Echographie devant une metrorragie du premier trimestre de ...

African Journals Online (AJOL)

Echographie devant une metrorragie du premier trimestre de grossesse sur uterus bicorne a issue favorable. Vaginal bleeding in a pregnant woman with a bicornuate uterus, ultrasound finding and favourable outcome.

Validating the TeleStroke Mimic Score: A Prediction Rule for Identifying Stroke Mimics Evaluated Over Telestroke Networks.

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Ali, Syed F; Hubert, Gordian J; Switzer, Jeffrey A; Majersik, Jennifer J; Backhaus, Roland; Shepard, L Wylie; Vedala, Kishore; Schwamm, Lee H

2018-03-01

Up to 30% of acute stroke evaluations are deemed stroke mimics, and these are common in telestroke as well. We recently published a risk prediction score for use during telestroke encounters to differentiate stroke mimics from ischemic cerebrovascular disease derived and validated in the Partners TeleStroke Network. Using data from 3 distinct US and European telestroke networks, we sought to externally validate the TeleStroke Mimic (TM) score in a broader population. We evaluated the TM score in 1930 telestroke consults from the University of Utah, Georgia Regents University, and the German TeleMedical Project for Integrative Stroke Care Network. We report the area under the curve in receiver-operating characteristic curve analysis with 95% confidence interval for our previously derived TM score in which lower TM scores correspond with a higher likelihood of being a stroke mimic. Based on final diagnosis at the end of the telestroke consultation, there were 630 of 1930 (32.6%) stroke mimics in the external validation cohort. All 6 variables included in the score were significantly different between patients with ischemic cerebrovascular disease versus stroke mimics. The TM score performed well (area under curve, 0.72; 95% confidence interval, 0.70-0.73; P mimic during telestroke consultation in these diverse cohorts was similar to its performance in our original cohort. Predictive decision-support tools like the TM score may help highlight key clinical differences between mimics and patients with stroke during complex, time-critical telestroke evaluations. © 2018 American Heart Association, Inc.

Home-based tele-assisted robotic rehabilitation of joint impairments in children with cerebral palsy.

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Chen, Kai; Ren, Yupeng; Gaebler-Spira, Deborah; Zhang, Li-Qun

2014-01-01

A portable rehabilitation robot incorporating intelligent stretching, robot-guided voluntary movement training with motivating games and tele-rehabilitation was developed to provide convenient and cost-effective rehabilitation to children with cerebral palsy (CP) and extend rehabilitation care beyond hospital. Clinicians interact with the patients remotely for periodic evaluations and updated guidance. The tele-assisted stretching and active movement training was done over 6-week 18 sessions on the impaired ankle of 23 children with CP in their home setting. Treatment effectiveness was evaluated using biomechanical measures and clinical outcome measures. After the tele-assisted home robotic rehabilitation intervention, there were significant increases in the ankle passive and active range of motion, muscle strength, a decrease in spasticity, and increases in balance and selective control assessment of lower-extremity.

A software communication tool for the tele-ICU.

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Pimintel, Denise M; Wei, Shang Heng; Odor, Alberto

2013-01-01

The Tele Intensive Care Unit (tele-ICU) supports a high volume, high acuity population of patients. There is a high-volume of incoming and outgoing calls, especially during the evening and night hours, through the tele-ICU hubs. The tele-ICU clinicians must be able to communicate effectively to team members in order to support the care of complex and critically ill patients while supporting and maintaining a standard to improve time to intervention. This study describes a software communication tool that will improve the time to intervention, over the paper-driven communication format presently used in the tele-ICU. The software provides a multi-relational database of message instances to mine information for evaluation and quality improvement for all entities that touch the tele-ICU. The software design incorporates years of critical care and software design experience combined with new skills acquired in an applied Health Informatics program. This software tool will function in the tele-ICU environment and perform as a front-end application that gathers, routes, and displays internal communication messages for intervention by priority and provider.

Efficiency evaluation of treatment of atrial rhythm disorders on the left ventricular function

International Nuclear Information System (INIS)

Alberini, J.L.; Mansour, H.; Victor, F.; De Place, C.; Carre, F.; Daubert, J.C.; Borguet, P.

1997-01-01

The goal of this prospective study was to evaluate the development and evolution of the LV function after treatment of atrial arrhythmias, evolving for at least three months, associated to an alteration of the LV function. Twelve patients (61.3 ± 13.9 years) were divided into two groups: Gr1 - treatment by cardio-version or radiofrequency; Gr2 - pharmacological treatment or ablation of atrial-ventricular junction and implantation of a cardiac pacemaker. An examination including ECG, Holter, test-to-effort, echocardiography, cavitary angio-scintigraphy was effectuated 48 h and 6 weeks after reduction. A net clinic amelioration was observed in the evolution, confirmed by results of the echocardiographic and angio-scintigraphic examinations (with a correlation coefficient of 0.87). In exchange, between the two examinations, there is no significant difference for the test-to-effort with medium or maximal cardiac frequencies and the diameters or tele-diastolic and tele-systolic volumes for echography. After the multi-variable analysis the initial angio-scintigraphic measurement of the LV function is a good predictive factor in ameliorating the LV function in patients maintained in sinusal rhythm. In conclusion, the angio-scintigraphy permits predicting the treatment efficiency of the atrial arrhythmias on the LV function

A low cost tele-imaging platform for developing countries

Directory of Open Access Journals (Sweden)

Kokou eADAMBOUNOU

2014-09-01

Full Text Available Purpose: To design a low cost tele-imaging method allowing real time tele-ultrasound expertise, delayed tele-ultrasound diagnosis and tele-radiology between remote peripherals hospitals and clinics (patient centres and university hospital centres (expert centre.Materials and Methods: A system of communication via internet (IP camera and remote access software enabling transfer of ultrasound videos and images between two centres, allows a real time tele-radiology expertise in the presence of a junior sonographer or radiologist at the patient centre. In the absence of a sonographer or radiologist at the patient centre, a 3D reconstruction program allows a delayed tele-ultrasound diagnosis with images acquired by a lay operator (e.g. midwife, nurse, technician. The system was tested both with high and low bandwidth. The system can further accommodate non-ultrasound tele-radiology (conventional radiography, mammography and computer tomography for example. The system was tested on 50 patients between CHR Tsevie in Togo (40km from Lomé-Togo and 4500km from Tours-France and CHU Campus at Lomé and CHU Trousseau in Tours.Results: A real time tele-expertise was successfully performed with a delay of approximately 1.5 seconds with an internet bandwidth of around 1Mbps (IP Camera and 512kbps (remote access software. A delayed tele-ultrasound diagnosis was also performed with satisfactory results. The transmission of radiological images from the patient centre to the expert centre was of adequate quality. Delayed tele-ultrasound and tele-radiology was possible even in the presence of a low bandwidth internet connection. Conclusion: This tele-imaging method, requiring nothing by readily available and inexpensive technology and equipment, offers a major opportunity for telemedicine in developing countries.

The duplex-Doppler colour echography of the scrotum and testicles in adults and boys. III. Assessment of chronic scrotal pathology

International Nuclear Information System (INIS)

Rangel-Villalobos, E.; Benjumeda, A.; Jimenez-Castellanos, R.; Linares, A.; Blanco, A

1999-01-01

To show the most outstanding findings from the chronic scrotal pathology of adults and boys, determining the benefits of the Doppler echography in the diagnostical valuation of the different cases analysed. 40 patients (19 adults and 21 boys) with chronic scrotal symptomatology were examined using a B mode echography followed by a colour duplex-Doppler (CDD) echography with a lineal 7.5 MHz transducer. We compared the findings obtained with those corresponding to the contralateral testicle and, depending on the pathology, we co-related them with surgery, pathologic anatomy or clinical-echograph evolution. The pathology found was very varied, it was distributed into: varicoceles (12), testicle tumours (9), extra-testicle tumours (4) and miscellaneous pathology (13). Two patients showed no changes, currently remaining asymptomatic. The treatment was surgical in 28 (70%) of the patients and traditional in the others. The B mode echography played a fundamental role in the diagnosis of chronic scrotal pathology, which in the majority of the cases was definitive, being completed with the application of the Doppler echograph to analyse the vascular condition of the lesions and the anatomical structures. The diagnosis utility of the CDD echograph in chronic scrotal pathology is controversial, it is not specific for testicle tumors, it is very useful for variocele and complementary, tp the B mode echograph for miscellaneous pathology. (Author) 31 refs

Tele-Pediatric Intensive Care for Critically Ill Children in Syria.

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Ghbeis, Muhammad Bakr; Steffen, Katherine M; Braunlin, Elizabeth A; Beilman, Gregory J; Dahman, Jay; Ostwani, Waseem; Steiner, Marie E

2017-12-12

Armed conflicts can result in humanitarian crises and have major impacts on civilians, of whom children represent a significant proportion. Usual pediatric medical care is often disrupted and trauma resulting from war-related injuries is often devastating. High pediatric mortality rates are thus experienced in these ravaged medical environments. Using simple communication technology to provide real-time management recommendations from highly trained pediatric personnel can provide substantive clinical support and have a significant impact on pediatric morbidity and mortality. We implemented a "Tele-Pediatric Intensive Care" program (Tele-PICU) to provide real-time management consultation for critically ill and injured pediatric patients in Syria with intensive care needs. Over the course of 7 months, 19 cases were evaluated, ranging in age from 1 day to 11 years. Consultation questions addressed a wide range of critical care needs. Five patients are known to have survived, three were transferred, five died, and six outcomes were unknown. Based on this limited undertaking with its positive impact on survival, further development of Tele-PICU-based efforts with attention to implementation and barriers identified through this program is desirable. Even limited Tele-PICU can provide timely and potentially lifesaving assistance to pediatric care providers. Future efforts are encouraged.

The Global Education Network for Retinopathy of Prematurity (Gen-Rop): Development, Implementation, and Evaluation of A Novel Tele-Education System (An American Ophthalmological Society Thesis)

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Chan, R.V. Paul; Patel, Samir N.; Ryan, Michael C.; Jonas, Karyn E.; Ostmo, Susan; Port, Alexander D.; Sun, Grace I.; Lauer, Andreas K.; Chiang, Michael F.

2015-01-01

Purpose: To describe the design, implementation, and evaluation of a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmology residents. Methods: A secure Web-based tele-education system was developed utilizing a repository of over 2,500 unique image sets of ROP. For each image set used in the system, a reference standard ROP diagnosis was established. Performance by ophthalmology residents (postgraduate years 2 to 4) from the United States and Canada in taking the ROP tele-education program was prospectively evaluated. Residents were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Accuracy and reliability of ROP diagnosis (eg, plus disease, zone, stage, category) were determined using sensitivity, specificity, and the kappa statistic calculations of the results from the pretest and posttest. Results: Fifty-five ophthalmology residents were provided access to the ROP tele-education program. Thirty-one ophthalmology residents completed the program. When all training levels were analyzed together, a statistically significant increase was observed in sensitivity for the diagnosis of plus disease, zone, stage, category, and aggressive posterior ROP (P<.05). Statistically significant changes in specificity for identification of stage 2 or worse (P=.027) and pre-plus (P=.028) were observed. Conclusions: A tele-education system for ROP education is effective in improving diagnostic accuracy of ROP by ophthalmology residents. This system may have utility in the setting of both healthcare and medical education reform by creating a validated method to certify telemedicine providers and educate the next generation of ophthalmologists. PMID:26538772

Tele-education in South Africa.

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Mars, Maurice

2014-01-01

Telemedicine includes the use of information and communication technology for education in the health sector, tele-education. Sub-Saharan Africa has an extreme shortage of health professionals and as a result, doctors to teach doctors and students. Tele-education has the potential to provide access to education both formal and continuing medical education. While the uptake of telemedicine in Africa is low, there are a number of successful and sustained tele-education programs. The aims of this study were (i) to review the literature on tele-education in South Africa, (ii) describe tele-education activities at the University of KwaZulu-Natal (UKZ-N) in South Africa, and (iii) review the development of these programs with respect to current thinking on eHealth project implementation. A literature review of tele-education in South Africa was undertaken. The development of the tele-education services at UKZ-N from 2001 to present is described. The approaches taken are compared with current teaching on eHealth implementation and a retrospective design-reality gap analysis is made. Tele-education has been in use in South Africa since the 1970s. Several forms of tele-education are in place at the medical schools and in some Provincial Departments of Health (DOH). Despite initial attempts by the National DOH, there are no national initiatives in tele-education. At UKZ-N, a tele-education service has been running since 2001 and appears to be sustainable and reaching maturity, with over 1,400 h of videoconferenced education offered per year. The service has expanded to offer videoconferenced education into Africa using different ways of delivering tele-education. Tele-education has been used in different forms for many years in the health sector in South Africa. There is little hard evidence of its educational merit or economic worth. What it apparent is that it improves access to education and training in resource constrained settings. The development of local and

The Global Education Network for Retinopathy of Prematurity (Gen-Rop): Development, Implementation, and Evaluation of A Novel Tele-Education System (An American Ophthalmological Society Thesis).

Science.gov (United States)

Chan, R V Paul; Patel, Samir N; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Port, Alexander D; Sun, Grace I; Lauer, Andreas K; Chiang, Michael F

2015-01-01

To describe the design, implementation, and evaluation of a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmology residents. A secure Web-based tele-education system was developed utilizing a repository of over 2,500 unique image sets of ROP. For each image set used in the system, a reference standard ROP diagnosis was established. Performance by ophthalmology residents (postgraduate years 2 to 4) from the United States and Canada in taking the ROP tele-education program was prospectively evaluated. Residents were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Accuracy and reliability of ROP diagnosis (eg, plus disease, zone, stage, category) were determined using sensitivity, specificity, and the kappa statistic calculations of the results from the pretest and posttest. Fifty-five ophthalmology residents were provided access to the ROP tele-education program. Thirty-one ophthalmology residents completed the program. When all training levels were analyzed together, a statistically significant increase was observed in sensitivity for the diagnosis of plus disease, zone, stage, category, and aggressive posterior ROP (Peducation system for ROP education is effective in improving diagnostic accuracy of ROP by ophthalmology residents. This system may have utility in the setting of both healthcare and medical education reform by creating a validated method to certify telemedicine providers and educate the next generation of ophthalmologists.

Virtual rapid response: the next evolution of tele-ICU.

Science.gov (United States)

Hawkins, Carrie L

2012-01-01

The first of its kind in the Veterans Affairs (VA) system, the Denver VA Medical Center's tele-intensive care unit (ICU) program is unique because it is entirely nurse driven. A nontraditional tele-ICU model, the program was tailored to meet the needs of rural veterans by using critical care nursing expertise in Denver, Colorado. An experienced CCRN-certified nurse manages the system 24 hours a day, 7 days a week, from Eastern Colorado Health Care System. The virtual ICU provides rapid response interventions through virtual technology. This tele-ICU technology allows for a "virtual handshake" by nursing staff at the start of the shift and a report on potential patient issues. Clinical relationships have been strengthened between all 5 VA facilities in the Rocky Mountain Region, increasing the likelihood of early consultation at the onset of clinical decline of a patient. In addition, the tele-ICU nurse is available for immediate nursing consultation and support, coordinates point-to-point virtual consultation between physicians at the rural sites and specialists in Denver, and assists in expediting critical care transfers. The primary objectives for the tele-ICU program include improving quality and access of care to critical care services in rural sites, reducing community fee basis costs and frequency of transfers, and increasing collaboration and collegiality among nursing and medical staff in all Region 19's medical centers.

Primary epiploic appendicitis and echography findings

International Nuclear Information System (INIS)

Mederos Curbelo, Orestes Noel; Da Costa Fernandez, Jose Manuel; Jequin Savariego, Esther; Ramos Hernandez, Ricardo Ulises

2010-01-01

This is the case of a woman aged 55 presenting with localized acute abdominal pain in right inferior quadrant of 12 hours of course, leukocytosis and peritoneal reaction. The abdominal echography findings showed a supposed epiploitis but the pain intensity and persistence determined the surgical intervention. Epiploic acute appendicitis is a infrequent affection that must to be suspected in case of acute pain in inferior abdominal quadrants and imaging studies are essential for preoperative diagnosis. (author)

Data retention in Europe - the Tele2 case and beyond

DEFF Research Database (Denmark)

Jakobsen, Søren Sandfeld; Udsen, Henrik; Pedersen, Anja Møller

2018-01-01

Analyses the Court of Justice of the European Union's judgment in the "Tele2 case" and evaluates the impact of the judgment on national data retention regimes.......Analyses the Court of Justice of the European Union's judgment in the "Tele2 case" and evaluates the impact of the judgment on national data retention regimes....

Evaluation of tele-ultrasound as a tool in remote diagnosis and clinical management at the Amundsen-Scott South Pole Station and the McMurdo Research Station.

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Otto, Christian; Shemenski, Ron; Scott, Jessica M; Hartshorn, Jeanette; Bishop, Sheryl; Viegas, Steven

2013-03-01

Abstract Background: A large number of Antarctic stations do not utilize ultrasound for medical care. Regular use of ultrasound imaging at South Pole and McMurdo Stations first began in October 2002. To date, there has been no evaluation of medical events requiring ultrasound examination from this remote environment. Additionally, the importance of tele-ultrasound for clinical management in Antarctica has not yet been assessed. We therefore conducted a retrospective analysis of all ultrasound exams performed at South Pole and McMurdo Stations between October 2002 and October 2003. Radiology reports and patient charts were reviewed for pre- and post-ultrasound diagnosis and treatment. Sixty-six ultrasound exams were conducted on 49 patients. Of the exams, 94.0% were interpreted by the store-and-forward method, whereas 6.0% were interpreted in "real-time" format. Abdominal, genitourinary, and gynecology ultrasound exams accounted for 63.6% of exams. Ultrasound examination prevented an intercontinental aeromedical evacuation in 25.8% of cases, and had a significant effect on the diagnosis and management of illness in patients at South Pole and McMurdo research stations. These findings indicate that diagnostic ultrasound has significant benefits for medical care at Antarctic stations and that tele-ultrasound is a valuable addition to remote medical care for isolated populations with limited access to tertiary-healthcare facilities.

Application of Handheld Tele-ECG for Health Care Delivery in Rural India

Directory of Open Access Journals (Sweden)

Meenu Singh

2014-01-01

Full Text Available Telemonitoring is a medical practice that involves remotely monitoring patients who are not at the same location as the health care provider. The purpose of our study was to use handheld tele-electrocardiogram (ECG developed by Bhabha Atomic Research Center (BARC to identify heart conditions in the rural underserved population where the doctor-patient ratio is low and access to health care is difficult. The objective of our study was clinical validation of handheld tele-ECG as a screening tool for evaluation of cardiac diseases in the rural population. ECG was obtained in 450 individuals (mean age 31.49 ± 20.058 residing in the periphery of Chandigarh, India, from April 2011 to March 2013, using the handheld tele-ECG machine. The data were then transmitted to physicians in Postgraduate Institute of Medical Education and Research (PGIMER, Chandigarh, for their expert opinion. ECG was interpreted as normal in 70% individuals. Left ventricular hypertrophy (9.3% was the commonest abnormality followed closely by old myocardial infarction (5.3%. Patient satisfaction was reported to be ~95%. Thus, it can be safely concluded that tele-ECG is a portable, cost-effective, and convenient tool for diagnosis and monitoring of heart diseases and thus improves quality and accessibility, especially in rural areas.

Customer needs, expectations, and satisfaction with clinical neurophysiology services in Ireland: a case for tele-neurophysiology development.

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Fitzsimons, M; Ronan, L; Murphy, K; Browne, G; Connolly, S; McMenamin, J; Delanty, N

2004-01-01

Although equitable access to services should be based on need, geographical location of patients and their clinicians can give rise to inequalities in healthcare delivery. Development of tele-medicine services can improve equity of access. The specialty of Clinical Neurophysiology (CN), currently under-developed in Ireland provides an example of such potential. This study aimed to determine the needs, expectations, and satisfaction of CN customers, namely patients and referring clinicians. The goal was to examine geographical impediments to access that might be addressed by the introduction of tele-neurophysiology. Two customer surveys were conducted: CN referring clinicians and CN patients. Thirty-one North Western Health Board (NWHB) consultant clinicians responded to a postal survey. Distance and delays caused by long waiting lists were felt to deter or make CN referral irrelevant. Ninety-seven percent believed the lack of a local service negatively impacts on patient management and 93% would welcome the introduction of a tele-neurophysiology service. The geographical location of patient's residence and/or the location of the referring clinician's practice influenced waiting lists for CN. Fifty-eight (105/182) percent of patients living in a region with a CN service compared to 39% (50/128) of those living in a region with no service received an appointment within one month. In addition to the current insufficient CN service capacity in Ireland, these surveys highlighted geographical inequities. Tele-neurophysiology has the potential to speed-up diagnosis, result in more patients being appropriately investigated and be fairer to patients.

Usefulness of Doppler echography for the diagnosis of traumatic carotid thrombosis

International Nuclear Information System (INIS)

Joaquín Castillo Duany.Santiago de Cuba (Cuba))" data-affiliation=" (Hospital Militar Joaquín Castillo Duany.Santiago de Cuba (Cuba))" >Rodríguez Montero, Enri; Joaquín Castillo Duany.Santiago de Cuba (Cuba))" data-affiliation=" (Hospital Militar Joaquín Castillo Duany.Santiago de Cuba (Cuba))" >González Méndez, Melvis; Joaquín Castillo Duany.Santiago de Cuba (Cuba))" data-affiliation=" (Hospital Militar Joaquín Castillo Duany.Santiago de Cuba (Cuba))" >González López, Ariel; Joaquín Castillo Duany.Santiago de Cuba (Cuba))" data-affiliation=" (Hospital Militar Joaquín Castillo Duany.Santiago de Cuba (Cuba))" >Campa, Belkis Ortega de la; Joaquín Castillo Duany.Santiago de Cuba (Cuba))" data-affiliation=" (Hospital Militar Joaquín Castillo Duany.Santiago de Cuba (Cuba))" >Germán Meliz, Jorge L.

2015-01-01

Carotid artery system traumas are rare and show high mortality rates. The case of right internal carotid artery thrombosis caused by a gunshot injury in the neck was presented in this report to show evidence of the usefulness of Doppler echography in the medical practice for the early diagnosis of these lesions in spite of the fact that literature highlights angiography, nuclear magnetic resonance and angioresonance as the imaging studies of choice. This case confirmed that carotid thrombosis due to trauma has low incidence but it can not be ignored in the cervical región traumas. For these reasons, the neurological complications stemming from artery occlusion are frequent and Doppler echography turned to be very useful for the early diagnosis of this illness in a patient. (author)

A Low-Cost Tele-Presence Wheelchair System

OpenAIRE

Shen, Jiajun; Xu, Bin; Pei, Mingtao; Jia, Yunde

2016-01-01

This paper presents the architecture and implementation of a tele-presence wheelchair system based on tele-presence robot, intelligent wheelchair, and touch screen technologies. The tele-presence wheelchair system consists of a commercial electric wheelchair, an add-on tele-presence interaction module, and a touchable live video image based user interface (called TIUI). The tele-presence interaction module is used to provide video-chatting for an elderly or disabled person with the family mem...

Measuring tele-ICU impact: does it optimize quality outcomes for the critically ill patient?

Science.gov (United States)

Goran, Susan F

2012-04-01

To determine the relationship between tele-ICU (intensive care unit) implementations and improvement in quality measures and patient outcomes. Tele-ICUs were designed to leverage scarce critical-care experts and promised to improve patient quality. Abstracts and peer-reviewed articles were reviewed to identify the associations between tele-ICU programmes and clinical outcomes, cost savings, and customer satisfaction. Few peer-reviewed studies are available and many variables in each study limit the ability to associate study conclusions to the overall tele-ICU programme. Further research is required to explore the impact of the tele-ICU on patient/family satisfaction. Research findings are highly dependent upon the level of ICU acceptance. The tele-ICU, in collaboration with the ICU team, can be a valuable tool for the enhancement of quality goals although the ability to demonstrate cost savings is extremely complex. Studies clearly indicate that tele-ICU nursing vigilance can enhance patient safety by preventing potential patient harm. Nursing managers and leaders play a vital part in optimizing the quality role of the tele-ICU through supportive modelling and the maximization of ICU integration. © 2012 Blackwell Publishing Ltd.

Bauru School of Dentistry Tele-Health League: an educational strategy applied to research, teaching and extension among applications in tele-health.

Science.gov (United States)

Silva, Andressa Sharllene Carneiro da; Rizzante, Fabio Antonio Piola; Picolini, Mirela Machado; Campos, Karis de; Corrêa, Camila de Castro; Franco, Elen Caroline; Pardo-Fanton, Cássia de Souza; Blasca, Wanderléia Quinhoneiro; Berretin-Felix, Giédre

2011-01-01

Tele-health is more than an innovative alternative; it is an excellent tool that enables access to health and education in health, making it possible to minimize distances, optimize time and reduce costs. Based on these advantages, some Brazilian Universities have used these actions in strategies of education, research and extension, aiming at the application of Tele-health in Brazil. In that way, the Bauru School of Dentistry - University of São Paulo (FOB-USP) has applied the use of information and communication technologies in health by means of a "Tele-Health League" (TL), in order to diagnose, prevent and treat diseases, in addition to educate the population and health services. The present study aims to introduce the characteristics of the Tele-Health League of FOB-USP, as well as the development of its projects. The Tele-Health League consisted as a Diffusion Course approved by the Provost of Culture and Academic Extension of the University of São Paulo. It is composed as a large group enclosing professoriate coordinator, academician principal, contributing professors and league members, those, diversified between undergraduates students, graduated, health employees, technology and information areas. The participant members are evaluated by the presence frequency (minimum of 85%), and by the performance of tests and paperwork about the theoretical content provided. In four years of activities, the TLFOB-USP obtained a high satisfaction index (90%), an increased number of vacancies due to the interest to become a member, more commitment of the professors of the University and the accomplishment of association with other Brazilian leagues. It is emphasized that the approval percentage of the course results in approval from approximately half of its members. Also, it is important to identify and repair the causes related to the quitting of some members. The results showed that the TLFOB-USP members, adjoining to the professor's participants, develop projects

Bauru School of Dentistry Tele-Health League: an educational strategy applied to research, teaching and extension among applications in tele-health

Directory of Open Access Journals (Sweden)

Andressa Sharllene Carneiro da Silva

2011-12-01

Full Text Available Tele-health is more than an innovative alternative; it is an excellent tool that enables access to health and education in health, making it possible to minimize distances, optimize time and reduce costs. Based on these advantages, some Brazilian Universities have used these actions in strategies of education, research and extension, aiming at the application of Tele-health in Brazil. In that way, the Bauru School of Dentistry - University of São Paulo (FOB-USP has applied the use of information and communication technologies in health by means of a "Tele-Health League" (TL, in order to diagnose, prevent and treat diseases, in addition to educate the population and health services. Objective: The present study aims to introduce the characteristics of the Tele-Health League of FOB-USP, as well as the development of its projects. Material and Methods: The Tele-Health League consisted as a Diffusion Course approved by the Provost of Culture and Academic Extension of the University of São Paulo. It is composed as a large group enclosing professoriate coordinator, academician principal, contributing professors and league members, those, diversified between undergraduates students, graduated, health employees, technology and information areas. The participant members are evaluated by the presence frequency (minimum of 85%, and by the performance of tests and paperwork about the theoretical content provided. Results: In four years of activities, the TLFOB-USP obtained a high satisfaction index (90%, an increased number of vacancies due to the interest to become a member, more commitment of the professors of the University and the accomplishment of association with other Brazilian leagues. It is emphasized that the approval percentage of the course results in approval from approximately half of its members. Also, it is important to identify and repair the causes related to the quitting of some members. Conclusions: The results showed that the TLFOB

A secure and synthesis tele-ophthalmology system.

Science.gov (United States)

Wei, Zhuo; Wu, Yongdong; Deng, Robert H; Yu, Shengsheng; Yao, Haixia; Zhao, Zhigang; Ngoh, Lek Heng; Han, Lim Tock; Poh, Eugenie W T

2008-10-01

This paper describes a secure and synthesis ophthalmology telemedicine system, referred to as TeleOph. Under a Secure Socket Layer (SSL) channel, patient prerecorded data can be safely transferred via the Internet. With encrypted videoconference and white-board, the system not only supports hospital-to-clinic consultation, but also supplies hospital-tohospital joint discussion. Based on Directshow technology (Microsoft Corporation, Redmond, WA), video cameras connected to the computer by firewire can be captured and controlled to sample video data. By using TWAIN technology, the system automatically identifies networked still cameras (on fundus and slitlamp devices) and retrieves images. All the images are stored in a selected format (such as JPEG, DICOM, BMP). Besides offline-transferring prerecorded data, the system also supplies online sampling of patient data (real-time capturing from remote places). The system was deployed at Tan Tock Seng Hospital, Singapore and Ang Mo Kio, Singapore, where 100 patients were enrolled in the system for examination. TeleOph can be successfully used for patient consultation, and hospital joint discussion. Meanwhile, TeleOph can supply both offline and online sampling of patient data.

Tele-transmission of EEG recordings.

Science.gov (United States)

Lemesle, M; Kubis, N; Sauleau, P; N'Guyen The Tich, S; Touzery-de Villepin, A

2015-03-01

EEG recordings can be sent for remote interpretation. This article aims to define the tele-EEG procedures and technical guidelines. Tele-EEG is a complete medical act that needs to be carried out with the same quality requirements as a local one in terms of indications, formulation of the medical request and medical interpretation. It adheres to the same quality requirements for its human resources and materials. It must be part of a medical organization (technical and medical network) and follow all rules and guidelines of good medical practices. The financial model of this organization must include costs related to performing the EEG recording, operating and maintenance of the tele-EEG network and medical fees of the physician interpreting the EEG recording. Implementing this organization must be detailed in a convention between all parties involved: physicians, management of the healthcare structure, and the company providing the tele-EEG service. This convention will set rules for network operation and finance, and also the continuous training of all staff members. The tele-EEG system must respect all rules for safety and confidentiality, and ensure the traceability and storing of all requests and reports. Under these conditions, tele-EEG can optimize the use of human resources and competencies in its zone of utilization and enhance the organization of care management. Copyright © 2015. Published by Elsevier SAS.

Customized CT angiogram planning for intraoperative transesophageal echography-guided endovascular exclusion of thoracic aorta penetrating ulcer.

Science.gov (United States)

Piazza, Michele; Lupia, Mario; Grego, Franco; Antonello, Michele

2015-04-01

The technique is demonstrated in a 78-year-old man; the preoperative CT angiogram showed a descending thoracic aorta ulcer of 5.9 cm in maximum diameter and 3.8 cm longitudinal extension. A ZTEG-2P-36-127-PF (Cook Medical) single tubular endograft was planned to be deployed. From the preoperative CT angiogram we planned to land 4.7 cm above the midline of the descending thoracic aorta ulcer and 8.0 cm below. In the operating room, under radioscopic vision the centre of the transesophageal echography probe was used as marker to identify the correspondent midline of the descending thoracic aorta ulcer and a centimeter-sized pigtail catheter in the aorta was used to calculate the desired length above and below the ulcer midline. The endograft was introduced and placed in the desired position compared to the transesophageal echography probe and the catheter; under transesophageal echography vision the graft was finally deployed. The CT angiogram at 1 month showed the correct endograft position, descending thoracic aorta ulcer exclusion with no signs of endoleak. In selected cases, this method allows planning in advance safe stent graft positioning and deployment totally assisted by transesophageal echography, with no risk of periprocedural contrast-related renal failure and reduced radiation exposure for the patient and operators. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Interactive tele-education applied to a distant clinical microbiology specialization university course.

Science.gov (United States)

Andreazzi, Denise B; Rossi, Flávia; Wen, Chao L

2011-09-01

The microbiology laboratory provides a strategic support for infectious disease diagnosis and also alerts the medical community about bacterial resistance to antibiotics. The microbiologists' training is a challenge in Brazil, a country with an extensive territory, a diverse population, and disparity of resource allocation. The aim of this study was to implement an interactive tele-educational course in clinical microbiology to reach distant laboratory workers and to improve their professional skills. The course scientific content was defined according to competences associated, distributed in 560 h, with laboratory practices (knowledge matrix-contextual education). The 11-module course structure comprised 70% distance learning, 22% on campus (integrated modules), and 8% monographs. The group included 7 physicians and 21 microbiologists from 20 different Brazilian cities. The time flexibility and location were the two main reasons for student participation, thus decreasing absences to the workplace, different from the traditional teaching methodologies. The group performance was measured by monthly evaluations, and 1 year postcourse, the researcher visited their workplace. There was significant improvement in microbiological practices performed before compared with after group participation. Therefore, 76.9% of laboratory practices were modified because of the knowledge acquired in the course. Students showed behavioral changes in relation to performance in infection control as well as on the dissemination of their knowledge. This specialization course using distance education did not compromise the quality. This educational methodology represents an alternative to teach clinical microbiology to laboratory workers from remote hospitals, as a nationwide continuing educational strategy.

Breast Malignant Processes Echography at V. I. Lenin Hospital

International Nuclear Information System (INIS)

Tamayo Hernandez, Lissette; Aguilar Munnoz, Liliana; Estevez de la Torre, Elyanne; Ricardo Guerrero, Migdania; Rodriguez Infanzon, Olga; Hung Arroyo, Jose Manuel

2007-01-01

A descriptive and cross-sectional study was carried out in patients with a presumptive diagnosis of breast malignant processes . The patients came from the breast cancer consulting room at V. I. Lenin Hospital from January 2005 to December 2005. A breast ultrasound imaging was done aimed at deepening in the diagnosis which was predominant in pre- menopausal women , being the left breast external upper quadrant the most frequent site of localization. The most suggestive echography pattern of malignant processes was the image with changes in its echostructure, soft echos in its inner part and irregular edge were observed. According to the mammography results the most frequent presentation was the visualization of a thick breast of irregular edge with spicule formations. There was a diagnostic correspondence between the echogram and the mammography considering that this is an adequate method for the initial evaluation of breast malignant processes

Usefulness of intraoperative echography for resection of a insulinoma located in the head of pancreas

International Nuclear Information System (INIS)

Cepero Valdes, Manuel; Hernandez Rivero, Hanoi; Ugarte Moreno, Dayana; Chao Gonzalez, Lissette

2011-01-01

The insulinoma is the more frequent neoplasms among the neuroendocrine tumors of pancreas. The aim of present paper is to describe the clinical picture, laboratory and imaging examinations and the surgical features as well as the complications in a patient diagnosed with insulinoma without evidences by preoperative images. Surgery was prescribed on the base of clinical and analytic evidences of hypoglycemia and hyperinsulinism and the carrying out of an exploratory laparatomy without any lesion with direct palpation of pancreas. Intraoperative echography was used to locate a 0,8 cm nodule in the head of pancreas. After enucleation the only postoperative complication was a low-flow pancreatic fistula with a spontaneous remission. The histological diagnosis was a benign insulinoma. Patient had a clinical reversion of symptoms in addition to normalization of glycemia values, compared to those intraoperative. (author)

Tele-periodontics - Oral health care at a grass root level.

Science.gov (United States)

Avula, Haritha

2015-01-01

A new concept of tele-periodontics, which merges the innovative technology of telecommunications and the field of periodontics, is proposed. This new field of tele-periodontics will have an infinite potential where access to a specialist will be provided at a grass root level, enhancing effective delivery of therapy and information to the rural and under privileged areas. It would allow the specialist and the patient to interact either by video conferencing (real time) or through supportive information (store and forward) over geographic distances. Different probabilities of tele-periodontics such as tele consultation, tele training, tele education and tele support are also discussed in this paper.

Lessons from tele-emergency: improving care quality and health outcomes by expanding support for rural care systems.

Science.gov (United States)

Mueller, Keith J; Potter, Andrew J; MacKinney, A Clinton; Ward, Marcia M

2014-02-01

Tele-emergency services provide immediate and synchronous audio/video connections, most commonly between rural low-volume hospitals and an urban "hub" emergency department. We performed a systematic literature review to identify tele-emergency models and outcomes. We then studied a large tele-emergency service in the upper Midwest. We sent a user survey to all seventy-one hospitals that used the service and received 292 replies. We also conducted telephone interviews and site visits with ninety clinicians and administrators at twenty-nine of these hospitals. Participants reported that tele-emergency improves clinical quality, expands the care team, increases resources during critical events, shortens time to care, improves care coordination, promotes patient-centered care, improves the recruitment of family physicians, and stabilizes the rural hospital patient base. However, inconsistent reimbursement policy, cross-state licensing barriers, and other regulations hinder tele-emergency implementation. New value-based payment systems have the potential to reduce these barriers and accelerate tele-emergency expansion.

Remote tele-mentored ultrasound for non-physician learners using FaceTime: A feasibility study in a low-income country.

Science.gov (United States)

Robertson, Thomas E; Levine, Andrea R; Verceles, Avelino C; Buchner, Jessica A; Lantry, James H; Papali, Alfred; Zubrow, Marc T; Colas, L Nathalie; Augustin, Marc E; McCurdy, Michael T

2017-08-01

Ultrasound (US) is a burgeoning diagnostic tool and is often the only available imaging modality in low- and middle-income countries (LMICs). However, bedside providers often lack training to acquire or interpret US images. We conducted a study to determine if a remote tele-intensivist could mentor geographically removed LMIC providers to obtain quality and clinically useful US images. Nine Haitian non-physician health care workers received a 20-minute training on basic US techniques. A volunteer was connected to an intensivist located in the USA via FaceTime. The intensivist remotely instructed the non-physicians to ultrasound five anatomic sites. The tele-intensivist evaluated the image quality and clinical utility of performing tele-ultrasound in a LMIC. The intensivist agreed (defined as "agree" or "strongly agree" on a five-point Likert scale) that 90% (57/63) of the FaceTime images were high quality. The intensivist felt comfortable making clinical decisions using FaceTime images 89% (56/63) of the time. Non-physicians can feasibly obtain high-quality and clinically relevant US images using video chat software in LMICs. Commercially available software can connect providers in institutions in LMICs to geographically removed intensivists at a relatively low cost and without the need for extensive training of local providers. Copyright © 2017 Elsevier Inc. All rights reserved.

Defining user requirements for tele-nuclear medicine applications: from technical feasibility to clinical results

International Nuclear Information System (INIS)

Todd-Pokropek, A.; Chanachai, R.

2002-01-01

Purpose: Defining the user requirements for tele-nuclear medicine systems, in particular in developing countries, is an important prerequisite to establishing a service. However, the availability of low cost PC based servers and, now, access to local ISPs, has made the technical provision of such networks relatively simple and low cost, although transfer of data to and form legacy systems still present many difficulties. Method and Materials: The key driving force in developing countries is the imbalance between skills in the relatively few centres of excellence and the increasing number of installations overall. Requirements include both very rapid remote reporting and/or overnight tele-consultation. Original raw NM data must be available not just 'images'. Using current network standards (VPN) data transfer rate requirements are low. Provision of image fusion between NM, CT and MRI is also highly desirable. Results: Experience has been obtained e.g. in Thailand and Morocco, where a network of servers and remote users, with cardiac application of particular importance, has demonstrated benefit, and increasing volumes of usage. Conclusions: However, the requirements need to be clearly defined, and a staff training program is essential, as is a full evaluation. The transfer of skills is important in raising the overall quality of health care

Experiences with tele-health follow-up in patients with rheumatoid arthritis: a qualitative interview study

DEFF Research Database (Denmark)

Raunsbæk Knudsen, Line; Thurah, Annette De; Lomborg, Kirsten

2017-01-01

the patients' different needs, wishes and abilities to take part in tele-health follow-up. Our findings reveal a need for more insight into how tele-health follow-up could be integrated in routine clinical practice, paying special attention to how reluctant patients may be supported.......: Adopting a strategy of interpretive description, we conducted individual, semi-structured interviews with 15 RA patients participating in a tele-health follow-up. Participants were selected purposively and consecutive from both genders and with various ages, disease durations and disease severity....... The analysis was inductive with a constant comparative approach. First, we identified the main themes conveying the participants' experiences. Then, we constructed patient typologies to explain different perspectives on the tele-health follow-up. RESULTS: Five themes covered the participants' experiences: 'A...

WTP (willingness to pay) for tele-health consultation service in Hokkaido, Japan.

Science.gov (United States)

Ogasawara, Katsuhiko; Abe, Tamotsu

2013-01-01

We developed a tele-health consultation system that combines a sphygmomanometer with a tele-conference system. These were placed in pharmacies and the University. We selected five pharmacies to set up a consultation room; one in a local area, two in a suburban area, and the remaining two in an urban area. Nurses with more than 5 years of clinical experience were assigned as consultants. These consultants offer health consultation but do not practice medicine. Some researchers have indicated the economic viability of at-home health management systems, but nothing has been researched on the economic viability of tele-health consultation. The objective of present study was estimated Willingness to Payment (WTP) of Tele-health consultation service. The WTP was estimated by Double-Bounded Dichotomous-Choice model. We performed logistic-regression analysis to confirm factors to affect WTP. The number of the respondent was 480. Mean WTP was calculated 495 yen and the median was 367 yen. There was significant difference for factor of "annual income", "have a willingness to use this system", and "have a child/children".

Early pregnancy diagnosis in goats by transrectal echography

International Nuclear Information System (INIS)

Acosta, JI

2007-01-01

Echography observations every 5 days from 20 until 45 days past-mating, were carried out to determine when the pregnancy in goats can he detected and which are the elements that can be used for the which are the elements that can be used for the diagnosis with are ultrasonic equipment Aloka SSD 500 with a 5.0 MHz probe. From 25 days the pregnancy can be detected when the embryonic vesicle the observed. However, the higher was used efficiency is attained between the 30 and 35 days when embryons with heart beat as main sign of viability are observed

ECHOGRAPHY POTENTIAL IN DIAGNOSTICS OF THE KNEE JOINT IMPAIRMENT IN THE EVENT OF THE JUVENILE ARTHRITIDES

Directory of Open Access Journals (Sweden)

N.V. Osipova

2008-01-01

Full Text Available The juvenile rheumatoid arthritis (JRA is one of the most widely spread rheumatic diseases among children, which is characterized by the steady progressive run, rapidly leading to the disability. Among numerous JRA manifestations, one of the leading is the joint syndrome with children mostly suffering from the knee joint impairment. With JRA, the initial changes in the joints affect the joint tissues and articular cartilage, while the bone changes evolve at the late stages of the disease. As a result, the echography plays an important role in the early arthritides diagnostics if compared to the x ray study and computerized tomography. To identify the typical features of the knee joint impairment, 97 children with JRA and 16 children with the juvenile spondyl arthritis (JSA underwent the high pitched linear transducer assisted echography. The overwhelming majority of patients showed the changes in the hyaline cartilage. The hyperechoic enlargements in the depth of the cartilage were typical of JRA, while the cartilage thinning was typical of JSA. About a half of the patients showed the effusion. Over a third of the patients showed the changes in the cortical layer of the articular bone surface.Key words: juvenile rheumatoid arthritis, juvenile spondyl arthritis, diagnostics, knee joint echography, children.

The development and feasibility of an online aphasia group intervention and networking program - TeleGAIN.

Science.gov (United States)

Pitt, Rachelle; Theodoros, Deborah; Hill, Anne J; Russell, Trevor

2017-09-04

Aphasia group therapy offers many benefits, however people with aphasia report difficulty accessing groups and speech-language pathologists are faced with many challenges in providing aphasia group therapy. Telerehabilitation may offer an alternative service delivery option. An online aphasia group therapy program - Telerehabilitation Group Aphasia Intervention and Networking (TeleGAIN) - has been developed according to the guidelines of the Medical Research Council (MRC) framework for complex interventions. The purpose of this paper is to describe the development of TeleGAIN and the results of a pilot trial to determine feasibility and acceptability. The development of TeleGAIN was informed through literature reviews in relevant topic areas, consideration of expert opinion and application of the social cognitive theory. TeleGAIN was then modelled through a feasibility pilot trial with four people with aphasia. TeleGAIN appeared to be feasible and acceptable to participants and able to be implemented as planned. Participant satisfaction with treatment was high and results suggested some potential for improvements in language functioning and communication-related quality of life. TeleGAIN appeared to be feasible and acceptable, however the study highlighted issues related to technology, clinical implementation and participant-specific factors that should be addressed prior to a larger trial.

The duplex-Doppler colour echography of the scrotum and testicles in adults and boys. II. the contribution of the urgent study of acute scrotum symptoms

International Nuclear Information System (INIS)

Rangel-Villalobos, E.; Jimenez-Castellanos, R.; Bustos, C.; Linares, A.; Gonzalez-Prada, F.

1999-01-01

To analyse the findings, contributions and limitations of the Doppler echography for the urgent study of acute scrotum symptoms, both in adults and in boys. 60 patients (22 adults and 38 boys) with acute scrotal symptomatology were examined using B mode echography, followed by a colour duplex-Doppler (CDD) echography with a lineal 7.5 MHz transducer. We compared the findings obtained with those of the healthy contralateral testicle and with surgery or clinical-echographical evolution. The most common pathology was inflammation (27%) followed by ischemic (24%) and traumatic (17%). 12% of the patients had miscellaneous conditions. To conclude, in 20% of the cases the B mode and the Doppler examination was normal, the symptoms were resolved spontaneously. After carrying out the CDD only 14 (23%) of the cases needed immediate surgery and 3 (5%) delayed surgery, the remaining 43 (72%) patients responded to the traditional treatment. The CDD allows for a safe, quick and harmless diagnosis in practically all the acute scrotum cases, for both adults and boys. Its limitations in pre-puberty patients or in cases that were atypical are overcome when put in the hands of an expert radiologist, as they need a longer exploration time and suitable Doppler equipment. The main contribution to the urgent diagnosis of acute scrotum symptoms is that it accurately establishes which patients should be chosen for immediate surgery. (Author) 33 refs

Attitudes of COPD patients towards tele-rehabilitation

DEFF Research Database (Denmark)

Dinesen, Birthe; Huniche, Lotte; Toft, Egon

2013-01-01

about their tele-rehabilitation: indifference, learning as part of situations in everyday life, feeling of security and motivation for performing physical training. The patients express the view that they circulate between these attitudes depending on their physical and emotional state as they perform......The aim of this paper is to describe patients’ attitudes towards tele-rehabilitation in the Danish TELEKAT (for Telehomecare, Chronic Patients and the Integrated Healthcare System) project, in order to better understand patients’ behavior when performing tele-rehabilitation activities in home...

Tele-centres as a way of achieving universal access

DEFF Research Database (Denmark)

Falch, Morten; Anyimadu, Amos

2003-01-01

The success of tele-centres in Ghana is discussed. The tele-centres offer a low cost opportunity to empower local communities in developed and developing countries to meet the challenges of the information society. The tele-centres can also contribute more directly to the supply of non-commercial...

TeleAbilitation

DEFF Research Database (Denmark)

Brooks, Anthony Lewis

2013-01-01

This chapter presents the TeleAbilitation concept and describes the potential of contemporary video game gesture controllers in rehabilitation and therapy via their online connectivity. It reflects on the author’s previous work focusing on ability rather than on impairment. A novel sensor-based p...

A pilot trial of tele-ophthalmology for diagnosis of chronic blurred vision.

Science.gov (United States)

Tan, Johnson Choon Hwai; Poh, Eugenie Wei Ting; Srinivasan, Sanjay; Lim, Tock Han

2013-02-01

We evaluated the accuracy of tele-ophthalmology in diagnosing the major causes of chronic blurring of vision. Thirty consecutive patients attending a primary eye-care facility in Singapore (the Ang Mo Kio Polyclinic, AMKP) with the symptom of chronic blurred vision were recruited. An ophthalmic technician was trained to perform Snellen acuity; auto-refraction; intraocular pressure measurement; red-colour perimetry; video recordings of extraocular movement, cover tests and pupillary reactions; and anterior segment and fundus photography. Digital information was transmitted to a tertiary hospital in Singapore (the Tan Tock Seng Hospital) via a tele-ophthalmology system for teleconsultation with an ophthalmologist. The diagnoses were compared with face-to-face consultation by another ophthalmologist at the AMKP. A user experience questionnaire was administered at the end of the consultation. Using face-to-face consultation as the gold standard, tele-ophthalmology achieved 100% sensitivity and specificity in diagnosing media opacity (n = 29), maculopathy (n = 23) and keratopathy (n = 30) of any type; and 100% sensitivity and 92% specificity in diagnosing optic neuropathy of any type (n = 24). The majority of the patients (97%) were satisfied with the tele-ophthalmology workflow and consultation. The tele-ophthalmology system was able to detect causes of chronic blurred vision accurately. It has the potential to deliver high-accuracy diagnostic eye support to remote areas if suitably trained ophthalmic technicians are available.

[Medical tele-imaging: a good chance for the future].

Science.gov (United States)

Bonnin, A

1999-01-01

problems concerning confidentiality, the right to compensation, patient information. It would be interesting in this context to open a discussion on the possible dangers of telemedicine, its value for the patients and the physicians, its role in emergency care, and the possibility of creating imaging data storage that may help radiologists in making diagnoses, especially for unusual images. Drawbacks not to be ignored: Poor digital images could lead to difficulties in their reading and interpretation. There is still a debate as to whether tele-diagnosis is reliable or not. Further evaluations must be made to as certain the effectiveness of these techniques. A certain dehumanization of medicine due to an increase in the distance between the physician and patient is another difficult issue. The great number of people involved in the process of tele-imaging could confuse the issue of determining individual responsibility. Such consultations of experts may reduce the freedom of patients to choose their doctor. Tele-consultation must not be performed without the patient's consent. If consent was not obtained before tele-transmission, the patient should be informed after the procedure; and the use of tele-consultation should be mentioned in the report. The utilization of public networks could lead to the manipulation of data as well as undermine confidentiality. These pitfalls must be avoided. Lastly, the financial ramifications of these new technologies must not be overlooked.

Our approach for breast cancer screening using both mammography and echography, with special reference to detection of nonpalpable minute invasive cancer

International Nuclear Information System (INIS)

Takebe, Koji; Izumori, Ayumi; Yasumo, Naomi

2007-01-01

We present the results of our approach for breast cancer screening using both mammography and echography. A total of 4,632 participants underwent screening with our own combined method using mammography and echography at our clinic during a two-year period in 2005 and 2006. Recall studies were carried out in 364 women (recall rate, 79%), and breast cancer was detected in 36 women (cancer detection rate, 0.78%). When the detected cancers were classified histopathologically, 22 were invasive ductal cancers and the remaining 14 were non-invasive cancers. Of the 22 women who proved to have invasive cancers, 14 had been unaware of their tumors, which were non-palpable. If an invasive cancer is overlooked, the consequences may be more serious than if a non-invasive cancer is missed, because the former is can be potentially fatal. In order to decrease breast cancer mortality, invasive cancers must be detected when they are small. Since we were able to detect many small and non-palpable breast cancers that had not been noticed by the participants, our current breast cancer screening system appears to be more efficient for life-saving than other systems. (author)

Introduction of Tele-ICU in rural hospitals: Changing organisational culture to harness benefits.

Science.gov (United States)

Goedken, Cassie Cunningham; Moeckli, Jane; Cram, Peter M; Reisinger, Heather Schacht

2017-06-01

This study evaluates rural hospital staff perceptions of a telemedicine ICU (Tele-ICU) before and after implementation. We conducted a longitudinal qualitative study utilising semistructured group or individual interviews with staff from three rural ICU facilities in the upper Midwest of the United States that received Tele-ICU support. Interviews occurred pre-implementation and at two time points post-implementation. Interviews were conducted with: ICU administrators (n=6), physicians (n=3), nurses (n=9), respiratory therapists (n=5) and other (n=1) from July 2011 to May 2013. Transcripts were analysed for thematic content. Overall, rural ICU staff viewed Tele-ICU as a welcome benefit for their facility. Major themes included: (1) beneficial where recruitment and retention of staff can be challenging; (2) extra support for day shifts and evening, night and weekend shifts; (3) reduction in the number of transfers larger tertiary hospitals in the community; (4) improvement in standardisation of care; and (5) organisational culture of rural ICUs may lead to under-utilisation. ICU staff at rural facilities view Tele-ICU as a positive, useful tool to provide extra support and assistance. However, more research is needed regarding organisational culture to maximise the potential benefits of Tele-ICU in rural hospitals. Published by Elsevier Ltd.

Empowering Patients with COPD Using Tele-Homecare Technology

DEFF Research Database (Denmark)

Huniche, Lotte

2010-01-01

Abstract. This paper describes how a tele-rehabilitation program using home tele-monitoring empowers patients with COPD. The paper is based on findings from an ongoing research and innovation project, called “Telehomecare, chronic patients and the integrated healthcare system” (the TELEKAT project......) that employs triple interventions related to patients, professionals, and the organisation of care. The ways COPD patients utilize home tele-monitoring in the TELEKAT project points to the relevance of empowerment, as rooted in ideologies of social action, and focusing on the improvement of both personal...

Tele-treatment of patients with amyotrophic lateral sclerosis (ALS)

NARCIS (Netherlands)

Oude Nijeweme-d'Hollosy, Wendy; Janssen, Emile P.F.; Huis in 't Veld, M.H.A.; Spoelstra, Jos; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.

2006-01-01

Management of patients with amyotrophic lateral sclerosis (ALS) mainly consists of (psycho) social support and advice on activities of daily living. We evaluated the effects of tele-treatment in addition to the conventional method of care in four patients with ALS. A Web application was built with

Design and performance of a multi-centre randomised controlled trial and economic evaluation of joint tele-consultations [ISRCTN54264250

Directory of Open Access Journals (Sweden)

Thompson Simon

2002-01-01

Full Text Available Abstract Background Appropriate information flow is crucial to the care of patients, particularly at the interface between primary and secondary care. Communication problems can result from inadequate organisation and training, There is a major expectation that information and communication technologies may offer solutions, but little reliable evidence. This paper reports the design and performance of a multi-centre randomised controlled trial (RCT, unparalleled in telemedicine research in either scale or range of outcomes. The study investigated the effectiveness and cost implications in rural and inner-city settings of using videoconferencing to perform joint tele-consultations as an alternative to general practitioner referral to the hospital specialist in the outpatient clinic. Methods Joint tele-consultation services were established in both the Royal Free Hampstead NHS Trust in inner London, and the Royal Shrewsbury Hospitals Trust, in Shropshire. All the patients who gave consent to participate were randomised either to joint tele-consultation or to a routine outpatients appointment. The principal outcome measures included the frequency of decision by the specialist to offer a follow-up outpatient appointment, patient satisfaction (Ware Specific Questionnaire, wellbeing (SF12 and enablement (PEI, numbers of tests, investigations, procedures and treatments. Results A total of 134 general practitioners operating from 29 practices participated in the trial, referring a total of 3170 patients to 20 specialists in ENT medicine, general medicine (including endocrinology, and rheumatology, gastroenterology, orthopaedics, neurology and urology. Of these, 2094 patients consented to participate in the study and were correctly randomised. There was a 91% response rate to the initial assessment questionnaires, and analysis showed equivalence for all key characteristics between the treatment and control groups. Conclusion We have designed and

Maestro: a tele-robotic system for decommissioning of nuclear plants

International Nuclear Information System (INIS)

Desbats, P.; Idasiak, J.M.

2008-01-01

Compared to electric manipulators, hydraulic manipulators can handle higher payloads with respect to their size and mass. However, due to their limited positioning resolution and dexterity, they are usually disqualified for precise tele-manipulation and high quality tele-operation. More over, experience feedback has shown that on-the-shelf hydraulic manipulators are not reliable when performing high demanding tasks in tele-operation for dismantling applications. In order to solve this problem, CEA (Commissariat l'Energie Atomique), in collaboration with Cybernetix company, has developed a computer-aided, high-precision remote handling system with force-feedback featuring the advanced hydraulic tele-robotic arm Maestro. (authors)

The development of graphic simulation technology for tele-operated robot

International Nuclear Information System (INIS)

Kim, Chang Hoi; Kim, Seung Ho; Kim, Ki Ho; Jung, Seung Ho; Hwang, Suk Yeoung; Kim, Byung Soo; Seo, Yong Chil; Lee, Young Kwang

1998-02-01

In hostile environments like a nuclear power plant, human access is limited to the strict minimum due to the high-level of radiation. The design of tele-robotic system requires careful preparation because of the nature of its safety. Also, the human operator should have a capability of supervising the robot system and responding promptly to the unexpected events. In this study, the graphic simulation technology has been developed to construct tele-robotic system which can effectively perform the specified tasks in nuclear facilities. The developed graphic simulator utilizes the Indigo 2 workstation of Silicon Graphics as a main computer and its software is written in the OpenGL graphic library in X windows environments. The developed simulator, interfaced with the control system of the real robot through the ethernet, acts as a supervisory controller. Since clear and concise visual information on real robot posture and task environments can be processed in real time, the efficiency of tele-operation can be remarkably enhanced with this simulator. This simulator using advanced 3 dimensional graphics has many advantages of modeling complicated shapes of robot and constructing the virtual work environments similar to the real ones. With the use of this developed simulator, the operator can evaluate the performance of the tele-robot before it is put into real operation. This system can prevents the possible disaster of the robot resulting from the collision with its work environments. (author). 9 refs., 23 tabs., 13 figs

An open real-time tele-stethoscopy system

Directory of Open Access Journals (Sweden)

Foche-Perez Ignacio

2012-08-01

Full Text Available Abstract Background Acute respiratory infections are the leading cause of childhood mortality. The lack of physicians in rural areas of developing countries makes difficult their correct diagnosis and treatment. The staff of rural health facilities (health-care technicians may not be qualified to distinguish respiratory diseases by auscultation. For this reason, the goal of this project is the development of a tele-stethoscopy system that allows a physician to receive real-time cardio-respiratory sounds from a remote auscultation, as well as video images showing where the technician is placing the stethoscope on the patient’s body. Methods A real-time wireless stethoscopy system was designed. The initial requirements were: 1 The system must send audio and video synchronously over IP networks, not requiring an Internet connection; 2 It must preserve the quality of cardiorespiratory sounds, allowing to adapt the binaural pieces and the chestpiece of standard stethoscopes, and; 3 Cardiorespiratory sounds should be recordable at both sides of the communication. In order to verify the diagnostic capacity of the system, a clinical validation with eight specialists has been designed. In a preliminary test, twelve patients have been auscultated by all the physicians using the tele-stethoscopy system, versus a local auscultation using traditional stethoscope. The system must allow listen the cardiac (systolic and diastolic murmurs, gallop sound, arrhythmias and respiratory (rhonchi, rales and crepitations, wheeze, diminished and bronchial breath sounds, pleural friction rub sounds. Results The design, development and initial validation of the real-time wireless tele-stethoscopy system are described in detail. The system was conceived from scratch as open-source, low-cost and designed in such a way that many universities and small local companies in developing countries may manufacture it. Only free open-source software has been used in order to

An open real-time tele-stethoscopy system.

Science.gov (United States)

Foche-Perez, Ignacio; Ramirez-Payba, Rodolfo; Hirigoyen-Emparanza, German; Balducci-Gonzalez, Fernando; Simo-Reigadas, Francisco-Javier; Seoane-Pascual, Joaquin; Corral-Peñafiel, Jaime; Martinez-Fernandez, Andres

2012-08-23

Acute respiratory infections are the leading cause of childhood mortality. The lack of physicians in rural areas of developing countries makes difficult their correct diagnosis and treatment. The staff of rural health facilities (health-care technicians) may not be qualified to distinguish respiratory diseases by auscultation. For this reason, the goal of this project is the development of a tele-stethoscopy system that allows a physician to receive real-time cardio-respiratory sounds from a remote auscultation, as well as video images showing where the technician is placing the stethoscope on the patient's body. A real-time wireless stethoscopy system was designed. The initial requirements were: 1) The system must send audio and video synchronously over IP networks, not requiring an Internet connection; 2) It must preserve the quality of cardiorespiratory sounds, allowing to adapt the binaural pieces and the chestpiece of standard stethoscopes, and; 3) Cardiorespiratory sounds should be recordable at both sides of the communication. In order to verify the diagnostic capacity of the system, a clinical validation with eight specialists has been designed. In a preliminary test, twelve patients have been auscultated by all the physicians using the tele-stethoscopy system, versus a local auscultation using traditional stethoscope. The system must allow listen the cardiac (systolic and diastolic murmurs, gallop sound, arrhythmias) and respiratory (rhonchi, rales and crepitations, wheeze, diminished and bronchial breath sounds, pleural friction rub) sounds. The design, development and initial validation of the real-time wireless tele-stethoscopy system are described in detail. The system was conceived from scratch as open-source, low-cost and designed in such a way that many universities and small local companies in developing countries may manufacture it. Only free open-source software has been used in order to minimize manufacturing costs and look for alliances to

Tele-education.

