Multiuser virtual safety training system for tower crane dismantlement

Tower crane dismantling is one of the most dangerous activities in the construction industry. Tower crane erection and dismantlement causes 10–12% of the fatalities of all crane accidents. The nature of the task is such that off-the-job training is not practicable, and the knowledge and expertise needed has to be gained on the job. However, virtual trainers such as Microsoft Flight Simulator for airplane pilots and mission rehearsal exercise (MRE) for army personnel have been developed and are known to provide a highly successful means of overcoming the risks involved in such on-the-job learning and clearly have potential in construction situations. This paper describes the newly developed multiuser virtual safety training system (MVSTS) aimed at providing a similar learning environment for those involved in tower crane dismantlement. The proposed training system is developed by modifying an existing game engine. Within the close-to-reality virtual environment, trainees can participate in a virtual dismantling process. During the process, they learn the correct dismantling procedure and working location and to cooperate with other trainees by virtually dismantling the crane. The system allows the trainees to experience the complete procedure in a risk-free environment. A case study is provided to demonstrate how the system works and its practical application. The proposed system was evaluated by interviews with 30 construction experts with different backgrounds, divided into three groups according to their experience and trained by the traditional and virtual methods, respectively. The results indicate that the trainees of the proposed system generally learned better than those using the traditional method. The ratings also indicate that the system generally has great potential as a training platform.

Inflammatory cytokine responses to progressive resistance training and supplementation with fortified milk in men aged 50+ years : an 18-month randomized controlled trial

We examined the effects of progressive resistance training (PRT) and supplementation with calcium-vitamin D(3) fortified milk on markers of systemic inflammation, and the relationship between inflammation and changes in muscle mass, size and strength. Healthy men aged 50-79 years (n = 180) participated in this 18-month randomized controlled trial that comprised a factorial 2 x 2 design. Participants were randomized to (1) PRT + fortified milk supplement, (2) PRT, (3) fortified milk supplement, or (4) a control group. Participants assigned to PRT trained 3 days per week, while those in the supplement groups consumed 400 ml day(-1) of milk containing 1,000 mg calcium plus 800 IU vitamin D(3). We collected venous blood samples at baseline, 12 and 18 months to measure the serum concentrations of IL-6, TNF-alpha and hs-CRP. There were no exercise x supplement interactions, but serum IL-6 was 29% lower (95% CI, -62, 0) in the PRT group compared with the control group after 12 months. Conversely, IL-6 was 31% higher (95% CI, -2, 65) in the supplement group compared with the non-supplemented groups after 12 and 18 months. These between-group differences did not persist after adjusting for changes in fat mass. In the PRT group, mid-tibia muscle cross-sectional area increased less in men with higher pre-training inflammation compared with those men with lower inflammation (net difference similar to 2.5%, p < 0.05). In conclusion, serum IL-6 concentration decreased following PRT, whereas it increased after supplementation with fortified milk concomitant with changes in fat mass. Furthermore, low-grade inflammation at baseline restricted muscle hypertrophy following PRT.

The effects of increased endurance training load on biomarkers of heat intolerance during intense exercise in the heat

The effects of increased training (IT) load on plasma concentrations of lipopolysaccharides (LPS), proinflammatory cytokines, and anti-LPS antibodies during exercise in the heat were investigated in 18 male runners, who performed 14 days of normal training (NT) or 14 days of 20% IT load in 2 equal groups. Before (trial 1) and after (trial 2) the training intervention, all subjects ran at 70% maximum oxygen uptake on a treadmill under hot (35 degrees C) and humid (similar to 40%) conditions, until core temperature reached 39.5 degrees C or volitional exhaustion. Venous blood samples were drawn before, after, and 1.5 h after exercise. Plasma LPS concentration after exercise increased by 71% (trial 1, p < 0.05) and 21% (trial 2) in the NT group and by 92% (trial 1, p < 0.01) and 199% (trial 2, p < 0.01) in the IT group. Postintervention plasma LPS concentration was 35% lower before exercise (p < 0.05) and 47% lower during recovery (p < 0.01) in the IT than in the NT group. Anti-LPS IgM concentration during recovery was 35% lower in the IT than in the NT group (p < 0.05). Plasma interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha concentrations after exercise (IL-6, 3-7 times, p < 0.01, and TNF-alpha, 33%, p < 0.01) and during recovery (IL-6, 2-4 times, p < 0.05, and TNF-alpha, 30%, p < 0.01) were higher than at rest within each group. These data suggest that a short-term tolerable increase in training load may protect against developing endotoxemia during exercise in the heat.

