bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tele-otology: Planning, design, development and implementation
Authors: Eikelboom Robert H , Atlas Marcus D , Mbao Mathew N , Gallop Mark 
Published: February 2003

summary The view of the tympanic membrane of the ear provides the specialist with important information for the assessment of ear disease and for treatment planning. In rural and remote areas, the incidence of ear disease is high but access to ear specialists is limited. As part of a project to deliver tele-otoscopy services to remote Western Australia, we have investigated various aspects of a tele-otoscopy system. We found that the MedRX video-otoscope is relatively safe to use and produces images of very good quality. A confident diagnosis could be made from still images compressed to 20 kByte. Video sequences could be compressed to a ratio of 1:300. Furthermore, a software package has been developed, and we are developing a training course for health-care workers in remote areas.
The use of telemedicine in primary care for women with cervical cytological abnormalities
Authors: Etherington Ian J , Watts Anne D , Hughes Elisabeth , Lester Helen E 
Published: February 2003

summary Telemedicine can be used in two different ways in the context of the National Health Service Cervical Screening Programme. The first method allows primary health-care providers to offer direct online booking of clinic appointments according to predefined algorithms based on the woman's cytological abnormality. The second method is telecolposcopy, which is designed to be used by nurses in primary care. Preliminary data confirm that such a system can be used reliably to make diagnoses. The technology is easily adaptable for realtime teleconsultation.
Child development services: A multidisciplinary approach to professional education via videoconference
Authors: Fitzgerald Antoinette , Bailey Maggie , Smith Anthony C , Webb Kerri , Keating Diane , Klepper Karin , Gibney Eileen 
Published: February 2003

summary We have piloted a monthly series of multidisciplinary case discussions via videoconference in the area of child development. The project provided a forum for clinical discussion of complex cases, peer review, professional development and networking for allied health professionals and paediatricians. Six sites in Queensland participated in the project; each site presented at least one case for discussion. The videoconferences ran for 90 min each and were attended by an average of 26 health professionals. The response rate for a questionnaire survey was 71%. The respondents rated the effectiveness of case summaries and the follow-up newsletter very positively. Despite some early difficulties with the technical aspects of videoconferencing, the evaluation demonstrated the participants’ satisfaction with the project and its relevance to their everyday practice.
Videoconferencing training for those working with at-risk young people in rural areas of Western Australia
Authors: Haythornthwaite Sarah 
Published: February 2003

summary Rural Links is a videoconference training initiative developed for those who work with at-risk young people in remote and rural regions of Western Australia. The training programme was run twice (in parallel) for two groups of participants: 17 workers from the Great Southern and South West regions of Western Australia and 15 workers from the Wheatbelt, Pilbara and Kimberley regions of Western Australia. The programme consisted of seven 2 h sessions presented over 12 weeks. Objectives of the training programme centred on increasing participants’ knowledge and confidence in relation to the training topics. The initiative also aimed to enhance consultation between rural youth networks and a metropolitan-based youth mental health service (YouthLink). Analyses indicated that there were improvements in workers’ knowledge and confidence in relation to training topics following participation in the programme. Comparisons of the improvements made by these rural participants, who accessed training via videoconferencing, and metropolitan participants, who accessed training face to face, revealed few significant differences. Rural participants reported high levels of satisfaction, decreased feelings of professional isolation and an increased likelihood of accessing YouthLink for consultative support as a result of completing the Rural Links training programme.
Controlled trial of discharge planning by video-link in a UK urban mental health service: Responses of staff and service users
Authors: Mclaren Paul , Jegan Sab , Ahlbom Johanna , Gallo Fidel , Gaughran Fiona , Forni Carlos 
Published: February 2003

