No abstract

BackgroundMen diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men’s awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers.ObjectiveThis study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game.MethodsThe study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey.ResultsA total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient’s health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes.ConclusionsSerious games are a promising approach to health education and decision support for older men. Participants were receptive to the idea of a serious game as a decision aid in localized prostate cancer. However, usability issues are a major concern for this demographic, as is clarity and transparency of data sources.

We highlight that the symptoms of appendicitis can be due to Enterobius vermicularis infestation without any histological evidence of acute inflammation. Surgeons need to be aware of this possibility during laparoscopic appendicectomy and simple techniques can minimise the risk of contamination. It also enables early diagnosis and treatment without awaiting histological findings.

Culicoides brevitursis is a biting midge and a vector of several viruses affecting livestock in Australia. An emergence chamber for collecting Culicoides spp. from dung was evaluated to determine its suitability for the study of C. brevitursis developing in dung at different temperatures in the laboratory. It enabled experiments to be carried out in the natural breeding medium, relative humidity to be maintained at high levels and temperature through the dung to be stabilised at treatment temperatures relatively quickly. C. brevitursis emerged within a temperature range of 17°C to 36°C with the greatest numbers between 25°C and 36°C. Males were dominant at low temperatures and females were dominant at high temperatures. Development times (to 50% emergence from deposition of the dung) and response times (to 50% emergence after starting to emerge) were least at the highest temperatures. Development times at the same temperature differed between experiments and this was associated with the temperature in the field before the dung was placed at a temperature treatment. Some survival occurred outside the 17°C to 36°C range, but emergence was dependent on the temperature eventually being changed to a more suitable level. The approximate lower threshold for emergence was about 17°C. At this temperature, numbers emerging were low, development was delayed significantly and none survived for more than 50 d. High numbers of adults started to emerge within 24 h from dung held at 17 "C for up to 42 d from the deposition of the dung when the temperature was raised to 25 "C or 28 "C. The results support field temperature data and were used in predicting the areas that may be free of the vector.

The study findings suggest a skill overlap between the Nintendo Wii and basic laparoscopic tasks. Surgical candidates with advanced Nintendo Wii ability may possess higher baseline laparoscopic ability.

Accurate incidence figures of an occult contralateral inguinal hernia will enhance the pre-operative information given to patients and may impact on resource allocation and planning theatre logistics. Finding and repairing an occult contralateral hernia at the time of TAPP has the distinct advantage that it saves the patient from further symptoms and from another operation with its associated potential morbidity.

SILA is a safe procedure for the treatment of acute appendicitis, with comparable clinical outcome to CLA when undertaken by experienced laparoscopic surgeons.

Laparoscopic surgery for treatment of adhesional SBO improves clinical outcomes and can be performed safely in selected cases with similar rates of bowel injury and reoperation to open surgery. Large scale randomized controlled trials are needed to validate the findings of this pooled analysis of non-randomized data.