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At least 307 records · Page 17Linked to original sources

PubMed2002

Virtual environment system for motor tele-rehabilitation.

The present cutting-edge communication technology applied to the rehabilitation may change the real possibility of providing therapeutic treatments to the patients at their home. In order to confirm this assertion a current study on motor telerehabilitation was undertaken. Through a virtual reality based system, and a complementary video conference apparatus, we supplied five post stroke patients with a motor rehabilitation therapy. The rehabilitation technique was based on the augmented feedback. Subjects underwent the telerehabilitation program for six weeks. Before and after the evaluated therapy, arm motor performance and the activities of daily living were evaluated by the means of clinical scales and measuring the affected arm velocity (end-effector). This pilot study suggested that telerehabilitation could promote the learning of arm motor abilities at distance from the health facilities. From an economic point of view, it could be proposed also as an opportune strategy for saving resources.

Ambulatory Care↗

PubMed2003

Online versus offline processing of visual feedback in the control of movement amplitude.

Researchers have suggested that visual feedback not only plays a role in the correction of errors during movement execution but that visual feedback from a completed movement is processed offline to improve programming on upcoming trials. In the present study, we examined the potential contribution of online and offline processing of visual feedback by analysing spatial variability at various kinematic landmarks in the limb trajectory (peak acceleration, peak velocity, peak negative acceleration and movement end). Participants performed a single degree of freedom video aiming task with and without vision of the cursor under four criterion movement times (225, 300, 375 and 450 ms). For movement times of 225 and 300 ms, the full vision condition was less variable than the no vision condition. However, the form of the variability profiles did not differ between visual conditions suggesting that the contribution of visual feedback was due to offline processes. In the 375 and 450 ms conditions, there was evidence for both online and offline control as the form of the variability profiles differed significantly between visual conditions.

Adolescent↗

PubMed1997

Trends and perspectives in minimally invasive surgery in otorhinolaryngology-head and neck surgery.

The roots of minimally invasive surgery (MIS) in otolaryngology-head and neck surgery (ORL-HNS) can be traced to the 1950s. Today, endonasal sinus surgery and endolaryngeal surgery already fulfill the principles of MIS. To widen its spectrum of indications, however, MIS must be able to offer three advantages that conventional macrosurgery and microsurgery already have: free maneuverability for the instrument, sensory feedback, and three-dimensional imaging. Every anatomical region (e.g., paranasal sinuses, upper aerodigestive tract, cerebellopontine angle) requires specific surgical instrumentation. Here, the authors present recently developed steerable instruments that allow two additional degrees of freedom not attainable with conventional instruments. These instruments may permit access to problem zones (e.g., laterally extending frontal and ethmoidal sinus recesses) in the near future. For better control of the instrument and the operative procedure, tactile feedback can be achieved with appropriate microsensor systems. Three-dimensional vision can be realized by three-dimensional video-endoscopes and sequential image processing.

Endoscopes↗

PubMed2002

Ensuring competency in end-of-life care: controlling symptoms.

BACKGROUND: Palliative medicine is assuming an increasingly important role in patient care. The Education for Physicians in End-of-life Care (EPEC) Project is an ambitious program to increase core palliative care skills for all physicians. It is not intended to transmit specialty level competencies in palliative care. METHOD: The EPEC Curriculum was developed to be a comprehensive syllabus including trainer notes, multiple approaches to teaching the material, slides, and videos of clinical encounters to trigger discussion are provided. The content was developed through a combination of expert opinion, participant feedback and selected literature review. Content development was guided by the goal of teaching core competencies not included in the training of generalist and non-palliative medicine specialist physicians. RESULTS: Whole patient assessment forms the basis for good symptom control. Approaches to the medical management of pain, depression, anxiety, breathlessness (dyspnea), nausea/vomiting, constipation, fatigue/weakness and the symptoms common during the last hours of life are described. CONCLUSION: While some physicians will have specialist palliative care services upon which to call, most in the world will need to provide the initial approaches to symptom control at the end-of-life.

