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Results for “Computer-Assisted Instruction”

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At least 307 records · Page 17Linked to original sources
PubMed1979

Computer-assisted learning in the teaching of anaesthesia.

A comparison of computer-assisted learning and small tutorial group teaching was carried out in the instruction of final year medical students in anaesthesia. The scores attained by fifteen of the sixteen students were higher after computer-assisted learning than after small group teaching. Statistical analyses of the results demonstrated that in this study computer-assisted learning was significantly better than small tutorial teaching.

Anesthesiology↗
PubMed1978

Attitudes of medical undergraduates in Glasgow to computer-assisted learning.

Computer-assisted learning (CAL) has been introduced as part of the undergraduate teaching course in general practice during the penultimate year of the medical course. The student is given an opportunity to make clinical decisions and to manage a case over a significant time scale. The attitudes of the students are favourable to this method of instruction.

Attitude of Health Personnel↗
PubMed1979

Quality assessment and the art of medicine: the anatomy of laceration care.

Assuring high quality medical care has remained an elusive goal because of several problems which have hampered development of effective medical audit programs: inadequate patient data, unreasonable evaluative criteria and insensitive audit procedures. The present study demonstrates the use of a clinical algorithm to help overcome these problems. An examination of medical record data from a series of 703 laceration patients treated in an emergency service yielded only 27 cases (4 per cent) with medical records sufficiently complete to use for auditing physician compliance with algorithmic criteria. Substituting a structured checklist for the handwritten note increased this rate to 86 per cent. A computer-assisted branching audit of 1,400 laceration cases demonstrated that 1) physician compliance with an algorithmic instruction varied significantly (p less than .001) according to the specific instruction, and 2) compliance with a given instruction varied significantly (p less than .001) across different providers. These results underscore the need for medical audit with educational feedback which is provider specific.

Connecticut↗
PubMed1992

Fentanyl does not alter the "sleep" plasma concentration of thiopental.

Thiopental and fentanyl are commonly combined for induction of anesthesia. The effect of an analgesic concentration of fentanyl on the plasma concentration of thiopental to induce sleep was studied in 46 unpremedicated patients. As a measure of drug effect, sleep (the lack of response to open eyes to a verbal command) was used. Forty-six patients were randomized to receive thiopental infused to one of several predetermined plasma concentrations. Twenty-two of these patients also received a fentanyl infusion to a desired analgesic concentration of 1 ng/mL. Thiopental and fentanyl were infused by means of a pharmacokinetic model-driven infusion device (computer-assisted continuous infusion, CACI). Venous blood samples were taken from the contralateral antecubital fossa at 5 and 10 min after the start of the infusion. At 10 min, the patients' names were firmly spoken, and they were instructed to open their eyes. If they did not respond to this command, they were considered to be asleep. Only patients in whom the 5- and 10-min measured plasma concentrations of thiopental and fentanyl, respectively, were within +/- 30% of each other were used for the determination of the Cp50(asleep), the plasma concentration at which 50% of the patients were asleep. The Cp50(asleep) with and without fentanyl was calculated by logistic regression. The Cp50(asleep) for patients in whom concentrations were maintained within +/- 30% for thiopental alone (n = 17) was 7.32 micrograms/mL (95% confidence interval, 5.53-10.95); for thiopental in the presence of fentanyl (n = 18 with a measured fentanyl concentration of 1.27 +/- 0.5 ng/mL), this was 7.22 micrograms/mL (95% confidence interval, 4.83-10.15).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

ROENTGEN: case-based reasoning and radiation therapy planning.

ROENTGEN is a design assistant for radiation therapy planning which uses case-based reasoning, an artificial intelligence technique. It learns both from specific problem-solving experiences and from direct instruction from the user. The first sort of learning is the normal case-based method of storing problem solutions so that they can be reused. The second sort is necessary because ROENTGEN does not, initially, have an internal model of the physics of its problem domain. This dependence on explicit user instruction brings to the forefront representational questions regarding indexing, failure definition, failure explanation and repair. This paper presents the techniques used by ROENTGEN in its knowledge acquisition and design activities.

Artificial Intelligence↗
PubMed1992

Reducing heart rate reactivity to stress with feedback. Generalization across task and time.

Heart rate (HR) reactions to two behavioral stressors (videogame and mental arithmetic) were measured in 8 experimental subjects who received biofeedback training and 8 matched control subjects during three assessment periods: pretraining, posttraining, and one-week follow-up. Experimental subjects exhibited significant reductions in HR following a training session in which they received ongoing HR feedback while playing a videogame. Control subjects, who played the same number of videogames without HR feedback, showed smaller HR reductions. During the training session, all subjects were instructed to reduce HR while maximizing game performance. In comparison to controls, experimental subjects (a) maintained lower HRs during videogame presentations after a one-week period and (b) generalized these HR reductions to the mental arithmetic challenge at follow-up. Performance on the videogame declined from posttraining to follow-up for experimental subjects but not for control subjects. No group difference in mental arithmetic performance was observed.

Adolescent↗
PubMed1992

Cardiovascular phase relationships to the cortical event-related potential of schizophrenic, depressed, and normal subjects.

Cardiovascular phase, especially diastole, influences attention and the event-related potential (ERP) of the right hemisphere of the brain. Depression and schizophrenia are characterized by attentional deficits, unique lateralization of brain function, and deviant phase relationships of biological oscillators. In the present study, the ERP was recorded during stimulation triggered by diastole and systole in control (n = 16), depressed (n = 16), and schizophrenic (n = 9) subjects. Fifty tones were presented and subjects were instructed to count them silently. Previous findings were supported of delayed latencies and increased amplitude in depressed patients and decreased amplitudes and delayed latencies in schizophrenics. An exaggerated effect of diastole on the ERP in the right hemisphere was observed in depressed patients, however, no cardiovascular effect on the ERP was apparent in schizophrenic patients. Results suggested that heart/brain networks are tightly coupled in normal controls, perhaps "overdriven" in depressed patients, and uncoupled in schizophrenics.

