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Videotelephony-based services--the proven improvement of quality of life.

As described above, the research activities showed very promising and fascinating results. It could be observed that the presumed acceptance problems of elderly technology users are not larger than in other groups. What is more: the elderly user of videotelephony-based services is a very pragmatic user. He or she accepts the new service offer as long as he or she sees the benefits. Decision makers in the social field should not be afraid of this client group! All of the users were willing to pay for the service--up to three times their current communication costs. It seems that there is a market for both the network providers and the telecommunication manufacturers. Private social service provider organisations were the first to realise the potential of the videotelephony-based social support and care services. Some of them are already developing service design schemes and are eagerly awaiting affordable technology. To ensure equal accessibility to these kind of services financial support is necessary to address the needs of socially disadvantaged user groups. Moreover, policy makers should concentrate on the definition of quality requirements for different issues. At the same time, neutral control institutions have to be set up to overcome prejudices and prevent misuse. All in all the authors still believe that picture-based social support and care services are one solution for the increasing problems resulting from demographical and social changes in many industrial societies. The technical evolution and the rapidly decreasing costs will lead to the implementation of picture-based social support and care services within a very short time. Some large application projects are currently underway throughout Europe. What is more: in Frankfurt/Germany, for instance, the first commercially available picture-based service will be introduced to the public in the spring of 1997.

Aged↗

[Specialist assessments and Law Decree 626/94 on operators employed at VDT/PCs].

Within the context of the health protection of employees working with monitors and personal computers, we evaluated the capacity of certain ophthalmologic tests, which can be used by corporate medical doctors even if they have not received specific ophthalmologic training, to identify ophthalmologic-visual conditions which should be referred to a specialist. 278 employees working with computers underwent a complete ophthalmologic test including contrast sensitivity, the red-green test, the dynamic acuity and the mesopic test. Two groups (with and without ocular pathologies) whose characteristics indicated the need of a specialist examination were then chosen, and the correlation and predictive capacities of the single tests or their combination was then evaluated with regard to the two groups. The model developed through a discriminating analysis vaunts a predictive sensibility above 95%, thus allowing to identify almost all persons in the sample group who should be referred to a specialist when used to identify those afflicted solely by refraction alterations, while it drops to 66% with a specific figure of 89% when non-refractive ocular pathologies coexist. The figures indicate that certain evaluation tests can be used to efficiently screen visual functionality by the corporate medical doctor. The authors offer suggestions on the need for a correct and carefully considered strategy to adopt for the screening of visual function.

Adult↗

Before you touch that keyboard....

New technology often gives rise to new health and safety concerns. The Model-T didn't come equipped with a seatbelt; now it is standard equipment. For years, bike helmets were purely optional; now many jurisdictions legislate their use. We wear seatbelts and helmets to prevent injuries, yet we spend hours each day at a potentially hazardous activity--keyboarding--with absolutely no thought to our own health and safety. This is starting to take a toll.

Canada↗

[Ergo-ophthalmologic problems of electronic display devices].

The paper approaches the problem of activity in front of a display. The authors show the compounds of an electronic device, theirs effects on visual acuity of the worker and the condition that are needed for visual comfort. Ergo-ophthalmologically it is important to examine periodically all the employers that use displays.

Computer Terminals↗

Evaluation of the laboratory and environmental factors that induce seizures in photosensitive epilepsy.

This paper evaluates the laboratory and environmental factors that induce seizures in photosensitive epileptic patients. The aims are (i) to identify those factors that trigger seizures so that the patients could take preventive measures, (ii) to advise the patients on appropriate preventive measures that could be taken to avoid spontaneous seizures. Thirty-six photosensitive epileptic patients were studied. The electroencephalographic laboratory seizure-inducing factors identified were intermittent photic stimulation (IPS), flickering lights from both the TV and the visual display unit (VDU) at various flashes per second, grid patterns (vertical, horizontal lines, squares, black and white lines) of various cycles per degree, and blank screens. In the environmental factor investigation, 10 out of 36 patients had series of seizures induced by narrow stripes of black and white, or white and red striped coloured dresses especially, when stepping outdoors on sunny days. Other environmental factors identified include moving escalators; 'moving' trees, bushes, and houses when travelling in a vehicle, including trains; faceted patterns in the bathroom windows with light passing through; swirling light patterns especially on displayed objects of black and white colours; telegraphic post, gantry post, and luminance variance when stepping outdoors from the dark in bright sunlight. The effective preventive measures were: (i) patients should occlude one eye when travelling in a vehicle or using computers or when stepping outdoors on a sunny day, or when there are various patterns before them, (ii) patients should sit at least 3 metres away from the TV when watching a programme, (iii) they should avoid any object that transmits luminance variance; if this is not possible, they should occlude one eye.

