bluuebunny/crossref_metadata_2025_split huggingface dataset:
WOUND HEALING EFFICACY OF HONEY, ALOE VERA, AND TURMERIC
Authors: Jamil Muhammad , Kashif Muhammad , Ahmad Bashir , Sadia Bibi , Khan Imtiaz , Qazi Imran , Khan Muhammad Fahimullah , Ali Mubarik , Rasheed Muhammad , Arif Muhammad Rehan 
Published: January 2022

Skin naturally acts as a body's protective layer and external environmental factors that can harm internal body organs are protected by it.So, maintaining skin integrity is vital for normal physiological functioning.In our daily lives, the bodies of both animals and humans are subjected to various forms of violence, some of which are severe enough to destroy the skin's continuity.A wound is a breakdown in the continuity of the skin. When the skin's continuity is disrupted, the body's interior organs are exposed.There's a risk of death in this case.There's a risk of death in this case. The skin's immediate response to a wound is the first step in the healing process, which begins automatically after the injury has been inflicted.It is possible to speed up this process in a variety of ways, including keeping the wound free of bacterial infection, moisture, and dirt.A number of antiseptic dressings are available for this purpose, and when applied topically,they help to speed up the healing process of wounds.They protect the wound from contamination by microorganisms and speed up the healing process.Among these are Aloe vera, honey, and turmeric, all of which have considerable wound healing capabilities.Turmeric, honey, and Aloe vera are all considered good for promoting wound healing.They are involved in the prevention of platelet aggregation, myocardial infarction, tumour formation, inflammatory cytokine release, oxidative stress, and metastasis.Several studies have demonstrated that they play a critical function in the promotion of wound healing. Their use for wound dressing has proven to be a successful method. The primary goal of this review is to summarise previous scientists' findings with authentic concluding verse for the use of Aloe vera,Turmeric and Honey that are safe, readily available, and less expensive.
Comparing Frequency of Cardiovascular Autonomic Neuropathy in Diabetic Cirrhotic with Non Diabetic Cirrhotic Patients
Authors: Bashir Afsheen , Ahmad Farida , Khan Sikandar Ali , Subhan Zakia , Shah Summeira Jabeen , Ali Karishama , Inayat Fawad , Ullah Irfan 
Published: January 2022

Cardiac autonomic neuropathy is most common secondary complication of diabetes mellitusis frequently undiagnosed and neglected complication even though it is an independent predictor of mortality and morbidity. This phenomenon can be further exacerbated with co-morbidities like cirrhosis. High prevalence of diabetes as well as cirrhosis has been reported in Pakistan. However, proper knowledge and information regarding incidence of diabetesin cirrhosis induced cardiovascular autonomic neuropathy in is lacking.So, its early detection and timely management is needed to prevent cirrhotic and diabetic cardiomyopathy. Our objective is to determine and compare the frequency of cardiovascular autonomic neuropathy in diabetic cirrhotic and non-diabetic cirrhotic patients. Methods:Cross sectional study was done on120 patients enrolled in Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan. Two groups, diabetic cirrhotic and nondiabetic cirrhotic patients were taken.Those diabetic cirrhotic patients were selected, who had controlled glycemic levels due to proper medication, and patients of both groups had a definite diagnosis of cirrhosis liver. Cardiac autonomic neuropathy was determined in each patient using five standard tests. There after Bellavere,s scoring system was applied to assess the extent of cardiac autonomic dysfunction in each subject. Results: There were 33 males and 27 females in diabetic cirrhotic group and 31 males and 29 females in non-diabetic cirrhotic group. The mean age was 57.48 ± 10.80 years in diabetic cirrhotic patients whereas in the non-diabetic cirrhotic patients, mean age was 51.92 ± 14.21 years. In the diabetic cirrhotic group, 52 patients had parasympathetic tests derangement and 50 patients had sympathetic tests derangement. In non-diabetic cirrhotic 48 patients had parasympathetic tests derangement and 47 patients had sympathetic test derangement. After analysing the results of frequency of cardiovascular autonomic neuropathy, the comparison between the two groups reveal that there is no significant difference between the two groups. Conclusions:This study shows that cardiovascular autonomic neuropathy develops frequently in cirrhotic subjects, that it is found with comparable frequency in diabetics and non-diabetics, and that it increases in severity with increase in severity of liver damage, suggesting that liver damage contributes to the neurological deficit.
53 Remote and Back Again: An Educator’s Tale of Simulation
Authors: Thorpe Amelia , Bailey Paul , Evans Laura , McDonald Christopher , Knight Paul , Howick Katie , Johnson Michael , Taylor Jennifer 
Published: January 2022

