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Video evaluation for mastication validation in persons with Down's syndrome.

This article reports the second stage of a validation process. It investigates the discriminatory ability of three video indicators of mastication for a group of people with Down's syndrome, representing a target group with neurological disabilities. The variables were generated through video recordings of 11 adults with Down's syndrome and 12 healthy subjects eating four natural foods varying in hardness. The collected variables were masticatory time, number of masticatory cycles, and number of open masticatory cycles. The analytical approach attempts to test four hypotheses exploring the variations of the video indicators according to food hardness for both groups. It was demonstrated that masticatory time and the number of masticatory cycles have very strong, positive correlations and the number of open masticatory cycles has a fair, positive correlation with the food hardness rankings for both groups. Video evaluation of the test variables using real foods in people with Down's syndrome was found to be a valid means of evaluating aspects of their masticatory function.

Adult↗

Quality improvement in laparoscopic radical prostatectomy for pT2 prostate cancer: impact of video documentation review on positive surgical margin.

PURPOSE: We correlated intraoperative video documentation and pathology findings to understand the mechanisms by which positive surgical margins occur and improve the surgical technique. MATERIALS AND METHODS: Between January 2003 and May 2004, 240 consecutive patients underwent laparoscopic radical prostatectomy, of whom 180 had pT2 prostate cancer and represent the population of this study. After the first 90 patients (group 1) we started a quality assurance study, analyzing intraoperative video recordings and correlating them with pathology findings in patients with a positive margin. The cancer characteristics and positive margin rate were compared between the first 90 patients and the subsequent 90 after the study was initiated (group 2). RESULTS: Of the 12 cases of positive surgical margins studied the video review helped identify 8 with a technical error. In all 4 cases in which a technical error could not be identified the positive margin site was at the distal apex. The most frequent identifiable mechanism by which positive margins occurred was a capsular tear during neurovascular bundle dissection. The 2 groups were comparable in regard to preoperative cancer characteristics and total tumor volume. In patients who underwent bilateral nerve sparing the positive margin rate was 10.6% in group 1 and 5.4% in group 2 (p = 0.18). All positive margins in group 2 involved the prostatic apex. CONCLUSIONS: Quality assurance efforts through pathological and intraoperative documentation review can help decrease the positive margin rate, particularly in organ confined disease. However, eradicating positive margins at the distal prostatic apex remains a challenge.

Humans↗

A change of the physicians' understanding of the encounter parallels competence development.

Patients today complain that physicians do not listen. There is a need to improve the professional competence in the patient encounter. According to theory, competence is a result of how people perceive their work. Observation and reflection can improve the competence. The aim of this study was to investigate if physicians can develop a more patient-centred consultation style by an experienced-based specialist course and how such a development is related to the physicians understanding of the task. The physicians video recorded consultations and reflected on these. The video consultations were analysed with a time study and Pendleton et al.'s consultation schedule [Pendleton D, Schoefield T, Tate P, Havelock P. The consultation: an approach to learning and teaching. Oxford: Oxford University Press, 1984.]. Before-after questions were answered. The study indicates that seven out of 10 physicians participating in the course had developed a patient-centred attitude and acted according to it. The time study gave ambiguous results. This study implicates that it is possible to initiate competence development by influencing the understanding of the encounter.

Adult↗

The identification of family members' contribution to patients' care in the intensive care unit: a naturalistic inquiry.

The admission of a patient to an intensive care unit (ICU) is recognized as being a stressful experience for their families. Many studies have focused on the needs of families within ICU, but few have highlighted the unique contribution that family members make towards patient care and recovery. Using a naturalistic approach, data were collected through observation, video recording, in-depth interviewing and reflective video analysis to explore the processes and factors underpinning families' contribution to patient care. The findings can be grouped into three themes: getting to know the patient through the family, family contribution to care and the nurses' role in supporting families of ICU patients. Families can have a very positive influence on the patient's care and recovery from ICU, but both the family members, and in turn the nursing staff, need to be supported appropriately if this valuable contribution to patient care is to be maximized and maintained.

Attitude of Health Personnel↗

Video controlled M-mode biometry.

To increase the accuracy of intraocular lens power calculation, an interface between an ultrasonic A-scanning device and a personal computer was created, allowing for an on-line interpretation of the ultrasonogram in an M-mode fashion. On the same computer display, a video recording of the movements of the transducer probe relative to the eye was inserted to obtain simultaneous information on the external alignment of the transducer probe. The precision of the experimental set-up in the measurement of intraocular distances was compared with conventional A-scanning procedures run in automatic mode. The video controlled M-mode biometry was found easy to operate and to result in reproducible axial length determination: The median value of the standard deviation was found to be below 0.04 mm as compared to a value of about 0.10 mm with conventional equipment. We concluded that video controlled M-mode biometry has great potential in the endeavour to increase the accuracy of intraocular lens calculation.

