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PubMed1992

Future-event schemas and certainty about the future: automaticity in depressives' future-event predictions.

The proposition was tested that depressives make predictions about the future based on a pessimistic future-event schema. Participants varying in depression predicted whether positive and negative events would happen to them (or to an average person) in the future by pressing yes or no at a computer terminal as quickly as possible, either under a concurrent attentional load or under no such load. As hypothesized, depressives predicted more negative events and fewer positive events than did mild depressives or nondepressives and showed greater automaticity in their predictions. That is, the attentional load did not increase depressives' response latencies for either negative or positive events, even though it did so reliably for both mildly depressed and nondepressed individuals. Depressives may thus possess a highly developed future-event schema that operates efficiently in enabling future-event predictions.

Adult↗
PubMed1990

A total audit of preventive procedures in 45 practices caring for 430,000 patients.

OBJECTIVE: To develop and report the results of a system of audit of computer records in general practice. DESIGN: A retrospective audit of records in practices using the same computer system. Information about recorded preventive procedures was collected by sending the same audit program to each practice on floppy disk. Other characteristics of the practices were determined by postal questionnaire. SETTING: Forty five general practices, widely distributed in England and Wales. SUBJECTS: All 430,901 patients registered with the practices. MAIN OUTCOME MEASURES: Within each practice the percentage of patients in specified age groups for whom certain preventive procedures were recorded as having been carried out. These measures were analysed in relation to practice characteristics. RESULTS: Practice characteristics and recording rates for preventive procedures varied over a wide range. Recording rates were higher in practices with computer terminals on every doctor's desk. Only one practice achieved the new contract target of 90% coverage for recorded primary immunisations, and fewer than two thirds recorded 80% coverage for cervical cytology in the past five years. Practices holding clinics did no better than those without. Smaller partnerships and smaller doctors' list sizes were associated with better performance. CONCLUSIONS: Centrally programmed audit of computerised records is a feasible method of providing data on a regular basis for epidemiological purposes and for performance review. The fact that practices with smaller list sizes had higher levels of recorded preventive care suggests that the trend towards larger lists promoted by the new contract might militate against the intended effect of better preventive care.

Adolescent↗
PubMed1989

Sustained maximal ventilation after endurance exercise in athletes.

Although impaired respiratory muscle performance that persists up to 5 min after exercise is stopped has been demonstrated during exhaustive exercise in normal young men, it is not known whether impaired respiratory muscle function follows endurance exercise to exhaustion in highly trained athletes. To study the effects of exercise on sustained maximal voluntary ventilation immediately after exercise, eight elite cross-country skiers performed a 4-min maximal sustained ventilation (MSV) test before and immediately after exhaustive exercise. Subjects were encouraged to maintain maximal ventilation (VE) throughout the MSV test. To encourage greater effort, rapid visual feedback of VE was provided on a computer terminal along with a target VE based on their 12-s maximum voluntary ventilation (MVV). The subjects (7 males, 1 female) were 18.5 +/- 0.9 yr old (mean +/- SD) and exercised for 62.5 +/- 16.7 min at 77 +/- 5% of their maximum oxygen consumption during which average VE was 106.7 +/- 24.2 l/min BTPS. The mean MVV was 196.0 +/- 29.9 l/min or 107% of their age- and height-predicted MVV. Before exercise the MSV was 86% of the MVV or 176.7 +/- 30.5 l/min, whereas after exercise the MSV was 90% of the MVV or 180.3 +/- 28.9 l/min (P = NS). The total volume of gas expired during the 4-min MSV was 706.7 +/- 121.9 liters before and 721.2 +/- 115.5 liters after exercise (P = NS). In this group of athletes, exhaustive exercise produced no deleterious effects on the ability to perform a 4-min MSV test immediately after exercise.

Adolescent↗
PubMed1985

Eliciting preferences for alternative cancer drug treatments. The influence of framing, medium, and rater variables.

In oncology there is increasing interest in the development of techniques to help patients choose between alternative therapies in ways that are consistent with their preferences. The purpose of this study was to examine some methodological problems associated with the elicitation of preferences. Preferences for alternative drug therapies were sought from 208 visitors to an open house at the Ontario Cancer Institute and from 216 university nursing students. Preferences were not significantly dependent on the sex, age or professional status of the respondents, nor on the medium used for elicitation of preferences (computer terminal versus pencil-and-paper questionnaire). In contrast, the importance of the way decision problems are framed was confirmed. Comparison of a positive frame (outcomes expressed as the probability of surviving) with a negative frame (outcomes expressed as the probability of dying) and a mixed frame (probabilities of surviving and dying were both given) pointed to the presence or absence of the word "survive" in the outcome description as the main source of framing bias. The framing effect was in the opposite direction to that hypothesized.

