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PubMed1999

Occupational stress in human computer interaction.

There have been a variety of research approaches that have examined the stress issues related to human computer interaction including laboratory studies, cross-sectional surveys, longitudinal case studies and intervention studies. A critical review of these studies indicates that there are important physiological, biochemical, somatic and psychological indicators of stress that are related to work activities where human computer interaction occurs. Many of the stressors of human computer interaction at work are similar to those stressors that have historically been observed in other automated jobs. These include high workload, high work pressure, diminished job control, inadequate employee training to use new technology, monotonous tasks, por supervisory relations, and fear for job security. New stressors have emerged that can be tied primarily to human computer interaction. These include technology breakdowns, technology slowdowns, and electronic performance monitoring. The effects of the stress of human computer interaction in the workplace are increased physiological arousal; somatic complaints, especially of the musculoskeletal system; mood disturbances, particularly anxiety, fear and anger; and diminished quality of working life, such as reduced job satisfaction. Interventions to reduce the stress of computer technology have included improved technology implementation approaches and increased employee participation in implementation. Recommendations for ways to reduce the stress of human computer interaction at work are presented. These include proper ergonomic conditions, increased organizational support, improved job content, proper workload to decrease work pressure, and enhanced opportunities for social support. A model approach to the design of human computer interaction at work that focuses on the system "balance" is proposed.

Boredom↗

PubMed2003

Improved accuracy of computer-assisted cervical pedicle screw insertion.

OBJECT: The authors introduce a unique computer-assisted cervical pedicle screw (CPS) insertion technique used in conjunction with specially modified original pedicle screw insertion instruments. The accuracy of screw placement as well as surgery-related outcome and complication rates were compared between two groups of patients: those in whom a computer-assisted and those in whom a conventional manual insertion technique was used. METHODS: The screw insertion guiding system consisted of a modified awl, probe, tap and a screwdriver specially designed for a computer-assisted CPS insertion. Using this system, real-time instrument/screw tip information was three dimensionally identified in each step of screw insertion. Seventeen patients underwent CPS fixation in which a computer-assisted surgical navigation system was used. The cervical disorders consisted of spondylotic myelopathy with segmental instability or kyphosis, metastatic spinal tumor, rheumatoid spine, and postlaminectomy kyphosis. The rate of pedicle wall perforation was significantly lower in the computer-assisted group than that in the other group (1.2 and 6.7%, respectively; p < 0.05). The screw trajectory in the horizontal plane was significantly closer to the anatomical pedicle axis in the computer-assisted group compared with the manual insertion group (p < 0.05). This factor significantly reduced the incidence of screw perforation laterally. Complications such as neural damage or vascular injury were not demonstrated in the computer-assisted group (compared with 2% in the manual insertion treatment group). The overall surgery-related outcome was satisfactory. CONCLUSIONS: In contrast to the previously reported computer-assisted technique, our CPS insertion technique provides real-time three-dimensional instrument/screw tip information. This serves as a powerful tool for safe and accurate pedicle screw placement in the cervical spine.

Adolescent↗

PubMed1991

Access to computers for older adults: problems and solutions.

Activity that involves a personal computer is a valuable modality for the rehabilitation of older adults. The therapist without specialized training, however, may have difficulty integrating computer use with adults with chronic health problems that impede such use. The purpose of this paper was to describe positioning, visual access, and input problems that may interfere with computer access and to identify solutions for use by the occupational therapist. Through a review of occupational therapy and adaptive computer literature, resources for adaptive computer hardware, software, and positioning devices are identified. Examples of how computer activities can be integrated into existing nursing home, day-care, and home-care programs are provided. Recommendations are made for training for the occupational therapist with limited experience with personal computers and adaptive computer technology.

Aged↗

PubMedDate not supplied

From hand twister to mind twister: computer-aided treatment in traumatic wrist fracture.

