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PubMed1997

Calculation of soil-water and benthic sediment partition coefficients for mercury.

To accurately model mercury transport to water bodies, an assessment of this pollutant's behavior in the watershed is critical. Partition coefficients, defined as an estimate of the ratio of the pollutant concentration sorbed onto soil/sediment particles to the pollutant concentration dissolved in pore water at equilibrium, is an important term in multimedia models. In this paper, partition coefficients are calculated for two broad species of mercury: inorganic mercuric mercury (Hg-II) and methylmercury (MHg). Although there is considerable variability in the calculated values, the approximate mean values for the soil-water partition coefficients range from 3.3 x 10(3) to 6.0 x 10(4) L/kg for Hg-II and 2.0 x 10(1) to 6.7 x 10(3) L/kg for MHg. For the benthic sediment partition coefficients, the values range from 5.7 x 10(3) to 9.9 x 10(5) L/kg for Hg-II, and 6.5 x 10(2) to 1.1 x 10(5) L/kg for MHg.

Animals↗

PubMed2000

Sensitivity analysis of mercury human exposure.

We present a comprehensive analysis of the sensitivity of mercury (Hg) human exposure to environmental variables using a multimedia model of the fate and transport of Hg in the environment. The results of the analysis show that the Hg dose is most sensitive to the lake pH, the burial rate of Hg adsorbed to sediments, and the chemical speciation of Hg emissions to the atmosphere. The lake pH has a strong non-linear effect on the methylation rate and bioaccumulation of Hg in fish. The burial of sediments is a major pathway for removing Hg from the lake cycling. The speciation of Hg emissions is important because Hg(II) is deposited much more rapidly than Hg(0). These results highlight the importance of key variables that should be investigated through well-designed field programs, so that we can minimize the overall uncertainties associated with the modeling of mercury fate and transport.

Confounding Factors, Epidemiologic↗

PubMed2000

Feasibility of assessing dermal exposure to PAHs of workers on gaswork sites--the SOLEX study.

Population exposure to pollutants in soil is an important public health concern. Difficult to measure, it is usually estimated using multimedia models. Modeling data predict that the skin surface is a predominant exposure route in roughly 15% of the US Superfund sites. Nonetheless, no study has confirmed these predictions. The SOLEX study was an opportunity to study the feasibility of estimating the cutaneous polycyclic aromatic hydrocarbons (PAHs: all 16 of the United States Environmental Protection Agency list) load of workers at three former manufactured gas sites, one of those being under remediation. Over two measurement periods (November 1997 and June 1998), 30 and 28 volunteers, respectively, were equipped for a single day work with five pads that collected soil particles and were placed at the neck, shoulder, wrist, groin, and ankle. Pad contamination was observed for six of the nine workers on the site being remediated but not on other sites. The wrist pad was most often affected, followed by the neck pad, these are, the exposed regions of the body. The PAHs most frequently identified were anthracene, fluoranthene, naphthalene, phenanthrene, and pyrene, at concentrations relatively high. In conclusion, this study showed that estimating skin exposure to soil pollutants is feasible. Secondly, it suggested that only subjects in close contact with the soil had a detectable exposure to PAHs. Extension of this approach to other exposure settings is warranted, especially among children playing in polluted public or private gardens, because their games lead to frequent contact with the soil.

Administration, Cutaneous↗

PubMed2002

The transport of beta-hexachlorocyclohexane to the western Arctic Ocean: a contrast to alpha-HCH.

A large database for alpha-hexachlorocyclohexane (alpha-HCH), together with multimedia models, shows this chemical to have exhibited classical 'cold condensation' behavior. The surface water of the Arctic Ocean became loaded between 1950 and 1990 because atmospheric transport of alpha-HCH from source regions to the Arctic was rapid and because alpha-HCH partitioned strongly into cold water there. Following emission reductions during the 1980s, alpha-HCH remained trapped under the permanent ice pack, with the result that the highest oceanic concentrations in the early 1990s were to be found in surface waters of the Canada Basin. Despite a much stronger partitioning into water than for alpha-HCH, beta-HCH did not accumulate under the pack ice of the Arctic Ocean, as might be expected from the similar emission histories for the two chemicals. Beta-HCH appears to have loaded only weakly into the high Arctic through the atmosphere because it was rained out or partitioned into North Pacific surface water. However, beta-HCH has subsequently entered the western Arctic in ocean currents passing through Bering Strait. Beta-HCH provides an important lesson that environmental pathways must be comprehensively understood before attempting to predict the behavior of one chemical by extrapolation from a seemingly similar chemical.

