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PubMedDate not supplied

An Internet-based exercise as a component of an overall training program addressing medical aspects of radiation emergency management.

The use of ionizing radiation and radioactive materials continues to increase worldwide in industry, medicine, agriculture, research, electrical power generation, and nuclear weaponry. The risk of terrorism using weapons of mass destruction or simple radiological devices also has increased, leading to heightened concerns. Radiation accidents occur as a consequence of errors in transportation of radionuclides, use of radiation in medical diagnosis and therapy, industrial monitoring and sterilization procedures, and rarely, nuclear power generation. Compared to other industries, a small number of serious radiation accidents have occurred over the last six decades with recent cases in the Republic of Georgia, Peru, Japan, and Thailand. The medical, psychological, and political consequences of such accidents can be considerable. A number of programs designed to train medical responders in the techniques of radiation accident management have been developed and delivered in many countries. The low frequency of serious radiation accidents requires constant re-training, as skills are lost and medical staff turnover occurs. Not all of the training involves drills or exercises in which responders demonstrate learning or communication over the broad spectrum of medical response capabilities. Medical preparedness within the context of a total emergency response program is lacking in many parts of the world, particularly in Central and Eastern Europe and the Newly Independent States. This paper describes an effort to enhance medical preparedness in the context of a total program of international cooperation and conventions facilitated by the International Atomic Energy Agency. The paper concludes that novel application of telecommunications technology as part of a training activity in radiation accident preparedness can help address gaps in training in this field in which preparedness is essential but experience and practical field exercises are lacking.

Attitude of Health Personnel↗

PubMed2002

IP telephony--new horizon for telemedicine and e-health.

Internet Protocol (IP) based networks are increasingly being used as alternatives to the traditional circuit-switched networks for carrying voice traffic. IP telephony is taking a firm hold in the world telecommunication market for a wide range of applications including telemedicine. The merits of IP telephony for telemedicine lie in cost-savings and new applications and functionalities it may render. In this paper, we try to discuss and analyze the implications of IP telephony on the evolution and deployment of telemedicine and e-health.

Computer Communication Networks↗

PubMed1998

Internet usage and potential impact for acute care hospitals: survey in the United States.

These survey results are from a national survey of acute care hospitals. A random sample of 813 hospitals was selected with 115 responding and 33 incorrect addresses resulting in a 15% response rate. The purpose of the study was to measure the extent of information systems integration in the financial, medical, and administrative systems of the hospitals. Internet usage including homepages and advertising was measured. Other selected telecommunication applications are analyzed. As demonstration projects from the literature are compared to the survey results, the potential for hospitals is tremendous. Resulting cost savings could be equally impressive. This information will provide a benchmark for hospitals to determine their position relative to Internet technology and to set goals.

Advertising↗

PubMed1996

Point-light facial displays enhance comprehension of speech in noise.

Seeing a talker's face can improve the perception of speech in noise. There is little known about which characteristics of the face are useful for enhancing the degraded signal. In this study, a point-light technique was employed to help isolate the salient kinematic aspects of a visible articulating face. In this technique, fluorescent dots were arranged on the lips, teeth, tongue, cheeks, and jaw of an actor. The actor was videotaped speaking in the dark, so that when shown to observers, only the moving dots were seen. To test whether these reduced images could contribute to the perception of degraded speech, noise-embedded sentences were dubbed with the point-light images at various signal-to-noise ratios. It was found that these images could significantly improve comprehension for adults with normal hearing and that the images became more effective as participants gained experience with the stimuli. These results have implications for uncovering salient visual speech information as well as in the development of telecommunication systems for listeners who are hearing impaired.

Adolescent↗

PubMed2003

A grounded theory study of the role that nurses play in increasing clients' willingness to access community mental health services.

