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PubMed2002

Multimedia telehomecare system using standard TV set.

Nowadays, there are a very large number of patients that need specific health support at home. The deployment of broadband communication networks is making feasible the provision of home care services with a proper quality of service. This paper presents a telehomecare multimedia platform that runs over integrated services digital network and internet protocol using videoconferencing standards H.320 and H.323, and standard TV set for patient interaction. This platform allows online remote monitoring: ECG, heart sound, blood pressure. Usability, affordability, and interoperability were considered for the design and development of its hardware and software components. A first evaluation of technical and usability aspects were carried forward with 52 patients of a private clinic and 10 students in the University. Results show a high rate (mean = 4.33, standard deviation--SD = 1.63 in a five-points Likert scale) in the global perception of users on the quality of images, voice, and feeling of virtual presence.

Computer Communication Networks↗
PubMed2005

Anti-collusion forensics of multimedia fingerprinting using orthogonal modulation.

Digital fingerprinting is a method for protecting digital data in which fingerprints that are embedded in multimedia are capable of identifying unauthorized use of digital content. A powerful attack that can be employed to reduce this tracing capability is collusion, where several users combine their copies of the same content to attenuate/remove the original fingerprints. In this paper, we study the collusion resistance of a fingerprinting system employing Gaussian distributed fingerprints and orthogonal modulation. We introduce the maximum detector and the thresholding detector for colluder identification. We then analyze the collusion resistance of a system to the averaging collusion attack for the performance criteria represented by the probability of a false negative and the probability of a false positive. Lower and upper bounds for the maximum number of colluders K(max) are derived. We then show that the detectors are robust to different collusion attacks. We further study different sets of performance criteria, and our results indicate that attacks based on a few dozen independent copies can confound such a fingerprinting system. We also propose a likelihood-based approach to estimate the number of colluders. Finally, we demonstrate the performance for detecting colluders through experiments using real images.

Algorithms↗
PubMed2006

A cross-layer diversity technique for multicarrier OFDM multimedia networks.

Diversity can be used to combat multipath fading and improve the performance of wireless multimedia communication systems. In this work, by considering transmission of an embedded bitstream over an orthogonal frequency division multiplexing (OFDM) system in a slowly varying Rayleigh faded environment, we develop a cross-layer diversity technique which takes advantage of both multiple description coding and frequency diversity techniques. More specifically, assuming a frequency-selective channel, we study the packet loss behavior of an OFDM system and construct multiple independent descriptions using an FEC-based strategy. We provide some analysis of this cross-layer approach and demonstrate its superior performance using the set partitioning in hierarchical trees image coder.

Algorithms↗
PubMed2006

Automatic object extraction over multiscale edge field for multimedia retrieval.

In this work, we focus on automatic extraction of object boundaries from Canny edge field for the purpose of content-based indexing and retrieval over image and video databases. A multiscale approach is adopted where each successive scale provides further simplification of the image by removing more details, such as texture and noise, while keeping major edges. At each stage of the simplification, edges are extracted from the image and gathered in a scale-map, over which a perceptual subsegment analysis is performed in order to extract true object boundaries. The analysis is mainly motivated by Gestalt laws and our experimental results suggest a promising performance for main objects extraction, even for images with crowded textural edges and objects with color, texture, and illumination variations. Finally, integrating the whole process as feature extraction module into MUVIS framework allows us to test the mutual performance of the proposed object extraction method and subsequent shape description in the context of multimedia indexing and retrieval. A promising retrieval performance is achieved, and especially in some particular examples, the experimental results show that the proposed method presents such a retrieval performance that cannot be achieved by using other features such as color or texture.

Algorithms↗
PubMed2006

Brain-computer interaction research at the Computer Vision and Multimedia Laboratory, University of Geneva.

This paper describes the work being conducted in the domain of brain-computer interaction (BCI) at the Multimodal Interaction Group, Computer Vision and Multimedia Laboratory, University of Geneva, Geneva, Switzerland. The application focus of this work is on multimodal interaction rather than on rehabilitation, that is how to augment classical interaction by means of physiological measurements. Three main research topics are addressed. The first one concerns the more general problem of brain source activity recognition from EEGs. In contrast with classical deterministic approaches, we studied iterative robust stochastic based reconstruction procedures modeling source and noise statistics, to overcome known limitations of current techniques. We also developed procedures for optimal electroencephalogram (EEG) sensor system design in terms of placement and number of electrodes. The second topic is the study of BCI protocols and performance from an information-theoretic point of view. Various information rate measurements have been compared for assessing BCI abilities. The third research topic concerns the use of EEG and other physiological signals for assessing a user's emotional status.

Animals↗
PubMed2004

Providing QoS through machine-learning-driven adaptive multimedia applications.