OBJECTIVE: The use of computers as a treatment modality in the occupational therapy hand clinic is, as yet, not common practice. A computer interface for wrist movements was developed, and a study to justify the application of such a device is presented. METHOD: Forty-seven patients in a day hand clinic who had traumatic fracture of one hand with limitation of wrist mobility participated in the study. Participants were divided into two treatment groups: computer-aided treatment (high technology) and traditional brush machine treatment (low technology). A device was developed based on the brush machine in which the brush machine's mechanism was converted into a medial-lateral joystick. Right-to-left movements were digitally transformed for the use of a computer game. Participants were treated for 5 weeks, and outcome measures included range of motion (ROM), grip strength, edema, and level of interest. RESULTS: Results showed significant improvement in ROM, grip strength, and edema across 5 weeks for all participants. Although no significant differences were found between the two groups in ROM, grip strength, and edema, the computer-aided group showed significantly more interest in treatment than did the brush machine group. Finally, the interaction between treatment group and the attitude toward computers was not significant. CONCLUSIONS: These results indicate the potential for more interesting motor treatment and rehabilitation of the wrist through the use of computer games. The efficacy of using computers in occupational therapy clinics needs further investigation.

Adult↗

PubMed2003

Development of neck and hand-wrist symptoms in relation to duration of computer use at work.

OBJECTIVES: This study attempted to identify risk factors for musculoskeletal symptoms in the neck and hand-wrist regions among employees using computers at work. METHODS: Computer users (N=5033) first received a questionnaire in the beginning of 1999 (69% response rate, N=3475), and a follow-up questionnaire was mailed in December of 2000 to the 3361 respondents to the baseline survey (77% response rate, N=2576). Health outcome was defined as musculoskeletal symptoms for >7 days within the last year of follow-up among the nonsymptomatic respondents at baseline. RESULTS: Men's and women's previous symptoms, women's low influence at work and high-placed computer screen, and men's short time in the same job and good computer skills were associated with neck symptoms. Hand-wrist symptoms were predicted by previous symptoms and low influence at work for both the men and women and sensorial demands for the women only. The duration of computer use predicted hand-wrist symptoms [eg, odds ratio (OR) of 2.3, 95% confidence interval (95% CI) 1.2-4.3, for almost continual computer use], but not neck symptoms. For those with almost continual computer use, hand-wrist symptoms were associated with mouse use for at least half of the worktime (OR 4.0, 95% CI 1.0-15.5) and not using the mouse at all (OR 4.0, 95% CI 1.1-14.4), as compared with mouse use for one-fourth of the worktime. CONCLUSIONS: Limiting computer use to less than three-fourths of the worktime would help to prevent hand-wrist symptoms. Furthermore, low influence at work predicts both neck and hand-wrist symptoms.

Adolescent↗

PubMed1999

Computing the mechanical index.

A computational nonlinear beam propagation model was used to compute the water path and in situ fields of a phased array transducer operating at 2 MHz. The computational source was matched to the transducer's z = 10 cm focal plane field. Subsequent computed propagations considered this source operating at source amplitudes up to 1.49 MPa in a water medium and in a tissue medium with an attenuation of 0.3 dB cm(-1) MHz(-1). The mechanical index was calculated in three ways based on these computations: extrapolated from one low amplitude water path propagation, extrapolated from a series of water path propagations using the existing Output Display Standard protocol, and directly from a series of tissue path propagations. These computed results suggest that extrapolation from derated measurements of a low level water path field can provide mechanical index estimates which progressively overestimate the in situ values. At the highest source amplitude considered, the linearly extrapolated mechanical index was 29% higher than the mechanical index computed by the tissue path propagations. The Output Display Standard protocol offered improved accuracy but consistently underestimated the in situ values. The maximum error for the Output Display Standard protocol was 8%. A variation of the Output Display Standard protocol in which mechanical index estimates were obtained from the on-axis spatial peak in the derated temporal peak rarefactional curve was also considered. The maximum error for this method was 3%. The results considered here also demonstrated the feasibility of computational investigations of high intensity clinical propagations.

Linear Models↗

PubMed2001

Spiral computed tomographic imaging related to computerized ultrasonographic images of carotid plaque morphology and histology.

