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PubMedDate not supplied

Practical evaluation of standard-based low-cost video conferencing in telemedicine and epidemiological applications.

The results of the evaluation of use of low-cost video conferencing systems (VCSs) in telemedicine is presented. Applications sharing, a new feature of these systems, recently has allowed high-quality computer-supported collaborative work (CSCW). The video conferencing (VCing) equipment used was Intel ProShare 200 v2.0a. It is representative of other low-cost VCSs. The areas of application are epidemiology and telemedicine (orthopaedics and radiology). Potential end users filled out 58 evaluation questionnaires concerning user profiles, contents and benefits of the sessions, organizational aspects, user friendliness, user acceptance, cost effectiveness, technical and multipoint related aspects. Although the end users had a lot of computer experience, their knowledge in VCSs was rather limited. The users assessed the system capable of being integrated into routine work, despite a high organizational impact. The VCS is user friendly, application sharing being used in almost every session. Audio quality was not always sufficient. The remote video was sufficient, as was the quality of medical images such as CT, MRI or X-ray. The user acceptance of the system was high. Multipoint sessions require a structured protocol to be effective. Some technical problems with MCUs (Multipoint Control Units) occurred. The use of low-cost standard VCSs in telemedicine is advisable and is a good substitute for real meetings.

Cost-Benefit Analysis↗

PubMed1999

Effective poultry programming in the next century. User fees for land grant universities-the Scottish experience.

In 1987 the U.K. government required the organizations through which it provided an extension service to adopt a cost-recovery system. Generally, this requirement applied to all advice with the exception of advice given in the areas of welfare, pollution control, and farm diversification. The Scottish Agricultural College (SAC), which provided advice in Scotland at this time, adopted a strategy aimed at maintaining its extension base in Scotland. The strategy was based on reforming the Extension Service into an Advisory Service. Whereas clients had received information from the Extension Service free of charge, fees were charged for most services offered by the Advisory Service (there were a few exceptions for which the government paid). In order to develop the service, the advisers started servicing contracts outside Scotland, firstly in the U.K. and, more recently, across the world. As the industry has changed, so the service offered has changed, with increasing reliance being put upon specialist advisers who provide advice not to the farm staff but to company technologists.

Agriculture↗

PubMed2005

The use of carers' and users' expectations of services (CUES) in an epidemiological survey of need.

BACKGROUND AND METHOD: This study surveyed need in a group of psychiatric patients in Gloucester, using a new instrument, the CUES. Keyworkers gave out questionnaires to all patients with psychosis in contact with specialist services. A total of 148 forms were anonymously completed, with a response rate of 37% of the mental health services caseload. RESULTS: 53.5 to 83.2% of patients were satisfied and 61.5 to 89.6% expressed their experiences 'as good as' a normative statement across the 16 domains. There was mostly 'moderate' agreement between satisfaction and normative questions by Kappa correlations, although responses to normative questions tended to be about 10% higher. Extensive free text responses were subject to content analysis, demonstrating needs across a wide range of health, social and leisure areas, many of which were not directly linked to the adequacy or otherwise of psychiatric treatment. CONCLUSIONS: The results imply that the CUES may be of value at an individual level to aid in care planning, and also have some value in aggregated form to benchmark user experiences of services.

Adult↗

PubMedDate not supplied

Nurses' experiences of a post-RN course by computer mediated conferencing: friendly users.

Students who had completed a post-RN university nursing course by computer mediated conferencing participated in a qualitative study examining their experience with this mode of delivery of distance education. All seven students reported that great difficulties with the technology at the beginning of the course caused them extreme frustration. However, despite the lack of user-friendliness of the technology, the students participated actively, functioned as a group, developed strong personal ties, and mastered the required content via the computer. These multiple-role women appreciated the ability to participate in discussion without the requirement of being at a specific place at a particular time. Having overcome the initial difficulties with the technology, all the students were enthusiastic about the method and would sign up for another computer mediated course.

Adult↗

PubMed2005

Digital microfluidics using soft lithography.

