Guidelines for producing training films and videos.
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Africa↗
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Results for “Manual Communication”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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Design and development of the pressure ulcer nursing information system for clinical risk management.
Since 2002, hospitals have to report to Nursing Service Department, Hospital Authority Head Office on the pressure ulcer trends for risk management in Hong Kong. In line with the strategy, hospitals have designed their own patient observation records and reporting forms for monthly analysis and reporting of in-patient hospital acquired pressure ulcers. The incidence rates of individual hospital and its specialties are then calculated manually or using electronic spread sheets. However, the diversity in data definition and vocabulary use generates difficulties in communication among professionals and hospital managers. The development of the system would help to standardize the requirements and to reduce the time required for generating trends and ulcer information. The system also lays the foundation for future systems integration with the changing information system infrastructure.
Hong Kong↗
The Tanzania National Tuberculosis/Leprosy Programme in the face of HIV infection.
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Communicable Disease Control↗
[Certain problems in developing the Automated Control System for the "Sanitary-Epidemiologic Service" of the Uzbek SSR].
The main difficulties of using the subsystem "Records, Accounts and Analysis of Morbidity in Infectious Diseases", developed by the Republican Information and Computing Center of the Ministry of Health of the Byelorussian SSR for integration into the automated control system, under conditions of the Uzbek SSR lied in the fact that the number of the coupons of Recond Forms 171-BM for computers, several times exceeding that used in the Byelourssian SSR, had to be previously handled manually and in a short time.
Communicable Diseases↗
[A clinical research of three dimensional computerized imaging in the aid of operative design for reconstructive surgery of the face].
This article reports the utilization of three dimensional imaging technique of computer in reconstructive surgery of the face. In 312 cases, the technique has been proved that it can make the preoperative analysis computerized, quantitated and picturized. The measurement and analysis through computer are quick and exact, rendering operative designs feasible. The use of the evaluation system can also help enhance the communication and understanding between the surgeon and his patient. The surgical simulation system can replace the traditional preoperative manual work such as paper molds, plaster casts, and wax mold, and it is therefore much valuable for practical use.
Computer-Aided Design↗
Electronic communication with patients. Evaluation of distance medicine technology.
OBJECTIVE: To evaluate controlled evidence on the efficacy of distance medicine technologies in clinical practice and health care outcome. DATA SOURCES: Systematic electronic database and manual searches (1966-1996) were conducted to identify clinical trial reports on distance medicine applications. STUDY SELECTION: Three eligibility criteria were applied: prospective, contemporaneously controlled clinical trial with random assignment of the intervention; electronic distance technology application in the intervention group and no similar intervention in the control group; and measurement of the intervention effect on process or outcome of care. DATA EXTRACTION: Data were abstracted by independent reviewers using a standardized abstraction form and the quality of methodology was scored. Distance technology applications were described in 6 categories: computerized communication, telephone follow-up and counseling, telephone reminders, interactive telephone systems, after-hours telephone access, and telephone screening. DATA SYNTHESIS: Of 80 eligible clinical trials, 61 (76%) analyzed provider-initiated communication with patients and 50 (63%) reported positive outcome, improved performance, or significant benefits, including studies of computerized communication (7 of 7), telephone follow-up and counseling (20 of 37), telephone reminders (14 of 23), interactive telephone systems (5 of 6), telephone access (3 of 4), and telephone screening (1 of 3). Significantly improved outcomes were demonstrated in studies of preventive care, management of osteoarthritis, cardiac rehabilitation, and diabetes care. CONCLUSIONS: Distance medicine technology enables greater continuity of care by improving access and supporting the coordination of activities by a clinician. The benefits of distance technologies in facilitating communication between clinicians and patients indicate that application of telemedicine should not be limited to physician-to-physician communication.
Communication↗
A method for automated detection of usability problems from client user interface events.
Think-aloud usability analysis provides extremely useful data but is very time-consuming and expensive to perform because of the extensive manual video analysis that is required. We describe a simple method for automated detection of usability problems from client user interface events for a developing medical intelligent tutoring system. The method incorporates (1) an agent-based method for communication that funnels all interface events and system responses to a centralized database, (2) a simple schema for representing interface events and higher order subgoals, and (3) an algorithm that reproduces the criteria used for manual coding of usability problems. A correction factor was empirically determining to account for the slower task performance of users when thinking aloud. We tested the validity of the method by simultaneously identifying usability problems using TAU and manually computing them from stored interface event data using the proposed algorithm. All usability problems that did not rely on verbal utterances were detectable with the proposed method.
