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Determinants of microcomputer technology use: implications for education and training of health staff.

In hospitals and other Healthcare settings, increasingly, hands-on computer use is becoming an important behaviour for effective job performance. The literature has identified differences that relate to computer use between occupational categories in health services. The objectives of this study were to identify factors that determine computer acceptance among occupational groups in Community Health and to predict the factors that relate to computer use. A survey was administered to all Community Health staff in one health service area. Health administrators were found to have a significantly higher training in computers, a higher frequency of use and a higher level of skill for both applications (word processing (WP) and database (DB)) than nurses. The results of a regression analysis shows that about 55% of the variation in the use of WP is explained by computer skills, perceived usefulness (PU) and designation. In the case of DB use, PU was the only significant predictor explaining 53% of the variation. Both level of education and prior training were not significant predictors. The implication for health informatics education (and service training) of these findings is that, in the workplace, health professionals would use computers when they perceive it to be useful for performance in their jobs.

Administrative Personnel↗

Distribution of Epi Info software: an evaluation using the Internet.

INTRODUCTION: Epi Info and Epi Map are computer programs for word processing, database management, epidemiologic statistics, and mapping designed for public health professionals. The programs are in the public domain, and distribution outside the Centers for Disease Control and Prevention (CDC) has been through a variety of informal channels. METHOD: Individuals and organizations known to have distributed Epi Info or Epi Map since 1987 provided information. Distributors included CDC, the World Health Organization (WHO), commercial vendors, translators, instructors in university and public health settings, and other public health professionals. Reports documented a minimum number of 145,320 copies distributed. CONCLUSIONS: Since 1994, the Internet has become a major means of propagation, accounting for 66% of the copies for which the method of distribution was known. The Internet also was a major information source for this study.

Centers for Disease Control and Prevention, U.S.↗

Ergonomic evaluation of working posture of VDT operation using personal computer with flat panel display.

The aim of this study was to evaluate working conditions using a personal computer with a flat panel display (FPD) in terms of visual and musculoskeletal comfort. Measurements of viewing distance, viewing angle, head angle, neck angle and electromyogram (EMG) activities of the neck, shoulder and back muscles of visual display terminal (VDT) operators were compared at workstations using an FPD and a desktop personal computer (DPC). A notebook personal computer (NPC) with a 10.4 inches FPD, was used in this experiment. Each of 10 healthy subjects performed word processing tasks using both NPC and DPC workstations. Significant differences in the work posture while using the NPC and DPC were seen with viewing distance, viewing angle and head angle. The characteristic features of the work posture using the NPC were a remarkably short viewing distance and a forward inclination of the head. The value of integrated EMG (IEMG) of the neck muscle was greater while using the NPC than when using the DPC. These phenomena were caused by the structure of NPCs; most NPCs have a display and keyboard which cannot be separated and are not adjustable without tilt and swivel mechanisms. VDT devices that cannot be adjusted may potentially make operators assume a poor posture while working, which could cause visual and musculoskeletal disorders. To prevent visual and musculoskeletal problems using NPCs, a more upright head and neck position was recommended. The addition of a mechanism for adjustment of the height of an NPC display would allow a comfortable downward gaze without the loss of correct posture.

Adolescent↗

Information and communication technology among undergraduate dental students in Finland.

Use of information and communication technology (ICT) is rapidly increasing in medical and dental education. The aim of the present study was to determine the knowledge, skills and opinions of dental undergraduate students regarding ICT and to analyze possible shifts in the acquisition of these resources. For these purposes a survey of all undergraduate dental students at the University of Oulu, Finland, was conducted during the spring term 2000. All the students in the 5 years of study (n = 140) were asked to answer a questionnaire presented during a lecture or demonstration. An overall response rate of 95% was achieved. The frequencies and percentage distributions of the items were analyzed separately for each year (1-5). All the students in the faculty are provided with personal e-mail addresses at the beginning of their studies and special emphasis has been laid on the utilization of their ICT knowledge and skills. An overwhelming majority of the students, more than 95%, judged themselves to have good or satisfactory skills in word processing, but only a slight majority considered that they could manage some advanced operating system functions. Use of ICT services was high, as about 60% of the students used e-mail and one-third WWW services daily. Literature retrieval was widely employed, so that almost 80% of the students had used literature databases (including Ovid Medline and collections of electronic full-text articles), which were introduced and provided by the Medical Library when the students were in their second year. More than 50% had received educational material in electronic form often or sometimes, and almost 80% had communicated by e-mail with a faculty teacher. A clear trend (P < 0.05) was found for the younger students to use ICT services in general and for educational purposes more often than the older ones. In conclusion, e-mail and WWW have been widely adopted for both private and educational purposes by dental students in Finland and are employed together with WWW-based medical and dental publication databases. The younger students have more interest in ICT and better skills, which presents a challenge for dental education in the future.