OBJECTIVE: Echolucency of carotid atherosclerotic plaques, as evaluated by computerized B-mode ultrasonographic images, has been associated with an increased incidence of brain infarcts on cerebral computed tomographic scans. We tested the hypotheses that characterization of carotid plaques on spiral computed tomographic images correlates with that on computerized B-mode ultrasonographic images and that spiral computed tomographic imaging predicts the histomorphometric plaque content. METHODS: The study included 38 patients with neurologic symptoms and at least 50% stenosis of the ipsilateral carotid artery. High-resolution B-mode ultrasonographic images and spiral computed tomographic images of carotid plaques were computer processed to yield a quantitative measure, the gray scale level of the plaque. RESULTS: The mean Hounsfield value for spiral computed tomographic images correlated with the gray scale median for B-mode ultrasonographic images (univariate linear regression analysis: r = 0.45; P = .01) and the histologic content of calcification in the plaque (r = 0.34; P = .04) but not with lipid, hemorrhage, or fibrous tissue in the plaque. CONCLUSIONS: Spiral computed tomographic imaging seems to correlate with B-mode ultrasonographic imaging for showing plaque characteristics. Spiral computed tomographic attenuation was also correlated with the amount of calcification noted on histologic examination but not with lipid and hemorrhage, the components thought to characterize vulnerable, rupture-prone plaques.

Carotid Arteries↗

PubMed2002

Assessment of therapeutic response in hepatocellular carcinoma treated with percutaneous radio frequency ablation: comparison of multiphase helical computed tomography and power Doppler ultrasonography with a microbubble contrast agent.

OBJECTIVE: To compare the results of multiphase helical computed tomography and power Doppler ultrasonography with a microbubble contrast agent in the assessment of the therapeutic response to radio frequency ablation in hepatocellular carcinoma. METHODS: In 66 patients with 73 nodular hepatocellular carcinomas ranging from 1.0 to 4.0 cm (mean, 2.6 cm) in diameter, contrast-enhanced power Doppler ultrasonography was performed after intravenous bolus injection of a galactose-based microbubble contrast agent before and after radio frequency ablation. The results of the studies were compared with the findings of follow-up 3-phase helical computed tomography. All patients were regularly followed up with computed tomography for more than 1 year (range, 13-19 months). RESULTS: In 8 (11%) of 73 hepatocellular carcinomas, immediate follow-up computed tomography obtained within 2 hours after radio frequency ablation showed focal enhancing portions within the treated lesions, suggesting residual non-necrotic tumors. All 8 of these tumors had intratumoral flow signals on contrast-enhanced power Doppler ultrasonography. The diagnostic agreement between computed tomography and contrast-enhanced power Doppler ultrasonography was achieved in 100%. Among the remaining 65 hepatocellular carcinomas with the absence of residual tumors at both immediate follow-up computed tomography and contrast-enhanced power Doppler ultrasonography, subsequent follow-up computed tomography showed local regrowth at the margins of 10 lesions (15%). CONCLUSIONS: The results of contrast-enhanced power Doppler ultrasonography closely correlated with those of immediate follow-up computed tomography for detecting residual tumors in hepatocellular carcinomas treated with radio frequency ablation. Both techniques, however, showed a limitation in detecting small or microscopic residual tumors and in predicting local regrowth in the treated lesions.

Adult↗

PubMed1982

The impact of computer-age technology on respiratory therapy.

Computer-age technology is changing the face of respiratory therapy as it is that of nearly every other technical field. In some hospital respiratory therapy departments computers are presently being used for a wide range of functions such as blood gas result reporting, billing, budgeting, purchasing, hemodynamic calculations, and respiratory monitoring. Microprocessor-controlled ventilators and respiratory monitoring systems are becoming increasingly utilized. In the future the computer may actually operate the ventilator. But who is going to operate the computer? The new breed of intensivist will be trained in critical care medicine, respiratory therapy, biomedical engineering, and computer technology. Respiratory therapists must recognize and rise to the challenge that computer-age technology presents if they are to continue as intensivists. The worst possible development of the future for respiratory therapy would be for computer-age technology to be applied to respiratory therapy without the input and inclusion of respiratory therapists. The challenge then is to be adequately prepared to utilize and apply this inevitable new computer-age technology.

Blood Gas Analysis↗

PubMed1999

General practitioners' use of computers during the consultation.

This study documents the extent of reported computer use by general practitioners (GPs) in consultations with patients, and identifies barriers to their use. There was a 65% response rate from a random sample of 600 GPs in the South and West National Health Service (NHS) region who were sent a questionnaire. Ninety-one per cent (357) had a desktop computer terminal in their consulting rooms. Of these, 98% used the computer to look up information or prescribe medication, 75% entered details about selected problems presented by patients, and 36% entered information about the patient's presenting problem at every consultation. Only 18% used computers to access reference information. Use of the computer for anything other than looking up patient information or prescribing was positively associated with fundholding status and use of a personal computer at home, and was independent of number of years in practice. Sixty-five per cent of responders had positive attitudes to the inclusion of management guidelines on the computer software, and 45% of responders held positive views towards the idea of integrating management guidelines with the patient's personal computerized medical record. Consideration should be given to targeting training at those GPs who appear to be reluctant to use computers during the consultation.

