Biomedical subjects

Parvati Dev

Publications and source records attributed to Parvati Dev.

At least 19 recordsLinked to original sources

PubMed2006

Canadian multidisciplinary core curriculum for musculoskeletal health.

OBJECTIVE: To determine the level of agreement among the Bone and Joint Decade Undergraduate Curriculum Group (BJDUCG) core curriculum recommendations for musculoskeletal (MSK) conditions targeted for undergraduate medical education and what the physicians and surgeons of Canada thought to be important at the postgraduate level of education. METHODS: An 80-item questionnaire was developed. A cross-sectional survey of educators representing 77 Canadian accredited academic programs representing 6 disciplines in medicine that manage patients with MSK conditions was completed. Histograms, Kruskal-Wallis, and principal component analyses were computed. RESULTS: In total, 164/175 (94%) respondents participated in the study. All 80 curriculum items received a mean score of at least 3.0/4.0. Sixty-four out of 80 items were ranked to be at least 3.5/4.0, and 35 items were ranked to be at least 3.8/4.0, suggesting that these items may be core content for all disciplines. CONCLUSION: The World Health Organization declared the years 2000 to 2010 as The Bone and Joint Decade. The main goal is to improve the quality of life for people with MSK disorders worldwide. One aim of the BJD is to increase education of healthcare providers at all levels. The BJDUCG established a set of core curriculum recommendations for MSK conditions. Our study gives reliable statistical evidence of agreement among what the BJDUCG recommended for an MSK core curriculum for medical schools and what the physicians and surgeons of Canada thought to be important for residency education in several disciplines.

Adult↗

PubMed2006

Using ontologies linked with geometric models to reason about penetrating injuries.

OBJECTIVE: Medical assessment of penetrating injuries is a difficult and knowledge-intensive task, and rapid determination of the extent of internal injuries is vital for triage and for determining the appropriate treatment. Physical examination and computed tomographic (CT) imaging data must be combined with detailed anatomic, physiologic, and biomechanical knowledge to assess the injured subject. We are developing a methodology to automate reasoning about penetrating injuries using canonical knowledge combined with specific subject image data. METHODS AND MATERIAL: In our approach, we build a three-dimensional geometric model of a subject from segmented images. We link regions in this model to entities in two knowledge sources: (1) a comprehensive ontology of anatomy containing organ identities, adjacencies, and other information useful for anatomic reasoning and (2) an ontology of regional perfusion containing formal definitions of arterial anatomy and corresponding regions of perfusion. We created computer reasoning services ("problem solvers") that use the ontologies to evaluate the geometric model of the subject and deduce the consequences of penetrating injuries. RESULTS: We developed and tested our methods using data from the Visible Human. Our problem solvers can determine the organs that are injured given particular trajectories of projectiles, whether vital structures--such as a coronary artery--are injured, and they can predict the propagation of injury ensuing after vital structures are injured. CONCLUSION: We have demonstrated the capability of using ontologies with medical images to support computer reasoning about injury based on those images. Our methodology demonstrates an approach to creating intelligent computer applications that reason with image data, and it may have value in helping practitioners in the assessment of penetrating injury.

Diagnosis, Computer-Assisted↗

PubMed2006

Collaborative learning using Internet2 and remote collections of stereo dissection images.

We have investigated collaborative learning of anatomy over Internet2, using an application called remote stereo viewer (RSV). This application offers a unique method of teaching anatomy, using high-resolution stereoscopic images, in a client-server architecture. Rotated sequences of stereo image pairs were produced by volumetric rendering of the Visible female and by dissecting and photographing a cadaveric hand. A client-server application (RSV) was created to provide access to these image sets, using a highly interactive interface. The RSV system was used to provide a "virtual anatomy" session for students in the Stanford Medical School Gross Anatomy course. The RSV application allows both independent and collaborative modes of viewing. The most appealing aspects of the RSV application were the capacity for stereoscopic viewing and the potential to access the content remotely within a flexible temporal framework. The RSV technology, used over Internet2, thus serves as an effective complement to traditional methods of teaching gross anatomy.

Anatomy↗

PubMed2006

Project hydra--a new paradigm of internet-based surgical simulation.

