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PubMed2004

Multimedia based medical instrumentation course in biomedical engineering.

Computer assisted instruction in education, including biomedical engineering education, has been explored and changed dramatically for more than two decades. The Internet, with its capacity to transmit synchronous and asynchronous audio, text, and graphics, presents educators with tremendous opportunies for distance education and independent learning. In this work, we have developed a new educational hypermedia for medical instrumentation courses. It is designed to be suitable for biomedical and technical curricula where these courses are scheduled. The courseware provides support for the education of medical instrumentation. The work is presented herein to provide multimedia course material with animations to assist learning some key Medical Instrumentation topics on the World Wide Web.

Biomedical Engineering↗
PubMed1998

Using multimedia for patient information--a program about nocturnal enuresis.

OBJECTIVES: To identify the information needs of children with nocturnal enuresis, and to design, produce and evaluate an interactive computer program to provide this information. SUBJECTS AND METHODS: The program was developed over an 18-month period using information provided by children, parents and professionals, and was evaluated in a hospital-based enuresis clinic in 65 children. Usability and knowledge gained were also evaluated in 43 healthy children aged 8-10 years attending a local inner-city primary school. RESULTS: An interactive program about nocturnal enuresis was developed, which runs on a personal computer and uses sound, voice, cartoon drawings and animation in a modular design. Knowledge scores increased in clinic attendees and in schoolchildren after using the program (Wilcoxon matched pairs test, P < 0.001). This improvement was maintained when the program was re-tested 6-10 months later. CONCLUSION: This interactive computer program holds children's attention and increases their understanding of enuresis. Interactive multimedia may be useful to complement the information provided by health professionals. This method of communication may be particularly useful for children with a low level of literacy.

CD-ROM↗
PubMed2002

A multimedia fugacity river model of pentachlorophenol in South Drainage Canal, China.

An investigation of Pentachlorophenol (PCP) in South Drainage Canal and Haihe Estuary, Tianjin, China was carried out from 1998 to 1999. PCP was found in each sample of the surface microlayer, subsurface water, sediment and air. The waste drainage from a PCP-producing plant was the main pollution source of PCP to Haihe Estuary. The enrichment phenomenon of PCP in the surface microlayer was reported for the first time. The maximum enrichment factor was 4.11. A multimedia (including air, the surface microlayer, water and sediment) fugacity river model was established and successfully applied to fate data for pentachlorophenol in South Drainage Canal. The results showed that under steady state, 97.09% of the loaded PCP was removed by advective outflow into Bohai Bay and 2.46% was by the biodegradation in the water phase. The residue of PCP in South Drainage Canal mainly distributed (99.56%) in the water phase. The discharge rate of PCP from South Drainage Canal to Bohai Bay was 53.4 kg/h.

Air↗
PubMed2003

A high-rate secondary treatment based on a moving bed bioreactor and multimedia filters for small wastewater treatment plants.

For small wastewater treatment plants (WWPTs), high-rate secondary treatment systems with good treatment efficiency and easy, stable, and robust operation are called for. In this paper an experimental study on a high rate secondary treatment based on moving bed biofilm reactor (MBBR) and multimedia filters is presented. A high rate MBBR converts easily biodegradable SCOD in short HRT (0.5 h) directly after screening, then a Kaldnes-Filtralite-Sand (KFS) filter removes the particulate COD and detached biofilms at filtration rates of 10-20 m/h. The whole system gave effluent SS and COD less than 30 mg/L and 100 mg/L when total detention time is less than 1 h and small dosage of chemicals (iron and/or cationic polymer) is used. A new scenario of high rate secondary system with a primary Kaldnes coarse media filter in front of high rate MBBR and the KFS filter is proposed and discussed. This scenario with total HRT less than 2h is more suitable for high influent SS concentrations and may also be extended for nitrogen and phosphorous removal. Compared to conventional secondary treatment, the high rate secondary treatment will be using only 1/5-1/10 of the space, resulting in considerable savings for construction, energy and operation.

Biofilms↗
PubMed2003

Completing a life: development of an interactive multimedia CD-ROM for patient and family education in end-of-life care.