Algorithms↗
The perception and metaperception of architectural designs communicated by video-computer imaging.
Non-architects answered multiple-choice questions about depth, size, shape, texture, and conformation in exterior building scenes presented by manual rendering or video-computer techniques including a single viewpoint, multiple viewpoints, and animation. They also rated (a) confidence in their answers, (b) overall judgments of clarity, and (c) overall impressions of realism. The viewing time needed for judgments was also measured. Presentation technique did not affect the viewing time, but it did affect perceptual accuracy and ratings of confidence, clarity, and realism. Animation yielded higher ratings in all categories. It also produced the highest accuracy for depth perception, but the lowest accuracy for size and texture perception. The low accuracy for size and texture was exacerbated by high confidence in the wrong answers. Multiple viewpoints caused neither false confidence nor reduced accuracy in any category, and yielded the highest accuracy in two categories: size and texture. The combined effects on perception and metaperception (knowledge about one's own perceptual processes) suggest that animation creates the best overall impression and is the best for conveying depth information. However, multiple viewpoints are better than animation for conveying size and texture information. These results are discussed with respect to theories of perceptual representation.
Adult↗
The relationship of theory of mind and executive functions to symptom type and severity in children with autism.
Although neurocognitive impairments in theory of mind and in executive functions have both been hypothesized to play a causal role in autism, there has been little research investigating the explanatory power of these impairments with regard to autistic symptomatology. The present study examined the degree to which individual differences in theory of mind and executive functions could explain variations in the severity of autism symptoms. Participants included 31 verbal, school-aged children with autism who were administered a battery of tests assessing the understanding of mental states (knowledge and false belief) and executive control skills (working memory, combined working memory and inhibitory control, and planning) and who were behaviorally evaluated for autism severity in the three core symptom domains. Whereas theory of mind and executive control abilities explained the significant variance beyond that accounted for by language level in communication symptoms, neither explained the significant variance in reciprocal social interaction or repetitive behaviors symptoms. These findings are discussed in terms of a proposed distinction between higher level, cognitive-linguistic aspects of theory of mind and related executive control skills, and more fundamental social-perceptual processes involved in the apprehension of mental state information conveyed through eyes, faces, and voices, which may be more closely linked to autistic deficits in social reciprocity.
Adolescent↗
Clinical-neuropathological correlations in Alzheimer's disease and related dementias.
OBJECTIVE: To compare neurologists' initial clinical diagnoses made according to National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) and Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition guidelines with neuropathological diagnoses of Alzheimer's disease (AD) and related dementias. DESIGN: Consecutive autopsies in a prospective cohort study. SETTING: Community-dwelling patients with dementia referred to neurologists at an Alzheimer's Disease Research Center and satellite clinics (n = 151) and patients initially evaluated when institutionalized (n = 19). PATIENTS: Of 204 elderly patients who had an autopsy performed, 170 had received a complete dementia evaluation according to NINCDS-ADRDA guidelines. MAIN OUTCOME MEASURES: Percentage agreement between neurologists' initial clinical diagnoses and pathological findings. RESULTS: Of 137 patients clinically diagnosed as having probable or possible AD, 123 (90%) had AD neuropathological findings; this included 29 with AD accompanied by Lewy bodies, and 14 with AD and one or more infarcts. Cases of vascular and mixed dementia (AD and infarct[s]) had lower rates of agreement with pathological findings. Possible AD cases were more likely than probable AD cases to show pathological features other than AD. Clinicians predicted the presence or absence of AD pathological findings significantly better than chance. In patients with AD pathological lesions, older age of onset and male gender were significantly associated with shorter duration from disease onset to death. CONCLUSIONS: Clinicians accurately predicted AD pathological findings or their absence in most cases. Attributing other degenerative dementias to AD, misdiagnosing patients with combined AD and Lewy bodies and misjudging the vascular contribution to dementia were the major areas of inaccuracy. Formal criteria for dementia associated with non-AD lesions, Lewy bodies, and infarcts need to be developed and tested.
Aged↗
Expanding the usefulness of Interpersonal Psychotherapy (IPT) for depressed elders with co-morbid cognitive impairment.