Adolescent↗

[Administrative perspectives at Sarasota Memorial Hospital].

Sarasota Memorial's Health VISION project goal is to develop an electronic patient record. This requires total reengineering of health care delivery in Sarasota county to provide optimal exchange of aggregate, educational, cost and patient information to hospitals, clinics, offices and homes.

Computer Terminals↗

Outflow uropathy: occupational disorder?

This paper alerts physicians, health care workers, and employers to a probable connection between voluntary, infrequent voiding and urinary dysfunction. The dysfunction includes abnormal uroflow patterns, increased urethral resistance, abnormal post-void residuals, chronic trigonitis, and urethrovesical inflammatory polyps. A review of intermittent uroflow and obstructive uroflow patterns reveals that all females in this study worked long hours without voiding.

Adult↗

[The measurement of linear dimensions from the x-ray image on a video monitor].

The proposed method for measuring the linear dimensions of viscera from their X-ray image on a video monitor is that a uniform X-ray contrast is placed on a recording screen, which fixes the image of a point object (for example, a catheter tip) which is situated in the plane of the required size. The patient is transferred in parallel with the screen at a given distance. Before and after transfer, a ratio of the scale change in the position of a point object image to its actual change is calculated. The ratio is used to measure any linear dimensions in the plane of an object.

Angiography↗

[Medical data in pathology--evaluation of a large collection. (530,000 diagnoses coded in SNOMED II)].

The paper is describing the design and the performance of the computerized system, from its introduction in 1982 until the present day. The first device, using the MUMPS language on a mini-computer, followed by a VAX computer with terminals have been replaced in 1996 by an application program, using ORACLE, based on the client-server concept. The content and the particularities of the different data groups are discussed, concerning the functional components of the data bank: 'PATIENTS', 'SPECIMEN', 'SENDERS', 'REPORT' and 'DIAGNOSES'. By means of examples, we demonstrate the chronological evolution of the registration of persons, the distribution of the diagnoses according to the organ systems, the possibilities to combine various lesions and an algorithm to assure that a given lesion is registered only once per patient. In first place, the efficiency and the reliability of manual coding by a pathologist using the Systematized Nomenclature of Medicine (SNOMED; 2nd edition [1979/1982]) is discussed. The data bank currently contains 530,000 diagnoses, distributed among on SNOMED's five main modules, obtained from 1500 autopsies, 140,000 surgical and 180,000 cytological specimens. Concluding the article, an analysis is made of desirable developments in the future with the aim of a better integration of the acquired information in routine work and an enhanced use of the medical content for epidemiological research or statistical analysis.

Abstracting and Indexing↗

Occupational risks for human reproduction: ELSPAC Study. European Longitudinal Study of Pregnancy and Childhood.

Pregnant women living in Brno who were contacted for the first time at 18th week of their pregnancies during the period from February 1990 to January 1992 were involved into the ELSPAC group. Among others, the exposure to different occupational factors in the three periods was obtained by the self-reported questionnaire: 1. the last 9 months before pregnancy, 2. the first, and 3. second trimester periods. The women's health status during pregnancy, the history of delivery and the developmental and health status of newborns were described in details by obstetrics and pediatrics according to another internationally unified questionnaire. All data obtained from 3,897 pregnant women living in Brno were computered. Smoking women were significantly more often than non-smokers occupationally exposed to ergonomic stressors associated with the monotony work, and to chemical substances. In the whole group, the intrauterine growth retardation has been positively associated with shifting (OR 1.59, p < 0.05) and occupational exposure to permanent noise (OR 1.92, < 0.05). Newborns of such exposed women had in average lower parameters of head cimcumstances (p < 0.01). Non-physiologic, non-spontaneous deliveries have been more often observed among VDTs users (OR 1.20-1.28, p < 0.05). Women exposed to organic solvents during 2nd trimester of pregnancy delivered more often babies with some congenital malformations (OR 2.31, p < 0.05). On the other hand, the different occupational factors seemed to be protective for several markers of the women health status, as the prevalence of reproductive damages was significantly lower among exposed women than in the non-exposed group. After the standardization of the smoking habit, more significant associations have occurred in the group of smokers occupationally exposed to: shift work (low-birth-weight babies: OR 1.98, p < 0.05), chemicals (bleeding during pregnancy: OR 2.00, p < 0.05), sedentary work (placental abnormalities and congenital malformations: OR 1.59, p < 0.05). Non-smoking women using VDTs had more often babies with intrauterine growth retardation (OR 2.29, p < 0.05). Newborns with different malformations were more often born to non-smoking women occupationally exposed to chemicals (OR 2.33, p > 0.05).

Computer Terminals↗