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At least 1,423 records · Page 79Linked to original sources
PubMed1998

Benchmarking the communication of continuous improvement activities.

Communication of a continuous improvement program in a large medical center was assessed using a formal benchmarking process with four non-health care organizations. Results indicated that continuous improvement must be integrated with the corporate strategic plan, must focus on customer satisfaction, and have active leadership support. A common framework should link different continuous improvement methodologies. Ongoing, open, multimedia two-way communication is required. Continuous improvement activities need to be integrated into all employees' daily work.

Benchmarking↗
PubMedDate not supplied

The child and the medication: education software on administering medication in pediatrics.

Computer science is being introduced in education at an accelerated pace, thus forcing educators and students to become familiar with the technology. The objective of this project was aimed at the development and evaluation of the education software, The Child and the Medication. The program uses multimedia resources in four topics: the child, the medication, who administers it, and medication administration. The evaluation showed good acceptance of the program, with most of the items receiving excellent approval. The emphasis in this report is on the importance of teaching strategy development using computational means to teach nursing, thus capacitating the nurses of the next millennium.

Child↗
PubMed1999

A pilot study of a headache program in the workplace. The effect of education.

Headache is a frequent problem in the workplace and contributes to absenteeism and productivity loss. Disease-management programs targeting headache may reduce its impact on employees, employers, and society. A pilot study was conducted in an employer setting (J.P. Morgan & Co., Incorporated; four locations in New York City and two in Delaware) to evaluate a multimedia computer-based (kiosk) headache program. Study objectives included assessing the effect of the program on participant outcomes and evaluating the educational component of the program. Through the kiosk, participants were questioned about the types, severity, and frequency of their headaches; the impact of headaches on their daily activities; and lost workdays as a result of headache. All participants received personalized reports about their headaches, and the participants in New York were given access to an on-site neurologist and additional educational information. A follow-up assessment was requested 3 months after the baseline screening to evaluate the effect of the program. A total of 185 participants completed both a baseline and follow-up session. Of 177 evaluable participants, 19% saw a physician for headache after their initial kiosk session. Fifty-six percent of evaluable participants reported overall improvement in headache symptoms at follow-up (P < 0.01), with decreased headache frequency and better understanding of headache most often selected as reasons for improvement. Participants also reported higher satisfaction with headache management after using the program and fewer urgent care/emergency room visits for headache (P < 0.01). For participants who reported lost workdays because of headache, the number of days missed had decreased by the follow-up. The results of this study indicate that the headache program improved outcomes. Because all participants received educational materials, it is likely that education played a role in the improvements observed. These results are encouraging and warrant further study in larger, controlled trials.

Adult↗
PubMed2006

Evaluation of learning outcomes in Web-based continuing medical education.

BACKGROUND: There has been significant growth in use of Web-based continuing medical education (CME) by physicians. A number of evaluation and metareview studies have examined the effectiveness of Web-based CME to varying degrees. One of the main limitations of this literature has been the lack of systematic evaluation across different clinical subject matter areas using standardized Web-based CME learning formats. METHOD: One group of pretest-postest designs were used to evaluate knowledge and self-reported confidence change across multiple Web-based courses using a standardized instructional format but comprising distinct clinical subject matter. Participants also completed a participant satisfaction survey and a self-reported retrospective skill/ability change survey. RESULTS: The majority of courses evaluated demonstrated significant pre to post knowledge and confidence effect size change, as well as significant self-reported retrospective practice change. CONCLUSIONS: A Web-based CME instructional format comprising multimedia-enhanced learning tutorials supplemented by asynchronous computer-mediated conferencing for case-based discussions was found to be effective in enhancing knowledge, confidence, and self-reported practice change outcomes across a variety of clinical subject matter areas.

Attitude of Health Personnel↗
PubMedDate not supplied

Outline of a medical genetics curriculum for internal medicine residency training programs.

