Introductory Presentations Research Articles

Assessment of a joint farmer-veterinarian discussion about biosecurity using novel social interaction analyses

Veterinarians are trusted by farmers and play an important role in assisting them to implement biosecurity. More research is needed that particularly focuses on the impact of joint farmer-veterinarian discussions to further understand the role of communication in altering biosecurity behaviours. The aim of this study was to analyse joint dairy cattle farmer-veterinarian discussions about the adoption of on-farm biosecurity using novel social interaction methodologies. Farmer and veterinarian stakeholders were invited to take part in a face-to-face meeting. Introductory presentations were given, followed by separate facilitated veterinarian and farmer discussions. All stakeholders were brought together for a final facilitated group discussion which was audio recorded. Corresponding transcripts from the recordings were analysed via thematic and conversation analyses. Conversation analysis assessments such as turn taking, repair, sequence organisation, overlap and asymmetry were employed to investigate the nature of the conversation. Thematic analysis identified the negative repercussions of conflicting information or ineffective communication surrounding biosecurity implementation. The type of, and importance of, the relationship farmers had with veterinarians and other stakeholders was highlighted. The need to provide personalised biosecurity protocols on farms was identified. Four key factors were identified via conversation analyses. These included: 1) how the conversation facilitated agreement, 2) how the conversation allowed the farmer and veterinarian participants to learn from one another in real time, 3) how the discussion enabled participants to expand upon points they were making, and 4) how participants were able to obtain a greater understanding of the other participants’ opinions, even without total resolution. Debate around the effective implementation of biosecurity measures on farms, explored using novel techniques, demonstrated the potential for utilising a discussive approach between veterinarians and farmers to lead to solutions not previously considered. Because of the nature of the discussion, conversation analysis resulted in an informative approach to encapsulating the nuanced dialogue between stakeholders, highlighting the potential of this analysis framework.

8.F. Round table: Digital Innovations in Health Financing: Experiences from sub-Saharan Africa

Abstract Background Universal Health Coverage (UHC) is key for reaching Sustainable Development Goal 3. Digital technologies for health financing (DTHF) may help countries in sub-Saharan Africa (SSA) make progress towards achieving UHC. DTHF are increasingly used to strengthen health financing systems across their three key functions, (1) raising revenues, (2) pooling resources, and (3) purchasing services. Objectives To provide an overview of the potential role of DTHF, discuss country case-studies of DTHF, explore possible risks and challenges, and outline a future research agenda. Together with the participants, we intend to discuss policy options to enable maximising the benefits, while mitigating the risks and challenges. Added value: The workshop will (1) identify potential benefits as well as risks and challenges of DTHF; (2) highlight the importance of politics and policies for reaping the benefits and minimizing their risks; and (3) establish the building blocks of a future research agenda on digital health financing technologies. Coherence of workshop: Following a brief presentation of benefits and risks of DTHF from the perspective of the World Health Organisation (WHO), the workshop will present four case studies: (1) Rwanda, where a near universal coverage systems is supported by the digital Mutuelle Membership Management System (3MS) facilitating revenue collection through mobile money; (2) Ghana, where the National Health Insurance Scheme (NHIS) is using a Mobile Renewal system to increase coverage rates, and where an electronic claims management system has been recently introduced; (3) Kenya, where a wide range of digital innovations for revenue raising and purchasing were introduced in the private sector, which are now (partially) integrating the public coverage system; and (4) Madagascar, where experiences with private sector initiatives could support the development of national health insurance. Finally, we will outline the research agenda of the DigitalUHC consortium and collect input on salient topics for policy-makers and researchers. Format The workshop is organised as a round-table panel discussion with panel members giving brief (5 min) introductory presentations before engaging in discussions with other panel members and the audience about cross-cutting issues, including (1) potential benefits of DTHF as well as risks and challenges; (2) the importance of politics and policies for reaping the benefits and minimizing the risks; and (3) the future research agenda. Several polling rounds will engage the audience and collect input on these topics, e.g. by asking participants about (a) examples of digital technologies that they know of, (b) their assessment of potential benefits, risks, and challenges, (c) necessary regulations in different countries, and (d) topics for future research. Funding German Alliance for Global Health Research (GLOHRA) with funds from the Federal Ministry of Education and Research (BMBF). Key messages • Digital technologies for health financing may help countries to achieve universal health coverage. • Politics and policies are important to reap the benefits and minimize potential risks. Speakers/Panellists Inke Mathauer WHO, Geneva, Switzerland Regis Hitimana Rwanda Social Security Board, Kigali, Rwanda Daniel Opoku KNUST, Kumasi, Ghana Diana Ratsiambakaina Ministry of Health, Antanarivo, Madagascar Abdhalan Ziraba APHRC, Nairobi, Kenya

