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PubMed2000

Developing a tobacco survey for deaf youth.

Formidable barriers hinder use of standard data collection methods among deaf youth. Culturally and linguistically sensitive data collection strategies are needed to identify the unmet health and programming needs of this population. Unfortunately, researchers often fail to describe the issues involved in developing such targeted methods. The authors describe development of a culturally appropriate data collection instrument for a study of tobacco-related knowledge, attitudes, and practices among deaf youth. The instrument uses interactive multimedia technology to administer a questionnaire translated into the primary languages used by the Deaf. The procedures taken to accommodate this technology to these languages and to Deaf culture are described. This process yielded useful insights with respect to data collection not only among the Deaf, but among other frequently overlooked and underserved populations as well.

Adolescent↗
PubMed1996

The Interactive Video-Questionnaire: a new technology for interviewing deaf persons.

This paper traces the development of a new technology, the Interactive Video-Questionnaire, for interviewing Deaf persons by using manually signed questionnaires. After encountering numerous obstacles to conducting surveys with Deaf persons about substance abuse using the same methods typically used with hearing persons, the researchers, with a Small Business Innovative Research grant from the National Institute on Drug Abuse, piloted a survey method that uses videodisc and bar code readers to present survey questions signed on screen in American Sign Language and Signed English. Following consultations with Deaf participants, deficiencies of this method were identified and corrected. An interactive multimedia program was created in Phase II of this research effort that offered questions visually in American Sign Language, Signed English, or Speechreading. All questions were subtitled in written English, with Touchscreen entry and automatic data capture and storage. The potential exists for many important uses of the Interactive Video-Questionnaire.

Communication↗
PubMed1995

Advanced learning technology for a bilingual education of deaf children.

Italian deaf children in elementary and middle school have limited competence in written Italian, which is in part caused by difficulties with lexical and morphosyntactic aspects of the Italian language. This study describes a recently developed interactive multimedia application designed to facilitate deaf children's access to new information and reports the results of an initial experiment conducted with deaf elementary and middle school children. Subjects were twelve deaf children with varying backgrounds and linguistic competencies, ranging in age from 6;6 to 16;1 years. Experimentation was structured in three phases. In the initial phase, children explored the computer environment freely, and in the two subsequent phases, children were presented with activities requiring use of the application to obtain information. Results of a final evaluation indicated that all children were able to use and profit from the application. Findings are discussed in terms of bilingual methods of education for deaf children and their implications for increasing deaf children's competence in written language.

Adolescent↗
PubMed2006

Community-based participatory research increases cervical cancer screening among Vietnamese-Americans.

Using community-based participatory research methods, a community-research coalition in Santa Clara County, California (SCC) conducted a quasi-experimental, controlled trial to increase Pap test receipt and to build community capacity among Vietnamese-American women. From 1999 to 2004, the Coalition planned and implemented an Action Plan with six components: multimedia campaign, lay health worker outreach, Vietnamese Pap clinic with patient navigation, registry and reminder system, continuing medical education for Vietnamese physicians, and restoring a Breast and Cervical Cancer Control Program site. Components were evaluated individually. Community-wide, cross-sectional telephone surveys of Vietnamese women in SCC (intervention community) and Harris County, Texas (comparison community) measured overall project impact. Receipt and currency of Pap tests increased significantly in the intervention compared with the comparison community. Community involvement, system changes, community and research capacity building, dissemination of results, and program sustainability were also demonstrated. Community-based participatory research is feasible and effective in Vietnamese-American communities.

Adolescent↗
PubMed1995

[Testing methods for the characterization of catheter balloons and lumina].

The present paper reports on the characterization of catheter balloons and lumina on the basis of such known parameters as residual volume, compliance, burst pressure and flow rate, with the aim of developing standards, test methods and testing equipment as well as standards. These are becoming ever more important with the coming into force of the EC directive on medical products [7] and the law governing medical products in Germany [13], which requires manufacturers to specify the properties of their products. Our testing concept is based on a commercially available machine that subjects materials to alternating extension and compression forces over the long-term, to which we added a special hydraulic module. Using the multimedia technology we achieved a real time superimposition of the volume-diameter curve on the balloon. The function of the testing device and method is demonstrated on dilatation catheters. Our initial results reveal compatibility with the requirements of the 1% accuracy class. Use of this methodology for comparative testing of catheters and quality evaluation is recommended.