Adolescent↗
PubMed1988

An evaluation of labeling-then-doing with moderately handicapped persons: acquisition and generalization with complex tasks.

We conducted two experiments in which moderately mentally retarded persons were trained first to label and then to enter characters into a computer, calculator, or checkbook (label-then-do) within a multiple baseline design. In Experiment 1, 5 young adults were trained to enter statistical programs into computers in an office setting. Following training, all subjects' use of verbal labels and key-entry skills generalized across tasks (programs) and settings (offices and computer terminals). In Experiment 2, 3 junior high school students were trained with self-labeling procedures to complete a key-entry task and to balance a checkbook. The performance of all students generalized across tasks and settings, and the use of labels generalized for 2 of the students. Results are discussed relative to mediated generalization and to establishing verbal control over behavior.

Adolescent↗
PubMed1987

Controlling relations in conditional discrimination and matching by exclusion.

Normally capable adults learned two-choice identity matching of three-digit numerals and arbitrary matching of physically dissimilar nonsense syllables. The stimuli were displayed on a computer terminal, and responses consisted of typing on the terminal's keyboard. In Experiment 1, every trial displayed a sample numeral, a comparison numeral, and three equal signs (= = =). The comparison stimulus was to be selected if it was identical with the sample; otherwise the equal sign was to be selected. This "single comparison" method was then used to show that arbitrary matching could be based upon either sample-S+ or sample-S- relations. In Experiment 2, a series of probe trials displayed a novel sample, a comparison stimulus from the arbitrary matching baseline, and = = =. Subjects typically selected = = =; they apparently were excluding the baseline comparison stimulus. Experiments 3 through 5 investigated which variables in training would lead to the selection of baseline comparison stimuli in response to novel samples. Behavior was usually unchanged when baseline training included relating comparison stimuli to as many as four different samples. Punishment contingencies were effective, but performance did not generalize unless those contingencies were applied in relation to more than one baseline comparison stimulus.

Cues↗
PubMed1991

Computerized clinic scheduling system at the University of Michigan Medical Center.

The University of Michigan Medical Center has a flexible computerized clinic scheduling system that handles approximately 750,000 visits per year at the main hospital and satellite locations. The system includes a wide variety of fully integrated functions, including appointment booking, multiple and series scheduling, wait and reschedule lists, routine reminder notices, routine requests for medical records and radiology reports, no-show follow-up, and managerial reporting at multiple levels of detail. The system is extremely flexible, and allows separate scheduling specifications for every physician and all other resources within the system. The system is available at any of the approximately 1,800 computer terminals throughout the Medical Center, and is regularly used at approximately 400 terminals.

Academic Medical Centers↗
PubMed1991

[The effect of training with computer equipment on the visual analyzer of 1st-grade pupils].

Examination are carried out on 64 school children Ist class from school "104", town of Sofia where computer training on mathematics and mother tongue is introduced in the frames of pedagogic experiment. The studies are performed parallelly at traditional and computer lessons, realized in two variants (with one and two school hours daily). In order to establish the functional status of the visual analyzer during computer training the following methods are used: studying the distance of the nearest point for clear vision (punctum proximum), stability of clear vision, threshold of the electric eye sensitivity, critical frequency of fusing of the light flickerings. A full preliminary ophthalmological examination is made by "Vision test", as well as chronometric control of each student to establish the real time of work with computers. Taken into consideration are also the data for illumination of the working places in the computer studies and class rooms where the traditional school hours are held. The analysis of the data received shows that the computer training (1 and 2 computer lessons daily) with schoolchildren, Ist class, has no unfavourable effect on the functional status of the visual analyzer in the limits of study hours up to 25 minutes.

Accommodation, Ocular↗
PubMed1991

Electromagnetic fields: biological and clinical aspects.

Our entire biosphere is immersed in a sea of man-made electromagnetic fields (EMF). Occupational and public health data suggest that these fields may be a health hazard, possibly involving cancer and fetal loss. This paper reviews the history and pertinent physics of electromagnetic fields and presents evidence from the authors' work, and that of others, of biological interaction with living systems. Epidemiological data suggesting EMF hazards are reviewed including a discussion of possible risks associated with Hawaii's Lualualei transmitter site, TV and FM antennas in high-density population areas, fields surrounding electric power transmission and computer terminals, and the plan to route a major highway through the near-field of an operating Omega signal-source. In the face of current public fear and controversial research reports about long-term EMF exposure, suggestions are presented for public policy about these local sources of concern, as well as for the EMF risks common to any similarly developed areas.

