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PubMedDate not supplied

Therapeutic computing: teaching therapeutic communications utilizing a videodisc.

Effective communication skills for nurses are essential and serve as the interface between patients and health care providers. Yet, teaching communication skills is subject to only limited success. Results vary according to the mix of students, the talent and interest of the instructor, and the availability of teaching time for the topic. The nursing program at Indiana University Kokomo is addressing the needs of nursing students with a multimedia computer system. A videodisc on therapeutic communication was purchased to supply the desired video-based examples. The programming of the computer interface was done by a senior information systems department major. Student attitudes measured after using the system the first year were very good.

Attitude↗
PubMed1994

Computer-assisted instruction in pathology residency training: design and implementation of integrated productivity and education workstations.

Computer-assisted instruction (CAI) has been significantly advanced by the development of inexpensive multimedia personal computers (PCs). As a part of efforts to integrate PC workstations as the primary interface to the anatomic pathology information system, we undertook an evaluation and implementation of image-based resident workstations drawing on technology and software now available. The goal was to develop an integrated diagnostic and research data center using PC workstations. After considerable analysis we implemented a Resident's Resource Center (RRC) to augment the training environment of the resident pathologist by providing productivity tools for the writing, research, and presentation needs of the trainee. We also provided video- and text-based education applications specifically tailored to the training pathologist. This led to the creation of two types of Windows-based workstations. The Productivity Workstation consists of a flatbed scanner, laser printer, and photorecorder connected to a 486-type PC. The Education Workstation consists of a high-resolution monitor and video disc player with bar code scanner connected to a 486-type PC. We briefly review the literature concerning CAI in pathology; outline the hardware, software, personnel and cost concerns that we faced in setting up our RRC; provide a partial list of vendors and programs currently on the market; review the software we have installed; and discuss the results of our efforts.

Computer Systems↗
PubMed1994

ARTEMIS-2: an application development experiment with the HELIOS environment.

A medical application is a highly complex system that embraces many data types and a very large number of data processing functions and methods. The development of integrated software engineering environments has deeply changed the conception of applications and the profile of the application developers. In this paper, we address the problem of the development process of a specific multimedia application, called ARTEMIS, within the distributed HELIOS environment. The application is intended to manage information about hypertensive patients, in particular, retrieval and display of administrative, clinical and biological data and display and analysis of digital angiography images and medical reports. The objective is to show how the developer can use, customize and organize the services HELIOS provides. A particular focus is set on reuse strategies and integration during the development process. A scenario has been realized and illustrates the current state of the application. The discussion focuses on the advantages of such distributed environments in medical application development.

Computer Communication Networks↗
PubMed1994

The HELIOS Image Related Services.

The HELIOS Software Engineering Environment is a tool for the construction of medical ward information systems. This paper describes the image processing tools which are a part of this system. The Image Related Services can be used both as ready-to-use end-user tools and as software modules for the construction of integrated multimedia applications. The tasks and architecture of the end-user tools and their integration into the HELIOS architecture are described. It is shown how the available image processing functionality can be used to build up new applications.

Computer Communication Networks↗
PubMedDate not supplied

Nutrition at school: preparing for the future. The Thirteenth Annual Nutrition Symposium.

Two of the best ways to improve the quality of childhood nutrition are (a) more collaboration at the national, State, and local levels and (b) adoption of innovative and multimedia learning methods, according to the leaders of nutrition education. These themes were discussed at the 13th Annual Nutrition Symposium, which was held March 9, 1994, in Washington, DC. In recognition of National Nutrition Month, a collaborative effort of the Public Health Service's Office of Disease Prevention and Health Promotion and the Centers for Disease Control and Prevention, the meeting was attended by more than 300 public and private sector nutrition educators and public health professionals. Their assignment was to analyze school-based nutrition education programs and the research being conducted on nutrition. Keynote speaker Surgeon General M. Joycelyn Elders, MD, issued the challenge for all Federal and State agencies to work with schools and nutrition education professionals to overcome limited resources and children's current eating habits to improve the nutritional status of children. Responding to that challenge, speakers from the Department of Health and Human Services, the agency sponsoring the meeting, the Department of Agriculture, the Department of Education, as well as from the Congress, business, and public schools addressed several initiatives.

Adolescent↗
PubMed1994

A comparative study between a computer-aided education (ISIS) and habitual education techniques for hypertensive patients.