summary We examined the use of videoconferencing in a UK urban mental health service for discharge planning within the framework of the Care Programme Approach (CPA). The study was an AB design. Baseline data were collected over three months, before the introduction of the CPA by videoconferencing. Twenty-seven CPA meetings were held in the baseline phase of the study and 23 during the video-link phase. Service users and professional participants were asked to complete the Guy's Communication Questionnaire (GCQ) at the end of the meeting. A total of 204 GCQs were completed (88% of those issued). Responses were compared between the face-to-face and video-link conditions. No significant differences were found in satisfaction measures between the two conditions. These data suggest that the video-link medium is acceptable to service users and professionals alike for discharge planning.
Teleneurology in Northern Ireland: A success
Authors: Patterson Victor 
Published: February 2003

summary In March 1998 two neurologists and a professor of telemedicine met to solve a clinical problem -how to get neurological expertise to patients admitted acutely to hospitals which had no resident neurologist. Four years later, two new consultant neurologists were appointed in Northern Ireland with sessions in telemedicine, possibly the first such appointments anywhere in the world. This feat was achieved by combining science with politics. First, we chose the most appropriate telemedicine equipment and bandwidth for our needs. Second, we altered our neurological consultation to use the technology efficiently. Third, we were able to show scientifically that teleneurology was reproducible, feasible in practice, safe, acceptable and cost-effective. This required money to pay for a research fellow and equipment, which was obtained initially from some departmental research funds and a local hospital. Conventional research funding bodies were, on the whole, unhelpful. It was serendipitous that a review of neurology services in Northern Ireland was set up by the Department of Health. This identified our original problem as one that it wanted solved and we were in the fortunate position of being able to offer telemedicine as a tested solution. One final political push was required to get the money released. The result of this juxtaposition of science and politics should bring benefit to our neurological patients and will perhaps help others trying to establish similar projects elsewhere.
Telenursing: Clinical nurse consultancy for rural paediatric nurses
Authors: Rosina Robyn , Starling Jean , Nunn Kenneth , Dossetor David , Bridgland Kim 
Published: February 2003

summary Videoconferencing is increasingly being accepted as a medium for health-care. Telenursing is in its infancy in Australia but has enormous potential for nursing care in remote areas. The Child and Adolescent Psychological Telemedicine Outreach Service (CAPTOS) began in 1997 and in its first evaluation recommended more support for paediatric nurses. CAPTOS telenursing began as a new initiative in late 2001. The telenursing project aims to link ward nurses to CAPTOS and local community teams, and to provide both clinical consultancy on nursing and interdisciplinary issues and locally based professional development. Telenursing supports nurses via site visits, videoconferencing sessions, an interactive Website and sabbatical opportunities. Telehealth works with existing services to enhance the nursing care of young people with a complex mixture of psychological and physical health problems.
A comparison of telepaediatric activity at two regional hospitals in Queensland
Authors: Smith Anthony C , Williams Michael , Van Der Westhuyzen Jasper , Mccrossin Robert , Isles Alan , Wootton Richard 
Published: February 2003

summary We conducted a 15-month feasibility study of telepaediatrics. A novel service was offered to two hospitals in Queensland (Mackay and Hervey Bay). We used data from all other hospitals throughout the state as the control group. Although both intervention hospitals were provided with the same service, the telepaediatric activity generated and the effect on admissions and outpatient activity were markedly different. There was a significant decrease in the number of patient admissions to Brisbane from the Mackay region. In addition, there was an increase in the number of Mackay patients treated locally (as outpatients). In contrast, little change was observed in Hervey Bay. We assessed whether the observed differences between the two hospitals were due to various factors which influenced the use of the telepaediatric service. These factors included the method of screening patients before transfer to the tertiary centre and the physical distance between each facility and the tertiary centre. We believe that the screening method used for patient referrals was the most important determinant of the use of the telepaediatric service.
International distance education and the transition from ISDN to high-bandwidth Internet connectivity
Authors: Vincent Dale S , Berg Benjamin W , Chitpatima Suwicha , Hudson Donald 
Published: February 2003