Anterior Chamber↗

Locomotor behaviours and respiratory pattern of the Mediterranean fin whale (Balaenoptera physalus).

Twenty-four Mediterranean fin whales were tracked in open sea with a method based on the assessment of the animal differential position in respect of the observer's absolute position aboard a vessel, with the concomitant recording of the respiratory activity. Short distance video recording was also performed in two whales, permitting the simultaneous determination of single breath expiratory (TE) and inspiratory (TI) durations. In the 24 whales swimming at an average velocity of 1.39 (0.47) m.s(-1) [mean (SD), range: 0.62-2.44 m.s(-1)], 2068 breaths organized in 477 respiratory cycles were observed. Each cycle entailed a prolonged apnoea dive phase [225 (91) s, Tdive) followed by a period near the surface [62 (28) s, surfacing], during which a series of breaths [4.6 (1.8)] was performed at short intervals. On the basis of track length and swimming velocity, two groups of animals were devised differing for convolution of the course (p<0.001), extension of ranging territory (p<0.01) and horizontal swimming velocity (p<0.05), which may represent two distinct behaviours. A possibly general mechanism of control of breathing in cetaceans was found, consistent with a model of constant tidal volume and variable respiratory frequency. Coherently with this model, TE was independent of TI or Tdive, in line with a passive expiration, while TI appeared to be negatively correlated with Tdive (p<0.05), otherwise suggesting, similarly with terrestrial mammals, a significant role of hypercapnic stimulation. The estimated O2 consumption of about 150 l.min(-1) is in line with the general allometric regression for mammals and corresponds to an energetic expenditure of 85-95 kJ.kg(-1).day(-1).

Animals↗

Competition for total mixed diets fed for ad libitum intake using one or four cows per feeding station.

When dairy cow facilities are being designed, a limited feeding area might be profitable and recommendable if the increased competition for feed does not harm the welfare of the animals or affect production negatively. An experiment was conducted at the University Cattle Research Centre (Uppsala, Sweden) to investigate the performance of individual cows as well as groups of cows. Treatments used 1 or 4 cows per feeding station with a total mixed diet fed for ad libitum intake. The feeding stations were troughs placed on electronic balances and were 1.08 m wide. Sixteen dairy cows were divided into two groups and were studied in an experiment with a change-over design so that each group went through each treatment twice. A computerized feeding system automatically recorded consumption data for feed and water. Video recordings were used to study the social dominance order, the level of aggression at the feeding area, and the time budget of the cows. The mean feed intake increased slightly, but the number of visits to the feeding stations did not change at the higher level of competition. The cows, however, spent significantly less time eating and increased their consumption rate when the competition level increased. The number of displacements at the feeding stations increased dramatically. Cows of low social rank were much more frequently displaced while eating. The effects of dominance value, age, eating rate, and energy requirement of the cows are presented.

Animal Feed↗

[Ocular counter-rolling after prolonged alteration in the direction of gravity].

To investigate the dynamics of otolith and oculomotor function, we subjected volunteers to a lateral body tilt for a period of two hours and analyzed ocular counter-rolling. Six healthy adult volunteers were roll-tilted along the naso-occipital axis at a speed of 0 degree/sec. from the 0 degree earth vertical position to the 90 degrees lateral tilt position. After two hours, the volunteers were returned to the 0 degree earth vertical position. Ocular counter-rolling was recorded using an infrared CCD camera. The video recordings were made in the dark while the volunteers had their eyes open. Recordings were obtained (1) as the volunteers was moved from the 0 degree earth vertical position to the 90 degrees lateral position, (2) 5 minutes after reaching the lateral position, (3) during the roll-back from the 90 degrees lateral position to the 0 degree upright position, two hours after the lateral tilt loading, and (4) 5 minutes after reaching the final upright position. The occurrence of ocular counter-rolling between the 0 degree upright position and the 30 degrees tilt position was confirmed during both roll movements from 0 degree to 90 degrees and from 90 degrees to 0 degree. The counter-rolling was most noticeable between the 0 degree and the 30 degrees positions. No differences in ocular counter-rolling during the roll-tilt and the roll-back situations were observed. These results indicate that the two-hour lateral tilt position did not produce any functional changes in the hair cells and/or the otolith-oculomotor system. All of the subjects exhibited ocular counter-counter-rolling during the initial stage of their roll-back to a normal upright position. This phenomenon might result from the additional bending of the hairs by inertia during the initiation of the backward roll motion.