Science.gov (United States)

Curran, Vernon R

2006-01-01

Tele-education has been used for many years to deliver continuing education programmes to rural health-care professionals. The main modes are audio, video and computer. Audio technologies involve the transmission of the spoken word (voice) between learners and instructors, either synchronously or asynchronously. Examples of the former include audioconferencing and short-wave radio; examples of the latter include audiotape or audiocassette. Video for distance learning, like audio, can be used in either synchronous or asynchronous fashion. Videoconferencing, or interactive television, are considered synchronous because there is the opportunity for live visual and verbal interaction between instructors and learners. Asynchronous instructional video tools include slow-scan video, interactive videodiscs and videotapes. Computer-assisted learning or instruction can be defined as any learning that is mediated by a computer and which requires no direct interaction between the user and a human instructor in order to run. It is becoming increasingly common. Examples include: the Internet and World Wide Web, email, synchronous and asynchronous computer-mediated communication applications and interactive multimedia applications on CD-ROM. Tele-education technologies have an important role to play in addressing the professional isolation which is experienced by rural and remote health-care professionals.

Real-Time Tele-Mentored Low Cost "Point-of-Care US" in the Hands of Paediatricians in the Emergency Department: Diagnostic Accuracy Compared to Expert Radiologists.

Directory of Open Access Journals (Sweden)

Floriana Zennaro

Full Text Available The use of point-of-care ultrasonography (POC US in paediatrics is increasing. This study investigated the diagnostic accuracy of POC US in children accessing the emergency department (ED when performed by paediatricians under the remote guidance of radiologists (TELE POC.Children aged 0 to 18 years accessing the ED of a third level research hospital with eight possible clinical scenarios and without emergency/severity signs at the triage underwent three subsequent US tests: by a paediatrician guided remotely by a radiologist (TELE POC; by the same radiologist (UNBLIND RAD; by an independent blinded radiologist (BLIND RAD. Tele-radiology was implemented using low cost "commercial off-the-shelf" (COTS equipment and open-source software. Data were prospectively collected on predefined templates.Fifty-two children were enrolled, for a total of 170 ultrasound findings. Sensitivity, specificity, positive and negative predictive values of TELE POC were: 93.8, 99.7, 96.8, 99.4 when compared to UNBLIND RAD and 88.2, 99.7, 96.8, 98.7 when compared to BLIND RAD. The inter-observers agreement between the paediatricians and either the unblind or blind radiologist was excellent (k = 0.93. The mean duration of TELE POC was 6.3 minutes (95% CI 4.1 to 8.5. Technical difficulties occurred in two (3.8% cases. Quality of the transmission was rated as fair, good, very good and excellent in 7.7%, 15.4%, 42.3% and 34.6% of cases respectively, while in no case was it rated as poor.POC US performed by paediatricians in ED guided via tele-radiology by an expert radiologist (TELE POC produced reliable and timely diagnoses. Findings of this study, especially for the rarer conditions under evaluation, need further confirmation. Future research should investigate the overall benefits and the cost savings of using tele-ultrasound to perform US "at children's bedsides", under remote guidance of expert radiologists.

Robotics and tele-operation technology for applications in nuclear fields

International Nuclear Information System (INIS)

Kosuge, Kazuhiro; Hirata, Yasuhisa; Takeo, Koji

2002-01-01

In this article, we introduce available robotics and tele-operation technology for applications in Nuclear Fields. First, robotics technology for manipulation of a large object is introduced which has been experimentally applied to ITER Maintenance Robot. Then, transportation technology of a large object by multiple mobile robots is reviewed. At last, recent tele-operation technologies and a prototype tele-operation system, referred to as VISIT (Visual Interface System for Interactive Task-execution), is introduced. Several experimental results are also introduced. (author)

Tele-auscultation support system with mixed reality navigation.

Science.gov (United States)

Hori, Kenta; Uchida, Yusuke; Kan, Tsukasa; Minami, Maya; Naito, Chisako; Kuroda, Tomohiro; Takahashi, Hideya; Ando, Masahiko; Kawamura, Takashi; Kume, Naoto; Okamoto, Kazuya; Takemura, Tadamasa; Yoshihara, Hiroyuki

2013-01-01

The aim of this research is to develop an information support system for tele-auscultation. In auscultation, a doctor requires to understand condition of applying a stethoscope, in addition to auscultatory sounds. The proposed system includes intuitive navigation system of stethoscope operation, in addition to conventional audio streaming system of auscultatory sounds and conventional video conferencing system for telecommunication. Mixed reality technology is applied for intuitive navigation of the stethoscope. Information, such as position, contact condition and breath, is overlaid on a view of the patient's chest. The contact condition of the stethoscope is measured by e-textile contact sensors. The breath is measured by a band type breath sensor. In a simulated tele-auscultation experiment, the stethoscope with the contact sensors and the breath sensor were evaluated. The results show that the presentation of the contact condition was not understandable enough for navigating the stethoscope handling. The time series of the breath phases was usable for the remote doctor to understand the breath condition of the patient.

Development Of A Mobile Robot As A Test Bed For Tele-Presentation

Directory of Open Access Journals (Sweden)

Diogenes Armando D. Pascua

2016-01-01

Full Text Available In this paper a human-sized tracked wheel robot with a large payload capacity for tele-presentation is presented. The robot is equipped with different sensors for obstacle avoidance and localization. A high definition web camera installed atop a pan and tilt assembly was in place as a remote environment feedback for users. An LCD monitor provides the visual display of the operator in the remote environment using the standard Skype teleconferencing software. Remote control was done via the internet through the free Teamviewer VNC remote desktop software. Moreover, this paper presents the design details, fabrication and evaluation of individual components. Core mobile robot movement and navigational controls were developed and tested. The effectiveness of the mobile robot as a test bed for tele-presentation were evaluated and analyzed by way of its real time response and time delay effects of the network.

Development of a Mobile Robot as a Test Bed for Tele-Presentation

Directory of Open Access Journals (Sweden)

Diogenes Armando D. Pascua

2016-05-01

Full Text Available In this paper a human-sized tracked wheel robot with a large payload capacity for tele-presentation is presented. The robot is equipped with different sensors for obstacle avoidance and localization. A high definition web camera installed atop a pan and tilt assembly was in place as a remote environment feedback for users. An LCD monitor provides the visual display of the operator in the remote environment using the standard Skype teleconferencing software. Remote control was done via the internet through the free Teamviewer VNC remote desktop software. Moreover, this paper presents the design details, fabrication and evaluation of individual components. Core mobile robot movement and navigational controls were developed and tested. The effectiveness of the mobile robot as a test bed for tele-presentation were evaluated and analyzed by way of its real time response and time delay effects of the network

Arizona TeleMedicine Project.

Science.gov (United States)

Arizona Univ., Tucson. Coll. of Medicine.

Designed to provide health services for American Indians living on rurally isolated reservations, the Arizona TeleMedicine Project proposes to link Phoenix and Tucson medical centers, via a statewide telecommunications system, with the Hopi, San Carlos Apache, Papago, Navajo, and White Mountain Apache reservations. Advisory boards are being…

O papel do escravo em Aristóteles e Hegel

OpenAIRE

Nicuia, Eurico Jorge

2009-01-01

A presente dissertação tem por objetivo analisar o papel do escravo em Aristóteles e em Hegel, tendo presente os contextos histórico-filosóficos da escravidão no primeiro capítulo; bem como a abordagem filosófica da escravidão em Aristóteles e em Hegel no segundo capítulo; finalmente, debruçar-se-á sobre o papel do escravo nos dois filósofos, no terceiro capítulo onde destacamos os seguintes: i) doméstico, o único papel descrito por Aristóteles porque o escravo não participava de outras ativi...

Communication Framework for Tele-rehabilitation Systems with QoS Guarantee

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Dandanov Nikolay

2017-01-01

Full Text Available Nowadays, there is great interest in developing telemedicine technologies. These technologies will provide health care from distance swiftly and lightly, as well as reduce the expenses for activities, such as rehabilitation. Telemedicine applications are possible due to the advances in information technologies and the ever-expanding communication network infrastructure. The network characteristics bandwidth, packet loss, latency, jitter and policies are crucial for the performance of tele-rehabilitation systems. Because in tele-rehabilitation human lives are at stake, guaranteeing the Quality of Service (QoS is important. In this paper, an approach for assuring the QoS for information transmission in tele-rehabilitation systems is proposed.

Disseminating Health Disparities Education Through Tele-Learning

Directory of Open Access Journals (Sweden)

LaSonya Knowles

2008-08-01

Full Text Available Twenty years of research demonstrate that there are wide disparities in health throughout America. Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist when specific population subgroups are compared. Health Disparities in America: Working Toward Social Justice is a course instructed every fall by Dr. Lovell Jones, director of The Center for Research on Minority Health (CRMH at UT M.D. Anderson Cancer Center. The CRMH has created a course that examines the social and societal factors that are fundamental in creating disparities in health. Students from 10 different academic programs and institutions participate in this course. The course is unique in the aspect that various, diverse speakers whom are experts in their field of study instruct each class. This health disparities course is conducted at one of three different academic institutions in the Houston area and broadcast via satellite to various academic institutions by means of teleeducation. Tele-education is defined as a mode of instruction utilizing different forms of media such as video, audio technology tools and computers. Video and audio technologies involve the transmission of interface between learners and instructors, either interactive or non-interactive. Tele-education technologies have an important role to play in addressing the dissemination of health disparities education. The purpose of this program is to determine the feasibility of tele-education as a mode of instruction to introduce the multi-disciplinary components of health disparities. Our findings suggest that tele-education is a useful tool in imparting health disparities education.

Tele-education as method of medical education.

Science.gov (United States)

Masic, Izet; Pandza, Haris; Kulasin, Igor; Masic, Zlatan; Valjevac, Salih

2009-01-01

Development of computer networks and introduction and application of new technologies in all aspects of human activity needs to be followed by universities in their transformation on how to approach scientific, research, and education teaching curricula. Development and increased use of distance learning (DL) over the past decade have clearly shown the potential and efficiency of information technology applied in education. Use of information technology in medical education is where medical informatics takes its place as important scientific discipline which ensures benefit from IT in teaching and learning process involved. Definition of telemedicine as "use of technologies based on health care delivered on distance" covers areas such as electronic health, tele-health (eHealth), telematics, but also tele-education. Web based medical education today is offered in different forms--from online lectures, online exams, web based continuous education programs, use of electronic libraries, online medical and scientific databases etc. Department of Medical Informatics of Medical Faculty of University of Sarajevo has taken many steps to introduce distance learning in medical curricula--from organising professional--scientific events (congresses, workshop etc), organizing first tele-exam at the faculty and among first at the university, to offering online lectures and online education material at the Department's website (www.unsa-medinfo.org). Distance learning in medical education, as well as telemedicine, significantly influence health care in general and are shaping the future model of medical practice. Basic computer and networks skills must be a part of all future medical curricula. The impact of technical equipment on patient-doctor relationship must be taken into account, and doctors have to be trained and prepared for diagnosing or consulting patients by use of IT. Telemedicine requires special approach in certain medical fields--tele-consultation, tele

Emotional attachment and emotional availability tele-intervention for adoptive families.

Science.gov (United States)

Baker, Megan; Biringen, Zeynep; Meyer-Parsons, Beatrice; Schneider, Abby

2015-01-01

This study evaluated the new online Emotional Attachment and Emotional Availability (EA2) Intervention for use with adoptive families in enhancing parent-child EA, parental perceptions of EA, child attachment behaviors, parent-child emotional attachment, and reducing parent-reported child behavioral problems and parenting-related stress. Participants in this study were adoptive parents and their adopted children ages 1.5 to 5 years old (N = 15 dyads). Participants were placed in an immediate intervention group (IG) or a delayed intervention group (DG) that would receive the 6-week EA2 Tele-Intervention after the IG. Results revealed significant differences in the IG in child behavioral problems, parent-child EA, parental perceptions of EA, and parent-child emotional attachment, improvements not seen in the DG. Analysis of effects of the DG after receiving the EA2 Tele-Intervention revealed significant differences over time also in most of these qualities. © 2015 Michigan Association for Infant Mental Health.

Leveraging Scarce Resources With Bone Health TeleECHO to Improve the Care of Osteoporosis.

Science.gov (United States)

Lewiecki, E Michael; Rochelle, Rachelle; Bouchonville, Matthew F; Chafey, David H; Olenginski, Thomas P; Arora, Sanjeev

2017-12-01

Osteoporosis is a common condition with serious consequences because of fractures. Despite availability of treatments to reduce fracture risk, there is a large osteoporosis treatment gap that has reached crisis proportions. There are too few specialists to provide services for patients who need them. Bone Health Extension for Community Health Care Outcomes (TeleECHO) is a strategy using real-time ongoing videoconferencing technology to mentor health care professionals in rural and underserved communities to achieve an advanced level of knowledge for the care of patients with skeletal diseases. Over the first 21 months of weekly Bone Health TeleECHO programs, there were 263 registered health care professionals in the United States and several other countries, with 221 attending at least 1 online clinic and typically 35 to 40 attendees at each session at the end of the reported period. Assessment of self-confidence in 20 domains of osteoporosis care showed substantial improvement with the ECHO intervention ( P = 0.005). Bone Health TeleECHO can contribute to mitigating the crisis in osteoporosis care by leveraging scarce resources, providing motivated practitioners with skills to provide better skeletal health care, closer to home, with greater convenience, and lower cost than referral to a specialty center. Bone Health TeleECHO can be replicated in any location worldwide to reach anyone with Internet access, allowing access in local time zones and languages. The ECHO model of learning can be applied to other aspects of bone care, including the education of fracture liaison service coordinators, residents and fellows, and physicians with an interest in rare bone diseases.

Nuclear tele medicine

International Nuclear Information System (INIS)

Vargas, L.; Hernandez, F.; Fernandez, R.

2005-01-01

The great majority of the digital images of nuclear medicine are susceptible of being sent through internet. This has allowed that the work in diagnosis cabinets by image it can benefit of this modern technology. We have presented in previous congresses works related with tele medicine, however, due to the speed in the evolution of the computer programs and the internet, becomes necessary to make a current position in this modality of work. (Author)

Tele-asistencia y tele-alarma para adultos mayores: experiencias preliminares en Mexico

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Liliana Giraldo-Rodriguez

2013-08-01

Full Text Available OBJETIVO Analizar el efecto de un programa piloto de tele-asistencia y tele-alarma en la autopercepción del estado de salud de los adultos mayores y conocer la satisfacción y aceptación del programa. METODOS Estudio transversal que incluyó entrevistas a 378 adultos mayores, 294 cuidadores/familiares y 53 profesionales de la salud, realizado en la Ciudad de México en 2010. Variables sociodemográficas, de autopercepción del estado de salud, satisfacción y aceptación del programa se obtuvieron por medio de cuestionario estandarizado. Se realizó análisis descriptivo y se utilizaron pruebas no paramétricas. RESULTADOS Se observaron efectos significativos en la autopercepción del estado de salud, 6,17 (DE 17,9 p < 0,05 puntos por encima de la media. El programa tuvo una buena aceptación por parte de los adultos mayores, de sus cuidadores familiares y de los profesionales de la salud. CONCLUSIONES El programa contribuye a mantener o mejorar la calidad de vida, permite la atención preventiva y es un medio ideal para dar apoyo psicosocial a los adultos mayores.

Construction Tele-Robotics System with AR Presentation

International Nuclear Information System (INIS)

Ootsubo, K; Kawamura, T; Yamada, H

2013-01-01

Tele-Robotics system using bilateral control is an effective tool for task in disaster scenes, and also in extreme environments. The conventional systems are equipped with a few color video cameras captures view of the task field, and their video images are sent to the operator via some network. Usually, the images are captured only from some fixed angles. So the operator cannot obtain intuitively 3D-sense of the task field. In our previous study, we proposed a construction tele-robotics system based on VR presentation. The operator intuits the geometrical states of the robot presented by CG, but the information of the surrounding environment is not included like a video image. So we thought that the task efficiency could be improved by appending the CG image to the video image. In this study, we developed a new presentation system based on augmented reality (AR). In this system, the CG image, which represents 3D geometric information for the task, is overlaid on the video image. In this study, we confirmed the effectiveness of the system experimentally. Additionally, we verified its usefulness to reduction of the communication delay associated with a tele-robotics system.

Application of an internet web-site of medical images in tele-radiology

International Nuclear Information System (INIS)

Wang Weizhong; Wang Hua; Xie Jingxia; Wang Songzhang; Li Xiangdong; Qian Min; Cao Huixia

2000-01-01

Objective: To build and Internet web-site of medical images for tele-education and tele-consultation. Methods: Collecting medical images of cases that fulfilled diagnostic standards for teaching and were pathologically proved. The images were digitized using digital camera and scanner. Frontpage 98, Homesite 2.5 and text editors were used for programming. Results: The web site encompasses many useful cases and was update every week. With smart and friendly interface, easy used navigation, the site runs reliably in TCP/IP environment. The site's URL is http://imager.163.net. At present, the site has received about 100 visits per week. Conclusion: The well-designed and programmed internet web site of medical images would be easily acceptable and is going to play an important role in tele-education and tele-consultation

Immersive Virtual Reality with Applications to Tele-Operation and Training

Science.gov (United States)

2016-03-07

reviewed journals : Number of Papers published in non peer-reviewed journals : Final Report: Immersive Virtual Reality with Applications to Tele-Operation... Immersive Virtual Reality with Applications to Tele-Operation and Training The proposed project aims to develop a fundamental framework for...establishing an immersive virtual reality environment for robust and scalable human robotics interaction in a cooperative intelligent architecture at the

Potential role of tele-rehabilitation to address barriers to implementation of physical therapy among West African stroke survivors: A cross-sectional survey.

Science.gov (United States)

Sarfo, Fred S; Adamu, Sheila; Awuah, Dominic; Sarfo-Kantanka, Osei; Ovbiagele, Bruce

2017-10-15

The greatest burden from stroke-related disability is borne by Low-and-Middle Income countries (LMICs) where access to rehabilitation after stroke is severely challenged. Tele-rehabilitation could be a viable avenue to address unmet rehabilitation needs in LMICs. To assess the burden of post-stroke physical deficits, rates of utilization of physiotherapy services, and perceptions of tele-rehabilitation among recent Ghanaian stroke survivors. Using a consecutive sampling strategy, 100 stroke survivors attending an outpatient Neurology clinic in a Ghanaian tertiary medical center were enrolled into this cross-sectional study. After collecting basic demographic data, clinical history on stroke type, severity and level of disability, we administered the validated 20-item Functional Independence Measure questionnaire to evaluate functional status of study participants and an 8-item questionnaire to assess participants' attitudes towards telemedicine administered rehabilitation intervention. Mean±SD age of study participants was 57.2±13.3years of which 51.0% were males with a mean duration of stroke of 1.3±2.2years. 53% had Modified Rankin scores of ≥3, 57% were fully independent and only 27% reported utilizing any physiotherapy services. Barriers to access to physiotherapy included financial constraints due to cost of physiotherapy services and transportation as well as premature discharge from physiotherapy to avoid overburdening of available physiotherapy services. These factors led to the limited provision of rehabilitative therapy. Participants held positive views of the potential for tele-rehabilitation interventions (80-93%). However, while 85% owned mobile phones, only 35% had smart phones. Despite, a high burden of residual disability, only about 1 out of 4 stroke patients in this Ghanaian cohort was exposed to post-stroke physiotherapy services, largely due to relatively high costs and limited health system resources. These Ghanaian stroke patients viewed

Tele-Intervention: The Wave of the Future Fits Families' Lives Today

Science.gov (United States)

Behl, Diane D.; Houston, K. Todd; Guthrie, W. Spencer; Guthrie, Nancy K.

2010-01-01

This article provides information on providing early intervention services virtually using distance communication technologies. It describes "tele-intervention," a new method of providing services to children and their families, and how it is used in a family with a deaf child. Tele-intervention has proven to be a viable service delivery model for…

TelePain: Primary Care Chronic Pain Management through Weekly Didactic and Case-based Telementoring.

Science.gov (United States)

Flynn, Diane M; Eaton, Linda H; McQuinn, Honor; Alden, Ashley; Meins, Alexa R; Rue, Tessa; Tauben, David J; Doorenbos, Ardith Z

2017-12-01

Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain) designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list controlled clinical trial to test: 1) effectiveness of the intervention, and 2) interviews to assess barriers and facilitators of the intervention implementation. The intervention involves a didactic presentation based on the Joint Pain Education Curriculum followed by patient case presentations and multi-disciplinary discussion via videoconference by clinicians working in the military health system. A panel of pain specialists representing pain medicine, internal medicine, anesthesiology, rehabilitation medicine, psychiatry, addiction medicine, health psychology, pharmacology, nursing, and complementary and integrative pain management provide pain management recommendations for each patient case. We use the Pain Assessment Screening Tool and Outcomes Registry (PASTOR) to measure patient outcomes, including pain, sleep, fatigue, anxiety, and depression. This article reports some of the challenges and lessons learned during early implementation of the TelePain intervention. Weekly telephone meetings among the multisite research team were instrumental in problem solving, identifying problem areas, and developing solutions. Solutions for recruitment challenges included additional outreach and networking to military health providers, both building on.

[Exploring a non-inflammatory clinical breast mass: Clinical practice guidelines].

Science.gov (United States)

Legendre, G; Guilhen, N; Nadeau, C; Brossard, A; Fauvet, R

2015-12-01

The aim of the study was to assess the diagnostic value of physical examination, radiologic explorations and percutaneous procedures of the breast in the exploration of a non-inflammatory palpable mass, in order to propose guidelines. A systematic literature review was conducted in the Medline and Cochrane library databases. International guidelines in French and English language were also consulted until April 30th 2015. Physical examination of a non-inflammatory palpable breast mass is not sufficient to eliminate a breast cancer (LE2). Mammography alone has a sensitivity between 70 and 95% for the diagnosis of breast cancer (LE3). Echography alone has a sensitivity of 98 to 100% for the diagnosis of breast cancer (LE2). The core needle biopsy has a better sensitivity and specificity than the fine-needle aspiration for breast cancer diagnosis (LE2). The association of mammography and 2D echography presents excellent sensitivity and negative predictive value (close to 100 %) to exclude a breast cancer (LE3). A double evaluation using mammography and echography is recommended in the exploration of a non-inflammatory palpable breast mass (grade B). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Tele-operated service robots : ROSE

NARCIS (Netherlands)

Osch, van M.P.W.J.; Bera, D.; Hee, van K.M.; Koks, Y.; Zeegers, H.

2014-01-01

Service robots are robots that are intended to perform tasks normally done by humans in an environment in which humans work as well. However, they are neither required to accomplish these tasks in the same way as humans nor need to look like a human being. A tele-operated robot is controlled from a

Technical guide to evaluate upper limb joints (shoulder, elbow and wrist) by ultrasound

International Nuclear Information System (INIS)

Obregon Baez, Luis Rafael

2014-01-01

A guideline to follow is offered to radiologists and residents of radiology service of medical imaging, when evaluating by ultrasound the shoulder joints, elbow, wrist. The importance to performing of musculoskeletal ultrasound by its pathology variable is established. The use of appropriate equipment and effective application of the techniques exposed of echography exploration have made enable the valuation of many pathologies with high sensitivity and specificity. The echography has been the musculoskeletal imaging technique that more rapidly has evolved. Currently, this technique has been replaced by magnetic resonance imaging in various clinical fields and also serves as a complement to other techniques. Exposed techniques have been of great benefit for radiologists medical and residents, obtaining with its use a quick guide for the realization of upper limb musculoskeletal ultrasounds. The appropriate and easy techniques are better known for the evaluation of these structures, and so document both sports injuries, as joint and rheumatic diseases [es

Preventative tele-health supported services for early stage chronic obstructive pulmonary disease: a protocol for a pragmatic randomized controlled trial pilot

Directory of Open Access Journals (Sweden)

Mountain Gail A

2011-01-01

Full Text Available Abstract Background Chronic Obstructive Pulmonary Disease (COPD is a prevalent debilitating long term condition. It is the second most common cause of emergency admission to hospital in the UK and remains one of the most costly conditions to treat through acute care. Tele-health monitoring offers potential to reduce the rates of re-hospitalisation and emergency department visits and improve quality of life for people with COPD. However, the current evidence base to support technology adoption and implementation is limited and the resource implications for implementing tele-health in practice can be very high. This trial will employ tele-health monitoring in a preventative capacity for patients diagnosed with early stage COPD following discharge from hospital to determine whether it reduces their need for additional health service support or hospital admission and improves their quality of life. Methods/Design We describe a pilot study for a two arm, one site randomized controlled trial (RCT to determine the effect of tele-health monitoring on self-management, quality of life and patient satisfaction. Sixty patients who have been discharged from one acute trust with a primary diagnosis of COPD and who have agreed to receive community clinical support following discharge from acute care will be randomly assigned to one of two groups: (a Tele-health supported Community COPD Service; or (b Usual Care. The tele-health supported service involves the patient receiving two home visits with a specialist COPD clinician (nurse or physiotherapist then participating in daily tele-monitoring over an eight week period. Usual care consists of six home visits to the patient by specialist COPD clinicians again over eight successive weeks. Health status and quality of life data for all participants will be measured at baseline, on discharge from the service and at six months post discharge from the service. Discussion The tele-health service under study is a

Persepsi Masyarakat terhadap Hidroponik di Kelurahan Teling Bawah, Kota Manado

OpenAIRE

Sengkey, Mercy Y; Wangke, Welson M; Manginsela, Elsje P

2017-01-01

This study aimed to analyze and determine the public perception of hydroponic in the distict Teling Bawah Manado City. This aims was conducted over five months from November 2016 to the month of Maret 2017 from preparation to the arrangement of research reports. The location of research is in districts Teling Bawah Manado City. This research uses primary data and secondary data. Primary data was obtained from 30 respondents using questionnaires, while secondary data obtained from the office d...

Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico.

Science.gov (United States)

Patel, Samir N; Martinez-Castellanos, Maria Ana; Berrones-Medina, David; Swan, Ryan; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Campbell, J Peter; Chiang, Michael F; Chan, R V Paul

2017-07-01

To evaluate a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmologists-in-training in Mexico. Prospective, randomized cohort study. Fifty-eight ophthalmology residents and fellows from a training program in Mexico consented to participate. Twenty-nine of 58 trainees (50%) were randomized to the educational intervention (pretest, ROP tutorial, ROP educational chapters, and posttest), and 29 of 58 trainees (50%) were randomized to a control group (pretest and posttest only). A secure web-based educational system was created using clinical cases (20 pretest, 20 posttest, and 25 training chapter-based) developed from a repository of over 2500 unique image sets of ROP. For each image set used, a reference standard ROP diagnosis was established by combining the clinical diagnosis by indirect ophthalmoscope examination and image-based diagnosis by multiple experts. Trainees were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. The accuracy of ROP diagnosis (e.g., plus disease, zone, stage, category) was determined using sensitivity and specificity calculations from the pretest and posttest results of the educational intervention group versus control group. The unweighted kappa statistic was used to analyze the intragrader agreement for ROP diagnosis by the ophthalmologists-in-training during the pretest and posttest for both groups. Trainees completing the tele-education system had statistically significant improvements (P education system performed better on the posttest for accurately diagnosing plus disease (67% vs. 48%; P = 0.04) and the presence of ROP (96% vs. 91%; P education system compared with the control group. Intragrader agreement improved for identification of plus disease, zone, stage, and category of ROP after completion of the educational intervention. A tele-education system for ROP education was effective in improving the diagnostic

Working Alliance, Interpersonal Problems, and Depressive Symptoms in Tele-Interpersonal Psychotherapy for HIV-infected Rural Persons: Evidence for Indirect Effects.

Science.gov (United States)

Anderson, Timothy; McClintock, Andrew S; McCarrick, Shannon S; Heckman, Timothy G; Heckman, Bernadette D; Markowitz, John C; Sutton, Mark

2018-03-01

Interpersonal psychotherapy (IPT) has demonstrated efficacy for the treatment of depression, yet little is known about its therapeutic mechanisms. As a specific treatment, IPT has been shown to directly reduce depressive symptoms, although it is unclear whether these reductions occur via interpersonal changes. Within IPT, the potential role of the working alliance, a common factor, as a predictor of depression and interpersonal changes is also unclear. Participants were 147 depressed persons living with HIV in rural communities of 28 U.S. states enrolled in a randomized clinical trial. Seventy-five patients received up to 9 sessions of telephone-administered IPT (tele-IPT) plus standard care and 72 patients received standard care only. Two models were tested; one included treatment condition (tele-IPT vs. control) and another included the working alliance as independent variables. The first model found an indirect effect whereby tele-IPT reduced depression via decreased social avoidance. There was a direct effect between tele-IPT and reduced depression. In the second model, the working alliance influenced depressive symptom relief via reductions in social avoidance. Both goal and task working alliance subscales were indirectly associated with reductions in depressive symptoms, also through reductions in social avoidance. There were no direct effects involving the working alliance. Tele-IPT's influence on depressive symptom reduction was primarily through a direct effect, whereas the influence of working alliance depression was almost entirely via an indirect effect through interpersonal problems. Study findings have implications for IPT when intervening with depressed rural people living with HIV/AIDS over the telephone. © 2017 Wiley Periodicals, Inc.

Co-operation and Haptic Assistance for Tele-manipulated Control over Two Asymmetric Slaves

NARCIS (Netherlands)

van Oosterhout, J.

2018-01-01

The success of future fusion power plants as a sustainable energy source greatly depends on their uptime. This uptime relies on the plant's maintenance, which must be performed via tele-manipulation. Tele-manipulated maintenance is challenging, as exemplified by strictly selected and highly trained

TAO2000 V2 computer-assisted force feedback tele-manipulators used as maintenance and production tools at the AREVA NC-La Hague fuel recycling plant

International Nuclear Information System (INIS)

Geffard, Franck; Garrec, Philippe; Piolain, Gerard; Brudieu, Marie-Anne; Thro, Jean-Francois; Coudray, Alain; Lelann, Eric

2012-01-01

During a 15-year joint research program, French Atomic Energy Agency Interactive Robotics Laboratory (CEA LIST) and AREVA have developed several remote operation devices, also called tele-robots. Some of them are now commonly used for maintenance operations at the AREVA NC (Nuclear Cycle) La Hague reprocessing plant. Since the first maintenance operation in 2005, several other successful interventions have been realized using the industrial MA23/RX170 tele-manipulation system. Moreover, since 2010, the through-the-wall tele-robot named MT200 TAO based on the slave arm of the MSM MT200 (La Calhene TM ), has been evaluated in an active production cell at the AREVA NC La Hague fuel recycling plant. Although these evaluations are ongoing, the positive results obtained have led to an update and industrialization program. All these developments are based on the same generic control platform, called TAO2000 V2. TAO2000 V2 is the second release of the CEA LIST core software platform dedicated to computer aided force-feedback tele-operation (TAO is the French acronym for computer aided tele-operation). This paper presents all these developments resulting from the joint research program CEA LIST/AREVA. The TAO2000 V2 controller is first detailed, and then two maintenance operations using the industrial robot RX170 are presented: the removal of the nuclear fuel dissolver wheel rollers and the cleanup of the dissolver wheel inter-bucket spaces. Finally, the new MT200 TAO system and its evaluations at the AREVA NC La Hague facilities are discussed. (authors)

TelePain: Primary care chronic pain management through weekly didactic and case‐based telementoring

Directory of Open Access Journals (Sweden)

Diane M. Flynn

2017-12-01

Full Text Available Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list cluster controlled clinical trial to test: 1 effectiveness of the intervention, and 2 interviews to assess barriers and facilitators of the intervention implementation. The intervention involves a didactic presentation based on the Joint Pain Education Curriculum followed by patient case presentations and multi-disciplinary discussion via videoconference by clinicians working in the military health system. A panel of pain specialists representing pain medicine, internal medicine, anesthesiology, rehabilitation medicine, psychiatry, addiction medicine, health psychology, pharmacology, nursing, and complementary and integrative pain management provide pain management recommendations for each patient case. We use the Pain Assessment Screening Tool and Outcomes Registry (PASTOR to measure patient outcomes, including pain, sleep, fatigue, anxiety, and depression. This article reports some of the challenges and lessons learned during early implementation of the TelePain intervention. Weekly telephone meetings among the multisite research team were instrumental in problem solving, identifying problem areas, and developing solutions. Solutions for recruitment challenges included additional outreach and networking to military health providers, both building on existing relationships and new relationships.

Resolution improvement of ultrasonic echography methods in non destructive testing by adaptative deconvolution

International Nuclear Information System (INIS)

Vivet, L.

1989-01-01

The ultrasonic echography has a lot of advantages which make it attractive for nondestructive testing. But the important acoustic energy useful to go through very attenuating materials can be got only with resonant translators, that is a limit for the resolution on measured echograms. This resolution can be improved by deconvolution. But this method is a problem for austenitic steel. Here is developed a method of time deconvolution which allows to take in account the characteristics of the wave. A first step of phase correction and a second step of spectral equalization which gives back the spectral contents of ideal reflectivity. The two steps use fast Kalman filters which reduce the cost of the method

Tele2 kutsus kliendid teatrisse ja kontsertidele

Index Scriptorium Estoniae

2007-01-01

Suvel kutsus Tele 2 kliendid Victor Hugo loo "Jumalaema kiriku kellamees" muusikalisele vaatemängule Tartus (lavastajad Urmas Lennuk ja Andres Dvinjaninov), Muhu Tulevikumuusika festivalile "Juu Jääb" ja Tallinna Linnateatri suvelavastusele "Ronk" (lavastaja Elmo Nüganen)

SatCom Systems for Health and Medical Care

Science.gov (United States)

Diez, Hubert

2002-01-01

Convinced since 1997 that the satellite was capable of providing a real added value either autonomously or as a complement to terrestrial infrastructures, CNES (the French Space Agency) began a determined study, validation and demonstration procedure for new satellite services. At a national but also European and worldwide level, several experiments or projects have been set-up. In each of them (tele-consultations, distant education, tele-epidemiology, tele-echography, assistance to people, training and therapeutic assistance, disaster telemedicine, etc...) well suited satcoms are used. (telecommunications for broadcasting, multicasting, downloading,...- localization, positioning, - low medium and high data rate bidirectional systems,). Medical reference people are associated in each pilot projects first to define the needs but also to manage the medical validation aspects. Our aim is always to test, validate and adapt these new services to bring them into line with the users' expectations. The value added of these technologies in sustainable healthcare services are systematically demonstrated in real situations, with real users, both in terms of quality of service and of economic validity. For several projects CNES has developed typical hardware, or technical on as technical platform. The main projects and their relevant satcom systems will be presented and discussed : - Tele-consultation, - Distance learning and training, - Assistance to people, - Tele-epidemiology, - Disaster telemedicine.

How to develop a tele-ICU model?

Science.gov (United States)

Rogove, Herb

2012-01-01

The concept of the tele-ICU (intensive care unit) is about 30 years old and more hospitals are utilizing it to cover multiple hospitals in their system or for hospitals that lack on-site critical care coverage such as in the rural setting. Doing a needs analysis, picking the appropriate committee to oversee development of the correct model, choosing quality metrics to measure, and designing an implementation plan that has a timeline is how the process should begin. Research including visitation to established programs and connecting with professional societies are helpful. Developing both a business and financial plan will optimize the value of a tele-ICU program. The innovative ICU nursing director will help to integrate a telemedicine program seamlessly with the on-site program to insure a successful program that benefits patients, their families, the ICU staff, and the hospital.

Force-feedback tele operation of industrial robots a cost effective solution for decontamination of nuclear plants

International Nuclear Information System (INIS)

Desbats, P.; Andriot, C.; Gicquel, P.; Viallesoubranne, J.P.; Souche, C.

1998-01-01

Decontamination and maintenance in hot cells are some new emerging applications of industrial robots in the nuclear fuel cycle plants. Industrial robots are low cost, accurate and reliable manipulator arms which are used in manufacturing industries usually. Thanks to the recent evolution of robotics technologies, some industrial robots may be adapted to nuclear environment. These robots are transportable, sealed and can be decontaminated, and they may be 'hardened' up to a level of irradiation dose sufficient for operation in low and medium irradiating/contaminating environments. Although industrial robots are usually programmed to perform specific and repetitive tasks, they may be remotely tele-operated by human operators as well. This allows industrial robots to perform usual tele-manipulation tasks encountered in the nuclear plants and more. The paper presents the computer based tele-operation control system TAO2000 TM , developed by the Tele-operation and Robotics Service of CEA, which has been applied to the RX90 TM industrial robot from ST-UBLI company. This robot has been selected in order to perform various maintenance and decontamination tasks in COGEMA plants. TAO2000 provides the overall tele-robotic and robotic functions necessary to perform any remote tele-operation application in hostile environment: force-feedback master-slave control; computer- assisted tele-operation of mechanical processes; trajectory programming as well as various robotics functions; graphical modelling of working environment and simulation; automatic path planning with obstacle avoidance; man-machine interface for tasks programming and mission execution. Experimental results reported in the paper demonstrate the feasibility of force-feedback master-slave control of standard industrial robots. Finally, the design of new, cost effective. tele-operation systems based on industrial robots may be intended for nuclear plants maintenance. (author)

Clinical and financial considerations for implementing an ICU telemedicine program.

Science.gov (United States)

Kruklitis, Robert J; Tracy, Joseph A; McCambridge, Matthew M

2014-06-01

As the population in the United States increases and ages, the need to provide high-quality, safe, and cost-effective care to the most critically ill patients will be of great importance. With the projected shortage of intensivists, innovative changes to improve efficiency and increase productivity will be necessary. Telemedicine programs in the ICUs (tele-ICUs) are a successful strategy to improve intensivist access to critically ill patients. Although significant capital and maintenance costs are associated with tele-ICUs, these costs can be offset by indirect financial benefits, such as decreased length of stay. To achieve the positive clinical outcomes desired, tele-ICUs must be carefully designed and implemented. In this article, we discuss the clinical benefits of tele-ICUs. We review the financial considerations, including direct and indirect reimbursement and development and maintenance costs. Finally, we review design and implementation considerations for tele-ICUs.

Demonstration of improved seismic source inversion method of tele-seismic body wave

Science.gov (United States)

Yagi, Y.; Okuwaki, R.

2017-12-01

Seismic rupture inversion of tele-seismic body wave has been widely applied to studies of large earthquakes. In general, tele-seismic body wave contains information of overall rupture process of large earthquake, while the tele-seismic body wave is inappropriate for analyzing a detailed rupture process of M6 7 class earthquake. Recently, the quality and quantity of tele-seismic data and the inversion method has been greatly improved. Improved data and method enable us to study a detailed rupture process of M6 7 class earthquake even if we use only tele-seismic body wave. In this study, we demonstrate the ability of the improved data and method through analyses of the 2016 Rieti, Italy earthquake (Mw 6.2) and the 2016 Kumamoto, Japan earthquake (Mw 7.0) that have been well investigated by using the InSAR data set and the field observations. We assumed the rupture occurring on a single fault plane model inferred from the moment tensor solutions and the aftershock distribution. We constructed spatiotemporal discretized slip-rate functions with patches arranged as closely as possible. We performed inversions using several fault models and found that the spatiotemporal location of large slip-rate area was robust. In the 2016 Kumamoto, Japan earthquake, the slip-rate distribution shows that the rupture propagated to southwest during the first 5 s. At 5 s after the origin time, the main rupture started to propagate toward northeast. First episode and second episode correspond to rupture propagation along the Hinagu fault and the Futagawa fault, respectively. In the 2016 Rieti, Italy earthquake, the slip-rate distribution shows that the rupture propagated to up-dip direction during the first 2 s, and then rupture propagated toward northwest. From both analyses, we propose that the spatiotemporal slip-rate distribution estimated by improved inversion method of tele-seismic body wave has enough information to study a detailed rupture process of M6 7 class earthquake.

Bravocom süüdistab Tele2 ja EMT-d alatus konkurentsivõitluses / Kristiina Viiron

Index Scriptorium Estoniae

Viiron, Kristiina, 1971-

2007-01-01

Kallines Tele2 ja EMT võrgust Bravocomi mobiilinumbritele helistamise minutihind. Bravocomi juhatuse esimees Peep Põldsamm peab nii kalli hinna - 4.50 minut - kehtestamist konkurentsivõitluseks. Tabelid: Hinnavõrdlus. Lisa: Tele2 ja EMT kommentaarid

Integrity mechanism for eHealth tele-monitoring system in smart home environment.

Science.gov (United States)

Mantas, Georgios; Lymberopoulos, Dimitrios; Komninos, Nikos

2009-01-01

During the past few years, a lot of effort has been invested in research and development of eHealth tele-monitoring systems that will provide many benefits for healthcare delivery from the healthcare provider to the patient's home. However, there is a plethora of security requirements in eHealth tele-monitoring systems. Data integrity of the transferred medical data is one of the most important security requirements that should be satisfied in these systems, since medical information is extremely sensitive information, and even sometimes life threatening information. In this paper, we present a data integrity mechanism for eHealth tele-monitoring system that operates in a smart home environment. Agent technology is applied to achieve data integrity with the use of cryptographic smart cards. Furthermore, the overall security infrastructure and its various components are described.

Improving fatigue in multiple sclerosis by smartphone-supported energy management: The MS TeleCoach feasibility study.

Science.gov (United States)

D'hooghe, Marie; Van Gassen, Geert; Kos, Daphne; Bouquiaux, Olivier; Cambron, Melissa; Decoo, Danny; Lysandropoulos, Andreas; Van Wijmeersch, Bart; Willekens, Barbara; Penner, Iris-Katharina; Nagels, Guy

2018-03-27

Fatigue is a frequently occurring, often disabling symptom in MS with no single effective treatment. In current fatigue management interventions, personalized, real-time follow-up is often lacking. The objective of the study is to assess the feasibility of the MS TeleCoach, a novel intervention offering telemonitoring of fatigue and telecoaching of physical activity and energy management in persons with MS (pwMS) over a 12-week period. The goal of the MS TeleCoach, conceived as a combination of monitoring, self-management and motivational messages, is to enhance levels of physical activity thereby improving fatigue in pwMS in an accessible and interactive way, reinforcing self-management of patients. We conducted a prospective, open-label feasibility study of the MS TeleCoach in pwMS with Expanded Disability Status Scale ≤ 4 and moderate to severe fatigue as measured by the Fatigue Scale for Motor and Cognitive Functions (FSMC). Following a 2-week run-in period to assess the baseline activity level per patient, the target number of activity counts was gradually increased over the 12-week period through telecoaching. The primary efficacy outcome was change in FSMC total score from baseline to study end. A subset of patients was asked to fill in D-QUEST 2.0, a usability questionnaire, to evaluate the satisfaction with the MS TeleCoach device and the experienced service. Seventy-five patients were recruited from 16 centres in Belgium, of which 57 patients (76%) completed the study. FSMC total score (p = 0.009) and motor and cognitive subscores (p = 0.007 and p = 0.02 respectively) decreased from baseline to week 12, indicating an improvement in fatigue. One third of participants with severe fatigue changed to a lower FSMC category for both FSMC total score and subscores. The post-study evaluation of patient satisfaction showed that the intervention was well accepted and that patients were very satisfied with the quality of the professional services

Arizona TeleMedicine Network: System Procurement Specifications.

Science.gov (United States)

Atlantic Research Corp., Alexandria, VA.

Providing general specifications and system descriptions for segments within the Arizona TeleMedicine Project (a telecommunication system designed to deliver health services to rurally isolated American Indians in Arizona), this document, when used with the appropriate route segment document, will completely describe the project's required…

75 FR 69470 - Tele Atlas North America, Inc., Currently Doing Business as Tom Tom Including Off-Site Workers...

Science.gov (United States)

2010-11-12

...,839B; TA-W-70,839C] Tele Atlas North America, Inc., Currently Doing Business as Tom Tom Including Off... Business as Tom Tom, Concord, MA; Tele Atlas North America, Inc. Currently Doing Business as Tom Tom, Detroit, MI; Tele Atlas North America, Inc. Currently Doing Business as Tom Tom, Redwood, CA; Amended...

[Quality management in cardiovascular echography].

Science.gov (United States)

Gullace, Giuseppe

2002-12-01

The quality management of an organization can be defined as the ability to identify, plan and implement programs of measure, analysis, verification and control that allow to monitor management, resources, activities, processes and output/outcome of the same organization, including the satisfaction of the customers. Whatever the model used, it is demonstrated that the management-quality system, either for professional quality or for organization, turns out to be effective even in the health organizations within and to any level of organizational-structural complexity. The present paper concerns the experience of the Italian Society of Cardiovascular Echography (SIEC) on quality certification, both as a scientific society compared to other health organizations and to cardiovascular echo laboratories, and the definition of minimum requirements for the accreditation of the same laboratories. The model most frequently used for quality management is represented by the ISO 9000: Vision 2000, that is a management model with specific reference to the organization and the customer satisfaction. The model applied to the health structure needs a rapid change in mentality that addresses the operators to define, share and achieve objectives to be brought on by means of an active collaboration, group activity and deep sense of belonging necessary to the attainment of expected objectives. When the model is applied by a scientific society, it is necessary to take into account the different structural and functional organization, the constitution and the operators differing on the point of view of origin, experiences, mentality, and roles. The ISO 9000: Vision 2000 model can be applied also to the cardiovascular echo laboratory which may be compared to a simple organization; for its corrected functioning, SIEC has defined minimal requirements for the accreditation, realization and modalities to carry out and manage quality. The quality system represents a new way of operating of an

Arizona TeleMedicine Network: Engineering Master Plan.

Science.gov (United States)

Atlantic Research Corp., Alexandria, VA.

As the planning document for establishing a statewide health communications system initially servicing the Papago, San Carlos and White Mountain Apache, Navajo, and Hopi reservations, this document prescribes the communications services to be provided by the Arizona TeleMedicine Network. Specifications include: (1) communications services for each…

Nuclear tele medicine; Telemedicina nuclear

Energy Technology Data Exchange (ETDEWEB)

Vargas, L.; Hernandez, F.; Fernandez, R. [Departamento de Medicina Nuclear, Imagenologia Diagnostica, Xalapa, Veracruz (Mexico)

2005-07-01

The great majority of the digital images of nuclear medicine are susceptible of being sent through internet. This has allowed that the work in diagnosis cabinets by image it can benefit of this modern technology. We have presented in previous congresses works related with tele medicine, however, due to the speed in the evolution of the computer programs and the internet, becomes necessary to make a current position in this modality of work. (Author)

Australian national networked tele-test facility for integrated systems

Science.gov (United States)

Eshraghian, Kamran; Lachowicz, Stefan W.; Eshraghian, Sholeh

2001-11-01

The Australian Commonwealth government recently announced a grant of 4.75 million as part of a 13.5 million program to establish a world class networked IC tele-test facility in Australia. The facility will be based on a state-of-the-art semiconductor tester located at Edith Cowan University in Perth that will operate as a virtual centre spanning Australia. Satellite nodes will be located at the University of Western Australia, Griffith University, Macquarie University, Victoria University and the University of Adelaide. The facility will provide vital equipment to take Australia to the frontier of critically important and expanding fields in microelectronics research and development. The tele-test network will provide state of the art environment for the electronics and microelectronics research and the industry community around Australia to test and prototype Very Large Scale Integrated (VLSI) circuits and other System On a Chip (SOC) devices, prior to moving to the manufacturing stage. Such testing is absolutely essential to ensure that the device performs to specification. This paper presents the current context in which the testing facility is being established, the methodologies behind the integration of design and test strategies and the target shape of the tele-testing Facility.

Effect of a tele-training programme on radiographers in the interpretation of CT colonography

DEFF Research Database (Denmark)

Lauridsen, Carsten; Lefere, Philippe; Gerke, Oke

2012-01-01

OBJECTIVE: To assess the performance of radiographers in CT colonography (CTC) after a tele-training programme, supervised by 2 experienced radiologists. MATERIALS AND METHODS: Five radiographers underwent training in CTC using a tele-training programme mainly based on the interpretation of 75...... training cases performed in the novice department. To evaluate the educational performance, each radiographer was tested on 20 test cases with 27 lesions >6mm (12: 6-9mm; 15: >10mm). Sensitivity, specificity and PPV for polyps ≥6mm and ≥10mm were calculated with point estimates and 95% confidence interval...... (95% CI). The results were compared by comparing 95% CI with a 5% significance level. RESULTS: In the training cases overall per-polyp sensitivity was 57% (95% CI 46.1-67.9) and 69.1% (95% CI 50.6-87.5) for lesions ≥6mm and ≥10mm, respectively. Overall per patient sensitivity, specificity and PPV were...

Prototyping a Hybrid Cooperative and Tele-robotic Surgical System for Retinal Microsurgery.

Science.gov (United States)

Balicki, Marcin; Xia, Tian; Jung, Min Yang; Deguet, Anton; Vagvolgyi, Balazs; Kazanzides, Peter; Taylor, Russell

2011-06-01

This paper presents the design of a tele-robotic microsurgical platform designed for development of cooperative and tele-operative control schemes, sensor based smart instruments, user interfaces and new surgical techniques with eye surgery as the driving application. The system is built using the distributed component-based cisst libraries and the Surgical Assistant Workstation framework. It includes a cooperatively controlled EyeRobot2, a da Vinci Master manipulator, and a remote stereo visualization system. We use constrained optimization based virtual fixture control to provide Virtual Remote-Center-of-Motion (vRCM) and haptic feedback. Such system can be used in a hybrid setup, combining local cooperative control with remote tele-operation, where an experienced surgeon can provide hand-over-hand tutoring to a novice user. In another scheme, the system can provide haptic feedback based on virtual fixtures constructed from real-time force and proximity sensor information.

The duplex-Doppler colour echography of the scrotum and testicles in adults and boys. II. the contribution of the urgent study of acute scrotum symptoms; Ecografia duples-Doppler color del escroto y el testiculo en el adulto y el nino. II. Aportacion al estudio urgente del escroto agudo

Energy Technology Data Exchange (ETDEWEB)

Rangel-Villalobos, E.; Jimenez-Castellanos, R.; Bustos, C.; Linares, A.; Gonzalez-Prada, F. [Hospital Universitario Virgen Macarena. Sevilla (Spain)

1999-07-01

To analyse the findings, contributions and limitations of the Doppler echography for the urgent study of acute scrotum symptoms, both in adults and in boys. 60 patients (22 adults and 38 boys) with acute scrotal symptomatology were examined using B mode echography, followed by a colour duplex-Doppler (CDD) echography with a lineal 7.5 MHz transducer. We compared the findings obtained with those of the healthy contralateral testicle and with surgery or clinical-echographical evolution. The most common pathology was inflammation (27%) followed by ischemic (24%) and traumatic (17%). 12% of the patients had miscellaneous conditions. To conclude, in 20% of the cases the B mode and the Doppler examination was normal, the symptoms were resolved spontaneously. After carrying out the CDD only 14 (23%) of the cases needed immediate surgery and 3 (5%) delayed surgery, the remaining 43 (72%) patients responded to the traditional treatment. The CDD allows for a safe, quick and harmless diagnosis in practically all the acute scrotum cases, for both adults and boys. Its limitations in pre-puberty patients or in cases that were atypical are overcome when put in the hands of an expert radiologist, as they need a longer exploration time and suitable Doppler equipment. The main contribution to the urgent diagnosis of acute scrotum symptoms is that it accurately establishes which patients should be chosen for immediate surgery. (Author) 33 refs.

TeleMed: Wide-area, secure, collaborative object computing with Java and CORBA for healthcare

Energy Technology Data Exchange (ETDEWEB)

Forslund, D.W.; George, J.E.; Gavrilov, E.M.

1998-12-31

Distributed computing is becoming commonplace in a variety of industries with healthcare being a particularly important one for society. The authors describe the development and deployment of TeleMed in a few healthcare domains. TeleMed is a 100% Java distributed application build on CORBA and OMG standards enabling the collaboration on the treatment of chronically ill patients in a secure manner over the Internet. These standards enable other systems to work interoperably with TeleMed and provide transparent access to high performance distributed computing to the healthcare domain. The goal of wide scale integration of electronic medical records is a grand-challenge scale problem of global proportions with far-reaching social benefits.

Network Support for Social 3-D Immersive Tele-Presence with Highly Realistic Natural and Synthetic Avatar Users

NARCIS (Netherlands)

R.N. Mekuria (Rufael); A. Frisiello (Antonella); M Pasin (Marco); P.S. Cesar Garcia (Pablo Santiago)

2015-01-01

htmlabstractThe next generation in 3D tele-presence is based on modular systems that combine live captured object based 3D video and synthetically authored 3D graphics content. This paper presents the design, implementation and evaluation of a network solution for multi-party real-time communication

TeleFood: a worldwide appeal.

Science.gov (United States)

1997-12-01

In 1997, the UN Food and Agriculture Organization (FAO) broadcast its first global television program on the theme of "Food for All" to an audience of approximately 450 million viewers. The objective of "TeleFood" was to raise awareness of the scale of the problem and to encourage solidarity in the fight against hunger. TeleFood raised funds to support the FAO's Special Programme for Food Security (SPFS) and similar grassroots projects that target rural people in developing countries. The SPFS project, now operational in 19 countries and being formulated in 32 more, emphasizes national ownership, farmer participation, environmental awareness, and recognition of the role of women in food production and marketing. The 3-year SPFS pilot phase involves 1) small-scale water harvesting, irrigation, and drainage; 2) sustainable intensification of crop production; 3) diversification of production; and 4) removal of policies that impede food security. Results to date include 1) greatly increased maize and potato yields in Bolivia and more modest increases in Nepal; 2) doubled yields of maize and rice in Tanzania; and 3) expansion of the area under low-cost irrigation in Zambia. South-South cooperation is allowing some developing countries to benefit from experience gained in other developing countries. The pilot activities are being funded with an increasing number of "soft" loans from governments and financial institutions.

Rapid Deployment of International Tele-Intensive Care Unit Services in War-Torn Syria.

Science.gov (United States)

Moughrabieh, Anas; Weinert, Craig

2016-02-01

The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country.

Tele-evidence: A videoconferencing tool as a viable alternative to physical appearance of doctors for the judicial summons.

Science.gov (United States)

Bari, S; Arora, P; Gupta, A K; Singh, M; Aggarwal, A K

2018-06-26

The role of physicians often extends beyond provision of direct patient care and includes appearance in courts as professional or expert witnesses to give their testimony in various legal cases. This often consumes precious time and resources of the doctors and the hospitals. This study was taken up to evaluate the present system of the physical appearance of the doctors to various courts and compare it with the videoconferencing mode of giving testimony (tele-evidence). Available records of summons and vehicles used were analyzed to calculate the cost involved and man-hours consumed in honoring the court summons. Telemedicine facility, available in our institute, was used for conducting tele-evidence with selected courts of the two states as a pilot, which was later expanded. A survey was also done to assess the experience of the physicians with physical appearance and videoconferencing using structured questionnaire after approval from the Institute's Ethics Committee. Likert scale of 0-10 points was used to measure satisfaction. There was 43% drop in the monthly mileage of vehicles, 49% reduction in the fuel cost per month, and 28% savings in terms of time consumed for court duties. Satisfaction score for parameters of time consumed, physical strain, mental strain, communication with Honorable Judges, and overall experience was 87% through tele-evidence as compared to 31% with physical appearance. Tele-evidence is an acceptable and implementable mode of testifying and has led to tremendous resource savings in our tertiary care setting. The model needs to be replicated for deliverance of justice and is in consonance with Government's push toward Digital India.

Advanced Tele-operation

International Nuclear Information System (INIS)

Decreton, M.

1998-01-01

Maintenance, repair, and dismantling operations in nuclear facilities have to be performed remotely when high radiation doses exclude hands-on operation, but also to minimize contamination risks and occupational doses to the operators. Computer-aided and sensor-based tele-operation enhances safety, reliability, and performance by helping the operator in difficult tasks with poor remote environmental perception. The objectives of work in this domain are to increase the scientific knowledge of the studied phenomena, to improve the interpretation of data, to improve the piloting og experimental devices during irradiation, to reveal and to understand possible unexpected phenomena occurring during irradiation. This scientific report describes the achievements for 1997 in the area of radiation tolerance for of remote-sensing, optical fibres and optical fibre sensors

Adaptive tele-application for remote neurology diagnosis.

Science.gov (United States)

Garcia, E; Guyennet, H; Lapayre, J-C; Moulin, T

2005-12-01

This paper presents the Collaborative Tele-Neurology (TeNeCi) project which allows practitioners to use telecommunication technologies to provide medical information and services for neurological diseases. Specificities of remote neurology are described and the Cooperative Application Framework (CAliF) multimedia platform on which TeNeCi relies is presented. The technical requirements of such a project in terms of communication and consistency management, audio and video transmissions, and network support, as well as implementation of TeNeCi was evaluated. The software used in this application is composed of several services, such as a Digital Imaging and Communications in Medicine (DICOM) explorer, a DICOM viewer, and a security service. Tests performed on this first TeNeCi release showed good results, and allowed us to explore a larger collaborative experimentation between hospitals in France and Switzerland.

The TeleTOP initiative: new learning, new technology

NARCIS (Netherlands)

Collis, Betty

2002-01-01

In response to the challenge to make learning more flexible while at the same time maintaining the positive qualities of classroom and campus-based settings, the TeleTOP Initiative at the University of Twente has grown from a faculty initiative to an internationally recognised Web-based learning

DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol.

Science.gov (United States)

Tobe, Sheldon W; Wentworth, Joan; Ironstand, Laurie; Hartman, Susan; Hoppe, Jackie; Whiting, Judi; Kennedy, Janice; McAllister, Colin; Kiss, Alex; Perkins, Nancy; Vincent, Lloyd; Pylypchuk, George; Lewanczuk, Richard Z

2009-05-09

The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Protocol NCT00325624.

Virtual TeleRehab: a case study.

Science.gov (United States)

Pareto, Lena; Johansson, Britt; Zeller, Sally; Sunnerhagen, Katharina S; Rydmark, Martin; Broeren, Jurgen

2011-01-01

We examined the efficacy of a remotely based occupational therapy intervention. A 40-year-old woman who suffered a stroke participated in a telerehabilitation program. The intervention method is based on virtual reality gaming to enhance the training experience and to facilitate the relearning processes. The results indicate that Virtual TeleRehab is an effective method for motivational, economical, and practical reasons by combining game-based rehabilitation in the home with weekly distance meetings.

THE EFFECT OF TELE-MONITORING ON EXERCISE TRAINING ADHERENCE, FUNCTIONAL CAPACITY, QUALITY OF LIFE AND GLYCEMIC CONTROL IN PATIENTS WITH TYPE II DIABETES

Directory of Open Access Journals (Sweden)

Tracy Marios

2012-03-01

Full Text Available We used tele-monitoring to attempt to improve exercise adherence (number of hours of exercise completed, peak VO2, HbA1c% and quality of life in an unsupervised, home based exercise program in people with type II diabetes, a cost analysis was also conducted. Thirty-nine patients with type II diabetes were randomized to tele-monitoring (TELE or control (CON groups. All patients were asked to complete 6 months exercise training and complete an exercise activity diary. The TELE group was instructed to record their exercise heart rates using a monitor and received weekly telephone calls from an exercise physiologist. Six TELE patients and seven CON patients did not complete the 6 month testing. TELE patients completed a mean weekly volume of 138 minutes, moderate intensity exercise, while CON patients completed 58 minutes weekly (p < 0.02. Neither group achieved the American Heart Association statement guideline for weekly exercise volume of 150 minutes. TELE patients improved peak VO2 (5.5 %, but neither group improved HbA1c% or quality of life. The CON group showed a 4.9% reduction in peak VO2. While tele-monitored patients completed more hours of exercise and demonstrated improved peak VO2 compared to controls, the exercise volume completed was insufficient to improve glycemic control. There is the potential via tele-monitoring to enable people with diabetes to meet exercise training guidelines.

Regulation, control, tele-management; Regulation, commande, telegestion

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

In 1998, the French public authorities have started an ambitious energy mastery policy under the auspices of the Agency of environment and energy mastery (Ademe). One aspect of this policy concerns the R and D, industrial development and applications of automation and computerized control to the energy systems of buildings. This RCT 2000 seminar takes stock of the recent advances in this domain 7 years after the previous RCT issue. The first day of the seminar was devoted to new developments in regulation and control (ergonomics aspects, lighting systems, air conditioning in accommodations, solar systems etc..). Stress was put on the revolution expected with the introduction of domestic computer applications and Internet. This first day ended with a precise status of the standardization and future regulatory aspects. The second day was dealing with tele-management and technical management systems for buildings with an analysis of the impact of Internet and of the sensors and actuators capacity in information processing. The consequences and new requirements of the thermal regulation 2000 and the factors of success of a new start-up of the tele-management market in local authorities and social accommodations were analyzed too. (J.S.)

