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PubMedDate not supplied

Cumulative trauma disorder risk for children using computer products: results of a pilot investigation with a student convenience sample.

OBJECTIVES: Cumulative trauma disorder is a major health problem for adults. Despite a growing understanding of adult cumulative trauma disorder, however, little is known about the risks for younger populations. This investigation examined issues related to child/adolescent computer product use and upper body physical discomfort. METHODS: A convenience sample of 212 students, grades 1-12, was interviewed at their homes by a college-age sibling or relative. One of the child's parents was also interviewed. A 22-item questionnaire was used for data-gathering. Questionnaire items included frequency and duration of use, type of computer products/games and input devices used, presence of physical discomfort, and parental concerns related to the child's computer use. RESULTS: Many students experienced physical discomfort attributed to computer use, such as wrist pain (30%) and back pain (15%). Specific computer activities-such as using a joystick or playing noneducational games-were significantly predictive of physical discomfort using logistic multiple regression. Many parents reported difficulty getting their children off the computer (46%) and that their children spent less time outdoors (35%). CONCLUSIONS: Computer product use within this cohort was associated with self-reported physical discomfort. Results suggest a need for more extensive study, including multiyear longitudinal surveys.

Adolescent↗

PubMed2003

Efficient classical simulation of slightly entangled quantum computations.

We present a classical protocol to efficiently simulate any pure-state quantum computation that involves only a restricted amount of entanglement. More generally, we show how to classically simulate pure-state quantum computations on n qubits by using computational resources that grow linearly in n and exponentially in the amount of entanglement in the quantum computer. Our results imply that a necessary condition for an exponential computational speedup (with respect to classical computations) is that the amount of entanglement increases with the size n of the computation, and provide an explicit lower bound on the required growth.

Journal Article↗

PubMed1993

The computer in the radiologist's office.

Today, the radiologist is able to equip his or her office with a powerful personal computer system equivalent to the large mainframe computers of just a few years ago. If funds permit, purchase of a 486 equivalent system with 200-300 Mbytes of hard-disk storage, 16 Mbytes of random access memory (RAM), a high-resolution color video card and monitor, and a laser printer is recommended. The practical uses for such a system are almost limitless and include word processing, spreadsheet and data-base management, telecommunications, multimedia presentations, business applications, teleradiology, resident and medical student education, and research applications. No matter how much one becomes involved in computer applications, it is essential to establish good habits for backing up critical data files and programs. Becoming familiar with computer technology is not easy at first. Finding a good computer buddy, taking simple night school courses, and reading computer articles and magazines are good ways to get started. Computers are wonderful devices. The day is fast approaching when they will become a necessary tool for every radiologist.

Microcomputers↗

PubMed2004

From the echocardiography machine to the lecture room: a simple method for transferring echocardiographic frames and loops to a personal computer.

UNLABELLED: The use of computers in scientific and educational presentations is rapidly increasing. As a digital presentation is ideal for showing moving images, the use of multimedia files, e.g., echocardiographic loops within these presentations, is common. Even though recent echocardiography machines store acquired data in a digital format, these data are often not readily accessible to be transferred to a personal computer. We present an easy and cost-efficient method for transferring frames and loops from any echocardiography machine into a personal computer using a digital video camera equipped with a standard analog input and flash memory. Still images and movies are stored in the camera to be subsequently transferred to a personal computer. In the computer, still images and movies are post-processed with graphical and video editing software. Finally, the still images and movies can be projected from the video camera or presented with specialized software such as PowerPoint. The images can also be used for Web-based publications and production of educational material or books on electronic media such as CD-ROM. The described method can also be used to transfer images from other proprietary devices and programs, as long as the devices are equipped with an analog video outlet. IMPLICATIONS: The transfer of frames and loops from echocardiographic machines to personal computers is often useful for publication, teaching, and educational purposes. We present an easy and cost-effective method for transferring frames and loops from any echocardiography machine into a personal computer using a digital video camera.

Audiovisual Aids↗

PubMed2003

Computer-generated holograms of three-dimensional objects synthesized from their multiple angular viewpoints.