Clients and caregivers frequently encounter difficulties in accessing mental health services. Early intervention to care and treatment is essential to recovery as delays can adversely affect the severity and the duration of the illness. This paper reports the factors that encouraged and deterred young adults with schizophrenia and their caregivers when trying to seek early access to community mental health services, and examines how community mental health nurses made themselves accessible to these individuals in order to increase their access to services. The findings showed that several factors simultaneously encouraged and inhibited individuals initiating contact at community mental health centres, and these had serious implications for care and treatment, and recovery. There were two client access pathways to care: a direct access pathway where an individual recognized signs of being unwell and sought help early; and an indirect access pathway where others, such as caregivers, general practitioners, police, and inpatient facilities initiated contact on an individual's behalf. Nurses used three strategies to enhance client and caregiver access to services: 'promoting favourable experiences to enhance approachability', 'using technology to promote access' and 'being available'. The findings have significance for nursing practice because they reinforce the importance of having good relationships with clients and caregivers, and the need to take account of the needs of caregivers. They highlight the benefits and drawbacks of using telecommunications to enhance accessibility, and why it is necessary to analyse nurses' workloads and time management skills.

Adult↗

PubMed2002

Interface of information technology and neuropsychology: ethical issues and recommendations.

Rapid advancements in information technology and telecommunications (ITT) offer exciting opportunities for neuropsychology. However, guidelines and recommendations for identifying and negotiating ethical challenges have not kept pace with the expansion of ITT. Because many neuropsychologists evaluate and/or treat individuals with cognitive, emotional, and/or physical limitations, neuropsychologists have a responsibility to be aware of the ethical issues associated with ITT use in order to avoid harming those who may be less able to understand or independently manipulate such technology themselves. The purpose of this paper is to raise awareness of potential implications of the interface between ethics and information technology for neuropsychologists. The first steps in this process include defining terms, identifying relevant issues and challenges, and identifying initial mechanisms to address ethical challenges. In addition, strategies for avoiding ethical misconduct related to information technology are discussed and specific recommendations are offered.

Clinical Competence↗

PubMed2002

Communication, information and well-being for Australians with physical disabilities.

PURPOSE: This paper is a literature review, the purpose of which was to examine the legislative framework and the Australian Government Information Policy and how this has impacted on virtual communication and the well-being of Australians with disabilities. METHOD: This has been a systematic review of current Australian literature that considers especially how communication and information can contribute positively towards connecting people with disabilities with other people during and post-rehabilitation. RESULTS: The results of this systematic literature review has been encouraging in that Australians with disabilities are being taken account of in the planning processes and evaluation of communications technologies. CONCLUSION: The paper also deals with how these interactive telecommunications may play an important role by assisting persons with disabilities in dealing with the loss of a sense of control over one's destiny, which is often prevalent during the acute phase of injury in persons with disabilities.

Australia↗

PubMedDate not supplied

Utilizing technology: the challenges and opportunities facing "substance abuse" professionals in rural communities.

Many rural communities are actively pursuing technology as a resource for solving education, health care, and economic development issues. These communities are establishing a technology and telecommunication infrastructure that makes them appealing to individuals and companies from urban communities. But this has created a challenge and an opportunity for the mental health industry in general, and more specifically, "substance abuse" professionals. The opportunity for the "substance abuse" profession is to design and use new services using the exact same technologies that may precipitate the need for the services.

Humans↗

PubMed1993

Measuring satisfaction with organizations. Predictions from information accessibility.

The study explored the process through which customers assess their satisfaction with service organizations. Our theoretical analysis suggests that when a general satisfaction question appears after questions about specific domains were asked (SG order), the earlier questions increase the accessibility of both positive and negative information. In contrast, when a general satisfaction question appears prior to any other question (GS order), negative information is more accessible than positive information. On the basis of these differences in accessibility we predicted (1) greater asymmetry in the impact of positive and negative information on the general satisfaction response in the GS order, (2) higher correspondence between domain-specific satisfaction and general satisfaction in the SG order, and (3) higher levels of general satisfaction in the SG order. These predictions were supported in analyses of customers' responses in a national survey of satisfaction with the Israel Telecommunication Corporation (Bezeq).

Consumer Behavior↗

PubMed1995

Tele-endoscopic otorhinolaryngological examination: preliminary study of patient satisfaction.

