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At least 325 records · Page 18Linked to original sources

PubMed2002

A feasibility study of remote monitoring of asthmatic patients.

We assessed the feasibility of a remote monitoring system for asthmatic patients to use in their own homes. Eighty-four patients were invited to participate following discharge from hospital after an acute exacerbation of their asthma. We remotely monitored 33 patients from two hospitals for two weeks. Their mean age was 34 years (range 17-50 years). Patient compliance with monitoring was 80% (range 45-231%) and compliance with transmitting the results using a modem was 52% (range 0-100%). The average time spent teaching patients how to perform measurements was 16 min (range 2-55 min) and time spent providing asthma education was 39 min (range 5-135 min). Ninety-six per cent of patients found the equipment easy or very easy to use and 92% said they would use the equipment again in the future. Medical intervention occurred in 48% of patients during the study period, which suggests that the use of remote monitoring could be important in reducing asthma morbidity and improving treatment outcomes.

Adolescent↗

PubMed2004

Distributed network imaging and electrical impedance tomography of minimally invasive surgery.

Minimally invasive surgery has become highly dependent on imaging. For instance, the effectiveness of cryosurgery in treating cancer is dependent on knowledge of freezing extent, and relies on real-time imaging techniques for monitoring. However, medical imaging is often very expensive and therefore not available to most of the world population. Here we propose the concept of distributed network imaging (DNI) which could make medical imaging and minimally invasive surgery available to all who need these advanced medical modalities. We demonstrate the concept through electrical impedance tomography (EIT) of cryosurgery. The central idea is to develop an inexpensive measurend (data collection hardware) at a remote site and then to connect the measurend apparatus to an advanced image reconstruction server, which can serve a large number of distributed measurends at remote sites, using existing communication conduits (Ethernet, telephone, satellite, etc.). These conduits transfer the raw data from the measurend to the server and the reconstructed image from the server to the measurend. Electrical impedance tomography (EIT) is an imaging modality which utilizes tissue impedance variation to construct an image. The EIT measurend which consists of electrodes, a power supply, and means to measure voltage is inexpensive, and therefore suitable for DNI. EIT is also very well-suited to imaging cryosurgery since frozen tissue impedance is much higher than that of unfrozen tissue. In this study, we first develop numerical models to illustrate the theoretical ability of EIT to image cryosurgery. We begin with a simplified two dimensional model, and then extend the study to the more appropriate three dimensional model. Our simulated finite element phantoms and pixel-based Newton-Raphson reconstruction algorithms were able to produce easily identifiable images of frozen regions within tissue. Then, we demonstrate the feasibility of the DNI concept though a case study using EIT to image an in vitro liver cryosurgery procedure through a modem. We find that the acquired raw data packets are less than 5KB per image and the images, using compression, do not exceed 50KB per image.

Algorithms↗

PubMed2006

Bridging Western ethics and Japanese local ethics by listening to nurses' concerns.

Among Japanese nurses ethics is perceived as being distant and unrelated to their practice, although this is filled with ethical concerns and the making of ethical decisions. The reasons for this dissociation are the primacy of western values in modem Japanese health care systems and the suppression of Japanese nurses' indigenous ethical values because of domination by western ethics. A hermeneutic study was conducted to listen to the ethical voices of Japanese nurses. Seven ethical concerns were revealed. Although some of these concerns may seem to share similar values with western ethical principles, the basis for the concerns was unique and rooted in the Japanese cultural value system. The meanings of each concern are explicated in conjunction with related background meanings. Listening and trying to understand these nurses' voices in their own context suggests a way of bridging the gap between abstract and universal ethics and practical and local ethics.

Adult↗

PubMed1996

Challenges and opportunities of the Internet for medical oncology.

PURPOSE: The internet, and in particular the world wide web (www), has a rapidly increasing potential to provide information for oncologists and their patients about cancer biology and treatment. A brief overview of this environment is given along with examples of how easily the information is accessed as a means of introducing the web page of the American Society of Clinical Oncology (ASCO), ASCO OnLine. METHODS: Oncology information sources on the www were accessed from the author's home using a 14.4 kbs modem, Netscape browser (Netscape communications Corp, Mountain View, CA), and the locations recorded for tabulation and discussion. RESULTS: Overwhelming amounts of oncology-related information are now available via the Internet. CONCLUSION: Oncology as a subspecialty is ideally suited to apply the newest information technology to traditional needs in areas of education, research, and patient care. Oncologists will increasingly act as information guides rather than information resources for patients and their families with cancer.