Computer Literacy↗

Cortical activation during spoken-word segmentation in nonreading-impaired and dyslexic adults.

We used magnetoencephalography to elucidate the cortical activation associated with the segmentation of spoken words in nonreading-impaired and dyslexic adults. The subjects listened to binaurally presented sentences where the sentence-ending words were either semantically appropriate or inappropriate to the preceding sentence context. Half of the inappropriate final words shared two or three initial phonemes with the highly expected semantically appropriate words. Two temporally and functionally distinct response patterns were detected in the superior temporal lobe. The first response peaked at approximately 100 msec in the supratemporal plane and showed no sensitivity to the semantic appropriateness of the final word. This presemantic N100m response was abnormally strong in the left hemisphere of dyslexic individuals. After the N100m response, the semantically inappropriate sentence-ending words evoked stronger activation than the expected endings in the superior temporal cortex in the vicinity of the auditory cortex. This N400m response was delayed for words starting with the same two or three first few phonemes as the expected words but only until the first evidence of acoustic-phonetic dissimilarity emerged. This subtle delay supports the notion of initial lexical access being based on phonemes or acoustic features. In dyslexic participants, this qualitative aspect of word processing appeared to be normal. However, for all words alike, the ascending slope of the semantic activation in the left hemisphere was delayed by approximately 50 msec as compared with control subjects. The delay in the auditory N400m response in dyslexic subjects is likely to result from presemantic-phonological deficits possibly reflected in the abnormal N100m response.

Acoustic Stimulation↗

The effect of a tilting seat on back, lower back and legs during sitting work.

The purpose of this study was to examine the possible effects of a tilting seat on the back, lower back and legs. Ten healthy male subjects aged 22-28 performed word-processing operations while sitting on a chair for one hour under two different seating conditions: the rocking condition and the fixed condition. While the subjects were performing the task, measurements of lower leg swelling were taken using bioelectrical impedance plethysmography, and pain scores were recorded every five min for the neck, shoulders, back, lower back, hips and legs. Electromyograms (EMGs) of the back and lower back (at Th5-6, Th8-9, L1-2 and L3-4) were recorded every sec. In addition, the subjects were videotaped while using the rocking seat, in order to analyze the angle and frequency of seat tilting. At the end of the experiment, the subjects were asked to evaluate the two conditions with respect to localized fatigue and operational efficiency. There was no significant difference in lower leg swelling between the two conditions. EMGs were significantly different at Th5-6, Th8-9 and L1-2 between the two conditions. The rocking condition generated greater EMGs at Th5-6 and L1-2, whereas the fixed condition produced greater EMGs at Th8-9. The pain scores for the neck, shoulders, back and lower back were higher under the fixed condition, while those for the buttocks were higher under the rocking condition. The average tilting frequency was as low as 25.2 times per hour, with 15.6 times per hour for tilting angles ranging from 1 to 2 degrees, and 9.6 times per hour for tilting angles exceeding 2 degrees. As for the subjective evaluations of localized fatigue, seven of the ten subjects preferred the rocking condition, while two preferred the fixed condition and one subject had no preference. Thus, there was a significant difference in the subjective evaluations of the two chairs. These findings suggest that the rocking condition, in contrast to the fixed seating condition, reduced back and lower back pain as a result of its tilting capability. The results of EMGs suggest that the rocking condition reduced back and lower back pain by increasing the overall muscle activity of the back and lower back. The leg impedance measurements showed no effect of the rocking condition on the leg swelling, as compared with the fixed condition.

Adult↗

Update on cochlear implantation.

Cochlear implants are computerized devices that partially replace the transduction and encoding functions of the cochlea. Over the past 20 years studies have demonstrated that cochlear implants are safe and effective, with modern computer-based multichannel devices providing open-set word understanding for the majority of implanted postlingually deafened adults as well as pre- and postlingually deafened children. Advances in word processing strategy have led to ever-improving word recognition skills and recent studies have demonstrated that oral language develops in congenitally deaf children who use cochlear implants.

Adult↗

Hypnotic susceptibility and verbal automaticity: automatic and strategic processing differences in the Stroop color-naming task.

The original hypothesis of Dixon, Brunet, and Laurence (1990) that highly hypnotizable (HH) subjects process words more automatically than do low hypnotizable (LH) subjects was retested in a paradigm that separated strategic from automatic processes in the Stroop color-naming task. The words red and blue preceded a color patch that was red or blue. Subjects were told that the word predicted the opposite color 75% of the time. Automatic and strategic processes were assessed by varying the interstimulus interval (ISI) between the word and the color patch. Both HH and LH subjects showed significant strategic effects (faster incongruent-trial, color-naming reaction times than congruent-trial reaction times at ISIs over 400 ms), but only HH subjects showed significant automaticity (significantly faster congruent-trial reaction times than incongruent-trial reaction times at 16.7 ms, the lowest ISI).