Although microfluidic chips have demonstrated basic functionality for single applications, performing varied and complex experiments on a single device is still technically challenging. While many groups have implemented control software to drive the pumps, valves, and electrodes used to manipulate fluids in microfluidic devices, a new level of programmability is needed for end users to orchestrate their own unique experiments on a given device. This paper presents an approach for programmable and scalable control of discrete fluid samples in a polydimethylsiloxane (PDMS) microfluidic system using multiphase flows. An immiscible fluid phase is utilized to separate aqueous samples from one another, and a novel "microfluidic latch" is used to precisely align a sample after it has been transported a long distance through the flow channels. To demonstrate the scalability of the approach, this paper introduces a "general-purpose" microfluidic chip containing a rotary mixer and addressable storage cells. The system is general purpose in that all operations on the chip operate in terms of unit-sized aqueous samples; using the underlying mechanisms for sample transport and storage, additional sensors and actuators can be integrated in a scalable manner. A novel high-level software library allows users to specify experiments in terms of variables (i.e., fluids) and operations (i.e., mixes) without the need for detailed knowledge about the underlying device architecture. This research represents a first step to provide a programmable interface to the microfluidic realm, with the aim of enabling a new level of scalability and flexibility for lab-on-a-chip experiments.

Computers↗

PubMed1999

A comparison of language achievement in children with cochlear implants and children using hearing aids.

English language achievement of 29 prelingually deaf children with 3 or more years of cochlear implant (CI) experience was compared to the achievement levels of prelingually deaf children who did not have such CI experience. Language achievement was measured by the Rhode Island Test of Language Structure (RITLS), a measure of signed and spoken sentence comprehension, and the Index of Productive Syntax (IPSyn), a measure of expressive (signed and spoken) English grammar. When the CI users were compared with their deaf age mates who contributed to the norms of the RITLS, it was found that CI users achieved significantly better scores. Likewise, we found that CI users performed better than 29 deaf children who used hearing aids (HAs) with respect to English grammar achievement as indexed by the IPSyn. Additionally, we found that chronological age highly correlated with IPSyn levels only among the non-CI users, whereas length of CI experience was significantly correlated with IPSyn scores for CI users. Finally, clear differences between those with and without CI experience were found by 2 years of post-implant experience. These data provide evidence that children who receive CIs benefit in the form of improved English language comprehension and production.

Achievement↗

PubMed1997

Experiences with computed radiography: can we afford the cost?

In summary, we believe that the CR system adds significantly to our department. The film quality is superb, and the learning curve for radiologists to adapt to the added noise from anatomic structures on chest radiographs is short. The inherent film latitude and flexibility add a new dimension to interpretation and film management. System costs are significantly greater than for traditional film-screen systems. Recurring operational costs are yet to be determined but certainly will be greater with the shorter expected life span of the imaging plates. Film cost savings cannot be a justifiable reason for using a CR system. Film cost savings must await the ultimate conversion to soft imaging through networks and workstations. Technical issues are significant and require structured and specific courses of study and workshops for users before implementation of the CR system. As CR owners, we were frustrated by the lack of published protocols and guides for the CR user. Most of our experiences were learned in practice, and we believed published guides would be useful for both existing users and future buyers. Careful attention to accuracy, histogram selection, positioning, collimation, and patient data input is critical to the success of CR. The persistent lack of a CR information system interface has led to occasional labeling errors and requires added vigilance on the part of both the technologist and the radiologist. Other important user problems we experienced with CR included the RVS. When images are reprinted from the RVS, they can be printed on 10 x 14 inch (26 x 36 cm) film only. Images that were acquired on the larger cassettes are printed on this smaller film, minified by one third from the original size. Minified images are unacceptable to our orthopedic colleagues. Networking problems have still not been resolved, and this resolution remains an important goal. The manipulation and transfer of images without loss of data were major reasons for our switch to electronic imaging and have still not been achieved. Unique image artifacts were encountered, as were new parameters to judge the quality of an image. The final issue is radiation dose. To assign dose reduction as an attribute of CR would be misleading. We have found that in many instances the reverse is true. Many examinations have required more radiation exposure than traditional film-screen techniques. At the least, to harvest the benefits of CR one must significantly alter technical exposure factors and understand how the system operates. The problems we encountered were not minor. Our technologists and radiologists and the Fuji personnel have put in many hours to implement and optimize our system. The image quality is superb, and we continue to work on the important networking and archival goals.

