A Survey of the Sources and Availability of Computer Software Applicable to Psychophysiological Research in the Periodical Literature

PP-T0003-0-I The increased usage of small computers in the research laboratory has made it necessary for the individual investigator to become familiar with computer science. A survey of sources, availability, and types of information distributed about computer software was made to determine their relevance to psychophysiology. Periodicals are divided into five classes and discussed as to the assets and liabilities of some of the present indexing and source references. The desirability of increasing the accessibility of software applications to psychophysiology is noted.     

The Use of Digital Techniques in Psychophysiological Research

PP-T-0014-0-I The development of digital techniques has enabled the psychophysiologist to extend the range and complexity of his experiments. The functioning of digital devices can be divided into four aspects, namely: 1) data acquisition, 2) data storage, 3) data analysis, and 4) data output. The principles underlying these techniques are outlined, the most fundamental step being the conversion of the analog signal to the digital value. Digital instruments in psychophysiology are reviewed including the data logger, the instrumentation-coupler, the special purpose computer, and the general purpose laboratory computer. The authors' experience with laboratory computers is described and the great flexibility of these devices in psychophysiological research is stressed.     

Examining gender specificity of sexual response with concurrent thermography and plethysmography

Men's genital responses are significantly greater to sexual stimuli of their preferred gender compared to their nonpreferred gender (gender‐specific), whereas androphilic (i.e., sexually attracted to men) women's genital responses are similar to sexual stimuli depicting either women or men (gender‐nonspecific). This gendered pattern of genital response has only been demonstrated using vaginal photoplethysmography (VPP) in women and primarily penile plethysmography (PPG) in men. These measures assess different aspects of genital vasocongestion, thereby limiting comparisons between genders. Thermography is a newer sexual psychophysiology methodology that measures genital vasocongestion via temperature change and is better suited to assess sexual response between genders because the dependent measure, change in genital temperature, is similar for women and men. Further, previous studies have assessed gender specificity of sexual response across relatively short sexual stimuli, allowing only the examination of initial phases of sexual response. We examined gender specificity of sexual arousal by measuring women's and men's genital responses to lengthier stimuli with concurrent thermography and VPP/PPG. Gynephilic men (i.e., sexually attracted to women; n = 27) and androphilic women (n = 28) viewed 10‐min films depicting men masturbating, women masturbating, and a nonsexual film, and reported feelings of sexual arousal while genital responses were assessed. Across measures, men's sexual responses were gender‐specific and women's responses were gender‐nonspecific, indicating that the gender difference in gender specificity of arousal is robust to methodology and stimulus duration. These findings replicate previous research, extend knowledge of gendered sexual response, and highlight the utility of multimethod approaches in sexual psychophysiology.     

Sources of error in computerized neuropsychological assessment

Computerized neuropsychological assessment has integrated slowly into research and practice since the introduction of the personal computer. Though initial integration of technology to the laboratory and clinical setting utilized specialized hardware and software, newer generation assessment tools are integrated with “off-the-shelf” operating systems. Further, neuropsychological assessment is beginning to find Internet-based application for remote assessment. As these applications are more broadly applied, it is essential to understand potential errors that can be created both in test administration and in reaction time measurement due to hardware and software interactions. In this article, user considerations are specifically addressed for resident and Internet-enabled assessment software. Potential hardware and software conflicts are defined and potential remediation is suggested. Computerized assessment is a valuable tool for neuropsychologists as long as it is used responsibly with an understanding of the potential technical complications.     

A microcomputer-controlled cardiac stimulator

Detailed investigation of abnormal heart rhythms requires electrical stimulators that can deliver sophisticated sequences of stimuli to the heart under controlled laboratory conditions. A dual-channel stimulator that provides an appropriate hardware interface between a controlling microcomputer and the patient is described. The computer gives the system power and flexibility and, most importantly, provides a suitable user interface. The hardware interface is designed to have an ergonomic division between set-up and run-time tasks. Both software and hardware are discussed, and clinical examples of typical usage of the stimulator are given.     

Physical, Physiological, and Psychological Factors That Affect Pain Reaction to Electric Shock

This paper reviews a number of years of comprehensive research in the use of electric shock as a pain stimulus in the psychophysiology laboratory. The development of a standard stimulation technique is described. Studies involving the use of this procedure to investigate psychological, physiological, and clinical factors that affect the evaluation of pain are discussed. Cultural and behavioral influences on pain tolerance are investigated and physiological response measures tested. Possible clinical applications are studied, and special consideration is given to the psychophysical evaluation of the sensory and connotative components of the pain experience.     

