Walking in a patient’s shoes: an evaluation study of immersive learning using a digital training intervention

Objectives: Evidence suggests that immersive learning increases empathy and understanding of the patient experience of illness. This study evaluated a digital training intervention ‘In Their Shoes’ which immerses participants in the experience of living with inflammatory bowel disease (IBD), highlighting the biopsychosocial impact. The simulation program uses a mobile application to deliver time-based tasks and challenges over 36 h, supplemented with telephone role-play and ‘kit’ items to open and use. This study investigated changes in IBD understanding and connection to patients, empathy and perception of job value in a group of pharmaceutical employees. Additionally, it explored experiences and impact of taking part in the intervention. Methods: A mixed methods pre–post design was utilized, with an opportunity sample of employees taking part in the training. 104 participants from sites in 12 countries completed measures at baseline and 97 post-intervention. Measures included the Toronto Empathy Questionnaire, Prosocial Job Characteristics Scale, and structured questions around IBD understanding and connection to patients. Two focus groups (N = 14) were conducted regarding participants experiences of the intervention to complement an open-response question in the questionnaire (N = 75). Qualitative data was analyzed using thematic analysis. Results: Following the intervention, there were statistically significant increases in IBD understanding and connection to patients (p < 0.00025), evaluation of organizational innovation (p < 0.00025), empathy (d = 0.45) and prosocial job perceptions (d = 0.28). Qualitative analysis revealed more fully the transformative personal journey undertaken by participants which provided ‘eye opening’ insight into the psychosocial impact of living and working with IBD. This insight encouraged patient perspective-taking and a strong desire to promote patient advocacy and reduce stigma around chronic illness. Finally, greater organizational pride and connectivity was evident for some participants. Conclusions: An immersive training program, focussing on the lived experience of illness, led to significant increases in disease understanding and empathy. These findings align with other literature evaluating immersive learning and the potential for increasing knowledge, empathy and motivation. The present study offers opportunities to extend this outside of the body of work focussing on healthcare practitioners and explores the benefits of using this type of learning experience within an organizational setting

Entanglement scaling at first order phase transitions

First order quantum phase transitions (1QPTs) are signaled, in the thermodynamic limit, by discontinuous changes in the ground state properties. These discontinuities affect expectation values of observables, including spatial correlations. When a 1QPT is crossed in the vicinity of a second order one (2QPT), due to the correlation length divergence of the latter, the corresponding ground state is modified and it becomes increasingly difficult to determine the order of the transition when the size of the system is finite. Here we show that, in such situations, it is possible to apply finite size scaling to entanglement measures, as it has recently been done for the order parameters and the energy gap, in order to recover the correct thermodynamic limit. Such a finite size scaling can unambigously discriminate between first and second order phase transitions in the vicinity of multricritical points even when the singularities displayed by entanglement measures lead to controversial results

POLICY REQUIREMENTS IN THE SEVENTIES: A FARMER'S VIEWPOINT

Agricultural and Food Policy,

The excitation of O2 in auroras

Newly measured electron impact cross sections for excitation of the a 1 Delta g and b 1 Sigma g+ electronic states of O2 were employed to predict the absolute volume emission rates from these states under auroral conditions. A secondary electron electron flux typical of an IBC II nighttime aurora was used and the most important quenching processes were included in the calculations. The new excitation cross sections for the a 1 Delta g and b 1 Sigma g+ states are more than an order of magnitude larger than previous estimates, and lead to correspondingly greater intensities in the atmospheric and IR-atmospheric band systems. The calculated intensity ratios of the volume emission rates of 7621 A and 1.27 microns to that for 3914 A are smaller than obtained from aircraft observations and recent rocket experiments

Three-frequency resonances in dynamical systems

We investigate numerically and experimentally dynamical systems having three interacting frequencies: a discrete mapping (a circle map), an exactly solvable model (a system of coupled ordinary differential equations), and an experimental device (an electronic oscillator). We compare the hierarchies of three-frequency resonances we find in each of these systems. All three show similar qualitative behaviour, suggesting the existence of generic features in the parameter-space organization of three-frequency resonances.Comment: See home page http://lec.ugr.es/~julya

