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At least 289 records · Page 16Linked to original sources
PubMed2006

Randomized clinical trial of telepsychiatry through videoconference versus face-to-face conventional psychiatric treatment.

Although telepsychiatry in the form of videoconferencing has been well received in terms of increasing access to care and user satisfaction, few data on treatment outcomes and efficacy from telepsychiatry applications are available at the present time. This paper evaluates the efficacy of telepsychiatry through videoconference in the treatment of mental disorders by comparing to face-to-face conventional (F2FC) treatment. We carried out a randomized clinical trial where 140 psychiatric outpatients were randomized to either F2FC treatment or videoconference telepsychiatry (VCTP) treatment. Patients were diagnosed according to International Classification of Diseases, 10th edition (ICD-10) criteria using the Composite International Diagnostic Interview. Treatment involves eight consultations lasting 30 minutes over the 24-week study period. Patients received pertinent psychotropic medication plus cognitive- behavioral therapy during sessions. The same psychiatrist diagnosed and treated all the patients that were recruited from the Community Mental Health Centre of San Sebastian de la Gomera, in the Canary Islands. Change in psychiatric test scores served as the primary efficacy criterion. Efficacy was determined by comparing baseline (visit 1) Clinical Global Impressions-Severity of Illness (CGI-S) and -Improvement (CGI-I) scales as well as Global Indexes (GSI, PSDI, and PST) from SCL-90R with scores obtained at the end of the study period (week 24). Response was defined as a CGI-I score of 1 or 2. Reliable Change Indexes were computed in SCL-90R Global Indexes scores. Of 140 patients randomized, 130 completed 24 weeks of treatment. Only 4 patients dropped out prematurely from the study in VCTP and 6 in F2FC. The study involves 534 teleconsultations, 522 F2FC consultations, and more than 500 hours of clinical practice. Significant improvements were found on the CGI and SCL-90- R Global Indexes scores of both treatment groups, showing clear clinical state improvement. No statistically significant differences were observed when the efficacy of VCTP treatment was compared to F2FC psychiatric treatment efficacy. This study demonstrated that telepsychiatry treatment through videoconference has equivalent efficacy to F2FC psychiatric treatment. Telepsychiatry showed to be an effective mean of delivering mental health services to psychiatric outpatients living in remote areas with limited resources.

Adult↗
PubMed2000

Tactile Contact by Deaf and Hearing Mothers During Face-to-Face Interactions With Their Infants.

Tactile contact with an infant plays an important role (though one largely overlooked by researchers until recently) in the development of synchronous interactive dialogues between caregiver and child. Dyads in which one or both partners are deaf present a unique opportunity to examine the use of touch as a means of optimizing or enhancing communication when the number of available sensory channels is restricted. Touch in these dyads may play an important role in eliciting visual attention, in alerting the infant that signed communication is forthcoming, in assisting the infant to achieve emotional regulation, or in simply maintaining contact even when the deaf child has looked away from the partner. The data presented here represent one attempt to investigate the role of touch in relation to deaf infants and deaf parents, for whom it may play a particularly salient role. Both deaf and hearing mothers were observed in videotaped face-to-face interactions with their infants (also either deaf or hearing); maternal behavior was coded for each event during which mothers initiated tactile contact with the infant and was classified according to intensity, location on the infant's body, and type of touch (e.g., active vs. passive). Results of this study indicate that deaf mothers may be especially responsive to the tactile needs of their deaf infants, as shown by qualitative differences in their behavioral interactions with 6- and 9-month-olds. However, hearing mothers with deaf infants also appear to be incorporating more active forms of touch in their interactions, although they tend to rely on longer durations of tactile contact than do the deaf mothers.

Journal Article↗
PubMed1998

A comparison of the vocal patterns of deaf and hearing mother-infant dyads during face-to-face interactions.