Engineering psychophysiology: Issues and applications, edited by Richard W. Backs and Wolfram Bousein. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 2000. 385 pp.

Advancing technology changes the very nature of the world in which we interact. Often these changes introduce unintended stresses and strains on the individual attempting to interact with this new technology. The objective of this 17-chapter edited volume is to promote engineering psychophysiology as a discipline that uses a variety of psychophysiological measures to understand and potentially improve the nature of our interactions in the real world. The target audience for the book is the researcher who is new to the use of psychophysiological measures in engineering applications.     

Psychophysiology at the Interface of Clinical Science, Cognitive Science, and Neuroscience

Research in schizophrenia illustrates that the field of psychophysiology lies at the interface of clinical science, cognitive science, and neuroscience. Electrodermal abnormalities in schizophrenic patients have been found reliably across laboratories, and data reported here demonstrate that these abnormalities are at least partially dependent upon the clinical state of the patients. Both tonic and phasic electrodermal activity increased when schizophrenic patients entered into a psychotic episode, and preliminary evidence suggests that the increases may serve as early prodromal signs of an impending episode. Significance of the electrodermal abnormalities for understanding cognitive and attentional deficits is suggested by associations with secondary reaction time and startle blink probe findings. Neuroscience implications are highlighted by the correlation of the electrodermal abnormalities with regional brain metabolic activity indexed by positron emission tomography. An important task for the future is to interrelate measures from these various domains. The field of psychophysiology is particularly well positioned for this task.     

Heart rate variability: Origins, methods, and interpretive caveats

Components of heart rate variability have attracted considerable attention in psychology and medicine and have become important dependent measures in psychophysiology and behavioral medicine. Quantification and interpretation of heart rate variability, however, remain complex issues and are fraught with pitfalls. The present report (a) examines the physiological origins and mechanisms of heart rate variability, (b) considers quantitative approaches to measurement, and (c) highlights important caveats in the interpretation of heart rate variability. Summary guidelines for research in this area are outlined, and suggestions and prospects for future developments are considered.     

Norwegians GPs’ use of electronic patient record systems

Objective

To evaluate GPs use of three major electronic patient record systems with emphasis on the ability of the systems to support important clinical tasks and to compare the findings with results from a study of the three major hospital-wide systems.

Methods

A national, cross-sectional questionnaire survey was conducted in Norwegian primary care. 247 (73%) of 338 GPs responded. Proportions of the respondents who reported to use the EPR system to conduct 23 central clinical tasks, differences in the proportions of users of different EPR systems and user satisfaction and perceived usefulness of the EPR system were measured.

Results

The GPs reported extensive use of their EPR systems to support clinical tasks. There were no significant differences in functionality between the systems, but there were differences in reported software and hardware dysfunction and user satisfaction. The respondents reported high scores in computer literacy and there was no correlation between computer usage and respondent age or gender. A comparison with hospital physicians’ use of three hospital-wide EPR systems revealed that GPs had higher usage than the hospital-based MDs. Primary care EPR systems support clinical tasks far better than hospital systems with better overall user satisfaction and reported impact on the overall quality of the work.

Conclusion

EPR systems in Norwegian primary care that have been developed in accordance with the principles of user-centered design have achieved widespread adoption and highly integrated use. The quality and efficiency of the clinical work has increased in contrast to the situation of their hospital colleagues, who report more modest use and benefits of EPR systems.     

Knowledge-based systems in laboratory medicine and pathology. A review and survey of the field

Knowledge-based systems are computer systems designed to handle knowledge-intensive tasks, usually involving reasoning and inference. They are increasingly being applied to problems in laboratory medicine and pathology. In this article we provide a brief introduction to the basic concepts of knowledge-based systems, review some of their published applications, and report on an informal survey of specialists in laboratory medicine and pathology. The survey, sent to 102 individuals, indicated that 24% were involved in developing knowledge-based systems, with most systems at an early stage of development. Recent advances in knowledge-based systems research as well as survey responses suggest that this technology will have increasing value in laboratory medicine and pathology.     

