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The authors present one-year experience of the multimedia role in ophthalmology with particularly review on example in vitreoretinal surgery. It has been shown goal of the project, methodology, evaluation of one-year work results and possibility of project's expansion.
Despite the substantial body of literature concerned with the ways in which digital media are transforming contemporary society and institutional life, we have relatively little understanding of the ways in which new technologies feature in day to day organizational conduct and interaction. There is however a growing corpus of empirical research which places the situated and contingent character of new technologies at the heart of the analytic agenda, but as yet, these studies are relatively little known within sociology. They include ethnographies of command and control centres, financial institutions, the news media, and the construction industry. They address the ways in which tools and technologies, ranging from paper documents through to complex multimedia systems, feature in work and collaboration. In this paper, we discuss these so-called 'workplace studies' and consider their implications for our understanding of organizational conduct, social interaction and new technology.
The concepts expressed in this paper concerns the activities to be developed within HEALTHLINE, a European project under the Telematics Application programme. HEALTHLINE is an umbrella project which takes initiatives and provides links to other international projects on health telematics. The projects involved are NIVEMES and RISE; they represent the starting point from which a common approach will be developed. The experience gained from these projects has highlighted two emerging requirements: information dissemination and training. To fulfil the needs of information, an Internet corner will be set up; it will allow citizens and health professionals to find and exchange information as well as to discuss themes concerning health care. Due to the most advanced technologies recently introduced, the Health care sector has had to modify its traditional ways of working to aid professionals in exploiting new training techniques and Health Care provision methods. HEALTHLINE will focus on training and on the development of the use of new tools and services. Furthermore, the project will exploit the training methodologies based on multimedia technology for developing training-on-the-job modules. The entire system, in its final stage, will consist of a network for co-operating training and information dissemination; European sites in the project will share information, training material and provide education and information on tele-health, medical and health-care issues to health care providers, beneficiaries and the general public.
This paper will present a brief review of the use of simulations in clinical reasoning research and education, followed by a case-study describing the development of a research tool which attempted to elicit the decision-making strategies of novice and competent hospital nurses. The central feature of this simulation was the degree of flexibility and control it gave to the nurse participants over their information seeking strategies. The ability of this interactive multimedia simulation to mimic a real ward environment has a great potential in the teaching of clinical reasoning skills to health professionals.
The high cost of virtual reality simulators has posed a major obstacle to the widespread adoption of simulators for medical training. HT Medical broke through this cost barrier by developing the PreOp Flexible Bronchoscopy simulator, a realistic training simulation system that integrates force feedback, multimedia, and 3D graphics on a PC. We are currently extending the PreOp platform so that it can simulate other endoscopic procedures. This paper discusses our efforts to extend the platform to simulate flexible sigmoidoscopy and ureteroscopy.
MEDICOM system is a world wide telematics application for electronic commerce of medical devices. It has been designed so as to provide the health care professionals with a central Internet access to up-to-date information about medical equipment from multiple manufacturers, in a particular easy and friendly way. Moreover, the Medicom system will serve the health care professionals' requirements for high-quality information about specific products in a form of multimedia presentations and that of a secure communication channel with the community of manufacturers, especially for post marketing surveillance. The system will provide the medical staff (physicians and technicians) with demonstrations of the operation procedures and the functioning of high-tech equipment in a form of virtual models. Moreover, through the medicom system the end users of medical devices can have access to on line libraries and participate in special newsgroups. This paper discusses the architectural structure of the MEDICOM system with emphasis to its educational and training functionality.
Preferences for health outcomes, often called utilities, are numeric measurements of the patients' opinions about overall quality of life with a disease or a health condition. These measurements are used in economic studies (cost effectiveness analysis) as weights for life years (so called Quality adjusted life years or QALYs), in development of guidelines for clinical care (again as quality weights for life years), and to help identify the best treatment alternative for individual patients through application of decision analysis. iMPACT3 (Internet Multimedia Preference Assessor Construction Tool) is a free publicly accessible web site that helps researchers design experimental protocols for measurement of utilities. When the researcher is finished with his or her design, iMPACT3 generates a set of HTML files that use Javascript to implement the protocol. iMPACT3 then downloads those to the researcher's computer, where they can be used in a stand alone fashion to collect data from patients in a clinic or published on the web. We describe and discuss computer approaches for measurement of utilities and their applications in healthcare. We then discuss the design of iMPACT3 and approaches for automatic generation of web sites for data collection in clinical studies.