Computer-based surgical simulation systems have produced tremendous benefits and demonstrated validity as a better method for many areas of surgical skills acquisition. However, despite these benefits, broad proliferation of these systems has continued to be elusive. While in large part this lag in adoption of this technology is due to social factors (organizational momentum, curriculum integration difficulties, etc), the cost of computer-based simulation systems has certainly remained a major deterrent toward broad deployment. Instead, what if it were possible to eliminate the cost of the large computer completely from the system, yet provide a much more extensive and detailed simulation than currently available? Finally, what if a simulation with even greater detail over a wider anatomical area were possible?This is the genesis of Project Hydra- a shared simulation supercomputer were made available for free and all that is required to access it is a low-end Internet-connected computer and, optionally, interaction/haptics devices as needed for the particular task. This would enable supercomputer-class simulation at every desktop with much greater fidelity than any user could individually afford and provide an online community for simulation research and application. Further, Internet-based simulation provides for many other benefits as well. By the user merely plugging optional, additional hardware into their existing, low-end PC and using the Internet as a means of simulation dissemination, distribution, and delivery means that the user can have immediate access to simulation updates/upgrades and download/access new content (didactic curriculum and cases). Further, this ease of access and use could lead to accelerated adoption and use of simulation within the medical curriculum and this access is provided anywhere in the world 24 x 7. In addition, once connected, a server-based simulation system would be a natural point for performing easy, automated clinical studies of surgical performance and skills.

Computer Simulation↗

PubMed2005

Application of an algorithm-driven protocol to simultaneously provide universal and targeted prevention programs.

OBJECTIVE: Our objective was to develop a model to simultaneously prevent eating disorders and weight gain among female high school students. METHOD: Of 188 female 10th graders enrolled in health classes, 174 elected to participate in the current study. They were assessed on-line and decided to participate in one of four interventions appropriate to their risk. RESULTS: The algorithm identified 111 no-risk (NR), 36 eating disorder risk (EDR), 16 overweight risk (OR), and 5 both risks. Fifty-six percent of the EDR and 50% of the OR groups elected to receive the recommended targeted curricula. Significant improvements in weight and shape concerns were observed in all groups. DISCUSSION: An Internet-delivered program can be used to assess risk and provide simultaneous universal and targeted interventions in classroom settings.

Adolescent↗

PubMed2005

Comparison of training on two laparoscopic simulators and assessment of skills transfer to surgical performance.

BACKGROUND: Several studies have investigated the transfer of surgical trainees' skills acquired on surgical simulators to the operating room setting. The purpose of this study was to compare the effectiveness of two laparoscopic surgery simulators by assessing the transfer of skills learned on simulators to closely matched surgical tasks in the animal laboratory. STUDY DESIGN: In this post-test-only Control group study design, 46 surgically naive medical student volunteers were randomly assigned to one of three groups: Tower Trainer group (n = 16), LapSim group (n = 17), and Control group (n = 13). Outcomes measures included both time and accuracy scores on three laparoscopic tasks (Task 1: Grasp and Place; Task 2: Run the Bowel; Task 3: Clip and Cut) performed on live anesthetized pigs, and a global rating of overall performance as judged by four experienced surgeons. RESULTS: The Tower Trainer group performed significantly better than the Control group on 1 of 7 outcomes measures-Task 3: Time (p < 0.032), although the LapSim group performed significantly better than the Control group on 2 of 7 measures-Task 3: Time (p < 0.008) and Global score (p < 0.005). In comparing the two simulators, the LapSim group performed significantly better than the Tower Trainer group on 3 of 7 outcomes measures-Task 2: Time (p < 0.032), Task 2: Accuracy (p < 0.030) and Global score (p < 0.005), although the Tower Trainer group did not perform significantly better than the LapSim group on any measure. CONCLUSIONS: This study demonstrated that naive subjects trained on a virtual-reality part-task trainer performed better on live surgical tasks in a porcine model as compared with those trained with a traditional box trainer. These findings could aid in selection of appropriate training methodologies.

Adult↗

PubMed2005

The visible human and digital anatomy learning initiative.

A collaborative initiative is starting within the Internet2 Health Science community to explore the development of a framework for providing access to digital anatomical teaching resources over Internet2. This is a cross-cutting initiative with broad applicability and will require the involvement of a diverse collection of communities. It will seize an opportunity created by a convergence of needs and technical capabilities to identify the technologies and standards needed to support a sophisticated collection of tools for teaching anatomy.

