Academic Services and Registrar - Research Publications
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ItemAssessing the carbon footprint of digital health interventions: a scoping review(OXFORD UNIV PRESS, 2022-11-14)OBJECTIVE: Integration of environmentally sustainable digital health interventions requires robust evaluation of their carbon emission life-cycle before implementation in healthcare. This scoping review surveys the evidence on available environmental assessment frameworks, methods, and tools to evaluate the carbon footprint of digital health interventions for environmentally sustainable healthcare. MATERIALS AND METHODS: Medline (Ovid), Embase (Ovid). PsycINFO (Ovid), CINAHL, Web of Science, Scopus (which indexes IEEE Xplore, Springer Lecture Notes in Computer Science and ACM databases), Compendex, and Inspec databases were searched with no time or language constraints. The Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA_SCR), Joanna Briggs Scoping Review Framework, and template for intervention description and replication (TiDiER) checklist were used to structure and report the findings. RESULTS: From 3299 studies screened, data was extracted from 13 full-text studies. No standardised methods or validated tools were identified to systematically determine the environmental sustainability of a digital health intervention over its full life-cycle from conception to realisation. Most studies (n = 8) adapted publicly available carbon calculators to estimate telehealth travel-related emissions. Others adapted these tools to examine the environmental impact of electronic health records (n = 2), e-prescriptions and e-referrals (n = 1), and robotic surgery (n = 1). One study explored optimising the information system electricity consumption of telemedicine. No validated systems-based approach to evaluation and validation of digital health interventions could be identified. CONCLUSION: There is a need to develop standardised, validated methods and tools for healthcare environments to assist stakeholders to make informed decisions about reduction of carbon emissions from digital health interventions.
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ItemNo Preview AvailableEndothelial protein C receptor is increased in preterm preeclampsia and fetal growth restriction(WILEY, 2022-12)Placental dysfunction is the leading cause of both preeclampsia and fetal growth restriction. This study aimed to characterize endothelial protein C receptor (EPCR) in preterm preeclampsia, term preeclampsia, and fetal growth restriction (defined by delivery of a small for gestational age [SGA] infant [<10% birthweight centile]) and examine its regulation in primary syncytiotrophoblast. Placental EPCR mRNA and protein were significantly increased in patients with preterm preeclampsia (<34 weeks gestation) compared to gestation-matched controls (p < .0001). In the plasma, EPCR was also significantly elevated (p = .01) in established preterm preeclampsia while its substrate, protein C (PC) was significantly reduced (p = .0083). Placentas from preterm small for gestational age (SGA) cases, had elevated EPCR mRNA expression (p < .0001) relative to controls. At 36 weeks, no significant changes in plasma EPCR were detected in samples from patients destined to develop preeclampsia or deliver an SGA infant at term. In terms of syncytiotrophoblast, hypoxia significantly increased EPCR mRNA expression (p = .008), but Tumor Necrosis Factor Alpha (TNF-α) decreased EPCR mRNA. Interleukin-6 (IL-6) had no significant effect on EPCR mRNA expression. When isolated syncytiotrophoblast was treated with metformin under hypoxia (1% O2 ) or normoxia (8% O2 ), EPCR mRNA expression was significantly reduced (p = .008) relative to control. In conclusion, EPCR is markedly elevated in the placenta and the circulation of patients with established preterm preeclampsia and placental increases may be associated with hypoxia. Additionally, fetal growth-restricted pregnancies (as defined by the delivery of an SGA infant) also demonstrated elevated placental EPCR.
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ItemA single-blind, randomised controlled trial of a physical health nurse intervention to prevent weight gain and metabolic complications in first-episode psychosis: the Physical Health Assistance in Early Psychosis (PHAstER) study(CAMBRIDGE UNIV PRESS, 2022-10-18)BACKGROUND: Factors that contribute to the early mortality observed in psychotic disorders, specifically obesity, smoking and sedentary behaviour, occur early in the disorder. AIMS: We aimed to determine whether the integration of a physical health nurse in the care of young people with first-episode psychosis could prevent clinically significant weight gain (≥7% body weight). Secondary outcomes included rates of smoking, metabolic syndrome and sedentary behaviour. METHOD: In this single-blind, randomised controlled trial, participants who had received under 4 weeks of antipsychotic medication were randomly allocated to either the intervention (addition of a physical health nurse to their care) or treatment as usual (TAU) for 12 weeks. RESULTS: Of the 77 participants, there were follow-up data for 86.8% (n = 33) of the intervention group and 82.1% (n = 32) of the TAU group. After 12 weeks, 27.3% of the intervention group experienced clinically significant weight gain compared with 34.4% of the TAU group (odds ratio 0.72, 95% CI 0.25-2.06, P = 0.54). After 6 months, 40.7% of the intervention group gained clinically significant weight compared with 44.1% of the TAU group (P = 0.79). There was no difference in mean change in weight between groups after 12 weeks (2.6 kg v. 2.9 kg, P = 0.87) or 6 months (3.6 kg v. 4.3 kg, P = 0.64). There were no differences in the rates of tobacco smoking cessation, prevalence of metabolic syndrome or physical activity levels. CONCLUSIONS: This intervention failed to prevent the metabolic complications that are highly prevalent in psychotic disorders in the short to medium term, indicating that more intensive interventions are required.
