335 resultados para surgical training
Resumo:
The value and effectiveness of driver training as a means of improving driver behaviour and road safety continues to fuel research and societal debates. Knowledge about what are the characteristics of safe driving that need to be learnt is extensive. Research has shown that young drivers are over represented in crash statistics. The encouraging fact is that novice drivers have shown improvement in road scanning pattern after training. This paper presents a driver behaviour study conducted on a closed circuit track. A group of experienced and novice drivers performed repeated multiple manoeuvres (i.e. turn, overtake and lane change) under identical conditions Variables related to the driver, vehicle and environment were recorded in a research vehicle equipped with multiple in-vehicle sensors such as GPS accelerometers, vision processing, eye tracker and laser scanner. Each group exhibited consistently a set of driving pattern characterising a particular group. Behaviour such as the indicator usage before lane change, following distance while performing a manoeuvre were among the consistent observed behaviour differentiating novice from experienced drivers. This paper will highlight the results of our study and emphasize the need for effective driver training programs focusing on young and novice drivers.
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Relevance Feedback (RF) has been proven very effective for improving retrieval accuracy. Adaptive information filtering (AIF) technology has benefited from the improvements achieved in all the tasks involved over the last decades. A difficult problem in AIF has been how to update the system with new feedback efficiently and effectively. In current feedback methods, the updating processes focus on updating system parameters. In this paper, we developed a new approach, the Adaptive Relevance Features Discovery (ARFD). It automatically updates the system's knowledge based on a sliding window over positive and negative feedback to solve a nonmonotonic problem efficiently. Some of the new training documents will be selected using the knowledge that the system currently obtained. Then, specific features will be extracted from selected training documents. Different methods have been used to merge and revise the weights of features in a vector space. The new model is designed for Relevance Features Discovery (RFD), a pattern mining based approach, which uses negative relevance feedback to improve the quality of extracted features from positive feedback. Learning algorithms are also proposed to implement this approach on Reuters Corpus Volume 1 and TREC topics. Experiments show that the proposed approach can work efficiently and achieves the encouragement performance.
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INTRODUCTION. Following anterior thoracoscopic instrumentation and fusion for the treatment of thoracic AIS, implant related complications have been reported as high as 20.8%. Currently the magnitudes of the forces applied to the spine during anterior scoliosis surgery are unknown. The aim of this study was to measure the segmental compressive forces applied during anterior single rod instrumentation in a series of adolescent idiopathic scoliosis patients. METHODS. A force transducer was designed, constructed and retrofitted to a surgical cable compression tool, routinely used to apply segmental compression during anterior scoliosis correction. Transducer output was continuously logged during the compression of each spinal joint, the output at completion converted to an applied compression force using calibration data. The angle between adjacent vertebral body screws was also measured on intra-operative frontal plane fluoroscope images taken both before and after each joint compression. The difference in angle between the two images was calculated as an estimate for the achieved correction at each spinal joint. RESULTS. Force measurements were obtained for 15 scoliosis patients (Aged 11-19 years) with single thoracic curves (Cobb angles 47˚- 67˚). In total, 95 spinal joints were instrumented. The average force applied for a single joint was 540 N (± 229 N)ranging between 88 N and 1018 N. Experimental error in the force measurement, determined from transducer calibration was ± 43 N. A trend for higher forces applied at joints close to the apex of the scoliosis was observed. The average joint correction angle measured by fluoroscope imaging was 4.8˚ (±2.6˚, range 0˚-12.6˚). CONCLUSION. This study has quantified in-vivo, the intra-operative correction forces applied by the surgeon during anterior single rod instrumentation. This data provides a useful contribution towards an improved understanding of the biomechanics of scoliosis correction. In particular, this data will be used as input for developing patient-specific finite element simulations of scoliosis correction surgery.
