bluuebunny/crossref_metadata_2025 huggingface dataset:
What Went Wrong at University Hospital? An Exercise Assessing Training Effectiveness
Authors: Brown Travor C. , Li Stan X. , Sargent Leisa D. , Tasa Kevin
Published: August 2003

Many organizations struggle with effective training interventions—in particular, the transfer of skills learned in the classroom to the workplace. The present experiential exercise allows students, who are asked to play the role of consultants, to assess training effectiveness from pretraining to posttraining. Student feedback demonstrates that this exercise provides a practical and realistic simulation that aids in the understanding of effective training interventions. This article presents the University Hospital exercise, its linkage to Goldstein's Instructional Systems Design framework, instructor notes, and questions for students. The exercise can be used for undergraduate, graduate, and professional courses.
Development of the Korean Career Indecision Inventory
Authors: Tak Jinkook , Lee Ki-Hak
Published: August 2003

The purpose of this study was to develop a Korean Career Indecision Inventory (K-CII) applicable to Korean university students. A total procedure of five steps was conducted to develop and validate the scale. The K-CII comprises five factors: Lack of Career Information, Lack of Necessity Recognition, Lack of Self-Identity, Indecisiveness, and External Barrier. The External Barrier includes the items of financial difficulty, parents, the tendency for academy cliques to dominate, and age, representing factors specific to Korean culture. The same five factors consistently emerged in Steps 2, 3, and 5. In addition, the results of the confirmatory factor analysis in Step 3 showed that the five-factor solution had a good fit to the data. Internal consistency reliabilities and test-retest reliabilities showed that the K-CII was reasonably reliable. The K-CII factors were significantly related to similar constructs such as decidedness and certainty factors of career maturity, supporting the convergent validity. The K-CII total score and factors also showed significant correlations with various mental health variables, supporting the criterion-related validity of the K-CII. Finally, the implications of the results and the need for future studies were pointed out.
Learning to Interview in the Social Sciences
Authors: Roulston Kathryn , deMarrais Kathleen , Lewis Jamie B.
Published: August 2003

A large proportion of social science investigations rely on interview data, yet few researchers received formal training in interviewing. The authors investigated how novice researchers developed their interview skills, reporting on postgraduate students' experiences and reflections during an intensive 15-day interview course. Data analyzed for the article include audiotapes and transcripts of in-depth interviews and students' written critiques and journal reflections. Challenges faced by novice interviewers conducting in-depth interviews included unexpected participant behaviors, dealing with the consequences of the interviewers' own actions and subjectivities, constructing and delivering questions, and handling sensitive research topics. The authors also discuss the transcription of audio-recorded talk and include their own and students' reflections concerning the learning and teaching of interviewing. Finally, the authors provide recommendations for teaching interview skills for the purpose of doing social science research. This study informs teachers of qualitative research and researchers who seek to develop their interview skills.
At the Meeting Place of Word and Picture: Between Art and Inquiry
Authors: Sava Inkeri , Nuutinen Kari
Published: August 2003

This article focuses on dialogue between inquiry and art. What happens as words change into pictures? Do word and picture meet each other and, if they do, how? The article has a three-layered process of writing. First, there is the layer of word-picture-performance itself. In this performance, the researcher/writer (Inkeri Sava) produces the words, the artist/painter (Kari Nuutinen) draws the pictures for them. Second, there is the layer of a reflective textual dialogue. Finally, there is a general discussion, a meta-text—opening and closing curtain—about the word-picture-performation and reflections on it. As a whole, the article asks whether the meeting place of word and picture is a question of change, transformation, sliding, flowing, or streaming of word/text into a picture (or vice versa) in the associative, arts-based or performative dialogue between a writer and maker of pictures.
Bodily Flashes of Dancing Women: Dance as a Method of Inquiry
Authors: Ylönen Maarit E.
Published: August 2003

In May 1997 I was in Nicaragua researching a dance ritual known as May Pole. The act of dancing itself became a method of inquiry in my research process. This article concentrates on the interaction of two dancing women, Evelyn and me. My dance experience has acquired different interpretations in relation to time and context as I have reflected on it. I also enrich this experience with other dance experiences to explore my dancing body in its different forms. This hermeneutical starting point creates the conditions for trusting my instrument, my body, as a source of bodily knowledge.
“Art as a Way to Life”: Bereavement and the Healing Power of Arts and Writing
Authors: Saresma Tuija
Published: August 2003

Reading, writing, music, and fine arts are widely acknowledged to have therapeutic value to those bereaved. Narratives of coping with the help of arts are commonly told. Yet, the experiences of bereavement and the healing powers of arts and writing are rarely discussed and analyzed in social sciences. In this article, I search for a way to study the therapeutic power of arts and writing on a personal level. Using empathy as a metaphorical tool, I read an unpublished autobiography about a mother's grief and coping process through my own experiences of bereavement. I strive for emotional verisimilitude and apply a poetic form when citing the autobiography to highlight the evocative tone of the story. Using my personal experiences and experimental representation strategies, I reach for “a new ethics of writing” (Denzin, 1999), for knowledge connecting head to heart (Josselson, 2000), and for a union between poetics and science (Richardson, 1997).
Toward Performative Research: Embodied Listening to the Self/Other
Authors: Oikarinen-Jabai Helena
Published: August 2003

