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PubMedDate not supplied

Distance learning: an innovative approach to nursing education.

This article presents four views encompassing one nursing department's experience using distance learning technology. The challenge of presenting a nursing class through distance technology is discussed from the perspective of the telecommunication faculty providing the technological support, the nursing faculty teaching the on-campus course, the off-campus nursing faculty coordinating the course at the outreach site, and the head of the Department of Nursing. Review of course grades demonstrated that off-campus students achieved higher grades than on-campus students. All students evaluated the teacher as being effective; however, off-campus students were not as strong in their opinion.

Attitude↗

PubMed2005

2.45 GHz radiofrequency fields alter gene expression in cultured human cells.

The biological effect of radiofrequency (RF) fields remains controversial. We address this issue by examining whether RF fields can cause changes in gene expression. We used the pulsed RF fields at a frequency of 2.45 GHz that is commonly used in telecommunication to expose cultured human HL-60 cells. We used the serial analysis of gene expression (SAGE) method to measure the RF effect on gene expression at the genome level. We observed that 221 genes altered their expression after a 2-h exposure. The number of affected genes increased to 759 after a 6-h exposure. Functional classification of the affected genes reveals that apoptosis-related genes were among the upregulated ones and the cell cycle genes among the downregulated ones. We observed no significant increase in the expression of heat shock genes. These results indicate that the RF fields at 2.45 GHz can alter gene expression in cultured human cells through non-thermal mechanism.

Dose-Response Relationship, Radiation↗

PubMed2005

Geomedical warning system against epidemics.

We describe aims, usage and evaluation of the computer-based early warning system telecommunication on medical events (TeCoMed), which achieves tracking down of temporal and spatial spread of epidemics for seasonal communicable diseases. It uses experiences from former waves of communicable diseases down to fine-grained local areas. Data is delivered by the biggest German insurance scheme. The results are presented by means of a commercial, geomedical information system. The evaluation of the system's performance concerning influenza shows that timely risk assessment and warnings are possible.

Communicable Disease Control↗

PubMed2006

Healthcare practice ISOlation: articulating systems that drift toward higher quality.

Can higher quality healthcare practices emerge from the development and use of a loosely integrated set of intranets? This paper examines that question through a series of empirical examples that draw on data from one healthcare organization that was part of a multi-year, multi-industry study of intranets. Some of this organization's intranets link clinical practice guidelines to healthcare delivery, in ways that mimic manufacturing sector efforts to improve product quality and reliability. Others act as staging grounds and information repositories for coordinating responses to new rulings and changing interpretations of how to implement recently enacted healthcare legislation. This activity is reminiscent of coordinated responses, among firms and their legal counsel, to new legislation in other industries, like telecommunications; and to wide-reaching regulatory efforts, like environmental protection. Although the technologies have changed and the legislative objectives vary greatly, organizational approaches to such improvements are less varied. Ironically, these overarching similarities focus attention on the need for continued articulation of changes and local differences in information system use, and the ability of boundary-spanners to introduce ways of working that bridge these gaps and refine healthcare practices that drift toward higher quality.

Computer Communication Networks↗

PubMedDate not supplied

Innovations in midwifery education.

Midwifery educators and the American College of Nurse-Midwives (ACNM) have created educational pathways for Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) based on sound principles and creativity. A review of these educational innovations portrays the strong foundation that exists and provides direction for the future. Accreditation of educational programs, the development of core competencies, and the certification process for graduates of midwifery education programs form the foundation for excellence in midwifery education, while the early development of the modular mastery learning curriculum provided a transition to later use of telecommunications and the incorporation of various instructional technologies into midwifery education. Midwifery educators have continued to innovate with distance-learning, Web-enhanced curricula and community-based clinical preceptorships, and a master's degree in midwifery option to increase access to midwifery education and degree programs. Continued innovation and creativity will be required to prepare midwives for the 21st century.

Certification↗

PubMedDate not supplied

Redesigning courses for the World Wide Web.

The use of computer-based instructional technologies has become almost ubiquitous in education, including health professions education. In addition, clinical practice requires the use of digital information, networking, and continued learning. Faculty, students, and clinicians must be prepared to use computer-based technologies and telecommunications. Many faculty members in the health professions need assistance with the transfer of traditional (campus-based) courses or course material to the World Wide Web. This article presents the instructional design and pedagogical aspects of redesigning a traditional campus-based course for the World Wide Web. Specific steps and a template are identified. The development of a virtual community of learners is also discussed as a critical element of on-line teaching and learning.

Computer-Assisted Instruction↗

PubMed1998

Nuclear medicine data communications.