Between November 2020 and May 2021, 61 simulation sessions were run either face-to-face or remotely for foundation-level doctors and pre-registration pharmacists. A total of 346 participants attended. Thirty-three sessions were face-to-face (185 participants) and 28 were remotely via Microsoft Teams (161 participants). The content was the same for both modalities.The aim of the study was to discern whether there was a difference in learning points and confidence scores between face-to-face and remote participants.Participants were asked to rate their confidence (see Table 1) before and after the course. They were asked to provide their main learning points and what they gained from the course. Confidence scores were compared and assessed for change. Responses were compared between face-to-face and remote.Confidence score change on Likert scale 1–5.All participants reported increased confidence. Table 1 shows that the changes were comparable, with the changes in the remote participants all being marginally higher than in face-to-face. The distribution of learning points for remote and face-to-face participants was identical. For both modalities, the top two points were communication and escalation. The dominant theme in remote was escalation and communication in face-to-face. Remote participants were positive about the course, in their free-text responses, ‘most innovative use of technology I have seen during COVID’ and ‘My hands are sweating, I can’t believe how real that felt’ a common theme in the comments was that they would rather do the course face-to-face.While not preferred, remote simulation appears to deliver equivalent learning and is a suitable alternative when face-to-face is impossible. The main difference seen was in communication skills, which is concurrent with Cheng et al.
88 Streaming High-Fidelity ECMO Simulation from a Moving Ambulance
Authors: Hayes Thomas , Bernasol Aldwin , Pulford Lindsey , Bedingfield Rachael 
Published: January 2022

The Trust needed to offer extra-corporeal membrane oxygenation (ECMO) The aim of the study was to deliver high-fidelity ECMO simulation in a moving vehicle while simultaneously allowing candidates and faculty to watch the scenarios take place remotely.A custom video-over-IP system was used to run three camera feeds and a patient monitor output. A laptop captured this in a quad-view format and streamed it to a dedicated video streamer. This was then networked locally via a router with a secondary laptop which displayed the stream. The router was connected to a mobile 4G modem, allowing the secondary laptop to share this video stream via Microsoft Teams (MS Teams). In addition, a USB audio interface and microphones ensured intelligibility while the vehicle was in motion.Teaching groups were made up of 3–4 candidates from the ECMO team and 3–4 candidates from patient transport. Scenarios outlined a paediatric patient, currently on ECMO, being transferred to a specialist hospital in the region via ambulance. One or two candidates from each service would take part in the scenario and the remaining candidates would view the simulation in the centre debrief room. A technician in front of the ambulance controlled the simulator and monitored the streams. The lead ECMO specialist nurse spoke to the technician from the simulation centre via a mobile phone link. The role of a consultant was played by a member of the transport faculty on the ambulance. This allowed the faculty to oversee and prompt when necessary. Using MS Teams meant the stream could be shared with the debrief room at the centre, the control room, and with other interested parties outside of the centre. This created a unique learning experience where all candidates could see each scenario and play an active role in debrief when the ambulance returned to the centre. Successful delivery of this course will improve patient safety during potentially complex ECMO transfers. We hope to invite more remote participants via MS Teams to view the simulations and take part in the debrief, increasing learning opportunities for ECMO and transfer staff.
200 Paramedic Online Simulation: A Novel Approach
Authors: Watkins Charli , Hilliard Martin 
Published: January 2022

In response to an initial lack of opportunity for frontline ambulance placements during the early stages of the COVID-19 pandemic, a university lecturing team developed a novel, interactive online simulation format for student paramedic education.The technique aimed to provide the students with the opportunity to continue to practice and refine their questioning and clinical decision-making abilities, even without having a physical patient present.The subsequently developed format was designed to help ensure continuing development of newly acquired clinical assessment principles. Case-based scenarios took the students through key stages of a pre-hospital patient encounter. These were carefully created to resemble the real-life setting as closely as possible.The Blackboard Collaborate teaching platform was utilized in conjunction with pre-designed slides on Microsoft PowerPoint to facilitate the learning activity. Open access images of specific scenes, hazards, people and medication were selected to create visual cues and context for the initial stages of the call, with pre-recorded sounds enhancing this experience. Students were encouraged to use microphones and the chat functionality of Blackboard to interact with their simulated patient, who was played by a lecturer, and responded in real time. Simulated monitors and pre-recorded heart and lung sounds were utilized to provide students with clinical information in a similar timeframe and format to real-life clinical encounters. On the basis of the information gathered, students then devised clinical treatment plans and delivered virtual ‘handovers’ verbally. Debriefing immediately followed the scenario, with self-reflection from participating candidates actively encouraged and supported. Spectating students were then invited to provide their observations on the scenario itself, including facilitation of peer review. All scenario debriefs further contained specific learning points for discussion and exploration, helping to ensure learning was meaningful, with a strong relationship to contemporary issues in paramedic practice. Students reported a high level of satisfaction with this technique, repeatedly describing it anecdotally as both engaging and useful to their clinical development. Facilitator learning has included refinement of techniques and strategies, along with widening participation with other professions. Subsequently, the format has been employed in teaching a range of different healthcare professions, along with being used for online inter-professional learning events between student paramedics, nurses, and midwives, and registered pre-hospital clinicians alike.
136 Point-of-View Simulation of Illness Experiences for Health Professions: A Scoping Review of the Literature
Authors: Karvelyte Milda , Gormley Gerard J , Rogers Janet 
Published: January 2022