Negotiating different identities and otherness in myself is an important precondition for understanding transcultural and hybrid art education processes. I discovered my own ethnicity when I moved to Sweden, my Whiteness when living in Gambia. On returning to Finland, I noticed that the space and culture where I had expected to find my roots began to look like a hall of mirrors in an amusement park. The images that I met in such cultural mirrors sometimes turned out to be absurd and even frightening. The routes that I had thought I knew led me into odd situations, occasionally into deadlocks. I discuss the processes that researching and writing mystory with the support of my Gambian-Finnish daughters have opened in me. I view researching as a holistic activity that involves one with her embodied reality and history. I am also asking what performative writing and researching could be.
FAC-SEM: A Methodology for Modeling Factorial Structural Equations Models, Applied to Cross-Cultural and Cross-Industry Drivers of Customer Evaluations
Authors: Iacobucci Dawn , Grisaffe Doug , Duhachek Adam , Marcati Alberto
Published: August 2003

This article presents factorial structural equations models (FAC-SEM). An experimenter conducting ANOVAs on means can use FAC-SEM on covariance matrices. To illustrate, the authors model customer evaluations and examine how construct relationships vary by sector and country. The methodological approach presented in this article is new to the literature and easily implemented.
The Impact of Customer Satisfaction on Share-of-Wallet in a Business-to-Business Environment
Authors: Keiningham Timothy L. , Perkins-Munn Tiffany , Evans Heather
Published: August 2003

Research has found that customer satisfaction is positively related to repurchase intention, actual repurchase, market share, and word of mouth. There is growing recognition among managers of the importance of measuring the share of business a customer conducts with a particular service provider (share-of-wallet) as opposed to simply repurchasing a product or service at some point in the future or continuing to keep a business relationship with a service provider. Currently there is very little empirical research concerning the relationship between customer satisfaction and share-of-wallet. This article examines the relationship between satisfaction and actual share-of-wallet in a business-to-business environment. The authors not only find that there is a positive relationship but that the relationship is nonlinear, with the greatest positive impact occurring at the upper extreme of satisfaction levels.
Consumer Involvement in Relationship Marketing of Services
Authors: Varki Sajeev , Wong Shirley
Published: August 2003

The authors examine the impact of consumer involvement on consumers'willingness to engage in relationships with service providers, because healthy relationships between consumers and service providers depend on the voluntary participation of consumers in relationships. They also examine the effect that involvement has on consumers' expectations of relational efforts by the service provider. On the basis of survey results from the telecom and health sector, the authors' results indicate that more involved consumers express greater interest in engaging in relationships with service providers. Also, although high-involvement customers do not differ from their low-involvement counterparts in terms of their expectations that their service providers communicate with them regularly and be price-competitive, they express a greater desire for fairness in treatment and being involved in solutions to their problems. These results indicate that the opportunity exists to engage high-involvement customers in long-term relationship programs tailored to their unique needs.
Reconsidering Performance at the Summer Olympics and Revealed Comparative Advantage
Authors: Tcha Moonjoong , Pershin Vitaly
Published: August 2003

This article examines the performance of the participating countries at the Summer Olympic Games. It investigates each country's performance and attempts to identify the determinants of this performance in each sport, and also examines other issues related to specialization at these games, using the concept of revealed comparative advantage (RCA) developed in the field of international economics. Each country's RCA is explained by geographical, biological, and economic variables of the participating countries. Most previous studies investigated the correlation between total/per capita performance and a wide range of variables using a range of methods the authors' consider inappropriate. A few studies employed more appropriate censoring methods; however, they did not consider heteroscedasticity or nonnormality in their regressions that could make the estimates inconsistent. In addition, RCA and specialization in the Olympics has never been analyzed. The analyses present the determinants of each country's specialization in sports and the patterns of RCA, which are substantially different from those obtained when analyzing total and per capita performance. The authors found that high-income countries specialize less; in other words, they win medals in a more diversified range of sports, which is analogous to a country's patterns of specialization in production, a topic frequently explored in international economics.
The Stadium Game
Authors: Owen Jeffrey G.
Published: August 2003

The intangible benefits of sports teams are a source of social value that cannot be captured completely by teams through ticket sales and other revenues. A model is developed in which teams attempt to capture social value through stadium subsidies. The number of teams in the league, determined endogenously, increases when subsidies to teams are permitted. The size of the subsidy paid by a city depends on the threat point of teams based on the social value of a team to the largest city without one. Larger cities pay smaller subsidies and may not pay anything. Cartelized leagues substantially increase subsidies by reducing the number of teams, but subsidies are not eliminated in the case of free entry.
Technical Efficiency in the Major League Soccer
Authors: Haas Dieter J.
Published: August 2003

