Firing Room 2 in Launch Control Center at KSC during Apollo 9 countdown test

NASA Image and Video Library

1969-02-23

S69-25880 (23 Feb. 1969) --- Overall view of Firing Room 2 in the Launch Control Center, Launch Complex 39, Kennedy Space Center, during an Apollo 9 Countdown Demonstration Test. Astronauts James A. McDivitt, David R. Scott, and Russell L. Schweickart were participating in a training exercise in preparation for their scheduled 10-day Earth-orbital space mission.

77 FR 2350 - Agency Information Collection (Request for Change of Program or Place of Training): Activity...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

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75 FR 51485 - Comment Request for Information Collection for OMB Control No. 1205-0033; Job Corps Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

... Employment and Training Administration is soliciting comments concerning the collection of data about Job... Health and Wellness Manager, Employment and Training Administration, Office of Job Corps, Room N-4507.... Background Job Corps is an intensive, residential training program for at-risk youth age 16 through 24 to...

Key facilitators and best practices of hotel-style room service in hospitals.

PubMed

Sheehan-Smith, Lisa

2006-04-01

This qualitative study sought to identify the features, advantages, and disadvantages of hotel-style room service; the barriers to, and facilitators for, implementing the process; and "best practices." The study took place in four heterogeneous hospitals. Participants included hospital administrators, managers, and room-service employees. Data-collection methods included semi-structured interviews, observations, and document analysis. Common features of hotel-style room service were meal delivery within 30 to 45 minutes, a restaurant-style menu, procedures to feed ineligible patients, tray assembly on demand, scripting, and waitstaff uniforms for room-service employees. The major barrier to implementing room service was obtaining nursing support. The key facilitators were the hospital's service-oriented culture, using a multidisciplinary planning team, engaging nursing departments early in the planning stages, and intense customer-service training of room-service employees. The overwhelming advantage was patients' control over their food choices. The main disadvantage was cost. Initial best practices in hotel-style room service include: (a) taking a multidisciplinary team approach for developing and implementing the process, (b) customer-service training, (c) using a customer-driven menu, (d) wearing waitstaff uniforms, and (e) using carts with airpots for dispensing hot beverages.

Integrated Launch Operations Applications Remote Display Developer

NASA Technical Reports Server (NTRS)

Flemming, Cedric M., II

2014-01-01

This internship provides the opportunity to support the creation and use of Firing Room Displays and Firing Room Applications that use an abstraction layer called the Application Control Language (ACL). Required training included video watching, reading assignments, face-to-face instruction and job shadowing other Firing Room software developers as they completed their daily duties. During the training period various computer and access rights needed for creating the applications were obtained. The specific ground subsystems supported are the Cryogenics Subsystems, Liquid Hydrogen (LH2) and Liquid Oxygen (LO2). The cryogenics team is given the task of finding the best way to handle these very volatile liquids that are used to fuel the Space Launch System (SLS) and the Orion flight vehicles safely.

Perceptions of Recent Graduates of the Adequacy of Anesthesia Training Programs.

ERIC Educational Resources Information Center

Spielman, Fred J.; Bowe, Edwin A.

1983-01-01

A survey examined physician attitudes toward operating room, nonoperating room, and nonpatient care responsibilities in their residencies. Training for operating room responsibilities was deemed adequate by most, and nonoperating room training inadequate. Recommendations include: hospital cooperation, more effective sessions, and supplementary…

A systematic review of surgical skills transfer after simulation-based training: laparoscopic cholecystectomy and endoscopy.

PubMed

Dawe, Susan R; Windsor, John A; Broeders, Joris A J L; Cregan, Patrick C; Hewett, Peter J; Maddern, Guy J

2014-02-01

A systematic review to determine whether skills acquired through simulation-based training transfer to the operating room for the procedures of laparoscopic cholecystectomy and endoscopy. Simulation-based training assumes that skills are directly transferable to the operation room, but only a few studies have investigated the effect of simulation-based training on surgical performance. A systematic search strategy that was used in 2006 was updated to retrieve relevant studies. Inclusion of articles was determined using a predetermined protocol, independent assessment by 2 reviewers, and a final consensus decision. Seventeen randomized controlled trials and 3 nonrandomized comparative studies were included in this review. In most cases, simulation-based training was in addition to patient-based training programs. Only 2 studies directly compared simulation-based training in isolation with patient-based training. For laparoscopic cholecystectomy (n = 10 studies) and endoscopy (n = 10 studies), participants who reached simulation-based skills proficiency before undergoing patient-based assessment performed with higher global assessment scores and fewer errors in the operating room than their counterparts who did not receive simulation training. Not all parameters measured were improved. Two of the endoscopic studies compared simulation-based training in isolation with patient-based training with different results: for sigmoidoscopy, patient-based training was more effective, whereas for colonoscopy, simulation-based training was equally effective. Skills acquired by simulation-based training seem to be transferable to the operative setting for laparoscopic cholecystectomy and endoscopy. Future research will strengthen these conclusions by evaluating predetermined competency levels on the same simulators and using objective validated global rating scales to measure operative performance.

Virtual reality as a human factors design analysis tool: Macro-ergonomic application validation and assessment of the Space Station Freedom payload control area

NASA Technical Reports Server (NTRS)

Hale, Joseph P.

1994-01-01

A virtual reality (VR) Applications Program has been under development at MSFC since 1989. Its objectives are to develop, assess, validate, and utilize VR in hardware development, operations development and support, missions operations training, and science training. A variety of activities are under way within many of these areas. One ongoing macro-ergonomic application of VR relates to the design of the Space Station Freedom Payload Control Area (PCA), the control room from which onboard payload operations are managed. Several preliminary conceptual PCA layouts have been developed and modeled in VR. Various managers and potential end users have virtually 'entered' these rooms and provided valuable feedback. Before VR can be used with confidence in a particular application, it must be validated, or calibrated, for that class of applications. Two associated validation studies for macro-ergonomic applications are under way to help characterize possible distortions of filtering of relevant perceptions in a virtual world. In both studies, existing control rooms and their 'virtual counterparts will be empirically compared using distance and heading estimations to objects and subjective assessments. Approaches and findings of the PCA activities and details of the studies are presented.

STS-26 simulation activities in JSC Mission Control Center (MCC)

NASA Technical Reports Server (NTRS)

1987-01-01

Overall view of JSC Mission Control Center (MCC) Bldg 30 Flight Control Room (FCR) during Flight Day 1 of STS-26 integrated simulations in progress between MCC and JSC Mission Simulation and Training Facility Bldg 5 fixed-base (FB) shuttle mission simulator (SMS).

[Team training and assessment in mixed reality-based simulated operating room : Current state of research in the field of simulation in spine surgery exemplified by the ATMEOS project].

PubMed

Stefan, P; Pfandler, M; Wucherer, P; Habert, S; Fürmetz, J; Weidert, S; Euler, E; Eck, U; Lazarovici, M; Weigl, M; Navab, N

2018-04-01

Surgical simulators are being increasingly used as an attractive alternative to clinical training in addition to conventional animal models and human specimens. Typically, surgical simulation technology is designed for the purpose of teaching technical surgical skills (so-called task trainers). Simulator training in surgery is therefore in general limited to the individual training of the surgeon and disregards the participation of the rest of the surgical team. The objective of the project Assessment and Training of Medical Experts based on Objective Standards (ATMEOS) is to develop an immersive simulated operating room environment that enables the training and assessment of multidisciplinary surgical teams under various conditions. Using a mixed reality approach, a synthetic patient model, real surgical instruments and radiation-free virtual X‑ray imaging are combined into a simulation of spinal surgery. In previous research studies, the concept was evaluated in terms of realism, plausibility and immersiveness. In the current research, assessment measurements for technical and non-technical skills are developed and evaluated. The aim is to observe multidisciplinary surgical teams in the simulated operating room during minimally invasive spinal surgery and objectively assess the performance of the individual team members and the entire team. Moreover, the effectiveness of training methods and surgical techniques or success critical factors, e. g. management of crisis situations, can be captured and objectively assessed in the controlled environment.

VISITOR - SULTAN - JSC

NASA Image and Video Library

1985-04-04

S85-29711 (April 1985) --- Ronald C. Epps, right of the training division in the mission operations directorate, briefs the Saudi Arabian payload specialist, Sultan Salman Abdelazize Al-Saud, and his backup, Abdulmohsen Hamad Al-Bassam, in the flight control room (FCR) of the mission control center (MCC). Erlinda Stevenson is also pictured.

76 FR 56815 - Workforce Investment Act; Native American Employment and Training Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

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Future of operating rooms.

PubMed

Reijnen, Michel M P J; Zeebregts, Clark J; Meijerink, Wilhelmus J H J

2005-01-01

Operating-room design has not changed significantly since the modern era of surgery began. Minimal invasive, endoscopic, procedures, and evolution of technology will affect operating-room design in the near future. Poor ergonomics has always been one of the major drawbacks of endoscopic surgery. Use of retractable arms and monitors will improve ergonomics of the operating team. Developments in telecommunication will allow surgeons to communicate with colleagues and experts during the procedure in virtually any location around the world, which increases teaching possibilities and procedural safety. Introduction and further development of intraoperative imaging, including real-time, three-dimensional (3-D) reconstructions of patient, and computer-aided surgery offer surgeons the opportunity to train the planned surgical procedure. Moreover, they will improve control and supervision of the procedure in learning situations. The last decade's robotics have made their introduction into the operating rooms. They improve control over the operating-room environment and will facilitate the performance of more complex procedures. However, high costs and lack of force feedback remain its major drawbacks. Improvements of robotic techniques and its implementation into the operating rooms will further guide their design into highly specialized operating units.

STS-26 simulation activities in JSC Mission Control Center (MCC)

NASA Technical Reports Server (NTRS)

1987-01-01

In JSC Mission Control Center (MCC) Bldg 30 Flight Control Room (FCR), astronauts John O. Creighton (right) and L. Blaine Hammond review their notes while serving as spacecraft communicators (CAPCOMs) for STS-26 simulations in progress between MCC and JSC Mission Simulation and Training Facility Bldg 5 fixed-base (FB) shuttle mission simulator (SMS).

STS-26 simulation activities in JSC Mission Control Center (MCC)

NASA Technical Reports Server (NTRS)

1987-01-01

In JSC Mission Control Center (MCC) Bldg 30 Flight Control Room (FCR), flight directors (FDs) Lee Briscoe (left) and Charles W. Shaw, seated at FD console, view front visual display monitors during STS-26 simulations in progress between MCC and JSC Mission Simulation and Training Facility Bldg 5 fixed-base (FB) shuttle mission simulator (SMS).

Play to become a surgeon: impact of Nintendo Wii training on laparoscopic skills.

PubMed

Giannotti, Domenico; Patrizi, Gregorio; Di Rocco, Giorgio; Vestri, Anna Rita; Semproni, Camilla Proietti; Fiengo, Leslie; Pontone, Stefano; Palazzini, Giorgio; Redler, Adriano

2013-01-01

Video-games have become an integral part of the new multimedia culture. Several studies assessed video-gaming enhancement of spatial attention and eye-hand coordination. Considering the technical difficulty of laparoscopic procedures, legal issues and time limitations, the validation of appropriate training even outside of the operating rooms is ongoing. We investigated the influence of a four-week structured Nintendo® Wii™ training on laparoscopic skills by analyzing performance metrics with a validated simulator (Lap Mentor™, Simbionix™). We performed a prospective randomized study on 42 post-graduate I-II year residents in General, Vascular and Endoscopic Surgery. All participants were tested on a validated laparoscopic simulator and then randomized to group 1 (Controls, no training with the Nintendo® Wii™), and group 2 (training with the Nintendo® Wii™) with 21 subjects in each group, according to a computer-generated list. After four weeks, all residents underwent a testing session on the laparoscopic simulator of the same tasks as in the first session. All 42 subjects in both groups improved significantly from session 1 to session 2. Compared to controls, the Wii group showed a significant improvement in performance (p<0.05) for 13 of the 16 considered performance metrics. The Nintendo® Wii™ might be helpful, inexpensive and entertaining part of the training of young laparoscopists, in addition to a standard surgical education based on simulators and the operating room.

Association of a Surgical Task During Training With Team Skill Acquisition Among Surgical Residents: The Missing Piece in Multidisciplinary Team Training.

PubMed

Sparks, Jessica L; Crouch, Dustin L; Sobba, Kathryn; Evans, Douglas; Zhang, Jing; Johnson, James E; Saunders, Ian; Thomas, John; Bodin, Sarah; Tonidandel, Ashley; Carter, Jeff; Westcott, Carl; Martin, R Shayn; Hildreth, Amy

2017-09-01

The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers. This pre-post educational intervention pilot study compared the gains in teamwork skills for midlevel surgical residents at Wake Forest Baptist Medical Center after they participated in a standardized multidisciplinary team training scenario with 3 possible levels of surgical realism: (1) SimMan (Laerdal) (control group, no surgical anatomy); (2) "synthetic anatomy for surgical tasks" mannequin (medium-fidelity anatomy), and (3) a patient simulated by a deceased donor (high-fidelity anatomy). Participation in the simulation scenario and the subsequent debriefing. Teamwork competency was assessed using several instruments with extensive validity evidence, including the Nontechnical Skills assessment, the Trauma Management Skills scoring system, the Crisis Resource Management checklist, and a self-efficacy survey instrument. Participant satisfaction was assessed with a Likert-scale questionnaire. Scenario participants included midlevel surgical residents, anesthesia providers, scrub nurses, and circulating nurses. Statistical models showed that surgical residents exposed to medium-fidelity simulation (synthetic anatomy for surgical tasks) team training scenarios demonstrated greater gains in teamwork skills compared with control groups (SimMan) (Nontechnical Skills video score: 95% CI, 1.06-16.41; Trauma Management Skills video score: 95% CI, 0.61-2.90) and equivalent gains in teamwork skills compared with high-fidelity simulations (deceased donor) (Nontechnical Skills video score: 95% CI, -8.51 to 6.71; Trauma Management Skills video score: 95% CI, -1.70 to 0.49). Including a surgical task in operating room team training significantly enhanced the acquisition of teamwork skills among midlevel surgical residents. Incorporating relatively inexpensive, medium-fidelity synthetic anatomy in human patient simulators was as effective as using high-fidelity anatomies from deceased donors for promoting teamwork skills in this learning group.

Emotions on the loose: emotional contagion and the role of oxytocin in pigs.

PubMed

Reimert, Inonge; Bolhuis, J Elizabeth; Kemp, Bas; Rodenburg, T Bas

2015-03-01

We studied emotional contagion, a simple form of empathy, and the role of oxytocin herein in pigs. Two training pigs per pen (n = 16 pens) were subjected to a positive treatment (pairwise access to a large compartment filled with peat, straw and some chocolate raisins) and a negative treatment (social isolation in a small compartment) in a test room using a within-subjects design. Thereafter, two naive pen mates joined the training pigs in the test room, but were not given access to the treatments. This allowed testing for emotional contagion. Subsequently, the naive pigs, serving as their own controls, were given 24 IU of oxytocin or a placebo intranasally 30 min before accompanying the training pigs, which were exposed to either the negative or positive treatment, to the test room. Behavioral differences found between the positive and negative treatments (e.g., play and "tail wagging" vs. standing alert, urinating, defecating and ears backward) show that the treatments induced a positive and negative emotional state in the training pigs, respectively. Changes in behaviors of the training pigs with and without naive pigs present (e.g., in ears backwards) and of the naive pigs with and without training pigs present (e.g., in standing alert) indicated that emotional contagion occurred, especially during the negative treatment. Oxytocin did not seem to affect the behavior of the treated naive pigs, but did affect behaviors (e.g., defecating) of the training pigs which had not received oxytocin. This suggests a role for oxytocin in pig communication, which merits further research.

Impact of animal-assisted therapy for outpatients with fibromyalgia.

PubMed

Marcus, Dawn A; Bernstein, Cheryl D; Constantin, Janet M; Kunkel, Frank A; Breuer, Paula; Hanlon, Raymond B

2013-01-01

Animal-assisted therapy using dogs trained to be calm and provide comfort to strangers has been used as a complementary therapy for a range of medical conditions. This study was designed to evaluate the effects of brief therapy dog visits for fibromyalgia patients attending a tertiary outpatient pain management facility compared with time spent in a waiting room. Open label with waiting room control. Tertiary care, university-based, outpatient pain management clinic. A convenience sample of fibromyalgia patients was obtained through advertisements posted in the clinic. Participants were able to spend clinic waiting time with a certified therapy dog instead of waiting in the outpatient waiting area. When the therapy dog was not available, individuals remained in the waiting area. OUTCOME MEASURES.: Self-reported pain, fatigue, and emotional distress were recorded using 11-point numeric rating scales before and after the therapy dog visit or waiting room time. Data were evaluated from 106 therapy dog visits and 49 waiting room controls, with no significant between-group demographic differences in participants. Average intervention duration was 12 minutes for the therapy dog visit and 17 minutes for the waiting room control. Significant improvements were reported for pain, mood, and other measures of distress among patients after the therapy dog visit, but not the waiting room control. Clinically meaningful pain relief (≥2 points pain severity reduction) occurred in 34% after the therapy dog visit and 4% in the waiting room control. Outcome was not affected by the presence of comorbid anxiety or depression. Brief therapy dog visits may provide a valuable complementary therapy for fibromyalgia outpatients. Wiley Periodicals, Inc.

Evaluation of Modern Navies’ Damage Control and Firefighting Training using Simulator Platforms

DTIC Science & Technology

2011-09-01

Figure 18 below is a two-story concrete structure including holes in bulkheads, ruptured pipelines, and almost all situations that can cause flooding...the four simulators address Class A, B, and C fires. The first one—the “Basic Firefighting Trainer”—is a single-story concrete structure with four...Figure 19—is a three-story concrete structure that houses berthing facilities, engine rooms, storage compartments and electrical and engine room mock

Association Between Barracks Type and Acute Respiratory Infection in a Gender Integrated Army Basic Combat Training Population

PubMed Central

White, Duvel W.; Feigley, Charles E.; McKeown, Robert E.; Hout, Joseph J.; Hebert, James R.

2015-01-01

Background Acute respiratory infections (ARIs) are the leading cause of acute morbidity and lost work time in the United States. Few studies have looked at building design and transmission of ARIs. Objectives This study explores the association of ventilation design, room occupancy numbers, and training week with ARI rates in Army Basic Combat Training barracks. Methods This observational study captured the overall incidence of ARI in a cohort of 16,258 individuals attending basic combat training at Fort Jackson, South Carolina. Results ARI risk was higher among trainees living in the 60-person room barracks compared with those living in 8-person rooms, which increased rapidly for the first few weeks of training and then declined to baseline. Conclusions Findings support direct contact as primary ARI transmission mode in this study population based on observed lower ARI risk in smaller room barracks and similar risk in large room barracks despite heating, ventilation, and air conditioning system variability. PMID:21882781

Play to Become a Surgeon: Impact of Nintendo WII Training on Laparoscopic Skills

PubMed Central

Giannotti, Domenico; Patrizi, Gregorio; Di Rocco, Giorgio; Vestri, Anna Rita; Semproni, Camilla Proietti; Fiengo, Leslie; Pontone, Stefano; Palazzini, Giorgio; Redler, Adriano

2013-01-01

Background Video-games have become an integral part of the new multimedia culture. Several studies assessed video-gaming enhancement of spatial attention and eye-hand coordination. Considering the technical difficulty of laparoscopic procedures, legal issues and time limitations, the validation of appropriate training even outside of the operating rooms is ongoing. We investigated the influence of a four-week structured Nintendo® Wii™ training on laparoscopic skills by analyzing performance metrics with a validated simulator (Lap Mentor™, Simbionix™). Methodology/Principal Findings We performed a prospective randomized study on 42 post-graduate I–II year residents in General, Vascular and Endoscopic Surgery. All participants were tested on a validated laparoscopic simulator and then randomized to group 1 (Controls, no training with the Nintendo® Wii™), and group 2 (training with the Nintendo® Wii™) with 21 subjects in each group, according to a computer-generated list. After four weeks, all residents underwent a testing session on the laparoscopic simulator of the same tasks as in the first session. All 42 subjects in both groups improved significantly from session 1 to session 2. Compared to controls, the Wii group showed a significant improvement in performance (p<0.05) for 13 of the 16 considered performance metrics. Conclusions/Significance The Nintendo® Wii™ might be helpful, inexpensive and entertaining part of the training of young laparoscopists, in addition to a standard surgical education based on simulators and the operating room. PMID:23460845

Lack of transfer of skills after virtual reality simulator training with haptic feedback.

PubMed

Våpenstad, Cecilie; Hofstad, Erlend Fagertun; Bø, Lars Eirik; Kuhry, Esther; Johnsen, Gjermund; Mårvik, Ronald; Langø, Thomas; Hernes, Toril Nagelhus

2017-12-01

Virtual reality (VR) simulators enrich surgical training and offer training possibilities outside of the operating room (OR). In this study, we created a criterion-based training program on a VR simulator with haptic feedback and tested it by comparing the performances of a simulator group against a control group. Medical students with no experience in laparoscopy were randomly assigned to a simulator group or a control group. In the simulator group, the candidates trained until they reached predefined criteria on the LapSim ® VR simulator (Surgical Science AB, Göteborg, Sweden) with haptic feedback (Xitact TM IHP, Mentice AB, Göteborg, Sweden). All candidates performed a cholecystectomy on a porcine organ model in a box trainer (the clinical setting). The performances were video rated by two surgeons blinded to subject training status. In total, 30 students performed the cholecystectomy and had their videos rated (N = 16 simulator group, N = 14 control group). The control group achieved better video rating scores than the simulator group (p < .05). The criterion-based training program did not transfer skills to the clinical setting. Poor mechanical performance of the simulated haptic feedback is believed to have resulted in a negative training effect.

Analysis of verbal communication during teaching in the operating room and the potentials for surgical training.

PubMed

Blom, E M; Verdaasdonk, E G G; Stassen, L P S; Stassen, H G; Wieringa, P A; Dankelman, J

2007-09-01

Verbal communication in the operating room during surgical procedures affects team performance, reflects individual skills, and is related to the complexity of the operation process. During the procedural training of surgeons (residents), feedback and guidance is given through verbal communication. A classification method based on structural analysis of the contents was developed to analyze verbal communication. This study aimed to evaluate whether a classification method for the contents of verbal communication in the operating room could provide insight into the teaching processes. Eight laparoscopic cholecystectomies were videotaped. Two entire cholecystectomies and the dissection phase of six additional procedures were analyzed by categorization of the communication in terms of type (4 categories: commanding, explaining, questioning, and miscellaneous) and content (9 categories: operation method, location, direction, instrument handling, visualization, anatomy and pathology, general, private, undefinable). The operation was divided into six phases: start, dissection, clipping, separating, control, closing. Classification of the communication during two entire procedures showed that each phase of the operation was dominated by different kinds of communication. A high percentage of explaining anatomy and pathology was found throughout the whole procedure except for the control and closing phases. In the dissection phases, 60% of verbal communication concerned explaining. These explaining communication events were divided as follows: 27% operation method, 19% anatomy and pathology, 25% location (positioning of the instrument-tissue interaction), 15% direction (direction of tissue manipulation), 11% instrument handling, and 3% other nonclassified instructions. The proposed classification method is feasible for analyzing verbal communication during surgical procedures. Communication content objectively reflects the interaction between surgeon and resident. This information can potentially be used to specify training needs, and may contribute to the evaluation of different training methods.

Body temperature and cold sensation during and following exercise under temperate room conditions in cold-sensitive young trained females.

PubMed

Fujii, Naoto; Aoki-Murakami, Erii; Tsuji, Bun; Kenny, Glen P; Nagashima, Kei; Kondo, Narihiko; Nishiyasu, Takeshi

2017-11-01

We evaluated cold sensation at rest and in response to exercise-induced changes in core and skin temperatures in cold-sensitive exercise trained females. Fifty-eight trained young females were screened by a questionnaire, selecting cold-sensitive (Cold-sensitive, n  = 7) and non-cold-sensitive (Control, n  = 7) individuals. Participants rested in a room at 29.5°C for ~100 min after which ambient temperature was reduced to 23.5°C where they remained resting for 60 min. Participants then performed 30-min of moderate intensity cycling (50% peak oxygen uptake) followed by a 60-min recovery. Core and mean skin temperatures and cold sensation over the whole-body and extremities (fingers and toes) were assessed throughout. Resting core temperature was lower in the Cold-sensitive relative to Control group (36.4 ± 0.3 vs. 36.7 ± 0.2°C). Core temperature increased to similar levels at end-exercise (~37.2°C) and gradually returned to near preexercise rest levels at the end of recovery (>36.6°C). Whole-body cold sensation was greater in the Cold-sensitive relative to Control group during resting at a room temperature of 23.5°C only without a difference in mean skin temperature between groups. In contrast, cold sensation of the extremities was greater in the Cold-sensitive group prior to, during and following exercise albeit this was not paralleled by differences in mean extremity skin temperature. We show that young trained females who are sensitive to cold exhibit augmented whole-body cold sensation during rest under temperate ambient conditions. However, this response is diminished during and following exercise. In contrast, cold sensation of extremities is augmented during resting that persists during and following exercise. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Improving residency training in arthroscopic knee surgery with use of a virtual-reality simulator. A randomized blinded study.

PubMed

Cannon, W Dilworth; Garrett, William E; Hunter, Robert E; Sweeney, Howard J; Eckhoff, Donald G; Nicandri, Gregg T; Hutchinson, Mark R; Johnson, Donald D; Bisson, Leslie J; Bedi, Asheesh; Hill, James A; Koh, Jason L; Reinig, Karl D

2014-11-05

There is a paucity of articles in the surgical literature demonstrating transfer validity (transfer of training). The purpose of this study was to assess whether skills learned on the ArthroSim virtual-reality arthroscopic knee simulator transferred to greater skill levels in the operating room. Postgraduate year-3 orthopaedic residents were randomized into simulator-trained and control groups at seven academic institutions. The experimental group trained on the simulator, performing a knee diagnostic arthroscopy procedure to a predetermined proficiency level based on the average proficiency of five community-based orthopaedic surgeons performing the same procedure on the simulator. The residents in the control group continued their institution-specific orthopaedic education and training. Both groups then performed a diagnostic knee arthroscopy procedure on a live patient. Video recordings of the arthroscopic surgery were analyzed by five pairs of expert arthroscopic surgeons blinded to the identity of the residents. A proprietary global rating scale and a procedural checklist, which included visualization and probing scales, were used for rating. Forty-eight (89%) of the fifty-four postgraduate year-3 residents from seven academic institutions completed the study. The simulator-trained group averaged eleven hours of training on the simulator to reach proficiency. The simulator-trained group performed significantly better when rated according to our procedural checklist (p = 0.031), including probing skills (p = 0.016) but not visualization skills (p = 0.34), compared with the control group. The procedural checklist weighted probing skills double the weight of visualization skills. The global rating scale failed to reach significance (p = 0.061) because of one extreme outlier. The duration of the procedure was not significant. This lack of a significant difference seemed to be related to the fact that residents in the control group were less thorough, which shortened their time to completion of the arthroscopic procedure. We have demonstrated transfer validity (transfer of training) that residents trained to proficiency on a high-fidelity realistic virtual-reality arthroscopic knee simulator showed a greater skill level in the operating room compared with the control group. We believe that the results of our study will stimulate residency program directors to incorporate surgical simulation into the core curriculum of their residency programs. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Improving operating room safety

PubMed Central

2009-01-01

Despite the introduction of the Universal Protocol, patient safety in surgery remains a daily challenge in the operating room. This present study describes one community health system's efforts to improve operating room safety through human factors training and ultimately the development of a surgical checklist. Using a combination of formal training, local studies documenting operating room safety issues and peer to peer mentoring we were able to substantially change the culture of our operating room. Our efforts have prepared us for successfully implementing a standardized checklist to improve operating room safety throughout our entire system. Based on these findings we recommend a multimodal approach to improving operating room safety. PMID:19930577

Auto identification technology and its impact on patient safety in the Operating Room of the Future.

PubMed

Egan, Marie T; Sandberg, Warren S

2007-03-01

Automatic identification technologies, such as bar coding and radio frequency identification, are ubiquitous in everyday life but virtually nonexistent in the operating room. User expectations, based on everyday experience with automatic identification technologies, have generated much anticipation that these systems will improve readiness, workflow, and safety in the operating room, with minimal training requirements. We report, in narrative form, a multi-year experience with various automatic identification technologies in the Operating Room of the Future Project at Massachusetts General Hospital. In each case, the additional human labor required to make these ;labor-saving' technologies function in the medical environment has proved to be their undoing. We conclude that while automatic identification technologies show promise, significant barriers to realizing their potential still exist. Nevertheless, overcoming these obstacles is necessary if the vision of an operating room of the future in which all processes are monitored, controlled, and optimized is to be achieved.

76 FR 12395 - Small Business Jobs Act Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-07

... 1, Continued. Room 2 Lender Roundtable, Continued. Room 3 Investing in Counseling and Training... Counseling and Training Services to Support the Growth of Small Business. Please note that the SBA will also... business contracting. Expanding Resources for Counseling and Training SBA has at least one District Office...

Does theatre improve the quality of life of people with dementia?

PubMed

van Dijk, A Marijke; van Weert, Julia C M; Dröes, Rose-Marie

2012-03-01

A new communication method, the "Veder method", has recently been developed. Caregivers are trained to apply this method in a group activity ("living-room theatre activity") for people with dementia in which theatrical stimuli are used in combination with proven emotion-oriented care methods. The aim of this exploratory study was to evaluate the added value of the Veder method group activity compared to a regular reminiscence group activity and to investigate whether professional carers can achieve the same effects with the Veder method as professional actors. A quasi-experimental three-group design was used. Experimental group 1 (E1; n = 65) joined a living-room theatre activity offered by trained professional caregivers. Experimental group 2 (E2; n = 31) joined a living-room theatre activity offered by professional actors. The control group (n = 55) received a usual reminiscence group activity. Behavior, mood and aspects of quality of life were measured using standardized observation scales at three points in time: (T1) pretest; (T2) during the intervention and; (T3) post-test, two hours after the intervention. During the intervention, significant differences were found in favor of the group that was offered a living-room theatre activity by actors (E2) on different aspects of behavior, mood and quality of life. At post-test, people in E2 were more alert compared to the control group. Moreover, they recalled more memories and showed less socially isolated behavior compared to the control group. This exploratory study shows that the Veder method has some clear positive effects on behavior and mood of people with dementia when applied by professional actors.

Moving Beyond the Training Room: Fostering Workplace Learning through Online Journaling

ERIC Educational Resources Information Center

Cyboran, Vincent L.

2005-01-01

A variety of instructional methods have been shown to be effective in fostering employee learning in workplace training. These include problem-based learning, cooperative learning, and situated learning. Despite their success, however, there are at least two important reasons to actively foster learning beyond the training room: The transfer of…

Working memory training in old age: an examination of transfer and maintenance effects.

PubMed

Borella, Erika; Carretti, Barbara; Zanoni, Giulia; Zavagnin, Michela; De Beni, Rossana

2013-06-01

The present study examined the efficacy of a verbal working memory (WM) training program in old-old individuals (over 75 years of age). Thirty-six adults aged 75-87 took part in the study: 18 were randomly assigned to receive training and the remainder served as active controls. Specific training gains in a verbal WM task (criterion task), and transfer effects on measures of visuospatial WM, short-term memory, inhibition, processing speed, and fluid intelligence were examined. The trained old-old adults performed better than the controls in the criterion task, and this benefit persisted after 8 months; they also showed an increase in the efficiency of inhibitory mechanisms at follow-up compared with pretest. The results of this study suggest that the present WM training program produces benefits maintained over time even in old-old adults. These findings confirm that there is still room for plasticity in the basic mechanisms of cognition in advance old age.

Using simulation to train orthopaedic trainees in non-technical skills: A pilot study.

PubMed

Heaton, Samuel R; Little, Zoe; Akhtar, Kash; Ramachandran, Manoj; Lee, Joshua

2016-08-18

To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire (strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself. Twenty-six orthopaedic residents participated (24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showed that while the majority of candidates recognised the importance of non-technical (NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course (Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the course achieved its intended aims with realistic simulation scenarios. Participants believed patient care, patient safety and team working would all improve with further human factors training (4.4-4.6). and felt that NT skills learnt through simulation-based training should become an integral component of their training program. Participants demonstrated improved understanding of non-technical performance, recognised its relevance to patient safety and expressed a desire for its integration in training.

The Whys and Hows of Training Rooms.

ERIC Educational Resources Information Center

Sturgeon, Julie

2000-01-01

Offers advice on building and equipping a college athletic training room that can serve in preventing and treating athletic injuries. Issues concerning space utilization, protecting confidentiality, and making accommodations for amenities such as hydrotherapy pools are addressed. (GR)

STS-26 simulation activities in JSC Mission Control Center (MCC)

NASA Technical Reports Server (NTRS)

1987-01-01

In JSC Mission Control Center (MCC) Bldg 30 Flight Control Room (FCR), flight controller Granvil A. Pennington, leaning on console, listens to communications during the STS-26 integrated simulations in progress between MCC and JSC Mission Simulation and Training Facility Bldg 5 fixed-base (FB) shuttle mission simulator (SMS). MCC FCR visual displays are seen in background. Five veteran astronauts were in the FB-SMS rehearsing their roles for the scheduled June 1988 flight aboard Discovery, Orbiter Vehicle (OV) 103.

A simple highly efficient non invasive EMG-based HMI.

PubMed

Vitiello, N; Olcese, U; Oddo, C M; Carpaneto, J; Micera, S; Carrozza, M C; Dario, P

2006-01-01

Muscle activity recorded non-invasively is sufficient to control a mobile robot if it is used in combination with an algorithm for its asynchronous analysis. In this paper, we show that several subjects successfully can control the movements of a robot in a structured environment made up of six rooms by contracting two different muscles using a simple algorithm. After a small training period, subjects were able to control the robot with performances comparable to those achieved manually controlling the robot.

Cognitive Virtualization: Combining Cognitive Models and Virtual Environments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tuan Q. Tran; David I. Gertman; Donald D. Dudenhoeffer

2007-08-01

3D manikins are often used in visualizations to model human activity in complex settings. Manikins assist in developing understanding of human actions, movements and routines in a variety of different environments representing new conceptual designs. One such environment is a nuclear power plant control room, here they have the potential to be used to simulate more precise ergonomic assessments of human work stations. Next generation control rooms will pose numerous challenges for system designers. The manikin modeling approach by itself, however, may be insufficient for dealing with the desired technical advancements and challenges of next generation automated systems. Uncertainty regardingmore » effective staffing levels; and the potential for negative human performance consequences in the presence of advanced automated systems (e.g., reduced vigilance, poor situation awareness, mistrust or blind faith in automation, higher information load and increased complexity) call for further research. Baseline assessment of novel control room equipment(s) and configurations needs to be conducted. These design uncertainties can be reduced through complementary analysis that merges ergonomic manikin models with models of higher cognitive functions, such as attention, memory, decision-making, and problem-solving. This paper will discuss recent advancements in merging a theoretical-driven cognitive modeling framework within a 3D visualization modeling tool to evaluate of next generation control room human factors and ergonomic assessment. Though this discussion primary focuses on control room design, the application for such a merger between 3D visualization and cognitive modeling can be extended to various areas of focus such as training and scenario planning.« less

Clinical Efficacy of Simulated Vitreoretinal Surgery to Prepare Surgeons for the Upcoming Intervention in the Operating Room

PubMed Central

Deuchler, Svenja; Wagner, Clemens; Singh, Pankaj; Müller, Michael; Al-Dwairi, Rami; Benjilali, Rachid; Schill, Markus; Ackermann, Hanns; Bon, Dimitra; Kohnen, Thomas; Schoene, Benjamin; Koss, Michael; Koch, Frank

2016-01-01

Purpose To evaluate the efficacy of the virtual reality training simulator Eyesi to prepare surgeons for performing pars plana vitrectomies and its potential to predict the surgeons’ performance. Methods In a preparation phase, four participating vitreoretinal surgeons performed repeated simulator training with predefined tasks. If a surgeon was assigned to perform a vitrectomy for the management of complex retinal detachment after a surgical break of at least 60 hours it was randomly decided whether a warmup training on the simulator was required (n = 9) or not (n = 12). Performance at the simulator was measured using the built-in scoring metrics. The surgical performance was determined by two blinded observers who analyzed the video-recorded interventions. One of them repeated the analysis to check for intra-observer consistency. The surgical performance of the interventions with and without simulator training was compared. In addition, for the surgeries with simulator training, the simulator performance was compared to the performance in the operating room. Results Comparing each surgeon’s performance with and without warmup trainingshowed a significant effect of warmup training onto the final outcome in the operating room. For the surgeries that were preceeded by the warmup procedure, the performance at the simulator was compared with the operating room performance. We found that there is a significant relation. The governing factor of low scores in the simulator were iatrogenic retinal holes, bleedings and lens damage. Surgeons who caused minor damage in the simulation also performed well in the operating room. Conclusions Despite the large variation of conditions, the effect of a warmup training as well as a relation between the performance at the simulator and in the operating room was found with statistical significance. Simulator training is able to serve as a warmup to increase the average performance. PMID:26964040

Enhancement of gesture recognition for contactless interface using a personalized classifier in the operating room.

PubMed

Cho, Yongwon; Lee, Areum; Park, Jongha; Ko, Bemseok; Kim, Namkug

2018-07-01

Contactless operating room (OR) interfaces are important for computer-aided surgery, and have been developed to decrease the risk of contamination during surgical procedures. In this study, we used Leap Motion™, with a personalized automated classifier, to enhance the accuracy of gesture recognition for contactless interfaces. This software was trained and tested on a personal basis that means the training of gesture per a user. We used 30 features including finger and hand data, which were computed, selected, and fed into a multiclass support vector machine (SVM), and Naïve Bayes classifiers and to predict and train five types of gestures including hover, grab, click, one peak, and two peaks. Overall accuracy of the five gestures was 99.58% ± 0.06, and 98.74% ± 3.64 on a personal basis using SVM and Naïve Bayes classifiers, respectively. We compared gesture accuracy across the entire dataset and used SVM and Naïve Bayes classifiers to examine the strength of personal basis training. We developed and enhanced non-contact interfaces with gesture recognition to enhance OR control systems. Copyright © 2018 Elsevier B.V. All rights reserved.

An Evaluative Study on Building the Bridge between the Training Room and the Workplace

ERIC Educational Resources Information Center

Chaloner, Brian

2006-01-01

A study is reported of the use of a personal journal as a tool for transferring learning from the training room to the workplace. The targeted learning event was an English for Communication training programme. This programme was an intensive four-day course that grouped together participants from the non-UK sites of the aircraft manufacturer…

Dressing Rooms & Related Service Facilities for Physical Education, Athletics, and Recreation.

ERIC Educational Resources Information Center

Ragsdale, Lee; And Others

The purpose of this publication is to identify significant considerations in the planning of dressing-locker rooms and related service facilities such as shower rooms, toilet and lavatory rooms, toweling areas, storage and supply rooms, laundries, training and first aid rooms, and custodial facilities. However, only a perfunctory treatment of each…

Laparoscopic assistance by operating room nurses: Results of a virtual-reality study.

PubMed

Paschold, M; Huber, T; Maedge, S; Zeissig, S R; Lang, H; Kneist, W

2017-04-01

Laparoscopic assistance is often entrusted to a less experienced resident, medical student, or operating room nurse. Data regarding laparoscopic training for operating room nurses are not available. The aim of the study was to analyse the initial performance level and learning curves of operating room nurses in basic laparoscopic surgery compared with medical students and surgical residents to determine their ability to assist with this type of procedure. The study was designed to compare the initial virtual reality performance level and learning curves of user groups to analyse competence in laparoscopic assistance. The study subjects were operating room nurses, medical students, and first year residents. Participants performed three validated tasks (camera navigation, peg transfer, fine dissection) on a virtual reality laparoscopic simulator three times in 3 consecutive days. Laparoscopic experts were enrolled as a control group. Participants filled out questionnaires before and after the course. Nurses and students were comparable in their initial performance (p>0.05). Residents performed better in camera navigation than students and nurses and reached the expert level for this task. Residents, students, and nurses had comparable bimanual skills throughout the study; while, experts performed significantly better in bimanual manoeuvres at all times (p<0.05). The included user groups had comparable skills for bimanual tasks. Residents with limited experience reached the expert level in camera navigation. With training, nurses, students, and first year residents are equally capable of assisting in basic laparoscopic procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effect of mentoring on clinical perioperative competence in operating room nursing students.

PubMed

Mirbagher Ajorpaz, Neda; Zagheri Tafreshi, Mansoureh; Mohtashami, Jamileh; Zayeri, Farid; Rahemi, Zahra

2016-05-01

The aim of this study was to investigate the effects of mentoring on the clinical perioperative competence of nursing operating room students in Iran. Mentoring is an essential part of clinical education, which has been studied in different populations of students. However, there is a need to assess its effectiveness in operating room students' competence. A randomised controlled trial was performed. Sixty nursing operating room students were randomly assigned to experimental and control groups. Both the control and experimental groups had routine training in the form of faculty supervision. The experimental group had an additional mentoring program. Using the Persian Perceived Perioperative Competence Scale-Revised, clinical competence was compared between the two groups, before and after the intervention. Using SPSS 19, descriptive and inferential statistics, including chi-square and t-tests, were conducted. In the experimental group, the difference between the mean scores of clinical competence before (19·43 ± 2·80) and after (27·86 ± 1·87) the intervention was significant (p ≤ 0·001). After intervention, the difference between the mean scores of the control (3·9 ± 0·15) and experimental (8·61 ± 0·68) groups was significant (p ≤ 0·003). Findings affirmed the positive effect of mentorship programmes on clinical competence in nursing operating room students. Mentoring is an effective method for preparing nursing students in practice. Health care systems may improve as a result of staff-student relationships that ultimately increase the quality care for patients. © 2016 John Wiley & Sons Ltd.

Early detection and control of an Acinetobacter baumannii multi-resistant outbreak in a hospital in Quito, Ecuador.

PubMed

Cartelle Gestal, Monica; Zurita, Jeannete; Gualpa, Gabriela; Gonzalez, Cecibel; Paz Y Mino, Ariane

2016-12-30

Acinetobacter baumannii (ABA) is an important opportunistic pathogen associated with high mortality rates in intensive care units (ICUs). An outbreak in the ICU of a secondary-level hospital in Quito, Ecuador, occurred during April and May 2015 and was successfully controlled. Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) and repetitive element palindromic (REP)-PCR was conducted on all isolates recovered from patients, as well as environmental samples, to confirm the presence of an outbreak. A case-control study was conducted by comparing the clinical histories of the affected patients and of control patients present in the ICU during the outbreak period who did not present a positive culture for ABA. Five patients were infected and two were colonized with the same clonal strain of ABA, which was also identified on the stethoscope and a monitor associated with an isolation room. Statistical analysis of case histories did not identify any additional risk factors, but the outbreak was initiated by one patient in the isolation room of the ICU who was infected with the outbreak strain. All patients who ocupied that room after the index case tested positive for at least one culture of ABA. The outbreak strain was found on the stethoscope, and a subclone was found on the monitor of that room. Having access to basic equipment will enable well-trained professionals to rapidly detect and initiate the control process of an outbreak, saving lives and money spent on nosocomial infection treatments.

Infection Control Practice in the Operating Room: Staff Adherence to Existing Policies in a Developing Country

PubMed Central

Cawich, Shamir O; Tennant, Ingrid A; McGaw, Clarence D; Harding, Hyacinth; Walters, Christine A; Crandon, Ivor W

2013-01-01

Context: Infection control interventions are important for containing surgery-related infections. For this reason, the modern operating room (OR) should have well-developed infection control policies. The efficacy of these policies depends on how well the OR staff adhere to them. There is a lack of available data documenting adherence to infection control policies. Objective: To evaluate OR staff adherence to existing infection control policies in Jamaica. Methods: We administered a questionnaire to all OR staff to assess their training, knowledge of local infection control protocols, and practice with regard to 8 randomly selected guidelines. Adherence to each guideline was rated with fixed-choice items on a 4-point Likert scale. The sum of points determined the adherence score. Two respondent groups were defined: adherent (score > 26) and nonadherent (score ≤ 26). We evaluated the relationship between respondent group and age, sex, occupational rank, and time since completion of basic medical training. We used χ2 and Fisher exact tests to assess associations and t tests to compare means between variables of interest. Results: The sample comprised 132 participants (90 physicians and 42 nurses) with a mean age of 36 (standard deviation ± 9.5) years. Overall, 40.1% were adherent to existing protocols. There was no significant association between the distribution of adherence scores and sex (p = 0.319), time since completion of basic training (p = 0.595), occupational rank (p = 0.461), or age (p = 0.949). Overall, 19% felt their knowledge of infection control practices was inadequate. Those with working knowledge of infection control practices attained it mostly through informal communication (80.4%) and self-directed research (62.6%). Conclusion: New approaches to the problem of nonadherence to infection control guidelines are needed in the Caribbean. Several unique cultural, financial, and environmental factors influence adherence in this region, in contrast to conditions in developed countries. PMID:24355900

Technical Basis for Physical Fidelity of NRC Control Room Training Simulators for Advanced Reactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Minsk, Brian S.; Branch, Kristi M.; Bates, Edward K.

2009-10-09

The objective of this study is to determine how simulator physical fidelity influences the effectiveness of training the regulatory personnel responsible for examination and oversight of operating personnel and inspection of technical systems at nuclear power reactors. It seeks to contribute to the U.S. Nuclear Regulatory Commission’s (NRC’s) understanding of the physical fidelity requirements of training simulators. The goal of the study is to provide an analytic framework, data, and analyses that inform NRC decisions about the physical fidelity requirements of the simulators it will need to train its staff for assignment at advanced reactors. These staff are expected tomore » come from increasingly diverse educational and experiential backgrounds.« less

Virtual Environment Training: Auxiliary Machinery Room (AMR) Watchstation Trainer.

ERIC Educational Resources Information Center

Hriber, Dennis C.; And Others

1993-01-01

Describes a project implemented at Newport News Shipbuilding that used Virtual Environment Training to improve the performance of submarine crewmen. Highlights include development of the Auxiliary Machine Room (AMR) Watchstation Trainer; Digital Video Interactive (DVI); screen layout; test design and evaluation; user reactions; authoring language;…

Housekeeping. An Approach to Housekeeping Training.

ERIC Educational Resources Information Center

Hotel and Catering Industry Training Board, Wembley (England).

This booklet examines the training required by staff employed in housekeeping departments in the hotel and catering industry. It details specifications of particular tasks--baths/cloakrooms; service pantries and utility rooms; beds; furniture/fittings; floors/walls and ceilings; carpets/upholstery/soft furnishings; linen handling; linen room work;…

STS-26 long duration simulation in JSC Mission Control Center (MCC) Bldg 30

NASA Technical Reports Server (NTRS)

1988-01-01

STS-26 long duration simulation is conducted in JSC Mission Control Center (MCC) Bldg 30 Flight Control Room (FCR). Front row of consoles with Propulsion Engineer (PROP) and Guidance, Navigation, and Control Systems Engineer (GNC) are visible in the foreground. CBS television camera personnel record front visual displays (orbital chart and data) for '48 Hours' program to be broadcast at a later date. The integrated simulation involved communicating with crewmembers stationed in the fixed based (FB) shuttle mission simulator (SMS) located in JSC Mission Simulation and Training Facility Bldg 5.

STS-26 long duration simulation in JSC Mission Control Center (MCC) Bldg 30

NASA Technical Reports Server (NTRS)

1988-01-01

STS-26 long duration simulation is conducted in JSC Mission Control Center (MCC) Bldg 30 Flight Control Room (FCR). Director of Mission Operations Directorate (MOD) Eugene F. Kranz (left) and Chief of the Flight Directors Office Tommy W. Holloway monitor activity during the simulation. The two are at their normal stations on the rear row of consoles. The integrated simulation involves MCC flight controllers communicating with crewmembers stationed in the fixed based (FB) shuttle mission simulator (SMS) located in JSC Mission Simulation and Training Facility Bldg 5.

Communication and the electronic health record training: a comparison of three healthcare systems.

PubMed

Lynott, Michelle H; Kooienga, Sarah A; Stewart, Valerie T

2012-01-01

The electronic health record (EHR) used in the examination room, is becoming the primary method of medical data storage in primary care practice in the USA. One of the challenges in using EHRs is maintaining effective patient-provider communication. Many studies have focused on communication in the examination room. Scant research exists on the best methods in educating nurse practitioners and other primary care providers (clinicians). The purpose of this study was to explore various health record training programmes for clinicians. One researcher participated in and observed three health systems' EHR training programmes for ambulatory care providers in the Pacific Northwest. A focused ethnographic approach was used, emphasising patient-provider communication. Only one system had formalised communication training in their class, the other two systems emphasised only the software and data aspects of the EHR. The fact that clinicians are expected to use EHRs in the examination room necessitates the inclusion of communication training in EHR training programmes and/or as a part of primary care nurse practitioner education programmes.

In Situ Operating Room-Based Simulation: A Review.

PubMed

Owei, Lily; Neylan, Christopher J; Rao, Raghavendra; Caskey, Robert C; Morris, Jon B; Sensenig, Richard; Brooks, Ari D; Dempsey, Daniel T; Williams, Noel N; Atkins, Joshua H; Baranov, Dimitry Y; Dumon, Kristoffel R

To systematically review the literature surrounding operating room-based in situ training in surgery. A systematic review was conducted of MEDLINE. The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, and employed the Population, Intervention, Comparator, Outcome (PICO) structure to define inclusion/exclusion criteria. The Kirkpatrick model was used to further classify the outcome of in situ training when possible. The search returned 308 database hits, and ultimately 19 articles were identified that met the stated PICO inclusion criteria. Operating room-based in situ simulation is used for a variety of purposes and in a variety of settings, and it has the potential to offer unique advantages over other types of simulation. Only one randomized controlled trial was conducted comparing in situ simulation to off-site simulation, which found few significant differences. One large-scale outcome study showed improved perinatal outcomes in obstetrics. Although in situ simulation theoretically offers certain advantages over other types of simulation, especially in addressing system-wide or environmental threats, its efficacy has yet to be clearly demonstrated. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

75 FR 7524 - Workforce Investment Act; Native American Employment and Training Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-19

... Constitution Avenue, NW., Room S- 2322, Washington, DC 20210. SUPPLEMENTARY INFORMATION: The meeting will be.... Evangeline M. Campbell, Designated Federal Official (DFO), U.S. Department of Labor, 200 Constitution Avenue... Program, Employment and Training Administration, U.S. Department of Labor, Room S-4209, 200 Constitution...

Cluster randomized trial to evaluate the impact of team training on surgical outcomes.

PubMed

Duclos, A; Peix, J L; Piriou, V; Occelli, P; Denis, A; Bourdy, S; Carty, M J; Gawande, A A; Debouck, F; Vacca, C; Lifante, J C; Colin, C

2016-12-01

The application of safety principles from the aviation industry to the operating room has offered hope in reducing surgical complications. This study aimed to assess the impact on major surgical complications of adding an aviation-based team training programme after checklist implementation. A prospective parallel-group cluster trial was undertaken between September 2011 and March 2013. Operating room teams from 31 hospitals were assigned randomly to participate in a team training programme focused on major concepts of crew resource management and checklist utilization. The primary outcome measure was the occurrence of any major adverse event, including death, during the hospital stay within the first 30 days after surgery. Using a difference-in-difference approach, the ratio of the odds ratios (ROR) was estimated to compare changes in surgical outcomes between intervention and control hospitals. Some 22 779 patients were enrolled, including 5934 before and 16 845 after team training implementation. The risk of major adverse events fell from 8·8 to 5·5 per cent in 16 intervention hospitals (adjusted odds ratio 0·57, 95 per cent c.i. 0·48 to 0·68; P < 0·001) and from 7·9 to 5·4 per cent in 15 control hospitals (odds ratio 0·64, 0·50 to 0·81; P < 0·001), resulting in the absence of difference between arms (ROR 0·90, 95 per cent c.i. 0·67 to 1·21; P = 0·474). Outcome trends revealed significant improvements among ten institutions, equally distributed across intervention and control hospitals. Surgical outcomes improved substantially, with no difference between trial arms. Successful implementation of an aviation-based team training programme appears to require modification and adaptation of its principles in the context of the the surgical milieu. Registration number: NCT01384474 (http://www.clinicaltrials.gov). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

A Randomized Cohort Controlled Trial to Compare Intern Sign-Out Training Interventions.

PubMed

Lee, Soo-Hoon; Terndrup, Christopher; Phan, Phillip H; Zaeh, Sandra E; Atsina, Kwame; Minkove, Nicole; Billioux, Alexander; Chatterjee, Souvik; Montague, Idoreyin; Clark, Bennett; Hughes, Andrew; Desai, Sanjay V

2017-12-01

Although previous studies have investigated the efficacy of specific sign-out protocols (such as the illness severity, patient summary, action list, situation awareness and contingency planning, and synthesis by reviewer [I-PASS] bundle), the implementation of a bundle can be time consuming and costly. We compared 4 sign-out training pedagogies on sign-out quality. To evaluate training interventions that best enhance multidimensional sign-out quality measured by information exchange, task accountability, and personal responsibility. Four general internal medicine firms were randomly assigned into 1 of the following 4 training interventions: didactics (control), I-PASS, policy mandate on task accountability, and Plan-Do-Study-Act (PDSA). First-year interns at a large, Mid-Atlantic internal medicine residency program. Eight trained observers examined 10 days each in the pre- and postintervention periods for each firm using a standardized sign-out checklist. Pre- and postintervention differences showed significant improvements in the transfer of patient information, task accountability, and personal responsibility for the I-PASS, policy mandate, and PDSA groups, respectively, in line with their respective training foci. Compared to the control, I-PASS reported the best improvements in sign-out quality, although there was room to improve in task accountability and responsibility. Different training emphases improved different dimensions of sign-out quality. A combination of training pedagogies is likely to yield optimal results. © 2017 Society of Hospital Medicine

75 FR 61321 - Domestic Licensing of Production and Utilization Facilities; Updates to Incorporation by...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-05

... electronic reading room at http://www.nrc.gov/reading-rm/adams.html . From this page, the public can gain... Regulatory Guides dated April 2009. The NRC's electronic reading room contains later versions of these Draft... in the training provided to examiners. Computer-based training, through the use of animations...

Gaze training enhances laparoscopic technical skill acquisition and multi-tasking performance: a randomized, controlled study.