Software Defect Association Mining and Defect Correction Effort Prediction

Much current software defect prediction work concentrates on the number of defects remaining in software system. In this paper, we present association rule mining based methods to predict defect associations and defect-correction effort. This is to help developers detect software defects and assist project managers in allocating testing resources more effectively. We applied the proposed methods to the SEL defect data consisting of more than 200 projects over more than 15 years. The results show that for the defect association prediction, the accuracy is very high and the false negative rate is very low. Likewise for the defect-correction effort prediction, the accuracy for both defect isolation effort prediction and defect correction effort prediction are also high. We compared the defect-correction effort prediction method with other types of methods: PART, C4.5, and Na¨ıve Bayes and show that accuracy has been improved by at least 23%. We also evaluated the impact of support and confidence levels on prediction accuracy, false negative rate, false positive rate, and the number of rules. We found that higher support and confidence levels may not result in higher prediction accuracy, and a sufficient number of rules is a precondition for high prediction accuracy

Polarization Observations with the Cosmic Background Imager

We describe polarization observations of the CMBR with the Cosmic Background Imager, a 13 element interferometer which operates in the 26-36 GHz band from Llano de Chajnantour in northern Chile. The array consists of 90-cm Cassegrain antennas mounted on a steerable platform which can be rotated about the optical axis to facilitate polarization observations. The CBI employs single mode circularly polarized receivers which sample multipoles from ℓ~400 to ℓ~4250. The instrumental polarization of the CBI was calibrated with 3C279, a bright polarized point source which was monitored with the VLA

The Biomechanics of Keratorefractive Surgery

Corneal biomechanics is the study of the mechanical properties and responses of the cornea. The cornea’s remarkable transparency and strength allow it to contain the intraocular pressure, serve as a protective layer and act as the major refracting surface of the eye. The shape of the cornea, and hence its refractive properties, is directly determined by its ultrastructural and biomechanical properties. In keratorefractive surgery the aim is to alter the cornea’s refractive power by changing its shape. In the early days of laser vision correction it was assumed that the postoperative change in corneal shape was determined directly by the pattern of tissue ablation.1 Now it is clear that this is an oversimplification because biomechanical and wound healing changes also influence final corneal shape.2 This is illustrated by the hyperopic shift that typically occurs following phototherapeutic keratectomy, a procedure that a simple shape subtraction theory would predict to be refractively neutral. Like all technical subjects biomechanics has its own language and this complicates understanding for the non-specialist. The purpose of this article is not to review biomechanical theory in general or even to describe all that is known about corneal biomechanics but rather to provide the reader with an understanding of the most clinically relevant concepts and principles so enabling an appreciation of how this important subject can impact on clinical practice

ECONOMICS OF ALTERNATIVE BEEF CATTLE GENOTYPE AND MANAGEMENT/MARKETING SYSTEMS

Livestock Production/Industries,

The pure rotation spectrum of ammonia

New experimental means for the study of absorption spectra in the extreme infra-red are described. These have been used in extending our knowledge of the pure rotation spectra to the case of a polyatomic molecule. The absorption spectrum of ammonia has been investigated in the region between 55μ and 130μ, and a very simple structure was found. Six lines were observed which belong to a pure rotation spectrum and are apparently due to changes in the energy of rotation of the ammonia molecule about an axis normal to the line of symmetry, that is, to transitions in which the quantum number j increases by unity. Other lines due to transitions with a change also of τ, the quantum number connected with rotations about the axis of symmetry, are absent. These facts are briefly discussed in connection with the predictions of the wave mechanics with which they are shown to be in accord. The moment of inertia of the ammonia molecule about an axis normal to the line of symmetry is estimated to be 2.77×10^(-40) gm cm^2