Synthesizing computer-generated holograms (CGHs) of a general three-dimensional (3D) object is usually a heavy computational task. We propose and demonstrate a new algorithm for computing CGHs of 3D objects. In our scheme, many different angular projections of computer-designed 3D objects are numerically processed to yield a single two-dimensional complex matrix. This matrix is equivalent to the complex amplitude of a wave front on the rear focal plane of a spherical lens when the object is located near the front focal point and illuminated by a plane wave. Therefore the computed matrix can be used as a CGH after it is encoded to a real positive-valued transparency. When such CGH is illuminated by a plane wave, a 3D real image of the objects is constructed. The number of computer operations are equivalent to those of a two-dimensional Fourier CGH. Computer and optical constructions of 3D objects, both of which show the feasibility of the proposed approach, are described.

Journal Article↗

PubMed1984

On-line computer scoring of the auditory brainstem response for estimation of hearing threshold.

Auditory brainstem responses (ABRs) to click stimuli have become established as a useful indicator of hearing thresholds in infants and young children. Although the investigation is objective in so far as the patient is concerned, a subjective element remains in the decision by the operator as to whether or not an ABR is present in an averaged waveform. A simple on-line computer detection technique is described which removes some of the reliance placed upon the operator. The technique employs a scanning window for correlation and amplitude analysis of pairs of averaged ABR waveforms. The reliability and accuracy of computer and operator scoring of 25 thresholds in normally hearing adults and 50 thresholds in infants and young children with suspected hearing impairment have been investigated. In the adult group, 96% of computer estimates of the threshold were within +/- 10 dB of the subjective hearing threshold, compared with 92% for operator scoring. There were 92% of computer and operator scores within +/- 10 dB of each other. In the patient group there was equally good agreement between computer and operator scoring with 90% of the thresholds within +/- 10 dB of each other; the incidence of possible false-positive thresholds was also lower with computer scoring. This on-line scoring technique, therefore, offers useful assistance to the operator; requires only limited computing power, and is suitable for use in a routine clinical environment.

Adult↗

PubMed2003

A computer algorithm for calculating the adequacy of antidepressant treatment in unipolar and bipolar depression.

BACKGROUND: Major depression is often treated with medications in doses that are too low or too short in duration. We published an early version of the Antidepressant Treatment History Form (ATHF) that rates the adequacy of antidepressant treatment. The updated ATHF presented here includes newer medications and a computer algorithm to automate the evaluation of the adequacy of pharmacotherapy or electroconvulsive therapy for depression. METHOD: The computer algorithm was written in MS-DOS Q-BASIC and in Visual Basic 5.0. Treatment data from 47 depressed (Structured Clinical Interview for DSM-III-R) patients were scored by the computer algorithm and assigned a number from 0 to 5 for the adequacy of antidepressant treatment. A psychiatrist blinded to the computer ratings manually rated the treatment using the ATHF. RESULTS: The computer algorithm, based on an updated version of the ATHF, estimates the adequacy of treatment of unipolar and bipolar depression. Computer algorithm results agreed with those generated by a clinician completing the form manually (kappa = 0.88 to 1.00). CONCLUSION: The computer algorithm can be used to analyze large databases and may help reduce the morbidity and mortality associated with major depression by improving the assessment of adequacy of pharmacologic treatments for research and quality assurance purposes. The availability of the updated ATHF on the Internet for downloading allows for modifications according to the user's purposes.

Algorithms↗

PubMed1993

An analysis of computer-related articles in occupational therapy periodicals.

The introduction of personal computers in the late 1970s and early 1980s has affected occupational therapy. Nine journals, three trade newspapers, and one series book published over an 11-year period by four English-speaking countries were catalogued for articles pertaining to computer use in occupational therapy. This investigation yielded 174 articles that were categorized by information type, application of computers covered, sophistication of technology, computer brand, and country of publication. Most articles provided general information, described clinical training applications, used an Apple computer, and were from an American publication. Few articles were reports of research. The percentage of computer-related articles has substantially increased in the observed 11-year period. These findings indicate increased computer use in occupational therapy.