PubMed

Wilson, Mark R; Vine, Samuel J; Bright, Elizabeth; Masters, Rich S W; Defriend, David; McGrath, John S

2011-12-01

The operating room environment is replete with stressors and distractions that increase the attention demands of what are already complex psychomotor procedures. Contemporary research in other fields (e.g., sport) has revealed that gaze training interventions may support the development of robust movement skills. This current study was designed to examine the utility of gaze training for technical laparoscopic skills and to test performance under multitasking conditions. Thirty medical trainees with no laparoscopic experience were divided randomly into one of three treatment groups: gaze trained (GAZE), movement trained (MOVE), and discovery learning/control (DISCOVERY). Participants were fitted with a Mobile Eye gaze registration system, which measures eye-line of gaze at 25 Hz. Training consisted of ten repetitions of the "eye-hand coordination" task from the LAP Mentor VR laparoscopic surgical simulator while receiving instruction and video feedback (specific to each treatment condition). After training, all participants completed a control test (designed to assess learning) and a multitasking transfer test, in which they completed the procedure while performing a concurrent tone counting task. Not only did the GAZE group learn more quickly than the MOVE and DISCOVERY groups (faster completion times in the control test), but the performance difference was even more pronounced when multitasking. Differences in gaze control (target locking fixations), rather than tool movement measures (tool path length), underpinned this performance advantage for GAZE training. These results suggest that although the GAZE intervention focused on training gaze behavior only, there were indirect benefits for movement behaviors and performance efficiency. Additionally, focusing on a single external target when learning, rather than on complex movement patterns, may have freed-up attentional resources that could be applied to concurrent cognitive tasks.

Effectiveness of a training program for police officers who come into contact with people with mental health problems: A pragmatic randomised controlled trial.

PubMed

Scantlebury, Arabella; Fairhurst, Caroline; Booth, Alison; McDaid, Catriona; Moran, Nicola; Parker, Adwoa; Payne, Rebecca; Scott, William J; Torgerson, David; Webber, Martin; Hewitt, Catherine

2017-01-01

Police officers frequently come into contact with individuals with mental health problems. Specialist training in this area for police officers may improve how they respond to individuals with mental health problems; however, evidence to support this is sparse. This study evaluated the effectiveness of one bespoke mental health training package for frontline police officers relative to routine training. Pragmatic, two-armed cluster randomised controlled trial in one police force in England. Police stations in North Yorkshire were randomised with frontline police officers receiving either a bespoke mental health training package or routine training. The primary outcome was the number of incidents which resulted in a police response reported to the North Yorkshire Police control room up to six months after delivery of training. Secondary outcomes included: likelihood of incidents using Section 136 of the Mental Health Act; likelihood of incidents having a mental health tag applied; and number of individuals with a mental health warning marker involved in incidents. The appropriateness of mental health tags applied to a random sample of incidents was checked by an independent mental health professional. Routinely collected data were used. Twelve police stations were recruited and randomised (Intervention group n = 6; Control group n = 6), and 249 officers received the bespoke mental health training intervention. At follow-up, a median of 397 incidents were assigned to trial stations in the intervention group, and 498 in the control group. There was no evidence of a difference in the number of incidents with a police response (adjusted incidence rate ratio (IRR) 0.92, 95% CI 0.61 to 1.38, p = 0.69), or in the number of people with mental health warning markers involved in incidents (adjusted IRR 1.39, 95% CI 0.91 to 2.10, p = 0.13) between the intervention and control groups up to six months following the intervention; however, incidents assigned to stations in the intervention group were more likely to have a mental health tag applied to them than incidents assigned to control stations (adjusted odds ratio 1.41, 95% CI 1.16 to 1.71, p = 0.001). The review of 100 incidents suggests that there may be incidents involving individuals with mental health issues that are not being recorded as such (Kappa coefficient 0.65). There was no statistically significant difference in the likelihood of Section 136 of the Mental Health Act being applied to an incident. The bespoke one day mental health training delivered to frontline officers by mental health professionals did not reduce the number of incidents reported to the police control room up to six months after its delivery; however training may have a positive effect on how the police record incidents involving individuals with mental health problems. Our trial has shown that conducting pragmatic trials within the police setting is feasible and acceptable. There is a wealth of routinely collected police data that can be utilised for research and further collaboration between police forces and academia is encouraged. ISRCTN (ISRCTN11685602). The authors confirm that all ongoing and related trials for this drug/intervention are registered.

Experience using radio frequency laptops to access the electronic medical record in exam rooms.

PubMed Central

Dworkin, L. A.; Krall, M.; Chin, H.; Robertson, N.; Harris, J.; Hughes, J.

1999-01-01

Kaiser Permanente, Northwest, evaluated the use of laptop computers to access our existing comprehensive Electronic Medical Record in exam rooms via a wireless radiofrequency (RF) network. Eleven of 22 clinicians who were offered the laptops successfully adopted their use in the exam room. These clinicians were able to increase their exam room time with the patient by almost 4 minutes (25%), apparently without lengthening their overall work day. Patient response to exam room computing was overwhelmingly positive. The RF network response time was similar to the hardwired network. Problems cited by some laptop users and many of the eleven non-adopters included battery issues, different equipment layout and function, and inadequate training. IT support needs for the RF laptops were two to four times greater than for hardwired desktops. Addressing the reliability and training issues should increase clinician acceptance, making a successful general roll-out for exam room computing more likely. PMID:10566458

STS-26 long duration simulation in JSC Mission Control Center (MCC) Bldg 30

NASA Technical Reports Server (NTRS)

1988-01-01

STS-26 long duration simulation is conducted in JSC Mission Control Center (MCC) Bldg 30 Flight Control Room (FCR). CBS television camera personnel record MCC activities at Spacecraft Communicator (CAPCOM) and Flight Activities Officer (FAO) (foreground) consoles for '48 Hours' program to be broadcast at a later date. The integrated simulation involved communicating with crewmembers stationed in the fixed based (FB) shuttle mission simulator (SMS) located in JSC Mission Simulation and Training Facility Bldg 5. MCC FCR visual displays are seen in front of the rows of consoles.

A preliminary empirical evaluation of virtual reality as an instructional medium for visual-spatial tasks

NASA Technical Reports Server (NTRS)

Regian, J. Wesley; Shebilske, Wayne; Monk, John M.

1993-01-01

We explored the training potential of Virtual Reality (VR) technology. Thirty-one adults were trained and tested on spatial skills in a VR. They learned a sequence of button and knob responses on a VR console and performed flawlessly on the same console. Half were trained with a rote strategy; the rest used a meaningful strategy. Response times were equivalent for both groups and decreased significantly over five test trials indicating that learning continued on VR tests. The same subjects practiced navigating through a VR building, which had three floors with four rooms on each floor. The dependent measure was the number of rooms traversed on routes that differed from training routes. Many subjects completed tests in the fewest rooms possible. All subjects learned configurational knowledge according to the criterion of taking paths that were significantly shorter than those predicted by a random walk as determined by a Monte Carlo analysis. The results were discussed as a departure point for empirically testing the training potential of VR technology.

Virtual operating room for team training in surgery.

PubMed

Abelson, Jonathan S; Silverman, Elliott; Banfelder, Jason; Naides, Alexandra; Costa, Ricardo; Dakin, Gregory

2015-09-01

We proposed to develop a novel virtual reality (VR) team training system. The objective of this study was to determine the feasibility of creating a VR operating room to simulate a surgical crisis scenario and evaluate the simulator for construct and face validity. We modified ICE STORM (Integrated Clinical Environment; Systems, Training, Operations, Research, Methods), a VR-based system capable of modeling a variety of health care personnel and environments. ICE STORM was used to simulate a standardized surgical crisis scenario, whereby participants needed to correct 4 elements responsible for loss of laparoscopic visualization. The construct and face validity of the environment were measured. Thirty-three participants completed the VR simulation. Attendings completed the simulation in less time than trainees (271 vs 201 seconds, P = .032). Participants felt the training environment was realistic and had a favorable impression of the simulation. All participants felt the workload of the simulation was low. Creation of a VR-based operating room for team training in surgery is feasible and can afford a realistic team training environment. Copyright © 2015 Elsevier Inc. All rights reserved.

Hybrid simulation: bringing motivation to the art of teamwork training in the operating room.

PubMed

Kjellin, A; Hedman, L; Escher, C; Felländer-Tsai, L

2014-12-01

Crew resource management-based operating room team training will be an evident part of future surgical training. Hybrid simulation in the operating room enables the opportunity for trainees to perform higher fidelity training of technical and non-technical skills in a realistic context. We focus on situational motivation and self-efficacy, two important factors for optimal learning in light of a prototype course for teams of residents in surgery and anesthesiology and nurses. Authentic operating room teams consisting of residents in anesthesia (n = 2), anesthesia nurses (n = 3), residents in surgery (n = 2), and scrub nurses (n = 6) were, during a one-day course, exposed to four different scenarios. Their situational motivation was self-assessed (ranging from 1 = does not correspond at all to 7 = corresponds exactly) immediately after training, and their self-efficacy (graded from 1 to 7) before and after training. Training was performed in a mock-up operating theater equipped with a hybrid patient simulator (SimMan 3G; Laerdal) and a laparoscopic simulator (Lap Mentor Express; Simbionix). The functionality of the systematic hybrid procedure simulation scenario was evaluated by an exit questionnaire (graded from 1 = disagree entirely to 5 = agree completely). The trainees were mostly intrinsically motivated, engaged for their own sake, and had a rather great degree of self-determination toward the training situation. Self-efficacy among the team members improved significantly from 4 to 6 (median). Overall evaluation showed very good result with a median grading of 5. We conclude that hybrid simulation is feasible and has the possibility to train an authentic operating team in order to improve individual motivation and confidence. © The Finnish Surgical Society 2014.

AVESTAR Center for Operational Excellence of Electricity Generation Plants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zitney, Stephen

2012-08-29

To address industry challenges in attaining operational excellence for electricity generation plants, the U.S. Department of Energy’s (DOE) National Energy Technology Laboratory (NETL) has launched a world-class facility for Advanced Virtual Energy Simulation Training and Research (AVESTARTM). This presentation will highlight the AVESTARTM Center simulators, facilities, and comprehensive training, education, and research programs focused on the operation and control of high-efficiency, near-zero-emission electricity generation plants. The AVESTAR Center brings together state-of-the-art, real-time, high-fidelity dynamic simulators with full-scope operator training systems (OTSs) and 3D virtual immersive training systems (ITSs) into an integrated energy plant and control room environment. AVESTAR’s initial offeringmore » combines--for the first time--a “gasification with CO2 capture” process simulator with a “combined-cycle” power simulator together in a single OTS/ITS solution for an integrated gasification combined cycle (IGCC) power plant with carbon dioxide (CO2) capture. IGCC systems are an attractive technology option for power generation, especially when capturing and storing CO2 is necessary to satisfy emission targets. The AVESTAR training program offers a variety of courses that merge classroom learning, simulator-based OTS learning in a control-room operations environment, and immersive learning in the interactive 3D virtual plant environment or ITS. All of the courses introduce trainees to base-load plant operation, control, startups, and shutdowns. Advanced courses require participants to become familiar with coordinated control, fuel switching, power-demand load shedding, and load following, as well as to problem solve equipment and process malfunctions. Designed to ensure work force development, training is offered for control room and plant field operators, as well as engineers and managers. Such comprehensive simulator-based instruction allows for realistic training without compromising worker, equipment, and environmental safety. It also better prepares operators and engineers to manage the plant closer to economic constraints while minimizing or avoiding the impact of any potentially harmful, wasteful, or inefficient events. The AVESTAR Center is also used to augment graduate and undergraduate engineering education in the areas of process simulation, dynamics, control, and safety. Students and researchers gain hands-on simulator-based training experience and learn how the commercial-scale power plants respond dynamically to changes in manipulated inputs, such as coal feed flow rate and power demand. Students also analyze how the regulatory control system impacts power plant performance and stability. In addition, students practice start-up, shutdown, and malfunction scenarios. The 3D virtual ITSs are used for plant familiarization, walk-through, equipment animations, and safety scenarios. To further leverage the AVESTAR facilities and simulators, NETL and its university partners are pursuing an innovative and collaborative R&D program. In the area of process control, AVESTAR researchers are developing enhanced strategies for regulatory control and coordinated plant-wide control, including gasifier and gas turbine lead, as well as advanced process control using model predictive control (MPC) techniques. Other AVESTAR R&D focus areas include high-fidelity equipment modeling using partial differential equations, dynamic reduced order modeling, optimal sensor placement, 3D virtual plant simulation, and modern grid. NETL and its partners plan to continue building the AVESTAR portfolio of dynamic simulators, immersive training systems, and advanced research capabilities to satisfy industry’s growing need for training and experience with the operation and control of clean energy plants. Future dynamic simulators under development include natural gas combined cycle (NGCC) and supercritical pulverized coal (SCPC) plants with post-combustion CO2 capture. These dynamic simulators are targeted for use in establishing a Virtual Carbon Capture Center (VCCC), similar in concept to the DOE’s National Carbon Capture Center for slipstream testing. The VCCC will enable developers of CO2 capture technologies to integrate, test, and optimize the operation of their dynamic capture models within the context of baseline power plant dynamic models. The objective is to provide hands-on, simulator-based “learn-by-operating” test platforms to accelerate the scale-up and deployment of CO2 capture technologies. Future AVESTAR plans also include pursuing R&D on the dynamics, operation, and control of integrated electricity generation and storage systems for the modern grid era. Special emphasis will be given to combining load-following energy plants with renewable and distributed generating supplies and fast-ramping energy storage systems to provide near constant baseload power.« less

Validation of a structured training and assessment curriculum for technical skill acquisition in minimally invasive surgery: a randomized controlled trial.

PubMed

Palter, Vanessa N; Orzech, Neil; Reznick, Richard K; Grantcharov, Teodor P

2013-02-01

: To develop and validate an ex vivo comprehensive curriculum for a basic laparoscopic procedure. : Although simulators have been well validated as tools to teach technical skills, their integration into comprehensive curricula is lacking. Moreover, neither the effect of ex vivo training on learning curves in the operating room (OR), nor the effect on nontechnical proficiency has been investigated. : This randomized single-blinded prospective trial allocated 20 surgical trainees to a structured training and assessment curriculum (STAC) group or conventional residency training. The STAC consisted of case-based learning, proficiency-based virtual reality training, laparoscopic box training, and OR participation. After completion of the intervention, all participants performed 5 sequential laparoscopic cholecystectomies in the OR. The primary outcome measure was the difference in technical performance between the 2 groups during the first laparoscopic cholecystectomy. Secondary outcome measures included differences with respect to learning curves in the OR, technical proficiency of each sequential laparoscopic cholecystectomy, and nontechnical skills. : Residents in the STAC group outperformed residents in the conventional group in the first (P = 0.004), second (P = 0.036), third (P = 0.021), and fourth (P = 0.023) laparoscopic cholecystectomies. The conventional group demonstrated a significant learning curve in the OR (P = 0.015) in contrast to the STAC group (P = 0.032). Residents in the STAC group also had significantly higher nontechnical skills (P = 0.027). : Participating in the STAC shifted the learning curve for a basic laparoscopic procedure from the operating room into the simulation laboratory. STAC-trained residents had superior technical proficiency in the OR and nontechnical skills compared with conventionally trained residents. (The study registration ID is NCT01560494.).

Astronauts Hoffman and Musgrave monitor Neutral Buoyancy Simulator training

NASA Image and Video Library

1993-06-15

Astronauts Jeffrey A. Hoffman (far left) and F. Story Musgrave (second left) monitor a training session from consoles in the control room for the Neutral Buoyancy Simulator (NBS) at the Marshall Space Flight Center (MSFC). Seen underwater in the NBS on the big screen and the monitors at the consoles is astronaut Thomas D. Akers. The three mission specialists, along with astronaut Kathryn C. Thornton, are scheduled to be involved in a total of five sessions of extravehicular activity (EVA) to service the Hubble Space Telescope (HST) in orbit during the STS-61 mission, scheduled for December 1993.

CONARC Training Workshop, Fort Gordon, Georgia, 5-7 October 1971. Volume III. Educational Television and Training Films Specialty Workshop.

DTIC Science & Technology

1971-10-01

creative orgasm and you again splash yourself all over the control room, you don’t really care if there are kids out there, a lot of times to follow this... orgasm of a unic, that it has a lot of contortions, a lot of spasms, and a lot of moving around but no real issue. I generally agree with what you have...CONARC system that is over- stimulating anybody. My complaint is the opposite - we have all of these things and we haven’t used them. Granted you go with

'In situ simulation' versus 'off site simulation' in obstetric emergencies and their effect on knowledge, safety attitudes, team performance, stress, and motivation: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Unexpected obstetric emergencies threaten the safety of pregnant women. As emergencies are rare, they are difficult to learn. Therefore, simulation-based medical education (SBME) seems relevant. In non-systematic reviews on SBME, medical simulation has been suggested to be associated with improved learner outcomes. However, many questions on how SBME can be optimized remain unanswered. One unresolved issue is how 'in situ simulation' (ISS) versus 'off site simulation' (OSS) impact learning. ISS means simulation-based training in the actual patient care unit (in other words, the labor room and operating room). OSS means training in facilities away from the actual patient care unit, either at a simulation centre or in hospital rooms that have been set up for this purpose. Methods and design The objective of this randomized trial is to study the effect of ISS versus OSS on individual learning outcome, safety attitude, motivation, stress, and team performance amongst multi-professional obstetric-anesthesia teams. The trial is a single-centre randomized superiority trial including 100 participants. The inclusion criteria were health-care professionals employed at the department of obstetrics or anesthesia at Rigshospitalet, Copenhagen, who were working on shifts and gave written informed consent. Exclusion criteria were managers with staff responsibilities, and staff who were actively taking part in preparation of the trial. The same obstetric multi-professional training was conducted in the two simulation settings. The experimental group was exposed to training in the ISS setting, and the control group in the OSS setting. The primary outcome is the individual score on a knowledge test. Exploratory outcomes are individual scores on a safety attitudes questionnaire, a stress inventory, salivary cortisol levels, an intrinsic motivation inventory, results from a questionnaire evaluating perceptions of the simulation and suggested changes needed in the organization, a team-based score on video-assessed team performance and on selected clinical performance. Discussion The perspective is to provide new knowledge on contextual effects of different simulation settings. Trial registration ClincialTrials.gov NCT01792674. PMID:23870501

'In situ simulation' versus 'off site simulation' in obstetric emergencies and their effect on knowledge, safety attitudes, team performance, stress, and motivation: study protocol for a randomized controlled trial.

PubMed

Sørensen, Jette Led; Van der Vleuten, Cees; Lindschou, Jane; Gluud, Christian; Østergaard, Doris; LeBlanc, Vicki; Johansen, Marianne; Ekelund, Kim; Albrechtsen, Charlotte Krebs; Pedersen, Berit Woetman; Kjærgaard, Hanne; Weikop, Pia; Ottesen, Bent

2013-07-17

Unexpected obstetric emergencies threaten the safety of pregnant women. As emergencies are rare, they are difficult to learn. Therefore, simulation-based medical education (SBME) seems relevant. In non-systematic reviews on SBME, medical simulation has been suggested to be associated with improved learner outcomes. However, many questions on how SBME can be optimized remain unanswered. One unresolved issue is how 'in situ simulation' (ISS) versus 'off site simulation' (OSS) impact learning. ISS means simulation-based training in the actual patient care unit (in other words, the labor room and operating room). OSS means training in facilities away from the actual patient care unit, either at a simulation centre or in hospital rooms that have been set up for this purpose. The objective of this randomized trial is to study the effect of ISS versus OSS on individual learning outcome, safety attitude, motivation, stress, and team performance amongst multi-professional obstetric-anesthesia teams.The trial is a single-centre randomized superiority trial including 100 participants. The inclusion criteria were health-care professionals employed at the department of obstetrics or anesthesia at Rigshospitalet, Copenhagen, who were working on shifts and gave written informed consent. Exclusion criteria were managers with staff responsibilities, and staff who were actively taking part in preparation of the trial. The same obstetric multi-professional training was conducted in the two simulation settings. The experimental group was exposed to training in the ISS setting, and the control group in the OSS setting. The primary outcome is the individual score on a knowledge test. Exploratory outcomes are individual scores on a safety attitudes questionnaire, a stress inventory, salivary cortisol levels, an intrinsic motivation inventory, results from a questionnaire evaluating perceptions of the simulation and suggested changes needed in the organization, a team-based score on video-assessed team performance and on selected clinical performance. The perspective is to provide new knowledge on contextual effects of different simulation settings. ClincialTrials.gov NCT01792674.

Learning gestures for customizable human-computer interaction in the operating room.

PubMed

Schwarz, Loren Arthur; Bigdelou, Ali; Navab, Nassir

2011-01-01

Interaction with computer-based medical devices in the operating room is often challenging for surgeons due to sterility requirements and the complexity of interventional procedures. Typical solutions, such as delegating the interaction task to an assistant, can be inefficient. We propose a method for gesture-based interaction in the operating room that surgeons can customize to personal requirements and interventional workflow. Given training examples for each desired gesture, our system learns low-dimensional manifold models that enable recognizing gestures and tracking particular poses for fine-grained control. By capturing the surgeon's movements with a few wireless body-worn inertial sensors, we avoid issues of camera-based systems, such as sensitivity to illumination and occlusions. Using a component-based framework implementation, our method can easily be connected to different medical devices. Our experiments show that the approach is able to robustly recognize learned gestures and to distinguish these from other movements.

Is There Room in the Graduate Curriculum to Learn How to Be a Grad Student? An Approach Using a Graduate-Level Biochemical Engineering Course

ERIC Educational Resources Information Center

Aucoin, Marc G.; Jolicoeur, Mario

2009-01-01

Undergraduate and graduate engineering training differ significantly. The former looks to established protocols and formulas to design and control processes while the latter often involves questioning established protocols and formulas to better suit and describe phenomena. Although we do not dispute the benefits of practical hands-on approaches,…

Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: a randomized controlled trial.

PubMed

Palter, Vanessa N; Grantcharov, Teodor P

2014-03-01

The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. Training on VR simulators has been shown to improve technical performance in the operating room (OR). Currently described VR curricula consist of trainees practicing the same tasks until expert proficiency is reached. It has yet to be investigated whether the individualized deliberate practice, where curricula tasks vary depending on prior levels of technical proficiency, would translate into the OR. This single-blinded prospective trial randomized 16 novice surgical residents to a deliberate practice (DP) group and a conventional residency training group. Both groups performed a laparoscopic cholecystectomy in the OR that was video-recorded. Technical performance of DP group residents in the OR was assessed using 3 validated assessment tools. A score of less than 60% on any component of the assessment tool resulted in the trainee practicing a specific task on the VR simulator. The DP group practiced on the simulator as per their individualized schedule. Both groups then performed another laparoscopic cholecystectomy. A blinded expert assessed the OR recordings using a validated global rating scale. Although both groups had similar technical abilities preintervention [DP: median score, 13.5 (9.3-15.0); control: median score, 14.5 (9.3-17.8); P = 0.45], the DP residents had a superior technical performance postintervention [DP: median score, 17.0 (15.3-18.5); control: median score, 12.5 (7.5-14.0); P = 0.03]. Of 8 DP residents, 6 practiced 5 basic VR tasks (median 1 trial to pass), and 7 of 8 practiced 2 advanced tasks (median 4 trials to pass). A curriculum of deliberate individualized practice on a VR simulator improves technical performance in the OR. This has implications to greatly improve the feasibility of implementing simulation-based curricula in residency training programs, rather then having them being limited to research protocols.

Applied virtual reality in aerospace design

NASA Technical Reports Server (NTRS)

Hale, Joseph P.

1995-01-01

A virtual reality (VR) applications program has been under development at the Marshall Space Flight Center (MSFC) since 1989. The objectives of the MSFC VR Applications Program are to develop, assess, validate, and utilize VR in hardware development, operations development and support, mission operations training and science training. Before VR can be used with confidence in a particular application, VR must be validated for that class of applications. For that reason, specific validation studies for selected classes of applications have been proposed and are currently underway. These include macro-ergonomic 'control room class' design analysis, Spacelab stowage reconfiguration training, a full-body microgravity functional reach simulator, a gross anatomy teaching simulator, and micro-ergonomic design analysis. This paper describes the MSFC VR Applications Program and the validation studies.

EFFECTIVENESS OF A COMPREHENSIVE MENTAL SKILLS CURRICULUM IN ENHANCING SURGICAL PERFORMANCE: RESULTS OF A RANDOMIZED CONTROLLED TRIAL

PubMed Central

Stefanidis, Dimitrios; Anton, Nicholas E; Howley, Lisa D; Bean, Eric; Yurco, Ashley; Pimentel, Manuel E; Davis, Cameron K

2016-01-01

Introduction We hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress. Methods Sixty volunteer novices were randomized into intervention and control groups. All participants received FLS training while the intervention group also participated in the MSC. Skill transfer and retention were assessed on a live porcine model after training and 2 months later, respectively. Performance was assessed using the Test of Performance Strategies-2 (TOPS-2) for mental skills, FLS metrics for laparoscopic performance, and the State Trait Anxiety Inventory (STAI-6) and heart rate (HR) for stress. Results Fifty-five participants (92%) completed training and the transfer test, and 46 (77%) the retention test. There were no significant differences between groups at baseline. Compared to controls the intervention group significantly improved their mental skill use, demonstrated higher laparoscopic skill improvement during retention, and reported less stress during the transfer test. Conclusions The MSC implemented in this study effectively enhanced participants’ mental skill use, reduced cognitive stress in the operating room with a small impact on laparoscopic performance. PMID:27908500

Prevalence and risk factors of needlestick injuries, sharps injuries, and blood and body fluid exposures among operating room nurses in Thailand.

PubMed

Kasatpibal, Nongyao; Whitney, JoAnne D; Katechanok, Sadubporn; Ngamsakulrat, Sukanya; Malairungsakul, Benjawan; Sirikulsathean, Pinyo; Nuntawinit, Chutatip; Muangnart, Thanisara

2016-01-01

Operating room nurses are at high risk for occupational exposure to bloodborne pathogens. This study examined the prevalence of and risk factors for needlestick injuries (NSIs), sharps injuries (SIs), and blood and body fluid exposures (BBFEs) among operating room nurses in Thai hospitals. A cross-sectional study was performed in 247 Thai hospitals. Questionnaires eliciting demographic data and information on injury occurrence and risk factors were distributed to 2500 operating room nurses, and 2031 usable questionnaires were returned, for a response rate of 81.2%. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multiple logistic regression analysis. The prevalence of NSIs, SIs, and BBFEs was 23.7%, 9.8%, and 40.0%, respectively. Risk factors for NSIs were training without practice (OR, 1.67; 95% CI, 1.29-2.17), haste (OR, 4.81; 95% CI, 3.41-6.79), lack of awareness (OR, 1.36; 95% CI, 1.04-1.77), inadequate staffing (OR, 1.60; 95% CI, 1.21-2.11), and outdated guidelines (OR, 1.69; 95% CI, 1.04-2.74). One risk factor was identified for SIs: haste (OR, 2.43; 95% CI, 1.57-3.76). Risk factors for BBFEs were long working hours per week (OR, 2.07; 95% CI, 1.06-4.04), training without practice (OR, 1.55; 95% CI, 1.25-1.91), haste (OR, 1.66; 95% CI, 1.30-2.13), lack of awareness (OR, 1.54; 95% CI, 1.22-1.95), not wearing protective equipment (OR, 1.61; 95% CI, 1.26-2.06), and inadequate staffing (OR, 1.63; 95% CI, 1.26-2.11). This study highlights the high prevalence of NSIs, SIs, and BBFEs among Thai operating room nurses. Preventable risk factors were identified. Appropriate guidelines, adequate staffing, proper training, and self-awareness may reduce these occurrences. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

POINTER: Portable Intelligent Trainer for External Robotics

NASA Technical Reports Server (NTRS)

Kuiper, Hilbert; Rikken, Patrick J.

1994-01-01

Intelligent tutoring systems (ITS's) play an increasing role in training and education of people with different levels of skill and knowledge. As compared to conventional computer based training (CBT) an ITS provides more tailored instruction by trying to mimic the teaching behavior of a human instructor as much as possible and is therefore much more flexible. This paper starts with an introduction to ITS's, followed by the description of an ITS for training of an (astronaut) operator in monitoring and controlling robotic arm procedures. The robotic arm will be used for exchange of equipment between a space station and a space plane involving critical and accurate movements of the robotic arm. The ITS for this application, called Pointer, is developed by TNO Physics and Electronics Laboratory and is based upon an existing ITS that includes procedural training. Pointer has been developed on a workstation whereas the target platform was a portable computer. Therefore, a lot of attention had to be paid to scaling effects and keeping up with user friendliness of the much smaller user interface. Although the learning domain was the control of a robotic arm, it is clear that use of intelligent training technologies on a portable computer has many other applications (payload operations, operation control rooms, etc.). Training can occur at any time and place in an attractive and cost effective way.

Operating room discharge after deep neuromuscular block reversed with sugammadex compared with shallow block reversed with neostigmine: a randomized controlled trial.

PubMed

Putz, Laurie; Dransart, Christophe; Jamart, Jacques; Marotta, Maria-Laura; Delnooz, Geraldine; Dubois, Philippe E

2016-12-01

To determine if reversing a deep or moderate block with sugammadex, compared with a shallow block reversed with neostigmine, reduces the time to operating room discharge after surgery and the time spent in the postanesthesia care unit. A randomized controlled trial. Monocentric study performed from February 2011 until May 2012. One hundred consenting women with American Society of Anesthesiologists grade I or II were randomized into 2 groups. Laparoscopic hysterectomy was performed under desflurane general anesthesia. For the neostigmine (N) group, 0.45 mg · kg -1 rocuronium was followed by spontaneous recovery. A 5-mg rescue bolus was administered only if surgical evaluation was unacceptable. At the end of surgery, 50 μg · kg -1 neostigmine with glycopyrrolate was administered. For the sugammadex (S) group, a higher intubating rocuronium dose (0.6 mg · kg -1 ) was followed by 5-mg boluses each time the train-of-four count exceeded 2. Sugammadex (2-4 mg · kg -1 ) was administered to reverse the block. All patients were extubated after obtaining a train-of-four ratio of 0.9. The duration between the end of surgery and operating room discharge and the time spent in the postanesthesia care unit. The time till operating room discharge was shorter and more predictable in group S (9.15±4.28 minutes vs 13.87±11.43 minutes in group N; P=.005). The maximal duration in group S was 22 minutes, compared with 72 minutes in group N. The time spent in the postanesthesia care unit was not significantly different (group S: 47.75±31.77 minutes and group N: 53.43±40.57 minutes; P=.543). Maintaining a deep neuromuscular block during laparoscopic hysterectomy reversed at the end of the procedure with sugammadex enabled a faster and more predictable time till operating room discharge than did the classical combination of a shallower block reversed with neostigmine. Copyright © 2016 Elsevier Inc. All rights reserved.

Effectiveness of a training program for police officers who come into contact with people with mental health problems: A pragmatic randomised controlled trial

PubMed Central

Fairhurst, Caroline; Booth, Alison; McDaid, Catriona; Moran, Nicola; Parker, Adwoa; Payne, Rebecca; Scott, William J.; Torgerson, David; Webber, Martin; Hewitt, Catherine

2017-01-01

Introduction Police officers frequently come into contact with individuals with mental health problems. Specialist training in this area for police officers may improve how they respond to individuals with mental health problems; however, evidence to support this is sparse. This study evaluated the effectiveness of one bespoke mental health training package for frontline police officers relative to routine training. Design Pragmatic, two-armed cluster randomised controlled trial in one police force in England. Police stations in North Yorkshire were randomised with frontline police officers receiving either a bespoke mental health training package or routine training. The primary outcome was the number of incidents which resulted in a police response reported to the North Yorkshire Police control room up to six months after delivery of training. Secondary outcomes included: likelihood of incidents using Section 136 of the Mental Health Act; likelihood of incidents having a mental health tag applied; and number of individuals with a mental health warning marker involved in incidents. The appropriateness of mental health tags applied to a random sample of incidents was checked by an independent mental health professional. Routinely collected data were used. Results Twelve police stations were recruited and randomised (Intervention group n = 6; Control group n = 6), and 249 officers received the bespoke mental health training intervention. At follow-up, a median of 397 incidents were assigned to trial stations in the intervention group, and 498 in the control group. There was no evidence of a difference in the number of incidents with a police response (adjusted incidence rate ratio (IRR) 0.92, 95% CI 0.61 to 1.38, p = 0.69), or in the number of people with mental health warning markers involved in incidents (adjusted IRR 1.39, 95% CI 0.91 to 2.10, p = 0.13) between the intervention and control groups up to six months following the intervention; however, incidents assigned to stations in the intervention group were more likely to have a mental health tag applied to them than incidents assigned to control stations (adjusted odds ratio 1.41, 95% CI 1.16 to 1.71, p = 0.001). The review of 100 incidents suggests that there may be incidents involving individuals with mental health issues that are not being recorded as such (Kappa coefficient 0.65). There was no statistically significant difference in the likelihood of Section 136 of the Mental Health Act being applied to an incident. Conclusions The bespoke one day mental health training delivered to frontline officers by mental health professionals did not reduce the number of incidents reported to the police control room up to six months after its delivery; however training may have a positive effect on how the police record incidents involving individuals with mental health problems. Our trial has shown that conducting pragmatic trials within the police setting is feasible and acceptable. There is a wealth of routinely collected police data that can be utilised for research and further collaboration between police forces and academia is encouraged. Trial registration ISRCTN (ISRCTN11685602). The authors confirm that all ongoing and related trials for this drug/intervention are registered. PMID:28886163

Effects of Snoezelen Room, Activities of Daily Living Skills Training, and Vocational Skills Training on Aggression and Self-Injury by Adults with Mental Retardation and Mental Illness

ERIC Educational Resources Information Center

Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Molina, Enrique J.; Sage, Monica; Brown, Stephen; Groeneweg, Jop

2004-01-01

Multi-sensory stimulation provided in a Snoezelen room is being used increasingly for individuals with mental retardation and mental illness to facilitate relaxation, provide enjoyment, and inhibit behavioral challenges. We observed aggressive and self-injurious behavior in three groups of 15 individuals with severe or profound mental retardation…

Training in surgical oncology - the role of VR simulation.

PubMed

Lewis, T M; Aggarwal, R; Rajaretnam, N; Grantcharov, T P; Darzi, A

2011-09-01

There have been dramatic changes in surgical training over the past two decades which have resulted in a number of concerns for the development of future surgeons. Changes in the structure of cancer services, working hour restrictions and a commitment to patient safety has led to a reduction in training opportunities that are available to the surgeon in training. Simulation and in particular virtual reality (VR) simulation has been heralded as an effective adjunct to surgical training. Advances in VR simulation has allowed trainees to practice realistic full length procedures in a safe and controlled environment, where mistakes are permitted and can be used as learning points. There is considerable evidence to demonstrate that the VR simulation can be used to enhance technical skills and improve operating room performance. Future work should focus on the cost effectiveness and predictive validity of VR simulation, which in turn would increase the uptake of simulation and enhance surgical training. Copyright © 2011 Elsevier Ltd. All rights reserved.

Virtual reality in surgical skills training.

PubMed

Palter, Vanessa N; Grantcharov, Teodor P

2010-06-01

With recent concerns regarding patient safety, and legislation regarding resident work hours, it is accepted that a certain amount of surgical skills training will transition to the surgical skills laboratory. Virtual reality offers enormous potential to enhance technical and non-technical skills training outside the operating room. Virtual-reality systems range from basic low-fidelity devices to highly complex virtual environments. These systems can act as training and assessment tools, with the learned skills effectively transferring to an analogous clinical situation. Recent developments include expanding the role of virtual reality to allow for holistic, multidisciplinary team training in simulated operating rooms, and focusing on the role of virtual reality in evidence-based surgical curriculum design. Copyright 2010 Elsevier Inc. All rights reserved.

Effect of respiratory muscle training on GLUT-4 in the sheep diaphragm.

PubMed

Bhandari, A; Xia, Y; Cortright, R; Dohm, G L; Bazzy, A R

2000-08-01

Endurance exercise training is associated with enhanced glucose uptake and hence improvement in carbohydrate metabolism. Glucose transport (GLUT) membrane proteins are regulated by a variety of physiological stimuli, including exercise. In limb muscle, both acute exercise and endurance training enhance the expression of the skeletal muscle transporter, GLUT-4. The purpose of this study is to determine whether chronic loading enhances GLUT-4 expression in the diaphragm. The effect of chronic inspiratory flow resistive (IFR) loading on diaphragm GLUT-4 was studied in a model of respiratory muscle endurance training in sheep. IFR loads (resistance 50-100 cm H2O x L(-1) x s(-1)) were maintained for 3 h x d(-1), 5-6 d x wk(-1) for 3 wk. Loading was adjusted so that PaO2 was >60 Torr and PaCO2 <45 Torr in room air. Six untrained sheep were used as controls. GLUT-4 protein and mRNA were analyzed by Western and Northern analysis respectively. GLUT-4 protein levels were two-fold greater in trained animals when compared with controls (P < 0.01). GLUT-4 mRNA levels in the trained muscles was not significantly different from controls. We conclude that in the sheep diaphragm, chronic IFR loading increases GLUT-4 protein levels. This increase may be one of the mechanisms contributing to the improved respiratory muscle endurance previously demonstrated in this animal model of respiratory muscle training.

Current status of personnel and infrastructure resources for infection prevention and control programs in the Republic of Korea: A national survey.

PubMed

Yoon, Young Kyung; Lee, Sung Eun; Seo, Beom Sam; Kim, Hyeon Jeong; Kim, Jong Hun; Yang, Kyung Sook; Kim, Min Ja; Sohn, Jang Wook

2016-11-01

There is significant variability in personnel and infrastructural resources for infection prevention and control (IPC) among health care institutions. The aim of this study is to evaluate the current status of individual hospital-based IPC programs in the Republic of Korea (ROK). A multicenter cross-sectional survey of 100 hospitals participating in the national surveillance programs for multidrug-resistant organisms (MDROs) in the ROK was conducted in September 2015. The survey consisted of 140 standardized Web-based questionnaires. The survey response rate was 41.0%. The responding hospitals are largely organized with multibed rooms, with an insufficient numbers of single rooms. Employment status of infection specialists and hand hygiene resources were better in larger hospitals. The responding hospitals had 1 full-time infection control nurse per 400.3 ± 154.1 beds, with wide variations in training and experience. Facilities have great diversity in their approach to preventing MDROs. There appeared to be no difference in supplies consumption and protocols for IPC among the hospitals, stratified according to size. A greater availability of specialist personnel, single rooms, and a comprehensive IPC program, with the support of a policy-oriented management, is necessary to achieve effective IPC. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Progress in virtual reality simulators for surgical training and certification.

PubMed

de Visser, Hans; Watson, Marcus O; Salvado, Olivier; Passenger, Joshua D

2011-02-21

There is increasing evidence that educating trainee surgeons by simulation is preferable to traditional operating-room training methods with actual patients. Apart from reducing costs and risks to patients, training by simulation can provide some unique benefits, such as greater control over the training procedure and more easily defined metrics for assessing proficiency. Virtual reality (VR) simulators are now playing an increasing role in surgical training. However, currently available VR simulators lack the fidelity to teach trainees past the novice-to-intermediate skills level. Recent technological developments in other industries using simulation, such as the games and entertainment and aviation industries, suggest that the next generation of VR simulators should be suitable for training, maintenance and certification of advanced surgical skills. To be effective as an advanced surgical training and assessment tool, VR simulation needs to provide adequate and relevant levels of physical realism, case complexity and performance assessment. Proper validation of VR simulators and an increased appreciation of their value by the medical profession are crucial for them to be accepted into surgical training curricula.

Virtual reality training in laparoscopic surgery: A systematic review & meta-analysis.

PubMed

Alaker, Medhat; Wynn, Greg R; Arulampalam, Tan

2016-05-01

Laparoscopic surgery requires a different and sometimes more complex skill set than does open surgery. Shortened working hours, less training times, and patient safety issues necessitates that these skills need to be acquired outside the operating room. Virtual reality simulation in laparoscopic surgery is a growing field, and many studies have been published to determine its effectiveness. This systematic review and meta-analysis aims to evaluate virtual reality simulation in laparoscopic abdominal surgery in comparison to other simulation models and to no training. A systematic literature search was carried out until January 2014 in full adherence to PRISMA guidelines. All randomised controlled studies comparing virtual reality training to other models of training or to no training were included. Only studies utilizing objective and validated assessment tools were included. Thirty one randomised controlled trials that compare virtual reality training to other models of training or to no training were included. The results of the meta-analysis showed that virtual reality simulation is significantly more effective than video trainers, and at least as good as box trainers. The use of Proficiency-based VR training, under supervision with prompt instructions and feedback, and the use of haptic feedback, has proven to be the most effective way of delivering the virtual reality training. The incorporation of virtual reality training into surgical training curricula is now necessary. A unified platform of training needs to be established. Further studies to assess the impact on patient outcomes and on hospital costs are necessary. (PROSPERO Registration number: CRD42014010030). Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

First Integrated Flight Simulation For STS 114

NASA Image and Video Library

2004-10-13

JSC2004-E-45138 (13 October 2004) --- Astronaut Stephen N. Frick monitors communications at the spacecraft communicator (CAPCOM) console in the Shuttle Flight Control Room (WFCR) in Johnson Space Center’s (JSC) Mission Control Center (MCC) with the STS-114 crewmembers during a fully-integrated simulation on October 13. The seven member crew was in a JSC-based simulator during the sims. The dress rehearsal of Discovery's rendezvous and docking with the International Space Station (ISS) was the first flight-specific training for the Space Shuttle's return to flight.

Crew resource management: using aviation techniques to improve operating room safety.

PubMed

Ricci, Michael A; Brumsted, John R

2012-04-01

Since the publication of the Institute of Medicine report estimating nearly 100,000 deaths per year from medical errors, hospitals and physicians have a renewed focus upon error reduction. We implemented a surgical crew resource management (CRM) program for all operating room (OR) personnel. In our academic medical center, 19,000 procedures per year are performed in 27 operating rooms. Mandatory CRM training was implemented for all peri-operative personnel. Aviation techniques introduced included a pre-operative checklist and brief, post-operative debrief, read and initial files, and various other aviation-based techniques. Compliance with conduct of the brief/debrief was monitored as well as wrong-site surgeries and retained foreign body events. The malpractice insurance database for claims was also queried for the period prior to and after training. Initial training was accomplished for 517 people, including all anesthesiologists, surgeons, nurses, technicians, and OR assistants. Pre-operative briefing increased from 6.7 to 99% within 4 mo. Wrong site surgeries and retained foreign bodies decreased from a high of seven in 2007 to none in 2008, but, after 14 mo without additional training, these rose to five in 2009. Malpractice expenses (payouts and legal fees) totaled $793,000 (2003-2007), but have been zero since 2008. CRM training and implementation had an impact on reducing the incidence of wrong site surgery and retained foreign bodies in our operating rooms. However, constant reinforcement and refresher training is necessary for sustained results. Though no one technique can prevent all errors, CRM can effect culture change, producing a safer environment.

Randomized clinical trial of virtual reality simulation for laparoscopic skills training.

PubMed

Grantcharov, T P; Kristiansen, V B; Bendix, J; Bardram, L; Rosenberg, J; Funch-Jensen, P

2004-02-01

This study examined the impact of virtual reality (VR) surgical simulation on improvement of psychomotor skills relevant to the performance of laparoscopic cholecystectomy. Sixteen surgical trainees performed a laparoscopic cholecystectomy on patients in the operating room (OR). The participants were then randomized to receive VR training (ten repetitions of all six tasks on the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR)) or no training. Subsequently, all subjects performed a further laparoscopic cholecystectomy in the OR. Both operative procedures were recorded on videotape, and assessed by two independent and blinded observers using predefined objective criteria. Time to complete the procedure, error score and economy of movement score were assessed during the laparoscopic procedure in the OR. No differences in baseline variables were found between the two groups. Surgeons who received VR training performed laparoscopic cholecystectomy significantly faster than the control group (P=0.021). Furthermore, those who had VR training showed significantly greater improvement in error (P=0.003) and economy of movement (P=0.003) scores. Surgeons who received VR simulator training showed significantly greater improvement in performance in the OR than those in the control group. VR surgical simulation is therefore a valid tool for training of laparoscopic psychomotor skills and could be incorporated into surgical training programmes. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

ATV Engineering Support Team Safety Console Preparation for the Johannes Kepler Mission

NASA Astrophysics Data System (ADS)

Chase, R.; Oliefka, L.

2010-09-01

This paper describes the improvements to be implemented in the Safety console position of the Engineering Support Team(EST) at the Automated Transfer Vehicle(ATV) Control Centre(ATV-CC) for the upcoming ATV Johannes Kepler mission. The ATV missions to the International Space Station are monitored and controlled from the ATV-CC in Toulouse, France. The commanding of ATV is performed by the Vehicle Engineering Team(VET) in the main control room under authority of the Flight Director. The EST performs a monitoring function in a room beside the main control room. One of the EST positions is the Safety console, which is staffed by safety engineers from ESA and the industrial prime contractor, Astrium. The function of the Safety console is to check whether the hazard controls are available throughout the mission as required by the Hazard Reports approved by the ISS Safety Review Panel. Safety console preparation activities were limited prior to the first ATV mission due to schedule constraints, and the safety engineers involved have been working to improve the readiness for ATV 2. The following steps have been taken or are in process, and will be described in this paper: • review of the implementation of Operations Control Agreement Documents(OCADs) that record the way operational hazard controls are performed to meet the needs of the Hazard Reports(typically in Flight Rules and Crew Procedures), • crosscheck of operational control needs and implementations with respect to ATV's first flight observations and post flight evaluations, with a view to identifying additional, obsolete or revised operational hazard controls, • participation in the Flight Rule review and update process carried out between missions, • participation in the assessment of anomalies observed during the first ATV mission, to ensure that any impacts are addressed in the ATV 2 safety documentation, • preparation of a Safety console handbook to provide lists of important safety aspects to be monitored at various stages of the mission, including links to relevant Hazard Reports, Flight Rules, and supporting documentation, • participation to training courses conducted in the frame of the ATV Training Academy(ATAC), and provision of courses related to safety for the other members of the VET and EST, • participation to simulations conducted at ATV-CC, including off-nominal cases. The result of these activities will be an improved level of readiness for the ATV 2 mission.

Virtual environment for training in microsurgery

NASA Astrophysics Data System (ADS)

Montgomery, Kevin N.; Stephanides, Michael; Brown, Joel; Latombe, Jean-Claude; Schendel, Stephen A.

1999-05-01

Microsurgery is a well-established medical field, and involves repair of approximately 1mm vessels and nerves under an operating microscope in order to reattach severed fingers or transfer tissue for reconstruction. Initial skill sin microvascular surgery are usually developed in the animal lab and subsequently in the operating room. Development of these skills typically requires about 6 months of animal based training before additional learning takes place in the operating room.

14 CFR 141.55 - Training course: Contents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Training course: Contents. 141.55 Section... Training course: Contents. (a) Each training course for which approval is requested must meet the minimum... trained in the room at one time; (2) A description of each type of audiovisual aid, projector, tape...

75 FR 78807 - Agency Information Collection (Other On-The-Job Training and Apprenticeship Training Agreement...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC...-The-Job Training and Apprenticeship Training Agreement and Standards and Employer's Application To Provide Job Training) Activity Under OMB Review AGENCY: Veterans Benefits Administration, Department of...

INTERIOR OF BRIEFING ROOM A. view TO NORTHWEST Plattsburgh ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

INTERIOR OF BRIEFING ROOM A. view TO NORTHWEST - Plattsburgh Air Force Base, Target Intelligence Training Building-Combat Center, Off Connecticut Road, east of Idaho Avenue, Plattsburgh, Clinton County, NY

INTERIOR OF TARGET INTELLIGENCE ROOM. view TO WEST. Plattsburgh ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

INTERIOR OF TARGET INTELLIGENCE ROOM. view TO WEST. - Plattsburgh Air Force Base, Target Intelligence Training Building-Combat Center, Off Connecticut Road, east of Idaho Avenue, Plattsburgh, Clinton County, NY

Development, initial reliability and validity testing of an observational tool for assessing technical skills of operating room nurses.

PubMed

Sevdalis, Nick; Undre, Shabnam; Henry, Janet; Sydney, Elaine; Koutantji, Mary; Darzi, Ara; Vincent, Charles A

2009-09-01

The recent emergence of the Systems Approach to the safety and quality of surgical care has triggered individual and team skills training modules for surgeons and anaesthetists and relevant observational assessment tools have been developed. To develop an observational tool that captures operating room (OR) nurses' technical skill and can be used for assessment and training. The Imperial College Assessment of Technical Skills for Nurses (ICATS-N) assesses (i) gowning and gloving, (ii) setting up instrumentation, (iii) draping, and (iv) maintaining sterility. Three to five observable behaviours have been identified for each skill and are rated on 1-6 scales. Feasibility and aspects of reliability and validity were assessed in 20 simulation-based crisis management training modules for trainee nurses and doctors, carried out in a Simulated Operating Room. The tool was feasible to use in the context of simulation-based training. Satisfactory reliability (Cronbach alpha) was obtained across trainers' and trainees' scores (analysed jointly and separately). Moreover, trainer nurse's ratings of the four skills correlated positively, thus indicating adequate content validity. Trainer's and trainees' ratings did not correlate. Assessment of OR nurses' technical skill is becoming a training priority. The present evidence suggests that the ICATS-N could be considered for use as an assessment/training tool for junior OR nurses.

Training Medical Novices in Spinal Microsurgery: Does the Modality Matter? A Pilot Study Comparing Traditional Microscopic Surgery and a Novel Robotic Optoelectronic Visualization Tool

PubMed Central

Tubbs, R. Shane; Page, Jeni; Chapman, Alexandra; Burgess, Brittni; Laws, Tyler; Warren, Haylie; Oskouian, Rod J

2016-01-01

The operative microscope has been a staple instrument in the neurosurgical operating room over the last 50 years. With advances in optoelectronics, options such as robotically controlled high magnification have become available. Such robotically controlled optoelectronic systems may offer new opportunities in surgical technique and teaching. However, traditionally trained surgeons may find it hard to accept newer technologies due to an inherent bias emerging from their previous background. We, therefore, studied how a medically naïve population in a pilot study would meet set microsurgical goals in a cadaver experiment using either a conventional operative microscope or BrightMatter™ Servo system, ​a robotically controlled optoelectronic system (Synaptive Medical, Toronto, Ontario, Canada). We found that the relative ease in teaching medical novices with a robotically controlled optoelectronic system was more valuable when compared to using a modern-day surgical microscope. PMID:26973804

DETAIL OF DOORWAY INTO ROOM 102. view TO SOUTH. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL OF DOORWAY INTO ROOM 102. view TO SOUTH. - Plattsburgh Air Force Base, Target Intelligence Training Building-Combat Center, Off Connecticut Road, east of Idaho Avenue, Plattsburgh, Clinton County, NY

Attitudes to teamwork and safety among Italian surgeons and operating room nurses.

PubMed

Prati, Gabriele; Pietrantoni, Luca

2014-01-01

Previous studies have shown that surgical team members' attitudes about safety and teamwork in the operating theatre may play a role in patient safety. The aim of this study was to assess attitudes about teamwork and safety among Italian surgeons and operating room nurses. Fifty-five surgeons and 48 operating room nurses working in operating theatres at one hospital in Italy completed the Operating Room Management Attitudes Questionnaire (ORMAQ). Results showed several discrepancies in attitudes about teamwork and safety between surgeons and operating room nurses. Surgeons had more positive views on the quality of surgical leadership, communication, teamwork, and organizational climate in the theatre than operating room nurses. Operating room nurses reported that safety rules and procedures were more frequently disregarded than the surgeons. The results are only partially aligned with previous ORMAQ surveys of surgical teams in other countries. The differences emphasize the influence of national culture, as well as the particular healthcare system. This study shows discrepancies on many aspects in attitudes to teamwork and safety between surgeons and operating room nurses. The findings support implementation and use of team interventions and human factor training. Finally, attitude surveys provide a method for assessing safety culture in surgery, for evaluating the effectiveness of training initiatives, and for collecting data for a hospital's quality assurance programme.

An Assessment-based Solution to a Human-Service Employee Performance Problem

PubMed Central

Wilder, David A.; Majdalany, Lina; Mathisen, David; Strain, Leigh Ann

2013-01-01

The PDC-HS implicated a lack of proper training on participant duties and a lack of performance feedback as contributors to the performance problems. As a result, an intervention targeting training on participant duties and performance feedback was implemented across eight treatment rooms; the intervention increased performance in all rooms. This preliminary validation study suggests the PDC-HS may prove useful in solving performance problems in human-service settings. PMID:25729505

27. VIEW OF UNDERWATER WELDING/SCUBA ROOM, FIRST FLOOR, LOOKING NORTH. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

27. VIEW OF UNDERWATER WELDING/SCUBA ROOM, FIRST FLOOR, LOOKING NORTH. Former location of tank indicated by circular ridge in linoleum at bottom right, and by framing of second floor at top right. Silhouettes of driver and two sharks on the floor are associated with the use of this building for scuba training. - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

DETAIL OF DOORWAY INTO COMBAT INTELLIGENCE ROOM. view TO WEST. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL OF DOORWAY INTO COMBAT INTELLIGENCE ROOM. view TO WEST. - Plattsburgh Air Force Base, Target Intelligence Training Building-Combat Center, Off Connecticut Road, east of Idaho Avenue, Plattsburgh, Clinton County, NY

24. VIEW OF EQUIPMENT ROOM WITH TRIPLELOCK RECOMPRESSION CHAMBER, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

24. VIEW OF EQUIPMENT ROOM WITH TRIPLE-LOCK RECOMPRESSION CHAMBER, LOOKING SOUTHWEST - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

SCE&G Cope Station simulator training program development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stottlemire, J.L.; Fabry, R.

1996-11-01

South Carolina Electric and Gas Company made a significant investment into meeting the needs of their customers in designing and building the new fossil Generating Station near Cope, South Carolina. Cope Station is a state-of-the-art, 385 MW plant, with equipment and design features that will provide the plant with the capabilities of achieving optimum availability and capability. SCE&G has also implemented a team concept approach to plant organization at Cope Station. The modern plant design, operating philosophy, and introduction of a large percentage of new operations personnel presented a tremendous challenge in preparing for plant commissioning and commercial operation. SCE&G`smore » answer to this challenge was to hire an experienced operations trainer, and implement a comprehensive training program. An important part of the training investment was the procurement of a plant specific control room simulator. SCE&G, through tailored collaboration with the Electric Power Research Institute (EPRI), developed a specification for a simulator with the features necessary for training the initial plant staff as well as advanced operator training. The high-fidelity CRT based training simulator is a stimulated system that completely and accurately simulates the various plant systems, process startups, shutdowns, normal operating scenarios, and malfunctions. The process model stimulates a Foxboro Distributed Control System consisting of twelve control processors, five WP51 work stations, and one AW51 file server. The workstations, file server and support hardware and software necessary to interface with ESSCOR`s FSIM4 software was provided by Foxoboro.« less

Staphylococcus aureus and community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in and around therapeutic whirlpools in college athletic training rooms.