Taking data for the year 2000 season the technical efficiency of soccer teams in the Major League Soccer is measured by Data Envelopment Analysis (DEA). The inputs used by the teams are approached by the variables players' wage bill and wage of the head coach. Output is measured by points awarded, absolute number of spectators, and revenues. Efficiency scores are highly correlated with performance in the league, and when decomposing inefficiency into technical inefficiency and scale inefficiency it can be shown that the largest part of inefficiency can be explained by suboptimal scale of production.
The Relationship between Recruiting and Team Performance in Division 1A College Football
Authors: Langelett George
Published: August 2003

There is much hype and excitement each year surrounding each school's recruiting classes in Division 1A football. Much of this excitement is based on an underlying assumption that a top-10 recruiting class will result in a highly touted football team in the future. This article examines the relationship between college football recruiting and team performance through regression analysis. The results find both that recruiting significantly affects team performance and team performance significantly contributing to recruiting results. This reinforcing cycle may explain why certain teams are able to continuously be top-25 teams and other teams are never able to rise substantially in their competitiveness.
Reframing American Highway Politics, 1956-1995
Authors: Rose Mark H.
Published: August 2003

In 1956, President Dwight D. Eisenhower and members of Congress approved the Federal-Aid Highway Act, launching the nation on a vast and expensive program of highway building. As part of this legislation, the federal government would finance 90 percent of the cost of constructing a national system of freeways, known popularly as the Interstate system. Control of highway building rested exclusively in the hands of state and federal highway engineers. In 1991, however, President George H. W. Bush and members of Congress approved the Intermodal Surface Transportation Act of 1991 (ISTEA). Although the federal government would still pay most of the cost of highway building, day-to-day control of projects devolved into the hands of local politicians located in Metropolitan Planning Organizations (MPOs). Moreover, leaders of those MPOs were authorized to spend money not only on highways but also on bicycle paths, buses, and on projects dubbed “intermodal.” In great measure, approval of the ISTEA represented another triumph of suburban politicians seeking federal funds and local control over their use. Both in 1956 and in 1991, federal officials had framed the institutional relationship that guided transportation politics and subsequent land uses.
Planning Histories, Urban Futures, and the World Trade Center Attack
Authors: Nasr Joe
Published: August 2003

This article seeks to explore the place of planning history in the discussion of the destruction of the World Trade Center on 11 September 2001 and of its aftermath. It is based on an analysis of a range of articles and messages published on this subject, particularly within a month of the attack: newspapers, a planning Web site, a listserv for urban historians, and academic planning journals. After indicating the types of presence that planning and urban histories have had in the post-9/11 discourse, the article outlines some of the debates on urban futures—and assumptions about urban pasts— that have been common in this period, before concluding with observations on the various identities of those involved in these discussions. The article not only seeks to assess the lessons from this retrospective process of looking toward the “ghosts” of wars and reconstructions past but also examines how these—as well as planning history—have been instrumentalized to imagine alternative urban futures.
Intussusception:
Authors: Pendergast Lee Ann , Wilson Michelle
Published: August 2003

Intussusception, the invagination of one portion of the intestine into another, is considered a true emergency, which most commonly affects pediatric patients. It occurs when bowel (small or large) telescopes within itself, creating an obstructive mass. Peristalsis exacerbates the more proximal bowel into the lesion, causing the intussusception to have a “sleeve”-like shape. The lesion propagates distally, with obstructive ischemia and possible necrosis occurring over time. With the improvement of technology in diagnostic imaging, sonography has become the initial imaging modality of choice. The authors present a case study and current review of the literature regarding intussusception from a sonographer's viewpoint.
Assisted Reproduction and the Multiple Pregnancy:
Authors: Hill Jennifer
Published: August 2003

Heterotopic pregnancy is defined as an intrauterine pregnancy that coexists with an ectopic pregnancy. Many predisposing factors contribute to this condition and include pelvic inflammatory disease, endometriosis, and ovulation induction. In vitro implantation with multiple embryos has caused an increased rate of heterotopic pregnancies. The demonstration of an intrauterine pregnancy is no longer a reliable indicator for excluding an ectopic pregnancy.
Prenatal Sonographic Diagnosis of a Vein of Galen Aneurysmal Malformation in a Twin
Authors: Liriano Bienvenido , Levy Rafael
Published: August 2003

