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PubMed2001

Telepathology overview: from concept to implementation.

Telepathology is the practice of pathology at a distance by using video imaging and telecommunications. Significant progress has been made in telepathology. To date, 12 classes of telepathology systems have been engineered. Rapid and ultrarapid virtual slide processors may further expand the range of telepathology applications. Next-generation digital imaging light microscopes, such as miniaturized microscope arrays (MMA), may make virtual slide processing a routine laboratory tool. Diagnostic accuracy of telepathology is comparable with that of conventional light microscopy for most diagnoses. Current telepathology applications include intraoperative frozen sections services, routine surgical pathology services, second opinions, and subspecialty consultations. Three telepathology practice models are discussed: the subspecialty practice (SSP) model; the case triage practice (CTP) model; and the virtual group practice (VGP) model. Human factors influence performance with telepathology. Experience with 500 telepathology cases from multiple organs significantly reduces the video viewing time per case (P < .01). Many technology innovations can be represented as S-curves. After long incubation periods, technology use and/or efficiency may accelerate. Telepathology appears to be following an S-curve for a technical innovation.

Diffusion of Innovation↗
PubMed2001

Clinical evaluation of an international static image-based telepathology service.

Telepathology is the use of telecommunications technology as a means to facilitate transfer of image-rich pathology data between remote locations for the purposes of diagnosis, education, and research. Although varying levels of technology exist to accomplish this task, static image--based systems are currently the most widely used around the world. Field selection and image quality have often been identified as major impediments to the successful use of static images for diagnostic telepathology. Between November 1994 and July 1999, the Armed Forces Institute of Pathology (AFIP) performed electronic consultation on over 1,250 static image--based cases, recording a clinically significant concordance rate of 97.3% between telepathology and final diagnosis (in cases in which follow-up material was available). For the same subset of cases, an absolute concordance rate of 73.7% was attained. A review of the case flow and construction of the AFIP telepathology system is presented, as well as factors that have an impact on the diagnostic accuracy of static image-based telepathology sytems in general.

Diagnostic Errors↗
PubMedDate not supplied

Practice management skills for the nurse practitioner.

The faculties of three schools of nursing involved in a collaborative family nurse practitioner (FNP) program designed a study to address issues involved in preparing the nurse practitioner for the challenges of practice management in the clinical environment. The purposes of the study were to (1) identify business concepts necessary to successfully manage a primary care practice; (2) determine which of these concepts should be incorporated into an FNP curriculum; and (3) clarify information to be taught regarding each identified concept. Fifty-four business concepts related to primary care were identified from a literature review. A survey was then developed to assess the extent to which the identified concepts were necessary for an FNP to effectively manage a practice. Seven experts and five FNP faculty responded to the survey. The Content Validity Index (CVI) defined by Lynn (1986) was applied and 20 concepts necessary for an FNP to effectively manage a practice were identified. A focus group that included nurse practitioners (both faculty and nonfaculty) from the three collaborative sites connected by interactive telecommunications determined that all 20 of the identified concepts should be included in an FNP curriculum. Additionally, the focus group clarified relevant information to be taught regarding each identified concept.

Curriculum↗
PubMedDate not supplied

Telehealth's impact on nursing and the development of the interstate compact.

The information age has opened a new era for nursing practice. Advances in telecommunications technology now allow nurses to care for patients and their families in geographic locations throughout the country. This new practice environment challenges many of the assumptions that have created a state-based system of nurse practice acts and licensing. In response to this challenge, the creation of a new mechanism for licensure and practice, the interstate compact, is developing. In this article, the development and regulatory challenges created by telenursing and the interstate compact are discussed.

Humans↗
PubMed2002

Telehealth provides effective pediatric surgery care to remote locations.