PubMed

Kahanov, Leamor; Kim, Young Kyun; Eberman, Lindsey; Dannelly, Kathleen; Kaur, Haninder; Ramalinga, A

2015-04-01

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a leading cause of skin and soft tissue infection in the nonhospitalized community. Care of the athletes in athletic training rooms is specifically designed with equipment tailored to the health care needs of the athletes, yet recent studies indicate that CA-MRSA is still prevalent in athletic facilities and that cleaning methods may not be optimal. To investigate the prevalence of Staphylococcus aureus and CA-MRSA in and around whirlpools in the athletic training room. Cross-sectional study. National Collegiate Athletic Association Division I university. Student-athletes (n = 109) consisting of 46 men (42%) and 63 women (58%) representing 6 sports. Presence of MRSA and Staphylococcus aureus in and around the whirlpool structures relative to sport and number of athletes using the whirlpools. We identified Staphylococcus aureus in 22% (n = 52/240) of the samples and MRSA in 0.8% (n = 2/240). A statistically significant difference existed between the number of athletes using the whirlpool and the presence of Staphylococcus aureus in and around the whirlpools (F(2,238) = 2.445, P = .007). However, Staphylococcus aureus was identified regardless of whether multiple athletes used a whirlpool or no athletes used a whirlpool. We did not identify a relationship between the number of athletes who used a whirlpool and Staphylococcus aureus or MRSA density (P = .134). Staphylococcus aureus and MRSA were identified in and around the whirlpools. Transmission of the bacteria can be reduced by following the cleaning and disinfecting protocols recommended by the Centers for Disease Control and Prevention. Athletic trainers should use disinfectants registered by the Environmental Protection Agency to sanitize all whirlpools between uses.

42 CFR 73.15 - Training.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., growth chambers, animal rooms, greenhouses, storage areas, shipping/receiving areas, production... behaviors. (c) Refresher training must be provided annually for individuals with access approval from the...

42 CFR 73.15 - Training.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., growth chambers, animal rooms, greenhouses, storage areas, shipping/receiving areas, production... behaviors. (c) Refresher training must be provided annually for individuals with access approval from the...

Training 101: Four Ghosts and Two Heads.

ERIC Educational Resources Information Center

Petrini, Catherine M., Ed.; And Others

1993-01-01

Laus and Champagne offer clues for identifying training room "ghosts" (participants' past experiences, histories, demands, and needs) and describe how to get rid of them. Plutschak and Luke discuss the benefits of team training and suggest five rules to heed when training by the buddy system. (JOW)

10. VIEW, LOOKING NORTHWEST FROM LEFT TO RIGHT, SHOWING PUMP ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. VIEW, LOOKING NORTHWEST FROM LEFT TO RIGHT, SHOWING PUMP ROOM AND DRESSING ROOM - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

A Multi-Level Approach to Caregiver Training Accessibility.

ERIC Educational Resources Information Center

Range, Diana

This brief paper discusses how in 10 year's time a system for providing caregiver training was developed in Texas. The training accessibility system consists of five dimensions: publications, free materials, resource rooms, child development specialists, Title XX training contracts and traveling resource vans. Tips for program continuity under…

Simulation Training Versus Real Time Console Training for New Flight Controllers

NASA Technical Reports Server (NTRS)

Heaton, Amanda

2010-01-01

For new flight controllers, the two main learning tools are simulations and real time console performance training. These benefit the new flight controllers in different ways and could possibly be improved. Simulations: a) Allow for mistakes without serious consequences. b) Lets new flight controllers learn the working style of other new flight controllers. c) Lets new flight controllers eventually begin to feel like they have mastered the sim world, so therefore they must be competent in the real time world too. Real time: a) Shows new flight controllers some of the unique problems that develop and have to be accounted for when dealing with certain payloads or systems. b) Lets new flight controllers experience handovers - gathering information from the previous shift on what the room needs to be aware of and what still needs to be done. c) Gives new flight controllers confidence that they can succeed in the position they are training for when they can solve real anomalies. How Sims could be improved and more like real-time ops for the ISS Operations Controller position: a) Operations Change Requests to review. b) Fewer anomalies (but still more than real time for practice). c) Payload Planning Manager Handover sheet for the E-1 and E-3 reviews. d) Flight note in system with at least one comment to verify for the E-1 and E-3 reviews How the real time console performance training could be improved for the ISS Operations Controller position: a) Schedule the new flight controller to be on console for four days but with a different certified person each day. This will force them to be the source of knowledge about every OCR in progress, everything that has happened in those few days, and every activity on the timeline. Constellation program flight controllers will have to learn entirely from simulations, thereby losing some of the elements that they will need to have experience with for real time ops. It may help them to practice real time console performance training in the International Space Station or Space Shuttle to gather some general anomaly resolution and day-to-day task management skills.

Desktop-based computer-assisted orthopedic training system for spinal surgery.

PubMed

Rambani, Rohit; Ward, James; Viant, Warren

2014-01-01

Simulation and surgical training has moved on since its inception during the end of the last century. The trainees are getting more exposed to computers and laboratory training in different subspecialties. More needs to be done in orthopedic simulation in spinal surgery. To develop a training system for pedicle screw fixation and validate its effectiveness in a cohort of junior orthopedic trainees. Fully simulated computer-navigated training system is used to train junior orthopedic trainees perform pedicle screw insertion in the lumbar spine. Real patient computed tomography scans are used to produce the real-time fluoroscopic images of the lumbar spine. The training system was developed to simulate pedicle screw insertion in the lumbar spine. A total of 12 orthopedic senior house officers performed pedicle screw insertion in the lumbar spine before and after the training on training system. The results were assessed based on the scoring system, which included the amount of time taken, accuracy of pedicle screw insertion, and the number of exposures requested to complete the procedure. The result shows a significant improvement in amount of time taken, accuracy of fixation, and the number of exposures after the training on simulator system. This was statistically significant using paired Student t test (p < 0.05). Fully simulated computer-navigated training system is an efficient training tool for young orthopedic trainees. This system can be used to augment training in the operating room, and trainees acquire their skills in the comfort of their study room or in the training room in the hospital. The system has the potential to be used in various other orthopedic procedures for learning of technical skills in a manner aimed at ensuring a smooth escalation in task complexity leading to the better performance of procedures in the operating theater. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Applying a Wearable Voice-Activated Computer to Instructional Applications in Clean Room Environments

NASA Technical Reports Server (NTRS)

Graves, Corey A.; Lupisella, Mark L.

2004-01-01

The use of wearable computing technology in restrictive environments related to space applications offers promise in a number of domains. The clean room environment is one such domain in which hands-free, heads-up, wearable computing is particularly attractive for education and training because of the nature of clean room work We have developed and tested a Wearable Voice-Activated Computing (WEVAC) system based on clean room applications. Results of this initial proof-of-concept work indicate that there is a strong potential for WEVAC to enhance clean room activities.

75 FR 32507 - Submission for OMB Review: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... Department of Labor--Employment and Training Administration (ETA), Office of Management and Budget, Room... information technology, e.g., permitting electronic submission of responses. Agency: Employment and Training... not include hour costs): $0. Description: The Department of Labor's Employment and Training...

Virtual reality simulators and training in laparoscopic surgery.

PubMed

Yiannakopoulou, Eugenia; Nikiteas, Nikolaos; Perrea, Despina; Tsigris, Christos

2015-01-01

Virtual reality simulators provide basic skills training without supervision in a controlled environment, free of pressure of operating on patients. Skills obtained through virtual reality simulation training can be transferred on the operating room. However, relative evidence is limited with data available only for basic surgical skills and for laparoscopic cholecystectomy. No data exist on the effect of virtual reality simulation on performance on advanced surgical procedures. Evidence suggests that performance on virtual reality simulators reliably distinguishes experienced from novice surgeons Limited available data suggest that independent approach on virtual reality simulation training is not different from proctored approach. The effect of virtual reality simulators training on acquisition of basic surgical skills does not seem to be different from the effect the physical simulators. Limited data exist on the effect of virtual reality simulation training on the acquisition of visual spatial perception and stress coping skills. Undoubtedly, virtual reality simulation training provides an alternative means of improving performance in laparoscopic surgery. However, future research efforts should focus on the effect of virtual reality simulation on performance in the context of advanced surgical procedure, on standardization of training, on the possibility of synergistic effect of virtual reality simulation training combined with mental training, on personalized training. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

A unique facility for V/STOL aircraft hover testing

NASA Technical Reports Server (NTRS)

Culpepper, R. G.; Murphy, R. D.

1979-01-01

The paper discusses the Navy's XFV-12A tethered hover testing capabilities utilizing NASA's Impact Dynamic Research Facility (IDRF) at Langley. The facility allows for both static and dynamic tethered hover test operations to be undertaken with safety. The installation which consists of the 'Z' system (tether), restraint system, static tiedowns and the control room and console, is presented in detail. Among the capabilities demonstrated were the ability to recover the aircraft anytime during a test, to rapidly and safely define control limits, and to provide a realistic environment for pilot training and proficiency in VTOL flight.

Full immersion simulation: validation of a distributed simulation environment for technical and non-technical skills training in Urology.

PubMed

Brewin, James; Tang, Jessica; Dasgupta, Prokar; Khan, Muhammad S; Ahmed, Kamran; Bello, Fernando; Kneebone, Roger; Jaye, Peter

2015-07-01

To evaluate the face, content and construct validity of the distributed simulation (DS) environment for technical and non-technical skills training in endourology. To evaluate the educational impact of DS for urology training. DS offers a portable, low-cost simulated operating room environment that can be set up in any open space. A prospective mixed methods design using established validation methodology was conducted in this simulated environment with 10 experienced and 10 trainee urologists. All participants performed a simulated prostate resection in the DS environment. Outcome measures included surveys to evaluate the DS, as well as comparative analyses of experienced and trainee urologist's performance using real-time and 'blinded' video analysis and validated performance metrics. Non-parametric statistical methods were used to compare differences between groups. The DS environment demonstrated face, content and construct validity for both non-technical and technical skills. Kirkpatrick level 1 evidence for the educational impact of the DS environment was shown. Further studies are needed to evaluate the effect of simulated operating room training on real operating room performance. This study has shown the validity of the DS environment for non-technical, as well as technical skills training. DS-based simulation appears to be a valuable addition to traditional classroom-based simulation training. © 2014 The Authors BJU International © 2014 BJU International Published by John Wiley & Sons Ltd.

High-fidelity, simulation-based, interdisciplinary operating room team training at the point of care.

PubMed

Paige, John T; Kozmenko, Valeriy; Yang, Tong; Paragi Gururaja, Ramnarayan; Hilton, Charles W; Cohn, Isidore; Chauvin, Sheila W

2009-02-01

The operating room (OR) is a dynamic, high risk setting requiring effective teamwork for the safe delivery of care. Teamwork in the modern OR, however, is less than ideal. High fidelity simulation is an attractive approach to training key teamwork competencies. We have developed a portable simulation platform, the mobile mock OR (MMOR) that permits bringing team training over long distances to the point of care. We examined the effectiveness of this innovative, simulation-based interdisciplinary operating room (OR) team training model on its participants. All general surgical OR team members at an academic affiliated medical center underwent scenario-based training using a mobile mock OR. Pre- and post-session mean scores were calculated and analyzed for 15 Likert-type items measuring self-efficacy in teamwork competencies using t test. The mean gain in pre-post item scores for 38 participants averaged 0.4 units on a 6-point Likert scale. The significance was demonstrated in 4 of the items: role clarity (Delta = 0.6 units, P = .02), anticipatory response (Delta = 0.6 units, P = .01), cross monitoring (Delta = 0.6 units, P < .01), and team cohesion and interaction (Delta = 0.7 units, P < .01). High-fidelity, simulation-based OR team training at the point of care positively impacts self-efficacy for effective teamwork performance in everyday practice.

The Future Training Room.

ERIC Educational Resources Information Center

Barbian, Jeff

2001-01-01

Looks at some of the electronic learning technology that has already been developed and will become common for training, including robots, lucid dreaming, tele-immersion, human interface technology, among others. (JOW)

Astronaut Scott Carpenter completes top egress training in white room

NASA Image and Video Library

1962-03-16

S62-01383 (1962) --- Project Mercury astronaut M. Scott Carpenter, prime pilot of the Mercury-Atlas 7 (the nation's second manned orbital flight), completes top egress training in the white room at Cape Canaveral, Florida. The line he is holding is known as the "man line" which attaches the survival kit to the astronaut. The bag is the survival kit he carries for contingency landings. Clearly visible around his neck is the bag containing the life vest. Photo credit: NASA

Cognitive training for technical and non-technical skills in robotic surgery: a randomised controlled trial.

PubMed

Raison, Nicholas; Ahmed, Kamran; Abe, Takashige; Brunckhorst, Oliver; Novara, Giacomo; Buffi, Nicolò; McIlhenny, Craig; van der Poel, Henk; van Hemelrijck, Mieke; Gavazzi, Andrea; Dasgupta, Prokar

2018-05-07

To investigate the effectiveness of motor imagery (MI) for technical skill and non-technical skill (NTS) training in minimally invasive surgery (MIS). A single-blind, parallel-group randomised controlled trial was conducted at the Vattikuti Institute of Robotic Surgery, King's College London. Novice surgeons were recruited by open invitation in 2015. After basic robotic skills training, participants underwent simple randomisation to either MI training or standard training. All participants completed a robotic urethrovesical anastomosis task within a simulated operating room. In addition to the technical task, participants were required to manage three scripted NTS scenarios. Assessment was performed by five blinded expert surgeons and a NTS expert using validated tools for evaluating technical skills [Global Evaluative Assessment of Robotic Skills (GEARS)] and NTS [Non-Technical Skills for Surgeons (NOTSS)]. Quality of MI was assessed using a revised Movement Imagery Questionnaire (MIQ). In all, 33 participants underwent MI training and 29 underwent standard training. Interrater reliability was high, Krippendorff's α = 0.85. After MI training, the mean (sd) GEARS score was significantly higher than after standard training, at 13.1 (3.25) vs 11.4 (2.97) (P = 0.03). There was no difference in mean NOTSS scores, at 25.8 vs 26.4 (P = 0.77). MI training was successful with significantly higher imagery scores than standard training (mean MIQ score 5.1 vs 4.5, P = 0.04). Motor imagery is an effective training tool for improving technical skill in MIS even in novice participants. No beneficial effect for NTS was found. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

DETAIL OF DOORWAYS INTO ROOMS I18 (LEFT) AND 113 (RIGHT). ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL OF DOORWAYS INTO ROOMS I18 (LEFT) AND 113 (RIGHT). view TO NORTHWEST. - Plattsburgh Air Force Base, Target Intelligence Training Building-Combat Center, Off Connecticut Road, east of Idaho Avenue, Plattsburgh, Clinton County, NY

9. VIEW, LOOKING NORTH FROM LEFT TO RIGHT, SHOWING MEDICAL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. VIEW, LOOKING NORTH FROM LEFT TO RIGHT, SHOWING MEDICAL RESEARCH LABORATORY ANNEX, EXAMINING ROOM, AND EQUIPMENT ROOM - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

13. VIEW, LOOKING WEST FROM LEFT TO RIGHT, SHOWING HIGH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. VIEW, LOOKING WEST FROM LEFT TO RIGHT, SHOWING HIGH PRESSURE AIR FLASK ROOM AND PUMP ROOM - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

75 FR 53951 - North Pacific Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-02

...) Groundfish Plan Teams will meet in Seattle, WA. DATES: The meetings will be held September 20-23, 2010. The...., Building 4, Observer Training Room (GOA Plan Team) and Traynor Room (BS/AI Plan Team), Seattle, WA. Council...

Current State of Overlapping, Concurrent, and Multiple-Room Surgery in Otolaryngology: A National Survey.

PubMed

Cognetti, David M; Nussenbaum, Brian; Brenner, Michael J; Chi, David H; McCormick, Michael E; Venkatraman, Giri; Zhan, Tingting; McKinlay, Alex J

2017-12-01

Objective Multiple-room surgery has gained attention due to reports in the lay press scrutinizing the activity, with hospitals and the government collecting data on current practice. We studied practices and attitudes toward multiple-room surgery in otolaryngology. Methods A survey was developed by members of the Patient Safety and Quality Improvement Committee of the American Academy of Otolaryngology-Head and Neck Surgery. The survey was distributed to members of the Academy and included questions on demographics, current practices, and opinions regarding multiple-room surgery. The survey was designed to capture the spectrum of multidisciplinary, overlapping, and simultaneous/concurrent surgery practices. Data were collected via SurveyMonkey. Results A total of 907 of 9520 members completed the survey. Of the respondents, 40.4% reported performing some form of multiple-room surgery. Multiple-room surgery is more common amongst subspecialists than general otolaryngologists. Most believed that regulations disallowing multiple-room surgery would result in an increase in late starts (73.5%), an increase in the time to schedule surgery (84.5%), a detriment to residency training (63.1%), and no improvement in patient safety (60%.) Discussion Multiple-room surgery is common among responding otolaryngologists. Most respondents consider the practice to serve a role in facilitating access, efficiency, and training. Implications for Practice Due to recent attention placed on multiple-room surgery, institutions are reviewing policies regarding the practice. This survey suggests that policy changes that restrict multiple-room surgery must consider a potential unintended negative impact on patient care and access.

Trauma team leaders' non-verbal communication: video registration during trauma team training.

PubMed

Härgestam, Maria; Hultin, Magnus; Brulin, Christine; Jacobsson, Maritha

2016-03-25

There is widespread consensus on the importance of safe and secure communication in healthcare, especially in trauma care where time is a limiting factor. Although non-verbal communication has an impact on communication between individuals, there is only limited knowledge of how trauma team leaders communicate. The purpose of this study was to investigate how trauma team members are positioned in the emergency room, and how leaders communicate in terms of gaze direction, vocal nuances, and gestures during trauma team training. Eighteen trauma teams were audio and video recorded during trauma team training in the emergency department of a hospital in northern Sweden. Quantitative content analysis was used to categorize the team members' positions and the leaders' non-verbal communication: gaze direction, vocal nuances, and gestures. The quantitative data were interpreted in relation to the specific context. Time sequences of the leaders' gaze direction, speech time, and gestures were identified separately and registered as time (seconds) and proportions (%) of the total training time. The team leaders who gained control over the most important area in the emergency room, the "inner circle", positioned themselves as heads over the team, using gaze direction, gestures, vocal nuances, and verbal commands that solidified their verbal message. Changes in position required both attention and collaboration. Leaders who spoke in a hesitant voice, or were silent, expressed ambiguity in their non-verbal communication: and other team members took over the leader's tasks. In teams where the leader had control over the inner circle, the members seemed to have an awareness of each other's roles and tasks, knowing when in time and where in space these tasks needed to be executed. Deviations in the leaders' communication increased the ambiguity in the communication, which had consequences for the teamwork. Communication cannot be taken for granted; it needs to be practiced regularly just as technical skills need to be trained. Simulation training provides healthcare professionals the opportunity to put both verbal and non-verbal communication in focus, in order to improve patient safety. Non-verbal communication plays a decisive role in the interaction between the trauma team members, and so both verbal and non-verbal communication should be in focus in trauma team training. This is even more important for inexperienced leaders, since vague non-verbal communication reinforces ambiguity and can lead to errors.

Use of neurosurgical decision-making and damage-control neurosurgery courses in the Iraq and Afghanistan conflicts: a surgeon's experience.

PubMed

Teff, Richard J

2010-05-01

A shortage of Coalition neurological surgeons in the Iraq conflict prompted a creative approach to standardized neurosurgical care in 2007. After formulation of theater-wide clinical pathway guidelines, a need for standardized triage and neurological resuscitation was identified. The object was to establish a simple, reproducible course for medics, forward surgical and emergency room personnel, and other critical care providers to quickly standardize the ability of all deployed health care personnel to provide state-of-the-art neurosurgical triage and damage-control interventions. The methods applied were Microsoft PowerPoint presentations and hands-on learning. The year-long project resulted in more than 100 individuals being trained in neurosurgical decision making and in more than 15 surgeons being trained in damage-control neurosurgery. At the year's conclusion, hundreds of individuals received exceptional neurosurgical care from nonneurosurgical providers and a legacy course was left for future deployed providers to receive ongoing education at their own pace.

Medical Team Training Improves Team Performance: AOA Critical Issues.

PubMed

Carpenter, James E; Bagian, James P; Snider, Rebecca G; Jeray, Kyle J

2017-09-20

Effective teamwork and communication can decrease medical errors in environments where the culture of safety is enhanced. Health care can benefit from programs that are based on teamwork, as in other high-stress industries (e.g., aviation), with crew resource management programs, simulator use, and utilization of checklists. Medical team training (MTT) with a strong leadership commitment was used at our institution to focus specifically on creating open, yet structured, communication in operating rooms. Training included the 3 phases of the World Health Organization protocol to organize communication and briefings: preoperative verification, preincision briefing, and debriefing at or near the end of the surgical case. This training program led to measured improvements in job satisfaction and compliance with checklist tasks, and identified opportunities to improve training sessions. MTT provides the potential for sustainable change and a positive impact on the environment of the operating room.

Acceptability of the aquatic environment for exercise training by people with chronic obstructive pulmonary disease with physical comorbidities: Additional results from a randomised controlled trial.

PubMed

McNamara, Renae J; McKeough, Zoe J; McKenzie, David K; Alison, Jennifer A

2015-06-01

Water-based exercise training is a relatively new concept in the management of people with COPD. This study aimed to examine the acceptability of the aquatic environment as a medium for exercise training in people with COPD with physical comorbidities. Following a supervised eight week, three times a week, water-based exercise training programme conducted in a hospital hydrotherapy pool as part of a randomised controlled trial, participants completed a questionnaire about their experience with exercise training in the pool including adverse events, barriers and factors enabling exercise programme completion, satisfaction with the aquatic environment and their preference for an exercise training environment. All 18 participants (mean (SD) age 72 (10) years; FEV1% predicted 60 (10) %) who commenced the water-based exercise training programme completed the questionnaire. Three participants withdrew from training. High acceptability of the water and air temperature, shower and change-room facilities, staff assistance and modes of pool entry was reported (94% to 100%). Six factors were highly rated as enabling exercise programme adherence and completion: staff support (chosen by 93% of participants), enjoyment (80%), sense of achievement (80%), noticeable improvements (73%), personal motivation (73%) and participant support (53%). Eighty-nine percent of the participants indicated they would continue with water-based exercise. This study provides the first insight into the acceptability of the aquatic environment for exercise training in people with COPD and indicates water-based exercise and the aquatic environment is well accepted. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Objective Assessment of Surgical Technical Skill and Competency in the Operating Room.

PubMed

Vedula, S Swaroop; Ishii, Masaru; Hager, Gregory D

2017-06-21

Training skillful and competent surgeons is critical to ensure high quality of care and to minimize disparities in access to effective care. Traditional models to train surgeons are being challenged by rapid advances in technology, an intensified patient-safety culture, and a need for value-driven health systems. Simultaneously, technological developments are enabling capture and analysis of large amounts of complex surgical data. These developments are motivating a "surgical data science" approach to objective computer-aided technical skill evaluation (OCASE-T) for scalable, accurate assessment; individualized feedback; and automated coaching. We define the problem space for OCASE-T and summarize 45 publications representing recent research in this domain. We find that most studies on OCASE-T are simulation based; very few are in the operating room. The algorithms and validation methodologies used for OCASE-T are highly varied; there is no uniform consensus. Future research should emphasize competency assessment in the operating room, validation against patient outcomes, and effectiveness for surgical training.

75 FR 21365 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... DEPARTMENT OF LABOR Employment and Training Administration Investigations Regarding Certifications... Assistance, Employment and Training Administration, has instituted investigations pursuant to section 221(a... Training Administration, U.S. Department of Labor, Room N-5428, 200 Constitution Avenue, NW., Washington...

77 FR 46124 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-02

... DEPARTMENT OF LABOR Employment and Training Administration Investigations Regarding Eligibility To... and Training Administration, has instituted investigations pursuant to Section 221(a) of the Act. The... and Training Administration, U.S. Department of Labor, Room N-5428, 200 Constitution Avenue NW...

35. INTERIOR VIEW OF EQUIPMENT HOUSE, SUBMARINE ESCAPE TRAINING TANK, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

35. INTERIOR VIEW OF EQUIPMENT HOUSE, SUBMARINE ESCAPE TRAINING TANK, PRIOR TO ENLARGEMENT OF ROOM AND INSTALLATION OF TRIPLE-LOCK RECOMPRESSION CHAMBER IN 1957 - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

75 FR 10324 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

... DEPARTMENT OF LABOR Employment and Training Administration Investigations Regarding Certifications... Assistance, Employment and Training Administration, has instituted investigations pursuant to Section 221(a..., Employment and Training Administration, U.S. Department of Labor, Room N-5428, 200 Constitution Avenue, NW...

Cleaning Physical Education Areas.

ERIC Educational Resources Information Center

Griffin, William R.

1999-01-01

Discusses techniques to help create clean and inviting school locker rooms. Daily, weekly or monthly, biannual, and annual cleaning strategies for locker room showers are highlighted as are the specialized maintenance needs for aerobic and dance areas, running tracks, and weight training areas. (GR)

[Simulation-based training and OR apprenticeship for medical students : A prospective, randomized, single-blind study of clinical skills].

PubMed

Ott, T; Schmidtmann, I; Limbach, T; Gottschling, P F; Buggenhagen, H; Kurz, S; Pestel, G

2016-11-01

Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site. Whether SBT has an effect on medical students' skills in anesthesiology in the clinical setting is controversial. To explore this issue, we designed a prospective, randomized, single-blind trial that was integrated into the undergraduate anesthesiology curriculum of our department during the second year of the clinical phase of medical school. This study intended to explore the effect of SBT on medical students within the mandatory undergraduate anesthesiology curriculum of our department in the operating room with respect to basic skills in anesthesiology. After obtaining ethical approval, the participating students of the third clinical semester were randomized into two groups: the SIM-OR group was trained by a 225 min long SBT in basic skills in anesthesiology before attending the operating room (OR) apprenticeship. The OR-SIM group was trained after the operating room apprenticeship by SBT. During SBT the students were trained in five clinical skills detailed below. Further, two clinical scenarios were simulated using a full-scale simulator. The students had to prepare the patient and perform induction of anesthesia, including bag-mask ventilation after induction in scenario 1 and rapid sequence induction in scenario 2. Using the five-point Likert scale, five defined skills were evaluated at defined time points during the study period. 1) application of the safety checklist, 2) application of basic patient monitoring, 3) establishment of intravenous access, 4) bag-and-mask ventilation, and 5) adjustment of ventilatory parameters after the patients' airways were secured. A cumulative score of 5 points was defined as the best and a cumulative score of 25 as the worst rating for a defined time point. The primary endpoint was the cumulative score after day 1 in the operating room apprenticeship and the difference in cumulative scores from days 1 to 4. Our hypothesis was that the SIM-OR group would achieve a better score after day 1 in the operating room apprenticeship and would gain a larger increase in score from day 1 to day 4 than the OR-SIM group. 73 students were allocated to the OR-SIM group and 70 students to the SIM-OR group. There was no significant difference between the two groups after day 1 of the operating room apprenticeship and no difference in increase of the cumulative score from day 1 to day 4 (median of cumulative score on day 1: 'SIM-OR' 11.2 points vs. 'OR-SIM' 14.6 points; p = 0.067; median of difference from day 1 to day 4: 'SIM-OR' -3.7 vs. 'OR-SIM' -6.4; p = 0.110). With the methods applied, this study could not prove that 225 min of SBT before the operating room apprenticeship increased the medical students' clinical skills as evaluated in the operating room. Secondary endpoints indicate that medical students have better clinical skills at the end of the entire curriculum when they have been trained through SBT before the operating room apprenticeship. However, the authors believe that simulator training has a positive impact on students' acquisition of procedural and patient safety skills, even if the methods applied in this study may not mirror this aspect sufficiently.

KSC-06pd0396

NASA Image and Video Library

2006-03-01

KENNEDY SPACE CENTER, FLA. - The Operations Support Building II at NASA's Kennedy Space Center is seen here, newly built and landscaped. The building replaced modular housing and trailers in the Launch Complex 39 area. The five-story, 189,000-square-foot building consists of approximately 860 office spaces, training rooms, computer rooms, multimedia conference rooms, technical libraries, and a 352-person mission conference center with observation deck. Photo credit: Cory Huston

Operator's Manual, Boiler Room Operations and Maintenance. Supplement A, Air Pollution Training Institute Self-Instructional Course SI-466.

ERIC Educational Resources Information Center

Environmental Protection Agency, Research Triangle Park, NC. Air Pollution Training Inst.

This Operator's Manual is a supplement to a self-instructional course prepared for the United States Environmental Protection Agency. This publication is the Boiler Room Handbook for operating and maintaining the boiler and the boiler room. As the student completes this handbook, he is putting together a manual for running his own boiler. The…

Maximizing time from the constraining European Working Time Directive (EWTD): The Heidelberg New Working Time Model.

PubMed

Schimmack, Simon; Hinz, Ulf; Wagner, Andreas; Schmidt, Thomas; Strothmann, Hendrik; Büchler, Markus W; Schmitz-Winnenthal, Hubertus

2014-01-01

The introduction of the European Working Time Directive (EWTD) has greatly reduced training hours of surgical residents, which translates into 30% less surgical and clinical experience. Such a dramatic drop in attendance has serious implications such compromised quality of medical care. As the surgical department of the University of Heidelberg, our goal was to establish a model that was compliant with the EWTD while avoiding reduction in quality of patient care and surgical training. We first performed workload analyses and performance statistics for all working areas of our department (operation theater, emergency room, specialized consultations, surgical wards and on-call duties) using personal interviews, time cards, medical documentation software as well as data of the financial- and personnel-controlling sector of our administration. Using that information, we specifically designed an EWTD-compatible work model and implemented it. Surgical wards and operating rooms (ORs) were not compliant with the EWTD. Between 5 pm and 8 pm, three ORs were still operating two-thirds of the time. By creating an extended work shift (7:30 am-7:30 pm), we effectively reduced the workload to less than 49% from 4 pm and 8 am, allowing the combination of an eight-hour working day with a 16-hour on call duty; thus, maximizing surgical resident training and ensuring patient continuity of care while maintaining EDTW guidelines. A precise workload analysis is the key to success. The Heidelberg New Working Time Model provides a legal model, which, by avoiding rotating work shifts, assures quality of patient care and surgical training.

Simulation in laparoscopic surgery.

PubMed

León Ferrufino, Felipe; Varas Cohen, Julián; Buckel Schaffner, Erwin; Crovari Eulufi, Fernando; Pimentel Müller, Fernando; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Boza Wilson, Camilo

2015-01-01

Nowadays surgical trainees are faced with a more reduced surgical practice, due to legal limitations and work hourly constraints. Also, currently surgeons are expected to dominate more complex techniques such as laparoscopy. Simulation emerges as a complementary learning tool in laparoscopic surgery, by training in a safe, controlled and standardized environment, without jeopardizing patient' safety. Simulation' objective is that the skills acquired should be transferred to the operating room, allowing reduction of learning curves. The use of simulation has increased worldwide, becoming an important tool in different surgical residency programs and laparoscopic training courses. For several countries, the approval of these training courses are a prerequisite for the acquisition of surgeon title certifications. This article reviews the most important aspects of simulation in laparoscopic surgery, including the most used simulators and training programs, as well as the learning methodologies and the different key ways to assess learning in simulation. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Virtual reality colonoscopy simulation: a compulsory practice for the future colonoscopist?

PubMed

Ahlberg, G; Hultcrantz, R; Jaramillo, E; Lindblom, A; Arvidsson, D

2005-12-01

As for any manual procedure, the learning curves for medical interventions can have undesirable phases, occurring mostly in the early experience of applying a technique. There have been impressive advances in endoscopic procedures during recent years, and there is an emerging trend that the number of procedures is increasing in parallel with these. In addition, the introduction of screening programs for colorectal cancer will also increase the numbers of procedures needed. Recent developments in medical simulation seem promising with regard to the possibility of "training out" undesirable parts of the learning curve outside the operating room. The aim of this study was to investigate whether the use of the AccuTouch flexible endoscopy simulator improves the early part of the learning curve in colonoscopy training. 12 endoscopy trainees, 10 surgeons and two medical gastroenterologists, all with experience in gastroscopy but with no specific colonoscopy experience, were randomly assigned to either simulator training or to a control group. They all received the same theoretical study package and the training group practiced with the AccuTouch colonoscopy simulator until a predefined expert level of performance was reached. All trainees performed their first ten individual colonoscopies described in detail in a separate protocol. Trainees in the simulator-trained group performed significantly better (P=0.0011) and managed to reach the cecum in 52% of their cases (vs. 19% in the control group), and were 4.53 times more likely to succeed compared with the controls. Additionally, there was a significantly shorter procedure time and less patient discomfort in the hands of the simulator-trained group. Skills acquired using the AccuTouch simulator transfer well into the clinical colonoscopy environment. The results of this trial clearly support the plan to integrate simulator training into endoscopic education curricula.

143. ARAIII Control building (ARA607) Floor plan. Shows control room, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

143. ARA-III Control building (ARA-607) Floor plan. Shows control room, contaminated work area, counting and computer room, health physics room, instrument repair room, offices, and other rooms. Aerojet-general 880-area/GCRE-607-A-1. Date: February 1958. Ineel index code no. 063-0607-00-013-102546. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

An anatomically sound surgical simulation model for myringotomy and tympanostomy tube insertion.

PubMed

Hong, Paul; Webb, Amanda N; Corsten, Gerard; Balderston, Janet; Haworth, Rebecca; Ritchie, Krista; Massoud, Emad

2014-03-01

Myringotomy and tympanostomy tube insertion (MT) is a common surgical procedure. Although surgical simulation has proven to be an effective training tool, an anatomically sound simulation model for MT is lacking. We developed such a model and assessed its impact on the operating room performance of senior medical students. Prospective randomized trial. A randomized single-blind controlled study of simulation training with the MT model versus no simulation training. Each participant was randomized to either the simulation model group or control group, after performing an initial MT procedure. Within two weeks of the first procedure, the students performed a second MT. All procedures were performed on real patients and rated with a Global Rating Scale by two attending otolaryngologists. Time to complete the MT was also recorded. Twenty-four senior medical students were enrolled. Control and intervention groups did not differ at baseline on their Global Rating Scale score or time to complete the MT procedure. Following simulation training, the study group received significantly higher scores (P=.005) and performed the MT procedure in significantly less time (P=.034). The control group did not improve their performance scores (P>.05) or the time to complete the procedure (P>.05). Our surgical simulation model shows promise for being a valuable teaching tool for MT for senior medical students. Such anatomically appropriate physical simulators may benefit teaching of junior trainees. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Zinc Bromide Flow Battery Installation for Islanding and Backup Power

DTIC Science & Technology

2016-09-18

ability to control the generation has become more difficult with the increase of renewable energy systems such as solar photovoltaics ( PV ) and wind... PV and Inverter Room Building 6311 Rooftop Solar PV 30kW 232kW STC PV Array B5-PS2T33 Pad Switchboard ZnBr Energy Storage System (ESS) PowerBoxEnergy...Agreement • 1.5 MW of Photovoltaic • PV Parking lot lights • 24 Solar Thermal systems including the Combat Training Tank (Pool) Energy/Water Efficiency

75 FR 52372 - Agency Information Collection Activities; Proposals, Submissions, and Approvals

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-25

... information technology, e.g., permitting electronic submission of responses. Agency: Employment and Training Administration. Type of Review: New. Title of Collection: Evaluation of the Community-Based Job Training Grants... Department of Labor--Employment and Training Administration, Room 10235, Washington, DC 20503, Telephone: 202...

Human factors in telemanipulation: Perspectives from the Oak Ridge National Laboratory experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Draper, J.V.

1994-01-01

Personnel at the Robotics and Process Systems Division (RPSD) of the Oak Ridge National Laboratory (ORNL) have extensive experience designing, building, and operating teleoperators for a variety of settings, including space, battlefields, nuclear fuel reprocessing plants, and hazardous waste retrieval. In the course of the last decade and a half, the RPSD designed, built, and operated 4 telemanipulators (M-2, ASM, LTM, CESAR arm) and operated another half dozen (M-8, Model 50, TOS SM-229, RM-10, PaR 5000, BilArm 83A). During this period, human factors professionals have been closely integrated with RPSD design teams, investigating telemanipulator feedback and feed forward, designing cockpitsmore » and control rooms, training users and designers, and helping to develop performance specifications for telemanipulators. This paper presents a brief review of this and other work, with an aim towards providing perspectives on some of the human factors aspects of telemanipulation. The first section of the paper examines user tasks during supervisory control and discusses how telemanipulator responsiveness determines the appropriate control metaphor for continuous manual control. The second section provides an ecological perspective on telemanipulator feedback and feed-forward. The third section briefly describes the RPSD control room design approach and how design projects often serve as systems integrators.« less

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department.

PubMed

Thomas, Anita A; Uspal, Neil G; Oron, Assaf P; Klein, Eileen J

2016-12-01

Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills ( P  < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use ( P  = .30, paired difference -0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use ( P  < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use ( P  < .05, paired difference -0.4 points). Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training.

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department

PubMed Central

Thomas, Anita A.; Uspal, Neil G.; Oron, Assaf P.; Klein, Eileen J.

2016-01-01

Background  Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. Objective  We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Methods  Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Results  Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills (P < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use (P = .30, paired difference −0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use (P < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use (P < .05, paired difference −0.4 points). Conclusions  Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training. PMID:28018542

[Justifying measures to correct functional state of operators varying in personal anxiety].

PubMed

2012-01-01

Workers of operating and dispatching occupations are exposed to high nervous and emotional exertion that result in increased personal anxiety, working stress and overstrain. That requires physiologically justified correction of hazardous psycho-physiologic states via various prophylactic measures (stay in schungite room, autogenous training, central electric analgesia, electric acupuncture). Attempted relaxation sessions in schungite room revealed in highly anxious individuals an increased velocity of visual signals perception, of attention concentration and shifting. Autogenous training sessions improve memory and have significant hypotensive effect in highly anxious individuals.

FRAMEWORK AND APPLICATION FOR MODELING CONTROL ROOM CREW PERFORMANCE AT NUCLEAR POWER PLANTS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ronald L Boring; David I Gertman; Tuan Q Tran

2008-09-01

This paper summarizes an emerging project regarding the utilization of high-fidelity MIDAS simulations for visualizing and modeling control room crew performance at nuclear power plants. The key envisioned uses for MIDAS-based control room simulations are: (i) the estimation of human error associated with advanced control room equipment and configurations, (ii) the investigative determination of contributory cognitive factors for risk significant scenarios involving control room operating crews, and (iii) the certification of reduced staffing levels in advanced control rooms. It is proposed that MIDAS serves as a key component for the effective modeling of cognition, elements of situation awareness, and riskmore » associated with human performance in next generation control rooms.« less

46 CFR 12.602 - Basic training.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Swimming while wearing a lifejacket. (v) Keeping afloat without a lifejacket. (2) Fire prevention and... extinguishers. (ii) Extinguishing smaller fires. e.g., electrical fires, oil fires, and propane fires. (iii... firefighting agent in an accommodation room or simulated engine room with fire and heavy smoke. (vii...

26. VIEW OF PUMP ROOM, SHOWING PORTIONS OF HIGH PRESSURE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

26. VIEW OF PUMP ROOM, SHOWING PORTIONS OF HIGH PRESSURE AIR SYSTEM AT LEFT AND CENTER AND OVERFLOW STORAGE TANK AT RIGHT, LOOKING NORTHWEST - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

10. CONTROL ROOM INTERIOR. Looking into southwest corner. CONTROL ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. CONTROL ROOM INTERIOR. Looking into southwest corner. CONTROL ROOM INTERIOR, SHOWING ESCAPE HATCH. Looking north along east wall. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Instrumentation & Control Building, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

Does a surgical simulator improve resident operative performance of laparoscopic tubal ligation?

PubMed

Banks, Erika H; Chudnoff, Scott; Karmin, Ira; Wang, Cuiling; Pardanani, Setul

2007-11-01

The purpose of this study was to assess whether a surgical skills simulator laboratory improves resident knowledge and operative performance of laparoscopic tubal ligation. Twenty postgraduate year 1 residents were assigned randomly to either a surgical simulator laboratory on laparoscopic tubal ligation together with apprenticeship teaching in the operating room or to apprenticeship teaching alone. Tests that were given before and after the training assessed basic knowledge. Attending physicians who were blinded to resident randomization status evaluated postgraduate year 1 performance on a laparoscopic tubal ligation in the operating room with 3 validated tools: a task-specific checklist, global rating scale, and pass/fail grade. Postgraduate year 1 residents who were assigned randomly to the surgical simulator laboratory performed significantly better than control subjects on all 3 surgical assessment tools (the checklist, the global score, and the pass/fail analysis) and scored significantly better on the knowledge posttest (all P < .0005). Compared with apprenticeship teaching alone, a surgical simulator laboratory on laparoscopic tubal ligation improved resident knowledge and performance in the operating room.

SIG -- The Role of Human-Computer Interaction in Next-Generation Control Rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ronald L. Boring; Jacques Hugo; Christian Richard

2005-04-01

The purpose of this CHI Special Interest Group (SIG) is to facilitate the convergence between human-computer interaction (HCI) and control room design. HCI researchers and practitioners actively need to infuse state-of-the-art interface technology into control rooms to meet usability, safety, and regulatory requirements. This SIG outlines potential HCI contributions to instrumentation and control (I&C) and automation in control rooms as well as to general control room design.

Energy Systems Integration Facility Control Room | Energy Systems

Science.gov Websites

Integration Facility | NREL Energy Systems Integration Facility Control Room Energy Systems Integration Facility Control Room The Energy Systems Integration Facility control room allows system engineers as the monitoring point for the facility's integrated safety and control systems. Photo of employees

Task Engagement in Young Adults with High-Functioning Autism Spectrum Disorders: Generalization Effects of Behavioral Skills Training

ERIC Educational Resources Information Center

Palmen, Annemiek; Didden, Robert

2012-01-01

This study evaluated the effectiveness of a behavioral skills training package on task engagement in six young adults with high-functioning ASD who worked in a regular job-training setting. Experimental sessions were implemented in a small-group training format in a therapy room using unknown tasks. Data were collected on participant's off-task…

Document handover of ISS Flight Control room to new Flight Control Room in old MCC

NASA Image and Video Library

2006-10-06

JSC2006-E-43863 (6 Oct. 2006)--- International Space Station flight controllers have this area as their new home with increased technical capabilities, more workspace and a long, distinguished history. The newly updated facility is just down the hall from its predecessor at NASA's Johnson Space Center, Houston. This view is toward the rear of the "new" room. Known as Flight Control Room 1, it was first used to control a space flight 38 years ago, the mission of Apollo 7 launched Oct. 11, 1968. It was one of two control rooms for NASA's manned missions. The room it replaces in its new ISS role, designated the Blue Flight Control Room, had been in operation since the first station component was launched in 1998.

Characterization of Train-Induced Vibration and its Effect on Fecal Corticosterone Metabolites in Mice

PubMed Central

Atanasov, Nicholas A; Sargent, Jennifer L; Parmigiani, John P; Palme, Rupert; Diggs, Helen E

2015-01-01

Excessive environmental vibrations can have deleterious effects on animal health and experimental results, but they remain poorly understood in the animal laboratory setting. The aims of this study were to characterize train-associated vibration in a rodent vivarium and to assess the effects of this vibration on the reproductive success and fecal corticosterone metabolite levels of mice. An instrumented cage, featuring a high-sensitivity microphone and accelerometer, was used to characterize the vibrations and sound in a vivarium that is near an active railroad. The vibrations caused by the passing trains are 3 times larger in amplitude than are the ambient facility vibrations, whereas most of the associated sound was below the audible range for mice. Mice housed in the room closest to the railroad tracks had pregnancy rates that were 50% to 60% lower than those of mice of the same strains but bred in other parts of the facility. To verify the effect of the train vibrations, we used a custom-built electromagnetic shaker to simulate the train-induced vibrations in a controlled environment. Fecal pellets were collected from male and female mice that were exposed to the simulated vibrations and from unexposed control animals. Analysis of the fecal samples revealed that vibrations similar to those produced by a passing train can increase the levels of fecal corticosterone metabolites in female mice. These increases warrant attention to the effects of vibration on mice and, consequently, on reproduction and experimental outcomes. PMID:26632783

Characterization of Train-Induced Vibration and its Effect on Fecal Corticosterone Metabolites in Mice.

PubMed

Atanasov, Nicholas A; Sargent, Jennifer L; Parmigiani, John P; Palme, Rupert; Diggs, Helen E

2015-11-01

Excessive environmental vibrations can have deleterious effects on animal health and experimental results, but they remain poorly understood in the animal laboratory setting. The aims of this study were to characterize train-associated vibration in a rodent vivarium and to assess the effects of this vibration on the reproductive success and fecal corticosterone metabolite levels of mice. An instrumented cage, featuring a high-sensitivity microphone and accelerometer, was used to characterize the vibrations and sound in a vivarium that is near an active railroad. The vibrations caused by the passing trains are 3 times larger in amplitude than are the ambient facility vibrations, whereas most of the associated sound was below the audible range for mice. Mice housed in the room closest to the railroad tracks had pregnancy rates that were 50% to 60% lower than those of mice of the same strains but bred in other parts of the facility. To verify the effect of the train vibrations, we used a custom-built electromagnetic shaker to simulate the train-induced vibrations in a controlled environment. Fecal pellets were collected from male and female mice that were exposed to the simulated vibrations and from unexposed control animals. Analysis of the fecal samples revealed that vibrations similar to those produced by a passing train can increase the levels of fecal corticosterone metabolites in female mice. These increases warrant attention to the effects of vibration on mice and, consequently, on reproduction and experimental outcomes.

The costs and quality of operative training for residents in tympanoplasty type I.

PubMed

Wang, Mao-Che; Yu, Eric Chen-Hua; Shiao, An-Suey; Liao, Wen-Huei; Liu, Chia-Yu

2009-05-01

A teaching hospital would incur more operation room costs on training surgical residents. To evaluate the increased operation time and the increased operation room costs of operations performed by surgical residents. As a model we used a very common surgical otology procedure -- tympanoplasty type I. From January 1, 2004 to December 31, 2004, we included in this study 100 patients who received tympanoplasty type I in Taipei Veterans General Hospital. Fifty-six procedures were performed by a single board-certified surgeon and 44 procedures were performed by residents. We analyzed the operation time and surgical outcomes in these two groups of patients. The operation room cost per minute was obtained by dividing the total operation room expenses by total operation time in the year 2004. The average operation time of residents was 116.47 min, which was significantly longer (p<0.0001) than that of the board-certified surgeon (average 81.07 min). It cost USD $40.36 more for each operation performed by residents in terms of operation room costs. The surgical success rate of residents was 81.82%, which was significantly lower (p=0.016) than that of the board-certified surgeon (96.43%).

77 FR 64116 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-18

... Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting In accordance with section... following meeting: Name: Advisory Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD... and Dentistry, Bureau of Health Professions, Health Resources and Services Administration, Room 9A-27...

The Current State of Middle Management Preparation, Training, and Development in Academic Libraries

ERIC Educational Resources Information Center

Rooney, Michael P.

2010-01-01

This study examined the management experience, preparation, and training possessed by middle managers in academic libraries through the analysis of survey results. The analysis showed both advances in middle management preparation over recent decades and room for improvement in several aspects of management development and training within the…

A Mode of Government-Enterprise-University-Institute-Employer Cooperation for Innovative Postgraduate Cultivation

ERIC Educational Resources Information Center

Tu, Yaqing; Yang, Huiyue; Shu, Li; Tu, Wangshu; Chen, Baoxin

2015-01-01

Innovative talent training is an important task of postgraduate education. From the survey of innovative postgraduate training in China, we conclude that there is still much room for improvement in the innovative postgraduate cultivation. The survey shows that insufficient professional practice, simplex training mode and a mismatch between…

Staphylococcus aureus and Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) in and Around Therapeutic Whirlpools in College Athletic Training Rooms

PubMed Central

Kahanov, Leamor; Kim, Young Kyun; Eberman, Lindsey; Dannelly, Kathleen; Kaur, Haninder; Ramalinga, A.

2015-01-01

Context: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a leading cause of skin and soft tissue infection in the nonhospitalized community. Care of the athletes in athletic training rooms is specifically designed with equipment tailored to the health care needs of the athletes, yet recent studies indicate that CA-MRSA is still prevalent in athletic facilities and that cleaning methods may not be optimal. Objective: To investigate the prevalence of Staphylococcus aureus and CA-MRSA in and around whirlpools in the athletic training room. Design: Cross-sectional study. Setting: National Collegiate Athletic Association Division I university. Patients or Other Participants: Student-athletes (n = 109) consisting of 46 men (42%) and 63 women (58%) representing 6 sports. Main Outcome Measure(s): Presence of MRSA and Staphylococcus aureus in and around the whirlpool structures relative to sport and number of athletes using the whirlpools. Results: We identified Staphylococcus aureus in 22% (n = 52/240) of the samples and MRSA in 0.8% (n = 2/240). A statistically significant difference existed between the number of athletes using the whirlpool and the presence of Staphylococcus aureus in and around the whirlpools (F2,238 = 2.445, P = .007). However, Staphylococcus aureus was identified regardless of whether multiple athletes used a whirlpool or no athletes used a whirlpool. We did not identify a relationship between the number of athletes who used a whirlpool and Staphylococcus aureus or MRSA density (P = .134). Conclusions: Staphylococcus aureus and MRSA were identified in and around the whirlpools. Transmission of the bacteria can be reduced by following the cleaning and disinfecting protocols recommended by the Centers for Disease Control and Prevention. Athletic trainers should use disinfectants registered by the Environmental Protection Agency to sanitize all whirlpools between uses. PMID:25710853

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ragan, Eric D; Bowman, Doug A; Scerbo, Siroberto

Virtual reality (VR) systems have been proposed for use in numerous training scenarios, such as room clearing, which require the trainee to maintain spatial awareness. But many VR training systems lack a fully surrounding display, requiring trainees to use a combination of physical and virtual turns to view the environment, thus decreasing spatial awareness. One solution to this problem is to amplify head rotations, such that smaller physical turns are mapped to larger virtual turns, allowing trainees to view the surrounding environment with head movements alone. For example, in a multi-monitor system covering only a 90-degree field of regard, headmore » rotations could be amplified four times to allow the user to see the entire 360-degree surrounding environment. This solution is attractive because it can be used with lower-cost VR systems and does not require virtual turning. However, the effects of amplified head rotations on spatial awareness and training transfer are not well understood. We hypothesized that small amounts of amplification might be tolerable, but that larger amplifications might cause trainees to become disoriented and to have decreased task performance and training transfer. In this paper, we will present our findings from an experiment designed to investigate these hypotheses. The experiment placed users in a virtual warehouse and asked them to move from room to room, counting objects placed around them in space. We varied the amount of amplification applied during these trials, and also varied the type of display used (head-mounted display or CAVE). We measured task performance and spatial awareness. We then assessed training transfer in an assessment environment with a fully surrounding display and no amplification. The results of this study will inform VR training system developers about the potential negative effects of using head rotation amplification and contribute to more effective VR training system design.« less

OVERVIEW OF SECOND FLOOR CONFERENCE ROOM. VIEW FACING NORTHWEST ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

OVERVIEW OF SECOND FLOOR CONFERENCE ROOM. VIEW FACING NORTHWEST - U.S. Naval Base, Pearl Harbor, Ford Island Polaris Missile Lab & U.S. Fleet Ballistic Missile Submarine Training Center, Between Lexington Boulvevard and the sea plane ramps on the southwest side of Ford Island, Pearl City, Honolulu County, HI

77 FR 65535 - North Pacific Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... Islands (BSAI) Groundfish Plan Teams will meet in Seattle, WA. DATES: The meetings will be held November... NE., Building 4, Observer Training Room 1055 (GOA Plan Team) and Traynor Room 2076 (BS/AI Plan Team... Fishery Management Council; telephone: (907) 271-2809. SUPPLEMENTARY INFORMATION: The Plan Teams will...

Classroom Management and the Socially Disadvantaged.

ERIC Educational Resources Information Center

Ogletree, Earl

Because of their deficits in academic attainments and different cultural styles, socially disadvantaged children create more potential than other children for classroom management problems. To improve classroom management, teachers should maintain a clean room and train their students to enter that room in an orderly fashion. In dealing with their…

"My Daddy's Number Is C-92760."

ERIC Educational Resources Information Center

Hughes, James E.

1982-01-01

Specially trained inmates in a maximum security prison supervised a play area in the prison visiting room where children could play in a safe and structured way with materials appropriate to their developmental needs. Children were thus able to master, in age-appropriate ways, the circumstances of the visiting room. (Author/CMG)

75 FR 67450 - Pipeline Safety: Control Room Management Implementation Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-02

... PHMSA-2010-0294] Pipeline Safety: Control Room Management Implementation Workshop AGENCY: Pipeline and...) on the implementation of pipeline control room management. The workshop is intended to foster an understanding of the Control Room Management Rule issued by PHMSA on December 3, 2009, and is open to the public...

Little room for error in Canada's postgraduate training system

PubMed Central

Robertson, S

1997-01-01

Although the majority of physicians entering residency training in Canada will enjoy fulfilling careers in their chosen specialty, today's postgraduate training system has its critics. Among them are the new graduates who are not satisfied with the residency positions offered to them and practising physicians who would like to re-enter the system to train in a new specialty but find themselves locked out. PMID:9068578

Maximizing time from the constraining European Working Time Directive (EWTD): The Heidelberg New Working Time Model

PubMed Central

2014-01-01

Background The introduction of the European Working Time Directive (EWTD) has greatly reduced training hours of surgical residents, which translates into 30% less surgical and clinical experience. Such a dramatic drop in attendance has serious implications such compromised quality of medical care. As the surgical department of the University of Heidelberg, our goal was to establish a model that was compliant with the EWTD while avoiding reduction in quality of patient care and surgical training. Methods We first performed workload analyses and performance statistics for all working areas of our department (operation theater, emergency room, specialized consultations, surgical wards and on-call duties) using personal interviews, time cards, medical documentation software as well as data of the financial- and personnel-controlling sector of our administration. Using that information, we specifically designed an EWTD-compatible work model and implemented it. Results Surgical wards and operating rooms (ORs) were not compliant with the EWTD. Between 5 pm and 8 pm, three ORs were still operating two-thirds of the time. By creating an extended work shift (7:30 am-7:30 pm), we effectively reduced the workload to less than 49% from 4 pm and 8 am, allowing the combination of an eight-hour working day with a 16-hour on call duty; thus, maximizing surgical resident training and ensuring patient continuity of care while maintaining EDTW guidelines. Conclusion A precise workload analysis is the key to success. The Heidelberg New Working Time Model provides a legal model, which, by avoiding rotating work shifts, assures quality of patient care and surgical training. PMID:25984433

Informatics in radiology: use of a C-arm fluoroscopy simulator to support training in intraoperative radiography.