We investigate the optimization of the quality of service (QoS) offered by real-time multimedia adaptive applications through machine learning algorithms. These applications are able to adapt in real time their internal settings (i.e., video sizes, audio and video codecs, among others) to the unpredictably changing capacity of the network. Traditional adaptive applications just select a set of settings to consume less than the available bandwidth. We propose a novel approach in which the selected set of settings is the one which offers a better user-perceived QoS among all those combinations which satisfy the bandwidth restrictions. We use a genetic algorithm to decide when to trigger the adaptation process depending on the network conditions (i.e., loss-rate, jitter, etc.). Additionally, the selection of the new set of settings is done according to a set of rules which model the user-perceived QoS. These rules are learned using the SLIPPER rule induction algorithm over a set of examples extracted from scores provided by real users. We will demonstrate that the proposed approach guarantees a good user-perceived QoS even when the network conditions are constantly changing.

Algorithms↗
PubMed2001

Randomised controlled trial of an interactive multimedia decision aid on benign prostatic hypertrophy in primary care.

OBJECTIVE: To determine whether a decision aid on benign prostatic hypertrophy influences decision making, health outcomes, and resource use. DESIGN: Randomised controlled trial. SETTING: 33 general practices in the United Kingdom. PARTICIPANTS: 112 men with benign prostatic hypertrophy. INTERVENTION: Patients' decision aid consisting of an interactive multimedia programme with booklet and printed summary. OUTCOME MEASURES: Patients' and general practitioners' perceptions of who made the decision, decisional conflict scores, treatment choice and prostatectomy rate, American Urological Association symptom scale, costs, anxiety, utility, and general health status. RESULTS: Both patients and general practitioners found the decision aid acceptable. A higher proportion of patients (32% v 4%; mean difference 28%, 95% confidence interval 14% to 41%) and their general practitioners (46% v 25%; 21%, 3% to 40%) perceived that treatment decisions had been made mainly or only by patients in the intervention group compared with the control group. Patients in the intervention group had significantly lower decisional conflict scores than those in the control group at three months (2.3 v 2.6; -0.3, -0.5 to -0.1, P<0.01) and this was maintained at nine months. No differences were found between the groups for anxiety, general health status, prostatic symptoms, utility, or costs (excluding costs associated with the video disc equipment). CONCLUSIONS: The decision aid reduced decisional conflict in men with benign prostatic hypertrophy, and the patients played a more active part in decision making. Such programmes could be delivered cheaply by the internet, and there are good arguments for coordinated investment in them, particularly for conditions in which patient utilities are important.

Aged↗
PubMedDate not supplied

Estimating software development costs for a patient multimedia education project.

The authors compare alternative methods of cost estimation for a patient multimedia education (PME) program, using a computerized weight-reduction PME project as an example. Data from the project planning and budgeting process and actual costs of the completed project are analyzed retrospectively to calculate three different estimates-pre-work, post-work, and actual work. Three traditional methods of estimating the cost of computer programs (the lines-of-code, function point, and task ratio analyses) underestimate costs in this example. A commercial program (Cost Xpert) that calculates the cost of developing a graphical user interface provided a better estimate, as did a tally reflecting the complexity and quality of media material in the project.

Costs and Cost Analysis↗
PubMed2006

A randomised pilot study to assess the efficacy of an interactive, multimedia tool of cognitive stimulation in Alzheimer's disease.

OBJECTIVE: To determine the usefulness of an interactive multimedia internet-based system (IMIS) for the cognitive stimulation of Alzheimer's disease. METHODS: This is a 24-week, single-blind, randomised pilot study conducted on 46 mildly impaired patients suspected of having Alzheimer's disease receiving stable treatment with cholinesterase inhibitors (ChEIs). The patients were divided into three groups: (1) those who received 3 weekly, 20-min sessions of IMIS in addition to 8 h/day of an integrated psychostimulation program (IPP); (2) those who received only IPP sessions; and (3) those who received only ChEI treatment. The primary outcome measure was the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog). Secondary outcome measures were: Mini-Mental State Examination (MMSE), Syndrom Kurztest, Boston Naming Test, Verbal Fluency, and the Rivermead Behavioral Memory Test story recall subtest. RESULTS: After 12 weeks, the patients treated with both IMIS and IPP had improved outcome scores on the ADAS-Cog and MMSE, which was maintained through 24 weeks of follow-up. The patients treated with IPP alone had better outcome than those treated with ChEIs alone, but the effects were attenuated after 24 weeks. All patients had improved scores in all of the IMIS individual tasks, attaining higher levels of difficulty in all cases. CONCLUSION: Although both the IPP and IMIS improved cognition in patients with Alzheimer's disease, the IMIS program provided an improvement above and beyond that seen with IPP alone, which lasted for 24 weeks.