Syllabi collection on diversity and intersectionality in public health: reflecting on the development

Abstract Background Highlighting the intersectionalities between different markers of diversity and health inequities encourages the reconsideration of normativities in public health (PH). We developed an open access collection of syllabi on the relevance of intersectionality and diversity in PH together with the Association of Schools of Public Health in the European Region (ASPHER). Objectives We developed the syllabi in a participatory, iterative process guided by transformative teaching pedagogy. We reflect on this process and how this can inform the enhancement of the syllabi themselves, as well as future curriculum development. Results We recruited a core group of 9 PH researchers, teachers and professionals from all career levels from participants of introductory session presentations in different settings (e.g., 14th EPHC, ASPHER Retreat). The core group met once a month for one year online, and each meeting took the form of co-working sessions in breakout rooms to develop the syllabi based on interest and expertise. We designed a qualitative online survey to evaluate and ensure the scientific rigor and pedagogical value of the syllabi. We invited critical and constructive input from ASPHER member school professionals with expertise in intersectionality, diversity or curriculum development in PH in terms of content and pedagogy. Conclusions Drawing from the expertise of the PH community we combined diverse professional and cultural backgrounds, experiences from different career levels and PH education systems, as well as specialisation in the PH field. The transformative pedagogical approach was considered particularly valuable in strengthening competences such as reflexive strategies and self-, social- and global awareness which are key to teaching on diversity and intersectionality issues. The peer-review structure supports the uptake in PH education and a sustainable implementation. The collection will also allow PH faculty to diversify their pedagogical approaches. Key messages • Inclusion of health inequities, diversity and social injustice issues is crucial in public health curricula, since an intersectional perspective is increasingly acknowledged in public health research. • The syllabi collection will equip public health teachers of all career levels to develop their own course material on social identities and their significance for public health.

4.F. Skills building seminar: How can we achieve effective interdisciplinarity in digital public health practice?

Abstract Digital technology, which is driven by technical opportunities rather than by demands, can fail to realise the critical objectives of evidence-based public health and pose novel ethical, legal, sociocultural, and equity-related challenges. While individual health already needs various disciplines to be adequately addressed, even more fields gain importance when it comes to population health. Public health requires collaboration across all domains: Those that tackle an individual's health but also those that set the framework for health practices (e.g., law, medicine, psychology, ethics, or sociology), measure health outcomes on a population-level (e.g., epidemiology), or that develop interventions to improve the populations’ health (e.g., health promotion, health management, implementation science). During the last years, health has become more and more digitalised. Adding the digital level to public health also brings more and increasingly important players on the stage (e.g., human-computer-interaction, computer science, or engineering), who are needed to develop and improve evidence-based digital technologies and innovations on a population level. Having various disciplines collaborating with each other can offer new opportunities but also create new challenges if there is no mutual understanding of digital public health. This skill-building workshop aims to foster awareness of interdisciplinary approaches in public health research and practice. Two short introductory presentations (10 minutes each) will form the frame for the workshop. The first talk will introduce participants to the idea of interdisciplinarity in research and practice and highlight the prerequisites for effective and sustainable interdisciplinary collaborations. The second talk will build on this understanding and present a holistic (digital) public health model that displays how different disciplines contribute to the field and how an interdisciplinary approach can be used to overcome individual challenges. Based on the talks, participants will be invited to work on a case study regarding mobile mental health apps as a digital public health intervention. We will apply the world coffee method, in which each table will display one individual discipline (epidemiology, health economics, psychology, law, ethics, and computer science). An expert in the field will support each table to assist the participants if needed. Every participant will be able to discuss their ideas at three tables (10 min. each). The goal will be to work out how one could best integrate the individual disciplines when developing, implementing, and evaluating mental health apps in the digital public health environment. We discuss what each discipline can contribute to the topic and for which aspects it needs support from other scientific fields. The final results will be collected and summarised as a chapter in a digital public health handbook published by the Leibniz ScienceCampus Digital Public Health. Key messages • Considering different disciplines when developing and implementing digital public health interventions improves the interventions’ outcomes and long-term acceptability in user groups. • Interdisciplinarity in digital public health requires a mindset from researchers that is characterised by empathy/curiosity towards other disciplines and a common understanding of the intervention.