PubMed

Bott, Oliver Johannes; Dresing, Klaus; Wagner, Markus; Raab, Björn-Werner; Teistler, Michael

2011-01-01

Mobile image intensifier systems (C-arms) are used frequently in orthopedic and reconstructive surgery, especially in trauma and emergency settings, but image quality and radiation exposure levels may vary widely, depending on the extent of the C-arm operator's knowledge and experience. Current training programs consist mainly of theoretical instruction in C-arm operation, the physical foundations of radiography, and radiation avoidance, and are largely lacking in hands-on application. A computer-based simulation program such as that tested by the authors may be one way to improve the effectiveness of C-arm training. In computer simulations of various scenarios commonly encountered in the operating room, trainees using the virtX program interact with three-dimensional models to test their knowledge base and improve their skill levels. Radiographs showing the simulated patient anatomy and surgical implants are "reconstructed" from data computed on the basis of the trainee's positioning of models of a C-arm, patient, and table, and are displayed in real time on the desktop monitor. Trainee performance is signaled in real time by color graphics in several control panels and, on completion of the exercise, is compared in detail with the performance of an expert operator. Testing of this computer-based training program in continuing medical education courses for operating room personnel showed an improvement in the overall understanding of underlying principles of intraoperative radiography performed with a C-arm, with resultant higher image quality, lower overall radiation exposure, and greater time efficiency. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.313105125/-/DC1. Copyright © RSNA, 2011.

Expedition 19 Crew Training

NASA Image and Video Library

2009-03-20

Expedition 19 Commander Gennady I. Padalka is seen through a quarantine windowed room as he and other crew memebers participate in Soyuz rendezvous and docking training at the Cosmonaut Hotel, Saturday, March 21, 2009 in Baikonur, Kazakhstan. (Photo Credit: NASA/Bill Ingalls)

Comprehensive Training Curricula for Minimally Invasive Surgery

PubMed Central

Palter, Vanessa N

2011-01-01

Background The unique skill set required for minimally invasive surgery has in part contributed to a certain portion of surgical residency training transitioning from the operating room to the surgical skills laboratory. Simulation lends itself well as a method to shorten the learning curve for minimally invasive surgery by allowing trainees to practice the unique motor skills required for this type of surgery in a safe, structured environment. Although a significant amount of important work has been done to validate simulators as viable systems for teaching technical skills outside the operating room, the next step is to integrate simulation training into a comprehensive curriculum. Objectives This narrative review aims to synthesize the evidence and educational theories underlining curricula development for technical skills both in a broad context and specifically as it pertains to minimally invasive surgery. Findings The review highlights the critical aspects of simulation training, such as the effective provision of feedback, deliberate practice, training to proficiency, the opportunity to practice at varying levels of difficulty, and the inclusion of both cognitive teaching and hands-on training. In addition, frameworks for integrating simulation training into a comprehensive curriculum are described. Finally, existing curricula on both laparoscopic box trainers and virtual reality simulators are critically evaluated. PMID:22942951

Document handover of ISS Flight Control room to new Flight Control Room in old MCC

NASA Image and Video Library

2006-10-06

JSC2006-E-43860 (6 Oct. 2006)--- International Space Station flight controllers have this area as their new home with increased technical capabilities, more workspace and a long, distinguished history. The newly updated facility is just down the hall from its predecessor at NASA's Johnson Space Center, Houston. Known as Flight Control Room 1, it was first used to control a space flight 38 years ago, the mission of Apollo 7 launched Oct. 11, 1968. It was one of two control rooms for NASA's manned missions. The room it replaces in its new ISS role, designated the Blue Flight Control Room, had been in operation since the first station component was launched in 1998.

A pilot study of the utility of a laboratory-based spinal fixation training program for neurosurgical residents.

PubMed

Sundar, Swetha J; Healy, Andrew T; Kshettry, Varun R; Mroz, Thomas E; Schlenk, Richard; Benzel, Edward C

2016-05-01

OBJECTIVE Pedicle and lateral mass screw placement is technically demanding due to complex 3D spinal anatomy that is not easily visualized. Neurosurgical and orthopedic surgery residents must be properly trained in such procedures, which can be associated with significant complications and associated morbidity. Current training in pedicle and lateral mass screw placement involves didactic teaching and supervised placement in the operating room. The objective of this study was to assess whether teaching residents to place pedicle and lateral mass screws using navigation software, combined with practice using cadaveric specimens and Sawbones models, would improve screw placement accuracy. METHODS This was a single-blinded, prospective, randomized pilot study with 8 junior neurosurgical residents and 2 senior medical students with prior neurosurgery exposure. Both the study group and the level of training-matched control group (each group with 4 level of training-matched residents and 1 senior medical student) were exposed to a standardized didactic education regarding spinal anatomy and screw placement techniques. The study group was exposed to an additional pilot program that included a training session using navigation software combined with cadaveric specimens and accessibility to Sawbones models. RESULTS A statistically significant reduction in overall surgical error was observed in the study group compared with the control group (p = 0.04). Analysis by spinal region demonstrated a significant reduction in surgical error in the thoracic and lumbar regions in the study group compared with controls (p = 0.02 and p = 0.04, respectively). The study group also was observed to place screws more optimally in the cervical, thoracic, and lumbar regions (p = 0.02, p = 0.04, and p = 0.04, respectively). CONCLUSIONS Surgical resident education in pedicle and lateral mass screw placement is a priority for training programs. This study demonstrated that compared with a didactic-only training model, using navigation simulation with cadavers and Sawbones models significantly reduced the number of screw placement errors in a laboratory setting.

Effectiveness of Virtual Reality Training in Orthopaedic Surgery.

PubMed

Aïm, Florence; Lonjon, Guillaume; Hannouche, Didier; Nizard, Rémy

2016-01-01

The purpose of this study was to conduct a systematic review to determine the effectiveness of virtual reality (VR) training in orthopaedic surgery. A comprehensive systematic review was performed of articles of VR training in orthopaedic surgery published up to November 2014 from MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases. We included 10 relevant trials of 91 identified articles, which all reported on training in arthroscopic surgery (shoulder, n = 5; knee, n = 4; undefined, n = 1). A total of 303 participants were involved. Assessment after training was made on a simulator in 9 of the 10 studies, and in one study it took place in the operating room (OR) on a real patient. A total of 32 different outcomes were extracted; 29 of them were about skills assessment. None involved a patient-related outcome. One study focused on anatomic learning, and the other evaluated technical task performance before and after training on a VR simulator. Five studies established construct validity. Three studies reported a statistically significant improvement in technical skills after training on a VR simulator. VR training leads to an improvement of technical skills in orthopaedic surgery. Before its widespread use, additional trials are needed to clarify the transfer of VR training to the OR. Systematic review of Level I through Level IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room.

PubMed

Yule, Steven; Parker, Sarah Henrickson; Wilkinson, Jill; McKinley, Aileen; MacDonald, Jamie; Neill, Adrian; McAdam, Tim

2015-01-01

To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03). Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Leadership in Surgery for Public Sector Hospitals in Jamaica: Strategies for the Operating Room

PubMed Central

Cawich, Shamir O; Harding, Hyacinth E; Crandon, Ivor W; McGaw, Clarence D; Barnett, Alan T; Tennant, Ingrid; Evans, Necia R; Martin, Allie C; Simpson, Lindberg K; Johnson, Peter

2013-01-01

The barriers to health care delivery in developing nations are many: underfunding, limited support services, scarce resources, suboptimal health care worker attitudes, and deficient health care policies are some of the challenges. The literature contains little information about health care leadership in developing nations. This discursive paper examines the impact of leadership on the delivery of operating room (OR) services in public sector hospitals in Jamaica. Delivery of OR services in Jamaica is hindered by many unique cultural, financial, political, and environmental barriers. We identify six leadership goals adapted to this environment to achieve change. Effective leadership must adapt to the environment. Delivery of OR services in Jamaica may be improved by addressing leadership training, workplace safety, interpersonal communication, and work environment and by revising existing policies. Additionally, there should be regular practice audits and quality control surveys. PMID:24355903

Housing and testing in mixed-sex rooms increases motivation and accuracy during operant testing in both male and female mice.

PubMed

Lloyd, Kelsey R; Yaghoubi, Sarah K; Makinson, Ryan A; McKee, Sarah E; Reyes, Teresa M

2018-04-01

Operant behavior tasks are widely used in neuroscience research, but little is known about how variables such as housing and testing conditions affect rodent operant performance. We have previously observed differences in operant performance in male and female mice depending on whether mice were housed and tested in rooms containing only one sex versus rooms containing both sexes. Here, male and female mice in either single-sex or mixed sex housing rooms were trained on fixed ratio 1 (FR1) and progressive ratio (PR) tasks. For both sexes, animals in the mixed sex room had more accurate performance in FR1 and were more motivated in the PR task. We then moved the single sex housed animals to the mixed sex room and vice versa. Animals that started in mixed sex housing had no change to PR, but both sexes who started in single sex housing were more motivated after the switch. Additionally, the females that moved into single-sex housing performed less accurately in FR1. We conclude that housing and testing conditions can affect performance on FR1 and PR tasks. As these tasks are commonly used as training steps to more complex tasks, housing and testing conditions should be carefully considered during experiment design and reported in publications. Copyright © 2018 Elsevier Inc. All rights reserved.

75 FR 69912 - Pipeline Safety: Control Room Management/Human Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-16

... 192 and 195 [Docket ID PHMSA-2007-27954] RIN 2137-AE64 Pipeline Safety: Control Room Management/Human... rulemaking; Extension of comment period. SUMMARY: On September 17, 2010, PHMSA published a Control Room... Control Room Management/Human Factors rule at 49 CFR 192.631 and 195.446. The NPRM proposes to expedite...

Code Blue Emergencies: A Team Task Analysis and Educational Initiative.

PubMed

Price, James W; Applegarth, Oliver; Vu, Mark; Price, John R

2012-01-01

The objective of this study was to identify factors that have a positive or negative influence on resuscitation team performance during emergencies in the operating room (OR) and post-operative recovery unit (PAR) at a major Canadian teaching hospital. This information was then used to implement a team training program for code blue emergencies. In 2009/10, all OR and PAR nurses and 19 anesthesiologists at Vancouver General Hospital (VGH) were invited to complete an anonymous, 10 minute written questionnaire regarding their code blue experience. Survey questions were devised by 10 recovery room and operation room nurses as well as 5 anesthesiologists representing 4 different hospitals in British Columbia. Three iterations of the survey were reviewed by a pilot group of nurses and anesthesiologists and their feedback was integrated into the final version of the survey. Both nursing staff (n = 49) and anesthesiologists (n = 19) supported code blue training and believed that team training would improve patient outcome. Nurses noted that it was often difficult to identify the leader of the resuscitation team. Both nursing staff and anesthesiologists strongly agreed that too many people attending the code blue with no assigned role hindered team performance. Identifiable leadership and clear communication of roles were identified as keys to resuscitation team functioning. Decreasing the number of people attending code blue emergencies with no specific role, increased access to mock code blue training, and debriefing after crises were all identified as areas requiring improvement. Initial team training exercises have been well received by staff.

Passive ultra-brief video training improves performance of compression-only cardiopulmonary resuscitation.

PubMed

Benoit, Justin L; Vogele, Jennifer; Hart, Kimberly W; Lindsell, Christopher J; McMullan, Jason T

2017-06-01

Bystander compression-only cardiopulmonary resuscitation (CPR) improves survival after out-of-hospital cardiac arrest. To broaden CPR training, 1-2min ultra-brief videos have been disseminated via the Internet and television. Our objective was to determine whether participants passively exposed to a televised ultra-brief video perform CPR better than unexposed controls. This before-and-after study was conducted with non-patients in an urban Emergency Department waiting room. The intervention was an ultra-brief CPR training video displayed via closed-circuit television 3-6 times/hour. Participants were unaware of the study and not told to watch the video. Pre-intervention, no video was displayed. Participants were asked to demonstrate compression-only CPR on a manikin. Performance was scored based on critical actions: check for responsiveness, call for help, begin compressions immediately, and correct hand placement, compression rate and depth. The primary outcome was the proportion of participants who performed all actions correctly. There were 50 control and 50 exposed participants. Mean age was 37, 51% were African-American, 52% were female, and 10% self-reported current CPR certification. There were no statistically significant differences in baseline characteristics between groups. The number of participants who performed all actions correctly was 0 (0%) control vs. 10 (20%) exposed (difference 20%, 95% confidence interval [CI] 8.9-31.1%, p<0.001). Correct compression rate and depth were 11 (22%) control vs. 22 (44%) exposed (22%, 95% CI 4.1-39.9%, p=0.019), and 5 (10%) control vs. 15 (30%) exposed (20%, 95% CI 4.8-35.2%, p=0.012), respectively. Passive ultra-brief video training is associated with improved performance of compression-only CPR. Copyright © 2017 Elsevier B.V. All rights reserved.

THE TRAINING CENTER, DIFFERENT PURPOSES, DIFFERENT DESIGNS, A LOOK AT SELECTED CORPORATE TRAINING CENTERS.

ERIC Educational Resources Information Center

MAHLER, HARRY B.

UNIQUE FEATURES AND FLOOR PLANS OF FUNCTIONALLY DESIGNED CORPORATE TRAINING CENTERS ARE DESICRIBED. THE TRAVELERS EDUCATION CENTER HAS SIMPLY DESIGNED ROOMS AND FEW AUDIOVISUAL AIDS (AV). BUTLER MANUFACTURING HAS ITS STUDY CENTER IN A WING OF A MOTEL WHICH IS CONVENIENT TO THE GENERAL OFFICES AND DOWNTOWN AREA. SINCE COMPANY PERSONNEL USE THE…

Perceptions, training experiences, and preferences of surgical residents toward laparoscopic simulation training: a resident survey.

PubMed

Shetty, Shohan; Zevin, Boris; Grantcharov, Teodor P; Roberts, Kurt E; Duffy, Andrew J

2014-01-01

Simulation training for surgical residents can shorten learning curves, improve technical skills, and expedite competency. Several studies have shown that skills learned in the simulated environment are transferable to the operating room. Residency programs are trying to incorporate simulation into the resident training curriculum to supplement the hands-on experience gained in the operating room. Despite the availability and proven utility of surgical simulators and simulation laboratories, they are still widely underutilized by surgical trainees. Studies have shown that voluntary use leads to minimal participation in a training curriculum. Although there are several simulation tools, there is no clear evidence of the superiority of one tool over the other in skill acquisition. The purpose of this study was to explore resident perceptions, training experiences, and preferences regarding laparoscopic simulation training. Our goal was to profile resident participation in surgical skills simulation, recognize potential barriers to voluntary simulator use, and identify simulation tools and tasks preferred by residents. Furthermore, this study may help to inform whether mandatory/protected training time, as part of the residents' curriculum is essential to enhance participation in the simulation laboratory. A cross-sectional study on general surgery residents (postgraduate years 1-5) at Yale University School of Medicine and the University of Toronto via an online questionnaire was conducted. Overall, 67 residents completed the survey. The institutional review board approved the methods of the study. Overall, 95.5% of the participants believed that simulation training improved their laparoscopic skills. Most respondents (92.5%) perceived that skills learned during simulation training were transferrable to the operating room. Overall, 56.7% of participants agreed that proficiency in a simulation curriculum should be mandatory before operating room experience. The simulation laboratory was most commonly used during work hours; lack of free time during work hours was most commonly cited as a reason for underutilization. Factors influencing use of the simulation laboratory in order of importance were the need for skill development, an interest in minimally invasive surgery, mandatory/protected time in a simulation environment as part of the residency program curriculum, a recommendation by an attending surgeon, and proximity of the simulation center. The most preferred simulation tool was the live animal model followed by cadaveric tissue. Virtual reality simulators were among the least-preferred (25%) simulation tools. Most residents (91.0%) felt that mandatory/protected time in a simulation environment should be introduced into resident training protocols. Mandatory and protected time in a simulation environment as part of the resident training curriculum may improve participation in simulation training. A comprehensive curriculum, which includes the use of live animals, cadaveric tissue, and virtual reality simulators, may enhance the laparoscopic training experience and interest level of surgical trainees. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Expedition 19 Crew Training

NASA Image and Video Library

2009-03-20

Expedition 19 Flight Engineer Michael R. Barratt and Spaceflight Participant Charles Simonyi, background, are seen through a quarantine windowed room as they participate in Soyuz rendezvous and docking training at the Cosmonaut Hotel, Saturday, March 21, 2009 in Baikonur, Kazakhstan. (Photo Credit: NASA/Bill Ingalls)

Industrial Safety Training for Soviet Workers.

ERIC Educational Resources Information Center

Semenov, A.

1978-01-01

Various forms of worker training in industrial safety in the Soviet Union are described by a Soviet labor inspector, with special "industrial safety rooms" the principal means of inplant instruction. Safety education in vocational schools and "people's universities" is also touched on. (MF)

Baseline Study Methodology for Future Phases of Research on Nuclear Power Plant Control Room Technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Blanc, Katya Lee; Bower, Gordon Ross; Hill, Rachael Ann

In order to provide a basis for industry adoption of advanced technologies, the Control Room Upgrades Benefits Research Project will investigate the benefits of including advanced technologies as part of control room modernization This report describes the background, methodology, and research plan for the first in a series of full-scale studies to test the effects of advanced technology in NPP control rooms. This study will test the effect of Advanced Overview Displays in the partner Utility’s control room simulator

75 FR 66071 - North Pacific Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

... Way NE., Building 4, Observer Training Room (GOA Plan Team) and Traynor Room (BS/AI Plan Team.../Aleutian Islands (BS/AI) Groundfish plan teams will meet in Seattle, WA. DATES: The meetings will be held...: (907) 271-2809. SUPPLEMENTARY INFORMATION: The plan teams will prepare and review the stock [[Page...

78 FR 65292 - North Pacific Fishery Management Council (NPFMC); Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

..., 7600 Sand Point Way NE., Building 4, Observer Training Room 1055 (GOA Plan Team) and Traynor Room 2076 (BS/AI Plan Team), Seattle, WA. Council address: North Pacific Fishery Management Council, 605 W. 4th... Sea/Aleutian Islands (BSAI) Groundfish Plan Teams will meet in Seattle, WA. DATES: The meetings will...

VIEW OF COMPRESSOR ROOM AT GROUND LEVEL SHOWING COMPRESSOR EQUIPMENT. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW OF COMPRESSOR ROOM AT GROUND LEVEL SHOWING COMPRESSOR EQUIPMENT. VIEW FACING SOUTH - U.S. Naval Base, Pearl Harbor, Ford Island Polaris Missile Lab & U.S. Fleet Ballistic Missile Submarine Training Center, Between Lexington Boulvevard and the sea plane ramps on the southwest side of Ford Island, Pearl City, Honolulu County, HI

78 FR 3031 - Workforce Investment Act; Native American Employment and Training Council

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-15

... is being held at the U.S. Department of Labor, Francis Perkins Building, 200 Constitution Avenue... Constitution Avenue, Northwest, Room S-4209, Washington, DC 20210. The formal agenda will focus on the... Administration, U.S. Department of Labor, Room S-4209, 200 Constitution Avenue, Northwest, Washington, DC 20210...

76 FR 66274 - North Pacific Fishery Management Council (NPFMC); Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

... Sea/Aleutian Islands (BS/AI) Groundfish Plan Teams will meet in Seattle. DATES: November 14-18, 2011...., Building 4, Observer Training Room (GOA Plan Team) and Traynor Room (BS/AI Plan Team), Seattle, WA. Council.... SUPPLEMENTARY INFORMATION: The Plan Teams will compile and review the annual Groundfish Stock Assessment and...

Operating room efficiency: benefits of an orthopaedic traumatologist at a level II trauma center.

PubMed

Althausen, Peter L; Kauk, Justin R; Shannon, Steven; Lu, Minggen; O'Mara, Timothy J; Bray, Timothy J

2014-05-01

Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. Retrospective review. Level II community-based trauma hospital. Patients who presented to the emergency room at our institution with fractures and orthopaedic conditions requiring surgical intervention from January 1, 2010, to December 31, 2011. Operative fracture fixation by members of our orthopaedic trauma panel, including fellowship and nontrauma fellowship-trained orthopaedic surgeons. Our institutional database was queried to determine operative times, surgical supply and implant costs, and surgery labor expenses. Patients were stratified according to those treated by our trauma panel's 3 traumatologists and those treated by the 15 GOSs on our trauma panel. These 2 groups were then compared using standard statistical methods. A total of 6449 orthopedic cases were identified and 2076 of these involved fracture care. One thousand one hundred ninety-nine patients were treated by traumatologists and 877 by GOSs. There was no statistical difference detected in American Society of Anesthesiologists score between trauma and nontrauma groups. Overall, the traumatologist group demonstrated significantly decreased procedure times when compared with the GOS group (55.6 vs. 75.8 minutes, P < 0.0001). In 16 of 18 most common procedure types, traumatologists were more efficient. This led to significantly decreased surgical labor costs ($381.4 vs. $484.8; P < 0.0001) and surgical supply and implant costs ($2567 vs. $3003; P < 0.0001). This study demonstrates that in our community-based trauma system, fracture care provided by traumatologists results in improved utilization of hospital-based resources when compared with equivalent services provided by GOSs. Significantly decreased operative times, surgical labor expenses, and supply and implant costs by the fellowship-trained group represent enhanced control of the design, plan, execution, and monitoring of orthopaedic trauma care. Traumatologists can provide leadership recommendations for operating room efficiency in community-based orthopaedic trauma care models. Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Operating Room Efficiency: Benefits of an Orthopaedic Traumatologist at a Level II Trauma Center.

PubMed

Althausen, Peter L; Kauk, Justin R; Shannon, Steven; Lu, Minggen; O'Mara, Timothy J; Bray, Timothy J

2016-12-01

Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. Retrospective review. Level II community-based trauma hospital. Patients who presented to the emergency room at our institution with fractures and orthopaedic conditions requiring surgical intervention from January 1, 2010, to December 31, 2011. Operative fracture fixation by members of our orthopaedic trauma panel, including fellowship and nontrauma fellowship-trained orthopaedic surgeons. Our institutional database was queried to determine operative times, surgical supply and implant costs, and surgery labor expenses. Patients were stratified according to those treated by our trauma panel's 3 traumatologists and those treated by the 15 GOSs on our trauma panel. These 2 groups were then compared using standard statistical methods. A total of 6449 orthopedic cases were identified and 2076 of these involved fracture care. One thousand one hundred ninety-nine patients were treated by traumatologists and 877 by GOSs. There was no statistical difference detected in American Society of Anesthesiologists score between trauma and nontrauma groups. Overall, the traumatologist group demonstrated significantly decreased procedure times when compared with the GOS group (55.6 vs. 75.8 minutes, P , 0.0001). In 16 of 18 most common procedure types, traumatologists were more efficient. This led to significantly decreased surgical labor costs ($381.4 vs. $484.8; P < 0.0001) and surgical supply and implant costs ($2567 vs. $3003; P < 0.0001). This study demonstrates that in our communitybased trauma system, fracture care provided by traumatologists results in improved utilization of hospital-based resources when compared with equivalent services provided by GOSs. Significantly decreased operative times, surgical labor expenses, and supply and implant costs by the fellowship-trained group represent enhanced control of the design, plan, execution, and monitoring of orthopaedic trauma care. Traumatologists can provide leadership recommendations for operating room efficiency in community-based orthopaedic trauma care models. Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

The University of Pennsylvania curriculum for training otorhinolaryngology residents in transoral robotic surgery.

PubMed

Sperry, Steven M; O'Malley, Bert W; Weinstein, Gregory S

2014-01-01

To define a curriculum for the development of robotic surgical skills in otorhinolaryngology residency training. A systematic review of the current literature on robotic surgery training was performed. Based on prior reports in other specialties, a curriculum for otorhinolaryngology residents was created that progresses through several modules, including didactics, inanimate skills laboratory, and operative experience. The curriculum for residents in otorhinolaryngology was designed as follows: didactics include an overview of the robotic device and instruments, a tutorial in basic controls and function, and a room setup and positioning. The anatomy and steps of transoral procedures are taught through books, videos, operative observations, and cadaver dissections. Skills are developed with a virtual reality robotic simulator and robotics labs. The operative experience progresses from case observation to bedside assistant to console surgeon. The role of the console surgeon progresses in a stepwise fashion, and the procedures of radical tonsillectomy, supraglottic partial laryngectomy, and base of tongue resection have been organized as a series of steps. A structured curriculum for training residents in transoral robotic surgery was developed. This training is important for otorhinolaryngology residents to acquire the knowledge and skills to perform robotic surgery safely. © 2015 S. Karger AG, Basel.

A Research Framework for Demonstrating Benefits of Advanced Control Room Technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Blanc, Katya; Boring, Ronald; Joe, Jeffrey

Control Room modernization is an important part of life extension for the existing light water reactor fleet. None of the 99 currently operating commercial nuclear power plants in the U.S. has completed a full-scale control room modernization to date. A full-scale modernization might, for example, entail replacement of all analog panels with digital workstations. Such modernizations have been undertaken successfully in upgrades in Europe and Asia, but the U.S. has yet to undertake a control room upgrade of this magnitude. Instead, nuclear power plant main control rooms for the existing commercial reactor fleet remain significantly analog, with only limited digitalmore » modernizations. Previous research under the U.S. Department of Energy’s Light Water Reactor Sustainability Program has helped establish a systematic process for control room upgrades that support the transition to a hybrid control. While the guidance developed to date helps streamline the process of modernization and reduce costs and uncertainty associated with introducing digital control technologies into an existing control room, these upgrades do not achieve the full potential of newer technologies that might otherwise enhance plant and operator performance. The aim of the control room benefits research presented here is to identify previously overlooked benefits of modernization, identify candidate technologies that may facilitate such benefits, and demonstrate these technologies through human factors research. This report serves as an outline for planned research on the benefits of greater modernization in the main control rooms of nuclear power plants.« less

9 CFR 121.15 - Training.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Training. 121.15 Section 121.15 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VIRUSES...., laboratories, growth chambers, animal rooms, greenhouses, storage areas, shipping/receiving areas, production...

8. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS NORTHEAST CORNER. TELEMETRY ROOM VISIBLE THROUGH WINDOWS IN SOUTH WALL. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

7. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS SOUTHWEST CORNER. NOTE RAISED FLATFORM IN CENTER OF ROOM. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

A Proficiency Based Stepwise Endovascular Curricular Training (PROSPECT) Program Enhances Operative Performance in Real Life: A Randomised Controlled Trial.

PubMed

Maertens, H; Aggarwal, R; Moreels, N; Vermassen, F; Van Herzeele, I

2017-09-01

Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions. All subjects performed two endovascular interventions treating patients with symptomatic iliac and/or superficial femoral artery stenosis under supervision. Primary outcomes were technical performances (Global Rating Scale [GRS]; Examiner Checklist), operative metrics, and patient outcomes, adjusted for case difficulty and trainee experience. Secondary outcomes included knowledge and technical performance after 6 weeks and 3 months. Thirty-two general surgical trainees were randomised into three groups. Besides traditional training, the first group (n = 11) received e-learning and simulation training (PROSPECT), the second group (n = 10) only had access to e-learning, while controls (n = 11) did not receive supplementary training. Twenty-nine trainees (3 dropouts) performed 58 procedures. Trainees who completed PROSPECT showed superior technical performance (GRS 39.36 ± 2.05; Checklist 63.51 ± 3.18) in real life with significantly fewer supervisor takeovers compared with trainees receiving e-learning alone (GRS 28.42 ± 2.15; p = .001; Checklist 53.63 ± 3.34; p = .027) or traditional education (GRS 23.09 ± 2.18; p = .001; Checklist 38.72 ± 3.38; p = .001). Supervisors felt more confident in allowing PROSPECT trained physicians to perform basic (p = .006) and complex (p = .003) procedures. No differences were detected in procedural parameters (such as fluoroscopy time, DAP, procedure time, etc.) or complications. Proficiency levels were maintained up to 3 months. A structured, stepwise, proficiency based endovascular curriculum including e-learning and simulation based training should be integrated early into training programs to enhance trainee performance. Copyright © 2017. Published by Elsevier Ltd.

Do the skills acquired by novice surgeons using anatomic dry models transfer effectively to the task of diagnostic knee arthroscopy performed on cadaveric specimens?

PubMed

Butler, Aaron; Olson, Tyson; Koehler, Ryan; Nicandri, Gregg

2013-02-06

The use of surgical simulation in orthopaedic education is increasing; however, its ideal place within the training curriculum remains unknown. The purpose of this study was to determine the effectiveness of training novice surgeons on an anatomic dry model of the knee prior to training them to perform diagnostic arthroscopy on cadaveric specimens. Fourteen medical students were randomly assigned to two groups. The experimental group was trained to perform diagnostic arthroscopy of the knee on anatomic dry models prior to training on cadaveric specimens. The control group was trained only on cadaveric specimens. Proficiency was assessed with use of a modified version of a previously validated objective assessment of arthroscopic skill, the Basic Arthroscopic Knee Skill Scoring System (BAKSSS). The mean number of trials required to attain minimal proficiency when performing diagnostic knee arthroscopy was compared between the groups. The cumulative transfer effectiveness ratio (CTER) was calculated to measure the transfer of skills acquired by the experimental group. The mean number of trials to demonstrate minimum proficiency was significantly lower in the experimental group (2.57) than in the control group (4.57) (p < 0.01). The mean time to demonstrate proficiency was also significantly less in the experimental group (37.51 minutes) than in the control group (60.48 minutes) (p < 0.01). The CTER of dry-model training for the task of performing diagnostic knee arthroscopy on cadaveric specimens was 0.2. Previous training utilizing an anatomic dry knee model resulted in improved proficiency for novice surgeons learning to perform diagnostic knee arthroscopy on cadaveric specimens. A CTER of 0.2 suggests that dry models can serve as a useful adjunct to cadaveric training for diagnostic knee arthroscopy but cannot entirely replace it within the orthopaedic curriculum. Further work is necessary to determine the optimal amount of training on anatomic dry models that will maximize transfer effectiveness and to determine how well skills obtained in the simulated environment transfer to the operating room.

Effects of room environment and nursing experience on clinical blood pressure measurement: an observational study.

PubMed

Zhang, Meng; Zhang, Xuemei; Chen, Fei; Dong, Birong; Chen, Aiqing; Zheng, Dingchang

2017-04-01

This study aimed to examine the effects of measurement room environment and nursing experience on the accuracy of manual auscultatory blood pressure (BP) measurement. A training database with 32 Korotkoff sounds recordings from the British Hypertension Society was played randomly to 20 observers who were divided into four groups according to the years of their nursing experience (i.e. ≥10 years, 1-9 years, nursing students with frequent training, and those without any medical background; five observers in each group). All the observers were asked to determine manual auscultatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) both in a quiet clinical assessment room and in a noisy nurse station area. This procedure was repeated on another day, yielding a total of four measurements from each observer (i.e. two room environments and two repeated determinations on 2 separate days) for each Korotkoff sound. The measurement error was then calculated against the reference answer, with the effects of room environment and nursing experience of the observer investigated. Our results showed that there was no statistically significant difference for BPs measured under both quiet and noisy environments (P>0.80 for both SBP and DBP). However, there was a significant effect on the measurement accuracy between the observer groups (P<0.001 for both SBP and DBP). The nursing students performed best with overall SBP and DBP errors of -0.8±2.4 and 0.1±1.8 mmHg, respectively. The SBP measurement error from the nursing students was significantly smaller than that for each of the other three groups (all P<0.001). Our results indicate that frequent nursing trainings are important for nurses to achieve accurate manual auscultatory BP measurement.

New Age Teaching: Beyond Didactics

PubMed Central

Vlaovic, Peter D.; McDougall, Elspeth M.

2006-01-01

Widespread acceptance of laparoscopic urology techniques has posed many challenges to training urology residents and allowing postgraduate urologists to acquire often difficult new surgical skills. Several factors in surgical training programs are limiting the ability to train residents in the operating room, including limited-hours work weeks, increasing demand for operating room productivity, and general public awareness of medical errors. As such, surgical simulation may provide an opportunity to enhance residency experience and training, and optimize post-graduate acquisition of new skills and maintenance of competency. This review article explains and defines the various levels of validity as it pertains to surgical simulators. The most recently and comprehensively validity tested simulators are outlined and summarized. The potential role of surgical simulation in the formative and summative assessment of surgical trainees, as well as, the certification and recertification process of postgraduate surgeons will be delineated. Surgical simulation will be an important adjunct to the traditional methods of surgical skills training and will allow surgeons to maintain their proficiency in the technically challenging aspects of minimally invasive urologic surgery. PMID:17619704

Surgical simulation in orthopaedic skills training.

PubMed

Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

2012-07-01

Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

Individualized feedback during simulated laparoscopic training: a mixed methods study

PubMed Central

Weurlander, Maria; Hedman, Leif; Nisell, Henry; Lindqvist, Pelle G.; Felländer-Tsai, Li; Enochsson, Lars

2015-01-01

Objectives This study aimed to explore the value of indi-vidualized feedback on performance, flow and self-efficacy during simulated laparoscopy. Furthermore, we wished to explore attitudes towards feedback and simulator training among medical students. Methods Sixteen medical students were included in the study and randomized to laparoscopic simulator training with or without feedback. A teacher provided individualized feedback continuously throughout the procedures to the target group. Validated questionnaires and scales were used to evaluate self-efficacy and flow. The Mann-Whitney U test was used to evaluate differences between groups regarding laparoscopic performance (instrument path length), self-efficacy and flow. Qualitative data was collected by group interviews and interpreted using inductive thematic analyses. Results Sixteen students completed the simulator training and questionnaires. Instrument path length was shorter in the feedback group (median 3.9 m; IQR: 3.3-4.9) as com-pared to the control group (median 5.9 m; IQR: 5.0-8.1), p<0.05. Self-efficacy improved in both groups. Eleven students participated in the focus interviews. Participants in the control group expressed that they had fun, whereas participants in the feedback group were more concentrated on the task and also more anxious. Both groups had high ambitions to succeed and also expressed the importance of getting feedback. The authenticity of the training scenario was important for the learning process. Conclusions This study highlights the importance of individualized feedback during simulated laparoscopy training. The next step is to further optimize feedback and to transfer standardized and individualized feedback from the simulated setting to the operating room. PMID:26223033

Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training.

PubMed

Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi; Højgaard-Olsen, Klavs; Subhi, Yousif; Saleh, George M; Park, Yoon Soo; la Cour, Morten; Konge, Lars

2017-04-01

To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. Multicenter masked clinical trial. Eighteen cataract surgeons with different levels of experience. Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. Novices (non-independently operating surgeons) and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the OR-32% and 38%, respectively-after virtual reality training (P = 0.008 and P = 0.018). More experienced cataract surgeons did not benefit from simulator training. The reliability of the assessments was high with a generalizability coefficient of 0.92 and 0.86 before and after the virtual reality training, respectively. Clinically relevant cataract surgical skills can be improved by proficiency-based training on a virtual reality simulator. Novices as well as surgeons with an intermediate level of experience showed improvement in OR performance score. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

PBF Control Building (PER619). Interior of control room shows control ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

PBF Control Building (PER-619). Interior of control room shows control console from direction facing visitors room and its observation window. Camera facing northeast. Date: May 2004. INEEL negative no. HD-41-7-1 - Idaho National Engineering Laboratory, SPERT-I & Power Burst Facility Area, Scoville, Butte County, ID

Benefits of Advanced Control Room Technologies: Phase One Upgrades to the HSSL, Research Plan, and Performance Measures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Blanc, Katya; Joe, Jeffrey; Rice, Brandon

Control Room modernization is an important part of life extension for the existing light water reactor fleet. None of the 99 currently operating commercial nuclear power plants in the U.S. has completed a full-scale control room modernization to date. A full-scale modernization might, for example, entail replacement of all analog panels with digital workstations. Such modernizations have been undertaken successfully in upgrades in Europe and Asia, but the U.S. has yet to undertake a control room upgrade of this magnitude. Instead, nuclear power plant main control rooms for the existing commercial reactor fleet remain significantly analog, with only limited digitalmore » modernizations. Previous research under the U.S. Department of Energy’s Light Water Reactor Sustainability Program has helped establish a systematic process for control room upgrades that support the transition to a hybrid control room. While the guidance developed to date helps streamline the process of modernization and reduce costs and uncertainty associated with introducing digital control technologies into an existing control room, these upgrades do not achieve the full potential of newer technologies that might otherwise enhance plant and operator performance. The aim of the control room benefits research is to identify previously overlooked benefits of modernization, identify candidate technologies that may facilitate such benefits, and demonstrate these technologies through human factors research. This report describes the initial upgrades to the HSSL and outlines the methodology for a pilot test of the HSSL configuration.« less

Survey of Current Doctrine, Training, and Special Considerations for Military Operations on Urbanized Terrain (MOUT).

DTIC Science & Technology

1983-11-01

Securing and fortifying (a) Doors (b) Hallways (c) Stairs (d) Windows (e) Floors (f) Ceilings 3 (g) Unoccupied rooms (h) Basements (i) Upper floors...observed, the instructors were interviewed, and training K was assessed through administration of a multiple-choice test and a Perception of Training...instructing clearing procedures. It would provide the opportunity to both critique and practice, using one structure. A Perception of Training

Expedition 19 Crew Training

NASA Image and Video Library

2009-03-20

Spaceflight Participant Charles Simonyi and Expedition 19 Flight Engineer Michael R. Barratt, foreground, along with cosmonaut instructors are seen through a quarantine windowed room as they participate in Soyuz rendezvous and docking training at the Cosmonaut Hotel, Saturday, March 21, 2009 in Baikonur, Kazakhstan. (Photo Credit: NASA/Bill Ingalls)

9 CFR 121.15 - Training.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Training. 121.15 Section 121.15 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VIRUSES... select agents or toxins are handled or stored (e.g., laboratories, growth chambers, animal rooms...

A framework for physician activity during disasters and surge events.

PubMed

Griffiths, Jane L; Estipona, Aurora; Waterson, James A

2011-01-01

Delineation of the problem of physician role during disaster activations both for disaster responders and for general physicians in a Middle East state facility. The hospital described has 500 medical-surgical beds, 59 intensive care unit beds, eight operating rooms (ORs), and 60 emergency room (ER) beds. Its ER sees 150,000 presentations per year and between 11 and 26 multitrauma cases per day. Most casualties are the result of industrial accidents (50.5 percent) and road traffic accidents (34 percent). It is the principle trauma center for Dubai, UAE. The hospital is also the designated primary regional responder for medical, chemical, and biological events. Its disaster plan has been activated 10 times in the past 3 years and it is consistently over its bed capacity. A review of the activity of physicians during disaster activations revealed problems of role identification, conflict, and lack of training. Interventions included training nonacute teams in reverse triaging and responder teams in coordinated emergency care. Both actions were fostered and controlled by a Disaster Control Centre and its Committee. Clear identification of medical leadership in disaster situations, introduction of a process of reverse triage to meet surge based on an ethical framework, and improvement of flow through the ER and OR. Reverse triage can be made to work in the Middle East despite its lack of primary healthcare infrastructure. Lessons from the restructuring of responder teams may be applicable to the deployment to prehospital environments of hospital teams, and further development of audit tools is required to measure improvement in these areas.

77. ARAII. Room at northeast corner of ARA606 used for ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

77. ARA-II. Room at northeast corner of ARA-606 used for welding training and welding procedure qualification and performance testing. This was only building in use at ARA-II by 1983. Date: 1983. Ineel photo no. 83-476-3-5. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

Designing and Using a High School Cardio Room

ERIC Educational Resources Information Center

Wilkinson, Carol; Hall, Amber

2012-01-01

Attending a gym, fitness center or health club is a popular pastime of many people who wish to exercise and get in shape. Classes are offered in activities such as cardio endurance, toning, Pilates, spinning, step aerobics, core training, and kick boxing. Participants also use rooms with cardio equipment to get their own cardio workout. As many…

Immersive virtual reality used as a platform for perioperative training for surgical residents.

PubMed

Witzke, D B; Hoskins, J D; Mastrangelo, M J; Witzke, W O; Chu, U B; Pande, S; Park, A E

2001-01-01

Perioperative preparations such as operating room setup, patient and equipment positioning, and operating port placement are essential to operative success in minimally invasive surgery. We developed an immersive virtual reality-based training system (REMIS) to provide residents (and other health professionals) with training and evaluation in these perioperative skills. Our program uses the qualities of immersive VR that are available today for inclusion in an ongoing training curriculum for surgical residents. The current application consists of a primary platform for patient positioning for a laparoscopic cholecystectomy. Having completed this module we can create many different simulated problems for other procedures. As a part of the simulation, we have devised a computer-driven real-time data collection system to help us in evaluating trainees and providing feedback during the simulation. The REMIS program trains and evaluates surgical residents and obviates the need to use expensive operating room and surgeon time. It also allows residents to train based on their schedule and does not put patients at increased risk. The method is standardized, allows for repetition if needed, evaluates individual performance, provides the possible complications of incorrect choices, provides training in 3-D environment, and has the capability of being used for various scenarios and professions.

Effect of obstetric team training on team performance and medical technical skills: a randomised controlled trial.

PubMed

Fransen, A F; van de Ven, J; Merién, A E R; de Wit-Zuurendonk, L D; Houterman, S; Mol, B W; Oei, S G

2012-10-01

To determine whether obstetric team training in a medical simulation centre improves the team performance and utilisation of appropriate medical technical skills of healthcare professionals. Cluster randomised controlled trial. The Netherlands. The obstetric departments of 24 Dutch hospitals. The obstetric departments were randomly assigned to a 1-day session of multiprofessional team training in a medical simulation centre or to no such training. Team training was given with high-fidelity mannequins by an obstetrician and a communication expert. More than 6 months following training, two unannounced simulated scenarios were carried out in the delivery rooms of all 24 obstetric departments. The scenarios, comprising a case of shoulder dystocia and a case of amniotic fluid embolism, were videotaped. The team performance and utilisation of appropriate medical skills were evaluated by two independent experts. Team performance evaluated with the validated Clinical Teamwork Scale (CTS) and the employment of two specific obstetric procedures for the two clinical scenarios in the simulation (delivery of the baby with shoulder dystocia in the maternal all-fours position and conducting a perimortem caesarean section within 5 minutes for the scenario of amniotic fluid embolism). Seventy-four obstetric teams from 12 hospitals in the intervention group underwent teamwork training between November 2009 and July 2010. The teamwork performance in the training group was significantly better in comparison to the nontraining group (median CTS score: 7.5 versus 6.0, respectively; P = 0.014). The use of the predefined obstetric procedures for the two clinical scenarios was also significantly more frequent in the training group compared with the nontraining group (83 versus 46%, respectively; P = 0.009). Team performance and medical technical skills may be significantly improved after multiprofessional obstetric team training in a medical simulation centre. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

6. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS SOUTHEAST CORNER - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

My revolutionary adventures in the development of modern emergency medical systems in our country.

PubMed

Edlich, Richard F

2008-05-01

The purpose of this article is to describe my exciting adventures in the development of the emergency medical systems in our country. After my training in plastic surgery at the University of Virginia, I accepted the position of Acting Director of the Emergency Room at the University of Virginia Health Science Center. Working with gifted physicians, basic scientists, nurses, and students, we coordinated the development of an emergency medical system that has been replicated throughout our country. Our system included the following: State legislation for the sexual assault victim, public access by the 9-1-1 telephone number, training of rescue squads, emergency radio communication system, trauma centers, poison control centers, emergency medical plan for the President of the United States, national telecommunications system for the deaf, and the first air medical transportation system in Virginia.

Development and validation of an artificial wetlab training system for the lumbar discectomy.

PubMed

Adermann, Jens; Geissler, Norman; Bernal, Luis E; Kotzsch, Susanne; Korb, Werner

2014-09-01

An initial research indicated that realistic haptic simulators with an adapted training concept are needed to enhance the training for spinal surgery. A cognitive task analysis (CTA) was performed to define a realistic and helpful scenario-based simulation. Based on the results a simulator for lumbar discectomy was developed. Additionally, a realistic training operating room was built for a pilot. The results were validated. The CTA showed a need for realistic scenario-based training in spine surgery. The developed simulator consists of synthetic bone structures, synthetic soft tissue and an advanced bleeding system. Due to the close interdisciplinary cooperation of surgeons between engineers and psychologists, the iterative multicentre validation showed that the simulator is visually and haptically realistic. The simulator offers integrated sensors for the evaluation of the traction being used and the compression during surgery. The participating surgeons in the pilot workshop rated the simulator and the training concept as very useful for the improvement of their surgical skills. In the context of the present work a precise definition for the simulator and training concept was developed. The additional implementation of sensors allows the objective evaluation of the surgical training by the trainer. Compared to other training simulators and concepts, the high degree of objectivity strengthens the acceptance of the feedback. The measured data of the nerve root tension and the compression of the dura can be used for intraoperative control and a detailed postoperative evaluation.

Naval Expeditionary Logistics Support Group, Training and Evaluation Unit: An Analysis of Current Operations While Searching for Training Efficiencies

DTIC Science & Technology

2009-12-01

of-the-art-classrooms and virtual reality rooms for small arms training. The outlying operational training areas are spread across Cheatham Annex...Movement, and Integration RFM Ready for Mobilization RFT Ready for Tasking SME Subject Matter Expert SWOT Strengths, Weaknesses, Opportunities...document shows that the position is filled (1.0 qualified) but the reality is that the individual is not fully qualified for the required billet (0

Operators in the Plum Brook Reactor Facility Control Room

NASA Image and Video Library

1970-03-21

Donald Rhodes, left, and Clyde Greer, right, monitor the operation of the National Aeronautics and Space Administration’s (NASA) Plum Brook Reactor Facility from the control room. The 60-megawatt test reactor, NASA’s only reactor, was the eighth largest test reactor in the world. The facility was built by the Lewis Research Center in the late 1950s to study the effects of radiation on different materials that could be used to construct nuclear propulsion systems for aircraft or rockets. The reactor went critical for the first time in 1961. For the next two years, two operators were on duty 24 hours per day working on the fission process until the reactor reached its full-power level in 1963. Reactor Operators were responsible for monitoring and controlling the reactor systems. Once the reactor was running under normal operating conditions, the work was relatively uneventful. Normally the reactor was kept at a designated power level within certain limits. Occasionally the operators had to increase the power for a certain test. The shift supervisor and several different people would get together and discuss the change before boosting the power. All operators were required to maintain a Reactor Operator License from the Atomic Energy Commission. The license included six months of training, an eight-hour written exam, a four-hour walkaround, and testing on the reactor controls.

Effectiveness of Educational Poster on Knowledge of Emergency Management of Dental Trauma–Part 1. Cluster Randomised Controlled Trial for Primary and Secondary School Teachers

PubMed Central

Young, Cecilia; Wong, Kin Yau; Cheung, Lim K.

2013-01-01

Objective To investigate the effectiveness of educational posters in improving the knowledge level of primary and secondary school teachers regarding emergency management of dental trauma. Methods A cluster randomised controlled trial was conducted. 32 schools with a total of 515 teachers were randomised into intervention (poster) and control groups at the school level. Teachers’ baseline levels of knowledge about dental trauma were obtained by using a questionnaire. Posters containing information on dental trauma management were displayed in the school medical room, the common room used by staff, and on a notice board for 2 weeks in each school of the intervention group; in the control group, no posters were displayed. Teachers in both groups completed the questionnaire after 2 weeks. Results The teachers in the intervention schools (where posters were displayed for 2 weeks) showed statistically significant improvement in scores in cases where they had not previously learned about dental emergencies from sources other than first aid training, with an average score increase of 2.6656 (score range of questionnaire, −13 to 9; p-value <0.0001). Conclusion Educational posters on the management of dental trauma can significantly improve the level of knowledge of primary and secondary school teachers in Hong Kong. KClinicalTrials.com HKCTR-1307 ClinicalTrials.gov: NCT01707355 PMID:24147154

Hospital infectious disease emergency preparedness: a 2007 survey of infection control professionals.

PubMed

Rebmann, Terri; Wilson, Rita; LaPointe, Sue; Russell, Barbara; Moroz, Dianne

2009-02-01

Hospital preparedness for infectious disease emergencies is imperative. A 40-item hospital preparedness survey was administered to Association for Professionals in Infection Control and Epidemiology, Inc, members. Kruskal-Wallis tests were used to evaluate the relationship between hospital size and emergency preparedness in relation to various surge capacity measures. Significant findings were followed by Mann-Whitney U post hoc tests. Most hospitals have an infection control professional on their disaster committee, 24/7 infection control support, a health care worker prioritization plan for vaccine or antivirals, and nonhealth care facility surge beds but lack health care worker, laboratory, linen, and negative-pressure room surge capacity. Many hospitals participated in a disaster exercise recently and are stockpiling N95 respirators and medications. Few are stockpiling ventilators, surgical masks, or patient linens; those that are have

PBF Control Building (PER619). Interior of control room. Control console ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

PBF Control Building (PER-619). Interior of control room. Control console in center of room. Indicator panels along walls. Window shown in ID-33-F-120 is between control panels at left. Camera facing northwest. Date: May 2004. INEEL negative no. HD-41-7-3 - Idaho National Engineering Laboratory, SPERT-I & Power Burst Facility Area, Scoville, Butte County, ID

Study About Ceiling Design for Main Control Room of NPP with HFE

NASA Astrophysics Data System (ADS)

Gu, Pengfei; Ni, Ying; Chen, Weihua; Chen, Bo; Zhang, Jianbo; Liang, Huihui

Recently since human factor engineering (HFE) has been used in control room design of nuclear power plant (NPP), the human-machine interface (HMI) has been gradual to develop harmoniously, especially the use of the digital technology. Comparing with the analog technology which was used to human-machine interface in the past, human-machine interaction has been more enhanced. HFE and the main control room (MCR) design engineering of NPP is a combination of multidisciplinary cross, mainly related to electrical and instrument control, reactor, machinery, systems engineering and management disciplines. However, MCR is not only equipped with HMI provided by the equipments, but also more important for the operator to provide a work environment, such as the main control room ceiling. The ceiling design of main control room related to HFE which influences the performance of staff should also be considered in the design of the environment and aesthetic factors, especially the introduction of professional design experience and evaluation method. Based on Ling Ao phase II and Hong Yanhe project implementation experience, the study analyzes lighting effect, space partition, vision load about the ceiling of main control room of NPP. Combining with the requirements of standards, the advantages and disadvantages of the main control room ceiling design has been discussed, and considering the requirements of lightweight, noise reduction, fire prevention, moisture protection, the ceiling design solution of the main control room also has been discussed.

KSC-2012-6402

NASA Image and Video Library

2012-11-16

CAPE CANAVERAL, Fla. – Firing Room 1, also known as the Young-Crippen Firing Room, has been outfitted with computer, communications and networking systems to host rockets and spacecraft that are currently under development. The firing room is where the launch of rockets and spacecraft are controlled at NASA's Kennedy Space Center in Florida. Flight controllers also monitor processing and preparations of launch vehicles from the firing room. There are four firing rooms inside the Launch Control Center at Kennedy. Photo credit: NASA/Dmitri Gerondidakis

KSC-2012-6401

NASA Image and Video Library

2012-11-16

CAPE CANAVERAL, Fla. – Firing Room 1, also known as the Young-Crippen Firing Room, has been outfitted with computer, communications and networking systems to host rockets and spacecraft that are currently under development. The firing room is where the launch of rockets and spacecraft are controlled at NASA's Kennedy Space Center in Florida. Flight controllers also monitor processing and preparations of launch vehicles from the firing room. There are four firing rooms inside the Launch Control Center at Kennedy. Photo credit: NASA/Dmitri Gerondidakis

View of White Room atop Pad A during Apollo 9 Countdown Demonstration Test

NASA Technical Reports Server (NTRS)

1969-01-01

Interior view of the White Room atop Pad A, Launch Complex 39, Kenndy Space Center, during Apollo 9 Countdown Demonstration Test activity. Standing next to spacecraft hatch is Astronaut James A. McDivitt, commander. Also taking part in the training exercise were Astronauts David R. Scott, command module pilot; and Russell L. Schweickart, lunar module pilot.

[Anesthesia in obstetrics: Tried and trusted methods, current standards and new challenges].

PubMed

Kranke, P; Annecke, T; Bremerich, D H; Hanß, R; Kaufner, L; Klapp, C; Ohnesorge, H; Schwemmer, U; Standl, T; Weber, S; Volk, T

2016-01-01

Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. This review article deals with some evergreens and hot topics of obstetric anesthesia and essential new knowledge on these aspects is described. The article summarizes the talks given at the 16th symposium on obstetric anesthesia organized by the Scientific Committee for Regional Anaesthesia and Obstetric Anaesthesia within the German Society of Anaesthesiology. The topics are in particular, special features and pitfalls of informed consent in the delivery room, challenges in education and training in obstetric anesthesia, expedient inclusion of simulation-assisted training and further education on risk minimization, knowledge and recommendations on fasting for the delivery room and cesarean sections, monitoring in obstetric anesthesia by neuraxial and alternative procedures, the possibilities and limitations of using ultrasound for lumbal epidural catheter positioning in the delivery room, recommended approaches in preparing peridural catheters for cesarean section, basic principles of cardiotocography, postoperative analgesia after cesarean section, the practice of early bonding in the delivery room during cesarean section births and the management of postpartum hemorrhage.

ANALYSIS RESULTS FOR BUILDING 241 702-AZ A TRAIN

DOE Office of Scientific and Technical Information (OSTI.GOV)

DUNCAN JB; FRYE JM; COOKE CA

2006-12-13

This report presents the analyses results for three samples obtained under RPP-PLAN-28509, Sampling and Analysis Plan for Building 241 702-AZ A Train. The sampling and analysis was done in response to problem evaluation request number PER-2004-6139, 702-AZ Filter Rooms Need Radiological Cleanup Efforts.

76 FR 44047 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Workforce...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

... of Labor (DOL) is submitting the revised Employment and Training Administration (ETA) sponsored... Training Administration (ETA), Office of Management and Budget, Room 10235, Washington, DC 20503, Telephone... Investment Act Title I programs. Applications are submitted to the ETA National Office on behalf of states...

77 FR 19036 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Labor...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-29

..., 2012, the Department of Labor (DOL) will submit the Employment and Training Administration (ETA... Regulatory Affairs, Attn: OMB Desk Officer for DOL-ETA, Office of Management and Budget, Room 10235... services through ETA 9002 reports and for Veterans' Employment and Training Services (VETS)- funded labor...

78 FR 7457 - Agency Information Collection Activities; Submission for OMB Review; Comment Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... request (ICR) titled, ``International Training Application,'' to the Office of Management and Budget (OMB... for OMB Review; Comment Request; International Training Application ACTION: Notice. SUMMARY: The... Information and Regulatory Affairs, Attn: OMB Desk Officer for DOL-BLS, Office of Management and Budget, Room...

