Realtime transfer of live video images in parallel with three-dimensional modelling of the surgical field in computer-assisted telesurgery

We have carried out three-dimensional, computer-assisted, functional endoscopic sinus telesurgery. Surgeons at different locations up to 300 km apart could not only see and transfer video images but also transfer three-dimensional computer models and manipulate them in realtime during surgery. Two different approaches were used. In the first telesurgery procedure we used M-JPEG compression and transmitted the data using fibre optic connections (ATM OC-3) at a bandwidth of 155 Mbit/s. In the second telesurgery procedure video images were transmitted over four E1 digital lines, amounting to about 8 Mbit/s of bandwidth, with better compression standards, such as MPEG1 and 2. We found that MPEG2 video compression produced the best picture quality for the operating field and endoscopic cameras. For conferencing and consultation between two or more connected sites during the surgery, we used JPEG and MPEG1 video compression with audio. The main feature of our three-dimensional telesurgery was the use of three-dimensional modelling of the operative field. This is important for emergency surgical interventions. We do not advocate that inexperienced surgeons operate on patients, not even with the guidance of a remote surgeon. However, three-dimensional telesurgery may become very valuable for experienced surgeons in the future.     

Creating an animation-enhanced video library of hepato-pancreato-biliary and transplantation surgical procedures

The potential for integrating real-time surgical video and state-of-the art animation techniques has not been widely applied to surgical education. This paper describes the use of new technology for creating videos of liver, pancreas and transplant surgery, annotating them with 3D animations, resulting in a freely-accessible online resource: The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery (http://tvasurg.ca). The atlas complements the teaching provided to trainees in the operating room, and the techniques described in this study can be readily adapted by other surgical training programmes.     

Use of an innovative video feedback technique to enhance communication skills training

CONTEXT: Despite growing interest in medical communication by certification bodies, significant methodological and logistic challenges are evident in experiential methods of instruction. OBJECTIVE: There were three study objectives: 1) to explore the acceptability of an innovative video feedback programme to residents and faculty; 2) to evaluate a brief teaching intervention comprising the video feedback innovation when linked to a one-hour didactic and role-play teaching session on paediatric residents' communication with a simulated patient; and 3) to explore the impact of resident gender on communication change. DESIGN: Pre/post comparison of residents' performance in videotaped interviews with simulated patients before and after the teaching intervention. Individually tailored feedback on targeted communication skills was facilitated by embedding the Roter Interaction Analysis System (RIAS) within a software platform that presents a fully coded interview with instant search and review features. SETTING/PARTICIPANTS: 28 first year residents in a large, urban, paediatric residency programme. RESULTS: Communication changes following the teaching intervention were demonstrated through significant improvements in residents' performance with simulated patients pre and post teaching and feedback. Using paired t-tests, differences include: reduced verbal dominance; increased use of open-ended questions; increased use of empathy; and increased partnership building and problem solving for therapeutic regimen adherence. Female residents demonstrated greater communication change than males. CONCLUSIONS: The RIAS embedded CD-ROM provides a flexible structure for individually tailoring feedback of targeted communication skills that is effective in facilitating communication change as part of a very brief teaching intervention.     

Does an informative video before inguinal hernia surgical repair influence postoperative quality of life? Results of a prospective randomized study

Purpose Patients undergoing surgery can be impaired in several health-related quality of life areas. As a result, a modern and effective presentation of medical information before elective surgery is of great importance. Thorough preoperative education of the patient could possibly lead to an improvement of postoperative quality of life. Materials and methods In a prospective randomized study we examined the influence of a preoperative informative video on the postoperative quality of life of patients undergoing elective surgery for inguinal hernia. Quality of life was assessed with a short form questionnaire (SF-36) preoperatively, on the first postoperative day and 3, 6, and 12 months after surgery. Results From January 2004 until January 2005, 100 patients were included in the study (video group n = 50 patients, control group n = 50 patients). Quality of life was measured higher in the video group soon after surgery and until 3 months afterwards. In the same group other aspects evaluated such as “global health” and “social role” showed higher values postoperatively and resumption of preoperative activities took place earlier. No difference was detectable 6 months after surgery. Conclusion Informative video presents a modern and cost-effective method for the justified and detailed education of the patient about the several pre-, intra-, and postoperative steps of an elective groin hernia operation. The higher information level and the better conditions of surgical care, as the patients perceive these, lead to a better postoperative quality of life.     