Assisted supervision of a computer aided tele-operation system

Energy Technology Data Exchange (ETDEWEB)

Le Bars, H; Gravez, P; Fournier, R

1994-12-31

This paper talks about Computer Aided Tele-operation (CAT) in dismantling and maintenance of nuclear plants. The current research orientations at CEA, basic concepts of the supervision assistance system and the realisation of a prototype are presented. (TEC). 3 refs., 4 figs.

Assisted supervision of a computer aided tele-operation system

International Nuclear Information System (INIS)

Le Bars, H.; Gravez, P.; Fournier, R.

1994-01-01

This paper talks about Computer Aided Tele-operation (CAT) in dismantling and maintenance of nuclear plants. The current research orientations at CEA, basic concepts of the supervision assistance system and the realisation of a prototype are presented. (TEC). 3 refs., 4 figs

Tele command and network automation: strategy and results; Telecomando e automacao de redes: estrategia e resultados

Energy Technology Data Exchange (ETDEWEB)

Bargigia, Angelo; Cerreti, Alberto; Lembo, Giorgio di; Rogai, Sergio; Veglio, Gianfranco [Enel Distribuzione Spa, Rome (Italy)

2004-02-01

This article presents the adopted by the ENEL Distribuzione, Italy, for the tele command and automation in the distribution line. The article describes the medium term implementation program, based on the installation of remote terminal unities, with communication through cell phone GMS for transmission of collected data to the control centers of the network. A cost versus benefit analysis conducted and the obtained results are also evaluated.

DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol

Directory of Open Access Journals (Sweden)

Kiss Alex

2009-05-01

Full Text Available Abstract Background The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. Methods and design The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. Discussion The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Trial Registration Protocol NCT00325624

3D Stereo Visualization for Mobile Robot Tele-Guide

DEFF Research Database (Denmark)

Livatino, Salvatore

2006-01-01

The use of 3D stereoscopic visualization may provide a user with higher comprehension of remote environments in tele-operation when compared to 2D viewing. In particular, a higher perception of environment depth characteristics, spatial localization, remote ambient layout, as well as faster system...

POT: Planning, Organisation and Tele-Information

DEFF Research Database (Denmark)

Vidal, Rene Victor Valqui

1996-01-01

The main purpose of this paper is to introduce the framwork of a research project carried out at the Technical University of Denmark dealing with 'holistic' and interdisciplinary (systems oriented)methods for strategic planning and organisational re-design in connection with the introduction...... of tele-information technologies and hte new demands of hte so-called information society, the POT proejct. Three specirfic projects are shortly introduced: planning in networked firms, strategic approaches to climate change and strategies for the schools of the future....

Passive hybrid force-position control for tele-operation based on real-time simulation of a virtual mechanism

International Nuclear Information System (INIS)

Joly, L.; Andriot, C.

1995-01-01

Hybrid force-position control aims at controlling position and force in separate directions. It is particularly useful to perform certain robotic tasks. In tele-operation context, passivity is important because it ensures stability when the system interacts with any passive environment. In this paper, we propose an original approach to hybrid force-position control of a force reflecting tele-robot system. It is based on real-time simulation of a virtual mechanism corresponding to the task. the resulting control law is passive. Experiments on a 6 degrees of freedom tele-operation system consisting in following a bent pipe under several control modes validate the approach. (authors). 12 refs., 6 figs

O PERCURSO EPISTÊMICO DO SÁBIO NA METAFÍSICA DE ARISTÓTELES

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Carlos Wagner Benevides Gomes

2015-06-01

Full Text Available Aristóteles (383-322 a.C foi considerado, dentre os primeiros pensadores (os Pré-Socráticos, o responsável pela pesquisa sistemática da filosofia. Aristóteles, em Metafísica, explicita com a chamada “filosofia primeira” o problema de um conceito de Sabedoria e da “ciência investigada”, que é a do ser enquanto ser. Diferente da tradição platônica, Aristóteles propôs uma filosofia voltada para o mundo exterior, pois enquanto o conhecimento para Platão tinha relação com uma “reminiscência das formas” (Teoria das Ideias ou das Formas, para Aristóteles o conhecimento se diz de muitas maneiras, porque relaciona-se aos diversos modos de captarmos os objetos pelas senso-percepções. Este artigo tem como objetivo explicitar, a partir da Metafísica, nos Livros I (capítulos 1, 2 e 3, II (capítulo 1 e III (capítulo 1, o processo epistemológico do Sábio (Sophos, perpassando pelos elementos que conduzem à Sabedoria (Sophia como ciência teórica. Por conseguinte, analisa-se alguns conceitos pertinentes às seguintes problemáticas do conhecimento humano: a senso-percepção, a imagem, a memória e a experiência. Além de, a questão do Sábio, as Causas, a investigação da verdade e as ciências especulativas e práticas. Portanto, conclui-se que Aristóteles mostrou o percurso das senso-percepções à formulação do “Universal” que conduz o filósofo à Sabedoria, ou seja, aos princípios primeiros que consistem no conhecimento das causas de todas as coisas, à medida que o Sábio enfrenta algumas dificuldades (Aporia.

TELE-X and its role in a future operational Nordic satellite system

Science.gov (United States)

Anderson, Lars

In the middle of 1987 it is planned to launch TELE-X, the first Nordic telecommunications satellite. The Swedish-Norwegian company NOTELSAT (Nordic Telecommunications Satellite Corporation) will be responsible for the operation of the TELE-X system. Via the experimental TELE-X satellite the Nordic countries will get access to direct broadcasting of two TV-programs and at least four digital sound programs in stereo by use of two transponders in the 12.2 to 12.5 GHz band. The programs are planned to be composed of nationally produced programs in Norway. Sweden and Finland. By means of distributing these programs via satellite they will reach up to 4 times as many viewers and listernes as presently in the terrestrial national systems. The basic motivations for exchanging programs are to strengthen the cultural ties between the Nordic countries and to give the individuals more freedom in the choice of programs. Another goal is to give the public a better sound and picture quality than can be achieved today. These quality improvements shall be met by using small receiver parabolas of less than 1 m in diameter. Contributing to the improved quality is the choice of the C-MAC (Multiplexed Analoque Components) modulation system. TELE-X is a multipurpose satellite which besides the two TV-transponders will have two transponders for data/video communication in the frequency band 12.5 to 12.75 GHz. The choice of system for data and video is based on the philosophy of thin-route traffic between small and low cost earth stations (1.8 to 2.5 m) placed directly at the subscribers premises. The system includes an advanced Data/Video Control Station which automatically connects the traffic stations with standarized transmission speeds up to 2 Mbps. The system which is based on the SCPC/DAMA method can be expanded up to 5000 traffic stations. Numerous data/video applications will be investigated in the initial experimental phase of the project which also will be used for market

Estabelecimento de serviço de tele-eletrocardiografia digital no sul do Brasil = Establishment of a Digital Tele-Electrocardiographic System in southern Brazil

Directory of Open Access Journals (Sweden)

Sparenberg, Adolfo Luiz Falcão

2005-01-01

Conclusão: Em decorrência dos resultados descritos e de seu baixo custo, o Sistema de Tele-ECG Digital foi considerado como de grande utilidade para as Instituições de Saúde, beneficiando pequenas cidades, comunidades remotas e áreas rurais do Brasil

Limitations of CT and ultrasound diagnoses in the evaluation of uterine cancer involvement

International Nuclear Information System (INIS)

Sato, Yasumi; Maki, Masahiro; Seki, Haruo; Saito, Yoshiharu.

1988-01-01

The concordance rates between preoperative diagnostic imagings and postoperative pathologic findings were examined in a total of 36 patients with resectable uterine cancer (19 with cervical cancer and 27 with endometrial cancer). The accuracy of CT was 47 % in the evaluation of cervical cancer involvement to the parametrium; and was 83 % in the evaluation of wall involvement of endometrial cancer. The concordance rate was 74 % in the evaluation of stage-grouping in endometrial cancer. Out of 8 patients with resectable stage II cervical cancer, four (50 %) were found to have had involvement to the parametrium by transrectal echography. The results indicate that CT scanning and transrectal echography have limitations in the diagnosis of cervical cancer involvement to the parametrium. (Namekawa, K.)

Effect of tele health care on exacerbations and hospital admissions in patients with chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Ringbæk, Thomas; Green, Allan; Laursen, Lars Christian

2015-01-01

BACKGROUND AND OBJECTIVE: Tele monitoring (TM) of patients with chronic obstructive pulmonary disease (COPD) has gained much interest, but studies have produced conflicting results. Our aim was to investigate the effect of TM with the option of video consultations on exacerbations and hospital...... not reduce hospital admissions for exacerbated COPD, but TM may be an alternative to visits at respiratory outpatient clinics. Further studies are needed to establish the optimal role of TM in the management of severe COPD....

The development of advanced robotic technology. A study on the tele-existence and intelligent control of a robot system for nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Chung, Myung Jin; Byun, Jueng Nam; Kim, Jong Hwan; Lee, Ju Jang; Bang, Seok Won; Chu, Gil Hwan; Park, Jong Cheol; Choi, Jong Seok; Yang, Jung Min; Hong, Sun Ki [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

1995-07-01

To increase the efficiency of human intelligence it is required to develop an intelligent monitoring and system. In this research, we develop intelligent control methods related with tele-operation, tele-existence, real-time control technique, and intelligent control technique. Those are key techniques in tele-operation, especially for the repair and maintenance of nuclear power plants. The objective of this project is to develop of the tele-existence and intelligent control system for a robot used in the nuclear power plants. (author). 20 refs.

Assistant Personal Robot (APR: Conception and Application of a Tele-Operated Assisted Living Robot

Directory of Open Access Journals (Sweden)

Eduard Clotet

2016-04-01

Full Text Available This paper presents the technical description, mechanical design, electronic components, software implementation and possible applications of a tele-operated mobile robot designed as an assisted living tool. This robotic concept has been named Assistant Personal Robot (or APR for short and has been designed as a remotely telecontrolled robotic platform built to provide social and assistive services to elderly people and those with impaired mobility. The APR features a fast high-mobility motion system adapted for tele-operation in plain indoor areas, which incorporates a high-priority collision avoidance procedure. This paper presents the mechanical architecture, electrical fundaments and software implementation required in order to develop the main functionalities of an assistive robot. The APR uses a tablet in order to implement the basic peer-to-peer videoconference and tele-operation control combined with a tactile graphic user interface. The paper also presents the development of some applications proposed in the framework of an assisted living robot.

Design of a Tele-Control Electrical Vehicle System Using a Fuzzy Logic Control

Directory of Open Access Journals (Sweden)

M. Boukhnifer

2012-11-01

Full Text Available This paper presents a fuzzy logic design of a tele-control electrical vehicle system. We showed that the application of fuzzy logic control allows the stability of tele-vehicle system in spite of communication delays between the operator and the vehicle. A robust bilateral controller design using fuzzy logic frameworks was proposed. This approach allows a convenient means to trade off robustness and stability for a pre-specified time-delay margin. Both the performance and robustness of the proposed method were demonstrated by simulation results for a constant time delay between the operator and the electrical vehicle system.

An open real-time tele-stethoscopy system

OpenAIRE

Foche-Perez, Ignacio; Ramirez-Payba, Rodolfo; Hirigoyen-Emparanza, German; Balducci-Gonzalez, Fernando; Simo-Reigadas, Francisco-Javier; Seoane-Pascual, Joaquin; Corral-Peñafiel, Jaime; Martinez-Fernandez, Andres

2012-01-01

Abstract Background Acute respiratory infections are the leading cause of childhood mortality. The lack of physicians in rural areas of developing countries makes difficult their correct diagnosis and treatment. The staff of rural health facilities (health-care technicians) may not be qualified to distinguish respiratory diseases by auscultation. For this reason, the goal of this project is the development of a tele-stethoscopy system that allows a physician to receive real-time cardio-respir...

EQClinic: a platform for learning communication skills in clinical consultations.

Science.gov (United States)

Liu, Chunfeng; Scott, Karen M; Lim, Renee L; Taylor, Silas; Calvo, Rafael A

2016-01-01

Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of

EQClinic: a platform for learning communication skills in clinical consultations

Directory of Open Access Journals (Sweden)

Chunfeng Liu

2016-07-01

Full Text Available Background: Doctors’ verbal and non-verbal communication skills have an impact on patients’ health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient–doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods: We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs, with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results: Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7, and reported that the structure (5.4/7 and information (5.8/7 were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion: It is not easy to improve non

Analysis of human-in-the-loop tele-operated maintenance inspection tasks using VR

International Nuclear Information System (INIS)

Boessenkool, H.; Abbink, D.A.; Heemskerk, C.J.M.; Steinbuch, M.; Baar, M.R. de; Wildenbeest, J.G.W.; Ronden, D.; Koning, J.F.

2013-01-01

Highlights: ► Execution of tele-operated inspection tasks for ITER maintenance was analyzed. ► Human factors experiments using Virtual Reality showed to be a valuable approach. ► A large variation in time performance and number of collisions was found. ► Results indicate significant room for improvement for teleoperated free space tasks. ► A promising solution is haptic shared control: assist operator with guiding forces. -- Abstract: One of the challenges in future fusion plants such as ITER is the remote maintenance of the plant. Foreseen human-in-the-loop tele-operation is characterized by limited visual and haptic feedback from the environment, which results in degraded task performance and increased operator workload. For improved tele-operated task performance it is required to get insight in the expected tasks and problems during maintenance at ITER. By means of an exploratory human factor experiment, this paper analyses problems and bottlenecks during the execution of foreseen tele-operated maintenance at ITER, identifying most promising areas of improvement. The focus of this paper is on free space (sub)tasks where contact with the environment needs to be avoided. A group of 5 subjects was asked to carry-out an ITER related free space task (visual inspection), using a six degree of freedom master device connected to a simulated hot cell environment. The results show large variation in time performance between subjects and an increasing number of collisions for more difficult tasks, indicating room for improvement for free space (sub)tasks. The results will be used in future research on the haptic guidance strategies in the ITER Remote Handling framework

Analysis of human-in-the-loop tele-operated maintenance inspection tasks using VR

Energy Technology Data Exchange (ETDEWEB)

Boessenkool, H., E-mail: h.boessenkool@differ.nl [FOM Institute DIFFER (Dutch Institute for Fundamental Energy Research), Association EURATOM-FOM, Partner in the Trilateral Euregio Cluster, PO Box 1207, 3430 BE Nieuwegein (Netherlands); Eindhoven University of Technology, Department of Mechanical Engineering, Dynamics and Control Group, PO Box 513, 5600 MB Eindhoven (Netherlands); Abbink, D.A. [Delft University of Technology, Faculty of 3mE, BioMechanical Engineering Department, Mekelweg 2, 2628 CD Delft (Netherlands); Heemskerk, C.J.M. [Heemskerk Innovative Technology B.V., Jonckerweg 12, 2201 DZ Noordwijk (Netherlands); Steinbuch, M. [Eindhoven University of Technology, Department of Mechanical Engineering, Dynamics and Control Group, PO Box 513, 5600 MB Eindhoven (Netherlands); Baar, M.R. de [FOM Institute DIFFER (Dutch Institute for Fundamental Energy Research), Association EURATOM-FOM, Partner in the Trilateral Euregio Cluster, PO Box 1207, 3430 BE Nieuwegein (Netherlands); Eindhoven University of Technology, Department of Mechanical Engineering, Dynamics and Control Group, PO Box 513, 5600 MB Eindhoven (Netherlands); Wildenbeest, J.G.W. [Delft University of Technology, Faculty of 3mE, BioMechanical Engineering Department, Mekelweg 2, 2628 CD Delft (Netherlands); Heemskerk Innovative Technology B.V., Jonckerweg 12, 2201 DZ Noordwijk (Netherlands); Ronden, D. [FOM Institute DIFFER (Dutch Institute for Fundamental Energy Research), Association EURATOM-FOM, Partner in the Trilateral Euregio Cluster, PO Box 1207, 3430 BE Nieuwegein (Netherlands); Koning, J.F. [Heemskerk Innovative Technology B.V., Jonckerweg 12, 2201 DZ Noordwijk (Netherlands)

2013-10-15

Highlights: ► Execution of tele-operated inspection tasks for ITER maintenance was analyzed. ► Human factors experiments using Virtual Reality showed to be a valuable approach. ► A large variation in time performance and number of collisions was found. ► Results indicate significant room for improvement for teleoperated free space tasks. ► A promising solution is haptic shared control: assist operator with guiding forces. -- Abstract: One of the challenges in future fusion plants such as ITER is the remote maintenance of the plant. Foreseen human-in-the-loop tele-operation is characterized by limited visual and haptic feedback from the environment, which results in degraded task performance and increased operator workload. For improved tele-operated task performance it is required to get insight in the expected tasks and problems during maintenance at ITER. By means of an exploratory human factor experiment, this paper analyses problems and bottlenecks during the execution of foreseen tele-operated maintenance at ITER, identifying most promising areas of improvement. The focus of this paper is on free space (sub)tasks where contact with the environment needs to be avoided. A group of 5 subjects was asked to carry-out an ITER related free space task (visual inspection), using a six degree of freedom master device connected to a simulated hot cell environment. The results show large variation in time performance between subjects and an increasing number of collisions for more difficult tasks, indicating room for improvement for free space (sub)tasks. The results will be used in future research on the haptic guidance strategies in the ITER Remote Handling framework.

Development of a program for tele-rehabilitation of COPD patients across sectors: co-innovation in a network

Directory of Open Access Journals (Sweden)

Birthe Dinesen

2011-03-01

Full Text Available Introduction: The aim of the Telekat project is to prevent re-admissions of patients with chronic obstructive pulmonary disease (COPD by developing a preventive programof tele-rehabilitation across sectors for COPD patients. The development of the program is based on a co-innovation process between COPD patients, relatives, healthcare professionals and representatives from private firms and universities. This paper discusses theobstacles that arise in the co-innovation process of developing an integrated technique for tele-rehabilitation of COPD patients.Theory: Network and innovation theory.Methods: The casestudy was applied. A triangulation of data collection techniques was used: documents, observations (123 hours, qualitative interviews (n=32 and action research.Findings: Obstacles were identified in the network context; these obstacles included the mindset of the healthcare professionals, inter-professionals relations, views of technology as a tool and competing visions for the goals of tele-rehabilitation.Conclusion: We have identified obstacles that emerge in the co-innovation process when developing a programme for tele-rehabilitation of COPD patients in an inter-organizational context. Action research has been carried out and can have helped to facilitate the co-innovation process.

A novel remote center of motion mechanism for the force-reflective master robot of haptic tele-surgery systems.

Science.gov (United States)

Hadavand, Mostafa; Mirbagheri, Alireza; Behzadipour, Saeed; Farahmand, Farzam

2014-06-01

An effective master robot for haptic tele-surgery applications needs to provide a solution for the inversed movements of the surgical tool, in addition to sufficient workspace and manipulability, with minimal moving inertia. A novel 4 + 1-DOF mechanism was proposed, based on a triple parallelogram linkage, which provided a Remote Center of Motion (RCM) at the back of the user's hand. The kinematics of the robot was analyzed and a prototype was fabricated and evaluated by experimental tests. With a RCM at the back of the user's hand the actuators far from the end effector, the robot could produce the sensation of hand-inside surgery with minimal moving inertia. The target workspace was achieved with an acceptable manipulability. The trajectory tracking experiments revealed small errors, due to backlash at the joints. The proposed mechanism meets the basic requirements of an effective master robot for haptic tele-surgery applications. Copyright © 2013 John Wiley & Sons, Ltd.

Health Economic Evaluation of Telehealthcare

DEFF Research Database (Denmark)

Udsen, Flemming Witt

for decision making meant to inform adaptation of the health economic evaluation approach. Based on developments in realist evaluation and experiences with conducting the evaluation of TeleCare North, four principles for health economic evaluation of complex telehealthcare interventions is outlined in order....... The results from the TeleCare North trial were used directly in a national decision to implement the telehealthcare solution to patients with severe COPD in Denmark and lead to considerable debate nationally. This debate could be viewed as an actual account of the usefulness of health economic evaluation...

Beating the blues after Cancer: randomised controlled trial of a tele-based psychological intervention for high distress patients and carers

Directory of Open Access Journals (Sweden)

Hutchison Sandy

2009-06-01

Full Text Available Abstract Background The diagnosis and treatment of cancer is a major life stress such that approximately 35% of patients experience persistent clinically significant distress and carers often experience even higher distress than patients. This paper presents the design of a two arm randomised controlled trial with patients and carers who have elevated psychological distress comparing minimal contact self management vs. an individualised tele-based cognitive behavioural intervention. Methods/design 140 patients and 140 carers per condition (560 participants in total will been recruited after being identified as high distress through caller screening at two community-based cancer helplines and randomised to 1 a single 30-minute telephone support and education session with a nurse counsellor with self management materials 2 a tele-based psychologist delivered five session individualised cognitive behavioural intervention. Session components will include stress reduction, problem-solving, cognitive challenging and enhancing relationship support and will be delivered weekly. Participants will be assessed at baseline and 3, 6 and 12 months after recruitment. Outcome measures include: anxiety and depression, cancer specific distress, unmet psychological supportive care needs, positive adjustment, overall Quality of life. Discussion The study will provide recommendations about the efficacy and potential economic value of minimal contact self management vs. tele-based psychologist delivered cognitive behavioural intervention to facilitate better psychosocial adjustment and mental health for people with cancer and their carers. Trial Registration ACTRN12609000301268.

The Arab Spring is a Latin American Winter: TeleSUR’s “Ideological Approach” and the Breakaway from the Al-Jazeera Network

Directory of Open Access Journals (Sweden)

Massimo Di Ricco

2012-05-01

Full Text Available The Arab Spring represents a breaking point in the cooperation between the pan-Latin American satellite television TeleSUR and Al-Jazeera. Even if in February TeleSUR firmly condemned the closure by Egyptian authorities of the Al-Jazeera Cairo offices, NATO military intervention in Libya and the beginning of protests in Syria provoked an important change in TeleSUR coverage of the Arab Spring. This shift coincided with a departure from the Al-Jazeera network, sanctioning the possible end of a collaboration that always had strong political connotations. TeleSUR joined the cause of the protesters in the coverage of the Egyptian and Tunisian uprisings, meanwhile it took what we can refer to as an “ideological approach” in the coverage of the uprisings after the international intervention in Libya, implicitly embracing the official media version of the Arab regimes. This stance sparked controversy especially within grassroots Latin American movements, igniting a strong debate mainly visible on the web. At an international level, the undeclared departure from the Al-Jazeera network reflects the future split between leftist Latin American governments, who embrace and fund the multi-state TV network TeleSUR, and the forces that will come out from the Arab Spring. Finally, the Arab Spring represented a missing opportunity for TeleSUR to play an important role in global media, and not only for a national or regional audience. Indeed, TeleSUR gave more importance to the political interests of the channel's founders, than in pursuing a balanced information out of ideological interests or geopolitical strategies..

Imposing motion constraints to a force reflecting tele-robot through real-time simulation of a virtual mechanism

Energy Technology Data Exchange (ETDEWEB)

Joly, L.; Andriot, C.

1995-12-31

In a tele-operation system, assistance can be given to the operator by constraining the tele-robot position to remain within a restricted subspace of its workspace. A new approach to motion constraint is presented in this paper. The control law is established simulating a virtual ideal mechanism acting as a jig, and connected to the master and slave arms via springs and dampers. Using this approach, it is possible to impose any (sufficiently smooth) motion constraint to the system, including non linear constraints (complex surfaces) involving coupling between translations and rotations and physical equivalence ensures that the controller is passive. Experimental results obtained with a 6-DOF tele-operation system are given. Other applications of the virtual mechanism concept include hybrid position-force control and haptic interfaces. (authors). 11 refs., 7 figs.

Imposing motion constraints to a force reflecting tele-robot through real-time simulation of a virtual mechanism

International Nuclear Information System (INIS)

Joly, L.; Andriot, C.

1995-01-01

In a tele-operation system, assistance can be given to the operator by constraining the tele-robot position to remain within a restricted subspace of its workspace. A new approach to motion constraint is presented in this paper. The control law is established simulating a virtual ideal mechanism acting as a jig, and connected to the master and slave arms via springs and dampers. Using this approach, it is possible to impose any (sufficiently smooth) motion constraint to the system, including non linear constraints (complex surfaces) involving coupling between translations and rotations and physical equivalence ensures that the controller is passive. Experimental results obtained with a 6-DOF tele-operation system are given. Other applications of the virtual mechanism concept include hybrid position-force control and haptic interfaces. (authors). 11 refs., 7 figs

Tele-care robot for assisting independent senior citizens who live at home.

Science.gov (United States)

Katz, Reuven

2015-01-01

In the last twenty years most developed countries face dramatic demographic changes, and predominantly the rapid aging of their population. As the share of elderly people is climbing while the number of care providers is declining, the aging problem is becoming an increasingly important social and economic challenge. The supply of care at home, utilizing affordable tele-care systems and smart home technologies, is one of the promising strategies to cope with challenges posed by these demographic changes. The goal of this paper is to present a tele-care robot (TCR) aimed to assist Senior citizens who live independently at their home, that need assistance in daily life activities. The idea of the proposed system is that a caregiver, operating from a central location, will be able to service between 10 to 20 patients living at their home, by using the tele-care robot. The robot will possess motion control capabilities to move inside the house of each patient and alert in case that emergency events occur. The robot will allow the care provider to communicate remotely with the patient using audio and video equipment installed on the robot. By using the robot, the caregiver will be able to examine several times during the day the well-being of the patient, his medication consumption, and his overall functionality.

Tele-education vs classroom training of neonatal resuscitation: a randomized trial.

Science.gov (United States)

Jain, A; Agarwal, R; Chawla, D; Paul, V; Deorari, A

2010-12-01

To compare gain in knowledge and skills of neonatal resuscitation using tele-education instruction vs conventional classroom teaching. This randomized controlled trial was conducted in the tele-education facility of a tertiary care center. In-service staff nurses were randomized to receive training by tele-education instruction (TI, n=26) or classroom teaching (CT, n=22) method from two neonatology instructors using a standardized teaching module on neonatal resuscitation. Gain in knowledge and skill scores of neonatal resuscitation were measured using objective assessment methods. Age, educational qualification and professional experience of the participants in two groups were comparable. Pre-training mean knowledge scores were higher in TI group (8.3±1.7 vs 6.6±1.4, P=0.004). However, skill scores were comparable in the two groups (11.7±3 vs 10.3±2.9, P=0.13). Training resulted in a significant and comparable gain in knowledge scores (4.2±2.2 vs 5.3±1.7; P=0.06) and skills scores (4.5±3.3 vs 5.0±3.1, P=0.62) in both the groups. The post-training knowledge scores (TI: 12.5±1.7 vs CT: 12.0±1.7, P=0.37) and the post-training skill scores (TI: 16.0±0.5 vs CT: 15.6±2.5, P=0.55) were comparable in the two groups. However, the post-training scores, adjusted for baseline knowledge scores, were statistically higher in the in-person group compared with the telemedicine group (knowledge: 12.46±0.03 vs 12.16±0.01, P=0.00; skills: 15.6±2.5 vs 16.0±2.8, P=0.00). The quantum of lower scores in the telemedicine group was only 2% for knowledge and 6% for skills. This difference was felt to be of only marginal importance. Satisfaction scores among trainees and instructors were comparable in the two groups. Tele-education offers a feasible and effective alternative to conventional training in neonatal resuscitation among health-care providers.

A Browser-Server-Based Tele-audiology System That Supports Multiple Hearing Test Modalities.

Science.gov (United States)

Yao, Jianchu Jason; Yao, Daoyuan; Givens, Gregg

2015-09-01

Millions of global citizens suffering from hearing disorders have limited or no access to much needed hearing healthcare. Although tele-audiology presents a solution to alleviate this problem, existing remote hearing diagnosis systems support only pure-tone tests, leaving speech and other test procedures unsolved, due to the lack of software and hardware to enable communication required between audiologists and their remote patients. This article presents a comprehensive remote hearing test system that integrates the two most needed hearing test procedures: a pure-tone audiogram and a speech test. This enhanced system is composed of a Web application server, an embedded smart Internet-Bluetooth(®) (Bluetooth SIG, Kirkland, WA) gateway (or console device), and a Bluetooth-enabled audiometer. Several graphical user interfaces and a relational database are hosted on the application server. The console device has been designed to support the tests and auxiliary communication between the local site and the remote site. The study was conducted at an audiology laboratory. Pure-tone audiogram and speech test results from volunteers tested with this tele-audiology system are comparable with results from the traditional face-to-face approach. This browser-server-based comprehensive tele-audiology offers a flexible platform to expand hearing services to traditionally underserved groups.

Tele-Lab IT-Security: an Architecture for an online virtual IT Security Lab

Directory of Open Access Journals (Sweden)

Christoph Meinel

2008-05-01

Full Text Available Recently, Awareness Creation in terms of IT security has become a big thing – not only for enterprises. Campaigns for pupils try to highlight the importance of IT security even in the user’s early years. Common practices in security education – as seen in computer science courses at universities – mainly consist of literature and lecturing. In the best case, the teaching facility offers practical courses in a dedicated isolated computer lab. Additionally, there are some more or less interactive e-learning applications around. Most existing offers can do nothing more than impart theoretical knowledge or basic information. They all lack of possibilities to provide practical experience with security software or even hacker tools in a realistic environment. The only exceptions are the expensive and hard-to-maintain dedicated computer security labs. Those can only be provided by very few organizations. Tele-Lab IT-Security was designed to offer hands-on experience exercises in IT security without the need of additional hardware or maintenance expenses. The existing implementation of Tele-Lab even provides access to the learning environment over the Internet – and thus can be used anytime and anywhere. The present paper describes the extended architecture on which the current version of the Tele-Lab server is built.

Magnetic resonance angiography in renal grafts. Comparison with color Doppler echography

International Nuclear Information System (INIS)

Yanagisawa, Takayoshi; Otsubo, Osamu; Nozaki, Harushige

1995-01-01

We studied relationship between magnetic resonance angiography (MRA) of renal graft and renal graft function in 14 renal transplantations (10 from living donors, 4 from cadaveric donors). MRA was performed on 0.3-T permanent magnet system (MRP 7000, HITACHI, JAPAN) using 2 dimensional time of flight technique (FOV: 350 mm 2 , RT: 60 msec, ET: 10 msec, FA: 90deg, Slice: volumes 60, thickness 4 mm, overlap 1 mm). As for parameters of renal graft function, we evaluated color doppler echography (CD) of transplanted renal artery, renal blood flow (RBF), velocity of interlobar artery (ILA) and serum creatinine level (S-Cr). CD, RBF and velocity of ILA were visualized and measured by duplex color doppler echosystem (EUB-565A, HITACHI, JAPAN). Depending on visualization of transplanted renal artery, MRA was graded into 3 groups (MA Grade 3: visualization of ILA, MA Grade 2: visualization of segmental artery and the first branch but no visualization of ILA, MA Grade 1: visualization of main renal artery only). Likewise, visualization of CD was graded into 3 groups (CD Grade 3: good visualization of arcuate artery (AA) and ILA, CD Grade 2: poor visualization of AA but good visualization of ILA, CD Grade 1: poor visualization of ILA). The MRA grading had a very significant correlation (r=0.79, p<0.001) with the CD grading. As for RBF and velocity of ILA, the RBF of MA Grade 3 group (n=8) was significantly (p<0.05) higher than the MA Grade 2 group (n=4) and the MA Grade 1 group (n=2), and the velocity of ILA of MA Grade 3 group was also higher than the above groups but not significantly. Furthermore, the S-Cr of MA Grade 3 was significantly (p<0.05) lower than the others. These results showed that MRA of renal graft had a qualitative index of renal graft function. (author)

Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

Science.gov (United States)

Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

2017-01-01

This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (psarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning of the lower limbs from the perspective of sarcopenia improvement among the elderly

Radiological Protection and Quality Assurance in Health Sciences: Tele-Education for continued Postgraduate Training

International Nuclear Information System (INIS)

Alcaraz, M.; Chico, P.; Armero, D.; Saura Iniesta, A. M.; Vicente, V.

2003-01-01

The establishment of an inter departmental project, financed by the Spanish Ministry of Education, has made possible the development to specific didactic materials on Radiological Protection and Quality Assurance in Medical Radiodiagnostic Practices. These have been published as a manual and practical notebook. This material constitutes the grounding work for the first continuous tele-education training course via Internet that Spanish professionals exposed to ionising radiation are following. Interactive multimedia training and tele-education may become one of the alternatives that allow health science professionals to receive continuous training, provided that adequate content and aims had been established during undergraduate training. (Author) 18 refs

Tele Hyper Virtuality

Science.gov (United States)

Terashima, Nobuyoshi

1994-01-01

In the future, remote images sent over communication lines will be reproduced in virtual reality (VR). This form of virtual telecommunications, which will allow observers to engage in an activity as though it were real, is the focus of considerable attention. Taken a step further, real and unreal objects will be placed in a single space to create an extremely realistic environment. Here, imaginary and other life forms as well as people and animals in remote locations will gather via telecommunication lines that create a common environment where life forms can work and interact together. Words, gestures, diagrams and other forms of communication will be used freely in performing work. Actual construction of a system based on this new concept will not only provide people with experiences that would have been impossible in the past, but will also inspire new applications in which people will function in environments where it would have been difficult if not impossible for them to function until now. This paper describes Tele Hyper Virtuality concept, its definition, applications, the key technologies to accomplish it and future prospects.

Mobile application development for Tele-ECG

International Nuclear Information System (INIS)

Srivastava, Shikha; Bharade, Sandeep; Sinha, Vineet; Sarade, Bhagyashree; Jindal, G.D.; Ananthakrishnan, T.S.; Pithawa, C.K.

2010-01-01

Mobile computing has caught the attention of research community for quite some time. The constant improvement of hardware and software related to mobile computing (e.g. better computing power, larger wireless network bandwidth) clearly enhance capabilities of mobile devices. The acceptance of mobile technology by the population at large would suggest that this could be the basis of a system for the communication of medical data from patients to remote physician and vice versa. This paper presents a mobile solution, which makes use of a Tele-ECG unit with a mobile phone to collect, store and forward ECG data to a cardiologist for diagnosis and recommendation. (author)

A novel approach to haptic tele-operation of aerial robot vehicles

NARCIS (Netherlands)

Stramigioli, Stefano; Mahony, Robert; Corke, Peter

2010-01-01

We present a novel, simple and effective approach for tele-operation of aerial robotic vehicles with haptic feedback. Such feedback provides the remote pilot with an intuitive feel of the robot's state and perceived local environment that will ensure simple and safe operation in cluttered 3D

Ultrasonic pulse echography for bubbles traveling in the proximity of a wall

International Nuclear Information System (INIS)

Park, Hyun Jin; Tasaka, Yuji; Murai, Yuichi

2015-01-01

The behavior of a bubbly two-phase flow in the vicinity of a wall affects heat, mass, and momentum transfer; therefore, there is great interest in developing a quantitative technique to monitor this behavior. Herein we propose a new method based on ultrasound echo signal processing that it feasible for industrial applications where the boundary layer is modified by traveling bubbles. By introducing time-resolved direct waveform analysis at 100 MHz, we have succeeded in the spatio-temporal detection of bubble surfaces at echographic profiling frequencies in the range of 15–20 kHz. Unlike conventional approaches, which use short pulses, a relatively long pulse length is applied to allow ultrasound Doppler velocimetry in the liquid phase. Examination of the horizontal bubbly two-phase turbulent channel flows demonstrated the feasibility of this method; spatio-temporal echography of moving bubble surfaces is successfully achieved as the bubbles travel on length scales smaller than the spatial ultrasonic pulse length near the wall. The applicable range of parameters (e.g. bubble size and shape, and flow speed) was determined by 3D numerical analysis of the wave equation and its application to bubbles flowing beneath a flat-bottom model ship. (paper)

Evaluation of patient and doctor perception toward the use of telemedicine in Apollo Tele Health Services, India

Directory of Open Access Journals (Sweden)

Rajesh V Acharya

2016-01-01

Full Text Available Introduction: Telemedicine incorporates electronic information and medical technology. It connects healthcare through vast distances which would benefit both patients and doctors. The aim of this questionnaire study was to evaluate the effects of telemedicine on patients and medical specialists. Methods: A cross-sectional study was conducted among 122 participants (71 patients and 51 doctors on satisfaction in quality of service, cost-effectiveness, and problems encountered in healthcare provided by the telemedicine in Apollo Tele Health Services, Hyderabad, Telangana, India. The data for each group were calculated and compared. Results: About 80% patients and all the doctors reported their satisfaction on the quality of treatment given through telemedicine. Approximately, 90% of the participants found telemedicine cost-effective and 61% of the doctors found an increase in patient's inflow apart for their regular practice. Problems encountered in telemedicine were 47% in technical issues and 39% in time scheduling by doctors and 31% of patients were uncomfortable to face the camera, and 24% had technical issues. Conclusions: The results of the present study showed that telemedicine in healthcare could prove to be useful to patients in distant regions and to rural doctors in India. In the near future, telemedicine can be considered as an alternate to face to face patient care.

A Bio-Inspired Model-Based Approach for Context-Aware Post-WIMP Tele-Rehabilitation

Directory of Open Access Journals (Sweden)

Víctor López-Jaquero

2016-10-01

Full Text Available Tele-rehabilitation is one of the main domains where Information and Communication Technologies (ICT have been proven useful to move healthcare from care centers to patients’ home. Moreover, patients, especially those carrying out a physical therapy, cannot use a traditional Window, Icon, Menu, Pointer (WIMP system, but they need to interact in a natural way, that is, there is a need to move from WIMP systems to Post-WIMP ones. Moreover, tele-rehabilitation systems should be developed following the context-aware approach, so that they are able to adapt to the patients’ context to provide them with usable and effective therapies. In this work a model-based approach is presented to assist stakeholders in the development of context-aware Post-WIMP tele-rehabilitation systems. It entails three different models: (i a task model for designing the rehabilitation tasks; (ii a context model to facilitate the adaptation of these tasks to the context; and (iii a bio-inspired presentation model to specify thoroughly how such tasks should be performed by the patients. Our proposal overcomes one of the limitations of the model-based approach for the development of context-aware systems supporting the specification of non-functional requirements. Finally, a case study is used to illustrate how this proposal can be put into practice to design a real world rehabilitation task.

Globalization and pollution: tele-connecting local primary PM2.5 emissions to global consumption.

Science.gov (United States)

Meng, Jing; Liu, Junfeng; Xu, Yuan; Guan, Dabo; Liu, Zhu; Huang, Ye; Tao, Shu

2016-11-01

Globalization pushes production and consumption to geographically diverse locations and generates a variety of sizeable opportunities and challenges. The distribution and associated effects of short-lived primary fine particulate matter (PM 2.5 ), a representative of local pollution, are significantly affected by the consumption through global supply chain. Tele-connection is used here to represent the link between production and consumption activity at large distances. In this study, we develop a global consumption-based primary PM 2.5 emission inventory to track primary PM 2.5 emissions embodied in the supply chain and evaluate the extent to which local PM 2.5 emissions are triggered by international trade. We further adopt consumption-based accounting and identify the global original source that produced the emissions. We find that anthropogenic PM 2.5 emissions from industrial sectors accounted for 24 Tg globally in 2007; approximately 30% (7.2 Tg) of these emissions were embodied in export of products principally from Brazil, South Africa, India and China (3.8 Tg) to developed countries. Large differences (up to 10 times) in the embodied emissions intensity between net importers and exporters greatly increased total global PM 2.5 emissions. Tele-connecting production and consumption activity provides valuable insights with respect to mitigating long-range transboundary air pollution and prompts concerted efforts aiming at more environmentally conscious globalization.

Globalization and pollution: tele-connecting local primary PM2.5 emissions to global consumption

Science.gov (United States)

Meng, Jing; Xu, Yuan; Guan, Dabo; Liu, Zhu; Huang, Ye; Tao, Shu

2016-01-01

Globalization pushes production and consumption to geographically diverse locations and generates a variety of sizeable opportunities and challenges. The distribution and associated effects of short-lived primary fine particulate matter (PM2.5), a representative of local pollution, are significantly affected by the consumption through global supply chain. Tele-connection is used here to represent the link between production and consumption activity at large distances. In this study, we develop a global consumption-based primary PM2.5 emission inventory to track primary PM2.5 emissions embodied in the supply chain and evaluate the extent to which local PM2.5 emissions are triggered by international trade. We further adopt consumption-based accounting and identify the global original source that produced the emissions. We find that anthropogenic PM2.5 emissions from industrial sectors accounted for 24 Tg globally in 2007; approximately 30% (7.2 Tg) of these emissions were embodied in export of products principally from Brazil, South Africa, India and China (3.8 Tg) to developed countries. Large differences (up to 10 times) in the embodied emissions intensity between net importers and exporters greatly increased total global PM2.5 emissions. Tele-connecting production and consumption activity provides valuable insights with respect to mitigating long-range transboundary air pollution and prompts concerted efforts aiming at more environmentally conscious globalization. PMID:27956874

Globalization and pollution: tele-connecting local primary PM2.5 emissions to global consumption

Science.gov (United States)

Meng, Jing; Liu, Junfeng; Xu, Yuan; Guan, Dabo; Liu, Zhu; Huang, Ye; Tao, Shu

2016-11-01

Globalization pushes production and consumption to geographically diverse locations and generates a variety of sizeable opportunities and challenges. The distribution and associated effects of short-lived primary fine particulate matter (PM2.5), a representative of local pollution, are significantly affected by the consumption through global supply chain. Tele-connection is used here to represent the link between production and consumption activity at large distances. In this study, we develop a global consumption-based primary PM2.5 emission inventory to track primary PM2.5 emissions embodied in the supply chain and evaluate the extent to which local PM2.5 emissions are triggered by international trade. We further adopt consumption-based accounting and identify the global original source that produced the emissions. We find that anthropogenic PM2.5 emissions from industrial sectors accounted for 24 Tg globally in 2007; approximately 30% (7.2 Tg) of these emissions were embodied in export of products principally from Brazil, South Africa, India and China (3.8 Tg) to developed countries. Large differences (up to 10 times) in the embodied emissions intensity between net importers and exporters greatly increased total global PM2.5 emissions. Tele-connecting production and consumption activity provides valuable insights with respect to mitigating long-range transboundary air pollution and prompts concerted efforts aiming at more environmentally conscious globalization.

Soil remediation: New strategy by the combine of F.I.S. H. and Geo-Radar Tele detection

International Nuclear Information System (INIS)

Garbi, C.; Mengs, G.; Gonzalez Motalvo, D.; Martin, M.

2009-01-01

One of the most important targets in bioremediation to treat contaminated soils is the developing of new technologies. In this project we have developed a new strategy to eliminate in situ pollutants from hydrocarbons contaminated soils, supported with two specific techniques: FISH and Geo-Radar tele detection. With these techniques we try to delimit the pollutants distribution is oil, and to develop DNA and PNA biosensors with high specificity to evaluate the natural attenuation soil capacity using fluorescence in situ hybridization (FISH). (Author)

Soil remediation: New strategy by the combine of F.I.S. H. and Geo-Radar Tele detection

Energy Technology Data Exchange (ETDEWEB)

Garbi, C.; Mengs, G.; Gonzalez Motalvo, D.; Martin, M.

2009-07-01

One of the most important targets in bioremediation to treat contaminated soils is the developing of new technologies. In this project we have developed a new strategy to eliminate in situ pollutants from hydrocarbons contaminated soils, supported with two specific techniques: FISH and Geo-Radar tele detection. With these techniques we try to delimit the pollutants distribution is oil, and to develop DNA and PNA biosensors with high specificity to evaluate the natural attenuation soil capacity using fluorescence in situ hybridization (FISH). (Author)

Ocio estético valioso en la Poética de Aristóteles

Directory of Open Access Journals (Sweden)

Mª Luisa Amigo Fernández De Arroyabe

2015-01-01

Full Text Available Este artículo se centra en el ocio estético valioso en Aristóteles, partiendo del análisis de la Poética y, específicamente, de la comprensión de la experiencia estética como actividad mental. Se destaca su dimensión ética, realzando su valor en el desarrollo del ser humano, así como el de la propia obra de arte, en la medida en que el poeta ha sabido construirla, encarnando en la trama los hechos y universalizándolos, al modo que le es propio. Aristóteles se refiere a la tragedia, pero por extensión esta valoración proporciona una pauta de lectura de la experiencia de ocio estético. El marco autónomo para el ámbito estético, que inaugura Aristóteles, y su valoración vinculada a la dimensión ética, a la comprensión intelectual y al placer estético proporcionan la base para sostener que el ocio estético se confirma como un horizonte enmarcado en la senda de lo valioso y adecuado para realizar la vida que le es propia al ser humano.

Histamine and tele-methylhistamine quantification in cerebrospinal fluid from narcoleptic subjects by liquid chromatography tandem mass spectrometry with precolumn derivatization.

Science.gov (United States)

Croyal, Mikaël; Dauvilliers, Yves; Labeeuw, Olivier; Capet, Marc; Schwartz, Jean-Charles; Robert, Philippe

2011-02-01

An ultra-performance liquid chromatography tandem mass spectrometry (UPLC™-MS/MS) assay was developed for the simultaneous analysis of histamine, its major metabolite tele-methylhistamine, and an internal standard (N-tele-(R)-α-dimethylhistamine) from human cerebrospinal fluid (CSF) samples. The method involves derivatization of primary amines with 4-bromobenzenesulfonyl chloride and subsequent analysis by reversed phase liquid chromatography with mass spectrometry detection and positive electrospray ionization. The separation of derivatized biogenic amines was achieved within 3.5 min on an Acquity® BEH C(18) column by elution with a linear gradient of acetonitrile/water/formic acid (0.1%). The assay was linear in the concentration range of 50-5000 pM for each amine (5.5-555 pg/ml for histamine and 6.25-625 pg/ml for tele-methylhistamine). For repeatability and precision determination, coefficients of variation (CVs) were less than 11.0% over the tested concentration ranges, within acceptance criteria. Thus, the developed method provides the rapid, easy, highly sensitive, and selective requirement to quantify these amines in human CSF. No significant difference was found in the mean ± standard error levels of these amines between a group of narcoleptic patients (histamine=392 ± 64 pM, tele-methylhistamine=2431 ± 461 pM, n=7) and of neurological control subjects (histamine=402 ± 72 pM, tele-methylhistamine=2209 ± 463 pM, n=32). Copyright © 2010 Elsevier Inc. All rights reserved.

Information management flow for tele-homecare for the elderly; An emerging need for continuity of care.

Science.gov (United States)

Jeddi, Fatemeh Rangraz; Akbari, Hossein; Rasouli, Somayeh

2017-06-01

Tele-homecare methods can be used to provide home care for the elderly, if information management is provided. The aim of this study was to compare the places and methods of the data collection and media that use Tele-homecare for the elderly in selected countries in 2015. A comparative-applied library study was conducted in 2015. The study population were five countries, including Canada, Australia, England, Denmark, and Taiwan. The data collection tool was a checklist based on the objectives of study. Persian and English papers from 1998 to 2014, related to the Electronic Health Record, home care and the elderly were extracted from authentic journals and reference books as well as academic and research websites. Data were collected by reviewing the papers. After collecting data, comparative tables were prepared and the weak and strong points of each case were investigated and analyzed in selected countries. Clinical, laboratory, imaging and pharmaceutical data were obtained from hospitals, physicians' offices, clinics, pharmacies and long-term healthcare centers. Mobile and tablet-based technologies and personal digital assistants were used to collect data. Data were published via Internet, online and offline databanks, data exchange and dissemination via registries and national databases. Managed care methods were telehealth management systems and point of service. For continuity of care, it is necessary to consider managed care and equipment with regard to obtaining data in various forms from various sources, sharing data with registries and national databanks as well as the Electronic Health Record. With regard to the emergence of wearable technology and its use in home care, it is suggested to study the integration of its data with Electronic Health Records.

Tele-education and competencies assessment to Brazilian's auxiliary nurse A Tele-educação e a avaliação de competências profissionais da auxiliar de enfermagem no Brasil

Directory of Open Access Journals (Sweden)

Claudia Maria da Silva Marques

2007-12-01

Full Text Available This paper presents Brazilian's experience with the organization of methods and strategies for the assessment of competencies for technical level of nursing workers. The evaluative process proposed includes the creation of a learning-oriented and distance-based virtual assessment environment. The proposed methodology for professional competencies assessment adopted a critical-emancipatory perspective. A tele-education environment was deployed, involving software development - a virtual man - and an assessment cybertutor. Learning modules for the cybertutor were developed and videos of clinical simulations, structured around assessment in cognitive, behavioral, and simulation areas. The evaluation modules considered aspects of competencies in know-know, know-how and know-act professional ethics. Also the variability of practices of nursing - hospitals and primary health care units - was considered. This instrument showed as an important strategy for the optimization of assessment procedures that are widely used across Brazil and it is a powerful tool for incorporation into the continuing professional education.Presenta-se la experiencia brasileña en la organización de metodología y estrategias de evaluación de las competencias profesionales de los afiliares de enfermería. El proceso evaluativo propuesto por el Ministerio de la Salud incluí la creación del ambiente virtual que tiene como premisa la evaluación formativa y à la distancia. Dentro de la propuesta metodológica de evaluación de las competencias profesionales en la perspectiva critico-emancipatória, fue desarrollado un ambiente de tele-educación, con la creación de software, del hombre virtual y del cybertutor de la evaluación. Los módulos de evaluación consideraran las competencias en las dimensiones del saber-saber, sa-ber-hacer y saber-ser, con bases en perfil de los profesionales de los hospitales y de unidades de salud. El instrumento mostró ser una importante

An intelligent tele-healthcare environment offering person-centric and wellness-maintenance services.

Science.gov (United States)

Abidi, S S

2001-06-01

Worldwide healthcare delivery trends are undergoing a subtle paradigm shift--patient centered services as opposed to provider centered services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE--Tele-Healthcare Information and Diagnostic Environment. TIDE manifests an 'intelligent' healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services--i.e., both wellness maintenance and illness management services--ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role--spanning from wellness to illness issues--the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro-active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies--Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics--to implement a sophisticated healthcare delivery infostructure.

Aristóteles: justicia y eudaimonia. Una investigación sobre la ética neoaristotélica

OpenAIRE

Clusa Capell, Josep

2015-01-01

El objetivo de la tesis es hacer una contribución al debate entre la ética neoaristotélica contemporánea y sus rivales —las éticas deontológica y consecuencialista— por medio de un análisis de los conceptos de justicia y eudaimonia en Aristóteles. Los filósofos morales neoaristotélicos (autores como Elizabeth Anscombe, Philippa Foot, o Julia Annas) asumen, como Aristóteles, una conexión esencial entre ambos conceptos: la justicia constituye un ingrediente indispensable de la eudaimonia. En ca...

Evaluation of a Telehealthcare Intervention for Patients with COPD

DEFF Research Database (Denmark)

Lilholt, Pernille Heyckendorff

of telehealthcare, but they generally conclude that there is a need for more large-scale studies to obtain sufficient evidence. In this context, a Danish large-scale trial (TeleCare North) was launched in the North Denmark Region in 2012 to enable the management of COPD from patients’ home environments through...... telehealthcare. The overall aim of this dissertation was to evaluate the TeleCare North trial’s intervention. The PhD thesis focused more specifically on I) developing a trial protocol for the Danish, cluster-randomized, large-scale trial, TeleCare North; II) evaluating the trial’s telehealthcare system, Telekit......, in terms of its usability and patient experiences; and III) evaluating the trial’s outcomes regarding health-related quality of life (HRQoL). These focus areas were addressed in seven papers....

Low Complexity Connectivity Driven Dynamic Geometry Compression for 3D Tele-Immersion

NARCIS (Netherlands)

R.N. Mekuria (Rufael); D.C.A. Bulterman (Dick); P.S. Cesar Garcia (Pablo Santiago)

2014-01-01

htmlabstractGeometry based 3D Tele-Immersion is a novel emerging media application that involves on the fly reconstructed 3D mesh geometry. To enable real-time communication of such live reconstructed mesh geometry over a bandwidth limited link, fast dynamic geometry compression is needed. However,

TeleSUR: la creación televisiva de “lo latinoamericano”

Directory of Open Access Journals (Sweden)

Günther Maihold

2014-06-01

Full Text Available Nueva Televisión del Sur C. A. (Tele-SUR es el nombre de la empresa interestatal que ha iniciado sus transmisiones en el año 2005, en el marco de las nuevas iniciativas integracionistas del presidente venezolano Hugo Chávez, enfocada fundamentalmente al área noticiera para el continente americano. Concebida por su director general, el periodista uruguayo Aram Aharonian, como “alternativa a la hegemonía comunicacional, al pensamiento y la imagen únicas”, TeleSUR es parte de un proceso político más amplio, recubierto de barniz bolivariano, para reencontrar, a través de los medios electrónicos, la unidad e identidad latinoamericana frente a las grandes cadenas y corporaciones informativas internacionales, entre las cuales cuentan CNN en español, Fox News, ESPN y la BBC, con sus programas en castellano, y las grandes empresas nacionales como Televisa de México, Globo en Brasil y tanto el grupo Cisneros en Venezuela como Clarín en Argentina.

Communication Framework for Tele-rehabilitation Systems with QoS Guarantee

OpenAIRE

Dandanov Nikolay; Semov Plamen; Ivanov Antoni; Christoff Nicole; Poulkov Vladimir

2017-01-01

Nowadays, there is great interest in developing telemedicine technologies. These technologies will provide health care from distance swiftly and lightly, as well as reduce the expenses for activities, such as rehabilitation. Telemedicine applications are possible due to the advances in information technologies and the ever-expanding communication network infrastructure. The network characteristics bandwidth, packet loss, latency, jitter and policies are crucial for the performance of tele-reh...

Clinical evaluation of scintigraphy for malignant tumors in children

International Nuclear Information System (INIS)

Ishii, Katsumi; Aso, Koichi; Yamada, Nobuaki; Horiike, Shigeharu; Matsubayashi, Takashi

1982-01-01

X-ray study, Computed tomography, Echography and Scintigraphy are chosen to draw visual images of malignant tumors in children. To obtain higher diagnostic sensitivity, we recommend that 67-Ga-scintigraphy and other different scitigraphy for organs are performed on each child suspected of having malignant tumor. 67-Ga does not have accurate sensitivity for neuroblastoma, but bone scintigraphy with 99m-Tc-labelled phosphate complexes detects neuroblastoma as a positive image. 67-Ga scintigraphy and other different radiopharmaceutical scintigraphy should be used for primary visualization and control of malignant tumor in children. Serial scintigraphy at proper intervals are very effective to detect local recurrence and metastasis of malignant tumors. (author)

Adaptive Tele-Therapies Based on Serious Games for Health for People with Time-Management and Organisational Problems: Preliminary Results

OpenAIRE

Frutos-Pascual, Maite; García Zapirain, Begoña; Méndez Zorrilla, Amaia

2014-01-01

Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decis...

A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare': Study protocol

Directory of Open Access Journals (Sweden)

Hare David L

2011-02-01

the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the government. Discussion This manuscript presents the protocol for a randomised, multi-centre trial to evaluate the feasibility of a tele-based depression management and CHD secondary prevention program for ACS patients. The results of this trial will provide valuable new information about potential psychological and wellbeing benefits, cost-effectiveness and acceptability of an innovative tele-based depression management and secondary prevention program for CHD patients experiencing depression. Trial Registration Number Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12609000386235

Secure environment for real-time tele-collaboration on virtual simulation of radiation treatment planning.

Science.gov (United States)

Ntasis, Efthymios; Maniatis, Theofanis A; Nikita, Konstantina S

2003-01-01

A secure framework is described for real-time tele-collaboration on Virtual Simulation procedure of Radiation Treatment Planning. An integrated approach is followed clustering the security issues faced by the system into organizational issues, security issues over the LAN and security issues over the LAN-to-LAN connection. The design and the implementation of the security services are performed according to the identified security requirements, along with the need for real time communication between the collaborating health care professionals. A detailed description of the implementation is given, presenting a solution, which can directly be tailored to other tele-collaboration services in the field of health care. The pilot study of the proposed security components proves the feasibility of the secure environment, and the consistency with the high performance demands of the application.

Echographic handling of the acute appendicitis

International Nuclear Information System (INIS)

Neira de Ortiz, Clara Lucia; Vela H, Gregorio

1993-01-01

This study made an evaluation of the echography as a diagnostic method of the acute appendicitis in 22 paediatric patients with clinical suspicion of acute appendicitis. It was found a sensibility of 95% and a specificity of 90% for this diagnosis

Teledermatology: quality assessment by user satisfaction and clinical efficiency.

Science.gov (United States)

Klaz, Itay; Wohl, Yonit; Nathansohn, Nir; Yerushalmi, Nir; Sharvit, Sharon; Kochba, Ilan; Brenner, Sarah

2005-08-01

The Israel Defense Forces implemented a pilot teledermatology service in primary clinics. To assess user satisfaction and clinical short-term effectiveness of a computerized store and forward teledermatology service in urban and rural units. A multi-center prospective uncontrolled cohort pilot trial was conducted for a period of 6 months. Primary care physicians referred patients to a board-certified dermatologist using text email accompanied by digital photographs. Diagnosis, therapy and management were sent back to the referring PCP. Patients were asked to evaluate the level of the CSAFTD service, effect of the service on accessibility to dermatologists, respect for privacy, availability of drugs, health improvement and overall satisfaction. PCPs assessed the quality of the teledermatology consultations they received, the contribution to their knowledge, and their overall satisfaction. Tele-diagnosis alone was possible for 95% (n=413) of 435 CSAFTD referrals; 22% (n=95) of referrals also required face-to-face consultation, Satisfaction with CSAFTD was high among patients in both rural and urban clinics, with significantly higher scores in rural units. Rural patients rated the level of service, accessibility and overall satisfaction higher than did urban patients. PCPs were satisfied with the quality of the service and its contribution to their knowledge. Rural physicians rated level of service and overall satisfaction higher than did urban physicians. Tele-referrals were completed more efficiently than referral for face-to-face appointments. CSAFTD provided efficient, high quality medical service to rural and urban military clinics in the IDF.

Preliminary experience of shared clinical management between Milan and Pointe Noire using the INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS): telemedicine between Milan and Africa.

Science.gov (United States)

Malacarne, Mara; Lesma, Alessandro; Madera, Angelo; Malfatti, Eugenio; Castelli, Alberto; Lucini, Daniela; Pizzinelli, Paolo; Pagani, Massimo

2004-01-01

This paper describes preliminary experience in shared clinical management of patients located in Pointe Noire, Africa, and a referral center, Sacco University Hospital, located in Milan, Italy. The employed infrastructure INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS) jointly developed by CEFRIEL (Center of Excellence For Research, Innovation, Education & Industrial Labs partnership) and ENI (Ente Nazionale Idrocarburi) is based on commercial off-the-shelf technology. This minimizes maintenance problems, while permitting a simple and friendly sharing of data using the telephone and e-mail for store-and-forward applications. The critical aspect of the flow of events comprising the exchange of information is discussed. In 60% of cases, only one telemedicine consultation was required. In the remainder 40%, a number of telemedicine consultations were required for appropriate management of clinical cases. The project demonstrated flexibility as documented by the wide range of pathologies that can be dealt with it. Finally the possibility of using shared clinical management as a learning tool is highlighted by the steep and rising learning curve. We conclude, however, that the patient, although handled in a "virtual" manner, should be viewed as very "real," as some of them elected to close the gap physically between Pointe Noire and Milan, and chose to be treated at the referral site.

Comparative cost-benefit analysis of tele-homecare for community-dwelling elderly in Japan: Non-Government versus Government Supported Funding Models.