PURPOSE: The aim of this study was to document the experience and patient satisfaction with providing pediatric surgery consultations and follow-up appointments to remote locations via audiovisual telecommunications technology. METHODS: From January 2000 to April 2001, 16 consecutive pediatric general surgery clinics were reviewed for the type of patient (new or review), the diagnosis, the adequacy and accuracy of the evaluation, and the ability to formulate a plan. In the first year, first-time users were requested to complete a satisfaction survey of 15 questions. Responses to 13 questions were recorded on a 4-point Likert scale, and 2 questions required a "yes" or "no" response. RESULTS: One hundred eighteen appointments were scheduled. Twenty patients did not show up or cancelled. There were 45 new patient consultations. Thirty-three patients were scheduled for surgery, of which, 21 are completed, and 12 are pending. There were no errors in diagnosis or changes in planned procedures. There were 42 patients seen in 53 follow-up sessions. Thirty-six surveys of a possible 53 were available for analysis. The mean rating of overall treatment experience at Telehealth was 3.47 (95% confidence interval 0.17). One hundred percent responded they would use Telehealth again and would recommend it to another person. CONCLUSION: Telehealth is an effective and acceptable way to provide pediatric general surgery clinics to remote locations.

Adult↗
PubMed2001

Health informatics and oncology nursing.

OBJECTIVES: To provide an overview of the essential role of health and nursing informatics in meeting the 21st century call to provide state-of-the-art oncology care. DATA SOURCES: Published articles, research studies, and documents relating to informatics. CONCLUSIONS: Health and nursing informatics encompass the pivotal roles of data and information; identifying and documenting essential data using nursing vocabularies; ensuring adequate computer-based patient record systems; accessing and building knowledge; using telecommunications to support care delivery; empowering the consumer through health informatics; transforming education; and enhancing decision making in oncology nursing through national research agendas. IMPLICATIONS FOR NURSING PRACTICE: The information age calls us to explore digital and information technologies as extensions of human capacity. Oncology nursing practice is especially positioned to contribute to the health of our population.

Forecasting↗
PubMed2001

[Telemedicine in phoniatrics and pediatric audiology--possible applications, technical implementation, economic aspects].

BACKGROUND: Phoniatrics and Paedaudiology investigate and treat disorders of communication more than other medical specialties and are indicated by a distinctive interdisciplinary character. The methods of diagnosis and therapy are concentrated on a few specialists and produce a large quantity of multi-media data from daily clinical practice and research. For the cooperation between the specialists of these and neighboring branches and to reduce the costs for a second opinion these data must be available anywhere and any time using modern telecommunication and information technologies. METHODS: Following applications for a bi- or multidirectional data transmission are possible: Teleconsulting (second opinion of a far located specialist). Teleteaching (use of different data sources for education) and Teleroboting (remote control of medical equipment). Data sources can be: speaking and singing voice, sound, pictures (X-ray, CT, MR, ultrasound, voice range profile, audiogramm), video signals (stroboscopy, cinematography, intraoperative pictures) and written information (computer presentations) in all combinations. The transmission can be carried out synchronously or asynchronously, i.e. at the time for their generation or independent of this. This paper discusses the basics and the advantages and disadvantages of the available technologies and compares it for phoniatric/paedaudiologic applications in an experimental transmission. RESULTS: Use of the different technologies should be carried out depending upon the required quality, the availability and the costs considering medico-legal aspects. Relatively cheap and always available technologies are suitable for many applications in Phoniatrics and Paedaudiology. High costs for acquisition of the equipments could lowered by a common use of different medical branches. Expensive procedures with excellent communication quality are confined to special applications at the moment. CONCLUSION: Telemedicine can optimize quality and extend of the medical care and education in Phoniatrics and Paedaudiology with a simultaneous cost reduction and should increasingly be used in this branch.

Child↗
PubMed1991

[The telephone accident--a contribution to the history of traumatic neuroses].

In the decades after the introduction of the Bell telephone in 1876, a variety of otological and neurological disorders were described as an effect of the sustained use of the telephone. Telephone accidents giving rise to symptoms of traumatic neurosis were conceived of as being caused by electric current, by acoustical trauma or by an emotional shock, reflecting the general discussions concerning the aetiology of traumatic neurosis. With regard to the evidence documenting the anxiety aroused by the experience of the new telecommunicative medium, the disappearance of the phenomena of telephone trauma can be attributed to the habituation to this experience in the process of civilization.

Europe↗
PubMed1999

A brave new world: telemedicine and the facial plastic surgeon.

Telemedicine is defined by the American Medical Association (AMA) as "the provision of health-care consultation and education using telecommunication networks to communicate information." Properly used, telemedicine can provide rapid and easy access to general and specialized medical care. Most telemedical programs have focused on general medical care, but telemedicine can be utilized for subspecialty care. However, technical financial, and legal restrictions must be addressed before more widespread use of telemedicine in facial plastic surgery. This article describes the opportunities and impediments presented to the facial plastic surgeon by telemedicine.