Computer Communication Networks↗

PubMed1998

Development of a new production system for weaned and growing pigs.

The design of modem housing systems for farm animals calls for cooperation between scientists within different disciplines. This article describes the design of a new production system for weaned and growing pigs, as well as the analyses and working processes behind its development. The aim of the study was to develop an economically competitive system that also provided better welfare for the animals and a healthier environment for the workers. Analyses were carried out with emphasis on behavioral needs and building design and economy. The resulting system, the "safari system," consists of a number of straw flow pens of increasing size. Pigs are moved to larger and larger pens each week until slaughter. The main advantage is that pigs are not mixed during the growth period and that they are given more space, especially toward the end of the growth period when their space demand is high. Furthermore, the provision of straw for comfort and exploration and of wallow basins for cooling in the pens for the larger pigs were considered significant welfare improvements. An analysis revealed that the safari system would be economically competitive in comparison to traditional intensive systems.

Journal Article↗

PubMed1993

Psychological tests don't think: an appreciation of Schafer's Psychoanalytic Interpretation in Rorschach Testing.

Roy Schafer 's Psychoanalytic Interpretation in Rorschach Testing has, for nearly 40 years, represented a hallmark of psychodynamically informed psychological assessment. In this article, Schafer's contribution is reviewed in light of recent contributions to the Rorschach literature. Following a summary of the main sections of the work, Schafer's approach to the Rorschach is critically re-examined from the perspective of modem assessment practice. Differences between the epistemological bases of psychoanalytic and empirical methods of Rorschach interpretation are highlighted, and the prospects for an integration of these two approaches are considered. It is concluded that Schafer's contribution remains as fresh today as when written 40 years ago.

Journal Article↗

PubMed1997

Connectionism, parallel constraint satisfaction processes, and gestalt principles: (re) introducing cognitive dynamics to social psychology.

We argue that recent work in connectionist modeling, in particular the parallel constraint satisfaction processes that are central to many of these models, has great importance for understanding issues of both historical and current concern for social psychologists. We first provide a brief description of connectionist modeling, with particular emphasis on parallel constraint satisfaction processes. Second, we examine the tremendous similarities between parallel constraint satisfaction processes and the Gestalt principles that were the foundation for much of modem social psychology. We propose that parallel constraint satisfaction processes provide a computational implementation of the principles of Gestalt psychology that were central to the work of such seminal social psychologists as Asch, Festinger, Heider, and Lewin. Third, we then describe how parallel constraint satisfaction processes have been applied to three areas that were key to the beginnings of modern social psychology and remain central today: impression formation and causal reasoning, cognitive consistency (balance and cognitive dissonance), and goal-directed behavior. We conclude by discussing implications of parallel constraint satisfaction principles for a number of broader issues in social psychology, such as the dynamics of social thought and the integration of social information within the narrow time frame of social interaction.

Journal Article↗

PubMed1988

NeuroSIG: the computer network of the Congress of Neurological Surgeons.

A sophisticated computer network has been developed specifically for use by the Congress of Neurological Surgeons. This network provides a variety of communication and information features. These include public and private message transmission, teleconferencing, numerous data libraries, programs that may be downloaded and executed on the user's own computer, high resolution color graphics image transmission, an extensive neurosurgical database, and extensive on-line "help" features. The system can be accessed using almost any personal computer and a telephone modem.

Computer Communication Networks↗

PubMed2005

Automation in drug inventory management saves personnel time and budget.

Automation in the drug distribution processes is helpful to pharmacists in creating new clinical services. We have ameliorated the drug inventory control system seamlessly connected with the physician order-entry system. This control system application, named Artima, allows inventory functions to be faster and more efficient in real time. The medicines used in our hospital are automatically fixed and arranged to sold-packages, and are ordered from each wholesaler by a fax-modem every day. Artima can search the lot number and expiration date of drug in the purchase and delivery records. These functions are powerful and useful in patient's safety and cost containment. We surveyed the inventory amount stored in the computer database, and evaluated time required for inventory management by tabulating working records of employees during past decades. Inventory decreased by 70% along with the continuous improvement of the system during the past decade. The workload in the inventory management in each section of the Pharmacy Department as well as in clinical units was dramatically reduced after the implementation of this system. The automation system in the drug inventory management allows creating new clinical positions for pharmacists. This system also could pay for itself in time.

