Application of virtual reality for peritoneal dialysis exchange learning in patients with end-stage renal disease and cognitive impairment.

Cognitive impairment is not uncommon in patients with end-stage renal disease and can make it more difficult for these patients to carry out peritoneal dialysis (PD) on their own. Their attempts to do so may result in adverse consequences such as peritonitis. PD exchange is a complex procedure demanding knowledge and skill which requires close supervision and guidance by a renal nurse specialist. In this study, a non-immersive virtual reality (VR) training program using a Leap motion hand tracking device was developed to facilitate patients' understanding and learning of the PD exchange procedure before attempting real task practice. This study was a two-center single-blinded randomized controlled trial on 23 incident PD patients. Patients in the experimental group received 8 sessions of VR training, while patients in the control were provided with printed educational materials. The results showed that there were significant differences between the two groups in performance of the overall PD exchange sequence, especially on the crucial steps. VR had a patient satisfaction rate of 89%, and all patients preferred to have the VR aid incorporated in PD training. Our findings conclude VR can be a useful aid in the training and reinforcement of PD exchange procedures, with distinct merits of being free from restrictions of time, space, and manpower.

Incorporating Worker Awareness in the Generation of Hazard Proximity Warnings.

Proximity warning systems for construction sites do not consider whether workers are already aware of the hazard prior to issuing warnings. This can generate redundant and distracting alarms that interfere with worker ability to adopt timely and appropriate avoidance measures; and cause alarm fatigue, which instigates workers to habitually disable the system or ignore the alarms; thereby increasing the risk of injury. Thus, this paper integrates the field-of-view of workers as a proxy for hazard awareness to develop an improved hazard proximity warning system for construction sites. The research first developed a rule-based model for the warning generation, which was followed by a virtual experiment to evaluate the integration of worker field-of-view in alarm generation. Based on these findings, an improved hazard proximity warning system incorporating worker field-of-view was developed for field applications that utilizes wearable inertial measurement units and localization sensors. The system's effectiveness is illustrated through several case studies. This research provides a fresh perspective to the growing adoption of wearable sensors by incorporating the awareness of workers into the generation of hazard alarms. The proposed system is anticipated to reduce unnecessary and distracting alarms which can potentially lead to superior safety performance in construction.