Health professionals who have experienced ill-health appear to demonstrate greater empathy towards their patients. Simulation can afford learners opportunities to experience aspects of illness but to date there has been no overarching review of the extent of this practice or the impact on empathic skills. Our aim was to determine from the evidence – what is known about simulation-based learning methods of creating illness experiences for health professions and the impact on their empathic skills.Arksey and O’Malley’s methodological framework informed our scoping review of articles relevant to our research question. Three databases (Medline, Embase and Web of Science) were searched in November 2020 and a sample of 516 citations were exported to Covidence Systematic Review Software© for screening. Following review and application of our exclusion criteria, 79 articles were selected in February 2021 to be included in this review.Of the 79 articles, 52 [66%] originated from the USA, 37 (47%) were qualitative based and 17 (28%) used a mixed-methods model. 77 (97%) of the articles explored the impact on learners with the majority (85%) reporting positive impact and range of emotions evoked. For instance, loss of independence throughout paralysis or impairment simulations left the majority of participants feeling vulnerable – ‘somebody they did not want to be, something negative’. Often learners gained a greater sense of empathy towards their patients, generating a range of measures that they could translate into practice to demonstrate a more holistic approach (providing more time, conveying reduced amounts of information). However, some studies observed more negative effects and additional debriefing was required post-simulation. For example, auditory hallucination studies reported a decrease in intention to help or interact with individuals with a mental illness, they did not engender goodwill or a desire to have contact, but rather facilitated social distance and negative emotions, as well as an increased willingness to apply forced treatment. A sense of suspicion and less positive attitudes towards older adults was likewise observed in some simulations of old age. Learners were noted to internalize perceived experiences of illness and to critically reflect on their empathic role as healthcare providers.A diverse range of simulation methods and techniques, evoking an emotional and embodied experience, appear to have a positive impact on empathy and could be argued as offering a complementary approach in healthcare education; however, the long-term impact remains largely unknown.
105 A Simulation-Based Departmental Induction Using Virtual Reality 360
Authors: Powell Sarah , Kasfiki Eirini , Blackmore Andrew , Wright David 
Published: January 2022

One of the challenges faced during the COVID-19 pandemic was the need for quick departmental inductions to allow rotating and redeployed junior doctors to familiarize themselves with rapidly changing departmental environments. We were unable to continue traditional inductions due to various challenges including lack of senior staff to provide the induction due to increased workload; lack of administrative staff to support inductions due to sickness and self-isolation; and lack of physical space under the constraints of social distancing. Thus, an alternative was needed incorporating all aspects of a traditional induction. Video Reality 360 (VR360) technology and video simulation have been on the rise during the last few years in medicine The aim of the study was to produce a simulation-based departmental induction programme that would be equally effective to the traditional model.We started with identifying the components of a departmental induction and then held a multi-disciplinary team meeting to encourage the addition of topics felt to be important and often overlooked. Stakeholders were involved in a needs analysis on the induction material; previous and current departmental junior doctors, the lead pharmacist, medical registrars, emergency physicians, acute physicians, the clinical lead, the medical director and the director of medical education were all contacted with specific questions on content and junior doctors’ needs. Components of the recent General Medical Council surveys were taken into account to allow for a more junior doctor-centred induction. Subsequently, scenarios were designed with input from the directors of simulation and approved by the acute medical unit (AMU) lead. With the help of our colleagues at Hull Institute of Learning & Simulation (HILS) the scenarios were filmed, edited, and filed to produce an educational tool.The end-product of our VR360 induction has been checked by the educational lead of AMU against specific variables and standards and was characterized as ‘much more flexible and a potentially more effective educational tool for junior doctors’ medical induction’. Initial feedback from junior doctors has been very positive; however, further feedback comparing traditional and VR360 induction is needed. Work is ongoing to produce an interactive VR360 induction video with the hope that this could replace face-to-face departmental induction within our hospital.
160 Applying Human Factors Practices and Simulation to Develop Systems and Processes for a Pandemic Vaccine Service
Authors: Gurnett Phil , Scott Julia 
Published: January 2022