Arteriovenous malformations are the most common vascular congenital malformation of the brain. The vein of Galen arteriovenous malformation (VGAM) consists of end-to-end aneurysms in which the artery and vein connect without intervening capillaries. Cardiomegaly with congestive heart failure and increased intracranial pressure with hydrocephaly are the most common features in the neonate. In this case report, both features are present in utero. Prenatal morbidity and mortality are high due to cardiac failure. The authors present a case of spontaneous delivery at 35 weeks with one twin affected with vein of Galen aneurysm.
Sonographic Investigation of the Pediatric Navicular:
Authors: Evans Angela M. , Scutter Sheila D. , Iasiello Hala
Published: August 2003

Exploring the structures of the pediatric foot may guide both clinicians and researchers toward better examination techniques. The navicular is the last foot bone to complete ossification and a crucial component of the medial column of the foot. This study explores the developing morphology of the navicular in a sample of four-year-old children using nonionizing sonographic imaging. Correlation was found between the length of the foot and the length of the navicular, with inverse correlation between navicular length and the depth of the navicular from the skin surface. There is preliminary suggestion of a critical foot length at which navicular palpation (and hence associated clinical measures) becomes more accurate. It appears that young children's feet require a different examination approach from more skeletally mature foot structures.
Brain–computer interfaces: a review
Authors: Coyle Shirley , Ward Tomas , Markham Charles
Published: August 2003

'Can the brain understand the brain?Can it understand the mind?'Such questions, here posed by neurophysiologist and 1981 Nobel laureate David Hubel, are under constant debate, but through the investigations of neurobiologists, psychologists, and physiologists, current knowledge and understanding has come a long way since brain exploration began hundreds of years BC. This article looks at how insights from some of the pioneers of neuroscience have begun to be integrated with today's technology, so bringing about the dawn of an era of brain and computer interfacing. One result has been brain–computer interfaces that can liberate the thoughts of those suffering from ‘locked in’ syndrome, by detection and interpretation of the brain's physiological signals. Also, manipulation of and support for the body's electrical and chemical signalling network has led to a variety of rehabilitation and therapeutic benefits, for example the possibility of giving sight to the blind. Brain–computer interfacing offers scope for augmentative channels for the brain, allowing it to become more directly connected with its environment, and extending the boundaries imposed by our own biological systems. Such interfaces will form a part of the future of rehabilitation engineering and contribute to improving the quality of life of many people.
Danger: Derrida at work
Authors: Armstrong Jim
Published: August 2003

The term ‘safety critical’ applies to a wide range of technologies, from car braking systems, through trains and their signalling systems, to advanced air and space technology, both civil and military. It is a rather sophisticated euphemism for ‘dangerous';and like the word ‘safe’, it suggests the existence of some spectral but inherent property beneficial to human health that could be lost under certain conditions, but does not have to be. How far can the discourse about safety be trusted?And why are debates about risk sometimes so heated?In this paper it is proposed that literary theory, particularly work on ‘deconstruction’ by philosopher Jacques Derrida, can shed some light on these questions. Unsurprisingly, deconstruction cannot say much to safety engineers about the technicalities of system building. But then again questions about whether and why we continue to build and rely upon safety critical technologies are not simply technical; the language used in them is almost always politically charged.
The importance of exercising in space
Authors: Hawkey Adam
Published: August 2003

As a direct consequence of exposure to microgravity, astronauts experience a set of physiological changes which can have serious medical implications when they return to earth. Most immediate and significant are the headward shift of body fluids and the removal of gravitational loading from bone and muscles, which lead to progressive changes in the cardiovascular and musculoskeletal systems. Cardiovascular adaptations result in an increased incidence of orthostatic intolerance (fainting) following flight, decreased cardiac output, and reduced capacity for exercise. Changes in the musculoskeletal system contribute significantly to impaired function experienced in the post-flight period. The underlying factor producing these changes is the absence of gravity, and countermeasures are therefore designed primarily to simulate earthlike movements, stresses, and system interactions. Exercise is one approach that has had wide operational use and acceptance in both the US and Russian space programmes, and it has enabled humans to stay relatively healthy in space for well over a year. Although it remains the most effective countermeasure currently available, significant physiological degradation still occurs. The development of other countermeasures will be necessary for missions of longer duration, for example for human exploration of Mars.
The authority of science and the postmodern reformation
Authors: Broks Peter
Published: August 2003

Popular reactions against science are as old as science itself. The challenge from postmodernity, however, is more fundamental, because it challenges not only what science does, but what science is. The epistemological authority of science is now challenged in much the same way as the spiritual authority of the Catholic Church was challenged by the Reformation. The experience of disruption and instability, the pluralism, relativism, and loss of absolutes of the earlier period are not unlike what we find in our own postmodern condition. Luther's priesthood of all believers has become a priesthood of all knowers in our postmodern reformation. More particularly, we can see how the advent of printing, the humanist cultivation of individuality, and the Copernican mapping of the heavens all have their (post)modern counterparts, in the development of the internet, the cult of narcissism, and the mapping of the human genome.
Behavioural investigation of polarisation sensitivity in the Japanese quail (Coturnix coturnix japonica) and the European starling(Sturnus vulgaris)
Authors: Greenwood Verity J. , Smith Emma L. , Church Stuart C. , Partridge Julian C.
Published: August 2003

