Challenges and opportunities of undertaking a video ethnographic study to understand medication communication

AIMS AND OBJECTIVES: To examine the challenges and opportunities of undertaking a video ethnographic study on medication communication among nurses, doctors, pharmacists and patients. BACKGROUND: Video ethnography has proved to be a dynamic and useful method to explore clinical communication activities. This approach involves filming actual behaviours and activities of clinicians to develop new knowledge and to stimulate reflections of clinicians on their behaviours and activities. However, there is limited information about the complex negotiations required to use video ethnography in actual clinical practice. DESIGN: Discursive paper. METHOD: A video ethnographic approach was used to gain better understanding of medication communication processes in two general medical wards of a metropolitan hospital in Melbourne, Australia. This paper presents the arduous and delicate process of gaining access into hospital wards to video-record actual clinical practice and the methodological and ethical issues associated with video-recording. CONCLUSIONS: Obtaining access to clinical settings and clinician consent are the first hurdles of conducting a video ethnographic study. Clinicians may still feel intimidated or self-conscious in being video recorded about their medication communication practices, which they could perceive as judgements being passed about their clinical competence. By thoughtful and strategic planning, video ethnography can provide in-depth understandings of medication communication in acute care hospital settings. Ethical issues of informed consent, patient safety and respect for the confidentiality of patients and clinicians need to be carefully addressed to build up and maintain trusting relationships between researchers and participants in the clinical environment. RELEVANCE TO CLINICAL PRACTICE: By prudently considering the complex ethical and methodological concerns of using video ethnography, this approach can help to reveal the unpredictability and messiness of clinical practice. The visual data generated can stimulate clinicians' reflexivity about their norms of practice and bring about improved communication about managing medications.

A compilation of consumers' stories: the development of a video to enhance medication adherence in newly transplanted kidney recipients

AIM: To describe the design, development and evaluation of a consumer-centred video, which was underpinned by the Theory of Planned Behaviour and it was created to educate newly transplanted kidney recipients about the importance of medication adherence. BACKGROUND: Kidney transplantation is a treatment whereby medication adherence is critical to ensure long-term kidney graft success. To date, many interventions aimed to improve medication adherence in kidney transplantation have been conducted but consumers remain largely uninvolved in the interventional design. DESIGN: Qualitative sequential design. METHODS: Twenty-two participants who had maintained their kidney transplant for at least 8 months and three participants who had experienced a kidney graft loss due to non-adherence were interviewed from March-May 2014 in Victoria, Australia. These interviews were independently reviewed by two researchers and were used to guide the design of the story plot and to identify storytellers for the video. The first draft of the video was evaluated by a panel of seven experts in the field, one independent educational expert and two consumers using Lynn's content validity questionnaire. The content of the video was regarded as highly relevant and comprehensive, which achieved a score of >3·7 out of a possible 4. RESULTS/FINDINGS: The final 18-minute video comprised 15 sections. Topics included medication management, the factors affecting medication adherence and the absolute necessity of adherence to immunosuppressive medications for graft survival. CONCLUSION: This paper has demonstrated the feasibility of creating a consumer-driven video that supports medication adherence in an engaging way.

Learning clinical skills during bedside teaching encounters in general practice: a video-observational study with insights from activity theory

Purpose – This paper aims to explore how opportunities for learning clinical skills are negotiated within bedside teaching encounters (BTEs). Bedside teaching, within the medical workplace, is considered essential for helping students develop their clinical skills. Design/methodology/approach – An audio and/or video observational study examining seven general practice BTEs was undertaken. Additionally, audio-recorded, semi-structured interviews were conducted with participants. All data were transcribed. Data analysis comprised Framework Analysis informed by Engeström’s Cultural Historical Activity Theory. Findings – BTEs can be seen to offer many learning opportunities for clinical skills. Learning opportunities are negotiated by the participants in each BTE, with patients, doctors and students playing different roles within and across the BTEs. Tensions emerged within and between nodes and across two activity systems. Research limitations/implications – Negotiation of clinical skills learning opportunities involved shifts in the use of artefacts, roles and rules of participation, which were tacit, dynamic and changing. That learning is constituted in the activity implies that students and teachers cannot be fully prepared for BTEs due to their emergent properties. Engaging doctors, students and patients in refecting on tensions experienced and the factors that infuence judgements in BTEs may be a useful frst step in helping them better manage the roles and responsibilities therein. Originality/value – The paper makes an original contribution to the literature by highlighting the tensions inherent in BTEs and how the negotiation of roles and division of labour whilst juggling two interacting activity systems create or inhibit opportunities for clinical skills learning. This has signifcant implications for how BTEs are conceptualised.