Journal Article↗

PubMed1989

Rapid and accurate estimation of release conditions in the javelin throw.

We have developed a system to measure initial conditions in the javelin throw rapidly enough to be used by the thrower for feedback in performance improvement. The system consists of three subsystems whose main tasks are: (A) acquisition of automatically digitized high speed (200 Hz) video x, y position data for the first 0.1-0.2 s of the javelin flight after release (B) estimation of five javelin release conditions from the x, y position data and (C) graphical presentation to the thrower of these release conditions and a simulation of the subsequent flight together with optimal conditions and flight for the sam release velocity. The estimation scheme relies on a simulation model and is at least an order of magnitude more accurate than previously reported measurements of javelin release conditions. The system provides, for the first time ever in any throwing event, the ability to critique nearly instantly in a precise, quantitative manner the crucial factors in the throw which determine the range. This should be expected to much greater control and consistency of throwing variables by athletes who use system and could even lead to an evolution of new throwing techniques.

Algorithms↗

PubMed1999

Therapeutic massage: an education program for rural and remote workers in the palliative care field.

This paper, drawing upon data from a Rural Health, Support, Education and Training (RHSET) funded project, focuses on the evaluation of a massage education program developed specifically for rural and remote palliative care workers. An 8 week pilot massage education course was run for palliative care workers in the Albury-Wodonga area and, from this course, an instructional video education package on massage has been developed. The program was evaluated by using a questionnaire, journals and focus group interviews. Feedback from participants was incorporated into both the pilot course and final education package, which was consistent with the action research framework. The major findings of the project were that skill development in the therapeutic use of massage was attained and that job satisfaction was indeed achieved by palliative care workers.

Attitude of Health Personnel↗

PubMed1998

Skin cancer prevention counseling by pharmacists: specific outcomes of an intervention trial.

The purpose of this study was to evaluate the effects of an intervention on pharmacists' behaviors, knowledge, and attitudes related to skin cancer prevention counseling. Fifty-four pharmacy sites (N = 178 pharmacists) were randomly assigned to the intervention or control condition. Intervention consisted of video-based training, prompts installed in the pharmacy to promote pharmacist-patient discussions on the topic, and group-based feedback on previous week's counseling rates. Outcomes were measured using a mailed survey. The proportion of patients counseled at post-test was significantly higher among intervention subjects, adjusting for pretest values. Similar results were found for pharmacists' skin cancer knowledge and self-rated expertise, but not for counseling-related attitudes. The intervention was successful. If implemented on a wide scale, large segments of the U.S. population would be exposed to skin cancer prevention advice.

Adult↗

PubMed2004

Face, content and construct validity of the University of Washington virtual reality transurethral prostate resection trainer.

PURPOSE: We examined the face, content and construct validity of version 1.0 of the University of Washington transurethral prostate resection (TURP) trainer. MATERIALS AND METHODS: Version 1.0 of a virtual reality based simulator for transurethral skills was developed at our laboratory by integrating TURP hardware with our virtual 3-dimensional anatomy, irrigation control, cutting, bleeding and haptics force feedback. A total of 72 board certified urologists and 19 novices completed a pre-task questionnaire, viewed an introductory training video and performed a pre-compiled 5-minute resection task. The simulator logged operative errors, gm resected, blood loss, irrigant volume, foot pedal use and differential time spent with orientation, cutting or coagulation. Trainees and experts evaluated the simulator on a modified likert scale. The 2-tailed Levene t test was used to compare means between experts and novices. RESULTS: Overall version 1.0 content was between slightly and moderately acceptable. Experts spent less time with orientation (p < 0.0001), resected more total tissue (p < 0.0001), had more gm resected per cut (p = 0.002) and less blood loss per gm resected (p = 0.032), used less irrigant per gm resected (p = 0.02) and performed fewer errors (p < 0.0001) than novices. CONCLUSIONS: We established the face, content and construct validity for version 1.0 of the University of Washington TURP trainer to simulate the skills necessary to perform TURP. A predictive validity study showing a translation of skills from the virtual environment to the operating room will complete the validation of this model.