Many animals have sensitivity to the e-vector of linearly polarised light,which may assist in visually mediated behaviours such as navigation,signalling and foraging. However, it is still controversial as to whether birds possess polarisation sensitivity. Several studies have found that altering the polarisation patterns of the broad visual field surrounding birds alters their intended migratory orientation. However, electrophysiological tests have failed to elicit evidence for polarisation sensitivity in birds,and the mechanism by which birds might perceive polarised light is unknown. In this experiment, we trained Japanese quail and European starlings to discriminate stimuli differing in their polarisation pattern. Although both quail and starlings were able to discriminate stimuli in which the stimulus sub-components either differed or had the same radiant intensity (the control task), they were unable to discriminate stimuli in which the e-vector orientations of the stimulus sub-components either differed by 90° or had the same angle of polarisation. The birds' successful performance on the control task, but failure to complete the polarisation task, demonstrated that they had all the necessary cognitive abilities to make the discrimination except sensitivity to angle of polarisation. We conclude that quail and starlings are unable to use polarisation cues in this foraging task.
Urea transport in kidney brush-border membrane vesicles from an elasmobranch, Raja erinacea
Authors: Morgan Robyn L. , Wright Patricia A. , Ballantyne James S.
Published: August 2003

Marine elasmobranch fishes maintain high urea concentrations and therefore must minimize urea loss to the environment in order to reduce the energetic costs of urea production. Previous studies have identified a facilitated urea transporter in the kidney of the dogfish. We examined mechanisms of urea transport in the kidney of the little skate Raja erinacea using an isolated brush-border membrane vesicle preparation. Urea uptake by brush-border membrane vesicles is by a phloretin-sensitive, non-saturable uniporter in the dorsal section and a phloretin-sensitive, sodium-linked urea transporter (Km=0.70 mmol l–1, Vmax=1.18 μmol h–1mg–1 protein) in the ventral section of the kidney. This provides evidence for two separate urea transporters in the dorsal versus ventral sections of the kidney. We propose that these two mechanisms of urea transport are critical for renal urea reabsorption in the little skate.
The design of pilot telecare projects and their integration into mainstream service delivery
Authors: Barlow James , Bayer Steffen , Curry Richard
Published: August 2003

summary

We studied the introduction of a telecare and rehabilitation scheme in north-west Surrey. It was decided not to create a new team to provide the new services, but to involve established teams and individuals. The introduction of telecare therefore added to the roles and responsibilities of these teams. This staffing policy helped to establish awareness of the project within the local care system and to support its subsequent deployment. An education and training unit was established to demonstrate what the technology could do and to act as a focus for training health and social care professionals. The study suggested that for telecare to achieve its full potential, pilot projects must be designed to be evaluated, and more attention must be paid to the degree of integration with the care system as a whole.
Telemedicine model for training non-medical persons in the early recognition of melanoma
Authors: Chao L W , Enokihara M Y , Silveira P S P , Gomes S R , Böhm G M
Published: August 2003

summary

A Web-based educational model, called JUTE, was developed for the early diagnosis of melanoma. It was compared with a control Website composed of information available on the Internet for teaching undergraduate medical students. The JUTE model was designed to allow the student linear navigation of the main topics that were assumed to be important in learning to make a diagnosis. The rate of success in correctly deciding to refer pigmented lesions to a dermatologist was compared among 34 new medical students who were randomly divided into two groups. There was no significant difference between the JUTE and control groups in the pre-test. When comparing the pre- and post-tests, the number of correct decisions increased significantly only in the JUTE group. In the JUTE group there was a slight but significant improvement when comparing decisions about thin melanoma before and after the training. The educational approach chosen for the JUTE Website appears to be useful for teaching the early recognition of melanoma and could be used for larger educational campaigns of skin cancer prevention.
The application of the MPEG-4 standard to telepathology images for electronic patient records
Authors: Brox Georg A , Huston Janis L
Published: August 2003

summary

We conducted a pilot study to compare the diagnostic quality of digital telepathology images compressed using two software packages, each of which incorporated the MPEG-4 standard. Both software packages produced lossy (rather than lossless) compressed images. Lossy images can be less reliable for diagnostic purposes and the aim of the study was to examine how the MPEG-4 standard affects image quality. The results showed that manipulation of the images by the software did not dramatically alter the image quality but they highlighted the need to develop both pixel-mapping software and associated standards. Standards will help to determine which bits of a diagnostic image can be safely removed during compression while ensuring the integrity and reliability of images for diagnostic purposes.
The reliability of digital images when used to assess burn wounds
Authors: Jones O C , Wilson D I , Andrews S
Published: August 2003