summary The Thailand-Hawaii Assessment of Interactive Healthcare Initiative (THAI-HI) is an international distance-education project between two teaching hospitals in Honolulu and Bangkok that uses videoconferencing over three ISDN lines. A ‘morning report’ format is used to discuss clinical cases primarily covering infectious disease and critical-care topics. An audience response system is used at both sites to add interactivity. From July 2001 to May 2002, 816 health-care providers attended 20 clinical conferences. Audiences rated the conferences as highly relevant and as having high training value. Since the ISDN connection is expensive, we plan to convert the telecommunications to a high-bandwidth Internet connection. The Honolulu site will use a 45 Mbit/s commercial connection to the Hawaii Intranetwork Consortium, which links to the Abilene Network on the US mainland. The Bangkok hospital will use a 155 Mbit/s wireless optical connection to UNINET Thailand, which has a 45 Mbit/s circuit to Abilene.
The diffusion of innovation: Factors influencing the uptake of telehealth
Authors: Walker Judi , Whetton Sue 
Published: February 2003

summary The actual use of telehealth, particularly for clinical consultations, has in many cases been less than anticipated. The literature identifies a number of factors or barriers. These include legal issues, technical difficulties, time and convenience, cost and training/familiarity with the equipment. No single factor has been identified as being consistently present. Rogers’ diffusion of innovation theory suggests that organizational structures and cultures will affect health professionals’ perceptions of telehealth. The introduction of telehealth services affects existing work practices and workflows. We believe that it is necessary to develop strategies for the introduction of telehealth applications which take into account the idiosyncrasies of the health service sector, and the particular structures and cultures of individual organizations within that sector.
Logistical aspects of large telemedicine networks. 1: Site directories
Authors: Wootton Richard , Smith Anthony C , Gormley Sinead , Patterson Jessica 
Published: February 2003

summary We carried out a survey of the site coordinators in a mature telemedicine network of about 200 sites. The site directory contained information about 221 videoconference facilities. There were 191 site coordinators in all (i.e. some coordinators were responsible for more than one site). Of the 221 sites, we were able to contact 87 on first attempt and 155 by the fourth attempt. Thus there were 66 sites (30%) which were not contactable. We asked each site coordinator to describe any videoconference activity that had taken place over the previous five working days. Of the contacted 155 sites, 78 reported some videoconference activity during the period in question. The total reported videoconference activity was 12,800 min during the one-week monitoring period, that is, an estimated 924 h per month. The most common categories of work were education or training (511 h) and management or administration (225 h), which between them accounted for 80% of all reported videoconference activity. Fifty of the 155 sites (32%) reported that the equipment was not located in an area suitable for patient consultations. In addition, 20 sites (13%) volunteered that their videoconferencing facilities were not in working order at the time of the survey. We did not ask this question in the survey, so that this result represents a lower bound for the true number of inoperable systems.
Government relations, government regulations: Jumping through the hoops
Authors: Yellowlees Peter 
Published: February 2003

summary Over the last decade, telehealth in Australia has been primarily facilitated and driven by government funding. The government now has a major policy initiative in online health. However, in pursuing the broad initiative there is a danger that some of the smaller components can get lost, and this is probably what has happened to telehealth. There appear to be a number of steps required if telehealth in Australia is to keep up the pace of development that occurred in the 1990s, as we move into what is now being called the era of e-health, involving broadband Internet health service delivery. This area is changing extremely rapidly and is increasingly migrating away from the public sector in Australia, where most of the developmental work has occurred, and into the private sector. Many of the issues that require consideration within the domain of e-health in Australia are also relevant to other countries. E-health will significantly change the way that health-care is practised in future, and it is clear that it is the human factors that are more difficult to overcome, rather than the technological ones.
Structural and Textural Properties of Perchlorated and Persulphated Mixed (Hydr)Oxides of Zirconium and Titanium
Authors: Shafei Gamal M.S. El , Zahran Afaf A. 
Published: February 2003

