Use of functional near-infrared spectroscopy to evaluate cognitive change when using healthcare simulation tools

This is an accepted manuscript of an article published by BMJ on 01/11/2020, available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936993/ The accepted version of the publication may differ from the final published version.Background The use of brain imaging techniques in healthcare simulation is relatively rare. However, the use of mobile, wireless technique, such as functional nearinfrared spectroscopy (fNIRS), is becoming a useful tool for assessing the unique demands of simulation learning. For this study, this imaging technique was used to evaluate cognitive load during simulation learning events. Methods This study took place in relation to six simulation activities, paired for similarity, and evaluated comparative cognitive change between the three task pairs. The three paired tasks were: receiving a (1) face-toface and (2) video patient handover; observing a simulated scene in (1) two dimensions and (2) 360° field of vision; and on a simulated patient (1) taking a pulse and (2) taking a pulse and respiratory rate simultaneously. The total number of participants was n=12. Results In this study, fNIRS was sensitive to variations in task difficulty in common simulation tools and scenarios, showing an increase in oxygenated haemoglobin concentration and a decrease in deoxygenated haemoglobin concentration, as tasks increased in cognitive load. Conclusion Overall, findings confirmed the usefulness of neurohaemoglobin concentration markers as an evaluation tool of cognitive change in healthcare simulation. Study findings suggested that cognitive load increases in more complex cognitive tasks in simulation learning events. Task performance that increased in complexity therefore affected cognitive markers, with increase in mental effort required

Nurses’ perceptions, attitudes, and perspectives in relation to climate change and sustainable healthcare practices:A systematic review

AbstractBackgroundClimate change threatens human existence and is caused by increasing carbon emissions. Healthcare systems generate about 5% of global net CO2 emissions, further contributing to the crisis. Green healthcare practices could be implemented and nurses, as the largest workforce group, could potentially drive these practices. This review explored nurses’ awareness, perceptions, attitudes and perspectives towards sustainable nursing and healthcare practices concerning climate change.MethodsThe Joanna Briggs Institute [JBI] methodology for conducting mixed methods systematic reviews was applied and results were reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines. CINAHL, PsycINFO, SCOPUS, and PUBMED databases were searched. JBI and Mixed Method Appraisal Tool [MMAT] critical appraisal tools were used for the data appraisal. Data synthesis and integration followed the JBI convergent integrated approach and thematic analysis was performed. https://doi.org/10.17605/OSF.IO/8H3TC.FindingsEighteen papers were included that represented nine different countries across five continents. One study was found in Africa, no studies in South America, and three in Asia. Five key themes were identified: i) knowledge and awareness of climate change, ii) link between nursing and climate change, iii) environmental sustainability, iv) barriers to environmentally responsible healthcare, and v) routes to environmentally sustainable nursing practices.InterpretationThe review indicates the need to raise awareness regarding climate change and sustainable practices among nurses. It is vital policy makers, and healthcare leaders ensure criteria relating to environmental sustainability and carbon reduction are included in decisions about procurement and service delivery. Nurses’ engagement could drive forward a net-zero agenda

Greater than the sum of the parts? unpacking ethics of care within a community supported agriculture scheme

Book synopsis: Reconnecting so-called alternative food geographies back to the mainstream food system - especially in light of the discursive and material 'transgressions' currently happening between alternative and conventional food networks, this volume critically interrogates and evaluates what stands for 'food politics' in these spaces of transgression now and in the near future and addresses questions such as: What constitutes 'alternative' food politics specifically and food politics more generally when organic and other 'quality' foods have become mainstreamed? What has been the contribution so far of an 'alternative food movement' and its potential to leverage further progressive change and/or make further inroads into conventional systems? What are the empirical and theoretical bases for understanding the established and growing 'transgressions' between conventional and alternative food networks? Offering a better understanding of the evolving position of the corporate food system vis a vis alternative food networks, this book considers the prospects for economic, social, cultural and material transformations led by an increasingly powerful and legitimated alternative food network

Patient Communication Simulators for Interprofessional Healthcare Education:Work in Progress - Poster Presentation

Background and aim: The use of virtual technology has increased in clinical education since the pandemic, which necessitated a rapid shift to computer-generated experiences [1]. Whilst student placements have essentially returned to a face-to-face model, plans to continue an element of virtual simulation remain [2]. One area where virtual simulation remains of benefit is interprofessional education (IPE). Online delivery can overcome timetabling challenges that present when coordinating multiple programmes across different disciplines [3]. This project aims to build an IPE scenario that follows a virtual patient journey using an extended reality (XR) platform. Method: An existing scenario based on a service user encountered during a physiotherapy placement, was developed into an IPE resource. Collaboration occurred between the university research team, the simulation department and the IPE working groups, in conjunction with the software creation team. Multiple professional scripts were added to the scenario. Two time points were built into a virtual patient with frailty syndrome, to facilitate student interviews with paramedics, emergency clinicians, diagnostic radiographers, geriatricians, physiotherapists, occupational therapists, nurses, operating department practitioners, dietetics, and social workers. Results: To date, 68 user testing sessions have been conducted to allow the software developers to refine the conversational artificial intelligence (AI).Discussion: There were two key lessons. Firstly, the information's volume, complexity and interrelatedness lend best to data collection via a co-creation process, rather than approaching each profession separately (effectively building scenarios in silos). Secondly, appropriate training and setting user testers’ expectations are recommended to maximise participation and engagement.There are three future research directions. Stakeholder interviews of the contributors, co-creation to develop the allied health scripting and recruiting larger numbers of user testers to develop the conversational AI. This is the first custom case of this size and complexity. The resource will be available within the university to support IPE activities. Conclusion: This project is an example of how XR technology can be developed in a clinical context. The resource is intended to illustrate the value of a joined up care pathway, to develop a systems mindset in healthcare students