Planning for Chaos: Developing the Concept of Emergency Preparedness through the Experience of the Paramedic.

Objective: Emergency preparedness is a developing specialty with a limited evidence base. Published literature primarily offers a retrospective view of experience, with few studies examining and understanding the individual lived experience of practitioners prospectively. This study explores paramedics' lived experience of emergency preparedness and applies that learning.

Effect of Number of Digits on Human Precision Manipulation Workspaces.

Precision manipulation, or moving small objects held in the fingertips, is likely the most heavily utilized class of dexterous within-hand manipulation and adds greatly to the capabilities of the human hand. This article focuses on studying the effects of varying the number of digits used on the resulting manipulation abilities, in terms of translational workspaces and rotational ranges, by manipulating two circular objects, 50 mm and 80 mm in diameter. In general, as the number of digits in contact with the object increases, the results show a significant reduction in precision manipulation workspace range for four of the six translation and rotation directions and no significant change in the other two, suggesting that for these particular metrics, more fingers result in a reduction in performance.

A 'Learning conversation' as a style of feedback.

This article was migrated. The article was marked as recommended. This paper explores the history behind the introduction and use of a 'learning conversation' as a mechanism of providing effective feedback to students on resuscitation courses.

Rotational ranges of human precision manipulation when grasping objects with two to five digits.

The ability to move and manipulate objects within the hand is important for the overall performance of the human hand. Such movements are key for many tasks, including writing, using precision tools, turning knobs, and operating various haptic interfaces. In this work we analyze the ability of 17 unimpaired subjects to rotate objects 50 and 80 mm in diameter using 2 to 5 digits, while maintaining the initial finger-object contact locations.

Human precision manipulation workspace: Effects of object size and number of fingers used.

Precision manipulation, or moving small objects in the fingertips, is important for daily tasks such as writing and key insertion, as well as medically relevant tasks such as scalpel cuts and surgical teleoperation. While fingertip force coordination has been studied in some detail, few previous works have experimentally studied the kinematics of human precision manipulation with real objects. The present work focuses on studying the effects of varying object size and the number of fingers used on the resulting manipulation workspace, or range of motions that the object can be moved through.

Electronic learning in advanced resuscitation training: The perspective of the candidate.

Background: Studies have shown that blended approaches combining e-learning with face-to-face training reduces costs whilst maintaining similar learning outcomes. The preferences in learning approach for healthcare providers to this new style of learning have not been comprehensively studied. The aim of this study is to evaluate the acceptability of blended learning to advanced resuscitation training.

Editorial comment: How true outcomes-based commissioning can really 'liberate' healthcare services.

Editorial comment on 'How true outcomes-based commissioning can really 'liberate' healthcare services' by Diane Bell, Thomas Kelley and Nicholas Hicks.

Workspace Shape and Characteristics for Human Two- and Three-Fingered Precision Manipulation.

Goal: To study precision manipulation, which involves repositioning an object in the fingertips and is used in everyday tasks such as writing and key insertion, and also for domain-specific tasks such as small scalpel cuts, using tweezers, and hand soldering.

Methods: In this study, the range of positions (workspace) through which 19 participants manipulated a 3.3-4.

Analysis of human grasping behavior: correlating tasks, objects and grasps.

This paper is the second in a two-part series analyzing human grasping behavior during a wide range of unstructured tasks. It investigates the tasks performed during the daily work of two housekeepers and two machinists and correlates grasp type and object properties with the attributes of the tasks being performed. The task or activity is classified according to the force required, the degrees of freedom, and the functional task type.

Analysis of human grasping behavior: object characteristics and grasp type.

This paper is the first of a two-part series analyzing human grasping behavior during a wide range of unstructured tasks. The results help clarify overall characteristics of human hand to inform many domains, such as the design of robotic manipulators, targeting rehabilitation toward important hand functionality, and designing haptic devices for use by the hand. It investigates the properties of objects grasped by two housekeepers and two machinists during the course of almost 10,000 grasp instances and correlates the grasp types used to the properties of the object.