BACKGROUND: The utility of Interpersonal Psychotherapy (IPT) has been documented as a maintenance treatment for late life depression as mono-therapy or in combination with antidepressant medication. Late life depression, however, is frequently co-morbid with declining memory or other cognitive abilities such that the usefulness of one-to-one psychotherapies is called into question for this subgroup. Additionally, concerned caregivers often accompany these patients to request help and their role in the presenting symptoms and in their potential resolution must also be addressed by any successful psychotherapy in this population. OBJECTIVES: To explore ways in which IPT could be modified to better serve the particular presentation and needs of depressed elders with cognitive decline along with their caregivers. METHODS: Various modifications of traditional IPT techniques were experimented with and refined in our collaborative late life research center using regular group supervision and feedback from patients and their caregivers. RESULTS: A key component of these modifications involves the integration of the caregiver into the treatment process in flexible ways that recognize their own role transition that is taking place simultaneously with that of the patient's role transition from a greater to a lesser functional state. Other techniques for resolving role conflicts, particularly those directly involving care issues for the patient, are also delineated. These modifications are collectively referred to as IPT-CI for cognitive impairment. A brief case vignette is presented. CONCLUSION: The modifications outlined in this communication reflect an evolving work-in-progress and serve as a framework for the future development of a manual of guidelines to assist healthcare personnel to optimally treat this population and their caregivers.
Aged↗
Simple method for computer-aided analysis of echocardiograms.
The use of echocardiography in the diagnosis and assessment of heart disease is increasing as greater familiarity is obtained with this noninvasive procedure. Quantitative evaluation of echocardiographic studies has heretofore required time-consuming manipulation of mathematical formulas. A simple method utilizing a sonic digitizing tablet has been developed for computer-aided analysis of M-mode echocardiograms. This device can convert a point located manually with a digitizing pen into X and Y coordinates and with use of the standard telephone network can communicate on a time-shared basis with a DECSYSTEM-10 computer. A program has been written to compute and type the results of standard calculations involving mitral valve motion and left ventricular function. The information can also be stored on disk by the computer for future use. This simple, relatively inexpensive system is valuable because of the ease with which it permits usually laboriously obtained information to be extracted from the standard echocardiogram.
Diagnosis, Computer-Assisted↗
The management of acute respiratory infections in Honduras: a field test of the Focused Ethnographic Study (FES).
The World Health Organization has recently developed an ethnographic research manual, The Focused Ethnographic Study (FES) for ARI, whose purpose is to facilitate Acute Respiratory Infection (ARI) program development by providing information about the context in which families perceive and respond to ARI, and by identifying factors that facilitate or impede prompt care-seeking for children with pneumonia. The methodology is focused around answering a set of pre-defined "Programme Managers' Questions" which represent the main concerns and needs of ARI programs. The FES is designed to address both the need for in-depth information about the household and community-level factors which affect the management of ARI, and the need for timely, program relevant, and focused information. A field test of this manual was conducted in Honduras, and a number of recommendations to the local ARI program were developed concerning improving communication about ARI with mothers of young children. The Honduran field-test of the FES shows how systematic ethnographic research can be conducted and translated into concrete recommendations for bridging the social and communication gap which so often exists between health workers and the communities they serve.
Acute Disease↗
Coordinated computer reporting of microbiology data in the clinical laboratory.
The details of incorporating microbiology results into a single computerized report that also includes all other laboratory results for each patient in the hospital are described. Including the microbiology results in this way allows provision of a consolidated flow sheet of all laboratory work on each chart, replacing the myriad single-sheet reports so common to manual systems. The results are tabulated, and are easily read by clinicians after some experience. This system also enables communication of updated results daily to clinicians and monitoring of infectious diseases in the hospital.
Computers↗
The efficacy of acamprosate in the maintenance of abstinence in alcohol-dependent individuals: results of a meta-analysis.
