An immersive virtual reality communication skills training for dietitians: A feasibility study.

Objective: The training of dietitians emphasizes the development of strong communication skills. Immersive virtual reality (IVR) has been successfully employed for various healthcare scenarios; however, it is yet understudied in dietetics education. Therefore, we conducted a feasibility study to investigate the usefulness of IVR for the purpose of communication skills training. Methods: We designed a multi-user virtual hospital environment that enabled the training of professional conversations between dietitians and patients. Divided into groups of three, 30 dietetics students participated in a role-play task. Taking a qualitative approach to inquiry, we evaluated how participants assessed the benefits and limitations of the IVR training. Results: Participants appreciated the authenticity of the training environment and mentioned various advantages of IVR (e.g., sense of privacy, better focus on conversation) over traditional modes of instruction. On the other side, participants frequently mentioned that the lack of avatars' facial expressions might present an obstacle for effective communication skills training. Conclusion: IVR enables authentic communication skills trainings for dietitians. Special consideration should be given to providing ample social cues during training. Innovation: The study demonstrates that the promising results from other healthcare professions regarding the usefulness of IVR training also apply to dietetics.

Group Decision-Making in Multi-User Immersive Virtual Reality.

Head-mounted displays enable social interactions in immersive virtual environments. However, it is yet unclear whether the technology is also suitable for collaborative work between remote group members. Previous research comparing group performance in nonimmersive computer-mediated communication and face-to-face (FtF) interaction yielded inconsistent results. For this reason, we set out to compare multi-user immersive virtual reality (IVR), video conferencing (VC), and FtF interaction in a group decision task. Furthermore, we examined whether the conditions differed with respect to cognitive load and social presence. Using the hidden profile paradigm, we tested 174 participants in a fictional personnel selection case. Discussion quality in IVR did not differ from VC and FtF interaction. All conditions showed the typical bias for discussing information that was provided for all participants (i.e., shared information) compared with information that was only disclosed to individual participants (i.e., unshared information). Furthermore, we found that IVR groups showed the same probability of solving the task correctly. Social presence in IVR was reduced compared with FtF interaction; however, we found no differences in cognitive load. In sum, our results imply that IVR can effectuate efficient group behavior in a modern working environment that is characterized by a growing demand for remote collaboration.

Impaired math achievement in patients with acute vestibular neuritis.

Broad cognitive difficulties have been reported in patients with peripheral vestibular deficit, especially in the domain of spatial cognition. Processing and manipulating numbers relies on the ability to use the inherent spatial features of numbers. It is thus conceivable that patients with acute peripheral vestibular deficit show impaired numerical cognition. Using the number Stroop task and a short math achievement test, we tested 20 patients with acute vestibular neuritis and 20 healthy, age-matched controls. On the one hand, patients showed normal congruency and distance effects in the number Stroop task, which is indicative of normal number magnitude processing. On the other hand, patients scored lower than healthy controls in the math achievement test. We provide evidence that the lower performance cannot be explained by either differences in prior math knowledge (i.e., education) or slower processing speed. Our results suggest that peripheral vestibular deficit negatively affects numerical cognition in terms of the efficient manipulation of numbers. We discuss the role of executive functions in math performance and argue that previously reported executive deficits in patients with peripheral vestibular deficit provide a plausible explanation for the lower math achievement scores. In light of the handicapping effects of impaired numerical cognition in daily living, it is crucial to further investigate the mechanisms that cause mathematical deficits in acute PVD and eventually develop adequate means for cognitive interventions.

Bactericidal and Fungicidal Activity of N-Chlorotaurine Is Enhanced in Cystic Fibrosis Sputum Medium.