summary

Sixty burn wounds were assessed in person. The same observer later assessed them using digital images of different sizes. The file sizes tested were 2.25, 5.5 and 9 MByte per image. There was good agreement between the diagnoses of burn depth made using the digital images and those made in person, with kappa scores of 0.53–0.60. There were no major differences between the three file sizes. The assessments made of the partial-thickness burns showed a lower rate of agreement between the in-person and the digital image assessments and for these burns the 2.25 MByte images were apparently as good or better than the larger images. There was little difference between the three file sizes in terms of observer confidence, usefulness of the location shot, or perceived image quality. There was no significant advantage in using larger file sizes to assess burn wounds.
Why do telemedicine systems fail to normalize as stable models of service delivery?
Authors: May Carl , Harrison Robert , Macfarlane Anne , Williams Tracy , Mair Frances , Wallace Paul
Published: August 2003

summary

Two groups independently carried out qualitative studies of the development, implementation and evaluation of telehealth systems and services in the UK. The data collected (in more than 600 discrete data collection episodes) included semistructured interviews, observations and documents. We conducted a conjoint reanalysis of the data. The objective was to identify the conditions which dispose a telehealth service to be successful or to fail. There appear to be four conditions necessary for a telemedicine system to stabilize and then normalize as a means of service delivery. When one or more is absent, failure can be expected. These conditions are often overlooked by local proponents of telemedicine, who seem to rely on demonstrations that the equipment works as the primary criterion of success.
Choosing networks for picture archiving and communication systems and teleradiology
Authors: Aas I H Monrad , Geitung Jonn Terje
Published: August 2003

summary

Qualitative interviews were performed with 26 resource persons with experience of picture archiving and communication systems and teleradiology. The results reported here concern the different types of networks there was interest in establishing. Eight types of networks were considered to be of interest. The two main reasons for wanting the networks were related to clinical communication and improved exploitation of resources. Use of such networks means cooperation across organizational boundaries. Networks can play an organizational role and this raises questions concerning the future organization of radiology services.
Social dilemmas in a telemedicine network: Experience with the implementation of the Norwegian Pathology Network
Authors: Obstfelder Aud
Published: August 2003

summary

The implementation process for the Norwegian Pathology Network (PatNet) was explored. Fourteen departments of pathology in Norwegian university and local hospitals that subscribed to PatNet were investigated. Sociological theory was applied to analyse the obstacles to implementation in terms of coordination and cooperation. Successful collective action requires that the dilemma between collective and individual interests is resolved. The establishment of PatNet has not accomplished this to a sufficient degree. The originators of PatNet expected that easy access to the network combined with comprehensive information and discussion within the network would attract users. More information and discussions were meant to be produced by users and thus attract further users. In this way the network was expected to run by itself. However, this strategy did not work. New strategies to handle the dilemma concerning collective and individual interests have not been discussed openly. The present study suggests that an open discussion among pathologists to explore and highlight this dilemma would be useful.
An evaluation of pre-hospital communication between ambulances and an accident and emergency department
Authors: Rowlands Andrew
Published: August 2003

summary

We studied pre-hospital notification and the quality of data received from ambulance crews transporting seriously ill or injured patients to an accident and emergency department. During a two-month study period, pre-hospital notification was received for 54 patients. However, the department was notified about only 25 of 62 patients (40%) who, on arrival by ambulance, were triaged as emergencies. Despite developing a data protocol for emergency pre-hospital communication and being equipped to receive emergency ambulance calls directly, many such patients still arrived either unannounced or described in insufficient detail to allow appropriate preparations to be made for them.
A multidisciplinary approach to the treatment of eating disorders via videoconferencing in north-east Scotland
Authors: Simpson Susan , Knox Jane , Mitchell Derek , Ferguson James , Brebner John , Brebner Eileen
Published: August 2003

summary

Until recently many remote communities in Scotland, especially on the northern islands, were unable to access specialist eating disorder services. The Grampian Eating Disorder Service, based in the north-east of Scotland, has developed a video-therapy service that offers specialist psychological and nutritional therapy for sufferers of eating disorders. Twelve patients have been treated via videoconferencing. Patients consistently rated high levels of satisfaction with all aspects of video-therapy, and after their last session 67% preferred video-therapy to face-to-face therapy. A number of patients commented that, compared with face-to-face therapy, they felt more in control and less intimidated in video-therapy. There was also a trend for patients to become more comfortable with video-therapy over the course of treatment. Nutritional knowledge increased for all patients, and the nutritional content of dietary intake also markedly improved over the course of therapy.
Use of the Internet to optimize self-management of type 1 diabetes: Preliminary experience with DiasNet
Authors: Cavan D A , Everett J , Plougmann S , Hejlesen O K
Published: August 2003