Database Management Systems↗

PubMed1991

Computer-assisted compounding of neonatal/pediatric parenteral nutrition solutions.

A computer software package was developed to perform the calculations involved in compounding neonatal/pediatric parenteral nutrition (PN) solutions. A 16-bit micro-computer was used to develop and evaluate the software. The program requires a minimum of user input and is menu-driven. It performs the calculations, prints appropriate labels, a preparation card and a summary of the nutritional content of the solution. Error check routines and a check for calcium-phosphate compatibility are imbedded in the program. The effect of the package on PN compounding was evaluated using a computer model. The evaluation indicated the computer-assisted system was more efficient than a manual system and the possibility of computational error was reduced. The increase in efficiency with the computer-assisted system was between 12-15% compared to a manual system. Computer modeling appeared to be a useful tool in both evaluating the software package and determining the effect it would have on work flow.

Canada↗

PubMed2002

Effects of a participatory ergonomics intervention computer workshop for university students: a pilot intervention to prevent disability in tomorrow's workers.

A participatory approach was used to create a computer ergonomics workshop for college students, incorporating an instructional systems design process and adult learning inquiry perspectives. The primary objective of this participatory ergonomic pilot intervention was to involve students throughout the training design process in solving computer workstation ergonomic problems and adopting healthy computing behaviors. Students' level of participation included becoming part of the training design team, a co-facilitator, or a student trainee. A second objective was to examine the translation of an industrial office ergonomics training program into a college computer ergonomics training program. The long term goal was to reduce upper extremity symptoms and disability. The program was piloted at one private university. The three student trainees significantly increased their knowledge of computer ergonomics from 69% of test items answered correctly pre-training to 82% post-training. Trainees were also successful in conducting computer ergonomic evaluations of students' computing work areas. They achieved 100% accuracy in identifying ergonomic problems and proposing solutions in five ergonomic workstation assessments in the field. This approach was successful in creating a sense of ownership among the student developers and facilitators as reflected in their self-reports during a post-intervention debriefing. The results of this pilot study justify formal controlled trials of this intervention in university students, who will become tomorrow's workers.

Adult↗

PubMedDate not supplied

A computer-based outpatient medical record for a teaching hospital.

We developed a computer-based outpatient medical record system to facilitate direct physician interaction with the clinical computing system at the Beth Israel Hospital in Boston. During the 2 years since the medical record system was installed, 20 staff physicians, 5 fellows, 64 residents, and 11 nurse practitioners have entered 15,121 active problems and 1996 inactive problems for 3524 patients, as well as 12,651 active medications and 1894 discontinued medications for 3430 patients. Another 20,321 items were entered on health-promotion and disease-prevention screening sheets, and with the help of automatic updating by the computer, an additional 21,897 entries on screening sheets were made for 8686 patients. Clinicians wrote 10.9 +/- 12.8 (mean +/- SD) words per problem when they were working at the computer, as compared with 4.3 +/- 2.5 words per problem when they were writing in the paper medical record. We conclude that physicians will readily enter data directly into a computing system when they are given appropriate tools, and that they consider the computer-based problem list to be a valuable improvement over its paper counterpart. Use of a computer-based medical record system has obvious benefits for data management and patient care.

Ambulatory Care Information Systems↗

PubMed1986

Computer software.

Software is the component in a computer system that permits the hardware to perform the various functions that a computer system is capable of doing. The history of software and its development can be traced to the early nineteenth century. All computer systems are designed to utilize the "stored program concept" as first developed by Charles Babbage in the 1850s. The concept was lost until the mid-1940s, when modern computers made their appearance. Today, because of the complex and myriad tasks that a computer system can perform, there has been a differentiation of types of software. There is software designed to perform specific business applications. There is software that controls the overall operation of a computer system. And there is software that is designed to carry out specialized tasks. Regardless of types, software is the most critical component of any computer system. Without it, all one has is a collection of circuits, transistors, and silicone chips.

History, 19th Century↗

PubMed1994

Evaluating the accuracy of transcribed computer-stored immunization data.