Workshop Safety and Uncertainty

Abstract. Uncertainties have a significant influence on the assessment and evaluation of the safety of a repository system for high-level radioactive waste. Significant reasons for uncertainties concerning the safety barriers of a repository are: Conducting experiments on the long-term behaviour of the repository in real time is impossible due to the long assessment period over which the repository is supposed to ensure safety. The extrapolation of results from time-limited experiments, e.g. on the corrosion of container materials, to other temporal dimensions is associated with uncertainties. Uncertainties also stem from differences between experimental situations, e.g. laboratory experiments, and the real conditions in the repository. The interpretation of empirical results can be ambiguous and therefore associated with uncertainties. The development of future impacts on the barriers can only be predicted to a limited extent. Therefore, the future behaviour of the barriers can only be extrapolated into the future to a limited extent on the basis of experience gained in the past and uncertainties remain. The construction and operation of the repository will disturb its natural environment. The geological environment in which the repository is embedded behaves differently from a natural geological system, which in turn is associated with uncertainties. A major source of uncertainties is also the natural inhomogeneity of the geological barrier, which can only be investigated on a sample basis. During excavation and other construction work underground, unforeseen situations are to be expected, which make it necessary to act situationally. The complexity of the disposal path where decisions are interlinked, creates further uncertainties. Last but not least, it is uncertain what further findings on the safety of the repository will be obtained in the future along the disposal path. For safety studies, especially studies on the long-term safety of repository systems, methods and conventions for dealing with uncertainties have become established internationally. In the site selection process, these methods and conventions are questioned and, if necessary, must be further developed so that they ultimately also convince the interested public and scientists from other disciplines. In the workshop, uncertainties will be examined in particular from the perspectives of a civil engineer and of a materials researcher with introductory presentations. This will be followed by a moderated discussion. The workshop will focus on the preliminary safety investigations; however, the discussion can also refer to later phases of the disposal path. The aim of the discussion is to arrive at a common synthesis: Where have good practices for dealing with uncertainties already been established? Where is there still a need for research and clarification? What needs to be considered in the dialogue with the interested public?

Knowledge and preparedness of healthcare providers towards bioterrorism

BackgroundSeveral emergent circumstances require healthcare providers to recognize the unusual and dangerous and pathogenic agents. An in-depth literature review showed that studies about bioterrorism preparedness amongst healthcare providers are lacking. Therefore, this study aimed to investigate the knowledge and preparedness level of first emergency respondents towards bioterrorism events.MethodsThis study has a cross-sectional design and was carried out at the Emergency departments and poison control centers/clinical laboratories three in major tertiary care hospitals in Riyadh, Saudi Arabia. The subjects were randomly selected to complete the self-administered questionnaire to collect study outcomes.ResultsA total of 1030 participants were included in the final data analysis. The mean knowledge score in the basic concepts of bioterrorism and introductory clinical presentations of bioterrorism-related agents was 4.92 ± 1.86 out of 12 points.Moreover, the findings showed a mean knowledge score of 22.80 ± 3.92 out of 38 in the bioterrorism preparedness and governing policies and procedures. Respondents who received previous training in bioterrorism preparedness had a significantly higher number of perceived benefits than those not sure and without prior training (z = − 2.67, p = 0.008) and (z = − 4.4, p < 0.0001), respectively. About 79.4% of participants did not have previous training in bioterrorism preparedness, but 68.7% expressed willingness in the institution’s response and control to assist in a bioterrorist attack incident.ConclusionAlthough healthcare professionals have reported their desire to help in bioterrorism events, they need to enhance their knowledge of bioterrorism preparedness.