Adult↗

Physicians' accuracy and interrator reliability for the diagnosis of unstable meniscal tears in patients having osteoarthritis of the knee.

OBJECTIVE: To determine clinicians' accuracy and reliability for the clinical diagnosis of unstable meniscus tears in patients with symptomatic osteoarthritis of the knee. DESIGN: A prospective cohort study. SETTING: A single tertiary care centre. PATIENTS: One hundred and fifty-two patients with symptomatic osteoarthritis of the knee refractory to conservative medical treatment were selected for prospective evaluation of arthroscopic debridement. INTERVENTION: Arthroscopic debridement of the knee, including meniscal tear and chondral flap resection, without abrasion arthroplasty. OUTCOME MEASURES: A standardized assessment protocol was administered to each patient by 2 independent observers. Arthroscopic determination of unstable meniscal tears was recorded by 1 observer who reviewed a video recording and was blinded to preoperative data. Those variables that had the highest interobserver agreement and the strongest association with meniscal tear by univariate methods were entered into logistic regression to model the best prediction of resectable tears. RESULTS: There were 92 meniscal tears (77 medial, 15 lateral). Interobserver agreement between clinical fellows and treating surgeons was poor to fair (kappa < 0.4) for all clinical variables except radiographic measures, which were good. Fellows and surgeons predicted unstable meniscal tear preoperatively with equivalent accuracy of 60%. Logistic regression modelling revealed that a history of swelling and a ballottable effusion were negative predictors. A positive McMurray test was the only positive predictor of unstable meniscal tear. "Mechanical" symptoms were not reliable predictors in this prospective study. The model was 69% accurate for all patients and 76% for those with advanced medial compartment osteoarthritis defined by a joint space height of 2 mm or less. CONCLUSIONS: This study underscored the difficulty in using clinical variables to predict unstable medial meniscal tears in patients with pre-existing osteoarthritis of the knee. The lack of interobserver agreement must be overcome to ensure that the findings can be generalized to other physician observers.

Adult↗

Video analysis: a method of assessing changes in preverbal and early linguistic communication after cochlear implantation.

As the age of cochlear implantation in children decreases, there is an increasing need for methods to monitor the preverbal and early linguistic development of children fitted with these devices. One method that has been used successfully to monitor children wearing acoustic amplifying hearing aids entails the video recording over time of child-adult interactions in a conversational setting, and the subsequent methodical analysis of various aspects of the interaction. These aspects include eye contact, turn taking, autonomy, and auditory processing. The same method has been applied to children wearing the Nucleus 22-electrode cochlear implant system. An overview is given of the video analysis results for a group of 10 children studied from a period before implantation up to one year postimplantation. The results illustrate group changes in the various measures due to the provision of auditory information by the cochlear implant, plus the scatter of individual data. It is concluded that early indications of progress over time generally predict the level of functioning achieved at 12 months postimplantation. The method provides essential objective information, which enables discrete changes in behavior to be monitored realistically. Two case studies are presented to illustrate the application of the video analysis method to obtain information for clinical management of children with cochlear implants.

Child↗

A model-based image-matching technique for three-dimensional reconstruction of human motion from uncalibrated video sequences.

In many situations, e.g. sports injuries, three-dimensional kinematics cannot be obtained with traditional lab methods. However, if methods for reconstructing motion patterns from video sequences were available, our understanding of injury mechanisms could be improved. The aim of this study was to assess the accuracy of a new model-based image-matching technique for human motion reconstruction from one or more uncalibrated video sequences, using traditional motion analysis as a gold standard. A laboratory trial was conducted with one test subject performing jogging and side step cutting, while being filmed with three ordinary video cameras. This provided three single camera matchings, three double camera matchings and one triple camera matching for each of the motions. The test subject wore 33 reflective skin markers and was filmed with a seven-camera, 240 Hz motion analysis system. Root mean square (RMS) hip and knee flexion/extension angle differences were less than 12 degrees for all the matchings. Estimates for ad-/abduction (<15 degrees) and internal/external rotation (<16 degrees) were less precise. RMS velocity differences up to 0.62 m/s were found for the single camera matchings, but for the triple camera matching the RMS differences were less than 0.13 m/s for each direction. In conclusion, a new model-based image-matching technique has been developed, that can be used to estimate temporal joint angle histories, velocities and accelerations from uncalibrated video recordings. The kinematic estimates, in particular for center of mass velocity and acceleration, are clearly better when two or more camera views are available. This method can potentially be used to arrive at more precise descriptions of the mechanisms of sports injuries than what has been possible without elaborate methods for three-dimensional reconstruction from uncalibrated video sequences, e.g. for knee injuries.