OBJECTIVE: To evaluate the accuracy of immunization records transcribed into a computer-based immunization tracking system and to assess factors that contribute to inaccurate or incomplete immunization record keeping. DESIGN: Computer-stored immunization records were analyzed for 2098 children up to 2 years of age at the time of their most recent well-child visit to the UCLA Children's Health Center over a 12-month period. For children whose immunizations were not up to date, the computer-stored records were analyzed for sources of inaccuracy by comparison with the handwritten records from which the computer-stored data were transcribed. RESULTS: An underimmunization rate of 22.5% (472 of 2098) was observed based on analysis of the computer-stored records. Comparison of the computer-stored and handwritten records revealed an overall transcription error rate of at least 10.2%. In addition, 38.4% of these apparently underimmunized children had received unrecorded immunizations from providers outside UCLA. When transcription errors were corrected and other available sources of immunization data were taken into account, the estimated rate of underimmunization decreased from 22.5% to 10.9%. CONCLUSION: Unavoidable inaccuracies can diminish the utility of the data recorded in an immunization tracking system. Some inaccuracies are related to the process of transcription, but failures to record and communicate immunization data consistently also contribute to the inaccuracy of computer-stored immunization records.

Child Health Services↗

PubMed1995

ICOHR: intelligent computer based oral health record.

The majority of work on computer use in the dental field has focused on non-clinical practice management information needs. Very few computer-based dental information systems provide management support of the clinical care process, particularly with respect to quality management. Traditional quality assurance methods rely on the paper record and provide only retrospective analysis. Today, proactive quality management initiatives are on the rise. Computer-based dental information systems are being integrated into the care environment, actively providing decision support as patient care is being delivered. These new systems emphasize assessment and improvement of patient care at the time of treatment, thus building internal quality management into the caregiving process. The integration of real time quality management and patient care will be expedited by the introduction of an information system architecture that emulates the gathering and storage of clinical care data currently provided by the paper record. As a proposed solution to the problems associated with existing dental record systems, the computer-based patient record has emerged as a possible alternative to the paper dental record. The Institute of Medicine (IOM) recently conducted a study on improving the efficiency and accuracy of patient record keeping. As a result of this study, the IOM advocates the development and implementation of computer-based patient records as the standard for all patient care records. This project represents the ongoing efforts of The University of Iowa College of Dentistry's collaboration with the University of Uppsala Data Center, Uppsala, Sweden, on a computer-based patient dental record model. ICOHR (Intelligent Computer Based Oral Health Record) is an information system which brings together five important parts of the patient's dental record: medical and dental history; oral status; treatment planning; progress notes; and a Patient Care Database, generated from their clinical care information (the database is also stored in the ICOHR). ICOHR is designed to be integrated into a traditional practice management system. The components of the ICOHR system support the use of various types of clinical care quality management tools, including medical alerts, clinical care guidelines, care modifiers, and diagnostic decision support. Data input is multimodal, so the user may use both voice recognition and direct input with a digitizer board to enter information into the database. ICOHR is designed to be integrated into the clinical environment in an ergonomic fashion in order to facilitate the unobtrusive and efficient acquisition of patient information. ICOHR is currently under clinical evaluation in both private practice and institutional environments. The private practice is a large general dentistry practice with over twenty sites scattered throughout a large metropolitan area. The institutional settings are a College of Dentistry and a Hospital Dentistry program. The evaluations have started in two of the sites and the other site will be phased in during the next six months. Our demonstration of the system will include both prepared presentations of the system's various functions and provide an opportunity for hands-on use of the system for interested attendees.

Artificial Intelligence↗

PubMed1998

Neural Network Computer Analysis of Fetal Heart Rate.