Perchlorated and persulphated mixed hydroxides of zirconium and titanium were prepared by coprecipitation and impregnation in aqueous HClO4 or (NH4)2S2O8 solutions of 0.05, 0.10, 0.20 and 0.40 M concentrations. An alternate sequence of impregnation followed by calcination or vice versa was conducted and the samples obtained studied using XRD, FT-IR, pyridine titration and low-temperature (–196°C) nitrogen adsorption methods. XRD indicated that the presence of titanium stabilized the tetragonal modification of zirconia and almost completely prevented the usual tetragonal → monoclinic transformation upon calcination at 650°C. Both S2O82– and ClO4− anions at their lowest concentration level (0.05 M) partially retarded the crystallization which occurred upon calcination at 650°C in their absence. However, the two anions showed different effects. Whereas the perchlorate anion prevented the formation of a crystalline titania phase (anatase) to a greater extent than that of crystalline zirconia, the persulphate anion showed the opposite effect. Complete inhibition was observed with both anions at a concentration of 0.4 M. This effect was attributed to adsorption of the anions on the hydroxy species of zirconium and titanium formed initially, as demonstrated by IR spectroscopy which showed that the anions were of lower symmetry, viz. C2v, due to their bonding to the hydroxy species. Calcination at 650°C caused the material formed initially to lose virtually all its initial high surface area because of crystallization. The prevention of crystallization by added anions was reflected in the retention of a relatively high surface area even after calcination at 650°C. The recorded difference in the interactions of the anions with the hydroxy species formed initially was also reflected in the texture of the anion-modified solids. The protecting influence of the ClO4− anion increased with its increasing concentration in the system, whereas the corresponding effect with the S2O82– anion increased up to 0.10 M concentration and then decreased at higher concentrations.
Heavy Metal Ion Adsorption Properties of Methacrylamidocysteine-Containing Porous Poly(Hydroxyethyl Methacrylate) Chelating Beads
Authors: Denizli Adil , Garipcan Bora , Emir Sibel , Patir Süleyman , Say Ridvan 
Published: February 2003

Details of the adsorption performance of poly(2-hydroxyethylmethacrylate–methacrylamidocysteine) [p(HEMA–MAC)] beads towards the removal of heavy metal ions from aqueous solution were studied. The metal-complexing ligand and/or co-monomer MAC was newly synthesized from methylacrylochloride and cysteine. Spherical beads of average size 150–200 mm were obtained by the radical suspension polymerization of MAC and HEMA conducted in an aqueous dispersion. The p(HEMA–MAC) beads obtained had a specific surface area of 18.9 m2/g. p(HEMA–MAC) beads were characterized by swelling studies, FT-IR spectroscopy and elemental analysis. Such beads with a swelling ratio of 72%, and containing 3.9 mmol MAC/g, were used for heavy metal removal studies. The adsorption capacities of the beads for selected metal ions, i.e. CdII, AsIII, CrIII, HgII and PbII, were investigated in aqueous media containing different amounts of these ions (10–750 mg/l) and at different pH values (3.0–7.0). The adsorption rate was fast in all cases. The maximum adsorption capacities of the p(HEMA–MAC) beads were 1058.2 mg/g for CdII, 123.4 mg/g for AsIII, 199.6 mg/g for CrIII, 639.1 mg/g for PbII and 1018.6 mg/g for HgII. On a molar basis, the following affinity order was observed: CdII > HgII > CrIII > PbII >AsIII. The adsorption capacity of the MAC-incorporated beads was affected significantly by the pH value of the aqueous medium. The adsorption of heavy metal ions from artificial wastewater was also studied. In this case, the adsorption capacities were 52.2 mg/g for CdII, 23.1 mg/g for CrIII, 83.4 mg/g for HgII, 62.6 mg/g for PbII and 11.1 mg/g for AsIII at an initial metal ion concentration of 0.5 mmol/l. The chelating beads could be regenerated easily with a higher effectiveness by 0.1 M HNO3. These features make p(HEMA–MAC) beads potential candidates for heavy metal ion removal at high capacity.
Poly(Methacrylic Acid) Adsorption and Electrical Surface Properties of Titanium Dioxide Suspensions
Authors: Soltys M.M. , Yaremko Z.M. , Tkachenko N.H. , Havryliv V.D. 
Published: February 2003

