Negative-pressure isolation rooms are required to house patients infected with agents transmissible by the aerosol route in order to minimise exposure of healthcare workers and other patients. Housing patients in a separate room provides a barrier which minimises any physical contact with other patients. An isolation room held at negative pressure to reduce aerosol escape and a high air-change rate to allow rapid removal of aerosols can eliminate transmission of infectious aerosols to those outside the room. However, badly designed and/or incorrectly operating isolation rooms have been shown to place healthcare workers and other patients at risk from airborne diseases such as tuberculosis. Few standards are available for the design of isolation rooms and no pressure differential or air-change rates are specified. Techniques such as aerosol particle tracer sampling and computational fluid dynamics can be applied to study the performance of negative-pressure rooms and to assess how design variables can affect their performance. This should allow cost-effective designs for isolation rooms to be developed. Healthcare staff should be trained to understand how these rooms operate and there should be systems in place to ensure they are functioning correctly.

ObjectivesThe aim of the study was to gather the views of sexual health clinic staff and male clinic users regarding digital sexual health promotion and online trial procedures.MethodsThe Men’s Safer Sex website was offered on tablet computers to men in the waiting rooms of three sexual health clinics, in a feasibility online randomised controlled trial (RCT). Interviews were conducted with 11 men who had participated in the trial and with nine clinic staff, to explore their views of the website and views of the online trial. Interviews were audio-recorded and transcribed, and we conducted a thematic analysis of interviews and of 281 free text comments from the online RCT outcome questionnaires.ResultsClinic users and staff felt that digital interventions such as the Men’s Safer Sex website are useful, especially if NHS endorsed. Pre-appointment waiting time presents a good opportunity for intervention but clinic users and staff felt that a website should supplement rather than replace face-to-face healthcare. The RCT procedures fitted well around clinical activities, but men did not self-direct to the tablet computers. Staff were more concerned about consent and confidentiality than clinic users, and staff and patients were frustrated by multiple technical problems. The trial outcome questionnaire was thought-provoking and could constitute an intervention in itself. Participants felt that clinics would need to promote a digital intervention and/or offer the site routinely to promote engagement.ConclusionDigital interventions could usefully supplement in-person sexual health care, but there are important obstacles in terms of IT access in NHS settings, and in promoting engagement.

Dynamics and control characteristics of a quadrotor heavy lift airship with a sling load are determined while the vehicle is hovering in a turbulent cross wind. Results are presented which show the significance of the dynamic coupling between the vehicle and payload in their response to wind disturbances and control inputs. Typical characteristics of a closed-loop control system and its ability to limit the excursions of the vehicle and payload during loading or unloading are also examined.//* Nomenclature = system dynamics matrices = system control matrix = feedback gain matrix -feedback gain proportional to vehicle velocity = feedback gain proportional to vehicle displacement = feedback gain proportional to payload velocity = feedback gain proportional to payload displacement = acceleration due to gravity, ft/s 2 = sling load aerodynamic drag constant = scale of turbulence, ft = length of the payload suspension cable, ft = mass of the vehicle, slug = mass of the payload, slug = static lift, Ib = disturbance matrix = control variable = mean wind velocity, ft/s = total velocity of the sling load, ft/s = lateral velocity of the vehicle along its y body axis, ft/s = turbulence velocity, ft/s = lateral velocity of the payload relative to the vehicle along the y body axis of the vehicle, ft/s = gross weight of the vehicle, Ib = gross weight of the sling load, Ib = state vector = derivative of the state vector with respect to time = lateral control force derivative, Ib/rad = vehicle lateral aerodynamic force derivative with respect to its lateral velocity, Ib/ft/s = vehicle lateral aerodynamic force derivative with respect to its lateral acceleration, slug = lateral displacement of the vehicle along its y body axis, ft = lateral displacement of the payload relative to the vehicle along the y body axis of the vehicle, ft = lateral displacement of the payload relative to the ground, ft = prefix used for small perturbation = damping ratio =root mean square value of fluctuating wind velocity in the y direction of vehicle body axes, ft/s = power spectrum of wind turbulence, ft 3 /s 2 = circular frequency, rad/s = natural frequency, rad/s = spatial frequency (= a;/ V), rad/ft

OBJECTIVETo assess the respective value of Traditional clinical rotation and High Fidelity Simulation (HFS) on the acquisition of clinical reasoning (CR) skills in Medical Students. METHODSA randomized controlled trial was conducted. Forty medical students were exposed to a full day of HFS, either during their Paediatric Term (PT) (Experimental group = PT+, HFS+) or, after completion of their PT (Control group = PT+, HFS-). CR skills were assessed by a Script Concordance Test (SCT) prior to group allocation and at the completion of PT. RESULTS39 out of 40 students completed both SCT. Scores before (mean/SD 57.4/6.7) and after (mean/SD 61.1/7.0) the PT were significantly improved (mean increase [95% confidence interval (CI)]: 3.6 [2.0-5.2]; p<0.0001; n=39). There was no added improvement from involvement in a full day of HFS in SCT scores between the experimental and the control groups (mean increase [95% CI]: 3.2 [0.5-5.9], n=18 versus 4.0 [1.9-6.1], n=21, respectively; p=0.61).

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