OBJECTIVE: Modern telecommunications and computer technologies enable the delivery of expert consultations and remote diagnoses that previously required transportation of patients or medical specialists. The purpose of this study was to determine whether patients are satisfied with one form of telemedicine consultation. METHODS: A general practitioner was trained to perform endoscopic otorhinolaryngological examinations. After the training period, he examined patients at a local health center in Alta, 250 km from Tromsø. Images from the endoscopic examination were transmitted to the otorhinolaryngologist at the University Hospital of Tromsø for real-time consultation. Twenty-six patients, on a randomly selected day, were asked to complete a questionnaire after the tele-endoscopic examination. The questionnaire was returned anonymously by 24 of the patients. RESULTS: Although patients interacted with the specialist only via videoconferencing, the results show that most (23/24) were satisfied with this type of consultation, and they reported more advantages than disadvantages. Twenty-one patients indicated that they would accept another tele-endoscopic consultation if they required examination by an otorhinolaryngologist in the future. CONCLUSION: Although the sample is limited, the results justify continued investigation of this and other types of telemedicine consultations.

Adult↗

PubMed1998

Telemedicine using a desktop conference system (Phoenix) in Kyushu, Japan.

OBJECTIVE: The Kyushu area of southwestern Japan has several mountains and 157 inhabited islands. We assessed the feasibility of implementing a desktop conference (DTC) system to improve medical care in this area. TELECOMMUNICATIONS TECHNOLOGY AND EQUIPMENT: The Phoenix DTC system (NTT Corporation, Tokyo, Japan) for personal computers includes a microphone, speaker, color CCD camera, and appropriate software. We used a digital camera for still pictures and image-analysis software for radiographs and CT and MRI films. The system was installed on a Pentium 133 MHz computer, which was connected by ISDN line at a 128 kbps data rate to a clinic on a small island where one physician cares for 1000 residents, two small nursing offices where each nurse tends 100 residents, two nursing homes, a hospital in a mountainous area, and the residence of a patient with atopic dermatitis. Connections were made once a week for a period of 6 months. RESULTS: The transmitted still pictures; e.g., senile nevus, atopic dermatitis, chickenpox, and a radiograph of a suspected fracture, were useful for diagnosis and clinical decision making. We received and responded to inquiries from residents of the participating nursing homes on nutrition, senile depression, nevus, decubitus ulcers, urinary tract infection, and protection against Legionella infection. We also used the system to deliver lectures on pediatrics to nurses; provided case discussions on diaphragmatic herniation and subtentorial tumor; and had on-line presentation of a patient with beta-thalassemia using presentation software. CONCLUSION: The DTC system used in the present study seemed technically satisfactory and useful in improving medical care in remote sites of Japan.

Child, Preschool↗

PubMed2004

Design evolution of an interactive robot for therapy.

This paper describes a project using telecommunication and robotics to develop a system that addresses developmental goals for children with disabilities. A user-centered design was employed to meet the needs of the end users: children with disabilities, therapists, educators, and parents. The design team developed the prototype robot system for therapy, education, and play. The robot system is an adaptable, programmable robot, designed to address a wide range of disabilities, interests, and developmental goals. The production design will include data collection and remote monitoring capabilities. The steps leading to the prototype and its evaluation are described, including identification of user needs and system requirements to satisfy these needs.

Child↗

PubMed2005

Adaptive tele-application for remote neurology diagnosis.

This paper presents the Collaborative Tele-Neurology (TeNeCi) project which allows practitioners to use telecommunication technologies to provide medical information and services for neurological diseases. Specificities of remote neurology are described and the Cooperative Application Framework (CAliF) multimedia platform on which TeNeCi relies is presented. The technical requirements of such a project in terms of communication and consistency management, audio and video transmissions, and network support, as well as implementation of TeNeCi was evaluated. The software used in this application is composed of several services, such as a Digital Imaging and Communications in Medicine (DICOM) explorer, a DICOM viewer, and a security service. Tests performed on this first TeNeCi release showed good results, and allowed us to explore a larger collaborative experimentation between hospitals in France and Switzerland.

Emergency Medical Services↗

PubMed2004

Evaluation of the electromagnetic field level emitted by medium frequency AM broadcast stations.

In order to estimate the level of the electromagnetic field produced by telecommunication systems, different computational techniques can be employed whose complexity depends on the accuracy of the final results. In this paper, we present the validation of a code based on the method of moments that allows us to analyse the electromagnetic field emitted by radio-communication systems operating at medium frequencies. The method is able to provide an accurate estimate of the levels of electromagnetic field produced by this type of device and, consequently, it can be used as a method for verifying the compliance of the system with the safe exposure level regulations and population protection laws. Some numerical and experimental results are shown relevant to an amplitude modulated (AM) radio transmitter, together with the results of a forthcoming system that will be operative in the near future.