Attitude to Computers↗

PubMedDate not supplied

[PROCID: a project of the European Community for the study and prevention of muscular disorders in computer terminal operators].

This paper presents an EC funded concerted action aimed at studying the prevention of muscle disorders in the operation of computer input devices. About 40% the today's working population use computers in their daily work. This percentage is expected to increase dramatically in the coming years. At the same time health statistics indicate an increased incidence of work related musculoskeletal disorders among computer users. A deeper knowledge in this field may improve the health risk assessment approach, the design of computer input devices and the revision process of existing standards, norms and guidelines concerning computer work. Specific research objectives include: the development of intramuscular techniques suitable for mapping motor unit recruitment under operation of computer input devices; the evaluation of muscle fatigue and motor unit recruitment in dynamic tasks in normal subjects and in patients with pain syndromes; the experimental evaluation of stress induced muscular tension at the motor unit level, in operation of computer input devices; the formulation of recommendations for work with computer input devices.

Computer Terminals↗

PubMed2004

Upper extremity musculoskeletal symptoms and functional impairment associated with computer use among college students.

PURPOSE: Occupational computer use has been associated with upper extremity musculoskeletal disorders among working-age adults, but little is known about computer-related musculoskeletal problems among college students. We carried out a descriptive epidemiological study of computer use-associated symptoms, functional limitations, and medication and health care utilization in this population. SUBJECTS AND METHODS: Cross-sectional survey of 240 undergraduates in the second through fourth years at a residential dormitory at a four-year college with random housing assignments. RESULTS: 194 students returned useable surveys (81% response rate). 42% reported upper extremity pain or discomfort when using a computer in the preceding two weeks. 41% said this pain or discomfort caused functional limitation and 9% said that these symptoms hindered academic or extracurricular performance. 23% reported taking medications for upper extremity pain related to computing (4% regularly) and 16% had seen a health care provider for computer-related symptoms. Female students, students of racial/ethnic minority groups, and students who experienced symptoms with < or = 1 hour of computer use were more likely to report symptom-related functional limitation than others. CONCLUSION: College students report high rates of computer use-associated upper extremity musculoskeletal symptoms and symptom-related functional limitation. Future studies should more closely examine exposure, demographic, and ergonomic correlates of these symptoms and outcomes.

Adult↗

PubMed2006

Computer and Internet usage by Canadian dentists.

OBJECTIVES: To determine the frequency of computers in Canadian dental offices and to assess their use; to evaluate Internet access and use in Canadian dental offices; and to compare use of computers and the Internet by Canadian dentists, by the general public and by other dental groups. METHODS: An anonymous, self-administered survey of Canadian dentists was conducted by mail. A potential mailing list of 14,052 active Canadian dentists was compiled from the 2003 records of provincial regulatory bodies. For each province, 7.8% of the general dentists were randomly selected with the help of computer software. The surveys were mailed to this stratified random sample of 1,096 dentists. RESULTS: The response rate was 28%. Of the 312 respondents, 4 (1%) were in full-time academic positions, 15 (5%) were not practising, and 9 (3%) provided incomplete data. Therefore, 284 survey responses were available for descriptive analysis. Two hundred and fifty-seven (90%) of the respondents had a computer in their primary practice. Computers were used mainly for administrative tasks (accounting, bookkeeping and scheduling) rather than clinical tasks. Internet access was common (185/250 or 74%), and high-speed Internet access (93/250 or 37%) was increasingly common, judging from the results of previous studies on computer use. The main reasons given for not having in-office Internet access were security or privacy concerns and no reported need for or interest in the service. CONCLUSIONS: Computer use was high in this sample of Canadian dentists, but a small proportion of dental offices remained without computers. Canadian dentists" use of the Internet was greater than that of American dentists, private enterprise and the North American public in general.

Canada↗

PubMed2006

Factors associated with computer literacy among nurses.