This study was part of a longitudinal investigation of the impact of deafness on the cognitive, social, and communicative development of infants. The current study reports analyses of the vocalizations of deaf and hearing infants and their Deaf or hearing mothers during normal face-to-face interactions when the infants were 9 months old. Results indicate essentially no differences in the amount of positive or negative vocalizations emitted by infants in any of the four groups observed. However, there is a heightened use of vocal games by hearing mothers interacting with deaf infants, indicating that these mothers are incorporating several additional sensory modalities into their vocal expressions. This is interpreted as one way in which parents make their vocal communication more salient and accessible to an infant with a hearing loss. Deaf mothers are also highly active and engaged with their infants, but have been found to rely more extensively on vigorous tactile contact rather than auditory input during these same interactions.

Journal Article↗
PubMedDate not supplied

The use of non face-to-face communication to enhance preventive strategies.

Multiple studies have demonstrated disappointingly low rates of persistence with therapies recommended to reduce cardiovascular risk. Non face-to-face communication has been employed as a strategy to increase the rate of adherence with both pharmacologic and lifestyle modification risk-reduction measures. In addition to the impact on adherence, these interventions have the potential to affect intermediate measures, such as increased access to care, increased patient satisfaction, and decreased resource utilization. Improvement in clinical outcomes is the ultimate measure of success of this intervention.

Cardiovascular Diseases↗
PubMed2002

Cross-face nerve graft with free-muscle transfer for reanimation of the paralyzed face: a comparative study of the single-stage and two-stage procedures.

The most accepted method for reanimation of the paralyzed face is the two-stage method that combines cross-face nerve graft with free-muscle transfer. Although the results of reconstruction with this method are satisfactory, there is an excessive delay between stages, which prolongs the period of rehabilitation. In 1995, Kumar overcame this and presented his preliminary results from a single-stage transfer of the gracilis. We compared the long-term results of the single-stage with the two-stage method of reconstruction. Patients selected the method of reconstruction on the basis of the information, photographs of scars, and video recording of results given to them at a special facial palsy clinic. Ten patients selected the single-stage reconstruction and 15 selected the two-stage reconstruction. The mean follow-up period was 3 years. The results of the two methods are comparable, with 90 percent of the patients who underwent the single-stage and 93 percent of those who underwent the two-stage procedures having good and fair results. However, the two-stage method scored good symmetry at rest in 67 percent, compared with 20 percent for the single-stage method. There were fewer complications with the single-stage method, and none of the patients had any problems relating to the donor site. The period of rehabilitation was reduced by 10 months with the single-stage method.

Adolescent↗
PubMed2003

Dynamical properties of lasers coupled face to face.

We derive a reduced model to describe two identical lasers coupled face to face. Two limits are introduced in the Maxwell-Bloch equations: adiabatic elimination of the material polarization and large distance between the two lasers. The resulting model describes coupled homogeneously broadened lasers, including semiconductor lasers. It consists of two coupled delay differential equations with delayed linear cross-coupling and an instantaneous self-coupling nonlinearity. The study is analytical and numerical. We focus on the properties of steady and periodic amplitudes of the electric fields. In steady state, there are symmetric, antisymmetric, and asymmetric solutions with respect to a permutation of the two fields. A similar classification holds for the periodic states. The stability of these solutions is determined partly analytically and partly numerically. A homoclinic point is associated with the asymmetric periodic solutions.

Journal Article↗
PubMed1985

Manual actions of nine- to fifteen-week-old human infants during face-to-face interaction with their mothers.

This paper presents evidence that the manual actions of infants as young as 9 weeks of age may occur in relation to their facial expression, gaze direction, and vocalization. 28 full-term, healthy infants were observed during a 2-min spontaneous face-to-face interaction with their mothers. Videotapes were coded in real time using the following categories of manual action: POINT, SPREAD, CURL, and GRASP. Facial expressions, gaze direction, and vocalizations also were coded for each infant. All of the infants displayed CURL, 20 infants displayed SPREAD, 18 POINTED, and 11 showed GRASP. Right/left differences appeared for the categories CURL, SPREAD, and GRASP, but not for POINT. Hand action was systematically organized into sequences with other infant action. POINT occurred before or after mouthing and vocalization, CURL during vocalization, and SPREAD when the baby was looking away from the mother. The results are discussed in relation to their implications for the ontogeny of nonverbal communicative gestures.

