A comprehensive description of the competencies required for the performance of an ultrasound-guided axillary brachial plexus blockade

We addressed four research questions, each relating to the training and assessment of the competencies associated with the performance of ultrasound-guided axillary brachial plexus blockade (USgABPB). These were: (i) What are the most important determinants of learning of USgABPB? (ii) What is USgABPB? What are the errors most likely to occur when trainees learn to perform this procedure? (iii) How should end-user input be applied to the development of a novel USgABPB simulator? (iv) Does structured simulation based training influence novice learning of the procedure positively? We demonstrated that the most important determinants of learning USgABPB are: (a) Access to a formal structured training programme. (b) Frequent exposure to clinical learning opportunity in an appropriate setting (c) A clinical learning opporunity requires an appropriate patient, trainee and teacher being present at the same time, in an appropriate environment. We carried out a comprehensive description of the procedure. We performed a formal task analysis of USgABPB, identifying (i) 256 specific tasks associated with the safe and effective performance of the procedure, and (ii) the 20 most critical errors likely to occur in this setting. We described a methodology for this and collected data based on detailed, sequential evaluation of prototypes by trainees in anaesthesia. We carried out a pilot randomised control trial assessing the effectiveness of a USgABPB simulator during its development. Our data did not enable us to draw a reliable conclusion to this question; the trail did provide important new learning (as a pilot) to inform future investigation of this question. We believe that the ultimate goal of designing effective simulation-based training and assessment of ultrasound-guided regional anaesthesia is closer to realisation as a result of this work. It remains to be proven if this approach will have a positive impact on procedural performance, and more importantly improve patient outcomes.

Delivering mobile cloud services to the user: description, discovery, and consumption

The mobile cloud computing paradigm can offer relevant and useful services to the users of smart mobile devices. Such public services already exist on the web and in cloud deployments, by implementing common web service standards. However, these services are described by mark-up languages, such as XML, that cannot be comprehended by non-specialists. Furthermore, the lack of common interfaces for related services makes discovery and consumption difficult for both users and software. The problem of service description, discovery, and consumption for the mobile cloud must be addressed to allow users to benefit from these services on mobile devices. This paper introduces our work on a mobile cloud service discovery solution, which is utilised by our mobile cloud middleware, Context Aware Mobile Cloud Services (CAMCS). The aim of our approach is to remove complex mark-up languages from the description and discovery process. By means of the Cloud Personal Assistant (CPA) assigned to each user of CAMCS, relevant mobile cloud services can be discovered and consumed easily by the end user from the mobile device. We present the discovery process, the architecture of our own service registry, and service description structure. CAMCS allows services to be used from the mobile device through a user's CPA, by means of user defined tasks. We present the task model of the CPA enabled by our solution, including automatic tasks, which can perform work for the user without an explicit request.

SDC: Scalable description coding for adaptive streaming media

Video compression techniques enable adaptive media streaming over heterogeneous links to end-devices. Scalable Video Coding (SVC) and Multiple Description Coding (MDC) represent well-known techniques for video compression with distinct characteristics in terms of bandwidth efficiency and resiliency to packet loss. In this paper, we present Scalable Description Coding (SDC), a technique to compromise the tradeoff between bandwidth efficiency and error resiliency without sacrificing user-perceived quality. Additionally, we propose a scheme that combines network coding and SDC to further improve the error resiliency. SDC yields upwards of 25% bandwidth savings over MDC. Additionally, our scheme features higher quality for longer durations even at high packet loss rates.

Application description and policy model in collaborative environment for sharing of information on epidemiological and clinical research data sets.

BACKGROUND: Sharing of epidemiological and clinical data sets among researchers is poor at best, in detriment of science and community at large. The purpose of this paper is therefore to (1) describe a novel Web application designed to share information on study data sets focusing on epidemiological clinical research in a collaborative environment and (2) create a policy model placing this collaborative environment into the current scientific social context. METHODOLOGY: The Database of Databases application was developed based on feedback from epidemiologists and clinical researchers requiring a Web-based platform that would allow for sharing of information about epidemiological and clinical study data sets in a collaborative environment. This platform should ensure that researchers can modify the information. A Model-based predictions of number of publications and funding resulting from combinations of different policy implementation strategies (for metadata and data sharing) were generated using System Dynamics modeling. PRINCIPAL FINDINGS: The application allows researchers to easily upload information about clinical study data sets, which is searchable and modifiable by other users in a wiki environment. All modifications are filtered by the database principal investigator in order to maintain quality control. The application has been extensively tested and currently contains 130 clinical study data sets from the United States, Australia, China and Singapore. Model results indicated that any policy implementation would be better than the current strategy, that metadata sharing is better than data-sharing, and that combined policies achieve the best results in terms of publications. CONCLUSIONS: Based on our empirical observations and resulting model, the social network environment surrounding the application can assist epidemiologists and clinical researchers contribute and search for metadata in a collaborative environment, thus potentially facilitating collaboration efforts among research communities distributed around the globe.

One hundred years of forgetting: A quantitative description of retention

A sample of 210 published data sets were assembled that (a) plotted amount remembered versus time, (b) had 5 or more points, and (c) were smooth enough to fit at least 1 of the functions tested with a correlation coefficient of .90 or greater. Each was fit to 105 different 2-parameter functions. The best fits were to the logarithmic function, the power function, the exponential in the square root of time, and the hyperbola in the square root of time. It is difficult to distinguish among these 4 functions with the available data, but the same set of 4 functions fit most data sets, with autobiographical memory being the exception. Theoretical motivations for the best fitting functions are offered. The methodological problems of evaluating functions and the advantages of searching existing data for regularities before formulating theories are considered.

Description of a procedure to identify strategies: The case of the tiles problem

In this paper we present a procedure to describe strategies in problems which can be solved using inductive reasoning. This procedure is based on some aspects of the analysis of the specific subject matter, concretely on the elements, the representation systems and the transformations involved. We show an example of how we used this procedure for the tiles problem. Finally we present some results and conclusions.

A mathematical description of the acoustic coupling of the mass/spring model

This paper describes hybrid mathematical model which couples the mechanics of the mass/spring model to the acoustic wave propagation model for use in generating the acoustic signal emitted by complex structures of paper fibres under strain. A discussion of the coupling method is presented including remarks on the errors encountered intrinsic to the discretisation scheme. The numerical results of a vibrating rubber band and a vibrating paper fibre are compared to their experimental counterparts. The fundamental frequencies of the acoustic signals are compared showing a close agreement between the experimental and numerical results

Continuing Professional Development: rhetoric and practice in the NHS

This article explores the experience of Continuing Professional Development (CPD) by supervisory-level clinical staff in the National Health Service. Four main themes are highlighted in the literature, namely the nature and experience of CPD, its relationship with human resource management practices and in particular in career development and planning. These themes are examined utilising sources of (triangulated) empirical data based on a 2500 sample survey conducted across five NHS Trusts. A key finding was that responsibility for learning and development was perceived as belonging to the individual rather than the organisation. Other findings concern a lack of resource-based commitment by the organisation to CPD for clinical staff undertaking supervisory-level roles and evidence of 'credentialism' with its emphasis on seeking certificated qualifications. The findings raise concerns about the potential for clinical staff to become disillusioned and to perceive a potential breach in their psychological contract because of problems in reconciling their own interests with those of their professional body, and that of their employer in relation to CPD.