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Teaching psychotherapy by use of brief typescripts.

A typescript of a 10-minute segment of a taped therapeutic interview, coded by using a modification of the Gottshalk scales, quite clearly demonstrates the patient's current focal conflict. Recognition of the current focal conflict is thus taught, and this is used as an organizing principle in supervision of psychotherapy.

Conflict, Psychological↗

Prerecorded telemedicine.

In prerecorded telemedicine (also known as asynchronous or store-and-forward), the person sending the information and the person receiving it do not need to do so simultaneously; thus, viewing the information can be done at some later time. Prerecorded telemedicine is therefore not appropriate for emergency consultations. In prerecorded telemedicine systems, the following steps can be distinguished: (1) the acquisition of diagnostic information at the remote site; (2) its storage, which can be at either site, or at both; (3) its delivery to the expert site through an appropriate connection; and (4) its display at the expert site. The types of information transferred include audio, data and text, still images and moving images (i.e. video). An increasingly common way of doing prerecorded telemedicine is by email sent via the Internet. Although there are some problems associated with the Internet, its wide availability and low cost have encouraged its use. Examples where email has been used successfully include teleradiology, telecardiology, teledermatology and telepathology. In some situations prerecorded telemedicine is the only way to provide remote medical services, or the most cost-effective method. Clearly, there are also situations when prerecorded telemedicine is not an appropriate way to deliver health services, for example whenever the sender of the information is not qualified to sample the information acquired or the specialist receiving the information must manipulate it, during acquisition, in some way.

Copying Processes↗

Text slides.

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Audiovisual Aids↗

Short communication: A method for verified access when using soft copy display.

Soft copy display is a rapidly developing area. To date, most soft copy systems can be classed by their application, e.g. review or reporting. With technology convergence this distinction is becoming less defined by the hardware and more defined by the software functionality. Although it is accepted that routine quality assurance should be conducted on soft copy monitors, this would be logistically difficult to achieve if any monitor within a hospital could be used for image review or reporting. This work proposes a simple psychophysical check to ensure optimal display performance before viewing software can be run. This is in the form of a challenge/response code constructed from letters just above the threshold of detection. This verified login would act as a portal to launching the image viewing software. The developed system was tested on three different types of monitor and five observers. Results indicate that the verified login was able to control access for displays below the optimal settings but was not as sensitive for adjustments above the optimum. However it is believed this is still of value as the lower presentation will compress the display gamma curve and reduce detail contrast. It also provides a minimum level of audit and quality control that might otherwise be missing.

Computer Communication Networks↗

An overview of radiographic film holders.

OBJECTIVES: To provide an overview of radiographic film holders, from their inception in the early 1900s to present day. METHODS: A Medline literature search was conducted for dental studies that used keywords that pertain to radiographic film holders. Hand searches of the bibliographies were also conducted. Sixty articles (dating from 1896 to 1998) that describe new or improved film holders are reviewed here. RESULTS: From the earliest days of dental radiography, dentists attempted to standardize radiographic images and techniques. The focus of researchers in the 1950s to the 1970s was to develop a film holder that would hold the film and allow easy and predictable alignment of the X-ray tube. As research projects became more dependent on dental radiographic measurements, the focus shifted to producing reproducible radiographic images, from which highly repeatable measurements could be made. CONCLUSION: Existing devices have strengths and weaknesses. Readily available devices are adequate for routine clinical use; however, user-friendly and patient-friendly film-holding devices that result in highly reliable and accurate measurements have yet to be introduced.

Copying Processes↗

Assessing the accuracy of caries diagnosis via radiograph. Film versus print.

BACKGROUND: The authors conducted this study to determine if proximal caries diagnoses made using bitewing radiographic images printed on photographic paper were comparable with diagnoses made using traditional radiographic film images. METHODS: The authors digitized 15 posterior bitewing radiographs that contained 74 carious and 127 sound unrestored proximal surfaces and printed them on photographic paper. Fourteen dentists evaluated the radiographs and two printed image formats (4 x 3 centimeters and 8 x 6 cm) for evidence of caries. The diagnostic accuracy and interobserver agreement for caries diagnoses obtained in the two printed image formats were compared with those for radiographic film images. RESULTS: Overall, the diagnostic accuracy of printed images did not differ significantly from radiographic film images for dentinal caries. However, for caries limited to the enamel surface, a decrease in sensitivity was noted in six of the 14 observers for the smaller print images, while no significant differences in the diagnoses of enamel caries were observed among any of the observers in the enlarged print format. CONCLUSION: This study provides evidence that printed images can be used to diagnose dental caries reliably. CLINICAL IMPLICATIONS: The results of this study indicate that the diagnostic information obtained by viewing printed images is equivalent to that obtained by viewing standard radiographs. Size of the printed image also may be important in caries diagnosis and care must be taken to print bitewing radiographic images at a size that optimizes interpretation. Other factors that must be considered are the type of printer, printer resolution, paper quality and type of ink used. With careful consideration of printing parameters, clinicians can be assured of diagnostic quality in printed images.

Copying Processes↗