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PubMedDate not supplied

Clinical skill-building simulations in cardiology: HeartLab and EkgLab.

HeartLab and EkgLab are two simulation-based programs designed to teach medical students the essentials of the auscultatory cardiac examination and of electrocardiogram interpretation, respectively. The issues considered throughout the development of these projects, namely implementation language selection, program architecture, simulation design, patient models, and the approach to verification, are applicable to the design of any simulation-based system.

Cardiology↗
PubMed1980

Language recovery in aphasia: effect of systematic filmed programmed instruction.

This project investigated the effect of systematic filmed programmed instruction on language recovery of aphasic subjects with markedly disturbed communication skills. Fourteen male veterans between 32 and 69 years of age who had suffered cerebrovascular accidents were randomly assigned to an experimental or control group of 7 patients each. All subjects had completed elementary school; the majority had attended high school and several had attended college. Each subject was receiving and continued to receive speech therapy. In addition, the experimental subjects received supplementary filmed programmed instruction while the control group viewed slides, attended bibliotherapy and engaged in other nonprogrammed, activity. Each subject submitted to pretests, midtests, posttests of reading recognition and comprehension, figure background, visual learning, visual closure, and vocabulary. Study of the results and statistical analysis of the data did not show significant improvement either due to speech therapy or filmed programmed instruction for these subjects. The results of this project cannot be generalized because of limitations of number, subject categories, widespread time since onset, and for the experimental group, the filmed material utilized.

Adult↗
PubMed1997

Using software agents to maintain autonomous patient registries for clinical research.

A software agent is an application that can function in an autonomous and intelligent fashion. We have used mobile software agents to maintain clinicians' patient research databases (patient registries). Agents were used to acquire data from the clinician and place it into the registries, copy data from hospital databases into the registries, and report data from the registries. The agents were programmed with the intelligence to navigate through complex network security, interact with legacy systems, and protect themselves from various forms of failure at multiple levels. To maximize the separation between our system and the hospital information infrastructure we often used Java, a platform-independent language, to program and distribute our software agents. By using mobile agents, we were able to distribute the computing time required by these applications to underutilized host machines upon which the registries could be maintained.

Databases as Topic↗
PubMed1976

Mime in language therapy and clinician training.

A speech pathologist developed a program with language goals which included spontaneous communication, focus, attention span, auditory memory, receptive and expressive vocabulary, and concepts such as body image, spatial relationships, and same and different polarities. The services of a professional mime were used to translate these goals into mimetic activities and to perform the activities in group sessions with the children. In addition, the mime taught the speech clinicians some simple mimetic activities. The subjects were five children with mental retardation, language delay, lack of spontaneity, short attention span and very poor visual and auditory memory. The results suggested increase in spontaneity and attention span in all the children and a facility to remember the illusions depicted for them by the mime. The experience with the mime training for clinicians was also positive.

Adolescent↗
PubMedDate not supplied

[Evaluation of the Program of the Feeding and Language Stimulation Centers in 3 Chilean regions].

To evaluate the effect of attendance to a non traditional day care center ("CADEL") on physical and psychomotor development, 366 children aged 2-5 years belonging to 22 centers were studied. Weight and height were measured at 0, 4 and 8 months and weight for age, height for age and weight for height indexes were calculated from WHO/NCHS standards. Psychomotor development at the beginning of the study and 8 months latter through a standard test (TEPSI) was evaluated. Mean weight and height monthly increments were 144 +/- 83 g and 0.54 +/- 0.16 cm, 72 and 90% respectively of normal growth. Protein energy malnutrition prevalence (30.8%) was not modified but subnormal values of psychomotor development (40.9%) decreased during the study (p less than 0.05 global, coordination and motor function). Language retardation did not improve with the attendance to the program. These centers represent low cost alternatives to extended coverage of preschool services for low income families. More active family integration and reinforcement of stimulation and educational activities may improve program effectiveness.

Child Day Care Centers↗
PubMed2003

The truth about language barriers: one residency program's experience.

OBJECTIVE: To describe perceptions of how a lack of house staff Spanish proficiency adversely affects communication with Spanish-speaking families with limited English proficiency (LEP). METHODS: An anonymous, structured questionnaire was administered to the house staff an of urban, university-affiliated children's hospital that serves a population in which 10%-20% have LEP. RESULTS: Ninety-four percent (59 of 63) completed the questionnaire. Sixty-eight percent (40 of 59) reported that they spoke little or no Spanish (although 36 of 40 expressed a desire to learn Spanish). Fifty-three percent (21 of 40) of these nonproficient residents reported that they used their inadequate language skills in the care of patients "often" or "every day." Many of these residents believed that LEP families under their care "never" or only "sometimes" understood their child's diagnosis (21 of 40), medications (11 of 40), discharge instructions (17 of 40), or follow-up plan (16 of 40). Eighty percent (32 of 40) admitted to avoiding communication with such families. Although all (40 of 40) agreed that hospital interpreters were effective, 30 of 40 nonproficient residents reported use of hospital interpreters "never" or only "sometimes." Fifty-three percent (21 of 40) of these nonproficient residents reported calling on their proficient colleagues "often" or "every day" for assistance. Thirty-two percent (19 of 59) of residents described themselves as "fluent" or "proficient" in Spanish. Fifty-eight percent (11 of 19) reported that they were asked to interpret for fellow residents "often" or "every day." Proficient residents estimated that they spent a mean of 2.3 hours per week interpreting for other residents. CONCLUSIONS: Despite a perception that they are providing suboptimal communication, nonproficient residents rarely use professional interpreters. Instead, they tend to rely on their own inadequate language skills, impose on their proficient colleagues, or avoid communication with Spanish-speaking families with LEP.