Het onzichtbare Olympia

Abstract Although ancient Olympia is usually viewed as a Classical Greek site, most buildings that are visible nowadays were not there yet when Pindar celebrated famous victors or Peisistratos and Alcibiades won their races. More generally, even though new research has substantially improved our knowledge, the early history of the site is often still neglected in introductory presentations of the site. In this article some important main issues are discussed. First, new excavations have revealed that Bronze Age occupation of the area cannot be connected to the later cult, as some scholars have argued in the past. The older remains were covered by flooding of the nearby rivers when the sanctuary was founded in the 11th century BCE. Up to the late 7th century the sanctuary remained an open area around a large ash altar. Its main structure was a large dam protecting it from floods. The temple now associated with Hera, built around 600 BCE, was the first monumental building of the sanctuary. Recent research suggests this may originally have been dedicated to Zeus, but this cannot be proven conclusively. The common idea that this temple was originally a wooden construction has now also been debunked.

Maintenance of Health Behaviors: Exploring the Construct and Its Implications on Research, Education, and Practice

Modifying health behaviors, including diet, physical activity, sleep, and/or medication adherence, can have a range of positive effects on older adults’ overall health, function, and well-being. Although many evidence-based programs exist to support the initiation of health behavior changes, few address longterm maintenance. Emerging research suggests initiation and maintenance are distinct constructs, each requiring unique skills. Furthermore, maintaining health behaviors depends upon health promotion programs that are sustained, or continually delivered with high fidelity, at community and population levels. The objective of this symposium is to present findings from a series of research projects designed to investigate the concept of behavior change maintenance. Activities were supported by NIA Research Centers Collaborative Network (RCCN) funding and included community listening sessions plus an interdisciplinary think tank of national thought leaders. This symposium will begin with an overview of health behavior change, including the rationale for studying maintenance as a critical yet overlooked phase of successful behavior change (J. Hughes). A proposed conceptual model of maintenance will then be discussed, including constructs distinguishing maintenance from initiation (Raj). These introductory presentations will be followed by a discussion of multi-level barriers and facilitators related to maintenance on individual, community, and population levels (S. Hughes). The session will close with implications for research, education, and practice (Bettger).

Introductory presentations at the Conference

Introductory presentations at the Conference

Leading and Sustaining Curricular Change: Workshop Proceedings from the 2018 Sex and Gender Health Education Summit.

The education of health science professionals must balance the incorporation of new and essential content against the current curriculum density. Scientific evidence documenting the impact of sex and gender on health outcomes establishes the need for incorporation of these topics into the health science curriculum. An interprofessional workshop was designed to provide participants with the knowledge and skills to effectively champion curricular change. Surveys before and after the workshop assessed the participants' perception of curriculum change. Introductory presentations addressed topics of organizational readiness and characteristics of change agents. This was followed by role-play activities in groups of 8 to 10, utilizing two scenarios. The first scenario involved a faculty champion advocating for change to the school curriculum leadership, and the second scenario involved the curriculum leadership advocating for change to the teaching faculty. After the role-play, participants shared the important points discovered by their groups, and the same information was collected by survey. After the workshop, 95% participants reported an increased ability to advocate for the inclusion of sex and gender topics in the curriculum. The most important aspect of the workshop was the providing of resources related to the teaching of sex and gender topics. We conclude that a workshop format balancing didactic information and role-playing scenarios is an effective tool for empowering faculty to introduce changes in health sciences curricula in areas that may be new to faculty or health science school leadership, such as the impact and role of sex and gender on health outcomes.