Catheterization↗
PubMed1995

[Evaluating an interactive, multi-media learning system for the study of primary open angle glaucoma].

Using the interactive multimedia learning system for studying open-angle glaucoma [3] a prospective, randomized, case-controlled study was carried out to determine the value of this new form of learning in terms of acceptance and the imparting of knowledge. This article describes details of the study and presents their results. Results were established on the basis of targeted questions asked prior to and after the learning phase, followed by an analysis of frequencies and significance testing by the Chi squared method. It was shown that the imparting of knowledge is significantly improved when this learning system is employed. In addition, after its first use, acceptance of this new medium rose dramatically.

Case-Control Studies↗
PubMed2006

Learning from technical documents: the role of intermodal referring expressions.

OBJECTIVE: We investigated the impact of two types of intermodal referring expressions on efficiency of instructions for use. BACKGROUND: User manuals for software or technical devices such as a video recording system frequently combine verbal instructions and illustrations. Much research has shown that the presence of an illustration has a beneficial effect on learning. The present study focuses on a factor that modulates this beneficial effect. The combination of text and an illustration can be effective only if the user integrates the information coming from these two media. This integration depends largely on the intermodal referential expressions, the function of which is to mark explicitly the relations between the text and the illustration. METHOD: In an experiment (N = 104), we compared the effectiveness of two intermodal referring expressions often used in procedural texts: indexes (numbers introduced in the illustrations and in the instructions to establish cross-references) and icons (visual representations of the components of the device, which are inserted in the verbal instructions). RESULTS: The icons condition led to the most efficient use of the device. CONCLUSION: This experiment shows that learning from multimedia documents depends on the possibility of effectively connecting the verbal instructions to the illustration. APPLICATION: Taking into account the ergonomic properties of the cross-media referring expressions should allow text designers to improve the effectiveness of technical documents.

Belgium↗
PubMed2000

Baby CareLink: using the internet and telemedicine to improve care for high-risk infants.

OBJECTIVE: To evaluate an Internet-based telemedicine program designed to reduce the costs of care, to provide enhanced medical, informational, and emotional support to families of very low birth weight (VLBW) infants during and after their neonatal intensive care unit (NICU) stay. BACKGROUND: Baby CareLink is a multifaceted telemedicine program that incorporates videoconferencing and World Wide Web (WWW) technologies to enhance interactions between families, staff, and community providers. The videoconferencing module allows virtual visits and distance learning from a family's home during an infant's hospitalization as well as virtual house calls and remote monitoring after discharge. Baby CareLink's WWW site contains information on issues that confront these families. In addition, its security architecture allows efficient and confidential sharing of patient-based data and communications among authorized hospital and community users. DESIGN/METHODS: A randomized trial of Baby CareLink was conducted in a cohort of VLBW infants born between November 1997 and April 1999. Eligible infants were randomized within 10 days of birth. Families of intervention group infants were given access to the Baby CareLink telemedicine application. A multimedia computer with WWW browser and videoconferencing equipment was installed in their home within 3 weeks of birth. The control group received care as usually practiced in this NICU. Quality of care was assessed using a standardized family satisfaction survey administered after discharge. In addition, the effect of Baby CareLink on hospital length of stay as well as family visitation and interactions with infant and staff were measured. RESULTS: Of the 176 VLBW infants admitted during the study period, 30 control and 26 study patients were enrolled. The groups were similar in patient and family characteristics as well as rates of inpatient morbidity. The CareLink group reported higher overall quality of care. Families in the CareLink group reported significantly fewer problems with the overall quality of care received by their family (mean problem score: 3% vs 13%). In addition, CareLink families also reported greater satisfaction with the unit's physical environment and visitation policies (mean problem score: 13% vs 50%). The frequency of family visits, telephone calls to the NICU, and holding of the infant did not differ between groups. The duration of hospitalization until ultimate discharge home was similar in the 2 groups (68.5 +/- 28.3 vs 70.6 +/- 35.6 days). Among infants born weighing <1000 g (n = 31) there was a tendency toward shorter lengths of stay (77.4 +/- 26.2 vs 93.1 +/- 35.6 days). All infants in the CareLink group were discharged directly to home whereas 6/30 (20%) of control infants were transferred to community hospitals before ultimate discharge home. CONCLUSIONS: CareLink significantly improves family satisfaction with inpatient VLBW care and definitively lowers costs associated with hospital to hospital transfer. Our data suggest the use of telemedicine and the Internet support the educational and emotional needs of families facilitating earlier discharge to home of VLBW infants. We believe that further extension of the Baby CareLink model to the postdischarge period will significantly improve the coordination and efficiency of care.

