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PubMed2005

A comparative evaluation of computer literacy amongst dental educators and students.

A task-oriented questionnaire was designed, aiming to quickly assess competence with the use of computers. The questionnaire consisted of distinct computer-related skills, representing various competences in educational computer use. A total score from 0 to 49 was calculated upon completion of the questionnaire, based on the sum of all the positively identified competences. The questionnaire was distributed to an international group of leading dental educators during the DentEd Global Congress in Prague in 2001 and to a cohort of first year dental students (2001) in the Dental Faculty, University of Malmo, Sweden. Certain attitudes towards the role of information and communication technology (ICT) in dental education were also measured through Visual Analogue Scales in the educator's group. A total of 149 questionnaires were collected from the educators' group and 58 from the dental students. There was no significant difference in the average computer competence score between the two groups. The educators' group average score was 20.7 (SD 9.9) and students' average was 18.1 (SD 8.5). A significant positive correlation (r = 0.395277, P < 0.0001) was found between the competence measured by the questionnaire and the year of graduation in the educators' group. The attitudes towards the role of ICT in dental education amongst the educators were very positive, regardless of their competence with computers, year of graduation or academic position. The results from this study indicate that there is wide diversity in computer competence amongst both students and academic staff. In addition, students' actual competence in the use of computers might not be as high as is often perceived through self-assessment and ordinal scales.

Adult↗
PubMedDate not supplied

Computer addiction: implications for nursing psychotherapy practice.

TOPIC: Nurse psychotherapists will encounter the impact of today's technology on the daily lives of people including computer addiction. Computer addiction may also present with comorbidities such as depression, gambling, substance abuse, and marital infidelity and divorce. PURPOSE: This overview article presents what is currently documented in the literature regarding the incidence, symptomatology, and nursing psychotherapy interventions relevant to computer addiction and its treatment. Issues presented include computer addiction, virtual relationships, online marital infidelity, and compulsive online sexual behavior. SOURCES: Review of literature from Medline, Psychoinfo, CINAHL, and current texts. CONCLUSIONS: Given the increased use of computers in today's society, there is the potential for overuse of technology and neglect of others and self as a result of computer addiction. Computer disorders also present themselves as marital or couple discord with the potential for online extramarital affairs and compulsive sexual online behavior. A summary and an assessment tool are provided to guide the nurse psychotherapist in practice.

Behavior, Addictive↗
PubMedDate not supplied

Testing of a medical linear accelerator's computer-control system.

In August of 1987, the Radiation Oncology Center at the Mallinckrodt Institute of Radiology became the first academic-medical-center user of Varian's computer-controlled therapy accelerator, a prototype version of the 2100C. Installation was accomplished by the retrofit of a computer system to our two-year-old Clinac 1800. Being well aware of the malfunctions that occurred in other computer-controlled accelerators, we took extraordinary measures to assure proper operation of the new, computerized, system. Our acceptance procedure included tests of (i) mechanical systems (isocentricity, digital readouts, etc.); (ii) radiation parameters (flatness, symmetry, output, etc.); (iii) manual safety systems (emergency off switches, etc.); (iv) the computer console systems (communications integrity, state integrity, etc.); and (v) the interlock systems (some 50 electrical, mechanical, and/or computer-controlled interlocks). As items (i), (ii), and (iii) do not differ significantly from the tests for a non-computer-controlled machine, they will not be discussed here. Rather, this report will concentrate on the methods that were devised to test the computer-control and interlock systems.

Computer Systems↗
PubMed1999

Computer support for recording and interpreting family histories of breast and ovarian cancer in primary care (RAGs): qualitative evaluation with simulated patients.

OBJECTIVES: To explore general practitioners' attitudes towards and use of a computer program for assessing genetic risk of cancer in primary care. DESIGN: Qualitative analysis of semistructured interviews and video recordings of simulated consultations. PARTICIPANTS: Purposive sample of 15 general practitioners covering a range of computer literacy, interest in genetics, age, and sex. INTERVENTIONS: Each doctor used the program in two consultations in which an actor played a woman concerned about her family history of cancer. Consultations were videotaped and followed by interviews with the video as a prompt to questioning. MAIN OUTCOME MESURESs: Use of computer program in the Consultation. RESULTS: The program was viewed as an appropriate application of information technology because of the complexity of cancer genetics and a sense of "guideline chaos" in primary care. Doctors found the program easy to use, but it often affected their control of the consultation. They needed to balance their desire to share the computer screen with the patient, driven by their concerns about the effect of the computer on doctor-patient communication, against the risk of premature disclosure of bad news. CONCLUSIONS: This computer program could provide the necessary support to assist assessment of genetic risk of cancer in primary care. The potential impact of computer software on the consultation should not be underestimated. This study highlights the need for careful evaluation when developing medical information systems.