Adult↗

Frequency of uncommon abbreviations in medical journals.

Although the use of abbreviations not understood by the average reader is discouraged by journal editors, I nevertheless found that 43% of 147 articles published during June 1993 in eight general and surgical journals contained uncommon abbreviations. In 26 (18%) of the 147 articles, all the abbreviations and their explanatory decoding words appeared at the front of the article, either in the abstract or in the first paragraph. This up front position makes easier the reader's back-search. In 37 other articles (25%), at least one uncommon abbreviation was decoded somewhere in the body of the article. In 21 articles (14%) the uncommon abbreviations appeared in the concluding or summating paragraph(s) and the explanatory decoding words were buried in the body of the article, thus making difficult the reader's back-search. Corrective action might include (1) editorial and peer review enforcement of the "no nonstandard abbreviation" policy, which is easily done with computerized word processing; (2) tabulation of all abbreviations with their decoding words either just below the abstract at the front of the article or just above the bibliography at the rear; or (3) expansion of each abbreviation in a footnote at the bottom of the appropriate page.

Abbreviations as Topic↗

Making sense out of jargon: a neurolinguistic and computational account of jargon aphasia.

OBJECTIVE: To identify the cognitive and neuroanatomic bases of neologistic jargon aphasia with spared comprehension and production of written words. METHODS: Detailed analysis of performance across experiments of naming, reading, writing, repetition, and word/picture matching by a 68-year-old woman (J.B.N.) served to identify which cognitive mechanisms underlying naming and word comprehension were impaired. J.B.N.'s impairments were then simulated by selectively "lesioning" a computer model of word production that has semantic, word form, and subword phonologic levels of representation (described by Dell in 1986). RESULTS: In comprehension experiments, J.B.N. made far more errors with spoken word input than with written word or picture input (chi-square = 40-59; df = 1; p < 0.0001) despite intact auditory discrimination. In naming experiments (with picture, definition, or tactile input), J.B.N. made far more errors in spoken output relative to written output (chi-square = 14-56; df = 1; p < 0.0001). These selective impairments of spoken word processing were simulated by reducing connection strength between word-level and subword-level phonologic units but maintaining full connection strength between word-level and semantic units in Dell's model. The simulation yielded a distribution of error types that was nearly identical to that of J.B.N., and her CT and MRI scans showed a small subarachnoid hemorrhage in the left sylvian fissure without infarct. Cerebral angiogram showed focal vasospasm in sylvian branches of the left middle cerebral artery. CONCLUSION: Focal left perisylvian dysfunction can result in a highly selective "disconnection" between word-level and subword-level phonologic representations manifest as neologistic jargon aphasia with intact understanding and production of written words.

Aged↗

Selective attention in perceptual adjustments to voice.

The effects of perceptual adjustments to voice information on the perception of isolated spoken words were examined. In two experiments, spoken target words were preceded or followed within a trial by a neutral word spoken in the same voice or in a different voice as the target. Over-all, words were reproduced more accurately on trials on which the voice of the neutral word matched the voice of the spoken target word, suggesting that perceptual adjustments to voice interfere with word processing. This result, however, was mediated by selective attention to voice. The results provide further evidence of a close processing relationship between perceptual adjustments to voice and spoken word recognition.

Attention↗

[A test of a hypothesis of automatic phonological processing of Kanji words].

This paper aims to examine a hypothesis that phonological processing should occur in Japanese Kanji words as well as in Kana words, but automatic in Kanji words. In Experiment 1, subjects performed concurrent articulation or finger tapping during a semantic processing task of Kana words with 2 to 4 phonemes, for which phonological processing should be indispensable. Concurrent articulation was found to eliminate the phoneme number effect found in the control condition, but finger tapping was not. This result indicates the effectiveness of concurrent articulation in articulatory suppression. In Experiment 2, the materials were changed to Kanji words, for which phonological processing had been supposed to be dispensable, and subjects performed the same task. The results showed no phoneme number effect even in the control condition, and the reaction time in the concurrent articulation condition was delayed significantly. These results suggest the existence of automatic phonological processing of Kanji words. Finally, the pertinence of this hypothesis was confirmed by applying it to the explanations of 3 kinds of Japanese dyslexia.

Adult↗

On pure word deafness, temporal processing, and the left hemisphere.