Aftercare↗
PubMed2002

Effect of an educational intervention about breastfeeding on the knowledge, confidence, and behaviors of pediatric resident physicians.

OBJECTIVE: Breastfeeding is the preferred nutrition for infants, but many pediatricians report inadequate training to advise mothers who breastfeed. This study was designed to examine the effect of an educational intervention on pediatric residents' knowledge about breastfeeding, their confidence in addressing lactation issues, and their management skills during clinical encounters with breastfeeding mothers. DESIGN: An interactive multimedia curricular intervention was designed for pediatric residents to increase their knowledge about common lactation issues. The residents completed questionnaires before and after the intervention to measure knowledge and confidence. Resident behaviors in the clinical setting were measured before and after the intervention using telephone surveys of breastfeeding mothers after a clinic visit with a pediatric resident. RESULTS: Forty-nine pediatric residents participated in the study. Mean knowledge scores increased from 69% before the intervention to 80% after the intervention. Significant increases in knowledge included advising mothers about low milk supply, mastitis, abscess, or using medication, and in recognizing the benefit of the decreased risk of maternal cancer. Management skills with breastfeeding mothers and infants in the clinical setting improved significantly. Before the intervention residents performed an acceptable number of behaviors 22% of the time, while after the intervention their performance was acceptable 65% of the time. Particular behaviors that showed significant improvement after the intervention included discussing signs of breastfeeding adequacy with the mother and correct management of lactation problems. CONCLUSIONS: These results indicate that not only breastfeeding knowledge and confidence, but most importantly clinical behaviors of pediatric residents can be enhanced through innovative educational opportunities. Appropriate counseling for breastfeeding mothers by pediatricians might contribute to an increase in the duration of breastfeeding.

Adult↗
PubMed2006

A randomized, controlled trial of an interactive educational computer package for children with asthma.

OBJECTIVE: The purpose of this study was to evaluate the impact and acceptability of an educational multimedia program designed to promote self-management skills in children with asthma. METHODS: We conducted a randomized, controlled trial with measures at baseline and 1- and 6-month follow-up. The trial was conducted in pediatric outpatient respiratory clinics in 3 United Kingdom hospitals. Participants included 101 children aged 7 to 14 years under the care of hospital-based asthma services. The children were randomly assigned to receive an asthma information booklet alone or the booklet plus The Asthma Files, an interactive CD-ROM for children with asthma. Asthma knowledge was the primary outcome measure. Other measures included asthma locus of control, lung function, use of oral steroids, and school absence. RESULTS: At the 1-month follow-up (n = 99), children in the computer group had improved knowledge compared with the control group and a more internal locus of control. There were no differences in objective lung-function measures, hospitalizations, or oral steroid use. The study participants were positive in their evaluation of the intervention. At the 6-month follow-up (n = 90), significantly fewer children in the intervention group had required oral steroids and had had time off school for asthma in the previous 6 months. The difference did not reach statistical significance in the intention-to-treat analysis for both steroid use and school absence. CONCLUSION: The Asthma Files was found to be an effective and popular health education tool for promoting asthma self-management skills within pediatric care.