Consumer evaluation of hospital foodservice quality: an empirical investigation

PURPOSE: The purpose of this article is to estimate the relationship between acute care consumers' satisfaction with hospital foodservices, foodservice characteristics, demographic and contextual variables. DDESIGN/METHODOLOGY/APPROACH: The acute care hospital foodservice patient satisfaction questionnaire was administered to 2347 patients in Queensland, Australia from 1996-2001. Regression analysis was conducted to measure the influence of 21 foodservice attributes and seven contextual/demographic items on overall foodservice satisfaction. FFINDINGS: Foodservice satisfaction was strongly associated with variety, flavour, meat texture, temperature, meal taste, and menu staff (p < 0.01). Consumers aged 70 years or more rated their overall satisfaction significantly lower than younger consumers (p < 0.01), but no statistically significant differences in overall ratings existed for other contextual or demographic groups. RESEARCH LIMITATIONS/IMPLICATIONS: This new foodservice instrument and the methods of analysis may be generalisable, but application is likely to be context-specific. Further applications of the instrument are required to produce greater confidence in its validity and reliability across different foodservice settings. PRACTICAL IMPLICATIONS: Global statements often used in health service satisfaction surveys (e.g. a single rating of "food quality") provide insufficient information to allow managers to adapt foodservices to suit consumers' preferences. ORIGINALITY/VALUE: Detailed information of the kind produced here is required for the formulation of managerial and sectoral policies to improve the quality of health and consumer nutrition care. The findings are noteworthy and, as far as the literature review showed, no previously published study has produced this level of detail on consumer preferences across foodservice attributes or their relationship to overall foodservice satisfaction.     

登革热网络教育游戏作品的形成评价

目的 探索性了解特定的网民通过网络游戏获取健康知识的需求现况,以及对登革热教育游戏作品的接受程度,为健康教育游戏作品的设计、修订和传播提供依据.方法 采用立意抽样和方便抽样在广州市的学生和办公人员中开展需求评估,用SWOT分析法分析登革热教育游戏作品的设计的环境;作品设计完成后通过网络进行预试验,观察教育前后登革热知识知晓水平的变化情况和游戏满意度.结果 327名需求评估对象中47.1％的人愿意通过玩网络游戏了解健康知识;适宜设计的教育游戏形式为网页单机游戏;312人预试验结果显示游戏后预防登革热相关知识知晓率合计提高9.2％,游戏满意度达到80.0％.结论 近半数的调查对象对网络游戏形式的健康教育有需求,预期利用本项目设计的网页单机游戏开展传播能较好地提高登革热预防的知晓水平.     

Aerobic residential onsite sewage systems: an evaluation of treated-effluent quality

This retrospective cohort study used existing data to evaluate the quality of effluent from three of the most common types of onsite residential aerobic treatment sewage systems (Multi-Flo, Norweco, and Whitewater) installed in Kitsap County, Washington. Five-day biochemical oxygen demand (BOD5), total suspended solids (TSS), and fecal-coliform-bacteria parameters were used to determine performance. Although most (77 percent) of the systems were less than one year old at the time of sampling, over a third failed to meet NSF certification standards for BOD5 and TSS in effluent (< 30 milligrams per liter [mg/L]). Over two-thirds of systems failed to meet Washington State Board of Health Treatment Standard 2 criteria for BOD5 and TSS (< 10 mg/L). Furthermore, an average of 59 percent of the systems failed to meet state standards for fecal coliform (< 800 fecal coliform bacteria per 100 milliliters).     

The Cleveland Health Quality Choice Program: an evaluation of quality

The Cleveland Health Quality Choice Program, since early in its inception, has taken advantage of the unique relationship between the purchasers of health care and the providers. Regardless of the outcome of this endeavor, a collaboration has been established between the two and among the medical community involved in this program--a collaboration that the Cleveland community hopes to maintain in the future. Picture it...the business and medical communities sitting down at one table and coming to a consensus on various issues...quite an accomplishment in itself.     

基于4I理论的科普期刊网络直播营销策略探究

【目的】 基于4I理论探索科普期刊网络直播营销的策略。【方法】 以文献研究、案例分析方法为主,构建以内容为王、利益双赢、参与互动、优化体验为主的科普期刊网络直播营销模型,基于此管窥科普期刊网络直播营销发展中存在的问题,并探索科普期刊开展网络直播营销的策略。【结果】 目前科普期刊网络直播营销中存在的主要问题包括营销内容单一、营销互动较少、营销模式单一、营销个性化服务有待于提升。【结论】 基于4I理论提出科普期刊网络直播营销策略：深度挖掘用户需求,以趣味性知识进行引流;深化利益双赢意识,以实现用户价值为导向;深耕用户互动机制,善用多样化营销模式;深入开展个性化服务,以强化期刊直播营销效果。     

Clinical evaluation of mastication: validation of video versus electromyography

BACKGROUNDS AND AIMS: The ability to evaluate masticatory function in people with neurological disabilities is important as this function is often compromised in these groups. However, current standard techniques are often impossible in such groups due to cognitive difficulties. This study is a validation of several variables read from standardised video recordings of mastication as indicators of masticatory function. METHODS: Fifteen healthy, fully dentate male subjects were recorded using EMG and by video simultaneously. An evaluation was undertaken of the video parameters (i) to compare their validity against the electromyographic parameters, (ii) to test intra-rater and inter-rater reliability and (iii) to test the ability to discriminate between four model foods differing in hardness. RESULTS: Masticatory time and the number of masticatory cycles counted on video were found to be valid and reliable indicators. In addition, the number of active chewing cycles performed with an open mouth and identification of the chewing side, were found to have reasonable validity and reliability. The former may allow discrimination between food types. CONCLUSION: As an alternative to the complex evaluation of masticatory function, observation of certain parameters from video recording could be an alternative for use in uncooperative patients.