There are relatively few comprehensive and empowering educational tools to assist people with terminal illness in addressing important end-of-life issues. Identifying this scarcity, a design team of health and multimedia professionals created an interactive, educational CD-ROM entitled Completing a Life. The primary goal of the project was to provide rich content in a style that was easy to access, understand, and use. The interactive medium of the CD-ROM enabled a large amount and wide array of material to be presented in manageable segments. These segments are connected by hyperlinks, providing self-guided control over the selection, pace, and order of material. The CD puts the learning experience in the hands of the learner. The format and design is also intended to generate a sense of empowerment, at a time and around issues often associated with a loss of control. Completing a Life covers a wide range of information for the user to choose from, spanning physical, emotional, family, and spiritual issues. A calm and comforting tone and welcoming environment enhances the users' ability to take in the information and make proactive decisions about his/her own well-being and care. The CD contains video narratives of individuals who tell their own stories of living with terminal illness. In addition to being a highly relevant means of conveying sensitive, health-related information, this collection of personal interviews may offer a form of "virtual support group" for the user. Finally, the interactive format allows stories and informational content to be linked in topic-specific ways that complement one another.

CD-ROM↗
PubMed1998

The multimedia CD ROM: an innovative teaching tool for endoscopic sinus surgery.

The recent explosive growth in the use of endoscopic techniques in the performance of surgical procedures has created an important need for educational materials on this subject. However, limitations of currently available teaching tools frustrate the user and hamper the teaching and spread of these procedures. To improve on currently available methods, we developed a CD ROM video atlas of techniques in endoscopic sinus surgery (ESS). The multimedia CD ROM video atlas combines the best features of the surgical atlas with conventional videotapes. The component steps of procedures in ESS are presented to the viewer as brief, individual video sequences, accompanied by narration and a text of the highlights of each procedure. The use of digital video allows the user to access the segment of interest directly, in the order of preference, without having to sift through the other segments, as with conventional videocassettes. An interface allows control over playback of the video, and sequences can be reviewed instantly. Storage capacity of the CD ROM allows up to 60 minutes of video to be stored on each disk. The CD ROM combines the best elements of currently available educational tools and may represent a new approach for medical education.

CD-ROM↗
PubMed2006

Multimedia data capture and management for surgical events: Evaluation of a system.

The objective of this study was to design an electronic form of documentation of surgical procedures, which would include audio and video recording of the entire surgical procedure. Video clips have shown promise for teaching surgical procedures. To date, no systems have been described to fully record video and audio of all events during a surgical procedure. Much as such systems have aided the airline industry, surgical safety, documentation, and education could benefit from comprehensive, multimedia documentation systems. Four camcorders provided views of: (1) anesthetic monitors, (2) laparoscopic images, (3) room view, and (4) surgical field view. All video and audio were combined with real-time written documentation of events within a simple, inexpensive database for archiving, review, and evaluation. Electronic records provided answers to more than 90% of the structured review questions, leaving only 6% unanswered, versus 92% unanswerable based on the traditional paper records. This electronic documentation system provides a much more comprehensive and easily mined means of surgical documentation than traditional paper records.

Cholecystectomy, Laparoscopic↗
PubMed2004

The effectiveness of an interactive multimedia program to influence eating habits.

An interactive multimedia program to encourage individuals to decrease their dietary fat consumption and to increase consumption of fruits and vegetables was developed and evaluated at two worksites. The program presented content tailored to the user by gender, content interests, race, and age group. It was tested using a randomized treatment and wait list control design (n = 517). Repeated-measures ANOVAs indicated significant intervention effects after 30 days for self-reported consumption of fat and of fruits and vegetables, for stage of change to adopt a low-fat diet, for intention and self-efficacy to reduce dietary fat, and for attitude toward the importance of diet. In addition, 60-day follow-up of the treatment subjects found that program effects were maintained on all measures. Within- subject analyses showed that program effects were replicated with the wait list group at 30 days. These results demonstrate the potential for short-exposure interactive programs to positively impact eating habits of employee populations.

Adult↗
PubMed1999

Interactive multimedia and risk communication.

As our understanding of risk factors and their interaction with individual susceptibility to disease improves, general messages designed to communicate risk seem increasingly ineffective and often misleading. Risk messages communicated through the mass media cannot convey an individual's personal susceptibility to preventable diseases or the seriousness of these diseases. The advent of new media technologies allows us to better reach the public with programs tailored to the needs and interests of individual users. Although similar in outward appearance to mass media, programs delivered through the Internet, CD-ROM, and computer kiosks offer the potential for vastly improved efficacy in communicating risk. This paper outlines the potential uses of interactive multimedia within the traditional goals of risk communication. A significant research endeavor, coupled with stronger avenues for dissemination, is recommended to achieve the potential of new media in a timely manner.

CD-ROM↗
PubMed1990

Integrated radiologic information system: a radiology multimedia communication system.

