Locked Room Research Articles

Escape the Trauma Room.

Traditional conference didactics may not be effectively meeting the learning needs of today's emergency medicine (EM) residents, and educators are employing various interactive approaches to engage learners. Escape Room is a popular adventure game in which participants must work together to solve a series of puzzles to escape a locked room. Our aim was to adapt this game design to teach core EM content and procedural aptitude. Upon entering the "locked" room residents were faced with a series of puzzles involving concepts such as toxicology antidotes, ventilator management, echocardiogram interpretations, airway foreign body removal, arterial line transducer setup, and using a cast cutter. Using teamwork and limited clues learners had to work together to "escape" the room. Afterward, a didactic summary was given to enhance knowledge retention. The Escape Room construct was successfully adopted as an engaging model to teach EM core content and procedure skills while simultaneously fostering team building. Feedback received was overwhelmingly positive. This unique alternative educational activity can be easily implemented at any EM residency program as an effective alternative educational tool.

Investigating Recommendation Algorithms for Escape Rooms

An escape room is a physical puzzle solving game, where participants solve a series of riddles within a limited time to exit a locked room. Escape rooms differ in their theme, environment, and difficulty, and people hence often differ on their preferences over escape rooms. As such, recommendation systems can help people in deciding which room to visit. In this paper, we describe the properties of the escape rooms recommendation problem, with respect to other popular recommendation problems. We describe a dataset of reviews collected within a current system. We provide an empirical comparison between a set of recommendation algorithms over two problems, top-N recommendation and rating prediction. In both cases, a KNN method performed the best.

Decrypting the Real Life Escape Room Experience

An escape room is a game that requires a group of players to solve a variety of tasks within a given amount of time in order to fulfill a specific goal, typically escaping a locked room. Despite gaining tremendous popularity of the game in Malaysia, there is no study being conducted in this area. Existing customer experience frameworks offer a limited explanation of this rising phenomena due to the unique inherent nature of Escape Room. Towards this end, the present paper aims to identify the key constructs of Malaysian Escape Room customer experience and determinants of the players revisit intention with respect to the Escape Room. The research is conducted on 20 players who have played at least one game in any Escape Room establishment in Malaysia. This study adopts the sequential incident technique, a qualitative approach to unearth the hidden perception of players. Thematic analysis was subsequently used to analyse the data which revealed fifteen determinants of which 9 are related to the model of goal-directed behaviour. Our research contributes to the body of knowledge in mapping customer experience in this fair nascent industry. Insights from this study are aimed at benefiting Malaysian Escape Room business operators in designing and enhancing the customer experience in their escape rooms.

Collecting Community Stories: Local Studies Collections and What They Can Tell You About the Community

Collecting Community Stories: Local Studies Collections and What They Can Tell You About the Community

An Escape Room as a Simulation Teaching Strategy

BackgroundThis teaching project describes the process of creating, implementing, and appraising the use of escape room concepts within a urosepsis high-fidelity simulation scenario. MethodInstead of a locked room, Breakout EDU locked boxes were incorporated into a clinical simulation. Nursing students applied concepts learned in class and analyzed patient data to obtain clues. These clues helped determine the combination to four locks and progress through the simulation within 60 minutes. After completing the escape room simulation, each group had an opportunity to gather for a team photo, which they posted on social media. ResultsStudents reported the escape game contributed to their learning and improved their ability to delegate tasks and work as a team. Preliminary observations reveal that “time” may be a significant factor associated with this teaching strategy. ConclusionThe concept of an escape room or serious game-based learning was found to be an engaging teaching strategy by faculty and students.

Can You Escape Nursing School? Educational Escape Room in Nursing Education.

Escape rooms, a form of collaborative live-action gaming requiring participants to solve clues to escape a locked room, have grown in popularity across the nation. Games bring together problem solving, critical thinking, and teamwork. This game method has not yet appeared in nursing education literature. The authors describe two versions of the innovative escape room pedagogical method used in undergraduate nursing education. Theoretical bases, learning activities, and types of game clues that could be used are detailed. Future research will address the ability of students to reach learning objectives before and after the game.