Arctic Regions↗

PubMed2002

Transfer of dioxin risk between nine major municipal waste incinerators in Taiwan.

The objective of this study was to assess site-specific carcinogenic risks of incinerator-emitted dioxins and risk transfers among the areas covered by nine municipal incinerators in Taiwan. We used actual emission data and the industrial source complex short-term model (ISCST3) to determine the dioxin impact areas within the 8 x 8-km simulation regions surrounding the incinerators. We then used multimedia model to estimate cancer risks in individual impact areas for two exposure scenarios, which were sufficient (SFP) and insufficient food production (IFP) for residents' consumption in each impact area. We also used information of food supply and consumption between impact areas to calculate risk transfers among these nine incinerators. We found that dioxins' carcinogenic risks ranged from 1.4 x 10(-8) (Incinerator F) to 7.1 x 10(-5) (Incinerator A) for the nine incinerators under the exposure scenario of SFP, and ranged from 8.7 x 10(-8) (Incinerator D) to 1.1 X 10(-6) (Incinerator E) under the exposure scenario of IFP. The food ingestion was the main exposure pathway, which accounted for 64-99% of total dioxin risks among nine impact areas. For the nine major food items consumed by residents in the impact areas, eggs (14-35%) and chicken (11-26%) were two main routes of dioxin exposure in the SFP scenario, while chicken (8-78%) and vegetables (0.2-81%) were two main routes of dioxin exposure in the IFP scenario. Significant risks of dioxins were transferred among incinerators, which accounted for up to 88% among the incinerators. Incinerator E was the major risk-exporting source to six Incinerators C, D, F, G, H, and I. For these six incinerators, Incinerator E accounted for their 51-88% imported risks. We concluded that risk transfers among incinerators through routes of food consumption should be considered in assessing health risks associated with incinerator-emitted dioxins in Taiwan. We should place high priority on implementing control measures to lower dioxin emissions in important food-exporting areas like Incinerator E. We should also emphasize analyzing dioxin contents in eggs, chicken, and vegetables in order to improve dioxin-related health risk assessments in the future.

Air Pollutants↗

PubMed2003

Modelling the environmental fate of the polybrominated diphenyl ethers.

In response to growing alarm over the occurrence of polybrominated diphenyl ethers (PBDEs) in remote regions, this study considers their physical chemistry, environmental partitioning and considerations regarding potential for long-range atmospheric transport (LRAT). Internally consistent physical-chemical property data are presented for five representative congeners (PBDE-15, -28, -47, -99, -153) and used in a multimedia modelling approach. Results of the Level II model indicate that PBDEs will largely partition to organic carbon in soil and sediment and that their persistence will be strongly influenced by degradation rates in these media that are not well known. TaPL3 model estimates of their characteristic travel distance (CTD) suggest limited LRAT potential. The LRAT is also evaluated qualitatively, in terms of surface-air exchange behaviour. PBDEs are shown to be sensitive to seasonally and diurnally fluctuating temperatures. When vegetation is included in the model, 50% of the total mass of PBDE-47 deposited to vegetation returns to the atmosphere, suggesting that it may migrate through a series of deposition/volatilisation hops. Key data that needs to be identified in this evaluation include a better understanding of air-surface exchange, particularly to foliage, and measurements of degradation rates in soil, sediment and vegetation.

Atmosphere↗

PubMed2001

Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program.

