Revision of NHTSA curriculum packages. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Your time to shine: planning guide.

Mode of access: Internet.

Orientation seminars for revised NHTSA curriculum packages. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

EMS outcomes evaluation: an examination of key issues and future directions.

Mode of access: Internet.

Law, Rights and Reproduction: Reproductive Autonomy in Ethical Rationalism

As medical technology has advanced, so too have our attitudes towards the level of control we can expect to hold over our procreative capacities. This creates a multi-dimensional problem for the law in terms of access to services which prevent conception, access to services which terminate a pregnancy and recompensing those whose choices to avoid procreating are frustrated. These developments go to the heart of our perception of autonomy. In order to evaluate these three issues in relation to reproductive autonomy, I set out to investigate how the Gewirthian theory of ethical rationalism can be used to understanding the intersection between law, rights, and autonomy. As such, I assert that it is because of agents’ ability to engage in practical reason that the concept of legal enterprise should be grounded in rationality. Therefore, any attempt to understand notions of autonomy must be based on the categorical imperative derived from the Principle of Generic Consistency (PGC). As a result, I claim that (a) a theory of legal rights must be framed around the indirect application of the PGC and (b) a model of autonomy must account for the limitations drawn by the rational exercise of reason. This requires support for institutional policies which genuinely uphold the rights of agents. In so doing, a greater level of respect for and protection of reproductive autonomy is possible. This exhibits the full conceptual metamorphosis of the PGC from a rational moral principle, through an ethical collective principle, a constitutional principle of legal reason, a basis for rights discourse, and to a model of autonomy. Consequently, the law must be reformed to reflect the rights of agents in these situations and develop an approach which demonstrates a meaningful respect of autonomy. I suggest that this requires rights of access to services, rights to reparation and duties on the State to empower productive agency.

Ambulance Treatment Space Ergonomic Layout

This is the first time a multidisciplinary team has employed an iterative co-design method to determine the ergonomic layout of an emergency ambulance treatment space. This process allowed the research team to understand how treatment protocols were performed and developed analytical tools to reach an optimum configuration towards ambulance design standardisation. Fusari conducted participatory observations during 12-hour shifts with front-line ambulance clinicians, hospital staff and patients to understand the details of their working environments whilst on response to urgent and emergency calls. A simple yet accurate 1:1 mock-up of the existing ambulance was built for detailed analysis of these procedures through simulations. Paramedics were called in to participate in interviews and role-playing inside the model to recreate tasks, how they are performed, the equipment used and to understand the limitations of the current ambulance. The use of Link Analysis distilled 5 modes of use. In parallel, an exhaustive audit of all equipment and consumables used in ambulances was performed (logging and photography) to define space use. These developed 12 layout options for refinement and CAD modelling and presented back to paramedics. The preferred options and features were then developed into a full size test rig and appearance model. Two key studies informed the process. The 2005 National Patient Safety Agency funded study “Future Ambulances” outlined 9 design challenges for future standardisation of emergency vehicles and equipment. Secondly, the 2007 EPSRC funded “Smart Pods” project investigated a new system of mobile urgent and emergency medicine to treat patients in the community. A full-size mobile demonstrator unit featuring the evidence-based ergonomic layout was built for clinical tests through simulated emergency scenarios. Results from clinical trials clearly show that the new layout improves infection control, speeds up treatment, and makes it easier for ambulance crews to follow correct clinical protocols.

An approach to emotion recognition in single-channel EEG signals: a mother child interaction

In this work, we perform a first approach to emotion recognition from EEG single channel signals extracted in four (4) mother-child dyads experiment in developmental psychology -- Single channel EEG signals are analyzed and processed using several window sizes by performing a statistical analysis over features in the time and frequency domains -- Finally, a neural network obtained an average accuracy rate of 99% of classification in two emotional states such as happiness and sadness

Diagnóstico de la relación entre el uso excesivo de las TICs y síntomas depresivos y ansiedad en estudiantes de medicina, Universidad de Cuenca, Ecuador