Adult↗

PubMed2004

Communication skills training in postgraduate medicine: the development of a new course.

It has long been accepted that communication is of central importance in healthcare, and a core aspect of clinical competence. Many educational institutions and Royal Colleges now reflect this and consider communication skills a priority in postgraduate examination. The new examination "Practical Assessment of Clinical and Examination Skills" has replaced the Royal College of Physicians MRCP part 2 clinical and oral examination. This examination now consists of five clinical stations, two of which focus on communication skills. A short course for postgraduate trainees has been designed to address the communication skills requirements of the part 2 clinical examination. The aims, development, and content of the course are described. Emphasis is placed on candidates practising skills with patients and receiving feedback during the course. Evidence suggests that practice with feedback is an essential ingredient of communication skills courses, and is more effective than other methods such as observing experts or video examples, or simply discussing issues in communication. Results of a preliminary evaluation indicate that the course was perceived as valuable by candidates and that the aims, format, and content were appropriate. Although the preliminary evaluation was largely positive, it could be argued that the acid test of the effectiveness of a course is an objective evaluation of skills, observed before and after the course, a development that is being considered for future evaluation of the course. Recommendations for applying this type of training to postgraduate trainees in any branch of medicine are given.

Clinical Competence↗

PubMed2002

Collaborative online learning: a new approach to distance CME.

OBJECTIVE: Continuing medical education (CME) has not taken advantage of the ability to communicate and collaborate online. Collaborative learning is an important learning principle, yet online CME programs are generally completed in a one-on-one relationship between the computer and the learner. This limits opportunities for reflective learning, and does not access the rich learning available from interacting with peers. We believe online CME will benefit from interaction between learners and from opportunities for reflection. DESCRIPTION: We implemented a prototype online course designed to improve the skills of general practitioners (GPs) in the care of patients with type 2 diabetes. The course design reflects adult learning principles but, uniquely, applies them to online learning. Currently, 20 GPs from England are enrolled, including one based in Bosnia, and one GP from New Zealand. The course uses BlackBoard(TM) software. Participants log in twice weekly for seven weeks to study one of seven interactive modules on diabetes from evidence-based sources. Modules provide for branched learning via links to additional resources. Subsequently, GPs engage in two online discussions, which are at the learner's convenience rather than requiring adherence to a set schedule. One discussion group is for reflection on the modules, with an assignment to discuss how the material is being applied clinically. Participants also respond to colleagues' postings each week. In a second discussion group, learners apply concepts from the modules to the collaborative management of a problem-based case of a patient with newly diagnosed diabetes. The patient is presented via an online medical chart and streaming videos. She returns each week of the course to mimic 18 months of care. Faculty facilitate the discussion groups and provide feedback. DISCUSSION: We are in the last week of the class and the participant feedback has been overwhelmingly positive. Many note how well the course design and timing match their learning styles and schedule constraints. A powerful feature has been our ability to identify additional educational needs, and quickly add corresponding content online. So far, participants have provided 340 postings, which include evidence of course effectiveness and documentation of application of course objectives and disease management strategies to change actual practice patterns. GPs report changing: screening practices for diabetic renal disease; prescribing of diabetic medications; screening protocols for diabetes; and organizing practice management systems to better track diabetic care. After diagnosing and managing a new diabetic patient during the course, one participant wrote: "It was fantastic to feel that I am offering an up-to-date evidence-based approach in something that I am deskilled in." This course is unique in online CME. It is international in scope, collaborative, asynchronous in delivery, flexible, responsive to learner needs in real time, and has yielded evidence of its effectiveness in changing the actual clinical practices of participants. It will next enroll GPs in Singapore and additional UK-based GPs. Additional CME courses will be developed using this method.