OBJECTIVES: (1) To describe baseline patterns of adherence to American Diabetes Association and American Academy of Ophthalmology vision care guidelines for diabetes in the Diabetic Retinopathy Awareness Program, and (2) to evaluate factors associated with nonadherence. This paper describes the baseline characteristics of a population enrolled in a prospective, randomized clinical trial. DESIGN: Cross-sectional study. PARTICIPANTS: Between October 1993 and May 1994, the study identified 2308 persons with diabetes, 18 years of age or older, who were residents of Suffolk County, New York, via a multimedia community-wide recruitment campaign. INTERVENTION AND METHODS: Eligibility for the trial was determined during a 20-minute phone interview, which included questions about vision care practices; diabetes management; and knowledge, attitudes, and beliefs about diabetes, vision, and diabetic retinopathy. This paper describes these patient characteristics at baseline. Eligible patients would be randomized subsequently to a 2-year diabetes educational intervention arm, which included mailed packets and newsletters focused on vision care, or to a control nonintervention arm. MAIN OUTCOME MEASURE: Nonadherence to guidelines at baseline was defined as the absence of a dilated eye examination during the year before recruitment into the study. RESULTS: Of the 2308 persons interviewed, 813 (35%) did not follow the vision care guidelines; two thirds of this group reported no eye examination in the year before the interview, and one third had an undilated examination. Ophthalmologists performed 49% of the examinations in the nonadherent group, versus 86% in the adherent group. In logistic regression analyses, factors related to nonadherence were: younger age (odds ratio [OR] = 0.97), type 2 diabetes with or without insulin use (OR = 1.62 and 1.99, respectively), shorter diabetes duration (OR = 0.97), last eye examination performed by an optometrist (OR = 5.32) or other nonophthalmologist (OR = 4.29), less practical knowledge about diabetes (OR = 1.57), and no prior formal diabetes education (OR = 1.30). CONCLUSIONS: Within this population, more than one third of participants had not been following vision care guidelines. Nonadherence was linked to several potentially modifiable factors; changes in these factors could enhance the early detection of diabetic retinopathy.

Adolescent↗

PubMed1993

Interactive videodisc and compact disc-interactive for ophthalmic basic science and continuing medical education.

BACKGROUND: The authors designed and implemented a complete curriculum in ophthalmic pathology using IBM- and Macintosh-based interactive videodisc (IVD) technology. They also redesigned a portion of this curriculum for a new television-based platform, compact disc-interactive (CD-I). METHODS: The following issues were addressed: curriculum design, instructional design, the assembly of illustrations and the ownership of such materials, the generation of computer-based medical art and animation, and programming. The issue of academic credit for faculty participating in this effort also was considered. RESULTS: The computer-based IVD program provides the following features: (1) rapid access to thousands of high-quality illustrations with the option of superimposing graphic labels and text directly over pictures; (2) the ability to view enlargements of photographs; (3) an online glossary to view definition of terms coupled with high-quality photographs; and (4) a dynamic introduction to pathophysiology using interactive animation sequences. The authors were able to incorporate the same interactive features into the CD-I version. High-quality medical illustrations can be used effectively on the CD-I platform. CONCLUSIONS: Computer-based multimedia workstations are relatively expensive for personal use but may be useful if the equipment can be shared in a learning center or library. Compared with interactive computer-based solutions, consumer-oriented television-based technology such as CD-I is a relatively inexpensive vehicle for providing continuing medical education programs intended for use in the individual practitioner's office or home.

Compact Disks↗

PubMed1998

Digital video: a tool for correlating neuronal firing patterns with hand motor behavior.

This report describes the use of multimedia technology for simultaneous recording of single unit responses in cerebral cortex, and imaging of hand kinematics as monkeys grasp and manipulate objects. These imaging methods allow direct correlation of full-frame, full-field video images with the actual spike trains recorded with microelectrodes. Our implementation of digital video provides high-resolution snapshots of the hand motor behavior every 33.3 ms, and a precise calibration and display of the synchronously recorded electrophysiological activity digitized at rates up to 44.5 kHz on the same platform. These imaging methods permit non-invasive, non-traumatic monitoring of both trained and spontaneous activity in experimental animals, while providing synchronized digitized records of neuronal spike trains. We also describe software instruments that quantify and analyze the digitized spike trains. One instrument employs user-selectable objective criteria for distinguishing spikes from noise, separates individual action potential waveforms by their amplitude and duration, and compiles time stamps for each spike train. A second instrument constructs rasters and histograms of repeated behavioral trials using the timing of the corresponding video frame for alignment. These analyses reveal functional classes of cortical neurons signaling specific stages of prehension.

Animals↗

PubMed2001

Real-time radiology--new concepts for teleradiology.