To keep pace with the rapid advances in medical genetics, internal medicine residency training programs need to train internists to develop new attitudes, knowledge bases, and skill sets. Currently, such programs have no medical genetics curriculum. Thus, to set a minimum standard for genetics education in the context of training in internal medicine, the Internal Medicine Residency Training Program Genetics Curriculum Committee was formed, with members representing professional organizations of medical geneticists, internists, genetic counselors, internal medicine and genetics residency program directors, and internal medicine residents. The committee's task was to develop a concise outline of a medical genetics curriculum for residents in internal medicine in accordance with requirements of the Residency Review Committee for Internal Medicine of the Accreditation Council for Graduate Medical Education. The curriculum outline was drafted and circulated for comment. Before publication, the final document was approved by those member organizations that had a policy of approving curricula. Key learning objectives of the curriculum include appreciation of the rapid advances in genetics, the need for lifelong learning, the need for referral, and the role of genetic counselors and medical geneticists, as well as developing the ability to construct and analyze a three-generation pedigree. A wide variety of teaching methods can be useful in these regards, including didactic lectures, multimedia CD- ROMs, and clinical experience. Teaching should be related to clinical experiences whenever possible. The curriculum developed by the committee and presented in this article will assist in teaching residents the attitudes, knowledge, and skills they will require.

Accreditation↗
PubMed2003

Spinal cord injury computer-assisted instruction for medical students.

OBJECTIVE: To determine if a computer-assisted instruction program would improve fourth-year medical students' knowledge base related to spinal cord injury, as determined by pretest and posttest scores. DESIGN: A multimedia computer-assisted instruction program was developed and offered on a volunteer basis to an entire class of fourth-year medical students (n = 168). Effectiveness of the instructional content was evaluated with pretests and posttests, and overall user satisfaction with the module was assessed with the courseware evaluation. RESULTS: The responses yielded 83 sets of completed pretest and posttest pairs and 80 sets of fully completed courseware evaluations. Mean posttest score was significantly higher than the mean pretest score (pretest, 6.65 +/- 1.44, vs. posttest, 7.36 +/- 1.38; df = 82, t = -4.74, P < 0.001). Courseware evaluations yielded positive ratings in all areas, including applicability and usability. CONCLUSIONS: The significantly increased posttest scores suggest that the students left the program with an expanded knowledge base in the content areas of spinal cord injury medicine covered in the computer-assisted instruction program.

Clinical Competence↗
PubMed2004

Musculoskeletal education in physical medicine and rehabilitation residency programs.

OBJECTIVE: To characterize current musculoskeletal (MSK) education experiences in physical medicine and rehabilitation residency programs and to identify perceived barriers to providing more extensive MSK education experiences. In addition, to establish utilization patterns for the PASSOR Physical Examination Core Competencies List. DESIGN: Between March and November 2003, all 81 physical medicine and rehabilitation residency program directors were asked to complete an MSK education survey developed by the authors. RESULTS: A total of 69 of 81 program directors (86%) responded after multiple contacts. The most frequently utilized MSK education formats were MSK lecture series, MSK departmental conferences, and physical examination workshops. Potential barriers to expanded MSK education included money, time, and staff number. Given unlimited resources, most residency programs would greatly increase utilization of visiting lecturers, CD-ROMs/DVDs, objective structured clinical examinations, and physical examination videos. Of the 30 program directors who recalled receiving the Core Competencies List, only 40% (12 of 30) have formally integrated the list into their residency training. Barriers to implementation included logistical challenges and lack of direction regarding implementation. CONCLUSIONS: Residency program directors indicate a strong interest in expanding resident MSK education through the use of CD-ROMs/DVDs, physical examination videos, objective structured clinical examinations, and visiting lecturer programs. CD-ROMs/DVDs and videos represent particularly attractive educational formats for supplementing resident MSK education due to the advantages of central production, nominal costs, widespread distribution, multimedia capabilities, and accessibility. These educational formats should be considered for targeted educational initiatives to enhance resident MSK education, regardless of residency program size or resources.

Clinical Competence↗
PubMed2003

Internet-based intervention to promote organ donor registry participation and family notification.