Owners of about 15% to 20% of the homes in Wisconsin have tested their indoor air for the carcinogenic gas radon. Five percent to 10% of homes have year-average main-floor radon levels that exceed the US Environmental Protection Agency (EPA) exposure guideline, and they are found in most regions of the state. Attempting to retroactively seal foundations to keep radon from the ground out of a home is largely ineffective. However, a soil-depressurization radon mitigation system is highly effective for existing houses, and new homes can easily be built radon-resistant. As the number of homeowners obtaining needed repairs increases, significant lung cancer risk reduction is being achieved in a voluntary, non-regulatory setting. In coming years, as radon in community drinking water supplies becomes regulated under the federal 1996 Safe Drinking Water Act, the "multimedia" option of the act may result in additional attention to mitigation of radon in indoor air.
Silver Cross Hospital and Medical Centers, Joliet, Ill., is promoting its Web site as a tool for gathering health information about patients and prospective patients in order to build a relationship marketing database. The database will enable the hospital to identify health care needs of consumers in Joliet, Will County and many southwestern suburbs of Chicago. The Web site is promoted in a multimedia advertising campaign that invites residents to participate in a Healthy Living Quiz that rewards respondents with free health screenings. The effort is part of a growing planning and marketing strategy in the health care industry called customer relationship management (CRM). Not only does a total CRM plan offer health care organizations the chance to discover the potential for meeting consumers' needs; it also helps find any marketplace gaps that may exist.
Development of portable ventilators has enabled patients suffering from respiratory failure to live outside hospitals. The number of patients with neuromuscular disorders receiving home mechanical ventilation (HMV) has been increasing year by year. However, Japanese social support services are not sufficient for these patients. Thus, we tried to establish a system to support patients under HMV using SpO2 monitoring system and videoconference system. Pulse oximeter was connected to a portable personal computer, which stores real-time data and send daily data to hospital. The computer in our hospital receives patient's data and prints out it as a trend-graph, which enables medical staffs to know patient's condition. When SpO2 deteriorates significantly, alarm system works automatically to warn patient's family. In case SpO2 worsens more severely, alarm also warns medical staffs in our hospital to call the patient to confirm patient's condition and to give advices. Videoconference system was also introduced to communicate quickly and correctly. Thirty-four patients with progressive muscular dystrophy attended this study after informed consents. They used these systems in the period between discharge and first visit to hospital. Videoconference system was utilized in only two patients, because it required a digital line. These systems were effective in decreasing anxieties of patients and their families about HMV. According to daily check, 16 of 34 patients showed temporary deterioration of respiratory condition, although all patients had been in good condition in hospital. Loosening of the belt of nasal mask, air leak from opened mouth were frequent causes for the deteriorations. These problems could be corrected smoothly after discussion and advices. Thus this system was very useful to establish good respiratory management in a short period. Monitoring system also detected troubles of ventilators. Two patients showed progressive worsening of SpO2 day by day, however we could not find any problems in their respiratory managements. When we checked the ventilator, there were lumps of dust at the upper-pressure limit valves, which caused air leak. It was revealed that 3 of 27 ventilators had the same troubles, which caused leaks more than 10% of the flow volume. This fact proved that this system was also effective to prevent severe troubles from unexpected problems about HMV. Videoconference system enabled us to communicate quickly and correctly. It was also convenient to give advices. It is quite difficult for ordinary people to explain and understand physical condition and methods to handle respirator with only oral communication. Visual communication solved these troubles almost completely. Although there are some problems about this system including high cost and quality of picture, it is undoubtedly powerful tool. It is natural for patients with respiratory failure to wish to stay their home, when they possessed portable respirators. So it is important to decrease the risk related to HMV. We verified that the combination of monitoring system and multimedia can produce effective support system. It is important to improve these systems and cut down the cost for popularization.