We propose two new concepts for teleradiology: 'real-time radiology' and 'seamless operation of a workstation to view images from both local and remote hospitals'. In this paper, we describe an experimental real-time radiology system with a new multimedia diagnostic workstation, which has been established under teleradiology concepts and can be used for cooperative diagnosis by interchanging radiographic images bilaterally in real-time during an audio-visual discussion. The clinical evaluation of real-time radiology using a newly developed diagnostic workstation demonstrated the system to be practical and routinely available to enhance the radiological diagnostic quality of teleradiology.

Hospitals, University↗

PubMed1997

KAMEDIN: a telemedicine system for computer supported cooperative work and remote image analysis in radiology.

The software system KAMEDIN (Kooperatives Arbeiten und MEdizinische Diagnostik auf Innovativen Netzen) is a multimedia telemedicine system for exchange, cooperative diagnostics, and remote analysis of digital medical image data. It provides components for visualisation, processing, and synchronised audio-visual discussion of medical images. Techniques of computer supported cooperative work (CSCW) synchronise user interactions during a teleconference. Visibility of both local and remote cursor on the conference workstations facilitates telepointing and reinforces the conference partner's telepresence. Audio communication during teleconferences is supported by an integrated audio component. Furthermore, brain tissue segmentation with artificial neural networks can be performed on an external supercomputer as a remote image analysis procedure. KAMEDIN is designed as a low cost CSCW tool for ISDN based telecommunication. However it can be used on any TCP/IP supporting network. In a field test, KAMEDIN was installed in 15 clinics and medical departments to validate the systems' usability. The telemedicine system KAMEDIN has been developed, tested, and evaluated within a research project sponsored by German Telekom.

Humans↗

PubMed2000

Development of computerized screening system for dementia and its preliminary field test.

The population of aged persons is increasing along with an extension of the average span of human life. Therefore, the number of persons who suffer from dementing disorders is also increasing. Because the various psychotic symptoms and behavioral problems are frequently observed in persons with dementia, the families taking care of such people require help to reduce their mental and physical load. Therefore, maintenance and enhancement of the social support system for aged persons are urgent issues. Early identification is important because immediate recognition of dementia people and appropriate follow up treatment can prevent the progress of the disease. Clinical interviews are one general method for detecting patients with dementing disorders, and the Hasegawa Dementia Scale is one of the most popular methods in Japan. The test takes about 10 min per person, but it requires a lot of time and burden for medical staff to screen patients with dementia from the increasing number of aged persons. Therefore, new methods for assessing cognitive functions are requested. A computerized assessment system was developed for dementia which is based on the Hasegawa Dementia Scale. This system was designed for aged persons with no previous computer experience to operate easily by making efficient use of multimedia. In this paper, the system and preliminary results of the field-test are reported.

Aged↗

PubMed2000

Live interdisciplinary teaching via the internet.

The independence of teachers and students is one of the main advantages of teleteaching. Specialties considered unsuitable for combined lessons are manageable using the internet. This study outlines simultaneous communication with students and lecturers over long distances between the anatomical dissection laboratory, the operating theatre, and the lecture hall. In several three-directional on-line lectures, different equipment was used. Students could also participate using personal computers from other locations. During the presentations, the participants have the opportunity to discuss problems with any lecturer. It was possible to demonstrate sufficient transmission capability for real-time application with the use of the new internet technology. No important qualitative differences can be reported between: hardware and software based solutions; or commercial and free offers. Although it is often difficult to reconcile the timetable of surgeries and lectures, multimedia on-line teaching via the internet provides new potential for interdisciplinary medical education.

Computer-Assisted Instruction↗

PubMed1997

Enhancing nurse mobility in Europe: a case for language skills.

The recognition of professional qualifications in all European Union (EU) member states for nurses is covered by both sectoral and general systems directives, yet in reality, few nurses take up their rights as European citizens to live and work in another EU country. One of the main reasons for this is a lack of linguistic skills. This article argues that the nursing profession should be taking a more active role in enabling nurses to move freely around Europe by encouraging language acquisition. It is argued that there are political, social, economic, professional and individual reasons why this should be so. The author gives a brief account of a pilot project which is currently under way to help improve (albeit in a small way) this situation. The project, which has been granted financial support of 100,000 ECU from the European Commission's new training programme, Leonardo da Vinci, will create a multimedia language pack in four languages aimed specifically at nurses.

Communication Barriers↗

PubMed1997

Implications of computer networking and the Internet for nurse education.