Child Language↗
PubMedDate not supplied

Cost-effectiveness of face-to-face smoking cessation interventions: a dynamic modeling study.

OBJECTIVES: To estimate the cost-effectiveness of five face-to-face smoking cessation interventions (i.e., minimal counseling by a general practitioner (GP) with, or without nicotine replacement therapy (NRT), intensive counseling with NRT, or bupropion, and telephone counseling) in terms of costs per quitter, costs per life-year gained, and costs per quality-adjusted life-year (QALY) gained. METHODS: Scenarios on increased implementation of smoking cessation interventions were compared with current practice in The Netherlands. One of the five interventions was implemented for a period of 1, 10, or 75 years reaching 25% of the smokers each year. A dynamic population model, the RIVM chronic disease model, was used to project future gains in life-years and QALYs, and savings of health-care costs from a decrease in the incidence of 11 smoking-related diseases over a time horizon of 75 years. This model allows the repetitive application of increased cessation rates to a population with a changing demographic and risk factor mix. Sensitivity analyses were performed for variations in costs, effects, time horizon, program size, and discount rates. RESULTS: Compared with current practice, minimal GP counseling was a dominant intervention, generating both gains in life-years and QALYs and savings that were higher than intervention costs. For the other interventions, incremental costs per QALY gained ranged from about 1100 per thousand for telephone counseling to 4900 per thousand for intensive counseling with nicotine patches or gum for implementation periods of 75 years. CONCLUSIONS: All five smoking cessation interventions were cost-effective compared with current practice, and minimal GP counseling was even cost-saving.

Adolescent↗
PubMed2005

Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients.

BACKGROUND: Audio computer assisted self interview (ACASI) may minimise social desirability bias in the ascertainment of sensitive behaviours. The aim of this study was to describe the difference in reporting risk behaviour in ACASI compared to a face to face interview (FFI) among public sexually transmitted diseases (STD) clinic attendees. STUDY DESIGN: Randomly selected patients attending a public STD clinic in Baltimore, Maryland, sequentially took an ACASI formatted risk behaviour assessment followed by an FFI conducted by a single clinician, with both interview modalities surveying sexual and drug use behaviours. Binary responses were compared using the sign test, and categorical responses were compared using the Wilcoxon signed rank test to account for repeated measures. RESULTS: 671 (52% men, mean age 30 years, 95% African American) of 795 clinic attendees screened consented to participate. Subjects affirmed sensitive sexual behaviours such as same sex contact (p = 0.012), receptive rectal sexual exposure (p < 0.001), orogenital contact (p < 0.001), and a greater number of sex partners in the past month (p < 0.001) more frequently with ACASI than with an FFI. However, there were no differences in participant responses to questions on use of illicit drugs or needle sharing. CONCLUSIONS: Among STD clinic patients, reporting of sensitive sexual risk behaviours to clinicians was much more susceptible to social desirability bias than was reporting of illegal drug use behaviours. In STD clinics where screening of sexual risk is an essential component of STD prevention, the use of ACASI may be a more reliable assessment method than traditional FFI.

Adult↗
PubMed2006

A randomised controlled trial comparing computer-assisted with face-to-face sexual history taking in a clinical setting.

AIM: To compare computer-assisted self-interview (CASI) with routine face-to-face interview (FTFI) for sexual history taking from patients in a clinical setting. METHODS: A randomised controlled trial was undertaken at the Melbourne Sexual Health Centre, Melbourne, Victoria, Australia, in 2005. New, walk-in patients triaged into the centre were eligible for the study. Those who consented to the study were randomly allocated (initially at a ratio of 2:1, then 1:1) to either CASI or FTFI. Those randomised to CASI also subsequently undertook FTFI. RESULTS: During the study period, of 713 patients approached, 611 agreed to participate in the study; 356 were randomised to FTFI and 255 to CASI. Overall, the responses to questioning using CASI and FTFI were similar except that women undertaking the CASI reported a significantly higher median number of male partners for the preceding 12 months (3 v 2, p = 0.05) and the CASI participants reported previous hepatitis B vaccination more often (50% v 37%, p = 0.01). Most participants found the CASI either easy (31; 13%) or very easy (193; 82%) to complete; 83 (35%) were comfortable and 121 (51%) were very comfortable with it. CONCLUSIONS: CASI may be a reliable, efficient and highly acceptable method for the screening of sexual risk in clinical sexual health settings and could be used routinely to improve the efficiency of clinical services.