Educational Gaming for Pharmacy Students – Design and Evaluation of a Diabetes-themed Escape Room

Objective. To design an educational game that will increase third-year professional pharmacy students' knowledge of diabetes mellitus disease management and to evaluate their perceived value of the game. Methods. Faculty members created an innovative educational game, the diabetes escape room. An authentic escape room gaming environment was established through the use of a locked room, an escape time limit, and game rules within which student teams completed complex puzzles focused on diabetes disease management. To evaluate the impact, students completed a pre-test and post-test to measure the knowledge they've gained and a perception survey to identify moderating factors that could help instructors improve the game's effectiveness and utility. Results. Students showed statistically significant increases in knowledge after completion of the game. A one-sample t-test indicated that students' mean perception was statistically significantly higher than the mean value of the evaluation scale. This statically significant result proved that this gaming act offers a potential instructional benefit beyond its novelty. Conclusion. The diabetes escape room proved to be a valuable educational game that increased students' knowledge of diabetes mellitus disease management and showed a positive perceived overall value by student participants.

Seclusion and Psychiatric Intensive Care Evaluation Study (SPICES): combined qualitative and quantitative approaches to the uses and outcomes of coercive practices in mental health services

BackgroundSeclusion (the isolation of a patient in a locked room) and transfer to a psychiatric intensive care unit (PICU; a specialised higher-security ward with higher staffing levels) are two common methods for the management of disturbed patient behaviour within acute psychiatric hospitals. Some hospitals do not have seclusion rooms or easy access to an on-site PICU. It is not known how these differences affect patient management and outcomes.ObjectivesTo (1) assess the factors associated with the use of seclusion and PICU care, (2) estimate the consequences of the use of these on subsequent violence and costs (study 1) and (3) describe differences in the management of disturbed patient behaviour related to differential availability (study 2).DesignThe electronic patient record system at one trust was used to compare outcomes for patients who were and were not subject to seclusion or a PICU, controlling for variables, including recent behaviours. A cost-effectiveness analysis was performed (study 1). Nursing staff at eight hospitals with differing access to seclusion and a PICU completed attitudinal measures, a video test on restraint-use timing and an interview about the escalation pathway for the management of disturbed behaviour at their hospital. Analyses examined how results differed by access to PICU and seclusion (study 2).ParticipantsPatients on acute wards or PICUs in one NHS trust during the period 2008–13 (study 1) and nursing staff at eight randomly selected hospitals in England, with varying access to seclusion and to a PICU (study 2).Main outcome measuresAggression, violence and cost (study 1), and utilisation, speed of use and attitudes to the full range of containment methods (study 2).ResultsPatients subject to seclusion or held in a PICU were more likely than those who were not to be aggressive afterwards, and costs of care were higher, but this was probably because of selection bias. We could not derive satisfactory estimates of the causal effect of either intervention, but it appeared that it would be feasible to do so for seclusion based on an enriched sample of untreated controls (study 1). Hospitals without seclusion rooms used more rapid tranquillisation, nursing of the patient in a side room accompanied by staff and seclusion using an ordinary room (study 2). Staff at hospitals without seclusion rated it as less acceptable and were slower to initiate manual restraint. Hospitals without an on-site PICU used more seclusion, de-escalation and within-eyesight observation.LimitationsOfficial record systems may be subject to recording biases and crucial variables may not be recorded (study 1). Interviews were complex, difficult, constrained by the need for standardisation and collected in small numbers at each hospital (study 2).ConclusionsClosing seclusion rooms and/or restricting PICU access does not appear to reduce the overall levels of containment, as substitution of other methods occurs. Services considering expanding access to seclusion or to a PICU should do so with caution. More evaluative research using stronger designs is required.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Merasakan Tasawuf

<p>Abstract</p><p>Awareness has inspired humans to feel Sufi sm. Various kinds of questions lie about mutasawifi n, including Who am I? Where am I? For what I created? How do I fi ll out alive? What am I looking for? What kind of life I want to pick up after death? If I could go back to my native place safely? And other fundamental questions in human beings. Religion deifying vehicle, Iman deifying fuel, and the man who drove, the religion with the contents of the sentences noble in heart, it was the straight path. Th e way of approaching Him is to continue to multiply zikrullah. Zikir is the parent of worship, then where is the zikir when penetrating into the heart of a clean then it will feel the souls kesufi an true. Hearts (qolbu) can also be likened to building a house. He was surrounded by walls and secured with a gate or gate locked. Only family members and guests who comes who may enter it. While the heart of the deeper (lubb) is a locked room that holds valuable heirlooms belonging to the family. Only a few family members who have the key. So when the door was open means opened the doors of Sufi sm in human beings and to feel the pleasure that can perform worship and all the good deeds that will save people in the world and the hereafter.</p><p><br />Keyword: <em>Sufi sm, qolbu, zikir</em></p>

Seclusion experienced by mental health professionals.