A multimedia radiologic communication system has been developed that achieves the system design goal of providing a clinical communication service that is an efficient improvement over present methods of communication. The system allows users to access, through a workstation, digitized radiographic images, voice reports, and other patient data. Physicians can consult with each other while simultaneously accessing this information through a shared visual workspace, even though they are in different places. The system was designed by a multidisciplinary team including radiologists, clinicians, engineers, user-interface specialists, and psychologists from hospital, university, and research settings in an effort to maximize system performance and clinical utility.

Computer Communication Networks↗
PubMed1978

Teaching psychiatry in a new medical school: a multimedia approach.

As a developing department in a new medical school, we were able to improve our curriculum by using a multimedia approach to teaching psychiatry. We relied heavily on a programmed self-instructional text with videotaped clinical examples (PLS), learning objectives, formal classroom presentations, small group discussions, self-assessment exercises, an affective approach to the patient-doctor relationship using role-playing and videotaped patient vignettes, and finally live patient interviews. We believe we have been able to present the widely agreed upon content in the basic science years, using a wide variety of teaching materials and technics which maintain the interest of most students.

Audiovisual Aids↗
PubMed1998

A unified multimedia database system to support telemedicine.

A unified approach to managing multimedia medical databases in a telemedicine system is proposed. In order to manage, search, and display patient information more efficiently, we define a patient information package (PIP) as a concise data set of a patient's medical information from each visit. By means of PIP's, both patient-oriented and problem-oriented query strategies, which are most frequently used in daily clinical practice and medical education, can be accommodated. We also provide a unified methodology for accessing various types of patient medical records as well as design two types of user interfaces, high-quality data display and web-based interface, for different medical service purposes. The PIP-based management of databases has been successfully implemented between the National Taiwan University (NTUH), Taipei, and the Chinshan health care center, Chinshan, Taiwan, for teleconsultation, telediagnosis, and tele-education.

Database Management Systems↗
PubMed2003

Validation of multimedia models assessing exposure to PAHs--the SOLEX study.

Polluted soils have become a public health problem. While population exposure to soil pollutants is generally quantified using multimedia models, their estimations have not been validated, and studies that attempted to do so are scarce. The objective of the SOLEX study was to compare the predictions of pyrene exposure levels (converted into 1 hydroxypyrene) computed by several models with the results of urinary 1-hydropyrene (1-HOP) assays among 110 employees working at three sites polluted during their past use as manufactured gas plants. Four models were used: AERIS (Canada), CalTOX (California, USA), CLEA (UK), and HESP (The Netherlands). Three occupational exposure scenarios--with office, mixed, and outdoor workers--were constructed, based upon job activities during two measurement campaigns, one in winter and one in summer. The exposure levels estimated by the four models could differ markedly (from 7 up to 80 times) according to the exposure scenario. Also, the predominant exposure routes differed according to the model (direct soil ingestion for HESP and CalTOX, inhalation for AERIS, and dermal absorption for CLEA). The predictions of CalTOX are consistent with the 1-HOP measurements for all the scenarios. For HESP, the consistency is observed for the scenarios, office and mixed, for which the pyrene level in the soil is low. AERIS and CLEA yield results that are systematically above the 1-HOP measurements. This study confirms that validation of the models is crucial and points out to the need to proceed to assess components of the models that are the most influential using appropriate statistical analysis in combination with true field data.

Adult↗
PubMed2005

Teaching paediatric residents about learning disorders: use of standardised case discussion versus multimedia computer tutorial.

BACKGROUND: We developed a standardised case-based educational exercise on the topic of childhood learning disorders, and a multimedia computerised adaptation of this exercise, as part of a national curriculum project based on the Bright Futures guidelines. OBJECTIVE: To explore resident perceptions of the facilitated case discussion (FCD) and the computerised tutorial (CT). DESIGN: Quasi-randomised comparison of two educational interventions. SETTING: Preclinic teaching conferences at a large urban children's hospital. PARTICIPANTS: A total of 46 paediatric residents years 1-3 assigned to either FCD (n = 21) or CT (n = 25). INTERVENTIONS: FCD residents met in groups of 8-12 with a trained facilitator for a structured case discussion, while CT residents worked in groups of 2-3 at a computer station linked to an interactive website. OUTCOME MEASURES: Participant responses during semistructured focus group interviews. ANALYSIS: Focus group transcripts, field notes and computer logs were analysed simultaneously using qualitative grounded theory methodology. RESULTS: Residents experienced CT as fun, offering flexibility, greater auditory and visual appeal and more opportunities for active learning. FCD allowed greater contact with expert faculty and made the material more relevant to clinical practice. FCD participants emphasised the clinical skills gleaned and stated that the learning experience would change their future patient management. Both groups reported that case discussion was more interactive than computer learning. Median time spent on learning was slightly shorter for the CT group. All groups of learners arrived at the correct final diagnosis. CONCLUSIONS: FCD and CT stimulate different types of learning among paediatric residents. Future studies are needed to determine how to integrate these two techniques to meet the learning needs of residents in diverse settings.

