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Background: Virtual-reality (VR) based simulation techniques offer an efficient and low cost alternative to conventional surgery training. This article describes a VR training and assessment system in laparoscopic rectum surgery., Methods: To give a realistic visual performance of interaction between membrane tissue and surgery tools, a generalized cylinder based collision detection and a multi-layer mass-spring model are presented. A dynamic assessment model is also designed for hierarchy training evaluation., Results: With this simulator, trainees can operate on the virtual rectum with both visual and haptic sensation feedback simultaneously. The system also offers surgeons instructions in real time when improper manipulation happens. The simulator has been tested and evaluated by ten subjects., Conclusions: This prototype system has been verified by colorectal surgeons through a pilot study. They believe the visual performance and the tactile feedback are realistic. It exhibits the potential to effectively improve the surgical skills of trainee surgeons and significantly shorten their learning curve., (Copyright © 2014 John Wiley & Sons, Ltd.)

Background: Medical simulators with vision and haptic feedback techniques offer a cost-effective and efficient alternative to the traditional medical trainings. They have been used to train doctors in many specialties of medicine, allowing tasks to be practised in a safe and repetitive manner. This paper describes a virtual-reality (VR) system which will help to influence surgeons' learning curves in the technically challenging field of laparoscopic surgery of the rectum., Methods: Data from MRI of the rectum and real operation videos are used to construct the virtual models. A haptic force filter based on radial basis functions is designed to offer realistic and smooth force feedback. To handle collision detection efficiently, a hybrid model is presented to compute the deformation of intestines. Finally, a real-time cutting technique based on mesh is employed to represent the incision operation., Results: Despite numerous research efforts, fast and realistic solutions of soft tissues with large deformation, such as intestines, prove extremely challenging. This paper introduces our latest contribution to this endeavour. With this system, the user can haptically operate with the virtual rectum and simultaneously watch the soft tissue deformation., Conclusions: Our system has been tested by colorectal surgeons who believe that the simulated tactile and visual feedbacks are realistic. It could replace the traditional training process and effectively transfer surgical skills to novices., (Copyright © 2011 John Wiley & Sons, Ltd.)

Objective: To assess the performance of the colposcopy service of the teaching hospitals of Cardiff and Vale Trust, University of Wales, Cardiff, South Wales, UK by determining if patients attending colposcopy clinic had been managed in accordance with the local departmental, regional and national (National Health Service Cervical Screening Programme) guidelines with the ultimate purpose of identifying areas for improvement in patients' care., Methods: We retrospectively analysed the case notes of 426 women who attended the colposcopy clinic over a three-month period in 2005., Results: This study has shown that five of the national standards have been achieved. These relate to availability of cytology report at the time of colposcopic assessment, recording of colposcopist's impression as to the nature of the cervical lesion, suitability of biopsy samples for histological analysis, primary haemorrhage as a complication of large loop excision of transformation zone treatment and inpatient admission following this treatment. However, other five unmet standards relate to recording of visibility of squamocolumnar junction, predictability of high-grade lesion, taking a biopsy from a high-grade lesion as suggested by smear, recording consent of treatment, and number of treatments performed as an outpatient., Conclusion: Our findings should lead to changes in the structure and functioning of the colposcopy clinic that would improve the detection of significant disease and the timeliness of diagnosis and the speed with which results are communicated.

Although the value of human capital is not captured on company balance sheets, it may account for about half of the gap between a company's market value and book value. Yet, many companies do not focus comparable scrutiny on human capital management as compared with other large assets, nor do they systematically measure its output (ie, productivity). Methods are emerging to enable employers to assess productivity losses, including absenteeism and presenteeism, and to understand the associated costs (ie, direct medical costs, total productivity loss). This will permit employers to assess the value of programs to enhance health and productivity. We contend that the effective workforce is probably decreased by 5% to 10% because of health problems. We believe that employers who increase their investments in healthy human capital now will emerge tomorrow as the companies leading the gains in US productivity.