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Item‘It’s not so scary anymore. It’s actually exhilarating’: A proof-of-concept study using virtual reality technology for music performance training under pressure(ASCILITE Publications, 2022-11-18)Extended lockdowns associated with the COVID-19 pandemic severely ruptured the capacity of performing artists to connect with peers and colleagues in professional and educational contexts. In this study we test a protocol for the use of immersive performance technologies in tertiary institutions to provide developing and early career musicians to connect with pedagogues and access safe, realistic spaces within which to practice performing under varying degrees of pressure. We investigated the affordances of a VR environment to trigger performance anxiety, and the effectiveness of a synchronous digitally mediated environment for tertiary educators to train a key performance psychology skill. Heart rate, self-reported anxiety and confidence measurements were taken over four levels of situational stress and performance demands. Results revealed that the technology enabled a pre-performance routine to be effectively taught online by an instructor to a musician wearing a VR headset. Notably, this was achieved by both participants being in separate locations without detriment to the teacher-student relationship. This study provides encouraging insight into the capacity for immersive technologies to help students effectively manage the stresses of live performance in both virtual and real worlds.
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ItemNo turning back on global open access.(BMJ, 2022-10-05)
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ItemNo Preview AvailableReimagining the performance experience through the establishment of a virtual performance hall.( 2021-10-27)Paper presented as part of the symposium "Reimagining Performance with Immersive Reality Technologies" at ISPS 2021, 27-30 October, Montreal, Canada.
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ItemDesign principles for immersive reality to enhance creativity and performance through transdisciplinary collaboration.( 2021-10-27)Paper presented as part of the symposium "Reimagining Performance with Immersive Reality Technologies" at ISPS 2021, 27-30 October, Montreal, Canada.
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ItemReimagining music performance with immersive reality technologies.( 2021-11-05)NowNet Arts Conference 2021 Network Arts: Transformation of Distance.
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ItemNo Preview AvailableExploring opportunities for musician’s health and performance enhancement using VR simulation training.( 2021-10-07)Paper presented at Games for Change Asia-Pacific Festival 2021, 5-7 October, online conference.
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ItemNo Preview AvailableEthical considerations for sustainable music training using VR technology: a case study of performance anxiety.( 2022-04-08)Presentation given at the 2022 Teaching Music Online in Higher Education (TMOHE) and Music, Education and Technology (MET) online international conference. INTRODUCTION Simulation training is used to develop performance skills in various disciplines, particularly where in-situ training is either impossible or unsafe to implement (Renganayagalu et al., 2021). Such training enables learners to acclimatise to real-life stressors and anxiety-inducing scenarios in a physically and/or psychologically safe environments, to protect against performance decrements which reveal themselves in high pressure contexts rather than low-stress practice sessions. BACKGROUND Recent work using immersive virtual reality (VR) provides preliminary evidence of the capacity of this technology to evoke music performance anxiety (Fadeev et al., 2020; Fanger et al., 2020). In this study, we explore the capacity of VR to assist music students to develop technical and psychological competence to perform at their best under pressure implemented within tertiary music institution settings. METHOD Richie’s Plank Experience (Toast VR, 2016) was used to approximate the physiological symptoms of high-stress performance in a single case pilot study with a highly trained violinist. Prior to exposure, a performance psychologist taught the participant a pre-performance routine with demonstrated utility in musicians (Osborne et al., 2014). The psychologist subsequently guided the participant remotely through the routine via Zoom, whilst the participant was immersed in the VR environment. Heart rate, subjective units of distress, and confidence measurements were taken across five levels of exposure which varied the integration of instrument and intervention. FINDINGS The plank task induced a notable stress response. Additionally, the musician was receptive to pre-performance routine instructions to downregulate their stress response. This created a performance focus when in the VR environment, demonstrated by decreased anxiety and increased confidence ratings across performance tasks. IMPLICATIONS/RECOMMENDATIONS We provide preliminary evidence for the capacity of immersive VR to induce the situational stress required to trigger a cascade of physical and psychological responses. The benefits of this technology need to be considered alongside areas such as privacy, storage, access, and accessibility