summary

Six patients with type 1 diabetes participated in a pilot trial. Their median age was 36 years (range 29–61) and the median duration of diabetes was 10 years (range 3–29). They were asked to enter, from their home or work PC, blood glucose values, insulin doses and a food diary. From the data entered, a computer model generated a simulation of the blood glucose concentration for the data collection period. It could then suggest alternative insulin doses (or regimes), or meal sizes, to reduce the risk of hypo- and hyperglycaemia. During a six-month study, patients entered a median of five sets of data (range two to eight). Feedback from participants revealed that while the system was helpful, difficulties with data entry hindered its use. Information gained from this exercise is shaping further development of the system.
User satisfaction with allied health services delivered to residential facilities via videoconferencing
Authors: Guilfoyle Clare , Wootton Richard , Hassall Stacey , Offer Jann , Warren Margo , Smith Debbie , Eddie Michelle
Published: August 2003

summary

We have investigated the role of videoconferencing in allied health service provision to high-care clients in rural residential facilities. Videoconferencing equipment was set up at a rural aged-care facility and a metropolitan allied health centre; ISDN transmission at 384 kbit/s was used to link the equipment. Twelve residents were assessed by both videoconference and face to face across five allied health disciplines (a total of 120 assessments). User satisfaction was measured using questionnaires and focus groups. Face-to-face assessment took significantly longer than videoconferencing assessment. However, the mean satisfaction ratings for face-to-face assessments were higher than for videoconferencing and the majority of the staff preferred the face-to-face format. Videoconferencing was particularly useful for consultations and the initial stages of the assessment process. A number of issues relating to the videoconferencing equipment, to the environment in which assessments were performed and to the clients themselves need to be addressed in order for this form of service delivery to be effective.
Realtime ultrasound screening by satellite telecommunication
Authors: Miyashita Toyohisa , Takizawa Masaomi , Nakai Keiji , Okura Hirofumi , Kanda Hirohito , Murase Sumio , Ichijo Tetsuya , Karaki Yoshiaki , Oue Toru , Yagi Kazuo
Published: August 2003

summary

Realtime ultrasound screening was carried out using a medical examination vehicle equipped with a diagnostic ultrasound scanner and a satellite telecommunication system. Screening was performed on 205 residents in a rural community in Japan and consisted of 57 cardiac, 57 abdominal, 60 thyroid and 31 breast ultrasound scans. The resolution of the realtime ultrasound images sent via communications satellite at 1.5 Mbit/s was almost identical to that of the original images taken by the ultrasound scanner. A disorder was diagnosed in 11 (19%) of the cardiac examinations, 28 (49%) of the abdominal, 19 (32%) of the thyroid and 7 (23%) of the breast examinations. Although some technical problems occurred, ultrasound screening by telemedicine appears to be a promising technique for those who live in rural communities.
Current legal and ethical concerns in telemedicine and e-medicine
Authors: Silverman Ross D
Published: August 2003

summary

Telemedicine and e-medicine have the potential to transform medical practice. However, while the benefits have long been known, many physicians and health systems have been reluctant to engage in such practices due to unresolved legal and ethical concerns. I conducted a systematic examination of US and European statutes, regulations and civil, criminal and administrative decisions pertaining to telemedicine and e-medicine, as well as a review of the ethical, legal and medical literature pertaining to the practice of telemedicine and e-medicine in the US and Europe. There appear to be four main areas of concern: the doctor-patient relationship; malpractice and cross-border licensure; standards; and reimbursement. The lack of generally agreed interstate and international standards of law and ethics means that telemedicine and e-medicine will continue to struggle to gain widespread support from providers, patients and regulatory bodies as an acceptable means of health service delivery. Progress may depend on federal and international leadership.
A preliminary assessment of Internet-based nuclear telecardiology to support the clinical management of cardiac disease in a remote community
Authors: Tually Peter , Janssen Johan , Cowell Simon , Walker John
Published: August 2003

summary

A portable nuclear medicine (NM) processing system was established in Kalgoorlie and an acute myocardial perfusion scintigraphy (MPS) service was provided for the local regional hospital. After scanning the patient, the data were processed on a laptop computer and JPEG images were transmitted to a secure Web server. A secure email message, with the URL link enclosed and a provisional indication of normal or abnormal findings, was sent to the referring clinician from the NM facility. Use of the Internet allowed for a group consultation between the NM technician, the referrer and the cardiologist in Perth. During a three-month study period, 42 patients were referred for exclusion of acute coronary syndrome. Of these, 21 (50%) demonstrated abnormal perfusion studies, two of which were classified as requiring urgent medical intervention. Seventeen studies were normal (41%) and four (10%) were designated equivocal. There was an alteration in the treatment plan for 32 patients (76%), including four for whom admission or further investigation was deemed unwarranted. The results suggest that MPS findings, distributed via the Internet, allow for earlier risk stratification and have a direct affect on clinical decision making.
Titelbild: Chemie und Biologie des Roseophilins und der Prodigiosin‐Alkaloide: 2500 Jahre im Überblick (Angew. Chem. 31/2003)
Authors: Fürstner Alois
Published: August 2003