Seclusion in psychiatric inpatient care means confining service users in a locked room. Service users and staff seem to have different opinions on the usefulness of seclusion. This is possibly the first time when two mental health nurses went voluntarily into seclusion and reported their experiences. The nurses felt that the seclusion room was inhumane and proposed improvements to seclusion in general and to the seclusion facilities in particular. Seclusion in psychiatric hospital care refers to isolating a service user from other service users and staff, most often in a locked and unfurnished room. Service users' experiences of seclusion are mostly negative, and although some have seen a rationale for its use, mental health nurses should be encouraged to evaluate current seclusion practices from the service user's perspective. In this small-scale experiment, two mental health nurses were voluntarily secluded for 24 h. The aim was to explore the experience of being secluded, to understand and evaluate the impact of seclusion in greater detail, and to encourage discussion on one of the controversies in mental health nursing. To the best of our knowledge, this is the first attempt to evaluate the impact of seclusion based on mental health nurses' firsthand experiences. The nurses received usual seclusion treatment and described their experiences of this every 6 h. Based on the nurses' experiences, seclusion, even in voluntary, safe and planned circumstances, may increase anxiety and frustration. Seclusion was viewed negatively and the physical environment was considered inhumane. The nurses offered some practical suggestions for updating seclusion practices and re-designing seclusion facilities. Mental health nurses, who frequently decide on and invariably implement seclusion, are key to improving seclusion practices.

A Simple Solution to Safeguarding Sedation Medications

Universally, sedation and anesthesia providers are challenged with the task of effectively securing sedation and anesthesia medications from the time of preparation until time of administration. When sedation or anesthesia is provided in a setting such as an operating room or an organized sedation space, the medications are generally considered to be secured by virtue of the controlled space. Securing sedation medications can become problematic with “off-site” sedation or anesthesia, such as in the MRI setting, oncology unit, dental clinic and other areas. The Joint Commission defines medications being secure as: “In a locked container, in a locked room or under constant surveillance”. [1] Anesthesia and sedation providers must maintain medication safety and integrity, though they’re not permitted to carry the medications on their person. Patient safety and quality of care are likely to be in jeopardy if the integrity of sedation medications is not maintained, and medications are not readily available for immediate use.

The True Tale of the Monster Billy Dean telt by hisself by David Almond (review)

Reviewed by: The True Tale of the Monster Billy Dean telt by hisself by David Almond Karen Coats Almond, David. The True Tale of the Monster Billy Dean telt by hisself. Candlewick, 2014. [272p]. Trade ed. ISBN 978-0-7636-6309-4 $17.99 E-book ed. ISBN 978-0-7636-6725-2 $17.99 Reviewed from galleys R Gr. 9-12. Billy Dean is born on the day suicide bombers decimate his home city of Blinkbonny. Miraculously, he and his mother are unharmed, but his father, for reasons of his own, decides that Billy must be reared in secret. Thus Billy grows up in a single locked room, attended to by his loving but simple mother; his unbalanced father, who visits only occasionally, brings with him stories, lessons, and the belief that his miracle child will have preternatural insight given the circumstances of his birth and his isolated upbringing. When his father leaves town, his mother brings thirteen-year-old Billy out into the world with the help of the local butcher and the woman who had served as midwife at his birth; while the butcher offers fatherly affection, Missus Malone seeks to exploit Billy, believing, like his father, that he has special gifts for communicating with the dead and healing the sick. Sure enough, Billy does appear to have some powers, but the mantle of responsibility they incur does not rest easily with him, and his father’s mental instability has not yet finished inflicting its damage. Billy’s story is told entirely through invented phonetic spelling, which, while always comprehensible, slows the reading down and enhances the sense of Billy’s vulnerability in a confusing and devastated world. His ability to find surreal beauty in strange things, such as the dead mice he lovingly dissects in his room, hearkens back to Almond’s treatment of Skellig (Skellig, BCCB 3/99) and Heaven Eyes (Heaven Eyes, BCCB 4/01), and the message is also similar: wonder and loveliness can be recovered from the ashes of festering evil. Billy’s innocence doesn’t save him from that evil, but his steadfast ability to find goodness, beauty, love, and mystery in the darkest places lights the way forward, for himself and readers alike. Copyright © 2014 The Board of Trustees of the University of Illinois