Adult↗
PubMed2005

Health information technology and physician-patient interactions: impact of computers on communication during outpatient primary care visits.

OBJECTIVE: The aim of this study was to evaluate the impact of introducing health information technology (HIT) on physician-patient interactions during outpatient visits. DESIGN: This was a longitudinal pre-post study: two months before and one and seven months after introduction of examination room computers. Patient questionnaires (n = 313) after primary care visits with physicians (n = 8) within an integrated delivery system. There were three patient satisfaction domains: (1) satisfaction with visit components, (2) comprehension of the visit, and (3) perceptions of the physician's use of the computer. RESULTS: Patients reported that physicians used computers in 82.3% of visits. Compared with baseline, overall patient satisfaction with visits increased seven months after the introduction of computers (odds ratio [OR] = 1.50; 95% confidence interval [CI]: 1.01-2.22), as did satisfaction with physicians' familiarity with patients (OR = 1.60, 95% CI: 1.01-2.52), communication about medical issues (OR = 1.61; 95% CI: 1.05-2.47), and comprehension of decisions made during the visit (OR = 1.63; 95% CI: 1.06-2.50). In contrast, there were no significant changes in patient satisfaction with comprehension of self-care responsibilities, communication about psychosocial issues, or available visit time. Seven months post-introduction, patients were more likely to report that the computer helped the visit run in a more timely manner (OR = 1.76; 95% CI: 1.28-2.42) compared with the first month after introduction. There were no other significant changes in patient perceptions of the computer use over time. CONCLUSION: The examination room computers appeared to have positive effects on physician-patient interactions related to medical communication without significant negative effects on other areas such as time available for patient concerns. Further study is needed to better understand HIT use during outpatient visits.

Adult↗
PubMed2000

Clinicians and computers: friends or foes?

BACKGROUND: Computer-aided learning is accepted by students as a learning resource, but the views of the teaching community are largely unknown. PURPOSE: To document clinicians' experience with computers and to record their attitudes toward computer usage in clinical practice and student education. METHODS: Questionnaire mailed out to all clinicians, including interns and residents, fellows, and attending physicians in 3 major teaching hospitals in South Australia, with a total of 646 clinical staff. RESULTS: Replies were received from 246 staff. Eighty percent of clinicians had at least 2 years of experience with computers and used computers for at least 2 hr each week. Despite this, there was an obvious lack of conviction among clinicians that computer-aided learning was of use in student education and assessment. This may reflect their lack of experience with this medium as an educational tool. CONCLUSIONS: If computer-aided learning is to make any significant impact on medical student education, it must be carefully and objectively evaluated, and its benefit must be clearly demonstrated to clinical teachers.

Adult↗
PubMed2003

Using three-channel video to evaluate the impact of the use of the computer on the patient-centredness of the general practice consultation.

The aim of this study was to assess the feasibility of using three-channel video to explore the impact of the computer on general practitioner (GP) consultations. A previous study had highlighted the limitations of using single-channel video: firstly, there was a lack of information about exactly how the computer was being used, and secondly difficulty in interpreting the body language of the consulting clinician. More information was needed to understand the impact of the computer on the consultation, and in this pilot three-channel video was used to overcome these constraints. Four doctors consulted, with the patient's role played by an actor with a preset script and preloaded personal and family history record programmed into the computer. The output was analysed using the Roter Interaction Analysis System (RIAS) and observational methods were used to explore the effect of computers on aspects of verbal and non-verbal behaviour and the completeness of the computer data record. Three-channel video proved to be a feasible and valuable technique for the analysis of primary care GP consultations, with advantages over single-channel video. Interesting differences in non-verbal and verbal behaviour became apparent with different types of computer use during the consultation. Implications for the three-channel video technique for training, monitoring GP competence and providing feedback are discussed.