Skills building seminar: Capacity-building for implementing integrated care

Abstract Rationale The significance of integrated care as a means for improving health outcomes and effectiveness and sustainability of health and care systems is widely acknowledged. Integrated care is a central element in many on-going or planned healthcare system reforms, however, the main challenge remains of how to build relevant capacity and know-how for the successful implementation of integrated care. Capacity-building is both the foundation and aspiration of SCIROCCO Exchange EU Health Programme funded project. The project aims to facilitate access to tailored, evidence-based support and improvement planning by recognising different staring points, or levels of maturity of healthcare systems in Europe. Objectives This round table aims to explore different levels of local maturity and capacity to implement integrated care in three European regions; Basque Country, Flanders and Poland. The workshop will be a practical opportunity to dispute what actions and activities should be prioritised in these regions in order to improve their capacities for the adoption and scaling-up of integrated care. The workshop also aims to raise awareness about different levels and mechanisms of capacity-building support for integrated care that exists at European level. In particular, the workshop will feature SCIROCCO Exchange Knowledge Management Hub as one of the capacity-building tools and its application in the real-life settings. Added value Sharing learning more widely will help to build sustainable integrated care systems and tackle the risks of people working in isolation or re-inventing the wheel. Format of the workshop The workshop will consist of two keynote presentations, providing necessary background into the existing European policies, programmes and initiatives to support the adoption and scaling-up of integrated care. The introductory presentations will then follow by three snapshot presentations of 5 minutes featuring the main findings on the maturity and capacity of three European regions to implement integrated care. In the second part of the meeting, the participants will have the opportunity to discuss interactively with the representatives of the regions the use of SCIROCCO Exchange Knowledge Management Hub in the real-life settings, its added value and implications of the outcomes for future actions and improvement planning. The ultimate objective is to stimulate the discussion and knowledge on how to address the existing difficulties in implementing integrated care. Key messages Integrated care is considered as fundamental element driving transformation of healthcare systems. The challenge remains how to address different levels of capacities to implement integrated care. SCIROCCO Exchange can facilitate the access to capacity-building support that is needed for transition and/or improvement of existing systems for the adoption and scaling-up of integrated care.

\u201cBe an ambassador for change that you would like to see\u201d: a call to action to all stakeholders for co-creation in healthcare and medical research to improve quality of life of people with a neuromuscular disease

BackgroundPatient and public involvement for co-creation is increasingly recognized as a valuable strategy to develop healthcare research targeting patients’ real needs. However, its practical implementation is not as advanced and unanimously accepted as it could be, due to cultural differences and complexities of managing healthcare programs and clinical studies, especially in the rare disease field.Main bodyThe European Neuromuscular Centre, a European foundation of patient organizations, involved its key stakeholders in a special workshop to investigate the position of the neuromuscular patient community with respect to healthcare and medical research to identify and address gaps and bottlenecks. The workshop took place in Milan (Italy) on January 19–20, 2018, involving 45 participants who were mainly representatives of the patient community, but also included experts from clinical centers, industry and regulatory bodies. In order to provide practical examples and constructive suggestions, specific topics were identified upfront. The first set of issues concerned the quality of life at specific phases of a patient’s life, such as at the time of diagnosis or during pediatric to adult transition, and patient involvement in medical research on activities in daily living including patient reported outcome measures. The second set of issues concerned the involvement of patients in the management of clinical research tools, such as registries and biobanks, and their participation in study design or marketing authorization processes. Introductory presentations were followed by parallel working group sessions, to gain constructive contributions from all participants. The concept of shared decision making was used to ensure, in discussions, a partnership-based identification of the wishes and needs of all stakeholders involved, and the “ladder of participation” tool served as a model to evaluate the actual and the desired level of patients’ involvement in all topics addressed. A general consensus on the outcome of the meeting was collected during the final plenary session.This paper reports the outcome of the workshop and the specific suggestions derived from the analysis of the first set of topics, related to quality of life. The outcomes of the second set of topics are reported elsewhere and are only briefly summarized herein for the sake of completeness.ConclusionsThe neuromuscular community proved to be very active and engaged at different levels in the healthcare initiatives of interest. The workshop participants critically discussed several topics, providing practical examples where different stakeholders could play a role in making a change and bridging gaps. Overall, they indicated the need for education of all stakeholders for better communication, where everyone should become an ambassador to promote real change. Support should also come from institutions and healthcare bodies both at structural and economic level.

Conference report: 2018 materials and data science hackathon (MATDAT18)

MATDAT18 organizers and participants.