Cooperative Behavior↗

PubMed1999

The development, validation, and application of a video-based technique for measuring an everyday risk-taking behavior: drivers' speed choice.

Drivers' choice of speed is an important aspect of everyday risk-taking behavior because it has been shown to be one of the most important predictors of road accident involvement. This research developed, validated, and applied a measure of drivers' speed choice that combined a high degree of experimental control with external and ecological validity. In Study 1, a video-simulation measure of drivers' speed choice was developed and found to relate specifically to speed-related accident involvement, implying a degree of external validity. In Study 2, the measure was used to investigate the effect of auditory feedback on drivers' speed choice. It was found that increasing the level of internal car noise decreased drivers' preferred speeds. Further analyses indicated that this was likely due to perceptual effects on speed estimation. Results are discussed in terms of road safety and the ability of video-based measures to facilitate experimental control over tasks involving complex ecological stimuli.

Acceleration↗

PubMed1997

Influence of frame rate and image delay on virtual driving performance.

The control and navigation of unmanned ground vehicles (UGVs) by humans requires a thorough understanding of the limitations in human perception and performance. Images of the external world recorded by cameras mounted on the UGV are presented as a video display to the operator, who then remotely manipulates the vehicle using a standard control. Operator performance is directly proportional to the computational complexity associated with the processing of video data. This work studies the effects of frame rate and image delay (lag) on remote driving performance. Experiments were conducted with five subjects using a driving simulator with a 1 dof force feedback steering wheel control. After sufficient training on the simulator, subjects drove a virtual car on a standard track under varying settings of frame rate and lag. Performance was measured by the duration to complete the course. Comparison of performance both within and between subjects showed characteristic driving patterns at different settings. Implications of the findings are discussed in relation to video data presentation for remote driving applications.

Automobile Driving↗

PubMed2002

Care at the end of life: a novel curriculum module implemented by medical students.

End-of-life (EOL) and palliative care education in medical school curricula stand at a crossroads. Consensus has emerged that these topics merit systematic instruction throughout medical school training, yet curricula all too often consist of sporadic lectures focused on bioethics instead of clinical skills. The medical student authors identified a deficit in their curriculum, and designed and implemented an EOL curriculum module for their colleagues. In early 2000 the authors surveyed senior medical students about their experiences with EOL and palliative education, identifying deficits in clinical training and recommendations for interventions. They then designed a case-based educational module to teach EOL communication skills to medical students commencing clinical training. Faculty with national and local experience with EOL and palliative care reviewed the curriculum. Twelve of these faculty were oriented to the curriculum and then taught it in pairs to groups of 12 to 16 medical students in 2000 and 2001. The curriculum develops skills, attitudes, and knowledge relevant for communicating bad news and establishing treatment options in the EOL setting by utilizing trigger videos, group discussion, role plays, and case discussions. Approximately 75% of the 86 eligible students attended the module in 2000 and 2001. Feedback has guided the curriculum's refinement by the medical student authors. In addition, a standardized patient exercise, introduced in 2001, allowed students to reinforce the skills learned during the module.

Curriculum↗

PubMed2002

Disturbance-free high-speed sinusoidal phase-modulating laser diode interferometer.

A surface profiler that incorporates a feedback controller to eliminate external disturbances is proposed and demonstrated. Its overall performance is dependent on the frequency response of the feedback loop. The frequency of the modulating signal strongly influences the response of the feedback controller. When we used the integrating-bucket method, the CCD camera had to be operated at a low-frequency video rate. Our technique uses a CCD camera equipped with an electronic shutter. The shutter function enables us to apply high-speed sinusoidal phase modulation to the conventional integrating-bucket method under the standard video rate.

Journal Article↗

PubMed2001

An optimal period for setting sustained variability levels.