This application report describes the technologies and strategies used by MedStage, an open infrastructure for secure telemedical internet applications. The infrastructure includes several technical and application frameworks including a public key infrastructure for providing professional security solutions, like certificate-based authentication, secure transport protocol, strong data encryption and digital signature. The key components are an universal healthcare data repository based on the work of CEN TC 251 with extensions for the storage of multimedia data, an exchangeable authorization management, an exchangeable patient index service based on CORBAmed PIDS and a set of XML-based import and export modules. Additionally there are prototype applications for home-monitoring, telereporting and personal health passport.
AUDIX is a knowledge-based multimedia system for auditory discrimination exercises. The aim of AUDIX is to provide patients with a computer-based therapy system which they can use between sessions with the human therapist, at home on an 'on-demand' basis. It is centered around computer based cognitive rehabilitation therapy whereas most existing programs in this area are only used for assessment. The auditory discrimination exercise system is designed for adult people who are speech-impaired as a result of a stroke. These people have auditory perceptual problems. The nature of the perceptual problem is an inability to perceive differences between phonemes. This requires a type of therapy called auditory discrimination training. The system provides computer-based auditory discrimination training. Through the knowledge-based design the domain dependent therapy knowledge is separated from the system core and provides a way for the therapist to add new knowledge, as new stimuli, or to create a new knowledge base to provide special exercises for an individual patient. The AUDIX architecture is described and the advantages of computer-based therapy are discussed.
In this paper we presented a new compression intension based on VQ with an in tension to provide an efficient approach to compressing medical ultrasonic images and thus make the establishment of a medical multimedia database possible. The major advantages of this coding scheme are: high compression rate, low distortion, higher speed of encoding procedure as compared with ordinary VQ. These benefits are mainly due to the unique design of the codebook and enhanced table look-up techniques. In addition, a comparison of this scheme with JPEG compression method (at high compression rate) was presented.
Millions of students across the United States cannot benefit fully from a traditional educational program because they have a disability that impairs their ability to participate in a typical classroom environment. For these students, computer-based technologies can play an especially important role. Not only can computer technology facilitate a broader range of educational activities to meet a variety of needs for students with mild learning disorders, but adaptive technology now exists than can enable even those students with severe disabilities to become active learners in the classroom alongside their peers who do not have disabilities. This article provides an overview of the role computer technology can play in promoting the education of children with special needs within the regular classroom. For example, use of computer technology for word processing, communication, research, and multimedia projects can help the three million students with specific learning and emotional disorders keep up with their nondisabled peers. Computer technology has also enhanced the development of sophisticated devices that can assist the two million students with more severe disabilities in overcoming a wide range of limitations that hinder classroom participation--from speech and hearing impairments to blindness and severe physical disabilities. However, many teachers are not adequately trained on how to use technology effectively in their classrooms, and the cost of the technology is a serious consideration for all schools. Thus, although computer technology has the potential to act as an equalizer by freeing many students from their disabilities, the barriers of inadequate training and cost must first be overcome before more widespread use can become a reality.
Computer-mediated communications (CMC) such as e-mail, websites, and CD-ROM and DVD programs, both on and off the Internet, will play an ever larger role in the future of behavioral health care. This address describes the current rapid expansion of CMC and some profound changes that are likely in the future. The reasons for using such CMC programs are addressed, and an example of a new multimedia version of the Addiction Severity Index is described. Issues and concerns about future uses of CMC are raised, as are possible implications for psychology.