BACKGROUND: Little is known regarding the potential of Internet-based educational interventions to increase organ donor registry participation and family notification of donation wishes. We studied the effects of an Internet-based multimedia intervention (www.journey.transweb.org) on donor registry participation and family notification. METHODS: Visitors to a specially designed web site were studied between December 14, 2000, and March 31, 2002. Demographic characteristics were requested, and a pretest was administered to one half of the participants (selected randomly) before web site content exposure. All visitors were offered a posttest. Eight knowledge questions (true/false), three attitude questions (7-point scale), and three behaviors (yes/no) were assessed. RESULTS: A total of 10,884 visitors provided demographic data. Correct answers to knowledge questions increased from 85.1% to 87.0% overall (pretest vs. posttest; P<0.001) and from 80.6% to 82.0% for teenagers (P<0.001). Willingness to donate increased (scores of 6.34 vs. 6.39; P<0.001), as did willingness to join a donor registry (scores of 5.53 vs. 5.67; P<0.001). Willingness measures were less positive among teenagers but increased significantly after exposure to the intervention. Almost 10% of visitors directly linked to an online registry and 2,489 (23%) used the web site facilities to communicate donation wishes. Increases in knowledge were not associated with changes in attitudes, but an increase in pro-donation attitude was a significant predictor of donor registry participation (P<0.001). CONCLUSIONS: Increases in donation attitudes among visitors to an organ donation web site resulted in positive behaviors, such as enrollment in a donor registry and family notification. Future efforts should focus on using Internet-based interventions to improve attitudes toward donation and to facilitate pro-donation behaviors.

Adolescent↗
PubMed2003

Abstraction and art.

In a given social context, artistic creation comprises a set of processes, which relate to the activity of the artist and the activity of the spectator. Through these processes we see and understand that the world is vaster than it is said to be. Artistic processes are mediated experiences that open up the world. A successful work of art expresses a reality beyond actual reality: it suggests an unknown world using the means and the signs of the known world. Artistic practices incorporate the means of creation developed by science and technology and change forms as they change. Artists and the public follow different processes of abstraction at different levels, in the definition of the means of creation, of representation and of perception of a work of art. This paper examines how the processes of abstraction are used within the framework of the visual arts and abstract painting, which appeared during a period of growing importance for the processes of abstraction in science and technology, at the beginning of the twentieth century. The development of digital platforms and new man-machine interfaces allow multimedia creations. This is performed under the constraint of phases of multidisciplinary conceptualization using generic representation languages, which tend to abolish traditional frontiers between the arts: visual arts, drama, dance and music.

Art↗
PubMed1993

3-D computation of E fields by the volume-surface integral equation (VSIE) method in comparison with the finite-integration theory (FIT) method.

An algorithm has been developed for calculation of 3-dimensional E fields by the volume-surface integral equation (VSIE) method. Integration over surface elements is performed by elementary analytical formulas, assuming a linear interpolation of surface charges. Grid points at electrical interfaces are split off, well considering the E field behavior at these contours, specifically at sharp bends and multimedia junctions. Averaging procedures are utilized in order to avoid undefined or infinite values at critical points. The VSIE is solved by iteration using GMRES ("general minimum residuum") solver on a SUN workstation SPARC-IPX or Cray XMP, whereby convergence speed decreases considerably as the heterogeneity of the problem increases. Computation time (e.g., 20 min on a supercomputer for approximately 30,000 cells) needs to be reduced by further code development. Results for 3-D test cases (plane wave illuminating a layered cylinder) generally agree well with the finite-integration-theory (FIT) method if high E field gradients occur perpendicular to electrical boundaries. The VSIE method predicts slightly higher E fields only in critical regions. On the other hand, the FIT method at present is more efficient with respect to computation time for large domains with high cell numbers (> 100,000 cells).

Algorithms↗
PubMed1995

A video-based system for acquiring biomechanical data synchronized with arbitrary events and activities.

