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At least 361 records · Page 20Linked to original sources

PubMed2003

Evaluation of a tool to categorize patients by reading literacy and computer skill to facilitate the computer-administered patient interview.

Past efforts to collect clinical information directly from patients using computers have had limited utility because these efforts required users to be literate and facile with the computerized information collecting system. In this paper we describe the creation and use of a computer-based tool designed to assess a user's reading literacy and computer skill for the purpose of adapting the human-computer interface to fit the identified skill levels of the user. The tool is constructed from a regression model based on 4 questions that we identified in a laboratory study to be highly predictive of reading literacy and 2 questions predictive of computer skill. When used in 2 diverse clinical practices the tool categorized low literacy users so that they received appropriate support to enter data through the computer, enabling them to perform as well as high literacy users. Confirmation of the performance of the tool with a validated reading assessment instrument showed a statistically significant difference (p=0.0025) between the two levels of reading literacy defined by the tool. Our assessment tool can be administered through a computer in less than two minutes without requiring any special training or expertise making it useful for rapidly determining users' aptitudes.

Computer Literacy↗

PubMed2004

New tools in cybertherapy: the VEPSY web site.

In the last years the rapid development of the Internet and new communication technologies has had a great impact on psychology and psychotherapy. Psychotherapists seem to rely with more and more interest on the new technological tools such as videophone, audio and video chat, e-mail, SMS and the new Instant Messaging Tools (IMs). All these technologies outline a stimulating as well as complex scenario: in order to effectively exploit their potential, it is important to study which is the possible role played by the Internet-based tools inside a psychotherapeutic iter. Could the technology substitute the health care practitioners or are these tools only a resource in addition to the traditional ones in the therapist's hand? The major aim of this chapter is to provide a framework for the integration of old and new tools in mental health care. Different theoretical positions about the possible role played by e-therapy are reported showing the possible changes that psychotherapy will necessarily face in a cyber setting. The VEPSY website, an integration of different Internet-based tools developed within the VEPSY UPDATED Project, is described as an example of clinical application matching between old (and functional) practices with new (and promising) media for the treatment of different mental disorders. A rationale about the possible scenarios for the use of the VEPSY website in the clinical process is provided.

Humans↗

PubMed2002

The Blue DRAGON--a system for monitoring the kinematics and the dynamics of endoscopic tools in minimally invasive surgery for objective laparoscopic skill assessment.

Minimally invasive surgeiy (MIS) involves a multi-dimensional series of tasks requiring a synthesis between visual information and the kinematics and dynamics of the surgical tools. Analysis of these sources of information is a key step in mastering MIS surgery but may also be used to define objective criteria for characterizing surgical performance. The BIueDRAGON is a new system for acquiring the kinematics and the dynamics of two endoscopic tools along with the visual view of the surgical scene. It includes two four-bar mechanisms equipped with position and force torque sensors for measuring the positions and the orientations (P/O) of two endoscopic tools along with the forces and torques applied by the surgeons hands. The methodology of decomposing the surgical task is based on a fully connected, finite-states (28 states) Markov model where each states corresponded to a fundamental tool/tissue interaction based on the tool kinematics and associated with unique F/T signatures. The experimental protocol included seven MIS tasks performed on an animal model (pig) by 30 surgeons at different levels of their residency training. Preliminary analysis of these data showed that major differences between residents at different skill levels were: (i) the types of tool/tissue interactions being used, (ii) the transitions between tool/tissue interactions being applied by each hand, (iii) time spent while perfonning each tool/tissue interaction, (iv) the overall completion time, and (v) the variable F/T magnitudes being applied by the subjects through the endoscopic tools. Systems like surgical robots or virtual reality simulators that inherently measure the kinematics and the dynamics of the surgical tool may benefit from inclusion of the proposed methodology for analysis of efficacy and objective evaluation of surgical skills during training.

Animals↗

PubMed2004

Lifestyle screening: development of an acceptable multi-item general practice tool.