Attitude to Computers↗
PubMed2005

Noninvasive coronary angiography using computed tomography.

While noninvasive imaging of the coronary lumen remains challenging, great strides have been made with computed tomography. Two variations of computed tomography are used in the study of the coronary tree: multislice or multidetector computed tomography and electron-beam computed tomography. Both have high spatial and temporal resolutions as well as excellent signal-to-noise ratios, which allows major branches of the coronary tree to be depicted. Impaired image quality, due to dense calcifications and multiple image artifacts including coronary artery motion and breathing artifacts, limits the clinical utility of noninvasive coronary angiography. Early studies with electron-beam angiography demonstrated an overall sensitivity of 85% and specificity of 89% for the detection of obstructive coronary artery disease. With early diastolic imaging, the sensitivity and specificity increases to 92 and 93%, respectively (rather than 80% of the cardiac interbeat interval, where coronary motion is more pronounced). Multidetector computed tomography, with improved spatial resolution but decreased temporal resolution, produces results that vary depending on the equipment. Four-slice scanners have an average sensitivity of only 61%, and only 38% of patients have all four vessels or 15 segments available for analysis, due to both cardiac motion and calcification. Thinner slice collimation with eight and 16 slices have allowed for improved detection. Sensitivity and specificity improve to 80 and 86%, respectively. Furthermore, the number of assessable segments with eight-to 16-slice scanners improves significantly, compared with four-slice scanners (85 vs. 73%; p<0.001). If only assessable segments are included in analysis, sensitivity and specificity for multidetector-row computed tomography improves to nearly 90%. Compared with magnetic resonance imaging, with a reported accuracy of 72% in the only multicenter study, computed tomography has great promise to become the primary method of noninvasive coronary angiography.

Coronary Angiography↗
PubMed2006

Reliability and reproducibility of dens fracture classification with use of plain radiography and reformatted computer-aided tomography.

BACKGROUND: The classification system of dens fractures by Anderson and D'Alonzo has been widely used in clinical studies. Of the three types of fractures, Type II and Type III are of particular importance because the distinction between them may affect treatment decisions. The purposes of this study were to assess whether this classification is reliable and reproducible and to determine whether computed tomography can improve its reliability and reproducibility. METHODS: Plain radiographs and spiral computed tomography images of dens fractures in eleven patients were assessed, and the fractures were assigned a classification of Type II or Type III at two readings, separated by six months, by two spine surgeons and three neuroradiologists. Kappa coefficients of agreement between the raters as well as the reproducibility of the classifications made by the individual raters were calculated independently for the fracture classifications based on the plain radiographs and those based on the reformatted computed tomography scans. RESULTS: The kappa coefficient for classifications based on plain radiographs was 0.30 and 0.25 (fair agreement) at the first and second readings, respectively. For classifications based on computed tomography scans, the corresponding kappa coefficients were 0.46 (moderate agreement) and 0.67 (substantial agreement). The kappa coefficients for intrarater reliability among the five raters averaged 0.56 (moderate agreement) when computed tomography scans were used and 0.28 (fair agreement) when plain radiographs were used. CONCLUSIONS: Substantial variation with regard to the classification of dens fractures was found within our group of raters. Greater agreement occurred when reformatted computed tomography scans rather than plain radiographs were used as the basis for classification. When classifying dens fractures according to the system of Anderson and D'Alonzo, one should consider using reformatted computed tomography scans and reaching a consensus with multiple raters.

Adolescent↗
PubMed2001

Comparison of axial reconstructed ultrasonographic images from three-dimensional data volumes and computed tomographic scans in the documentation and detection of liver lesions.