Pure word deafness (PWD) is a rare neurological syndrome characterized by severe difficulties in understanding and reproducing spoken language, with sparing of written language comprehension and speech production. The pathognomonic disturbance of auditory comprehension appears to be associated with a breakdown in processes involved in mapping auditory input to lexical representations of words, but the functional locus of this disturbance and the localization of the responsible lesion have long been disputed. We report here on a woman with PWD resulting from a circumscribed unilateral infarct involving the left superior temporal lobe who demonstrated significant problems processing transitional spectrotemporal cues in both speech and nonspeech sounds. On speech discrimination tasks, she exhibited poor differentiation of stop consonant-vowel syllables distinguished by voicing onset and brief formant frequency transitions. Isolated formant transitions could be reliably discriminated only at very long durations (> 200 ms). By contrast, click fusion threshold, which depends on millisecond-level resolution of brief auditory events, was normal. These results suggest that the problems with speech analysis in this case were not secondary to general constraints on auditory temporal resolution. Rather, they point to a disturbance of left hemisphere auditory mechanisms that preferentially analyze rapid spectrotemporal variations in frequency. The findings have important implications for our conceptualization of PWD and its subtypes.

Adult↗

The influence of sublexical and lexical representations on the processing of spoken words in English.

Previous research suggests that sublexical and lexical representations are involved in spoken word recognition. The current experiment examined when sublexical and lexical representations are used in the processing of real words in English. The same set of words varying in phonotactic probability/neighbourhood density was presented in three different versions of a same-different matching task: (1) mostly real words as filler items, (2) an equal number of words and nonsense words as filler items and (3) mostly nonsense words as filler items. The results showed that lexical representations were used in version 1 of the same-different matching task to process the words, whereas sublexical representations were used in version 3 of the same-different matching task to process the words. Finally, in version 2 of the same-different matching task individual variation was observed in the form of distinct sublexical and lexical biases. Implications for the processing of spoken words are discussed.

Cognition↗

Semantic and spatial components of selective attention.

Semantic and spatial effects on selective processing were examined. A prime presented 250 ms or 1,000 ms before a pair of masked words was related to 1 of the words on 1/3 of the trials. Although Experiments 1 and 2 required report of both words, processing was selective; typically, just 1 word could be reported. In Experiment 1, reported words were more often top words, showing spatial selectivity, and more often words related to the prime, showing semantic selectivity. Experiment 2 included to-be-ignored peripheral cues 50 ms before the pair. Related words were reported more often at both delays, and cuing produced an additive benefit at 1,000 ms. Experiment 3 required report of just the cued word and included 100-ms cues. Cued words were reported more often, especially at 1,000 ms and with 100-ms cues, but semantic selectivity also occurred. Selectivity via semantic priming and via location reflect separate attentional mechanisms.

Attention↗

Oral language deficits in dyslexic children: weaknesses in working memory and verbal planning.

This paper focuses on the relationships among language processing (word- and sentence-level), working memory, and verbal/nonverbal linguistic output. The study examined oral language abilities in a group of 26 French-speaking dyslexic children, compared to two control groups (26 normally developing age-matched children and 26 normally developing younger children). The experimental procedure consisted of tasks involving auditory memory skills (digit span, unfamiliar word repetition, sentence repetition), word retrieval (with semantic, phonological and grammatical criteria), and sentence processing (with verbal and act-out production). The major findings reveal that (a) compared with their age-mates, the dyslexic children exhibited a significant deficit affecting all tasks; and (b) the dyslexic children and the younger controls performed similarly on several tasks. The results are consistent with the processing limitation hypothesis and suggest that the core deficit is the formulation of cognitive plans from auditory input to verbal output.

Child↗

Words and sentences: event-related brain potential measures.

Interactions between sentences and the individual words that comprise them are reviewed in studies using the event-related brain potential (ERP). Results suggest that, for ambiguous words preceded by a biasing sentence context, context is used at an early stage to constrain the relevant sense of a word rather than select among multiple active senses. A study comparing associative single-word context and sentence-level context also suggests that sentence context influences the earliest stage of semantic analysis, but that the ability to use sentence context effectively is more demanding of working memory than the ability to use single-word contexts. Another indication that sentence context has a dramatic effect on single-word processing was the observation that high- and low-frequency words elicit different ERPs at the beginnings of sentences but that this effect is suppressed by a meaningful sentence context.

Evoked Potentials↗

Visual field effects for processing content and function words.

This study investigated the processing of content and function words when input to the left vs right hemispheres. For both lexical decision and naming there was a larger RVF advantage for function as compared to content words: function words were processed more slowly than content in the LVF, but not in the RVF. These results do not replicate the previous report of Bradley and Garrett, Neuropsychologia 21, 155-159, 1983, and provide some support for the view that function words are less accessible to the right hemisphere. In a second experiment, there was no difference in VF asymmetry when acceptability judgments were required for function vs content word phrases. Grammaticality judgments, of any sort, may be predominantly processed in the left hemisphere.

Female↗