AIMS: To develop a short screening tool for lifestyle and mental-health risk factors that adults can self-administer, and to determine acceptability and feasibility of use of this tool in primary care settings. METHODS: The multi-item tool was designed to screen patients in rural and urban New Zealand general practices for smoking, alcohol and drug misuse, problem gambling, depression, anxiety, abuse, anger, sedentary lifestyle, and weight issues. Patients were offered help for identified risk factors. Fifty consecutive adult patients per practice (n=2,543) were recruited to participate from 20 randomly-selected urban general practitioners; 20 general practice nurses and 11 rural general practitioners. RESULTS: Patients came from diverse ethnic, geographical, and socioeconomic backgrounds. The sample prevalence of positive responses identified ranged from 2.8% (gambling) to 42.7% (depression). The number of patients requesting immediate assistance with these responses (0.5 to 13.5%) did not overwhelm clinicians. The tool was well accepted by patients, with few objections to specific questions (0.1-0.8%). Most practitioners stated they will use the screening tool once available. CONCLUSIONS: Screening for lifestyle and mental health risk factors is becoming increasingly important in primary health care. This screening tool was acceptable to patients and was not considered overly burdensome by practitioners.

Adult↗

PubMed2005

The unannounced standardised patient methodology--a potential feedback tool for registrar training.

BACKGROUND: The external clinical teaching visits (ECTV) remain the primary method of monitoring registrar progress and provide valuable feedback. The unannounced standardised patient (USP) methodology may represent an innovative tool to assess registrar performance and provide feedback that could complement the current ECTV program. OBJECTIVE: This article provides an overview of current feedback processes in registrar training, presents a review of the literature on the USP as an innovative performance assessment tool, and proposes its potential application for general practice registrar training as an effective audit and feedback tool. CONCLUSION: The USP methodology has been thoroughly tested, validated and embraced by many countries. Recently, the USP tool has been described as the validated, gold standard methodology to discriminate among variations in the quality of clinical practice. Most studies have used the USP tool to assess actual performance of practising doctors, with minimal attention being given to its potential as a feedback/teaching tool. The use of the USP for this purpose represents an opportunity for further research.

Australia↗

PubMed2006

New tools for sculpting cranial implants in a shared haptic augmented reality environment.

New volumetric tools were developed for the design and fabrication of high quality cranial implants from patient CT data. These virtual tools replace time consuming physical sculpting, mold making and casting steps. The implant is designed by medical professionals in tele-immersive collaboration. Virtual clay is added in the virtual defect area on the CT data using the adding tool. With force feedback the modeler can feel the edge of the defect and fill only the space where no bone is present. A carving tool and a smoothing tool are then used to sculpt and refine the implant. To make a physical evaluation, the skull with simulated defect and the implant are fabricated via stereolithography to allow neurosurgeons to evaluate the quality of the implant. Initial tests demonstrate a very high quality fit. These new haptic volumetric sculpting tools are a critical component of a comprehensive tele-immersive system.

Computer-Aided Design↗

PubMed2006

[Prototype of a system for electric conduction at contact with laparoscopic tools].

The authors present their prototype of a system for electric conduction at contact with laparoscopic tools, devised, designed and produced by them at the Politecnico di Torino, Department of Mechanical Engineering. The system consists of a two sided plate, one side is a non conducting adhesive surface to stick to the surgical glove and the other side is a subtle flexible shell of a conductor. The Authors used the instrument with surgical tools with a metallic handle, during three cholecystectomies. Nowadays all standard laparoscopic tools have the chance and the need to be electrified. Now the way commonly used to electrify a laparoscopic tool is using a wire plugged to a fixed conducting point of the instrument. This prototype has been devised and produced to avoid some discomforts met during the numerous manoeuvres of connecting and disconnecting the wire at the time of a surgical intervention. This device permits the direct transfer (by contact) of electric energy from the wire to surgical tools. The advantage is to be more rapid in changing surgical tools obtaining, immediately an electrified instrument in your hand.

Cholecystectomy, Laparoscopic↗

PubMedDate not supplied

Development of a quality assurance tool for critical care.

Current conditions in the health care arena demand that nurses be held accountable for the quality of nursing care delivered. Nursing administrators today face multiple challenges which include incorporating the expanding role of the nurse, dealing with financial constraints, and meeting the demands of an increasingly informed public. These factors combine to emphasize the need to examine the quality of care delivered and to identify and promote effective nursing care behaviours. The use of a quality assurance tool can be invaluable in revealing areas of both excellence and weakness in the care of clients, as well as providing a solid foundation for change. This paper will follow the authors through the development and implementation of a unit-specific quality assurance tool for a critical care area. We begin with a brief review of the literature and explore the factors relevant to our decision to choose a concurrent chart audit as our tool. We then describe the discovery of standards, the design of the tool itself, and follow the process of testing, approval and implementation of the tool for use in our institution. Finally, we explain the methods used to introduce the tool to staff and elicit their support to monitor and thus improve the quality of nursing care delivered.