Asthma↗
PubMedDate not supplied

[Children and medications: educational software on drug administration in pediatrics].

The purpose of this study is the development and evaluation of an educational software on the administration of pediatric medicaments called "Children and medication". The pedagogical framework of Robert M. Gagné and the Three Stages Model, proposed by Price (1991) to develop CAI programs, were used. The software utilizes multimedia resources and is composed of four topics: the child, the medicament, the person who administers it and the administering of the medication. After the development of the program, it went through an evaluation process which was divided in three phases and had the participation of system analyst professionals and the target population to which the software was designed. Data analysis of the software showed that most of the items received excellent approval by the evaluators. It was observed that the software was accepted by the users and that it contributed for the nursing teaching of pediatric medicament administering through a new resource.

Child↗
PubMedDate not supplied

[Development and evaluation of an educational software for pediatric nursing education].

Computer Science is being introduced in education at an accelerated pace, thus forcing educators and students to become familiarized with such technology. This study aimed at the development and evaluation of the educational software "Children and medication". The program utilizes multimedia resources in four topics: the child, medication, the person who administers and administration of medication. The evaluation showed a large acceptance of the program, with most of the items being rated as excellent. We emphasize the importance of the development of teaching strategies utilizing computer resources in nursing education and in the development of nurses for the new millenium.

Evaluation Studies as Topic↗
PubMed2003

Recent developments in broadly applicable structure-biodegradability relationships.

Biodegradation is one of the most important processes influencing concentration of a chemical substance after its release to the environment. It is the main process for removal of many chemicals from the environment and therefore is an important factor in risk assessments. This article reviews available methods and models for predicting biodegradability of organic chemicals from structure. The first section of the article briefly discusses current needs for biodegradability estimation methods related to new and existing chemicals and in the context of multimedia exposure models. Following sections include biodegradation test methods and endpoints used in modeling, with special attention given to the Japanese Ministry of International Trade and Industry test; a primer on modeling, describing the various approaches that have been used in the structure/biodegradability relationship work, and contrasting statistical and mechanistic approaches; and recent developments in structure/biodegradability relationships, divided into group contribution, chemometric, and artificial intelligence approaches.

Artificial Intelligence↗
PubMed2004

A food chain model to predict the levels of lipophilic organic contaminants in humans.

A fugacity-based, nonsteady state, mechanistic model called ACC-HUMAN was developed to describe bioaccumulation of lipophilic organic pollutants from air, water, and soil to humans. The physical environment was linked via a marine and an agricultural food chain model to a human bioaccumulation model. Contaminant uptake via the primary dietary sources of persistent lipophilic contaminants in industrialized countries was addressed, namely fish, dairy products, and beef. In addition, uptake from air and water was considered, allowing the model also to treat less lipophilic compounds. To evaluate the model, the food chain characteristics were parameterized for southern Sweden and historical scenarios of polychlorinated biphenyl (PCB) concentrations in air, water, and soil in this region were constructed from published data. The resulting model predictions of PCB concentrations in fish, milk, beef, and human tissue agreed well with measured concentrations from Swedish monitoring programs. This suggests that ACC-HUMAN is a useful tool for predicting human exposure to bioaccumulative organic compounds. It can be linked easily to existing multimedia fate and transport models.

Agriculture↗
PubMed2004

Modeling the fate of polychlorinated biphenyls in the inner Oslofjord, Norway.

A dynamic, segmented, multimedia fate and transport model has been developed, evaluated, and applied to gain insight regarding the behavior of seven polychlorinated biphenyl (PCB) congeners in the Inner Oslofjord (Norway). A comparison with a dated sediment core reveals that the model is not capable of reproducing some key features of the observed, historical, long-term trend in sediments, although better agreement is observed for six of seven PCB congeners over the last two decades. The model also underestimates the concentrations of PCBs in surface sediments in areas adjacent to the city of Oslo (Norway). In general, deviations between modeled and observed concentrations indicate that the historical emissions and discharges of PCBs are not sufficiently characterized and described. Net fluxes predicted by the model suggest that several congeners may have experienced a reversal of air-water and seawater-sediment exchange during the last decade or even earlier. The present study further suggests that the benefit of the proposed removal of the most contaminated sediments of the Inner Oslofjord needs to be assessed, with consideration of the relative contribution of current atmospheric inputs as well as the leaching of PCBs from less contaminated sediments.

