The Effect of Vitamin E Therapy on Post Chemotherapy Mucositis in Leukemic Patients

Introduction: Chemotherapy is one of the most common treatment modalities for blood malignancies such as leukemia, with several potential complications. Mucositis is one of the complications of chemotherapy, manifested with different severities. The aim of this study was to evaluate the prophylactic effect of vitamin E on reducing the severity of chemotherapy-induced mucositis. Materials & Methods: This randomized clinical trial was performed in Ahvaz’s Shafa Hospital on 56 leukemic patients, undergoing chemotherapy. The patients were divided into 3 groups: 1) systemic treatment group, case group 1; 2) topical treatment group, the case group 2; and 3) control group. The oral mucosa of the patients was evaluated for the severity of mucositis and the patient’s response to pain. Data were analyzed with Mann-Whitney test and t-test (α = 0.05). Results: In relation to the severity of mucositis, based on the results of Mann-Whitney test, there was a significant difference between the case group 2 and control group (p value ≤ 0.01). There was no significant difference between the two case groups (p value = 0.2). In relation to the patient’s response to pain, there was a significant difference between the case group 2 and control group (p value ≤ 0.01). There was no significant difference between the two case groups (p value = 0.4). Therefore, vitamin E decreased the incidence of thermotherapy-induced mucositis. Conclusion: Within the limitations of this study, vitamin E in its topical form is an effective medicament for reducing the severity and pain of chemotherapy-induced mucositis

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Virtual reality may be the next frontier in remote mental health care

In recent years, experts have focused on finding better ways to improve remotely delivered mental health care. Now, virtual reality (VR) may pave the way for myriad new opportunities

Evaluating Virtual Reality-based Training Programs for Mine Rescue Brigades in New South Wales (Australia)

Most safety critical industries such as mining, rail or aviation aim to comply with Highly Reliable Organisation (HRO) standards. HROs have been defined as organisations that operate in hazardous conditions but manage to maintain almost error-free levels of performance. Accidents do not occur in isolation, they are usually the consequence of a chain of events ranging from the organisational level to unsafe acts of individual employees. Hence, it is of prime importance to design and deliver effective training programs that can not only expose workers to workplace hazards but also, and more importantly, ensure that this knowledge is adequately mobilised later on. The Australian mining industry has steadily achieved remarkable performance and safety results through the continuous improvement of its training standards. Virtual Reality-based (VR-based) training is the most recent technology used to enhance miners’ competencies in a safe and controlled environment that allows for replicable testing of extreme event scenarios. Like any other training method, VR-based training needs to be assessed in order to evaluate the advantages and limitations of this innovative technology, compared with more traditional approaches. Our research aims to design and implement an evaluation framework that can be used to assess VR-based training programs across four dimensions: (1) the actual training needs, (2) the limitations of traditional training approaches, (3) the theoretical capabilities of VR environments for training purposes and (4) the perceived learning outcomes. Our research was conducted in collaboration with Mines Rescue Pty Ltd, a training provider for the coal mining industry in Australia, and focussed on training programs developed for mine rescue brigades. These brigades are made up of highly specialized volunteers who are the primary responders for major mining incidents or accidents. The study examined the relationships between the training needs of 372 trainees, the technological capabilities of two VR training environments (360-degree immersive theatre and a desktop interactive simulator) and the implementation of training scenarios over a twelve month period. Our mixed-method approach included direct observations of training sessions, pre- and post-session surveys of trainees and interviews (including competency tests) with trainers and VR program designers. The findings suggest that VR-based training programs are able to address the identified training needs and overcome some of the limitations and constraints of traditional onsite training. The study also highlights current weaknesses of the VR technology-in-use and suggests future enhancement pathways. The assessment framework is generic enough to be easily adapted for other training objectives in the mining industry or for other high risk industries

Assessing the Impact of Virtual Reality-Based Training on Health and Safety Issues in the Mining Industry

Abstract: Best practice in the mining industry includes extensive initial and professional training for staff involved in field operations. Whereas changes in mining technology and operations accelerate to improve productivity, health, and safety standards have to be continuously evaluated and improved, putting more pressure on training deliveries. Borrowing from Defence and Airspace industries, training in the mining industry is increasingly relying on immersive virtual reality to simulate complex operations and procedures in potentially dangerous environments. Coal Services Pty Ltd is at the forefront of modern training facilities in Australia. This paper presents a qualitative and quantitative research framework designed to analyse the impact of past and current training sessions on staff’s ability to better perform their tasks, overall safety standards, and mine productivity. Interviews with trainees, trainers, and managers are used alongside session recordings to qualitatively evaluate levels of knowledge transfer and aptitudes to perform in a real environment. Then, a cost-benefit analysis is used to evaluate the added-value of virtual reality-based on technological and operational costs weighed against overall productivity of the mine being negatively affected by any safety issue. Citation: Pedram, S., Perez, P. & Dowsett, B. (2014). Assessing the Impact of Virtual Reality-Based Training on Health and Safety Issues in the Mining Industry. In: Campbell P. and Perez P. (Eds), Proceedings of the International Symposium of Next Generation Infrastructure, 1-4 October 2013, SMART Infrastructure Facility, University of Wollongong, Australia

Evaluating the influence of virtual reality-based training on workers\u27 competencies in the mining industry