A video-based data acquisition and interactive multimedia data extraction system are described for measuring and synchronizing large quantities of biomechanical analog data with arbitrary events and activities. Analog signals from up to 32 channels are digitized, frequency-shift key (FSK) coded, and recorded directly onto the audio tracks of a video tape in synchronization with the video information. The data acquisition system includes an A/D converter that digitizes up to 16 multiplexed channels of 8-b data at a fixed sample rate between 60 and 960 Hz, and an FSK modem that transfers the data onto one of two VHS high fidelity (20 Hz-20 kHz bandwidth) audio tracks. Twenty megabytes of digitized data and time codes, along with associated video and normal audio are contained on a conventional 120-min video tape. An analyst interactively reviews the video tape off-line using a computer-controlled VCR and identifies specific events that divide arbitrary activities into time segments. The computer automatically extracts the biomechanical data corresponding to each time segment for further processing or analysis. This system is useful for ergonomics, gait analysis, sports medicine, sleep laboratory, biomechanics, or any application where complex visual events are synchronized with low-frequency analog data.

Analog-Digital Conversion↗
PubMed1997

An architecture for naval telemedicine.

Navy fleets have a defined overall objective for mission readiness impacted by the health of personnel aboard the ships. Medical treatment facilities on the ships determines the degree of mission readiness. This paper describes the concepts and technologies necessary to establish a Naval telemedicine system, which can drastically improve health care delivery. It consists of various combinations of the following components: Fleet Naval Medical Consultation and Diagnostic Centers, Shipboard Naval Medical Consultation and Diagnostic Centers (hospital ship or combatant ships with medical specialists on board), and Remote Medical Referring Centers such as a ship, a small Naval station annex, or a field hospital. This Naval telemedicine architecture delivers clinical medicine and continuing medical education (CME) by means of computers, video-conferencing systems, or telephony to enhance the quality of care through improved access to research, medical and nonmedical imaging, remote consultations, patient clinical data, and multimedia medical education programs. It integrates the informatics infrastructure and provides a medical telepresence among participants.

Computer Systems↗
PubMed1998

Interactive DICOM image transmission and telediagnosis over the European ATM network.

The European High-Performance Information Infrastructure in Medicine, n(o)B3014 (HIM3) project of the Trans-European Network--Integrated Broadband Communications (TEN-IBC) program, started on March 1996 and finished on February 1997, aimed to test the medical usability of the European asynchronous transfer mode (ATM) network in medical image transmission. The Department of Radiology, University of Pisa, Pisa, Italy, and St-Luc University Hospital, Brussels, Belgium, involved in the project as healthcare partners in the radiological domain, established several connection sessions finalized to test the usability of Digital Imaging and Communication (DICOM) image transmission and interactive telediagnosis tools in the daily radiological practice. The Pisa site was connected to the Italian ATM pilot (Sirius Network) through the Tuscany metropolitan area network (MAN), while St-Luc University Hospital was connected to Belgium ATM network through the Brussels MAN. By means of international connections provided by the European JAMES project, a link between the two sites was established, connecting both national ATM networks. Due to the large variety of hardware present in the medical centers, multiplatform software tools were used and tested: central test node (CTN) release 2.8 [3], VAT [6], NV-3.3 [7], and IDI (UCL homemade multiplatform teleradiology tool for interactive visualization and processing of DICOM images). During the telediagnosis session, lead by radiologists in both hospitals, each site submitted neuroradiological clinical cases to the other for remote consultation. The connection, available for a period of two weeks, at 2-Mbit/s bandwidth, allowed the transmission of MR images (256 x 256 x 12 bit) and simultaneous multimedia interactive discussion of the cases. Both off-line transmission and review of the images, using the CTN DICOM transfer routines, and on-line interactive image discussion, using the IDI telediagnosis software, were tested successfully from the technical and medical point of view.

Computer Communication Networks↗
PubMed1997

WebOnCOLL: medical collaboration in regional healthcare networks.