Nuclear Medicine was one of the earliest imaging modalities to adopt the use of computers for acquisition, processing, storage, and display of digital images. Originally used for processing images, computer technologies were quickly adopted for image storage, display, and transmission. Modern nuclear medicine cameras produce digital images that can be transmitted over computer networks to other cameras, storage devices, workstations, and printers. In order to achieve nuclear medicine data communication, images must be successfully acquired and transmitted to the appropriate location to be displayed or printed. Standards have been developed over the years to facilitate the creation of interfaces between vendors and equipment, notably the interfile format for nuclear medicine and the DICOM standard for medical images. Studies can be transmitted over network communication links to other sites using telecommunication protocol standards where they can be stored and/or displayed on a wide variety of devices. This ability to move images in a well-understood format to general purpose devices using standard equipment enables the use of the Internet to disseminate nuclear medicine study information over a wide area for clinical use, research, and education. A number of universities have created Internet sites with nuclear medicine teaching files and information. As technology advances, it will be feasible to transmit medical images of all kinds to virtually anyone who needs them in near real-time, without regard to the distance between locations, or the types of instrumentation and computers used. The next few years should prove to be very interesting for digital medical imaging in general and nuclear medicine in particular.

Computer Communication Networks↗

PubMed1999

The management and policy challenges of the globalisation effect of informatics and telemedicine.

Managers and policy makers face new and as yet unrecognised challenges--particularly loss of control--through the application of new information technologies in healthcare. Whilst informatics and telemedicine are important developments, the potential for adverse organisational and societal effects should be recognised and anticipated. Health organisations are frequently seen as circumscribed networks, and these in turn form local alliances with related organisations. Information technologies are frequently construed as relating to operational systems within organisations, not least electronic patient record systems and diagnostic systems. These can then be linked to new generation health business systems, to provide accurate management information at low additional cost. However, this pair of assumptions is now seriously flawed, due to the effects of the latest developments in health informatics and telemedicine. In particular, telecommunications and Internet technologies render ineffectual previous external barriers of distance and national boundaries, whilst within the organisation the combination of knowledge bases with information technologies creates tendencies towards internal autonomy. Organisational and national policy control of health care face direct and radical challenges through perverse effects of otherwise beneficial developments, and early action is needed.

Database Management Systems↗

PubMed2001

Telemedical support using real-time ultrasonography and endoscopy images.

We developed a telecommunications apparatus (TMS-6101, NIHON KOHDEN WELLNESS CORPORATION, Tokyo, Japan) and evaluated its clinical utility as a telemedical support system. It is capable of transmitting on a real-time basis such vital signs as blood pressure, arterial O2 saturation and ECG recordings, which are measured at bedside using the Life-Mate monitor (NIHON KOHDEN WELLNESS Co.). It is also capable of transmitting moving video-camera pictures in real time. In this study we assessed its application for telemedical supports with particular emphasis on ultrasonography and endoscopy images since reports of such applications are lacking. Employing this system, several kinds of technically demanding endoscopic procedures were supported successfully under the supervision of at least one off-site specialist physician. The system proved to be a very useful medical resource, since it facilitated high quality medical care and specialist consultation at any location without those specialists traveling to the scene.

Endoscopy↗

PubMed1999

Internet for clinical trials: past, present, and future.

The Internet and World Wide Web have recently been introduced into the management of some aspects of large-scale clinical trials such as remote randomization and data entry and the distribution of information on trial progress. Electronic mail and websites have also been used to enhance communication among people involved in a clinical trial. The Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico acuto (GISSI) used telecommunications and the Internet in some recent large-scale clinical trials. GISSI constructed a website to keep the medical and cardiology community informed about the progress of its studies. Websites for clinical trials could play an important role in the future, especially in international clinical trials. The website could provide information such as study material and study news and tools such as electronic forums on protocol application for use by investigators around the world. This article describes the GISSI experience and outlines an appropriate structure for a clinical trial website.

Clinical Trials as Topic↗

PubMed2003

Gender differences in excessive daytime sleepiness among Japanese workers.

Excessive daytime sleepiness (EDS) is serious concern in the workplace with respect to errors, accidents, absenteeism, reduced productivity and impaired personal or professional life. Previous community studies found a female preponderance of EDS, however, there is little research on EDS and gender in occupational settings. We examined the gender differences in prevalence and risk factors of EDS among employees working at a telecommunications company in the Tokyo metropolitan area. Our outcome measure of EDS was the Epworth Sleepiness Scale (ESS). A self-administered questionnaire on health and sleep including ESS was distributed to 5,571 workers between December 1999 and January 2000, and 5,072 responses were returned (91.0%). A total of 4,722 full-time, non-manual and non-shift employees aged 20-59 were used for analysis (3,909 men and 813 women). Chi-squared tests and multiple logistic regression analyses were applied for examining the gender differences in the prevalence and risk factors of EDS. The prevalence rates of EDS were 13.3% for women and 7.2% for men (P<0.001). We identified that deprived nocturnal sleep, an irregular sleep-wake schedule and depression were the risk factors of EDS for both genders, and being married worked as a protective factor against EDS for men alone. It is obvious that a ban on overtime work and a provision of mental health hygiene are the general strategies for reducing EDS at worksites. In the case of women, we suggest the formation of effective strategies for improving women's status at home and in the workplace must also be a solution for the prevention of EDS (e.g. promoting gender equality in the division of labor at home and strengthening family care policies for working women).