Se trata de un estudio descriptivo de corte transversal entre estudiantes de la Facultad de Ciencias Médicas de la Universidad de Cuenca1, para determinar la magnitud del uso excesivo de Tecnologías de Información y Comunicación (TICs), su variación en función de la edad, sexo, estado civil y la carrera; así como su asociación con síntomas depresivos y de ansiedad. En el cuestionario previamente validado que fue aplicado a muestra aleatoria por conglomerados de 333 estudiantes, se integraron preguntas de información demográfica, test de uso excesivo de TICs y de síntomas depresivos y de ansiedad. El concepto de Riesgo Relativo y su Intervalo de Confianza al 95% fue utilizado para el análisis estadístico. Los resultados nos revelan que la edad promedio de la muestra de la población fue de 22 años, 37,2% con uso excesivo de TICs, el 18,3% presentan síntomas depresivos y 39,8% de ansiedad. Entre las variables asociadas de manera significativa con el uso excesivo de TICs están: la edad menor de 19 años (RR 2,04; IC 95% 1,31-3,20), el género masculino (RR 1,36; IC 95% 1,03-1,80) y la carrera de Tecnología Médica (RR 1,83; IC 95% 1,28-2,63). El uso excesivo de las TICs no está asociado con el estado civil. Sin embargo, el análisis estadístico nos muestra la existencia de una correlación positiva entre el uso excesivo de las TICs y la frecuencia de estudiantes con síntomas depresivos (RR 1,88; IC 95% 1,45-2,44) y de ansiedad (RR 2,61; IC 95% 1,64-4,15).

The MATCH project: collaboration between academia and industry

The university sector offers innovative research initiatives which industry should be tapping. Michael Craven, Senior Research Fellow at the University of Nottingham, reports on a unique collaboration between academia and industry that is helping companies assess the value of medical technology.

Relación de la imagen corporal percibida con el índice de masa corporal real en estudiantes de la Escuela de Tecnología Médica de la Universidad de Cuenca. Cuenca octubre 2015 – marzo 2016

OBJETIVO: Determinar la relación de la imagen corporal percibida con el índice de masa corporal real en estudiantes de la Escuela de Tecnología Médica de la Universidad de Cuenca. MATERIALES Y METODOS: Estudio transversal efectuado en estudiantes de la Escuela de Tecnología Médica, con una muestra probabilística aleatoria de 250 alumnos. Previo consentimiento informado, se encuestó a los estudiantes a través del “Cuestionario de la forma corporal” elaborado por: Cooper, Taylor y Fairburn; posteriormente se les presentó a los estudiantes el test de fotografías corporales de los autores Harris y Col., en el cual eligieron una de las figuras con las que se sentían mejor identificados; consecutivamente se procedió a la toma de las medidas antropométricas para la obtención del estado nutricional; finalmente se comparó la imagen corporal percibida con el estado nutricional de cada estudiante. La información fue analizada en el programa SPSS V22 y Excel 2013. RESULTADOS: Del total de la muestra de 251 estudiantes, el 69.7% presentaron un estado nutricional normal; el 4.4% bajo peso; el 20.7% sobrepeso y el 5.2% presentó obesidad. El 67.3% de los estudiantes presentó una adeudada percepción de su imagen corporal, el 6.8% sobrestima su peso y el 25.9% de la muestra lo subestimó. CONCLUSIONES: La mayor parte de los estudiantes universitarios presentaron una correcta percepción de su imagen corporal, al compararla con el IMC real; se evidenció un mínimo porcentaje de distorsión, donde se presentó una tendencia a la subestimación, condición que aumenta el riesgo de padecer enfermedades relacionadas con la alimentación.

The impact of health information technology on the quality of medical and health care : a systematic review