Aged↗

PubMed1982

Peer perceptions of geriatrics wearing hearing aids.

This study investigated whether geriatric observers having varying amounts of experience with hearing aid users formed different initial impressions of their peers who were shown in three conditions of hearing aid use, and whether the size of the aid affected their ratings. Stimuli consisted of 36 photographic slides, three each of six men and six women shown wearing: (a) a body type hearing aid, (b) a post-auricular type aid, and (c) no aid. The stimuli were presented to 72 geriatric observers drawn from three groups: (a) 24 with no prior hearing aid experience, (b) 24 having some experience with a spouse, family member, or close friend who wore an aid, and (c) 24 who were hearing aid users. The observers rated the 12 geriatrics on a 16-item semantic differential. Factor analysis of the ratings resulted in three factors: achievement, personality, and appearance. Analyses of variance revealed that none of the three observer groups rated the geriatrics lower on any of the three factors when they were shown wearing hearing aids. These findings indicate that these peer observers did not perceive a "hearing aid effect" for the geriatric hearing aid wearers.

Aged↗

PubMed1997

Hormone replacement therapy among Danish women aged 45-65 years: prevalence, determinants, and compliance.

OBJECTIVE: To study the prevalence and determinants of consultation for climacteric complaints and the prescription, commencement, and continuation of hormone replacement therapy (HRT) among women aged 45-65 years. METHODS: A cross-sectional national survey was conducted in Denmark in November 1994 among 1459 women. A total of 1015 women (response rate 69.6%) agreed to participate and provided questionnaire data. RESULTS: Of the women who had experienced climacteric complaints, 67.4% (95% confidence interval [CI] 63.3, 71.4%) had consulted a physician. More women consulted if their complaints were severe rather than slight-to-moderate (odds ratio [OR] 6.46). Within the total sample, 33.4% of the women had been prescribed HRT at some time, and 94.1% of these women actually had started the treatment. Of the women who started the treatment, 66.3% reported that they still were using HRT at the time of the survey. The current HRT use rate among all respondents was 18.4% (95% CI 16.1, 20.9%). Women with severe or slight-to-moderate climacteric complaints more often reported having had HRT prescribed than women without complaints (OR 23.2 and 5.80, respectively). Furthermore, women who had had a hysterectomy with bilateral oophorectomy more often reported use than women with an intact uterus (OR 10.0). Hormone replacement therapy prescription was associated only weakly with osteoporosis concerns (OR 1.74). Its continuation decreased with age, was higher after hysterectomy and among women who regularly participated in sports or exercised, but was not (P > .05) related to osteoporosis concerns. Age-specific HRT continuation rates decreased among users who reported withdrawal bleeding (P < .05) but not among users who did not experience such bleeding (P > .05). CONCLUSION: In this survey, HRT had been used by one in three women at menopause, mainly for the alleviation of climacteric complaints and hardly ever because of osteoporosis concerns. Although it might be expected that HRT users who are concerned about developing osteoporosis in later life would be likely to continue the treatment for longer than other users, the study results did not bear this out. Continuation depended mainly on having had a hysterectomy and participation in sports and was higher among users with an intact uterus if they had had no withdrawal bleeding.

Age Factors↗

PubMed1997

Evaluating the options for developing databases to support research-based medicine at the NHS Centre for Reviews and Dissemination.

The paper presents the results of a questionnaire survey and user interface review group experiments to determine the value and ease of use of the Database of Abstracts of Reviews of Effectiveness (DARE) and the NHS Economic Evaluations Database (NEED). The results are interpreted with other recent studies of the use of electronic databases, including the NHS Research Register User Requirements Specification. The study found that most frequent users of the DARE database tend to use the CD-ROM version. Librarians were found to have the greatest awareness of the databases, with relatively low levels of use by operational NHS Staff. Untrained users found the online databases difficult to access and had erroneous perceptions of the database content which were only realised when queries returned unexpected answers. Experienced users of online information systems tended to want more sophisticated search facilities than inexperienced users. Nearly all users in the review groups wanted to access the databases in conjunction with other information sources, such as the Cochrane Library, Medline and the ACP Journal Club, highlighting the need for cross organisational strategies for the dissemination of research-based information.