Whose Benefit is it Anyway? Public Expectations of Public Benefits from Health Informatics Research

IntroductionPublic benefits serve as a key justification for secondary uses of data in health research. Yet, while it is known that assurances of public benefits are vital for ongoing public support, there is a lack of clarity regarding what constitutes a public benefit.&#x0D; Objectives and ApproachOur research aimed to understand public expectations regarding “public benefits” from health informatics research.&#x0D; In May and June 2017 three full-day deliberative workshops were held with members of the public across Scotland (between 20 and 25 participants per workshop). Participants were selected through quota sampling to represent key demographic characteristics. Workshops were structured around brief introductory presentations, videos in which data scientists presented the ways in which their research was anticipated to lead to public benefits, small group discussions, plenary discussions and activities.&#x0D; ResultsWorkshop participants generally conceptualised “the public” as being “everyone” and had an inclusive view of this often taking an international or global perspective. This led to preferences for research to benefit the widest possible public, however participants also discussed the potential for benefits to be focussed at vulnerable or disadvantaged groups. There were wide-ranging views on what would constitute a “benefit” and participants generally acknowledged the value in keeping this loosely defined. A key theme to emerge was that, while some research might benefit particular individuals or groups more than others, the benefits should be societal benefits. In discussing the various data science projects presented, it was considered important that research had mechanisms in place in order to realise the benefits it was aiming for.&#x0D; Conclusion/ImplicationsPerceived public benefits are crucial for maintaining public support for health informatics research. Our workshops found that there is value in keeping "public benefits" as a broad, loosely defined term. Nevertheless, across each of the workshops the discussions suggested that research should benefit society as widely and fully as possible.

An Integrated, Multimodal Resident Curriculum in Patient Safety and Quality Improvement.

Patient safety and quality improvement are essential components of modern medicine. The traditional model of graduate medical education does not lend itself well to learning these disciplines. This curriculum encompasses these disciplines across multiple modalities and extends throughout residency. The curriculum includes introductory presentations suitable for naive audiences. Following these is a structured rotation that provides the opportunity both to experience in-depth self-directed learning and to practice skills involved in quality and safety. This rotation includes existing online courses published elsewhere, reflective writing exercises based on self-directed learning, and practice cases. Finally, residents lead a morbidity, mortality, and improvement conference where adverse events are identified and reviewed, specific interventions and outcome objectives are selected, and action teams are identified. After two presentations on system issues and individual issues, responses to the prompt "This talk will aid in my professional development" were 4.75 and 4.59 out of 5, respectively. Eighty-three percent of residents agreed they had a better understanding of the concepts of patient safety and/or quality improvement than they did before the rotation. Audience members for the resident-led morbidity, mortality, and improvement conference agreed it would lead to a change in their own practice. The contents of this longitudinal curriculum have been incorporated into the core requirements of our general pediatrics residency program and could reasonably be imported into any residency requiring a robust longitudinal experience in quality improvement and patient safety.

Experiences with Railway Regulation in Great Britain and the Czech Republic – Round Table Report1

Abstract The aim of the Round Table was to compare British and Czech experiences with railway regulation and competition introduction and to determine which lessons can be learnt. Special attention was paid to the question of whether the very complex British reform can be an inspiration for further liberalisation of the railway sector in the Czech Republic or whether there are any reform mistakes that are best avoided. Based on two introductory presentations and subsequent plenary discussion, some consensus emerged. The participants agreed that there is no one-size-fits-all solution to railway regulation and that the introduction of competition should take into account the different circumstances of a particular country. Franchising in passenger operations in Britain successfully stimulated demand but also increased costs to the industry, so its implementation should be completed with care. It seems very unlikely that open-access competition would be a viable solution for the whole passenger rail market because it is limited to a few commercially attractive routes, and as Czech experience suggests, it creates many new problems. Finally, it was confirmed that a strong and dedicated regulator is needed in a newly liberalised environment in order to solve many emerging conflicts and disputes.