The Australian mining industry has achieved remarkable performance and safety results through continuous improvement of its training standards. Interactive virtual reality-based training is the most recent technology used to enhance workers\u27 competencies in a safe and controlled environment that allows for replicable testing of extreme event scenarios. Like any other training method, VR-based training needs to be assessed in order to evaluate the advantages and limitations of this innovative technology, compared with more traditional approaches. Our research aims to design and implement an evaluation framework that can be used to assess VR-based training programs developed, amongst other training methods, by Coal Services Pty Ltd, a pioneering training provider for the coal mining industry in Australia. Our research focuses on specific training programs developed for mining rescue brigades. These teams are made up of highly specialized miner volunteers who are in charge of primary response in case of major incident. The evaluation framework aims at identifying adequacy between competency needs, technological capabilities and the implementation of interactive simulation. Research outcomes are meant to provide evidence-based information on the advantages and limitations of VR-based training for mining rescue brigades. The evaluation framework is flexible enough to be applied to other types of training for the mining industry or even to be adapted for use in other industries

A Systematic Approach to Evaluate the Role of Virtual Reality as a Safety Training Tool in the Context of the Mining Industry

The Australian mining industry has achieved impressive performance and safety results through continuous improvement of its training standards. Interactive virtual reality-based training is the most recent technology used to enhance workers’ competencies in a safe and controlled environment which allows the replicable testing of extreme event scenarios. Like any other training method, Virtual reality (VR) -based training must be assessed in order to evaluate the advantages and limitations of this innovative technology, compared with more traditional approaches. Research was aimed at designing and implementing a framework to tackle the cultural issues involved in accepting innovative VR-based training programs developed for high risk industries. The present study was conducted with Coal Services Pty Ltd, a pioneering training provider for the coal mining industry in NSW, Australia. The research focussed on specific training programs developed for the mine rescue brigades. These brigade teams are made up of highly specialized miner volunteers who provide the primary response to major incidents. The research framework examined the adequacy of training needs, technological capabilities and the implementation of interactive simulation. The research outcomes provide evidence-based information on the advantages and limitations of VR-based training for mining rescue brigades. The framework is flexible and can be applied to other types of training for the mining industry or adapted for use in other industries

Assessing the validity of VR as a training tool for medical students

The advances in Virtual Reality technologies, increased availability and reducing hardware costs have diminished many of the early challenges in the adoption of VR. However, a commonly identified gap in immersive Virtual Reality-Head Mounded Display (VR-HMD) training for medical education is the confidence in the long-term validity of the applications, in particular, the acceleration of the learning curve efficacy of learning outcomes over time and actual skills translation into real environments. Research shows a wide range of ad hoc applications, with superficial evaluations often conducted by technology vendors, based on assumed environments and tasks, envisaged (as opposed to actual) users and effectiveness of learning outcomes underpinned with little or no research focusing on a requirements-driven validation approach. This presents decision-making challenges for those seeking to adopt, implement and embed such systems in teaching practice. The current paper aims to (i) determine whether medical VR training improves the skill acquisition of training candidates, (ii) determine the factors affecting the acquisition of skills and (iii) validate the VR-based training using requirement-driven approach. In this paper, we used within- and between-subject design approaches to assess the validity of VR-based surgical training platform developed by Vantari VR against requirements which have been identified to have impact on learning processes and outcomes in VR-based training. First, study and control groups were compared based on their level of skill acquisitions. Then, by tailoring a requirements framework, the system was validated against the appropriate requirements. In total, 74 out of 109 requirements were investigated and evaluated against survey, observer and stakeholder workshop data. The training scenario covered the topic of Arterial Blood Gas (ABG) collection for second-year university medical students. In total 44 students volunteered to participate in this study, having been randomly assigned to either the study or control group. Students exposed to VR training (the study group) outperformed the control group in practical clinical skills training tasks and also adhered to better safety and hygiene practices. The study group also had a greater procedural completion rate over the control group. Students showed increased self-efficacy and knowledge scores immediately post-VR training. Prior ABG training did not impact on VR training outcomes. Low levels of simulation sickness, physical strain and stress, coupled with high levels of enjoyability, engagement, presence and fidelity were identified as factors affecting the overall training experience. In terms of learning, high scores were recorded for active learning, cognitive benefit and reflective thinking. Lastly, by validating the system against 74 system requirements, the study found a user acceptance level of 75%. This enabled the identification of weaknesses of the current system and possible future directions

Toward the validation of VR-HMDs for medical education: a systematic literature review

The latest technological advancements in the domain of virtual reality (VR) have created new opportunities to use VR as a training platform for medical students and practitioners more broadly. Despite the growing interest in the use of VR as a training tool, a commonly identified gap in VR-training for medical education is the confidence in the long-term validity of the applications. A systematic literature review was undertaken to explore the extent of VR (in particular head-mounted displays) applications for medical training with an additional focus on validation measures. The papers included in this review discussed empirical case studies of specific applications; however, these were mostly concerned with human–computer interaction and were polarized between demonstrating that a conceptual technology solution was feasible for simulation or looked at specific areas of VR usability with little discussion on validation measures for long-term training effectiveness and outcomes. The review uncovered a wide range of ad hoc applications and studies in terms of technology vendors, environments, tasks, envisaged users and effectiveness of learning outcomes. This presents decision-making challenges for those seeking to adopt, implement and embed such systems in teaching practice. The authors of this paper then take a wider socio-technical systems perspective to understand how the holistic training system can be engineered and validated effectively as fit for purpose, through distillation of a generic set of requirements from the literature review to aid design specification and implementation, and to drive more informed and traceable validation of these types of systems. In this review, we have identified 92 requirement statements in 11 key areas against which a VR-HMD training system could be validated; these were grouped into design considerations, learning mechanisms and implementation considerations