Anatomy↗

PubMed2005

Using an ontology of human anatomy to inform reasoning with geometric models.

The Virtual Soldier project is a large effort on the part of the U.S. Defense Advanced Research Projects agency to explore using both general anatomical knowledge and specific computed tomographic (CT) images of individual soldiers to aid the rapid diagnosis and treatment of penetrating injuries. Our goal is to develop intelligent computer applications that use this knowledge to reason about the anatomic structures that are directly injured and to predict propagation of injuries secondary to primary organ damage. To accomplish this, we needed to develop an architecture to combine geometric data with anatomic knowledge and reasoning services that use this information to predict the consequences of injuries.

Computer Simulation↗

PubMed2005

Building an internationalized content delivery architecture: lessons learned.

Increasingly, small development teams are building internationalized architectures for delivering large amounts of content. The AIM e-Learning project is one such example: in 2 years, 4 people built a system which currently delivers the print equivalent of 1500 pages of text, in 4 languages, to users in over 140 countries world wide. Here we discuss the lessons we have learned through development, including issues surrounding staffing, process, technologies and next steps.

Education, Distance↗

PubMed2005

A framework for evaluating new learning technologies in medicine.

The SUMMIT Evaluation Framework provides a comprehensive model to guide researchers, developers and curriculum decision-makers in conducting the most relevant type of evaluation for a range of learning technologies. In this poster we present the framework and give examples of how we have used it to guide our evaluation efforts.

Curriculum↗

PubMed2004

Audience response made easy: using personal digital assistants as a classroom polling tool.

Both teachers and students benefit from an interactive classroom. The teacher receives valuable input about effectiveness, student interest, and comprehension, whereas student participation, active learning, and enjoyment of the class are enhanced. Cost and deployment have limited the use of existing audience response systems, allowing anonymous linking of teachers and students in the classroom. These limitations can be circumvented, however, by use of personal digital assistants (PDAs), which are cheaper and widely used by students. In this study, the authors equipped a summer histology class of 12 students with PDAs and wireless Bluetooth cards to allow access to a central server. Teachers displayed questions in multiple-choice format as a Web page on the server and students responded with their PDAs, a process referred to as polling. Responses were immediately compiled, analyzed, and displayed. End-of-class survey results indicated that students were enthusiastic about the polling tool. The surveys also provided technical feedback that will be valuable in streamlining future trials.

California↗

PubMed2004

Combining universal and targeted prevention for school-based eating disorder programs.

OBJECTIVE: This study examined a step toward providing a universal prevention program to all students while targeting those at risk. METHOD: Seventy-eight 10th-grade female students were provided an on-line eating disorder prevention program and randomized to participate in (1) a higher risk and higher motivated group, (2) a lower risk or lower motivated group, or (3) a combined group. RESULTS: The students in the first group made significantly fewer negative and more positive comments in the on-line group discussion than the higher risk and higher motivated participants in the combined group. However, there were no differences among groups on outcome measures. DISCUSSION: The results suggest that, because it is relatively easy to provide interventions with separate groups, it seems appropriate to do so, if for no other reason than to minimize the few very negative comments that were posted by students that might have created an adverse environment for the higher risk-participants that the intervention specifically targets.

Adolescent↗

PubMed2004

LUCY: a 3-D pelvic model for surgical simulation.

Development of 3-D models of human anatomy for use in virtual reality simulators is anticipated to enhance surgical training. These models may be a valuable resource for gaining mastery of minimal-access procedures. The pelvis portion (hip to upper-thigh) of a 32-year-old female cadaver was frozen and sectioned axially in approximately 2-mm increments as the first step in producing an accurately representative 3-D model of the human female pelvis. Photographic exposures of the entire series of 95 sections were then converted to digital format. Adobe PhotoShop masks for each structure were created and converted into wire-frame and surface-textured models; this aggregate model set was named "LUCY." To date, 3-D representations of 40 pelvic structures (over 2200 individual masks) have been modeled In conjunction with haptic technology, these virtual anatomic models will enable users to practice fundamental surgical manipulations and procedures such as tubal ligation and ovariectomy. The deployment of surgical-simulation models such as LUCY may facilitate technical-performance aspects of surgical training, particularly those associated with minimal-access procedures. Manipulations and procedures can be practiced over the Internet, providing a host of flexible options to enhance the surgical curricula.

