梁氏距离法的建立及其在卫生机构消毒质量综合评价中的应用

本文通过创立梁代距离系数并在优劣距离法、密切值法和相对差距和法等综合评价方法的基础上建立起来的一种综合评价方法——梁氏距离法。应用此方法综合评价广西北海市1995～1999年市区医疗卫生机构消毒质量状况,收到了良好的效果。该方法的优点是:①科学性较强。该方法引进了优劣距离法、密切值法和相对差距和法等评价方法的原理和方法,因而具有较高科学性;②原量简明,操作方便,方法易于掌握;③结果直观;④灵敏度较高;⑤能充分得用原始资料的信息;⑥能体现各指标在评价中的实际作用,因而评价结果客观性较高;⑦使用方法灵活,可根据数据的性质等情况对方法的各个步骤进行取舍。该方法的缺点是:①要求各被评价对象的指标要一致且各指标的数值要齐全;②要求指标的数值不能为负值。本文认为该方法为一实用的综合评价方法,特别适合在广大基层推广使用。     

Ventricular shape visualization using selective volume rendering of cardiac datasets

In this paper, we present a novel technique of improving volume rendering quality and speed by integrating original volume data and global model information attained by segmentation. The segmentation information prevents object occlusions that may appear when volume rendering is based on local image features only. Thus the presented visualization technique provides meaningful visual results that enable a clear understanding of complex anatomical structures. In the first part, we describe a segmentation technique for extracting the region of interest based on an active contour model. In the second part, we propose a volume rendering method for visualizing the selected portions of fuzzy surfaces extracted by local image processing methods. We show the results of selective volume rendering of left and right ventricle based on cardiac datasets from clinical routines. Our method offers an accelerated technique to accurately visualize the surfaces of segmented objects.     

Surface energy,its density and distance: New measures with application to human cerebral potentials

Summary In this paper, we propose three new measures for topographic studies of event related potentials (ERP) called the surface energy (SE), its density (SED) and the distance of surface energy density fields (DSED) based on the entire scalp current density (SCD) field. These measures have a specific physical meaning, are free of the reference electrode and any physical conductive model of the head. They capture not only spatial properties, but also continuous time elements present and smeared in the original scalp potential records. They provide a common base for comparisons of recorded potentials among different time points, subjects, regions on the scalp, or experimental conditions. We also construct a statistical inference based on these new measures, and provide an application to human event-related potentials in a visual short-term memory experiment.This work was supported by N.I.H. grants AA-02686 and AA-05524.     

Distance estimation in the visual and visuomotor systems

Previous work has demonstrated that monocular vision affects the kinematics of skilled visually guided reaching movements in humans. In these experiments, prior to movement onset, subjects appeared to be underestimating the distance of objects (and as a consequence, their size) under monocular viewing relative to their reaches made under binocular control. The present series of experiments was conducted to assess whether this underestimation was a consequence of a purely visual distance underestimation under monocular viewing or whether it was due to some implicit inaccuracy in calibrating the reach by a visuomotor system normally under binocular control. In a purely perceptual task, a group of subjects made similar explicit distance estimations of the objects used in the prehension task under monocular and binocular viewing conditions, with no time constraints. A second group of subjects made these explicit distance estimations with only 500-ms views of the objects. No differences were found between monocular and binocular viewing in either of these explicit distance-estimation tasks. The limited-views subjects also performed a visually guided reaching task under monocular and binocular conditions and showed the previously demonstrated monocular underestimation (in that their monocular grasping movements showed lower peak velocities and smaller grip apertures). A distance underestimation of 4.1 cm in the monocular condition was computed by taking the y intercepts of the monocular and binocular peak velocity functions and dividing them by a common slope that minimised the sum of squares error. This distance underestimation was then used to predict the corresponding underestimation of size that should have been observed in the monocular reaches – a value closely approximating the observed value of 0.61 cm. Taken together, these results suggest that the monocular underestimation in the prehension task is not a consequence of a purely perceptual bias but rather it is visuomotor in nature – a monocular input to a system that normally calibrates motor output on the basis of binocular vision. Received: 30 November 1998 / Accepted: 19 June 1999     

Teaching Interprofessional Collaboration: Using Online Education Across Institutions

ABSTRACT

Interdisciplinary courses among students in occupational therapy, physical therapy, and speech-language pathology are important for addressing teamwork, communication, and understanding of professional roles, especially in pre-service training for early intervention and school-based practice where collaboration is essential. Although interprofessional education (IPE) as a part of higher education in the health sciences has been strongly encouraged, IPE courses are difficult to schedule and implement. This article discusses the challenges of developing and delivering two IPE courses in an online format, specifically the innovation that addresses logistics, time factors, and social presence for the IPE courses across two institutions.     

The contribution of distance learning to the knowledge of nursing lecturers regarding assessment of chronic wounds

OBJECTIVE:

to identify the contribution made by a refresher course on the assessment of chronic wounds, offered through the Moodle virtual learning environment (VLE), to the knowledge relating to this issue of nursing lecturers and nurses linked to higher education.

