Virtual reality exposure therapy: 150-degree screen to desktop PC

Virtual reality exposure therapy (VRET) developed using immersive or semi-immersive virtual environments present a usability problem for practitioners. To meet practitioner requirements for lower cost and portability VRET programs must often be ported onto desktop environments such as the personal computer (PC). However, success of VRET has been shown to be linked to presence, and the environment's ability to evoke the same reactions and emotions as a real experience. It is generally accepted that high-end virtual environments ( VEs) are more immersive than desktop PCs, but level of immersion does not always predict level of presence. This paper reports on the impact on presence of porting a therapeutic VR application for Schizophrenia from the initial research environment of a semi-immersive curved screen to PC. Presence in these two environments is measured both introspectively and across a number of causal factors thought to underlie the experience of presence. Results show that the VR exposure program successfully made users feel they were present in both platforms. While the desktop PC achieved higher scores on presence across causal factors participants reported they felt more present in the curved screen environment. While comparison of the two groups was statistically significant for the PQ but not for the IPQ, subjective reports of experiences in the environments should be considered in future research as the success of VRET relies heavily on the emotional response of patients to the therapeutic program.

Embedding defeasible logic into logic programming

Defeasible reasoning is a simple but efficient approach to nonmonotonic reasoning that has recently attracted considerable interest and that has found various applications. Defeasible logic and its variants are an important family of defeasible reasoning methods. So far no relationship has been established between defeasible logic and mainstream nonmonotonic reasoning approaches. In this paper we establish close links to known semantics of logic programs. In particular, we give a translation of a defeasible theory D into a meta-program P(D). We show that under a condition of decisiveness, the defeasible consequences of D correspond exactly to the sceptical conclusions of P(D) under the stable model semantics. Without decisiveness, the result holds only in one direction (all defeasible consequences of D are included in all stable models of P(D)). If we wish a complete embedding for the general case, we need to use the Kunen semantics of P(D), instead.

Antibacterial dosing in intensive care: Pharmacokinetics, degree of disease and pharmacodynamics of sepsis

Treatment of sepsis remains a significant challenge with persisting high mortality and morbidity. Early and appropriate antibacterial therapy remains an important intervention for such patients. To optimise antibacterial therapy, the clinician must possess knowledge of the pharmacokinetic and pharmacodynamic properties of commonly used antibacterials and how these parameters may be affected by the constellation of pathophysiological changes occurring during sepsis. Sepsis, and the treatment thereof, increases renal preload and, via capillary permeability, leads to 'third-spacing', both resulting in higher antibacterial clearances. Alternatively, sepsis can induce multiple organ dysfunction, including renal and/or hepatic dysfunction, causing a decrease in antibacterial clearance. Aminoglycosides are concentration-dependent antibacterials and they display an increased volume of distribution (V-d) in sepsis, resulting in decreased peak serum concentrations. Reduced clearance from renal dysfunction would increase the likelihood of toxicity. Individualised dosing using extended interval dosing, which maximises the peak serum drug concentration (C-max)/minimum inhibitory concentration ratio is recommended. beta-Lactams and carbapenems are time-dependent antibacterials. An increase in Vd and renal clearance will require increased dosing or administration by continuous infusion. If renal impairment occurs a corresponding dose reduction may be required. Vancomycin displays predominantly time-dependent pharmacodynamic properties and probably requires higher than conventionally recommended doses because of an increased V-d and clearance during sepsis without organ dysfunction. However, optimal dosing regimens remain unresolved. The poor penetration of vancomycin into solid organs may require alternative therapies when sepsis involves solid organs (e.g. lung). Ciprofloxacin displays largely concentration-dependent kill characteristics, but also exerts some time-dependent effects. The V-d of ciprofloxacin is not altered with fluid shifts or over time, and thus no alterations of standard doses are required unless renal dysfunction occurs. In order to optimise antibacterial regimens in patients with sepsis, the pathophysiological effects of systemic inflammatory response syndrome need consideration, in conjunction with knowledge of the different kill characteristics of the various antibacterial classes. In conclusion, certain antibacterials can have a very high V-d, therefore leading to a low C-max and if a high peak is needed, then this would lead to underdosing. The Vd of certain antibacterials, namely aminoglycosides and vancomycin, changes over time, which means dosing may need to be altered over time. Some patients with serum creatinine values within the normal range can have very high drug clearances, thereby producing low serum drug levels and again leading to underdosing. Copyright © 2010 Elsevier Inc. All rights reserved.

Embedding e-portfolios for effective lifelong learning:a case study

Lifelong learning is a ‘keystone’ of educational policies (Faure, 1972) where the emphasis on learning shifts from teacher to learner. Higher Education (HE) institutions should be committed to developing lifelong learning, that is promoting learning that is flexible, diverse and relevant at different times, and in different places, and is pursued throughout life. Therefore the HE sector needs to develop effective strategies to encourage engagement in meaningful learning for diverse student populations. The use of e-portfolios, as a ‘purposeful aggregation of digital items’ (Sutherland & Powell, 2007), can meet the needs of the student community by encouraging reflection, the recording of experiences and achievements, and personal development planning (PDP). The use of e-portfolios also promotes inclusivity in learning as it provides students with the opportunity to articulate their aspirations and take the first steps along the pathway of lifelong learning. However, ensuring the uptake of opportunities within their learning is more complex than the students simply having access to the software. Therefore it is argued here that crucial to the effective uptake and engagement of the e-portfolio is embedding it purposefully within the curriculum. In order to investigate effective implementation of e-portfolios an explanatory case study on their use was carried out, initially focusing on 3 groups of students engaged in work-based learning and professional practice. The 3 groups had e-Portfolios embedded and assessed at different levels. Group 1 did not have the e-Portfolio embedded into their curriculum nor was the e-Portfolio assessed. Group 2 had the e-Portfolio embedded into the curriculum and formatively assessed. Group 3 also had the e-Portfolio embedded into the curriculum and were summatively assessed. Results suggest that the use of e-Portfolios needs to be integral to curriculum design in modules rather than used as an additional tool. In addition to this more user engagement was found in group 2 where the e-Portfolio was formatively assessed only. The implications of this case study are further discussed in terms of curriculum development.