The Physical Demands and Ergonomics of Working with Young Children.

ERIC Educational Resources Information Center

Gratz, Rene R.; Claffey, Anne; King, Phyllis; Scheuer, Gina

2002-01-01

Examines the physical demands and ergonomic concerns within child care settings. Discusses problem areas and ergonomic recommendations for room design and staff training. Presents important implications for writing job descriptions, determining essential job functions, orienting and training staff, and committing to improving the child care work…

78 FR 15283 - Uniform National Threshold Entered Employment Rate for Veterans

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

... DEPARTMENT OF LABOR Veterans' Employment and Training Service 20 CFR Part 1001 RIN 1293-AA18... Training Service, U.S. Department of Labor, 200 Constitution Avenue NW., Room S-1325, Washington, DC 20210... include ''labor exchange services * * * offered in accordance with the Wagner-Peyser Act.'' We interpret...

Application of Biofeedback/Relaxation Training to Exceptional Children.

ERIC Educational Resources Information Center

Carter, John L.

A series of investigations was conducted to determine the effects of biofeedback training on 20 learning disabled elementary boys, 16 educable retarded boys, and 5 "non-diagnosed" elementary children with learning problems. Treatment of each group consisted of getting the children settled into the room and listening to a pre-recorded…

Assessment of a short hypnosis in a paediatric operating room in reducing postoperative pain and anxiety: A randomised study.

PubMed

Duparc-Alegria, Nathalie; Tiberghien, Karine; Abdoul, Hendy; Dahmani, Souhayl; Alberti, Corinne; Thiollier, Anne-Francoise

2018-01-01

To assess the impact of a short hypnotic session on postoperative anxiety and pain in major orthopaedic surgery. Despite specific information given before a scheduled paediatric surgery, perioperative anxiety can become important. Randomised Clinical Study. The study is an open single-centre randomised clinical study comparing a "control" group versus a "hypnosis" group receiving a short hypnosis pre-induction session as additional experimental analgesic procedure. The primary endpoint was the postoperative anxiety, blindly assessed using a visual analogue scale. The study involved 120 children (age 10-18 years). The results showed no difference between control group versus hypnosis group. Twenty-four hours after surgery (Day+1), the patient's anxiety score was not different between control and hypnosis groups (median [Q1-Q3]: 1 [0; 3] vs. 0 [0; 3], respectively, p = .17). Each group experienced a significant decrease in anxiety level between the day before surgery (Day-1) and the day after surgery (Day+1) (median ([Q1-Q3]) difference of the anxiety score: 2 [4; 0] and 2 [4; 0], respectively, p < .0001 in each group). The postoperative pain scores were low and not different between groups (median [Q1-Q3]: 2 [0; 3] in control group vs. 3 [1; 3] in hypnosis group, p = .57). This randomised study on a short hypnosis session performed in the operating room prior to a major surgery showed no difference in postoperative anxiety and pain levels. The decrease in anxiety and pain levels may be due to the addition of nurse pre-operative interviews and optimisation in communication in the operating room. As postoperative anxiety level was low in both control and hypnosis groups, nurse pre-operative interviews and nurse training in hypnosis may contribute to the optimisation of global management and decrease the postoperative anxiety level. © 2017 John Wiley & Sons Ltd.

Bio-Kil, a nano-based disinfectant, reduces environmental bacterial burden and multidrug-resistant organisms in intensive care units.

PubMed

Lee, Wen-Sen; Hsieh, Tai-Chin; Shiau, Justine C; Ou, Tsong-Yih; Chen, Fu-Lun; Liu, Yu-Hsin; Yen, Muh-Yong; Hsueh, Po-Ren

2017-10-01

This prospective before-after study was intended to investigate the effect of Bio-Kil on reducing environmental bacterial burden and healthcare-associated infections (HAIs) in intensive care units (ICUs) at the Municipal Wan-Fang Hospital, Taipei, Taiwan in 2014. Four rooms in the medical and surgical ICUs were investigated and designated as study rooms (n = 2) or control rooms (n = 2). Routine disinfection was performed during the pre-intervention period in both room types. Bio-Kil was applied to the fomites and surroundings of the study rooms during the intervention period. Total bacterial burden and proportion of colonization of fomites and surroundings by multidrug-resistance organisms (MDROs) were determined before and after the intervention. The demographic characteristics, underlying conditions, and clinical outcomes of patients were analyzed. After application of Bio-Kil, the bacterial burden declined in both groups, although the reduction was greater in the study rooms as compared with the control rooms (p = 0.001). During the pre-intervention period, 16 patients were admitted to control rooms and 18 patients to study rooms. After the intervention, 22 patients were admitted to control rooms and 21 patients to study rooms. The number of cases of new-onset sepsis declined in the intervention group (from 33% to 23.8%), but increased in the control group (from 25% to 40.9%); however, there was no significant difference in incidence of new-onset sepsis between the study and control rooms after intervention. Application of Bio-Kil reduced the environmental bacterial burden and MDROs in ICUs. Further studies are needed to evaluate the efficacy of this nanotechnology-based disinfectant in reducing HAIs. Copyright © 2016. Published by Elsevier B.V.

Implementing a robotics curriculum at an academic general surgery training program: our initial experience.

PubMed

Winder, Joshua S; Juza, Ryan M; Sasaki, Jennifer; Rogers, Ann M; Pauli, Eric M; Haluck, Randy S; Estes, Stephanie J; Lyn-Sue, Jerome R

2016-09-01

The robotic surgical platform is being utilized by a growing number of hospitals across the country, including academic medical centers. Training programs are tasked with teaching their residents how to utilize this technology. To this end, we have developed and implemented a robotic surgical curriculum, and share our initial experience here. Our curriculum was implemented for all General Surgical residents for the academic year 2014-2015. The curriculum consisted of online training, readings, bedside training, console simulation, participating in ten cases as bedside first assistant, and operating at the console. 20 surgical residents were included. Residents were provided the curriculum and notified the department upon completion. Bedside assistance and operative console training were completed in the operating room through a mix of biliary, foregut, and colorectal cases. During the fiscal years of 2014 and 2015, there were 164 and 263 robot-assisted surgeries performed within the General Surgery Department, respectively. All 20 residents completed the online and bedside instruction portions of the curriculum. Of the 20 residents trained, 13/20 (65 %) sat at the Surgeon console during at least one case. Utilizing this curriculum, we have trained and incorporated residents into robot-assisted cases in an efficient manner. A successful curriculum must be based on didactic learning, reading, bedside training, simulation, and training in the operating room. Each program must examine their caseload and resident class to ensure proper exposure to this platform.

Simulation-based camera navigation training in laparoscopy-a randomized trial.

PubMed

Nilsson, Cecilia; Sorensen, Jette Led; Konge, Lars; Westen, Mikkel; Stadeager, Morten; Ottesen, Bent; Bjerrum, Flemming

2017-05-01

Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon-all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room. A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group). Participants were surgical novices without prior laparoscopic experience. The primary outcome was assessment of camera navigation skills during a laparoscopic cholecystectomy. The secondary outcome was technical skills after training, using a previously developed model for testing camera navigational skills. The exploratory outcome measured participants' motivation toward the task as an operating assistant. Thirty-six participants were randomized. No significant difference was found in the primary outcome between the three groups (p = 0.279). The secondary outcome showed no significant difference between the interventions groups, total time 167 s (95% CI, 118-217) and 194 s (95% CI, 152-236) for the camera group and the procedure group, respectively (p = 0.369). Both interventions groups were significantly faster than the control group, 307 s (95% CI, 202-412), p = 0.018 and p = 0.045, respectively. On the exploratory outcome, the control group for two dimensions, interest/enjoyment (p = 0.030) and perceived choice (p = 0.033), had a higher score. Simulation-based training improves the technical skills required for camera navigation, regardless of practicing camera navigation or the procedure itself. Transfer to the clinical setting could, however, not be demonstrated. The control group demonstrated higher interest/enjoyment and perceived choice than the camera group.

KSC-07pd1990

NASA Image and Video Library

2007-07-19

KENNEDY SPACE CENTER, Fla. --In the White Room on Launch Pad 39A, STS-118 Mission Specialist Rick Mastracchio is eager to enter Space Shuttle Endeavour for a simulated launch countdown, the culmination of terminal countdown demonstration test activities. The White Room is situated at the end of the orbiter access arm and provides entry into the orbiter. TCDT activities also include M-113 training, payload familiarization and emergency egress training at the pad. The mission is the 22nd flight to the International Space Station and Space Shuttle Endeavour will carry a payload including the S5 truss, a SPACEHAB module and external stowage platform 3. STS-118 is targeted for launch on Aug. 7. Photo credit: NASA/Amanda Diller

The role of simulation in urological training - A quantitative study of practice and opinions.

PubMed

Aydin, Abdullatif; Ahmed, Kamran; Shafi, Ahmed M A; Khan, Muhammad Shamim; Dasgupta, Prokar

2016-12-01

Over the past few decades, simulation-based training has rapidly been adopted by many centres for effective technical and non-technical skills training, as a supplementary method to traditional operating room experience. The aim of this study is to assess the current practice in training and seek opinion regarding the future role of simulation in urological training. A cross sectional survey was designed and distributed amongst expert and trainee urological surgeons. The survey consisted of twenty-two questions that were split into three sections; Introduction (6), Technical Skills training in urology (10) and Non-technical skills training in urology (6). A total of 91 residents and 172 specialists completed the survey. In both groups, there was an agreed consensus that laparoscopic training and exposure was insufficient as only 21% of trainees and 23% of specialists believed that they had sufficient training in this area. Furthermore, both groups lacked simulation-based training in common urological procedures including nephrectomy (62%), cystoscopy (69-74%), ureteroscopy (47-59%), transurethral resection of the prostate (56-65%) and percutaneous renal surgery (76-73%). 90% of trainees and 70% of specialists believed (agreed and strongly agreed) that there is a role for non-technical skills simulation in urological training. Simulation training has been under-used thus far and trainees face an uphill challenge to enhance their skills and technical abilities in the operating room. Simulation is recommended by both trainees and specialists and may represent one of the solutions to the challenges of safe and effective urology procedural training. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

[The 'Surgical Deck': a new generation of integrated operational rooms for ENT].

PubMed

Strauss, G; Gollnick, I; Neumuth, T; Meixensberger, J; Lueth, T C

2013-02-01

Existing operating room concepts do not meet modern technological opportunities anymore. The "Surgical Deck" is supposed to represent a prototype for a new operating room generation. The objective of the project is to achieve a better integration of functions and to develop an innovative concept for a highly developed surgical workstation. 3 working areas are defined: Surgical, Airway and Technical Cockpit. The evaluation was conducted on 284 surgeries carried out from 01.08. 2011 to 31.01. 2012. The evaluation team consisted of 6 surgeons, 3 surgery nurses, 3 anesthesiologists and 4 anesthesia nurses. Within a detailed analysis, the data of 50 FESS surgeries were compared to those of a control group. Within the FESS group, the average slot time was reduced by 13%. 88.2% of those questioned assessed ergonomics as being better than in the conventional OR. 71.5% stated that the Surgical Deck provided an added value with regard to the surgical procedure. 91.3% confirmed that the system control required additional training. 79.3% described the cost-benefit-ratio as appropriate. For 96% of the surgeries, respondents said that they were feeling adequately supported by the technology. The results show a clear advantage of the system architecture. The Surgical Deck may present a solid foundation with regard to the transfer of the system into the clinical practice. This is relevant for new assistance functions such as process control software or navigation-based collision warning systems. It is to be expected that the project will significantly contribute to further develop the future surgical workstation and its standardization. © Georg Thieme Verlag KG Stuttgart · New York.

Design, development, and evaluation of an online virtual emergency department for training trauma teams.

PubMed

Youngblood, Patricia; Harter, Phillip M; Srivastava, Sakti; Moffett, Shannon; Heinrichs, Wm LeRoy; Dev, Parvati

2008-01-01

Training interdisciplinary trauma teams to work effectively together using simulation technology has led to a reduction in medical errors in emergency department, operating room, and delivery room contexts. High-fidelity patient simulators (PSs)-the predominant method for training healthcare teams-are expensive to develop and implement and require that trainees be present in the same place at the same time. In contrast, online computer-based simulators are more cost effective and allow simultaneous participation by students in different locations and time zones. In this pilot study, the researchers created an online virtual emergency department (Virtual ED) for team training in crisis management, and compared the effectiveness of the Virtual ED with the PS. We hypothesized that there would be no difference in learning outcomes for graduating medical students trained with each method. In this pilot study, we used a pretest-posttest control group, experimental design in which 30 subjects were randomly assigned to either the Virtual ED or the PS system. In the Virtual ED each subject logged into the online environment and took the role of a team member. Four-person teams worked together in the Virtual ED, communicating in real time with live voice over Internet protocol, to manage computer-controlled patients who exhibited signs and symptoms of physical trauma. Each subject had the opportunity to be the team leader. The subjects' leadership behavior as demonstrated in both a pretest case and a posttest case was assessed by 3 raters, using a behaviorally anchored scale. In the PS environment, 4-person teams followed the same research protocol, using the same clinical scenarios in a Simulation Center. Guided by the Emergency Medicine Crisis Resource Management curriculum, both the Virtual ED and the PS groups applied the basic principles of team leadership and trauma management (Advanced Trauma Life Support) to manage 6 trauma cases-a pretest case, 4 training cases, and a posttest case. The subjects in each group were assessed individually with the same simulation method that they used for the training cases. Subjects who used either the Virtual ED or the PS showed significant improvement in performance between pretest and posttest cases (P < 0.05). In addition, there was no significant difference in subjects' performance between the 2 types of simulation, suggesting that the online Virtual ED may be as effective for learning team skills as the PS, the method widely used in Simulation Centers. Data on usability and attitudes toward both simulation methods as learning tools were equally positive. This study shows the potential value of using virtual learning environments for developing medical students' and resident physicians' team leadership and crisis management skills.

How much guidance is given in the operating room? Factors influencing faculty self-reports, resident perceptions, and faculty/resident agreement.

PubMed

Torbeck, Laura; Williams, Reed G; Choi, Jennifer; Schmitz, Connie C; Chipman, Jeffrey G; Dunnington, Gary L

2014-10-01

Guidance in the operating room impacts resident confidence and ability to function independently. The purpose of this study was to explore attending surgeon guidance practices in the operating room as reported by faculty members themselves and by junior and senior residents. This was an exploratory, cross-sectional survey research study involving 91 categorical residents and 82 clinical faculty members at two academic general surgery training programs. A series of analyses of variance along with descriptive statistics were performed to understand the impact of resident training year, program, and surgeon characteristics (sex and type of surgery performed routinely) on guidance practices. Resident level (junior versus senior) significantly impacted the amount of guidance given as reported by faculty and as perceived by residents. Within each program, junior residents perceived less guidance than faculty reported giving. For senior guidance practices, however, the differences between faculty and resident practices varied by program. In terms of the effects of surgeon practice type (mostly general versus mostly complex cases), residents at both institutions felt they were more supervised closely by the faculty who perform mostly complex cases. More autonomy is given to senior than to junior residents. Additionally, faculty report a greater amount of change in their guidance practices over the training period than residents perceive. Faculty and resident agreement about the need for guidance and for autonomy are important for achieving the goals of residency training. Copyright © 2014 Elsevier Inc. All rights reserved.

Final Environmental Assessment for a Proposed Pararescue and Combat Rescue Officer Training Campus at Kirtland Air Force Base

DTIC Science & Technology

2006-09-01

tank with adjacent training structure and hoist for inflatable boat training. An indoor climbing wall, a weight/fitness room, and staff and student...climbing; rappelling/litter evacuation; Tyrolean traverses; suspended harness parachuting emergency procedures; aircraft hoist infiltration...characteristics in common. Bulldozers, backhoes, and front-end loaders would be on site throughout periods of excavation and/or site preparation. Dump

[Impact of simulation to reduce neonatal and maternal morbidity of shoulder dystocia].

PubMed

Legendre, G; Bouet, P-E; Sentilhes, L

2015-12-01

To assess the role of simulation in reducing morbidity and mortality of shoulder dystocia. A systematic literature review was conducted in the Medline database. Regarding the prevention of complications of shoulder dystocia, practical training using mannequin is associated with improvements in management shoulder dystocia than training using video tutorial (EL2). Practical training using simulation for shoulder dystocia allows an improvement for manoeuvres mainly for trainees, but simulation seems to benefit to all caregivers for the communication (EL3). The effect of training sessions using simulation for learning writing the medical observation allows only a modest improvement in the medical record transcription (EL3). The interest of a specific grid for reporting shoulder dystocia seems interesting to increase the amount of information transcribed by the caregiver (EL3). The establishment of a practical training using simulation and concerning all caregivers of the delivery room is associated with a significant reduction in neonatal injury (EL3). The establishment of a training program using simulation does not seem to decrease maternal morbidity in case of shoulder dystocia (EL3). A teaching using simulation for the management of shoulder dystocia is encouraged for the initial and continuing formation of different actors in the delivery room (professional agreement). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Cost analysis of objective resident cataract surgery assessments.

PubMed

Nandigam, Kiran; Soh, Jonathan; Gensheimer, William G; Ghazi, Ahmed; Khalifa, Yousuf M

2015-05-01

To compare 8 ophthalmology resident surgical training tools to determine which is most cost effective. University of Rochester Medical Center, Rochester, New York, USA. Retrospective evaluation of technology. A cost-analysis model was created to compile all relevant costs in running each tool in a medium-sized ophthalmology program. Quantitative cost estimates were obtained based on cost of tools, cost of time in evaluations, and supply and maintenance costs. For wet laboratory simulation, Eyesi was the least expensive cataract surgery simulation method; however, it is only capable of evaluating simulated cataract surgery rehearsal and requires supplementation with other evaluative methods for operating room performance and for noncataract wet lab training and evaluation. The most expensive training tool was the Eye Surgical Skills Assessment Test (ESSAT). The 2 most affordable methods for resident evaluation in operating room performance were the Objective Assessment of Skills in Intraocular Surgery (OASIS) and Global Rating Assessment of Skills in Intraocular Surgery (GRASIS). Cost-based analysis of ophthalmology resident surgical training tools are needed so residency programs can implement tools that are valid, reliable, objective, and cost effective. There is no perfect training system at this time. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Using in situ simulation to identify and resolve latent environmental threats to patient safety: case study involving operational changes in a labor and delivery ward.

PubMed

Hamman, William R; Beaudin-Seiler, Beth M; Beaubien, Jeffrey M; Gullickson, Amy M; Orizondo-Korotko, Krystyna; Gross, Amy C; Fuqua, Wayne; Lammers, Richard

2010-01-01

Since the publication of "To Err Is Human" in 1999, health care professionals have looked to high-reliability industries such as aviation for guidance on improving system safety. One of the most widely adopted aviation-derived approaches is simulation-based team training, also known as crew resource management training. In the health care domain, crew resource management training often takes place in custom-built simulation laboratories that are designed to replicate operating rooms or labor and delivery rooms. Unlike these traditional crew resource management training programs, "in situ simulation" occurs on actual patient care units, involves actual health care team members, and uses actual organization processes to train and assess team performance. During the past 24 months, our research team has conducted nearly 40 in situ simulations. In this article, we present the results from 1 such simulation: a patient who experienced a difficult labor that resulted in an emergency caesarian section and hysterectomy. During the simulation, a number of latent environmental threats to safety were identified. This article presents the latent threats and the steps that the hospital has taken to remedy them.

Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized educational trial.

PubMed

Oestergaard, Jeanett; Bjerrum, Flemming; Maagaard, Mathilde; Winkel, Per; Larsen, Christian Rifbjerg; Ringsted, Charlotte; Gluud, Christian; Grantcharov, Teodor; Ottesen, Bent; Soerensen, Jette Led

2012-02-28

Several studies have found a positive effect on the learning curve as well as the improvement of basic psychomotor skills in the operating room after virtual reality training. Despite this, the majority of surgical and gynecological departments encounter hurdles when implementing this form of training. This is mainly due to lack of knowledge concerning the time and human resources needed to train novice surgeons to an adequate level. The purpose of this trial is to investigate the impact of instructor feedback regarding time, repetitions and self-perception when training complex operational tasks on a virtual reality simulator. The study population consists of medical students on their 4th to 6th year without prior laparoscopic experience. The study is conducted in a skills laboratory at a centralized university hospital. Based on a sample size estimation 98 participants will be randomized to an intervention group or a control group. Both groups have to achieve a predefined proficiency level when conducting a laparoscopic salpingectomy using a surgical virtual reality simulator. The intervention group receives standardized instructor feedback of 10 to 12 min a maximum of three times. The control group receives no instructor feedback. Both groups receive the automated feedback generated by the virtual reality simulator. The study follows the CONSORT Statement for randomized trials. Main outcome measures are time and repetitions to reach the predefined proficiency level on the simulator. We include focus on potential sex differences, computer gaming experience and self-perception. The findings will contribute to a better understanding of optimal training methods in surgical education. NCT01497782.

Cervical Spine Collar Removal by Emergency Room Nurses: A Quality Improvement Project.

PubMed

Fontaine, Guillaume; Forgione, Massimo; Lusignan, Francis; Lanoue, Marc-André; Drouin, Simon

2018-05-01

The Canadian C-Spine Rule (CCR) is a clinical decision aid to facilitate the safe removal of cervical collars in the alert, orientated, low-risk adult trauma patient. Few health care settings have assessed initiatives to train charge nurses to use the CCR. This practice improvement project conducted in a secondary trauma center in Canada aimed to (1) train charge nurses of the emergency room to use the CCR, (2) monitor its use throughout the project period, and (3) compare the assessments of the charge nurses with those of emergency physicians. The project began with the creation of an interdisciplinary team. Clinical guidelines were established by the interdisciplinary project team. Nine charge nurses of the emergency room were then trained to use the CCR (3 on each 8-hour shift). The use of the CCR was monitored throughout the project period, from June 1 to October 5, 2016. The 3 aims of this practice improvement project were attained successfully. Over a 5-month period, 114 patients were assessed with the CCR. Charge nurses removed the cervical collars for 54 of 114 patients (47%). A perfect agreement rate (114 of 114 patients, 100%) was attained between the assessments of the nurses and those of physicians. This project shows that the charge nurses of a secondary trauma center can use the CCR safely on alert, orientated, and low-risk adult trauma patients as demonstrated by the agreement in the assessments of emergency room nurses and physicians. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Deep Neural Network Based Supervised Speech Segregation Generalizes to Novel Noises through Large-scale Training

DTIC Science & Technology

2015-01-01

Table 2: Segregation results in terms of STOI on a variety of novel noises (SNR=-2 dB) Babble-20 Cafeteria Factory Babble-100 Living Room Cafe Park...NOISEX-92 corpus [13], and a living room, a cafe and a park noise from the DEMAND corpus [12]. To put the performance of the noise-independent model in

Specialized operating room for cesarean section in the perinatal care unit: a review of the opening process and operating room management.

PubMed

Kasagi, Yoshihiro; Okutani, Ryu; Oda, Yutaka

2015-02-01

We have opened an operating room in the perinatal care unit (PNCU), separate from our existing central operating rooms, to be used exclusively for cesarean sections. The purpose is to meet the increasing need for both emergency cesarean sections and non-obstetric surgeries. It is equipped with the same surgical instruments, anesthesia machine, monitoring system, rapid infusion system and airway devices as the central operating rooms. An anesthesiologist and a nurse from the central operating rooms trained the nurses working in the new operating room, and discussed solutions to numerous problems that arose before and after its opening. Currently most of the elective and emergency cesarean sections carried out during the daytime on weekdays are performed in the PNCU operating room. A total of 328 and 347 cesarean sections were performed in our hospital during 2011 and 2012, respectively, of which 192 (55.5 %) and 254 (73.2 %) were performed in the PNCU operating room. The mean occupancy rate of the central operating rooms also increased from 81 % in 2011 to 90 % in 2012. The PNCU operating room was built with the support of motivated personnel and multidisciplinary teamwork, and has been found to be beneficial for both surgeons and anesthesiologists, while it also contributes to hospital revenue.

Gender influences on career opportunities, practice choices, and job satisfaction in a cohort of physicians with certification in sports medicine.

PubMed

Pana, A L; McShane, J

2001-04-01

To examine the gender differences in practice patterns, experiences, and career opportunities for family physicians who practice sports medicine. Descriptive, self-administered questionnaire. Family physicians with Certificate of Added Qualification (CAQ) in sports medicine were surveyed. The survey was sent to all women with a CAQ in Sports Medicine and a random sample of 20% of the men with CAQs in sports medicine. Survey consisted of multiple choice, Likert scale, and opened-ended questions. The data was analyzed with contingency tables, with gender as the dependent variable. Response rate to the survey was 75%, which included 42 females and 102 males. Demographics of our population demonstrated some gender differences. Males were of higher average age (41.1 vs. 38.1), and more likely to be married and have children. Practice types, location, and time spent in sports medicine did not differ with the exception of training room and event coverage. Males were more likely to cover all levels of training room except at the Division I level, where the percent of males and females covering training rooms were equal. Males were also more likely to cover all types of sporting events. Job satisfaction and reasons for choosing current jobs did not show significant gender differences. However, factors affecting career opportunities did vary. Professional relationships with athletic trainers and coaches were perceived to be different by males and females surveyed. Our survey of sports medicine physicians showed some gender differences in practice patterns relative to training room and sporting event coverage. Surprisingly, there were not many differences in the factors that affected job choice and factors affecting job opportunities with the exception of gender itself. However, our study does not conclude how or when gender begins to affect the female sports medicine physician's career opportunities.

Expedition 19 Crew Training

NASA Image and Video Library

2009-03-20

Expedition 19 Commander Gennady I. Padalka, left, Flight Engineer Michael R. Barratt, right, and Spaceflight Participant Charles Simonyi, 2nd row right, along with cosmonaut instructors are seen through a quarantine windowed room as they participate in Soyuz rendezvous and docking training at the Cosmonaut Hotel, Saturday, March 21, 2009 in Baikonur, Kazakhstan. (Photo Credit: NASA/Bill Ingalls)

77 FR 71634 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Employment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-03

... Training Administration (ETA) sponsored information collection request (ICR) titled, ``Employment and Training Administration Financial Report,'' (Forms ETA-9130, ETA-9130-A, and ETA-9130-B) to the Office of... Regulatory Affairs, Attn: OMB Desk Officer for DOL-ETA, Office of Management and Budget, Room 10235, 725 17th...

77 FR 2351 - Agency Information Collection (Monthly Certification of On-the-Job and Apprenticeship Training...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC... Certification of On-the- Job and Apprenticeship Training): Activity Under OMB Review AGENCY: Veterans Benefits... abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission...

77 FR 7242 - Agency Information Collection (Agreement To Train on the Job Disabled Veterans): Activity Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-10

..., OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC... (Agreement To Train on the Job Disabled Veterans): Activity Under OMB Review AGENCY: Veterans Benefits... to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the...

Rescuing Tomorrow Today: Fixing Training and Development for DHS Leaders

DTIC Science & Technology

2016-09-01

training, personnel development, mentorship, e -learning, blended learning solutions, Hurricane Katrina 15. NUMBER OF PAGES 91 16. PRICE CODE 17...5  D.  HYPOTHESES AND ASSUMPTIONS ...................................................8  E .  RESEARCH DESIGN...19  D.  THERE IS ALWAYS ROOM FOR IMPROVEMENT.......................20  E .  KATRINA LESSONS LEARNED

KSC-2011-1449

NASA Image and Video Library

2011-02-15

CAPE CANAVERAL, Fla. -- At NASA's Kennedy Space Center in Florida, workers receive training atop a mast climber that is attached to launch simulation towers outside the Launch Equipment Test Facility. The training includes attaching carrier plates, water and air systems, and electricity to the climber to simulate working in Kennedy's Vehicle Assembly Building (VAB). Mast climbers can be substituted for fixed service structures currently inside the VAB to provide access to any type of launch vehicle. Since 1977, the facility has supported NASA’s Launch Services, shuttle, International Space Station, and Constellation programs, as well as commercial providers. Last year, the facility underwent a major upgrade to support even more programs, projects and customers. It houses a 6,000-square-foot high bay, cable fabrication and molding shop, pneumatics shop, machine and weld shop and full-scale control room. Outside, the facility features a water flow test loop, vehicle motion simulator and a cryogenic system. Photo credit: NASA/Jim Grossmann

KSC-2011-1446

NASA Image and Video Library

2011-02-15

CAPE CANAVERAL, Fla. -- At NASA's Kennedy Space Center in Florida, workers receive training atop a mast climber that is attached to launch simulation towers outside the Launch Equipment Test Facility. The training includes attaching carrier plates, water and air systems, and electricity to the climber to simulate working in Kennedy's Vehicle Assembly Building (VAB). Mast climbers can be substituted for fixed service structures currently inside the VAB to provide access to any type of launch vehicle. Since 1977, the facility has supported NASA’s Launch Services, shuttle, International Space Station, and Constellation programs, as well as commercial providers. Last year, the facility underwent a major upgrade to support even more programs, projects and customers. It houses a 6,000-square-foot high bay, cable fabrication and molding shop, pneumatics shop, machine and weld shop and full-scale control room. Outside, the facility features a water flow test loop, vehicle motion simulator and a cryogenic system. Photo credit: NASA/Jim Grossmann

KSC-2011-1450

NASA Image and Video Library

2011-02-15

CAPE CANAVERAL, Fla. -- At NASA's Kennedy Space Center in Florida, training takes place atop a mast climber that is attached to launch simulation towers outside the Launch Equipment Test Facility. The training includes attaching carrier plates, water and air systems, and electricity to the climber to simulate working in Kennedy's Vehicle Assembly Building (VAB). Mast climbers can be substituted for fixed service structures currently inside the VAB to provide access to any type of launch vehicle. Since 1977, the facility has supported NASA’s Launch Services, shuttle, International Space Station, and Constellation programs, as well as commercial providers. Last year, the facility underwent a major upgrade to support even more programs, projects and customers. It houses a 6,000-square-foot high bay, cable fabrication and molding shop, pneumatics shop, machine and weld shop and full-scale control room. Outside, the facility features a water flow test loop, vehicle motion simulator and a cryogenic system. Photo credit: NASA/Jim Grossmann

KSC-2011-1448

NASA Image and Video Library

2011-02-15

CAPE CANAVERAL, Fla. -- At NASA's Kennedy Space Center in Florida, workers receive training atop a mast climber that is attached to launch simulation towers outside the Launch Equipment Test Facility. The training includes attaching carrier plates, water and air systems, and electricity to the climber to simulate working in Kennedy's Vehicle Assembly Building (VAB). Mast climbers can be substituted for fixed service structures currently inside the VAB to provide access to any type of launch vehicle. Since 1977, the facility has supported NASA’s Launch Services, shuttle, International Space Station, and Constellation programs, as well as commercial providers. Last year, the facility underwent a major upgrade to support even more programs, projects and customers. It houses a 6,000-square-foot high bay, cable fabrication and molding shop, pneumatics shop, machine and weld shop and full-scale control room. Outside, the facility features a water flow test loop, vehicle motion simulator and a cryogenic system. Photo credit: NASA/Jim Grossmann

KSC-2011-1447

NASA Image and Video Library

2011-02-15

CAPE CANAVERAL, Fla. -- At NASA's Kennedy Space Center in Florida, workers receive training on a mast climber that is attached to launch simulation towers outside the Launch Equipment Test Facility. The training includes attaching carrier plates, water and air systems, and electricity to the climber to simulate working in Kennedy's Vehicle Assembly Building (VAB). Mast climbers can be substituted for fixed service structures currently inside the VAB to provide access to any type of launch vehicle. Since 1977, the facility has supported NASA’s Launch Services, shuttle, International Space Station, and Constellation programs, as well as commercial providers. Last year, the facility underwent a major upgrade to support even more programs, projects and customers. It houses a 6,000-square-foot high bay, cable fabrication and molding shop, pneumatics shop, machine and weld shop and full-scale control room. Outside, the facility features a water flow test loop, vehicle motion simulator and a cryogenic system. Photo credit: NASA/Jim Grossmann

Main Control Room, view to the east. The door to ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Main Control Room, view to the east. The door to the motor room is to the right, and the main control cabinets are to the left - Wellton-Mohawk Irrigation System, Pumping Plant No. 1, Bounded by Gila River & Union Pacific Railroad, Wellton, Yuma County, AZ

Certified Athletic Trainers' Knowledge of Methicillin-Resistant Staphylococcus aureus and Common Disinfectants

PubMed Central

Kahanov, Leamor; Gilmore, Elizabeth J.; Eberman, Lindsey E.; Roberts, Jeffrey; Semerjian, Tamar; Baldwin, Linda

2011-01-01

Context: Methicillin-resistant Staphylococcus aureus (MRSA) infections are increasingly common in athletic settings. The MRSA knowledge and infection-control practices of certified athletic trainers (ATs) and the cleanliness of the athletic training room are important factors in preventing MRSA infections. Objective: To assess knowledge of MRSA and the use of common disinfectants among ATs and to explore their infection-control practices. Design: Cross-sectional study. Setting: High school and collegiate athletic training rooms. Patients or Other Participants: A total of 163 ATs from National Collegiate Athletic Association Divisions I, II, and III and high schools, representing all 10 National Athletic Trainers' Association districts. Main Outcome Measure(s): Frequencies, analyses of variance, and χ2 tests were used to assess current practices and opinions and relationships between factors. Results: Methicillin-resistant Staphylococcus aureus was perceived as a national problem by 92% of respondents; 57% perceived MRSA as a problem in their practice setting. Most respondents had treated general infections (88%), staphylococcal infections (75%), and MRSA infections (57%). Male sex was associated with treating all 3 types of infections (χ2 test, P < .05). Noncurriculum education was associated with a lack of recognition of environmental issues as risk factors and with the use of isopropyl alcohol for disinfection (χ2 test, P < .05). For example, 10% of respondents did not recognize that contaminated whirlpools can be a source of MRSA infection. Respondents also incorrectly identified effective cleaning solutions. Thirty percent of respondents cleaned their hands frequently or sometimes before treating each athlete and 35% cleaned their hands sometimes, occasionally, or never after seeing each athlete. Conclusions: The majority of ATs were informed about MRSA and made correct disinfection choices. However, improvements are still needed, and not all ATs were using proper disinfection practices. PMID:21944074

A study to enhance clinical end-user MEDLINE search skills: design and baseline findings.

PubMed

McKibbon, K A; Haynes, R B; Johnston, M E; Walker, C J

1991-01-01

To determine if a preceptor and timely, individualized feedback improves the performance of physicians in searching MEDLINE using GRATEFUL MED in clinical settings. Randomized controlled trial. A 300 bed primary to tertiary care teaching hospital. Computers were installed in wards and clinics of 6 major clinical services, and the emergency room, intensive care and neonatal intensive care units. All physicians and physicians-in-training from the departments of Medicine, Family Medicine, Surgery, Psychiatry, Pediatrics, and Obstetrics and Gynecology were included if they made patient care decisions for at least 8 weeks during the study period. All participants were given a 1-hour training class and 1 hour of individualized searching with 1 of the 2 study librarians. After training, participants were randomized to a control group who received no further intervention or to an intervention group in which each person chose a clinical preceptor experienced in MEDLINE searching and received individualized feedback by a study librarian on their first 10 searches, indicating search quality and providing suggestions for improvement. Feedback was mailed the first week day after the search was done. Baseline characteristics by study group, department and level of training, study participation rates, and searching rates. 308 of 392 eligible physicians joined the study. Participation was almost 80% with some variation by department and level of training. Excellent balance in the baseline characteristics was achieved for the 2 groups, as well as for the number who did first searches. Intervention group participants searched MEDLINE more often than did controls (3.5 searches per month vs 2.5 per month for controls, P = 0.046). The recall and precision for first searches for both groups was significantly less than that of librarians. The analysis of study data will be completed by September 1991. Clinicians are willing to do self-service searching of MEDLINE in clinical settings but their precision and recall are less than a trained librarian at baseline. Search skills enhancements are needed and the effect of feedback and preceptors is being tested. U.S. National Library of Medicine and Ontario Ministry of Health.

Counter Narcoterrorism Technology Program Office Task Orders Had Excess Fees, and the Army Was Incorrectly Billed

DTIC Science & Technology

2011-11-01

604-8932, or by mail: ODIG-AUD (ATTN: Audit Suggestions) Department of Defense Inspector General 400 Army Navy Drive (Room 801...Command USTC U.S. Training Center INSPECTOR GENERAL DEPARTMENT OF DEFENSE 400 ARMY NAVY DRIVE ARLINGTON, VIRGINIA 22202- 4704 November 1, 2011...Training Center, Inc. (USTC) (formerly Blackwater Lodge and Training, Inc.). 2 The CNTPO IDIQ contracts allow for three task order types—firm-fixed

[Theatre as communication method in psychogeriatric care: effects on behaviour, mood and quality of life of people with dementia ].

PubMed

van Dijk, A M; van Weert, J C M; Dröes, R M

2012-12-01

Recently, a new communication method was introduced in nursing homes for people with dementia. This so-called Veder Method, developed by professional actors with former educational background in care,combines proven effective emotion-oriented care methods, like reminiscence,with theatrical stimuli like songs and poetry. The method is applied during theatre shows and living room theatre activities. In this exploratory study the surplus value of a living room theatre activity according to the Veder method compared to a reminiscence group activity was evaluated. Within a quasi experimental design, three groups of nursing home residents with dementia were compared: Experimental group 1 (E1; N=64)joined a 'living room theatre activity' offered by trained caregivers. Experimental group 2 (E2; N=31) joined a 'living room theatre activity' offered by professional actors. The control group (N=52) received a reminiscence group activity. Behaviour, mood and quality of life were measured using standardized observation scales at three points in time: (T1) pretest; (T2)during the intervention and; (T3) posttest, two hours after the intervention. During and after the intervention, positive effects were found in favour of E2 on behaviour (i.e. laughing, recalled memories), mood (i.e. happy/content) and quality of life (i.e. social involvement, feeling at home). A living room theatre activity according to the Veder Method has more positive effect on nursing home residents compared to a normal reminiscence group activity, if offered by professional actors.This article is a slightly edited translation of Does theatre improve the quality of life of people with dementia? International Psychogeriatrics2012;24: 36r381 by the same authors.

Development, validation and operating room-transfer of a six-step laparoscopic training program for the vesicourethral anastomosis.

PubMed

Klein, Jan; Teber, Dogu; Frede, Tom; Stock, Christian; Hruza, Marcel; Gözen, Ali; Seemann, Othmar; Schulze, Michael; Rassweiler, Jens

2013-03-01

Development and full validation of a laparoscopic training program for stepwise learning of a reproducible application of a standardized laparoscopic anastomosis technique and integration into the clinical course. The training of vesicourethral anastomosis (VUA) was divided into six simple standardized steps. To fix the objective criteria, four experienced surgeons performed the stepwise training protocol. Thirty-eight participants with no previous laparoscopic experience were investigated in their training performance. The times needed to manage each training step and the total training time were recorded. The integration into the clinical course was investigated. The training results and the corresponding steps during laparoscopic radical prostatectomy (LRP) were analyzed. Data analysis of corresponding operating room (OR) sections of 793 LRP was performed. Based on the validity, criteria were determined. In the laboratory section, a significant reduction of OR time for every step was seen in all participants. Coordination: 62%; longitudinal incision: 52%; inverted U-shape incision: 43%; plexus: 47%. Anastomosis catheter model: 38%. VUA: 38%. The laboratory section required a total time of 29 hours (minimum: 16 hours; maximum: 42 hours). All participants had shorter execution times in the laboratory than under real conditions. The best match was found within the VUA model. To perform an anastomosis under real conditions, 25% more time was needed. By using the training protocol, the performance of the VUA is comparable to that of an surgeon with experience of about 50 laparoscopic VUA. Data analysis proved content, construct, and prognostic validity. The use of stepwise training approaches enables a surgeon to learn and reproduce complex reconstructive surgical tasks: eg, the VUA in a safe environment. The validity of the designed system is given at all levels and should be used as a standard in the clinical surgical training in laparoscopic reconstructive urology.

[Problems of X-ray mammology manpower training and management].

PubMed

Rozhkova, N I

2014-01-01

The paper considers the issues of manpower training in X-ray mammology. It mentions staff shortage and no special training, which reduces the efficient activities of X-ray mammographic rooms, as well as shortage of training facilities and no unified educational programs within interdisciplinary integration, inadequate technical equipment in the training facilities, the lack of an accounting system for training higher- and mid-level health workers, as well as engineers. Emphasis is placed on that the educational programs must comply with the organizational forms of testing the specialists to be employed. The introduction of a continuous education system should be accelerated to rule out the decay period of specialists' competence.

Leadership and Management: Techniques and Principles for Athletic Training

PubMed Central

Nellis, Stephen M.

1994-01-01

Leadership and management have become topics of recent interest in athletic training. These skills are distinct from each other and are vital to a successful and efficient athletic training room. Leadership is an influence relationship, while management is an authority relationship. Leadership is concerned with knowing yourself, your staff, your profession, and how to apply people skills. Management is concerned with organization, communication, and the development of your athletic training facility's mission. By applying good management and leadership skills, you can implement your mission statement, evaluate your results, and improve the performance of your athletic training facility. PMID:16558296

Distributed virtual environment for emergency medical training

NASA Astrophysics Data System (ADS)

Stytz, Martin R.; Banks, Sheila B.; Garcia, Brian W.; Godsell-Stytz, Gayl M.

1997-07-01

In many professions where individuals must work in a team in a high stress environment to accomplish a time-critical task, individual and team performance can benefit from joint training using distributed virtual environments (DVEs). One professional field that lacks but needs a high-fidelity team training environment is the field of emergency medicine. Currently, emergency department (ED) medical personnel train by using words to create a metal picture of a situation for the physician and staff, who then cooperate to solve the problems portrayed by the word picture. The need in emergency medicine for realistic virtual team training is critical because ED staff typically encounter rarely occurring but life threatening situations only once in their careers and because ED teams currently have no realistic environment in which to practice their team skills. The resulting lack of experience and teamwork makes diagnosis and treatment more difficult. Virtual environment based training has the potential to redress these shortfalls. The objective of our research is to develop a state-of-the-art virtual environment for emergency medicine team training. The virtual emergency room (VER) allows ED physicians and medical staff to realistically prepare for emergency medical situations by performing triage, diagnosis, and treatment on virtual patients within an environment that provides them with the tools they require and the team environment they need to realistically perform these three tasks. There are several issues that must be addressed before this vision is realized. The key issues deal with distribution of computations; the doctor and staff interface to the virtual patient and ED equipment; the accurate simulation of individual patient organs' response to injury, medication, and treatment; and an accurate modeling of the symptoms and appearance of the patient while maintaining a real-time interaction capability. Our ongoing work addresses all of these issues. In this paper we report on our prototype VER system and its distributed system architecture for an emergency department distributed virtual environment for emergency medical staff training. The virtual environment enables emergency department physicians and staff to develop their diagnostic and treatment skills using the virtual tools they need to perform diagnostic and treatment tasks. Virtual human imagery, and real-time virtual human response are used to create the virtual patient and present a scenario. Patient vital signs are available to the emergency department team as they manage the virtual case. The work reported here consists of the system architectures we developed for the distributed components of the virtual emergency room. The architectures we describe consist of the network level architecture as well as the software architecture for each actor within the virtual emergency room. We describe the role of distributed interactive simulation and other enabling technologies within the virtual emergency room project.

Maximum performance synergy: A new approach to recording studio control room design

NASA Astrophysics Data System (ADS)

Szymanski, Jeff D.

2003-10-01

Popular recording studio control room designs include LEDE(tm), RFZ(tm), and nonenvironment rooms. The common goal of all of these is to create an accurate acoustical environment that does not distort or otherwise color audio reproduction. Also common to these designs is the frequent need to have multiple ancillary recording rooms, often adjacent to the main control room, where group members perform. This approach, where group members are physically separated from one another, can lead to lack of ensemble in the finished recordings. New twists on old acoustical treatment techniques have been implemented at a studio in Nashville, Tennessee, which minimize the need for multiple ancillary recording rooms, thus creating an environment where talent, producer and recording professionals can all occupy the same space for maximum performance synergy. Semi-separated performance areas are designed around a central, critical listening area. The techniques and equipment required to achieve this separation are reviewed, as are advantages and disadvantages to this new control room design approach.

Virtual reality training versus blended learning of laparoscopic cholecystectomy: a randomized controlled trial with laparoscopic novices.

PubMed

Nickel, Felix; Brzoska, Julia A; Gondan, Matthias; Rangnick, Henriette M; Chu, Jackson; Kenngott, Hannes G; Linke, Georg R; Kadmon, Martina; Fischer, Lars; Müller-Stich, Beat P

2015-05-01

This study compared virtual reality (VR) training with low cost-blended learning (BL) in a structured training program.Training of laparoscopic skills outside the operating room is mandatory to reduce operative times and risks.Laparoscopy-naïve medical students were randomized in 2 groups stratified for sex. The BL group (n = 42) used E-learning for laparoscopic cholecystectomy (LC) and practiced basic skills with box trainers. The VR group (n = 42) trained basic skills and LC on the LAP Mentor II (Simbionix, Cleveland, OH). Each group trained 3 × 4 hours followed by a knowledge test concerning LC. Blinded raters assessed the operative performance of cadaveric porcine LC using the Objective Structured Assessment of Technical Skills (OSATS). The LC was discontinued when it was not completed within 80 min. Students evaluated their training modality with questionnaires.The VR group completed the LC significantly faster and more often within 80 min than BL (45% v 21%, P = .02). The BL group scored higher than the VR group in the knowledge test (13.3 ± 1.3 vs 11.0 ± 1.7, P < 0.001). Both groups showed equal operative performance of LC in the OSATS score (49.4 ± 10.5 vs 49.7 ± 12.0, P = 0.90). Students generally liked training and felt well prepared for assisting in laparoscopic surgery. The efficiency of the training was judged higher by the VR group than by the BL group.VR and BL can both be applied for training the basics of LC. Multimodality training programs should be developed that combine the advantages of both approaches.

The impact of constructive feedback on training in gastrointestinal endoscopy using high-fidelity Virtual-Reality simulation: a randomised controlled trial.

PubMed

Kruglikova, Irina; Grantcharov, Teodor P; Drewes, Asbjorn M; Funch-Jensen, Peter

2010-02-01

Recently, virtual reality computer simulators have been used to enhance traditional endoscopy teaching. Previous studies have demonstrated construct validity of these systems and transfer of virtual skills to the operating room. However, to date no simulator-training curricula have been designed and there is very little evidence on the impact of external feedback on acquisition of endoscopic skills. The aim of the present study was to assess the impact of external feedback on the learning curves on a VR colonoscopy simulator using inexperienced trainees. 22 trainees, without colonoscopy experience were randomised to a group which received structured feedback provided by an experienced supervisor and a controlled group. All participants performed 15 repetitions of task 3 from the Introduction colonoscopy module of the Accu Touch Endoscopy simulator. Retention/transfer tests on simulator were performed 4-6 weeks after the last repetition. The proficiency levels were based on the performance of eight experienced colonoscopists. All subjects were able to complete the procedure on the simulator. There were no perforations in the feedback group versus seven in the non-feedback group. Subjects in the feedback group reached expert proficiency levels in percentage of mucosa visualised and time to reach the caecum significantly faster compared with the control group. None of the groups demonstrated significant degradation of performance in simulator retention/transfer tests. Concurrent feedback given by supervisor concur an advantage in acquisition of basic colonoscopy skills and achieving of proficiency level as compared to independent training.

Mental training in surgical education: a systematic review.

PubMed

Davison, Sara; Raison, Nicholas; Khan, Muhammad S; Dasgupta, Prokar; Ahmed, Kamran

2017-11-01

Pressures on surgical education from restricted working hours and increasing scrutiny of outcomes have been compounded by the development of highly technical surgical procedures requiring additional specialist training. Mental training (MT), the act of performing motor tasks in the 'mind's eye', offers the potential for training outside the operating room. However, the technique is yet to be formally incorporated in surgical curricula. This study aims to review the available literature to determine the role of MT in surgical education. EMBASE and Medline databases were searched. The primary outcome measure was surgical proficiency following training. Secondary analyses examined training duration, forms of MT and trainees level of experience. Study quality was assessed using Consolidated Standards of Reporting Trials scores or Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. Fourteen trials with 618 participants met the inclusion criteria, of which 11 were randomized and three longitudinal. Ten studies found MT to be beneficial. Mental rehearsal was the most commonly used form of training. No significant correlation was found between the length of MT and outcomes. MT benefitted expert surgeons more than medical students or novice surgeons. The majority studies demonstrate MT to be beneficial in surgical education especially amongst more experienced surgeons within a well-structured MT programme. However, overall studies were low quality, lacked sufficient methodology and suffered from small sample sizes. For these reasons, further research is required to determine optimal role of MT as a supplementary educational tool within the surgical curriculum. © 2017 Royal Australasian College of Surgeons.

Optoelectronics applications in multimedia shooting training systems: SPARTAN

NASA Astrophysics Data System (ADS)

Glogowski, Tomasz; Hlosta, Pawel; Stepniak, Slawomir; Swiderski, Waldemar

2017-10-01

Multimedia shooting training systems are increasingly being used in the training of security staff and uniformed services. An advanced practicing-training system SPARTAN for simulation of small arms shooting has been designed and manufactured by Autocomp Management Ltd. and Military Institute of Armament Technology for the Polish Ministry of National Defence. SPARTAN is a stationary device designed to teach, monitor and evaluate the targeting of small arms and to prepare soldiers for: • firing the live ammunition at open ranges for combat targets and silhouettes • detection, classification and engagement of real targets upon different terrains, weather conditions and periods during the day • team work as a squad during the mission by using different types of arms • suitable reactions in untypical scenarios. Placed in any room the training set consists of: • the projection system that generates realistic 3D imaging of the battlefield (such as combat shooting range) in high-resolution • system that tracks weapons aiming points • sound system which delivers realistic mapping of acoustic surroundings • operator station with which the training is conducted and controlled • central processing unit based on PC computers equipped with specialist software realizing individual system functions • units of smart weapons equipped with radio communication modules, injection laser diodes and pneumatic reloading system. The system make possible training by firing in dynamic scenarios, using combat weapons and live ammunition against visible targets moving on a screen. The use of infrared camera for detecting the position of impact of a projectile.

5. "UNDERGROUND CONTROL ROOM AT TEST STAND 1A, DIRECTORATE OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. "UNDERGROUND CONTROL ROOM AT TEST STAND 1-A, DIRECTORATE OF MISSILE CAPTIVE TEST, EDWARDS AFB, 15 JAN 58, 3097.58." Two men working in the control room. Photo no. "3097 58; G-AFFTC 15 JAN 58, T.S. 1-A Control". - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Control Center, Test Area 1-115, near Altair & Saturn Boulevards, Boron, Kern County, CA

[Advanced Trauma Life Support (ATLS) in the emergency room. Is it suitable as an SOP?].

PubMed

Shafizadeh, S; Tjardes, T; Steinhausen, E; Balke, M; Paffrath, T; Bouillon, B; Bäthis, H

2010-08-01

There is clinical evidence that a standardized management of trauma patients in the emergency room improves outcome. ATLS is a training course that teaches a systematic approach to the trauma patient in the emergency room. The aims are a rapid and accurate assessment of the patient's physiologic status, treatment according to priorities, and making decisions on whether the local resources are sufficient for adequate definitive treatment of the patient or if transfer to a trauma center is necessary. Above all it is important to prevent secondary injury, to realize timing as a relevant factor in the initial treatment, and to assure a high standard of care. A standard operating procedure (SOP) exactly regulates the approach to trauma patients and determines the responsibilities of the involved faculties. An SOP moreover incorporates the organizational structure in the treatment of trauma patients as well as the necessary technical equipment and staff requirements. To optimize process and result quality, priorities are in the fields of medical fundamentals of trauma care, education, and fault management. SOPs and training courses increase the process and result quality in the treatment of the trauma patient in the emergency room. These programs should be based on the special demands of the physiology of the trauma as well as the structural specifics of the hospital. ATLS does not equal an SOP but it qualifies as a standardized concept for management of trauma patients in the emergency room.

Applied Virtual Reality in Reusable Launch Vehicle Design, Operations Development, and Training

NASA Technical Reports Server (NTRS)

Hale, Joseph P.

1997-01-01

Application of Virtual Reality (VR) technology offers much promise to enhance and accelerate the development of Reusable Launch Vehicle (RLV) infrastructure and operations while simultaneously reducing developmental and operational costs. One of the primary cost areas in the RLV concept that is receiving special attention is maintenance and refurbishment operations. To produce and operate a cost effective RLV, turnaround cost must be minimized. Designing for maintainability is a necessary requirement in developing RLVs. VR can provide cost effective methods to design and evaluate components and systems for maintenance and refurbishment operations. The National Aeronautics and Space Administration (NASA)/Marshall Space Flight Center (MSFC) is beginning to utilize VR for design, operations development, and design analysis for RLVs. A VR applications program has been under development at NASA/MSFC since 1989. The objectives of the MSFC VR Applications Program are to develop, assess, validate, and utilize VR in hardware development, operations development and support, mission operations training and science training. The NASA/MSFC VR capability has also been utilized in several applications. These include: 1) the assessment of the design of the late Space Station Freedom Payload Control Area (PCA), the control room from which onboard payload operations are managed; 2) a viewing analysis of the Tethered Satellite System's (TSS) "end-of-reel" tether marking options; 3) development of a virtual mockup of the International Space Welding Experiment for science viewing analyses from the Shuttle Remote Manipulator System elbow camera and as a trainer for ground controllers; and 4) teleoperations using VR. This presentation will give a general overview of the MSFC VR Applications Program and describe the use of VR in design analyses, operations development, and training for RLVs.

Main control room, showing original sixpane windows and doors to ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Main control room, showing original six-pane windows and doors to pump motor room at left. The main control cabinets and switchgear, visible on right, were replaced in 2003. View to the south - Wellton-Mohawk Irrigation System, Pumping Plant No. 2, Bounded by Interstate 8 to south, Wellton, Yuma County, AZ

VIEW OF PDP CONTROL ROOM PANELS, LEVEL 0’, LOOKING WEST. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW OF PDP CONTROL ROOM PANELS, LEVEL 0’, LOOKING WEST. THESE PANELS WERE WHERE THE A-MOTOR TAPES WOULD HAVE BEEN VISIBLE IN THE CONTROL ROOM. MORE RECENT MONITOR IN UPPER CENTER FOR “LTR FLUX MONITORS” - Physics Assembly Laboratory, Area A/M, Savannah River Site, Aiken, Aiken County, SC

77 FR 23764 - Comment Request for Information Collection for Site Visit Data Collection; American Recovery and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-20

... data will affect our ability to conduct rigorous evaluations of these grants. For example, site visits are the only way the research team can observe the training programs in operation and collect real... Development and Research, Room N-5641, Employment and Training Administration, U.S. Department of Labor, 200...