Electromagnetic Fields↗
PubMed1990

[Electronic organization of patient records as a component of integrated medical informatics].

Conventional patient records are not only inconvenient to store, their structure is often not consistent and faulty, research is difficult and quality control is not possible. One solution to this problem is the computerized patient record. It contains all necessary data beginning with the first medical statements and ending with the final results of treatment. At any time and from any with the system connected computer terminal it allows immediate access to all medical records. In addition to medical information also administrative data are stored. The here presented system of a computerized medical record has proven to be an effective tool in the daily work as well for clinical, administrative and research tasks.

Humans↗
PubMed1990

Outpatient pharmacy redesign to improve work flow, waiting time, and patient satisfaction.

An outpatient pharmacy redesign in which a pharmacist located outside the dispensing area speaks with each patient before the prescription is processed is described, and the effect of patients' waiting time and satisfaction is reported. Adoption of an open pharmacy plan at a Veterans Administration outpatient pharmacy allows patients to present their prescriptions to pharmacists in consultation booths equipped with computer terminals. The pharmacist promptly identifies and resolves any problem associated with a prescription or medication profile. The prescription then enters the dispensing work area, which was also redesigned to improve efficiency; patients now pick up their medications at a window on the opposite end of the dispensing area from where the pharmacist initially receives the prescription. Workload data and waiting times before and after implementation of the open pharmacy showed that prescriptions could be processed more quickly under the new system; average waiting times decreased from more than one hour to 30 minutes. Interviews of randomly selected patients indicated that the reduced waiting times led to increased patient satisfaction. The open pharmacy design appeared to improve work flow and to improve patient satisfaction by decreasing waiting times.

Consumer Behavior↗
PubMed1990

A low cost ECG central station for intensive care.

A electrocardiogram (ECG) central station has been developed for the Intensive Care Unit at Christchurch Hospital. The system allows the selection and display of four ECGs selected from seven bedside monitors in the Unit. It also provides for automatic display, hard copy and audio alarm of ECG from any monitor which has detected an alarm condition--irrespective of whether that channel was being displayed prior to alarm detection. The system comprises a control unit (based on an 8085 microprocessor) and a mobile ECG station (4-channel ECG monitor, ECG recorder and computer terminal). Over the three years since its installation, the central station has been used 24 hours a day by medical and nursing staff and has proven to be a valued and reliable instrument in an intensive care environment.

Electrocardiography↗
PubMed1986

[Dynamic EEG mapping--an imaging procedure for studying perceptive, motor and cognitive brain performance].

The spatial pattern and time course of cortical activation can be studied when the event-related desynchronization in 30 EEG recordings is being quantified, averaged over about 60 events and displayed in form of maps with integration times of 125 ms (8 maps/s). This method was named dynamic mapping and used for investigating cortical activation pattern during the following tasks: Planning and execution of voluntary self-paced thumb movements, tactile stimulation of the foot sole and recognition of words, displayed shortly on a computer terminal. All these experiments resulted in localized activation pattern.

Cognition↗
PubMed1985

Full-text medical literature retrieval by computer. A pilot test.

A pilot test of a full-text, medical literature retrieval service demonstrated its capabilities for on-line search and retrieval of references, abstracts, and/or full-text journal articles. During a three-month test period, more than 500 health care professionals conducted 9,377 searches using computer terminals located in seven different health care sites. Searches were initiated for purposes of patient care, medical education, research, or for browsing. The majority of responders to a questionnaire given during the test period said they would continue to use the service during the pilot test, and only about 1% reported the search process difficult to use or not "user-friendly." It is predictable that with a comprehensive data base, full-text medical literature retrieval can be very useful for medical practice, medical education, and research.

Consumer Behavior↗
PubMed1977

A minirecord: an aid to continuity of care.

A simple, low cost computerized minirecord system (minimal essential record) has been in full operation for two years in the Medical Clinic of The Johns Hopkins Hospital. The primary objective of the minirecord system is to permit rapid retrieval of current information concerning Medical Clinic patients. The system provides a computer-printed listing of problems and medications in the front of each chart and on-line display of this information at strategically located computer terminals. The information is generated via existing simple systems with minimal additional effort and with the use of any terminology deemed appropriate. Chart review revealed that minirecords were actually present in 92% of the charts and that significant improvement occurred in the recognition of a subsequent visit of clearly defined problems and therapies noted on the initial minirecord. Current modifications will replace the separate minirecord and encounter form (registration and visit note) with a single form that will facilitate completion an updating. The rapid availability of this information provides a mechanism for coordinating continuing care in a university hospital system that is otherwise inevitably fragmented and composed of multiple health care providers.

Comprehensive Health Care↗