Technical note: Rationale, development, use and evaluation of an equipment management and image storage system

Lack of space and organization have become significant problems in the contemporary business world. Modern industries must eliminate mountains of paper and better organize themselves. With the incorporation of a fully automated equipment management system and image storage system, the Jacobi Medical Center has succeeded in correcting these problems. This technical note shows how the use of computer software and hardware components can be integrated to manage electronic patient care equipment. The adoption of this new technology was applied to equipment maintenance, tracking and record-keeping, thereby accomplishing the aims of space conservation and organization. As the components became more advanced, the technology included computer software products that could store more information and electronically effect a more rapid document retrieval. This will eventually allow for a paperless operation. The latest available equipment management software is supported by an image storage system that may contain important signature documents and outside vendor information. The applicability of these systems to the biomedical engineering field is obvious: (a) space efficiency eliminates folders and files; (b) simultaneous technician access to equipment history; and (c) rapid archive retrieval of data as well as vendor information and safety alerts.     

Cone-Beam Micro-CT System Based on LabVIEW Software

Construction of a cone-beam computed tomography (CBCT) system for laboratory research usually requires integration of different software and hardware components. As a result, building and operating such a complex system require the expertise of researchers with significantly different backgrounds. Additionally, writing flexible code to control the hardware components of a CBCT system combined with designing a friendly graphical user interface (GUI) can be cumbersome and time consuming. An intuitive and flexible program structure, as well as the program GUI for CBCT acquisition, is presented in this note. The program was developed in National Instrument’s Laboratory Virtual Instrumentation Engineering Workbench (LabVIEW) graphical language and is designed to control a custom-built CBCT system but has been also used in a standard angiographic suite. The hardware components are commercially available to researchers and are in general provided with software drivers which are LabVIEW compatible. The program structure was designed as a sequential chain. Each step in the chain takes care of one or two hardware commands at a time; the execution of the sequence can be modified according to the CBCT system design. We have scanned and reconstructed over 200 specimens using this interface and present three examples which cover different areas of interest encountered in laboratory research. The resulting 3D data are rendered using a commercial workstation. The program described in this paper is available for use or improvement by other researchers.     

Operational, analogical and genuine definitions of psychophysiology

The reason for considering definitional issues is not that of arriving at a universally agreed-to definition, but rather that of illuminating scientific disagreements. From this viewpoint it will be argued that operational and analogical definitions which have been offered by psychophysiology are not useful, because they do not permit the settling of disputes on objective grounds. Those grounds are relevant only for genuine definitions, which can be tested in terms of the counter-example argument in general, and in particular in terms of whether they adequately differentiate psychophysiology from the closely related but diffent area of physiological psychology. One such genuine but inadequate definition is that offered by Stern (1964), which differentiates the two areas in terms of the dependent and independent variables being, respectively, manipulated and measured. The definition offered here is in terms of the interests of the investigator, and is that psychophysiology is the study of psychological processes in the intact organism as a whole by means of unobtrusively measured physiological processes. I shall argue that this definition more adequately differentiates psychophysiology from physiological psychology than does Stern's definition. In addition, I shall suggest that adopting this definition does not isolate the two areas from one another, but rather brings them into a more scientifically meaningful relationship. Finally, I shall illustrate, with some examples, how (implicity adopted) definitions that are different from the proposed one here lead to substantive differences in both the conduct and evaluation of research in psychophysiology. Definitional issues, in other words, are not only of relevance for ivory-tower, armchair philosophers. They affect not only the practice of empirical basic research, but also applied practice.     

The computer at the pathologist's laboratory

Computers are coming into practical use by pathologists. The computer hardware and software are briefly outlined. The software is discussed while drawing up protocols on the examination of biopsies, operative materials and autopsies. A special attention is given to the SNOP and SNOMED coding of diagnoses. How to operate on a computer is described in the paper. The latter provides evidence for applying the computer to the formulation of laboratory documents.     

Cost Savings Realized by Implementation of Routine Microbiological Identification by Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

Matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) mass spectrometry (MS) is an emerging technology for rapid identification of bacterial and fungal isolates. In comparison to conventional methods, this technology is much less labor intensive and can provide accurate and reliable results in minutes from a single isolated colony. We compared the cost of performing the bioMérieux Vitek MALDI-TOF MS with conventional microbiological methods to determine the amount saved by the laboratory by converting to the new technology. Identification costs for 21,930 isolates collected between April 1, 2013, and March 31, 2014, were directly compared for MALDI-TOF MS and conventional methodologies. These isolates were composed of commonly isolated organisms, including commonly encountered aerobic and facultative bacteria and yeast but excluding anaerobes and filamentous fungi. Mycobacterium tuberculosis complex and rapidly growing mycobacteria were also evaluated for a 5-month period during the study. Reagent costs and a total cost analysis that included technologist time in addition to reagent expenses and maintenance service agreement costs were analyzed as part of this study. The use of MALDI-TOF MS equated to a net savings of $69,108.61, or 87.8%, in reagent costs annually compared to traditional methods. When total costs are calculated to include technologist time and maintenance costs, traditional identification would have cost $142,532.69, versus $68,886.51 with the MALDI-TOF MS method, resulting in a laboratory savings of $73,646.18, or 51.7%, annually by adopting the new technology. The initial cost of the instrument at our usage level would be offset in about 3 years. MALDI-TOF MS not only represents an innovative technology for the rapid and accurate identification of bacterial and fungal isolates, it also provides a significant cost savings for the laboratory.     

Use of an interactive tool to assess patients' willingness-to-pay

Assessment of willingness to pay (WTP) has become an important issue in health care technology assessment and in providing insight into the risks and benefits of treatment options. We have accordingly explored the use of an interactive method for assessment of WTP. To illustrate our methodology, we describe the development and testing of an interactive tool to administer a WTP survey in a dental setting. The tool was developed to measure patient preference and strength of preference for three dental anesthetic options in a research setting. It delivered written and verbal formats simultaneously, including information about the risks and benefits of treatment options, insurance, and user-based WTP scenarios and questions on previous dental experience. Clinical information was presented using a modified decision aid. Subjects could request additional clinical information and review this information throughout the survey. Information and question algorithms were individualized, depending on the subject's reported clinical status and previous responses. Initial pretesting resulted in substantial modifications to the initial tool: shortening the clinical information (by making more of it optional reading) and personalizing the text to more fully engage the user. In terms of results 196 general population subjects were recruited using random-digit dialing in southwestern Ontario, Canada. Comprehension was tested to ensure the instrument clearly conveyed the clinical information; the average score was 97%. Subjects rated the instrument as easy/very easy to use (99%), interesting/very interesting (91%), and neither long nor short (72.4%). Most subjects were comfortable/very comfortable with a computer (84%). Indirect evaluation revealed most subjects completed the survey in the expected time (30 min). Additional information was requested by 50% of subjects, an average of 2.9 times each. Most subjects wanted this type of information available in the provider's office for use in clinical decision making (92%). Despite extensive pretesting, three "bugs" remained undiscovered until live use. We have demonstrated that the detailed information, complex algorithms, and cognitively challenging questions involved in a WTP survey can be successfully administered using a tailor-made, patient-based, interactive computer tool. Key lessons regarding the use of such tools include allowing the user to set the pace of information flow and tailor the content, engaging the user by personalizing the textual information, inclusion of tests of comprehension and offering opportunities for correction, and pretesting by fully mimicking the live environment.     

Multi-adjustable chairs for children with disabilities

There is a growing demand that severely disabled children should be offered a normal-looking, comfortable alternative to highly supportive wheelchair seating to facilitate relaxation and social integration. An evaluation of five chairs, funded by Medical Devices Agency, an executive agency of the Department of Health, was undertaken with potential and actual users of these chairs to investigate the chairs'function with respect to the child's posture, and what features were effective. Twenty-nine children tried five chairs for up to 30 min in each; and a postal survey received 100 responses. The chairs seem to meet many users’ postural needs (78% of postal survey; 31 -72% of short-term evaluation depending on chair); the chairs’ adjustability and availability of special features are important in meeting the needs of this user group; evidence of poor design and its implications are discussed.     

Respiratory sinus arrhythmia,shyness, and effortful control in preschool-age children

Resting respiratory sinus arrhythmia (RSA) and shyness were examined as predictors of effortful control (EC) in a sample of 101 preschool-age children. Resting RSA was calculated from respiration and heart rate data collected during a neutral film; shyness was measured using parents’, preschool teachers’, and classroom observers’ reports; and EC was measured using four laboratory tasks in addition to questionnaire measures. Principal components analysis was used to create composite measures of EC and shyness. The relation between RSA and EC was moderated by shyness, such that RSA was positively related to EC only for children high in shyness. This interaction suggests that emotional reactivity affects the degree to which RSA can be considered a correlate of EC. This study also draws attention to the need to consider the measurement context when assessing resting psychophysiology measures; shy individuals may not exhibit true baseline RSA responding in an unfamiliar laboratory setting.