Science.gov (United States)

Akiyama, Miki; Abraham, Chon

2017-08-01

Tele-homecare is gaining prominence as a viable care alternative, as evidenced by the increase in financial support from international governments to fund initiatives in their respective countries. The primary reason for the funding is to support efforts to reduce lags and increase capacity in access to care as well as to promote preventive measures that can avert costly emergent issues from arising. These efforts are especially important to super-aged and aging societies such as in Japan, many European countries, and the United States (US). However, to date and to our knowledge, a direct comparison of non-government vs. government-supported funding models for tele-homecare is particularly lacking in Japan. The aim of this study is to compare these operational models (i.e., non-government vs. government-supported funding) from a cost-benefit perspective. This simulation study applies to a Japanese hypothetical cohort with implications for other super-aged and aging societies abroad. We performed a cost-benefit analysis (CBA) on two operational models for enabling tele-homecare for elderly community-dwelling cohorts based on a decision tree model, which we created with parameters from published literature. The two models examined are (a) Model 1-non-government-supported funding that includes monthly fixed charges paid by users for a portion of the operating costs, and (b) Model 2-government-supported funding that includes startup and installation costs only (i.e., no operating costs) and no monthly user charges. We performed base case cost-benefit analysis and probabilistic cost-benefit analysis with a Monte Carlo simulation. We calculated net benefit and benefit-to-cost ratios (BCRs) from the societal perspective with a five-year time horizon applying a 3% discount rate for both cost and benefit values. The cost of tele-homecare included (a) the startup system expense, averaged over a five-year depreciation period, and (b) operation expenses (i.e., labor and non

PERCEPÇÃO E CONHECIMENTO SEGUNDO ARISTÓTELES, PLATÃO E PROTÁGORAS: UMA BREVE COMPARAÇÃO

Directory of Open Access Journals (Sweden)

Juliana Aggio

2009-02-01

Full Text Available O texto examina a relação entre conhecimento e sensação, sensação e pensamento, ser eperceber segundo Protágoras, Platão e Aristóteles, com o objetivo de mostrar o que é a percepçãosegundo o paradigma sofístico e o platônico e, por fim, qual é o lugar da tese aristotélica sobre apercepção diante desses dois paradigmas. Como resultado da investigação, temos que, paraAristóteles, diferentemente de Protágoras, a sensação não é responsável por todos os julgamentos,nem por discriminar todos objetos cognoscíveis; também para Aristóteles e diferentemente de Platão,o extremo oposto não é verdadeiro, a saber, que a sensação não discrimina seus próprios objetos.Conhecimento e sensação, portanto, não devem ser idênticos ou distintos de modo absoluto, nem oser é absolutamente ser percebido, nem o ser percebido é absolutamente indeterminado, mas, paraAristóteles, o ser é, em parte, percebido e determinado pela faculdade perceptiva e, em parte,conhecido pelo intelecto. O texto, deste modo, pretende elucidar como o ser é conhecido pelapercepção segundo Aristóteles, tratando assim de um ponto extremamente controverso, a saber:como a sensação discrimina seus próprios objetos sem a intervenção do pensamento, se taldiscriminação resume-se apenas em processos fisiológicos ou é também uma atividade da alma e, seé também uma atividade da alma, em que sentido a alteração física ocorrida no corpo,conjuntamente com uma certa atividade da alma, constituem a percepção.

PERANCANGAN SISTEM TELE-NAVIGATION PADA PESAWAT TANPA AWAK (MICRO UAV

Directory of Open Access Journals (Sweden)

Agus Basukesti

2016-04-01

Full Text Available Sistem navigasi pada pengoperasian pesawat tanpa awak (Micro UAV saat ini terdapat 2 cara yaitu dengan cara pandangan manual (line of sight dan sistem autopilot. Sistem navigasi line of sight memiliki kelemahan jangkauan pesawat tanpa awak hanya pada radius 200 meter karena keterbatasan penglihatan dari pengendali. Metode autopilot adalah metode kendali pesawat dengan algoritma lock position and homing. Sistem autopilot bekerja dengan cara mencari koordinat posisi yang dituju kemudian kembali ke lokasi awal. Keunggulan teknologi ini adalah pesawat dapat menjangkau jarak yang cukup jauh. Akan tetapi metode ini memiliki kelemahan yaitu pesawat harus terbang tinggi dan pesawat belum bisa menghindari halangan seperti gedung pencakar langit maupun pepohonan tinggi. Dalam penelitian ini dirancang sebuah sistem tele-navigasi yang merupakan modifikasi sistem navigasi line of sight dan autopilot sehingga dapat menutupi kelemahan dari masing masing metode navigasi yang ada saat ini. metode penelitian yang digunakan dalam penelitian ini adalah metode eksperimen yaitu dengan membuat pilot plan sistem Tele-navigasi yang selanjutnya akan diuji dengan pesawat tanpa awak (micro UAV jenis flying wing. Metode dokumentasi dan metode studi pustaka juga digunakan untuk melengkapi data teknis alat yang digunakan sehingga dapat dilakukan analisis mendalam terhadap performa alat yang dirancang. Kata kunci: line of sight, lock position and homing, autopilot, micro UAV.

Effects of a tele-prehabilitation program or an in-person prehabilitation program in surgical candidates awaiting total hip or knee arthroplasty: Protocol of a pilot single blind randomized controlled trial.

Science.gov (United States)

Doiron-Cadrin, Patrick; Kairy, Dahlia; Vendittoli, Pascal-André; Lowry, Véronique; Poitras, Stéphane; Desmeules, François

2016-12-15

The accessibility for total joint arthroplasty often comes up against long wait lists, and may lead to deleterious effects for the awaiting patients. This pilot single blind randomized controlled trial aims to evaluate the impact of a telerehabilitation prehabilitation program before a hip or knee arthroplasty compared to in-person prehabilitation or to usual wait for surgery. Thirty-six patients on a wait list for a total hip or knee arthroplasty will be recruited and randomly assigned to one of three groups. The in-person prehabilitation group (n = 12) will receive a 12-week rehabilitation program (2 sessions/week) including education, exercises of the lower limb and cardiovascular training. Patients in the tele-prehabilitation group (n = 12) will receive the same intervention using a telecommunication software. The control group (n = 12) will be provided with the hospital's usual documentation before surgery. The Lower Extremity Functional Scale (LEFS) will be the primary outcome measure taken at baseline and at 12 weeks. Secondary measures will include self-reported function and quality of life as well as performance tests. A mixed-model, 2-way repeated-measure ANOVA will be used to analyse the effects of the rehabilitation programs. This pilot study is the first to evaluate the feasibility and the impact of a telerehabilitation prehabilitation program for patients awaiting a total joint arthroplasty. The results of this pilot-RCT will set the foundations for further research in the fields of rehabilitation and tele-medicine for patients suffering from lower limb osteoarthritis. ClinicalTrials.gov: NCT02636751.

Adaptive Tele-Therapies Based on Serious Games for Health for People with Time-Management and Organisational Problems: Preliminary Results

Directory of Open Access Journals (Sweden)

Maite Frutos-Pascual

2014-01-01

Full Text Available Attention Deficit with Hyperactivity Disorder (ADHD is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users’ needs, as well as boosting time management skills among teenagers with and without ADHD.

Adaptive tele-therapies based on serious games for health for people with time-management and organisational problems: preliminary results.

Science.gov (United States)

Frutos-Pascual, Maite; Zapirain, Begoña García; Zorrilla, Amaia Méndez

2014-01-07

Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users' needs, as well as boosting time management skills among teenagers with and without ADHD.

Adaptive Tele-Therapies Based on Serious Games for Health for People with Time-Management and Organisational Problems: Preliminary Results

Science.gov (United States)

Frutos-Pascual, Maite; García Zapirain, Begoña; Méndez Zorrilla, Amaia

2014-01-01

Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users’ needs, as well as boosting time management skills among teenagers with and without ADHD. PMID:24402063

Apendicitis epiploica primaria y hallazgos de la ecografía Primary epiploic appendicitis and echography findings

Directory of Open Access Journals (Sweden)

Orestes Noel Mederos Curbelo

2010-03-01

Full Text Available Se presenta el caso de una mujer de 55 años que presentaba dolor abdominal agudo localizado en el cuadrante inferior derecho, de 12 h de evolución, leucocitosis y reacción peritoneal. La ecografía abdominal fue indicativa de una presunta epiploitis, pero la intensidad y persistencia del dolor determinaron la intervención quirúrgica. La apendicitis aguda epiploica es una afección infrecuente pero debe sospecharse ante el dolor agudo en los cuadrantes abdominales inferiores, y la imagenología es fundamental para el diagnostico preoperatorio.This is the case of a woman aged 55 presenting with localized acute abdominal pain in right inferior quadrant of 12 hours of course, leukocytosis and peritoneal reaction. The abdominal echography findings showed a supposed epiploitis but the pain intensity and persistence determined the surgical intervention. Epiploic acute appendicitis is a infrequent affection that must to be suspected in case of acute pain in inferior abdominal quadrants and imaging studies are essential for preoperative diagnosis.

MASCOT 6: a modern computer-assisted haptic tele-manipulator

International Nuclear Information System (INIS)

Skilton, R.; Owen, T.

2015-01-01

MASCOT is a two-armed master-slave tele-manipulator device with 7 degrees of freedom per arm. The master and slave movements are linked by force-reflecting servomechanisms, giving the operator a tactile sensation of doing the work. The slave is typically attached to a boom which transports it to the work area. The master is normally located in the control room from where the operator-controlled input actions provide the motion that the Mascot slave will replicate. MASCOT version 4.5 is currently in use at the Joint European Torus (JET) experimental nuclear fusion facility. Its role is to maintain the inside of the reactor vessel without the need for manned entry. The MASCOT-6 project, funded by EFDA, was initiated to address reliability and availability issues arising as a result of obsolete technologies. In particular, the Mascot actuators based around obsolete 2-phase AC induction motors are to be replaced with actuators based on commercial off-the-shelf (COTS) Permanent Magnet Synchronous Motors (PMSMs). As a consequence of its highly integrated, monolithic design, the entire Mascot 4.5 control system, including servo-amplifiers, controllers, control software and HMI (Human Machine Interface)needs to be redesigned. The MASCOT-6 control system is designed to maximise reliability, availability, maintainability, and inspectability (RAMI) of the system, as well as providing significant future-proofing. EtherCAT has been selected as a scalable, modular and extremely fast field-bus to provide communication between the control system and easily replaceable COTS servo drives. MASCOT-6 includes a high-level control system designed with modern software engineering practises in mind, and provides a modular, generic framework which can be extended to cater for any tele-operation or robotic system. Advanced Computer-Aided-Tele-operation features such as dynamic force compensation and load cancellation are presented. Communication between the MASCOT-6 control system and its

Effect of Nurse-Led Telephone Follow ups (Tele-Nursing) on Depression, Anxiety and Stress in Hemodialysis Patients.

Science.gov (United States)

Kargar Jahromi, Marzieh; Javadpour, Shohreh; Taheri, Leila; Poorgholami, Farzad

2015-07-26

Depressive and anxious patients on hemodialysis have a higher risk of death and hospitalizations. The aim of this study was to evaluate the effect of nurse-led telephone follow ups (tele-nursing) on depression, anxiety and stress in hemodialysis patients. The subjects of the study who were selected based on double blind randomized clinical trial consisted of 60 patients with advanced chronic renal disease treated with hemodialysis. The patients were placed in two groups of 30 individuals. Before the intervention, a questionnaire was completed by patients.  There was no telephone follow up in the control group and the patients received only routine care in the hospital. The participants allocated to the intervention group received telephone follow-up 30 days after dialysis shift, in addition to conventional treatment. Every session lasted 30 minutes, as possible. Then the DASS scale was filled out by the patients after completion of study by two groups. Significant differences were observed between the two groups in the posttest regarding the dimensions scores of DASS scale. The result of this trial is expected to provide new knowledge to support the effective follow-up for hemodialysis patient in order to improve their emotional and health status.

Patient-Provider Teamwork via Cooperative Note Taking on Tele-Board MED.

Science.gov (United States)

Perlich, Anja; Meinel, Christoph

2016-01-01

There is significant, unexploited potential to improve the patients' engagement in psychotherapy treatment through technology use. We develop Tele-Board MED (TBM), a digital tool to support documentation and patient-provider collaboration in medical encounters. Our objective is the evaluation of TBM's practical effects on patient-provider relationships and patient empowerment in the domain of talk-based mental health interventions. We tested TBM in individual therapy sessions at a psychiatric ward using action research methods. The qualitative results in form of therapist observations and patient stories show an increased acceptance of diagnoses and patient-therapist bonding. We compare the observed effects to patient-provider relationship and patient empowerment models. We can conclude that the functions of TBM - namely that notes are shared and cooperatively taken with the patient, that diagnostics and treatment procedures are depicted via visuals and in plain language, and that patients get a copy of their file - lead to increased patient engagement and an improved collaboration, communication and integration in consultations.

The Fountain of Health: Bringing Seniors’ Mental Health Promotion into Clinical Practice

Science.gov (United States)

Thoo, Vanessa; Freer, Janya; Cassidy, Keri-Leigh

2015-01-01

Background The Fountain of Health (FoH) initiative offers valuable evidence-based mental health knowledge and provides clinicians with evaluated tools for translating knowledge into practice, in order to reduce seniors’ risks of mental disorders, including dementia. Methods A presentation on mental health promotion and educational materials were disseminated to mental health clinicians including physicians and other allied health professionals either in-person or via tele-education through a provincial seniors’ mental health network. Measures included: 1) a tele-education quality evaluation form, 2) a knowledge transfer questionnaire, 3) a knowledge translation-to-practice evaluation tool, and 4) a quality assurance questionnaire. Results A total of 74 mental health clinicians received the FoH education session. There was a highly significant (p < .0001) difference in clinicians’ knowledge transfer questionnaire scores pre- and post-educational session. At a two-month follow-up, 19 (25.7%) participants completed a quality assurance questionnaire, with all 19 (100%) of respondents stating they would positively recommend the FoH information to colleagues and patients. Eleven (20.4%) translation-to-practice forms were also collected at this interval, tracking clinician use of the educational materials. Conclusions The use of a formalized network for knowledge transfer allows for education and evaluation of health-care practitioners in both acquisition of practical knowledge and subsequent clinical behavior change. PMID:26740830

Diagnostic Indication for Venous Echo-Doppler of the Lower Limbs in the Diagnosis of Thromboembolic

International Nuclear Information System (INIS)

Bolado, A. G.; Barcena, M. V.; Cura, J. L. del; Gorrno, O.; Grande, D.

2003-01-01

To study the effectiveness of Doppler echography in the deep venous system of the lower limbs for deep venous thrombosis detection in patients suspected of having pulmonary thromboembolism. There were received 341 consecutive suspected pulmonary thromboembolism patients, all of whom were emergency room attended. All were submitted to CT pulmonary angiography in order to evaluate thrombus presence in the pulmonary tree. Without knowing the results of the previous exploration, we studied 301 of the patients using Doppler echography in deep venous system of the lower limbs in order to evaluate thrombus presence. In the group of CT-detected pulmonary thromboembolism patients, the percentage of Doppler echography-detected deep venous thrombosis was 46.3%, while in the group of non-detected patients this percentage decreased to 4.7%. Additional deep venous system exploration in clinically suspected pulmonary thiolcarbamate patients is useful, since it can increase the detection rate of venous thromboembolic disease, thereby leading to early treatment and prevention of the disease's manifestation in the lungs. Realization of Doppler echography is especially beneficial in those patients who exhibit no factors which predispose them to thromboembolic disease, as well as in patients who have previously had venous thrombosis. This exploration account for 4.7% of non-detected pulmonary embolism patients being added to the ranks of those with thromboembolic disease, an important percentage when taking into consideration the high pulmonary thromboembolism morbimortality rate. (Author) 30 refs

Diagnostic Indication for Venous Echo-Doppler of the Lower Limbs in the Diagnosis of Thromboembolic; Indicacion de eco-Doppler venosa de extremidades inferiores en el diagnostico de la enfermedad tromboembolica ante una sospecha de tromboembolismo pulmonar

Energy Technology Data Exchange (ETDEWEB)

Bolado, A. G.; Barcena, M. V.; Cura, J. L. del; Gorrno, O.; Grande, D. [Hospital de Basurto. Bilbao (Spain)

2003-07-01

To study the effectiveness of Doppler echography in the deep venous system of the lower limbs for deep venous thrombosis detection in patients suspected of having pulmonary thromboembolism. There were received 341 consecutive suspected pulmonary thromboembolism patients, all of whom were emergency room attended. All were submitted to CT pulmonary angiography in order to evaluate thrombus presence in the pulmonary tree. Without knowing the results of the previous exploration, we studied 301 of the patients using Doppler echography in deep venous system of the lower limbs in order to evaluate thrombus presence. In the group of CT-detected pulmonary thromboembolism patients, the percentage of Doppler echography-detected deep venous thrombosis was 46.3%, while in the group of non-detected patients this percentage decreased to 4.7%. Additional deep venous system exploration in clinically suspected pulmonary thiolcarbamate patients is useful, since it can increase the detection rate of venous thromboembolic disease, thereby leading to early treatment and prevention of the disease's manifestation in the lungs. Realization of Doppler echography is especially beneficial in those patients who exhibit no factors which predispose them to thromboembolic disease, as well as in patients who have previously had venous thrombosis. This exploration account for 4.7% of non-detected pulmonary embolism patients being added to the ranks of those with thromboembolic disease, an important percentage when taking into consideration the high pulmonary thromboembolism morbimortality rate. (Author) 30 refs.

Comparative Survey of Ultrasound Images Compression Methods Dedicated to a Tele-Echography Robotic System

National Research Council Canada - National Science Library

Delgorge, C

2001-01-01

.... For the purpose of this work, we selected seven compression methods : Fourier Transform, Discrete Cosine Transform, Wavelets, Quadtrees Transform, Fractals, Histogram Thresholding, and Run Length Coding...

Evaluation of isocenter reproducibility in telemedicine of 3D-radiotherapy treatment planning

International Nuclear Information System (INIS)

Hirota, Saeko; Tsujino, Kayoko; Kimura, Kouji; Takada, Yoshiki; Hishikawa, Yoshio; Kono, Michio; Soejima, Toshinori; Kodama, Akihisa

2000-01-01

To evaluate the utility in telemedicine of Three-Dimensional Radiotherapy Treatment Planning (tele-3D-RTP) and to examine the accuracy of isocenter reproducibility in its offline trial. CT data of phantoms and patients in the satellite hospital were transferred to our hospital via floppy-disk and 3D-radiotherapy plans were generated by 3D-RTP computer in our hospital. Profile data of CT and treatment beams in the satellite hospital were pre-installed into the computer. Tele-3D-RTPs were performed in 3 phantom plans and 14 clinical plans for 13 patients. Planned isocenters were well reproduced, especially in the immobilized head and neck/brain tumor cases, whose 3D-vector of aberration was 1.96±1.38 (SD) mm. This teletherapy system is well applicable for practical use and can provides cost-reduction through sharing the resources of expensive equipment and radiation oncologists. (author)

Evaluation of isocenter reproducibility in telemedicine of 3D-radiotherapy treatment planning

Energy Technology Data Exchange (ETDEWEB)

Hirota, Saeko; Tsujino, Kayoko; Kimura, Kouji; Takada, Yoshiki; Hishikawa, Yoshio; Kono, Michio [Hyogo Medical Center for Adults, Akashi (Japan); Soejima, Toshinori; Kodama, Akihisa

2000-09-01

To evaluate the utility in telemedicine of Three-Dimensional Radiotherapy Treatment Planning (tele-3D-RTP) and to examine the accuracy of isocenter reproducibility in its offline trial. CT data of phantoms and patients in the satellite hospital were transferred to our hospital via floppy-disk and 3D-radiotherapy plans were generated by 3D-RTP computer in our hospital. Profile data of CT and treatment beams in the satellite hospital were pre-installed into the computer. Tele-3D-RTPs were performed in 3 phantom plans and 14 clinical plans for 13 patients. Planned isocenters were well reproduced, especially in the immobilized head and neck/brain tumor cases, whose 3D-vector of aberration was 1.96{+-}1.38 (SD) mm. This teletherapy system is well applicable for practical use and can provides cost-reduction through sharing the resources of expensive equipment and radiation oncologists. (author)

Objective video quality measure for application to tele-echocardiography.

Science.gov (United States)

Moore, Peter Thomas; O'Hare, Neil; Walsh, Kevin P; Ward, Neil; Conlon, Niamh

2008-08-01

Real-time tele-echocardiography is widely used to remotely diagnose or exclude congenital heart defects. Cost effective technical implementation is realised using low-bandwidth transmission systems and lossy compression (videoconferencing) schemes. In our study, DICOM video sequences were converted to common multimedia formats, which were then, compressed using three lossy compression algorithms. We then applied a digital (multimedia) video quality metric (VQM) to determine objectively a value for degradation due to compression. Three levels of compression were simulated by varying system bandwidth and compared to a subjective assessment of video clip quality by three paediatric cardiologists with more than 5 years of experience.

Avaliação do Tratamento Clínico da Endometriose Clinical Treatment Evaluation of Endometriosis

Directory of Open Access Journals (Sweden)

Marcos Dias de Moura

1999-03-01

according to a preestablished protocol were examined. Results: mean patient age was 31 years, most patients were white, with regular menstrual cycles. The most frequently observed symptoms were dysmenorrhea, pelvic pain and infertility and were mild in most of the cases. The diagnostic methods utilized were laparoscopy or echography. There was agreement between echography and laparoscopy in 96% of cases. Laparotomy was required in 28% of cases for diagnostic elucidation and/or treatment. Endometrioma was detected in 37% of the cases and endometriosis was confirmed in only 74% of the biopsies from the lesion by anatomopathological examination. There was a significant improvement with clinical treatment regardless of the drug used, with improved symptoms in approximately 50% of the patients. Assisted fertilization was performed in 34 patients, consisting of in vitro fertilization (IVF for 80% of them, with a 27% pregnancy/transfer rate. Conclusions: the diagnostic method of choice should be laparoscopy, although echography presented a high rate of agreement. Anatomopathological examination of the lesions should be used as an adjuvant method in the diagnosis since it is not confirmatory in all of the cases. Clinical treatment with assisted reproductive technologies is a good therapeutic option, especially with the use of IVF.

Video equipment of tele dosimetry and audio

International Nuclear Information System (INIS)

Ojeda R, M.A.; Padilla C, I.

2007-01-01

To develop a work in an area with high radiation, it requires of a detailed knowledge of the surroundings work, a communication and effective vision, a near dosimetric control. In a work where the spaces variables and reduced accesses exist, noise that hinders the communication, defendant operative condition, radiation field and taking of decision, it is necessary to have tools that allow a total control of the environment to make opportune and effective decisions, there where the task is developed. Under this elementary concept, it was developed in the Laguna Verde Central a project that it allowed a mechanism, interactive of control in spaces complex; to see, to hear, to speak, to measure. This concept takes to the creation of an equipped system with closed circuit of television, wireless communication systems, tele dosimetry wireless systems, VHS and DVD recording equipment, uninterrupted energy units. The system requires of an electric power socket, and the installation of two cables by CCTV camera. The system is mobilized by a person. He puts on in operation in 5 minutes using a verification list. The concept was developed in the project denominated VETA-1, (Video Equipment of Tele dosimetry and Audio). It is objective of this work to present before the society the development of the VETA-1 tool that conclude in their first prototype in May of the present year. The VETA-1 project arises by a necessity of optimizing dose, it is an ALARA tool, with a countless applications, like it was proven in the 12 recharge stop of the Unit 1. The VETA-1 project integrate a recording system, with the primary end of analyzing in the place where the task is developed the details for an effective and opportune decision, but the resulting information is of utility for the personnel's training and the planning of future works. The VETA-1 system is an ALARA tool of quick response control. (Author)

Development of a prototype of the tele-localisation system in radiotherapy using personal digital assistant via wireless communication.

Science.gov (United States)

Wu, Vincent Wing-Cheung; Tang, Fuk-hay; Cheung, Wai-kwan; Chan, Kit-chi

2013-02-01

In localisation of radiotherapy treatment field, the oncologist is present at the simulator to approve treatment details produced by the therapist. Problems may arise if the oncologist is not available and the patient requires urgent treatment. The development of a tele-localisation system is a potential solution, where the oncologist uses a personal digital assistant (PDA) to localise the treatment field on the image sent from the simulator through wireless communication and returns the information to the therapist after his or her approval. Our team developed the first tele-localisation prototype, which consisted of a server workstation (simulator) for the administration of digital imaging and communication in medicine localisation images including viewing and communication with the PDA via a Wi-Fi network; a PDA (oncologist's site) installed with the custom-built programme that synchronises with the server workstation and performs treatment field editing. Trial tests on accuracy and speed of the prototype system were conducted on 30 subjects with the treatment regions covering the neck, skull, chest and pelvis. The average time required in performing the localisation using the PDA was less than 1.5 min, with the blocked field longer than the open field. The transmission speed of the four treatment regions was similar. The average physical distortion of the images was within 4.4% and the accuracy of field size indication was within 5.3%. Compared with the manual method, the tele-localisation system presented with an average deviation of 5.5%. The prototype system fulfilled the planned objectives of tele-localisation procedure with reasonable speed and accuracy. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

National French survey on tele-transmission of EEG recordings: More than a simple technological challenge.

Science.gov (United States)

Sauleau, Paul; Despatin, Jane; Cheng, Xufei; Lemesle, Martine; Touzery-de Villepin, Anne; N'Guyen The Tich, Sylvie; Kubis, Nathalie

2016-04-01

Assessment of current practice and the need for tele-transmission and remote interpretation of EEG in France. Transmission of EEG to a distant center could be a promising solution to the problem of decreasing availability of neurophysiologists for EEG interpretation, in order to provide equity within health care services in France. This practice should logically follow the legal framework of telemedicine and the recommendations that were recently edited by the Société de neurophysiologie clinique de langue française (SNCLF) and the Ligue française contre l'épilepsie (LCFE). A national survey was designed and performed under the auspices of the SNCLF. This survey reveals that there is an important gap between the official recommendations and the "reality on the ground". These local organizations were mainly established through the impulse of individual initiatives, rarely driven by health regulatory authorities and sometimes far from legal frameworks. For the majority, they result from a need to improve medical care, especially in pediatrics and neonatology, and to ensure continuity of care. When present, tele-transmission of EEG is often only partially satisfactory, since many technical procedures have to be improved. Conversely, the lack of tele-transmission of EEG would penalize medical care for some patients. The survey shows both the wealth of local initiatives and the fragility of most existing networks, emphasizing the need for better cooperation between regulatory authorities and health care professionals to establish or improve the transmission of EEG in France. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Satellites, Plasmas and Law: The Role of TeleCourt in Changing Conceptions of Justice and Authority in Ethiopia

Directory of Open Access Journals (Sweden)

Zenebe Beyene

2015-05-01

Full Text Available An ambitious experiment in the ICT and justice sector is underway in Ethiopia. As part of an effort to improve service delivery and the responsiveness of the state, the Ethiopian government has created 'TeleCourt,' a system that allows trials to take place between remote areas and regional or federal courts through videoconferencing and a satellite Internet connection. This article is the first to analyze how TeleCourt operates, with a particular focus on the perspectives of end-users, those who have had first-hand experience of how 'justice at a distance' actually works. The findings suggest general satisfaction with the savings - both in terms of financial burden and time costs that are often incurred when travelling to trials - which TeleCourt allows. As the system improves ways to provide justice to the grassroots, in line with the government's commitment towards peasants, this must also be considered in the context of the Ethiopian government's growing efforts to use law to curb political dissent. This is indicative of a broader tendency of selectively adopting and reshaping ICTs and extending them to the poorest people in Ethiopia in order to support the functioning of the state, while other uses of ICTs that are seen as potentially destabilizing are discouraged or forbidden.

Specification and evaluation of a regional PACS in the SaxTeleMed project

Science.gov (United States)

Lemke, Heinz U.; Niederlag, W.; Heuser, H.

2002-05-01

During the early development phase of PACS, its implementation was mainly a matter of the radiological department of a hospital. This is changing rapidly and PACS planning and realization is increasingly seen in the context of a hospital-wide approach. With a growth of networking amongst healthcare institutions and the growing relevance of teleradiological scenarios, new strategies must be followed which take not only local but also regional and global aspects of PACS into consideration. One such regional PACS project was initiated by the Ministry of Social Welfare of the Free State of Saxony in Germany. This 'reference model program for the digitization of imaging procedures and communication of images between hospitals in the free state of Saxony' (SaxTeleMed) covers seven regional projects distributed throughout Saxony. Each regional project is organized around so called lead hospitals, which network with other cooperating hospitals and medical practices. The regional reference projects are designed to be largely independent from one another. In some instances, however, a network connection between reference projects is also considered. Altogether, 39 hospitals and medical centers are involved in the model program. The aim of this program is to test the technical, organizational, legal and economic problems in the area of digitization and networking within the free State of Saxony. With the knowledge gained it is expected to improve future investment decisions in healthcare and above all to implement secure systems.

Lahendite Tele2 Sverige ja Digital Rights Ireland mõju sideandmete mugavkasutusele Eestis / Piret Schasmin, Carri Ginter

Index Scriptorium Estoniae

Schasmin, Piret, 1987-

2017-01-01

Euroopa Kohtu Tele2 Sverige ja Digital Rights Ireland kohtulahendi mõjust Eesti õiguse seaduslikkusele, Eesti kohtutele ja uurimisasutustele. Puudustest Eesti kehtivas õiguses, elektroonilise side andmete säilitamisest, kasutamisest ja hävitamisest

Privacy enhanced group communication in clinical environment

Science.gov (United States)

Li, Mingyan; Narayanan, Sreeram; Poovendran, Radha

2005-04-01

Privacy protection of medical records has always been an important issue and is mandated by the recent Health Insurance Portability and Accountability Act (HIPAA) standards. In this paper, we propose security architectures for a tele-referring system that allows electronic group communication among professionals for better quality treatments, while protecting patient privacy against unauthorized access. Although DICOM defines the much-needed guidelines for confidentiality of medical data during transmission, there is no provision in the existing medical security systems to guarantee patient privacy once the data has been received. In our design, we address this issue by enabling tracing back to the recipient whose received data is disclosed to outsiders, using watermarking technique. We present security architecture design of a tele-referring system using a distributed approach and a centralized web-based approach. The resulting tele-referring system (i) provides confidentiality during the transmission and ensures integrity and authenticity of the received data, (ii) allows tracing of the recipient who has either distributed the data to outsiders or whose system has been compromised, (iii) provides proof of receipt or origin, and (iv) can be easy to use and low-cost to employ in clinical environment.

Use of a standard set of profiles of open fields for photon beams in hand-held calculator (tele)

International Nuclear Information System (INIS)

Perez Guevara, Adrian; Rodriguez Zayas, Michael; Reyes Gonzalez, Tommy; Gonzalez Perez, Yelina; Sola Rodriguez, Yeline; Sanchez Zamora, Luis; Caballero, Roberto

2009-01-01

Clinical Dosimetry has gone through different stages in their evolution to our days advanced computer programs for treatment planning show the 3D dose distribution, complex algorithms for calculating 3D dose, complex treatment techniques, etc. All this has made the verification field treatment time or dose given to the PTV using calculations manuals are increasingly uncertain, reaching values that can exceed ±10%. It is proposed a calculation tool that uses EXCEL parameters obtained by fitting model profiles open fields. This calculator (TELE) taking information from the fields of PTV and treatments patient anatomical data allows verification of the dose contributions any point, correction of surface heterogeneity of the tissues present in the beam to the point of calculation. (Author)

Image-guided neurosurgery. Global concept of a surgical tele-assistance using obstacle detection robotics

International Nuclear Information System (INIS)

Desgeorges, M.; Bellegou, N.; Faillot, Th.; Cordoliani, Y.S.; Dutertre, G.; Blondet, E.; Soultrait, F. de; Boissy, J.M.

2000-01-01

Surgical tele-assistance significantly increases accuracy of surgical gestures, especially in the case of brain tumor neurosurgery. The robotic device is tele-operated through a microscope and the surgeon's gestures are guided by real-time overlaying of the X-ray imagery in the microscope. During the device's progression inside the brain, the focus is ensured by the microscope auto-focus feature. The surgeon can thus constantly check his position on the field workstation. Obstacles to avoid or dangerous areas can be previewed in the operation field. This system is routinely used for 5 years in the neurosurgery division of the Val de Grace hospital. More than 400 brain surgery operations have been done using it. An adaptation is used for rachis surgery. Other military hospitals begin to be equipped with similar systems. It will be possible to link them for data transfer. When it will be operational, such a network it will show what could be, in the future, a medical/surgical remote-assistance system designed to take care of wounded/critical conditions people, including assistance to surgical gestures. (authors)

Course on Radiological Protection and Quality Assurance in Radiology. Tele-education course: A Possible Solution to continued Postgraduate training

International Nuclear Information System (INIS)

Alcaraz, M.; Chico, P.; Saura Iniesta, A.; Armero, D.; Vicente, V.

2004-01-01

The creation of an interdepartmental project subsidised by the Spanish Ministry of Education has made it possible to create a series of specific didactic materials on Radiological Protection and Quality Assurance in Medical Radiodiagnostic Practices, leading to the publication of a specific manual and practical notebook. As a result, this material now constitutes the working basis for those professionals exposed to ionising radiation who are following the first continuous tele-education training course in Spanish via the Internet on this subject. Interactive multimedia training and tele-education may become one of the alternatives that allow health science professionals to receive continuous training, if adequate content and aims have been established during undergraduate training. (Author) 18 refs

Task analysis of human-in-the-loop tele-operated maintenance: What can be learned from JET?

International Nuclear Information System (INIS)

Boessenkool, H.; Thomas, J.; Heemskerk, C.J.M.; Baar, M.R. de; Steinbuch, M.; Abbink, D.A.

2014-01-01

Highlights: •Maintenance task execution at JET was analyzed to guide improvements for ITER. •A large variation in task duration was found for various operator experience levels. •Results indicate significant room for improvement for tele-operated performance. •Improvent of visual feedback and artificial guiding forces was considered promising. -- Abstract: Remote maintenance will determine the available uptime of future fusion plants such as ITER. Experience at predecessor JET showed that a human-in-the-loop tele-operated approach is crucial, although this approach entails drawbacks such as the unavoidable extensive operator training and relatively long execution times. These drawbacks are common knowledge, but little quantitative research is available to guide improvements (such as improved training methods, or active operator support systems). The aim of this paper is to identify the key areas for further improvement of tele-operated maintenance. This is achieved by a detailed task analysis based on recent maintenance at JET, using task logbooks and video data as well as interviews with experienced master–slave operators. The resulting task analysis shows the (sub)tasks that were most time-consuming and shows a large variance in time performance within operators, but also substantial differences between qualified operators with different levels of experience. The operator interviews indicate that intuitive (virtual) visual feedback and artificial (guiding) forces are promising directions for improvement. The results found in this study will be used for future research and development activities focusing on haptic guiding strategies, with the aim to further design and optimize RH maintenance systems for ITER and beyond

ARISTÓTELES Y LA ECONOMÍA ENTRE LOS LÍMITES DE LA RAZÓN PRÁCTICA

Directory of Open Access Journals (Sweden)

MATTHIAS VOLLET

2007-01-01

Full Text Available Resumen: Comparada con la economía de hoy, la de la Grecia antigua -por lo menos en una de sus concepciones- era una economía limitada. Exteriormente, porque en Hesíodo sirve para el sustento de la casa, y en Aristóteles para el sustento de la ciudad; interiormente y de manera sistemática, en el primer caso, por su origen divino y su sentido dentro de la relación hombre-dioses, y en el segundo caso, por su subordinación a la teleología ética y política de la vida humana, tal y como la concibe Aristóteles. La autarquía, como límite de la economía, es doble. Por una parte, autarquía económica en sentido estricto, ya que la economía sólo ha de llegar hasta el punto de poder asegurar la supervivencia de la comunidad que es su sujeto. Pero, por otra, la autarquía, para Aristóteles, tiene sobre todo un sentido antropológico: el hombre más autárquico es el que practica aquello que, para su praxis, no necesita de otra cosa: esta praxis más alta es la de la razón, desarrollada en la Polis, que es su meta. Esta autarquía del ser razonable da sentido y también límite al buen actuar económico, que es una mera herramienta.

Real-time non-rigid target tracking for ultrasound-guided clinical interventions

Science.gov (United States)

Zachiu, C.; Ries, M.; Ramaekers, P.; Guey, J.-L.; Moonen, C. T. W.; de Senneville, B. Denis

2017-10-01

Biological motion is a problem for non- or mini-invasive interventions when conducted in mobile/deformable organs due to the targeted pathology moving/deforming with the organ. This may lead to high miss rates and/or incomplete treatment of the pathology. Therefore, real-time tracking of the target anatomy during the intervention would be beneficial for such applications. Since the aforementioned interventions are often conducted under B-mode ultrasound (US) guidance, target tracking can be achieved via image registration, by comparing the acquired US images to a separate image established as positional reference. However, such US images are intrinsically altered by speckle noise, introducing incoherent gray-level intensity variations. This may prove problematic for existing intensity-based registration methods. In the current study we address US-based target tracking by employing the recently proposed EVolution registration algorithm. The method is, by construction, robust to transient gray-level intensities. Instead of directly matching image intensities, EVolution aligns similar contrast patterns in the images. Moreover, the displacement is computed by evaluating a matching criterion for image sub-regions rather than on a point-by-point basis, which typically provides more robust motion estimates. However, unlike similar previously published approaches, which assume rigid displacements in the image sub-regions, the EVolution algorithm integrates the matching criterion in a global functional, allowing the estimation of an elastic dense deformation. The approach was validated for soft tissue tracking under free-breathing conditions on the abdomen of seven healthy volunteers. Contact echography was performed on all volunteers, while three of the volunteers also underwent standoff echography. Each of the two modalities is predominantly specific to a particular type of non- or mini-invasive clinical intervention. The method demonstrated on average an accuracy of�

Long-term hand tele-rehabilitation on the PlayStation 3: benefits and challenges.

Science.gov (United States)

Burdea, Grigore C; Jain, Abhishek; Rabin, Bryan; Pellosie, Richard; Golomb, Meredith

2011-01-01

Rehabilitation interventions for the hand have shown benefits for children with Hemiplegia due to cerebral palsy or traumatic brain injury. Longer interventions are facilitated if training is provided in the patient's home, due to easier access to care and reduced impact on school or work activities. Providing remote rehabilitation over lengthy periods of time has however its own challenges. This paper presents two pediatric patients with hemiplegia, who practiced virtual hand rehabilitation games using a modified PlayStation 3 and 5DT sensing gloves. Despite severe initial hand spasticity, and occasional technology shortcomings, the subjects practiced for about 14 months, and 6 months, respectively. Game performance data for the second patient is presented. Follow-up evaluations 14 months from the removal of the PlayStation 3 from the home of the child with cerebral palsy showed that the patient had good retention in terms of grasp strength, hand function and bone health. Challenges of long-term home tele-rehabilitation are also discussed.

Tele-facilities for medicine, imaging, quality controls and maintenance services in the health sector for the developing countries and its present and future scope in Bangladesh

International Nuclear Information System (INIS)

Jahangir, Saleh Mahmud; Xie, Y.; Uddin, Rokon Md.; Haque, Mohammod Abu Sayid; Hoq, Mahbubul; Mawla, Yasmeen; Morium, Tasnim

2002-01-01

The information revolution is transforming health technology itself. With the development of international fiberoptic networks, satellite communications and the ever expanding Internet, technology is now going from revolutionary to routine, from unimaginable to indispensable. There has been little practical experience with telemedicine of a direct clinical kind in the developing world which contains 80% of the world's population. In the 45 poorest countries, it is estimated that only 50% of the population have access to health services. Arguably, it is those same countries that stand to gain most from a simple and cheap telemedicine system, on the principle that it could improve access to health care specialists and enhance research and the education of local health care workers. The work of the Swinfen Charitable trust demonstrates, useful clinical and educational results can be achieved using low cost telemedicine methods. As with the rest of telemedicine, the guiding principle seems to be that it is important to be clear about what problem we are trying to solve. Bangladesh has already entered the age of telemedicine. Under the umbrella of the IAEA TC Project on tele-nuclear medicine and tele-maintenance of nuclear medical equipment it will gradually step forward to reach its desired goal. What role telemedicine will play in the developing countries is yet to be determined. In terms of global health care the relevancy of telemedicine can only be ascertained after successful implementation of these projects

Unique identification code for medical fundus images using blood vessel pattern for tele-ophthalmology applications.

Science.gov (United States)

Singh, Anushikha; Dutta, Malay Kishore; Sharma, Dilip Kumar

2016-10-01

Identification of fundus images during transmission and storage in database for tele-ophthalmology applications is an important issue in modern era. The proposed work presents a novel accurate method for generation of unique identification code for identification of fundus images for tele-ophthalmology applications and storage in databases. Unlike existing methods of steganography and watermarking, this method does not tamper the medical image as nothing is embedded in this approach and there is no loss of medical information. Strategic combination of unique blood vessel pattern and patient ID is considered for generation of unique identification code for the digital fundus images. Segmented blood vessel pattern near the optic disc is strategically combined with patient ID for generation of a unique identification code for the image. The proposed method of medical image identification is tested on the publically available DRIVE and MESSIDOR database of fundus image and results are encouraging. Experimental results indicate the uniqueness of identification code and lossless recovery of patient identity from unique identification code for integrity verification of fundus images. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Design and development of a tele-healthcare information system based on web services and HL7 standards.

Science.gov (United States)

Huang, Ean-Wen; Hung, Rui-Suan; Chiou, Shwu-Fen; Liu, Fei-Ying; Liou, Der-Ming

2011-01-01

Information and communication technologies progress rapidly and many novel applications have been developed in many domains of human life. In recent years, the demand for healthcare services has been growing because of the increase in the elderly population. Consequently, a number of healthcare institutions have focused on creating technologies to reduce extraneous work and improve the quality of service. In this study, an information platform for tele- healthcare services was implemented. The architecture of the platform included a web-based application server and client system. The client system was able to retrieve the blood pressure and glucose levels of a patient stored in measurement instruments through Bluetooth wireless transmission. The web application server assisted the staffs and clients in analyzing the health conditions of patients. In addition, the server provided face-to-face communications and instructions through remote video devices. The platform deployed a service-oriented architecture, which consisted of HL7 standard messages and web service components. The platform could transfer health records into HL7 standard clinical document architecture for data exchange with other organizations. The prototyping system was pretested and evaluated in a homecare department of hospital and a community management center for chronic disease monitoring. Based on the results of this study, this system is expected to improve the quality of healthcare services.

Master-slave tele-tongs

International Nuclear Information System (INIS)

1992-05-01

In a 'hot laboratory', manipulation is concerned with mechanical devices, controlled by a human operator and used to move or manipulate radioactive objects without direct contact. Master-slave Manipulators and Tele-tongs are devices permitting a worker on one side of the shield of a 'hotcell' or a 'gloves-box', to carry out safe laboratory operations, with radioactive materials on the other side. This instrument is used mainly for remote-manipulation purposes, that is, to handle elements, substances or equipment across a protective wall. A typical example of its use is the fractioning of radioisotopes (for medical and agricultural purposes), or the handling of toxic substances, the fractioning and/or mixing of noxious components constituting a health hazard for operators, etc. Mechanic-type manipulator and tongs usually operated in pairs, endowed with a high level of sensitivity which enables the operator, duly protected, to perform what would otherwise be hazardous and delicate tasks. INVAP manipulators are suitable for all king of installations with 'hot-cells' or 'gloves-box'. INVAP manipulators were developed to meet the problem of introducing it through the shielding wall of the 'hotcells' or 'gloves-box', without violating shielding integrity. To prevent any possibility of contamination, the telemanipulator has been lined with an airtight sheath or booting, also especially developed by INVAP for this instrument. Moreover, it has developed a special set of tools for booting- changing under perfectly safe conditions

A literature review of tele-dermatology programs in the South African public health sector: Kwazulu-Natal perspective

CSIR Research Space (South Africa)

Walters, Laticha EM

2015-11-01

Full Text Available South Africa’s HIV/AIDS prevalence rate is 17,9%, the highest being in KwaZulu-Natal. Dermatological diseases are linked to HIV/AIDS. Tele-dermatology was not part of the 1998 National Telemedicine Project. Only phase I (of three) was implemented...

The development of Windows based control system for the tele-robotics

International Nuclear Information System (INIS)

Kim, Byung Soo; Kim, Seung Ho; Seo, Yong Chil; Kim, Ki Ho; Hwang, Suk Yeoung; Kim, Chang Hoi; Jung, Seung Ho; Lee, Young Kwang

1998-03-01

The WSCS (Windows-based Supervisory Control System) has been developed for the efficient control of the mobile robot in the hazardous area, such as reactor surroundings of HPWR (Heavy Pressurized Water Reactor). The WSCS is basically computer program which consists windows menu-program, socket-based communication program, force reflection joystick program, and OpenGL-based 3D graphic program. Also, the WSCS includes the force control algorithm of a master control device ( in this case, joystick) for the enhanced operability. To evaluate the effectiveness of the designed WSCS and the force reflection control algorithm, a series of experiments has been made in such a way that human operators command the desired motion of robot by manipulating the joystick in the virtual environment. As a result, it was proven that the designed WSCS is very easy-to-use and effective. Also, the developed force reflection algorithm is more efficient than that of general tele-operation, even though there are some difference in human dexterity. In near future, the WSCS will be applied in the next version of KAEROT. (author). 11 refs., 14 tabs., 1 fig

Borges, Averroes y Aristóteles: Literatura y filosofía

OpenAIRE

Kamel, Fawzia

2006-01-01

El trabajo es un acercamiento a "La busca de Averroes" de J. L. Borges donde el autor reitera su fe en una biblioteca universal de múltiples culturas (La biblioteca de Babel) pero, a la vez, reconoce la dificultad de la tarea. Las dificultades con que se enfrenta Averroes en explicar el texto de Aristóteles sin ver ni saber qué es teatro, se ven desdobladas en la dificultad de Borges pintando a Averroes, en la España del siglo XII, a través de unas pocas notas biográficas. El cuento es la his...

A tele-home care system exploiting the DVB-T technology and MHP.

Science.gov (United States)

Angius, G; Pani, D; Raffo, L; Randaccio, P; Seruis, S

2008-01-01

The aim of this research work is the development of a low-cost system for telemedicine based on the DVB-T technology. The diffusion of DVB-T standard and the low cost of DVB-T set-top boxes bring the vision of a capillary distribution of tele-home care monitoring systems with easy-to-use patient's interface. Exploiting the potentiality of the DVB-T set-top box, we transformed it into an "on-demand tele-home care interface". The Xlet we developed is able to govern the functionality of an external microcontroller-based unit for the acquisition of the bio-signals of interest. The uplink connection is used to send the exam results to a remote care center. The Xlet providing the patient interface on the set-top box is uploaded by a DVB-T broadcaster without any intervention in the patient's home. A prototypal low-cost base station for the acquisition of the patient's signals (1-lead ECG) has been developed. It is able to be connected to the set-top box via an infrared link. A smart-card-based system is in charge for the customization of the Xlet for every patient. The proposed system, based on a currently widespread infrastructure, is able to allow the patients monitoring from home without any installation procedure. Even untrained (or elderly) people can easily use such system due to their practice with the basic DVB-T home-entertainment equipments.

Training of beauty salon professionals in disease prevention using interactive tele-education.

Science.gov (United States)

Vieira Júnior, Elso Elias; Wen, Chao Lung

2015-01-01

Infectious diseases can be acquired in places where invasive procedures are often performed without the proper care of hand washing and material sterilization. There are approximately 500,000 beauty and esthetics centers in Brazil, which are visited by thousands of people every day. Many diseases, including sexually transmitted infections, are still highly prevalent in Brazil, such as warts caused by human papillomavirus, hepatitis B and C, and human immunodeficiency virus infection, and can be transmitted in beauty salons. We have developed a tele-education course divided into four main themes: sexually transmitted infections, indoor health in beauty salon workplaces, hand washing, and material sterilization. The course was made available through a Web site, which included a face-to-face meeting, Web synchronous meetings (chats and Web conferences), and asynchronous resources (reading material, discussion lists, situations simulator, educational videos, and three-dimensional virtual human video animation on sexually transmitted infections and hand washing), mediated by professors and coordinators. Fifty-two beauty professionals and 33 other professionals were enrolled from different regions. Of the 61 who completed the course and received a certificate at the course's end, 100% considered good to excellent the course's applicability to everyday life and would recommend it to a fellow professional. The results demonstrate the feasibility of an interactive, tele-education model using low-cost tools as an educational resource to teach beauty professionals. In the future, this may become a branch of nationwide telehealth action.

Os princí­pios de verdade no Livro IV da Metafí­sica de Aristóteles

Directory of Open Access Journals (Sweden)

Nazareno Eduardo de Almeida

2010-09-01

Full Text Available Este artigo mostra que o princípio primário da ciência do ente enquanto ente, apresentado e defendido por Aristóteles no Livro IV da Metafísica, é constituído pela bi-implicaçáo necessária (modal entre os princípios de náo-contradiçáo e do terceiro excluído, e náo somente, como na interpretaçáo tradicional, pelo primeiro destes princípios. Tal é mostrado através de uma interpretaçáo de uma parte do capítulo 3 e, em especial, de três partes do capítulo 4 deste escrito, onde Aristóteles desenvolve o que chamou "demonstraçáo refutativa", que consiste na demonstraçáo indireta do princípio primário por meio da refutaçáo da tese que nega (de modo forte este mesmo princípio. A interpretaçáo apresentada no artigo mostra que neste procedimento lógico Aristóteles está defendendo tanto o princípio de náo-contradiçáo quanto o princípio do terceiro excluído, assumindo ambos como formulações equivalentes do princípio primário da ciência do ser enquanto ser.

Importance and significance of liver echotomography in Wilson disease childhood

Energy Technology Data Exchange (ETDEWEB)

Corda, R; Nurchi, A M; Corrias, A; Corda, A; Giagheddu, M; Campisi, G

1987-01-01

We studed the hepatic echography patterns of young patients suffering from Wilson's Disease and compared these with results obtained from laboratory tests and parenchymal biopsy. Eight children, aged between 5 and 12 years (4 males and 4 females), were examined. The symptomatological pattern showed hepatomegaly and liver dysfunction with undetectable or very low serum ceruloplasmine levels and typical aspects of organic copper metabolism. In 50% of cases echography revealed a variable hyperreflection of the whole parenchyma, in connection with the presence of steatosis and aspects of intralobular inflammation. Fine and linear echoes were present, in 50% of the cases, with varying degrees of brightness, which was associated with the presence of fibrotic component or copper granules. Further echographic modifications were less frequent. Echography in close relatives of our patients was observed hepatomegaly and alteration of hepatic reflection associated with fibrotic component. In the evaluation of liver involvement in Wilson's Disease, these findings show that echotomography, when compared to hepatic biopsy, is less efficient in detecting different types of hepatic lesion but on a clinical basis it offers the possibility of evaluating their presence and gravity during the evolutive phase of the illness. This examination, unlike other methods, is completely non invasive; it may easily be repeated and may, in the future, come to be used as more precise diagnostic complement. 30 refs.

Enabling 3D Tele-Immersion with Live Reconstructed Mesh Geometry with Fast Mesh Compression and Linear Rateless Coding

NARCIS (Netherlands)

R.N. Mekuria (Rufael); M. Sanna (Michele); E Izquierdo (Ebroul); D.C.A. Bulterman (Dick); P.S. Cesar Garcia (Pablo Santiago)

2014-01-01

htmlabstract3D Tele-immersion enables participants in remote locations to share, in real-time, an activity. It offers users interactive and immersive experiences, but it challenges current media streaming solutions. Work in the past has mainly focused on the efficient delivery of image-based 3D

Enabling 3D Tele-Immersion with Live Reconstructed Mesh Geometry with Fast Mesh Compression and Linear Rateless Coding

NARCIS (Netherlands)

Mekuria, R.; Sanna, M.; Izquierdo, E; Bulterman, D.; Garcia, P.

2014-01-01

3-D tele-immersion (3DTI) enables participants in remote locations to share, in real time, an activity. It offers users interactive and immersive experiences, but it challenges current media-streaming solutions. Work in the past has mainly focused on the efficient delivery of image-based 3-D videos

The Role of Retinal Imaging and Portable Screening Devices in Tele-ophthalmology Applications for Diabetic Retinopathy Management.

Science.gov (United States)

DeBuc, Delia Cabrera

2016-12-01

In the years since its introduction, retinal imaging has transformed our capability to visualize the posterior pole of the eye. Increasing practical advances in mobile technology, regular monitoring, and population screening for diabetic retinopathy management offer the opportunity for further development of cost-effective applications through remote assessment of the diabetic eye using portable retinal cameras, smart-phone-based devices and telemedicine networks. Numerous retinal imaging methods and mobile technologies in tele-ophthalmology applications have been reported for diabetic retinopathy screening and management. They provide several advantages of automation, sensitivity, specificity, portability, and miniaturization for the development of point-of-care diagnostics for eye complications in diabetes. The aim of this paper is to review the role of retinal imaging and mobile technologies in tele-ophthalmology applications for diabetic retinopathy screening and management. At large, although improvements in current technology and telemedicine services are still needed, telemedicine has demonstrated to be a worthy tool to support health caregivers in the effective management and prevention of diabetes and its complications.

What extension evaluation before therapy have we to do in the nasopharynx cancers?

International Nuclear Information System (INIS)

Elloumi, F.; Mnejja, W.; Siala, W.; Daoud, J.; Hammami, B.; Ghorbel, M.; Frikhan, M.

2007-01-01

NMR imaging has proved its superiority on scanography in the study of limits and tumor extension and should be the first examination. The practice of of a scanography or cervical NMR should be the best mean of ganglions evaluation. As regards the extension evaluation at distance, it is recommended to require systematically a thorax radiograph and a bone scintigraphy for any patient. The liver echography is rather indicated among male patients, aged between 40 and 45 and having a stage 3 lymph node (according to the U.I.C.C. 1997 classification). (N.C.)

STRUCTURED CLINICAL EVALUATION

Directory of Open Access Journals (Sweden)

Arabela Maria Barbosa Sampaio

2014-05-01

Full Text Available In a world experiencing profound technological and socio-political changes in areas of knowledge and capacity, healthcare can not remain static. A new kind of professional is required, whose practice is based on ethics, scientific standards, integrity, citizenship, and health promotion, who develops skills beyond healthcare, such as decision making, communication,leadership, management, and continuing education. No single method can assess all of these elements (knowledge, skills, and attitudes, and only a combination of methods is able to produce a valid evaluation. An alternative method exists: structured clinical assessments based on observation of "to do, or how to do" that aim to complete this evaluation by focusing attention on the performance of specific skills. In order to broaden the scope of evaluation methods that have been used in health education, this article, a literature review, intends to offer readers an overview of the diverse types of structured clinical evaluation, emphasizing Objective Structured Clinical Examination, the most widely used in Brazil, with a goal of advancing opportunities for health professionals to make use of this evaluative tool.

Ähvardus : olümpiamängude teleülekanne jääb ära / Kai Kalamees

Index Scriptorium Estoniae

Kalamees, Kai

2005-01-01

Riigikogu liige Jaak Allik peab vajalikuks leida ETV-le lisamiljoneid olümpiamängude ja jalgpalli MM-i teleülekanneteks. Riigikogu liikmed Olav Aarna ja Katrin Saks kritiseerisid valitsust, et rahvusringhäälingu arengukava suhtes pole võetud seisukohta. Kultuuriminister Raivo Palmaru arvamusi. Lisa: Ringhäälingureform tulekul

Echography in appendicitis acute diagnosis

International Nuclear Information System (INIS)

Ripolles Gonzalez, T.; Sanguesa Nebot, C.; Ambit Capdevila, S.; Lazaro y de Molina, S.

1993-01-01

Over an 18-month period, high resolution ultrasound was used to assess 220 patients with doubtful clinical diagnosis of acute appendicitis. The ultrasonographic findings were correlated with the surgical results and the pathological results in 115 cases, and with clinical follow-up in the rest. This technique has been found to be effective in the diagnosis of acute appendicitis, with a sensitivity of 90.4%, and similar specificity and reliability (90.2%). The positive predictive value of the test was 89% and the negative predictive value, 91%. The ultrasonographic criteria applied for the diagnosis of acute appendicitis was the detection of an understood appendix measuring over 6 mm. All cases with perforation were correctly diagnosed as acute appendicitis. The observation of an accumulation of fluid pooled in DIF in patients with ultrasonographic findings suggestive of appendicitis points to a diagnosis of perforation or complicated (gangrenous) appendicitis. A relationship between complicated appendicitis and the detection of appendicoliths within the enlarged appendix was also observed. The results obtained demonstrate that high resolution ultrasound is indicated in the diagnosis of acute appendicitis in all cases in which the clinical findings are doubtful

SRT project: tele-robotics maintenance of nuclear power plants

International Nuclear Information System (INIS)

Gomez-Santamaria, J.; Calleja, J.M.; Carmena, P.; Avello, A.; Rubio, Y.A.

2001-01-01

The main aim of the SRT project was to develop a family of robots to help in the operation of nuclear power plants. Four robotic systems were developed and this paper focuses on three of them: ANAES -a steam leak detector through noise analysis-, MALIBA -a master-slave tele-operation system with force feedback- and ROBICEN -a compact pneumatic wall climbing robot-. ANAES (the Spanish acronym of spectrum analysis) consists of a set of sensor heads attached to a computer. Each head has two microphones and a video camera installed on it, and a DC motor that rotates the head. The heads are shielded with lead and boron steel, especially near the video camera. The noise generated by the plant is recorded every day at the same time and the software compares the recorded noise with the mean values of past records. The system can discern whether the noise has remarkably changed and, through phase analysis of the sound recorded by both microphones, identifies the direction of arrival (DOA) of the new noise, probably a steam leak. Using several heads, the new noise source can be identified. The video camera can be used to ease the location of the steam leaks. The stationariness of the measured noise has been tested in C.N. Cofrentes -a Spanish BWR-6 reactor-. A finished system with six heads has recently been installed in the MSR (moisture separator reheater) of the same plant. MALIBA is a master-slave tele-operated system with force feedback. It consists of two robots: a Stewart platform used as master robot and an open chain robot used as slave. The slave robot follows faithfully the movements of the master, and the master robot can reflect a force proportional to the force exerted by the slave on the environment. Three tools have been developed for the slave robot: a robot hand that includes a small video camera, a pneumatic drill and a rectifier. The results obtained have shown its effectiveness for the designed operations. ROBICEN is a lightweight pneumatic robot

SRT project: tele-robotics maintenance of nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Gomez-Santamaria, J. [Iberdrola SA, Madrid (Spain); Calleja, J.M.; Carmena, P. [Endesa, Madrid (Spain); Avello, A.; Rubio, Y.A. [CEIT-Centro de Estudias e Investigaciones Tecnicas de Guipuzcoa, San Sebastian (Spain)

2001-07-01

The main aim of the SRT project was to develop a family of robots to help in the operation of nuclear power plants. Four robotic systems were developed and this paper focuses on three of them: ANAES -a steam leak detector through noise analysis-, MALIBA -a master-slave tele-operation system with force feedback- and ROBICEN -a compact pneumatic wall climbing robot-. ANAES (the Spanish acronym of spectrum analysis) consists of a set of sensor heads attached to a computer. Each head has two microphones and a video camera installed on it, and a DC motor that rotates the head. The heads are shielded with lead and boron steel, especially near the video camera. The noise generated by the plant is recorded every day at the same time and the software compares the recorded noise with the mean values of past records. The system can discern whether the noise has remarkably changed and, through phase analysis of the sound recorded by both microphones, identifies the direction of arrival (DOA) of the new noise, probably a steam leak. Using several heads, the new noise source can be identified. The video camera can be used to ease the location of the steam leaks. The stationariness of the measured noise has been tested in C.N. Cofrentes -a Spanish BWR-6 reactor-. A finished system with six heads has recently been installed in the MSR (moisture separator reheater) of the same plant. MALIBA is a master-slave tele-operated system with force feedback. It consists of two robots: a Stewart platform used as master robot and an open chain robot used as slave. The slave robot follows faithfully the movements of the master, and the master robot can reflect a force proportional to the force exerted by the slave on the environment. Three tools have been developed for the slave robot: a robot hand that includes a small video camera, a pneumatic drill and a rectifier. The results obtained have shown its effectiveness for the designed operations. ROBICEN is a lightweight pneumatic robot

Tele-operated search robot for human detection using histogram of oriented objects

Science.gov (United States)

Cruz, Febus Reidj G.; Avendaño, Glenn O.; Manlises, Cyrel O.; Avellanosa, James Jason G.; Abina, Jyacinth Camille F.; Masaquel, Albert M.; Siapno, Michael Lance O.; Chung, Wen-Yaw

2017-02-01

Disasters such as typhoons, tornadoes, and earthquakes are inevitable. Aftermaths of these disasters include the missing people. Using robots with human detection capabilities to locate the missing people, can dramatically reduce the harm and risk to those who work in such circumstances. This study aims to: design and build a tele-operated robot; implement in MATLAB an algorithm for the detection of humans; and create a database of human identification based on various positions, angles, light intensity, as well as distances from which humans will be identified. Different light intensities were made by using Photoshop to simulate smoke, dust and water drops conditions. After processing the image, the system can indicate either a human is detected or not detected. Testing with bodies covered was also conducted to test the algorithm's robustness. Based on the results, the algorithm can detect humans with full body shown. For upright and lying positions, detection can happen from 8 feet to 20 feet. For sitting position, detection can happen from 2 feet to 20 feet with slight variances in results because of different lighting conditions. The distances greater than 20 feet, no humans can be processed or false negatives can occur. For bodies covered, the algorithm can detect humans in cases made under given circumstances. On three positions, humans can be detected from 0 degrees to 180 degrees under normal, with smoke, with dust, and with water droplet conditions. This study was able to design and build a tele-operated robot with MATLAB algorithm that can detect humans with an overall precision of 88.30%, from which a database was created for human identification based on various conditions, where humans will be identified.