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Purpose – The purpose of this paper is to determine the patterns of transitional employment (TE) aspirations and training and development (T&D) needs of women within local government. Design/methodology/approach – A quantitative survey methodology was used to identify aspirations in a sample of 1,068 employees from the Australian Local Government Association. Findings – Mature-aged women were very interested in continuous learning at work despite their limited formal education. Their training preferences consisted of informal delivery face-to-face or online in the areas of management or administration. Younger women were interested in undertaking university courses, while a minority were interested in blue collar occupations. Practical implications – Through the identification of patterns of TE and T&D aspirations, long term strategies to develop and retain women in local government may be developed. Findings suggest that mature-aged women would benefit from additional T&D to facilitate entry into management and senior administration positions, as well as strategies to facilitate a shift in organizational climate. Social implications – Mature-aged women were found to be a potentially untapped resource for management and senior administrative roles owing to their interest in developing skills in these fields and pursuing TE. Younger women may also benefit from T&D to maintain their capacity during breaks from employment. Encouragement of women in non-traditional areas may also address skill shortages in the local government. Originality/value – Mature-aged women were found to be a potentially untapped resource for management and senior administrative roles owing to their interest in developing skills in these fields and pursuing TE. Younger women may also benefit from T&D to maintain their capacity during breaks from employment. Encouragement of women in non-traditional areas may also address skill shortages in the local government.
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The Australian e-Health Research Centre in collaboration with the Queensland University of Technology's Paediatric Spine Research Group is developing software for visualisation and manipulation of large three-dimensional (3D) medical image data sets. The software allows the extraction of anatomical data from individual patients for use in preoperative planning. State-of-the-art computer technology makes it possible to slice through the image dataset at any angle, or manipulate 3D representations of the data instantly. Although the software was initially developed to support planning for scoliosis surgery, it can be applied to any dataset whether obtained from computed tomography, magnetic resonance imaging or any other imaging modality.
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Background Significant ongoing learning needs for nurses have occurred as a direct result of the continuous introduction of technological innovations and research developments in the healthcare environment. Despite an increased worldwide emphasis on the importance of continuing education, there continues to be an absence of empirical evidence of program and session effectiveness. Few studies determine whether continuing education enhances or develops practice and the relative cost benefits of health professionals’ participation in professional development. The implications for future clinical practice and associated educational approaches to meet the needs of an increasingly diverse multigenerational and multicultural workforce are also not well documented. There is minimal research confirming that continuing education programs contribute to improved patient outcomes, nurses’ earlier detection of patient deterioration or that standards of continuing competence are maintained. Crucially, evidence-based practice is demonstrated and international quality and safety benchmarks are adhered to. An integrated clinical learning model was developed to inform ongoing education for acute care nurses. Educational strategies included the use of integrated learning approaches, interactive teaching concepts and learner-centred pedagogies. A Respiratory Skills Update education (ReSKU) program was used as the content for the educational intervention to inform surgical nurses’ clinical practice in the area of respiratory assessment. The aim of the research was to evaluate the effectiveness of implementing the ReSKU program using teaching and learning strategies, in the context of organisational utility, on improving surgical nurses’ practice in the area of respiratory assessment. The education program aimed to facilitate better awareness, knowledge and understanding of respiratory dysfunction in the postoperative clinical environment. This research was guided by the work of Forneris (2004), who developed a theoretical framework to operationalise a critical thinking process incorporating the complexities of the clinical context. The framework used educational strategies that are learner-centred and participatory. These strategies aimed to engage the clinician in dynamic thinking processes in clinical practice situations guided by coaches and educators. Methods A quasi experimental pre test, post test non–equivalent control group design was used to evaluate the impact of the ReSKU program on the clinical practice of surgical nurses. The research tested the hypothesis that participation in the ReSKU program improves the reported beliefs and attitudes of surgical nurses, increases their knowledge and reported use of respiratory assessment skills. The study was conducted in a 400 bed regional referral public hospital, the central hub of three smaller hospitals, in a health district servicing the coastal and hinterland areas north of Brisbane. The sample included 90 nurses working in the three surgical wards eligible for inclusion in the study. The experimental group consisted of 36 surgical nurses who had chosen to attend the ReSKU program and consented to be part of the study intervention group. The comparison group included the 39 surgical nurses who elected not to attend the ReSKU program, but agreed to participate in the study. Findings One of the most notable findings was that nurses choosing not to participate were older, more experienced and less well educated. The data demonstrated that there was a barrier for training which impacted on educational strategies as this mature aged cohort was less likely to take up educational opportunities. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group’s reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales following attendance at the ReSKU program. These subscales included influence on nursing care, educational preparation and clinical development. Findings suggest that the use of an integrated educational model underpinned by a robust theoretical framework is a strong factor in some perceptions of the ReSKU program relating to attitudes and behaviour. There were minimal differences in knowledge between groups across time. Conclusions This study was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies and a robust overarching theoretical framework to support study concepts. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful and collective reflection, was a powerful educational strategy to enhance competency and capability in clinicians.