Enhancement of Student Learning Through the Incorporation of Virtual Reality Simulation when Studying Anatomy

The opportunities provided by virtual reality (VR) are substantial and it is crucial that we recognize the potential application of this advancing technology. PURPOSE: To measure and compare student learning of anatomical structures when studying in virtual reality simulation and when studying using traditional physical models. METHODS: Ten undergraduate students were randomly assigned to either group A or group B and attended two sessions, each lasting 60 minutes. During session one, each participant first completed a pre-test based on pelvic girdle anatomy in under 15 minutes. The first pre-test consisted of 7 fill-in the blank questions with a word bank provided. After completing given pre-exam, participants from group A studied the anatomy of the pelvic girdle independently for up to 30 minutes using VR (virtual reality) goggles on Organon 3D application. Participants from group B independently studied pelvic girdle anatomy on a skeletal model for up to 30 minutes. Following the 30 minutes of study, participants completed a post-exam in under 15 minutes. The first post-test consisted of 7 fill-in the blank questions with word bank provided based on pelvic girdle anatomy. Within the same week, participants attended a second session. Participants first completed a pre-test based on the anatomy of the spine, in under 15 minutes. The second pre-test consisted of 7 fill-in the blank questions with a provided word bank. Following the completion of the second pre-test, each participant from group B individually studied spinal anatomy for up to 30 minutes, using VR (virtual reality) goggles on an app called Organon 3D. Participants from group A individually studied spinal anatomy on a skeletal model for up to 30 minutes. Succeeding the second study session, participants finished a post-exam based on the anatomy of the spine. The second post-exam composed of 7 fill-in the blank questions with a word bank provided.RESULTS: Exams scores were converted to percentages for data analysis. The average pre-exam score for VR= 60.7% and for Skeletal models= 44.6%. The average post-test score for VR= 66.1% and for Skeletal model= 82.1% There was not a significant difference between studying for exams on VR vs. studying on skeletal model ( P p2 = 0.355). CONCLUSION: Previous studies have suggested VR as a study tool has a significant effect on learning, these findings suggest that there is not a significant difference between study modes. These findings may also suggest that these modes are comparably beneficial for student learning

Rapidly increasing trend of recorded alcohol consumption since the end of the armed conflict in Sri Lanka

Aim: To evaluate temporal changes in recorded alcohol consumption in Sri Lanka during and after the armed conflict 1998 – 2013. Methods: District level alcohol sales, and mid-year population data for the whole study period (1998-2013) were consistently available from the Department of Excise and the Department of Census and Statistics for 18 of 25 districts. These data were used to estimate the recorded per capita consumption for the areas that were not directly exposed to the armed conflict. An interrupted time series design was employed to estimate the impact of the end of the armed conflict on recorded adult per capita alcohol consumption of population lived in the 18 districts. Results: Adult per capita recorded alcohol consumption among Sri Lankans living in the 18 districts was 1.59 litres of pure alcohol in 1998. This increased up to 2.07 litres in 2009 and 2.55 litres in 2013. Prior to the end of the conflict in 2009 adult per capita recorded consumption increased by 0.051 litres of pure alcohol per year (95% CI 0.029-0.074, p<0.001); after 2009 this was 0.166 litres per year (95% CI 0.095-0.236, p<0.001). Beer consumption showed the highest per capita growth compared with other beverages. Conclusions: Adult per capita recorded alcohol consumption among Sri Lankans living in areas that were not directly exposed to the conflict increased markedly after the end of the conflict. Rapid socio-economic development, alcohol industry penetration and lack of alcohol control strategies during the post-conflict period may have driven this increase

Measuring alcohol consumption in population surveys: a review of international guidelines and comparison with surveys in England

Aims: To review the international guidelines and recommendations on survey instruments for measurement of alcohol consumption in population surveys, and to examine how national surveys in England meet the core recommendations. Methods: A systematic search for international guidelines for measuring alcohol consumption in population surveys was undertaken. The common core recommendations for alcohol consumption measures and survey instruments were identified. Alcohol consumption questions in national surveys in England were compared with these recommendations for specific years and over time since 2000. Results: Four sets of international guidelines and three core alcohol consumption measures (alcohol consumption status, average volume of consumption, frequency and volume of binge drinking) with another optional measure (drinking context) were identified. English national surveys have been inconsistent over time in including questions that provide information on average volume of consumption but have not included questions on another essential alcohol consumption measure, frequency of heavy episodic drinking. Instead they have used questions that focus only on maximum volume of alcohol consumed on any day in the previous week. Conclusions: International guidelines provide consistent recommendations for measuring alcohol consumption in population surveys. These recommendations have not been consistently applied in English national surveys and this has contributed to the inadequacy of survey measurements for monitoring vital aspects of alcohol consumption in England over recent years