The influence of adsorbed poly(methacrylic acid) (PMAA) of molecular weight 10 × 103 on the aggregation stability of titanium dioxide suspensions and on the zeta potential of the particles has been studied over a wide range of pH (from 2.0 to 12.0). The dependence of the zeta potential of titanium dioxide particles in aqueous suspension on the pH of the system was typical for metal oxides and passed through an isoelectric point at pH0 = 6.2. Adsorption of poly(methacrylic acid) on to titanium dioxide particles had a considerable effect on the dependence of the zeta potential of the particles on the pH of the suspension medium. The change of zeta potential both in the absence and presence of PMAA correlated well with the aggregation stability of the suspensions, which was estimated from the mean radius of the particles. The influence of the adsorbed poly(methacrylic acid) macromolecules on the zeta potential of the particles can be explained according to a scheme which envisages both a decrease in the particle surface potential and a change in the potential distribution in the electrical double layer.
Exchanging Preliminary Information in Concurrent Engineering: Alternative Coordination Strategies
Authors: Terwiesch Christian , Loch Christoph H. , Meyer Arnoud De 
Published: February 2003

Successful application of concurrent development processes (concurrent engineering) requires tight coordination. To speed development, tasks often proceed in parallel by relying on preliminary information from other tasks, information that has not yet been finalized. This frequently causes substantial rework using as much as 50% of total engineering capacity. Previous studies have either described coordination as a complex social process, or have focused on the frequency, but not the content, of information exchanges. Through extensive fieldwork in a high-end German automotive manufacturer, we develop a framework of preliminary information that distinguishes information precision and information stability. Information precision refers to the accuracy of the information exchanged. Information stability defines the likelihood of changing a piece of information later in the process. This definition of preliminary information allows us to develop a time-dependent model for managing interdependent tasks, producing two alternative strategies: iterative and set-based coordination. We discuss the trade-offs in choosing a coordination strategy and how they change over time. This allows an organization to match its problem-solving strategy with the interdependence it faces. Set-based coordination requires an absence of ambiguity, and should be emphasized if either starvation costs or the cost of pursuing multiple design alternatives in parallel are low. Iterative coordination should be emphasized if the downstream task faces ambiguity, or if starvation costs are high and iteration (rework) costs are low.
FOXL2‐mutations in blepharophimosis‐ptosis—epicanthus inversus syndrome (BPES); challenges for genetic counseling in female patients
Authors: Fokstuen Siv , Antonarakis Stylianos E. , Blouin Jean‐Louis 
Published: February 2003

AbstractMutations in the forkhead transcription factor gene 2 (FOXL2) were recently reported to cause blepharophimosis‐ptosis‐epicanthus inversus syndrome (BPES) types I and II. Evidence was provided that BPES type I (eyelid abnormalities and female infertility) is caused by mutations resulting in a truncated FOXL2 protein. In contrast, mutant FOXL2 proteins, either with inserted aminoacids in the forkhead domain or polyalanine tract, or with novel aminoacids at the carboxyl end, were found in BPES type II, in which fertility is generally normal. We report a 32‐year‐old female patient with sporadic BPES and a history of menstrual cycle irregularities and periods of secondary amenorrhoea. A heterozygous frameshift mutation (c959‐960insG) was found in the FOXL2 gene, resulting in a predicted FOXL2 protein with 212 novel aminoacids in the carboxyl end, suggesting BPES type II despite menstrual irregularities. The clinical presentations of our patient and of three female patients with BPES type II in the report of De Baere et al. [2001: Hum Mol Genet 10:1591–1600.] indicate phenotypic overlap between BPES type I and II. These observations do not support a clear‐cut prediction of female fertility based on the FOXL2 molecular defect. As a consequence, FOXL2 mutation testing in female patients of child‐bearing age with BPES should be handled with caution, and a two‐step genetic counseling approach, including an initial pre‐test information session, is proposed. © 2003 Wiley‐Liss, Inc.