Breast Cancer Screening Knowledge and Skills of Students upon Entering and Exiting a Medical School.

ERIC Educational Resources Information Center

Kann, P. Elizabeth; Lane, Dorothy S.

1998-01-01

A study compared the breast cancer screening knowledge of 27 medical students in first and fourth years. In the fourth year additional questions were asked about training and training needs. Although students performed significantly better on knowledge-based questions in the fourth year, considerable room for improvement remained. Most students…

Expedition 19 Crew Training

NASA Image and Video Library

2009-03-20

Expedition 19 Commander Gennady I. Padalka, 3rd from left, Flight Engineer Michael R. Barratt, 4th from left, and Spaceflight Participant Charles Simonyi, far right, along with cosmonaut instructors are seen through a quarantine windowed room as they participate in Soyuz rendezvous and docking training at the Cosmonaut Hotel, Saturday, March 21, 2009 in Baikonur, Kazakhstan. (Photo Credit: NASA/Bill Ingalls)

HOTEL AND MOTEL HOUSEKEEPING AIDE, A SUGGESTED TRAINING PROGRAM.

ERIC Educational Resources Information Center

Office of Education (DHEW), Washington, DC.

A LOCAL TRAINING PROGRAM TO PREPARE HOTEL AND MOTEL HOUSEKEEPING AIDES CAN BE DEVELOPED FROM RESOURCE MATERIAL IN THIS GUIDE. PROGRAM OBJECTIVES ARE TO PREPARE TRAINEES TO PERFORM THE JOBS INVOLVED IN KEEPING HOTEL OR MOTEL ROOMS CLEAN, TO FOLLOW CORRECT PROCEDURES IN USING EQUIPMENT AND SUPPLIES REQUIRED IN CARING FOR BEDROOMS AND BATHROOMS, AND…

KSC-2014-1973

NASA Image and Video Library

2014-04-03

CAPE CANAVERAL, Fla. – The Mobile Launcher is visible through a window inside Firing Room 4 in the Launch Control Center at NASA's Kennedy Space Center in Florida. The Ground Systems Development and Operations Program is overseeing efforts to create a new multi-user firing room in Firing Room 4. The main floor consoles, cabling and wires below the floor and ceiling tiles above have been removed. Sub-flooring has been installed and the room is marked off to create four separate rooms on the main floor. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Ben Smegelsky

Front view of bldg 30 which houses mission control

NASA Image and Video Library

1984-08-30

41D-3072 (30 Aug 1984) --- A 41-D shift change is taking place in the Johnson Space Center's Building 30. In its twenty years of operation, the mission control center has been the scene of many such changes. The windowless wing at left houses three floors, including rooms supporting flight control rooms 1 & 2 (formerly called mission operations control rooms 1 & 2).

VIEW OF CABLES AND TAPES ASSOCIATED WITH ADRIVE CONTROL ROD ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW OF CABLES AND TAPES ASSOCIATED WITH A-DRIVE CONTROL ROD SYSTEM, AT LEVEL +15’, DIRECTLY ABOVE PDP CONTROL ROOM, LOOKING NORTHWEST. THE CABLES FROM THE PDP ROOM GO THROUGH THE CONCRETE WALL, MAKE A RIGHT ANGLE TURN DOWNWARD, AND DESCEND INTO THE PDP CONTROL ROOM AS VERTICAL TAPES - Physics Assembly Laboratory, Area A/M, Savannah River Site, Aiken, Aiken County, SC

10. Interior view of control room in Components Test Laboratory ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Interior view of control room in Components Test Laboratory (T-27), looking east. The control room is located in the center of the building and abuts the Test Cell 8, 9, and 10 and equipment room wings. Photograph shows upgraded instrumentation, piping, and technological modifications installed in 1997-99 to accommodate component testing requirements for the Atlas V missile. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

Analysis of Special Forces Medic (18D) Attrition

DTIC Science & Technology

1994-08-01

130 students per year, 18D should reach 100% strength in the second quarter of FY95. Training Issues The biggest single reason for the high attrition...including a library and 24-hour study rooms, ix SOMED and SOMTC should consider incorporating computer-based training into the 18D training. The PA...particularly in the sciences. Given this, the high SOMED attrition rate is to be expected. Some have suggested that a greater effort should be made to recruit

Experimental investigation of railway train-induced vibrations of surrounding ground and a nearby multi-story building

NASA Astrophysics Data System (ADS)

Xia, He; Chen, Jianguo; Wei, Pengbo; Xia, Chaoyi; de Roeck, G.; Degrande, G.

2009-03-01

In this paper, a field experiment was carried out to study train-induced environmental vibrations. During the field experiment, velocity responses were measured at different locations of a six-story masonry structure near the Beijing-Guangzhou Railway and along a small road adjacent to the building. The results show that the velocity response levels of the environmental ground and the building floors increase with train speed, and attenuate with the distance to the railway track. Heavier freight trains induce greater vibrations than lighter passenger trains. In the multi-story building, the lateral velocity levels increase monotonically with floor elevation, while the vertical ones increase with floor elevation in a fluctuating manner. The indoor floor vibrations are much lower than the outdoor ground vibrations. The lateral vibration of the building along the direction of weak structural stiffness is greater than along the direction with stronger stiffness. A larger room produces greater floor vibrations than the staircase at the same elevation, and the vibration at the center of a room is greater than at its corner. The vibrations of the building were compared with the Federal Transportation Railroad Administration (FTA) criteria for acceptable ground-borne vibrations expressed in terms of rms velocity levels in decibels. The results show that the train-induced building vibrations are serious, and some exceed the allowance given in relevant criterion.

Knowledge gap regarding dementia care among nurses in Taiwanese acute care hospitals: A cross-sectional study.

PubMed

Lin, Pei-Chao; Hsieh, Mei-Hui; Chen, Meng-Chin; Yang, Yung-Mei; Lin, Li-Chan

2018-02-01

The quality of dementia care in hospitals is typically substandard. Staff members are underprepared for providing care to older people with dementia. The objective of the present study was to examine dementia care knowledge, attitude and behavior regarding self-education about dementia care among nurses working in different wards. This was a descriptive cross-sectional study. The present study was carried out from July 2013 to December 2013. In total, 387 nurses working in different wards were recruited from two hospitals in Taiwan by using convenience sampling. The nurses completed a self-report questionnaire on demographic data, experience and learning behavior, and attitude towards dementia care, and a 16-item questionnaire on dementia care knowledge. Descriptive and inferential statistics were used to analyze the status and differences in dementia care knowledge among nurse in different wards. The average dementia care knowledge score was 10.46 (SD 2.13), with a 66.5% mean accuracy among all nurses. Dementia care knowledge was significantly associated with age, nursing experience, possession of a registered nurse license, holding a bachelor's degree, work unit, training courses and learning behavior towards dementia care. The dementia care knowledge of the emergency room nurses was significantly lower than that of the psychiatric and neurology ward nurses. A significantly lower percentage of emergency room nurses underwent dementia care training and actively searched for information on dementia care, compared with the psychiatric and neurology ward nurses. Hospital nurses show a knowledge gap regarding dementia care, especially emergency room nurses. Providing dementia care training to hospital nurses, particularly emergency room nurses, is crucial for improving the quality of care for patients with dementia. Geriatr Gerontol Int 2018; 18: 276-285. © 2017 Japan Geriatrics Society.

Undergraduate training in neonatal resuscitation -- a modified approach.

PubMed

Bhat, B V; Biswal, N; Bhatia, B D; Nalini, P

1993-01-01

On one day in January 1993, in Pondicherry, India, prior to rounds in the labor room, professors trained 50 final year, undergraduate medical students at the Jawaharlal Institute of Postgraduate Medical Education and Research in neonatal resuscitation using a modified program of the neonatal advanced life support course. They compared their results with those from students in the March-April 1992 multiday course, which occurred after some students had finished their labor room rounds. In 1992, the pretest was administered after the theory lectures, while, in 1993, it was administered before the course, including the theory lectures, began. The 1992 students scored significantly higher on the pretest than did the 1993 students (e.g., score of 11-20, 73.3% vs. 0%; p .001). There was essentially no difference in posttest scores between the 2 groups, however. All the 1993 students did the resuscitation procedure on the mannequin on their own. 92% rated the content of the program and use of audiovisual aids to be optimum. The same percentage wanted the neonatal advanced life support program to last one day. About 33% wanted a short respite between lectures. The students identified the following messages to be important: early identification of the high risk neonate, correct resuscitation techniques, and use and misuse of drugs during resuscitation. They all considered the training to be adequate, informative, and applicable to real life during their labor room rounds and later as a basic physician. These findings indicated that the modified neonatal advanced life support course was effective and that professors should conduct it for all final year medical students before the student begin labor room rounds, ideally in one day.

3. OBLIQUE VIEW OF THE PRESENT CONTROL ROOM (ORIGINALLY THE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. OBLIQUE VIEW OF THE PRESENT CONTROL ROOM (ORIGINALLY THE TRANSFORMER ROOM). - Washington Water Power Company Post Falls Power Plant, Middle Channel Powerhouse & Dam, West of intersection of Spokane & Fourth Streets, Post Falls, Kootenai County, ID

5. INTERIOR VIEW, SHOWING A CONTROL ROOM INSIDE THE RADIOGRAPHY ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. INTERIOR VIEW, SHOWING A CONTROL ROOM INSIDE THE RADIOGRAPHY ROOM; PASS-THROUGH FOR EXPOSED FILM ON RIGHT - Fort McCoy, Building No. T-1031, North side of South Tenth Avenue, Block 10, Sparta, Monroe County, WI

Measuring Human Performance in Simulated Nuclear Power Plant Control Rooms Using Eye Tracking

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kovesdi, Casey Robert; Rice, Brandon Charles; Bower, Gordon Ross

Control room modernization will be an important part of life extension for the existing light water reactor fleet. As part of modernization efforts, personnel will need to gain a full understanding of how control room technologies affect performance of human operators. Recent advances in technology enables the use of eye tracking technology to continuously measure an operator’s eye movement, which correlates with a variety of human performance constructs such as situation awareness and workload. This report describes eye tracking metrics in the context of how they will be used in nuclear power plant control room simulator studies.

KSC-2014-1972

NASA Image and Video Library

2014-04-03

CAPE CANAVERAL, Fla. – The Ground Systems Development and Operations Program is overseeing efforts to create a new multi-user firing room in Firing Room 4 in the Launch Control Center at NASA's Kennedy Space Center in Florida. The main floor consoles, cabling and wires below the floor and ceiling tiles have been removed. Sub-flooring has been installed and the room is marked off to create four separate rooms on the main floor. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Ben Smegelsky

Interior of display area (room 101), looking south towards TV ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Interior of display area (room 101), looking south towards TV control panel room (room 139) at far left corner. The stairway leads to the commander's quarters and the senior battle viewing bridge at top right. Control and communication consoles at the right - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

Impact of imaging room environment: staff job stress and satisfaction, patient satisfaction, and willingness to recommend.

PubMed

Quan, Xiaobo; Joseph, Anjali; Ensign, Janet C

2012-01-01

The built environment significantly affects the healthcare experiences of patients and staff. Healthcare administrators and building designers face the opportunity and challenge of improving healthcare experience and satisfaction through better environmental design. The purpose of the study was to evaluate how a novel environmental intervention for imaging rooms, which integrated multiple elements of healing environments including positive distractions and personal control over environment, affects the perceptions and satisfactions of its primary users-patients and staff. Anonymous questionnaire surveys were conducted to compare patient and staff perceptions of the physical environment, satisfaction, and stress in two types of imaging rooms: imaging rooms with the intervention installed (intervention rooms) and traditionally designed rooms without the intervention (comparison rooms). Imaging technologists and patients perceived the intervention rooms to be significantly more pleasant-looking. Patients in the intervention rooms reported significantly higher levels of environmental control and were significantly more willing to recommend the intervention rooms to others. The environmental intervention was effective in improving certain aspects of the imaging environment: pleasantness and environmental control. Further improvement of the imaging environment is needed to address problematic areas such as noise.

11. Historic view of Building 100 control room, showing personnel ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Historic view of Building 100 control room, showing personnel operating rocket engine test controls and observer watching activity from observation room. May 27, 1957. On file at NASA Plumbrook Research Center, Sandusky, Ohio. NASA photo number C-45020. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Advanced visualization platform for surgical operating room coordination: distributed video board system.

PubMed

Hu, Peter F; Xiao, Yan; Ho, Danny; Mackenzie, Colin F; Hu, Hao; Voigt, Roger; Martz, Douglas

2006-06-01

One of the major challenges for day-of-surgery operating room coordination is accurate and timely situation awareness. Distributed and secure real-time status information is key to addressing these challenges. This article reports on the design and implementation of a passive status monitoring system in a 19-room surgical suite of a major academic medical center. Key design requirements considered included integrated real-time operating room status display, access control, security, and network impact. The system used live operating room video images and patient vital signs obtained through monitors to automatically update events and operating room status. Images were presented on a "need-to-know" basis, and access was controlled by identification badge authorization. The system delivered reliable real-time operating room images and status with acceptable network impact. Operating room status was visualized at 4 separate locations and was used continuously by clinicians and operating room service providers to coordinate operating room activities.

Update on simulation-based surgical training and assessment in ophthalmology: a systematic review.

PubMed

Thomsen, Ann Sofia S; Subhi, Yousif; Kiilgaard, Jens Folke; la Cour, Morten; Konge, Lars

2015-06-01

This study reviews the evidence behind simulation-based surgical training of ophthalmologists to determine (1) the validity of the reported models and (2) the ability to transfer skills to the operating room. Simulation-based training is established widely within ophthalmology, although it often lacks a scientific basis for implementation. We conducted a systematic review of trials involving simulation-based training or assessment of ophthalmic surgical skills among health professionals. The search included 5 databases (PubMed, EMBASE, PsycINFO, Cochrane Library, and Web of Science) and was completed on March 1, 2014. Overall, the included trials were divided into animal, cadaver, inanimate, and virtual-reality models. Risk of bias was assessed using the Cochrane Collaboration's tool. Validity evidence was evaluated using a modern validity framework (Messick's). We screened 1368 reports for eligibility and included 118 trials. The most common surgery simulated was cataract surgery. Most validity trials investigated only 1 or 2 of 5 sources of validity (87%). Only 2 trials (48 participants) investigated transfer of skills to the operating room; 4 trials (65 participants) evaluated the effect of simulation-based training on patient-related outcomes. Because of heterogeneity of the studies, it was not possible to conduct a quantitative analysis. The methodologic rigor of trials investigating simulation-based surgical training in ophthalmology is inadequate. To ensure effective implementation of training models, evidence-based knowledge of validity and efficacy is needed. We provide a useful tool for implementation and evaluation of research in simulation-based training. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized educational trial

PubMed Central

2012-01-01

Abstract Background Several studies have found a positive effect on the learning curve as well as the improvement of basic psychomotor skills in the operating room after virtual reality training. Despite this, the majority of surgical and gynecological departments encounter hurdles when implementing this form of training. This is mainly due to lack of knowledge concerning the time and human resources needed to train novice surgeons to an adequate level. The purpose of this trial is to investigate the impact of instructor feedback regarding time, repetitions and self-perception when training complex operational tasks on a virtual reality simulator. Methods/Design The study population consists of medical students on their 4th to 6th year without prior laparoscopic experience. The study is conducted in a skills laboratory at a centralized university hospital. Based on a sample size estimation 98 participants will be randomized to an intervention group or a control group. Both groups have to achieve a predefined proficiency level when conducting a laparoscopic salpingectomy using a surgical virtual reality simulator. The intervention group receives standardized instructor feedback of 10 to 12 min a maximum of three times. The control group receives no instructor feedback. Both groups receive the automated feedback generated by the virtual reality simulator. The study follows the CONSORT Statement for randomized trials. Main outcome measures are time and repetitions to reach the predefined proficiency level on the simulator. We include focus on potential sex differences, computer gaming experience and self-perception. Discussion The findings will contribute to a better understanding of optimal training methods in surgical education. Trial Registration NCT01497782 PMID:22373062

KSC-2014-1971

NASA Image and Video Library

2014-04-03

CAPE CANAVERAL, Fla. – The Ground Systems Development and Operations Program is overseeing efforts to create a new multi-user firing room in Firing Room 4 in the Launch Control Center at NASA's Kennedy Space Center in Florida. The main floor consoles, cabling and wires below the floor and ceiling tiles above have been removed. Sub-flooring has been installed and the room is marked off to create four separate rooms on the main floor. In view along the soffit are space shuttle launch plaques for 21 missions launched from Firing Room 4. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Ben Smegelsky

[Modern didactics in surgical education--between demand and reality].

PubMed

Pape-Köhler, C; Chmelik, C; Rose, M; Heiss, M M

2010-12-01

Surgical residency contains an inadequate amount of hands-on training in the operating room and time constraints further make this type of education on the floor unlikely. Due to these deficits in residency training, private surgical courses outside of the established residency programmes are in high demand. Therefore, surgical residents must spend their own resources and time in addition to their residency training in order to receive adequate clinical exposure. Didactic approaches like problem-based learning have begun to influence our modern education. These novel education approaches along with visualisation training, video-based presentations, and multimedia-based training can be useful adjuncts to traditional surgical training. © Georg Thieme Verlag Stuttgart ˙ New York.

A Pilot Study Investigating the Effects of Advanced Nuclear Power Plant Control Room Technologies: Methods and Qualitative Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

BLanc, Katya Le; Powers, David; Joe, Jeffrey

2015-08-01

Control room modernization is an important part of life extension for the existing light water reactor fleet. None of the 99 currently operating commercial nuclear power plants in the U.S. has completed a full-scale control room modernization to date. Nuclear power plant main control rooms for the existing commercial reactor fleet remain significantly analog, with only limited digital modernizations. Upgrades in the U.S. do not achieve the full potential of newer technologies that might otherwise enhance plant and operator performance. The goal of the control room upgrade benefits research is to identify previously overlooked benefits of modernization, identify candidate technologiesmore » that may facilitate such benefits, and demonstrate these technologies through human factors research. This report describes a pilot study to test upgrades to the Human Systems Simulation Laboratory at INL.« less

General surgery education across three continents.

PubMed

McIlhenny, Craig; Kurashima, Yo; Chan, Carlos; Hirano, Satoshi; Domínguez-Rosado, Ismael; Stefanidis, Dimitrios

2018-02-01

Surgical education has seen tremendous changes in the US over the past decade. The Halstedian training model of see one, do one, teach one that governed surgical training for almost 100 years has been replaced by the achievement of the ACGME competencies, milestones, entrustable professional activities (EPAs), and acquisition of surgical skill outside the operating room on simulators. Several of these changes in American medical education have been influenced by educators and training paradigms abroad. In this paper, we review the training paradigms for surgeons in the UK, Japan, and Mexico to allow comparisons with the US training paradigm and promote the exchange of ideas. Copyright © 2017 Elsevier Inc. All rights reserved.

29. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

29. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, LOOKING SOUTH (LOCATION Q) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

28. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

28. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, LOOKING NORTH (LOCATION Q) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

West wall, display area (room 101), view 1 of 4: ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

West wall, display area (room 101), view 1 of 4: southwest corner, showing stairs to commander's quarters and viewing bridge, windows to controller's room (room 102), south end of control consoles, and holes in pedestal floor for computer equipment cables (tape drive I/O?) - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

Laboratory instrumentation modernization at the WPI Nuclear Reactor Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1995-01-01

With partial funding from the Department of Energy (DOE) University Reactor Instrumentation Program several laboratory instruments utilized by students and researchers at the WPI Nuclear Reactor Facility have been upgraded or replaced. Designed and built by General Electric in 1959, the open pool nuclear training reactor at WPI was one of the first such facilities in the nation located on a university campus. Devoted to undergraduate use, the reactor and its related facilities have been since used to train two generations of nuclear engineers and scientists for the nuclear industry. The low power output of the reactor and an ergonomicmore » facility design make it an ideal tool for undergraduate nuclear engineering education and other training. The reactor, its control system, and the associate laboratory equipment are all located in the same room. Over the years, several important milestones have taken place at the WPI reactor. In 1969, the reactor power level was upgraded from 1 kW to 10 kW. The reactor`s Nuclear Regulatory Commission operating license was renewed for 20 years in 1983. In 1988, under DOE Grant No. DE-FG07-86ER75271, the reactor was converted to low-enriched uranium fuel. In 1992, again with partial funding from DOE (Grant No. DE-FG02-90ER12982), the original control console was replaced.« less

Developing a taxonomy of coordination behaviours in nuclear power plant control rooms during emergencies.

PubMed

Wang, Dunxing; Gao, Qin; Li, Zhizhong; Song, Fei; Ma, Liang

2017-12-01

This study aims to develop a taxonomy of coordination behaviours during emergencies in nuclear power plants (NPPs). We summarised basic coordination behaviours from literature in aviation, health care and nuclear field and identified coordination behaviours specific to the nuclear domain by interviewing and surveying control crew operators. The established taxonomy includes 7 workflow stages and 24 basic coordination behaviours. To evaluate the reliability and feasibility of the taxonomy, we analysed 12 videos of operators' training sessions by coding coordination behaviours with the taxonomy and the inter-rater reliability was acceptable. Further analysis of the frequency, the duration and the direction of the coordination behaviours revealed four coordination problems. This taxonomy provides a foundation of systematic observation of coordination behaviours among NPP crews, advances researchers' understanding of the coordination mechanism during emergencies in NPPs and facilitate the possibility to deepen the understanding of the relationships between coordination behaviours and team performance. Practitioner Summary: A taxonomy of coordination behaviours during emergencies in nuclear power plants was developed. Reliability and feasibility of the taxonomy was verified through the analysis of 12 training sessions. The taxonomy can serve as an observation system for analysis of coordination behaviours and help to identify coordination problems of control crews.

Treadmill Kinematics Baseline Data Collection

NASA Image and Video Library

2011-05-12

PHOTO DATE: 5-12-11 LOCATION: Building 261 - Room 138 SUBJECT: Expedition 29 Preflight Training with Dan Burbank during Treadmill Kinematics Baseline Data Collection. WORK ORDER: 2011-1214 PHOTOGRAPHER: Lauren Harnett

Governing time in operating rooms.

PubMed

Riley, Robin; Manias, Elizabeth

2006-05-01

This paper examines how time is controlled and governed in operating rooms through interpersonal communication between nurses and doctors. Time is a valuable commodity in organizations with improvements often directed towards maximizing efficiencies. As a consequence, time can be a source of tension and interpersonal conflict as individuals compete for control of its use. The data in this paper emanate from an ethnographic study that explored a range of communication practices in operating room nursing. Participants comprised 11 operating room nurses. Data were collected over two years in three different institutional settings and involved participant observation, interviews and the keeping of a personal diary. A deconstructive analysis of the data was undertaken. Results are discussed in terms of the practices, in which clinicians are engaged in, to govern and control their use of time. The four practices presented in this paper include; questioning judgment and timing, controlling speed, estimating surgeons' use of time and coping with different perceptions of time. Time and speed were hotly contested by nurses. They used their personal knowledge of individual surgeon's habits of time to govern and control practice. Nurses thought about surgeons in terms of time and developed commonly accepted understandings about the length of surgical procedures. They used this knowledge to manage the scheduling of operations in the departments and to control the workflow in individual operating rooms. Knowledge of individual surgeons was a source of power for operating room nurses. Nurses have more power in the operating room than might be imagined but they exercise this power in subtle ways. If operating rooms are to work effectively, the operating room team must understand each others' work better.

Training Select-in Interviewers for Astronaut Selection: A Program Evaluation

NASA Technical Reports Server (NTRS)

Hysong, S.; Galarza, L.; Holland, A.; Billica, Roger (Technical Monitor)

2000-01-01

Psychological factors critical to the success of short and long-duration missions have been identified in previous research; however, evaluation for such critical factors in astronaut applicants leaves much room for human interpretation. Thus, an evaluator training session was designed to standardize the interpretation of critical factors, as well as the structure of the select-in interview across evaluators. The purpose of this evaluative study was to determine the effectiveness of the evaluator training sessions and their potential impact on evaluator ratings.

[Research as attractiveness parameter for young surgeons].

PubMed

Vollmar, B

2012-04-01

Increasing concern has been expressed about the significant shortage of new trainees in surgery. As research in the context of surgical education and training is an essential element of attraction for the field of surgery, there is an urgent priority to implement clear room for research in the concepts of education and training. In this article the relevance of both the thesis accompanying the study and research training during surgical residency for the clinical self-image, personal satisfaction and academic development of young surgeons will be presented.

Promoting Hand Hygiene With a Lighting Prompt.

PubMed

Diegel-Vacek, Lauren; Ryan, Catherine

2016-10-01

The objective of this pilot study was to assess an automatic sink light design intervention as a prompt for clinician hand hygiene (as defined by World Health Organization [WHO]). Healthcare-associated infections (HAIs) are still leading causes of morbidity and mortality and contribute to burdens on our healthcare system. Hand hygiene has been related to reducing the rate of HAIs and positively impacting both patient and hospital outcomes. This pilot study was a prospective, longitudinal observational study of a convenience sample of healthcare clinicians. In one inpatient room, clinicians were exposed to a hand hygiene reminder that consisted of a light turning on over the sink as they entered. A control room (the adjacent inpatient room) did not have the intervention. A total of 88 clinician encounters were monitored during the study. On the first observation day at the initial activation of the signal light system, the percentage of clinicians performing hand hygiene upon entering a room was only 7% in the control room and 23% in the intervention room. During the second observation (Day 14), those percentages were 16% in the control room and 30% in the intervention room. During the third observation (Day 21), those percentages were 23% in the control room and 23% in the intervention room. The healthcare system frequently relies on expensive technology to improve healthcare delivery, but implementation of low-cost, low-technology methods such as this light may be effective in prompting hand hygiene. © The Author(s) 2016.

Assessment of terminal cleaning in pediatric isolation rooms: Options for low-resource settings.

PubMed

Dramowski, Angela; Whitelaw, Andrew; Cotton, Mark F

2016-12-01

Few studies have evaluated terminal cleaning in low-resource settings. Adequacy of pediatric isolation room terminal cleaning was evaluated using quantitative bacterial surface cultures, ATP bioluminescence assays, and fluorescent high-touch surface markers at Tygerberg Children's Hospital in South Africa (August 1, 2014-October 31, 2015). Cleaning adequacy was assessed by comparing pre- and postcleaning measurements. Influence of verbal feedback was determined by comparing cleaners' first and subsequent cleaning episodes. Cleaning methods were compared for cost, time, and feasibility. Adequacy of terminal cleaning was evaluated in 25 isolation rooms after hospitalization for pulmonary tuberculosis (n = 13), respiratory (n = 5) and enteric viruses (n = 5), pertussis (n = 1), and methicillin-resistant Staphylococcus aureus (n = 1). Mean aerobic colony counts and mean ATP relative light units declined between pre- and postcleaning evaluations (39 ± 41 to 15 ± 30 [P < .001] and 72 ± 40 to 23 ± 11 [P < .001]). Fluorescent marker removal was initially poor, but improved significantly at subsequent cleaning episodes (17 out of 78 [22%] to 121 out of 198 [61%]; P < .001); mean aerobic colony counts and ATP values also declined significantly following feedback. Cost, time, and resources required for ATP and surface cultures far exceeded that required for fluorescent markers. Adequacy of isolation room cleaning improved following feedback to cleaning staff. Fluorescent markers are an inexpensive option for cleaning evaluation and training in low-resource settings. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Multidisciplinary team simulation for the operating theatre: a review of the literature.

PubMed

Tan, Shaw Boon; Pena, Guilherme; Altree, Meryl; Maddern, Guy J

2014-01-01

Analyses of adverse events inside the operating theatre has demonstrated that many errors are caused by failure in non-technical skills and teamwork. While simulation has been used successfully for teaching and improving technical skills, more recently, multidisciplinary simulation has been used for training team skills. We hypothesized that this type of training is feasible and improves team skills in the operating theatre. A systematic search of the literature for studies describing true multidisciplinary operating theatre team simulation was conducted in November and December 2012. We looked at the characteristics and outcomes of the team simulation programmes. 1636 articles were initially retrieved. Utilizing a stepwise evaluation process, 26 articles were included in the review. The studies reveal that multidisciplinary operating theatre simulation has been used to provide training in technical and non-technical skills, to help implement new techniques and technologies, and to identify latent weaknesses within a health system. Most of the studies included are descriptions of training programmes with a low level of evidence. No randomized control trial was identified. Participants' reactions to the training programme were positive in all studies; however, none of them could objectively demonstrate that skills acquired from simulation are transferred to the operating theatre or show a demonstrable benefit in patient outcomes. Multidisciplinary operating room team simulation is feasible and widely accepted by participants. More studies are required to assess the impact of this type of training on operative performance and patient safety. © 2013 Royal Australasian College of Surgeons.

Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program.

PubMed

Pollei, Taylor R; Barrs, David M; Hinni, Michael L; Bansberg, Stephen F; Walter, Logan C

2013-06-01

Describe the procedure length difference between surgeries performed by an attending surgeon alone compared with the resident surgeon supervised by the same attending surgeon. Case series with chart review. Tertiary care center and residency program. Six common otolaryngologic procedures performed between August 1994 and May 2012 were divided into 2 cohorts: attending surgeon alone or resident surgeon. This division coincided with our July 2006 initiation of an otolaryngology-head and neck surgery residency program. Operative duration was compared between cohorts with confounding factors controlled. In addition, the direct result of increased surgical length on operating room cost was calculated and applied to departmental and published resident case log report data. Five of the 6 procedures evaluated showed a statistically significant increase in surgery length with resident involvement. Operative time increased 6.8 minutes for a cricopharyngeal myotomy (P = .0097), 11.3 minutes for a tonsillectomy (P < .0001), 27.4 minutes for a parotidectomy (P = .028), 38.3 minutes for a septoplasty (P < .0001), and 51 minutes for tympanomastoidectomy (P < .0021). Thyroidectomy showed no operative time difference. Cost of increased surgical time was calculated per surgery and ranged from $286 (cricopharyngeal myotomy) to $2142 (mastoidectomy). When applied to reported national case log averages for graduating residents, this resulted in a significant increase of direct training-related costs. Resident participation in the operating room results in increased surgical length and additional system cost. Although residency is a necessary part of surgical training, associated costs need to be acknowledged.

Endurance Training in Normobaric Hypoxia Imposes Less Physical Stress for Geriatric Rehabilitation

PubMed Central

Pramsohler, Stephan; Burtscher, Martin; Faulhaber, Martin; Gatterer, Hannes; Rausch, Linda; Eliasson, Arn; Netzer, Nikolaus C.

2017-01-01

Rationale: Evidence suggests that training in hypoxia can be very effective even while requiring less physical effort. We therefore aimed to measure the effect of endurance training under hypoxic conditions on pulmonary and cardiovascular parameters in an elderly population undergoing inpatient rehabilitation. Methods: Forty patients over age 65 years with multiple co-morbid conditions were recruited during a 3-week stay in a geriatric rehabilitation center. Using a randomized, single-blinded, placebo-controlled design, patients were assigned to a hypoxic (HG) or normoxic (NG) group. HG patients completed seven training sessions of 30 min duration on a treadmill in a normobaric chamber with inspired oxygen fraction (FiO2) of 15.27%, with 10–30 min active training. Training was conducted with target heart rate at 80% of peak oxygen consumption (VO2-peak). NG group performed similar training in sham hypoxia (room air or FiO2 = 20.94%). At pre- and post-test completion, measures included: (1) cycle ergometry with ECG monitoring and measurement of VO2-peak, and (2) echocardiography for ejection fraction. Results: The physical effort required of patients to reach target heart rate was reduced significantly (−28%, p = 0.043) in the HG compared to NG. Cardiopulmonary parameters showed no differences between groups. Conclusion: Endurance training at 3,000 meters elevation imposes less stress on the locomotor systems while resulting in a similar physiological strain (i.e., heart rate). Hypoxic training holds promise for successful geriatric rehabilitation by being more accommodating to physical limitations in geriatric patients. Trial registration: Registration at DRKS. (Approval No. 359/12, Trial No. DRKS00005241). PMID:28785224

Design of the thermal insulating test system for doors and windows of buildings

NASA Astrophysics Data System (ADS)

Yu, Yan; Qi, Jinqing; Xu, Yunwei; Wu, Hao; Ou, Jinping

2011-04-01

Thermal insulating properties of doors and widows are important parameter to measure the quality of windows and doors. This paper develops the thermal insulating test system of doors and windows for large temperature difference in winter in north of China according to national standards. This system is integrated with temperature measurement subsystem, temperature control subsystem, the heating power measurement subsystem, and heat transfer coefficient calculated subsystem. The temperature measurement subsystem includes temperature sensor which is implemented by sixty-four thermocouple sensors to measure the key positions of cold room and hot room, and the temperature acquisition unit which adopts Agilent 34901A data acquisition card to achieve self-compensation and accurate temperature capture. The temperature control subsystem including temperature controller and compressor system is used to control the temperature between 0 degree to 20 degree for hot room and -20 degree to 0 degree for cold room. The hot room controller uses fuzzy control algorithm to achieve accurate control of temperature and the cold room controller firstly uses compressor to achieve coarse control and then uses more accurate temperature controller unit to obtain constant temperature(-20 degree). The heating power measurement is mainly to get the heat power of hot room heating devices. After above constant temperature environment is constructed, software of the test system is developed. Using software, temperature data and heat power data can be accurately got and then the heat transfer coefficient, representing the thermal insulating properties of doors and widows, is calculated using the standard formula. Experimental results show that the test system is simple, reliable and precise. It meets the testing requirements of national standard and has a good application prospect.

Are the urology operating room personnel aware about the ionizing radiation?

PubMed Central

Tok, Adem; Akbas, Alparslan; Aytan, Nimet; Aliskan, Tamer; Cicekbilek, Izzet; Kaba, Mehmet; Tepeler, Abdulkadir

2015-01-01

ABSTRACT Purpose: We assessed and evaluated attitudes and knowledge regarding ionizing radiation of urology surgery room staff. Materials and Methods: A questionnaire was sent by e-mail to urology surgery room personnel in Turkey, between June and August 2013. The questionnaire included demographic questions and questions regarding radiation exposure and protection. Results: In total, 127 questionnaires were answered. Of them, 62 (48.8%) were nurses, 51 (40.2%) were other personnel, and 14 (11%) were radiological technicians. In total, 113 (89%) participants had some knowledge of radiation, but only 56 (44.1%) had received specific education or training regarding the harmful effects of radiation. In total, 92 (72.4%) participants indicated that they used a lead apron and a thyroid shield. In the subgroup that had received education about the harmful effects of radiation, the use ratio for all protective procedures was 21.4% (n=12); this ratio was only 2.8% (n=2) for those with no specific training; the difference was statistically significant (p=0.004). Regarding dosimeters, the use rates were 100% for radiology technicians, 46.8% for nurses, and 31.4% for other hospital personnel; these differences were statistically significant (p<0.001). No significant relationship between working period in the surgery room, number of daily fluoroscopy procedures, education, task, and use of radiation protection measures was found. Conclusions: It is clear that operating room-allied health personnel exposed to radiation do not have sufficient knowledge of ionizing radiation and they do not take sufficient protective measures. PMID:26689525

Assessing the knowledge, attitudes, behaviors and training needs related to infant feeding, specifically breastfeeding, of child care providers.

PubMed

Clark, Alena; Anderson, Jennifer; Adams, Elizabeth; Baker, Susan

2008-01-01

The purpose of this study was to assess the knowledge, attitudes, behaviors and training needs of child care providers on infant feeding practices, specifically breastfeeding. Needs assessment surveys for child care directors and infant room teachers were developed, tested and mailed to the 277 Colorado child care centers licensed to care for infants (< or = 12 months); 1,385 surveys were mailed. A total of 267 surveys were received for an overall response rate of 20%. The majority (79%) of infant room teachers and directors reported low knowledge on ways to adequately store breastmilk and formula. Perceived attitudes on the advantages and disadvantages of breastmilk versus formula as well as behaviors associated with offering working mothers a supportive breastfeeding environment (e.g. breast pumps available at center, offer mothers a place to breastfeed) were also examined. Directors and infant room teachers desired updated infant feeding information for themselves, co-workers and parents. They wanted English and Spanish information regarding breastfeeding, formula feeding and introducing solid foods. Eighty-six percent of directors and 67% of teachers stated they have Internet access at work. Eighty-eight percent of directors and 79% of teachers would be interested in an infant feeding website. According to the results of the needs assessment, child care directors and infant room teachers are in need of current, accessible infant feeding information. Child care directors and infant room teachers desired a website with bilingual and best practice infant feeding information specific to the needs of child care providers.

Software Support during a Control Room Upgrade

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michele Joyce; Michael Spata; Thomas Oren

2005-09-21

In 2004, after 14 years of accelerator operations and commissioning, Jefferson Lab renovated its main control room. Changes in technology and lessons learned during those 14 years drove the control room redesign in a new direction, one that optimizes workflow and makes critical information and controls available to everyone in the control room. Fundamental changes in a variety of software applications were required to facilitate the new operating paradigm. A critical component of the new control room design is a large-format video wall that is used to make a variety of operating information available to everyone in the room. Analogmore » devices such as oscilloscopes and function generators are now displayed on the video wall through two crosspoint switchers: one for analog signals and another for video signals. A new software GUI replaces manual configuration of the oscilloscopes and function generators and helps automate setup. Monitoring screens, customized for the video wall, now make important operating information visible to everyone, not just a single operator. New alarm handler software gives any operator, on any workstation, access to all alarm handler functionality, and multiple users can now contribute to a single electronic logbook entry. To further support the shift to distributed access and control, many applications have been redesigned to run on servers instead of on individual workstations.« less

KSC-2014-2302

NASA Image and Video Library

2014-04-25

CAPE CANAVERAL, Fla. – Construction workers have installed the framing and some of the inner walls inside Firing Room 4 in the Launch Control Center at NASA's Kennedy Space Center in Florida. Three rows of upper level management consoles remain. The Ground Systems Development and Operations Program is overseeing efforts to create a new firing room based on a multi-user concept. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Dimitri Gerondidakis

KSC-2014-2304

NASA Image and Video Library

2014-04-25

CAPE CANAVERAL, Fla. – Construction workers have installed the framing and some of the inner walls inside Firing Room 4 in the Launch Control Center at NASA's Kennedy Space Center in Florida. Three rows of upper level management consoles remain. The Ground Systems Development and Operations Program is overseeing efforts to create a new firing room based on a multi-user concept. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Dimitri Gerondidakis

KSC-2014-2303

NASA Image and Video Library

2014-04-25

CAPE CANAVERAL, Fla. – Construction workers have installed the framing and some of the inner walls inside Firing Room 4 in the Launch Control Center at NASA's Kennedy Space Center in Florida. Three rows of upper level management consoles remain. The Ground Systems Development and Operations Program is overseeing efforts to create a new firing room based on a multi-user concept. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Dimitri Gerondidakis

Advanced Proficiency EHR Training: Effect on Physicians’ EHR Efficiency, EHR Satisfaction and Job Satisfaction

PubMed Central

Dastagir, M. Tariq; Chin, Homer L.; McNamara, Michael; Poteraj, Kathy; Battaglini, Sarah; Alstot, Lauren

2012-01-01

The best way to train clinicians to optimize their use of the Electronic Health Record (EHR) remains unclear. Approaches range from web-based training, class-room training, EHR functionality training, case-based training, role-based training, process-based training, mock-clinic training and “on the job” training. Similarly, the optimal timing of training remains unclear--whether to engage in extensive pre go-live training vs. minimal pre go-live training followed by more extensive post go-live training. In addition, the effectiveness of non-clinician trainers, clinician trainers, and peer-trainers, remains unclearly defined. This paper describes a program in which relatively experienced clinician users of an EHR underwent an intensive 3-day Peer-Led EHR advanced proficiency training, and the results of that training based on participant surveys. It highlights the effectiveness of Peer-Led Proficiency Training of existing experienced clinician EHR users in improving self-reported efficiency and satisfaction with an EHR and improvements in perceived work-life balance and job satisfaction. PMID:23304282

Advanced proficiency EHR training: effect on physicians' EHR efficiency, EHR satisfaction and job satisfaction.

PubMed

Dastagir, M Tariq; Chin, Homer L; McNamara, Michael; Poteraj, Kathy; Battaglini, Sarah; Alstot, Lauren

2012-01-01

The best way to train clinicians to optimize their use of the Electronic Health Record (EHR) remains unclear. Approaches range from web-based training, class-room training, EHR functionality training, case-based training, role-based training, process-based training, mock-clinic training and "on the job" training. Similarly, the optimal timing of training remains unclear--whether to engage in extensive pre go-live training vs. minimal pre go-live training followed by more extensive post go-live training. In addition, the effectiveness of non-clinician trainers, clinician trainers, and peer-trainers, remains unclearly defined. This paper describes a program in which relatively experienced clinician users of an EHR underwent an intensive 3-day Peer-Led EHR advanced proficiency training, and the results of that training based on participant surveys. It highlights the effectiveness of Peer-Led Proficiency Training of existing experienced clinician EHR users in improving self-reported efficiency and satisfaction with an EHR and improvements in perceived work-life balance and job satisfaction.

Orthopaedic resident preparedness for closed reduction and pinning of pediatric supracondylar fractures is improved by e-learning: a multisite randomized controlled study.

PubMed

Hearty, Thomas; Maizels, Max; Pring, Maya; Mazur, John; Liu, Raymond; Sarwark, John; Janicki, Joseph

2013-09-04

There is a need to provide more efficient surgical training methods for orthopaedic residents. E-learning could possibly increase resident surgical preparedness, confidence, and comfort for surgery. Using closed reduction and pinning of pediatric supracondylar humeral fractures as the index case, we hypothesized that e-learning could increase resident knowledge acquisition for case preparation in the operating room. An e-learning surgical training module was created on the Computer Enhanced Visual Learning platform. The module provides a detailed and focused road map of the procedure utilizing a multimedia format. A multisite prospective randomized controlled study design compared residents who used a textbook for case preparation (control group) with residents who used the same textbook plus completed the e-learning module (test group). All subjects completed a sixty-question test on the theory and methods of the case. After completion of the test, the control group then completed the module as well. All subjects were surveyed on their opinion regarding the effectiveness of the module after performing an actual surgical case. Twenty-eight subjects with no previous experience in this surgery were enrolled at four academic centers. Subjects were randomized into two equal groups. The test group scored significantly better (p < 0.001) and demonstrated competence on the test compared with the control group; the mean correct test score (and standard deviation) was 90.9% ± 6.8% for the test group and 73.5% ± 6.4% for the control group. All residents surveyed (n = 27) agreed that the module is a useful supplement to traditional methods for case preparation and twenty-two of twenty-seven residents agreed that it reduced their anxiety during the case and improved their attention to surgical detail. E-learning using the Computer Enhanced Visual Learning platform significantly improved preparedness, confidence, and comfort with percutaneous closed reduction and pinning of a pediatric supracondylar humeral fracture. We believe that adapting such methods into residency training programs will improve efficiency in surgical training.

5. INSTRUMENT ROOM INTERIOR, SHOWING BACKS OF CONSOLE LOCKERS. Looking ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. INSTRUMENT ROOM INTERIOR, SHOWING BACKS OF CONSOLE LOCKERS. Looking northeast to firing control room passageway. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Firing Control Building, Test Area 1-100, northeast end of Test Area 1-100 Road, Boron, Kern County, CA

83. DETAIL OF HONEYWELL AIRCONDITIONING CONTROLS IN SLC3E CONTROL ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

83. DETAIL OF HONEYWELL AIR-CONDITIONING CONTROLS IN SLC-3E CONTROL ROOM - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

10. Credit BG. Interior of control and observation room at ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Credit BG. Interior of control and observation room at Control and Recording Center Building 4221/E-22. - Jet Propulsion Laboratory Edwards Facility, Control & Recording Center, Edwards Air Force Base, Boron, Kern County, CA

Evaluation of Medical Students' Attitudes and Performance of Basic Surgery Skills in a Training Program Using Fresh Human skin, Excised During Body Contouring Surgeries.

PubMed

Rothenberger, Jens; Seyed Jafari, Seyed Morteza; Schnabel, Kai P; Tschumi, Christian; Angermeier, Sarina; Shafighi, Maziar

2015-01-01

Learning surgical skills in the operating room may be a challenge for medical students. Therefore, more approaches using simulation to enable students to develop their practical skills are required. We hypothesized that (1) there would be a need for additional surgical training for medical students in the pre-final year, and (2) our basic surgery skills training program using fresh human skin would improve medical students' surgical skills. We conducted a preliminary survey of medical students to clarify the need for further training in basic surgery procedures. A new approach using simulation to teach surgical skills on human skin was set up. The procedural skills of 15 randomly selected students were assessed in the operating room before and after participation in the simulation, using Objective Structured Assessment of Technical Skills. Furthermore, subjective assessment was performed based on students' self-evaluation. The data were analyzed using SPSS, version 21 (SPSS, Inc., Chicago, IL). The study took place at the Inselspital, Bern University Hospital. A total of 186 pre-final-year medical students were enrolled into the preliminary survey; 15 randomly selected medical students participated in the basic surgical skills training course on the fresh human skin operating room. The preliminary survey revealed the need for a surgical skills curriculum. The simulation approach we developed showed significant (p < 0.001) improvement for all 12 surgical skills, with mean cumulative precourse and postcourse values of 31.25 ± 5.013 and 45.38 ± 3.557, respectively. The self-evaluation contained positive feedback as well. Simulation of surgery using human tissue samples could help medical students become more proficient in handling surgical instruments before stepping into a real surgical situation. We suggest further studies evaluating our proposed teaching method and the possibility of integrating this simulation approach into the medical school curriculum. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

17. NBS TOOL ROOM. MISCELLANEOUS TOOLS USED DURING EXTRA VEHICULAR ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. NBS TOOL ROOM. MISCELLANEOUS TOOLS USED DURING EXTRA VEHICULAR ACTIVITY (EVA) MISSIONS AND NBS TRAINING. FROM LEFT TO RIGHT THE TOOLS ARE: SHUTTLE TRANSPORTATION SYSTEM (STS) PORTABLE FOOT RESTRAINT (PFR), ESSEX WRENCH, SOCKET WRENCH, SAFETY TETHER REEL (LEFT REAR), MINI WORKSTATION (CENTER REAR), TETHERS (FRONT CENTER), HUBBLE SPACE TELESCOPE (HST) POWER TOOL (FRONT RIGHT), HUBBLE SPACE TELESCOPE & PORTABLE FOOT RESTRAINT (REAR RIGHT). - Marshall Space Flight Center, Neutral Buoyancy Simulator Facility, Rideout Road, Huntsville, Madison County, AL

Nuclear reactor control room construction

DOEpatents

Lamuro, R.C.; Orr, R.

1993-11-16

A control room for a nuclear plant is disclosed. In the control room, objects labelled 12, 20, 22, 26, 30 in the drawing are no less than four inches from walls labelled 10.2. A ceiling contains cooling fins that extend downwards toward the floor from metal plates. A concrete slab is poured over the plates. Studs are welded to the plates and are encased in the concrete. 6 figures.

Nuclear reactor control room construction

DOEpatents

Lamuro, Robert C.; Orr, Richard

1993-01-01

A control room 10 for a nuclear plant is disclosed. In the control room, objects 12, 20, 22, 26, 30 are no less than four inches from walls 10.2. A ceiling 32 contains cooling fins 35 that extend downwards toward the floor from metal plates 34. A concrete slab 33 is poured over the plates. Studs 36 are welded to the plates and are encased in the concrete.

17. CONTROL ROOM, NORTH SIDE, WITH BRIDGE SWING CONTROLS ON ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. CONTROL ROOM, NORTH SIDE, WITH BRIDGE SWING CONTROLS ON LEFT, SIGNAL CONTROLS ON RIGHT, WHISTLE PULL TOP. RADIO TELEPHONE IN CENTER BACK (Fred Small) - Burlington Northern Railroad Bridge, Spanning Willamette River at River Mile 6.9, Portland, Multnomah County, OR

Foundations for teaching surgeons to address the contributions of systems to operating room team conflict.

PubMed

Rogers, David A; Lingard, Lorelei; Boehler, Margaret L; Espin, Sherry; Schindler, Nancy; Klingensmith, Mary; Mellinger, John D

2013-09-01

Prior research has shown that surgeons who effectively manage operating room conflict engage in a problem-solving stage devoted to modifying systems that contribute to team conflict. The purpose of this study was to clarify how systems contributed to operating room team conflict and clarify what surgeons do to modify them. Focus groups of circulating nurses and surgeons were conducted at 5 academic medical centers. Narratives describing the contributions of systems to operating room conflict and behaviors used by surgeons to address those systems were analyzed using the constant comparative approach associated with a constructivist grounded theory approach. Operating room team conflict was affected by 4 systems-related factors: team features, procedural-specific staff training, equipment management systems, and the administrative leadership itself. Effective systems problem solving included advocating for change based on patient safety concerns. The results of this study provide clarity about how systems contribute to operating room conflict and what surgeons can do to effectively modify these systems. This information is foundational material for a conflict management educational program for surgeons. Copyright © 2013 Elsevier Inc. All rights reserved.

KSC-2009-5248

NASA Image and Video Library

2009-09-25

CAPE CANAVERAL, Fla. – This ribbon cutting officially turns over NASA Kennedy Space Center's Launch Control Center Firing Room 1 from the Space Shuttle Program to the Constellation Program. Participating are (from left) Pepper Phillips, director of the Constellation Project Office at Kennedy; Bob Cabana, Kennedy's director; Robert Crippen, former astronaut; Jeff Hanley, manager of the Constellation Program at NASA's Johnson Space Center; and Nancy Bray, deputy director of Center Operations at Kennedy. The room has undergone demolition and construction and been outfitted with consoles for the upcoming Ares I-X rocket flight test targeted for launch on Oct. 27. As the center of launch operations at Kennedy since the Apollo Program, the Launch Control Center, or LCC, has played a central role in NASA's human spaceflight programs. Firing Room 1 was the first operational firing room constructed. From this room, controllers launched the first Saturn V, the first crewed flight of Saturn V, the first crewed mission to the moon and the first space shuttle. Firing Room 1 will continue this tradition of firsts when controllers launch the Constellation Program's first flight test. Also, this firing room will be the center of operations for the upcoming Ares I and Orion operations. Photo credit: NASA/Kim Shiflett

[Occupational exposure risk to body fluids in the Felix Bulnes Hospital during eleven years].

PubMed

Villarroel, Julia; Bustamante, M Cecilia; Manríquez, Iván; Bertoglia, M Paz; Mora, María; Galarce, Natalie

2012-06-01

Accidents with risk of occupational exposure to body fluids constitute more of a third of labor accidents. To describe the annual incidence of accidents with exposure to body fluids in the Felix Bulnes Hospital from 1998 to 2008. A retrospective analysis of reports from the Infection Control Committee. During 11 years, there were 415 accidents with exposure to body fluids, with the cumulative incidence of 3,4% (range 1.3% to 6%). Sharp instrument accidents accounted for 92,5% of cases. The main health care providers affected were the paramedical technicians and the students. The highest frequency of accidents occurred in the obstetrical operating rooms (20%) and in the central operating rooms (17%). There were no cases of seroconversion and no exposure to HCV or HBV. The estimated costs were USD $35638,6 or USD $271 per 1000 staff per year. The incidence increased during the first years of the study and then remained stable since 2001, despite efforts in training personnel. Many factors contribute to the development of these accidents, such as lack of experience, type of clinical benefit and even daytime working hours.

Development of an image operation system with a motion sensor in dental radiology.

PubMed

Sato, Mitsuru; Ogura, Toshihiro; Yasumoto, Yoshiaki; Kadowaki, Yuta; Hayashi, Norio; Doi, Kunio

2015-07-01

During examinations and/or treatment, a dentist in the examination room needs to view images with a proper display system. However, they cannot operate the image display system by hands, because dentists always wear gloves to be kept their hands away from unsanitized materials. Therefore, we developed a new image operating system that uses a motion sensor. We used the Leap motion sensor technique to read the hand movements of a dentist. We programmed the system using C++ to enable various movements of the display system, i.e., click, double click, drag, and drop. Thus, dentists with their gloves on in the examination room can control dental and panoramic images on the image display system intuitively and quickly with movement of their hands only. We investigated the time required with the conventional method using a mouse and with the new method using the finger operation. The average operation time with the finger method was significantly shorter than that with the mouse method. This motion sensor method, with appropriate training for finger movements, can provide a better operating performance than the conventional mouse method.

[The operating room of the future].

PubMed

Broeders, I A; Niessen, W; van der Werken, C; van Vroonhoven, T J

2000-01-29

Advances in computer technology will revolutionize surgical techniques in the next decade. The operating room (OR) of the future will be connected with a laboratory where clinical specialists and researchers prepare image-guided interventions and explore the possibilities of these techniques. The virtual reality is linked to the actual situation in the OR with the aid of navigation instruments. During complicated operations the images prepared preoperatively will be corrected during the operation on the basis of the information obtained peroperatively. MRI currently offers maximal possibilities for image-guided surgery of soft tissues. Simpler techniques such as fluoroscopy and echography will become increasingly integrated in computer-assisted peroperative navigation. The development of medical robot systems will make possible microsurgical procedures by the endoscopic route. Tele-manipulation systems will also play a part in the training of surgeons. Design and construction of the OR will be adapted to the surgical technology, and include an information and control unit where preoperative and peroperative data come together and from where the surgeon operates the instruments. Concepts for the future OR should be regularly adjusted to allow for new surgical technology.

Potential Operating Room Fire Hazard of Bone Cement.

PubMed

Sibia, Udai S; Connors, Kevin; Dyckman, Sarah; Zahiri, Hamid R; George, Ivan; Park, Adrian E; MacDonald, James H

Approximately 600 cases of operating room (OR) fires are reported annually. Despite extensive fire safety education and training, complete elimination of OR fires still has not been achieved. Each fire requires an ignition source, a fuel source, and an oxidizer. In this case report, we describe the potential fire hazard of bone cement in the OR. A total knee arthroplasty was performed with a standard medial parapatellar arthrotomy. Tourniquet control was used. After bone cement was applied to the prepared tibial surface, the surgeon used an electrocautery device to resect residual lateral meniscus tissue-and started a fire in the operative field. The surgeon suffocated the fire with a dry towel and prevented injury to the patient. We performed a PubMed search with a cross-reference search for relevant papers and found no case reports outlining bone cement as a potential fire hazard in the OR. To our knowledge, this is the first case report identifying bone cement as a fire hazard. OR fires related to bone cement can be eliminated by correctly assessing the setting time of the cement and avoiding application sites during electrocautery.