Critical Care↗

PubMedDate not supplied

Development and use of a clinical evaluation tool.

Literature in nursing education reveals that there are few standardized clinical evaluation methods or tools used by nurse educators. Faculty at a Midwest school developed a clinical evaluation tool and have used it for one year. A questionnaire, developed and pilot tested, measured student and faculty satisfaction with the tool. Both students and faculty agreed that the tool was an accurate measure of clinical performance. This tool is adaptable to the hospital setting, where it may be used to evaluate the performance of staff nurses. The tool was cited for excellence by NLN visitors during a recent accreditation visit.

Education, Nursing, Associate↗

PubMed1983

Motor assessment tools: their concurrent validity in evaluating children with multiple handicaps.

Three developmental motor assessment tools were administered concurrently to 17 children with severe multiple handicaps in an effort to examine the relationship of developmental age equivalent scores among the 3 tools. The Bayley Scales of Infant Development, a standardized and norm-referenced infant assessment tool, was used as criterion for concurrent validity in evaluating the other 2 tools, the Callier-Azusa Scale and the Fircrest Deaf-Blind Motor Assessment Tool. In spite of variations in quantity and type of behaviors assessed on each of these 3 instruments, highly significant positive correlations were shown between age equivalent scores on the Bayley and those on each of the other 2 tests. These findings support the application of objective, quantifiable measurement tools for determining developmental motor age levels of severely disabled children with multiple handicaps.

Adolescent↗

PubMed1995

Validity and reliability of an oncology critical care patient acuity tool.

PURPOSE/OBJECTIVES: To test the reliability and validity of a patient acuity tool for use on a critical care oncology unit. DESIGN: Prototype classification system using therapeutic indicators to describe a patient's acuity. SETTING: Intensive care unit of a research and academic oncology hospital in the Southeastern United States. SAMPLE: Critical care nursing staff including management-level personnel at the research site. METHODS: An acuity tool for critical care was developed using the Johns Hopkins Oncology Center's patient classification system as a model. Content validity indexes were calculated based on ratings of nurse experts. interrater reliability was calculated based on two independent raters: a staff nurse and a patient care manager. MAIN RESEARCH VARIABLES: Appropriateness of language and categorization of therapeutic indicators developed for the tool. FINDINGS: The content validity index of the entire tool was 0.85; 24/25 indicators were retained. Reliability was r = 0.84. CONCLUSIONS: The tool is reliable and valid. IMPLICATIONS FOR NURSING PRACTICE: Acuity tools can be used to calculate unit productivity and assist with determination of staffing needs. In this age of healthcare reform, it is imperative that personpower needs in all care settings be accurately determined to provide cost-effective and safe care levels.

Critical Care↗

PubMed1995

A comprehensive pediatric bone marrow transplant documentation tool.

PURPOSE/OBJECTIVES: To describe the development and use of a tool to document assessment and provision of education to children undergoing bone marrow transplantation (BMT) and their families. DATA SOURCES: A hospital's BMT Clinical Issues Committee, BMT staff, and hospital standards. DATA SYNTHESIS: A comprehensive tool was developed to complement the hospital's admission tool to facilitate assessment and documentation of BMT-specific education of the patient and family. The implementation of the tool was specifically designed to facilitate its use across outpatient and inpatient settings. CONCLUSIONS: Based on quality assurance indicators, the tool has succeeded in documenting appropriate education activities. IMPLICATIONS FOR NURSING PRACTICE: A consistent and organized approach to documentation is beneficial to nursing practice. This tool can be adapted to any clinical situation where educational needs are great.

Bone Marrow Transplantation↗

PubMed1997

Requirements and implementation of a flexible kinetic modeling tool.

UNLABELLED: Kinetic (or compartment) modeling is a highly versatile tool for the analysis of experiments within living systems. In PET, it is essential for developing tracers, for assessing tracer behavior and for extracting quantitative information about the target process. However, tools to support the modeling tasks involved are not easily available. METHODS: This article presents a requirements analysis for kinetic modeling in PET. The interactive kinetic modeling tool KMZ implements many of these features. It facilitates model development by a set of predefined models and by the ease of introducing new models. Monte Carlo studies allow assessing parameter identifiability. The responses in the different compartments as well as the expected time-activity curve can be simulated for specific model configurations. For measured time-activity curves, model optimization can be performed by the Powell or the Marquardt algorithm. Both support weighted nonlinear least-squares fitting and allow optional constraints of parameter ranges. To further improve parameter estimation, the fitting of several regional time-activity curves can be coupled, resulting in lower standard errors for parameters common among regions. It is possible to highly automate the evaluation of study series and to forward the results into statistical analysis tools. RESULTS: The KMZ tool has proven highly suitable in evaluating data from different types of studies, and the intuitive user interface enables medical doctors to successfully perform routine evaluations after a short training period. CONCLUSION: A portable kinetic modeling tool with the described features would provide easy access to model development and may help consolidate kinetic modeling in clinical settings for well-defined applications.