Grasp frequency and usage in daily household and machine shop tasks.

In this paper, we present results from a study of prehensile human hand use during the daily work activities of four subjects: two housekeepers and two machinists. Subjects wore a head-mounted camera that recorded their hand usage during their daily work activities in their typical place of work. For each subject, 7.

The Warwick Patient Experiences Framework: patient-based evidence in clinical guidelines.

Objective: This paper presents the development of the Warwick Patient Experiences Framework (WaPEF) and describes how it informed the development of the NICE Guidance and Quality Standard, 'Patient experience in adult NHS services: improving the experience of care for people using adult NHS services'.

Design: The WaPEF was developed using a thematic qualitative overview that utilized a systematic review approach. Search strategies were developed, inclusion and exclusion criteria developed and data extracted from papers.

The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework.

Background: The case has been made for more and better theory-informed process evaluations within trials in an effort to facilitate insightful understandings of how interventions work. In this paper, we provide an explanation of implementation processes from one of the first national implementation research randomized controlled trials with embedded process evaluation conducted within acute care, and a proposed extension to the Promoting Action on Research Implementation in Health Services (PARIHS) framework.

Methods: The PARIHS framework was prospectively applied to guide decisions about intervention design, data collection, and analysis processes in a trial focussed on reducing peri-operative fasting times.

A pragmatic cluster randomised trial evaluating three implementation interventions.

Background: Implementation research is concerned with bridging the gap between evidence and practice through the study of methods to promote the uptake of research into routine practice. Good quality evidence has been summarised into guideline recommendations to show that peri-operative fasting times could be considerably shorter than patients currently experience. The objective of this trial was to evaluate the effectiveness of three strategies for the implementation of recommendations about peri-operative fasting.

Improving the efficiency of advanced life support training: a randomized, controlled trial.

Background: Each year, more than 1.5 million health care professionals receive advanced life support (ALS) training.

Objective: To determine whether a blended approach to ALS training that includes electronic learning (e-learning) produces outcomes similar to those of conventional, instructor-led ALS training.

Classifying human manipulation behavior.

This paper presents a taxonomy for detailed classification of human and anthropomorphic manipulation behavior. This hand-centric, motion-centric taxonomy differentiates tasks based on criteria such as object contact, prehension, and the nature of object motion relative to a hand frame. A sub-classification of the most dexterous categories, within-hand manipulation, is also presented, based on the principal axis of object rotation or translation in the hand frame.

Synopsis of the National Institute for Health and Clinical Excellence Guideline for management of transient loss of consciousness.

Description: Transient loss of consciousness (TLoC) is common and often leads to incorrect diagnosis, unnecessary investigation, or inappropriate choice of specialist referral. In August 2010, the National Institute for Health and Clinical Excellence published a guideline that addressed the initial assessment of and most appropriate specialist referral for persons who have experienced TLoC. The guideline focused on correct diagnosis and relevant specialist referral and did not make treatment recommendations.

A summary of the methods that the National Clinical Guideline Centre uses to produce clinical guidelines for the National Institute for Health and Clinical Excellence.

The National Clinical Guideline Centre develops evidence-based clinical guidelines on behalf of the National Institute for Health and Clinical Excellence in the United Kingdom. These guidelines are developed for the National Health Service in England, Wales, and Northern Ireland and establish recommendations on best practice. The authors summarize the main methods used in development, how evidence from systematic reviews is interpreted to form recommendations, who is involved in the process, and the main outputs that are published.

The effect of pre-course e-learning prior to advanced life support training: a randomised controlled trial.

Background: The role of e-learning in contemporary healthcare education is quickly developing. The aim of this study was to examine the relationship between the use of an e-learning simulation programme (Microsim, Laerdal, UK) prior to attending an Advanced Life Support (ALS) course and the subsequent relationship to candidate performance.

Methods: An open label, multi-centre randomised controlled study was conducted.