Arousal↗
PubMedDate not supplied

Microanalytical techniques and image analysis in the evaluation of immunogold-labeled specimens at the ultrastructural level.

Energy-dispersive X-ray microanalysis (EDX) interfaced to a scanning/transmission electron microscope allows direct visualization and photographing of structures analyzed under the electron beam. EDX can perform a point-by-point analysis as it searches for the ion whose X-ray window the computer has been instructed to localize. This technique has been utilized to define ultrastructural immunogold labeling patterns. Once a specimen is immunolabeled with gold, microanalytical techniques can identify the quantity and distribution of detected and labeled antigenic epitopes. Microanalytical techniques add a new objective dimension to ultrastructural gold labeling procedures. Quantitative microanalysis of the gold-labeled antigenic sites provides a way of assessing the specificity of the reactions and permits comparison of the degree of expression of antigenic determinants in different specimens. Image processing allows visual representation of the immunolabeling results. Furthermore, statistical analysis of a large number of parameters is also possible with the digitized images collected. Ultrastructural microanalytical techniques represent a new, unexplored application that may play an important role in the future of ultrastructural pathology and immunologic evaluation of diseased tissues.

Electron Probe Microanalysis↗
PubMed1992

P50 suppression is not affected by attentional manipulations.

Auditory evoked potentials (EP) to high or moderate intensity, single or paired clicks were recorded from normal young adult subjects. A choice-reaction-time paradigm had two sets of instructions, for intensity discrimination and for number (single versus paired stimulus) discrimination. For intensity discrimination, the second click had no informative value and its N100 amplitude was markedly reduced relative to the first click. For number discrimination, the presence or absence of the second click provided the salient information, and N100 amplitude was actually slightly larger for the second compared to the first click. In contrast, the attentional manipulation had no effect on P50 amplitude, which showed over 50% suppression from the first to the second click for both tasks. Thus, suppression of P50 amplitude to the second of a pair of clicks is insensitive to attentional manipulations that have major effects on N100 amplitude. These findings suggest that abnormalities of schizophrenic P50 suppression reflect neuronal rather than psychological phenomena.

Adult↗
PubMed1992

Masticatory muscle fatigue: endurance times and spectral changes in the electromyogram during the production of sustained bite forces.

The purpose of this experiment was to determine if the characteristics of fatigue observed in the limb muscle system are also evident in the muscles of mastication, specifically, the masseter and temporalis. Surface electrodes were placed bilaterally over the masseter and temporalis muscles of 10 adults. Each subject was instructed to maintain maximal and six levels of submaximal incisal bite forces for as long as possible. The power density spectrum of the electromyographic signals for each muscle was calculated at the onset and failure of the task. The decrease in endurance time with an increase in bite force followed a pattern similar to that in limb muscles, and each muscle was characterized by a consistent reduction in the mean power frequency of the power density spectrum and a variable change in r.m.s. power. The variability of changes in r.m.s. power (which is inconsistent with changes found in the limb muscles) was explained in terms of either changes in motor-unit firing rate or the muscle's relative contribution to the generation of bite force. The analyses also demonstrated a curvilinear relationship between bite force and r.m.s. power, but no relationship between bite force and the mean power frequency of the power density spectrum.

Adult↗
PubMed1992

A successful computerized protocol for clinical management of pressure control inverse ratio ventilation in ARDS patients.

We have developed a computerized protocol that provides a systematic approach for management of pressure control-inverse ratio ventilation (PCIRV). The protocols were used for 1,466 h in ten around-the-clock PCIRV evaluations on seven patients with severe adult respiratory distress syndrome (ARDS). Patient therapy was controlled by protocol 95 percent of the time (1,396 of 1,466 h) and 90 percent of the protocol instructions (1,937 of 2,158) were followed by the clinical staff. Of the 221 protocol instructions, 88 (39 percent) not followed were due to invalid PEEPi measurements. Compared with preceding values during CPPV, the expired minute ventilation was reduced by 27 percent during PCIRV while maintaining a pH that was not clinically different (mean difference in pH = 0.02). There was no difference in the PaO2, PEEPi, or the FIO2 between PCIRV and CPPV. The PEEP setting was reduced by 33 percent from 9 +/- 0.05 to 6 +/- 0.6 and the I:E ratio increased from 0.64 +/- 0.04 to 2.3 +/- 0.10. Peak airway pressure was reduced by 24 percent (from 59 +/- 1.5 to 45 +/- 0.6) and mean airway pressure increased by 27 percent (from 22 +/- 0.8 to 28 +/- 0.6) in PCIRV. Right atrial and pulmonary artery pressures were higher and cardiac output lower in PCIRV but blood pressure was unchanged. The success of this protocol has demonstrated the feasibility of using PEEPi as a primary control variable for oxygenation. This computerized PCIRV protocol should make the future use of PCIRV less mystifying, simpler, and more systematic.

Adult↗
PubMed1977

Roentgen-tele-data: a radiodiagnostic recording system.

A radiodiagnostic data-handling system with telephones connected to the hospital exchange is described. Time, date, and location of examination are automatically recorded. The system can deliver spoken instructions from the computer and warns if data are not valid. Diagnosis, their degree of verification, and cases of special interest are added at display terminals. Codes, equipment, and output are described. Costs represent 1% of the department's expenditures. Future plans include a booking sytem, rapid access, and on-line connection to the main data system.

Computers↗