This paper presents WebOnCOLL, a web-based medical collaboration environment, which has been designed in the context of the regional healthcare network of Crete. WebOnCOLL employs the infrastructure of regional healthcare networks to provide integrated services for virtual workspaces, annotations, e-mail, and on-line collaboration. Virtual workspaces support collaborative concepts like personal web pages, bulletin boards, discussion lists, shared workspaces, and medical case folders. Annotations provide a natural way for people to interact with multimedia content, while e-mail is one of the most popular forms of communication today. On-line collaboration satisfies the need for a more direct form of communication.

Biomedical Technology↗
PubMed1998

The construction of a simulation-based system for the development of powerful and realistic models and practicals for healthcare professionals.

The aim of this paper is to examine the importance of computer-based simulation by the demonstration and study of complex systems and the presentation of essential tools and applications that can help health professionals deliver good quality practicals, which is now impeded by cost and/or technical constrains. The tools that have been developed in the framework of the Courseware Authoring for Scientific Training (COAST) project are the "modeler environment," which is used to describe the different tools and mathematical functions available for building models, and the "simulation author environment," which is used for building simulation sequences and providing the required tools and functions. This effort provides scientists with new technological and cost-effective means, specifically based on multimedia simulation, for preparing educational material, so as to gradually replace laboratory practicals that are gradually becoming more expensive, and improves student's understanding of complex systems.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Relief for maritime medical emergencies through telematics.

MERMAID is a European Union (EU)-financed maritime telemedicine project with global reach and 24-h multilingual capability, so as to serve multinational crews working in the isolation of the world's oceans. It provides a model for the provision of healthcare services based on the electronic transmission of medical information via ISDN-based video conferencing. This model is not limited to medical diagnostics, but it encompasses all cases in which the actual delivery of healthcare services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an extensive telecommunications infrastructure that includes both satellite transmission for ship to shore communication and an extensive ground-based network for summoning expert medical help from around the world so as to meet the project's multilinguality requirements and, therefore, the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low-, medium-, and high-bandwidth data requirements) are considered, while the full range of network choices (digital land lines, cellular/wireless, satellite, and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their lifecycle. Finally, out of that, MERMAID utilizes advanced land-based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

Emergency Treatment↗
PubMed1998

A novel emergency telemedicine system based on wireless communication technology--AMBULANCE.

Recent studies conclude that early and specialized prehospital management contributes to emergency case survival. We have developed a portable medical device that allows telediagnosis, long distance support, and teleconsultation of mobile healthcare providers by expert physicians. The device allows the transmission of vital biosignals and still images of the patient from the emergency site to the consultation site using the GSM mobile telephony network. The device can telematically "bring" an expert specialist doctor at the site of the medical emergency, allow him/her to evaluate patient data, and issue directions to the emergency personnel on treatment procedures until the patient is brought to be hospital. Legal reasons mandated the inclusion at the consultation site of a multimedia database able to store and manage the data collected by the system. The performance of the system has been validated in four different countries using a controlled medical protocol and a set of 100 patients per country treated has been collected and analyzed.

Emergency Medical Services↗
PubMed2004

Content-based retrieval of historical Ottoman documents stored as textual images.

There is an accelerating demand to access the visual content of documents stored in historical and cultural archives. Availability of electronic imaging tools and effective image processing techniques makes it feasible to process the multimedia data in large databases. In this paper, a framework for content-based retrieval of historical documents in the Ottoman Empire archives is presented. The documents are stored as textual images, which are compressed by constructing a library of symbols occurring in a document, and the symbols in the original image are then replaced with pointers into the codebook to obtain a compressed representation of the image. The features in wavelet and spatial domain based on angular and distance span of shapes are used to extract the symbols. In order to make content-based retrieval in historical archives, a query is specified as a rectangular region in an input image and the same symbol-extraction process is applied to the query region. The queries are processed on the codebook of documents and the query images are identified in the resulting documents using the pointers in textual images. The querying process does not require decompression of images. The new content-based retrieval framework is also applicable to many other document archives using different scripts.

Abstracting and Indexing↗