Clinical Pharmacy Information Systems↗

PubMed2000

Telemedicine in the control of intra-ocular pressure.

Glaucoma is one of the most common causes of blindness in the Western world and a major risk factor is increased intra-ocular pressure. We therefore used telemedicine in its control. Patients measured their intra-ocular pressure several times a day with a portable instrument and the values were then entered into a portable digital assistant. These data were transmitted by a modem to a central server. If the intra-ocular pressure was pathologically high, an email message was automatically sent to the ophthalmologist. The pressure curve, including a statistical analysis, was displayed in an easily readable chart format. Ten patients with glaucoma participated in a trial. Self-tonometry with telemedicine enabled continuous evaluation of the patient by the ophthalmologist. This approach offered the advantage of controlling the treatment remotely. Advantages for the patient were that the measurements were easily done at home under normal conditions, and the patient could control when the measurement and data transmission would be performed. Telemedicine is a cost-effective technique enabling the early diagnosis of pathologically increased intra-ocular pressure.

Glaucoma↗

PubMed2000

Technical evaluation of a low-bandwidth, Internet-based system for teleconsultations.

A low-bandwidth telemedicine system was evaluated in eight community hospitals connected to a central hospital via the Internet. PCs were used with videoconferencing software and modem connections to the telephone network. The average data connection rates, still-image transfer times and live-video transmission rates were determined. The time to send 640 x 480, 320 x 240 and 160 x 120 pixel, 24-bit still images ranged from 29 s to 411 s. The average file transfer times for a 10 s MPEG video-clip was 8.6 min. The average live video frame rate was 1 frame/s (at the best image quality), with an average latency of 3 s. The results suggest that Internet-based videoconferencing is acceptable for certain telemedicine applications.

Canada↗

PubMed2001

Improvement in diabetes control with a monitoring system based on a hand-held, touch-screen electronic diary.

We conducted a six-month prospective interventional crossover study examining a computerized diabetes monitoring system (DMS) that conveyed dietary information. The objectives were to compare glycaemic control between intervention and control periods, and to assess patients' acceptance of the DMS. Nineteen patients were randomized into two groups, each using the DMS for three months and serving as the control group for another three months. The patients recorded information about their meal portions and blood glucose readings in a hand-held electronic diary. After transmitting the data to the DMS through a telephone modem, the patients received immediate feedback about the carbohydrate, protein and fat content of the meal, as well as the calorie content. A significant improvement in glycaemic control was achieved during intervention compared with control periods (mean HbA1C reduction of 0.825%). The DMS was also highly acceptable: 95% patients found it easy to operate while 63% found it useful. The DMS was thus a feasible model of telemedicine in diabetes care and a larger study is warranted to examine its cost-effectiveness.

Adult↗

PubMed2001

Low-bandwidth, Internet-based videoconferencing for physical rehabilitation consultations.

Low-bandwidth, Internet-based videoconferencing was used to provide physical rehabilitation consultation services for eight community hospitals. Videoconferencing and file transmission used a PC and modem. A separate telephone line was used for voice. Over 21 months, 47 physical rehabilitation consultations were completed for communication disorders, foot care, gait problems, orthotics, prosthetics, arm weakness and wheelchair prescription. Consultations were approximately 40 min long. Clinician questionnaires were completed by 47 individuals. While more than 80% of the questionnaire responses supported the telemedicine approach, remote clinicians rated their satisfaction higher than did the specialists. Client questionnaires were completed by 24 individuals (a response rate of 51%). All clients were comfortable with and had confidence in the teleconsultations.

Attitude of Health Personnel↗

PubMed2001

A study of Internet use by doctors and patients in Poland.