In two experiments, we investigated how explicit reinforcement of highly variable behavior at different points in training affected performance after the requirement was eliminated. Two versions of a computer game, differing in the number of possible solution paths, were used. In each, an optimal period of training for producing sustained high variability was found. Exposure to a high lag requirement shortly after acquisition sustained variability. Rewarding variability at other times did not have a sustained effect. The implications for learning and problem solving are discussed.

Adult↗

PubMed2005

The effectiveness of video support in the teaching of manual skills related to initial periodontal therapy tested on phantoms.

INTRODUCTION: The teaching of manual skills and competencies is among the most time-consuming aspects of oral health-care education, especially when large groups of students are involved. Video has been repeatedly used as an educational tool with varying results. PURPOSE: The present study aimed to investigate the effectiveness of a computer-based video support system during practical training of manual skills and competencies related to periodontal treatment. MATERIALS AND METHODS: Eighty-four students were randomized into 9 groups: 5 experimental and 4 control groups. The control groups received instruction in the use of scaling and root planing instruments during a 7-hour seminar, and 2 hours of manual practice. The experimental groups received the same instruction, but in addition had access to a computer-based video support system, the Visual Training System (VTS), during practical training. During the 2-hour long practice session, all students practiced 21 different procedures, which were video recorded. The videos were later evaluated by an independent observer. RESULTS: On the whole, the students in the experimental group performed significantly better than their colleagues in the control group. Specifically, the groups that utilized the VTS video support performed significantly better in 9 of the 21 procedures tested. CONCLUSION: These results suggest that this computer-based video support can be an effective aid in the teaching of manual skills related to oral health care.

Adult↗

PubMed2005

Video-recall procedures for examining subjective understanding in observational data.

Video-recall procedures allow researchers and clinicians to ascertain participants' subjective understanding of their interactions with significant others. The procedures involve recording participants' interactions and subsequently asking them to review the recorded interactions. The reviewing involves participants providing feedback about their perceptions of their interactions, behaviors, or experiences during the original interactions. Participants' subjective understandings can be contrasted with each other and with those of trained coders to examine shared and discrepant understandings and the differential predictive utility of interactional processes. In this article, the authors briefly review the literature on video-recall procedures, discuss their potential for application in a variety of areas in family psychology, and provide an analysis of current video-recall procedures. Finally, the authors present the Digital Video-Recall System as an example of current video-recall methodology.

Adolescent↗

PubMed2003

Tracking the optic nervehead in OCT video using dual eigenspaces and an adaptive vascular distribution model.

Optical coherence tomography (OCT) is a new ophthalmic imaging modality generating cross sectional views of the retina. OCT systems are essentially Michelson interferometers that form images in 1.5 s by directing a superluminescent diode (SLD) beam over the retinal surface. Involuntary eye motions frequently cause incorrect locations to be imaged. This motion may leave no obvious artifacts in the scan data and can easily go undetected. For glaucoma monitoring especially, knowing the measurement path, typically a circle concentric with the nerve head, is crucial. The commercially available OCT system displays a near-infrared video of the retina showing the SLD beam. This paper presents a prototype system to detect the nerve head and SLD beam in the video, and report the true scan path relative to the nerve head. Low image contrast and limited resolution make the reliable detection of retinal features difficult. In an adaptive model construction phase, the system directly detects retinal vasculature and the nerve head and incrementally builds a model of the current subject's vascular pattern relative to the optic disk. The nerve head identification is multitiered, using a novel dual eigenspace technique and a geometric comparison of detected vessel positions and nerve head hypotheses. In its operational phase, a correspondence is achieved between the currently detected vasculature and the model. Using subjects not included in training, the system located the optic nerve head to within 5 pixels (0.07 optic disk diameters, an error well below clinical significance) in 99.75% of 2800 video fields. In current clinical practice, motions as large as 1-2 disc diameters may go undetected, so this is a vast improvement.

Algorithms↗