Tele-yoga for Chronic Pain: Current Status and Future Directions.

Science.gov (United States)

Mathersul, Danielle C; Mahoney, Louise A; Bayley, Peter J

2018-01-01

Pain is a pervasive, debilitating disorder that is resistant to long-term pharmacological interventions. Although psychological therapies such as cognitive behavior therapy demonstrate moderate efficacy, many individuals continue to have ongoing difficulties following treatment. There is a current trend to establish complementary and integrative health interventions for chronic pain, for which yoga has been found to have exciting potential. Nevertheless, an important consideration within the field is accessibility to adequate care. Telehealth can be used to provide real-time interactive video conferencing leading to increased access to health care for individuals located remotely or who otherwise have difficulty accessing services, perhaps through issues of mobility or proximity of adequate services. This article assesses the current status and feasibility of implementing tele-yoga for chronic pain. Methodological limitations and recommendations for future research are discussed.

Pengaruh Distributed Generation Terhadap Stabilitas Transien Pada Sistem Distribusi (Studi Kasus: Penyulang Tl 2 Gi Tele )

OpenAIRE

Muhammad, Mahatir

2017-01-01

120402050 Penyulang TL 2 GI Tele pada jaringan distribusi listrik 20 kV terhubung dengan PLTMH Aek silang dan PLTMH Aek Sibundong dengan kapasitas masing-masing 750 kW. Distributed Generation (DG) dengan kapasitas yang kecil, akan mempengaruhi kestabilan sistem distribusi listrik. Begitu juga Distributed Generation (DG) yang mempunyai jumlah kapasitas yang besar mungkin dapat memberikan pengaruh lebih terhadap kestabilan sistem distribusi listrik. Untuk itu studi dan simu...

Image-guided neurosurgery. Global concept of a surgical tele-assistance using obstacle detection robotics; Neurochirurgie guidee par l'image. Concept global d'une tele-assistance chirurgicale a l'aide d'une robotique d'empechement

Energy Technology Data Exchange (ETDEWEB)

Desgeorges, M.; Bellegou, N.; Faillot, Th.; Cordoliani, Y.S.; Dutertre, G.; Blondet, E.; Soultrait, F. de; Boissy, J.M. [Hopital d' Instruction des Armees du Val-de-Grace, 75 - Paris (France)

2000-12-01

Surgical tele-assistance significantly increases accuracy of surgical gestures, especially in the case of brain tumor neurosurgery. The robotic device is tele-operated through a microscope and the surgeon's gestures are guided by real-time overlaying of the X-ray imagery in the microscope. During the device's progression inside the brain, the focus is ensured by the microscope auto-focus feature. The surgeon can thus constantly check his position on the field workstation. Obstacles to avoid or dangerous areas can be previewed in the operation field. This system is routinely used for 5 years in the neurosurgery division of the Val de Grace hospital. More than 400 brain surgery operations have been done using it. An adaptation is used for rachis surgery. Other military hospitals begin to be equipped with similar systems. It will be possible to link them for data transfer. When it will be operational, such a network it will show what could be, in the future, a medical/surgical remote-assistance system designed to take care of wounded/critical conditions people, including assistance to surgical gestures. (authors)

Application of advanced virtual reality and 3D computer assisted technologies in tele-3D-computer assisted surgery in rhinology.

Science.gov (United States)

Klapan, Ivica; Vranjes, Zeljko; Prgomet, Drago; Lukinović, Juraj

2008-03-01

The real-time requirement means that the simulation should be able to follow the actions of the user that may be moving in the virtual environment. The computer system should also store in its memory a three-dimensional (3D) model of the virtual environment. In that case a real-time virtual reality system will update the 3D graphic visualization as the user moves, so that up-to-date visualization is always shown on the computer screen. Upon completion of the tele-operation, the surgeon compares the preoperative and postoperative images and models of the operative field, and studies video records of the procedure itself Using intraoperative records, animated images of the real tele-procedure performed can be designed. Virtual surgery offers the possibility of preoperative planning in rhinology. The intraoperative use of computer in real time requires development of appropriate hardware and software to connect medical instrumentarium with the computer and to operate the computer by thus connected instrumentarium and sophisticated multimedia interfaces.

UMA ANÁLISE DA TEORIA DA JUSTIÇA EM ARISTÓTELES PRESENTE NA ÉTICA A NICÔMACO (LIVRO V

Directory of Open Access Journals (Sweden)

Maria Domingas Vale da Silva

2017-10-01

Este artículo es un tema de justicia este análisis en el Libro V de la obra “Ética a Nicómaco” del filósofo griego Aristóteles. Esto toma en cuenta las diversas cuestiones relacionadas con el término como se presenta el propio filósofo. Debido a esto, comenzar mediante la asignación de la justicia como una virtud por excelencia. Posteriormente se procede a analizar el significado y más tarde completa distinción entre la justicia y la justicia particular (este último distingue la justicia distributiva justicia correctiva, la justicia política y la justicia doméstica, la justicia natural y la justicia legal, la designación de la justicia como equidad, la relación entre la amistad y la justicia y, por último, una justicia tan viva la justicia. Palabras clave: Aristóteles; Justicia; Virtud.

Synergy-Based Bilateral Port: A Universal Control Module for Tele-Manipulation Frameworks Using Asymmetric Master–Slave Systems

Science.gov (United States)

Brygo, Anais; Sarakoglou, Ioannis; Grioli, Giorgio; Tsagarakis, Nikos

2017-01-01

Endowing tele-manipulation frameworks with the capability to accommodate a variety of robotic hands is key to achieving high performances through permitting to flexibly interchange the end-effector according to the task considered. This requires the development of control policies that not only cope with asymmetric master–slave systems but also whose high-level components are designed in a unified space in abstraction from the devices specifics. To address this dual challenge, a novel synergy port is developed that resolves the kinematic, sensing, and actuation asymmetries of the considered system through generating motion and force feedback references in the hardware-independent hand postural synergy space. It builds upon the concept of the Cartesian-based synergy matrix, which is introduced as a tool mapping the fingertips Cartesian space to the directions oriented along the grasp principal components. To assess the effectiveness of the proposed approach, the synergy port has been integrated into the control system of a highly asymmetric tele-manipulation framework, in which the 3-finger hand exoskeleton HEXOTRAC is used as a master device to control the SoftHand, a robotic hand whose transmission system relies on a single motor to drive all joints along a soft synergistic path. The platform is further enriched with the vision-based motion capture system Optitrack to monitor the 6D trajectory of the user’s wrist, which is used to control the robotic arm on which the SoftHand is mounted. Experiments have been conducted with the humanoid robot COMAN and the KUKA LWR robotic manipulator. Results indicate that this bilateral interface is highly intuitive and allows users with no prior experience to reach, grasp, and transport a variety of objects exhibiting very different shapes and impedances. In addition, the hardware and control solutions proved capable of accommodating users with different hand kinematics. Finally, the proposed control framework offers a

Synergy-Based Bilateral Port: A Universal Control Module for Tele-Manipulation Frameworks Using Asymmetric Master-Slave Systems.

Science.gov (United States)

Brygo, Anais; Sarakoglou, Ioannis; Grioli, Giorgio; Tsagarakis, Nikos

2017-01-01

Endowing tele-manipulation frameworks with the capability to accommodate a variety of robotic hands is key to achieving high performances through permitting to flexibly interchange the end-effector according to the task considered. This requires the development of control policies that not only cope with asymmetric master-slave systems but also whose high-level components are designed in a unified space in abstraction from the devices specifics. To address this dual challenge, a novel synergy port is developed that resolves the kinematic, sensing, and actuation asymmetries of the considered system through generating motion and force feedback references in the hardware-independent hand postural synergy space. It builds upon the concept of the Cartesian-based synergy matrix, which is introduced as a tool mapping the fingertips Cartesian space to the directions oriented along the grasp principal components. To assess the effectiveness of the proposed approach, the synergy port has been integrated into the control system of a highly asymmetric tele-manipulation framework, in which the 3-finger hand exoskeleton HEXOTRAC is used as a master device to control the SoftHand, a robotic hand whose transmission system relies on a single motor to drive all joints along a soft synergistic path. The platform is further enriched with the vision-based motion capture system Optitrack to monitor the 6D trajectory of the user's wrist, which is used to control the robotic arm on which the SoftHand is mounted. Experiments have been conducted with the humanoid robot COMAN and the KUKA LWR robotic manipulator. Results indicate that this bilateral interface is highly intuitive and allows users with no prior experience to reach, grasp, and transport a variety of objects exhibiting very different shapes and impedances. In addition, the hardware and control solutions proved capable of accommodating users with different hand kinematics. Finally, the proposed control framework offers a

Real-Time Spatial Monitoring of Vehicle Vibration Data as a Model for TeleGeoMonitoring Systems

OpenAIRE

Robidoux, Jeff

2005-01-01

This research presents the development and proof of concept of a TeleGeoMonitoring (TGM) system for spatially monitoring and analyzing, in real-time, data derived from vehicle-mounted sensors. In response to the concern for vibration related injuries experienced by equipment operators in surface mining and construction operations, the prototype TGM system focuses on spatially monitoring vehicle vibration in real-time. The TGM vibration system consists of 3 components: (1) Data Acquisition ...

An evaluation of the ECG gated cardiac CT on old myocardial infarction

International Nuclear Information System (INIS)

Tanegashima, Kazuhiro; Tejima, Yasuaki; Nakasone, Noriyo; Hyodo, Haruo

1984-01-01

In order to examine the accuracy of ECG gated cardiac CT (G-CCT), G-CCT findings were compared with ECG and cardiac echographic findings in 25 cases of old myocardial infarction. From the detection rate according to the infarct area, abnormal findings in the anterior wall and the septum obtained from G-CCT were in good accordance with those from ECG. Although all of the G-CCT findings did not agree with those of cardiac echography in cases in which abnormal findings were seen in multiple areas, the detection rate of cardiac abnormal findings as a whole by G-CCT was the same as that by cardiac echography. (Namekawa K.)

Research on Tele2 campaign "Meteorite". The real and the desirable perception by target audience

OpenAIRE

Kalve, Anita

2010-01-01

The theme of the Bachelor work is: ‘’Research on Tele2 campaign ‘’Meteorite’’. The real and the desirable perception by target audience.’’’’. Several subjects are described in this work, such as – communication process from a marketing perspective, integrated marketing communication, campaig planning, guerilla marketing and it’s tools. The problematics – perception of the target audience, which leads to the objective: finding out if the desirable perception which was planned...

Echography of clinically relevant disorders in the genital tract of female dromedary camels.

Science.gov (United States)

Ali, Ahmed; Derar, Derar; Alsamri, Ali; Al Sobayil, Fahd

2017-07-01

The aim of this study was to characterize the clinically relevant genital tract disorders of dromedary camels. Reproductive tract examinations were performed via transrectal palpation, ultrasonography and vaginal exploration. The ultrasonic appearance of the reproductive pathology was described and compared with its morphology at laparotomy, after surgical removal, during postmortem examination or upon slaughter. Diagnosis was also confirmed by histopathology. The most frequently encountered follicular structures were larger than typical follicles (56/338, 16.6%) having three echo textures: 1) thin walls and clear hyperechogenic content (11.6%); 2) thick walls and few fibrous trabeculae (33.7%); and 3) thick walls and many echogenic transecting fibrinous strands (54.7%). Corpora lutea with non-echoic central cavity (5/31, 16.1%) were greater in diameter than those with no cavity (26/31, 83.9%) (P=0.03). A granulosa cell tumor (1/338, 0.3%) was multilocular and honeycombed in shape. Presence of a large, well-demarcated, hypoechogenic sac lateral to or beneath the uterine horn encasing the ovary was diagnostic for ovarian hydrobursitis (102/338, 30.2%). Hydrosalpinx and pyosalpinx (6/338, 1.8%) were beaded in appearance, with the ovary located outside these structures. Clinical endometritis/cervicitis (122, 36.1%) was characterized by changes in the homogeneity in about half of the cases. A greatly dilated uterus with clear, hypoechogenic or echogenic contents with signs of hydrometra and pyometra, respectively, was another categorization of a reproductive pathology (24/338, 7.1%). Highly reflective, linear structures were observed in cases with intrauterine fetal bone retention (1/338, 0.3%). In conclusion, reproductive pathologies in dromedary camels can be efficiently imaged by use of ultrasonic technologies, thus familiarizing the practitioner with these disorders and facilitating application of these technologies so that suitable treatment can occur is important

VirtualizeMe: Real-time avatar creation for Tele-Immersion environments

KAUST Repository

Knoblauch, Daniel

2010-03-01

VirtualizeMe introduces a new design for a fully immersive Tele-Immersion system for remote collaboration and virtual world interaction. This system introduces a new avatar creation approach full-filling four main attributes: high resolution, scalability, flexibility and affordability. This is achieved by a total separation of reconstruction and rendering and exploiting the capabilities of modern graphic cards. The high resolution is achieved by using as much of the input information as possible through lossless compression of the input data and introducing a focused volumetric visual hull reconstruction. The resulting avatar allows eye-to-eye collaboration for remote users. The interaction with the virtual world is facilitated by the volumetric avatar model and allows a fully immersive system. This paper shows a proof of concept based on publicly available pre-recorded data to allow easier comparison. ©2010 IEEE.

Clinical use of gold-195m in evaluation of brain perfusion

International Nuclear Information System (INIS)

Bourgeois, P.; Erbsmann, F.; Hebbelinck, D.; De Maertelaere, P.; Fruehling, J.

1985-01-01

With a Byk-Mallinckrodt /sup 195m/Au generator, brain-perfusion studies in multiple incidences or in tomoscintigraphic mode were visualized in 22 patients. Of these, 17 were referred for investigation of cerebrovascular diseases and four for search for brain metastasis. One patient was normal. All these investigations were completed by a dynamic and static classic tomoscintigraphic study by using /sup 99m/Tc glucoheptonate or DTPA. Data obtained have been compared to other investigation methods, such as X-ray arteriography, Doppler echography, and X-ray computed tomography. Dynamic, as well as morphological, data concerning arteries appeared to be equivalent to those furnished by the /sup 99m/Tc classical studies. The main contribution of these /sup 195m/Au investigations, however, which appeared at the tomoscintigraphic level was the clear delineation of the main vessels involving not only the carotids but also the vertebral and, to a lesser extent, the intracerebral arteries

Development and verification of ground-based tele-robotics operations concept for Dextre

Science.gov (United States)

Aziz, Sarmad

2013-05-01

The Special Purpose Dextreous Manipulator (Dextre) is the latest addition to the on-orbit segment of the Mobile Servicing System (MSS); Canada's contribution to the International Space Station (ISS). Launched in March 2008, the advanced two-armed robot is designed to perform various ISS maintenance tasks on robotically compatible elements and on-orbit replaceable units using a wide variety of tools and interfaces. The addition of Dextre has increased the capabilities of the MSS, and has introduced significant complexity to ISS robotics operations. While the initial operations concept for Dextre was based on human-in-the-loop control by the on-orbit astronauts, the complexities of robotic maintenance and the associated costs of training and maintaining the operator skills required for Dextre operations demanded a reexamination of the old concepts. A new approach to ISS robotic maintenance was developed in order to utilize the capabilities of Dextre safely and efficiently, while at the same time reducing the costs of on-orbit operations. This paper will describe the development, validation, and on-orbit demonstration of the operations concept for ground-based tele-robotics control of Dextre. It will describe the evolution of the new concepts from the experience gained from the development and implementation of the ground control capability for the Space Station Remote Manipulator System; Canadarm 2. It will discuss the various technical challenges faced during the development effort, such as requirements for high positioning accuracy, force/moment sensing and accommodation, failure tolerance, complex tool operations, and the novel operational tools and techniques developed to overcome them. The paper will also describe the work performed to validate the new concepts on orbit and will discuss the results and lessons learned from the on-orbit checkout and commissioning of Dextre using the newly developed tele-robotics techniques and capabilities.

Monte-Carlo based assessment of MAGIC, MAGICAUG, PAGATUG and PAGATAUG polymer gel dosimeters for ovaries and uterus organ dosimetry in brachytherapy, nuclear medicine and Tele-therapy.

Science.gov (United States)

Adinehvand, Karim; Rahatabad, Fereidoun Nowshiravan

2018-06-01

Calculation of 3D dose distribution during radiotherapy and nuclear medicine helps us for better treatment of sensitive organs such as ovaries and uterus. In this research, we investigate two groups of normoxic dosimeters based on meta-acrylic acid (MAGIC and MAGICAUG) and polyacrylamide (PAGATUG and PAGATAUG) for brachytherapy, nuclear medicine and Tele-therapy in their sensitive and critical role as organ dosimeters. These polymer gel dosimeters are compared with soft tissue while irradiated by different energy photons in therapeutic applications. This comparison has been simulated by Monte-Carlo based MCNPX code. ORNL phantom-Female has been used to model the critical organs of kidneys, ovaries and uterus. Right kidney is proposed to be the source of irradiation and another two organs are exposed to this irradiation. Effective atomic numbers of soft tissue, MAGIC, MAGICAUG, PAGATUG and PAGATAUG are 6.86, 7.07, 6.95, 7.28, and 7.07 respectively. Results show the polymer gel dosimeters are comparable to soft tissue for using in nuclear medicine and Tele-therapy. Differences between gel dosimeters and soft tissue are defined as the dose responses. This difference is less than 4.1%, 22.6% and 71.9% for Tele-therapy, nuclear medicine and brachytherapy respectively. The results approved that gel dosimeters are the best choice for ovaries and uterus in nuclear medicine and Tele-therapy respectively. Due to the slight difference between the effective atomic numbers of these polymer gel dosimeters and soft tissue, these polymer gels are not suitable for brachytherapy since the dependence of photon interaction to atomic number, for low energy brachytherapy, had been so effective. Also this dependence to atomic number, decrease for photoelectric and increase for Compton. Therefore polymer gel dosimeters are not a good alternative to soft tissue replacement in brachytherapy. Copyright © 2018 Elsevier B.V. All rights reserved.

Cardiac variation of inferior vena cava: new concept in the evaluation of intravascular blood volume.

Science.gov (United States)

Nakamura, Kensuke; Tomida, Makoto; Ando, Takehiro; Sen, Kon; Inokuchi, Ryota; Kobayashi, Etsuko; Nakajima, Susumu; Sakuma, Ichiro; Yahagi, Naoki

2013-07-01

Evaluation of the intravascular blood volume is an important assessment in emergency and critical care medicine. Measurement of the inferior vena cava (IVC) respiratory variation by ultrasound echography is useful, but it entails subjective problems. We have hypothesized that IVC cardiac variation is also correlated with intravascular blood volume and analyzed it automatically using computer software of two kinds, later comparing the results. Snakes, software to track boundaries by curve line continuity, and template matching software were incorporated into a computer with an ultrasound machine to track the short-axis view of IVC automatically and analyze it with approximation by ellipse. Eight healthy volunteers with temporary mild hypovolemia underwent echography before and after passive leg raising and while wearing medical anti-shock trousers. IVC cardiac variation was visually decreased by both leg raising and medical anti-shock trousers. The collapse index (maximum - minimum/maximum) of area during three cardiac beats was decreased showing a good relationship to fluid load simulations; 0.24 ± 0.03 at baseline versus 0.11 ± 0.01 with leg raising and 0.12 ± 0.01 with medical anti-shock trousers. In conclusion, IVC cardiac variation has the potential to provide an evaluation of water volume. It presents some advantages in mechanical analysis over respiratory variation. At the very least, we need to exercise some caution with cardiac variation when evaluating respiratory variation.

The effect of compression on clinical diagnosis of glaucoma based on non-analyzed confocal scanning laser ophthalmoscopy images

NARCIS (Netherlands)

Abramoff, M.D.

2006-01-01

Knowledge of the effect of compression of ophthalmic images on diagnostic reading is essential for effective tele-ophthalmology applications. It was therefore with great anticipation that I read the article “The Effect of Compression on Clinical Diagnosis of Glaucoma Based on Non-analyzed Confocal

Effect of a real-time tele-transmission system of 12-lead electrocardiogram on the first-aid for athletes with ST-elevation myocardial infarction.

Science.gov (United States)

Zhang, Huan; Song, Donghan; An, Lina

2016-05-01

To study the effect of a real-time tele-transmission system of 12-lead electrocardiogram on door-to-balloon time in athletes with ST-elevation myocardial infarction. A total of 60 athletes with chest pain diagnosed as ST-elevation myocardial infarction (STEMI) from our hospital were randomly divided into group A (n=35) and group B (n=25), the patients in group A transmitted the real-time tele-transmission system of 12-lead electrocardiogram to the chest pain center before arriving in hospital, however, the patients in group B not. The median door-to-balloon time was significant shorter in-group A than group B (38min vs 94 min, p0.05). The median length of stay was significant reduced in-group A (5 days vs 7 days, pelectrocardiogram is beneficial to the pre-hospital diagnosis of STEMI.

Rural telemedicine project in northern New Mexico

Energy Technology Data Exchange (ETDEWEB)

Zink, S.; Hahn, H.; Rudnick, J.; Snell, J.; Forslund, D. [Los Alamos National Lab., NM (United States); Martinez, P. [Northern New Mexico Community Coll., Espanola, NM (United States)

1998-12-31

A virtual electronic medical record system is being deployed over the Internet with security in northern New Mexico using TeleMed, a multimedia medical records management system that uses CORBA-based client-server technology and distributed database architecture. The goal of the NNM Rural Telemedicine Project is to implement TeleMed into fifteen rural clinics and two hospitals within a 25,000 square mile area of northern New Mexico. Evaluation of the project consists of three components: job task analysis, audit of immunized children, and time motion studies. Preliminary results of the evaluation components are presented.

Tele-ophthalmology for diabetic retinopathy screening: 8 years of experience.

Science.gov (United States)

Pareja-Ríos, A; Bonaque-González, S; Serrano-García, M; Cabrera-López, F; Abreu-Reyes, P; Marrero-Saavedra, M D

2017-02-01

To describe the results of a diabetic retinopathy screening program implemented in a primary care area. A retrospective study was conducted using data automatically collected since the program began on 1 January 2007 until 31 December 2015. The number of screened diabetic patients has progressively increased, from 7,173 patients in 2007 to 42,339 diabetic patients in 2015. Furthermore, the ability of family doctors to correctly interpret retinographies has improved, with the proportion of retinal images classified as normal having increased from 55% in 2007 to 68% at the end of the study period. The proportion of non-evaluable retinographies decreased to 7% in 2015, having peaked at 15% during the program. This was partly due to a change in the screening program policy that allowed the use of tropicamide. The number of severe cases detected has declined, from 14% with severe non-proliferative and proliferativediabetic retinopathy in the initial phase of the program to 3% in 2015. Diabetic eye disease screening by tele-ophthalmology has shown to be a valuable method in a growing population of diabetics. It leads to a regular medical examination of patients, helps ease the workload of specialised care services and favours the early detection of treatable cases. However, the results of implementing a program of this type are not immediate, achieving only modest results in the early years of the project that have improved over subsequent years. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Towards a Location-based Service for Early Mental Health Interventions in Disaster Response Using Minimalistic Tele-operated Android Robots Technology

Science.gov (United States)

Vahidi, H.; Mobasheri, A.; Alimardani, M.; Guan, Q.; Bakillah, M.

2014-04-01

Providing early mental health services during disaster is a great challenge in the disaster response phase. Lack of access to adequate mental-health professionals in the early stages of large-scale disasters dramatically influences the trend of a successful mental health aid. In this paper, a conceptual framework has been suggested for adopting cellphone-type tele-operated android robots in the early stages of disasters for providing the early mental health services for disaster survivors by developing a locationbased and participatory approach. The techniques of enabling GI-services in a Peer-to-Peer (P2P) environment were studied to overcome the limitations of current centralized services. Therefore, the aim of this research study is to add more flexibility and autonomy to GI web services (WMS, WFS, WPS, etc.) and alleviate to some degree the inherent limitations of these centralized systems. A P2P system Architecture is presented for the location-based service using minimalistic tele-operated android robots, and some key techniques of implementing this service using BestPeer were studied for developing this framework.

Clinical Examination Component of Telemedicine, Telehealth, mHealth, and Connected Health Medical Practices.

Science.gov (United States)

Weinstein, Ronald S; Krupinski, Elizabeth A; Doarn, Charles R

2018-05-01

Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (eg, electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth). Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry. Copyright © 2018 Elsevier Inc. All rights reserved.

Pre-hospital electrocardiogram triage with tele-cardiology support is associated with shorter time-to-balloon and higher rates of timely reperfusion even in rural areas: data from the Bari- Barletta/Andria/Trani public emergency medical service 118 registry on primary angioplasty in ST-elevation myocardial infarction.

Science.gov (United States)

Brunetti, Natale Daniele; Di Pietro, Gaetano; Aquilino, Ambrogio; Bruno, Angela I; Dellegrottaglie, Giulia; Di Giuseppe, Giuseppe; Lopriore, Claudio; De Gennaro, Luisa; Lanzone, Saverio; Caldarola, Pasquale; Antonelli, Gianfranco; Di Biase, Matteo

2014-09-01

We report the preliminary data from a regional registry on ST-elevation myocardial infarction (STEMI) patients treated with primary angioplasty in Apulia, Italy; the region is covered by a single public health-care service, a single public emergency medical service (EMS), and a single tele-medicine service provider. Two hundred and ninety-seven consecutive patients with STEMI transferred by regional free public EMS 1-1-8 for primary-PCI were enrolled in the study; 123 underwent pre-hospital electrocardiograms (ECGs) triage by tele-cardiology support and directly referred for primary-PCI, those remaining were just transferred by 1-1-8 ambulances for primary percutaneous coronary intervention (PCI) (diagnosis not based on tele-medicine ECG; already hospitalised patients, emergency-room without tele-medicine support). Time from first ECG diagnostic for STEMI to balloon was recorded; a time-to-balloon primary-PCI). Pre-hospital triage with tele-cardiology ECG in an EMS registry from an area with more than one and a half million inhabitants was associated with shorter time-to-balloon and higher rates of timely treated patients, even in 'rural' areas. © The European Society of Cardiology 2014.

Collaborative Practice Improvement for Childhood Obesity in Rural Clinics: The Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP)

OpenAIRE

Shaikh, U; Nettiksimmons, J; Joseph, JG; Tancredi, D; Romano, PS

2014-01-01

© 2013 by the American College of Medical Quality. This study assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. A total of 7 primary care clinics in rural California included in the Healthy Eating Active Living TeleHealth Community of Practice and 288 children seen in these clinics for well-child care participated in this prospective observational pre-post study. Cl...

Muscle contracture diagnosis: the role of sonoelastography.

Science.gov (United States)

Bruschetta, Daniele; Milardi, Demetrio; Trimarchi, Fabio; DI Mauro, Debora; Valenti, Andrea; Arrigo, Alessandro; Valenti, Barbara; Santoro, Giuseppe; Cascio, Filippo; Vaccarino, Gianluigi; Cacciola, Alberto

2016-12-01

Sonoelastography plays today a major role in musculoskeletal disease, showing minor muscle injuries not well appreciable in conventional B-mode ultrasonography and integrating it in major muscle injuries diagnosis. The aim of this study was to demonstrate the ability of elastosonography in the diagnosis of muscular contracture in football players presenting negative basic echography. We examined twenty-two football players using basic echography and elastosonography approximately 24-48 hours after the traumatic event and we subsequently re-evaluated them after two weeks. Conventional echography showed, in the early stage, no muscle injuries; in twenty-two out of twenty-two patients, sonoelastography had instead underlined a heterogeneous colorimetric map, related to decreased elasticity in the area of the muscle contracture. An evaluation effected 1-2 weeks later showed a clear improvement of the sonoelastographic appearance. This information will be useful for prognostication, post-traumatic monitoring and to detect subclinical changes in MIs even before there are changes on the routine B-mode ultrasound.

Cooperación universitaria en redes telemáticas : tres propuestas para una Tele-Universidad Iberoamericana

OpenAIRE

Echeverría, Javier

2000-01-01

Echeverría, J. (2000). Cooperación universitaria en redes telemáticas: tres propuestas para una Tele-Universidad Iberoamericana. Redes 7(15), 131-138. Las nuevas tecnologías de la información y de las telecomunicaciones (NTIT) posibilitan la creación de un nuevo espacio social para las interrelaciones humanas al que denomino tercer entorno, para distinguirlo del entorno natural y del entorno urbano, es decir del campo y de la ciudad. Dicha transformación puede ser comparada con las grandes...

CBO-richtlijn 'Diepveneuze trombose en longembolie'; herziening van eerdere richtlijnen

NARCIS (Netherlands)

Büller, H. R.; van der Meer, J.; Oudkerk, M.

2000-01-01

Diagnosis of clinically suspected deep venous thrombosis is based on a clinical score, serial compression ultrasonography and D-dimer assay. For the diagnosis of pulmonary embolism perfusion scintigraphy, ventilation scintigraphy, echography of the leg veins and pulmonary angiography in that order

SCRIPT: Tele-robotics at Home; Functional Architecture and Clinical Application

NARCIS (Netherlands)

Prange, Grada Berendina; Hermens, Hermanus J.; Schäfer, J.; Nasr, N.; Mountain, G.; Stienen, Arno; Amirabdollahian, F

2012-01-01

After the event of a stroke, patients have at least 12 months during which their brains are highly susceptible to the benefits of neuro-rehabilitation treatments. On the other hand, due to the high costs of clinical neurorehabilitation, post-stroke treatments are limited in all countries to only a

Force Reflection Control for Master/Slave Tele-manipulators

International Nuclear Information System (INIS)

Kang, Min Sig; Kim, Doo Ho; Choi, Sun Il; Kim, Nam Hyung; Lee, Jong Bee

2009-04-01

This report concerns on a master/slave tele-manipulator which is used in highly hazardous hot cell. To design a force reflection and fine tracking control for the master-slave telemanipulator, the following has been carried out. (1) Variation of the moment of inertia of each link in the operating angle range, (2) Variation of the gratitational torque of each link in the operating angle range, (3) Dynamic characteristic analysis of the master-slave manipulator controlled by an output PD-control through a modal analysis, (4) Optimal static output feedback PD-control design by using modal analysis, (5) Controller design for each joint, (6) Adams-MatLab Simulink simulation model development. The results this project are as follows: (1) Program for analysis of the moment of inertia of each link in the operating angle range and simulation results, (2) Program for analysis of the gratitational torque of each link in the operating angle range and simulation results, (3) Dynamic characteristic of the master-slave manipulator controlled by an output PD-control through a modal analysis, (4) Program for designing optimal output PD-control by using modal analysis, (5) Controller designed for each joint, (6) Adams-MatLab Simulink simulation model, (7) Simulation results form output PD-control, etc

[Spleen autotransplant. Natural history and description of a case].

Science.gov (United States)

Ceccherini, E; Sereni, P; Ferrari, F; Fagioli Zucchi, A; Croce, F; Di Maggio, G; Vattimo, A; Mancini, S

1989-09-30

After considering the natural history of spleen auto-transplant, a clinical case followed up for seven months with instrumental (echography, scintigraphy) and humoral (Jolly bodies, Heinz bodies, reticulocytes, platelets, complement, immune globulin) examinations has been considered so as to verify "take" and function. One months after reimplantation the patient was again operated on for the onset of an intestinal occlusion due to adherences. On that occasion it was possible to control that the implant had taken. It is concluded that personally used parameters proved to be well correlated and that scintigraphy and echography are two complementary, effective techniques for monitoring auto-transplants.

Evaluating impact of clinical guidelines using a realist evaluation framework.

Science.gov (United States)

Reddy, Sandeep; Wakerman, John; Westhorp, Gill; Herring, Sally

2015-12-01

The Remote Primary Health Care Manuals (RPHCM) project team manages the development and publication of clinical protocols and procedures for primary care clinicians practicing in remote Australia. The Central Australian Rural Practitioners Association Standard Treatment Manual, the flagship manual of the RPHCM suite, has been evaluated for accessibility and acceptability in remote clinics three times in its 20-year history. These evaluations did not consider a theory-based framework or a programme theory, resulting in some limitations with the evaluation findings. With the RPHCM having an aim of enabling evidence-based practice in remote clinics and anecdotally reported to do so, testing this empirically for the full suite is vital for both stakeholders and future editions of the RPHCM. The project team utilized a realist evaluation framework to assess how, why and for what the RPHCM were being used by remote practitioners. A theory regarding the circumstances in which the manuals have and have not enabled evidence-based practice in the remote clinical context was tested. The project assessed this theory for all the manuals in the RPHCM suite, across government and aboriginal community-controlled clinics, in three regions of Australia. Implementing a realist evaluation framework to generate robust findings in this context has required innovation in the evaluation design and adaptation by researchers. This article captures the RPHCM team's experience in designing this evaluation. © 2015 John Wiley & Sons, Ltd.

Imperceptible watermarking for security of fundus images in tele-ophthalmology applications and computer-aided diagnosis of retina diseases.

Science.gov (United States)

Singh, Anushikha; Dutta, Malay Kishore

2017-12-01

The authentication and integrity verification of medical images is a critical and growing issue for patients in e-health services. Accurate identification of medical images and patient verification is an essential requirement to prevent error in medical diagnosis. The proposed work presents an imperceptible watermarking system to address the security issue of medical fundus images for tele-ophthalmology applications and computer aided automated diagnosis of retinal diseases. In the proposed work, patient identity is embedded in fundus image in singular value decomposition domain with adaptive quantization parameter to maintain perceptual transparency for variety of fundus images like healthy fundus or disease affected image. In the proposed method insertion of watermark in fundus image does not affect the automatic image processing diagnosis of retinal objects & pathologies which ensure uncompromised computer-based diagnosis associated with fundus image. Patient ID is correctly recovered from watermarked fundus image for integrity verification of fundus image at the diagnosis centre. The proposed watermarking system is tested in a comprehensive database of fundus images and results are convincing. results indicate that proposed watermarking method is imperceptible and it does not affect computer vision based automated diagnosis of retinal diseases. Correct recovery of patient ID from watermarked fundus image makes the proposed watermarking system applicable for authentication of fundus images for computer aided diagnosis and Tele-ophthalmology applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical image quality evaluation for panoramic radiography in Korean dental clinics

International Nuclear Information System (INIS)

Choi, Bo Ram; Choi, Da Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Choi, Soon Chul; Bae, Kwang Hak; Lee, Sam Sun

2012-01-01

The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

Evaluating critical thinking in clinical practice.

Science.gov (United States)

Oermann, M H

1997-01-01

Although much has been written about measurement instruments for evaluating critical thinking in nursing, this article describes clinical evaluation strategies for critical thinking. Five methods are discussed: 1) observation of students in practice; 2) questions for critical thinking, including Socratic questioning; 3) conferences; 4) problem-solving strategies; and 5) written assignments. These methods provide a means of evaluating students' critical thinking within the context of clinical practice.

Contribution of the PET-CT with {sup 18}F.D.G. in the non metastatic thyroid cancers with suspicion of residual or recurrent disease; Apport de la TEP-TDM au {sup 18}FDG dans les cancers de la thyroide non metastatiques avec suspicion de maladie residuelle ou recidivante

Energy Technology Data Exchange (ETDEWEB)

Ghander, C.; Taieb, D.; Tessonnier, L.; Mundler, O. [CHU Timone, Service central de biophysique et de medecine nucleaire, 13 - Marseille (France); Sebag, F.; Henry, J.F. [CHU Timone, service central de chirurgie generale et endocrinienne, 13 - Marseille (France); De Micco, C. [Inserm U555, service d' anatomopathologie, 13 - Marseille (France)

2010-07-01

Purpose: Recurrent thyroid carcinomas usually involve the cervical lymph nodes. The objective of this study was to evaluate the contribution of {sup 18}F-F.D.G. PET in the investigation of thyroid cancer compared with non-metastatic cervical echography. Conclusions: Due to the low overall sensitivity of PET / CT in thyroid carcinoma, its use should be reserved for cases of aggressive carcinoma and when the residual thyroglobulin under stimulation is high. In these cases it is a complementary information with neck echography. (N.C.)

Clinical image quality evaluation for panoramic radiography in Korean dental clinics

Energy Technology Data Exchange (ETDEWEB)

Choi, Bo Ram; Choi, Da Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Choi, Soon Chul; Bae, Kwang Hak; Lee, Sam Sun [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

2012-09-15

The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

[WMSDs in supermarket cashiers].

Science.gov (United States)

Di Pede, Cinzia; Manuli, Gianluca; Dini, Fulvia; Pinelli, Marco; Turini, Lucia; Mariani, Maurizio; Taddeo, Domenico

2011-01-01

High prevalence of Cumulative Trauma Disorders (CTD) of shoulder and wristle among supermarket cashiers have been reported by several studies. To evaluate CTD prevalence in a group of supermarket cashiers in Pisa area is the aim of this study. Standardized Questionnaire and clinical examination have been performed in 128 female supermarket cashiers. In subjects having Symptoms and Signs, Elettroneurography and Echography have been performed. 54 subjects had Paresthesias and performed elettroneurography: 44 (34,4%) had Median nerve impairment at the wrist and among them 37 cases were bilateral; 15 had Ulnar nerve impairment (11,7%), among them 8 were bilateral. Moreover we have performed the echographies in all the 25 subjects with a positive medical examination of the shoulder and they all (19,5% del totale) showed a rotator cuff tendinosis. 25 subjects with CTD (44,6%) showed a comorbidity. An index called BiCo considering both bilaterality and comorbility has been calculated. The percentage of CTD is much more elevated than in general population and many workers present comorbility and bilaterality: a strategy for primary prevention improving ergonomy and information is needed.

New tools for C.A.D. of input devices for tele-operation with force feedback

International Nuclear Information System (INIS)

Gosselin, F.

2000-01-01

The performances of a tele-operation system are related to the master arm's ability to emulate the behavior of the remote environment. Ideally, it allows the operator to control the slave arm in a natural way as if that were an extension of its own body. The criteria to be checked for that are known but contradictory. It is thus necessary to make trade-offs on which there is not consensus. Existing input devices are therefore very varied thus more or less adapted to the tasks considered, which is in general checked a posteriori. In this document, we propose an original approach allowing to dimension the master arm a priori according to the use which one wishes to make. For that, we developed two tools: - the first one makes it possible to establish his specifications by taking account of the transmission of information between the operator and the slave arm. By exploiting their respective limitations, one is assured that the master arm will not limit the performances of the system, - the second one allows to design it (kinematics, size, motorization... ) according to the preceding specifications. For that, we use well-known theoretical tools which however are approached here as design tools. This leads to the definition of new concepts which do not appear in the literature. This approach is used to establish the specifications of a master arm for nuclear and offshore tele-operation then to design two input devices answering these specifications. The first has 3 degrees of freedom with force feedback. Its performances are higher than those of the best existing input devices. The second is a mock-up of a 6 degrees of freedom master arm. It uses a new parallel structure that is redundant in actuation and whose performances are remarkable. (author) [fr

Tele-maintenance 'intelligent' system for technical plants result management

International Nuclear Information System (INIS)

Concetti, Massimo; Cuccioletta, Roberto; Fedele, Lorenzo; Mercuri, Giampiero

2009-01-01

The management of technical plant for productivity and safety is generally a complex activity, particularly when many plants distributed in the territory are considered (i.e. the more and more frequent case of outsourced plants maintenance by specialized companies), granted quality and cost results are required (i.e. the case of some rather innovative contract solutions) and the technology involved is heterogeneous and innovative (i.e. electro-mechanical plants). In order to efficiently achieve the above aims an 'intelligent' maintenance-management system for the distant monitoring and controlling by a remote control center has been developed. The so-called GrAMS (granted availability management system) system is conceived to give to organizations involved in technical-industrial plants management the possibility to tend to a 'well-known availability' and 'zero-failures' management. In particular, this study deals with the diagnostic aspects and safety level of technical plants (such as elevators, thermo-technical plants, etc.), and with the involvement of ad hoc designed software analysis tools based on neural networks and reliability indicators. Part of the research dealing with the tele-maintenance intelligent system has been financed by the Italian High Institute for Safety (ISPESL) and led to the development of a pre-industrial prototype whose realization and testing is here described

Metodología para la Evaluación de un Servicio de Tele-educación Multimedia

OpenAIRE

García Pañeda, Xicu Xabiel; Neira Álvarez, Angel; Melendi Palacio, David; García Fernández, Roberto; García García, Víctor Guillermo

2005-01-01

Este artículo presenta una metodología para la evaluación de un servicio de tele-educación a través de Internet, cuyos contenidos se ofrecen al usuario en formato audio/vídeo. A pesar de que existen diversos sistemas para hacer llegar este tipo de información a los usuarios, la tecnología de streaming resulta muy interesante, ya que permite transmitir a los usuarios la información que van solicitando en tiempo real. Esta característica hace posible evaluar el éxito de un determinado contenido...

Review of middle eastern hydro climatology and seasonal tele connections

International Nuclear Information System (INIS)

Pagano, T. C.; Mahani, S.; Nazemosadat, M. J.; Sorooshian, S.

2003-01-01

International hydro climatic variability in the Middle East is explored. A review is done on studies linking local climate with large-scale tele connections. These studies suggest that El Nino has a weak tendency of bringing better than normal conditions to the region during fall / winter. This signal is unstable in time and has considerable decadal variability. No consensus exists on the general start and end dates of various climate epochs, nor is there an explanation of the physical causes of the decad al variability, suggesting that the inter annual signal of El Nino in the Middle East may be transient and difficult to predict. In contrast, the influence of the North Atlantic Oscillation on temperature, precipitation and strea flow is strong, with high North Atlantic Oscillation winters favoring dry and cool conditions in the region. Recommendations are made on how to improve the ability to understand and forecast Middle Eastern inter annual variability, namely, 1) improve access to instrumental data, 2) coordinate research, forecasts and user involvement through a regional forum and 3) further explore the impacts of North Atlantic Oscillation in the Middle East

Building clinical networks: a developmental evaluation framework.

Science.gov (United States)

Carswell, Peter; Manning, Benjamin; Long, Janet; Braithwaite, Jeffrey

2014-05-01

Clinical networks have been designed as a cross-organisational mechanism to plan and deliver health services. With recent concerns about the effectiveness of these structures, it is timely to consider an evidence-informed approach for how they can be developed and evaluated. To document an evaluation framework for clinical networks by drawing on the network evaluation literature and a 5-year study of clinical networks. We searched literature in three domains: network evaluation, factors that aid or inhibit network development, and on robust methods to measure network characteristics. This material was used to build a framework required for effective developmental evaluation. The framework's architecture identifies three stages of clinical network development; partner selection, network design and network management. Within each stage is evidence about factors that act as facilitators and barriers to network growth. These factors can be used to measure progress via appropriate methods and tools. The framework can provide for network growth and support informed decisions about progress. For the first time in one place a framework incorporating rigorous methods and tools can identify factors known to affect the development of clinical networks. The target user group is internal stakeholders who need to conduct developmental evaluation to inform key decisions along their network's developmental pathway.

Alguns comentários sobre a Ética de Aristóteles

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Pedro Brocco

2017-04-01

Full Text Available O presente artigo tem o objetivo de apresentar alguns pontos relevantes acerca da concepção aristotélica de ética. Para tanto, será necessário situar sua teoria no interior do movimento da filosofia helênica, tomando como ponto de partida a relação estabelecida entre as obras de Aristóteles e Platão. Em um segundo momento, serão realçados alguns caminhos interpretativos e analíticos da ética aristotélica, com destaque para alguns conceitos principais, como phronesis, a noção de justiça, a amizade e o autodomínio. O objetivo do trabalho é contribuir para a análise e interpretação da ética aristotélica ou ética das virtudes, buscando diferenças em relação às éticas normativas.

Clinical education and clinical evaluation of respiratory therapy students.

Science.gov (United States)

Cullen, Deborah L

2005-09-01

Different blends of knowledge, decision making, problem solving,professional behaviors, values, and technical skills are necessary in the changing health care environments in which respiratory therapists practice. Frequently, novice students are expected to perform quickly and efficiently,and it may be forgotten that students are still learning and mastering the foundation pieces of practice. Clinical educators take on the responsibility of student development in addition to overseeing patient care. Normally,these volunteer instructors are role models for respiratory therapy students. The characteristic of initiative when demonstrated by a beginning student is attractive to the clinical instructor, promotes sharing of experiences, and may evolve into a mentor-protege relationship. Some clinical instructors may be underprepared to teach and are uncomfortable with student evaluation. Respiratory therapy facilities in conjunction with academic institutions may consider sponsoring ongoing programs for clinical teachers. Teaching and learning in the clinical environment is more than demonstration of skills and knowledge. Furthermore, it can be debated whether the memorization of facts or of the steps of a skill is more valuable than competency in problem solving, clinical reasoning, or information retrieval. New knowledge is built within a context and is further integrated when grounded by experience. Development of "prediction in practice" or the anticipation of the next necessary actions may be worth integrating into the instructional toolbox. Intuition has been defined as an "understanding without a rationale". This definition separates intuition from rational decision making and presents intuition as a type of innate ability. Reflection when guided by clinical instructors can help deepen critical thinking, as will Socratic questioning on a regular basis. Most clinical staff can agree on the performance of an incompetent student, but discrimination of the levels of

Clinical evaluation of patients with patellofemoral disorders.

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Post, W R

1999-01-01

Accurate clinical evaluation of patients with patellofemoral disorders is the cornerstone of effective treatment. This article defines how a careful history and physical examination can direct strategies for nonoperative and operative management. A critical analysis of traditional methods of evaluation and a streamlined rational approach to clinical evaluation is presented. Key questions and important physical findings that affect treatment decisions are emphasized.

Modelamiento de un agente de calidad multicriterio para un sistema de tele-enseñanza.

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Gladys Mansilla G.

2012-01-01

Full Text Available El presente artículo presenta un sistema de tele-educación configurable de modo de a través de un agente puede entregar a los alumnos un servicio de óptima calidad, tanto en audio como en video. Este sistema permite impartir clases en tiempo real. Existen varios métodos de modelar e implementar agentes entre ellos inteligencia artificial, lógica difusa, teoría de juegos y teoría de utilidad multiatributo/ multicriterio. Este trabajo contempla la construcción de un modelo de agentes que utiliza la teoría de utilidad multiatributo, para representar las interacciones de los diversos actores del sistema (alumnos, profesores, invitados, etc., de manera de lograr la mejor calidad de servicio.

Evaluation of stiffness feedback for hard nodule identification on a phantom silicone model.

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Li, Min; Konstantinova, Jelizaveta; Xu, Guanghua; He, Bo; Aminzadeh, Vahid; Xie, Jun; Wurdemann, Helge; Althoefer, Kaspar

2017-01-01

Haptic information in robotic surgery can significantly improve clinical outcomes and help detect hard soft-tissue inclusions that indicate potential abnormalities. Visual representation of tissue stiffness information is a cost-effective technique. Meanwhile, direct force feedback, although considerably more expensive than visual representation, is an intuitive method of conveying information regarding tissue stiffness to surgeons. In this study, real-time visual stiffness feedback by sliding indentation palpation is proposed, validated, and compared with force feedback involving human subjects. In an experimental tele-manipulation environment, a dynamically updated color map depicting the stiffness of probed soft tissue is presented via a graphical interface. The force feedback is provided, aided by a master haptic device. The haptic device uses data acquired from an F/T sensor attached to the end-effector of a tele-manipulated robot. Hard nodule detection performance is evaluated for 2 modes (force feedback and visual stiffness feedback) of stiffness feedback on an artificial organ containing buried stiff nodules. From this artificial organ, a virtual-environment tissue model is generated based on sliding indentation measurements. Employing this virtual-environment tissue model, we compare the performance of human participants in distinguishing differently sized hard nodules by force feedback and visual stiffness feedback. Results indicate that the proposed distributed visual representation of tissue stiffness can be used effectively for hard nodule identification. The representation can also be used as a sufficient substitute for force feedback in tissue palpation.

Evaluation of stiffness feedback for hard nodule identification on a phantom silicone model.

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Min Li

Full Text Available Haptic information in robotic surgery can significantly improve clinical outcomes and help detect hard soft-tissue inclusions that indicate potential abnormalities. Visual representation of tissue stiffness information is a cost-effective technique. Meanwhile, direct force feedback, although considerably more expensive than visual representation, is an intuitive method of conveying information regarding tissue stiffness to surgeons. In this study, real-time visual stiffness feedback by sliding indentation palpation is proposed, validated, and compared with force feedback involving human subjects. In an experimental tele-manipulation environment, a dynamically updated color map depicting the stiffness of probed soft tissue is presented via a graphical interface. The force feedback is provided, aided by a master haptic device. The haptic device uses data acquired from an F/T sensor attached to the end-effector of a tele-manipulated robot. Hard nodule detection performance is evaluated for 2 modes (force feedback and visual stiffness feedback of stiffness feedback on an artificial organ containing buried stiff nodules. From this artificial organ, a virtual-environment tissue model is generated based on sliding indentation measurements. Employing this virtual-environment tissue model, we compare the performance of human participants in distinguishing differently sized hard nodules by force feedback and visual stiffness feedback. Results indicate that the proposed distributed visual representation of tissue stiffness can be used effectively for hard nodule identification. The representation can also be used as a sufficient substitute for force feedback in tissue palpation.

Ciencia y moral: Eliano desde Aristóteles y a la luz del estoicismo y la “zoofilia” moderna

OpenAIRE

García Valdés, Manuela

2003-01-01

Se estudia De natura animalium de Eliano bajo la influencia recibida, principalmente, de la doctrina de Aristóteles en sus obras de biología y ética así como de la de los Estoicos. En ese marco ideológico se analizan con detalle las cualidades morales de los irracionales en la obra griega. La autora presenta, finalmente, una comparación de la postura de Eliano acerca de la consideración moral de los animales con la de algunos autores modernos y contemporáneos.

Natureza e Deliberação em Aristóteles: uma aproximação em diálogo com Pierre Aubenque

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José Edmar Lima Filho

2017-05-01

Full Text Available O presente artigo versa sobre uma possível interpretação da natureza em Aristóteles que corresponda à exigência da viabilidade da deliberação para a ação humana, ou seja, sobre o problema da articulação da natureza com a contingência como seu momento interno. Para isso, propõe-se a visualização de um percurso teórico que apresenta brevemente o conceito de natureza desde a Física aristotélica até a interpretação da possibilidade de uma ontologia da contingência  no pensamento do Estagirita, o que é realizado com base na hipótese interpretativade Pierre Aubenque. A consequência da defesa do estabelecimento de um lugar para a indeterminação e a imprevisibilidade, características da ação humana, fortalece a concepção de deliberação e demonstra a importância deste conceito para a política em Aristóteles, algo que justifica a relevância da presente proposta de trabalho.

Tele-surgery: a new virtual tool for medical education.

Science.gov (United States)

Russomano, Thais; Cardoso, Ricardo B; Fernandes, Jefferson; Cardoso, Paulizan G; Alves, Jarcedy M; Pianta, Christina D; Souza, Hamilton P; Lopes, Maria Helena I

2009-01-01

The rapid evolution of telecommunication technology has enabled advances to be made in low cost video-conferencing through the improvement of high speed computer communication networks and the enhancement of Internet security protocols. As a result of this progress, eHealth education programs are becoming a reality in universities, providing the opportunity for students to have greater interaction at live surgery classes by means of virtual participation. Undergraduate students can be introduced to new concepts of medical care, remote second opinion and to telecommunication systems, whilst virtually experiencing surgical procedures and lectures. The better access this provides to the operating theater environment, the patient and the surgeon can improve the learning process for students. An analogical system was used for this experimental pilot project due to the benefits of it being low cost with a comparatively easy setup. The tele-surgery lectures were also transmitted to other universities by means of a Pentium 4 computer using open source software and connected to a portable image acquisition device located in the São Lucas University Hospital. Telemedicine technology has proven to be an important instrument for the improvement of medical education and health care. This study allowed health professionals, professors and students to have greater interaction during surgical procedures, thus enabling a greater opportunity for knowledge exchange.

Reflective journaling for clinical judgment development and evaluation.

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Lasater, Kathie; Nielsen, Ann

2009-01-01

Reflective journaling is a strategy used often in clinical education to gain insight into students' clinical thinking; however, studies indicate that students may benefit from guided reflections. Numerous tools have been used to structure student reflection with varying results. This article describes the outcomes from using the Guide for Reflection based on Tanner's Clinical Judgment Model. The Lasater Clinical Judgment Rubric, created from the Model, is used to evaluate development of clinical judgment and provides language to communicate about clinical thinking with students. Senior immersion course competencies, also developed with language from Tanner's Clinical Judgment Model,offer a comprehensive package that fosters students' clinical judgment development, faculty-student communication about clinical judgment, and evaluation of students' clinical thinking.

Educational actions in human communication health: telehealth contributions in primary care

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Gabriela Guedes de Sá Leitão

Full Text Available ABSTRACT Objective: to characterize educational actions related to human communication health produced at the Tele-Health Center for health professionals in primary care. Methods: a cross-sectional study was conducted at the Tele-Health Center at the Federal University of Pernambuco Clinical Hospital. Educational actions produced by tele-consultants between 2008 and 2014 linked to the health of human communication were considered. Data collection was conducted in two phases. In the first phase, the data were explored and educational actions were selected based on the title and the relationship with human communication. In the second phase, each action was observed and evaluated for content. The data were analyzed using descriptive statistics. Results: a few educational actions related to human communication health were concentrated in 2014. Throughout the period analyzed, the actions were restricted to the field of language and concentrated on the education issue as well as the strategic area of child and adolescent health. The most frequent occupational category among the tele-consultants was nursing. Conclusion: a small number of educational actions addressing the health of human communication was produced and the participation of speech therapists remains incipient.

Developments in statistical evaluation of clinical trials

CERN Document Server

Oud, Johan; Ghidey, Wendimagegn

2014-01-01

This book describes various ways of approaching and interpreting the data produced by clinical trial studies, with a special emphasis on the essential role that biostatistics plays in clinical trials. Over the past few decades the role of statistics in the evaluation and interpretation of clinical data has become of paramount importance. As a result the standards of clinical study design, conduct and interpretation have undergone substantial improvement. The book includes 18 carefully reviewed chapters on recent developments in clinical trials and their statistical evaluation, with each chapter providing one or more examples involving typical data sets, enabling readers to apply the proposed procedures. The chapters employ a uniform style to enhance comparability between the approaches.

Evaluation Apprehension and Impression Management in Clinical Medical Education.

Science.gov (United States)

McGaghie, William C

2018-05-01

Historically, clinical medical education has relied on subjective evaluations of students and residents to judge their clinical competence. The uncertainty associated with these subjective clinical evaluations has produced evaluation apprehension among learners and attempts to manage one's professional persona (impression management) among peers and supervisors. Such behavior has been documented from antiquity through the Middle Ages to the present, including in two new qualitative studies in this issue of Academic Medicine on the social psychology of clinical medical education. New approaches to medical education, including competency-based education, mastery learning, and assessment methods that unite evaluation and education, are slowly changing the culture of clinical medical education. The author of this Invited Commentary argues that this shift will bring greater transparency and accountability to clinical medical education and gradually reduce evaluation apprehension and the impression management motives it produces.

Evaluating clinical librarian services: a systematic review.

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Brettle, Alison; Maden-Jenkins, Michelle; Anderson, Lucy; McNally, Rosalind; Pratchett, Tracey; Tancock, Jenny; Thornton, Debra; Webb, Anne

2011-03-01

  Previous systematic reviews have indicated limited evidence and poor quality evaluations of clinical librarian (CL) services. Rigorous evaluations should demonstrate the value of CL services, but guidance is needed before this can be achieved.   To undertake a systematic review which examines models of CL services, quality, methods and perspectives of clinical librarian service evaluations.   Systematic review methodology and synthesis of evidence, undertaken collaboratively by a group of 8 librarians to develop research and critical appraisal skills.   There are four clear models of clinical library service provision. Clinical librarians are effective in saving health professionals time, providing relevant, useful information and high quality services. Clinical librarians have a positive effect on clinical decision making by contributing to better informed decisions, diagnosis and choice of drug or therapy. The quality of CL studies is improving, but more work is needed on reducing bias and providing evidence of specific impacts on patient care. The Critical Incident Technique as part of a mixed method approach appears to offer a useful approach to demonstrating impact.   This systematic review provides practical guidance regarding the evaluation of CL services. It also provides updated evidence regarding the effectiveness and impact of CL services. The approach used was successful in developing research and critical appraisal skills in a group of librarians. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

Bidirectional and Multi-User Telerehabilitation System: Clinical Effect on Balance, Functional Activity, and Satisfaction in Patients with Chronic Stroke Living in Long-Term Care Facilities

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Kwan-Hwa Lin

2014-07-01

Full Text Available Background: The application of internet technology for telerehabilitation in patients with stroke has developed rapidly. Objective: The current study aimed to evaluate the effect of a bidirectional and multi-user telerehabilitation system on balance and satisfaction in patients with chronic stroke living in long-term care facilities (LTCFs. Method: This pilot study used a multi-site, blocked randomization design. Twenty-four participants from three LTCFs were recruited, and the participants were randomly assigned into the telerehabilitation (Tele and conventional therapy (Conv groups within each LTCF. Tele group received telerehabilitation but the Conv group received conventional therapy with two persons in each group for three sessions per week and for four weeks. The outcome measures included Berg Balance Scale (BBS, Barthel Index (BI, and the telerehabilitation satisfaction of the participants. Setting: A telerehabilitation system included “therapist end” in a laboratory, and the “client end” in LTCFs. The conventional therapy was conducted in LTCFs. Results: Training programs conducted for both the Tele and Conv groups showed significant effects within groups on the participant BBS as well as the total and self-care scores of BI. No significant difference between groups could be demonstrated. The satisfaction of participants between the Tele and the Conv groups also did not show significant difference. Conclusions: This pilot study indicated that the multi-user telerehabilitation program is feasible for improving the balance and functional activity similar to conventional therapy in patients with chronic stroke living in LTCFs.

Detection and surveillance of rejection reactions after heart transplant by means of a sequence of MRI of 'black blood' type

International Nuclear Information System (INIS)

David, N.; Escanye, J.M.; Marwan, N.S.; Marie, P.Y.; Perlot, P.; Angioi, M.; Walker, P.; Quiri, N.; Arsena, T.; Hassan, N.; Villemot, J.P.; Mattei, S.; Karcher, G.; Bertrand, A.

1997-01-01

A echocardiography and a MRI (Magnetic Resonance Imaging) investigation were achieved at 3 months to 7 years after heart transplant in 61 patients among whose 35 were suspected of rejection and 32 have had a myocardial biopsy. The myocardial (T 2 ) transversal relaxation time was determined by using an inversion-recovery/spin-echo upon a magnet of 0.5 T. The rejection diagnosis criteria by echography was compared with that of a anomalistic high value of T 2 : 1. the MRI was positive but the echography not in 5 cases, all having positive biopsies; 2. the echography was positive but the MRI was not in 10 cases among which all the biopsies were negative; 3. the MRI and the echography gave concordant results in 46 cases (7 positives and 39 negatives) among which an agreement with the biopsy results was observed in 91% (20/22) of cases. The 12 patients having a positive MRI have had a new examination at 2 to 15 days after the anti-rejection treatment; the T 2 values got normalized. In conclusion, the determination of the myocardial T 2 by means of a 'black blood' MRI sequence appears to be superior to an echocardiography in detecting the rejections after heart transplant and could be utilised to evaluate the efficiency of anti-rejection treatment

Phantasía logistikē en la configuración del deseo en Aristóteles

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Claudia Carbonell

2013-01-01

Full Text Available En De Anima III 10, Aristóteles introduce la noción de phantasía logistikē como uno de los principios de la acción racional. A partir de la exposición de algunos textos del De Anima y de Ética a Nicómaco, se busca interpretar el lugar de aquel tipo de imaginación en el razonamiento práctico. Para ello, se presenta primero la doctrina aristotélica de los principios de la acción y la problemática de su articulación, y luego se discute el papel de la imaginación racional en la configuración del objeto del deseo.