CD-ROM↗

PubMed1994

Platelet alpha-granule release in cocaine users.

BACKGROUND: Cocaine use has been associated with arterial occlusion resulting from platelet-rich thrombi and with an accelerated, often atypical atherosclerotic lesion that could be ascribed to platelet activation and platelet alpha-granule release. METHODS AND RESULTS: Using a flow cytometric method to quantitate the percent of circulating activated platelets in whole blood (those that express the alpha-granule membrane protein P-selectin), we found that 5 of 25 samples from 12 long-term cocaine users had a baseline level of circulating activated platelets > 3 SD (range, 19% to 60%) above the mean (4.4 +/- 3.7%, mean +/- 1 SD) for 85 nonusers (sample n = 130). This subset resulted in a significantly higher mean baseline level of circulating activated platelets (11.8 +/- 14.4%) for all cocaine users (P = .01). By contrast, cocaine and its metabolites, at concentrations documented as obtainable during in vivo cocaine use (10(-7) to 10(-5) mol/L), had no effect on in vitro platelet activation or aggregation, either directly or in concert with platelet agonists. However, in experiments in which cocaine users received blinded infusions of placebo or cocaine, the mean percent of circulating activated platelets rose significantly (P < .05) after infusion of either placebo (peak 77 +/- 31%) or cocaine (peak 65 +/- 28%), the latter at doses resulting in peak plasma cocaine levels averaging < 10(-6) mol/L. CONCLUSIONS: Long-term cocaine use in some subjects is intermittently associated with high basal levels of circulating platelets that have undergone alpha-granule release. The inability of cocaine and its metabolites at concentrations of 10(-7) to 10(-5) mol/L to cause platelet P-selectin expression in vitro in this study, coupled with the acute increase in circulating activated platelets observed in vivo after either cocaine or placebo infusion, suggests that in vivo platelet alpha-granule release associated with cocaine use may occur through indirect rather than direct effects of the drug.

Blood Platelets↗

PubMed1990

Adolescent drug abuse: problem and prospectus.

Available research indicates that adolescent alcohol and drug abuse is a multi-level phenomenon which seriously affects the functioning of the individual, his (her) interpersonal experiences, the school and society in terms of problem behaviour and other psychopathological and social dysfunctional correlates. Data of the prevalence and problems of abuse obtained by a survey of high school students indicate a high prevalence of alcohol and marijuana used combinationally and heavy users are likely to experience psychopathological consequences, including personal problems of identity diffusion, self-esteem, a motivational syndrome, and acute brain syndrome, interpersonal problems with peers and parents and problems with school participation and the law: adolescents who abuse alcohol and marijuana in combination at the same time are likely to have severe, chronic, and progressive psychopathological problems. Presented is an integrated prospectus for a comprehensive, integrated, longitudinal prevention and intervention program on the community level including components of a holistic information and education programme with a prevention focus; counselling through a student assistance programme of intervention, evaluation and treatment; and rehabilitation through alternative schools. Also included are recommendations for further study and a caution of the implications of drug research and programme for adolescents.

Adolescent↗

PubMed1990

A computer program for the statistical analysis of cancer inhibition/promotion experiments.

The computer program discussed and presented in this paper is designed for the statistical analysis of data from cancer inhibition/promotion experiments that involve Type I censoring. The theoretical derivation of the method is described in Biometrics 43 (1987) 525-534 and Appl. Math. Lett. 1 (1988) 197-201. Turbo Pascal is used to compute maximum likelihood estimates of the parameters of interest: the mean number of induced tumors per animal, and the mean time to tumor detection. The program conducts a likelihood ratio test to determine if there is an overall experiment effect, and allows the user to select options to isolate the pair(s) of groups contributing to the experiments effect, to isolate group differences in terms of tumor number and growth rate, and to graph 95% confidence regions for the vector parameter of interest.

Animals↗

PubMed2004

End-user perceptions of a computerized medication system: is there resistance to change?

Public mandate to control cost, while improving quality of service, leads health care administrators to look to information technology for innovative solutions. This case study of acute care registered nurses in a public hospital focuses on experiences of the end-users of a computerized medication system. Data was obtained by in-depth interviews and observation performed in the clinical setting. Findings fell into five challenging issues to the end-user and health care administration: end-user perceptions of inadequate training, negative experiences of implementation, perceived deficiencies in quality of technology, perceptions of lack of participatory design and a ensuing circumvention of the new system. Emphasis is on the relationship of the findings to the quality of public health care administration.