Adolescent↗
PubMed1992

Future trends in language intervention: addressing cultural bias in service delivery.

In this paper the cultural biases in a widely-used language intervention approach--the Hanen Early Language Parent Program--that trains parents to be conversational partners with their language-delayed children, are explored. In many respects this program represents the best of current clinical practice. It is empirically and theoretically grounded in recent research on parent-child interaction; studies have documented its efficacy; and it is a family-centred approach. And yet, in clinical practice, it does not work with all families. Not surprisingly, these families are often from nonmainstream backgrounds. Potential reasons for the lack of effectiveness with some families become apparent as research on patterns of language socialization in a wide variety of cultures is reviewed. This review reveals that all of the basic premises of this program rest on culturally relative beliefs and values. Specifically considered are cultural variation in (1) aspects of social organization related to interaction, (2) the value of talk, (3) how status is handled in interaction, (4) beliefs about intentionality, and (5) beliefs about teaching language to children. Suggestions for incorporating this information into clinical services with nonmainstream families are offered.

Child↗
PubMed1990

Expert systems for the prediction of ovulation: comparison of an expert system shell (Expertech Xi Plus) with a program written in a traditional language (BASIC).

The use of an expert system shell (EXPERTECH Xi Plus) in the construction of an expert system for the diagnosis of infertility has been evaluated. A module was devised for predicting ovulation from the medical history alone. Two versions of this system were constructed, one using the expert system shell, and the other using QuickBASIC. The two systems have been compared with respect to: (1) ease of construction; (2) ease of knowledge base update; (3) help and explanation facilities; (4) diagnostic accuracy; (5) acceptability to patients and clinicians; (6) user-friendliness and ease of use; (7) use of memory space; and (8) run time. The responses of patients and clinicians were evaluated by questionnaires. The predictions made by the computer systems were compared to the conclusions reached by clinicians and to the "gold standard" of day 21 progesterone. The conclusions of this pilot study are: (1) the construction of this expert system was NOT facilitated by the use of this expert system shell; (2) update of the knowledge base was not facilitated either; (3) the expert system shell offered built-in help and explanation facilities, but as the system increased in complexity these became less useful; (4) after initial adjustment of decision thresholds the diagnostic accuracy of the system equalled that of the clinician; (5) the patient response to computer history-taking was very favorable but much less favorable to computer diagnosis; (6) the clinicians took a positive attitude to computer diagnosis; (7) the systems were easy to use; (8) the expert systems shell required much more memory space and had a much slower response time than the system written in BASIC.

Diagnosis, Computer-Assisted↗
PubMed1989

A program package for self-assessment and examination in biochemistry.

A BASIC program has been developed for self-evaluation and testing of an individual's knowledge of main categories in biochemistry. The computer tests permit sequential or random distribution of items, random distribution of answers in each item at each new run, effective feedback control with the student, use of a program clock to determine different time allowance, precise and quick analysis and grading of student's answer thus saving the time and labour of examiners. Editing, deleting and appending of new items is easily achieved. Information is obtained for verifying the quality of the test itself. Examination versions of tests in ten categories have been combined into an annual computer test in biochemistry.

Algorithms↗
PubMed1986

Generalization of treatment effects by young language-delayed children: a longitudinal analysis.

This study investigated the generalized effects of a language intervention program on the structural aspects of 8 language-delayed preschool children's productive language. Subjects were observed in preschool free play for periods ranging from 12 to 24 months concurrent with receiving daily didactic language intervention. A total of 57 two-, three-, and four-word syntactic forms were taught to criterion. Generalized usage was determined from (verbatim) language samples collected during free play periods in the subjects' classroom. Forty-two (74%) of the treated forms generalized to the subjects' spontaneous language in free play. There was a relationship between the complexity and potential functions of the treated forms and their generalization to free play. This effect may have been related to the subjects' MLUs. Substantial changes also occurred in the subjects' MLUs, frequency of speaking, Peabody Picture Vocabulary Test scores, and Houston Test for Language Development scores over the period of instruction. These measures suggested that 4 of the 8 subjects were functioning near the normal range at the conclusion of treatment. Implications of these and other results are discussed.

Child Language↗
PubMed1992

Visualization of bioelectric phenomena.

Biomedical investigators are currently able to acquire and analyze physiological and anatomical data from three-dimensional structures in the body. Often, multiple kinds of data can be recorded simultaneously. The usefulness of this information, either for exploratory viewing or for presentation to others, is limited by the lack of techniques to display it in intuitive, accessible formats. Unfortunately, the complexity of scientific visualization techniques and the inflexibility of commercial packages deter investigators from using sophisticated visualization methods that could provide them added insight into the mechanisms of the phenomena under study. Also, the sheer volume of such data is a problem. High-performance computing resources are often required for storage and processing, in addition to visualization. This chapter describes a novel, language-based interface that allows scientists with basic programming skills to classify and render multivariate volumetric data with a modest investment in software training. The interface facilitates data exploration by enabling experimentation with various algorithms to compute opacity and color from volumetric data. The value of the system is demonstrated using data from cardiac mapping studies, in which multiple electrodes are placed in an on the heart to measure the cardiac electrical activity intrinsic to the heart and its response to external stimulation.

Algorithms↗