Development of a computer-assisted learning software package on dental traumatology

The development of computer-assisted learning software packages is a relatively new field of computer application. The progress made in personal computer technology toward more user-friendly operating systems has stimulated the academic community to develop computer-assisted learning for pre- and postgraduate students. The ability of computers to combine audio and visual data in an interactive form provides a powerful educational tool. The purpose of this study was to develop and evaluate a computer-assisted learning package on dental traumatology. This program contains background information on the diagnosis, classification, and management of dental injuries in both the permanent and the deciduous dentitions. It is structured into chapters according to the nature of the injury and whether injury has occurred in the primary or permanent dentition. At the end of each chapter there is a self-assessment questionnaire as well as references to relevant literature. Extensive use of pictures and video provides a comprehensive overview of the subject.     

Non-verbal affective communication as a factor in psychotherapy.

Examines aspects of general and specific factors in psychotherapy as they relate to interpersonal variables identified in analytic literature and in empirical research. It is suggested that 1 of the reasons why interpretation of the research concerning the role of empathy and understanding in the successful patient–therapist relationship is difficult and the results unclear is that many aspects of the interpersonal environment are more subtle and complex than existing research implies. Therapists of many persuasions who wish to enhance the effectiveness of psychotherapy may need to examine some of the less obvious aspects of the therapeutic environment. Evidence suggests that nonverbal affective interactive states are important as change producing agents. Even when specific techniques are applied, emotional aspects of the therapeutic relationship may have a powerful effect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gynaecological examination: a teaching package integrating assessment with learning (693)

Race and gender are important determinants of certain clinical outcomes in cardiovascular disease. To examine the influence of race and gender on care process, resource use, and hospital-based case outcomes for patients with congestive heart failure (CHF), we obtained administrative records on all 1995 New York State hospital discharges assigned ICD-9-CM codes indicative of this diagnosis. The following were compared among black and white women and men: demographics, comorbid illness, care processes, length of stay (LOS), hospital charges, mortality rate, and CHF readmission rate. We identified 45,894 patients (black women, 4,750; black men, 3,370; white women, 21,165; white men, 16,609). Blacks underwent noninvasive cardiac procedures more often than whites; procedure and specialty use rates were lower among women than among men. After adjusting for other patient characteristics and hospital type and location, we found race to be an important determinant of LOS (black, 10.4 days; white, 9.3 days; p = 0.0001), hospital charges (black, $13,711; white, $11,074; p = 0.0001), mortality (black-to-white odds ratio = 0.832; p = 0.003), and readmission (black-to-white odds ratio = 1.301; p = 0.0001). Gender was an important determinant of LOS (women, 9.8 days; men, 9.2 days; p = 0.0001), hospital charges (women, $11,690; men, $11,348; p = 0.02), and mortality (women-to-men odds ratio = 0.878; p = 0.0008). We conclude that race and gender influence care process and hospital-based case outcomes for patients with CHF.     

Epidemiology training for primary health care: the use of computer-assisted distance learning

The Liverpool Epidemiology Programme, based in the Liverpool School of Tropical Medicine, has designed a series of computer-based modules for use in distance learning. The purpose of this paper is to highlight the role of computers in training health workers in epidemiology in developing countries. The aim of the modules is to provide health workers with solutions to problems which they face in their everyday work. The modules are written in hypertext software for IBM compatible machines and interact with the epidemiological software Epi Info. Four modules are described: LEP-Nut which deals with nutritional surveillance, LEP-Ref which looks at the role of epidemiology within a refugee health care programme, LEP-Surv dealing with health surveillance and LEP-Rap which introduces the concept of rapid appraisal. They are also easily distributed, particularly with the development of the Internet. The modules are carefully evaluated before and after distribution. Issues related to their evaluation and subsequent revision are discussed, in particular is the content important, adequate, communicated and useful? A major advantage of computer-based learning materials is that they can be easily updated with new advancements of knowledge and experience from the field.     

