Publications

INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) remains a major cause of mortality in the UK, with survival rates remaining low despite advancements in resuscitation techniques. The European Resuscitation Council and Resuscitation Council UK guidelines recommend controlled ventilation during cardiopulmonary resuscitation (CPR), yet studies show that ambulance clinicians often fail to meet these standards. In particular, hyperventilation has been linked to worse outcomes. This protocol describes a study that will explore the impact of different applications of real-time ventilation feedback on the quality of ventilations during CPR in a simulated environment.

METHODS: This exploratory simulation study will assess the effectiveness of real-time feedback on the quality of ventilations delivered by ambulance clinicians. Participants from North East NHS Foundation Trust will be randomly assigned to three arms, receiving a single episode of feedback, regular feedback or no feedback (used as a control group). Each arm will complete four simulated OHCA scenarios over six months, and their ventilation quality will be assessed at each session. The primary outcome will be the quality of ventilations, measured by rate and tidal volume, at the six-month mark. Secondary outcomes include trends in ventilation quality over time and participant characteristics.

DISCUSSION: This study aims to explore whether regular feedback improves the quality of ventilations during CPR and whether feedback sessions influence skill retention over a six-month period. Findings could inform training strategies, highlighting the role of real-time feedback in maintaining high-quality CPR skills. With a lack of prior research on ventilation skill maintenance in the UK, this study is expected to provide valuable insights into optimising clinical performance.

Individuals with homonymous hemianopia (HH) may benefit from adopting compensatory crossing and scanning strategies to successfully cross streets. In this study, we explored the effect of HH on street crossing outcomes, crossing behavior and scanning behavior in a virtual environment. Individuals with real HH (N = 18), unimpaired vision (N = 18), and simulated HH (N = 18) crossed a virtual street displayed through a head-mounted display. Virtual cars approached from both directions, traveling at a speed of either 30 or 50 km/h. Participants' crossing and scanning behaviors were recorded and analyzed across groups and the two car speeds. Although individuals with real and simulated HH took more time to cross compared to individuals with unimpaired vision depending on the car speed, the number of collisions and time-to-contact after crossings did not differ between groups. We observed no differences in the selection of car gaps, crossing initiation, and scanning behavior between groups. Our findings suggest that individuals with real and simulated HH align their crossing behavior to their visuomotor capabilities by using varying compensatory strategies. HH did not alter scanning behavior before crossing a virtual street. Despite its current shortcomings, virtual reality holds promise for street crossing research and rehabilitation.

Augmented reality (AR) aims to combine elements of the surrounding environment with additional virtual content into a combined viewing scene. Displaying virtual human faces is a widespread practical application of AR technology, which can be challenging in optical see-through AR (OST-AR) because of limitations in its color reproduction. Specifically, OST-AR's additive optical blending introduces transparency and color-bleeding, which is exacerbated especially for faces having darker skin tones, and for brighter and more chromatic ambient environments. Given the increasing prevalence of social AR applications, it is essential to better understand how facial color reproduction is impacted by skin tone and ambient lighting in OST-AR. In this study, a psychophysical experiment was conducted to investigate how participants adjusted colorimetric dimensions of OST-AR-displayed faces to match the color of the same faces viewed on a conventional emissive display. These adjustments were made for faces having six different skin tones, while under different simulated ambient luminance ("low" vs. "high") and chromaticity (warm, neutral, cool). Additionally, participants rated their adjustments for overall appearance match and preference. The results indicate that the magnitude and specific dimensions of colorimetric adjustments needed to make matches varied across skin tones and ambient conditions. The current work is expected to facilitate virtual human face reproduction in AR applications and to foster more equitable and immersive extended reality environments.

PURPOSE: The purpose of this study was to investigate the development of contrast sensitivity function (CSF) in children with intermittent exotropia (IXT) over 1 year and to explore the impact of surgical realignment on CSF.

METHODS: A prospective study of 45 patients with IXT (aged 7-13 years) were matched with 30 healthy controls. Patients with IXT were categorized into the surgery group (n = 25) and the observation group (n = 20). Comprehensive ophthalmic examinations, including binocular and monocular CSF (measured by CSV-1000E), stereoacuity, and sensory fusion, were performed at baseline and the 1-year follow-up.

RESULTS: At baseline, the IXT surgery group exhibited significantly worse area under the log contrast sensitivity function (AULCSF) and contrast sensitivity (CS) at several spatial frequencies (SFs) compared with the controls (P < 0.05). After 1 year, the control group demonstrated significant improvement in binocular AULCSF and CS at 3, 12, and 18 cycles per degree (cpd; P < 0.05). The surgery group showed significant gains in binocular AULCSF, CS at 3 cpd, and 18 cpd (P < 0.05), whereas the observation group exhibited no significant changes in any metric (P > 0.05). Three-way analysis of covariance (ANCOVA), adjusting for baseline CS, revealed significant main effects of the group, SF, and eye condition on CS change (all P < 0.001), with no significant interactions. Post hoc comparisons showed that the control group had the greatest improvement, followed by the surgery group; whereas the observation group remained lowest across most metrics.

CONCLUSIONS: CSF is significantly impaired in children with IXT. The IXT may disrupt the normal development of contrast processing in children, whereas surgical realignment can partially reverse these effects. CSF assessment may provide valuable adjunctive information for the clinical management of pediatric IXT.

BACKGROUND: Enabling women with breast cancer to actively participate in their care requires a better understanding of the interplay between contextual factors and mediators. This research explored the determinants of supportive care experiences for women living with breast cancer in rural communities of British Columbia.

METHODS: The study used a quantitative, descriptive, cross-sectional design. A survey regarding demographic, health, decision support, and breast cancer supportive care experiences was administered to 100 participants.

RESULTS: The combination of being less than 40 years old, having an undergraduate education, and being three to five years post-diagnosis is associated with higher (more positive) total survey scores. A linear combination of undergraduate school and health problems post-treatment showed higher medical treatment scores, with R2 = 23%.

CONCLUSION: The findings emphasize the growing need for psychosocial and emotional supportive care for cancer survivors. The results highlight the potential benefits of informed decision-support tools to fortify supportive care, emphasizing the need to facilitate better supportive care services for women battling breast cancer.

RECOMMENDATION: Supportive care plays a crucial role in guiding individuals' experiences with cancer through the healthcare system. Increasing supportive care centres, especially in rural areas, could improve patient-reported outcomes, and experiences, and ensure timely access to care.