Air↗
PubMed2004

Finding fugacity feasible, fruitful, and fun.

A review is presented concerning the evolution of the fugacity concept as applied to environmental science. The series of serendipitous events that ultimately resulted in publication of the paper "Finding Fugacity Feasible" in 1979 is described. The use of fugacity as a surrogate for concentration is shown to facilitate the compilation and solution of mass-balance equations. It has proved to be valuable in a number of contexts, notably the description of chemical fate in unit worlds at various levels of complexity. More complex systems can be simulated as sets of connected unit worlds. The fugacity approach enables the multimedia character of organic chemicals to be deduced, thus contributing to the evaluation of chemical properties that impact persistence and long-range transport. It has proved to be especially insightful for describing bioconcentration, bioaccumulation, and pharmacokinetic phenomena. Applications to the sensing and monitoring of chemical presence in the environment are described. Suggestions are made for subject areas in which the fugacity concept may prove to be particularly valuable in the future. Finally, the many colleagues who have contributed to the use of fugacity when quantifying chemical behavior in the environment are acknowledged.

Environmental Monitoring↗
PubMed2006

The scope of integrated modelling: system boundaries, sub-systems, scales and disciplines.

Integrated modelling has become an urgent issue of urban drainage and wastewater treatment planning. The scope of integrated modelling, system boundaries and disciplines to be involved are addressed in view of future developments and new paradigms in urban drainage, demanding the inclusion of the full urban water cycle. A system analysis is demonstrated to identify relevant sub-systems and components, processes and interactions within the urban water system. The permissibility to exclude subsystems or neglect interactions is evaluated. Integrated modelling of urban water system is characterised as an ambitious task in regard to system complexity, heterogeneous scales and interface problems. The methodical status quo is characterised in preliminary approaches towards integrated modelling. It is concluded that it does not seem promising to create and apply one entity model for the scope of integrated urban water modelling. Instead, the development of adequate and efficient IT frameworks is identified as the key issue of integrated modelling. Harmonising interfaces to facilitate the linking of existing models is presented as the objective of a European research project HarmonlT and the U.S. EPA Multimedia Integrated Modelling System project MIMS.

Cities↗
PubMed2005

Shoestring budgets, band-AIDS, and team work: challenges and motivators in the development of a Web-based resource for undergraduate clinical skills teaching.

BACKGROUND: Learning how to conduct a medical interview and perform a physical examination is fundamental to the practice of medicine; however, when this project began, the methods used to teach these skills to medical students at the University of Toronto (U of T) had not changed significantly since the early 1990s despite increasing outpatient care, shorter hospital stays, and heavy preceptor workloads. In response, a Web-based clinical skills resource was developed for the first-year undergraduate medical course-The Art and Science of Clinical Medicine I (ASCM I). OBJECTIVES: This paper examines our experiences with the development of the ASCM I website and details the challenges and motivators inherent in the production of a Web-based, multimedia medical education tool at a large Canadian medical school. METHODS: Interviews and a focus group were conducted with the development team to discover the factors that positively and negatively affected the development process. RESULTS: Motivating factors included team attributes such as strong leadership and judicious use of medical students and faculty volunteers as developers. Other motivators included a growing lack of instructional equivalency across diverse clinical teaching sites and financial and resource support by the Faculty of Medicine. Barriers to development included an administrative environment that did not yet fully incorporate information technology into its teaching vision and framework, a lack of academic incentive for faculty participation, and inadequate technical support, space, and equipment. CONCLUSIONS: The success of electronic educational resources such as the ASCM I website has caused a significant cultural shift within the Faculty of Medicine, resulting in the provision of more space, resources, and support for IT endeavours in the undergraduate medical curriculum.

Budgets↗