OBJECTIVE: To compare axial reconstructed ultrasonographic images from three-dimensional data volumes and conventional computed tomographic scans in documentation and detection of liver lesions. METHODS: The livers of 23 patients were examined by a multifrequency curved array transducer to acquire three-dimensional data volumes and by conventional computed tomography The ultrasonographic device was equipped with three-dimensional ultrasonographic technology allowing for real-time parallel movement in every plane within an acquired data volume. Axial ultrasonographic images reconstructed from three-dimensional data volumes were compared with conventional computed tomographic scans. RESULTS: When both methods were taken together, a total of 51 different liver lesions could be detected. Reconstructed ultrasonographic images depicted 44 (86%) of 51 lesions, and computed tomographic scans showed 46 (90%) of 51 lesions. Compared with computed tomography, ultrasonography depicted 5 additional lesions in 3 of the patients (4 hemagiomas and 1 unspecified lesion), whereas 7 lesions were missed in another 4 patients (4 metastases, 2 calcifications, and 1 cyst). The Pearson correlation coefficient between ultrasonography and computed tomography was r = 0.84 (P < .001). CONCLUSIONS: Our study shows that ultrasonographic images can be effectively reconstructed from three-dimensional data volumes. With respect to documentation and detection of liver lesions, the results obtained by three-dimensional ultrasonography appear comparable with those obtained by conventional computed tomography. However, several technical and procedural limitations have to be respected.

Adult↗
PubMed1999

Choosing the right computer system.

We are living in a world where virtually any information you desire can be acquired in a matter of moments with the click of a mouse. The computer is a ubiquitous fixture in elementary schools, universities, small companies, large companies, and homes. Many dental offices have incorporated computers as an integral part of their management systems. However, the role of the computer is expanding in the dental office as new hardware and software advancements emerge. The growing popularity of digital radiography and photography is making the possibility of a completely digital patient record more desirable. The trend for expanding the role of dental office computer systems is reflected in the increased number of companies that offer computer packages. The purchase of one of these new systems represents a significant commitment on the part of the dentist and staff. Not only do the systems have a substantial price tag, but they require a great deal of time and effort to become fully integrated into the daily office routine. To help the reader gain some clarity on the blur of new hardware and software available, I have enlisted the help of three recognized authorities on the subject of office organization and computer systems. This article is not intended to provide a ranking of features and shortcomings of specific products that are available, but rather to present a process by which the reader might be able to make better choices when selecting or upgrading a computer system.

Appointments and Schedules↗
PubMed1993

Evaluating the computer as a data camera in family planning research.

"This chapter explores both the potential and limitations of the micro-computer as a research tool for unobtrusive data collection in the area of population and family planning.... To provide concrete examples of the computer's potential usefulness as well as its limitations, two research projects undertaken [in the United States] by the author and colleagues will be discussed.... Each program offers different applications of how the computer can be used to: (1) evaluate programs; (2) collect descriptive data about users' values, decisions, and previous behaviors regarding sexual issues, and (3) develop and test cognitive and behavior models. Each application also offers examples of the limitations of the computer in terms of external validity issues (i.e., how representative are samples of persons who use the computer voluntarily), the need to check the validity of responses typed by computer users, and ethical issues involved in using the computer to collect data."

Americas↗
PubMed2003

Low cost, highly effective parallel computing achieved through a Beowulf cluster.

A Beowulf cluster is a means of bringing together several computers and using software and network components to make this cluster of computers appear and function as one computer with multiple parallel computing processors. A cluster of computers can provide comparable computing power usually found only in very expensive super computers or servers.

Benchmarking↗
PubMed1992

Computer-based multimedia in plastic surgery education.

Rapid developments in communications networks (cellular telephone, direct-link satellite, and international high-speed computer nets) and the continued success of affordable powerful personal computers (desktop, laptop and soon "palmtop" devices) have set the stage for educational materials accessible by electronic means. Computer-based multimedia are sophisticated audiovisual teaching materials built from digitized illustrations, photographs, audio and video recordings viewed by display on a computer screen. The computer interface allows interactive access to information, and connectivity to other sources of information. Computer programmability allows presentation of a single collection of information at different levels of sophistication (the "patient", "medical student" or "surgeon trainee" level, for example), to appeal to different viewer needs. The information may be electronically updated or changed whenever appropriate. This desktop exhibit demonstrates multimedia plastic surgery teaching materials with full-fidelity digital sound, three-dimensional computer graphics, and "picture-in-picture" video capabilities that we have developed since 1989. We have used these materials at St. Louis University for patient informed consent, and the education of medical students and surgical trainees. We are excited that similar multimedia teaching materials are now becoming commercially available in other fields of medical education, attesting to broadening interest among educators and publishers.