Escala de riesgo Aristóteles como factor predictor de mortalidad en el cierre quirúrgico de persistencia de ductus arterioso en prematuros

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Antonio Jimenez-Aceituna

2017-07-01

Conclusiones: La mortalidad asociada al cierre quirúrgico del ductus persistente depende más del estado de prematuridad que de la cirugía, siendo la escala Aristóteles el factor más útil para determinar el grado de prematuridad y predecir la mortalidad hospitalaria. Los prematuros con 15 o más puntos en esta escala tuvieron una mayor mortalidad, para los que se propone un manejo conservador.

Telemedicine Based Ultrasound for Detecting Neonatal Heart Disease in Babies at Remote Military or Native American Health Care Facilities

Science.gov (United States)

2009-09-01

Telemedicine & Advanced Technology Research Center (TATRC). The additional funds are being used to extend the life of the TeleEcho Project in order to...practitioners for the Tele-ECHO project. This is held at Madigan Army Medical Center in the clinic and the NICU . Learning objectives: 1. Learners will...support and expertise. Funding is provided through AMEDD Advanced Medical Technology Initiative (AAMTI) FY09, APC-T690 Special Fund for TeleEcho. The

Effect of dietary supplement (cevas on the chemical composition of wild fish Brycon falcatus Müller & Troschel, 1844 in the Teles Pires river basin

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Liliane Stedile Matos

2017-05-01

Full Text Available In the Teles Pires River watershed, one of the most common techniques currently used by fishermen to catch fish is to provide a food supplement commonly known as “cevas”. The purpose of this study was to compare the chemical composition of fillets from Brycon falcatus that were caught in both the presence and absence of cevas. The fish were sampled monthly and captured in the following conditions: the Tapaiúna River without cevas, the Teles Pires River with one ceva/100 m, the Celeste River with one ceva/500 m, the Verde River with one ceva/1000 m and the Cristalino River (control area. Subsequent to capture, the fish were euthanized and preserved on ice to determine their water, ash, crude protein and fat contents. Fillets of fish from the control area exhibited a lower level of crude protein (17.81% compared with that of fish from the other rivers, which did not differ amongst one other. The fillets of fish from the river with the greatest density of cevas (1/100 m exhibited a higher fat content (3.63% than that of fish from the control area (1.51%. Thus, the cevas changed the chemical composition of B. falcatus fillets.

El ¿delito? de Aristóteles Aristotle's crime?

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MARÍA CLAUDIA CECCHI

2001-09-01

Full Text Available El filósofo griego Aristóteles es reconocido como uno de los más tempranos naturalistas del mundo occidental. Sus acabados y precisos conocimientos sobre zoología están contenidos en una variedad de escritos dedicados al estudio de los animales. Sorprende que, pese a su gran acervo de conocimientos biológicos, el estagirita nunca se planteó la posibilidad de que los organismos pudieran transformarse o estar conectados por relaciones de origen, ideas sustentadoras de la teoría de la evolución orgánica. Nosotros planteamos que hay en la biología aristotélica tres factores principales que explican esta falta de visión: (1 la idea eternizadora de la reproducción de los entes que no da lugar a la posibilidad de la transformación genérica de los organismos a través del nexo reproductivo; (2 el planteamiento que los fenómenos naturales tienen un propósito (causa final que determina su existencia, cuestión que lleva a desestimar la eventual existencia de conexiones en el origen entre los distintos géneros (sensu Aristóteles de organismos vivos; y (3 como consecuencia de lo anterior, la clasificación de los seres vivos según criterios analógico-funcionales que oscurece la existencia de vínculos estructurales y semejanzas de origen entre los organismos. El análisis de esta situación propia de la biología aristotélica nos lleva a examinar la importancia que tiene, para la formulación y desarrollo de las ideas evolucionistas, el advenimiento de una clasificación biológica de tipo jerárquica, inclusiva y ramificada, como la fundada por Linné y desarrollada, sobre la base de correspondencias estructurales y semejanzas de origen entre los organismos, por los grandes naturalistas del siglo XVIII y XIXThe Greek philosopher Aristotle is recognized as one of the earliest naturalists of the Western world. His thorough and precise knowledge of zoology is contained in various writings dedicated to the study of animals. It is

Sobre el sentimiento de vergüenza en la Ética Nicomaquea y la Retórica de Aristóteles

OpenAIRE

Gil Blasco, Marta

2013-01-01

En el siguiente estudio examinaremos el sentimiento de vergüenza desde dos planteamientos distintos formulados por Aristóteles: el de la Retórica, por una parte, y el de la Ética Nicomaquea, por otra, con la finalidad de dar cuenta de las diferencias, así como de los puntos de confluencia que existen entre ambos. Asimismo, consideraremos la intrincada conexión que existe entre la agencia humana y cuestiones tales como la voluntariedad, la responsabilidad y la culpa, así como el papel fundamen...

Establishment and preliminary application of the interactive tele-radiologic conference system based on virtual private network

International Nuclear Information System (INIS)

Wang Xuejian; Hu Jian; Wang Kang; Yu Hui; Luo Min; Lei Wenyong

2005-01-01

Objective: To investigate the establishment and characteristics of the interactive tele-radiological system (IATRS). Methods: Local area network (LAN) of local hospitals with firewall and ADSL Modem was connected into internet, then connected into the Virtual Private Network (VPN) server of the affiliated hospital of Guiyang Medical College (GMCAH) through anti-firewall of GMCAH. The VPN tunnel was acquired and LAN of local hospitals was connected into the PACS server of GMCAH, resulting in sharing of radiological data by both the GMCAH and local hospitals. Results: Radiological data from local hospitals could be transmitted by the PACS server of GMCAH safety and rapidly. The IATRS could provide high-quality images with high-speed, and with ease to perform. Conclusion: IATRS is useful and reliable for transmitting radiological data between remote places. (authors)

Evaluating online diagnostic decision support tools for the clinical setting.

Science.gov (United States)

Pryor, Marie; White, David; Potter, Bronwyn; Traill, Roger

2012-01-01

Clinical decision support tools available at the point of care are an effective adjunct to support clinicians to make clinical decisions and improve patient outcomes. We developed a methodology and applied it to evaluate commercially available online clinical diagnostic decision support (DDS) tools for use at the point of care. We identified 11 commercially available DDS tools and assessed these against an evaluation instrument that included 6 categories; general information, content, quality control, search, clinical results and other features. We developed diagnostically challenging clinical case scenarios based on real patient experience that were commonly missed by junior medical staff. The evaluation was divided into 2 phases; an initial evaluation of all identified and accessible DDS tools conducted by the Clinical Information Access Portal (CIAP) team and a second phase that further assessed the top 3 tools identified in the initial evaluation phase. An evaluation panel consisting of senior and junior medical clinicians from NSW Health conducted the second phase. Of the eleven tools that were assessed against the evaluation instrument only 4 tools completely met the DDS definition that was adopted for this evaluation and were able to produce a differential diagnosis. From the initial phase of the evaluation 4 DDS tools scored 70% or more (maximum score 96%) for the content category, 8 tools scored 65% or more (maximum 100%) for the quality control category, 5 tools scored 65% or more (maximum 94%) for the search category, and 4 tools score 70% or more (maximum 81%) for the clinical results category. The second phase of the evaluation was focused on assessing diagnostic accuracy for the top 3 tools identified in the initial phase. Best Practice ranked highest overall against the 6 clinical case scenarios used. Overall the differentiating factor between the top 3 DDS tools was determined by diagnostic accuracy ranking, ease of use and the confidence and

Chronic diarrhea. Diagnosis and clinical evaluation

International Nuclear Information System (INIS)

Pineda O, Luis F; Otero R, William; Arbelaez M, Victor

2004-01-01

Chronic diarrhea is a syndrome of great clinical complexity, which is frequently encountered by general physicians, internists and gastroenterologists. Differential diagnosis is very broad and sometime finding the precise cause can be difficult, expensive and frustration. Literature published about this topic lack, in general, adequate controlled studies and for this reason recommendations for diagnostic evaluation and treatment are based upon series of cases, experience of the institutions or expert opinion and not on reasonable evidence. On the other hand, many of the classical diagnostic tests that have survived until now were designed over physiologic foundations and have not been validated extensively with the precision of a clinical test. This limits its acceptance, application and standardization in the daily practice. There is not a general agreement about diagnosis and treatment of chronic diarrhea and many of the experts divert recommendation about their recommendations. The purpose of this paper is to define some general guidelines about the clinical evaluation of patients with chronic diarrhea that lead us to a rational approach based upon clinical trials and the appropriate use of the many different tests

S.H.A.S.T. and Tele-bio-sphere: Investigative Processes as Artistic Practices

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Maria Luiza Fragoso

2016-02-01

Full Text Available The subjects herein addressed make part of a series of lectures and workshops developed by me along with the team of the New Organisms Art Nucleus (NANO during the last two years (2013-2015. So, examples of methodological processes applied in the various activities we have developed with undergraduate and graduate students will be presented. The importance I attach to these issues is directly related to the academic practice as well as to the artistic production derived from creation processes, aiming at systematizing and expanding knowledge in the realm of arts and technology, being all of it addressed from a cross-cultural approach. Thus I intend to bring some viewpoints that may feed the discussion between arts and sciences, from an experimental and trans-disciplinary approach, proposing the concepts of hybridity and bio-telematics, so as to illustrate the methodological procedures applied in the artistic projects S.H.A.S.T. and Tele-bio-sphere. http://nano.eba.ufrj.br

The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting

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Anand Vinekar

2014-01-01

Full Text Available Aim: To report the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP program for retinopathy of prematurity (ROP screening in underserved rural areas using an indigenously developed tele-ROP model. Materials and Methods: KIDROP currently provides ROP screening and treatment services in three zones and 81 neonatal units in Karnataka, India. Technicians were trained to use a portable Retcam Shuttle (Clarity, USA and validated against ROP experts performing indirect ophthalmoscopy. An indigenously developed 20-point score (STAT score graded their ability (Level I to III to image and decide follow-up based on a three-way algorithm. Images were also uploaded on a secure tele-ROP platform and accessed and reported by remote experts on their smart phones (iPhone, Apple. Results: 6339 imaging sessions of 1601 infants were analyzed. A level III technician agreed with 94.3% of all expert decisions. The sensitivity, specificity, positive predictive value and negative predictive value for treatment grade disease were 95.7, 93.2, 81.5 and 98.6 respectively. The kappa for technicians to decide discharge of babies was 0.94 (P < 0.001. Only 0.4% of infants needing treatment were missed.The kappa agreement of experts reporting on the iPhone vs Retcam for treatment requiring and mild ROP were 0.96 and 0.94 (P < 0.001 respectively. Conclusions: This is the first and largest real-world program to employ accredited non-physicians to grade and report ROP. The KIDROP tele-ROP model demonstrates that ROP services can be delivered to the outreach despite lack of specialists and may be useful in other middle-income countries with similar demographics.

Política de Aristóteles y sus ciudades (infinitas

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Douglas-Miguel Llanos-Medina

2013-08-01

Full Text Available En las ciudades griegas de la antigüedad se observa cómo la estructura social intenta adaptarse a su forma urbana. Desde esta perspectiva, en el presente artículo se hace una revisión del pensamiento aristotélico, particularmente desarrollado en la obra Política, a fin de analizar el vínculo entre el orden social ideal griego y su espacio asociado. Para Aristóteles (348-322 a.C., la forma ideal de la ciudad es un espacio con-tenido, limitado y finito, a fin de evitar el sobrepoblamiento humano y, de esta manera, garantizar su autosuficiencia, belleza, virtud y goberna-bilidad. Primeramente, se presenta la definición de polis griega del filó-sofo estagirita; luego, una breve evolución del concepto de infinitud a través de la historia al partir del planteamiento aristotélico hasta nues-tros días. Es importante mencionar que las reflexiones aquí presentadas representan un primer avance de la investigación histórica desarrollada en torno al proceso de crecimiento urbano y las formas de limitar su ex-pansión física.

¿POR QUÉ ESTUDIAR LAS RELACIONES SOCIALES EN LAS TELE-ORGANIZACIONES?

Directory of Open Access Journals (Sweden)

Nora Inés Rubbini

2013-06-01

Full Text Available Con el desarrollo de la globalización y las tecnologías de la información y la comunicación aparecen las tele-organizaciones y el teletrabajo. Estos implican cambios en los modos de organización y trabajo tradicionales. Algunos, como los cambios en la estructura, la coordinación de actividades o el control del trabajo están siendo estudiados (aunque no acabadamente aún por la Administración. Otros, como las relaciones sociales en el trabajo, no.En este ensayo se argumenta por qué se considera de suma importancia que la Administración estudie cómo son las relaciones sociales que se gestan y sostienen en la organización cuando sus integrantes teletrabajan. Nos apoyamos en 1 la concepción del hombre como un ser social, 2 la importancia que éste asigna a los vínculos sociales en el trabajo, y 3 la concepción de la organización como un sistema social que para constituirse y mantenerse en el tiempo requiere encontrar un equilibrio entre sus intereses y los de sus integrantes. Palabras clave: Teletrabajo – Relaciones sociales - Administración

LO PÚBLICO O LO PRIVADO: UN PRESUPUESTO DE VIRTUD EN ARISTÓTELES

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Iván Cadavid

2010-01-01

Full Text Available Uno de los temas coyunturales de toda la teoría política del estagirita es el de lo público versus lo privado, desde el cual puede catalogarse la virtud o el vicio de un gobierno. Pero, entiéndase bien, para Aristóteles no puede existir una política buena o mala, que no devenga de una ética que la determine.De este modo, el tema de la virtud ética del gobernante, que es quienestá llamado a elegir entre lo público y lo privado, determina no solo su virtud sino también el futuro de una comunidad política. Pero aquí surge el problema, pues puede pensarse que si se privilegia al individuo se descuida a la sociedad, y a contrario sensu, si se privilegia la sociedad, se descuida al individuo. ¿Cómo sortear este problema? Ésta y otras cuestiones parecidas son las que se pretenden resolver en este artículo.

The costs of critical care telemedicine programs: a systematic review and analysis.

Science.gov (United States)

Kumar, Gaurav; Falk, Derik M; Bonello, Robert S; Kahn, Jeremy M; Perencevich, Eli; Cram, Peter

2013-01-01

Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology.

A systematic review of the effectiveness of videoconference-based tele-education for medical and nursing education.

Science.gov (United States)

Chipps, Jennifer; Brysiewicz, Petra; Mars, Maurice

2012-04-01

Rural nurses and doctors typically have little opportunity to further their education and training. Studies have shown high participant satisfaction with the use of educational technology, such as videoconferencing, for education. A review of effectiveness of videoconference-based tele-education for medical and nursing education was conducted. The aims of this study were to: (1) systematically review the literature and critique the research methods on studies addressing the review question: "How effective is videoconference-based education for the education of doctors and nurses?" (2) summarize the existing evidence on the effectiveness of videoconference education for medical and nursing staff; and (3) apply the findings to South Africa and other countries across the globe. Research citations from 1990 to 2011 from cumulative index of nursing and allied health literature, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews, the Cochrane Controlled Trial Registry, Database of Abstracts of Reviews of Effectiveness, unpublished abstracts through NEXUS and Internet search engines (Google/Google scholar) were searched. Review methods included searching, sifting, abstraction, and quality assessment of relevant studies by two reviewers. Studies were evaluated for sample, design, intervention, threats to validity, and outcomes. No meta-analysis was conducted as the studies provided heterogeneous outcome data. Five studies were reviewed. Videoconference and face-to-face education is at least equivalent and one study reported an increase in knowledge and knowledge integration. Despite the methodological limitations and heterogeneity of the reviewed studies, there appears to be sufficient evidence of effectiveness to provide a rigorous Grade B evidence-based recommendation of moderate support. The use of videoconferencing for nursing and medical education should be encouraged along with guidelines for the use of videoconferencing. The

Vascular rings in Bucaramanga 1999-2002: clinical Series and revision of the literature

International Nuclear Information System (INIS)

L M, Sosa Avila; J, Niederbacher; O, Fernandez; A, Duran

2003-01-01

They are denominated vascular rings to the group of early anomalies of the embryologic development of the aortic arches that they cause a spectrum of clinical manifestations for the compression of the air way and of the digestive tract. The authors report 8 cases presented among 1999-2002, with an average of age of 10 months at the moment of the diagnosis, 6 arches aortic right and two with double aortic arch. The strider from the birth and the syndrome appearance bronchia-obstructive during the first month was presented in all the cases and the digestive manifestations as dysphagia they accompanied to the cases of double aortic arch. The thorax x-ray allowed valuing the aortic arch it forms the shepherd's aortic crook and of the right the artery right subclavian in 62.5%, and the echography in 100% of the cases; the x-ray of digestive roads evidenced fixed notch in 71% of the cases. The echocardiogram allowed evaluating the origin of the glasses anomalous of the shepherd's crook in 62.5%. It was carried out surgical treatment in 87,5% of the cases, with complications pos-surgical in 1/7 consistent in chylethorax, and subcutaneous emphysema. The authors recommend evaluating for vascular ring to everything recently born with strider and rough obstruction by means of thorax x-ray, x-ray of digestive roads and echocardiogram. In selected cases it would be practiced endoscopy of the air way and the aortogram or the magnetic resonance of the thorax and their vessel for confirmation of the definitive diagnosis

Clinical simulation as an evaluation method in health informatics

DEFF Research Database (Denmark)

Jensen, Sanne

2016-01-01

Safe work processes and information systems are vital in health care. Methods for design of health IT focusing on patient safety are one of many initiatives trying to prevent adverse events. Possible patient safety hazards need to be investigated before health IT is integrated with local clinical...... work practice including other technology and organizational structure. Clinical simulation is ideal for proactive evaluation of new technology for clinical work practice. Clinical simulations involve real end-users as they simulate the use of technology in realistic environments performing realistic...... tasks. Clinical simulation study assesses effects on clinical workflow and enables identification and evaluation of patient safety hazards before implementation at a hospital. Clinical simulation also offers an opportunity to create a space in which healthcare professionals working in different...

A Clinical Evaluation Of Cone Beam Computed Tomography

Science.gov (United States)

2016-06-01

A CLINICAL EVALUATION OF CONE BEAM COMPUTED TOMOGRAPHY by Bryan James Behm, D.D.S. Lieutenant, Dental Corps United States Navy A thesis... COMPUTED TOMOGRAPHY " is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright owner. ~mes Behm Endodontic...printed without the expressed written permission of the author. IV ABSTRACT A CLINICAL EVALUATION OF CONE BEAM COMPUTED TOMOGRAPHY BRYAN JAMES

The Costs of Critical Care Telemedicine Programs

Science.gov (United States)

Falk, Derik M.; Bonello, Robert S.; Kahn, Jeremy M.; Perencevich, Eli; Cram, Peter

2013-01-01

Background: Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. Methods: We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Results: Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. Conclusions: The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology. PMID:22797291

Evaluating Faculty Clinical Excellence in the Academic Health Sciences Center.

Science.gov (United States)

Carey, Robert M.; And Others

1993-01-01

Evaluation of the clinical competence of medical faculty in teaching hospitals is discussed. Different approaches to clinical assessment and theoretical and practical problems in assessing clinical faculty's performance are discussed. A University of Virginia medical school system for evaluation that combines objective and subjective assessment is…

Multi-arm multilateral haptics-based immersive tele-robotic system (HITS) for improvised explosive device disposal

Science.gov (United States)

Erickson, David; Lacheray, Hervé; Lai, Gilbert; Haddadi, Amir

2014-06-01

This paper presents the latest advancements of the Haptics-based Immersive Tele-robotic System (HITS) project, a next generation Improvised Explosive Device (IED) disposal (IEDD) robotic interface containing an immersive telepresence environment for a remotely-controlled three-articulated-robotic-arm system. While the haptic feedback enhances the operator's perception of the remote environment, a third teleoperated dexterous arm, equipped with multiple vision sensors and cameras, provides stereo vision with proper visual cues, and a 3D photo-realistic model of the potential IED. This decentralized system combines various capabilities including stable and scaled motion, singularity avoidance, cross-coupled hybrid control, active collision detection and avoidance, compliance control and constrained motion to provide a safe and intuitive control environment for the operators. Experimental results and validation of the current system are presented through various essential IEDD tasks. This project demonstrates that a two-armed anthropomorphic Explosive Ordnance Disposal (EOD) robot interface can achieve complex neutralization techniques against realistic IEDs without the operator approaching at any time.

Transrectal echography in cancer of the rectum

International Nuclear Information System (INIS)

Lozano Barriga, Mauricio; Mejia Pineres, Fernando; Uriza, Felipe

1996-01-01

Study of the accuracy of trans rectal sonography for the establishment of tumour invasion to the rectal wall and detection of peri rectal ganglia, in patients with known rectal carcinoma and surgical confirmation of findings. Trans rectal sonography is the method of choice for the evaluation of rectal cancer

Instructional scaffolding to improve students' skills in evaluating clinical literature.

Science.gov (United States)

Dawn, Stefani; Dominguez, Karen D; Troutman, William G; Bond, Rucha; Cone, Catherine

2011-05-10

To implement and assess the effectiveness of an activity to teach pharmacy students to critically evaluate clinical literature using instructional scaffolding and a Clinical Trial Evaluation Rubric. The literature evaluation activity centered on a single clinical research article and involved individual, small group, and large group instruction, with carefully structured, evidence-based scaffolds and support materials centered around 3 educational themes: (1) the reader's awareness of text organization, (2) contextual/background information and vocabulary, and (3) questioning, prompting, and self-monitoring (metacognition). Students initially read the article, scored it using the rubric, and wrote an evaluation. Students then worked individually using a worksheet to identify and define 4 to 5 vocabulary/concept knowledge gaps. They then worked in small groups and as a class to further improve their skills. Finally, they assessed the same article using the rubric and writing a second evaluation. Students' rubric scores for the article decreased significantly from a mean pre-activity score of 76.7% to a post-activity score of 61.7%, indicating that their skills in identifying weaknesses in the article's study design had improved. Use of instructional scaffolding in the form of vocabulary supports and the Clinical Trial Evaluation Rubric improved students' ability to critically evaluate a clinical study compared to lecture-based coursework alone.

Increasing self-knowledge: Utilizing tele-coaching for patients with congestive heart failure.

Science.gov (United States)

Rosen, Daniel; Berrios-Thomas, Saskia; Engel, Rafael J

2016-10-01

The objective was to assess self-care knowledge changes with dually eligible Medicare and Medicaid patients diagnosed with congestive heart failure (CHF), who received a telecoaching protocol integrating symptom monitoring with face-to-face video chat with a social worker. We recruited 45 patients with CHF from a regional managed care organization. Sessions via a Health Insurance Portability and Accountability Act-compliant tablet-based platform focused on educational information designed to improve patient self-care. Social workers administered the 13-item Member Confidence Measure (MCM) at baseline and at a 30-day follow-up period. Scores were recorded to measure differences in patients' understanding of CHF and related symptoms, their knowledge of the disease, and the behaviors necessary to prevent their symptoms from getting worse. Over the 30-day period, scores significantly (p safety). Gender, race, and age were unrelated to these improvements. In addition, effect sizes for the sub-scales ranged from .54 to 1.08; the effect size of the intervention as expressed by the total scale score was 1.12. Overall, patients increased knowledge over a 30-day period. Tele-coaching by social workers holds promise as a feasible model for health education for high-risk populations.

Rationale and design of the Study of a Tele-pharmacy Intervention for Chronic diseases to Improve Treatment adherence (STIC2IT): A cluster randomized pragmatic trial

Science.gov (United States)

Choudhry, Niteesh K.; Isaac, Thomas; Lauffenburger, Julie C.; Gopalakrishnan, Chandrasekar; Khan, Nazleen F.; Lee, Marianne; Vachon, Amy; Iliadis, Tanya L.; Hollands, Whitney; Doheny, Scott; Elman, Sandra; Kraft, Jacqueline M.; Naseem, Samrah; Gagne, Joshua J.; Jackevicius, Cynthia A.; Fischer, Michael A.; Solomon, Daniel H.; Sequist, Thomas D.

2016-01-01

Background Approximately half of patients with chronic cardiometabolic conditions are non-adherent with their prescribed medications. Interventions to improve adherence have been only modestly effective because they often address single barriers to adherence, intervene at single points in time, or are imprecisely targeted to patients who may or may not need adherence assistance. Objective To evaluate the effect of a multi-component, behaviorally-tailored pharmacist-based intervention to improve adherence to medications for diabetes, hypertension, and hyperlipidemia. Trial design The STIC2IT (Study of a Tele-pharmacy Intervention for Chronic diseases To Improve Treatment adherence) trial is a cluster-randomized pragmatic trial testing the impact of a pharmacist-led multi-component intervention that uses behavioral interviewing, text messaging, mailed progress reports and video visits. Targeted patients are those who are non-adherent to glucose-lowering, anti-hypertensive, or statin medications and who also have evidence of poor disease control. The intervention is tailored to patients’ individual health barriers and their level of health activation. We cluster randomized 14 practice sites of a large multi-specialty group practice to receive either the pharmacist-based intervention or usual care. STIC2IT has enrolled 4,076 patients to be followed for 12 months after randomization. The trial’s primary outcome is medication adherence, assessed using pharmacy claims data. Secondary outcomes are disease control and healthcare resource utilization. Conclusion This trial will determine whether a technologically-enabled, behaviorally-targeted pharmacist-based intervention results in improved adherence and disease control. If effective, this strategy could be a scalable method of offering tailored adherence support to those with the greatest clinical need. PMID:27659887

Developing Tele-Operated Laboratories for Manufacturing Engineering Education. Platform for E-Learning and Telemetric Experimentation (PeTEX

Directory of Open Access Journals (Sweden)

A. Erman Tekkaya

2010-09-01

Full Text Available The aim of the PeTEX-project is to establish an e-Learning platform for the development, implementation, and delivery of educational training programs in the field of manufacturing engineering. The PeTEX team designs both: a technical platform for eLearning based on “Moodle” including distributed tele-operated experimentation facilities, and didactic and socio-technical requirements for a successful online learning community. User interfaces are deployed for remote access to instruments, data analysis and multiplexed data access via network protocols. Hence, the platform provides complex tools in order to perform various activities to support the educational process, from telemetric experimentation to virtual project groups for an entire community to the purpose of domain specific learning. This paper describes important steps of interdisciplinary participatory design and development of a remote lab-prototype in the field of manufacturing engineering.

Nurse educators’ perceptions of OSCE as a clinical evaluation method

Directory of Open Access Journals (Sweden)

MM Chabeli

2001-09-01

Full Text Available The South African Qualifications Authority, and the South African Nursing Council are in pursuit of quality nursing education to enable the learners to practise as independent and autonomous practitioners. The educational programme should focus on the facilitation of critical and reflective thinking skills that will help the learner to make rational decisions and solve problems. A way of achieving this level of functioning is the use of assessment and evaluation methods that measure the learners’ clinical competence holistically. This article is focused on the perceptions of twenty nurse educators, purposively selected from three Nursing Colleges affiliated to a university in Gauteng, regarding the use of OSCE (Objective Structured Clinical Examination as a clinical evaluation method within a qualitative and descriptive research strategy. Three focus group interviews were conducted in different sessions. A descriptive content analysis was used. Trustworthiness was ensured by using Lincoln and Guba’s model (1985. The results revealed both positive and negative aspects of OSCE as a clinical evaluation method with regard to: administrative aspects; evaluators; learners; procedures/instruments and evaluation. The conclusion drawn from the related findings is that OSCE does not measure the learners’ clinical competence holistically. It is therefore recommended that the identified negative perception be taken as challenges faced by nurse educators and that the positive aspects be strengthened. One way of meeting these recommendations is the use of varied alternative methods for clinical assessment and evaluation that focus on the holistic measurement of the learners’ clinical competence.

The Maastricht Clinical Teaching Questionnaire (MCTQ) as a valid and reliable instrument for the evaluation of clinical teachers.

Science.gov (United States)

Stalmeijer, Renée E; Dolmans, Diana H J M; Wolfhagen, Ineke H A P; Muijtjens, Arno M M; Scherpbier, Albert J J A

2010-11-01

Clinical teaching's importance in the medical curriculum has led to increased interest in its evaluation. Instruments for evaluating clinical teaching must be theory based, reliable, and valid. The Maastricht Clinical Teaching Questionnaire (MCTQ), based on the theoretical constructs of cognitive apprenticeship, elicits evaluations of individual clinical teachers' performance at the workplace. The authors investigated its construct validity and reliability, and they used the underlying factors to test a causal model representing effective clinical teaching. Between March 2007 and December 2008, the authors asked students who had completed clerkship rotations in different departments of two teaching hospitals to use the MCTQ to evaluate their clinical teachers. To establish construct validity, the authors performed a confirmatory factor analysis of the evaluation data, and they estimated reliability by calculating the generalizability coefficient and standard error measurement. Finally, to test a model of the factors, they fitted a structural linear model to the data. Confirmatory factor analysis yielded a five-factor model which fit the data well. Generalizability studies indicated that 7 to 10 student ratings can produce reliable ratings of individual teachers. The hypothesized structural linear model underlined the central roles played by modeling and coaching (mediated by articulation). The MCTQ is a valid and reliable evaluation instrument, thereby demonstrating the usefulness of the cognitive apprenticeship concept for clinical teaching during clerkships. Furthermore, a valuable model of clinical teaching emerged, highlighting modeling, coaching, and stimulating students' articulation and exploration as crucial to effective teaching at the clinical workplace.

[Development and clinical evaluation of an anesthesia information management system].

Science.gov (United States)

Feng, Jing-yi; Chen, Hua; Zhu, Sheng-mei

2010-09-21

To study the design, implementation and clinical evaluation of an anesthesia information management system. To record, process and store peri-operative patient data automatically, all kinds of bedside monitoring equipments are connected into the system based on information integrating technology; after a statistical analysis of those patient data by data mining technology, patient status can be evaluated automatically based on risk prediction standard and decision support system, and then anesthetist could perform reasonable and safe clinical processes; with clinical processes electronically recorded, standard record tables could be generated, and clinical workflow is optimized, as well. With the system, kinds of patient data could be collected, stored, analyzed and archived, kinds of anesthesia documents could be generated, and patient status could be evaluated to support clinic decision. The anesthesia information management system is useful for improving anesthesia quality, decreasing risk of patient and clinician, and aiding to provide clinical proof.

Evaluating clinical ethics support in mental healthcare: a systematic literature review.

NARCIS (Netherlands)

Hem, M.H.; Pedersen, R.; Norvoll, R.; Molewijk, A.C.

2015-01-01

A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five

Evaluation of performance of veterinary in-clinic hematology analyzers.

Science.gov (United States)

Rishniw, Mark; Pion, Paul D

2016-12-01

A previous study provided information regarding the quality of in-clinic veterinary biochemistry testing. However, no similar studies for in-clinic veterinary hematology testing have been conducted. The objective of this study was to assess the quality of hematology testing in veterinary in-clinic laboratories using results obtained from testing 3 levels of canine EDTA blood samples. Clinicians prepared blood samples to achieve measurand concentrations within, below, and above their RIs and evaluated the samples in triplicate using their in-clinic analyzers. Quality was assessed by comparison of calculated total error with quality requirements, determination of sigma metrics, use of a quality goal index, and agreement between in-clinic and reference laboratory instruments. Suitability for statistical quality control was determined using adaptations from the computerized program, EZRules3. Evaluation of 10 veterinary in-clinic hematology analyzers showed that these instruments often fail to meet quality requirements. At least 60% of analyzers reasonably determined RBC, WBC, HCT, and HGB, when assessed by most quality goal criteria; platelets were less reliably measured, with 80% deemed suitable for low platelet counts, but only 30% for high platelet counts, and automated differential leukocyte counts were generally considered unsuitable for clinical use with fewer than 40% of analyzers meeting the least stringent quality goal requirements. Fewer than 50% of analyzers were able to meet requirements for statistical quality control for any measurand. These findings reflect the current status of in-clinic hematology analyzer performance and provide a basis for future evaluations of the quality of veterinary laboratory testing. © 2016 American Society for Veterinary Clinical Pathology.

A Model for Evaluating Student Clinical Psychomotor Skills.

Science.gov (United States)

And Others; Fiel, Nicholas J.

1979-01-01

A long-range plan to evaluate medical students' physical examination skills was undertaken at the Ingham Family Medical Clinic at Michigan State University. The development of the psychomotor skills evaluation model to evaluate the skill of blood pressure measurement, tests of the model's reliability, and the use of the model are described. (JMD)

Clinical evaluation of three caries removal approaches in primary teeth

DEFF Research Database (Denmark)

Phonghanyudh, A; Phantumvanit, P; Songpaisan, Y

2012-01-01

To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques.......To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques....

An Evaluative Study of Clinical Preceptorship.

Science.gov (United States)

Kaviani, Nayer; Stillwell, Yvonne

2000-01-01

A training institute to prepare nurses to serve as preceptors of undergraduate clinical experience was evaluated by focus groups of 6 preceptors, 13 students, and 2 nurse managers. Formal preceptorship training enhanced student learning and promoted positive relationships between nurse educators and practitioners. (SK)

Tele-Coupling Energy Efficiency Polices in Europe: Showcasing the German Governance Arrangements

Directory of Open Access Journals (Sweden)

Marc Ringel

2018-05-01

Full Text Available Climate change entails many situations of tele-coupling. We analyze an example in the field of European climate and energy policy. The EU aims at an almost full decarbonisation of its economy by 2050. Achieving this objective asks for transforming the energy sectors of EU Member States. These are responsible for 80% of carbon emissions. Further to this policy coupling, the EU transformation objectives have to be implemented by the Member States, regions and local actors. This proves especially complex in the field of energy efficiency. Here, a variety of policy instruments and actors are in place. In our contribution, we investigate in the question how multi-level governance arrangements in the energy efficiency field are designed. We focus on Germany as example for a federal state setting. Our review method comprises literature content analysis, primary sources, expert interviews and an in-depth screening of the German Sustainable Energy Action Plans. We find that formal vertical coordination has been successfully backed up by horizontal and especially informal governance mechanisms, leading to a model of polycentric governance. This model might serve as blueprint for other multi-level governance arrangements. Yet, we find that the “last mile” of this coordination still needs strengthening: Local actors need more active engaging and empowering to reap the full potential of the governance arrangements.

A Tele-Behavioral Health Intervention to Reduce Depression, Anxiety, and Stress and Improve Diabetes Self-Management.

Science.gov (United States)

Mochari-Greenberger, Heidi; Vue, Lee; Luka, Andi; Peters, Aimee; Pande, Reena L

2016-08-01

Depression is prevalent among individuals with diabetes and associated with suboptimal self-management. Little is known about the feasibility and potential impact of tele-behavioral therapy to improve depressive symptoms and self-management among diabetes patients. This was a retrospective observational study of consecutive graduates enrolled in a national 8-week diabetes behavioral telehealth program between August 1, 2014, and January 31, 2015 (N = 466; mean age 56.8 ± 5.0 years; 56% female). Participant characteristics (demographics, comorbidities) were obtained by standardized questionnaire. Depression, anxiety, and stress symptoms (DASS; validated Depression Anxiety and Stress Scale 21 survey), and glucose self-testing frequency and values (point-of-care monitor) were measured at program start and completion. Changes in DASS severity and glucose self-testing frequency were assessed by chi-square tests. Changes in DASS and blood glucose levels were evaluated by paired t-tests. At baseline, approximately one in three participants had elevated depression (32%), anxiety (33%), or stress (31%) scores. Significant reductions in average DASS, depression (-8.8), anxiety (-6.9), and stress (-9.9), scores were observed at graduation among those with elevated baseline scores (p depression, anxiety, or stress categories. Improved glucose self-testing frequency (69% vs. 60% tested ≥once per week; p = 0.0005) and significant reductions in mean morning glucose levels (-12.3 mg/dL; p = 0.0002) were observed from baseline to graduation. Participants with normal versus non-normal depression scores were more likely to have lower (depression, anxiety, stress, and glucose levels, as well as increased frequency of glucose self-testing, among participants in a diabetes behavioral telehealth program.

Evaluation of clinical teaching quality in competency-based residency training in Lithuania

Directory of Open Access Journals (Sweden)

Eglė Vaižgėlienė

2017-12-01

Conclusions: Resident evaluations of clinical teachers are influenced by teachers’ age, gender, year of residency training, type of teachers’ academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers educational support and the implementation of e-portfolio.

Reporting and evaluation of HIV-related clinical endpoints in two multicenter international clinical trials

DEFF Research Database (Denmark)

Lifson, A; Rhame, F; Bellosa, W

2006-01-01

adjudication between reviewers before diagnostic certainty was assigned. CONCLUSION: Important requirements for HIV trials using clinical endpoints include objective definitions of "confirmed" and "probable," a formal reporting process with adequate information and supporting source documentation, evaluation......PURPOSE: The processes for reporting and review of progression of HIV disease clinical endpoints are described for two large phase III international clinical trials. METHOD: SILCAAT and ESPRIT are multicenter randomized HIV trials evaluating the impact of interleukin-2 on disease progression...... and death in HIV-infected patients receiving antiretroviral therapy. We report definitions used for HIV progression of disease endpoints, procedures for site reporting of such events, processes for independent review of reported events by an Endpoint Review Committee (ERC), and the procedure...

Evaluating biomarkers for prognostic enrichment of clinical trials.

Science.gov (United States)

Kerr, Kathleen F; Roth, Jeremy; Zhu, Kehao; Thiessen-Philbrook, Heather; Meisner, Allison; Wilson, Francis Perry; Coca, Steven; Parikh, Chirag R

2017-12-01

A potential use of biomarkers is to assist in prognostic enrichment of clinical trials, where only patients at relatively higher risk for an outcome of interest are eligible for the trial. We investigated methods for evaluating biomarkers for prognostic enrichment. We identified five key considerations when considering a biomarker and a screening threshold for prognostic enrichment: (1) clinical trial sample size, (2) calendar time to enroll the trial, (3) total patient screening costs and the total per-patient trial costs, (4) generalizability of trial results, and (5) ethical evaluation of trial eligibility criteria. Items (1)-(3) are amenable to quantitative analysis. We developed the Biomarker Prognostic Enrichment Tool for evaluating biomarkers for prognostic enrichment at varying levels of screening stringency. We demonstrate that both modestly prognostic and strongly prognostic biomarkers can improve trial metrics using Biomarker Prognostic Enrichment Tool. Biomarker Prognostic Enrichment Tool is available as a webtool at http://prognosticenrichment.com and as a package for the R statistical computing platform. In some clinical settings, even biomarkers with modest prognostic performance can be useful for prognostic enrichment. In addition to the quantitative analysis provided by Biomarker Prognostic Enrichment Tool, investigators must consider the generalizability of trial results and evaluate the ethics of trial eligibility criteria.

Clinical presentation and evaluation of dermatomyositis

Directory of Open Access Journals (Sweden)

Umaima Marvi

2012-01-01

Full Text Available Dermatomyositis (DM is a chronic inflammatory disorder of the skin and muscles. Evidence supports that DM is an immune-mediated disease and 50-70% of patients have circulating myositis-specific auto-antibodies. Gene expression microarrays have demonstrated upregulation of interferon signaling in the muscle, blood, and skin of DM patients. Patients with classic DM typically present with symmetric, proximal muscle weakness, and skin lesions that demonstrate interface dermatitis on histopathology. Evaluation for muscle inflammation can include muscle enzymes, electromyogram, magnetic resonance imaging, and/or muscle biopsy. Classic skin manifestations of DM include the heliotrope rash, Gottron′s papules, Gottron′s sign, the V-sign, and shawl sign. Additional cutaneous lesions frequently observed in DM patients include periungual telangiectasias, cuticular overgrowth, "mechanic′s hands", palmar papules overlying joint creases, poikiloderma, and calcinosis. Clinically amyopathic DM is a term used to describe patients who have classic cutaneous manifestations for more than 6 months, but no muscle weakness or elevation in muscle enzymes. Interstitial lung disease can affect 35-40% of patients with inflammatory myopathies and is often associated with the presence of an antisynthetase antibody. Other clinical manifestations that can occur in patients with DM include dysphagia, dysphonia, myalgias, Raynaud phenomenon, fevers, weight loss, fatigue, and a nonerosive inflammatory polyarthritis. Patients with DM have a three to eight times increased risk for developing an associated malignancy compared with the general population, and therefore all patients with DM should be evaluated at the time of diagnosis for the presence of an associated malignancy. This review summarizes the immunopathogenesis, clinical manifestations, and evaluation of patients with DM.

Clinic and Emergency Room Evaluation and Testing of Headache.

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Nye, Barbara L; Ward, Thomas N

2015-10-01

Evaluation of the headache patient in the outpatient clinic and emergency department (ED) has different focuses and goals. The focus of this paper is to review the evaluation of patients in both settings with mention of evaluation in the pediatric and pregnant patient population.  The patient's history should drive the practitioner's decision and evaluation choices. We review recommendations made by the American Board of Internal Medicine and American Headache Society through the Choosing Wisely Campaign, which has an emphasis on choosing the right imaging modality for the clinical situation and elimination/prevention of medication overuse headache, as well as the US Headache Consortium guidelines for migraine headache. We will also review focusing on ED evaluation of the pediatric patient and pregnant patient presenting with headache. At the end of the review we hope to have provided you with a framework to think about the headache patient and what is the appropriate test in the given clinical setting in order to ensure that the patient gets the right diagnosis and is set on a path to the appropriate management plan. © 2015 American Headache Society.

A randomized clinical trial in preterm infants on the effects of a home-based early intervention with the 'CareToy System'

DEFF Research Database (Denmark)

Sgandurra, Giuseppina; Lorentzen, Jakob; Inguaggiato, Emanuela

2017-01-01

and visual development in preterm infants. 41 preterm infants (range age: 3.0-5.9 months of corrected age) were enrolled and randomized into two groups, CareToy and Standard Care. 19 infants randomized in CareToy group performed a 4-week CareToy program, while 22 allocated to control group completed 4 weeks......CareToy system is an innovative tele-rehabilitative tool, useful in providing intensive, individualized, home-based, family-centred Early Intervention (EI) in infants. Our aim was to evaluate, through a Randomized Clinical Trial (RCT) study, the effects of CareToy intervention on early motor...... of Standard Care. Infant Motor Profile (IMP) was primary outcome measure, Alberta Infant Motor Scale (AIMS) and Teller Acuity Cards were secondary ones. Assessments were carried out at baseline (T0) and at the end of CareToy training or Standard Care period (T1). T1 was the primary endpoint. After RCT phase...

Challenges in Evaluating Clinical Governance Systems in Iran: A Qualitative Study

Science.gov (United States)

Hooshmand, Elaheh; Tourani, Sogand; Ravaghi, Hamid; Ebrahimipour, Hossein

2014-01-01

Background: In spite of the pivotal role of clinical governance in enhancing quality of services provided by hospitals across the country, a scientific framework with specific criteria for evaluating hospitals has not been developed so far. Objectives: This study was conducted with the aim to identify the challenges involved in evaluating systems of clinical governance in Iran. Materials and Methods: For the purposes of this qualitative study, 15 semi-structured interviews with experts in the field were conducted in 2011 and the data were analyzed using framework analysis method. Results: Five major challenges in evaluating clinical governance include managing human resources, improving clinical quality, managing development, organizing clinical governance, and providing patient-oriented healthcare system. Conclusions: Healthcare system in Iran requires a clinical governance program which has a patient-oriented approach in philosophy, operation, and effectiveness in order to meet the challenges ahead. PMID:24910799

Gallblader cancer

International Nuclear Information System (INIS)

Escalona Veloz, Rafael; Mila Pascual, Milagros de la Caridad

2011-01-01

The precise information about a 43 year-old patient, with a history of dyspepsias, in whom a gallbladder polyp was diagnosed by means of echography is presented. She was surgically treated because of it and a cholecystectomy was carried out, with a satisfactory clinical course; but the result of biopsy confirmed the presence of an adenoma in her gallbladder, with malignant transformation.(author)

Experimental evaluation of clinical colon anastomotic leakage.

Science.gov (United States)

Pommergaard, Hans-Christian

2014-03-01

Colorectal anastomotic leakage remains a frequent and serious complication in gastrointestinal surgery. Patient and procedure related risk factors for anastomotic leakage have been identified. However, the responsible pathophysiological mechanisms are still unknown. Among these, ischemia and insufficient surgical technique have been suggested to play a central role. Animal models are valuable means to evaluate pathophysiological mechanisms and may be used to test preventive measures aiming at reducing the risk of anastomotic leakage, such as external anastomotic coating. The aim of this thesis was to: Clarify the best suited animal to model clinical anastomotic leakage in humans; Create animal models mimicking anastomotic leakage in humans induced by insufficient surgical technique and tissue ischemia; Determine the best suited coating materials to prevent anastomotic leakage. This study is a systematic review using the databases MEDLINE and Rex. MEDLINE was searched up to October 2010 to identify studies on experimental animal models of clinical colon anastomotic leakage. From the Rex database, textbooks on surgical aspects as well as gastrointestinal physiology and anatomy of experimental animals were identified. The results indicated that the mouse and the pig are the best suited animals to evaluate clinical anastomotic leakage. However, the pig model is less validated and more costly to use compared with the mouse. Most frequently, rats are used as models. However, extreme interventions are needed to create clinical leakage in these animals. The knowledge from this study formed the basis for selecting the animal species most suited for the models in the next studies. STUDY 2: In this experimental study, technically insufficient colonic anastomoses were performed in 110 C57BL/6 mice. The number of sutures in the intervention group was reduced to produce a suitable leakage rate. Moreover, the analgesia and suture material were changed in order to optimize the

Field testing of a remote controlled robotic tele-echo system in an ambulance using broadband mobile communication technology.

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Takeuchi, Ryohei; Harada, Hiroshi; Masuda, Kohji; Ota, Gen-ichiro; Yokoi, Masaki; Teramura, Nobuyasu; Saito, Tomoyuki

2008-06-01

We report the testing of a mobile Robotic Tele-echo system that was placed in an ambulance and successfully transmitted clear real time echo imaging of a patient's abdomen to the destination hospital from where this device was being remotely operated. Two-way communication between the paramedics in this vehicle and a doctor standing by at the hospital was undertaken. The robot was equipped with an ultrasound probe which was remotely controlled by the clinician at the hospital and ultrasound images of the patient were transmitted wirelessly. The quality of the ultrasound images that were transmitted over the public mobile telephone networks and those transmitted over the Multimedia Wireless Access Network (a private networks) were compared. The transmission rate over the public networks and the private networks was approximately 256 Kbps, 3 Mbps respectively. Our results indicate that ultrasound images of far higher definition could be obtained through the private networks.

Pilot trial of a tele-rehab intervention to improve outcomes after stroke in Ghana: A feasibility and user satisfaction study.

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Sarfo, Fred S; Adusei, Nathaniel; Ampofo, Michael; Kpeme, Frank K; Ovbiagele, Bruce

2018-04-15

Tele-rehabilitation after stroke holds promise for under-resourced settings, especially sub-Saharan Africa (SSA), with its immense stroke burden and severely limited physical therapy services. To preliminarily assess the feasibility and outcomes of mobile technology-assisted physical therapy exercises for stroke survivors in Ghana. We conducted a prospective, single arm, pre-post study involving 20 stroke survivors recruited from a tertiary medical center, who received a Smartphone with the 9zest Stroke App® to deliver individualized, goal-targeted 5-days-a-week exercise program that was remotely supervised by a tele-therapist for 12 weeks. Outcome measures included changes in stroke levity scale scores (SLS), Modified Rankin score (MRS), Montreal Cognitive Assessment (MOCA), and feasibility indicators. Among study participants, mean ± SD age was 54.6 ± 10.2 years, 11 (55%) were men, average time from stroke onset was 6 months. No participants dropped out. Compared with baseline status, mean ± SD scores on SLS improved from 7.5 ± 3.1 to 11.8 ± 2.2 at month 1 (p < 0.0001) and 12.2 ± 2.4 at month 3 (p < 0.0001), MOCA scores improved from 18.2 ± 4.3 to 20.4 ± 4.7 at month 1 (p = 0.14), and 22.2 ± 7.6 at month 3 (p = 0.047). Mean ± SD weekly sessions performed by participants per month was 5.7 ± 5.8 and duration of sessions was 25.5 ± 16.2 min. Erratic internet connectivity negatively affected full compliance with the intervention, although satisfaction ratings by study participants were excellent. It is feasible to administer an m-health delivered physical therapy intervention in SSA, with high user satisfaction. Randomized trials to assess the efficacy and cost-effectiveness of this intervention are warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

Clinical scoring and instrumental analysis to evaluate skin types.

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Mercurio, D G; Segura, J H; Demets, M B A; Maia Campos, P M B G

2013-04-01

The biology of the skin is very complex, and there are a number of methods used to classify the different skin types. It is possible to measure or quantify the characteristics of the specific skin types, using a variety of techniques that can objectively evaluate the properties of the skin in a noninvasive manner. To clinically characterize different skin types by dermatological evaluation and biophysical and skin imaging techniques, and to evaluate the relationship between the different characteristics. The study recruited 26 volunteers. Clinical scoring was performed by a dermatologist who classified the volunteers' skin as normal or dry (group 1) and combination or oily (group 2). Objective measurements included skin microrelief, pH, oiliness, water content of the stratum corneum and transepidermal water loss (TEWL). Positive correlations were found between the level of skin oiliness and skin texture obtained from both instrumental analysis and clinical scoring. The combination and oily skin types had higher clinical scores for shine intensity, oiliness and tendency to pigmentation, and also had higher objective scores for sebum secretion, TEWL and roughness. Biophysical and skin imaging techniques are effective tools to help characterize skin type and assist in clinical dermatology. We found that different skin types had different characteristics related to skin microrelief, oiliness and TEWL, and therefore require specific dermatological treatments. © The Author(s) CED © 2013 British Association of Dermatologists.

Growth/differentiation factor-5: pre-clinical and clinical evaluations of periodontal regeneration and alveolar augmentation--review.

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Lee, Jaebum; Wikesjö, Ulf M E

2014-08-01

Growth/differentiation factor-5 (GDF-5) plays critical roles in mesenchymal cell differentiation and stimulates human periodontal ligament cell proliferation. Potentially, GDF-5 may also play roles in wound healing including periodontal regeneration and alveolar augmentation. The objective of this review was to provide up-to-date information from pre-clinical/clinical studies evaluating GDF-5 for these indications. A comprehensive search using PubMed and Google search engines was conducted to identify reports on GDF-5 applied to periodontal and alveolar indications. Two reviewers independently screened the titles and abstracts from a total of 479 reports. Full-length articles of 17 pre-clinical and four clinical studies were selected and reviewed. Canine-, porcine- and non-human primate-based models as well as human clinical trials were used in the evaluation of GDF-5 in support of periodontal regeneration and alveolar augmentation. An absorbable collagen sponge (ACS), β-tricalcium phosphate (β-TCP) and a poly(lactic-co-glycolic) acid (PLGA) were evaluated as candidate carriers for GDF-5 using various dose and healing intervals demonstrating significantly enhanced periodontal regeneration/alveolar augmentation including cementum, periodontal ligament and alveolar bone with limited, if any, adverse effects. Growth/differentiation factor-5 supports periodontal regeneration/alveolar augmentation without aberrant healing events documented in qualified pre-clinical models and clinical pilot studies. In perspective, GDF-5 appears a promising technology for periodontal regeneration/alveolar augmentation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A short-term clinical evaluation of IPS Empress 2 crowns.

Science.gov (United States)

Toksavul, Suna; Toman, Muhittin

2007-01-01

The aim of this study was to evaluate the clinical performance of all-ceramic crowns made with the IPS Empress 2 system after an observation period of 12 to 60 months. Seventy-nine IPS Empress 2 crowns were placed in 21 patients. The all-ceramic crowns were evaluated clinically, radiographically, and using clinical photographs. The evaluations took place at baseline (2 days after cementation) and at 6-month intervals for 12 to 60 months. Survival rate of the crowns was determined using Kaplan-Meier statistical analysis. Based on the US Public Health Service criteria, 95.24% of the crowns were rated satisfactory after a mean follow-up period of 58 months. Fracture was registered in only 1 crown. One endodontically treated tooth failed as a result of fracture at the cervical margin area. In this in vivo study, IPS Empress 2 crowns exhibited a satisfactory clinical performance during an observation period ranging from 12 to 60 months.

E-learning as new method of medical education.

Science.gov (United States)

Masic, Izet

2008-01-01

NONE DECLARED Distance learning refers to use of technologies based on health care delivered on distance and covers areas such as electronic health, tele-health (e-health), telematics, telemedicine, tele-education, etc. For the need of e-health, telemedicine, tele-education and distance learning there are various technologies and communication systems from standard telephone lines to the system of transmission digitalized signals with modem, optical fiber, satellite links, wireless technologies, etc. Tele-education represents health education on distance, using Information Communication Technologies (ICT), as well as continuous education of a health system beneficiaries and use of electronic libraries, data bases or electronic data with data bases of knowledge. Distance learning (E-learning) as a part of tele-education has gained popularity in the past decade; however, its use is highly variable among medical schools and appears to be more common in basic medical science courses than in clinical education. Distance learning does not preclude traditional learning processes; frequently it is used in conjunction with in-person classroom or professional training procedures and practices. Tele-education has mostly been used in biomedical education as a blended learning method, which combines tele-education technology with traditional instructor-led training, where, for example, a lecture or demonstration is supplemented by an online tutorial. Distance learning is used for self-education, tests, services and for examinations in medicine i.e. in terms of self-education and individual examination services. The possibility of working in the exercise mode with image files and questions is an attractive way of self education. Automated tracking and reporting of learners' activities lessen faculty administrative burden. Moreover, e-learning can be designed to include outcomes assessment to determine whether learning has occurred. This review article evaluates the current

Postoperative MRI evaluation of anorectal malformations with clinical correlation

International Nuclear Information System (INIS)

Fukuya, T.; Honda, H.; Kubota, M.; Hayashi, T.; Kawashima, A.; Tateshi, Y.; Shono, T.; Suita, S.; Masuda, K.

1993-01-01

Sixteen postoperative patients with anorectal malformation were evaluated by MRI, and the results compared with the clinical assessment. Patients were classified into three groups - good (group 1, n = 10), fair (group 2, n = 3) and poor (group 3, n = 3) - on the basis of Kelly's clinical score of incontinence. The degree of development of the puborectalis and external sphincter muscles and the levator hammock was evaluated on MRI in comparison with patients without anorectal disease. The proportions of fair or poor development of the muscles were 37% in group 1,22% in group 2 and 67% in group 3. Although fair or poor development of the muscles was seen more frequently in group 3, there was no statistically significant difference between groups. However, poorly developed muscles were seen only in patients with fair or poor clinical scores. The difference in the anorectal angle measured on sagittal MRI images between patients in group 1 and groups 2 or 3 was significant. Our study indicates that MRI evaluation based solely on muscle development can be misleading, and measurement of the anorectal angle should be included in the MRI evaluation. (orig.)

Evaluating clinical ethics support in mental healthcare: a systematic literature review.

Science.gov (United States)

Hem, Marit Helene; Pedersen, Reidar; Norvoll, Reidun; Molewijk, Bert

2015-06-01

A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded 'grey zone articles', in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients' and caregivers' views on ethical challenges, is presented. © The Author(s) 2014.

Gynecomastia: Clinical evaluation and management

Science.gov (United States)

Cuhaci, Neslihan; Polat, Sefika Burcak; Evranos, Berna; Ersoy, Reyhan; Cakir, Bekir

2014-01-01

Gynecomastia is the benign enlargement of male breast glandular tissue and is the most common breast condition in males. At least 30% of males will be affected during their life. Since it causes anxiety, psychosocial discomfort and fear of breast cancer, early diagnostic evaluation is important and patients usually seek medical attention. Gynecomastia was reported to cause an imbalance between estrogen and androgen action or an increased estrogen to androgen ratio, due to increased estrogen production, decreased androgen production or both. Evaluation of gynecomastia must include a detailed medical history, clinical examination, specific blood tests, imaging and tissue sampling. Individual treatment requirements can range from simple reassurance to medical treatment or even surgery. The main aim of any intervention is to relieve the symptoms and exclude other etiological factors. PMID:24741509

Gynecomastia: Clinical evaluation and management

Directory of Open Access Journals (Sweden)

Neslihan Cuhaci

2014-01-01

Full Text Available Gynecomastia is the benign enlargement of male breast glandular tissue and is the most common breast condition in males. At least 30% of males will be affected during their life. Since it causes anxiety, psychosocial discomfort and fear of breast cancer, early diagnostic evaluation is important and patients usually seek medical attention. Gynecomastia was reported to cause an imbalance between estrogen and androgen action or an increased estrogen to androgen ratio, due to increased estrogen production, decreased androgen production or both. Evaluation of gynecomastia must include a detailed medical history, clinical examination, specific blood tests, imaging and tissue sampling. Individual treatment requirements can range from simple reassurance to medical treatment or even surgery. The main aim of any intervention is to relieve the symptoms and exclude other etiological factors.

Cross-system evaluation of clinical trial search engines.

Science.gov (United States)

Jiang, Silis Y; Weng, Chunhua

2014-01-01

Clinical trials are fundamental to the advancement of medicine but constantly face recruitment difficulties. Various clinical trial search engines have been designed to help health consumers identify trials for which they may be eligible. Unfortunately, knowledge of the usefulness and usability of their designs remains scarce. In this study, we used mixed methods, including time-motion analysis, think-aloud protocol, and survey, to evaluate five popular clinical trial search engines with 11 users. Differences in user preferences and time spent on each system were observed and correlated with user characteristics. In general, searching for applicable trials using these systems is a cognitively demanding task. Our results show that user perceptions of these systems are multifactorial. The survey indicated eTACTS being the generally preferred system, but this finding did not persist among all mixed methods. This study confirms the value of mixed-methods for a comprehensive system evaluation. Future system designers must be aware that different users groups expect different functionalities.

Echographic monitoring of response of extraocular muscles to irradiation in graves' ophthalmopathy

International Nuclear Information System (INIS)

Erickson, Beth A.; Harris, Gerald J.; Lewandowski, Michael F.; Murray, Kevin J.; Massaro, Bruce M.

1995-01-01

Purpose: Confirmation of the efficacy of orbital irradiation in Graves' ophthalmopathy is needed due to the unpredictable natural history of the disease, the variation in individual clinical presentations, the contribution of other simultaneous treatments, and the lack of controlled studies using objective criteria to classify and assess response over time. Orbital echography before and at select intervals following orbital irradiation is proposed as an objective parameter of tissue response to orbital irradiation over time. Methods and Materials: From January, 1983 to September, 1993, 55 patients with progressive Graves' ophthalmopathy underwent 20 Gy retrobulbar irradiation. On retrospective review, standardized orbital echography was performed randomly prior to irradiation in 37 of the 55 patients to assess the acoustic characteristics of the extraocular muscles and to quantitate their individual and summed diameters. Twenty-one patients had at least one follow-up echographic evaluation at random intervals of 0 to 27.5 months following completion of irradiation. Twelve patients received steroids before or during irradiation, which were tapered in proximity to completion of radiation. Follow-up ranged from 2 to 65 months with the majority followed at least 6 months (18 patients). Results: Of the 21 patients with serial studies, 18 showed an interval decrease in individual and summed muscle size over time and return of symmetry. Interval improvement was documented as early as the 1 month follow-up study, with continued improvement seen during the 3-9 month studies, with stability typically achieved within 12 months. One patient had further changes between the 21 and 27.5 month follow-up studies. Exacerbation of disease was, however, echographically demonstrated in three patients at 6.5, 8.5, and 13 months. Follow-up studies in two of these patients again revealed improvement, one following tapered steroids. The third patient required orbital decompression

Impact of new information technologies on training and continuing education for rural health professionals.

Science.gov (United States)

Crandall, L A; Coggan, J M

1994-01-01

Recently developed and emerging information and communications technologies offer the potential to move the clinical training of physicians and other health professionals away from the resource intensive urban academic health center, with its emphasis on tertiary care, and into rural settings that may be better able to place emphasis on the production of badly needed primary care providers. These same technologies also offer myriad opportunities to enhance the continuing education of health professionals in rural settings. This article explores the effect of new technologies for rural tele-education by briefly reviewing the effect of technology on health professionals' education, describing ongoing applications of tele-education, and discussing the likely effect of new technological developments on the future of tele-education. Tele-education has tremendous potential for improving the health care of rural Americans, and policy-makers must direct resources to its priority development in rural communities.

[Elaboration and critical evaluation of clinical guidelines].