BACKGROUND: A number of clinical trials have been undertaken to determine the efficacy of acamprosate in the maintenance of abstinence in alcohol-dependent individuals. However, the reported differences in patient populations, treatment duration, and study endpoints make comparisons difficult. An assessment of the efficacy of treatment with acamprosate was, therefore, undertaken using meta-analytical techniques. METHODS: All randomized, placebo-controlled trials (RCTs) that fulfilled predetermined criteria were identified using (1) a language unrestricted search of 10 electronic databases; (2) a manual search of relevant journals, symposia, and conference proceedings; (3) cross-referencing of all identified publications; (4) personal communications with investigators; and (5) scrutiny of Merck-Santé's internal reports of all European trials. Study quality was assessed, independently, by three blinded workers. Key outcome data were identified; some outcome variables were recalculated to ensure consistency across trials. The primary outcome measure was continuous abstinence at 6 months; abstinence rates were determined by estimating Relative Benefit (RB). RESULTS: A total of 19 published 1 unpublished RCTs were identified that fulfilled the selection criteria; 3 were excluded because the documentation available was insufficient to allow adequate assessment. The remaining 17 studies, which included 4087 individuals, 53% of whom received active drug, were of good quality and were otherwise reasonably comparable. There was no evidence of publication bias. Continuous abstinence rates at 6 months were significantly higher in the acamprosate-treated patients (acamprosate, 36.1%; placebo, 23.4%; RB, 1.47; [95% confidence intervals (CI): 1.29-1.69]; p < 0.001). This effect was observed independently of the method used for assigning missing data. The effect sizes in abstinent rates at 3, 6, and 12 months were 1.33, 1.50, and 1.95, respectively. At 12 months, the overall pooled difference in success rates between acamprosate and placebo was 13.3% (95% CI, 7.8-18.7%; number needed to treat, 7.5). Acamprosate also had a modest but significant beneficial effect on retention (6.01%; [95% CI, 2.90-8.82]; p = 0.0106). CONCLUSION: Acamprosate has a significant beneficial effect in enhancing abstinence in recently detoxified, alcohol-dependent individuals.
Acamprosate↗
Priorities of undergraduate dental education: what do students think?
In recent years there has been an increasing interest in the teaching of behavioural sciences to dental undergraduates, but psychologists and sociologists can meet with resistance to their teaching from both staff and students. In an attempt to understand this resistance further, this paper provides the results of a cross-sectional survey conducted with undergraduate students at two UK dental schools. The results indicate that students believe that training in technical aspects of care (e.g. practice in manual skills, knowledge about anatomy) should assume a substantially higher priority than training in social aspects (e.g. practice in communication skills, knowledge about psychology). The students felt that they were increasingly prepared for both aspects of practice as they progressed through the course, and senior students were more likely to believe that their dental schools should give a higher priority to history-taking and psychological methods to control pain and anxiety than junior students. These results present a considerable challenge for psychologists and sociologists teaching at dental schools and suggest that appropriate curriculum design and integrated teaching may be the way forward.
Attitude of Health Personnel↗
Measurement of volume changes after sinus floor augmentation with a phycogenic hydroxyapatite.
PURPOSE: The purpose of this study was the determination of time-dependent volumetric changes of particulate sinus inlay grafts. A mixture of phycogenic hydroxyapatite (Algipore/C-Graft) and autologous bone collected from the surgical access area was used as the grafting material. MATERIALS AND METHODS: Thirty-three sinus floor augmentations using phycogenic hydroxyapatite combined with autologous bone collected at the augmentation site and venous blood were performed on 18 patients aged 57.4 +/- 12.5 years (mean +/- SD) with severe atrophy of the posterior maxilla. Graft volume was measured 1 to 14 days postoperatively and before the placement of dental implants 6.1 +/- 2.1 months later (mean +/- SD; range, 4 to 11 months) to evaluate the amount of time-dependent resorption of the implanted material on computerized tomographic (CT) images of the augmented region. The images were put into Digital Imaging and Communications in Medicine (DICOM) format and evaluated using the software library Analyze. The implanted bone replacement material was plotted manually on each CT slice, and the volume of the implanted material was calculated. RESULTS: The average volume loss of the bone replacement material during the observation period was 13.9% +/- 1.9% (mean +/- SEM). All sinus floor augmentations healed without complications except for delayed membrane exposure in 2 cases. DISCUSSION: The results indicate that the graft material, a mixture of Algipore, bone chips from the access area, and venous blood, exhibited a small volume loss over a period of approximately 6 months, thus providing predictable height for second-stage implant surgery. CONCLUSION: Further investigations are needed to evaluate long-term stability and implant success.
Adult↗
Beyond computer validation - a new role for quality assurance in systems development.
The Quality Assurance Unit (QAU) at Eli Lilly and Company is involved in the development of a new clinical pathology computer system in conjunction with the information systems area and the user area. This is the first time that the QAU had the opportunity to build our requirements into a new computer system. This is a new role for QA and includes both auditing and validation personnel who offer QA insights into issues. Benefits of QA involvement in the developmental process include saving time by building quality checks into the system, thus eliminating the need for manual review later in the process. Early resolution of issues leads to significant financial savings. Other benefits include improved communication among the three functional areas and a better understanding of the requirements and work processes. The team approach to the development of a new computer system results in a high-quality final product which meets all user and regulatory requirements, while also providing additional benefits to our organization.
Efficiency, Organizational↗