Computer Security↗
PubMed1987

A computer data base for information on cancer treatment.

The Physician Data Query (PDQ) system is a clinically oriented computer data base developed to make recent information on cancer treatment widely available to the medical community. It represents an effort by the National Cancer Institute to promote diffusion of information about the treatment of cancer throughout the country, facilitate access to clinical trials, and accelerate the practical application of advances in research. The computer system provides information about state-of-the-art cancer treatment, which is updated monthly by an editorial board. It also includes a file of active cancer-research protocols and a directory of physicians and organizations providing cancer care to which physicians can gain access by geographic location as well as other features. PDQ was designed for physicians who may not be familiar with computers, to permit them to search for and display information without learning a specialized search language. PDQ uses a computer mainframe, which allows a large amount of data to be stored and made available to physicians rapidly and accurately. Transmission of information about cancer over commercial telecommunication networks gives health professionals access to PDQ by means of a computer terminal and local telephone lines.

Directories as Topic↗
PubMed2005

Charge-transfer Zn-porphyrin derivatives with very large two-photon absorption cross sections at 1.3-1.5 microm fundamental wavelengths.

A series of charge-transfer Zn-porphyrin derivatives with large two-photon absorption cross sections at 1.3-1.5 microm fundamental wavelengths are designed using time-dependent hybrid density functional theory. The fluorescence of these chromospheres is expected to be in the region of 700-900 nm. These unique features make them suitable for a variety of biophotonic and telecommunication applications.

Absorption↗
PubMed2005

Calculation of the birefringences of nematic liquid crystals at optical and infrared wavelengths.

In this paper we critically examine computational methods for predicting the birefringences of nematic liquid crystals, with a view to screening molecules for potential use in infrared applications. Using the liquid-crystal 5CB as a test molecule, we calculate molecular electronic polarizabilities using ab initio quantum-mechanical techniques and a wide range of basis sets. We show that the polarizabilities tend to a limiting value as the quality of the basis set is improved. However, the biggest hurdle remains the determination of the refractive index from the polarizability data. We examine several methods for performing this conversion and conclude that the simplest equation, due to Vuks, is adequate for predicting the birefringence, given the uncertainties involved in other parameters. The agreement between calculation and experiment is best described as "semiquantitative." We perform similar calculations for a wide range of nematic liquid crystals at both 589 and 1550 nm, taking into account the likely impact of molecular vibrations at the longer wavelength. We demonstrate that there is a simple scale factor, for conventional nematics, between the birefringence at visible wavelengths and in the infrared. Thus knowledge of the birefringence at optical wavelengths, as widely available in the literature, is a good guide to the usefulness of conventional nematic liquid crystals as active elements for optical switching in the telecommunications industry.

Journal Article↗
PubMed2006

Quantum-chemical investigation of second-order nonlinear optical chromophores: comparison of strong nitrile-based acceptor end groups and role of auxiliary donors and acceptors.

We report a detailed quantum-chemical investigation of donor-acceptor substituted dipolar nonlinear optical chromophores incorporating the 4-(dimethylamino)phenyl donor end group and a variety of strong heterocyclic acceptor end groups, including tricyanofurans and tricyanopyrroles. In particular, we study the variation of the molecular second-order polarizability (beta) with the acceptor end group and when inserting auxiliary donors (thiophene) and acceptors (thiazole) into the pi bridge. Both finite-field calculations (in the context of local contributions) and sum-over-states calculations were carried out in order to probe the relationship between beta and the chemical structure of the various chromophores. The trends obtained with these two methods are fully consistent. The large beta values (up to 700 x 10(-30) esu) as well as the observed tunability of the optical absorption maximum (lambda(max)) make the chromophores investigated here interesting candidates for use in electro-optic applications at telecommunications wavelengths.

Journal Article↗
PubMed1993

Extracting prototypical facial images from exemplars.

A computer graphic method for extracting a natural image of an individual's facial prototype, or average appearance, from a number of different images of that individual is presented. The process improves upon previous photographic and computational techniques. Synthesis of a person's average expression and pose from a sample of images is derived in an automatic and quantitative way. Possible uses of composite faces produced in this manner in psychological investigations of facial qualities (eg attractiveness) and in applied areas such as telecommunication are pointed out.