The use of computerised simulators for training of transthoracic and transoesophageal echocardiography. The future of echocardiographic training?

Echocardiography is the commonest form of non-invasive cardiac imaging and is fundamental to patient management. However, due to its methodology, it is also operator dependent. There are well defined pathways in training and ongoing accreditation to achieve and maintain competency. To satisfy these requirements, significant time has to be dedicated to scanning patients, often in the time pressured clinical environment. Alternative, computer based training methods are being considered to augment echocardiographic training. Numerous advances in technology have resulted in the development of interactive programmes and simulators to teach trainees the skills to perform particular procedures, including transthoracic and transoesophageal echocardiography. 82 sonographers and TOE proceduralists utilised an echocardiographic simulator and assessed its utility using defined criteria. 40 trainee sonographers assessed the simulator and were taught how to obtain an apical 2 chamber (A2C) view and image the superior vena cava (SVC). 100% and 88% found the simulator useful in obtaining the SVC or A2C view respectively. All users found it easy to use and the majority found it helped with image acquisition and interpretation. 42 attendees of a TOE training day utilising the simulator assessed the simulator with 100% finding it easy to use, as well as the augmented reality graphics benefiting image acquisition. 90% felt that it was realistic. This study revealed that both trainee sonographers and TOE proceduralists found the simulation process was realistic, helped in image acquisition and improved assessment of spatial relationships. Echocardiographic simulators may play an important role in the future training of echocardiographic skills.

Is simulation training effective in increasing podiatrists' confidence in foot ulcer management?

Background: Foot ulcers are a frequent reason for diabetes-related hospitalisation. Clinical training is known to have a beneficial impact on foot ulcer outcomes. Clinical training using simulation techniques has rarely been used in the management of diabetes-related foot complications or chronic wounds. Simulation can be defined as a device or environment that attempts to replicate the real world. The few non-web-based foot-related simulation courses have focused solely on training for a single skill or “part task” (for example, practicing ingrown toenail procedures on models). This pilot study aimed to primarily investigate the effect of a training program using multiple methods of simulation on participants’ clinical confidence in the management of foot ulcers. Methods: Sixteen podiatrists participated in a two-day Foot Ulcer Simulation Training (FUST) course. The course included pre-requisite web-based learning modules, practicing individual foot ulcer management part tasks (for example, debriding a model foot ulcer), and participating in replicated clinical consultation scenarios (for example, treating a standardised patient (actor) with a model foot ulcer). The primary outcome measure of the course was participants’ pre- and post completion of confidence surveys, using a five-point Likert scale (1 = Unacceptable-5 = Proficient). Participants’ knowledge, satisfaction and their perception of the relevance and fidelity (realism) of a range of course elements were also investigated. Parametric statistics were used to analyse the data. Pearson’s r was used for correlation, ANOVA for testing the differences between groups, and a paired-sample t-test to determine the significance between pre- and post-workshop scores. A minimum significance level of p < 0.05 was used. Results: An overall 42% improvement in clinical confidence was observed following completion of FUST (mean scores 3.10 compared to 4.40, p < 0.05). The lack of an overall significant change in knowledge scores reflected the participant populations’ high baseline knowledge and pre-requisite completion of web-based modules. Satisfaction, relevance and fidelity of all course elements were rated highly. Conclusions: This pilot study suggests simulation training programs can improve participants’ clinical confidence in the management of foot ulcers. The approach has the potential to enhance clinical training in diabetes-related foot complications and chronic wounds in general.