ISIS is a patient education computer program about hypertension. It aims to be complementary to the habitual educational techniques by bringing into patient education the facility of multimedia features. Its efficiency in improving the knowledge about hypertension was tested among 158 hypertensive patients. Their prior knowledge was evaluated using a questionnaire. They were then randomly separated in a control group (CG) which had the regular education program and ISIS group or (IG) which, in addition, had an interactive session using ISIS. Two months after discharge, all the patients were asked the same questions over the telephone. A total of 138 observations (69 CG, 69 IG) were reported in the final analysis. The initial scores were significantly improved for both groups. The improvement is more evident in the IG, particularly among patients whose initial score was low and patients whose hypertension was discovered for more than 6 months. ISIS is actually used by hospitalized patients and by nurse students.

Computer Systems↗
PubMed1994

School nurse's assistant expert screening system.

The School Nurse's Assistant is designed to aid the School Nurse by providing a diagnostic discovery tool that also educates the student through the use of multimedia. Response initiated questions focus on the most pertinent student risk factors: lifestyle choices such as alcohol, drugs, and sexual activity. Because the questions are patient driven, the student stays interested as only relevant questions are presented. The School Nurse's Assistant provides the school nurse with increased sociographic information, and delivers cost-effective information to high risk segments of the student population. The potential for successful intervention is dramatic.

Adolescent↗
PubMed1994

Evolving a legacy system: restructuring the Mendelian Inheritance in Man database.

Mendelian Inheritance in Man (MIM) is an encyclopedia of medical genetics that has been in electronic form for over 30 years. In its lifetime, MIM has undergone many organizational and software changes. In 1994, a major transition was made based on three basic principles: industry standards, open systems architecture, and extensibility. The resulting MIM database allows users to navigate to other genomic databases, permits the delivery of multimedia information, and improves the quality of data. The new MIM database also improved its administration because of 1) an internal format that enforces consistency; 2) a lower maintenance cost of software; and 3) a better ability to migrate MIM content. In addition, the new architecture will allow MIM easily to adopt emergent technologies as they mature.

Computer Systems↗
PubMed1994

Visual design for the user interface, Part 2: Graphics in the interface.

Highly interactive multimedia electronic documents pose unique graphic information design problems. This paper is a discussion of some of the graphic design considerations that are unique to electronic documents, including the challenges of adapting existing graphic design skills to electronic documents that are displayed and read from computer screens.

Computer Graphics↗
PubMed1994

[Manganese in drinking water and its contribution to human exposure].

Methylcyclopentadienyl manganese tricarbonyl (MMT) has been used in Canada since 1976 as an additive in unleaded gasoline. The combustion of MMT leads to the emission of Mn oxides to the environment and may represent a potential risk to public health. It therefore seems important to assess the associated Mn exposure. The present study is part of a broader research program on total human exposure to Mn and aims specifically at assessing the level of exposure to Mn and other metals via drinking water. A comparative study was performed between two groups of workers (garage mechanics and blue collar workers of the University of Montreal) differentiated by their exposure to inhaled Mn. For Pb, Cu and Zn in residential tap water, significant differences were observed between the first sample and the one taken after one minute of flow. A significant difference was also found between the two groups of workers (combined flow time) for Mn, Cu and Ca. The Mn contribution from water is estimated to be 1% of the total dose from ingested food. This low exposure may become important (17%) for persons drinking well water, especially if we consider interactions between metals following multimedia exposure.

Calcium↗
PubMed1994

[Evaluation of computer-assisted instruction methods. Apropos of 26 comparative studies published between 1989 and 1992].

Information and knowledge processing technologies have contributed to the development of Computer assisted instruction (CAI) applications. Multimedia technologies will increase the possibilities of these programmes in the future. However the evaluation of the software as well as the other technologies is necessary. The authors have tried to quantify the contributions of CAI analysing the literature referenced in MEDLINE from 1989 to 1992. On the 470 papers indexed with the key-word "Computer Assisted Instruction", 56 studies take evaluation into account. Only 26, that is 5.5%, presented a clear and explicit methodology of evaluation. On the 26 studies, 16 were considered with positive result and among these, 6 presented a statistical significance. The conditions and the criteria of the evaluation studies do not permit a meta analysis. Is is necessary to develop standardized evaluation criteria to estimate the quantitative and qualitative impact of the CAI technics on the educational process and their own pedagogical contribution.

Computer-Assisted Instruction↗
PubMed1994

[Architecture and organization of PACS workstations: a critical overview].

The development and implementation of a workstation capable of handling medical images and data from different imaging modalities require a particular user-interface design so that it is easily accessible by clinical and non-computer-oriented users. Appropriate management of medical images from different imaging modalities is the first step toward the integration of multimedia information in a coherent computerized medical record. It is also the most challenging part because the amount of data obtained in the form of images is much greater than the text, graphic or sound elements. The proportion of clinical investigations based on imaging modalities is also constantly increasing. The goal of this paper is to review some important design concepts of imaging workstations and to explore the needs and requirements of medical image display and manipulation.