Algorithms↗

PubMed1998

EMG study of hand muscle recruitment during hard hammer percussion manufacture of Oldowan tools.

The activity of 17 hand muscles was monitored by electromyography (EMG) in three subjects during hard hammer percussion manufacture of Oldowan tools. Two of the subjects were archaeologists experienced in the replication of prehistoric stone tools. Simultaneous videotapes recorded grips associated with the muscle activities. The purpose of the study was to identify the muscles most likely to have been strongly and repeatedly recruited by early hominids during stone tool-making. This information is fundamental to the identification of skeletal features that may reliably predict tool-making capabilities in early hominids. The muscles most frequently recruited at high force levels for strong precision pinch grips required to control the hammerstone and core are the intrinsic muscles of the fifth finger and the thumb/index finger regions. A productive search for skeletal evidence of habitual Oldowan tool-making behavior will therefore be in the regions of the hand stressed by these intrinsic muscles and in the joint configurations affecting the relative lengths of their moment arms.

Animals↗

PubMed2002

New tool use by wild Sumatran orangutans (Pongo pygmaeus abelii).

Two forms of tool use by wild Sumatran orangutans are reported from the Agusan Monitoring Station, a new research site in Indonesia. One form, a branch "hook" used in locomotion, has not been reported previously in wild orangutans. The second form, a leaf "pad" used to protect the hands and feet from thorns while feeding, shares similarities in form and function with a tool type used by orangutans at Ketambe, a nearby research site. Both instances of tool use occurred in areas of disturbance, and appear to be spontaneous inventions under novel conditions, although habitual use of the tool in other ecological contexts is plausible. A summary of the distribution of tool use types in wild orangutans is presented.

Animals↗

PubMed1989

Ideational apraxia: a deficit in tool selection and use.

We report a 67-year-old left-handed man who exhibited an ideational apraxia in both clinical and nonclinical natural settings following a right hemisphere infarction. His inability to use tools could not be explained by a motor production deficit (ideomotor apraxia), because he made content errors and could not match tools with objects. His deficit could not be attributed to an agnosia or language comprehension deficit, because he could name tools and point to tools on command. Based on our testing, it appeared that this patient had a loss of knowledge related to tool use.

Aged↗

PubMed2004

The pedigree tool: web-based visualization of a family tree.

We describe the development of a novel tool that facilitates the design and visualization of pedigrees using a special Internet application. The tool is programmed in Java, using a PHP script as an interface. This web-based tool is used to generate, edit, and/or view pedigrees. The advantage of our novel tool is that it is based on a notation that allows the representation of any given number of generations, family members per generation, and multiple clinical or genetic features of an individual family member. In addition, the notation allows us to minimize the storage space by 100% to 500% and to standardize the presentation of family trees and segregation analysis for inheritance of mendelian disorders or even complex traits. This pedigree tool has been implemented with a database of thyroid-stimulating hormone receptor (TSHR) mutations (http://www.uni-leipzig.de/innere/tshr/).

Computer Graphics↗

PubMedDate not supplied

Towards a consensus on datasets and evaluation metrics for developing B-cell epitope prediction tools.

A B-cell epitope is the three-dimensional structure within an antigen that can be bound to the variable region of an antibody. The prediction of B-cell epitopes is highly desirable for various immunological applications, but has presented a set of unique challenges to the bioinformatics and immunology communities. Improving the accuracy of B-cell epitope prediction methods depends on a community consensus on the data and metrics utilized to develop and evaluate such tools. A workshop, sponsored by the National Institute of Allergy and Infectious Disease (NIAID), was recently held in Washington, DC to discuss the current state of the B-cell epitope prediction field. Many of the currently available tools were surveyed and a set of recommendations was devised to facilitate improvements in the currently existing tools and to expedite future tool development. An underlying theme of the recommendations put forth by the panel is increased collaboration among research groups. By developing common datasets, standardized data formats, and the means with which to consolidate information, we hope to greatly enhance the development of B-cell epitope prediction tools.

Animals↗