Raffaels “Messe von Bolsena” thematisiert das gleichnamige “Wunder” in Form einer “blutenden” Hostie, das sich 1263 in Bolsena, einer italienischen Kleinstadt nördlich von Rom, ereignet hat. Das Titelbild zeigt einen Ausschnitt aus diesem Fresko. Heute wissen wir, dass solche Phänomene, die im Mittelalter nicht anders als irrational erklärt werden konnten, auf Kolonien Prodigiosin‐produzierender Bakterien zurückzuführen sind. Mit Schwerpunkt auf den Totalsynthesen fasst A. Fürstner in seinem Aufsatz auf S. 3706 ff. die Chemie und Biologie dieser “wundersamen” Verbindungklasse zusammen.
Optical microscopy study on poly(p‐phenylene terephthalamide) fibers
Authors: Shahin M. M.
Published: August 2003

Two highly oriented poly(p‐phenylene terephthalamide) (PPT) fibers of different grades, commercially known as Kevlar and Twaron, were examined at high magnification under a transmission optical polarizing microscope in the extinction position between crossed polars. An image with regions of regular fine bands is produced for both classes of fibers, which is interpreted to be due to the passage of depolarized scattered light from a material with regularly spaced discontinuities. These bands reflect the periodic pleat structure of the fibers. The fibers were chemically etched, coated with gold, and investigated under a Nomarski differential interference contrast microscope in the extinction position between crossed polars. The observation for Kevlar fibers shows a clear periodicity of transverse bands perpendicular to the fiber axis, but this is much less evident for Twaron fibers. The etchant gives smooth, nearly flat sections through the Kevlar fibers, whereas it is not very effective for the Twaron fibers. The variable wavelength interferometry (VAWI) technique, which is valuable for studying highly oriented polymeric fibers, is used to measure the mean refractive indices and birefringence of a fiber as a function of light wavelength. The results show that these fibers absorb the surrounding liquid, which may change their optical properties. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 90: 360–369, 2003
Water and water vapor sorption studies in poly(propylene)‐zeolite composites
Authors: Pehlivan H. , Özmihçi F. , Tihminlioğlu F. , Balköse D. , Ülkü S.
Published: August 2003

Water and water vapor sorption to porous poly(propylene)zeolite composites prepared by hot pressing have been studied as a function of zeolite loading. This work presents the first report on the effect of the zeolite as a filler on the water sorption properties of PP composites. Water swelling experiments were conducted at 25°C using pure PP and PP‐zeolite film samples having different zeolite loadings (6–40 wt %). Since PP is a hydrophobic polymer, it does not sorp any water, but the composites having 10, 20, 30, and 40% zeolite sorbed 0.63, 1.00, 1.72 and 3.74 wt % water, respectively. The zeolite itself at the same conditions sorbed 24.5 wt % water. As the filler loading in the composites increased, equilibrium uptake values increased too. On the other hand, water vapor sorption and kinetics has been studied using a Cahn 2000 gravimetric sorption system. Within in the range 0.35–0.95%, water vapor was adsorbed by the composites containing 10–40 wt % zeolite. Experimental effective water vapor diffusivities of the composite films were about one order of magnitude higher than the experimental water diffusion coefficient in composites. The transport of water in composites was slower than that in the liquid water due to the longer diffusion pathway and adsorption on the surface of the composites. Although the liquid water may fill all the voids in the composite, water vapor is adsorbed on the surface of the zeolite only. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 90: 352–359, 2003
In situ formation and compounding of polyamide 12 by reactive extrusion
Authors: Wollny A. , Nitz H. , Faulhammer H. , Hoogen N. , Mülhaupt R.
Published: August 2003

The anionic polymerization of lauryllactam was initiated at 270°C using sodium hydride as an initiator and N,N′‐ethylene‐bisstearamide (EBS) as an activator (NaH:EBS molar ratio of 2). Polymerization occurred in less than 2 min and was successfully performed in an internal mixer and a twin‐screw extruder with corotating intermeshing screws (Werner & Pfleiderer ZSK 25). The content of residual monomer, as determined by thermogravimetric analysis, was lower than 0.5 wt %. Molecular weight, as measured by size exclusion chromatography, was governed by the lauryllactam:NaH molar ratio calculated on a Mn of 25 kg/mol at a constant NaH:EBS molar ratio of 2. Blends were prepared in situ by polymerization of lauryllactam solutions of various polymers. When poly(ethylene‐co‐butylacrylate) (Lotryl®; Atofina) was dissolved in lauryllactam, rubber‐toughened polyamide 12 blends were obtained. Mechanical properties of the injection‐molded polymers were examined by stress–strain as well as notched Charpy impact tests at different temperatures. Blend morphologies were imaged by scanning electron microscopy (SEM). © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 90: 344–351, 2003