Suicidal strangulation by double ligature: A case report

This article reports a self-strangulation suicide in which a double complex group of ligatures was used. Although similar cases have been referenced in forensic literature, this case is notable because of the unusual method used by the victim. A 61-year-old man was found in a locked room with a double elaborate ligature comprising six wire clothes hangers completely encircling the neck and a black rubber band in a double loop. Autopsy also documented parallel superficial cut lesions in proximal forearm interpreted as hesitation marks. It stresses the importance of characteristics such as analysis of number of ligatures, position of the knots, number of knots and turns of ligature marks and the absence of any defense and relevant internal injuries inherent to suicide ligature strangulation cases.

Narratives of enclosure in detective fiction: the locked room mystery

Preface Edgar Allan Poe and the Detective Story Narrative The Locked Compartment: Charles Dickens's The Signalman and Enclosure in the Railway Mystery Story The Body in the Library: Reading the Locked Room in Anna Katherine Green's The Filigree Ball G.K. Chesterton's Enclosure of Orthodoxy in The Wrong Shape The Hollow Text: Illusion as Theme in John Dickson Carr's The Hollow Man Jorge Luis Borges and the Labyrinth of Detection The Question is the Writer Himself: Paul Auster's Locked Room in the City of Glass The Narrative of Enclosure Index

Citadels: passive defence against pirate attacks

While awaiting a comprehensive solution to the problem of piracy off the Horn of Africa, governments and shipping companies have resorted to interim measures. A limited number of naval vessels have patrolled transit corridors through the affected waters, and merchant ships have applied self-defence techniques. Many countries, shippers, and insurance companies continue to resist ‘active defences’, such as armed security teams. On the other hand, ‘passive defences’ have proven surprisingly effective in many instances. Notable among these is the ‘citadel’, a locked safe room in which a crew can secure itself from a pirate boarding party, denying the pirates the advantage of holding hostages. Knowledge that a crew is out of harm’s way in a citadel permits naval forces to board and retake hijacked vessels without fear of collateral casualties. Several successful and unsuccessful cases are examined. Potential shortcomings are briefly discussed.

Shards of Memory

Memoirs are a kind of odd literary beast. Unlike regular fiction they purport to be a rendition of one’s own life—true to reality or at least as accurate as one’s selective and notoriously fickle memory will allow. structurally, however, they can be strangely akin to classic detective stories. As in those that begin with the discovery of a corpse in a locked room, the detective’s job is to pursue the clues that will allow him to reconstruct the events which brought the corpse to his doom. similarly the memoirist has the task of plunging into his own past to reveal the palimpsest of remembered selves and events that culminate in his present identity sitting in front of the typewriter or wordprocessor. In a curious way he combines in his own person the functions and characters of the policier: he moves the plot and acts as the detective, the victim, and, in some cases, the antagonist all at once. Whether this assemblage of selves is discovered or invented must necessarily be ambiguous—even, or especially, to the author; after all the Heisenberg principle must surely be in maximum effect when one is observing oneself. In the best memoirs the author’s pursuit of his own mysteries can lead to genuine self-discoveries that may be almost as luminous for the reader as they are for the writer. It’s difficult to apply a measure to these efforts, however, since memoirs differ in the balance of their intentions. some are sharply focused on the events and circumstances they describe, as the author stands on the sidelines as a seemingly objective commentator; others are more concerned with how the projected self filters and reacts to those events. the best memoirs are those that achieve a compelling illusion of authenticity and intimacy that captures the reader and may even provoke him to examine his own epistemological mysteries. these two memoirs are both written by baby boomers now in their early sixties, and, where my generation was formed by the Great depression and