Training program impact on thermoplastic immobilization for head and neck radiation therapy

Purpose: To determine whether uniform guidelines and training in the stabilization and formation of thermoplastic shells can improve the reproducibility of set-up for Head and Neck cancer patients. Methods and materials: Image based measurements of the planning and treatment positions for 35 head and neck cancer patients undergoing radical radiotherapy were analysed to provide a baseline of the reproducibility of thermoplastic immobilization. Radiation therapists (RT) were surveyed to establish a perception of their confidence in thermoplastic procedures. An evidence based staff training program was created and implemented. Set-up reproduction and staff perception were reviewed to measure the impact of the training program. Results: The mean (SD) 3D vectors of anatomical displacement, measured on the patient images, improved from 4.64 (2.03) for the baseline group compared to 3.02 (1.65) following training (p < 0.01). The proportion of 3D displacements of patient data exceeding 5 mm 3D vector was decreased from 37.1% to 5.7% (p < 0.001) and the 3 mm vector from 85.7% to 42.9% (p < 0.001). The post-training survey scores demonstrated improved confidence in reproducibility of set-up for head and neck patients. Conclusion: The Thermoplastic Shells Training Program has been found to improve the treatment reproducibility for head and neck radiation therapy patients. Uniform guidelines have increased RT confidence in thermoplastic procedures.

Compass points : the locations, landscapes and coordinates of identities in contemporary performance making : proceedings of the Australasian Association for Theatre, Drama & Performance Studies (ADSA) Conference 2012

Compass Points: The Locations, Landscapes and Coordinates of Identities' the Australasian Association for Theatre, Drama and Performance Studies (ADSA) Conference 2012 was held at Queensland University of Technology, July 3-6 2012. The Conference was sponsored by the Australasian Association for Theatre, Drama and Performance Studies (ADSA), Queensland University of Technology (QUT), Ian Potter Foundation, Arts Queensland, La Boite Theatre Company and Queensland Theatre Company. The papers selected for this collection represent a small sample of the scope, depth and diversity of scholarship presented at the conference - they cover a range of genres, cultures and contexts in contemporary performance making from autobiography, to playwrighting, to public space performance and beyond. The papers collected have been peer-reviewed to Australia’s Department of Education, Science and Training (DEST) standards - each has been subject to two blind reviews, followed by acceptance, rejection or revision, and editing of accepted papers - by colleagues from Australasia and overseas. The review process for the conference publication was separate from the review process for acceptance of abstracts for the actual conference presentations. The conference convenors, Bree Hadley and Caroline Heim, edited the collection, and would like to thank all those who gave their time to advise on the peer review process and act as reviewers - Tom Burvill, Christine Comans, Sean Edgecomb, Angela Campbell, Natalie Lazaroo, Jo Loth, Meg Mumford, Ulrike Garde, Laura Ginters, Andre Bastian, Sam Trubridge, Delyse Ryan, Georgia Seffrin, Gillian Arrighi, Rand Hazou, Rob Pensalfini, Sue Fenty-Studham, Mark Radvan, Rob Conkie, Kris Plummer, Lisa Warrington, Kate Flaherty, Bryoni Tresize, Janys Hayes, Lisa Warrington, Teresa Izzard, Kim Durban, Veronica Kelly, Adrian Keirnander, James Davenport, Julie Robson and others. We, and the authors, appreciate the rigour and care with which peers have approached the scholarship presented here. This collection was published in final form on July 3rd 2012, the first day of the ADSA Conference 2012.

The standard bearers : Governing teachers through professional standards

Teacher professional standards have become a key policy mechanism for the reform of teaching and education in recent years. While standards policies claim to improve the quality of teaching and learning in schools today, this paper argues that a disjunction exists between the stated intentions of such programmes and the intelligibility of the practices of government in which they are invested. To this effect, the paper conducts an analytics of government of the recently released National Professional Standards for Teachers (Australian Institute for Teaching and School Leadership, 2011) arguing that the explicit, calculated rationality of the programme exists within a wider field of effects. Such analysis has the critical consequence of calling into question the claims of the programmers themselves thus breaching the self-evidence on which the standards rest.