Computer-based self-instructional programs are frequently promoted as means to augment or replace the traditional anatomy curricula taught in medical schools. These programs may range from static slide shows to fully immersive virtual environments. However, the impact of these learning technologies on knowledge acquisition, and their comparative cost/benefit to education remain unclear. As a consequence, we are embarking on a series of experiments to compare knowledge acquisition and the meaningful use of information among students who are learning anatomy using one of two different computer-based self-instructional formats. These studies will be based on a specially developed learning module on basic lung anatomy; they will utilize a variety of assessment tools to measure factual knowledge, conceptual understanding of spatial-anatomic relationships, and the ability to apply newly acquired knowledge of anatomy to clinical problem-solving scenarios. The primary object of this paper is to describe the design and development of the underlying test module and to outline the two computer-based formats that will be evaluated. The virtual reality (VR) environment, UCSD's Anatomic VisualizeR, provides dynamic access to 3-dimensional polygonal models of the lesson content and supports student-centered exploration and learning. The multimedia environment, Microsoft PowerPoint, provides a structured presentation of the lesson content and illustrates important anatomic structures through the use of 2-dimensional images derived by screen captures of models available in the VR learning module. This paper also provides an overview of the first experiment in the series, a pilot study using first-year medical students without previous participation in a medical school anatomy curriculum. For this study, students will be prospectively randomized into two groups, each group learning the lung anatomy lesson using one of the computer-based formats described. Immediate knowledge retention will be measured by asking students to complete the assessment instrument immediately after completing their learning module. The results of the pilot study will be used to refine and improve the design of the remainder of studies planned in this experimental series.
As we enter the 21st century, military medicine struggles with critical issues. One of the most important issues is how to train medical personnel in peace for the realities of war. In April, 1998, The General Accounting Office (GAO) reported, "Military medical personnel have almost no chance during peacetime to practice battlefield trauma care skills. As a result, physicians both within and outside the Department of Defense (DOD) believe that military medical personnel are not prepared to provide trauma care to the severely injured soldiers in wartime. With some of today's training methods disappearing, the challenge of providing both initial; and sustainment training for almost 100,000 military medical personnel is becoming insurmountable. The "training gap" is huge and impediments to training are mounting. For example, restrictions on animal use are increasing and the cost of conducting live mass casualty exercises is prohibitive. Many medical simulation visionaries believe that four categories of medical simulation are emerging to address these challenges. These categories include PC-based multimedia, digital mannequins, virtual workbenches, and total immersion virtual reality (TIVR). The use of simulation training can provide a risk = free realistic learning environment for the spectrum of medical skills training, from buddy-aid to trauma surgery procedures. This will, in turn, enhance limited hands on training opportunities and revolutionize the way we train in peace to deliver medicine in war. High-fidelity modeling will permit manufacturers to prototype new devices before manufacture. Also, engineers will be able to test a device for themselves in a variety of simulated anatomical representations, permitting them to "practice medicine".
Agoraphobia consists of a group of fears of public places such as going outside, using public transportation and being in public places, which cause serious interference in daily life. Many studies demonstrated the effectiveness of a multicomponent cognitive-behavioral treatment strategy for panic disorder with agoraphobia. The traditional protocol involves a mixture of cognitive and behavioral techniques which are intended to help patients identify and modify their dysfunctional anxiety-related thoughts, beliefs and behavior. Emphasis is placed on reversing the maintaining factors identified in the cognitive and behavioral patterns. We use Virtual Reality (VR) to support Panic Disorder treatment. The preliminary treatment protocol for Panic Disorder and Agoraphobia, named Experiential-Cognitive Therapy (ECT), was developed at the Applied Technology for Neuro-Psychology Lab of Istituto Auxologico Italiano, Verbania, Italy, in cooperation with the Psychology Department of the Catholic University of Milan, Italy. The actual version included the efforts of researchers from the Center for Advanced Multimedia Psychotherapy, California School of Professional Psychology, San Diego (CA), USA, and from the Seoul Paik Hospital, Inje University, Seoul, Korea. The goal of ECT is to decondition fear reactions, to modify misinterpretational cognition related to panic symptoms and to reduce anxiety symptoms. The characteristics of the approach will be presented through the description of the clinical protocol.