PWE-423 Human factors training (hft) through simulation based scenarios in endoscopic haemostasis improves teamworking

Introduction In the early 1970s, number of air crashes were attributed to human error. HFT is well recognised for improving safety in aviation. Medical errors rank high amongst the leading causes of death and HFT is increasingly been recognised to reduce errors in CPR and anaesthetics. The value of HFT in endoscopy has not been evaluated. Method We delivered haemostasis and HFT to Gastroenterology Specialty trainee Registrars (StRs) at Lancashire simulation centre. A computer-based life-sized manikin with human physiology emulation capability was used. Its vital signs were controlled remotely. The manikin could talk and was connected to ECG, Pulse rate, SpO2 and BP monitor. Endoscopy equipment and porcine stomach models were used. Haemostatic methods including adrenaline injection, haemoclip placement, Haemospray, Sengstaken tube and Danis stent insertion were practiced. Introductory presentations on Human factors were delivered. 4 scenarios were written to provide ‘high-stress/high-stakes’ events that are encountered infrequently, but where rapid and professional responses are crucial i.e. patients with an upper GI bleed developing periarrest whilst in endoscopy unit. Each scenario involving 5 to 6 StRs was facilitated by Gastroenterologists and Simulation skills educators. Feedback was provided by peer observation. Microteaching was delivered using video assisted debrief. Pre and post course feedback was obtained. Results 23 StRs attended. Prior to this course 55% StRs have had no HFT, 14% had self directed learning, 9% received lectures and 22% had formal workshop based HFT. Data analysis showed improvement in all areas of Human Factor: decision making, situational awareness, team working and leadership skills. On the Likert scale (1 strongly disagree, 5 strongly agree) StRs felt scenarios were useful (Median 5, IQR 1), amount of information was appropriate (Median 5, IQR 1) and hands on training was useful (Median 5, IQR 1). StRs reported increased awareness of managing acutely ill patients in relation to sedation issues (Median 4, IQR 2), principles of resuscitation and fluid management (Median 4, IQR 2), improved leadership, teamwork and communication (Median 5, IQR 1). Qualitative feedback was positive. StRs however recommended smaller groups in future courses. 90% StRs felt that training on Human Factors and their influence on patient safety should be compulsory. Conclusion Human patient simulation provides ‘real life’ environment to observe Human Factors and allows chance to debrief, something that is difficult in the busy workplace. StRs benefit from HFT and report improvement in their skills. We recommend that HFT in endoscopy should be incorporated in competency based training curriculum and rolled out nationally. Disclosure of interest None Declared.

“The Scientific Method” as Myth and Ideal

“The Scientific Method” as it has been portrayed in popular and introductory contexts has been declared a myth. The variation that one finds in introductory presentations of “The Scientific Method” is explained by the fact that there is no canonical account among historians and philosophers of science. What, in particular, is wrong with “The Scientific Method”? This essay provides a fairly comprehensive survey of shortcomings of “The Scientific Method”. Included are corrections to several misconceptions that often accompany such presentations. Rather than treating “The Scientific Method” as a useful approximation or an ideal, the myth should be discarded. Lessons can be learned for introductory pedagogical contexts from considering the shortcomings of the myth.

Spherical-wave and plane-wave propagators

This paper explores the equivalence between spherical-wave and plane-wave propagators. Spherical-wave propagators are intimately part of diffraction and boundary scattering theory. They consequently are used almost exclusively in introductory presentations of electromagnetic theory. However, equivalent representations can be constructed from superpositions of propagating plane waves. This leads to two different approaches to diffraction theory. Spherical-wave computations are initiated by induced point sources. Plane-wave computations are initiated by an equivalent-aperture plane field. Subsequent propagation can be computed with Fourier transformations. Sampling requirements ultimately limit the utility of Fourier-domain computations. Examples are presented.

Exploring Priority Research Areas in Psoriasis and Psoriatic Arthritis from Dermatologists’ Perspective: A Report from the GRAPPA 2011 Annual Meeting

At the 2011 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Naples, Italy, the GRAPPA dermatology members led discussions on priority research areas in psoriasis and psoriatic arthritis (PsA). These discussions centered on 3 primary areas: evaluation of PsA screening tools, updates on psoriasis comorbidities, and new developments in genetics and comparative effectiveness research. Introductory presentations were followed by engaging panel discussions and audience interaction. The members agreed that screening tools are highly valuable in early detection of PsA among dermatology patients and that efforts are necessary to develop tools suitable for adoption in clinical practice. Members also agreed that a collaborative investigation to evaluate the effect of psoriasis treatments on cardiovascular comorbidities would be highly informative. Finally, the members supported continued efforts to explore the genetic basis of psoriasis and more studies focused on comparative effectiveness of existing treatments.