Coercion and Treatment Satisfaction Among Involuntary Patients

Coercion and Treatment Satisfaction Among Involuntary Patients

Coercion and Treatment Satisfaction Among Involuntary Patients

This study aimed to assess involuntary inpatients' satisfaction with treatment and explore how coercion and other factors are associated with satisfaction. An observational prospective study was conducted in 67 acute wards in 22 hospitals in England. A total of 778 involuntary inpatients were recruited, and their satisfaction with treatment was assessed a week after admission and at the one-month, three-month, and one-year follow-ups. Perceived and documented coercion at admission and during hospital treatment, sociodemographic and clinical characteristics, and clinical improvement were tested as potential predictors of satisfaction. Mean scores on the Client's Assessment of Treatment Scale measuring satisfaction with treatment ranged from 5.5 to 6.0 (on a scale with possible scores ranging from 0 to 10) at different time points and improved significantly from admission to the follow-ups. Patients who perceived less coercion at admission and during hospital treatment were more satisfied overall, whereas coercive measures documented in the medical records were not linked to satisfaction. Patients with more symptom improvement expressed higher levels of treatment satisfaction. Satisfaction with treatment among involuntary patients was associated with perceptions of coercion during admission and treatment, rather than with the documented extent of coercive measures. Interventions to reduce patients' perceived coercion might increase overall treatment satisfaction.

THE EVOLUTION AND IMPLEMENTATION OF GLOBAL ASSURANCE

Because of the Internet, a global economy has developed. No longer is information restricted to a central computer, in a physically locked room, and accessed only by computer professionals. Today, information is distributed outside the physical locked room and accessed by anyone, anywhere, anytime. In turn, security of the information has changed from local to global. This paper examines the development of global assurance from local computer security. The implications, such as no perimeter to protect, are then discussed. A definition of global assurance is provided. The purpose of this paper is to lay the foundation for further research in the development of global assurance, a new concept that corporations and governments must address.

Les chambres fermées en psychiatrie: poursuivre le débat pour dépasser les conflits

Constraining measures such as seclusion in a locked room are often used in psychiatry despite the restrictive legislative limits which emphasise the exceptional nature of these measures. In constant tension with various principles of medical ethics, seclusion constitutes a major hindrance to patient rights and liberty, but at the same time, it may arise from a duty to assist or protect the patient or a third party. Within the context of caring for the patient, seclusion in a locked room must be justified by the patient's clinical condition and must aim to attain a therapeutic goal which legitimises its use. Nevertheless, we cannot ignore the conflict of interests between the giver and the receiver of care, nor the controversies among health professionals about this issue. On the patients' side, the locked room is often considered as a punitive measure which intensifies the feelings of rejection and abandonment, producing fear, anxiety and frustration. Seen as a source of suffering, its therapeutic qualities are often unrecognised. On the caregivers' side theoretical, ethical and deontological debates examine the isolation issue with three identified objectives: therapy, security and punishment. At this time, a certain consensus has been established concerning how resorting to confinement should be incorporated within the therapeutic strategy. A list of widely accepted indications and counter-indications has been discussed. Many teams of caregivers include the follow-up of episodes of seclusion within the protocol of care. It has been recognised that the development of the use of alternative measures is necessary, and the patient's voice has finally begun to be heard. Nonetheless, using locked rooms as a tool in caring for patients continues to be difficult and traumatising for patients and a persistent source of uneasiness for caregivers. Certain issues remain unresolved; for example, the evaluation of the expected benefits of seclusion compared to its deleterious effects or the estimation of its efficacy compared to that of alternative measures. Little rigorous scientific research has been carried out attesting to the therapeutic effects of seclusion and calls have been made to eliminate it from hospital services. The debate must continue within the hospital network and outside this network with the participation of patients' associations and the support of political authorities. It is this debate which forces us to envision other, less coercive, measures, thus creating the conditions to reduce seclusion. In this way, the contributions of the various participants in this debate play a part in the establishment of new standards which encourage a culture of care rather than a culture of control and make a partnership possible in caring for the illness that respects patients' rights.