Improved ankle function in children with cerebral palsy after computer-assisted motor learning

The effect of biofeedback training on ankle function was studied in young children with cerebral palsy (CP) during a pilot study and a 6-week follow-up study. Patients underwent range of motion (ROM) and ankle dorsiflexor (DF) strength training in a laboratory 3 days per week, receiving auditory and visual feedback. An at-home programme used portable EMG units to help train DF muscle recruitment on the remaining days. Independent outcome measures included DF strength, active ROM, and tapping ability pretraining and 6 weeks and 14 months posttraining. Tapping ability increased significantly in the trained leg posttraining. It then fell significantly at the 6-weeks posttraining test, but remained significantly higher than pretest levels, and returned to pretraining levels by 14 months. Passive ROM was unchanged, but active ROM increased significantly in the trained leg. DF strength increased in most children posttraining in both the pilot and main study. Increased motor-unit recruitment is believed to explain the increases in DF strength and active ROM. These results suggest that biofeedback training can improve ankle function, and the implications for gait are discussed.     

EEG-based communication: evaluation of alternative signal prediction methods

Individuals can learn to control the amplitude of EEG activity in specific frequency bands over sensorimotor cortex and use it to move a cursor to a target on a computer screen. For one-dimensional (i.e., vertical) cursor movement, a linear equation translates the EEG activity into cursor movement. To translate an individual's EEG control into cursor control as effectively as possible, the intercept in this equation, which determines whether upward or downward movement occurs, should be set so that top and bottom targets are equally accessible. The present study compares alternative methods for using an individual's previous performance to select the intercept for subsequent trials. In offline analyses, five different intercept selection methods were applied to EEG data collected while trained subjects were moving the cursor to targets at the top or bottom edge of the screen. In the first two methods-moving average, and weighted sum-a single intercept was selected for the entire 1-2 sec period of each trial. In the other three methods-blocked moving average, blocked weighted sum, and blocked recursive sum (a variation of the weighted sum)-an intercept was selected for each 200-ms segment of the trial. The results from these methods were compared in regard to their balance between upward and downward movements and their consistency of performance across trials. For all subjects combined, the five methods performed similarly. However, performance across subjects was more consistent for the moving average, blocked moving average, and blocked recursive sum methods than for the weighted sum and blocked weighted sum methods. Due to its consistent performance and its computational simplicity, the moving average method, using the five most recent pairs of top and bottom trials, appears to be the method of choice.     

Learning voice analysis using an interactive multi-media package: development and preliminary evaluation

An important outcome of education for speech-language pathology practice is the ability to analyze voices perceptually, a complex task that is often difficult for novices. This article describes an interactive multi-media package, "A Sound Judgement," that is designed to help students develop skills in perceptual voice analysis and to link their perceptions to laryngeal physiology. The package presents a range of clients with vocal impairments at increasing levels of complexity. Each case has a videoed interview, endoscopic views and animations of the larynx, and case history information. Students make perceptual ratings of clients' voices on a format designed specifically for this package and feedback is provided using ratings made by expert speech-language pathologists. High levels of consensus for the perceptual judgments were achieved among the expert raters. Preliminary evaluations by students have demonstrated that "A Sound Judgement" is likely to be a valuable educational tool.     

Sex role learning and interview communication.

In a study with 32 female undergraduates, Ss who differed on a measure of parental identification discussed public and private areas of experience during dyadic interviews. Supporting the assumption that fathers are crucial to the expressive-role development of daughters, Ss who identified primarily with their father rather than with their mother were more personally disclosing overall and talked longer and maintained greater spontaneity on private topics. Contrary to expectation, daughters who identified with conventional-role parents vs sex-role reversed parents did not differ in expressive behaviors. Daughters who modeled after conventional-role mothers were least expressive with their interviewer, however. Implications of sex role identification in the counseling relationship are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evaluation of normal corneal topography in emmetropic eyes with computer-assisted videokeratography