Adult↗

PubMed2004

The fundamental manipulations of surgery: a structured vocabulary for designing surgical curricula and simulators.

A structured vocabulary is proposed for supporting the design and development of advanced surgical simulators. Nine fundamental surgical instrument-tissue actions or manipulations are defined and common synonyms provided. The vocabulary focuses on "target skills" that are familiar to surgeons, in comparison with "enabling skills" from the lexicon of instructional designers and psychometricians. The adoption of this vocabulary can facilitate communication among surgeons and bioengineers developing "high-fidelity" surgical simulators.

Computer Simulation↗

PubMed2003

Evaluation of an internet support group for women with primary breast cancer.

BACKGROUND: Women with breast carcinoma commonly experience psychologic distress following their diagnosis. Women who participate in breast cancer support groups have reported significant reduction in their psychologic distress and pain and improvement in the quality of their lives. Web-based breast cancer social support groups are widely used, but little is known of their effectiveness. Preliminary evidence suggests that women benefit from their participation in web-based support groups. METHODS: Seventy-two women with primary breast carcinoma were assigned randomly to a 12-week, web-based, social support group (Bosom Buddies). The group was semistructured, moderated by a health care professional, and delivered in an asynchronous newsgroup format. RESULTS: The results indicate that a web-based support group can be useful in reducing depression and cancer-related trauma, as well as perceived stress, among women with primary breast carcinoma. The effect sizes ranged from 0.38 to 0.54. Participants perceived a variety of benefits and high satisfaction from their participation in the intervention CONCLUSIONS: This study demonstrated that the web-based program, Bosom Buddies, was effective in reducing participants' scores on depression, perceived stress, and cancer-related trauma measures. The effect size of the intervention was in the moderate range. Although web-based social support groups offer many advantages, this delivery mechanism presents a number of ethical issues that need to be addressed.

Adult↗

PubMed2003

The Advanced Immunization Management (AIM) e-Learning Project.

New tools to educate immunization managers in developing countries are needed to keep these health policy makers current on the latest vaccines and procedures, and to provide support in decision making. The goal of the AIM e-Learning Project is to deliver up-to-date and engaging web-delivered media, with solid instructional design, to an audience relatively new to web-based learning. Accuracy of information and accessibility drive our design. Our ultimate objective is to aid immunization managers in developing timely, effective and sustainable policy.

Education, Distance↗

PubMed2002

Improving compliance in on-line, structured self-help programs: evaluation of an eating disorder prevention program.

Compliance rates from four iterations of Student Bodies, an 8-10 week computer assisted health education (CAHE) program for the prevention of eating disorders in college-aged women, were measured. Each iteration was modified with the hope of increasing participant compliance. Participants were 116 undergraduate women from two large West Coast universities who were randomly assigned to either the CAHE program or a wait-list group. Model 1 was delivered via CD-ROM, was anonymous, used an unstructured "grazing" approach, and participants received 10 dollars. Model 2 was web-based, had recommended assignments with telephone reminders, and participants received 25 dollars. Model 3 used a more structured approach to assignments. Model 4 eliminated anonymity, added an academic component, used email reminders, and offered course units as an incentive. Compliance was defined as percentage of screens read per number of screens assigned (n = 27-33). In Model 1, compliance was self-reported at 53%. In Models 2, 3, and 4, compliance, measured directly via computer logs, was 66%, 85%, and 84%, respectively. A Mann-Whitney test showed that the increase in compliance between Models 2 and 3 and Models 2 and 4 was statistically significant (p < 0.01). Compliance was significantly correlated with improvement on outcome. Suggestions for increasing compliance in other CAHE programs are offered.

Journal Article↗

PubMed2002

The Stanford MediaServer Project: strategies for building a flexible digital media platform to support biomedical education and research.

Medical media collections are growing at a pace that exceeds the value they currently provide as research and educational resources. To address this issue, the Stanford MediaServer was designed to promote innovative multimedia-based application development. The nucleus of the MediaServer platform is a digital media database strategically designed to meet the information needs of many biomedical disciplines. Key features include an intuitive web-based interface for collaboratively populating the media database, flexible creation of media collections for diverse and specialized purposes, and the ability to construct a variety of end-user applications from the same database to support biomedical education and research.

Abstracting and Indexing↗