Adult↗
PubMed2001

The effect of data collection mode on smoking attitudes and behavior in young African American and Latina women. Face-to-face interview versus self-administered questionnaires.

Evaluating smoking prevention and cessation programs requires valid data collection. This study examined two survey modes--face-to-face (FTF) interview and self-administered questionnaire (SAQ)--comparing response rates, sample characteristics, data quality, and response effects. From two family planning clinics, 601 female Latina and African American clients ages 12 to 21 were recruited and randomized to either group. Results reveal that neither mode is superior to the other. The SAQ may therefore be preferable for this population, despite its higher rate of incompletes, because it yields results similar to the FTF yet is more cost effective and less disruptive to clinic routines.

Adolescent↗
PubMed2006

Administering the MADRS by telephone or face-to-face: a validity study.

BACKGROUND: The Montgomery Asberg Depression Rating Scale (MADRS) is a frequently used observer-rated depression scale. In the present study, a telephonic rating was compared with a face-to-face rating in 66 primary care patients with minor or mild-major depression. The aim of the present study was to assess the validity of the administration by telephone. Additional objective was to study the validity of the first item, 'apparent sadness', the only item purely based on observation. METHODS: The present study was a validity study. During an in-person interview at the patient's home a trained interviewer administered the MADRS. A few days later the MADRS was administered again, but now by telephone and by a : Mean total score on the in-person administration was 24.0 (SD = 11.1), and on the telephone administration 23.5 (SD = 10.4). The ICC for the full scale was 0.65. Homogeneity analysis showed that the observation item 'apparent sadness' fitted well into the scale. CONCLUSION: The full MADRS, including the observation item 'apparent sadness', can be administered reliably by telephone.

Journal Article↗
PubMed2002

Self-help for bulimic disorders: a randomised controlled trial comparing minimal guidance with face-to-face or telephone guidance.

BACKGROUND: There is great potential demand for treatment of bulimia nervosa and binge eating disorder. Skilled therapists are in short supply. Self-help and guided self-help based upon books have shown some promise as an economical alternative to full therapy in some cases. AIMS: To investigate the efficacy and effectiveness of self-help with and without guidance in a specialist secondary service. METHOD: A randomised controlled trial comparing three forms of self-help over 4 months with a waiting-list comparison group and measurement of service consumption over the subsequent 8 months. RESULTS: Self-help delivered with four sessions of face-to-face guidance led to improved outcome over 4 months. There is also some evidence to support the use of telephone guidance. A minority of participants achieved lasting remission of their disorder in relation to self-help, but there was no significant difference in final outcome between the groups after they had progressed through the stepped care programme. Patients initially offered guided self-help had a lower long-term drop-out rate. CONCLUSIONS: Guided self-help is a worthwhile initial response to bulimia nervosa and binge eating disorder. It is a treatment that could be delivered in primary care and in other non-specialist settings.

Adult↗
PubMed1999

FACE: fear of loss of face and the five hazardous attitudes concept.

An aspect of human personality, fear of loss of face, has attracted only minimal experimental investigation, despite the widespread recognition of the condition and its potentially adverse effects on behavior. A survey of the available literature shows fear of loss of face to be an important aspect of pilot decision making. This article considers the phenomenon in more detail and recommends an amendment to the 5 hazardous attitudes concept developed at the Embry-Riddle Aeronautical University (Diehl, 1990). At the same time, recognition of the contribution of Telfer (1987, 1989) is also made, with a recommendation to incorporate Telfer's proposal to improve the concept.

