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Virtual reality and telepresence for military medicine.

For decades, warfighters have been putting in place a sophisticated "digital battlefield", an electronic communication and information system to support advanced technology. Medicine is now in a position to leverage these technologies to produce a fundamental revolution, and the keystone is the digital physician. Today nearly all information about a patient can be acquired electronically, and with the new technologies of teleoperation and telesurgery we can provide remote treatment and even surgery through telemedicine. The following framework for military medicine will leverage upon the current electronic battlefield. A personnel status monitor (PSM) will have a global positioning locator to tell the position of each soldier and a suite of vital signs sensors. When a soldier is wounded, the medic will instantly know the location of the soldier, and how serious is the casualty. This will permit the medic to locate the most critically wounded soldier. Once stabilised, he will be placed in a critical care pod, a fully automated intensive care unit in a stretcher, which will monitor his vital signs, administer fluids and medications and provide environmental protection. If immediate surgery is needed, a remote telepresence surgery vehicle will come to the wounded soldier, the medic will place him in the vehicle, and a surgeon will operate remotely using telepresence surgery from a distant Mobile Advance Surgical Hospital (MASH) to the combat zone. Also, the expertise from any specialist will be available from the rear echelons as far back as the home country. For education and training in combat casualty care, virtual reality simulators are being implemented. This same scenario can be utilised in civilian health care, especially in providing care to patients in remote areas who do not currently have access to simple, let alone sophisticated, health care.

Computer Simulation↗

[A diagnostic-therapeutic complex with changeable structure].

The paper describes the principles in the construction of diagnostic and examining complexes which record biological potentials in the frequency range of 0 to 20 kHz in real time and process them and, if required, either form the stimulating exposures or synchronize a recording process with external stimuli, as well as different purpose diagnostic and examining complexes designed by these principles. While solving different problems, the core of the complexes remains constant and only do the crate module ratio and attendant periphery change. The basic difference of the complexes is their software. The programme for examinations, processing of their results and creation of a database has a convenient interactive multi-window interface with an user.

Diagnosis, Computer-Assisted↗

Occupational health and safety information systems in the pharmaceutical industry.

This chapter outlines a health and safety management system that encompasses all of the work environments in a pharmaceutical company, including the laboratory, manufacturing, sales, and corporate forces. It discusses information flow and integration to address physical, biological, and chemical hazards present.

Computer Communication Networks↗

Florida physicians' guide to on-line information and the Internet.

The combination of new computing technology with progress in data communications over wide geographic areas offers computer users the opportunity to publish information to each other rapidly across wide geographic expanses. The concept of networking computers to gain access to the most recent and widest range of available information is consistent with the aims and methods of quality health care. The Internet is the ultimate extension to the computer network concept- an unlimited link of digital servers and users world-wide, united by common protocols for purposes of information exchange, self-policed and without central controls. Although the concept is attractive, on-line servers and the Internet are sophisticated information tools whose most effective use requires that users be oriented to basic concepts and conventions. This article summarizes the basic conventions in computer networking and data security; the differences in concept and use between bulletin board systems (BBSes), online systems, and the Internet for information access; the various classes of Internet information resources and their uses; the basic use of search engines to expedite information retrieval in the Internet; and offers practical advice in choosing methods of Internet access.

Computer Communication Networks↗

Ten basic World-Wide Web sites for Florida physicians.

The Internet is a rapidly growing information resource for rapid publication and access to information. While it has attracted a certain mystique and is undoubtedly attractive as an information source, its rapid and chaotic growth mitigates against ease of use for novices. The authors-all associated with health-care providers in the Dade/Broward market-offer the novice user their best assessment for initial Web sites to explore for health care information, and general guidance on using Internet search engines to direct effective searches.

Computer Communication Networks↗

Increasing the effectiveness and efficiency of academic advising through computerization.

Academic advising is an essential part of any university degree program and becomes especially important in programs where there is competitive and limited admission to professional courses. This requires that academic advisors have ready access to student scholastic and demographic data for counseling and statistical purposes. The use of computers in creating a database for student records has become routine in most universities and colleges. Computerization of these records through the registration process creates a university database with the potential for many different applications. This article describes the development of a computer software program for a baccalaureate science of nursing program that makes use of a university's database to provide the foundation of a computer software program used in the nursing academic advising office. Identifying the special needs and requirements of the nursing advising program and developing a close working relationship with the computer programmer were essential in the development and implementation process. The result was an increase in the effectiveness and efficiency of the advising process, better record keeping, and better use of available student data for statistical purposes.

Databases, Factual↗

Technology assessment. A framework for generating questions useful in evaluating nursing information systems.

Nursing information systems are computer systems that enable nurses to collect, manipulate, store, retrieve, display, and communicate data to administer nursing services and resources, manage nursing practice to improve patient care, and advance nursing knowledge. Selection and implementation of a nursing information system require a clear vision of the need for the system, careful planning, and astute forward thinking. Technology assessment provides a framework for generating pragmatic questions that can be used in systematically evaluating nursing information systems. This article provides a brief overview of nursing information systems, explains the technology assessment framework, and gives examples of questions useful in evaluating a nursing information system.