Positron emission tomography (PET) has been widely used in the study of stroke and related cerebrovascular diseases. It has shown the various stages leading to cerebral infarction and defined the significance of the ischaemic penumbra. PET scan can predict the clinical outcome of patients with acute ischaemic stroke. Several types of diaschisis can also be demonstrated by PET. They reflect different pathophysiological changes in supratentorial infarcts. Post-apoplectic seizures are shown to increase the ischaemic damage in the affected cerebral hemisphere. PET has contributed also to the concept of multi-infarct dementia, although the significance of chronic ischaemia in the pathogenesis of vascular dementia has not been fully investigated.     

Development and evaluation of a learning strategy training program.

Developed an interactive learning strategy system consisting of primary and support strategies. A set of training procedures was also created to facilitate the communication of this system to college-age students. This system was assessed in the context of a 15-wk (2 hrs/wk) learning skills course with 108 Ss. Results indicate that Ss receiving this training exhibited (p?     

Group learning and communication as a function of task and structure "demands."

"Left to themselves under constant situational pressures, groups modify their behavior at a characteristic rate which is independent of the demands placed on them. However, depending on the nature of the task, a given rate of behavior modification may have different consequences for the rate of improvement in some performance criterion such as errors." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accreditation of prior learning: is it worth it? An evaluation of a pilot scheme

A health-related mailed survey was conducted to investigate the effect of follow-up mailings to response rates. In addition, the answer distributions among early and late respondents were compared to check non-response bias. Approximately 3,000 persons aged 40-64 were randomized into two groups; a questionnaire with four pages (twenty-two questions) was assigned to the first group, and a questionnaire with eight pages (thirty-five questions) to the second group. Both questionnaires contained questions of current health status, health-related practice, smoking status, etc. Follow-up mailings were sent twice to non-respondents. Response rates were increased from 38% to 62% by the first follow-up mail, and to 71% by the second follow-up mail. Although the length of the questionnaire did not affect response rates, response rates among the older subjects was higher than the younger subjects. Positive response to current smoking status was 10% lower among early respondents than late respondents, collected after the second follow-up mailing, and response to regular participation in physical/medical checkup was 15% higher among early respondents, whereas there were few differences for answers to other questions. Odds ratios between current health status and several health-related questions may not be biased by late response. However, increased response rates are needed to prevent non-response bias, because there were some differences in responses from follow-up mailings.     

Using ARROWSMITH: a computer-assisted approach to formulating and assessing scientific hypotheses

The usefulness of Xe-133 and Tc-99m-MAA single photon emission computed tomography (SPECT) in identifying areas to be resected during video-assisted thoracoscopic lung reduction surgery for emphysema was examined. Twenty-nine patients with advanced emphysema were examined using Xe-133 and Tc-99m-MAA SPECT prior to and following surgery. For the Xe-133 dynamic SPECT, patients inhaled Xe-133 gas for 6 minutes. Equilibrium and subsequent washout SPECT images were acquired every 30 seconds for 6 to 7 minutes during spontaneous breathing. Ventilation was quantified by Xe-133 clearance time (T1/2) in addition to visual assessment. The patients underwent unilateral thoracoscopic volume reduction in the regions with abnormal Xe-133 retention and Tc-99m-MAA defect. All patients demonstrated marked, heterogeneous Xe-133 retention and Tc-99m-MAA defects preoperatively. The worst functioning areas were identified as nonventilated and noflow areas, or areas with air trapping and low perfusion. These changes were found even in patients with diffuse and symmetrical impairments on chest CT. After surgery, most of these "target areas" disappeared and pulmonary function tests demonstrated significant improvement. T1/2 correlated closely with the percent predicted FEV1 (%FEV) and 6-minute walk distance before and after surgery (p<0.0001). Xe-133 and Tc-99m-MAA SPECT imaging was useful in identifying "target areas" in the emphysematous lung. Directed unilateral thoracoscopic volume reduction based on these SPECT images is an effective treatment for emphysema.     