Physiological, perceptual and technical responses to on-court tennis training on hard and clay courts

The aim of this study was to investigate the effect of court surface (clay v hard-court) on technical, physiological and perceptual responses to on-court training. Four high-performance junior male players performed two identical training sessions on hard and clay courts, respectively. Sessions included both physical conditioning and technical elements as led by the coach. Each session was filmed for later notational analysis of stroke count and error rates. Further, players wore a global positioning satellite device to measure distance covered during each session; whilst heart rate, countermovement jump distance and capillary blood measures of metabolites were measured before, during and following each session. Additionally a respective coach and athlete rating of perceived exertion (RPE) were measured following each session. Total duration and distance covered during of each session were comparable (P>0.05; d<0.20). While forehand and backhands stroke volume did not differ between sessions (P>0.05; d<0.30); large effects for increased unforced and forced errors were present on the hard court (P>0.05; d>0.90). Furthermore, large effects for increased heart rate, blood lactate and RPE values were evident on clay compared to hard courts (P>0.05; d>0.90). Additionally, while player and coach RPE on hard courts were similar, there were large effects for coaches to underrate the RPE of players on clay courts (P>0.05; d>0.90). In conclusion, training on clay courts results in trends for increased heart rate, lactate and RPE values, suggesting sessions on clay tend towards higher physiological and perceptual loads than hard courts. Further, coaches appear effective at rating player RPE on hard courts, but may underrate the perceived exertion of sessions on clay courts.

Using critical incident interviews to identify the mental health knowledge, skills and attitudes of entry-level dietitians

Aim: This paper aims to explore new graduates experience working with clients with mental health issues using critical incident interviews. Methods: The qualitative research techniques were based on phenomenology. A purposive sample of 19 new graduate dietitians was drawn from a range of work settings and locations throughout Australia. Data was gathered using thirty minute Critical Incident Interviews. Audio-taped data was transcribed, coded to identify common themes, compared for congruence and then categorised into knowledge, skills and attitudes. Results: New graduates encountered a range of situations involving a variety of mental health, wellbeing, dietetic and clinical issues. Common themes highlighted the mental health knowledge, skills and attitudes required for entry-level dietitians which then informed the review of the National Competency Standards for Entry-Level Dietitians. Conclusion: New graduates encounter a variety of mental health and wellbeing issues in their everyday practice and therefore require training to address these situations competently.

Mixed methods research approach to the development and review of competency standards for dietitians

Aim: Competency standards support a range of professional activities including the accreditation of university courses. Reviewing these standards is essential to ensure universities continue to produce well equipped graduates, who can meet the challenge of changing workforce requirements. This paper has two aims: a) to provide an overview of the methodological approaches utilised for compilation and review of the Competency Standards for Dietetics and b) to evaluate the Dietitians Association of Australia’s Competency Standards and capture emerging and contemporary dietetic practice. Methods: A literature review of the methods used to develop Competency Standards for dietitians in Australia, including entry level, advanced level and DAA Fellow competencies and other specific areas of competency, such as public health nutrition and nutrition education is outlined and compared to other allied health professions. The mixed methods methodology used in the most recent review is described in more detail. Results: The history of Dietetic Competency Standards development and review in Australia is compared to dietetic Competency Standards internationally and within other health professions in Australia. The political context in which these standards have been developed in Australia and which has determined their format is also discussed. The results of the most recent Competency Standards review are reported to highlight emerging practice in Australia. Conclusion: The mixed methods approach used in this review provides rich data about contemporary dietetic practice. Our view supports a planned review of all Competency Standards to ensure practice informs education and credentialling and we recommend the Dietitians Association of Australia consider this in future

A simulation-based training system for surgical wound debridement

A simulation-based training system for surgical wound debridement was developed and comprises a multimedia introduction, a surgical simulator (tutorial component), and an assessment component. The simulator includes two PCs, a haptic device, and mirrored display. Debridement is performed on a virtual leg model with a shallow laceration wound superimposed. Trainees are instructed to remove debris with forceps, scrub with a brush, and rinse with saline solution to maintain sterility. Research and development issues currently under investigation include tissue deformation models using mass-spring system and finite element methods; tissue cutting using a high-resolution volumetric mesh and dynamic topology; and accurate collision detection, cutting, and soft-body haptic rendering for two devices within the same haptic space.

The Development of Competency Standards for Specialist Critical Care Nurses

In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry-to-practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into 'domains' or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice, reflective practice, enabling, clinical problem solving, teamwork, and leadership. Each of these domains is comprised of between two and seven competency standards. Each standard is further divided into component parts or 'elements' and the elements are illustrated with performance criteria. The competency standards are currently being used in several Australian critical care educational programmes and are the foundation for an emerging critical care credentialling process. They have been viewed with interest by a variety of non-critical care specialty groups and may form a common precursor from which further specialist nursing practice assessment will evolve.