METHOD:

a prospective, quasi-experimental study, with data collection before and after the educational intervention. The study was undertaken in three stages using the Moodle VLE. The sample was made up of 28 participants who answered the pre-test on the knowledge, devised in accordance with international guidelines on chronic wounds. Afterwards, the refresher course was offered (intervention) and was accessed in accordance with individuals'' schedules, during the established time period. At the end of the course, 26 participants answered the post-test. Those who did not participate in the post-tests were excluded from the study, as it is pairwise analysis of the sample.

RESULT:

the participants obtained, on average, 55.5% of correct answers in the pre-test on their knowledge, and 73.4% in the post-test, this difference being statistically significant. There was a negative correlation between the time of experience in lecturing and the performance in the test on their knowledge.

CONCLUSION:

the participation in the online refresher course contributed to improving the lecturers'' performance in the test on their knowledge, in relation to the recommendations for assessing chronic wounds, based in scientific evidence.     

Distance-mediated spatial neglect

Unilateral spatial neglect (USN) is usually assessed by means of individual stimuli or single arrays of stimuli. Seldom are stimuli presented as multiple objects or in spatially separated blocks, except in some tests for object-based neglect. The distance between individual objects or blocks of stimuli in such stimuli is implicitly considered irrelevant. We report on the case of a patient, EC, who showed severe USN in his everyday behavior, yet performed normally on standard tests for USN. Presented with stimuli in separate blocks, he performed flawlessly with 4 cm gaps between blocks, yet ignored all leftward blocks of stimuli when the gap was larger than this. EC’s dissociation between good performance on standard tasks and severe neglect with separate groups of stimuli, and the distance-mediated nature of his USN are novel observations with relevant theoretical and clinical implications.     

Fatigue matters: An intense 10 km run alters frontal and transverse plane joint kinematics in competitive and recreational adult runners

BackgroundFatigue is an essential component of distance running. Still, little is known about the effects of running induced fatigue on three-dimensional lower extremity joint movement, in particular in the frontal and transverse planes of motion.Research questionHow are non-sagittal plane lower extremity joint kinematics of runners altered during a 10 km treadmill run with near-maximum effort?MethodsIn a cross-sectional study design, we captured three-dimensional kinematics and kinetics at regular intervals throughout a 10 km treadmill run in 24 male participants (subdivided into a competitive and recreational runner group) at a speed corresponding to 105 % of their season-best time. We calculated average and peak joint angles at the hip, knee and ankle during the stance phase.ResultsWe observed peak deviations of 3.5°, 3° and 5° for the hip (more adduction), knee (more abduction) and ankle (more eversion) in the frontal plane when comparing the final (10 km) with the first (0 km) measurement. At the end of the run peak knee internal rotation angles increased significantly (up to 3° difference). Running with a more abducted knee joint and with a higher demand for hip abductor muscles in the unfatigued state was related to greater fatigue-induced changes of joint kinematics at the knee and hip.SignificanceThe fatigue related change of non-sagittal joint kinematics needs to be considered when addressing risk factors for running-related injuries, when designing shoe interventions as well as strengthening and gait retraining protocols for runners. We speculate that strengthening ankle invertors and hip abductors and monitoring the dynamic leg axis during running appear to be promising in preventing fatigue induced alterations of non-sagittal joint kinematics.     

共同性斜视眼外肌止端位置观察与分析

目的 探讨共同性斜视患者肌止端距离在斜视发病中可能的机理作用.方法 手术中测量17例共同性水平斜视患者内、外直肌止端距角膜缘距离,进行统计分析后与正常人群比较是否具有差异性.结果 在11例共同性外斜视患者中,外直肌止端距角膜缘4.0～ 7.0mm,平均（5.9±0.99）mm,正常参考值为6.9 mm（t=4.630,P＜0.05）;内直肌止端距角膜缘（4.5～6.0）mm,平均（5.3±0.57）mm,正常参考值为5.5 mm （t=1.053,P＞0.05）.在6例共同性内斜视患者中,外直肌止端距角膜缘6.5～7.0mm,平均（6.7±0.21） mm,正常参考值为6.9 mm（t=1.840,P＞0.05）;内直肌止端距角膜缘3.5～4.5mm,平均（4.3±0.41） mm,正常参考值为5.5 mm（t=7.185,P＜0.05）.结论 内、外直肌肌止端距角膜缘距离可能为共同性水平斜视的发病影响因素之一.     

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

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 >6 mm (12: 6–9 mm; 15: > 10 mm). Sensitivity, specificity and PPV for polyps ≥6 mm and ≥10 mm 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 ≥6 mm and ≥10 mm, respectively.Overall per patient sensitivity, specificity and PPV were 86.4% (95% CI 76.7–96.1), 85.4% (95% CI 77–93.9) and 78.3% (95% CI 64.9–91.7), respectively.In the test cases overall per-polyp sensitivity was 80.7% (95% CI 69.5–92) and 94.7% (95% CI 85.6–100×) for lesions ≥6 mm and ≥10 mm, respectively. Overal per patient sensitivity, specificity and PPV were 92.9% (95% CI 83.1–100×), 64% (95% CI 13.1–100×) and 87.8% (95% CI 71.7–100×), respectively. There was a statistically significant improvement in per-polyp sensitivity for lesions ≥6 mm in the test cases. No statistically significant differences were found in per patient sensitivity, specificity and PPV, but there was an improvement.

Conclusion

This training programme based on tele-training obtained good performance of radiographers in detecting tumoral lesions in CTC.