We evaluated Internet use in Poland in the field of obstetrics and gynaecology. Questionnaires were sent to 33 hospital departments of obstetrics and gynaecology; 25 replied (76%). The 25 departments contained a total of 275 doctors, 70% of whom (n=193) returned the questionnaire. We also invited 3054 people visiting a gynaecological Website for patients to complete an online form; 161 replied, a response rate of 5.3%. While 84% of the 102 doctors using the Internet were satisfied with Internet medical resources, only 24% of patients were. Patients searched for medical information less frequently than professionals and were younger. About half of the doctors and patients had only modem access to the Internet. The most popular services for professionals were databases and information services; patients were most interested in information on pregnancy, contraceptives, physiology and general female health. Most of the 45% of patients who said that they did not receive sufficient information from doctors could not usually find it on the Internet either.

Adolescent↗

PubMed2002

Integrated regional services: are working process changes desirable and achievable?

In the hospital district of Helsinki and Uusimaa, 32 municipalities with one or more health centres provide primary care to their residents. Legal and organizational barriers between primary care and hospital care impede the continuity of patient care. Integrating primary and secondary care with the aid of information technology may facilitate a virtual electronic patient record, in which the viewing of images and other patient data is possible regardless of the organization that produced them. For example, in one trial, diabetic patients sent their home blood glucose measurements by modem to their health centre. Preliminary observations suggest that they could increase their glucose testing largely because they were able to transmit the results to the database and receive teleconsultations. Also, a picture archiving and communication system (PACS) has been in operation in two clinics of the Helsinki University Central Hospital for over two years and seven hospitals had become filmless by the end of 2001. A regional PACS is planned to be completed by the year 2004.

Journal Article↗

PubMed2004

Nurse and patient communication via low- and high-bandwidth home telecare systems.

We examined nurse-patient communication on two videoconferencing systems: a video-phone (PSTN video) and a PC-based system (IP video). The former used data transmission via a modem at 33.6 kbit/s and the latter via a local-area network at up to 512 kbit/s. Twenty-six nurses and 18 volunteers (simulated patients) participated. On each video system nurse-patient dyads completed scripted interactions; they then completed questionnaires to assess communication. Of the participants, 84% (n=37) preferred IP video and 14% (n=6) preferred PSTN video (one expressed no preference). IP video was rated significantly higher in all communication quality areas except self-consciousness/embarrassment. Although participants' overall ratings were higher for the IP video system, two important advantages of the PSTN video system were identified by both nurses and patients: first, it provided superior visualization of the medication bottle, insulin syringe and the patient's skin; and second, it was easier to use. Video quality and audio quality are important determinants of patient and provider perceptions, but ease of use, clinical appropriateness, and the need for training and support must not be forgotten.

Adult↗

PubMed2005

Supporting families of critically ill children at home using videoconferencing.

Home videoconferencing links for families of children recently discharged with complex congenital heart disease may be useful in monitoring potentially unstable patients. A randomized controlled trial was carried out comparing home videoconferencing with telephone contact. Patients were randomized to an interventional videoconferencing group (n = 14), or to one of two control groups: the first (n = 9) received the same ad hoc telephone support that was available to all patients; the second group (n = 13) received regular telephone calls with the same protocol as those in the videoconferencing group. The results from the trial are still being analysed. Our experience with commercial cable modem transmission quickly showed that this is an unsuitable modality. Preliminary results with ISDN videoconferencing are encouraging. Initial results and feedback from families strongly suggest that videoconferencing provides significant benefits over telephone follow-up.

Child↗

PubMed2006

Four years' experience with antepartum cardiotocography using telemedicine.

We reviewed the first four years of experience with telemonitoring of patients with high-risk pregnancies. Nine peripheral units (eight in Campania, a region of south Italy, and one in Hungary) recorded cardiotocographic traces and transmitted them via modem to an operations centre at the University 'Federico II' in Naples, where the computerized analysis was performed. The medical report was returned to the peripheral unit via fax or email. Four thousand and twenty one traces were recorded: 2674 (67%) from 764 high-risk patients and 1347 (34%) from 499 patients at apparent low risk. The neonatal outcome was good overall. Questionnaires were sent to the operators working at the peripheral units to evaluate the acquisition of specific skills and their level of satisfaction. Sixty-six questionnaires about cardiotocographic trace interpretation were collected. The number of correct answers increased during the study. A total of 33 questionnaires about job satisfaction were collected. The answers showed that the operators gradually overcame their scepticism during the study. A total of 1098 questionnaires were answered by the patients. Their answers showed a moderate level of satisfaction. Telecardiotocography allowed the decentralization of prenatal surveillance.

Cardiotocography↗