Objective: To systematically review the published evidence of the impact of health information technology (HIT) on the quality of medical and health care specifically clinicians’ adherence to evidence-based guidelines and the corresponding impact this had on patient clinical outcomes. In order to be as inclusive as possible the research examined literature discussing the use of health information technologies and systems in both medical care such as clinical and surgical, and other health care such as allied health and preventive services.----- Design: Systematic review----- Data Sources: Relevant literature was systematically searched on English language studies indexed in MEDLINE and CINAHL(1998 to 2008), Cochrane Library, PubMed, Database of Abstracts of Review of Effectiveness (DARE), Google scholar and other relevant electronic databases. A search for eligible studies (matching the inclusion criteria) was also performed by searching relevant conference proceedings available through internet and electronic databases, as well as using reference lists identified from cited papers.----- Selection criteria: Studies were included in the review if they examined the impact of Electronic Health Record (EHR), Computerised Provider Order-Entry (CPOE), or Decision Support System (DS); and if the primary outcomes of the studies were focused on the level of compliance with evidence-based guidelines among clinicians. Measures could be either changes in clinical processes resulting from a change of the providers’ behaviour or specific patient outcomes that demonstrated the effectiveness of a particular treatment given by providers. ----- Methods: Studies were reviewed and summarised in tabular and text form. Due to heterogeneity between studies, meta-analysis was not performed.----- Results: Out of 17 studies that assessed the impact of health information technology on health care practitioners’ performance, 14 studies revealed a positive improvement in relation to their compliance with evidence-based guidelines. The primary domain of improvement was evident from preventive care and drug ordering studies. Results from the studies that included an assessment for patient outcomes however, were insufficient to detect either clinically or statistically important improvements as only a small proportion of these studies found benefits. For instance, only 3 studies had shown positive improvement, while 5 studies revealed either no change or adverse outcomes.----- Conclusion: Although the number of included studies was relatively small for reaching a conclusive statement about the effectiveness of health information technologies and systems on clinical care, the results demonstrated consistency with other systematic reviews previously undertaken. Widescale use of HIT has been shown to increase clinician’s adherence to guidelines in this review. Therefore, it presents ongoing opportunities to maximise the uptake of research evidence into practice for health care organisations, policy makers and stakeholders.

Educational technology in medical imaging education

Purpose The emergence of digital technologies has created enthusiasm for their application to student learning. An evolving issue in medical imaging is how these technologies might be implemented within programs. Method A review of the literature was performed to explore applications and issues of educational technology in medical imaging Results There are a range of applications for educational technology within medical imaging education however limitations do exist. Learners must be supported by the development of skills to utilize education technologies. The digital picture archival and communication environment presents an ideal opportunity to enhance student learning through interaction and engagement with images. Implementation of education technologies to support student placement activities is an area for future development provided equity of access is addressed. Conclusion Education technologies have specific application to medical imaging education as part of a blended curriculum.

Exploiting SNOMED CT concepts and relationships for clinical information retrieval : Australian e-Health Research Centre and Queensland University of Technology at the TREC 2012 Medical Track

The Australian e-Health Research Centre and Queensland University of Technology recently participated in the TREC 2012 Medical Records Track. This paper reports on our methods, results and experience using an approach that exploits the concept and inter-concept relationships defined in the SNOMED CT medical ontology. Our concept-based approach is intended to overcome specific challenges in searching medical records, namely vocabulary mismatch and granularity mismatch. Queries and documents are transformed from their term-based originals into medical concepts as defined by the SNOMED CT ontology, this is done to tackle vocabulary mismatch. In addition, we make use of the SNOMED CT parent-child `is-a' relationships between concepts to weight documents that contained concept subsumed by the query concepts; this is done to tackle the problem of granularity mismatch. Finally, we experiment with other SNOMED CT relationships besides the is-a relationship to weight concepts related to query concepts. Results show our concept-based approach performed significantly above the median in all four performance metrics. Further improvements are achieved by the incorporation of weighting subsumed concepts, overall leading to improvement above the median of 28% infAP, 10% infNDCG, 12% R-prec and 7% Prec@10. The incorporation of other relations besides is-a demonstrated mixed results, more research is required to determined which SNOMED CT relationships are best employed when weighting related concepts.

Comparison of North American universities with and without medical schools and their technology transfer initiatives

Empirical research available on technology transfer initiatives is either North American or European. Literature over the last two decades shows various research objectives such as identifying the variables to be measured and statistical methods to be used in the context of studying university based technology transfer initiatives. AUTM survey data from years 1996 to 2008 provides insightful patterns about the North American technology transfer initiatives, we use this data in our paper. This paper has three sections namely, a comparison of North American Universities with (n=1129) and without Medical Schools (n=786), an analysis of the top 75th percentile of these samples and a DEA analysis of these samples. We use 20 variables. Researchers have attempted to classify university based technology transfer initiative variables into multi-stages, namely, disclosures, patents and license agreements. Using the same approach, however with minor variations, three stages are defined in this paper. The first stage is to do with inputs from R&D expenditure and outputs namely, invention disclosures. The second stage is to do with invention disclosures being the input and patents issued being the output. The third stage is to do with patents issued as an input and technology transfers as outcomes.