Aged↗
PubMed2004

A novel multimedia tool to improve bedside teaching of cardiac auscultation.

Training in cardiac auscultation is a core element of undergraduate teaching but recent studies have documented a remarkable decline in auscultatory skills. Therefore there is an interest in new ways to teach cardiac auscultation. In analogy to phonocardiography, an electronic system for simultaneous auscultation and visualisation of murmurs was sought. For this purpose, an electronic stethoscope was linked to a laptop computer and software created to visualise auscultatory findings. In a preliminary trial in undergraduate students, this approach greatly facilitated teaching. Amalgamating traditional phonocardiography with a multimedia approach, this system represents a novel tool for bedside teaching of cardiac auscultation.

Education, Medical, Undergraduate↗
PubMed2002

The effectiveness of web-based, multimedia tutorials for teaching methods of human body composition analysis.

This study examined the effectiveness of a series of Web-based, multimedia tutorials on methods of human body composition analysis. Tutorials were developed around four body composition topics: hydrodensitometry (underwater weighing), dual-energy X-ray absorptiometry, bioelectrical impedance analysis, and total body electrical conductivity. Thirty-two students enrolled in the course were randomly assigned to learn the material through either the Web-based tutorials only ("Computer"), a traditional lecture format ("Lecture"), or lectures supplemented with Web-based tutorials ("Both"). All students were administered a validated pretest before randomization and an identical posttest at the completion of the course. The reliability of the test was 0.84. The mean score changes from pretest to posttest were not significantly different among the groups (65.4 plus minus 17.31, 78.82 plus minus 21.50, and 76 plus minus 21.22 for the Computer, Both, and Lecture groups, respectively). Additionally, a Likert-type assessment found equally positive attitudes toward all three formats. The results indicate that Web-based tutorials are as effective as the traditional lecture format for teaching these topics.

Body Composition↗
PubMed1999

Effect of an educational multimedia prostate program on the International Prostate Symptom Score.

OBJECTIVE: To determine the effect of an interactive multimedia prostate education program (MMP) on self assessment of symptom scores due to benign prostatic hyperplasia (BPH). METHODS: The interactive MMP was developed including a computer-administered version of the International Prostate Symptom Score (IPSS) questionnaire. Eighty-eight men referred to the Urology Out-patients with prostatic symptoms entered the study. They first completed the IPSS on paper and secondly used the MMP before completing the computer-administered IPSS. A final feedback questionnaire enquiring into their experience including previous exposure to computers, ease of use, and value of the program content was completed. RESULTS: The use of the MMP resulted in a significant decrease in mean IPSS score from 16.6 to 13.9 (t = 7.456, d.f. = 87, p < 0.01), but no change in quality of life. Patients felt that their knowledge had increased (chi2(1) = 21.253, p < 0.01) and that they had completed the IPSS more accurately (chi2(1) = 10.227, p < 0.01) with the MMP IPSS module compared to the IPSS on paper. Previous use of patient education, patient characteristics and MMP use beyond the information required for the IPSS did not affect IPSS difference (IPSS before versus after MMP use). CONCLUSION: The use of the MMP enhanced patients' knowledge of their condition and reduced patients' IPSS score. The results were independent of previous exposure to information, previous IPSS completion, computer use and age.

Aged↗
PubMed2003

Telemedicine in emergency evaluation of acute stroke: interrater agreement in remote video examination with a novel multimedia system.

BACKGROUND AND PURPOSE: In acute stroke care, rapid but careful evaluation of patients is mandatory but requires an experienced stroke neurologist. Telemedicine offers the possibility of bringing such expertise quickly to more patients. This study tested for the first time whether remote video examination is feasible and reliable when applied in emergency stroke care using the National Institutes of Health Stroke Scale (NIHSS). METHODS: We used a novel multimedia telesupport system for transfer of real-time video sequences and audio data. The remote examiner could direct the set-top camera and zoom from distant overviews to close-ups from the personal computer in his office. Acute stroke patients admitted to our stroke unit were examined on admission in the emergency room. Standardized examination was performed by use of the NIHSS (German version) via telemedicine and compared with bedside application. RESULTS: In this pilot study, 41 patients were examined. Total examination time was 11.4 minutes on average (range, 8 to 18 minutes). None of the examinations had to be stopped or interrupted for technical reasons, although minor problems (brightness, audio quality) with influence on the examination process occurred in 2 sessions. Unweighted kappa coefficients ranged from 0.44 to 0.89; weighted kappa coefficients, from 0.85 to 0.99. CONCLUSIONS: Remote examination of acute stroke patients with a computer-based telesupport system is feasible and reliable when applied in the emergency room; interrater agreement was good to excellent in all items. For more widespread use, some problems that emerge from details like brightness, optimal camera position, and audio quality should be solved.