Algorithms↗

PubMed2006

Exposure setup to study potential adverse effects at GSM 1800 and UMTS frequencies on the auditory systems of rats.

To investigate possible biological effects of exposure to electromagnetic (EM) fields at the frequencies of global system for mobile communication (GSM) 1800 system and universal mobile telecommunication system (UMTS) on the auditory system of rats, an exposure setup for in vivo experiments is presented. The study was carried out in the framework of two European research projects. The target of the investigation was the cochlea. A dosimetric study was performed, both numerically and through direct measurements, to assess the interaction of the radiated fields and the dose distribution in the biological target. For the local exposure of rats, a loop antenna operating at the frequency bands of interest was designed, realised and characterised through numerical and experimental dosimetric procedures. Moreover, an exposure apparatus was set up, consisting of three arrays of four loop antennas, placed on three levels, thus allowing simultaneous exposure of 12 rats to give statistical power to the experiments. To isolate the exposure arrays, the setup was assembled by a wooden rack with EM field absorbing panels, inserted among the levels and at the four sides of the rack. Isolation was verified by direct measurements. Two exposure arrays were simultaneously supplied, whereas the third one was used for sham exposure. Blind exposure was achieved through a black box, hiding physical connections to the microwave power supply. During exposure sessions, rats were restrained in special plastic jigs for repeatable positioning, thus assuring the fixed level of dose in the target.

Animals↗

PubMed1982

Telemedicine in critical care: problems in design, implementation, and assessment.

We introduced telemedicine, i.e., telecommunications for delivery of health services, to alleviate scarcity and maldistribution of critical care services. For 18 months, we used interactive television to provide consultation with university-based critical care physicians for patients in the ICU of a 100-bed hospital. Telemedicine "visits" (1548) were made to 395 patients. Television consultation had greater clinical and educational impact than consultation using the telephone. Equipment was expensive but proved to be reliable and easy to use. Interactive television extended the availability of specialist expertise, but full exploitation of this technology for delivery of critical care services was not achieved. Extensive background research, currently underway at the University of Pittsburgh, is necessary before the next telemedicine demonstration.

Critical Care↗

PubMed1990

Integrated Broadband Communication (IBC) requirements of people with special needs.

In order to make the benefits of the Integrated Broadband Communication (IBC) services available to the largest possible part of the population, special attention should be given to user groups with special needs, such as elderly and handicapped people. For some of these groups the IBC services will facilitate their members socio-economic integration and offer them the opportunity to satisfy some of their everyday needs (e.g. video-telephony for the inter-personal communication of hearing impaired people). For some other categories (e.g. people with motor or sensory impairment), special design considerations are needed at a very early stage of technical development, in order to ensure that they are not prevented from using future sophisticated telecommunication services (e.g. by incorporating appropriate man-machine interaction techniques in general purpose terminals, adapting the user interface of terminals, etc.). This paper gives an overview of the work that is currently taking place within the framework of the Research and development on Advanced Communication in Europe (RACE) programme.

Communication Devices for People with Disabilities↗

PubMed1990

Telework as an employment option for people with disabilities.

This feasibility study, based on intensive casework, examined the potential of home-based teleworking arrangements for people with severe physical disabilities. Eleven teleworking arrangements, each involving a unique combination of work, working conditions and worker characteristics, were set up in different parts of Ireland and monitored over periods ranging from 6 to 18 months. Eight were still operational at the end of the project and, with one exception, were set to continue as longer-term arrangements. Outcomes from this action-research project suggest that teleworking is a feasible form of employment for such persons--provided care is taken over selection of workers, identification of work that is suited to the telework format and management of telework units by employers. They also suggest that teleworking arrangements can be quite flexible, ranging from examples in which work is performed mainly from home to those which combine home-based activity with varying degrees of conventional office-based activity. It is concluded that telework will create new opportunities for people with severe disabilities, as well as enabling others who become disabled during employment to retain their jobs. However, it is important that workers are appropriately trained in the use of computers and advanced telecommunications and, in many cases, home-delivered training is required.

Adult↗