Computer Security↗

Interactive videodisc instruction is an alternative method for learning and performing a critical nursing skill.

A study was conducted to compare the effectiveness of interactive videodisc instruction (IVDI) with the traditional lecture/demonstration as an alternative method for learning and performing a critical nursing skill. Students were assigned randomly to a treatment group that worked in small groups to complete the IVDI on intravenous therapy skills and a control group receiving the same content in a classroom lecture/demonstration format. After the instruction, each subject performed a re-demonstration of the learned skills using specific guidelines. Results revealed that although the IVDI group scored higher on the overall re-demonstration, there was no significant difference in the ability of the two groups to effectively perform this critical nursing skill. These findings support the use of IVDI as an alternative self-paced, independent study method for learning psychomotor skills and are consistent with previous studies, which indicate that working in small groups on the computer has a positive effect on self-efficacy and achievement.

Computer-Assisted Instruction↗

The Psychophysics Toolbox.

The Psychophysics Toolbox is a software package that supports visual psychophysics. Its routines provide an interface between a high-level interpreted language (MATLAB on the Macintosh) and the video display hardware. A set of example programs is included with the Toolbox distribution.

Computer Terminals↗

The VideoToolbox software for visual psychophysics: transforming numbers into movies.

The VideoToolbox is a free collection of two hundred C subroutines for Macintosh computers that calibrates and controls the computer-display interface to create accurately specified visual stimuli. High-level platform-independent languages like MATLAB are best for creating the numbers that describe the desired images. Low-level, computer-specific VideoToolbox routines control the hardware that transforms those numbers into a movie. Transcending the particular computer and language, we discuss the nature of the computer-display interface, and how to calibrate and control it.

Calibration↗

Computed tomographic colography and virtual colonoscopy.

CT colography (CTC) is a powerful new approach to imaging the colorectum and a promising screening tool for the detection of colorectal neoplasia. From data generated by a helical CT scan, CTC uses virtual reality technology to produce highly discriminant two- and three-dimensional images that permit a thorough and minimally invasive evaluation of the entire colorectum. A dynamic CTC display technique from the endoluminal perspective, called cf2virtual colonoscopy,cf1 simulates colonoscopy by "flying" through the three-dimensional colon image. CTC offers potential advantages in diagnostic performance, safety, and patient acceptance over current screening approaches. Although early data suggest excellent colorectal polyp detection rates, this nascent technology will require rigorous clinical investigation and further refinements to assess adequately its place in the endoscopist's armamentarium.

Barium Sulfate↗

[Prospects for intensification of real motor activity during bonding of humans with virtual computer spaces].

In this article you can familiarize yourself with big experience of using computer signals that are necessary in order to operate by them. These signals arise on the basis of values transformation and afforts directions that are applied to powerful connections of different training devices. Similar opportunities of interaction with computer games programmes were tested on the basis of using a plant to control the dozing projection displacements of masses common centre on area of support.

Humans↗

Virtual reality exposure therapy.

It has been proposed that virtual reality (VR) exposure may be an alternative to standard in vivo exposure. Virtual reality integrates real-time computer graphics, body tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer-generated virtual environment. Virtual reality exposure is potentially an efficient and cost-effective treatment of anxiety disorders. VR exposure therapy reduced the fear of heights in the first controlled study of virtual reality in treatment of a psychiatric disorder. A case study supported the efficacy of VR exposure therapy for the fear of flying. The potential for virtual reality exposure treatment for these and other disorders is explored, and therapeutic issues surrounding the delivery of VR exposure are discussed.

Fear↗

Continuing medical education on the World Wide Web (WWW). Interactive pathology case studies on the Internet.

OBJECTIVE: To present interactive online continuing medical education (CME) over the World Wide Web as a more efficient alternative to traditional modes of CME delivery. DESIGN: A departmental Web site available to those with access to the Internet. SETTING: A tertiary-care teaching hospital in the United States. RESULTS: Comprehensive case studies have been developed and are complete with images, text, and questions, including explanations for correct and incorrect responses. The images are linked to pertinent text to maximize their educational value. The cases are easily accessible, user friendly, and fully referenced. The system became operational in January 1996, and the first CME certificate was awarded to a participant shortly thereafter. CONCLUSIONS: Continuing medical education over the World Wide Web is an efficient means of delivering CME to the community at large; it allows participating physicians the latitude to obtain convenient CME credit at their leisure, in contrast to the regimented experience of formal CME conferences or symposiums. The interactive format of the CME cases allows the participant to submit immediate comments or criticism to case authors and receive instant feedback on their own performance, features unavailable in comparable educational software packages. The dynamic environment of the World Wide Web lends itself to the production and dissemination of such flexible forms of CME for the physician and will continue to expand in this capacity into the foreseeable future.

Certification↗