11. CENTRAL ATLAS CONTROL CONSOLE IN SLC3W CONTROL ROOM. COMMUNICATIONS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. CENTRAL ATLAS CONTROL CONSOLE IN SLC-3W CONTROL ROOM. COMMUNICATIONS HEADSETS IN FOREGROUND. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Establishment of Next-Generation Neurosurgery Research and Training Laboratory with Integrated Human Performance Monitoring.

PubMed

Bernardo, Antonio

2017-10-01

Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training. Until recently, few means have allowed surgeons to obtain integrated surgical and technological training in an operating room setting. We report on a new model, currently in use at our institution, for technologically integrated surgical training and innovation using a next-generation microneurosurgery skull base laboratory designed to recreate the setting of a working operating room. Each workstation is equipped with a 3D surgical microscope, 3D endoscope, surgical drills, operating table with a Mayfield head holder, and a complete set of microsurgical tools. The laboratory also houses a neuronavigation system, a surgical robotic, a surgical planning system, 3D visualization, virtual reality, and computerized simulation for training of surgical procedures and visuospatial skills. In addition, the laboratory is equipped with neurophysiological monitoring equipment in order to conduct research into human factors in surgery and the respective roles of workload and fatigue on surgeons' performance. Copyright © 2017 Elsevier Inc. All rights reserved.

Photographic art in exam rooms may reduce white coat hypertension.

PubMed

Harper, Michael B; Kanayama-Trivedi, Stacy; Caldito, Gloria; Montgomery, David; Mayeaux, E J; DelRosso, Lourdes M

2015-12-01

Blood pressure (BP) elevation in medical office settings in patients who are normotensive in nonmedical settings is an effect known as 'white coat hypertension'. This phenomenon is thought to be due to situational anxiety caused by the experience of visiting a doctor and the anxiety-inducing nature of the medical office. Our study was designed to determine if carefully selected photographic art could counter the anxiety that causes white coat hypertension and lead to lower BP recordings in some patients. 117 adults, non-pregnant patients from the Louisiana State University Health Sciences Center Family Medicine Resident Clinic participated in this study. After the triage nurse measured the BP, the patients were randomly placed in either an exam room with standard medical posters (control room) or in an exam room with photographic art (photo room). The BP was measured in the exam room. After the medical visit, the patients switched rooms and the BP was measured a third time. The patients were asked to fill out a questionnaire to identify room preference. On average, the BP obtained in the control rooms was higher than that obtained in the photo rooms. There was a statistically significant difference between the mean arterial pressure, systolic BP and diastolic BP between the control room and the photo room. Landscape photographic art may have the beneficial effect of reducing BP in medical office examination rooms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

RADIOPROTECTION CAMPAIGN AND CARD: EDUCATIONAL STRATEGIES THAT REDUCE CHILDREN'S EXCESSIVE EXPOSURE TO RADIOLOGICAL EXAMS.

PubMed

Bernardo, Mônica Oliveira; Almeida, Fernando Antonio de; Morgado, Flavio

2017-01-01

To analyze the results of an initiative aimed at improving the reasonable use of radiological examinations, ensuring their technical quality, implementing a radioprotection campaign that includes training of the professional team, and introducing the radioprotection card for children under 12 years old as a tool for parents and doctors to control children's exposure to radiation. The study was held in a health care insurance system covering 140,000 people. A radioprotection campaign was implemented according to Image Gently • protocols, ensuring the lowest dose of radiation and the quality of examinations, and the radioprotection card was implemented. To assess the effectiveness of these actions, the number of radiological examinations performed at the pediatric emergency room in a period of one year preceding the campaign was compared with the number of radiological examinations performed one year after the campaign. The campaign was well accepted by all professionals, families, and patients involved. In the year following the implementation of radioprotection strategies, there was a 22% reduction of radiological examinations performed at the pediatric emergency room. There was also a 29% reduction in the request of two or more radiological examinations for the same child or examinations with two or more incidences. The campaign and the radioprotection card for children under 12 years old proved to be feasible strategies and correlated with a reduction in radiological examinations requested and performed at the pediatric emergency room.

77 FR 31371 - Public Workshop: Privacy Compliance Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-25

... identification, such as a driver's license, in order to verify their previously-provided registration information... handicapped accessible, with both the training rooms and restrooms situated on the ground floor. Mary Ellen...

CONTROL ROOM WITH SPRINKLER SYSTEM CONTROLS, INCLUDING MANUAL CONTROL BOXES ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

CONTROL ROOM WITH SPRINKLER SYSTEM CONTROLS, INCLUDING MANUAL CONTROL BOXES FOR THE VENTILATION SYSTEM AND A PLC SWITCH FOR AUTOMATIC CO (CARBON MONOXIDE) SYSTEM. THE AIR TESTING SYSTEM IS FREE STANDING AND THE FANS ARE COMPUTER-OPERATED. - Alaskan Way Viaduct and Battery Street Tunnel, Seattle, King County, WA

The Impact of Isolation on Healthcare Worker Contact and Compliance With Infection Control Practices in Nursing Homes.

PubMed

Pineles, Lisa; Petruccelli, Chris; Perencevich, Eli N; Roghmann, Mary-Claire; Gupta, Kalpana; Cadena, Jose; Baracco, Gio; Pfeiffer, Christopher D; Forrest, Graeme; Bradley, Suzanne F; Crnich, Chris; Reisinger, Heather; Morgan, Daniel J

2018-06-01

OBJECTIVETo directly observe healthcare workers in a nursing home setting to measure frequency and duration of resident contact and infection prevention behavior as a factor of isolation practiceDESIGNObservational studySETTING AND PARTICIPANTSHealthcare workers in 8 VA nursing homes in Florida, Maryland, Massachusetts, Michigan, Washington, and TexasMETHODSOver a 15-month period, trained research staff without clinical responsibilities on the units observed nursing home resident room activity for 15-30-minute intervals. Observers recorded time of entry and exit, isolation status, visitor type (staff, visitor, etc), hand hygiene, use of gloves and gowns, and activities performed in the room when visible.RESULTSA total of 999 hours of observation were conducted across 8 VA nursing homes during which 4,325 visits were observed. Residents in isolation received an average of 4.73 visits per hour of observation compared with 4.21 for nonisolation residents (P<.01), a 12.4% increase in visits for residents in isolation. Residents in isolation received an average of 3.53 resident care activities per hour of observation, compared with 2.46 for residents not in isolation (P<.01). For residents in isolation, compliance was 34% for gowns and 58% for gloves. Healthcare worker hand hygiene compliance was 45% versus 44% (P=.79) on entry and 66% versus 55% (P<.01) on exit for isolation and nonisolation rooms, respectively.CONCLUSIONSHealthcare workers visited residents in isolation more frequently, likely because they required greater assistance. Compliance with gowns and gloves for isolation was limited in the nursing home setting. Adherence to hand hygiene also was less than optimal, regardless of isolation status of residents.Infect Control Hosp Epidemiol 2018;39:683-687.

2. CONTROL ROOM INTERIOR, CONSOLE AND MONITORS. Looking west. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. CONTROL ROOM INTERIOR, CONSOLE AND MONITORS. Looking west. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Control Center, Test Area 1-115, near Altair & Saturn Boulevards, Boron, Kern County, CA

Fire Safety for the Oral and Maxillofacial Surgeon and Surgical Staff.

PubMed

Di Pasquale, LisaMarie; Ferneini, Elie M

2017-05-01

Fire in the operating room is a life-threatening emergency that demands quick, efficient intervention. Because the circumstances surrounding fires are generally well-understood, virtually every operating room fire is preventable. Before every operating room case, thorough preprocedure "time outs" should address each team members' awareness of specific fire risks and agreement regarding fire concerns and emergency actions. Fire prevention centers on 3 constituent parts of the fire triad necessary for fire formation. Regular fire drills should guide policies and procedures to prevent surgical fires. Delivering optimal patient care in emergent situations requires surgical team training, practicing emergency roles, and specific actions. Copyright © 2016 Elsevier Inc. All rights reserved.

TRITIUM LABORATORY, TRA666, INTERIOR. MAIN FLOOR. CONTROL ROOM ENCLOSURE AT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

TRITIUM LABORATORY, TRA-666, INTERIOR. MAIN FLOOR. CONTROL ROOM ENCLOSURE AT CENTER OF VIEW. SIGN ABOVE DOOR SAYS "HYDRAULIC TEST FACILITY CONTROL ROOM." SIGN IN WINDOW SAYS "EATING AREA." "EVACUATION AND EMERGENCY INFORMATION" IS POSTED ON CABINET AT LEFT OF VIEW. INL NEGATIVE NO. HD30-2-3. Mike Crane, Photographer, 6/2001 - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

13. CONTROL ROOM OF GENE PUMPING STATION. CONTROL CUBICLES ARRAYED ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. CONTROL ROOM OF GENE PUMPING STATION. CONTROL CUBICLES ARRAYED BEHIND MANAGER'S ART DECO-STYLE CONTROL DESK, WITH CONTROL CUBICLE 1 AT FAR RIGHT AND CONTROL CUBICLE 9 AT FAR LEFT. - Gene Pump Plant, South of Gene Wash Reservoir, 2 miles west of Whitsett Pump Plant, Parker Dam, San Bernardino County, CA

11. Credit BG. Interior of control and observation room at ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Credit BG. Interior of control and observation room at Control and Recording Center, showing detail of switchboard and closed circuit television monitors. - Jet Propulsion Laboratory Edwards Facility, Control & Recording Center, Edwards Air Force Base, Boron, Kern County, CA

5. INTERIOR VIEW OF UPPER LEVEL ROOM OF THE CONTROL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. INTERIOR VIEW OF UPPER LEVEL ROOM OF THE CONTROL HOUSE LOCATED ON THE SOUTH END OF BIG TUJUNGA DAM SHOWING THE CONTROL PANEL. - Big Tujunga Dam, Control House, 809 West Big Tujunga Road, Sunland, Los Angeles County, CA

Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial.

PubMed

Jamshidi Manesh, Mansoureh; Kalati, Mahnaz; Hosseini, Fatemeh

2015-05-01

One of the strategies for a good outcome and pain free childbearing is to design the delivery room. The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women. This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation. The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants' intervention vs. 66% of control participants had perinea laceration (P = 0.041). According to the findings of the present study, distracting senses in snoezelen room decreases mother's pain intensity, the length of labor, and incidence of episiotomy.

Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial

PubMed Central

Jamshidi Manesh, Mansoureh; Kalati, Mahnaz; Hosseini, Fatemeh

2015-01-01

Background: One of the strategies for a good outcome and pain free childbearing is to design the delivery room. Objectives: The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women. Patients and Methods: This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation. Results: The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants’ intervention vs. 66% of control participants had perinea laceration (P = 0.041). Conclusions: According to the findings of the present study, distracting senses in snoezelen room decreases mother’s pain intensity, the length of labor, and incidence of episiotomy. PMID:26082849

Retention of laparoscopic procedural skills acquired on a virtual-reality surgical trainer.

PubMed

Maagaard, Mathilde; Sorensen, Jette Led; Oestergaard, Jeanett; Dalsgaard, Torur; Grantcharov, Teodor P; Ottesen, Bent S; Larsen, Christian Rifbjerg

2011-03-01

Virtual-reality (VR) simulator training has been shown to improve surgical performance in laparoscopic procedures in the operating room. We have, in a randomised controlled trial, demonstrated transferability to real operations. The validity of the LapSim virtual-reality simulator as an assessment tool has been demonstrated in several reports. However, an unanswered question regarding simulator training is the durability, or retention, of skills acquired during simulator training. The aim of the present study is to assess the retention of skills acquired using the LapSim VR simulator, 6 and 18 months after an initial training course. The investigation was designed as a 6- and 18-month follow-up on a cohort of participants who earlier participated in a skills training programme on the LapSim VR. The follow-up cohort consisted of trainees and senior consultants allocated to two groups: (1) novices (experience < 5 procedures, n = 9) and (2) experts (experience > 200 procedures during the past 3 years, n = 10). Each participant performed ten sessions. Assessment of skills was based on time, economy of movement and the error parameter "bleeding". The novice group were re-tested after 6 and 18 months, whereas the expert group were only retested once, after 6 months. None of the novices performed laparoscopic surgery in the follow-up period. The experts continued their daily work with laparoscopic surgery. Novices showed retention of skills after 6 months. After 18 months, novices' laparoscopic skills had returned to the pre-training level. This indicates that laparoscopic skills seemed to deteriorate in the period between 6 and 18 months without training. Experts showed consistent performance over time. This information can be included when planning training curricula in minimal invasive surgery.

virtX - evaluation of a computer-based training system for mobile C-arm systems in trauma and orthopedic surgery.

PubMed

Bott, O J; Teistler, M; Duwenkamp, C; Wagner, M; Marschollek, M; Plischke, M; Raab, B W; Stürmer, K M; Pretschner, D P; Dresing, K

2008-01-01

Operating room personnel (ORP) operating mobile image intensifier systems (C-arms) need training to produce high quality radiographs with a minimum of time and X-ray exposure. Our study aims at evaluating acceptance, usability and learning effect of the CBT system virtX that simulates C-arm based X-ray imaging in the context of surgical case scenarios. Prospective, interventional study conducted during an ORP course with three groups: intervention group 1 (training on a PC using virtX), and 2 (virtX with a C-arm as input device), and a control group (training without virtX) - IV1, IV2 and CG. All participants finished training with the same exercise. Time needed to produce an image of sufficient quality was recorded and analyzed using One-Way-ANOVA and Dunnett post hoc test (alpha = .05). Acceptance and usability of virtX have been evaluated using a questionnaire. CG members (n = 21) needed more time for the exercise than those of IV2 (n = 20): 133 +/- 55 vs. 101 +/- 37 sec. (p = .03). IV1 (n = 12) also performed better than CG (128 +/- 48 sec.), but this was not statistically significant. Seventy-nine participants returned a questionnaire (81% female, age 34 +/- 9 years, professional experience 8.3 +/- 7.6 years; 77% regularly used a C-arm). 83% considered virtX a useful addition to conventional C-arm training. 91% assessed virtual radiography as helpful for understanding C-arm operation. Trainees experienced virtX as substantial enhancement of C-arm training. Training with virtX can reduce the time needed to perform an imaging task.

Development of testing and training simulator for CEDMCS in KSNP

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nam, C. H.; Park, C. Y.; Nam, J. I.

2006-07-01

This paper presents a newly developed testing and training simulator (TTS) for automatically diagnosing and tuning the Control Element Drive Mechanism Control System (CEDMCS). TTS includes a new automatic, diagnostic, method for logic control cards and a new tuning method for phase synchronous pulse cards. In Korea Standard Nuclear Power Plants (KSNP). reactor trips occasionally occur due to a damaged logic control card in CEDMCS. However, there is no pre-diagnostic tester available to detect a damaged card in CEDMCS before it causes a reactor trip. Even after the reactor trip occurs, it is difficult to find the damaged card. Tomore » find the damaged card. ICT is usually used. ICT is an automated, computer-controlled testing system with measurement capabilities for testing active and passive components, or clusters of components, on printed circuit boards (PCB) and/or assemblies. However, ICT cannot detect a time dependent fault correctly and requires removal of the waterproof mating to perform the test. Therefore, the additional procedure of re-coating the PCB card is required after the test. TTS for CEDMCS is designed based on real plant conditions, both electrically and mechanically. Therefore, the operator can operate the Control Element Drive Mechanism (CEDM), which is mounted on the closure head of the reactor vessel (RV) using the soft control panel in ITS, which duplicates the Main Control Board (MCB) in the Main Control Room (MCR). However, during the generation of electric power in a nuclear power plant, it is difficult to operate the CEDM so a CEDM and Control Element Assembly (CEA) mock-up facility was developed to simulate a real plant CEDM. ITS was used for diagnosing and tuning control logic cards in CEDMCS in the Ulchin Nuclear Power Plant No. 4 during the plant overhaul period. It exhibited good performance in detecting the damaged cards and tuning the phase synchronous pulse cards. In addition, TTS was useful in training the CEDMCS operator by supplying detail signal information from the logic cards. (authors)« less

Exploring the role of 3-dimensional simulation in surgical training: feedback from a pilot study.

PubMed

Podolsky, Dale J; Martin, Allan R; Whyne, Cari M; Massicotte, Eric M; Hardisty, Michael R; Ginsberg, Howard J

2010-12-01

Randomized control study assessing the efficacy of a pedicle screw insertion simulator. To evaluate the efficacy of an in-house developed 3-dimensional software simulation tool for teaching pedicle screw insertion, to gather feedback about the utility of the simulator, and to help identify the context and role such simulation has in surgical education. Traditional instruction for pedicle screw insertion technique consists of didactic teaching and limited hands-on training on artificial or cadaveric models before guided supervision within the operating room. Three-dimensional computer simulation can provide a valuable tool for practicing challenging surgical procedures; however, its potential lies in its effective integration into student learning. Surgical residents were recruited from 2 sequential years of a spine surgery course. Patient and control groups both received standard training on pedicle screw insertion. The patient group received an additional 1-hour session of training on the simulator using a CT-based 3-dimensional model of their assigned cadaver's spine. Qualitative feedback about the simulator was gathered from the trainees, fellows, and staff surgeons, and all pedicles screws physically inserted into the cadavers during the courses were evaluated through CT. A total of 185 thoracic and lumbar pedicle screws were inserted by 37 trainees. Eighty-two percent of the 28 trainees who responded to the questionnaire and all fellows and staff surgeons felt the simulator to be a beneficial educational tool. However, the 1-hour training session did not yield improved performance in screw placement. A 3-dimensional computer-based simulation for pedicle screw insertion was integrated into a cadaveric spine surgery instructional course. Overall, the tool was positively regarded by the trainees, fellows, and staff surgeons. However, the limited training with the simulator did not translate into widespread comfort with its operation or into improvement in physical screw placement.

Orientation and mobility training for adults with low vision.

PubMed

Virgili, G; Rubin, G

2006-07-19

Orientation and mobility (O&M) training is provided to people who are visually impaired to help them maintain travel independence. It teaches them new orientation and mobility skills to compensate for reduced visual information. The objective of this review was to assess the effects of (O&M) training, with or without associated devices, for adults with low vision. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) in The Cochrane Library, MEDLINE, SIGLE, EMBASE, National Research Register, Zetoc, LILACS, and the reference lists of articles. Updated searches were in 2006. We planned to include randomised or quasi-randomised trials comparing (O&M) training with no training in adults with low vision. Two authors independently assessed the search results for eligibility, evaluated study quality and extracted the data. Two small studies satisfied the inclusion criteria. They were consecutive phases of development of the same training curriculum and assessment tool. The intervention was administered by a volunteer on the basis of written and oral instruction. In both studies the randomisation technique was inadequate, being based on alternation, and masking was not achieved. Training had no effect in the first study while it was found to be beneficial in the second. Reasons for this may have been: the high scores obtained in the first study, suggestive of little need for training and small room for further improvement (a ceiling effect), and the refinement of the curriculum allowing better tailoring to patients' specific needs and characteristics, in the second study. The review found two small trials with similar methods, comparing (O&M) training to physical exercise, which were unable to demonstrate a difference. Therefore, there is little evidence on which type of orientation and mobility training is better for people with low vision who have specific characteristics and needs. Orientation and mobility instructors and scientists should plan randomised controlled studies to compare the effectiveness of different types of (O&M) training. A consensus is needed on the adoption of standard measurement instruments of mobility performance which are proved to be reliable and sensitive to the diverse mobility needs of people with low vision. For this purpose, questionnaires and performance-based tests may represent different tools that explore people with low vision's subjective experience or their objective functioning, respectively.

46 CFR 151.25-2 - Cargo handling space.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 5 2011-10-01 2011-10-01 false Cargo handling space. 151.25-2 Section 151.25-2 Shipping... BULK LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-2 Cargo handling space. Pump rooms, compressor rooms, refrigeration rooms, heating rooms, instrument rooms or other closed spaces...

46 CFR 151.25-2 - Cargo handling space.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 5 2012-10-01 2012-10-01 false Cargo handling space. 151.25-2 Section 151.25-2 Shipping... BULK LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-2 Cargo handling space. Pump rooms, compressor rooms, refrigeration rooms, heating rooms, instrument rooms or other closed spaces...

46 CFR 151.25-2 - Cargo handling space.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Cargo handling space. 151.25-2 Section 151.25-2 Shipping... BULK LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-2 Cargo handling space. Pump rooms, compressor rooms, refrigeration rooms, heating rooms, instrument rooms or other closed spaces...

46 CFR 151.25-2 - Cargo handling space.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 5 2014-10-01 2014-10-01 false Cargo handling space. 151.25-2 Section 151.25-2 Shipping... BULK LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-2 Cargo handling space. Pump rooms, compressor rooms, refrigeration rooms, heating rooms, instrument rooms or other closed spaces...

46 CFR 151.25-2 - Cargo handling space.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 5 2013-10-01 2013-10-01 false Cargo handling space. 151.25-2 Section 151.25-2 Shipping... BULK LIQUID HAZARDOUS MATERIAL CARGOES Environmental Control § 151.25-2 Cargo handling space. Pump rooms, compressor rooms, refrigeration rooms, heating rooms, instrument rooms or other closed spaces...

PLEASE NOTE CHANGE OF ROOM! Particle Dark Matter (2/4)

ScienceCinema

Hooper, Dan

2018-04-16

Academic Training Lecture Regular Programme. Previously discussed the process of freeze-out of dark matter in the early universe, now discussing how other particles might affect the process of freeze-out.

77 FR 75640 - Merchant Mariner Medical Advisory Committee: Intercessional Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-21

... Simulation, Training, Assessment, and Research (STAR) Center, Room 217, 2 West Dixie Highway, Dania Beach, FL... 6 (Medical Review Process, 4 (Medications), and 3 (Medical Conditions Subject to Further Review) of...

Facility uses Six Sigma to improve quality.

PubMed

2006-09-01

Initiative demonstrates a 23% improvement in first bed assignment to a private isolation room. Keys to improvement found in enhanced communication and staff training. Staff develop reporting mechanism to sustain and institutionalize project results.

Effects of a training workshop on suicide prevention among emergency room nurses.

PubMed

Kishi, Yasuhiro; Otsuka, Kotaro; Akiyama, Keiko; Yamada, Tomoki; Sakamoto, Yumiko; Yanagisawa, Yaeko; Morimura, Hiroshi; Kawanishi, Chiaki; Higashioka, Hiroaki; Miyake, Yasushi; Thurber, Steven

2014-01-01

Suicide attempts are frequently encountered by emergency department nurses. Such encounters can potentially provide a foundation for secondary suicide prevention. The aim of the present investigation was to evaluate the effect of a 7-hr training program for emergency room nursing personnel in Japan. In all, 52 nurses completed the questionnaires before the workshop and 1 month after the workshop. The nurses' understanding of and willingness to care for suicidal patients positively changed. It is feasible to provide a 7-hr, relatively short, workshop on suicidal prevention aimed at emergency medical staff and to improve attitudes during a follow-up of 1 month. It is uncertain whether the positive attitudes of emergency nurses toward suicide and/or educational interventions could impact the outcomes of these interventions. Further studies are needed to address these important questions in this field.

Training with video imaging improves the initial intubation success rates of paramedic trainees in an operating room setting.

PubMed

Levitan, R M; Goldman, T S; Bryan, D A; Shofer, F; Herlich, A

2001-01-01

Video imaging of intubation as seen by the laryngoscopist has not been a part of traditional instruction methods, and its potential impact on novice intubation success rates has not been evaluated. We prospectively tracked the success rates of novice intubators in paramedic classes who were required to watch a 26-minute instructional videotape made with a direct laryngoscopy imaging system (video group). We compared the prospectively obtained intubation success rate of the video group against retrospectively collected data from prior classes of paramedic students (traditional group) in the same training program. All classes received the same didactic airway instruction, same mannequin practice time, same paramedic textbook, and were trained in the same operating room with the same teaching staff. The traditional group (n=113, total attempts 783) had a mean individual intubation success rate of 46.7% (95% confidence interval 42.2% to 51.3%). The video group (n=36, total attempts 102) had a mean individual intubation success rate of 88.1% (95% confidence interval 79.6% to 96.5%). The difference in mean intubation success rates between the 2 groups was 41.4% (95% confidence interval 31.1% to 50.7%, P <.0001). The 2 groups did not differ in respect to age, male sex, or level of education. An instructional videotape made with the direct laryngoscopy video system significantly improved the initial success rates of novice intubators in an operating room setting.

Cognitive neuroscience of cognitive retraining for addiction medicine: From mediating mechanisms to questions of efficacy.

PubMed

Gladwin, Thomas E; Wiers, Corinde E; Wiers, Reinout W

2016-01-01

Cognitive retraining or cognitive bias modification (CBM) involves having subjects repeatedly perform a computerized task designed to reduce the impact of automatic processes that lead to harmful behavior. We first discuss the theory underlying CBM and provide a brief overview of important research progress in its application to addiction. We then focus on cognitive- and neural-mediating mechanisms. We consider recent criticism of both CBM and its theoretical foundations. Evaluations of CBM could benefit from considering theory-driven factors that may determine variations in efficacy, such as motivation. Concerning theory, while there is certainly room for fundamental advances in current models, we argue that the basic view of impulsive behavior and its control remains a useful and productive heuristic. Finally, we briefly discuss some interesting new directions for CBM research: enhancement of training via transcranial direct current stimulation, online training, and gamification, i.e., the use of gameplay elements to increase motivation. © 2016 Elsevier B.V. All rights reserved.

12. "TAPE ROOM" LOCATED AT SOUTHEAST CORNER OF MAIN ROOM. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. "TAPE ROOM" LOCATED AT SOUTHEAST CORNER OF MAIN ROOM. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Instrumentation & Control Building, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, FACING NORTH - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, FACING SOUTHEAST - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, FACING EAST - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 4, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 4, FACING WEST - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

Women's History Month Event

NASA Image and Video Library

2018-03-27

JoAnn Morgan, former associate director of NASA Kennedy Space Center, speaks to workers during a Women's History Month event at the center. With the theme "Nevertheless She Persisted," Morgan described her experience as the first female engineer working in the space program in the 1960s. Morgan was the first female in the Launch Control Center firing room during the Apollo 11 launch. The event was hosted by the center's Kennedy Networking Opportunities for Women (KNOW) and Launching Leaders organizations. The purpose of KNOW is to provide focus on issues such as employment, retention, promotion, training, career and personal development, education, and identify and eliminate barriers that hinder the advancement of women in the workforce.

Women's History Month Event

NASA Image and Video Library

2018-03-27

JoAnn Morgan, far left at the podium, former associate director of Kennedy Space Center, was the keynote speaker during a Women's History Month event at the center. With the theme "Nevertheless She Persisted," Morgan described her experience as the first female engineer working in the space program in the 1960s. Morgan was the first female in the Launch Control Center firing room during the Apollo 11 launch. The event was hosted by the center's Kennedy Networking Opportunities for Women (KNOW) and Launching Leaders organizations. The purpose of KNOW is to provide focus on issues such as employment, retention, promotion, training, career and personal development, education, and identify and eliminate barriers that hinder the advancement of women in the workforce.

Women's History Month Event

NASA Image and Video Library

2018-03-27

JoAnn Morgan, former associate director of NASA Kennedy Space Center, was the keynote speaker during a Women's History Month event at the center. With the theme "Nevertheless She Persisted," Morgan described her experience as the first female engineer working in the space program in the 1960s. Morgan was the first female in the Launch Control Center firing room during the Apollo 11 launch. The event was hosted by the center's Kennedy Networking Opportunities for Women (KNOW) and Launching Leaders organizations. The purpose of KNOW is to provide focus on issues such as employment, retention, promotion, training, career and personal development, education, and identify and eliminate barriers that hinder the advancement of women in the workforce.

Women's History Month Event

NASA Image and Video Library

2018-03-27

JoAnn Morgan, former associate director of Kennedy Space Center, was the keynote speaker during a Women's History Month event at the center. With the theme "Nevertheless She Persisted," Morgan described her experience as the first female engineer working in the space program in the 1960s. Morgan was the first female in the Launch Control Center firing room during the Apollo 11 launch. The event was hosted by the center's Kennedy Networking Opportunities for Women (KNOW) and Launching Leaders organizations. The purpose of KNOW is to provide focus on issues such as employment, retention, promotion, training, career and personal development, education, and identify and eliminate barriers that hinder the advancement of women in the workforce.

Introducing HEP to schools through educational scenaria

NASA Astrophysics Data System (ADS)

Kourkoumelis, C.; Vourakis, S.

2015-05-01

Recent activities, towards the goal of introducing High Energy Physics in the school class, are reviewed. The most efficient method is a half or a full day workshop where the students are introduced to one of the large LHC experiments, follow a "virtual visit" to the experiment's Control Room and perform an interactive analysis of real data. Science cafes and visits to the CERN expositions are also very helpful, provided that the tours/discussions are led by an active scientist and/or a trained teacher. Several EU outreach projects provide databases rich with education scenaria and data analysis tools ready to be used by the teachers in order to bridge the gap between modern research and technology and school education.

Mental practice enhances surgical technical skills: a randomized controlled study.

PubMed

Arora, Sonal; Aggarwal, Rajesh; Sirimanna, Pramudith; Moran, Aidan; Grantcharov, Teodor; Kneebone, Roger; Sevdalis, Nick; Darzi, Ara

2011-02-01

To assess the effects of mental practice on surgical performance. Increasing concerns for patient safety have highlighted a need for alternative training strategies outside the operating room. Mental practice (MP), "the cognitive rehearsal of a task before performance," has been successful in sport and music to enhance skill. This study investigates whether MP enhances performance in laparoscopic surgery. After baseline skills testing, 20 novice surgeons underwent training on an evidence-based virtual reality curriculum. After randomization using the closed envelope technique, all participants performed 5 Virtual Reality (VR) laparoscopic cholecystectomies (LC). Mental practice participants performed 30 minutes of MP before each LC; control participants viewed an online lecture. Technical performance was assessed using video Objective Structured Assessment of Technical Skills-based global ratings scale (scored from 7 to 35). Mental imagery was assessed using a previously validated Mental Imagery Questionnaire. Eighteen participants completed the study. There were no intergroup differences in baseline technical ability. Learning curves were demonstrated for both MP and control groups. Mental practice was superior to control (global ratings) for the first LC (median 20 vs 15, P = 0.005), second LC (20.5 vs 13.5, P = 0.001), third LC (24 vs 15.5, P < 0.001), fourth LC (25.5 vs 15.5, P < 0.001) and the fifth LC (27.5 vs 19.5, P = 0.00). The imagery for the MP group was also significantly superior to the control group across all sessions (P < 0.05). Improved imagery significantly correlated with better quality of performance (ρ 0.51–0.62, Ps < 0.05). This is the first randomized controlled study to show that MP enhances the quality of performance based on VR laparoscopic cholecystectomy. This may be a time- and cost-effective strategy to augment traditional training in the OR thus potentially improving patient care.

The WPI reactor-readying for the next generation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bobek, L.M.

1993-01-01

Built in 1959, the 10-kW open-pool nuclear training reactor at Worcester Polytechnic Institute (WPI) was one of the first such facilities in the nation located on a university campus. Since then, the reactor and its related facilities have been used to train two generations of nuclear engineers and scientists for the nuclear industry. With the use of nuclear technology playing an increasing role in many segments of the economy, WPI with its nuclear reactor facility is committed to continuing its mission of training future nuclear engineers and scientists. The WPI reactor includes a 6-in. beam port, graphite thermal column, andmore » in-core sample facility. The reactor, housed in an open 8000-gal tank of water, is designed so that the core is readily accessible. Both the control console and the peripheral counting equipment used for student projects and laboratory exercises are located in the reactor room. This arrangement provides convenience and flexibility in using the reactor for foil activations in neutron flux measurements, diffusion measurements, radioactive decay measurements, and the neutron activation of samples for analysis. In 1988, the reactor was successfully converted to low-enriched uranium fuel.« less

IET control building (TAN620). control room. facing north. control consoles ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

IET control building (TAN-620). control room. facing north. control consoles have been removed. Openings in floor were communication and control conduits. Periscope controls at center left (see also HAER No. ID-33-E-20). INEEL negative no. HD-21-3-1 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

The Florida Prostate Cancer Research Training Opportunities for Outstanding Leaders (ReTOOL) Program: Creating Opportunities for Minority HBCU Students

DTIC Science & Technology

2014-03-01

community outreach.” How has the ReTOOL program impacted you? “The ReTOOL Program has gotten me closer to doing what I love (making people happy ...features two story buildings with fun playgrounds, a pool and free resident parking. Tanglewood Village Amenities • High Speed Internet Access • Laundry...Rooms • Cable Television • Water • Local Phone Service • Evening Security Patrols • Recreation Rooms • Free Parking (Tanglewood Only) Please

A System Approach to Navy Medical Education and Training. Appendix 36. Competency Curriculum for Operating Room Assistant and Operating Room Technician.

DTIC Science & Technology

1974-08-31

These methods and curriculum materials constituted a third (instructional) sub-system. Thus, as originally proposed, a system capability has been...NODAL and its associated indexing techniques, it is possible to assemble modified or completely different inventories than those used in this research...covering all hair as a source of infection Method by which synthetic material causes static electricity Danger of static electricity in O.R. suite I

Survivability of a Propellant Fire inside a Simulated Military Vehicle Crew Compartment: Part 2 - Hazard Mitigation Strategies and Their Effectiveness

DTIC Science & Technology

2013-06-01

Weapons Propulsion Group where his work initially focussed on R&D relating to cast- composite rocket motors. The emphasis of his work then shifted to gun...Relative humidity RHS Rectangular Hollow Section t Time (s) T1 Ambient room temperature, ceiling-height (K) T2 Ambient room temperature...propellant and a centre- core igniter train. The BCM and UNCLASSIFIED DSTO-RR-0393 UNCLASSIFIED 2 TCM contain the same propellant formulation and

Phase 1 IWAR Test Results

DTIC Science & Technology

2010-01-01

Symantec Server Antivirus 1 1 1 1 2 7 8 8 Service Passwords 0 10 4 4 4 10 5 5 Banner Needs 0 0 0 0 0 0 0 0 Unauthorized Software 0 1 0 1 4 1 4 1... software needed to manage and operate systems in the testing rooms. Systems in the testing rooms were made to resemble shipboard Navy systems as closely...i.e., work- station and server software , routing and switching, operating systems, and so forth). This training was also designed to provide

MTR CONTROL ROOM WITH CONTROL CONSOLE AND STATUS READOUTS ALONG ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

MTR CONTROL ROOM WITH CONTROL CONSOLE AND STATUS READOUTS ALONG WALL. WORKERS MAKE ELECTRICAL AND OTHER CONNECTIONS. INL NEGATIVE NO. 4289. Unknown Photographer, 2/26/1952 - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

49 CFR 195.446 - Control room management.

Code of Federal Regulations, 2010 CFR

2010-10-01

... written control room management procedures that implement the requirements of this section. The procedures... define the roles and responsibilities of a controller during normal, abnormal, and emergency operating... operator must define each of the following: (1) A controller's authority and responsibility to make...

Designing an operator interface? Consider user`s `psychology`

DOE Office of Scientific and Technical Information (OSTI.GOV)

Toffer, D.E.

The modern operator interface is a channel of communication between operators and the plant that, ideally, provides them with information necessary to keep the plant running at maximum efficiency. Advances in automation technology have increased information flow from the field to the screen. New and improved Supervisory Control and Data Acquisition (SCADA) packages provide designers with powerful and open design considerations. All too often, however, systems go to the field designed for the software rather than the operator. Plant operators` jobs have changed fundamentally, from controlling their plants from out in the field to doing so from within control rooms.more » Control room-based operation does not denote idleness. Trained operators should be engaged in examination of plant status and cognitive evaluation of plant efficiencies. Designers who are extremely computer literate, often do not consider demographics of field operators. Many field operators have little knowledge of modern computer systems. As a result, they do not take full advantage of the interface`s capabilities. Designers often fail to understand the true nature of how operators run their plants. To aid field operators, designers must provide familiar controls and intuitive choices. To achieve success in interface design, it is necessary to understand the ways in which humans think conceptually, and to understand how they process this information physically. The physical and the conceptual are closely related when working with any type of interface. Designers should ask themselves: {open_quotes}What type of information is useful to the field operator?{close_quotes} Let`s explore an integration model that contains the following key elements: (1) Easily navigated menus; (2) Reduced chances for misunderstanding; (3) Accurate representations of the plant or operation; (4) Consistent and predictable operation; (5) A pleasant and engaging interface that conforms to the operator`s expectations. 4 figs.« less

An intervention for noise control of blast furnace in steel industry.

PubMed

Golmohammadi, Rostam; Giahi, Omid; Aliabadi, Mohsen; Darvishi, Ebrahim

2014-01-01

Noise pollution is currently a major health risk factor for workers in industries. The aim of this study was to investigate noise pollution and implement a control intervention plan for blast furnace in a steel industry. The measurement of sound pressure level (SPL) along with frequency analysis was done with the sound-level-meter Cell-450. Personal noise exposure was performed using dosimeter TES-1345 calibrated with CEL-282. Before planning noise controls, acoustic insulation properties of the furnace control unit and workers' rest room were assessed. Control room and workers' rest room were redesigned in order to improve acoustical condition. The SPL before intervention around the Blast Furnace was 90.3 dB (L) and its dominant frequency was 4000 Hz. Besides, noise transmission loss of the control and rest rooms were 10.3 dB and 4.2 dB, respectively. After intervention, noise reduction rates in the control and rest rooms were 27.4 dB and 27.7 dB, respectively. The workers' noise dose before and after the intervention was 240% and less than 100%, respectively. Improvement the workroom acoustic conditions through noise insulation can be considered effective method for preventing workers exposure to harmful noise.

A field demonstration of energy conservation using occupancy sensor lighting control in equipment rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dagle, J.E.

1992-09-01

The Pacific Northwest Laboratory identified energy savings potential of automatic equipment-room lighting controls, which was demonstrated by the field experiment described in this report. Occupancy sensor applications have gained popularity in recent years due to improved technology that enhances reliability and reduces cost. Automatic lighting control using occupancy sensors has been accepted as an energy-conservation measure because it reduces wasted lighting. This study focused on lighting control for equipment rooms, which have inherent conditions ideal for automatic lighting control, i.e., an area which is seldom occupied, multiple users of the area who would not know if others are in themore » room when they leave, and high lighting energy intensity in the area. Two rooms were selected for this study: a small equipment room in the basement of the 337 Building, and a large equipment area in the upper level of the 329 Building. The rooms were selected to demonstrate the various degrees of complexity which may be encountered in equipment rooms throughout the Hanford Site. The 337 Building equipment-room test case demonstrated a 97% reduction in lighting energy consumption, with an annual energy savings of $184. Including lamp-replacement savings, a total savings of $306 per year is offset by an initial installation cost of $1,100. The installation demonstrates a positive net present value of $2,858 when the lamp-replacement costs are included in a life-cycle analysis. This also corresponds to a 4.0-year payback period. The 329 Building equipment-room installation resulted in a 92% reduction in lighting energy consumption. This corresponds to annual energy savings of $1,372, and a total annual savings of $2,104 per year including lamp-replacement savings. The life-cycle cost analysis shows a net present value of $15,855, with a 5.8-year payback period.« less

27. Pump Room interiorDrainage pump motor control center with main ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

27. Pump Room interior-Drainage pump motor control center with main valve control panel at right. - Hunters Point Naval Shipyard, Drydock No. 4, East terminus of Palou Avenue, San Francisco, San Francisco County, CA

31. INTERIOR VIEW TO THE SOUTHWEST OF A THIRD CONTROL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

31. INTERIOR VIEW TO THE SOUTHWEST OF A THIRD CONTROL PANEL IN ROOM 105, THE CONTROL ROOM. - Nevada Test Site, Pluto Facility, Disassembly Building, Area 26, Wahmonie Flats, Cane Spring Road, Mercury, Nye County, NV

30. INTERIOR VIEW TO THE WEST OF A SECOND CONTROL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

30. INTERIOR VIEW TO THE WEST OF A SECOND CONTROL PANEL IN ROOM 105, THE CONTROL ROOM. - Nevada Test Site, Pluto Facility, Disassembly Building, Area 26, Wahmonie Flats, Cane Spring Road, Mercury, Nye County, NV

Front view of bldg 30 which houses mission control

NASA Technical Reports Server (NTRS)

1984-01-01

Front view of bldg 30 which houses mission control. A shift change for the 41-D mission is underway. The windowless wing at left houses three floors, including rooms supporting flight control room 1 and 2.

11. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF MECHANICAL ROOM. VIEW ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF MECHANICAL ROOM. VIEW TO SOUTHEAST. - Minuteman III ICBM Launch Control Facility November-1, 1.5 miles North of New Raymer & State Highway 14, New Raymer, Weld County, CO

12. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF GENERATOR ROOM. VIEW ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF GENERATOR ROOM. VIEW TO EAST. - Minuteman III ICBM Launch Control Facility November-1, 1.5 miles North of New Raymer & State Highway 14, New Raymer, Weld County, CO

Atmospheric Tracer Depletion Testing for Unfiltered Air In-Leakage Determination at the Wolf Creek Nuclear Power Plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sullivan, T. M.; Wilke, R. J.; Roberts, T.

Atmospheric Tracer Depletion tests were conducted at the Wolf Creek Nuclear Power Plant to quantify the unfiltered in-leakage (UI) into the Control Room (CR), Control Building (CB), and Equipment Rooms (ER) at the Wolf Creek Nuclear Power Plant. Wolf Creek has two independent charcoal filter Emergency Ventilation Systems (EVS) that can be used to purify air entering the control building and control room. The Bravo System contains a filtration system in Room 1501 in the Auxiliary Building for the Control Room and another filtration system (FGK02B) on Elevation 2016 for the Control Building. The Alpha system contains a filtration systemmore » in Room 1512 in the Auxiliary Building for the Control Room and another filtration system (FGK02A) on Elevation 2016 for the Control Building. The Atmospheric Tracer Depletion (ATD) test is a technique to measure in-leakage using the concentration of perfluorocarbon compounds that have a constant atmospheric background. These levels are present in the Control Room and Control Building under normal operating conditions. When air is supplied by either of the EVS, most of the PFTS are removed by the charcoal filters. If the concentrations of the PFTs measured in protected areas are the same as the levels at the output of the EVS, the in-leakage of outside air into the protected area would be zero. If the concentration is higher in the protected area than at the output of the filter system, there is in-leakage and the in-leakage can be quantified by the difference. Sampling was performed using state-of-the-art Brookhaven Atmospheric Tracer Samplers (BATS) air sampling equipment and analysis performed on Brookhaven National Laboratory (BNL) dedicated PFT analytical systems. In the Alpha test two tracers PMCH and mcPDCH were used to determine in-leakage into the control building. The analytical system was tuned to maximize sensitivity after initial analysis of the Alpha test. The increased sensitivity permitted accurate quantification of five isomers of the PFT PDCH (mtPDCH, pcPDCH, otPDCH, mcPDCH, and ptPDCH). These isomers were quantified in the low concentration samples in the Alpha test and in all samples in the Bravo test. The best estimates of UI (Rui) for the four zones are provided in Table ES-1. For the CB, this estimate averages the four tracers at the four elevations. For the CR, this estimate uses the four sampling units located in the Control Room.« less

Atmospheric Tracer Depletion Testing for Unfiltered Air In-Leakage Determination at the Wolf Creek Nuclear Power Plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sullivan, T. M.; Wilke, R. J.; Roberts, T.

Atmospheric Tracer Depletion tests were conducted at the Wolf Creek Nuclear Power Plant to quantify the unfiltered in-leakage (UI) into the Control Room (CR), Control Building (CB), and Equipment Rooms (ER) at the Wolf Creek Nuclear Power Plant. Wolf Creek has two independent charcoal filter Emergency Ventilation Systems (EVS) that can be used to purify air entering the control building and control room. The Bravo System contains a filtration system in Room 1501 in the Auxiliary Building for the Control Room and another filtration system (FGK02B) on Elevation 2016 for the Control Building. The Alpha system contains a filtration systemmore » in Room 1512 in the Auxiliary Building for the Control Room and another filtration system (FGK02A) on Elevation 2016 for the Control Building.The Atmospheric Tracer Depletion (ATD) test is a technique to measure in-leakage using the concentration of perfluorocarbon compounds that have a constant atmospheric background. These levels are present in the Control Room and Control Building under normal operating conditions. When air is supplied by either of the EVS, most of the PFTS are removed by the charcoal filters. If the concentrations of the PFTs measured in protected areas are the same as the levels at the output of the EVS, the in-leakage of outside air into the protected area would be zero. If the concentration is higher in the protected area than at the output of the filter system, there is in-leakage and the in-leakage can be quantified by the difference.Sampling was performed using state-of-the-art Brookhaven Atmospheric Tracer Samplers (BATS) air sampling equipment and analysis performed on Brookhaven National Laboratory (BNL) dedicated PFT analytical systems. In the Alpha test two tracers PMCH and mcPDCH were used to determine in-leakage into the control building. The analytical system was tuned to maximize sensitivity after initial analysis of the Alpha test. The increased sensitivity permitted accurate quantification of five isomers of the PFT PDCH (mtPDCH, pcPDCH, otPDCH, mcPDCH, and ptPDCH). These isomers were quantified in the low concentration samples in the Alpha test and in all samples in the Bravo test.The best estimates of UI (Rui) for the four zones are provided in Table ES-1. For the CB, this estimate averages the four tracers at the four elevations. For the CR, this estimate uses the four sampling units located in the Control Room.« less

49. Environmental equipment room, cbr filter at left, ventilation control ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

49. Environmental equipment room, cbr filter at left, ventilation control panel in center, brine chiller controls at right, looking southeast - Ellsworth Air Force Base, Delta Flight, Launch Control Facility, County Road CS23A, North of Exit 127, Interior, Jackson County, SD

Documentation of new mission control center White Flight Control Room (FLCR)

NASA Image and Video Library

1995-06-06

Documentation of the new mission control center White Flight Control Room (FLCR). Excellent overall view of White FLCR with personnel manning console workstations (11221). Fisheye lens perspective from Flight Director station with Brian Austin (11222). Environmental (EECOM) workstation and personnel (11223).

The cutting-edge training modalities and educational platforms for accredited surgical training: A systematic review.

PubMed

Forgione, Antonello; Guraya, Salman Y

2017-01-01

Historically, operating room (OR) has always been considered as a stand-alone trusted platform for surgical education and training. However, concerns about financial constraints, quality control, and patient safety have urged the surgical educators to develop more cost-effective, surgical educational platforms that can be employed outside the OR. Furthermore, trained surgeons need to regularly update their surgical skills to keep abreast with the emerging surgical technologies. This research aimed to explore the value of currently available modern surgical tools that can be used outside the OR and also elaborates the existing laparoscopic surgical training programs in world-class centers across the globe with a view to formulate a blended and unified structured surgical training program. Several data sources were searched using MeSH terms "Laparoscopic surgery" and "Surgical training" and "Surgical curriculum" and "fundamentals of endoscopic surgery" and "fundamentals of laparoscopic surgery" and "Telementoring" and "Box trainer." The eligibility criteria used in data extraction searched for original and review articles and by excluding the editorial articles, short communications, conference proceedings, personal view, and commentaries. Data synthesis and data analysis were done by reviewing the initially retrieved 211 articles. Irrelevant and duplicate and redundant articles were excluded from the study. Finally, 12 articles were selected for this systematic review. Data results showed that a myriad of cutting-edge technical innovations have provided modern surgical training tools such as the simulation-based mechanical and virtual reality simulators, animal and cadaveric labs, telementoring, telerobotic-assisted surgery, and video games. Surgical simulators allow the trainees to acquire surgical skills in a tension-free environment without supervision or time constraints. The existing world-renowned surgical training centers employ various clusters of training tools that essentially endeavor to embed the acquisition of knowledge and technical skills. However, a unified training curriculum that may be accepted worldwide is currently not available.

An integrated system for dynamic control of auditory perspective in a multichannel sound field

NASA Astrophysics Data System (ADS)

Corey, Jason Andrew

An integrated system providing dynamic control of sound source azimuth, distance and proximity to a room boundary within a simulated acoustic space is proposed for use in multichannel music and film sound production. The system has been investigated, implemented, and psychoacoustically tested within the ITU-R BS.775 recommended five-channel (3/2) loudspeaker layout. The work brings together physical and perceptual models of room simulation to allow dynamic placement of virtual sound sources at any location of a simulated space within the horizontal plane. The control system incorporates a number of modules including simulated room modes, "fuzzy" sources, and tracking early reflections, whose parameters are dynamically changed according to sound source location within the simulated space. The control functions of the basic elements, derived from theories of perception of a source in a real room, have been carefully tuned to provide efficient, effective, and intuitive control of a sound source's perceived location. Seven formal listening tests were conducted to evaluate the effectiveness of the algorithm design choices. The tests evaluated: (1) loudness calibration of multichannel sound images; (2) the effectiveness of distance control; (3) the resolution of distance control provided by the system; (4) the effectiveness of the proposed system when compared to a commercially available multichannel room simulation system in terms of control of source distance and proximity to a room boundary; (5) the role of tracking early reflection patterns on the perception of sound source distance; (6) the role of tracking early reflection patterns on the perception of lateral phantom images. The listening tests confirm the effectiveness of the system for control of perceived sound source distance, proximity to room boundaries, and azimuth, through fine, dynamic adjustment of parameters according to source location. All of the parameters are grouped and controlled together to create a perceptually strong impression of source location and movement within a simulated space.

KSC-2014-1969

NASA Image and Video Library

2014-04-03

CAPE CANAVERAL, Fla. – Three rows of upper level management consoles are all that remain in Firing Room 4 in the Launch Control Center at NASA’s Kennedy Space Center in Florida. The main floor consoles, cabling and wires below the floor and ceiling tiles above have been removed. The Ground Systems Development and Operations Program is overseeing efforts to create a new firing room based on a multi-user concept that will support NASA and commercial launch needs. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Ben Smegelsky

KSC-2014-1970

NASA Image and Video Library

2014-04-03

CAPE CANAVERAL, Fla. – Three rows of upper level management consoles are all that remain in Firing Room 4 in the Launch Control Center at NASA’s Kennedy Space Center in Florida. The main floor consoles, cabling and wires below the floor and ceiling tiles above have been removed. The Ground Systems Development and Operations Program is overseeing efforts to create a new firing room based on a multi-user concept that will support NASA and commercial launch needs. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Ben Smegelsky

Permanent education in the vaccination room: what is the reality?

PubMed

Martins, Jéssica Rauane Teixeira; Alexandre, Bruna Gabrielly Pereira; Oliveira, Valéria Conceição de; Viegas, Selma Maria da Fonseca

2018-01-01

To understand, from the perspective of the professional, the Permanent Education (PE) in the vaccination room in its real context. Multiple holistic-qualitative case studies, based on Maffesoli's Interpretive Sociology with 56 participants from four microregions of the Western Extended Region of Minas Gerais State. They present PE as infrequent and insufficient. They denote that the practical-theoretical experience with vaccine contributes to the work; the search for knowledge, starting from the professional itself; and the professional training fails to perform in the vaccination room. The notions of PE are linked to the daily needs of individuals and services, with indication of being interactive, periodic, in specific and non-global issues for better assimilation. Obstacles to the non-implementation of PEH are realized by the workload associated with insufficient human resources, the distance of the nurses from the vaccination room and the lack of support from the higher levels.

jsc2014e045626

NASA Image and Video Library

2014-05-16

DATE: 5-16-14. LOCATION: Bldg. 16N, Room 1040. SUBJECT: Expedition 47 (Soyuz 45) crew members Tim Kopra and Timothy Peake during FF T&C/R ADV2 training in the SES Alpha Cupola. PHOTOGRAPHER: Lauren Harnett

jsc2014e045623

NASA Image and Video Library

2014-05-16

DATE: 5-16-14. LOCATION: Bldg. 16N, Room 1040. SUBJECT: Expedition 47 (Soyuz 45) crew members Tim Kopra and Timothy Peake during FF T&C/R ADV2 training in the SES Alpha Cupola. PHOTOGRAPHER: Lauren Harnett

What Are the Signs and Symptoms of Concussion?

MedlinePlus

... TBI Online Concussion Training Press Room Guide to Writing about TBI in News and Social Media Living with TBI HEADS UP to Brain Injury Awareness Get Email Updates To receive email updates about this topic, ...

Modulation Spectroscopy and Opto Mechanics of Micro Toroidal Resonators

DTIC Science & Technology

2017-08-01

campus at UTRGV, 2) to initiate training of the UTRGV students in nano fabrication and clean room techniques, 3) to conduct experiments with silicon...Email: Volker.Quetschke@utb.edu RPPR Final Report as of 30-Oct-2017 Training Opportunities: During this reporting period PI and his students acquired...Lithography (EBL), Scanning Electron Microscope (SEM), and Reactive Ion-Etching (RIE) techniques. The students involved in this project attended the

11. CONTROL ROOM INTERIOR, SHOWING SEVERAL PERISCOPES. Looking north along ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. CONTROL ROOM INTERIOR, SHOWING SEVERAL PERISCOPES. Looking north along west wall. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Instrumentation & Control Building, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

29. INTERIOR VIEW TO THE NORTHEAST OF CONTROL PANEL AND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

29. INTERIOR VIEW TO THE NORTHEAST OF CONTROL PANEL AND VIEWING WINDOW IN ROOM 105, THE CONTROL ROOM. - Nevada Test Site, Pluto Facility, Disassembly Building, Area 26, Wahmonie Flats, Cane Spring Road, Mercury, Nye County, NV

8. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF DINING/RECREATION ROOM. VIEW ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF DINING/RECREATION ROOM. VIEW TO EAST. - Minuteman III ICBM Launch Control Facility November-1, 1.5 miles North of New Raymer & State Highway 14, New Raymer, Weld County, CO

Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study.

PubMed

Brueckmann, B; Sasaki, N; Grobara, P; Li, M K; Woo, T; de Bie, J; Maktabi, M; Lee, J; Kwo, J; Pino, R; Sabouri, A S; McGovern, F; Staehr-Rye, A K; Eikermann, M

2015-11-01

This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. Adult patients undergoing abdominal surgery received rocuronium, followed by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade. Timing of reversal agent administration was based on the providers' clinical judgement. Primary endpoint was the presence of residual neuromuscular blockade at PACU admission, defined as a train-of-four (TOF) ratio <0.9, using TOF-Watch® SX. Key secondary endpoint was time between reversal agent administration and operating room discharge-readiness; analysed with analysis of covariance. Of 154 patients randomized, 150 had a TOF value measured at PACU entry. Zero out of 74 sugammadex patients and 33 out of 76 (43.4%) usual care patients had TOF-Watch SX-assessed residual neuromuscular blockade at PACU admission (odds ratio 0.0, 95% CI [0-0.06], P<0.0001). Of these 33 usual care patients, 2 also had clinical evidence of partial paralysis. Time between reversal agent administration and operating room discharge-readiness was shorter for sugammadex vs usual care (14.7 vs. 18.6 min respectively; P=0.02). After abdominal surgery, sugammadex reversal eliminated residual neuromuscular blockade in the PACU, and shortened the time from start of study medication administration to the time the patient was ready for discharge from the operating room. Clinicaltrials.gov:NCT01479764. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Improving question asking in high-functioning adolescents with autism spectrum disorders: effectiveness of small-group training.