Characterizing tobacco control mass media campaigns in England

Aims To characterize publically funded tobacco control campaigns in England between 2004 and 2010 and to explore if they were in line with recommendations from the literature in terms of their content and intensity. International evidence suggests that campaigns which warn of the negative consequences of smoking and feature testimonials from real-life smokers are most effective, and that four exposures per head per month are required to reduce smoking prevalence. Design Characterization of tobacco control advertisements using a theoretically based framework designed to describe advertisement themes, informational and emotional content and style. Study of the intensity of advertising and exposure to different types of advertisement using data on population-level exposure to advertisements shown during the study period. Setting England. Measurements Television Ratings (TVRs), a standard measure of advertising exposure, were used to calculate exposure to each different campaign type. Findings A total of 89% of advertising was for smoking cessation; half of this advertising warned of the negative consequences of smoking, while half contained how-to-quit messages. Acted scenes featured in 72% of advertising, while only 17% featured real-life testimonials. Only 39% of months had at least four exposures to tobacco control campaigns per head. Conclusions A theory-driven approach enabled a systematic characterization of tobacco control advertisements in England. Between 2004 and 2010 only a small proportion of tobacco control advertisements utilized the most effective strategies—negative health effects messages and testimonials from real-life smokers. The intensity of campaigns was lower than international recommendations

How does the emotive content of televised anti-smoking mass media campaigns influence monthly calls to the NHS Stop Smoking helpline in England?

OBJECTIVE: To investigate the effects of different types of televised mass media campaign content on calls to the English NHS Stop Smoking helpline. METHOD: We used UK government-funded televised tobacco control campaigns from April 2005 to April 2010, categorised as either “positive” (eliciting happiness, satisfaction or hope) or “negative” (eliciting fear, guilt or disgust). We built negative binomial generalised additive models (GAMs) with linear and smooth terms for monthly per capita exposure to each campaign type (expressed as Gross Ratings Points, or GRPs) to determine their effect on calls in the same month. We adjusted for seasonal trends, inflation-adjusted weighted average cigarette prices and other tobacco control policies. RESULTS: We found non-linear associations between exposure to positive and negative emotive campaigns and quitline calls. The rate of calls increased more than 50% as exposure to positive campaigns increased from 0 to 400 GRPs (rate ratio: 1.58, 95% CI: 1.25–2.01). An increase in calls in response to negative emotive campaigns was only apparent after monthly exposure exceeded 400 GRPs. CONCLUSION: While positive campaigns were most effective at increasing quitline calls, those with negative emotive content were also found to impact on call rates but only at higher levels of exposure

Health Risks of Kretek Cigarettes: A Systematic Review

Objective To review the evidence on the health risks associated with smoking kretek cigarettes compared with not smoking or smoking regular cigarettes.Data Sources: We conducted a systematic literature search in five electronic databases: EMBASE (Ovid), ASSIA, PubMed and Scopus. Since kretek use is largely restricted to Indonesia, we identified additional studies using an online search for grey literature and studies in Indonesian journals and the National Library of Indonesia. We included relevant search terms in English (“kretek” and “clove cigarettes”) and Bahasa (“rokok” and “merokok”). Study selection: Studies which compared any health outcome between smokers of kretek cigarettes and non-smokers or smokers of regular cigarettes. We included studies in any smokers compared to non-smokers in Indonesia, since most Indonesian smokers use kretek, but analysed these separately. Data Extraction: Study data were extracted by a single reviewer and checked by two reviewers. Methodological quality was assessed using the Newcastle-Ottawa scale. Data synthesis: We identified 32 studies, all from Indonesia. There were 31 cross-sectional studies and one case control study. This systematic review identified a relatively limited number of studies, and most of these were of poor quality as assessed by the Newcastle Ottawa score. They were generally cross-sectional, small and lacking justification for sample size, had high potential for selection bias because of lack of data on non-respondents or those lost to follow up, and missing information about the statistical analysis. Fourteen studies looked specifically at kretek exposure and eighteen looked at any type of cigarette exposure but were conducted in Indonesia are therefore likely to predominantly reflect kretek exposure. Kretek were found to be associated with oral cancer, cardiovascular disease, chronic health disease, myocardial infarction, asthma, and oral diseases.Conclusion: Although existing studies are of poor quality, kretek are likely to be at least as harmful as regular cigarettes.Implications: Kretek cigarettes are the most commonly used tobacco product in Indonesia. Given the constituents of kretek cigarettes, there is no scientific basis for concluding that a kretek is any less hazardous than a regular cigarette; however, the evidence has not been systematically reviewed.There are few studies on the health risks of kretek, and the quality of existing evidence is poor. Nevertheless, they consistently indicate that the health effects of kretek use are likely to be similar to those for regular cigarettes.The current evidence base indicates that kretek cigarettes are at least as dangerous as regular cigarettes, and tobacco control efforts in settings where kreteks are commonly used must seek to incorporate measures to reduce kretek use