> Objective: A nonsubjective evaluation of intrapartum fetal heart rate (FHR) with a neural network (NNW) computer system and its clinical application. Methods: Eight simple FHR data were input into the NNW computer after 16-step normalizations. The computer was composed of 40 units in the input layer, 30 in intermediate layer, and 3 in the output layer, and the probabilities to be normal, suspicious, and pathological were obtained at the output. Before use, the computer was trained 10,000 times by 50-min teacher FHR data of 20 cases with known outcomes. The trained NNW computer was tested by FHRs of another 29 cases. The outcome probabilities in 15 min were calculated every 5 min in another 10 cases, and the bar graphs of the probabilities were displayed in sequence in the trendgrams. Results: The trained NNW computer was 100% accurate in the internal check; in the external check 86% of the results were evaluated correctly with the cardiotocogram, Apgar score, and umbilical arterial pH of the 29 test cases. The FHR scores of our conventional computer FHR analysis were higher in the suspicious and pathological groups than the normal group, and the fetal distress index was high in the pathological group. The trendgrams were simply accurate in typically normal or abnormal cases, transitory abnormal probabilities were shown in intermediate cases, and mixed suspicious and pathological probabilities suggested pathological outcome. Conclusions: The outcome probabilities and their trendgrams in the NNW FHR analysis are promising in objective decision making in the intrapartum stage.

Journal Article↗

PubMed2000

On-site to on-line: barriers to the use of computers for continuing education.

BACKGROUND: Continuing education/continuing medical education (CE/CME) programs that adopt self-directed, computer-based instruction formats via the Internet or CD-ROM can ease the demands placed on clinicians who are required by licensing boards to accumulate CE/CME credits as part of their career-long learning. Despite the benefits and availability of computer-based instruction, on-site programs still dominate current CE/CME delivery modes. In order to increase the use of computer-based CE/CME programs, it is important to identify the barriers that inhibit their use. METHOD: A survey was conducted to assess the practices, preferences, and barriers to use of CE/CME delivery methods among physicians, nurse practitioners, and physician assistants in Nevada. RESULTS: Of 3,213 surveys sent, 1,120 were completed and returned for an overall response rate of 35%. In-person conferences (93%) and print-based methods (66%) were the most frequently reported methods of acquiring CE/CME. The majority of respondents had access to computer-based technologies. Respondents with more years in clinical practice were less likely to have access to or to use computer-based technologies. The top three preferred CE/CME delivery modes, in rank order, were in-person conferences, print-based self-study, and CD-ROM. The least preferred method of receiving CE/CME was interactive audioconference (telephone conference calls). "Not knowing how" was the most frequently reported reason for not using the Internet for computer-based training and the second most frequent reason for not using a CD-ROM. IMPLICATIONS: Program planners may wish to offer training in new technologies during on-site conferences, provide CD-ROMs as take-home instructional materials, or promote technology awareness in other ways to help clinicians prepare for changes in the electronic delivery of health care and education.

Attitude of Health Personnel↗

PubMed2006

Computer utilization and clinical judgment in psychological assessment reports.

The process of assessment report writing is a complex one, involving both the statistical evaluation of data and clinical methods of data interpretation to appropriately answer referral questions. Today, a computer often analyzes data generated in a psychological assessment, at least in part. In this article, the author focuses on the interaction between the decision-making processes of human clinicians and the test interpretations that are computer-based. The benefits and problems with computers in assessment are highlighted and are presented alongside the research on the validity of automated assessment, as well as research comparing clinicians and computers in the decision-making process. The author concludes that clinical judgment and computer-based test interpretation each have weaknesses. However, by using certain strategies to reduce clinicians' susceptibility to errors in decision making and to ensure that only valid computer-based test interpretations are used, clinicians can optimize the accuracy of conclusions that they draw in their assessment report.

Decision Making↗

PubMed1987

What is the value of the computer for the physician?

Computer technology is advancing at an increasingly rapid rate. Although the computer's former role in the health care field was primarily limited to the financial and marketing departments of health care facilities, the computer is moving beyond the managerial departments and into the realm of the practicing physician. Much of this change in the use of computers in this field is due to the pressures of cost containment, DRG requirements, the availability of microcomputers, and the desire for improved health care. In the areas of clinical care, medical research, and medical education, the computer is rapidly becoming an indispensable tool through its technological adaptation. The computer is an obvious adjunct to the problem of improving cost efficiency without compromising the efforts toward better health care.

Computer Systems↗