Science.gov (United States)

García Villar, C

2015-11-01

Clinical guidelines are documents to help professionals and patients select the best diagnostic or therapeutic option. Elaborating guidelines requires an efficient literature search and a critical evaluation of the articles found to select the most appropriate ones. After that, the recommendations are formulated and then must be externally evaluated before they can be disseminated. Even when the guidelines are very thorough and rigorous, it is important to know whether they fulfill all the methodological requisites before applying them. With this aim, various scales have been developed to critically appraise guidelines. Of these, the AGREE II instrument is currently the most widely used. This article explains the main steps in elaborating clinical guidelines and the main aspects that should be analyzed to know whether the guidelines are well written. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

[Clinical data that are essential for the primary care clinical records: an experience of evaluation and improvement].

Science.gov (United States)

López-Picazo Ferrer, J J; Agulló Roca, F; Villaescusa Pedemonte, M; Cerezo Corbalán, J M

2002-06-30

To evaluate and improve the presence of essential clinical data in the clinical records of a primary care management area (PCMA) by means of an intervention programme. Intervention study without a control, using evaluation and improvement-of-quality methods. We chose 4 criteria from the minimum technical standards: personal history (PH), family background (FB), allergies to medicines (AM) and list of problems (LP). We evaluated overall compliance and compliance per primary care team (PCT) through batch quality acceptance of samples (LQAS), designed an intervention to improve the situation, and then re-evaluated. PCMA of Murcia (45 PCTs). Participants. 42 PCTs (3 were excluded because they had poor coverage in their records). These lasted 12 months (October 1999-October 2000) and involved the following: graphic report per PCT; session with the PCT; discussion on results and strategies in the Area Management Council; and inclusion of an explicit objective, with incentives, in the management contracts. Significant improvement of the four criteria of the PCMA (improvements: FB, 48.1%; PH, 51.1%; AM, 55.4%; LP, 50.9%). LQAS analysis: we rejected 24 batches (14.3%) at the 1st evaluation and 15 (9.0%) at the second, with FB being the criterion most rejected in both instances. Defects appeared in 14 PCT (33.3%; 3 PCT accounted for 41.7%) at the 1st evaluation, and 7 PCT at the re-evaluation (16.7%; 2 reaching 46.7%). The presence of essential clinical data in clinical records has improved. LQAS proved to be a rapid and simple method for evaluating, improving and monitoring quality in primary care.

Noonan Syndrome: An Underestimated Cause of Severe to Profound Sensorineural Hearing Impairment. Which Clues to Suspect the Diagnosis?

Science.gov (United States)

Ziegler, Alban; Loundon, Natalie; Jonard, Laurence; Cavé, Hélène; Baujat, Geneviève; Gherbi, Souad; Couloigner, Vincent; Marlin, Sandrine

2017-09-01

To highlight Noonan syndrome as a clinically recognizable cause of severe to profound sensorineural hearing impairment. New clinical cases and review. Patients evaluated for etiological diagnosis by a medical geneticist in a reference center for hearing impairment. Five patients presenting with confirmed Noonan syndrome and profound sensorineural hearing impairment. Diagnostic and review of the literature. Five patients presented with profound sensorineural hearing impairment and molecularly confirmed Noonan syndrome. Sensorineural hearing impairment has been progressive for three patients. Cardiac echography identified pulmonary stenosis in two patients and was normal for the three other patients. Short stature was found in two patients. Mild intellectual disability was found in one patient. Inconspicuous clinical features as facial dysmorphism, cryptorchidism, or easy bruising were of peculiar interest to reach the diagnosis of Noonan syndrome. Profound sensorineural hearing impairment can be the main feature of Noonan syndrome. Associated features are highly variable; thus, detailed medical history and careful physical examination are mandatory to consider the diagnosis in case of a sensorineural hearing impairment.

The process of clinical assessment: cognitions of the evaluator

Directory of Open Access Journals (Sweden)

Carmelo Ibáñez Aguirre

2013-08-01

Full Text Available The cognitive paradigm of the past few decades opens several new possibilities for psychological evaluation.  The objective of this essay is to emphasize the possibilities related to the quality of self-evaluation, specifically professional self-assessment, meaning a critical analysis of one’s own evaluation process. In this essay, metacognition activities and strategies are examined, as are the ways in which these activities and strategies relate to metacognition and cognitive skills. The intent of this theoretical essay is to offer answers to the clinical evaluator’s professional experience. The results indicate that the clinical professional must consider strategies to improve metacognition and cognitive skills through reflection, self-analysis and self-criticism to improve the quality and efficiency of their work.

Considerations for Clinical Neuropsychological Evaluation in Amyotrophic Lateral Sclerosis.

Science.gov (United States)

Woolley, Susan C; Rush, Beth K

2017-11-01

The clinical neuropsychologist has the opportunity to be uniquely involved in the evaluation and treatment of individuals with amyotrophic lateral sclerosis (ALS). We review the current literature that defines cognitive and behavioral symptoms in ALS, including current knowledge of the neuropathological and genetic underpinning for these symptoms. There are unique considerations for clinical neuropsychological evaluation and clinical research in ALS and we highlight these in this review. Specifically, we shed light on special factors that contribute to our understanding of cognitive and behavioral impairment in ALS, including co-morbid symptoms, differential diagnosis, and considerations for longitudinal tracking of phenotypes. We discuss the rationale for proposing a specific approach to such as cognitive screening, test selection, response modality consideration, and test-retest intervals. With this didactic overview, the clinical neuropsychologist has the potential to learn more about the heterogeneous presentation of motor and neuropsychological symptoms in ALS. Furthermore, the reader has the opportunity to understand what it takes to develop a valid assessment approach particularly when the phenotype of ALS remains undefined in some regards. This clinical practice review sets the stage for the clinical neuropsychologist to further contribute to our clinical and scientific understanding of ALS and cognition. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development and implementation of a competency-based clinical evaluation tool for midwifery education.

Science.gov (United States)

Woeber, Kate

2018-03-22

The learning goals and evaluation strategies of competency-based midwifery programs must be explicit and well-defined. In the US, didactic learning is evaluated through a standardized certification examination, but standardized clinical competence evaluation is lacking. The Midwifery Competency Assessment Tool (MCAT) has been adapted from the International Confederation of Midwives' (ICM) "Essential Competencies" and from the American College of Nurse-Midwives' (ACNM) "Core Competencies", with student self-evaluation based on Benner's Novice-to-Expert theory. The MCAT allows for the measurement and monitoring of competence development in all domains of full-scope practice over the course of the midwifery program. Strengths of the MCAT are that it provides clear learning goals and performance evaluations for students, ensures and communicates content mapping across a curriculum, and highlights strengths and gaps in clinical opportunities at individual clinical sites and for entire programs. Challenges of the MCAT lie in balancing the number of competency items to be measured with the tedium of form completion, in ensuring the accuracy of student self-evaluation, and in determining "adequate" competence achievement when particular clinical opportunities are limited. Use of the MCAT with competency-based clinical education may facilitate a more standardized approach to clinical evaluation, as well as a more strategic approach to clinical site development and use. Copyright © 2018 Elsevier Ltd. All rights reserved.

A systematic review of clinical supervision evaluation studies in nursing.

Science.gov (United States)

Cutcliffe, John R; Sloan, Graham; Bashaw, Marie

2018-02-15

According to the international, extant literature published during the last 20 years or so, clinical supervision (CS) in nursing is now a reasonably common phenomenon. Nevertheless, what appears to be noticeably 'thin on the ground' in this body of literature are empirical evaluations of CS, especially those pertaining to client outcomes. Accordingly, the authors undertook a systematic review of empirical evaluations of CS in nursing to determine the state of the science. Adopting the approach documented by Stroup et al. (JAMA, 283, 2000, 2008), the authors searched for reports of evaluation studies of CS in nursing - published during the years 1995 to 2015. Keywords for the search were 'clinical supervision', 'evaluation', 'efficacy', 'nursing', and combinations of these keywords. Electronic databases used were CINAHL, MEDLINE, PsychLIT, and the British Nursing Index. The research evidence from twenty-eight (28) studies reviewed is presented, outlining the main findings with an overview of each study presented. The following broad themes were identified and are each discussed in the study: narrative/anecdotal accounts of positive outcomes for clinical supervision, narrative/anecdotal accounts of negative outcomes for clinical supervision, empirical positive outcomes reported by supervisee, and empirical findings showing no effect by supervisee. © 2018 Australian College of Mental Health Nurses Inc.

Evaluation of stratification factors and score-scales in clinical trials of treatment of clinical mastitis in dairy cows.

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Hektoen, L; Ødegaard, S A; Løken, T; Larsen, S

2004-05-01

There is often a need to reduce sample size in clinical trials due to practical limitations and ethical considerations. Better comparability between treatment groups by use of stratification in the design, and use of continuous outcome variables in the evaluation of treatment results, are two methods that can be used in order to achieve this. In this paper the choice of stratification factors in trials of clinical mastitis in dairy cows is investigated, and two score-scales for evaluation of clinical mastitis are introduced. The outcome in 57 dairy cows suffering from clinical mastitis and included in a clinical trial comparing homeopathic treatment, placebo and a standard antibiotic treatment is investigated. The strata of various stratification factors are compared across treatments to determine which other factors influence outcome. The two score scales, measuring acute and chronic mastitis symptoms, respectively, are evaluated on their ability to differentiate between patients classified from clinical criteria as responders or non-responders to treatment. Differences were found between the strata of the factors severity of mastitis, lactation number, previous mastitis this lactation and bacteriological findings. These factors influence outcome of treatment and appear relevant as stratification factors in mastitis trials. Both score scales differentiated between responders and non-responders to treatment and were found useful for evaluation of mastitis and mastitis treatment.

Resident evaluation of clinical teachers based on teachers' certification.

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Steiner, Ivan P; Yoon, Philip W; Kelly, Karen D; Diner, Barry M; Donoff, Michel G; Mackey, Duncan S; Rowe, Brian H

2003-07-01

To examine the influence of emergency medicine (EM) certification of clinical teaching faculty on evaluations provided by residents. A prospective cohort analysis was conducted of assessments between July 1994 and July 2000 on residents' evaluations of EM faculty at the University of Alberta, Edmonton, Canada. Resident- and faculty-related variables were entered anonymously using the validated evaluation tool (ER Scale). Credentialing and demographic information on EM faculty was supplemented by data obtained through a nine-question survey. Groups were compared using ANOVA. The 562 residents returned 705 (91%) valid evaluation sheets on 115 EM faculty members. The four domains of didactic teaching, clinical teaching, approachability, and helpfulness were assessed. The majority of ratings were in the very good or superb categories for each domain. Instructors with certification in EM had higher scores in didactic, clinical teaching compared with others, and teachers without national certification scored lower in the helpful and approachable categories (p certifications either through training or practice eligibility did not affect scores. Instructors under the age of 40 years had higher scores than the older age groups in three of four categories (p certification in EM, academic track, rotation year, and site are all correlated with better teaching performance.

Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care.

Science.gov (United States)

Oksman, Erja; Linna, Miika; Hörhammer, Iiris; Lammintakanen, Johanna; Talja, Martti

2017-02-15

The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF). A total of 1570 patients were blindly randomized to intervention (n = 970) and control (n = 470) groups. The intervention group received monthly individual health coaching by telephone from a specially trained nurse for 12-months in addition to routine social and healthcare. Patients in the control group received routine social and health care. Quality of life was assessed at the beginning of the intervention and follow-up measurements were made after 12 months health coaching. The cost included all direct health-care costs supplemented with home care and nursing home-care costs in social care. Utility was based on a Health Related Quality of Life (HRQoL) measurement (15D instrument), and cost effectiveness was assessed using incremental cost-effectiveness ratios (ICERs). The cost-effectiveness of health coaching was highest in the T2D group (ICER €20,000 per Quality-Adjusted Life Years [QALY]). The ICER for the CAD group was more modest (€40,278 per QALY), and in the CHF group, costs increased with no marked effect on QoL. Probabilistic sensitivity analysis indicated that at the societal willingness to pay threshold of €50,000 per QALY, the probability of health coaching being cost effective was 55% in the whole study group. The cost effectiveness of health coaching may vary substantially across patient groups, and thus interventions should be targeted at selected subgroups of chronically ill. Based on the results of this study, health coaching improved the QoL of

Clinical evaluation of guidelines and two-test approach for lyme disease

NARCIS (Netherlands)

Blaauw, A. A.; van Loon, A. M.; Schellekens, J. F.; Bijlsma, J. W.

1999-01-01

The diagnosis of Lyme disease should be based on objective clinical signs and symptoms. In a clinical study, we have evaluated whether the recommended two-step approach for serodiagnosis of Lyme disease is useful in daily clinical practice and can influence clinical decision making. The signs and

Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

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Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

2017-07-01

Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic

[Methods of investigation in clinical cardiology. VIII. Socioeconomic evaluation of clinical cardiology practice].

Science.gov (United States)

Lázaro de Mercado, P

1997-06-01

Health services are systems whose mission is to improve the health status of both individuals and society in general. In recent decades, these systems have faced challenges such as their increasing complexity, limited resources, rapid innovation and diffusion of medical technologies, pressures on demand from society and professionals, and the lack of knowledge of the effects of these factors on costs and society's health. In addition, health care expenditures have grown twice as fast as wealth in industrialized countries during the last 25 years. These problems have prompted cost containment as a key issue in health policy and, at the same time, have promoted the development of socioeconomic evaluation as a scientific activity in the frame of health services research. Socioeconomic evaluation tries to determine if the sacrifice made by society, which devotes part of its limited resources to health care, maximizes the outcomes for population. This article describes basic concepts and methods of economic appraisal in health services which are illustrated with examples of clinical practice in cardiology. Common methods of evaluation are described; the relation between the clinical outcome of a procedure and its associated costs is emphasized in explaining the types of efficiency analysis (cost-efficacy, cost-effectiveness, cost-utility, and cost-benefit); and finally a guide for socioeconomic evaluation is provided.

Clinical evaluation of oropharyngeal dysphagia in Machado-Joseph disease

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Sabrina Mello Alves Corrêa

2010-12-01

Full Text Available CONTEXT: In Machado-Joseph disease, poor posture, dystonia and peripheral neuropathy are extremely predisposing to oropharyngeal dysphagia, which is more commonly associated with muscular dystrophy. OBJECTIVE: To evaluate the clinical characteristics of oropharyngeal dysphagia in Machado-Joseph disease patients. METHOD: Forty individuals participated in this study, including 20 with no clinical complaints and 20 dysphagic patients with Machado-Joseph disease of clinical type 1, who were all similar in terms of gender distribution, average age, and cognitive function. The medical history of each patient was reviewed and each subject underwent a clinical evaluation of deglutition. At the end, the profile of dysphagia in patients with Machado-Joseph disease was classified according to the Severity Scale of Dysphagia, as described by O'Neil and collaborators. RESULTS: Comparison between dysphagic patients and controls did not reveal many significant differences with respect to the clinical evaluation of the oral phase of deglutition, since afflicted patients only demonstrated deficits related to the protrusion, retraction and tonus of the tongue. However, several significant differences were observed with respect to the pharyngeal phase. Dysphagic patients presented pharyngeal stasis during deglutition of liquids and solids, accompanied by coughing and/or choking as well as penetration and/or aspiration; these signs were absent in the controls. CONCLUSIONS: Oropharyngeal dysphagia is part of the Machado-Joseph disease since the first neurological manifestations. There is greater involvement of the pharyngeal phase, in relation to oral phase of the deglutition. The dysphagia of these patients is classified between mild and moderate.

Evaluation of clinical teaching quality in competency-based residency training in Lithuania.

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Vaižgėlienė, Eglė; Padaiga, Žilvinas; Rastenytė, Daiva; Tamelis, Algimantas; Petrikonis, Kęstutis; Fluit, Cornelia

2017-12-01

In 2013, all residency programs at the Lithuanian University of Health Sciences were renewed into the competency-based medical education curriculum (CBME). In 2015, we implemented the validated EFFECT questionnaire together with the EFFECT-System for quality assessment of clinical teaching in residency training. The aim of this study was to investigate the influence of characteristics of the resident (year of training) and clinical teacher (gender, age, and type of academic position) on teaching quality, as well as to assess areas for teaching quality improvement. Residents from 7 different residency study programs filled out 333 EFFECT questionnaires evaluating 146 clinical teachers. We received 143 self-evaluations of clinical teachers using the same questionnaire. Items were scored on a 6-point Likert scale. Main outcome measures were residents' mean overall (MOS), mean subdomain (MSS) and clinical teachers' self-evaluation scores. The overall comparisons of MOS and MSS across study groups and subgroups were done using Student's t test and ANOVA for trend. The intraclass correlation coefficient (ICC) was calculated in order to see how residents' evaluations match with self-evaluations for every particular teacher. To indicate areas for quality improvement items were analyzed subtracting their mean score from the respective (sub)domain score. MOS for domains of "role modeling", "task allocation", "feedback", "teaching methodology" and "assessment" valued by residents were significantly higher than those valued by teachers (Pevaluation questionnaires were rated significantly higher by residents in role modeling subdomains (Phigher than the female teachers (Phigher (Pevaluations of clinical teachers are influenced by teachers' age, gender, year of residency training, type of teachers' academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers

Prostate needle biopsies: interobserver variation and clinical consequences of histopathological re-evaluation

DEFF Research Database (Denmark)

Berg, Kasper Drimer; Toft, Birgitte Grønkaer; Røder, Martin Andreas

2011-01-01

Histopathological grading of prostate cancer (PCa) is associated with significant interobserver variability. This, as well as clinical consequences of histopathological re-evaluation, was investigated. In 350 patients, histopathological re-evaluations of prostate biopsies were compared with primary...... pathology reports and with histopathology of the radical prostatectomy specimen. The consequences of re-evaluation for clinical workup and treatment of patients according to local algorithms were determined. For Gleason score (GS), complete agreement between primary report and re-evaluation was found in 76.......9%. The cancers were assessed with higher GS at re-evaluation in 25.0% of patients in cases with primary GS = 6, while scores were devaluated in 3.0% and 10.3% of the patients with primary GS = 7 and = 8, respectively. Strategies for clinical evaluation and treatment were changed as a result of the biopsy re...

Clinical diagnostic evaluation for scaphoid fractures: a systematic review and meta-analysis

NARCIS (Netherlands)

Mallee, Wouter H.; Henny, Erik P.; van Dijk, C. Niek; Kamminga, Sjoerd P.; van Enst, Wynanda A.; Kloen, Peter

2014-01-01

To provide an overview of available clinical evaluation tests for scaphoid fractures and to compare their diagnostic accuracies. PWe performed a systematic review of all studies assessing diagnostic characteristics of clinical evaluation in scaphoid fractures by searching MEDLINE, EMBASE, Cochrane,

Hombre y «polis»: el nudo gordiano de la educación en Aristóteles

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Concepción NAVAL

2013-11-01

Full Text Available La educación se puede ver como una ayuda para crecer en libertad y dignidad. Será educativo aquello que favorezca la perfección de la persona; y por eso, cuando se habla de la educación como un factor de reproducción social, se intentará referir unos factores externos a la propia persona, y determinarlos según la armonía personal. Esta cuestión de plena actualidad tienen un planteamiento sugerente en Aristóteles quien nos ofrece una visión del hombre y de la educación, en estrecha relación con la polis, que son de interés. El carácter social de la educación está siempre presente en la tradición y pensamiento griego, puesto que el hombre es un animal político. Sin embargo, también está vivo en este autor el conocimiento del valor individual. No existía un problema educativo separado del aspecto político y moral.

Slight Hydronephrosis in Newborns and Breast-fed Infants: Can the Presence of Vesicoureteral Reflux Be Predicted?

International Nuclear Information System (INIS)

Berrocal, T.; Pablo, T. de; Gutierrez, J.; Prieto, C.; Hoyo, M. L. del

2003-01-01

The purpose of this study was to determine the value of slight-to moderate echo graphically detected hydronephrosis in newborns and breast-fed infants that might serve as indicator for Vesicoureteral reflux (VUR), and to evaluate the necessity of performing micturating cystourethrougraphy (MCUG) in these patients. There were reviewed MCUG of 237 patients (174 boys and 63 girls between the ages of 0 and 18 months) with slight echo graphically detected hydronephrosis in order to evaluate the presence of primary VUR. Patients with secondary reflux or those that presented anomalies which made impossible an exact reflux gradind were excluded. However, normal kidneys with reflux which were contralateral to hydronephrotic kidneys were included in the study. For a statistical analysis of the data, each kidney was considered separately, thereby forming a total of 474 kidneys. Slight hydronephrosis was diagnosed when the renal pelvis anteroposterior diameter was observed to measure between 0.5 and 1.5 cm. The International Grading System was used to grade reflux during MCUG. Of the 474 kidneys evaluated, 306 showed slight hydromephrosis in the echography. Only 98 of these presented reflux (32%) (14 grade 1.50 grade II, 32 grade III and 2 grade IV). The echography was normal (i. e. hydronephrosis not present) in 52 kidneys with reflux (31%) which were contralateral to hydronephrotic kidneys, although 38 of these had reflux of grade II or higher. The echography showed slight hydronephrosis in 208 kidneys that did not have reflux during MCUG (68%). There were no significant differences in the incidence of VUR among normal or hydronephrotic kidneys. There is a poor correlation between slight hydronephrosis and presence or grade of reflux in newborns and breast-fed infants. The latter should not, therefore, be considered an indication for MCUC. (Author) 33 refs

Slight Hydronephrosis in Newborns and Breast-fed Infants: Can the Presence of Vesicoureteral Reflux Be Predicted?; Hidronefrosis leve en neonatos y lactantes: puede predecirse la presencia del reflujo vesicoureteral?

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Berrocal, T.; Pablo, T. de; Gutierrez, J.; Prieto, C.; Hoyo, M. L. del [Hospital Universitario La Paz. Madrid (Spain)

2003-07-01

The purpose of this study was to determine the value of slight-to moderate echo graphically detected hydronephrosis in newborns and breast-fed infants that might serve as indicator for Vesicoureteral reflux (VUR), and to evaluate the necessity of performing micturating cystourethrougraphy (MCUG) in these patients. There were reviewed MCUG of 237 patients (174 boys and 63 girls between the ages of 0 and 18 months) with slight echo graphically detected hydronephrosis in order to evaluate the presence of primary VUR. Patients with secondary reflux or those that presented anomalies which made impossible an exact reflux gradind were excluded. However, normal kidneys with reflux which were contralateral to hydronephrotic kidneys were included in the study. For a statistical analysis of the data, each kidney was considered separately, thereby forming a total of 474 kidneys. Slight hydronephrosis was diagnosed when the renal pelvis anteroposterior diameter was observed to measure between 0.5 and 1.5 cm. The International Grading System was used to grade reflux during MCUG. Of the 474 kidneys evaluated, 306 showed slight hydromephrosis in the echography. Only 98 of these presented reflux (32%) (14 grade 1.50 grade II, 32 grade III and 2 grade IV). The echography was normal (i. e. hydronephrosis not present) in 52 kidneys with reflux (31%) which were contralateral to hydronephrotic kidneys, although 38 of these had reflux of grade II or higher. The echography showed slight hydronephrosis in 208 kidneys that did not have reflux during MCUG (68%). There were no significant differences in the incidence of VUR among normal or hydronephrotic kidneys. There is a poor correlation between slight hydronephrosis and presence or grade of reflux in newborns and breast-fed infants. The latter should not, therefore, be considered an indication for MCUC. (Author) 33 refs.

Implementation and evaluation of Parkinson disease management in an outpatient clinical pharmacist-run neurology telephone clinic.

Science.gov (United States)

Stefan, Teodora Cristina; Elharar, Nicole; Garcia, Guadalupe

2018-05-01

Parkinson disease (PD) is a progressive, debilitating neurodegenerative disease that often requires complex pharmacologic treatment regimens. Prior to this clinic, there was no involvement of a clinical pharmacy specialist (CPS) in the outpatient neurology clinic at the West Palm Beach Veterans Affairs Medical Center. This was a prospective, quality-improvement project to develop a clinical pharmacist-run neurology telephone clinic and evaluate pharmacologic and nonpharmacologic interventions in an effort to improve the quality of care for patients with PD. Additionally, the CPS conducted medication education groups to 24 patients with PD and their caregivers, if applicable, at this medical center with the purpose of promoting patient knowledge and medication awareness. Medication management was performed via telephone rather than face to face. Only patients with a concomitant mental health diagnosis for which they were receiving at least one psychotropic medication were included for individual visits due to the established scope of practice of the CPS being limited to mental health and primary care medications. Data collection included patient and clinic demographics as well as pharmacologic and nonpharmacologic interventions made for patients enrolled from January 6, 2017, through March 31, 2017. A total of 49 pharmacologic and nonpharmacologic interventions were made for 10 patients. We successfully implemented and evaluated a clinical pharmacist-run neurology telephone clinic for patients with PD. Expansion of this clinic to patients with various neurological disorders may improve access to care using an innovative method of medication management expertise by a CPS.

Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic.

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Hilton, Lara; Elfenbaum, Pamela; Jain, Shamini; Sprengel, Meredith; Jonas, Wayne B

2018-03-01

The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies.

Correlation between radiographic, echographic and MRI changes and rheumatoid arthritis progression

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G. Garlaschi

2011-09-01

Full Text Available Objectives: To review the imaging methods used for the evaluation of disease progression in rheumatoid arthritis (RA and to evaluate the results of their application in pharmacological trials. Methods: Literature articles dealing with radiology, echography, and magnetic resonance imaging (MRI of patients with RA were evaluated in a non-systematic fashion. Results: Conventional radiology is the gold standard for the evaluation of disease progression in RA because of its diffusion, economy, and standardization. Different techniques have been proposed to evaluate radiological damage of the joints, with the Larsen’s and Sharp’s methods being most widely used. These methods are commonly used for the evaluation of the ability of DMARDs to slow RA progression. Among traditional DMARDs, gold salts, sulphasalazine, methotrexate, cyclosporin, and leflunomide have shown efficacy in slowing the appearance of new erosions. The same effect has been recently demonstrated for infliximab plus methotrexate, anakinra and etanercept. However, conventional radiology has several disadvantages, because it is monoplanar and has a low sensitivity to change. Newer imaging techniques, such as echography and MRI are extensively studied and have been used occasionally in the mediumterm evaluation of DMARDs, with promising results. Conclusions: Although conventional radiology is still the gold standard for the evaluation of disease progression in RA, newer techniques are increasingly studied. In particular, standardization of echographic and MRI imaging of the joints is in progress.

Comparative value of diagnostic imaging techniques in a cat with exophthalmos

International Nuclear Information System (INIS)

Ramsey, D.T.; Gerding, P.A. Jr.; Losonsky, J.M.; Kuriashkin, I.V.; Clarkson, R.D.

1994-01-01

A mass that appeared to originate from the frontal bone and extended into retrobulbar tissues of the light orbit was imaged in a cat using ultrasound, skull radiographs, computed tomography, and magnetic resonance imaging. The cat was presented with ventrolateral strabismus, exophthalmos, and elevated nictitans membrane of the tight eye. The mass was not delineated entirely after orbital echography and survey radiography of the skull was performed. Cytologic examination of fine-needle aspirate of the mass was suggestive of a neoplastic disease. Results of computed tomography indicated lysis of the calvarium but did not delineate borders of the mass in the calvarium. Magnetic resonance imaging was then used to confirm borders of the neoplasm. Magnetic resonance imaging was the only imaging technique that delineated the entire border of the neoplasm, including in the calvarium, when compared to postmortem evaluation. Results of orbital echography, skull radiographs, or computed tomography, when used as the only diagnostic imaging modality, must be interpreted with caution when evaluating borders of retrobulbar neoplasia prior to surgical planning

Developing an evaluation framework for clinical redesign programs: lessons learnt.

Science.gov (United States)

Samaranayake, Premaratne; Dadich, Ann; Fitzgerald, Anneke; Zeitz, Kathryn

2016-09-19

Purpose The purpose of this paper is to present lessons learnt through the development of an evaluation framework for a clinical redesign programme - the aim of which was to improve the patient journey through improved discharge practices within an Australian public hospital. Design/methodology/approach The development of the evaluation framework involved three stages - namely, the analysis of secondary data relating to the discharge planning pathway; the analysis of primary data including field-notes and interview transcripts on hospital processes; and the triangulation of these data sets to devise the framework. The evaluation framework ensured that resource use, process management, patient satisfaction, and staff well-being and productivity were each connected with measures, targets, and the aim of clinical redesign programme. Findings The application of business process management and a balanced scorecard enabled a different way of framing the evaluation, ensuring measurable outcomes were connected to inputs and outputs. Lessons learnt include: first, the importance of mixed-methods research to devise the framework and evaluate the redesigned processes; second, the need for appropriate tools and resources to adequately capture change across the different domains of the redesign programme; and third, the value of developing and applying an evaluative framework progressively. Research limitations/implications The evaluation framework is limited by its retrospective application to a clinical process redesign programme. Originality/value This research supports benchmarking with national and international practices in relation to best practice healthcare redesign processes. Additionally, it provides a theoretical contribution on evaluating health services improvement and redesign initiatives.

Evaluating Industry Payments Among Dermatology Clinical Practice Guidelines Authors.

Science.gov (United States)

Checketts, Jake X; Sims, Matthew Thomas; Vassar, Matt

2017-12-01

It is well documented that financial conflicts of interest influence medical research and clinical practice. Prior to the Open Payments provisions of the Affordable Care Act, financial ties became apparent only through self-disclosure. The nature of financial interests has not been studied among physicians who develop dermatology clinical practice guidelines. To evaluate payments received by physicians who author dermatology clinical practice guidelines, compare disclosure statements for accuracy, determine whether pharmaceutical companies from which the authors received payments manufactured products related to the guidelines, and examine the extent to which the American Academy of Dermatology enforced their Administrative Regulations for guideline development. Three American Academy of Dermatology guidelines published from 2013 to 2016 were retrieved. Double data extraction was used to record financial payments received by 49 guideline authors using the Open Payments database. Payments received by the authors from the date of the initial literature search to the date of publication were used to evaluate disclosure statement accuracy, detail the companies providing payments, and evaluate Administrative Regulations enforcement. This study is applicable to clinical practice guideline panels drafting recommendations, physicians using clinical practice guidelines to inform patient care, and those establishing policies for guideline development. Our main outcomes are the monetary values and types of payments received by physicians who author dermatology guidelines and the accuracy of disclosure statements. Data were collected from the Open Payments database and analyzed descriptively. Of the 49 authors evaluated, 40 received at least 1 reported industry payment, 31 accepted more than $1000, 25 accepted more than $10 000, and 18 accepted more than $50 000. Financial payments amounted to a mean of $157 177 per author. The total reimbursement among the 49 authors

Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination.

Science.gov (United States)

Urteaga, Elizabeth M; Attridge, Rebecca L; Tovar, John M; Witte, Amy P

2015-10-25

Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE). Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance. Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills. Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains.

Clinical performance of a glass ionomer restorative system: a 6-year evaluation.

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Gurgan, Sevil; Kutuk, Zeynep Bilge; Ergin, Esra; Oztas, Sema Seval; Cakir, Filiz Yalcin

2017-09-01

The aim of this study is to evaluate the long-term clinical performance of a glass ionomer (GI) restorative system in the restoration of posterior teeth compared with a micro-filled hybrid posterior composite. A total of 140 (80 Cl1 and 60 Cl2) lesions in 59 patients were restored with a GI system (Equia) or a micro hybrid composite (Gradia Direct). Restorations were evaluated at baseline and yearly during 6 years according to the modified-USPHS criteria. Negative replicas at each recall were observed under SEM to evaluate surface characteristics. Data were analyzed with Cohcran's Q and McNemar's tests (p evaluated in 47 patients with a recall rate of 79.6% at 6 years. Significant differences were found in marginal adaptation and marginal discoloration for both restorative materials for Cl1 and Cl2 restorations (p  0.05). A significant decrease in color match was observed in Equia restorations (p performance after 6 years. SEM evaluations were in accordance with the clinical findings. Both materials showed a good clinical performance for the restoration of posterior teeth during the 6-year evaluation. The clinical effectiveness of Equia and Gradia Direct Posterior was acceptable in Cl1 and Cl2 cavities subsequent to 6-year evaluation.

[Process and key points of clinical literature evaluation of post-marketing traditional Chinese medicine].

Science.gov (United States)

Liu, Huan; Xie, Yanming

2011-10-01

The clinical literature evaluation of the post-marketing traditional Chinese medicine is a comprehensive evaluation by the comprehensive gain, analysis of the drug, literature of drug efficacy, safety, economy, based on the literature evidence and is part of the evaluation of evidence-based medicine. The literature evaluation in the post-marketing Chinese medicine clinical evaluation is in the foundation and the key position. Through the literature evaluation, it can fully grasp the information, grasp listed drug variety of traditional Chinese medicines second development orientation, make clear further clinical indications, perfect the medicines, etc. This paper discusses the main steps and emphasis of the clinical literature evaluation. Emphasizing security literature evaluation should attach importance to the security of a comprehensive collection drug information. Safety assessment should notice traditional Chinese medicine validity evaluation in improving syndrome, improveing the living quality of patients with special advantage. The economics literature evaluation should pay attention to reliability, sensitivity and practicability of the conclusion.

Ultrasound Image Quality Assessment: A framework for evaluation of clinical image quality

DEFF Research Database (Denmark)

Hemmsen, Martin Christian; Pedersen, Mads Møller; Nikolov, Svetoslav Ivanov

2010-01-01

Improvement of ultrasound images should be guided by their diagnostic value. Evaluation of clinical image quality is generally performed subjectively, because objective criteria have not yet been fully developed and accepted for the evaluation of clinical image quality. Based on recommendation 50...... information, which is fast enough to get sufficient number of scans under realistic operating conditions, so that statistical evaluation is valid and reliable....

La filosofía de las matemáticas de Aristóteles

Directory of Open Access Journals (Sweden)

Miguel Martí Sánchez

2016-12-01

Full Text Available La filosofía de las matemáticas de Aristóteles es una investigación acerca de tres asuntos diferentes pero complementarios: (1 el lugar epistemológico de las matemáticas en el organigrama de las ciencias teoréticas o especulativas; (2 el estudio del método usado por el matemático para elaborar sus doctrinas, sobre todo la geometría y la aritmética; y (3 la averiguación del estatuto ontológico de las entidades matemáticas. Para comprender lo peculiar de la doctrina aristotélica es necesario tener en cuenta que su principal interés está en poner en relación la matemática con la filosofía primera u ontología y la física, y salvaguardar el campo de conocimiento propio de cada una de ellas. Aristotle’s Philosophy of Mathematics can be defined as the research about three different issues: (1 what is the epistemological place of mathematics inside the realm of speculative sciences; (2 what is the method of mathematics, especially the method of geometry and arithmetic; and (3 what is the ontological status or kind of existence of mathematical entities. The primary aim of Aristotle is to build a bridge between mathematics, ontology and philosophy of nature, in order to make clear what is the object of each one.

A review of methods of clinical image quality evaluation in mammography

International Nuclear Information System (INIS)

Li Yanpeng; Poulos, Ann; McLean, Donald; Rickard, Mary

2010-01-01

Purpose: Consistency in evaluation of mammography images in research and clinical practice is dependent on a standardised clinical image quality evaluation system. Currently two such systems are available-one developed by the American College of Radiology (ACR) and the other by the European Commission (EU guidelines). The purpose of this study was to review mammography clinical evaluation methods in research studies and their adherence to these systems. Method: A total of 23 research articles were reviewed from the period 2000-2006, 11 of these studies used digital images. The focus of the review was the criteria and rating scales used. Results: Only 5 studies used either the ACR (3) or EU guidelines (2). The remainder included aspects of these systems together with a range of other criteria and rating scales. Variation was found in the categories of criteria used, number of criteria, the descriptors of the criteria and the instructions used to evaluate the criteria. Instructions were frequently not specific and open to individual interpretation. Although breast density is an important criterion of image quality and contributes to perception of breast lesions, inclusion of this criterion was not universal, and even when used the area of breast density to be evaluated was not identified, thus enhancing inter-observer variability. Scales that were absolute or relative were used for evaluation, all of which incorporated inconsistent numbers of steps. Conclusion: Low adherence to ACR and EU Guidelines has resulted in considerable variation in the evaluation methods used in research studies. The implications of this variability are considerable both for evaluation of image quality in research outcomes and clinical practice.

Evaluation of Criteria-Based Clinical Audit in Improving Quality of ...

African Journals Online (AJOL)

Erah

ABSTRACT. Study evaluated criteria–based clinical audit in measuring and improving quality of obstetric care for five life-threatening obstetric complications: obstetric haemorrhage, eclampsia, genital tract infections, obstructed labor and uterine rupture. Clinical management of 65 patients was audited using a 'before.

Randomized trial of the ForeseeHome monitoring device for early detection of neovascular age-related macular degeneration. The HOme Monitoring of the Eye (HOME) study design - HOME Study report number 1.

Science.gov (United States)

Chew, Emily Y; Clemons, Traci E; Bressler, Susan B; Elman, Michael J; Danis, Ronald P; Domalpally, Amitha; Heier, Jeffrey S; Kim, Judy E; Garfinkel, Richard A

2014-03-01

To evaluate the effects of a home-monitoring device with tele-monitoring compared with standard care in detection of progression to choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD), the leading cause of blindness in the US. Participants, aged 55 to 90 years, at high risk of developing CNV associated with AMD were recruited to the HOme Monitoring of Eye (HOME) Study, an unmasked, multi-center, randomized trial of the ForeseeHome (FH) device plus standard care vs. standard care alone. The FH device utilizes preferential hyperacuity perimetry and tele-monitoring to detect changes in vision function associated with development of CNV, potentially prior to symptom and visual acuity loss. After establishing baseline measurements, subsequent changes on follow-up are detected by the device, causing the monitoring center to alert the clinical center to recall participants for an exam. Standard care consists of instructions for self-monitoring visual changes with subsequent self-report to the clinical center. The primary objective of this study is to determine whether home monitoring plus standard care in comparison with standard care alone, results in earlier detection of incident CNV with better present visual acuity. The primary outcome is the decline in visual acuity at CNV diagnosis from baseline. Detection of CNV prior to substantial vision loss is critical as vision outcome following anti-angiogenic therapy is dependent on the visual acuity at initiation of treatment. HOME Study is the first large scale study to test the use of home tele-monitoring system in the management of AMD patients. Published by Elsevier Inc.

Clinical and MRI evaluation of tuberculous meningitis

International Nuclear Information System (INIS)

Jiang Chunjing; Shu Jiner; Chen Jian; Sheng Sanlan; Lu Jinhua; Cai Xiaoxiao; Li Huimin

2010-01-01

Objective: To evaluate the relationship of clinical and magnetic resonance imaging (MRI) findings in patients with tuberculous meningitis (TBM), and to improve the understanding of TBM. Methods: The clinical and MRI findings in 42 patients with confirmed TBM were analyzed retrospectively. MRI examination was performed using a 1 Tesla system, including SE T 1 WI and T 2 WI. Intravenous contrast was injected in 29 patients, and follow-up scans were performed on 17 patients. Results: Of 24 patients with early TBM, MRI was abnormal in 5(21%) with slight Tl-hypointense meningeal (4) or ependymal thickening (1). MRI on 33/35 (94%) patients with late stage TBM was abnormal with T 1 hypointensity and T 2 hyperintensity including meningeal thickening (19), mild surrounding brain edema (10), nodules (11), tuberculoma (5) and abscess (2). There was significant plaque-like, nodular or rim enhancement with surrounding brain edema. Conclusion: Tuberculous meningitis has minimal clinical and MRI findings in the early phase and significant clinical and MRI findings in the late phase. The enhanced scan may help to detect the abnormality. (authors)

Evaluation of esophageal motor function in clinical practice.

Science.gov (United States)

Gyawali, C P; Bredenoord, A J; Conklin, J L; Fox, M; Pandolfino, J E; Peters, J H; Roman, S; Staiano, A; Vaezi, M F

2013-02-01

Esophageal motor function is highly coordinated between central and enteric nervous systems and the esophageal musculature, which consists of proximal skeletal and distal smooth muscle in three functional regions, the upper and lower esophageal sphincters, and the esophageal body. While upper endoscopy is useful in evaluating for structural disorders of the esophagus, barium esophagography, radionuclide transit studies, and esophageal intraluminal impedance evaluate esophageal transit and partially assess motor function. However, esophageal manometry is the test of choice for the evaluation of esophageal motor function. In recent years, high-resolution manometry (HRM) has streamlined the process of acquisition and display of esophageal pressure data, while uncovering hitherto unrecognized esophageal physiologic mechanisms and pathophysiologic patterns. New algorithms have been devised for analysis and reporting of esophageal pressure topography from HRM. The clinical value of HRM extends to the pediatric population, and complements preoperative evaluation prior to foregut surgery. Provocative maneuvers during HRM may add to the assessment of esophageal motor function. The addition of impedance to HRM provides bolus transit data, but impact on clinical management remains unclear. Emerging techniques such as 3-D HRM and impedance planimetry show promise in the assessment of esophageal sphincter function and esophageal biomechanics. © 2013 Blackwell Publishing Ltd.

Clinical evaluation of Proscillaridin-A with radioisotopes

International Nuclear Information System (INIS)

Franco, P.D.A.; Cordovil, I.L.; Rocha, A.F.G.

1976-01-01

Thirty patients with cardiac insufficiency were evaluated under the use of Proscillaridin-A. The analysis was based on classic clinical parameters and 11 patients through the circulation time with the radioisotopic technique. The results obtained are analysed and discussed about the absence of side effects, considering as well the therapeutic use of the drug [pt

Development and Psychometric Evaluation of the Nursing Instructors? Clinical Teaching Performance Inventory

OpenAIRE

Farahani, Mansoureh A.; Ghasemi, Hormat Sadat Emamzadeh; Nikpeyma, Nasrin; Fereidouni, Zhila; Rassouli, Maryam

2014-01-01

Evaluation of nursing instructors? clinical teaching performance is a prerequisite to the quality assurance of nursing education. One of the most common procedures for this purpose is using student evaluations. This study was to develop and evaluate the psychometric properties of Nursing Instructors? Clinical Teaching Performance Inventory (NICTPI). The primary items of the inventory were generated by reviewing the published literature and the existing questionnaires as well as consulting wit...

Efeitos de alterações na zona ripária sobre a integridade de igarapés amazônicos no Baixo rio Teles Pires, Norte de Mato Grosso

OpenAIRE

Bleich, Monica Elisa

2015-01-01

Na bacia Amazônica existem muitos riachos, localmente denominados de igarapés, inseridos em paisagens heterogêneas, considerando as variações naturais das condições geomorfológicas, os períodos hidrológicos e a degradação promovida pelo desmatamento, principalmente na borda sul da bacia. Logo, o objetivo do presente estudo foi avaliar os impactos de alterações na cobertura florestal ripária sobre a estrutura do ecossistema em igarapés de cabeceira no baixo rio Teles Pires, norte de Mato Gross...

Evaluating clinical teachers with the Maastricht clinical teaching questionnaire : How much 'teacher' is in student ratings?

NARCIS (Netherlands)

Boerboom, Tobias B. B.; Mainhard, Tim; Dolmans, Diana H. J. M.; Scherpbier, Albert J. J. A.; Van Beukelen, Peter; Jaarsma, A. D. (Debbie) C.

2012-01-01

Background: Students are a popular source of data to evaluate the performance of clinical teachers. Instruments to obtain student evaluations must have proven validity. One aspect of validity that often remains underexposed is the possibility of effects of between-student differences and teacher and

Mammary radiotherapy and patients-risks management with continue evaluation of clinical indicators

International Nuclear Information System (INIS)

Untereiner, M.; Frederick, B.; Burie, D.; Cavuto, C.; Rob, L.; Coiffier, N.; Colet, M.

2009-01-01

Purpose: The breast irradiation represents 25% of radiotherapy indication in the radiotherapy centers. The modeling of the management of complications risks and recurrences in relation with mammary irradiation constitutes a methodological base allowing to develop a general concept for any other indication of radiotherapy. The objective of the study was a continuous evaluation of clinical risks to get indicators of the therapy results: for the institution, to get an auto-evaluation tool of the functioning (continuous evaluation of clinical results, identification of sentinel events); for the patients to get precise and detailed information on the risks linked to their treatment (communication of clinical results, comparison with the literature, benchmarking). (N.C.)

Room 305/2 of the unit 4 of the Chernobyl ChNPP: its condition, evaluation of the fuel bulk

International Nuclear Information System (INIS)

Borovoj, A.A.; Pazukhin, Eh.M.; Lagunenko, A.S.

1998-01-01

The question on the bulk of the spent nuclear fuel in the room 305/2 of the Unit 4 has been given consideration. On the basis of the results of direct observations, tele- and photo shooting, data of chemical analysis of samples and measurement of the maximum exposure dose rate on drilling detailed model of the main elements relative position in the former core has been developed. Minimum fuel bulk in the room 305/2 has been evaluated

Mesotherapy for facial skin rejuvenation: a clinical, histologic, and electron microscopic evaluation.

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Amin, Snehal P; Phelps, Robert G; Goldberg, David J

2006-12-01

Mesotherapy, as broadly defined, represents a variety of minimally invasive techniques in which medications are directly injected into the skin and underlying tissue in order to improve musculoskeletal, neurologic, and cosmetic conditions. There are few clinical studies evaluating the efficacy and safety of mesotherapy in any form. This study evaluates the histologic and clinical changes associated with one of the simplest formulations of mesotheraphy commonly used for skin rejuvenation. Ten subjects underwent four sessions of mesotherapy involving multiple injections of a multivitamin and hyaluronic acid solution. Treatment was conducted at 4 monthly intervals. All subjects had pre- and post-treatment photographs and skin biopsies. Skin biopsies were evaluated with routine histology, mucin and elastin stains, and electron microscopy. Patient surveys were also evaluated. Evaluation of photographs at 0, 3, and 6 months revealed no significant clinical differences. Light microscopic examination of pre- and posttreatment specimens showed no significant changes. Electron microscopic analysis of collagen fibers measurements did show smaller diameter fibres posttreatment. No significant clinical or histologic changes were observed after multivitamin mesotherapy for skin rejuvenation. Multivitamin and hyaluronic acid solution facial mesotherapy does not appear to provide any significant benefit.

Efficacy of a telerehabilitation intervention programme using biofeedback among computer operators.

Science.gov (United States)

Golebowicz, Merav; Levanon, Yafa; Palti, Ram; Ratzon, Navah Z

2015-01-01

Computer operators spend long periods of time sitting in a static posture at computer workstations and therefore have an increased exposure to work-related musculoskeletal disorders (WRMSD). The present study is aimed at investigating the feasibility and effectiveness of a tele-biofeedback ergonomic intervention programme among computer operators suffering from WRMSD. Twelve subjects with WRMSD were assigned an ergonomic intervention accompanied by remote tele-biofeedback training, which was practised at their workstations. Evaluations of pain symptoms and locations, body posture and psychosocial characteristics were carried out before and after the intervention in the workplace. The hypothesis was partially verified as it showed improved body position at the workstation and decreased pain in some body parts. Tele-biofeedback, as part of an intervention, appears to be feasible and efficient for computer operators who suffer from WRMSD. This study encourages further research on tele-health within the scope of occupational therapy practice. Practitioner summary: Research concerning tele-health using biofeedback is scarce. The present study analyses the feasibility and partial effectiveness of a tele-biofeedback ergonomic intervention programme for computer operators suffering from WRMSD. The uniqueness and singularity of this study is the usage of remote communication between participants and practitioners through the Internet.

Evaluation of clinical skills for first-year surgical residents using orientation programme and objective structured clinical evaluation as a tool of assessment

Directory of Open Access Journals (Sweden)

Pandya J

2010-01-01

Full Text Available Background: Postgraduate specialities require a combination of knowledge and clinical skills. The internship year is less structured. Clinical and practical skills that are picked up during training are not well regulated and the impact is not assessed. In this study, we assessed knowledge and skills using objective structured clinical examination (OSCE. Aim: To evaluate the clinical skills of new first-year surgical residents using orientation programme and OSCE as a tool for assessment. Settings and Design: Observational study. Materials and Methods: Twenty new first-year surgical residents (10 each in 2008 and 2009 participated in a detailed structured orientation programme conducted over a period of 7 days. Clinically important topics and skills expected at this level (e.g., suturing, wound care etc. were covered. The programme was preceded by an OSCE to test pre-programme knowledge (the "pre-test". The questions were validated by senior department staff. A post-programme OSCE (the "post-test" helped to evaluate the change in clinical skill level brought about by the orientation programme. Statistical Analysis: Wilcoxson matched-pairs signed-ranks test. Results: Passing performance was achieved by all participants in both pre- and post-tests. Following the orientation programme, significant improvement was seen in tasks testing the psychomotor and cognitive domains. (P = 0.0001 and P = 0.0401, respectively. Overall reliability of the OSCE was found to be 0.7026 (Cronbach′s coefficient alpha. Conclusions: This study highlighted the lacunae in current internship training, especially for skill-based tasks. There is a need for universal inclusion of structured orientation programmes in the training of first-year residents. OSCE is a reliable, valid and effective method for the assessment of clinical skills.

Natureza e Deliberação em Aristóteles: uma aproximação em diálogo com Pierre Aubenque [Nature and Deliberation in Aristotle: an approach in dialogue with Pierre Aubenque

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José Edmar Lima Filho

2017-05-01

Full Text Available O presente artigo versa sobre uma possível interpretação da natureza em Aristóteles que corresponda à exigência da viabilidade da deliberação para a ação humana, ou seja, sobre o problema da articulação da natureza com a contingência como seu momento interno. Para isso, propõe-se a visualização de um percurso teórico que apresenta brevemente o conceito de natureza desde a Física aristotélica até a interpretação da possibilidade de uma ontologia da contingência  no pensamento do Estagirita, o que é realizado com base na hipótese interpretativade Pierre Aubenque. A consequência da defesa do estabelecimento de um lugar para a indeterminação e a imprevisibilidade, características da ação humana, fortalece a concepção de deliberação e demonstra a importância deste conceito para a política em Aristóteles, algo que justifica a relevância da presente proposta de trabalho.

Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

Science.gov (United States)

Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

2018-04-20

Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

Ongoing Evaluation of Clinical Ethics Consultations as a Form of Continuous Quality Improvement.

Science.gov (United States)

Volpe, Rebecca

2017-01-01

Ongoing evaluation of a clinical ethics consultation service (ECS) allows for continuous quality improvement, a process-based, data-driven approach for improving the quality of a service. Evaluations by stakeholders involved in a consultation can provide real-time feedback about what is working well and what might need to be improved. Although numerous authors have previously presented data from research studies on the effectiveness of clinical ethics consultation, few ECSs routinely send evaluations as an ongoing component of their everyday clinical activities. The primary purpose of this article is to equip and encourage others to engage in ongoing evaluation of their own ECS. Toward that end, the following resources are shared: (1) the survey tool used to gather the evaluation data, (2) the procedure used to elicit and collate responses, and (3) how the resulting data are used to support continuous quality improvement and justify the continued financial support of the ECS to hospital administration. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

Evaluating the effects of cognitive support on psychiatric clinical comprehension.

Science.gov (United States)

Dalai, Venkata V; Khalid, Sana; Gottipati, Dinesh; Kannampallil, Thomas; John, Vineeth; Blatter, Brett; Patel, Vimla L; Cohen, Trevor

2014-10-01

Clinicians' attention is a precious resource, which in the current healthcare practice is consumed by the cognitive demands arising from complex patient conditions, information overload, time pressure, and the need to aggregate and synthesize information from disparate sources. The ability to organize information in ways that facilitate the generation of effective diagnostic solutions is a distinguishing characteristic of expert physicians, suggesting that automated systems that organize clinical information in a similar manner may augment physicians' decision-making capabilities. In this paper, we describe the design and evaluation of a theoretically driven cognitive support system (CSS) that assists psychiatrists in their interpretation of clinical cases. The system highlights, and provides the means to navigate to, text that is organized in accordance with a set of diagnostically and therapeutically meaningful higher-level concepts. To evaluate the interface, 16 psychiatry residents interpreted two clinical case scenarios, with and without the CSS. Think-aloud protocols captured during their interpretation of the cases were transcribed and analyzed qualitatively. In addition, the frequency and relative position of content related to key higher-level concepts in a verbal summary of the case were evaluated. In addition the transcripts from both groups were compared to an expert derived reference standard using latent semantic analysis (LSA). Qualitative analysis showed that users of the system better attended to specific clinically important aspects of both cases when these were highlighted by the system, and revealed ways in which the system mediates hypotheses generation and evaluation. Analysis of the summary data showed differences in emphasis with and without the system. The LSA analysis suggested users of the system were more "expert-like" in their emphasis, and that cognitive support was more effective in the more complex case. Cognitive support impacts

Bacteriological And Clinical Evaluation Of Twelve Cases Of Post ...

African Journals Online (AJOL)

Bacteriological And Clinical Evaluation Of Twelve Cases Of Post-Surgical Sepsis Of Odontogenic Tumours At A ... East African Medical Journal ... Intervention: Adequate review of patient\\'s medical history, bacteriological investigations and

La Génesis de los Universales en Prasastapada y la Génesis de Los Principia Prima y los Universales en Aristóteles

Directory of Open Access Journals (Sweden)

Fernando Tola

2015-03-01

Full Text Available En este artículo los autores ofrecen un nuevo caso en soporte de su tesis concerniente a las frecuentes coincidencias temáticas en las Filosofías de la India y de Occidente, que ellos han desarrolladoen especial en sus libros On the Myth of the Opposition between Indian Thought and Western Philosophy, Hildesheim: Olms Verlag, 2004, reseñado por Ernst Steinkellner en Wiener Zeitschrift fürdie Kunde Südasiens Band XLVIII 2004, 224-225, y Yoga. Un Camino Místico Universal, Barcelona: Editorial Kairós, 2006. Dicha tesis apunta a lo que podríamos llamar una suerte de globalidad intrínseca del pensar filosófico, más allá de la cultura de que se trate. Prasastapada (circa segunda mitad del siglo VII d.C., en Prasastapadabhasya (llamado también Padarthadharmasngraha, Libro V: Samanyapadarthanirupana, da dos descripciones de la génesis de los universales. Describe primeramente de una manera abstracta y concisa el proceso de surgimiento de todo samanya, «universal», y después explica de una manera más concreta el surgimiento del universal inferior y del superior (satta, «la existencia», a través de la reiteración de la percepción de objetos que presentan similares atributos y de la intervención del recuerdo de percepciones similares pasadas. Aristóteles (siglo IV a.C., en Analytica Posteriora, Libro II, Capítulo XIX, y Temistio (circa 317-circa387, en su comentario, explican a su vez el modo en que son aprehendidos los principios universales o premisas de la demostración (principia prima. Los autores de este artículo muestran cómo la descripción de Aristóteles y Temistio de la génesis de los principia prima y los universales concuerda de manera sorprendente con la de Prasastapada concerniente a los universales.

Clinical evaluation in periodontitis patient after curettage

Directory of Open Access Journals (Sweden)

Widowati Witjaksono

2006-09-01

Full Text Available Curettage is used in periodontics to scrap off the gingival wall of a periodontal pocket, and is needed to reduce loss of attachment (LOA by developing new connective tissue attachment in patients with periodontitis. The purpose of this study was to evaluate the success of curettage by the formation of tissue attachment. This clinical experiment was done by comparing LOA before curettage, 2 weeks and 3 weeks after curettage on 30 teeth with the indication of curettage. Study population were periodontitis patient who attending dental clinic at Hospital University Science Malaysia (HUSM with inclusion criteria good general health condition, 18 to 55 years old male or female and presented with pocket depth > 3mm. The teeth were thoroughly scaling before intervention and evaluated by measuring the periodontal attachment before curettage, two weeks and three weeks after curettage. Repeated measure ANOVA and Paired T Test were used to analyze the data. The result of the study showed that there was reduction in the periodontal attachment loss in periodontitis patient after curettage either in the anterior or posterior teeth which were supported by statistical analysis. This study concluded that curettage could make reattachment of the tissue

Clinical evaluation of microhybrid composites in noncarious cervical ...

African Journals Online (AJOL)

2015-06-29

Jun 29, 2015 ... Subjects and Methods: Ninety‑seven NCCLs were restored with either TPH Spectrum (n = 48) or Filtek Z250 (n = 49) ... Key words: Clinical evaluation, microhybrid resin composites, .... difference was detected between the restorative materials in .... reported that not all marginal defects resulted in marginal.

Self-verification in clinical depression: the desire for negative evaluation.

Science.gov (United States)

Giesler, R B; Josephs, R A; Swann, W B

1996-08-01

Do clinically depressed individuals seek favorable or unfavorable information about the self? Self-verification theory makes the counterintuitive prediction that depressed individuals solicit feedback that confirms their negative self-views. To test this prediction, participants were classified on the basis of a structured clinical interview and self-report measures into high-esteem, low self-esteem, and depressed groups. All participants were offered a choice between receiving favorable or unfavorable feedback; 82% of the depressed participants chose the unfavorable feedback, compared to 64% of the low self-esteem participants and 25% of the high self-esteem participants. Additional evidence indicated that depressed individuals also failed to exploit fully an opportunity to acquire favorable evaluations that were self-verifying. The authors discuss how seeking negative evaluations and failing to seek favorable evaluations may help maintain depression.

Implications of process evaluation for clinical effectiveness and clinical practice in a trial on chronic shoulder complaints.

NARCIS (Netherlands)

Geraets, J.J.; Goossens, M.E.J.B.; Haastregt, J.C. van; Groot, I.J.M. de; Bruijn, C.P. de; Bie, R.A. de; Koke, A.J.; Heuvel, W.J.A. van den

2006-01-01

OBJECTIVE: The intervention process was evaluated in a randomised clinical trial on the effectiveness of a behavioural Graded Exercise Therapy (GET) programme for patients with chronic shoulder complaints in primary care settings. This process evaluation was done for three reasons: first, to know

Development of an Evaluative Procedure for Clinical Clerkships.

Science.gov (United States)

And Others; Pancorbo, Salvador

1980-01-01

In order to evaluate the clinical competencies of graduate pharmacy students upon the completion of a medicine rotation, an oral examination has been developed that requires students to present data and defend decisions. Objectives, responsibilities, and competencies required by the rotation and nine sample exam questions are appended. (JMD)

Process Evaluation of a Community Garden at an Urban Outpatient Clinic.

Science.gov (United States)

Milliron, Brandy-Joe; Vitolins, Mara Z; Gamble, Elizabeth; Jones, Robert; Chenault, Margaret C; Tooze, Janet A

2017-08-01

In addition to expediting patient recovery, community gardens that are associated with medical facilities can provide fresh produce to patients and their families, serve as a platform for clinic-based nutrition education, and help patients develop new skills and insights that can lead to positive health behavior change. While community gardening is undergoing resurgence, there is a strong need for evaluation studies that employ valid and reliable measures. The objective of this study was to conduct a process evaluation of a community garden program at an urban medical clinic to estimate the prevalence of patient awareness and participation, food security, barriers to participation, and personal characteristics; garden volunteer satisfaction; and clinic staff perspectives in using the garden for patient education/treatment. Clinic patients (n = 411) completed a community garden participation screener and a random sample completed a longer evaluation survey (n = 152); garden volunteers and medical staff completed additional surveys. Among patients, 39% had heard of and 18% had received vegetables from the garden; the greatest barrier for participation was lack of awareness. Volunteers reported learning about gardening, feeling more involved in the neighborhood, and environmental concern; and medical staff endorsed the garden for patient education/treatment. Comprehensive process evaluations can be utilized to quantify benefits of community gardens in medical centers as well as to point out areas for further development, such as increasing patient awareness. As garden programming at medical centers is formalized, future research should include systematic evaluations to determine whether this unique component of the healthcare environment helps improve patient outcomes.

A new universal simplified adhesive: 6-month clinical evaluation.

Science.gov (United States)

Mena-Serrano, Alexandra; Kose, Carlos; De Paula, Eloisa Andrade; Tay, Lidia Yileng; Reis, Alessandra; Loguercio, Alessandro D; Perdigão, Jorge

2013-02-01

Multimode adhesives, which can be used as etch-and-rinse or as self-etch adhesives, have been recently introduced without clinical data to back their use. To evaluate the 6-month clinical performance of Scotchbond Universal Adhesive (SU; 3M ESPE, St. Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-TEm: etch-and-rinse + moist dentin; SU-TEd: etch-and-rinse + dry dentin; SU-SEet: selective enamel etching; and SU-SE: self-etch. The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline and after 6 months using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed with Friedman repeated measures analysis of variance by rank and McNemar test for significance in each pair (α = 0.05). Only four restorations (SU-SE: 3 and SU-TEm: 1) were lost after 6 months (p > 0.05 for either criteria). Marginal discoloration occurred in one restoration in the SU-SE group (p > 0.05 for either criteria). Only 2/200 restorations were scored as bravo for marginal adaptation using the USPHS criteria (one for SU-SE and one for SU-SEet, p > 0.05). However, when using the FDI criteria, the percentage of bravo scores for marginal adaptation at 6 months were 32%, 36%, 42%, and 46% for groups SU-TEm, SU-TEd, SU-SEet, and SU-SE, respectively (p > 0.05). The clinical behavior of the multimode adhesive does not depend on the bonding strategy at 6 months. The FDI evaluation criteria are more sensitive than the USPHS criteria. At 6 months, the clinical behavior of the new multimode adhesive Scotchbond Universal was found to be reliable when used in noncarious cervical lesions and may not depend on the bonding strategy employed. © 2012 Wiley Periodicals, Inc.