Nowadays, many hospitals have adopted information technology (IT) to help nurses in their practice; therefore, computers have become critical instruments for nurses. Many researchers have studied what information literacy or computer competencies a nurse should possess, but less research has focused on the types of factors associated with computer literacy. The purpose of this study was to discover which variables influence the computer literacy of nurses. The questionnaire was the instrument for data collection. The respondents were 180 nurses in Taiwan. The results of this study revealed that computer experience of nurses and personal innovation in IT were both factors associated with computer literacy and computer anxiety. The findings could assist nursing managers to screen computer-literate nurses and course designers in nursing school or hospitals to add more practical trainings in courses.

Adult↗

PubMed1990

[Effect of the curriculum including the computer use on work capacity and health status of older schoolchildren].

Formation of computer skills + of pupils is one of the most acute tasks for school today. The relationship between the functional state of the central nervous system, visual analyser and efficiency of pupils with age, have been established. Motivation for work with the computer and quality of the computer video-terminal has been established. Questionnaires given to about 500 pupils have shown that the majority of pupils show an interest to working with computers: 82.5% of 13-14-year old and 70% of 16-17-year old adolescents. Efficiency of pupils becomes more stable with age. The highest number of astheno-neurotic tic symptoms and fatigue complaints are registered in pupils with a low interest to working with computers, as well as in pupils dealing with computers of low quality (of the type Personal Computer 0010). Duration of pupils' work with computers should be no longer than 30 minutes.

Adolescent↗

PubMed1986

Computer software for the professional. Its evolution and current status.

The development of software during the past 30 years has been just as dramatic in many respects as that of hardware. Whereas future developments in hardware technology can be expected to provide smaller, cheaper, and more powerful computers as has been the case during the past 25 years, future developments in software technology can be expected to play the equally important role of expanding the user base for computers, thus making it economically feasible to exploit new technologies on the hardware side. Although today's computer software offerings are very broad indeed in terms of the variety of tasks they perform, one can reasonably expect that entirely new uses will be found for computers, through the development of new types of software, in the future. By exploiting the huge memory capacities of today's newer computers, future software will be much easier to use and will be capable of carrying out several tasks simultaneously. It will also be much more forgiving, adapting itself automatically to the work style (and probably also to the mistakes) of the user. By incorporating at least a part of what constitutes the stock of knowledge in particular applications, so-called "expert systems," one may expect future software, particularly in areas such as financial and statistical analysis, to enable the computer to work more as a partner or colleague than as an unintelligent (albeit very fast) tool. Perhaps to an even greater extent in the future than has been true to date, the evolution of the computer as a useful tool will depend on software, rather than hardware, innovation. The hardware advances necessary to place hearing, speaking, seeing, and even thinking computers on everyone's desktop, each of which would be able to provide ready access to truly mind-boggling quantities of information, is at hand. Only the software really remains to be developed.

Computers↗

PubMed1986

[Possibilities of computer use in anesthesia and intensive care medicine].

Today anaesthesiologists are on familiar terms with computers. In fact, computer technology has come to stay especially in the monitoring and documentation of measurement data; no new developments in this field are possible without the aid of computers. Computer-monitored respirators, infusion pumps or anaesthetic vaporizers have been developed and tested in practice, but their use is at present still restricted to a small select circle of specialists. However, their routine use can be expected in the very near future. In the fields of training and communication of knowledge, computers are still in the developmental stage. Although so-called "expert systems" are already in use in certain fields of medicine, their application in anaesthesia remains an exception. Progress in this direction does not really depend so much on the availability of suitable computers--they are in fact already in operation. The crux of the problem will be the readiness of anaesthesiologists and anaesthesists to feed the computers with appropriate programmes and to accept computers as partners in their work and in the field of training.

Anesthesia, General↗

PubMed1985

Outpatient computer-based 32-hour esophageal pH studies teletransmitted to a central esophageal laboratory.

Using a computer-based 32-hour esophageal pH system with a small patient-worn digital recording computer, outpatient studies are performed in the physiologic environment of the patient's workplace and home. Samples are taken at 15-s intervals, and the pH data stored in this computer are then fed into the main computer in the Central Esophageal Laboratory for analysis, scoring, printing out, and storage. Satellite esophageal laboratories located in regional hospitals, clinics, and physicians' offices conduct pH studies by telecommunication, using antimony electrodes, a recording computer, and a modem to transmit data to the main computer for high-quality computer analysis. One main computer and associated personnel serve multiple satellite stations. This maintains patient-physician relationships and is highly cost-effective.

Computers↗