Computer Graphics↗
PubMed1993

Graphical electrocardiogram waveforms as part of an integrated hospital system's patient record.

The U.S. Department of Veterans Affairs (VA) has an ongoing project to integrate diagnostic images into its existing text-based hospital information system. High-quality images from cardiology, pulmonary medicine, gastroenterology, endoscopy, pathology, radiology, hematology and nuclear medicine can be displayed for clinicians quickly and conveniently on workstations throughout the hospital. As a part of this endeavor, diagnostic-quality computer generated 12-lead electrocardiograms, including both median and rhythm data, can be viewed as a part of the on-line patient record of an integrated hospital information system. Now computer generated graphics can be included in the longitudinal patient record. Incorporating generated graphics and images into a text based patient record is another step towards the next generation of integrated hospital information system with multimedia patient records.

District of Columbia↗
PubMed1993

Mechanisms for exchange of image data to support distant medical consultation.

The VA has developed an integrated infrastructure to support the exchange of medical data, including images and text report data, between medical centers. This capability is expected to support teleconsulting and meet a variety of existing medical staffing and consultation needs. Consultation from distant locations requires at least the same complete integrated patient record available to onsite physicians. Several mechanisms are being explored to support distant medical consultation. Multimedia extensions to the VA's electronic mail system have been developed to allow images and other data objects to be included in electronic mail messages. Another approach that has been prototyped is to extend existing local imaging networks to produce more widely distributed imaging systems. These approaches will be described and discussed.

Computer Communication Networks↗
PubMed1994

Pixel perception and voxel vision constructs for a new paradigm of dental care.

The introduction to dentistry of a multimedia computed approach with instant images, optical impressions, electronic periodontal probing and occlusal contact measurements, electronic storage and communications, has the potential to improve the quality of care, significantly reduce downtime, simplify infection control, expedite treatment, and take the dentist off the "treadmill" of the multi-operatory practice.

Computer-Aided Design↗
PubMedDate not supplied

Current issues in human lead exposure and regulation of lead.

Concern about lead as a significant public health problem has increased as epidemiological and experimental evidence has mounted regarding adverse health effects at successively lower levels of lead exposure. This concern has led to downward revision of criteria for acceptable blood lead concentrations to the 10 micrograms/dL mark now designated by EPA as a target level for regulatory development and enforcement/clean-up purposes. Much progress has been made in reducing lead exposures during the past 10-15 years, with marked declines evident both in air lead and blood lead concentrations in parallel to the phase-down of lead in gasoline and notable decreases in food lead exposure due to elimination of lead soldered cans by U.S. food processors. With the lessening of exposure from these sources, the importance of other components of multimedia exposure pathways has grown and stimulated increasing regulatory attention and abatement efforts to reduce health risks associated with lead exposure from drinking water, from lead-based paint, and from household dust and soil contaminated by deteriorating paint, smelter emissions, or various other sources. Increasing attention is also being accorded to reduction of occupational lead exposures (including those related to lead abatement activities), with particular concern for protection of men and women during their reproductive years.

Air Pollutants↗
PubMed1993

Prediction of the environmental fate of chemicals.

An overview is presented of the possibilities of applying multimedia compartmental evaluative models, and in particular the fugacity approach, to predict the environmental distribution and fate of organic chemicals. The use of this predictive approach for the evaluation of exposure to pollutants in the aquatic system is described, with reference to different environments or discharge patterns (surface and groundwaters, point and diffuse sources of pollution). The value and limitations of this approach are noted and the need for more research to improve predictive capability and practical usefulness is indicated. Finally some practical applications of evaluative models in the proposal of quantitative indices for ecotoxicological evaluation of risk from chemicals are described.

Environmental Pollutants↗
PubMed1993

[Development of oral reporting system in PACS environment].

An experimental radiologic reporting system using oral presentations has been developed and tested. The rewritable and compact magneto-optical disk (MOD) is employed to store oral diagnostic reports together with read radiologic images. The MOD is 5.25 inches in diameter, has a 600 MB memory capacity, and is erasable, light and compact. Advantages of the system are simultaneous retrieval of oral reports by a radiologist and the images he or she interpreted, and the capability of media circulation in addition to the function of filing. Thus MOD has a multimedia function of both off-line communication and filing. When medical images are interpreted and oral presentations are registered, automatically digitized oral reports and digitized images are filed in the MOD. Referring physicians can get oral diagnostic reports and can see the images at the same time on a personal computer. Furthermore, integration with voice recognition capability is being tried in our experiment.

Communication↗