Boston↗
PubMed2001

Adolescents' perceptions of a health survey using multimedia computer-assisted self-administered interview.

OBJECTIVE: To ascertain young people's perceptions of an adolescent health survey when administered by multimedia computer assisted self-administered Interview (M-CASI) through analysis of (1) questionnaire item responses and (2) focus group interviews. METHODOLOGY SETTING: Auckland, New Zealand, 1999. STUDY TYPE: Pilot testing of a 488-item branching questionnaire delivered using a youth-oriented and user-friendly M-CASI interface in a variety of settings using both desktop and laptop computers. Post pilot focus groups of participants identifying their perceptions and experiences of the survey. SAMPLE: 110 school students aged 12 to 18 years. RESULTS: The mean number of questions answered by participants was 316 with the median time to completion being 48 minutes. On average 65% of the total number of questions were seen and of these 1.5% were deliberately not answered. A high level of acceptability and enjoyment of M-CASI was found in the analysis of focus group responses and agreed with the item responses relating to M-CASI within the questionnaire itself. Participants identified privacy and confidentiality as being particularly important for the honesty of their responses. The passive matrix screens of the computers were popular as they could only be viewed from in front. CONCLUSIONS: M-CASI is an acceptable instrument for the administration of a youth health survey. Laptop computers with passive matrix screens are able to enhance perceptions of privacy and confidentiality, which may improve honesty of responses. IMPLICATIONS: M-CASI is now feasible and offers advantages in health surveying.

Adolescent↗
PubMedDate not supplied

Development of a Smiling Touchscreen multimedia program for HRQoL assessment in subjects with varying levels of literacy.

OBJECTIVE: As low literacy affects the assessment of health-related quality of life (HRQoL) in several ways (e.g., subject eligibility and cost of administration), better approaches to HRQoL assessment in subjects with varying literacy levels are needed. METHODS: We developed a multimedia touchscreen program (the Smiling Touchscreen, ST) to administer HRQoL instruments to subjects with varying levels of Chinese language and computer literacy, using an iterative process where patients' input on design, clarity of instructions, and user-friendliness were repeatedly gathered and incorporated in development. The ST thus has several user-friendly features for low-literacy subjects (e.g., presentation of individual items using visual and auditory stimuli, voice-text synchronization, and visual analog scale with a touch and drag function), which we evaluated using qualitative and quantitative methods. RESULTS: The ST was well accepted by subjects (n = 66, 76% female, median [interquartile] age: 49.0 [40.0, 56.0]) with high (n = 43) or low (n = 23) literacy, 98% of whom found it easy or very easy to use, and 85% found the voice-text synchronization feature useful. In low-literacy subjects without computer experience (30%), none reported any difficulties using the ST. The median (interquartile) time spent to complete the ST (four Instruction and Practice screens, 24 questions, one visual analog scale) for high- and low-literacy groups was 13.9 (9.6, 23.9) and 23.2 (15.8, 26.5) minutes, respectively. Among subjects expressing a preference (n = 47), 21 (47%) favored the ST over interviewer- or self-administration. CONCLUSION: The ST is well accepted by subjects with varying literacy levels, including those without computer experience. It is thus a promising new approach for HRQoL assessment among subjects with varying literacy levels.

Acoustic Stimulation↗
PubMedDate not supplied

Developing and testing a multimedia presentation of a health-state description.

Quality-adjustment weights for health states are an essential component of cost-utility analysis (CUA). Quality-adjustment weights are obtained by presenting large numbers of subjects with multiattribute descriptions of health states for rating. Comprehending multiattribute health states is a difficult task for most respondents. The authors hypothesized that multimedia (MM) presentation using computers might facilitate this task better than would a paper-based text (Text). To test this hypothesis, they developed closely matched MM and Text descriptions of health states in the first-person narrative style, and developed a method of testing the presentation of a health state. Subjects were randomized to exposure to either MM or Text and subject recall of the health state and recognition of features of the health state were tested. How well defined the preferences of the subjects were after each presentation method was assessed by having the subjects mark on a double-anchored visual-analog scale the "best" and "worst" they believed the quality of life in the health state might be. MM subjects had better recall (11.85 vs 9.44 of a total of 24 meaning units, p = 0.098) and better recognition (4.71 vs 4.22, p = 0.08). The average interval between the "best" and "worst" ratings was shorter for the MM subjects (2.19 cm vs 3.26 cm, p = 0.12).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