Acute Disease↗
PubMed2005

A multimedia violence prevention program increases pediatric residents' and childcare providers' knowledge about responding to childhood aggression.

A pre-post knowledge test using alternate forms was used to determine if a multimedia violence prevention program can increase knowledge about management of childhood aggression. The participants were pediatric residents and childcare workers who attended lectures about aggression management in young children. The intervention was a presentation of a 30 minute CD-ROM program, Play Nicely, which teaches how to manage aggression in young children ages 1 to 7 years. A pretest and posttest multiple-choice knowledge assessment that focused on the program's most important recommendations was administered. Childcare workers and pediatric residents had significantly increased knowledge scores after viewing the CD-ROM demonstration (F=6.8, p = 0.01). Childcare workers' scores improved by 2.6 points (p< 0.001) and residents' scores by 3.8 points (p< 0.001). A relatively short CD-ROM can improve knowledge about how to manage aggression in young children, indicating its usefulness as a violence prevention resource.

Aggression↗
PubMedDate not supplied

The development and pilot testing of a multimedia CD-ROM for diabetes education.

The multimedia CD-ROM program, Take Charge of Diabetes, was found to be accurate, easy to use, and enjoyable by the clients and health professionals who completed the pilot study. Participants perceived an increase in knowledge after completing the five modules. Two of the participants verbally stated that the program clarified information for them and they wished they had had such a program when they were first diagnosed with diabetes. Further evaluation is needed to generalize the effect of the program on knowledge of diabetes because the pilot study was not designed to fully evaluate the effectiveness of the program on knowledge level or behavior change. Behavior change resulting in better control of blood sugar levels and hemoglobin A1c within normal range is the goal for diabetes education. The person who lives with diabetes must learn self-care methods. To accomplish that, the person must be able to comprehend the material presented. CAI programs provide an individualized, interactive, and interesting way to learn about diabetes and self-care, using visual effects and audio to support the written text. CAI can provide an element of excitement that is not available with other conventional methods. Providing prompt reinforcement of correct answers in quiz sections and including positive written messages can increase patients' self-confidence and self-esteem. Computer-assisted instruction is not intended to replace personal contact with physicians and diabetes educators, but rather complement this contact, reinforce learning, and possibly increase self-motivation to take charge of one's diabetes.

CD-ROM↗
PubMed1997

Interactive multimedia software design: concepts, process, and evaluation.

This article provides the health educator with a review of the design and construction of computer-based health education materials. Specifically, this review considers questions of instructional objectives as defined in the field of instructional design, a body of expertise not often deployed in the area of health education. It discusses in some detail the computer materials development process, associated documentation, and the range of personnel required. This article also briefly updates discussion of the costing process, and current costs for multimedia hardware and authoring software. The review touches on, but does not synthesize, emerging possibilities with the Internet.

Computer-Assisted Instruction↗
PubMed2001

Interaction patterns between children and their teachers when using a specific multimedia and communication strategy: observations from children with autism and mixed intellectual disabilities.

This study reports on observed interaction patterns between 20 children with autism and mixed intellectual disabilities (mean chronological age = 11:4 years; language age = 4:7 years) and their nine teachers working with a specially developed multimedia program aiming to increase literacy skills. An increase in verbal expression was found over time for the total group. Children with autism also showed increased enjoyment and willingness to seek help from their teachers. Teachers for both diagnostic groups reduced their instructions on how to handle the computer during the program but the decrease was greater in the teachers for children with autism. When the total group of children was subdivided according to language age (high versus low), it appears that those with a low language age showed an increase in verbal expressiveness from start to end of training. Those with a high language age showed increased enjoyment. It is concluded that more detailed studies of the interaction patterns between teachers and children are needed, and these should be related to children's language level as well as to diagnostic group.

Adolescent↗
PubMed2003

Multimedia software to help caregivers cope.

OBJECTIVE: This report describes the design and evaluation of a software application to help carers cope when faced with caring problems and emergencies. DESIGN: The design process involved users at each stage to ensure the content of the software application was appropriate, and the research team carefully considered the requirements of disabled and elderly users. MEASUREMENTS: Focus group discussions and individual interviews were conducted in five European countries to ascertain the needs of caregivers in this area. The findings were used to design a three-part multimedia software application to help family caregivers prepare to cope with sudden, unexpected, and difficult situations that may arise during their time as a caregiver. This prototype then was evaluated via user trials and usability questionnaires to consider the usability and acceptance of the application and any changes that may be required. RESULTS: User acceptance of the software application was high, and the key features of usability such as content, appearance, and navigation were highly rated. In general, comments were positive and enthusiastic regarding the content of the software application and relevance to the caring situation. CONCLUSION: The software application has the potential to offer information and support to those who are caring for the elderly and disabled at home and to help them prepare for a crisis.

Aged↗