Attitude to Computers↗

PubMed1998

RETRACTED: An integrated analysis of nonmenstrual adverse events with Implanon.

This integrated analysis evaluates nonmenstrual adverse events, blood pressure, and body weight changes during the use of the single-rod etonogestrel-containing contraceptive implant, Implanon; these aspects are compared for Implanon and Norplant, the six-capsule implant containing levonorgestrel. Overall, 47% of Implanon users had drug-related adverse events, whereas in the comparative studies the figure for those using Implanon (61%) was slightly lower than that for Norplant users (69%). In all Implanon studies, 12 of 1716 women (0.7%) were affected by serious adverse events that were considered drug related. In comparative studies three of the 689 Implanon users (0.4%) and one of 689 Norplant users (0.1%) had such experiences. The most frequently reported drug-related adverse events were acne, breast pain, headache and weight gain. The adverse events that most often caused discontinuation of Implanon were weight gain and acne. The development or aggravation of acne was a frequent adverse event (in 18.5% of Implanon and 22.3% of Norplant users in the comparative studies) but individual studies indicated that there were also many subjects whose acne improved during implant use. There were gradual increases in body weight over time but these may be only partly attributable to implant use and partly attributable to normal increases over time.

Acne Vulgaris↗

PubMed1993

The families of problem drug users: a study of 50 close relatives.

The research described in this paper resulted from a collaborative multi-centre study of the relatives of problem drug users involving six practitioners and researchers, in four centres within the south-west of England. The objective of this research was simply to interview 50 close relatives of identified problem drug users, with the identification occurring through clinics and self-help groups. Quantitative and qualitative results show that large numbers of these relatives reported many negative experiences. The partners of illicit drug users reported both more and differently patterned problematic behaviours than those of prescribed tranquillizer users. The partners of illicit users also reported different problems to those of the parents. Relatives reported many negative effects in terms of how they viewed the drug user, and how the experiences had affected their health. They also described various coping mechanisms, and the extent of the support which they had received. The results are discussed in terms of coping, and similarity with research into the families of problem drinkers.

Adaptation, Psychological↗

PubMed1979

The Spartacus telethesis: manipulator control studies.

This paper describes a method and an experimental system permitting a severely handicapped operator, such as a quadriplegic, to control a telemanipulator. These developments form the first phase in the design of the Spartacus "telethesis". This is a manipulator system specifically developed for a quadriplegic person. Manipulator control experiments which are discussed concern four quadriplegics who have used the experimental system for significant periods of time. The present system is a laboratory simulation of a telethesis, consisting of an industrial manipulator controlled by a mini-computer. A flexible semi-sequential control and a variety of transducers permit the system to be adapted to the individual user. Thus far, the experiments performed have shown the feasibility for the four quadriplegics to effectively control a telemanipulator, using head movements and some remaining arm movements in various modes of end-point control. In particular, a position control and a "piloting" type of velocity control, both with the addition of some force limitation, have given promising results.

Activities of Daily Living↗

PubMedDate not supplied

Cocaine use patterns and overdose.

The question of how cocaine overdoses are related to preferred routes of cocaine administration and other aspects of cocaine use patterns is sufficiently complex that very little information is available on it. Even the most extensive information on cocaine overdoses, that of the Drug Abuse Warning Network, is severely limited for purposes of examining this topic. Findings are presented from a 1988-1990 study of a purposive but demographically diverse sample of 699 crack and other cocaine users in Miami, 349 of them interviewed in residential treatment and 350 interviewed on the street. Among these respondents: a history of cocaine overdose is extremely common; overdose episodes do not commonly motivate treatment entry and in some populations are relatively unlikely to result in an emergency room visit; cocaine overdose is less associated with crack smoking than with snorting or intravenous (IV) use, whereas IV use is especially likely to result in overdose; and the street and treatment samples are strikingly different in regard to drug use patterns, overdose history, changes some users made to use patterns as a result of overdose experiences, and reasons given by other users for not making such changes.

Adolescent↗