The policy & procedure manual: development of a computer-assisted process for review

This article documents the successful development of a computer-assisted process for systematic review of nursing policies and procedures at The Queen Elizabeth Hospital, Toronto, Ontario. Through broad staff input, policies and procedures are research-based yet grounded in the reality of the facility's nursing practice. Client-related standards are written as measurable, realistic statements of desired client outcomes, and as such are standards for client care. Policies and procedures have been rated according to the Canadian Council on Health Facilities Accreditation criteria (client centered, high risk, high volume, problem prone, interservice, outcome-related), so that important policies are easily identified to provide focus for quality assurance activities. The review process is structured so that over the course of a year, all policies are circulated for review by all levels of nursing staff.     

The effects of computer-assisted versus teacher-directed instruction on the multiplication performance of elementary students with learning disabilities

Relationships between leader behavior and subordinate work stress were examined from the perspectives of 343 leaders, their bosses, and their subordinates. Leader behaviors did relate to stress experienced by staff; however, leaders' views of what related to subordinate stress did not always coincide with the factors that subordinates themselves associated with stress. The relationships of leader delegation and subordinate participation to lower subordinate reports of stress were particularly underestimated by leaders. Implications for developing leaders as agents for employee stress reduction are discussed.     

SAMSON: a software package for the biopolymer primary structure analysis

One hundred and twenty seven patients belonging to Neurosurgery (49), Neuromedicine (48), Cardiac medicine (30) wards and Blood donors (30) as healthy controls were investigated for the prevalence of Toxoplasmosis by means of detecting specific IgM antibody against Toxoplasma gondii (T. gondii) employing Enzyme Immuno Assay (EIA). The detection rate of specific IgM antibody against T.gondii was found to be 32.7% (16/49) among Neurosurgery patients, 20.8% (10/48) among Neuromedical patients and 20% (6/30) among Cardiac medical patients. None of the voluntary blood donors tested was found to have T. gondii IgM antibody. Maximum prevalence rate was found among female patients undergoing Neurosurgery (42.3%) followed by Neuromedical patients (40%). There is an increasing rate of prevalence of Toxoplasmosis from the lower age group upto thirty years and a declining prevalence rate among the higher age groups. The present study revealed high prevalence rate of Toxoplasmosis in Neurosurgery patients (32.7%) and in particular among female (35.2%) than male (17.8%) patients.     

Prostate surgery: a communication challenge

Many patients requiring prostate surgery experience a lack of interest from health-care staff in relation to their views and opinions. Information offered to patients who have undergone prostate surgery is often inadequate as a result of poor communication by health staff. Nurses need to understand the priorities of their patients and use this information to inform the way in which advice is given.     

Referential communication and reading performance in learning disabled children over a 3-year period.

Examined the ability of 30 learning disabled (LD) and 30 non-LD (NLD) 6- and 7-yr-olds to understand a sequence of instructions, communicate the steps in a sequence to others, and rephrase their verbal messages across a 3-yr period using a referential communication task. In order to perform the puzzle-box task correctly, Ss had to execute 6 steps in an invariant sequence. After Ss demonstrated a perfect nonverbal enactment of the sequence, they were asked to communicate all information about how to open the box to a puppet. Upon completion, the puppet feigned poor memory and asked the Ss to explain the step-by-step process again. Subsequently, the puppet requested that Ss rephrase their explanation of each step by either a verbal or nonverbal rephrase request. Results reveal that LD children differed from NLD peers consistently on referential communication over the 3-yr period in terms of listener competence and speaker competence. For LD Ss, the ability to produce competent verbal messages was highly related to reading comprehension both concurrently and 3 yrs later. By the 3rd yr, NLD Ss were better able to rephrase information, indicating a growing awareness of the speaker's responsibility in communication. Findings suggest that the communication measures studied play very different roles for LD and NLD Ss with regard to reading achievement. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)