Adaptation, Psychological↗
PubMed2001

Accuracy of tele-oncology compared with face-to-face consultation in head and neck cancer case conferences.

Telemedicine was introduced for weekly tumour case conferences between Sahlgrenska University Hospital and two district hospitals in Sweden. The accuracy of tele-oncology was determined using simulated telemedicine consultations, in which all the material relating to each case was presented but without the patient in person. The people attending the conference were asked to determine the tumour ('TNM') classification and treatment. The patient was then presented in person, to give the audience the opportunity to ask questions and perform a physical examination. Then a new discussion regarding the tumour classification and the treatment plan took place, and the consensus was recorded. Of the 98 consecutive patients studied in this way, 80 could be evaluated by both techniques. Of these 80, 73 (91%) had the same classification and treatment plan in the telemedicine simulation as in the subsequent face-to-face consultation. In four cases the TNM classification was changed and for three patients the treatment plan was altered. The specialists also had to state their degree of confidence in the tele-oncology decisions. When they recorded uncertainty about their decision, it was generally because they wanted to palpate the tumour. In five of the seven patients with a different outcome, the clinical evaluation was stated to be dubious or not possible. The results show that telemedicine can be used safely for the management of head and neck cancers.

Aged↗
PubMed2002

Client satisfaction in a feasibility study comparing face-to-face interviews with telepsychiatry.

We carried out a pilot study comparing satisfaction levels between psychiatric patients seen face to face (FTF) and those seen via videoconference. Patients who consented were randomly assigned to one of two groups. One group received services in person (FTF from the visiting psychiatrist) while the other was seen using videoconferencing at 128 kbit/s. One psychiatrist provided all the FTF and videoconferencing assessment and follow-up visits. A total of 24 subjects were recruited. Three of the subjects (13%) did not attend their appointments and two subjects in each group were lost to follow-up. Thus there were nine in the FTF group and eight in the videoconferencing group. The two groups were similar in most respects. Patient satisfaction with the services was assessed using the Client Satisfaction Questionnaire (CSQ-8), completed four months after the initial consultation. The mean scores were 25.3 in the FTF group and 21.6 in the videoconferencing group. Although there was a trend in favour of the FTF service, the difference was not significant. Patient satisfaction is only one component of evaluation. The efficacy of telepsychiatry must also be measured relative to that of conventional, FTF care before policy makers can decide how extensively telepsychiatry should be implemented.

Adolescent↗
PubMed1999

Scoring written material from the Mini-Mental State Examination: a comparison of face-to-face, fax and video-linked scoring.

We assessed the reliability of scoring written items of the Mini-Mental State Examination (MMSE) using different communication modes: face to face, fax and videoconferencing. A total of 99 MMSEs were recovered from the records of a community mental health team for the elderly. The written parts of the examination (sentence and pentagrams) were scored--in person, using a faxed copy or over the video-link--according to published criteria. Relative to in-person scoring, sentences could be scored reliably when faxed (kappa = 0.80), as could pentagrams (kappa = 0.71). Sentences could be reliably scored over the videoconferencing link (kappa = 0.70), but pentagrams could not (kappa = 0.47). Caution is required before accepting the results of scoring such tests over video-links.

Aged↗
PubMed2000

Documenting English syntactic development in face-to-face signed communication.

The authors explored the face-to-face English competence of five students who were participating in a larger study of teachers' use of English-based signing. Using case studies, the authors report on the students' development of English-based signing at the beginning and end of their involvement in this 4-year study. Grammatical forms similar in English and American Sign Language (ASL) were initially more readily produced when tested for in English, and showed consistently higher attainment levels across all the students, than grammatical forms that are different in English and ASL. The authors found emerging English forms that could be documented (a) between prompted and imitated utterances and (b) within blocks of test items examining the same grammatical constructions. The authors conclude that teachers' concerted efforts to use English-based signing as a language of instruction enhance deaf students' English acquisition. Such signing helps build a bridge between native sign language and the development of English skills necessary for literacy.

Child↗