Lung infections with multiresistant pathogens are a major problem among patients suffering from cystic fibrosis (CF). N-Chlorotaurine (NCT), a microbicidal active chlorine compound with no development of resistance, is well tolerated upon inhalation. The aim of this study was to investigate the in vitro bactericidal and fungicidal activity of NCT in artificial sputum medium (ASM), which mimics the composition of CF mucus. The medium was inoculated with bacteria (Staphylococcus aureus, including some methicillin-resistant S. aureus [MRSA] strains, Pseudomonas aeruginosa, and Escherichia coli) or spores of fungi (Aspergillus fumigatus, Aspergillus terreus, Candida albicans, Scedosporium apiospermum, Scedosporium boydii, Lomentospora prolificans, Scedosporium aurantiacum, Scedosporium minutisporum, Exophiala dermatitidis, and Geotrichum sp.), to final concentrations of 107 to 108 CFU/ml. NCT was added at 37°C, and time-kill assays were performed. At a concentration of 1% (10 mg/ml, 55 mM) NCT, bacteria and spores were killed within 10 min and 15 min, respectively, to the detection limit of 102 CFU/ml (reduction of 5 to 6 log10 units). Reductions of 2 log10 units were still achieved with 0.1% (bacteria) and 0.3% (fungi) NCT, largely within 10 to 30 min. Measurements by means of iodometric titration showed oxidizing activity for 1, 30, 60, and >60 min at concentrations of 0.1%, 0.3%, 0.5%, and 1.0% NCT, respectively, which matches the killing test results. NCT demonstrated broad-spectrum microbicidal activity in the milieu of CF mucus at concentrations ideal for clinical use. The microbicidal activity of NCT in ASM was even stronger than that in buffer solution; this was particularly pronounced for fungi. This finding can be explained largely by the formation, through transhalogenation, of monochloramine, which rapidly penetrates pathogens.

Acute peripheral vestibular deficit increases redundancy in random number generation.

Unilateral peripheral vestibular deficit leads to broad cognitive difficulties and biases in spatial orientation. More specifically, vestibular patients typically show a spatial bias toward their affected ear in the subjective visual vertical, head and trunk orientation, fall tendency, and walking trajectory. By means of a random number generation task, we set out to investigate how an acute peripheral vestibular deficit affects the mental representation of numbers in space. Furthermore, the random number generation task allowed us to test if patients with peripheral vestibular deficit show evidence of impaired executive functions while keeping the head straight and while performing active head turns. Previous research using galvanic vestibular stimulation in healthy people has shown no effects on number space, but revealed increased redundancy of the generated numbers. Other studies reported a spatial bias in number representation during active and passive head turns. In this experiment, we tested 43 patients with acute vestibular neuritis (18 patients with left-sided and 25 with right-sided vestibular deficit) and 28 age-matched healthy controls. We found no bias in number space in patients with peripheral vestibular deficit but showed increased redundancy in patients during active head turns. Patients showed worse performance in generating sequences of random numbers, which indicates a deficit in the updating component of executive functions. We argue that RNG is a promising candidate for a time- and cost-effective assessment of executive functions in patients suffering from a peripheral vestibular deficit.

Self-motion direction discrimination in the visually impaired.

Despite the close interrelation between vestibular and visual processing (e.g., vestibulo-ocular reflex), surprisingly little is known about vestibular function in visually impaired people. In this study, we investigated thresholds of passive whole-body motion discrimination (leftward vs. rightward) in nine visually impaired participants and nine age-matched sighted controls. Participants were rotated in yaw, tilted in roll, and translated along the interaural axis at two different frequencies (0.33 and 2 Hz) by means of a motion platform. Superior performance of visually impaired participants was found in the 0.33 Hz roll tilt condition. No differences were observed in the other motion conditions. Roll tilts stimulate the semicircular canals and otoliths simultaneously. The results could thus reflect a specific improvement in canal-otolith integration in the visually impaired and are consistent with the compensatory hypothesis, which implies that the visually impaired are able to compensate the absence of visual input.

Direction detection thresholds of passive self-motion in artistic gymnasts.

In this study, we compared direction detection thresholds of passive self-motion in the dark between artistic gymnasts and controls. Twenty-four professional female artistic gymnasts (ranging from 7 to 20 years) and age-matched controls were seated on a motion platform and asked to discriminate the direction of angular (yaw, pitch, roll) and linear (leftward-rightward) motion. Gymnasts showed lower thresholds for the linear leftward-rightward motion. Interestingly, there was no difference for the angular motions. These results show that the outstanding self-motion abilities in artistic gymnasts are not related to an overall higher sensitivity in self-motion perception. With respect to vestibular processing, our results suggest that gymnastic expertise is exclusively linked to superior interpretation of otolith signals when no change in canal signals is present. In addition, thresholds were overall lower for the older (14-20 years) than for the younger (7-13 years) participants, indicating the maturation of vestibular sensitivity from childhood to adolescence.