This paper sets out the history of computer networking and its use in nursing and health care education, and places this in its wider historical and social context. The increasing availability and use of computer networks and the internet are producing a changing climate in education as well as in health care. Moves away from traditional face-to-face teaching with a campus institution to widely distributed interactive multimedia learning will affect the roles of students and teachers. The use of electronic mail, mailing lists and the World Wide Web are specifically considered, along with changes to library and information management skills, research methods, journal publication and the like. Issues about the quality, as well as quantity, of information available, are considered. As more and more organizations and institutions begin to use electronic communication methods, it becomes an increasingly important part of the curriculum at all levels, and may lead to fundamental changes in geographical and professional boundaries. A glossary of terms is provided for those not familiar with the technology, along with the contact details for mailing lists and World Wide Web pages mentioned.

Computer Communication Networks↗

PubMed1999

Issues in teaching and learning time-limited psychodynamic psychotherapy.

Psychodynamic psychotherapy training is briefly reviewed, with particular attention to short-term forms of treatment and to empirical investigations of therapy training. There have been relatively few investigations of actual psychotherapy training, and the prospect is for even fewer in the future. The traditional pedagogic strategy for conceptualizing and developing psychodynamic training programs has been to adapt psychoanalytic clinical theory for instructional purposes. It is proposed that concepts, principles, and instructional strategies from the area of the cognitive sciences concerned with the development of generic expertise offers a potentially more fruitful theoretical/empirical framework for understanding therapeutic expertise and can be applied to developing improved psychotherapy teaching methods. The mental processes of therapists are discussed from this perspective. A teaching format based on multimedia computer technology and designed to fill a gap between didactic course work and actual therapy supervision is briefly described. In addition, recommendations are offered for improving psychotherapy training using existing methods.

Cognition↗

PubMed2002

A Doppler system for dynamic vector velocity maps.

The aim of the vector Doppler technique is the quantitative reconstruction of a velocity field independently of the ultrasonic probe axis to flow angle. In particular, vector Doppler is interesting for studying vascular pathologies related to complex blood flows. A problem of vector Doppler is data representation in real-time that should be easy to interpret for the physician. In this work, we present a technique for dynamic display of vector velocity maps and some experimental results obtained in vitro with 2-D vector Doppler on flow phantoms reproducing complex flow conditions. An improvement in the map presentation was obtained by using velocity vector field interpolation. In this work, we considered the problem of spatial sampling for vector Doppler, establishing a relationship between sampling steps and scanning system characteristics. Finally, we developed a novel multimedia solution that uses both interpolated images and sound to discriminate between laminar and turbulent flows.

Blood Flow Velocity↗

PubMed1999

Pain related undergraduate teaching in medical faculties in Finland.

The present questionnaire study was conducted to examine how teachers in all Finnish medical faculties have included pain teaching in their courses for undergraduate medical students. The study was planned to compare the existing education in Finland with the IASP curriculum on pain for medical schools. In 1991 and 1995 the questionnaire was sent to a total of 135 and 130 university teachers, respectively. The teachers were asked about the quantity and quality of their pain teaching. Teachers' attitudes on pain related teaching were also examined. A Finnish translation of the IASP curriculum was provided, and university teachers were asked to evaluate it and compare it with their current teaching. The educational programs of all universities were also analyzed. After completion of these surveys, representatives of teachers responsible for teaching of pain, and of medical students from all Finnish medical faculties were invited to a meeting to discuss methods for improving and developing education. Completed questionnaires were received from 107 university teachers (78%) in 1991 and from 74 (60%) in 1995. No printed curricula for pain education were found in any university and in all universities pain teaching was provided in an inconsistent way. There were differences, yet statistically non-significant, between the faculties in the pain teaching. No major differences were observed between the two questionnaires. A serious lack of teaching in psychology of pain was a general finding. University teachers were found to have positive attitudes towards developing their teaching of pain. The IASP curriculum has not been fully followed but was considered a valuable tool in planning the educational programs. The curriculum should be distributed directly to the governmental bodies of the universities, since individual university teachers are not necessarily familiar with it. Local associations may have an important role in this distribution as we have shown. This report shows the necessity of changing the attitudes of university teachers providing concrete teaching programs for pain. A multimedia package of pain containing references, video tapes and cd-discs produced by a workshop of IASP would certainly be welcome.

Curriculum↗