Computer Graphics↗
PubMed2004

Computer interviewing in a primary care office: the patients are ready.

UNLABELLED: Computer patient interviewing has been used since 1968 and must be acceptable to a majority of patients for wide spread use to occur. Computer interviewing is still not used widely in the United States. Potential barriers have not been identified in the literature. METHODS: 150 of 164 (91.5%) eligible patients at a family medicine ambulatory practice were enrolled in a study to evaluate computer interview of cough and sore throat complaints. Subjects were given the choice to have the interview in the waiting or examination room. Telephone interviews were conducted 2-4 weeks later with 143/150 patients (95.3%). RESULTS: 102/150 (68%) of subjects chose the wait-ing room and 48/150 (32%) chose the examination room for the computer interview. 127/143 (88.8%) were willing to use the computer interview for evaluation of cough or sore throat again in the future. 116/143 (81.1%) were willing to use the computer interview for other medical complaints in the future. CONCLUSIONS: Patients are willing to use computer interview-ing and some interviews may be conducted in the waiting room.

Adolescent↗
PubMedDate not supplied

Computer graphics and developmental theory: a powerful partnership.

Educating student nurses to successfully use computer technology involves conscientious planning from nursing faculty responsible for curriculum integration. Many computer elements may be considered such as computer literacy, word processing, and computer assisted instruction. Database programs, spreadsheet applications, and statistical packages are also often incorporated into curriculum integration efforts. Computer graphics and desk-top publishing can also be used as an effective teaching strategy. The following describes an attempt to combine a creative teaching approach for developmental theory within a course on human development while expanding on students' computer skills in the field of computer graphics.

Computer Graphics↗
PubMed2005

User stress detection in human-computer interactions.

The emerging research area of Affective Computing seeks to advance the field of Human-Computer Interaction (HCI) by enabling computers to interact with users in ways appropriate to their affective states. Affect recognition, including the use of psychophysiologcal measures (e.g. heart rate), facial expressions, speech recognition etc. to derive an assessment of user affective state based on factors from the current task context, is an important foundation required for the development of Affective Computing. Our research focuses on the use of three physiological signals: Blood Volume Pulse (BVP), Galvanic Skin Response (GSR) and Pupil Diameter (PD), to automatically monitor the level of stress in computer users. This paper reports on the hardware and software instrumentation development and signal processing approach used to detect the stress level of a subject interacting with a computer, within the framework of a specific experimental task, which is called the 'Stroop Test'. For this experiment, a computer game was implemented and adapted to make the subject experience the Stroop Effect, evoked by the mismatch between the font color and the meaning of a certain word (name of a color) displayed, while his/her BVP, GSR and PD signals were continuously recorded. Several data processing techniques were applied to extract effective attributes of the stress level of the subjects throughout the experiment. Current results indicate that there exists interesting similarity among changes in those three signals and the shift in the emotional states when stress stimuli are applied to the interaction environment.

Adult↗
PubMed2005

Computationally efficient noninvasive cardiac activation time imaging.

OBJECTIVE: The computer model-based computation of the cardiac activation sequence in humans has been recently subject of successful clinical validation. This method is of potential interest for guiding ablation therapy of arrhythmogenic substrates. However, computation times of almost an hour are unattractive in a clinical setting. Thus, the objective is the development of a method which performs the computation in a few minutes run time. METHODS: The computationally most expensive part is the product of the lead field matrix with a matrix containing the source pattern on the cardiac surface. The particular biophysical properties of both matrices are used for speeding up this operation by more than an order of magnitude. A conjugate gradient optimizer was developed using C++ for computing the activation map. RESULTS: The software was tested on synthetic and clinical data. The increase in speed with respect to the previously used Fortran 77 implementation was a factor of 30 at a comparable quality of the results. As an additional finding the coupled regularization strategy, originally introduced for saving computation time, also reduced the sensitivity of the method to the choice of the regularization parameter. CONCLUSIONS: As it was shown for data from a WPWpatient the developed software can deliver diagnostically valuable information at a much shorter span of time than current clinical routine methods. Its main application could be the localization of focal arrhythmogenic substrates.

Arrhythmias, Cardiac↗