PubMed

Palmen, Annemiek; Didden, Robert; Arts, Marieke

2008-01-01

Small-group training consisting of feedback and self-management was effective in improving question-asking skills during tutorial conversations in nine high-functioning adolescents with autism spectrum disorder. Training was implemented in a therapy room and lasted 6 weeks. Sessions were conducted once a week and lasted about an hour. Experimenters collected data during tutorial conversations in a natural setting. Training of question-asking skills consisted of verbal feedback and role-play during short simulated conversations and a table game. A self-management strategy and common stimuli (e.g., flowchart) were included to promote generalization. Mean percentage of correct questions during tutorial conversations improved significantly after training. Response efficiency also increased. Participants and personal coaches evaluated the training as effective and acceptable.

Duration to Establish an Emergency Vascular Access and How to Accelerate It: A Simulation-Based Study Performed in Real-Life Neonatal Resuscitation Rooms.

PubMed

Schwindt, Eva M; Hoffmann, Florian; Deindl, Philipp; Waldhoer, Thomas J; Schwindt, Jens C

2018-05-01

To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. Retrospective analysis of audio-video recorded neonatal simulation training. Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany). Equipment was prepared the same way as for real clinical events. Medical teams of four to five persons with birth-related background (midwives, nurses, neonatologists, and anesthesiologists) in a realistic team composition. Audio-video recorded mannequin-based simulated resuscitation of an asphyxiated newborn including the establishment of either umbilical venous catheter or intraosseous access. The duration of access establishment (time from decision to first flush/aspiration), preparation (decision to start of procedure), and the procedure itself (start to first flush/aspiration) was significantly longer for umbilical venous catheter than for intraosseous access (overall duration 199 vs 86 s). Delaying factors for umbilical venous catheter establishment were mainly due to the complex approach itself, the multitude of equipment required, and uncertainties about necessary hygiene standards. Challenges in intraosseous access establishment were handling of the unfamiliar material and absence of an intraosseous access kit in the resuscitation room. There was no significant difference between the required duration for access establishment between large centers and small hospitals, but a trend was observed that duration for umbilical venous catheter was longer in small hospitals than in centers. Duration for intraosseous access was similar in both hospital types. Vascular access establishment in neonatal resuscitation could be accelerated by infrastructural improvements and specific training of medical teams. In simulated in situ neonatal resuscitation, intraosseous access is faster to establish than umbilical venous catheter. Future studies are required to assess efficacy and safety of both approaches in real resuscitation settings.

SU-F-P-18: Development of the Technical Training System for Patient Set-Up Considering Rotational Correction in the Virtual Environment Using Three-Dimensional Computer Graphic Engine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Imura, K; Fujibuchi, T; Hirata, H

Purpose: Patient set-up skills in radiotherapy treatment room have a great influence on treatment effect for image guided radiotherapy. In this study, we have developed the training system for improving practical set-up skills considering rotational correction in the virtual environment away from the pressure of actual treatment room by using three-dimensional computer graphic (3DCG) engine. Methods: The treatment room for external beam radiotherapy was reproduced in the virtual environment by using 3DCG engine (Unity). The viewpoints to perform patient set-up in the virtual treatment room were arranged in both sides of the virtual operable treatment couch to assume actual performancemore » by two clinical staffs. The position errors to mechanical isocenter considering alignment between skin marker and laser on the virtual patient model were displayed by utilizing numerical values expressed in SI units and the directions of arrow marks. The rotational errors calculated with a point on the virtual body axis as the center of each rotation axis for the virtual environment were corrected by adjusting rotational position of the body phantom wound the belt with gyroscope preparing on table in a real space. These rotational errors were evaluated by describing vector outer product operations and trigonometric functions in the script for patient set-up technique. Results: The viewpoints in the virtual environment allowed individual user to visually recognize the position discrepancy to mechanical isocenter until eliminating the positional errors of several millimeters. The rotational errors between the two points calculated with the center point could be efficiently corrected to display the minimum technique mathematically by utilizing the script. Conclusion: By utilizing the script to correct the rotational errors as well as accurate positional recognition for patient set-up technique, the training system developed for improving patient set-up skills enabled individual user to indicate efficient positional correction methods easily.« less

Improving Resident Performance in Knee Arthroscopy: A Prospective Value Assessment of Simulators and Cadaveric Skills Laboratories.

PubMed

Camp, Christopher L; Krych, Aaron J; Stuart, Michael J; Regnier, Terry D; Mills, Karen M; Turner, Norman S

2016-02-03

Cadaveric skills laboratories and virtual reality simulators are two common methods used outside of the operating room to improve residents' performance of knee arthroscopy. We are not aware of any head-to-head comparisons of the educational values of these two methodologies. The purpose of this prospective randomized trial was to assess the efficacy of these training methods, compare their rates of improvement, and provide economic value data to programs seeking to implement such technologies. Orthopaedic surgery residents were randomized to one of three groups: control, training on cadavera (cadaver group), and training with use of a simulator (simulator group). Residents completed pretest and posttest diagnostic knee arthroscopies on cadavera that were timed and video-recorded. Between the pretest and posttest, the control group performed no arthroscopy, the cadaver group performed four hours of practice on cadavera, and the simulator group trained for four hours on a simulator. All tests were scored in a blinded, randomized fashion using the validated Arthroscopy Surgical Skill Evaluation Tool (ASSET). The mean improvement in the ASSET score and in the time to complete the procedure were compared between the pretest and posttest and among the groups. Forty-five residents (fifteen per group) completed the study. The mean difference in the ASSET score from the pretest to the posttest was -0.40 (p = 0.776) in the control group, +4.27 (p = 0.002) in the cadaver group, and +1.92 (p = 0.096) in the simulator group (p = 0.015 for the comparison among the groups). The mean difference in the test-completion time (minutes:seconds) from the pretest to the posttest was 0:07 (p = 0.902) in the control group, 3:01 (p = 0.002) in the cadaver group, and 0:28 (p = 0.708) in the simulator group (p = 0.044 for the comparison among groups). Residents in the cadaver group improved their performance at a mean of 1.1 ASSET points per hour spent training whereas those in the simulator group improved 0.5 ASSET point per hour of training. Cadaveric skills laboratories improved residents' performance of knee arthroscopy compared with that of matched controls. Residents practicing on cadaveric specimens improved twice as fast as those utilizing a high-fidelity simulator; however, based on cost estimation specific to our institution, the simulator may be more cost-effective if it is used at least 300 hours per year. Additional study of this possibility is warranted. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Knee Arthroscopy Simulation: A Randomized Controlled Trial Evaluating the Effectiveness of the Imperial Knee Arthroscopy Cognitive Task Analysis (IKACTA) Tool.

PubMed

Bhattacharyya, Rahul; Davidson, Donald J; Sugand, Kapil; Bartlett, Matthew J; Bhattacharya, Rajarshi; Gupte, Chinmay M

2017-10-04

Virtual-reality and cadaveric simulations are expensive and not readily accessible. Innovative and accessible training adjuncts are required to help to meet training needs. Cognitive task analysis has been used extensively to train pilots and in other surgical specialties. However, the use of cognitive task analyses within orthopaedics is in its infancy. The purpose of this study was to evaluate the effectiveness of a novel cognitive task analysis tool to train novice surgeons in diagnostic knee arthroscopy in high-fidelity, phantom-limb simulation. Three expert knee surgeons were interviewed independently to generate a list of technical steps, decision points, and errors for diagnostic knee arthroscopy. A modified Delphi technique was used to generate the final cognitive task analysis. A video and a voiceover were recorded for each phase of this procedure. These were combined to produce the Imperial Knee Arthroscopy Cognitive Task Analysis (IKACTA) tool that utilizes written and audiovisual stimuli to describe each phase of a diagnostic knee arthroscopy. In this double-blinded, randomized controlled trial, a power calculation was performed prior to recruitment. Sixteen novice orthopaedic trainees who performed ≤10 diagnostic knee arthroscopies were randomized into 2 equal groups. The intervention group (IKACTA group) was given the IKACTA tool and the control group had no additional learning material. They were assessed objectively (validated Arthroscopic Surgical Skill Evaluation Tool [ASSET] global rating scale) on a high-fidelity, phantom-knee simulator. All participants, using the Likert rating scale, subjectively rated the tool. The mean ASSET score (and standard deviation) was 19.5 ± 3.7 points in the IKACTA group and 10.6 ± 2.3 points in the control group, resulting in an improvement of 8.9 points (95% confidence interval, 7.6 to 10.1 points; p = 0.002); the score was determined as 51.3% (19.5 of 38) for the IKACTA group, 27.9% (10.6 of 38) for the control group, and 23.4% (8.9 of 38) for the improvement. All participants agreed that the cognitive task analysis learning tool was a useful training adjunct to learning in the operating room. To our knowledge, this is the first cognitive task analysis in diagnostic knee arthroscopy that is user-friendly and inexpensive and has demonstrated significant benefits in training. The IKACTA will provide trainees with a demonstrably strong foundation in diagnostic knee arthroscopy that will flatten learning curves in both technical skills and decision-making.

LOFT. Interior, control room in control building (TAN630). Camera facing ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

LOFT. Interior, control room in control building (TAN-630). Camera facing north. Sign says "This control console is partially active. Do not operate any switch handle without authorization." Date: May 2004. INEEL negative no. HD-39-14-3 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

14. GENE PUMPING STATION CONTROL ROOM AS SEEN FROM MAIN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. GENE PUMPING STATION CONTROL ROOM AS SEEN FROM MAIN STATION MANAGER'S CONTROL DESK. ELECTRICAL CONTROL INDICATORS AND CONTROLS FOR REGULATING ELECTRICITY INTO PLANT AS WELL AS SYNCHRONIZING STARTUP OF PUMPS. - Gene Pump Plant, South of Gene Wash Reservoir, 2 miles west of Whitsett Pump Plant, Parker Dam, San Bernardino County, CA

The use of a virtual reality simulator to explore and understand the impact of Linac mis-calibrations

NASA Astrophysics Data System (ADS)

Beavis, Andrew W.; Ward, James W.

2014-03-01

Purpose: In recent years there has been interest in using Computer Simulation within Medical training. The VERT (Virtual Environment for Radiotherapy Training) system is a Flight Simulator for Radiation Oncology professionals, wherein fundamental concepts, techniques and problematic scenarios can be safely investigated. Methods: The system provides detailed simulations of several Linacs and the ability to display DICOM treatment plans. Patients can be mis-positioned with 'set-up errors' which can be explored visually, dosimetrically and using IGRT. Similarly, a variety of Linac calibration and configuration parameters can be altered manually or randomly via controlled errors in the simulated 3D Linac and its component parts. The implication of these can be investigated by following through a treatment scenario or using QC devices available within a Physics software module. Results: One resultant exercise is a systematic mis-calibration of 'lateral laser height' by 2mm. The offset in patient alignment is easily identified using IGRT and once corrected by reference to the 'in-room monitor'. The dosimetric implication is demonstrated to be 0.4% by setting a dosimetry phantom by the lasers (and ignoring TSD information). Finally, the need for recalibration can be shown by the Laser Alignment Phantom or by reference to the front pointer. Conclusions: The VERT system provides a realistic environment for training and enhancing understanding of radiotherapy concepts and techniques. Linac error conditions can be explored in this context and valuable experience gained in a controlled manner in a compressed period of time.

Information Foraging in Nuclear Power Plant Control Rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

R.L. Boring

2011-09-01

nformation foraging theory articulates the role of the human as an 'informavore' that seeks information and follows optimal foraging strategies (i.e., the 'information scent') to find meaningful information. This paper briefly reviews the findings from information foraging theory outside the nuclear domain and then discusses the types of information foraging strategies operators employ for normal and off-normal operations in the control room. For example, operators may employ a predatory 'wolf' strategy of hunting for information in the face of a plant upset. However, during routine operations, the operators may employ a trapping 'spider' strategy of waiting for relevant indicators tomore » appear. This delineation corresponds to information pull and push strategies, respectively. No studies have been conducted to determine explicitly the characteristics of a control room interface that is optimized for both push and pull information foraging strategies, nor has there been empirical work to validate operator performance when transitioning between push and pull strategies. This paper explores examples of control room operators as wolves vs. spiders and con- cludes by proposing a set of research questions to investigate information foraging in control room settings.« less

Interdisciplinary simulation-based training to improve delivery room communication.

PubMed

Dadiz, Rita; Weinschreider, Joanne; Schriefer, Jan; Arnold, Christine; Greves, Cole D; Crosby, Erin C; Wang, Hongyue; Pressman, Eva K; Guillet, Ronnie

2013-10-01

Poor communication among obstetric and pediatric professionals is associated with adverse perinatal events leading to severe disability and neonatal mortality. This study evaluated the effectiveness of an interdisciplinary simulation-based training (SBT) program to improve delivery room communication between obstetric and pediatric teams. Obstetric and pediatric teams participated in an SBT annually during 3 academic years, 2008-2011 (Y1-Y3), in a prospective, observational study. Eligible participants (n = 228) included attendings, fellows, house staff, midlevel providers, and nurses involved in delivery room care. Simulations were videotaped and evaluated using a validated 20-item checklist of best communication practices. Checklist scores were compared across years with the Kruskal-Wallis test. Providers were also surveyed annually regarding communication during actual deliveries using a standardized questionnaire. Ratings were analyzed using two-way analysis of covariance. At least 60% of eligible providers participated in 1 or more SBT sessions and completed surveys annually. Checklist scores on communication during SBT improved from Y1 (median, 6; interquartile range, 4) to Y3 (median, 11; interquartile range, 6) (P < 0.001). Survey results showed the perception of improvement over time in interteam communication during actual deliveries by obstetric (P < 0.005) and pediatric (P < 0.0001) providers. The obstetric team also perceived improved provider communication with the family (P < 0.05). Communication during SBT as well as the perception of communication during actual deliveries improved across the study period. The potential of a checklist to standardize delivery room communication and improve patient outcomes merits further investigation.

Validation of an endothelial roll preparation for Descemet Membrane Endothelial Keratoplasty by a cornea bank using "no touch" dissection technique.

PubMed

Marty, Anne-Sophie; Burillon, Carole; Desanlis, Adeline; Damour, Odile; Kocaba, Viridiana; Auxenfans, Céline

2016-06-01

Descemet Membrane Endothelial Keratoplasty (DMEK) selectively replaces the damaged posterior part of the cornea. However, the DMEK technique relies on a manually-performed dissection that is time-consuming, requires training and presents a potential risk of endothelial graft damages leading to surgery postponement when performed by surgeons in the operative room. To validate precut corneal tissue preparation for DMEK provided by a cornea bank in order to supply a quality and security precut endothelial tissue. The protocol was a technology transfer from the Netherlands Institute for Innovative Ocular Surgery (NIIOS) to Lyon Cornea Bank, after formation in NIIOS to the DMEK "no touch" dissection technique. The technique has been validated in selected conditions (materials, microscope) and after a learning curve, cornea bank technicians prepared endothelial tissue for DMEK. Endothelial cells densities (ECD) were evaluated before and after preparation, after storage and transport to the surgery room. Microbiological and histological controls have been done. Twenty corneas were manually dissected; 18 without tears. Nineteen endothelial grafts formed a double roll. The ECD loss after cutting was 3.3 % (n = 19). After transportation 7 days later, we found an ECD loss of 25 % (n = 12). Three days after cutting and transportation, we found 2.1 % of ECD loss (n = 7). Histology found an endothelial cells monolayer lying on Descemet membrane. The mean thickness was 12 ± 2.2 µm (n = 4). No microbial contamination was found (n = 19). Endothelial roll stability has been validated at 3 days in our cornea bank. Cornea bank technicians trained can deliver to surgeons an ECD controlled, safety and ready to use endothelial tissue, for DMEK by "no touch" technique, allowing time saving, quality and security for surgeons.

Neuromuscular blocking agent administration for emergent tracheal intubation is associated with decreased prevalence of procedure-related complications.

PubMed

Wilcox, Susan R; Bittner, Edward A; Elmer, Jonathan; Seigel, Todd A; Nguyen, Nicole Thuy P; Dhillon, Anahat; Eikermann, Matthias; Schmidt, Ulrich

2012-06-01

Emergent intubation is associated with a high rate of complications. Neuromuscular blocking agents are routinely used in the operating room and emergency department to facilitate intubation. However, use of neuromuscular blocking agents during emergent airway management outside of the operating room and emergency department is controversial. We hypothesized that the use of neuromuscular blocking agents is associated with a decreased prevalence of hypoxemia and reduced rate of procedure-related complications. Five hundred sixty-six patients undergoing emergent intubations in two tertiary care centers, Massachusetts General Hospital, Boston, MA, and the University of California Los Angeles, Ronald Reagan Medical Center, Los Angeles, CA, were enrolled in a prospective, observational study. The 112 patients intubated during cardiopulmonary resuscitation were excluded, leaving 454 patients for analysis. All intubations were supervised by attendings trained in Critical Care Medicine. We measured intubating conditions, oxygen saturation during and 5 mins following intubation. We assessed the prevalence of procedure-related complications defined as esophageal intubation, traumatic intubation, aspiration, dental injury, and endobronchial intubation. The use of neuromuscular blocking agents was associated with a lower prevalence of hypoxemia (10.1% vs. 17.4%, p = .022) and a lower prevalence of procedure-related complications (3.1% vs. 8.3%, p = .012). This association persisted in a multivariate analysis, which controlled for airway grade, sedation, and institution. Use of neuromuscular blocking agents was associated with significantly improved intubating conditions (laryngeal view, p = .014; number of intubation attempts, p = .049). After controlling for the number of intubation attempts and laryngoscopic view, muscle relaxant use is an independent predictor of complications associated with emergency intubation (p = .037), and there is a trend towards improvement of oxygenation (p = .07). The use of neuromuscular blocking agents, when used by intensivists with a high level of training and experience, is associated with a decrease in procedure-related complications.

Light Water Reactor Sustainability Program A Reference Plan for Control Room Modernization: Planning and Analysis Phase

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jacques Hugo; Ronald Boring; Lew Hanes

2013-09-01

The U.S. Department of Energy’s Light Water Reactor Sustainability (LWRS) program is collaborating with a U.S. nuclear utility to bring about a systematic fleet-wide control room modernization. To facilitate this upgrade, a new distributed control system (DCS) is being introduced into the control rooms of these plants. The DCS will upgrade the legacy plant process computer and emergency response facility information system. In addition, the DCS will replace an existing analog turbine control system with a display-based system. With technology upgrades comes the opportunity to improve the overall human-system interaction between the operators and the control room. To optimize operatormore » performance, the LWRS Control Room Modernization research team followed a human-centered approach published by the U.S. Nuclear Regulatory Commission. NUREG-0711, Rev. 3, Human Factors Engineering Program Review Model (O’Hara et al., 2012), prescribes four phases for human factors engineering. This report provides examples of the first phase, Planning and Analysis. The three elements of Planning and Analysis in NUREG-0711 that are most crucial to initiating control room upgrades are: • Operating Experience Review: Identifies opportunities for improvement in the existing system and provides lessons learned from implemented systems. • Function Analysis and Allocation: Identifies which functions at the plant may be optimally handled by the DCS vs. the operators. • Task Analysis: Identifies how tasks might be optimized for the operators. Each of these elements is covered in a separate chapter. Examples are drawn from workshops with reactor operators that were conducted at the LWRS Human System Simulation Laboratory HSSL and at the respective plants. The findings in this report represent generalized accounts of more detailed proprietary reports produced for the utility for each plant. The goal of this LWRS report is to disseminate the technique and provide examples sufficient to serve as a template for other utilities’ projects for control room modernization.« less

6. UNDERGROUND FIRING CONTROL ROOM, INTERIOR. Looking southeast to escape ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. UNDERGROUND FIRING CONTROL ROOM, INTERIOR. Looking southeast to escape tunnel. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Firing Control Building, Test Area 1-100, northeast end of Test Area 1-100 Road, Boron, Kern County, CA

7. CONTROL AND EQUIPMENT ROOM INTERIOR. Looking to southwest corner ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. CONTROL AND EQUIPMENT ROOM INTERIOR. Looking to southwest corner and entrance to cable tunnel. - Edwards Air Force Base, South Base Sled Track, Firing Control Blockhouse, South of Sled Track at east end, Lancaster, Los Angeles County, CA

Medical student and faculty perceptions of volunteer outpatients versus simulated patients in communication skills training.

PubMed

Clever, Sarah L; Dudas, Robert A; Solomon, Barry S; Yeh, Hsin Chieh; Levine, David; Bertram, Amanda; Goldstein, Mitchell; Shilkofski, Nicole; Cofrancesco, Joseph

2011-11-01

To determine whether medical students and faculty perceive differences in the effectiveness of interactions with real patients versus simulated patients (SPs) in communication skills training. In 2008, the authors recruited volunteer outpatients (VOs) from the Johns Hopkins University School of Medicine internal medicine practice to participate in communication skills training for all first-year medical students. VOs and SPs were assigned to clinic rooms in the simulation center. Each group of five students and its preceptor rotated through randomly assigned rooms on two of four session days; on both days, each student interviewed one patient for 15 minutes, focusing on past medical and family history or social history. Patients used their own histories, not scripts; students were not blinded to patient type. Students and faculty then rated aspects of the interview experience. Generalized linear latent and mixed-models analysis was used to compare ratings of communication skills training with VOs versus SPs. All 121 first-year students participated in 242 interviews, resulting in 237 usable questionnaires (98%). They rated their experiences with VOs significantly higher than those with SPs on comfort, friendliness, amount of learning, opportunity to build relationships, and overall meeting of communication skills training needs. The 24 faculty preceptors' ratings of the 242 interactions did not differ significantly between VOs and SPs. Use of VOs was well received by students and faculty for teaching communication skills. Expanding and further studying VOs' participation will allow greater understanding of their potential role in communication skills training of preclinical medical students.

An Assessment of Basic Patient Safety Skills in Residents Entering the First Year of Clinical Training.

PubMed

Comunale, Mark E; Sandoval, Mathew; Broussard, La Toya

2018-06-01

During safety rounds, we observed few residents demonstrating hand hygiene and patient identification as they began their postgraduate clinical training. We assessed baseline performance of these 2 basic safety skills in residents entering the first year of postgraduate clinical training (PGY1). PGY1 residents beginning training on July 1, 2013, and July 1, 2014, at our institution were examined using a simulated scenario testing for hand hygiene and patient identification. Nurse volunteers posed as patients and evaluated each resident using a standardized scoring tool. Residents were observed for the following behaviors when interacting: (1) hand hygiene before or upon entry into the patient's room (HHE); (2) resident introducing himself or herself (INTRO); (3) resident identifying patient (IDNB); (4) resident comparing patient's stated name and date of birth to patient's ID band (IDC); (5) resident explaining procedure to patient (EXP); and (6) resident performing hand hygiene upon exiting patient's room (HHL). A total of 114 residents were examined. Compliance results were as follows: HHE at 66% (75); INTRO at 96% (110); IDNB at 52% (59); IDC at 42% (48); EXP at 90% (103); and HHL at 58% (66). Developing and hardwiring basic patient safety skills is essential for creating an institutional culture of safety. We used a simulated patient scenario to provide a baseline assessment of 2 important safety skills.The results obtained demonstrate poor compliance with hand hygiene and patient identification. Our results suggest that there is a need for additional training and perhaps new methods of training and reinforcement in medical school and beyond, to hardwire these basic patient safety skills.

Nontechnical skills training for the operating room: A prospective study using simulation and didactic workshop.

PubMed

Pena, Guilherme; Altree, Meryl; Field, John; Sainsbury, David; Babidge, Wendy; Hewett, Peter; Maddern, Guy

2015-07-01

The best surgeons demonstrate skills beyond those required for the performance of technically competent surgery. These skills are described under the term nontechnical skills. Failure in these domains has been associated with adverse events inside the operating room. These nontechnical skills are not learned commonly in a structured manner during surgery training. The main purpose of this study was to explore the effects of participation in simulation-based training, either as a sole strategy or as part of a combined approach on surgeons and surgical trainees nontechnical skills performance in simulation environment. The study consisted of a single-blinded, prospective comparative trial. Forty participants were enrolled, all participating in 2 simulation sessions challenging nontechnical skills comprising 3 surgical scenarios. Seventeen participants attended a 1-day, nontechnical skills workshop between simulation sessions. Scenarios were video-recorded for assessment and debriefing purposes. Assessment was made by 2 observers using the Non-Technical Skills for Surgeons (NOTSS) scoring system. There was a significant improvement in nontechnical skills performance of both groups from the first to the second simulation session, for 2 of the 3 scenarios. No difference in performance between the simulation and the simulation plus workshop groups was noted. This study provides evidence that formal training in nontechnical skills is feasible and can impact positively participants' nontechnical performance in a simulated environment. The addition of a 1-day didactic workshop does not seem to provide additional benefit over simulation-based training as a sole strategy for nontechnical skills training. Copyright © 2015 Elsevier Inc. All rights reserved.

10 CFR 36.23 - Access control.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Access control. 36.23 Section 36.23 Energy NUCLEAR... Requirements for Irradiators § 36.23 Access control. (a) Each entrance to a radiation room at a panoramic... radiation room at a panoramic irradiator must have an independent backup access control to detect personnel...

10 CFR 36.23 - Access control.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Access control. 36.23 Section 36.23 Energy NUCLEAR... Requirements for Irradiators § 36.23 Access control. (a) Each entrance to a radiation room at a panoramic... radiation room at a panoramic irradiator must have an independent backup access control to detect personnel...

10 CFR 36.23 - Access control.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Access control. 36.23 Section 36.23 Energy NUCLEAR... Requirements for Irradiators § 36.23 Access control. (a) Each entrance to a radiation room at a panoramic... radiation room at a panoramic irradiator must have an independent backup access control to detect personnel...

Wide angle view of the Flight control room of Mission control center

NASA Image and Video Library

1984-10-06

Wide angle view of the flight control room (FCR) of the Mission Control Center (MCC). Some of the STS 41-G crew can be seen on a large screen at the front of the MCC along with a map tracking the progress of the orbiter.

Sound-field reproduction in-room using optimal control techniques: simulations in the frequency domain.

PubMed

Gauthier, Philippe-Aubert; Berry, Alain; Woszczyk, Wieslaw

2005-02-01

This paper describes the simulations and results obtained when applying optimal control to progressive sound-field reproduction (mainly for audio applications) over an area using multiple monopole loudspeakers. The model simulates a reproduction system that operates either in free field or in a closed space approaching a typical listening room, and is based on optimal control in the frequency domain. This rather simple approach is chosen for the purpose of physical investigation, especially in terms of sensing microphones and reproduction loudspeakers configurations. Other issues of interest concern the comparison with wave-field synthesis and the control mechanisms. The results suggest that in-room reproduction of sound field using active control can be achieved with a residual normalized squared error significantly lower than open-loop wave-field synthesis in the same situation. Active reproduction techniques have the advantage of automatically compensating for the room's natural dynamics. For the considered cases, the simulations show that optimal control results are not sensitive (in terms of reproduction error) to wall absorption in the reproduction room. A special surrounding configuration of sensors is introduced for a sensor-free listening area in free field.

A Semantic Labeling of the Environment Based on What People Do.

PubMed

Crespo, Jonathan; Gómez, Clara; Hernández, Alejandra; Barber, Ramón

2017-01-29

In this work, a system is developed for semantic labeling of locations based on what people do. This system is useful for semantic navigation of mobile robots. The system differentiates environments according to what people do in them. Background sound, number of people in a room and amount of movement of those people are items to be considered when trying to tell if people are doing different actions. These data are sampled, and it is assumed that people behave differently and perform different actions. A support vector machine is trained with the obtained samples, and therefore, it allows one to identify the room. Finally, the results are discussed and support the hypothesis that the proposed system can help to semantically label a room.

10. Photocopy of circa 1948 photograph showing a view of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photocopy of circa 1948 photograph showing a view of the Waiting Room Access of Train Shed, courtesy of Reading Company Archives - Philadelphia & Reading Railroad, Terminal Station, 1115-1141 Market Street, Philadelphia, Philadelphia County, PA

"Tuberculosis Case Management" Training.

ERIC Educational Resources Information Center

Knebel, Elisa; Kolodner, Jennifer

2001-01-01

The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to…

12. VIEW, LOOKING SOUTH FROM LEFT TO RIGHT, SHOWING DRESSING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. VIEW, LOOKING SOUTH FROM LEFT TO RIGHT, SHOWING DRESSING FROM AND WORK/CHAMBER ROOM - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

Roundabout design training for Alaska's engineers.

DOT National Transportation Integrated Search

2015-07-01

Roundabout are an emerging type of intersection design, are a relatively new addition to the transportation system in the United States. : As a result, guidelines for roundabout design and construction are very broad and leave much room for subjectiv...

Physician communication in the operating room.

PubMed

Kirschbaum, Kristin A; Rask, John P; Fortner, Sally A; Kulesher, Robert; Nelson, Michael T; Yen, Tony; Brennan, Matthew

2015-01-01

In this study, communication research was conducted with multidisciplinary groups of operating-room physicians. Theoretical frameworks from intercultural communication and rhetoric were used to (a) measure latent cultural communication variables and (b) conduct communication training with the physicians. A six-step protocol guided the research with teams of physicians from different surgical specialties: anesthesiologists, general surgeons, and obstetrician-gynecologists (n = 85). Latent cultural communication variables were measured by surveys administered to physicians before and after completion of the protocol. The centerpiece of the 2-hour research protocol was an instructional session that informed the surgical physicians about rhetorical choices that support participatory communication. Post-training results demonstrated scores increased on communication variables that contribute to collaborative communication and teamwork among the physicians. This study expands health communication research through application of combined intercultural and rhetorical frameworks, and establishes new ways communication theory can contribute to medical education.

Microcontroller based automatic temperature control for oyster mushroom plants

NASA Astrophysics Data System (ADS)

Sihombing, P.; Astuti, T. P.; Herriyance; Sitompul, D.

2018-03-01

In the cultivation of Oyster Mushrooms need special treatment because oyster mushrooms are susceptible to disease. Mushroom growth will be inhibited if the temperature and humidity are not well controlled because temperature and inertia can affect mold growth. Oyster mushroom growth usually will be optimal at temperatures around 22-28°C and humidity around 70-90%. This problem is often encountered in the cultivation of oyster mushrooms. Therefore it is very important to control the temperature and humidity of the room of oyster mushroom cultivation. In this paper, we developed an automatic temperature monitoring tool in the cultivation of oyster mushroom-based Arduino Uno microcontroller. We have designed a tool that will control the temperature and humidity automatically by Android Smartphone. If the temperature increased more than 28°C in the room of mushroom plants, then this tool will turn on the pump automatically to run water in order to lower the room temperature. And if the room temperature of mushroom plants below of 22°C, then the light will be turned on in order to heat the room. Thus the temperature in the room oyster mushrooms will remain stable so that the growth of oyster mushrooms can grow with good quality.

Applied Virtual Reality Research and Applications at NASA/Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Hale, Joseph P.

1995-01-01

A Virtual Reality (VR) applications program has been under development at NASA/Marshall Space Flight Center (MSFC) since 1989. The objectives of the MSFC VR Applications Program are to develop, assess, validate, and utilize VR in hardware development, operations development and support, mission operations training and science training. Before this technology can be utilized with confidence in these applications, it must be validated for each particular class of application. That is, the precision and reliability with which it maps onto real settings and scenarios, representative of a class, must be calculated and assessed. The approach of the MSFC VR Applications Program is to develop and validate appropriate virtual environments and associated object kinematic and behavior attributes for specific classes of applications. These application-specific environments and associated simulations will be validated, where possible, through empirical comparisons with existing, accepted tools and methodologies. These validated VR analytical tools will then be available for use in the design and development of space systems and operations and in training and mission support systems. Specific validation studies for selected classes of applications have been completed or are currently underway. These include macro-ergonomic "control-room class" design analysis, Spacelab stowage reconfiguration training, a full-body micro-gravity functional reach simulator, and a gross anatomy teaching simulator. This paper describes the MSFC VR Applications Program and the validation studies.

A comparative study of surface EMG classification by fuzzy relevance vector machine and fuzzy support vector machine.

PubMed

Xie, Hong-Bo; Huang, Hu; Wu, Jianhua; Liu, Lei

2015-02-01

We present a multiclass fuzzy relevance vector machine (FRVM) learning mechanism and evaluate its performance to classify multiple hand motions using surface electromyographic (sEMG) signals. The relevance vector machine (RVM) is a sparse Bayesian kernel method which avoids some limitations of the support vector machine (SVM). However, RVM still suffers the difficulty of possible unclassifiable regions in multiclass problems. We propose two fuzzy membership function-based FRVM algorithms to solve such problems, based on experiments conducted on seven healthy subjects and two amputees with six hand motions. Two feature sets, namely, AR model coefficients and room mean square value (AR-RMS), and wavelet transform (WT) features, are extracted from the recorded sEMG signals. Fuzzy support vector machine (FSVM) analysis was also conducted for wide comparison in terms of accuracy, sparsity, training and testing time, as well as the effect of training sample sizes. FRVM yielded comparable classification accuracy with dramatically fewer support vectors in comparison with FSVM. Furthermore, the processing delay of FRVM was much less than that of FSVM, whilst training time of FSVM much faster than FRVM. The results indicate that FRVM classifier trained using sufficient samples can achieve comparable generalization capability as FSVM with significant sparsity in multi-channel sEMG classification, which is more suitable for sEMG-based real-time control applications.

Arthroscopic Shoulder Surgical Simulation Training Curriculum: Transfer Reliability and Maintenance of Skill Over Time.

PubMed

Dunn, John C; Belmont, Philip J; Lanzi, Joseph; Martin, Kevin; Bader, Julia; Owens, Brett; Waterman, Brian R

2015-01-01

Surgical education is evolving as work hour constraints limit the exposure of residents to the operating room. Potential consequences may include erosion of resident education and decreased quality of patient care. Surgical simulation training has become a focus of study in an effort to counter these challenges. Previous studies have validated the use of arthroscopic surgical simulation programs both in vitro and in vivo. However, no study has examined if the gains made by residents after a simulation program are retained after a period away from training. In all, 17 orthopedic surgery residents were randomized into simulation or standard practice groups. All subjects were oriented to the arthroscopic simulator, a 14-point anatomic checklist, and Arthroscopic Surgery Skill Evaluation Tool (ASSET). The experimental group received 1 hour of simulation training whereas the control group had no additional training. All subjects performed a recorded, diagnostic arthroscopy intraoperatively. These videos were scored by 2 blinded, fellowship-trained orthopedic surgeons and outcome measures were compared within and between the groups. After 1 year in which neither group had exposure to surgical simulation training, all residents were retested intraoperatively and scored in the exact same fashion. Individual surgical case logs were reviewed and surgical case volume was documented. There was no difference between the 2 groups after initial simulation testing and there was no correlation between case volume and initial scores. After training, the simulation group improved as compared with baseline in mean ASSET (p = 0.023) and mean time to completion (p = 0.01). After 1 year, there was no difference between the groups in any outcome measurements. Although individual technical skills can be cultivated with surgical simulation training, these advancements can be lost without continued education. It is imperative that residency programs implement a simulation curriculum and continue to train throughout the academic year. Published by Elsevier Inc.

The cutting-edge training modalities and educational platforms for accredited surgical training: A systematic review

PubMed Central

Forgione, Antonello; Guraya, Salman Y.

2017-01-01

Background: Historically, operating room (OR) has always been considered as a stand-alone trusted platform for surgical education and training. However, concerns about financial constraints, quality control, and patient safety have urged the surgical educators to develop more cost-effective, surgical educational platforms that can be employed outside the OR. Furthermore, trained surgeons need to regularly update their surgical skills to keep abreast with the emerging surgical technologies. This research aimed to explore the value of currently available modern surgical tools that can be used outside the OR and also elaborates the existing laparoscopic surgical training programs in world-class centers across the globe with a view to formulate a blended and unified structured surgical training program. Materials and Methods: Several data sources were searched using MeSH terms “Laparoscopic surgery” and “Surgical training” and “Surgical curriculum” and “fundamentals of endoscopic surgery” and “fundamentals of laparoscopic surgery” and “Telementoring” and “Box trainer.” The eligibility criteria used in data extraction searched for original and review articles and by excluding the editorial articles, short communications, conference proceedings, personal view, and commentaries. Data synthesis and data analysis were done by reviewing the initially retrieved 211 articles. Irrelevant and duplicate and redundant articles were excluded from the study. Results: Finally, 12 articles were selected for this systematic review. Data results showed that a myriad of cutting-edge technical innovations have provided modern surgical training tools such as the simulation-based mechanical and virtual reality simulators, animal and cadaveric labs, telementoring, telerobotic-assisted surgery, and video games. Surgical simulators allow the trainees to acquire surgical skills in a tension-free environment without supervision or time constraints. Conclusion: The existing world-renowned surgical training centers employ various clusters of training tools that essentially endeavor to embed the acquisition of knowledge and technical skills. However, a unified training curriculum that may be accepted worldwide is currently not available. PMID:28567070

Saving robots improves laparoscopic performance: transfer of skills from a serious game to a virtual reality simulator.

PubMed

IJgosse, Wouter M; van Goor, Harry; Luursema, Jan-Maarten

2018-01-18

Residents find it hard to commit to structural laparoscopic skills training. Serious gaming has been proposed as a solution on the premise that it is effective and more motivating than traditional simulation. We establish construct validity for the laparoscopic serious game Underground by comparing laparoscopic simulator performance for a control group and an Underground training group. A four-session laparoscopic basic skills course is part of the medical master students surgical internship at the Radboud University Medical Centre. Four cohorts, representing 107 participants, were assigned to either the Underground group or the control group. The control group trained on the FLS video trainer and the LapSim virtual reality simulator for four sessions. The Underground group played Underground for three sessions followed by a transfer session on the FLS video trainer and the LapSim. To assess the effect of engaging in serious gameplay on performance on two validated laparoscopic simulators, initial performance on the FLS video trainer and the LapSim was compared between the control group (first session) and the Underground group (fourth session). We chose task duration as a proxy for laparoscopic performance. The Underground group outperformed the control group on all three LapSim tasks: Camera navigation F(1) = 12.71, p < .01; Instrument navigation F(1) = 8.04, p < .01; and Coordination F(1) = 6.36, p = .01. There was no significant effect of playing Underground for performance on the FLS video trainer Peg Transfer task, F(1) = 0.28, p = .60. We demonstrated skills transfer between a serious game and validated laparoscopic simulator technology. Serious gaming may become a valuable, cost-effective addition to the skillslab, if transfer to the operating room can be established. Additionally, we discuss sources of transferable skills to help explain our and previous findings.

Autophonic Loudness of Singers in Simulated Room Acoustic Environments.

PubMed

Yadav, Manuj; Cabrera, Densil

2017-05-01

This paper aims to study the effect of room acoustics and phonemes on the perception of loudness of one's own voice (autophonic loudness) for a group of trained singers. For a set of five phonemes, 20 singers vocalized over several autophonic loudness ratios, while maintaining pitch constancy over extreme voice levels, within five simulated rooms. There were statistically significant differences in the slope of the autophonic loudness function (logarithm of autophonic loudness as a function of voice sound pressure level) for the five phonemes, with slopes ranging from 1.3 (/a:/) to 2.0 (/z/). There was no significant variation in the autophonic loudness function slopes with variations in room acoustics. The autophonic room response, which represents a systematic decrease in voice levels with increasing levels of room reflections, was also studied, with some evidence found in support. Overall, the average slope of the autophonic room response for the three corner vowels (/a:/, /i:/, and /u:/) was -1.4 for medium autophonic loudness. The findings relating to the slope of the autophonic loudness function are in agreement with the findings of previous studies where the sensorimotor mechanisms in regulating voice were shown to be more important in the perception of autophonic loudness than hearing of room acoustics. However, the role of room acoustics, in terms of the autophonic room response, is shown to be more complicated, requiring further inquiry. Overall, it is shown that autophonic loudness grows at more than twice the rate of loudness growth for sounds created outside the human body. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

STS-109 Flight Control Room Photo

NASA Image and Video Library

2002-03-05

JSC2002-00575 (5 March 2002) --- The members of the STS-109 Orbit 3 Team pose for a group portrait in the shuttle flight control room (WFCR) in Houston’s Mission Control Center (MCC). Flight director Jeff Hanley is visible in the center foreground.

STS-109 Flight Control Room Photo

NASA Image and Video Library

2002-03-05

JSC2002-00576 (5 March 2002) --- The members of the STS-109 Orbit 3 Team pose for a group portrait in the shuttle flight control room (WFCR) in Houston’s Mission Control Center (MCC). Flight director Jeff Hanley is visible in the center foreground.

Control Room at the NACA’s Rocket Engine Test Facility

NASA Image and Video Library

1957-05-21

Test engineers monitor an engine firing from the control room of the Rocket Engine Test Facility at the National Advisory Committee for Aeronautics (NACA) Lewis Flight Propulsion Laboratory. The Rocket Engine Test Facility, built in the early 1950s, had a rocket stand designed to evaluate high-energy propellants and rocket engine designs. The facility was used to study numerous different types of rocket engines including the Pratt and Whitney RL-10 engine for the Centaur rocket and Rocketdyne’s F-1 and J-2 engines for the Saturn rockets. The Rocket Engine Test Facility was built in a ravine at the far end of the laboratory because of its use of the dangerous propellants such as liquid hydrogen and liquid fluorine. The control room was located in a building 1,600 feet north of the test stand to protect the engineers running the tests. The main control and instrument consoles were centrally located in the control room and surrounded by boards controlling and monitoring the major valves, pumps, motors, and actuators. A camera system at the test stand allowed the operators to view the tests, but the researchers were reliant on data recording equipment, sensors, and other devices to provide test data. The facility’s control room was upgraded several times over the years. Programmable logic controllers replaced the electro-mechanical control devices. The new controllers were programed to operate the valves and actuators controlling the fuel, oxidant, and ignition sequence according to a predetermined time schedule.

26. A typical outer rod room, or rack room, showing ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

26. A typical outer rod room, or rack room, showing the racks for the nine horizontal control rods (HCRs) that would be inserted or withdrawn from the pile to control the rate of reaction. In this case, it is the 105-F Reactor in February 1945. The view is looking away from the pile, which is out of the picture on the left. Several of the cooling water hose reels for the rods can be seen at the end of the racks near the wall. D-8323 - B Reactor, Richland, Benton County, WA

Evaluation of a localization training program for hearing impaired listeners.

PubMed

Kuk, Francis; Keenan, Denise M; Lau, Chi; Crose, Bryan; Schumacher, Jennifer

2014-01-01

To evaluate the effectiveness of a home-based and a laboratory-based localization training program. This study examined the effectiveness of a localization training program on improving the localization ability of 15 participants with a mild-to-moderately severe hearing loss. These participants had worn the study hearing aids in a previous study. The training consisted of laboratory-based training and home-based training. The participants were divided into three groups: a control group, a group that performed the laboratory training first followed by the home training, and a group that completed the home training first followed by the laboratory training. The participants were evaluated before any training (baseline), at 2 weeks, 1 month, 2 months, and 3 months after baseline testing. All training was completed by the second month. The participants only wore the study hearing aids between the second month and the third month. Localization testing and laboratory training were conducted in a sound-treated room with a 360 degree, 12 loudspeaker array. There were three stimuli each randomly presented three times from each loudspeaker (nine test items from each loudspeaker) for a total of 108 items on each test or training trial. The stimuli, including a continuous noise, a telephone ring, and a speech passage "Search for the sound from this speaker" were high-pass filtered above 2000 Hz. The test stimuli had a duration of 300 ms, whereas the training stimuli had five durations (3 s, 2 s, 1 s, 500 ms, and 300 ms) and four back attenuation (-8, -4, -2, and 0 dB re: front presentation) values. All stimuli were presented at 30 dB SL or the most comfortable listening level of the participants. Each participant completed 6 to 8, 2 hr laboratory-based training within a month. The home training required a two-loudspeaker computer system using 30 different sounds of various durations (5) by attenuation (4) combinations. The participants were required to use the home training program for 30 min per day, 5 days per week for 4 weeks. Localization data were evaluated using a 30 degree error criterion. There was a significant difference in localization scores for sounds that originated from the back between baseline and 3 months for the two groups that received training. The performance of the control group remained the same across the 3 month period. Generalization to other stimuli and in the unaided condition was also seen. There were no significant differences in localization performance from other directions between baseline and 3 months. These results indicated that the training program was effective in improving the localization skills of these listeners under the current test set-up. The current study demonstrated that hearing aid wearers can be trained on their front/back localization skills using either laboratory-based or home-based training program. The effectiveness of the training was generalized to other acoustic stimuli and the unaided conditions when the stimulus levels were fixed.

Nordic Pharmacy Schools’ Experience in Communication Skills Training

PubMed Central

Björnsdottir, Ingunn; Wallman, Andy; Sporrong, Sofia Kälvemark

2017-01-01

Objective. To assess communication skills training at Nordic pharmacy schools and explore ways for improvement. Methods. E-mail questionnaires were developed and distributed with the aim to explore current practice and course leaders’ opinions regarding teaching of patient communication skills at all the 11 master level Nordic (Denmark, Finland, Iceland, Norway and Sweden) pharmacy schools. The questionnaires contained both closed- and open-ended questions. Results. There was a variation of patient communication skills training among schools. In general, communication skills training was included in one to five courses (mode 1); varied in quantity (6-92 hours); had low use of experiential training methods; and had challenges regarding assessments and acquiring sufficient resources. However, some schools had more focus on such training. Conclusion. The results show room for improvement in patient communication skills training in most Nordic pharmacy schools and give insights into how to enhance communication skill building in pharmacy curricula. Suggestions for improving the training include: early training start, evidence-based frameworks, experiential training, and scaffolding. PMID:29302085

Closed-Loop Acoustic Control of Reverberant Room for Satellite Environmental Testing

NASA Astrophysics Data System (ADS)

Janssens, Karl; Bianciardi, Fabio; Sabbatini, Danilo; Debille, Jan; Carrella, Alex

2012-07-01

The full satellite acoustic test is an important milestone in a satellite launch survivability verification campaign. This test is required to verify the satellite’s mechanical design against the high-level acoustic loads induced by the launch vehicle during the atmospheric flight. During the test, the satellite is subjected to a broadband diffuse acoustic field, reproducing the pressure levels observed during launch. The excitation is in most cases provided by a combination of horns for the low frequencies and noise generators for the higher frequencies. Acoustic control tests are commonly performed in reverberant rooms, controlling the sound pressure levels in third octave bands over the specified target spectrum. This paper discusses an automatic feedback control system for acoustic control of large reverberation rooms for satellite environmental testing. The acoustic control system consists of parallel third octave PI (Proportional Integral) feedback controllers that take the reverberation characteristics of the room into consideration. The drive output of the control system is shaped at every control step based on the comparison of the average third octave noise spectrum, measured from a number of microphones in the test room, with the target spectrum. Cross-over filters split the output drive into band- limited signals to feed each of the horns. The control system is realized in several steps. In the first phase, a dynamic process model is developed, including the non-linear characteristics of the horns and the reverberant properties of the room. The model is identified from dynamic experiments using system identification techniques. In the next phase, an adequate control strategy is designed which is capable of reaching the target spectrum in the required time period without overshoots. This control strategy is obtained from model-in-the-loop (MIL) simulations, evaluating the performance of various potential strategies. Finally, the proposed strategy is implemented in real-time and its control performance tested and validated.

Clean room survey and assessment, volume 5, appendix H

NASA Technical Reports Server (NTRS)

1991-01-01

The scope of this task is to perform a comparative analysis of the various Environmental Control Life Support System (ECLSS) options for different growth scenarios. The Space Station Freedom ECLSS design and existing ground-based clean room facilities are used as a baseline for comparison. Specifically addressed here are the ground based clean room facilities at the Marshall Space Flight Center (MSFC). Given here is an evaluation of the facilities, equipment, technologies, and procedures used to maintain specified environments in typical aerospace industrial areas. Twenty-five specific clean rooms are evaluated. The objectives were to collect, compare, and catalog data for each specified facility in the areas of engineering and design, construction materials, work stations, contamination control, particulate elimination, entry systems, and instrumentation, and to make recommendations concerning enhancements required to assure an efficient and orderly evolution of MSFC clean room environmental control facilities.

A multicenter prospective cohort study on camera navigation training for key user groups in minimally invasive surgery.

PubMed

Graafland, Maurits; Bok, Kiki; Schreuder, Henk W R; Schijven, Marlies P

2014-06-01

Untrained laparoscopic camera assistants in minimally invasive surgery (MIS) may cause suboptimal view of the operating field, thereby increasing risk for errors. Camera navigation is often performed by the least experienced member of the operating team, such as inexperienced surgical residents, operating room nurses, and medical students. The operating room nurses and medical students are currently not included as key user groups in structured laparoscopic training programs. A new virtual reality laparoscopic camera navigation (LCN) module was specifically developed for these key user groups. This multicenter prospective cohort study assesses face validity and construct validity of the LCN module on the Simendo virtual reality simulator. Face validity was assessed through a questionnaire on resemblance to reality and perceived usability of the instrument among experts and trainees. Construct validity was assessed by comparing scores of groups with different levels of experience on outcome parameters of speed and movement proficiency. The results obtained show uniform and positive evaluation of the LCN module among expert users and trainees, signifying face validity. Experts and intermediate experience groups performed significantly better in task time and camera stability during three repetitions, compared to the less experienced user groups (P < .007). Comparison of learning curves showed significant improvement of proficiency in time and camera stability for all groups during three repetitions (P < .007). The results of this study show face validity and construct validity of the LCN module. The module is suitable for use in training curricula for operating room nurses and novice surgical trainees, aimed at improving team performance in minimally invasive surgery. © The Author(s) 2013.

IET. Control room in control building (TAN620). Terminal panels for ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

IET. Control room in control building (TAN-620). Terminal panels for instrumentation wiring. Note alarm horn and emergency light at right edge of view. Cable reel comes from Collier, Pawtucket, RI. Date: February 1955. INEEL negative no. 55-362 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Guidelines on ergonomic aspects of control rooms

NASA Technical Reports Server (NTRS)

Mitchell, C. M.; Bocast, A. K.; Stewart, L. J.

1983-01-01

The anthropometry, workstation design, and environmental design of control rooms are outlined. The automated interface and VDTs and displays and various modes of communication between the system and the human operator using VDTs are discussed. The man in the loop is examined, the single controller single task framework and multiple controller multiple tasks issues are considered.

Report: EPA’s Office of Environmental Information Should Improve Ariel Rios and Potomac Yard Computer Room Security Controls

EPA Pesticide Factsheets

Report #12-P-0879, September 26, 2012. The security posture and in-place environmental control review of the computer rooms in the Ariel Rios and Potomac Yard buildings revealed numerous security and environmental control deficiencies.

20. VIEW OF WASTE TREATMENT CONTROL ROOM IN BUILDING 374. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. VIEW OF WASTE TREATMENT CONTROL ROOM IN BUILDING 374. THE BUILDING 371/374 COMPLEX WAS DESIGNED TO EMPHASIZE AUTOMATICALLY CONTROLLED, REMOTELY OPERATED PROCESSES. (1/80) - Rocky Flats Plant, Plutonium Recovery Facility, Northwest portion of Rocky Flats Plant, Golden, Jefferson County, CO

The heat is on: room temperature affects laboratory equipment--an observational study.

PubMed

Butler, Julia M; Johnson, Jane E; Boone, William R

2013-10-01

To evaluate the effect of ambient room temperature on equipment typically used in in vitro fertilization (IVF). We set the control temperature of the room to 20 °C (+/-0.3) and used CIMScan probes to record temperatures of the following equipment: six microscope heating stages, four incubators, five slide warmers and three heating blocks. We then increased the room temperature to 26 °C (+/-0.3) or decreased it to 17 °C (+/-0.3) and monitored the same equipment again. We wanted to determine what role, if any, changing room temperature has on equipment temperature fluctuation. There was a direct relationship between room temperature and equipment temperature stability. When room temperature increased or decreased, equipment temperature reacted in a corresponding manner. Statistical differences between equipment were found when the room temperature changed. What is also noteworthy is that temperature of equipment responded within 5 min to a change in room temperature. Clearly, it is necessary to be aware of the affect of room temperature on equipment when performing assisted reproductive procedures. Room and equipment temperatures should be monitored faithfully and adjusted as frequently as needed, so that consistent culture conditions can be maintained. If more stringent temperature control can be achieved, human assisted reproduction success rates may improve.

View of White Room atop Pad A during Apollo 9 Countdown Demonstration Test

NASA Image and Video Library

1969-02-23

S69-25884 (23 Feb. 1969) --- Interior view of the white room atop Pad A, Launch Complex 39, Kennedy Space Center, during Apollo 9 Countdown Demonstration Test activity. Standing next to spacecraft hatch is astronaut James A. McDivitt, commander. Also, taking part in the training exercise were astronauts David R. Scott, command module pilot; and Russell L. Schweickart, lunar module pilot. The Apollo 9 mission will evaluate spacecraft lunar module systems performance during manned Earth-orbital flight. Apollo 9 will be the second manned Saturn V mission.

Special Operations Forces Language and Culture Needs Assessment Project: Defense Language Aptitude Battery (DLAB): Perspectives from the Field

DTIC Science & Technology

2010-09-29

facilities (the room was 100 degrees in the middle of a hot North Carolina summer) and because our drill sergeants did not let us get enough sleep the...inadquate facilities (the room was 100 degrees in the middle of a hot North Carolina summer) and because our drill sergeants did not let us get enough ...environment was too hot. Furthermore, some operators reported they did not receive adequate sleep the night before the test due to other training

KSC-2009-2975

NASA Image and Video Library

2009-05-06

CAPE CANAVERAL, Fla. – New windows are installed in the Launch Control Center's Firing Room 1 at NASA's Kennedy Space Center in Florida. The firing room will support the future Ares rocket launches as part of NASA's Constellation Program. Future astronauts will ride to orbit on Ares I, launched from Kennedy's Launch Pad 39B. The Launch Control Center firing rooms face the launch pads. Photo credit: NASA/Jack Pfaller

KSC-2009-2976

NASA Image and Video Library

2009-05-06

CAPE CANAVERAL, Fla. – New windows are installed in the Launch Control Center's Firing Room 1 at NASA's Kennedy Space Center in Florida. The firing room will support the future Ares rocket launches as part of NASA's Constellation Program. Future astronauts will ride to orbit on Ares I, launched from Kennedy's Launch Pad 39B. The Launch Control Center firing rooms face the launch pads. Photo credit: NASA/Jack Pfaller