The COVID-19 vaccine hubs required rapid implantation. While organizations had plans as part of the emergency resilience response to the community, there were particular challenges for setting up and running vaccine hubs for COVID-19 that Human Factors and Ergonomic practices could help to identify and address prior to opening as a vaccine hub.The aim of the study was to assist with understanding the abilities of vaccinators and design of processes for the vaccine service at Dartford and Gravesham NHS Trust.Simulation, observation, semi-structured interviews and Hierarchical Task Analysis (HTA) were used to understand the complexity of the vaccinator role and potential challenges for the implementation of the vaccine service. This was then used in identifying an area that could meet the capacity requirements identified and to help design the process and flow through the vaccine hub.The work undertaken was used to identify and design the processes required to deliver the vaccine service. This in turn helped to identify the space required and, due to changes in practice following potential reactions to the Pfizer BioNTech vaccine Using simulation and HFE processes as part of a collaborative process with staff trained with these skills can help to design safer, more effective processes in healthcare.
154 An Observational Study: An Examination of Eye Movements When Assessing a Deteriorating High-Fidelity Patient Simulator
Authors: Harris Kirsty , Ryder Isobel , Dicks Matt 
Published: January 2022

Simulation has been identified as one of the principles to improve patient safety The aim of this study was to explore the gaze patterns of healthcare students when assessing an HPS.A longitudinal study was conducted between 2014 and 2015 at three different time points (3, 6 and 12 months) with a final transfer study (with or without a patient monitor).The study was conducted in a simulated environment with student paramedics and operating department practitioners (N = 6). Participant eye movements were measured whilst participants assessed a simulated patient with and without a monitor.The images represent the gaze behaviour of 1 participant at testing phase 1 (Figure 1) and phase 3 (Figure 2). The gaze pattern changes and the participant demonstrates a more holistic approach when assessing a patient in phase 3 without monitor 3.Phase 1.Phase 3.Encourage the use of an algorithm from the end of the bed to recognize a deteriorating patient and teach simulation with the HPS monitor switched into the off mode. Training through the observation of gaze patterns may help develop the design of simulation alongside augmented or mixed reality technology for the future.
205 Simulation as a form of Immersive Theatre
Authors: Esposito Maria 
Published: January 2022

Immersive theatre is a style of theatre that removes the fourth wall of traditional theatre turning the audience into participants and engaging the five senses such as sight, sound, touch, taste and smell; a concept applied equally to multi-professional, human factor-based simulation. Peter Brook, one of our greatest theatre directors, says, ‘Drama is exposure; it is confrontation; it is a contradiction, and it leads to analysis, construction, recognition and eventually to an awakening of understanding’. This is without doubt what we do in simulation. We create scenarios, ‘the drama’, we create managing deteriorating patients, the ‘confrontation and contradiction’ and we enter debriefing, the ‘analysis, construction and eventual awakening of understanding’. Using the concepts of immersive theatre and drama, creating more realistic environments and authentic interactions, we can offer the participants a greater sense of reality in which to practice vital inter-professional medical care. High-fidelity simulation encompasses more than just a technological top of the range manikin which often comes at a premium cost. High-fidelity simulation is an attack on all of the senses, visually sick patients, noises and smells of the environment, even touch and taste. The soundscape of an emergency room, smells of humans, drugs, equipment, tastes of stewed tea and warm water, the touch of a sick patient or a disruptive relative in a visually authentic space creates the perfect setting for an immersive simulation experience. By implementing psychological, sociological and physical fidelity, we offer a unique way of practicing essential skills of interprofessional working not only to enhance patient care and safety but also to allow a greater understanding of ourselves and others in stressful, urgent and critical situations. Applying ideas from the world of drama and theatre, creating authentic immersive environments can give participants the freedom to be in the simulation and steer them away from acting in the simulation.
17 Improving Resus Handover for Critically Unwell and Injured Patients
Authors: Mallon Bernadette , McKenzie Euan 
Published: January 2022

During a single patient journey from admission to hospital discharge, multiple clinical handovers may occur between health professionals from different specialist inpatient teams and between staff at shift changes. Each handover carries a degree of risk for the patient. It is well recognized that poor communication during handovers has resulted in a significant proportion of preventable deaths The aim of our quality improvement (QI) project was to improve the handover process between Scottish Ambulance Service (SAS) staff and Emergency Department (ED) staff for critically unwell and injured patients arriving into resus. In addition, we aimed to improve communication and staff satisfaction with the handover process.By utilizing QI tools such as the model for improvement, process mapping and driver diagrams, change ideas were identified and trialled using inter-professional simulation as part of PDSA (Plan, Do, Study, Act) cycles. This project involved engagement with ED and SAS staff members via online surveys, simulation sessions and staff education.We increased staff satisfaction with the handover process from 24% to 88% and no adverse events relating to our changes were reported.From the information gathered during PDSA cycles, a new standard operating procedure (SOP) for handover in resus was created.