for mature striped dolphins. Conversely, the diet of both groups in 2007–2008 was more diverse, as hake and sardine contributed to less than 40% of the entire diet. These results suggest a dietary change that was possibly related to changes in food availability, which is consistent with the depletion of sardine stocks by fishing