Biomechanical Phenomena↗

Value and limitations of seizure semiology in localizing seizure onset.

Seizure semiology has been the foundation of clinical diagnosis of seizure disorders. This article discusses the value and the limitations of behavioral features of seizure episodes in localizing seizure onset. Studies have shown that some semiologic features of seizures are highly accurate in the hemispheric lateralization and lobar localization of seizures. There is good agreement between blinded reviewers in lateralizing video-recorded seizures in temporal lobe and extratemporal lobe epilepsies. However, seizure semiology alone should not be used to determine the site of seizure onset. Each semiologic feature may falsely localize seizure onset. Seizure semiology in some patients may signify the site of seizure propagation rather than origination. Moreover, seizure semiology may not be as reliable in multifocal epilepsies as it is in unifocal epilepsies. Many semiologic features of seizures of adults are often missing in seizures of children. Seizure semiology should be analyzed and integrated with EEG and neuroimaging data to localize the seizure focus. A sample of the recorded seizures should be shown to the patient's relatives or friends to verify that it is representative of habitual seizures.

Disease Progression↗

[Videostroboscopy of the larynx].

The technique of telescopic videostroboscopy permits simultaneous audio and video recording of a laryngoscopy and a subsequent stroboscopy of the larynx during the same examination. The combination of laryngoscopy and stroboscopy is very favorable not only because stroboscopy is not possible in all pathological cases, but also because each of both methods can reveal facts the other does not. In addition, the possibility of playing back the video tapes as often as desirable is an important diagnostic and pedagogic advantage.

Adult↗

Lana chimpanzee learns to count by "NUMATH": a summary of a videotaped experimental report.

This paper summarizes a videotaped presentation (Rumbaugh, Savage-Rumbaugh, Hopkins, Washburn, & Runfeldt, 1987) of computerized training programs whereby an adult female chimpanzee, Lana (Pan troglodytes), learned to use a joystick to remove from a screen the number of boxes appropriate to the value of a randomly selected Arabic numeral 1, 2, or 3. Initial training provided a variety of cues, both numeric and otherwise, to support correct performance. Across software programs, all cues other than numeric ones were deleted. In the final test, Lana was correct on over 80% of trials in which there was no residual feedback of intratrial events and where only her memory of those events could provide the cue to indicate that she had removed boxes in accordance with the value of the target numbers and should terminate the trial. The tape is narrated and consists of video recordings of Lana's performance on each software program.

Animals↗

Effect of electrolytes on bubble coalescence in columns observed with visualization techniques.

Bubble coalescence and the effect of electrolytes on this phenomenon have been previously studied. This interfacial phenomenon has attracted attention for reactor design/operation and enhanced oil recovery. Predicting bubble coalescence may help prevent low yields in reactors and predict crude oil recovery. Because of the importance of bubble coalescence, the objectives of this work were to improve the accuracy of measuring the percentage of coalescing bubbles and to observe the interfacial gas-liquid behavior. An experimental setup was designed and constructed. Bubble interactions were monitored with a visualization setup. The percentage of air bubble coalescence was 100% in distilled water, about 50% in 0.1 M sodium chloride (NaCl) aqueous solution, and 0% in 0.145 M NaCl aqueous solution. A reduction of the contact gas-liquid area was observed in distillate water. The volume of the resulting bubble was the sum of the original bubble volumes. Repulsion of bubbles was observed in NaCl solutions exceeding 0.07 M. The percentage of bubble coalescence diminishes as the concentration of NaCl chloride increases. High-speed video recording is an accurate technique to measure the percentage of bubble coalescence, and represents an important advance in gas-liquid interfacial studies.

Electrolytes↗

Teaching the teachers at Leicester: the general practice approach.

This article describes a systematic induction programme devised for newly appointed lecturers in general practice. The programme aims to help them develop skills in both teaching and assessment and to encourage self-appraisal. The progress of participants is monitored by direct observation and video-recording with the regular provision of feedback a prominent characteristic. All the lecturers have found participation in the programme an effective way of developing their teaching capabilities.

Education, Medical↗

Fountaindale Communication Project.

Voice output communication aids are expensive in terms of initial outlay and ongoing staff support. Further efficacy research and innovative methodologies are necessary to explore the role of this technology in facilitating communication and to develop more informed, effective therapeutic approaches to service delivery in this area. A research project is reported that evaluates the progress of four children using voice output communication aids. The children's progress has been video-recorded at six monthly intervals and analysed using conversation analysis and feedback questionnaires. Initial observations and implications for service delivery are discussed.

Cerebral Palsy↗