Evaluation of quality of life in oncology clinic

International Nuclear Information System (INIS)

Jarema, A.; Marzecki, Z.

1994-01-01

In 18 patients with various malignancies the quality of life was evaluated with the use of the SF-36 questionnaire before and after radiotherapy. The quality of life was better among patients whose physical condition was better both before and after radiotherapy. The quality of life deteriorated after radiotherapy in patients whose physical status before treatment was evaluated as more serious. After the treatment the correlation was found between the global evaluation of quality of life and the intensity of pain and physical disability. However, both before and after radiotherapy the correlation was found between global quality of life and the severity of depression. The subjective estimation of quality of life by cancer patients did not correlate with the clinical evaluation of the severity of their state in doctor's opinion. (author)

Integrating usability testing and think-aloud protocol analysis with "near-live" clinical simulations in evaluating clinical decision support.

Science.gov (United States)

Li, Alice C; Kannry, Joseph L; Kushniruk, Andre; Chrimes, Dillon; McGinn, Thomas G; Edonyabo, Daniel; Mann, Devin M

2012-11-01

Usability evaluations can improve the usability and workflow integration of clinical decision support (CDS). Traditional usability testing using scripted scenarios with think-aloud protocol analysis provide a useful but incomplete assessment of how new CDS tools interact with users and clinical workflow. "Near-live" clinical simulations are a newer usability evaluation tool that more closely mimics clinical workflow and that allows for a complementary evaluation of CDS usability as well as impact on workflow. This study employed two phases of testing a new CDS tool that embedded clinical prediction rules (an evidence-based medicine tool) into primary care workflow within a commercial electronic health record. Phase I applied usability testing involving "think-aloud" protocol analysis of 8 primary care providers encountering several scripted clinical scenarios. Phase II used "near-live" clinical simulations of 8 providers interacting with video clips of standardized trained patient actors enacting the clinical scenario. In both phases, all sessions were audiotaped and had screen-capture software activated for onscreen recordings. Transcripts were coded using qualitative analysis methods. In Phase I, the impact of the CDS on navigation and workflow were associated with the largest volume of negative comments (accounting for over 90% of user raised issues) while the overall usability and the content of the CDS were associated with the most positive comments. However, usability had a positive-to-negative comment ratio of only 0.93 reflecting mixed perceptions about the usability of the CDS. In Phase II, the duration of encounters with simulated patients was approximately 12 min with 71% of the clinical prediction rules being activated after half of the visit had already elapsed. Upon activation, providers accepted the CDS tool pathway 82% of times offered and completed all of its elements in 53% of all simulation cases. Only 12.2% of encounter time was spent using the

Evaluation of clinical methods for peroneal muscle testing.

Science.gov (United States)

Sarig-Bahat, Hilla; Krasovsky, Andrei; Sprecher, Elliot

2013-03-01

Manual muscle testing of the peroneal muscles is well accepted as a testing method in musculoskeletal physiotherapy for the assessment of the foot and ankle. The peroneus longus and brevis are primary evertors and secondary plantar flexors of the ankle joint. However, some international textbooks describe them as dorsi flexors, when instructing peroneal muscle testing. The identified variability raised a question whether these educational texts are reflected in the clinical field. The purposes of this study were to investigate what are the methods commonly used in the clinical field for peroneal muscle testing and to evaluate their compatibility with functional anatomy. A cross-sectional study was conducted, using an electronic questionnaire sent to 143 Israeli physiotherapists in the musculoskeletal field. The survey questioned on the anatomical location of manual resistance and the combination of motions resisted. Ninety-seven responses were received. The majority (69%) of respondents related correctly to the peronei as evertors, but asserted that resistance should be located over the dorsal aspect of the fifth metatarsus, thereby disregarding the peroneus longus. Moreover, 38% of the respondents described the peronei as dorsi flexors, rather than plantar flexors. Only 2% selected the correct method of resisting plantarflexion and eversion at the base of the first metatarsus. We consider this technique to be the most compatible with the anatomy of the peroneus longus and brevis. The Fisher-Freeman-Halton test indicated that there was a significant relationship between responses on the questions (P = 0.0253, 95% CI 0.0249-0.0257), thus justifying further correspondence analysis. The correspondence analysis found no clustering of the answers that were compatible with anatomical evidence and were applied in the correct technique, but did demonstrate a common error, resisting dorsiflexion rather than plantarflexion, which was in agreement with the described

Clinical evaluation of microhybrid composites in noncarious cervical ...

African Journals Online (AJOL)

Abstract. Objective: To evaluate the clinical performance of two different microhybrid resin composites in noncarious cervical lesions (NCCLs) after 24 months. Subjects and Methods: Ninety‑seven NCCLs were restored with either TPH Spectrum (n = 48) or Filtek Z250 (n = 49) using an etch‑and‑rinse adhesive in 20 patients.

Evaluation of the physicians‘ of n hospital opinion on clinical trials of medicinal products

OpenAIRE

Videikaitė, Lina

2014-01-01

Aim of the research. To evaluate the physicians‘ of N Hospital opinion on clinical trials of medicinal products. Objectives. To evaluate the factors affecting physicians' motivation to perform clinical trials of medicinal products as well as those that prevent the physicians getting involved in the trials. To assess physicians' attitude towards clinical trials of medicinal products. To compare the opinions of physicians who have and have’nt participated in clinical trials. Methods of...

Evaluation of psychology practitioner competence in clinical supervision.

Science.gov (United States)

Gonsalvez, Craig J; Crowe, Trevor P

2014-01-01

There is a growing consensus favouring the development, advancement, and implementation of a competency-based approach for psychology training and supervision. There is wide recognition that skills, attitude-values, and relationship competencies are as critical to a psychologist's competence as are knowledge capabilities, and that these key competencies are best measured during placements, leaving the clinical supervisor in an unparalleled position of advantage to provide formative and summative evaluations on the supervisee's progression towards competence. Paradoxically, a compelling body of literature from across disciplines indicates that supervisor ratings of broad domains of competence are systematically compromised by biases, including leniency error and halo effect. The current paper highlights key issues affecting summative competency evaluations by supervisors: what competencies should be evaluated, who should conduct the evaluation, how (tools) and when evaluations should be conducted, and process variables that affect evaluation. The article concludes by providing research recommendations to underpin and promote future progress and by offering practice recommendations to facilitate a more credible and meaningful evaluation of competence and competencies.

Effectiveness of faculty training to enhance clinical evaluation of student competence in ethical reasoning and professionalism.

Science.gov (United States)

Christie, Carole; Bowen, Denise; Paarmann, Carlene

2007-08-01

This study evaluated the short- and long-term effectiveness of faculty training to enhance clinical evaluation of ethical reasoning and professionalism in a baccalaureate dental hygiene program. Ethics, values, and professionalism are best measured in contexts comparable to practice; therefore, authentic evaluation is desirable for assessing these areas of competence. Methods were the following: 1) a faculty development workshop implementing a core values-based clinical evaluation system for assessing students' professional judgment; 2) subsequent evaluation of the clinical faculty's use of core values for grading and providing written comments related to students' professional judgment during patient care for three academic years; and 3) evaluation of program outcomes assessments regarding clinical learning experiences related to ethics and professionalism domains. Results revealed the clinical faculty's evaluation of professional judgment during patient care was enhanced by training; written comments more frequently related to core values defined in the American Dental Hygienists' Association (ADHA) Code of Ethics; and faculty members reported more confidence and comfort evaluating professional judgment after implementation of this evaluation system and receiving training in its application. Students were more positive in outcomes assessments about their competency and learning experiences related to professionalism and ethics. This article shares one approach for enhancing clinical faculty's authentic evaluation of student competence in ethical reasoning and professionalism.

Clinical evaluation of anti-alpha-fetoprotein radioimmunodetection

International Nuclear Information System (INIS)

Chapman, C.E.; Keeling, A.A.; Bradwell, A.R.; Chandler, S.T.; Dykes, P.W.

1986-01-01

Anti-alpha-fetoprotein (AFP) radioimmunodetection was performed in response to clinical requests in 16 patients. In two patients, assessment of a known tumour was required; the anti-AFP scans were accurate and provided useful clinical information in both cases. In the remaining 14 patients the request was for localisation of suspected recurrent tumour. Accurate information was provided in four of these patients. In this latter group, various conventional methods of investigation had failed to disclose the site of recurrence. However, of a total of 21 sites reported as positive in these 14 patients, eight proved to be false positives. Two false negative results also occurred in this group and nine could not be evaluated. Although occasionally patients were usefully scanned, improvements are necessary before consistently reliable information can be obtained using this technique. (author)

Early echographic findings in non-hemorrhagic periventricular leukomalacia of the premature infant

International Nuclear Information System (INIS)

Delaporte, B.; Dehan, M.; Labrune, M.; Imbert, M.C.

1985-01-01

The ultrasonic detection of periventricular leukomalacia is described in two neonatal patients. Confirmation of this condition by CT and post mortem was obtained in one case. CT scan and further echography was positive in the other. Neither patient had evidence of an intracranial hemorrhage. It is suggested that echography is of value in the early diagnosis of this lesion which may be similar to intraparenchymal hemorrhage in its mechanism and prognosis. (orig.)

Prostate needle biopsies: interobserver variation and clinical consequences of histopathological re-evaluation

DEFF Research Database (Denmark)

Berg, Kasper Drimer; Toft, Birgitte Grønkaer; Røder, Martin Andreas

2011-01-01

Histopathological grading of prostate cancer (PCa) is associated with significant interobserver variability. This, as well as clinical consequences of histopathological re-evaluation, was investigated. In 350 patients, histopathological re-evaluations of prostate biopsies were compared with primary.......9%. The cancers were assessed with higher GS at re-evaluation in 25.0% of patients in cases with primary GS ≤ 6, while scores were devaluated in 3.0% and 10.3% of the patients with primary GS = 7 and ≥ 8, respectively. Strategies for clinical evaluation and treatment were changed as a result of the biopsy re......-evaluations in 19.7% and 13.1% of patients, respectively. Gleason scoring based on the radical prostatectomy specimen was higher than in both primary reports and re-evaluation of biopsies. Although a relatively high degree of concordance was found between biopsy assessments, the significant trend towards higher...

Exercise intolerance in pulmonary hypertension: mechanism, evaluation and clinical implications.

Science.gov (United States)

Babu, Abraham Samuel; Arena, Ross; Myers, Jonathan; Padmakumar, Ramachandran; Maiya, Arun G; Cahalin, Lawrence P; Waxman, Aaron B; Lavie, Carl J

2016-09-01

Exercise intolerance in pulmonary hypertension (PH) is a major factor affecting activities of daily living and quality of life. Evaluation strategies (i.e., non-invasive and invasive tests) are integral to providing a comprehensive assessment of clinical and functional status. Despite a growing body of literature on the clinical consequences of PH, there are limited studies discussing the contribution of various physiological systems to exercise intolerance in this patient population. This review, through a search of various databases, describes the physiological basis for exercise intolerance across the various PH etiologies, highlights the various exercise evaluation methods and discusses the rationale for exercise training amongst those diagnosed with PH. Expert commentary: With the growing importance of evaluating exercise capacity in PH (class 1, Level C recommendation), understanding why exercise performance is altered in PH is crucial. Thus, the further study is required for better quality evidence in this area.

Some products from CLRI under clinical use and evaluation

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Some products from CLRI under clinical use and evaluation. As burn dressing materials. As wound healing support system. In dentistry: in treatment of gingivial recession. In ophthalmology: as lens support system.

Radiochemical studies, pre-clinical investigation and preliminary clinical evaluation of "1"7"0Tm-EDTMP prepared using in-house freeze-dried EDTMP kit

International Nuclear Information System (INIS)

Das, Tapas; Shinto, Ajit; Kamaleshwaran, Koramadai K.; Sarma, Haladhar D.; Mohammed, Sahiralam Khan; Mitra, Arpit; Lad, Sangita; Rajan, M.G.R.; Banerjee, Sharmila

2017-01-01

The objective of the present work is to formulate "1"7"0Tm-EDTMP using an in-house freeze-dried EDTMP kit and evaluate its potential as a bone pain palliation agent. Patient dose of "1"7"0Tm-EDTMP was prepared with high radiochemical purity using the lyophilized kit at room temperature within 15 min. Pre-clinical evaluation in normal Wistar rats revealed selective skeletal accumulation with extended retention. Preliminary clinical investigation in 8 patients with disseminated skeletal metastases exhibited selective uptake in the bone and retention therein for a long duration. - Highlights: • Formulation of patient dose of "1"7"0Tm-EDTMP using freeze-dried EDTMP kit. • Radiochemical studies and pre-clinical evaluation of the agent in animal model. • Clinical evaluation in eight cancer patients with disseminated skeletal metastases.

Echography by Thermonuclear Fusion

International Nuclear Information System (INIS)

Ramos, Ruben; Moreno, Carlos; Gonzalez, Jose; Florido, Pablo; Clausse, Alejandro

2003-01-01

A technique to substances detection in the neighbourhood of a compact Plasma Focus (PF) is presented. The method is based on the same principle of the sonar or the echographs.The measuring system is composed by two neutron detectors operated simultaneously on every shot.The first detector is used to register the PF neutron yield in each shot; whereas the other one was designed for detecting neutrons scattered by the blanket.The complete detecting system is very simple and inexpensive. The study consisted in measuring the reflection of neutrons emitted by a Deuterium pinch. The correlation of the counts recorded by the detectors located at different positions was mapped with the water distribution around the neutron source. Moreover, we obtained the maps of the substance positions coordinates in function of measurement variables. Also we used the MCNP code in order to simulate the experiments

Evaluating clinical teachers with the Maastricht clinical teaching questionnaire: how much 'teacher' is in student ratings?

Science.gov (United States)

Boerboom, Tobias B B; Mainhard, Tim; Dolmans, Diana H J M; Scherpbier, Albert J J A; Van Beukelen, Peter; Jaarsma, A D C

2012-01-01

Students are a popular source of data to evaluate the performance of clinical teachers. Instruments to obtain student evaluations must have proven validity. One aspect of validity that often remains underexposed is the possibility of effects of between-student differences and teacher and student characteristics not directly related to teaching performance. The authors examined the occurrence of such effects, using multilevel analysis to analyse data from the Maastricht clinical teaching questionnaire (MCTQ), a validated evaluation instrument, in a veterinary curriculum. The 15-item MCTQ covers five domains. The authors used multilevel analysis to divide the variance in the domain scores in components related to, respectively, teachers and students. They estimated subsequent models to explore how the MCTQ scores are dependent on teacher and student characteristics. Significant amounts of variance in student ratings were due to between-teacher differences, particularly for learning climate, modelling and coaching. The effects of teacher and student characteristics were mostly non-significant or small. Large portions of variance in MCTQ scores were due to differences between teachers, while the contribution of student and teacher characteristics was negligible. The results support the validity of student ratings obtained with the MCTQ for evaluating teacher performance.

Evaluation of degenerative changes in articular cartilage of osteoarthritis by Raman spectroscopy

Science.gov (United States)

Oshima, Yusuke; Ishimaru, Yasumitsu; Kiyomatsu, Hiroshi; Hino, Kazunori; Miura, Hiromasa

2018-02-01

Osteoarthritis (OA) is a very common joint disease in the aging population. Main symptom of OA is accompanied by degenerative changes of articular cartilage. Cartilage contains mostly type II collagen and proteoglycans, so it is difficult to access the quality and morphology of cartilage tissue in situ by conventional diagnostic tools (X-ray, MRI and echography) directly or indirectly. Raman spectroscopy is a label-free technique which enables to analyze molecular composition in degenerative cartilage. In this proposal, we aim to develop Raman spectroscopic system for the quality assessment of articular cartilage during arthroscopic surgery. Toward this goal, we are focusing on the proteoglycan content and collagen fiber alignment in cartilage matrix which may be associated with degenerative changes in OA, and we designed an original Raman device for remote sensing during arthroscopic surgery. In this project, we define the grading system for cartilage defect based on Raman spectroscopy, and we complete the evaluation of the Raman probing system which makes it possible to detect early stage of degenerative cartilage as a novel tool for OA diagnosis using human subject.

Crustal structure in the southern part of Central Java based on analysis of tele-seismic receiver function using a neighbourhood algorithm

Science.gov (United States)

Ariyanto, P.; Syuhada; Rosid, S.; Anggono, T.; Januarti, Y.

2018-03-01

In this study, we applied receiver functions analysis to determine the crustal thickness, the ratio of Vp/Vs and the S wave velocity in the southern part of the Central Java. We selected tele-seismic data with magnitude more than 6 (M>6) and epicenter distance 30°-90° recorded from 3 broadband stations: UGM, YOGI, and WOJI station, as part of Indonesia-Geophone Network (IA-GE). Inversions were performed using nonlinear Neighborhood Algorithm (NA). We observed Ps phase conversion on the receiver functions corresponding to Moho depth at around 36-39 km. We also observed strong negative phase arrivals at around 10-12 s which might be associated with Indo-Australian subducting slab underneath the stations. The inversion results show the presence of low velocity zone with high Vp/Vs ratio (>1.78) in the middle crust around the study area which could be related to the Merapi-Lawu Anomaly (MLA).

Establishment of quality assessment standard for mammographic equipment: evaluation of phantom and clinical images

International Nuclear Information System (INIS)

Lee, Sung Hoon; Choe, Yeon Hyeon; Chung, Soo Young

2005-01-01

The purpose of this study was to establish a quality standard for mammographic equipment Korea and to eventually improve mammographic quality in clinics and hospitals throughout Korea by educating technicians and clinic personnel. For the phantom test and on site assessment, we visited 37 sites and examined 43 sets of mammographic equipment. Items that were examined include phantom test, radiation dose measurement, developer assessment, etc. The phantom images were assessed visually and by optical density measurements. For the clinical image assessment, clinical images from 371 sites were examined following the new Korean standard for clinical image evaluation. The items examined include labeling, positioning, contrast, exposure, artifacts, collimation among others. Quality standard of mammographic equipment was satisfied in all equipment on site visits. Average mean glandular dose was 114.9 mRad. All phantom image test scores were over 10 points (average, 10.8 points). However, optical density measurements were below 1.2 in 9 sets of equipment (20.9%). Clinical image evaluation revealed appropriate image quality in 83.5%, while images from non-radiologist clinics were adequate in 74.6% (91/122), which was the lowest score of any group. Images were satisfactory in 59.0% (219/371) based on evaluation by specialists following the new Korean standard for clinical image evaluation. Satisfactory images had a mean score of 81.7 (1 S.D. =8.9) and unsatisfactory images had a mean score of 61.9 (1 S.D = 11). The correlation coefficient between the two observers was 0.93 (ρ < 0.01) in 49 consecutive cases. The results of the phantom tests suggest that optical density measurements should be performed as part of a new quality standard for mammographic equipment. The new clinical evaluation criteria that was used in this study can be implemented with some modifications for future mammography quality control by the Korean government

A methodology for evaluation of a markup-based specification of clinical guidelines.

Science.gov (United States)

Shalom, Erez; Shahar, Yuval; Taieb-Maimon, Meirav; Lunenfeld, Eitan

2008-11-06

We introduce a three-phase, nine-step methodology for specification of clinical guidelines (GLs) by expert physicians, clinical editors, and knowledge engineers, and for quantitative evaluation of the specification's quality. We applied this methodology to a particular framework for incremental GL structuring (mark-up) and to GLs in three clinical domains with encouraging results.

Arizona TeleMedicine Network: Segment Specifications--Tuba City via Mt. Elden, Phoenix; Keams Canyon, Second Mesa, Low Mountain; Phoenix, San Carlos, Bylas; Keams Canyon via Ganado Mesa, Ft. Defiance; Tuba City via Black Mesa, Ft. Defiance; and Budgetary Cost Information--Pinal Peak via San Xavier, Tucson.

Science.gov (United States)

Atlantic Research Corp., Alexandria, VA.

The communication links of five different segments of the Arizona TeleMedicine Network (a telecommunication system designed to provide health services for American Indians in rurally isolated areas) and budgetary cost information for Pinal Peak via San Xavier and Tucson are described in this document. The five communication links are identified…

Evaluation of medication treatment for Alzheimer's disease on clinical evidence

Directory of Open Access Journals (Sweden)

Meng-qiu LI

2014-03-01

Full Text Available Objective To formulate the best treatment plan for Alzheimer's disease patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Alzheimer's disease, donepezil, rivastigmine, galantamine, memantine, rosiglitazone, etc. were defined as retrieval words. PubMed, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure (CNKI databases were used with applying of manual searching. Systematic reviews, randomized controlled trials (RCT, controlled clinical trials and case-observation studies were collected and evaluated by Jadad Scale. Results After screening, 33 selected resources included 14 systematic reviews, 14 randomized controlled trials, 4 controlled clinical trials and 1 case-observation study. According to Jadad Scale, total 28 articles were evaluated to be high quality (12 with score 4, 10 score 5, 6 score 7, and 5 were low quality with score 3. It was summarized as follows: 1 Alzheimer's disease is a progressive neurodegenerative disease for which no cure exists. To date, only symptomatic treatments with cholinesterase inhibitors (donepezil, rivastigmine, galantamine and an N-methyl-D-aspartate (NMDA receptor noncompetitive antagonist (memantine, are effective and well tolerated to counterbalance the neurotransmitter disturbance, but cannot limit or impact on disease progression. 2 Disease modifying drug is an potential agent, with persistent effect on slowing the progression of structural damage, and can be detected even after withdrawing the treatment. Many types of disease modifying drugs are undergoing clinical trials. Conclusions Using evidence-based medicine methods can provide best clinical evidence on Alzheimer's disease treatment. doi: 10.3969/j.issn.1672-6731.2014.03.009

Evaluation of a cloud-based local-read paradigm for imaging evaluations in oncology clinical trials for lung cancer

International Nuclear Information System (INIS)

Sueoka-Aragane, Naoko; Kobayashi, Naomi; Bonnard, Eric; Charbonnier, Colette; Yamamichi, Junta; Mizobe, Hideaki; Kimura, Shinya

2015-01-01

Although tumor response evaluated with radiological imaging is frequently used as a primary endpoint in clinical trials, it is difficult to obtain precise results because of inter- and intra-observer differences. To evaluate usefulness of a cloud-based local-read paradigm implementing software solutions that standardize imaging evaluations among international investigator sites for clinical trials of lung cancer. Two studies were performed: KUMO I and KUMO I Extension. KUMO I was a pilot study aiming at demonstrating the feasibility of cloud implementation and identifying issues regarding variability of evaluations among sites. Chest CT scans at three time-points from baseline to progression, from 10 patients with lung cancer who were treated with EGFR tyrosine kinase inhibitors, were evaluated independently by two oncologists (Japan) and one radiologist (France), through a cloud-based software solution. The KUMO I Extension was performed based on the results of KUMO I. KUMO I showed discordance rates of 40% for target lesion selection, 70% for overall response at the first time-point, and 60% for overall response at the second time-point. Since the main reason for the discordance was differences in the selection of target lesions, KUMO I Extension added a cloud-based quality control service to achieve a consensus on the selection of target lesions, resulting in an improved rate of agreement of response evaluations. The study shows the feasibility of imaging evaluations at investigator sites, based on cloud services for clinical studies involving multiple international sites. This system offers a step forward in standardizing evaluations of images among widely dispersed sites

[An instrument in Spanish to evaluate the performance of clinical teachers by students].

Science.gov (United States)

Bitran, Marcela; Mena, Beltrán; Riquelme, Arnoldo; Padilla, Oslando; Sánchez, Ignacio; Moreno, Rodrigo

2010-06-01

The modernization of clinical teaching has called for the creation of faculty development programs, and the design of suitable instruments to evaluate clinical teachers' performance. To report the development and validation of an instrument in Spanish designed to measure the students' perceptions of their clinical teachers' performance and to provide them with feedback to improve their teaching practices. In a process that included the active participation of authorities, professors in charge of courses and internships, clinical teachers, students and medical education experts, we developed a 30-item questionnaire called MEDUC30 to evaluate the performance of clinical teachers by their students. The internal validity was assessed by factor analysis of 5214 evaluations of 265 teachers, gathered from 2004 to 2007. The reliability was measured with the Cronbach's alpha coefficient and the generalizability coefficient (g). MEDUC30 had good content and construct validity. Its internal structure was compatible with four factors: patient-centered teaching, teaching skills, assessment skills and learning climate, and it proved to be consistent with the structure anticipated by the theory. The scores were highly reliable (Cronbach's alpha: 0.97); five evaluations per teacher were sufficient to reach a reliability coefficient (g) of 0.8. MEDUC30 is a valid, reliable and useful instrument to evaluate the performance of clinical teachers. To our knowledge, this is the first instrument in Spanish for which solid validity and reliability evidences have been reported. We hope that MEDUC30 will be used to improve medical education in Spanish-speaking medical schools, providing teachers a specific feedback upon which to improve their pedagogical practice, and authorities with valuable information for the assessment of their faculty.

Challenges of teacher-based clinical evaluation from nursing students' point of view: Qualitative content analysis.

Science.gov (United States)

Sadeghi, Tabandeh; Seyed Bagheri, Seyed Hamid

2017-01-01

Clinical evaluation is very important in the educational system of nursing. One of the most common methods of clinical evaluation is evaluation by the teacher, but the challenges that students would face in this evaluation method, have not been mentioned. Thus, this study aimed to explore the experiences and views of nursing students about the challenges of teacher-based clinical evaluation. This study was a descriptive qualitative study with a qualitative content analysis approach. Data were gathered through semi-structured focused group sessions with undergraduate nursing students who were passing their 8 th semester at Rafsanjan University of Medical Sciences. Date were analyzed using Graneheim and Lundman's proposed method. Data collection and analysis were concurrent. According to the findings, "factitious evaluation" was the main theme of study that consisted of three categories: "Personal preferences," "unfairness" and "shirking responsibility." These categories are explained using quotes derived from the data. According to the results of this study, teacher-based clinical evaluation would lead to factitious evaluation. Thus, changing this approach of evaluation toward modern methods of evaluation is suggested. The finding can help nursing instructors to get a better understanding of the nursing students' point of view toward this evaluation approach and as a result could be planning for changing of this approach.

Clinical evaluation in hyperbaric oxygen therapy by using computerized tomography

International Nuclear Information System (INIS)

Matsuda, Kazumi; Kobayashi, Eiki; Mihara, Tadahiro; Asakura, Tetsuhiko; Fujimoto, Toshiro; Fujimoto, Seijiro.

1982-01-01

Hyperbaric Oxygen Therapy (H.O.T. for abbreviation), accompanied by usual conservative therapy, was performed on 30 patients with cerebrovascular disturbances (cerebral infarction: 20 cases; hypertensive intracerebral hemorrhage: 10 cases). The clinical signs and symptoms, clinical courses, EEG findings, and CT findings and agter the H.O.T. were then compared before. Moreover, by analyzing the changes in the CT findings (the size and Hounsfield Number of the low-density area and the effect of contrast enhancement), the authors have attempted a clinical evaluation of H.O.T. The results are as follows: 1) Infarction group: There is a tendency to have more changes in the CT findings (reduction of the low-density area, decrease in the Hounsfield Number in the low-density portion, and changes in the effect of contrast enhancement) in the earlier H.O.T. - starting group. However, there was no definite relation between the changes in the CT findings and the clinical signs and symptoms. 2) Hypertensive intracerebral hemorrhage group: there was a tendency to have a reduction in the low-density area and an improvement in the clinical signs and symptoms in cases who had an early start of H.O.T. So far as investigating hemodynamic changes is concerned, there is a limit to the ability of investigation by means of CT scan. In future, we hope to establish methods by which if will be possible to detect the hemodynamic changes more exactly with respect to the clinical evaluation of H.O.T. (author)

Use of clinical guidelines in remote Australia: A realist evaluation.

Science.gov (United States)

Reddy, Sandeep; Orpin, Victoria; Herring, Sally; Mackie-Schneider, Stephanie; Struber, Janet

2018-02-01

The aim of this evaluation was to assess the acceptability, accessibility, and compliance with the 2014 editions of the Remote Primary Health Care Manuals (RPHCM) in health care centres across remote areas of Northern and Central Australia. To undertake a comprehensive evaluation that considered context, the evaluation used a realist evaluation framework. The evaluation used a variety of methods including interviews and survey to develop and test a programme theory. Many remote health practitioners have adopted standardized, evidence-based practice because of the use of the RPHCM. The mechanisms that led to the use of the manuals include acceptance of the worth of the protocols to their clinical practice, reliance on manual content to guide their practice, the perception of credibility, the applicability of RPHCM content to the context, and a fear of the consequences of not using the RPHCMs. Some remote health practitioners are less inclined to use the RPHCM regularly because of a perception that the content is less suited to their needs and daily practice or it is hard to navigate or understand. The evaluation concluded that there is work to be done to widen the RPHCM user base, and organizations need to increase support for their staff to use the RPHCM protocols better. These measures are expected to enable standardized clinical practice in the remote context. © 2017 John Wiley & Sons, Ltd.

A formative evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic.

Science.gov (United States)

Hansen, Kevin T; McDonald, Cheryl; O'Hara, Sue; Post, Leslie; Silcox, Susan; Gutmanis, Iris A

2017-07-01

The number of older adults with multiple complex comorbidities and frailty is expected to increase dramatically in the coming decades, which will necessitate a concomitant increase in the need for skilled clinicians who are able to manage complex geriatric needs. Many physicians, however, lack the required formal training, often leading to long wait-lists for specialist clinics. Yet, clinics led by non-physician professionals specialising in geriatric care could decrease these delays. This article describes the development and evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic (Inter-D Clinic). A combination of semi-structured clinician interviews, post-clinic follow-up phone calls, satisfaction surveys, and information from the hospital workload management system served as data sources for this formative programme evaluation. Between January 2013 and December 2014, 293 patients were seen in the clinic with the majority being referred for either memory issues (49%) or functional decline (35%). The clinic assessment frequently uncovered other issues, which led to guidance around falls prevention, improved nutrition, medication management, and referrals to available community supports. Both patients and referring physicians were very satisfied with this model of care, which is likely transferable to other locations provided the needed clinical expertise and community support services are available.

[Telemedicine in Bolivia: RAFT-Altiplano project, experiences, future prospects, and recommendations].

Science.gov (United States)

Vargas, Alejandro; Ugalde, Miguel; Vargas, Reynaldo; Narvaez, Ramiro; Geissbuhler, Antoine

2014-01-01

The objective of the RAFT-Altiplano project (RAFT: Réseau en Afrique Francophone pour la Télémédecine, or African Francophone Telemedicine Network) is to evaluate the viability, potential, and risks of implementing and developing a telemedicine network in the context of a developing country-specifically, the Altiplano region of Bolivia-to improve access to medical care and continuing education in a rural area. The activities described in this report took place between 2011 and 2013. Digital telemedicine equipment was donated to the health centers and a Microsoft®-based platform capable of integration with other technologies (using standardized formats) was developed to manage documents and clinical content electronically. Health professionals were trained in teleconsultation and the teleconsultation workflow was designed. The tele-education system used is Dudal, which requires only a small bandwidth. After three years of implementation, an organized working structure of teleconsultation and tele-education tools, adapted to the Latin American context, is now in place and connections have been established with hospitals, institutions, and health centers. The project has improved access to specialized medical care in remote health centers and third-level hospitals in urban areas, and it has become the foundation for development of the national project "TeleSalud for Bolivia" promoted by the Ministry of Health, which involves use of the new Bolivian satellite, Túpac Katari. It is viable to develop and set up telemedicine tools to serve the population in remote regions of Bolivia when they are made available to government and municipal health institutions and communication between them and the health centers takes place in a coordinated manner. The sharing of experiences, challenges, and risks encountered is very useful in designing and implementing the telemedicine project "TeleSalud for Bolivia" on a national scale.

Ior-CEA-1: Labelling, quality control and clinical evaluation

International Nuclear Information System (INIS)

Pimentel, G.J.

1998-01-01

Within the Co-ordinated Programme on Labelling, Quality Control and Evaluation of Monoclonal Antibodies, the IAEA has made a great effort to expand efficient labelling methods, mainly those with radioisotopes which have been used for radioimmunoscintigraphy. In this sense, more recently 99 Tc m has been mostly employed in the majority of the investigations due to its ideal physical characteristics. Efficient labelling of monoclonal antibodies depends on a number of factors including the method and way of the label incorporation into the protein. During the last years several direct labelling approaches have been developed, which led to attain simple and inexpensive methods for medical practice, as well as safe and stable techniques which bring accurate and good quality images. Accordingly, this paper describes the results obtained during last five years which come from the comparison among different labelling systems, passing through the quality control to test the labelled monoclonal stability and the protein bioreactivity, to continue in the clinical evaluation of ior-CEA-1, as well as the evaluation of other antibodies. Up to now we have evaluated more than 70 patients with the anti-CEA monoclonal antibody (ior-CEA-1), examined in different clinical assays such as: pilot, phase I-II and extensive phase III-IV trials, whose results are encouraging. It confirms that the employed labelling approach was safe and adequate

Electronic clinical safety reporting system: a benefits evaluation.

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Elliott, Pamela; Martin, Desmond; Neville, Doreen

2014-06-11

Eastern Health, a large health care organization in Newfoundland and Labrador (NL), started a staged implementation of an electronic occurrence reporting system (used interchangeably with "clinical safety reporting system") in 2008, completing Phase One in 2009. The electronic clinical safety reporting system (CSRS) was designed to replace a paper-based system. The CSRS involves reporting on occurrences such as falls, safety/security issues, medication errors, treatment and procedural mishaps, medical equipment malfunctions, and close calls. The electronic system was purchased from a vendor in the United Kingdom that had implemented the system in the United Kingdom and other places, such as British Columbia. The main objective of the new system was to improve the reporting process with the goal of improving clinical safety. The project was funded jointly by Eastern Health and Canada Health Infoway. The objectives of the evaluation were to: (1) assess the CSRS on achieving its stated objectives (particularly, the benefits realized and lessons learned), and (2) identify contributions, if any, that can be made to the emerging field of electronic clinical safety reporting. The evaluation involved mixed methods, including extensive stakeholder participation, pre/post comparative study design, and triangulation of data where possible. The data were collected from several sources, such as project documentation, occurrence reporting records, stakeholder workshops, surveys, focus groups, and key informant interviews. The findings provided evidence that frontline staff and managers support the CSRS, identifying both benefits and areas for improvement. Many benefits were realized, such as increases in the number of occurrences reported, in occurrences reported within 48 hours, in occurrences reported by staff other than registered nurses, in close calls reported, and improved timelines for notification. There was also user satisfaction with the tool regarding ease of use

Clinical evaluation of joint scintigraphy in rheumatoid arthritis

International Nuclear Information System (INIS)

Shimabukuro, Kunisada; Sakata, Hiromichi; Shirono, Kazuo; Nakajo, Masataka; Shinohara, Shinji

1983-01-01

Pertechnetate (sup(99m)TcO 4 - ) joint scintigraphy was performed on 45 patients with rheumatoid arthritis, 3 with nonspecific arthritis and 6 normal subjects. 1) The sites of radioisotopic accumulation were generally in agreement with those of clinical involvement in rheumatoid arthritis. 2) By analysis of build-up curves in the wrist joint, tracer was found to be concentrated more rapidly in rheumatoid arthritis (T 1/2 = 0.67 min.) than in nonspecific arthritis (T 1/2 = 2.66 min.) 3) The degree of radioisotopic accumulation correlated well with the value of CRP and erythrocyte sedimentation rate. It could be cosidered that pertechnetate joint scintigraphy is useful for clinical evaluation of rheumatoid arthritis. (author)

Job evaluation for clinical nursing jobs by implementing the NHS JE system.

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Kahya, Emin; Oral, Nurten

2007-10-01

The purpose of this paper was to evaluate locally all the clinical nursing jobs implementing the NHS JE system in four hospitals. The NHS JE was developed by the Department of Health in the UK in 2003-2004. A job analysis questionnaire was designed to gather current job descriptions. It was distributed to each of 158 clinical nurses and supervisor nurses in 31 variety clinics at four hospitals in one city. The questionnaires were analysed to evaluate locally all the identified 94 nursing jobs. Fourteen of 19 nursing jobs in the medical and surgical clinics can be matched to the nurse national job in the NHS JE system. The results indicated that two new nursing jobs titled nurse B and nurse advanced B should be added to the list of national nursing jobs in the NHS JE system.

Aristóteles: perì demokratías. La cuestión de la democracia

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Álvarez Yágüez, Jorge

2009-12-01

Full Text Available The analysis of Aristotle on basic categories that define the political thing, that constitute the polis, should have the democracy as logic conclusion. However that was not the Aristotle’s conclusion. He directed hard critics against democracy, and he proposed the politeia as a realist and fair constitution. This issue has generated several and contradictory interpretations. This paper examines the real position of Aristotle on the democracy and his alternative regime.

El análisis de las categorías básicas definitorias de la política, lo que constituye a la polis misma, debieran llevar a Aristóteles a establecer la democracia como el régimen que mas fielmente las encarnaba, sin embargo las duras críticas hechas a lo que se conocía por democracia le condujeron a concluir que este era un régimen viciado y que la politeia sería la constitución plausible más justa. Esa alternativa ha acarreado un sinfín de interpretaciones diversas y contradictorias. Se pretende aquí arrojar un poco de claridad respecto de la posición aristotélica ante la democracia y la consecuencia de su alternativa.

Diversidad morfológica del sistema de conductos excretores de los peces teleósteos Morphological diversity of the excretory duct system of teleostean fishes

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Abraham Kobelkowsky

2007-06-01

Full Text Available Mediante el análisis anatómico de 70 especies de teleósteos, pertenecientes a 62 géneros, 39 familias y 20 órdenes, se reconoce la diversidad morfológica de los conductos excretores y de la vejiga urinaria. Se define como un patrón morfológico general de los teleósteos la fusión de ambos conductos arquinéfricos en el conducto urinario común y, en los machos, la unión del conducto urinario común con el conducto espermático común, formándose el conducto urogenital. Se reconoce una relación inversa de la longitud de los conductos arquinéfricos y la longitud de los riñones. Se describe la diversidad de situaciones morfológicas del trayecto y fusiones de los conductos excretores. Se reconoce la diversidad de formas de vejiga urinaria. Resalta la “inversión” de la posición de los conductos urinarios y urogenitales en los Pleuronectiformes. Se sugiere el origen de la vejiga urinaria a partir del conducto urinario común. Se manifiesta en algunas especies el dimorfismo sexual en la forma de las papilas urinaria y urogenital.By means of an anatomical analysis from 70 species of teleostean fishes, belonging to 62 genera, and 39 families, and 20 orders, the morphological diversity of the urinary Duch system is described. A general morphological teleostean pattern is defined as the fusion of both archinephric ducts in the common urinay duct, and the fusion in malesof the common urinary duct with the common spermatic duct in the urogenital duct. A relation between the length of thekidney and of the archinephric ducts is recongnized. The trajectory of the urinary ducts is described, with the “reversal”of the orientation of the urinary and urogenital ducts in Pleuronectiformes being noteworthy. The origin of the urinary bladder from the common urinary duct is suggested.

Clinical evaluation of ischemic heart diagnosis

International Nuclear Information System (INIS)

Kamei, Fumio

1983-01-01

Attempt were made to detect the existence of myocardial ischemia by means of both radiographic and scintigraphic techniques. Firstly, a new polygraph was especially designed for selecting the arbitrary phases in a cardiac cycle at which the corresponding radiogram should be synchronously obtained. A comparative investigation on the difference between end-systolic and-diastolic cardiac transverse diameters revealed a remarkable difference of 3.6% in normal subjects and 0.6% in patients with ischemic heart disease. These data indicating the difference of overall heart size was reflected in local dyskinesis documentation of recently developed techniques. For daily clinical purposes, radiography of the chest based on synchronously selected phases would contribute to accurate diagnosis and treatment of heart disease. Secondly, scintigraphic display using intravenously injected thallium-201 was clinically applied. For detection of ischemia, comparative study was performed of initial image relative to selective coronary cineangiography and stress scintigraphy. The former indicated a good correlation of 90%, whereas the latter served to enhnace sensitivity. Sequential images (initial and delayed) facilitated the distinction of normal, necrotic, and ischemic areas. Scintigram was used for objective evaluation of coronary dilator (dilazep), either at immediate or follow-up stage. In the same way, it was also possible to indicate the effectiveness of sublingually given nitroglycerin by myocardial scintigram, where by significant increase of uptake was observed 20 minutes after administration. Rehabilitation after acute heart disease was discussed, especially on the peripheral effect. Ratio of the thigh muscle to myocardium shown in this study was useful fer objective evaluation. Another preliminary study is to separate normal coronary arteries from myocardial necrosis. (J.P.N.)

Clinical evaluation of ischemic heart diagnosis

Energy Technology Data Exchange (ETDEWEB)

Kamei, Fumio [Sendai Railway Hospital (Japan)

1983-09-01

Attempt were made to detect the existence of myocardial ischemia by means of both radiographic and scintigraphic techniques. Firstly, a new polygraph was especially designed for selecting the arbitrary phases in a cardiac cycle at which the corresponding radiogram should be synchronously obtained. A comparative investigation on the difference between end-systolic and-diastolic cardiac transverse diameters revealed a remarkable difference of 3.6% in normal subjects and 0.6% in patients with ischemic heart disease. These data indicating the difference of overall heart size was reflected in local dyskinesis documentation of recently developed techniques. For daily clinical purposes, radiography of the chest based on synchronously selected phases would contribute to accurate diagnosis and treatment of heart disease. Secondly, scintigraphic display using intravenously injected thallium-201 was clinically applied. For detection of ischemia, comparative study was performed of initial image relative to selective coronary cineangiography and stress scintigraphy. The former indicated a good correlation of 90%, whereas the latter served to enhance sensitivity. Sequential images (initial and delayed) facilitated the distinction of normal, necrotic, and ischemic areas. Scintigram was used for objective evaluation of coronary dilator (dilazep), either at immediate or follow-up stage. In the same way, it was also possible to indicate the effectiveness of sublingually given nitroglycerin by myocardial scintigram, where by significant increase of uptake was observed 20 minutes after administration. Rehabilitation after acute heart disease was discussed, especially on the peripheral effect. Ratio of the thigh muscle to myocardium shown in this study was useful for objective evaluation. Another preliminary study is to separate normal coronary arteries from myocardial necrosis.

FORENSIC-CLINICAL INTERVIEW: RELIABILITY AND VALIDITY FOR THE EVALUATION OF PSYCHOLOGICAL INJURY

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Francisca Fariña

2013-01-01

Full Text Available Forensic evaluation of psychological injury involves the use of a multimethod approximation i.e., a psychometric instrument, normally the MMPI-2, and a clinical interview. In terms of the clinical interview, the traditional clinical interview (e.g., SCID is not valid for forensic settings as it does not fulfil the triple objective of forensic evaluation: diagnosis of psychological injury in terms of Post Traumatic Stress Disorder (PTSD, a differential diagnosis of feigning, and establishing a causal relationship between allegations of intimate partner violence (IPV and psychological injury. To meet this requirement, Arce and Fariña (2001 created the forensic-clinical interview based on two techniques that do not contaminate the contents i.e., reinstating the contexts and free recall, and a methodic categorical system of contents analysis for the diagnosis of psychological injury and a differential diagnosis of feigning. The reliability and validity of the forensic-clinical interview designed for the forensic evaluation of psychological injury was assessed in 51 genuine cases of (IPV and 54 mock victims of IPV who were evaluated using a forensic-clinical interview and the MMPI-2. The result revealed that the forensic-clinical interview was a reliable instrument (α = .85 for diagnostic criteria of psychological injury, and α = .744 for feigning strategies. Moreover, the results corroborated the predictive validity (the diagnosis of PTSD was similar to the expected rate; the convergence validity (the diagnosis of PTSD in the interview strongly correlated with the Pk Scale of the MMPI-2, and discriminant validity (the diagnosis of PTSD in the interview did not correlate with the Pk Scale in feigners. The feigning strategies (differential diagnosis also showed convergent validity (high correlation with the Scales and indices of the MMPI2 for the measure of feigning and discriminant validity (no genuine victim was classified as a feigner

Can complex health interventions be evaluated using routine clinical and administrative data? - a realist evaluation approach.

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Riippa, Iiris; Kahilakoski, Olli-Pekka; Linna, Miika; Hietala, Minni

2014-12-01

Interventions aimed at improving chronic care typically consist of multiple interconnected parts, all of which are essential to the effect of the intervention. Limited attention has been paid to the use of routine clinical and administrative data in the evolution of these complex interventions. The purpose of this study is to examine the feasibility of routinely collected data when evaluating complex interventions and to demonstrate how a theory-based, realist approach to evaluation may increase the feasibility of routine data. We present a case study of evaluating a complex intervention, namely, the chronic care model (CCM), in Finnish primary health care. Issues typically faced when evaluating the effects of a complex intervention on health outcomes and resource use are identified by using routine data in a natural setting, and we apply context-mechanism-outcome (CMO) approach from the realist evaluation paradigm to improve the feasibility of using routine data in evaluating complex interventions. From an experimentalist approach that dominates the medical literature, routine data collected from a single centre offered a poor starting point for evaluating complex interventions. However, the CMO approach offered tools for identifying indicators needed to evaluate complex interventions. Applying the CMO approach can aid in a typical evaluation setting encountered by primary care managers: one in which the intervention is complex, the primary data source is routinely collected clinical and administrative data from a single centre, and in which randomization of patients into two research arms is too resource consuming to arrange. © 2014 John Wiley & Sons, Ltd.

[Establish research model of post-marketing clinical safety evaluation for Chinese patent medicine].

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Zheng, Wen-ke; Liu, Zhi; Lei, Xiang; Tian, Ran; Zheng, Rui; Li, Nan; Ren, Jing-tian; Du, Xiao-xi; Shang, Hong-cai

2015-09-01

The safety of Chinese patent medicine has become a focus of social. It is necessary to carry out work on post-marketing clinical safety evaluation for Chinese patent medicine. However, there have no criterions to guide the related research, it is urgent to set up a model and method to guide the practice for related research. According to a series of clinical research, we put forward some views, which contained clear and definite the objective and content of clinical safety evaluation, the work flow should be determined, make a list of items for safety evaluation project, and put forward the three level classification of risk control. We set up a model of post-marketing clinical safety evaluation for Chinese patent medicine. Based this model, the list of items can be used for ranking medicine risks, and then take steps for different risks, aims to lower the app:ds:risksrisk level. At last, the medicine can be managed by five steps in sequence. The five steps are, collect risk signal, risk recognition, risk assessment, risk management, and aftereffect assessment. We hope to provide new ideas for the future research.

Evaluation of clinical information modeling tools.

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Moreno-Conde, Alberto; Austin, Tony; Moreno-Conde, Jesús; Parra-Calderón, Carlos L; Kalra, Dipak

2016-11-01

Clinical information models are formal specifications for representing the structure and semantics of the clinical content within electronic health record systems. This research aims to define, test, and validate evaluation metrics for software tools designed to support the processes associated with the definition, management, and implementation of these models. The proposed framework builds on previous research that focused on obtaining agreement on the essential requirements in this area. A set of 50 conformance criteria were defined based on the 20 functional requirements agreed by that consensus and applied to evaluate the currently available tools. Of the 11 initiative developing tools for clinical information modeling identified, 9 were evaluated according to their performance on the evaluation metrics. Results show that functionalities related to management of data types, specifications, metadata, and terminology or ontology bindings have a good level of adoption. Improvements can be made in other areas focused on information modeling and associated processes. Other criteria related to displaying semantic relationships between concepts and communication with terminology servers had low levels of adoption. The proposed evaluation metrics were successfully tested and validated against a representative sample of existing tools. The results identify the need to improve tool support for information modeling and software development processes, especially in those areas related to governance, clinician involvement, and optimizing the technical validation of testing processes. This research confirmed the potential of these evaluation metrics to support decision makers in identifying the most appropriate tool for their organization. Los Modelos de Información Clínica son especificaciones para representar la estructura y características semánticas del contenido clínico en los sistemas de Historia Clínica Electrónica. Esta investigación define, prueba y valida

Development and psychometric evaluation of the nursing instructors' clinical teaching performance inventory.

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A Farahani, Mansoureh; Emamzadeh Ghasemi, Hormat Sadat; Nikpaima, Nasrin; Fereidooni, Zhila; Rasoli, Maryam

2014-10-29

Evaluation of nursing instructors' clinical teaching performance is a prerequisite to the quality assurance of nursing education. One of the most common procedures for this purpose is using student evaluations. This study was to develop and evaluate the psychometric properties of Nursing Instructors' Clinical Teaching Performance Inventory (NICTPI). The primary items of the inventory were generated by reviewing the published literature and the existing questionnaires as well as consulting with the members of the Faculties Evaluation Committee of the study setting. Psychometric properties were assessed by calculating its content validity ratio and index, and test-retest correlation coefficient as well as conducting an exploratory factor analysis and an internal consistency assessment. The content validity ratios and indices of the items were respectively higher than 0.85 and 0.79. The final version of the inventory consisted of 25 items, and in the exploratory factor analysis, items were loaded on three factors which jointly accounting for 72.85% of the total variance. The test-retest correlation coefficient and the Cronbach's alpha of the inventory were 0.93 and 0.973, respectively. The results revealed that the developed inventory is an appropriate, valid, and reliable instrument for evaluating nursing instructors' clinical teaching performance.

Vindicación y elogio de la retórica deliberativa: glosas de Aristóteles

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Vega Reñón, Luis

2013-06-01

Full Text Available Today we are witnessing the increasing interest in the argumentative rhetoric because of its close relationship with the public discourse. Two points have been highlighted in this regard: 1, the contribution of rhetoric to the critical revision of the ongoing programs of the so-called “deliberative democracy”; 2, the reading of Aristotle’s Rhetoric in line with these critical purposes. The aim of my paper is to develop this second point through an examination of the Aristotelian conception of rhetoric and his vindication of public deliberation.Hoy estamos asistiendo a un creciente interés por la retórica argumentativa debido a su estrecha relación con el discurso público. Tienen especial relieve dos puntos a este respecto: 1, la contribución de la retórica a la revisión crítica de los programas en curso de la llamada “democracia deliberativa”; 2, la lectura de la Retórica de Aristóteles en la línea de estos propósitos críticos. Mi artículo se propone desarrollar este segundo punto a través de un examen de la concepción aristotélica de la retórica y de su vindicación de la deliberación pública.

Epidemiological, clinical and sleep laboratory evaluations of insomnia

Science.gov (United States)

Bixler, E. O.; Kales, A.; Kales, J. D.

1975-01-01

Epidemiological studies have contributed to the understanding of the total scope of the insomnia problem, both in terms of the incidence of sleep difficulties, and the extent and frequency of hypnotic drug use. Clinical studies - at the Sleep Research and Treatment Center - have been used to evaluate the medical, psychological, pharmacological and situational factors contributing to insomnia, and to evaluate the psychotherapy and chemotherapy best suited to treatment of insomnia. The sleep laboratory studies were of two types: (1) the study of sleep induction, sleep maintenance, and sleep stages, and (2) the use of hypnotic drugs, emphasizing their effectiveness in inducing and maintaining sleep, and the duration of this effectiveness.

Evaluation of Medical Students During a Clinical Clerkship in Internal Medicine

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O'Donohue, W. J., Jr.; Wergin, Jon F.

1978-01-01

During a three-month clinical clerkship in medicine 175 medical students were evaluated. A proficiency assessment process was developed that included preceptor evaluation of on-the-job performance as well as oral and written examinations. Data analysis showed small correlations among the three measurements of competence. (Author/LBH)

A virtual reality-based method of decreasing transmission time of visual feedback for a tele-operative robotic catheter operating system.

Science.gov (United States)

Guo, Jin; Guo, Shuxiang; Tamiya, Takashi; Hirata, Hideyuki; Ishihara, Hidenori

2016-03-01

An Internet-based tele-operative robotic catheter operating system was designed for vascular interventional surgery, to afford unskilled surgeons the opportunity to learn basic catheter/guidewire skills, while allowing experienced physicians to perform surgeries cooperatively. Remote surgical procedures, limited by variable transmission times for visual feedback, have been associated with deterioration in operability and vascular wall damage during surgery. At the patient's location, the catheter shape/position was detected in real time and converted into three-dimensional coordinates in a world coordinate system. At the operation location, the catheter shape was reconstructed in a virtual-reality environment, based on the coordinates received. The data volume reduction significantly reduced visual feedback transmission times. Remote transmission experiments, conducted over inter-country distances, demonstrated the improved performance of the proposed prototype. The maximum error for the catheter shape reconstruction was 0.93 mm and the transmission time was reduced considerably. The results were positive and demonstrate the feasibility of remote surgery using conventional network infrastructures. Copyright © 2015 John Wiley & Sons, Ltd.

Specific technological communication skills and functional health literacy have no influence on self-reported benefits from enrollment in the TeleCare North trial.

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Lilholt, Pernille Heyckendorff; Hæsum, Lisa Korsbakke Emtekær; Ehlers, Lars Holger; Hejlesen, Ole K

2016-07-01

The Danish TeleCare North trial has developed a telehealth system, Telekit, which is used for self-management by patients diagnosed with chronic obstructive pulmonary disease (COPD). Self-management is the engagement in one's own illness and health by monitoring and managing one's symptoms and signs of illness. The study examines the association between COPD patients' use of Telekit and their functional health literacy and the association between their use of Telekit and their specific technological communication skills. A consecutive sample of participants (n=60) from the TeleCare North trial were recruited. Face-to-face interviews were conducted with each participant to collect demographic data. Functional health literacy was measured with the Danish TOFHLA test. Participants completed a non-standardised questionnaire about their health status, their use of the Telekit system, and their specific technological communication skills. Binary logistic regressions were performed to examine how functional health literacy and specific technological communication skills influenced the use of Telekit by giving users an enhanced sense of freedom, security, control, and a greater awareness of COPD symptoms. Participants (27 women, 33 men) had a mean age of 70 (SD: 8.37) years. Functional health literacy levels were classified as inadequate in 14 (23%) participants, as marginal in 12 (20%), and as adequate in 34 (57%). Participants self-reported a feeling of increased security (72%), greater freedom (27%), more control (62%), and greater awareness of symptoms (50%) when using Telekit. The use of Telekit was not significantly associated with levels of functional health literacy or with the number of specific technological communication skills (p>0.05) based on the binary logistic regressions. The enhanced sense of security, freedom, control, and the greater awareness of COPD symptoms achieved by using Telekit were unassociated both with the patients' score of functional health

Case studies on clinical evaluation of biosimilar monoclonal antibody: scientific considerations for regulatory approval.

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Kudrin, Alex; Knezevic, Ivana; Joung, Jeewon; Kang, Hye-Na

2015-01-01

The objective of this paper is to provide considerations based on comprehensive case studies important for regulatory evaluation of monoclonal antibodies as similar biotherapeutic products (SBPs) with a special emphasis on clinical aspects. Scientific principles from WHO Guidelines on SBPs were used as a basis for the exercise. Working groups consisted of regulators, manufacturers and academia. The following topics were discussed by the working groups: clinical criteria for biosimilarity, extrapolation approach and the overall regulatory decision making process. In order to determine typical pitfalls in the design of a SBP clinical programme and evaluate the gap of knowledge, amongst different industry and regulatory stakeholders on the appraisal of the data arising from SBP clinical studies, we have presented two fictional but realistic clinical case studies. The first case consists of the fictional development programme for an infliximab SBP candidate. The second case describes clinical studies proposed for a fictional rituximab SBP candidate. In the first scenario a highly similar quality profile has been taken forward into clinical studies whereas there was an important residual difference in functional attributes for the rituximab SBP candidate. These case studies were presented at the WHO implementation workshop for the WHO guidelines on evaluation of similar biotherapeutic products held in Seoul, Republic of Korea, in May 2014. The goal was to illustrate the interpretation of the clinical data arising from studies with SBP candidates and elicit knowledge gaps in clinical assessment. This paper reflects the outcome of the exercise and discussions held in Seoul and offers an analysis of the case studies as a learning opportunity on clinical development and evaluation of SBPs. Copyright © 2014 The International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

[Discussion on development of four diagnostic information scale for clinical re-evaluation of postmarketing herbs].

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He, Wei; Xie, Yanming; Wang, Yongyan

2011-12-01

Post-marketing re-evaluation of Chinese herbs can well reflect Chinese medicine characteristics, which is the most easily overlooked the clinical re-evaluation content. Since little attention has been paid to this, study on the clinical trial design method was lost. It is difficult to improving the effectiveness and safety of traditional Chinese medicine. Therefore, more attention should be paid on re-evaluation of the clinical trial design method point about tcm syndrome such as the type of research program design, the study of Chinese medical information collection scale and statistical analysis methods, so as to improve the clinical trial design method study about tcm syndrome of Chinese herbs postmarketing re-evalutation status.

Comparative analysis of the results of echo- and roentgenography in children with pleuritides and pneumonia

International Nuclear Information System (INIS)

Zagorodskaya, M.M.; Antonova, R.A.; Kareva, E.A.; Gonchar, A.A.

1988-01-01

The methods of echography and roentgenography were used for examination of 170 children (74 with acute pneumonia, 52 with pneumonia and pleuritis and 44 with clinical suspicion of acute pneumonia) in order to study the potentialities of echocardography as a screening method for diagnosis of pneumonia. The results indicated that roentgenography was the chief and more reliable method thatechography, however the latter can substitute for it at some stages of investigation of patients over time decreasing total-body radiation exposure of patients

Clinical evaluation of mammography using a screen-film system. Pt. 3

International Nuclear Information System (INIS)

Wurm, J.; Behrends, E.; Hofmann-Preiss, K.; Paterok, E.M.; Saebel, M.; Weishaar, J.

1983-01-01

In a clinical image quality test, the parameter image quality is analysed using the ROC method and on the basis of mammograms already classified by means of histological findings into ''benign'' and ''malignant'' cases. The results of this analysis confirmed those of the first two studies: The screen-film system, due to its almost equally good image quality, achieves a diagnostic accuracy as good as the Definix test film without screen. In addition, the following two parameters have been investigated in this clinical test: Different knowledge and experience of the evaluating experts in the field of mammography, and the learning progress in the course of expert training. The difference in knowledge and experience of the various evaluators becomes apparent in ROC analysis only with an evaluator having much more experience than the others in the field of mammography. The parameter learning progress - as shown by repeating the evaluation after three months of intensive training - does not come forth clear enough in the ROC curves. An analysis of the frequency distribution of the five decision thresholds reveals the approach of the individual evaluator. (orig.) [de

Design and Realization of Call Center Module of Tele-Screening System for Diabetic Retinopathy%糖尿病性视网膜病变筛查系统呼叫中心模块设计与实现

Institute of Scientific and Technical Information of China (English)

谢慧; 余轮; 郑绍华; 陈健

2014-01-01

糖尿病性视网膜病变是导致眼病患者致盲的重要因素之一，定期的视网膜病变筛查对及时发现病变并治疗有很大的帮助，糖尿病性视网膜病变远程筛查是提高患者筛查依从性的一种有效方法，已经得到广泛认可。本文将对远程糖尿病性视网膜病变筛查系统进行分析，并且提出呼叫中心模块的系统设计方案。该模块由语音卡搭建，文中介绍了系统硬件架构，以及软件的实现。通过测试，本方案所构建的糖尿病性视网膜病变远程筛查呼叫中心模块能够很好地满足整个系统的功能要求，并且结构较为简单，通用性良好。%Diabetic retinopathy is one of main diseases which can lead to blindness. Regular screening for diabetic retinopathy is an effective way for the timely detection and treatment of diabetic retinopathy. Tele-screening for diabetic retinopathy will help patients to improve their screening compliance. Based on the analysis of the tele-screening system for diabetic retinopathy, this paper puts forward a design scheme of call center module which is established with phonic card for the system. This paper introduces the hardware architecture and software implementation of the call center module. The testing results showed that the call center module with simple structures and good generality can meet the functional requirements of the tele-screening system for diabetic retinopathy.

Portfolio assessment and evaluation: implications and guidelines for clinical nursing education.

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