Characterizing tobacco control mass media campaigns in England

Aims To characterize publically funded tobacco control campaigns in England between 2004 and 2010 and to explore if they were in line with recommendations from the literature in terms of their content and intensity. International evidence suggests that campaigns which warn of the negative consequences of smoking and feature testimonials from real-life smokers are most effective, and that four exposures per head per month are required to reduce smoking prevalence. Design Characterization of tobacco control advertisements using a theoretically based framework designed to describe advertisement themes, informational and emotional content and style. Study of the intensity of advertising and exposure to different types of advertisement using data on population-level exposure to advertisements shown during the study period. Setting England. Measurements Television Ratings (TVRs), a standard measure of advertising exposure, were used to calculate exposure to each different campaign type. Findings A total of 89% of advertising was for smoking cessation; half of this advertising warned of the negative consequences of smoking, while half contained how-to-quit messages. Acted scenes featured in 72% of advertising, while only 17% featured real-life testimonials. Only 39% of months had at least four exposures to tobacco control campaigns per head. Conclusions A theory-driven approach enabled a systematic characterization of tobacco control advertisements in England. Between 2004 and 2010 only a small proportion of tobacco control advertisements utilized the most effective strategies—negative health effects messages and testimonials from real-life smokers. The intensity of campaigns was lower than international recommendations

Effectiveness of tobacco control television advertising in changing tobacco use in England: a population‐based cross‐sectional study

AIM: To examine whether government‐funded tobacco control television advertising shown in England between 2002 and 2010 reduced adult smoking prevalence and cigarette consumption. DESIGN: Analysis of monthly cross‐sectional surveys using generalised additive models. SETTING: England. PARTICIPANTS: More than 80 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey. MEASUREMENTS: Current smoking status, smokers' daily cigarette consumption, tobacco control gross rating points (GRPs—a measure of per capita advertising exposure combining reach and frequency), cigarette costliness, tobacco control activity, socio‐demographic variables. FINDINGS: After adjusting for other tobacco control policies, cigarette costliness and individual characteristics, we found that a 400‐point increase in tobacco control GRPs per month, equivalent to all adults in the population seeing four advertisements per month (although actual individual‐level exposure varies according to TV exposure), was associated with 3% lower odds of smoking 2 months later [odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95, 0.999] and accounted for 13.5% of the decline in smoking prevalence seen over this period. In smokers, a 400‐point increase in GRPs was associated with a 1.80% (95%CI = 0.47, 3.11) reduction in average cigarette consumption in the following month and accounted for 11.2% of the total decline in consumption over the period 2002–09. CONCLUSION: Government‐funded tobacco control television advertising shown in England between 2002 and 2010 was associated with reductions in smoking prevalence and smokers' cigarette consumption

Ambiguous Tests of General Relativity on Cosmological Scales

There are a number of approaches to testing General Relativity (GR) on linear scales using parameterized frameworks for modifying cosmological perturbation theory. It is sometimes assumed that the details of any given parameterization are unimportant if one uses it as a diagnostic for deviations from GR. In this brief report we argue that this is not necessarily so. First we show that adopting alternative combinations of modifications to the field equations significantly changes the constraints that one obtains. In addition, we show that using a parameterization with insufficient freedom significantly tightens the apparent theoretical constraints. Fundamentally we argue that it is almost never appropriate to consider modifications to the perturbed Einstein equations as being constraints on the effective gravitational constant, for example, in the same sense that solar system constraints are. The only consistent modifications are either those that grant near-total freedom, as in decomposition methods, or ones which map directly to a particular part of theory space

Impact of room acoustics and visual cues on speech perception and talker localization by children with mild bilateral or unilateral hearing loss

IntroductionThis study evaluated the ability of children (8–12 years) with mild bilateral or unilateral hearing loss (MBHL/UHL) listening unaided, or normal hearing (NH) to locate and understand talkers in varying auditory/visual acoustic environments. Potential differences across hearing status were examined.MethodsParticipants heard sentences presented by female talkers from five surrounding locations in varying acoustic environments. A localization-only task included two conditions (auditory only, visually guided auditory) in three acoustic environments (favorable, typical, poor). Participants were asked to locate each talker. A speech perception task included four conditions [auditory-only, visually guided auditory, audiovisual, auditory-only from 0° azimuth (baseline)] in a single acoustic environment. Participants were asked to locate talkers, then repeat what was said.ResultsIn the localization-only task, participants were better able to locate talkers and looking times were shorter with visual guidance to talker location. Correct looking was poorest and looking times longest in the poor acoustic environment. There were no significant effects of hearing status/age. In the speech perception task, performance was highest in the audiovisual condition and was better in the visually guided and auditory-only conditions than in the baseline condition. Although audiovisual performance was best overall, children with MBHL or UHL performed more poorly than peers with NH. Better-ear pure-tone averages for children with MBHL had a greater effect on keyword understanding than did poorer-ear pure-tone averages for children with UHL.ConclusionAlthough children could locate talkers more easily and quickly with visual information, finding locations alone did not improve speech perception. Best speech perception occurred in the audiovisual condition; however, poorer performance by children with MBHL or UHL suggested that being able to see talkers did not overcome reduced auditory access. Children with UHL exhibited better speech perception than children with MBHL, supporting benefits of NH in at least one ear