Adult↗

PubMed1977

Telemedicine in critical care: an experiment in health care delivery.

We hypothesized that telemedicine -- medicine practiced from a distance using telecommunications -- can solve some problems related to the scarcity and maldistribution of specialists in critical care medicine. Using a two-way audiovisual link between a small private hospital and a large university medical center, we have provided daily consultations by an intensivist to patients in the small institution. During the first 175 days of the project we found: 1) regular consultations in critical care can be provided using the audiovisual link; 2) current technology is adequate but expensive; 3) telemedicine consultations can be made acceptable to users and providers; 4) telemedicine can be a valuable educational resource; 5) telemedicine can influence the process and probably the outcome of patient care; 6) the audiovisual link is superior to the telephone for these consultations; and 7) telemedicine can serve as an important link between a small hospital and a large medical center favorably influencing the quality of care in the critical care unit of the small hospital.

Audiovisual Aids↗

PubMed2000

Teleradiology in Europe.

The new concept of teleradiology is centered on the consideration that it involves management of medical information rather than the simple transmission of diagnostic images from one location to another. Teleradiology must therefore be able to contribute to the seamless integration of the digital environment in which medical data are managed throughout and beyond the hospital, generating value added services for the patients as well as prospective economical benefits for the institution. In this perspective the evolution of telecommunication with the spectacular success of mobile telephony and Internet will play and increasingly important role, by allowing further development in the exchange of multimedia medical information on a regional as well as international level. However, new responsibilities are being given to the radiologists, who must take all necessary technical and organizational actions in order to avoid that the digital management of data may endanger the confidentiality and the integrity of patients' data.

Computer Security↗

PubMed1998

Challenges of teaching graduate psychiatric-mental health nursing with distance education technologies.

As student demographics change and distance educational technology continues to evolve, faculty teaching advanced psychiatric-mental health nursing are attempting to meet the needs of students at distant sites through telecommunications. Graduate education in psychiatric-mental health nursing at the University of Minnesota School of Nursing has used distance education technology since 1994. The use of technology, such as interactive television, audio and audio/video telephone conferencing, facsimile, and electronic mail to teach has been exciting and challenging. This article discusses challenges related to connectedness, confidentiality, and communication; describes approaches to address these challenges; and identifies student, faculty, and environmental attributes that help make teaching with this technology successful.

Education, Nursing, Graduate↗

PubMed2001

Pediatric hematology-oncology outreach for developing countries.

Health care in some developing countries is now at a level that makes programs for care of children with cancer feasible. Examples of successful international programs in this field include twinning programs, nongovernmental assistance organizations, such as the National Children's Cancer Society, and committees of professional organizations, such as the International Society of Pediatric Oncology (SIOP). The international outreach program at St. Jude Children's Research Hospital includes training programs within the hospital, partner sites in 13 countries, a school for Latin American nurses, a distance learning website, and telecommunications programs, which are described in detail. Future programs should be designed to maximize and evaluate impact, report accomplishments and failures, and avoid duplication.

Adolescent↗

PubMed2003

Neural independent component analysis by 'maximum-mismatch' learning principle.

The aim of the present paper is to apply Sudjanto-Hassoun theory of Hebbian learning to neural independent component analysis. The basic learning theory is first recalled and expanded in order to make it suitable for a network of non-linear complex-weighted neurons; then its interpretation and application is shown in the context of blind separation of complex-valued sources. Numerical results are given in order to assess the effectiveness of the proposed learning theory and the related separation algorithm on telecommunication signals; a comparison with other existing techniques finally helps assessing the performances and computational requirements of the proposed algorithm.

Algorithms↗

PubMed1997

A network of web multimedia medical information servers for a medical school and university hospital.

Modern medicine requires a rapid access to information including clinical data from medical records, bibliographic databases, knowledge bases and nomenclature databases. This is especially true for University Hospitals and Medical Schools for training as well as for fundamental and clinical research for diagnosis and therapeutic purposes. This implies the development of local, national and international cooperation which can be enhanced via the use and access to computer networks such as Internet. The development of professional cooperative networks goes with the development of the telecommunication and computer networks and our project is to make these new tools and technologies accessible to the medical students both during the teaching time in Medical School and during the training periods at the University Hospital. We have developed a local area network which communicates between the School of Medicine and the Hospital which takes advantage of the new Web client-server technology both internally (Intranet) and externally by access to the National Research Network (RENATER in France) connected to the Internet network. The address of our public web server is http:(/)/www.med.univ-rennesl.fr.

Artificial Intelligence↗

PubMedDate not supplied

Earning a Master's of Science in Nursing through distance education.

The increased availability of telecommunications technology has made possible the offering of degree programs via distance education. Such programs make courses and degrees more readily accessible to a wider range of students than has traditionally been the case. The University of Tennessee, Memphis, College of Nursing has undertaken to offer a Master's of Science in Nursing degree entirely by distance education. The challenges, successes, and technology of the program are discussed.

Computer Communication Networks↗