Attention↗
PubMed2001

Emergency and primary care at a Melbourne hospital: reasons for attendance and satisfaction.

The reasons for attendance, presenting health problems, functional status, pain and severity, and satisfaction with emergency and primary care were examined using routinely collected data and an interviewer-assisted survey of patients. Patients attended, mostly after hours, because they believed their health problems required hospital-based management. GPs referred for admission and further evaluation. Ethnicity, employment status, gender and age contributed to differences in access, morbidity and pain scores. Pain scores, functional status and English language skills influenced satisfaction. Culturally sensitive hospital- and community-based clinicians are important to promote better services, after-hours care, referral and triage. It is essential to have appropriate policy and legislation, adequate infrastructure and resources, good communication strategies, telecommunication technology, explicit evidence-based protocols for shared care, referral and triage and ongoing training and support for clinicians and consumers.

Adolescent↗
PubMed2002

All-optical processing with molecular switches.

A gradual transition from electrical to optical networks is accompanying the rapid progress of telecommunication technology. The urge for enhanced transmission capacity and speed is dictating this trend. In fact, large volumes of data encoded on optical signals can be transported rapidly over long distances. Their propagation along specific routes across a communication network is ensured by a combination of optical fibers and optoelectronic switches. It is becoming apparent, however, that the interplay between the routing electrical stimulations and the traveling optical signals will not be able to support the terabit-per-second capacities that will be needed in the near future. Electrical inputs cannot handle the immense parallelism potentially possible with optical signals. Operating principles to control optical signals with optical signals must be developed. Molecular and supramolecular switches are promising candidates for the realization of innovative materials for information technology. Binary digits can be encoded in their chemical, electrical, or optical inputs and outputs to execute specific logic functions. We have developed a simple strategy to gate optical signals with optical signals by using a photoactive molecular switch. We have demonstrated that NAND, NOR, and NOT operations can be implemented exclusively with optical inputs and optical outputs coupling from one to three switching elements. Our remarkably simple approach to all-optical switching might lead to the development of a new generation of devices for digital processing and communication technology.

Journal Article↗
PubMed2005

The new nutrition science: sustainability and development.

OBJECTIVE: To show that nutrition science is anchored in food systems and is influenced by the social, through the environmental to the cosmological, life's connections and rhythms. To indicate that an integrative approach is now becoming possible with advances in food technology, in the understanding of food choice and of human behaviour, and in a preparedness to recognise nutritional inputs in the full sweep of life-long well-being and health outcomes. METHOD: An analysis of the much broader understanding of nutritionally related diseases from an ecological perspective, with attention to economic development, beginning with poverty alleviation. Recognition that the biological dimension of nutrition science is undergoing a profound reappraisal; that technologies will allow us to change the course of nutritionally related diseases for the better; and that nutrition science will find partners in information technology and telecommunications, food technology and energy technology. CONCLUSION: A new generation of nutrition scientists can help build a new economy that supports development amongst communities, whether close or distant from each other. The opportunities for this kind of development to be realised between Asia, Latin America and Africa are considerable. At all times, however, nutrition scientists must uphold the paramount importance of good governance, conflict resolution and maternal literacy if their work is to achieve its growing potential.

Developing Countries↗
PubMed2000

The information and communication society: how people will live and work in the new millennium.

This paper analyses information and communication technology (ICT) and its relation to work organizations, human communication, stress, allocation issues, knowledge transfer and global villages. An interdisciplinary research programme on 'Computer technology and work life' was initiated and led by the author at Stockholm University in 1974, followed by many programmes in Sweden in the field. A theoretical framework was developed including two theoretical models, one more general, the other where the concepts and their interrelationships were specified. The models were tested empirically in three large work organizations in Sweden, representing three main historical periods of computer technology. It was also used as a model in discussing what might be desirable goals in the information society. The present fourth period, the 'Network period', is characterized by a convergence of three main technologies: computer, telecommunication and media. ICT is used in almost every activity and is embedded in many things. The author proposes a superimposed theoretical model reflecting 'ICT and the psychosocial life environment', a revised model of her initial models. Finally, future research is discussed with reference to theoretical models revised, and conclusions address major psychosocial processes, psychosocial life environments and a call for synthesis.

Computer Communication Networks↗