The construction of power in family medicine bedside teaching: a video observation study

INTRODUCTION: Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. METHODS: A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. RESULTS: Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. CONCLUSIONS: Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student-patient-doctor relationship within bedside teaching.

Online video recommendation in sharing community

The creation of sharing communities has resulted in the astonishing increasing of digital videos, and their wide applications in the domains such as entertainment, online news broadcasting etc. The improvement of these applications relies on effective solutions for social user access to video data. This fact has driven the recent research interest in social recommendation in shared communities. Although certain effort has been put into video recommendation in shared communities, the contextual information on social users has not been well exploited for effective recommendation. In this paper, we propose an approach based on the content and social information of videos for the recommendation in sharing communities. Specifically, we first exploit a robust video cuboid signature together with the Earth Mover's Distance to capture the content relevance of videos. Then, we propose to identify the social relevance of clips using the set of users belonging to a video. We fuse the content relevance and social relevance to identify the relevant videos for recommendation. Following that, we propose a novel scheme called sub-community-based approximation together with a hash-based optimization for improving the efficiency of our solution. Finally, we propose an algorithm for efficiently maintaining the social updates in dynamic shared communities. The extensive experiments are conducted to prove the high effectiveness and efficiency of our proposed video recommendation approach.

Bayesian nonparametric approaches to abnormality detection in video surveillance

In data science, anomaly detection is the process of identifying the items, events or observations which do not conform to expected patterns in a dataset. As widely acknowledged in the computer vision community and security management, discovering suspicious events is the key issue for abnormal detection in video surveil-lance. The important steps in identifying such events include stream data segmentation and hidden patterns discovery. However, the crucial challenge in stream data segmenta-tion and hidden patterns discovery are the number of coherent segments in surveillance stream and the number of traffic patterns are unknown and hard to specify. Therefore, in this paper we revisit the abnormality detection problem through the lens of Bayesian nonparametric (BNP) and develop a novel usage of BNP methods for this problem. In particular, we employ the Infinite Hidden Markov Model and Bayesian Nonparamet-ric Factor Analysis for stream data segmentation and pattern discovery. In addition, we introduce an interactive system allowing users to inspect and browse suspicious events.

Piloting the feasibility of head-mounted video technology to augment student feedback during simulated clinical decision-making: an observational design pilot study

BACKGROUND: Clinical decision-making is a complex activity that is critical to patient safety. Simulation, augmented by feedback, affords learners the opportunity to learn critical clinical decision-making skills. More detailed feedback following simulation exercises has the potential to further enhance student learning, particularly in relation to developing improved clinical decision-making skills. OBJECTIVE: To investigate the feasibility of head-mounted video camera recordings, to augment feedback, following acute patient deterioration simulations. DESIGN: Pilot study using an observational design. METHODS: Ten final-year nursing students participated in three simulation exercises, each focussed on detection and management of patient deterioration. Two observers collected behavioural data using an adapted version of Gaba's Clinical Simulation Tool, to provide verbal feedback to each participant, following each simulation exercise. Participants wore a head-mounted video camera during the second simulation exercise only. Video recordings were replayed to participants to augment feedback, following the second simulation exercise. Data were collected on: participant performance (observed and perceived); participant perceptions of feedback methods; and head-mounted video camera recording feasibility and capability for detailed audio-visual feedback. RESULTS: Management of patient deterioration improved for six participants (60%). Increased perceptions of confidence (70%) and competence (80%), were reported by the majority of participants. Few participants (20%) agreed that the video recording specifically enhanced their learning. The visual field of the head-mounted video camera was not always synchronised with the participant's field of vision, thus affecting the usefulness of some recordings. CONCLUSION: The usefulness of the video recordings, to enhance verbal feedback to participants on detection and management of simulated patient deterioration, was inconclusive. Modification of the video camera glasses, to improve visual-field synchronisation with participants' actual visual field, is recommended to further explore this technology for enhancing student performance.

A inovação do AMV: o Anime Music Video e suas relações com a pós-modernidade e a cibercultura

Dissertação apresentada ao Programa de Mestrado em Comunicação da Universidade Municipal de São Caetano do Sul - USCS

Brazilian indexing and inertial inflation: evidence from time-varying estimates of an inflation transfer function

This paper is a theoretica1 and empirica1 study of the re1ationship between indexing po1icy and feedback mechanisms in the inflationary adjustment process in Brazil. The focus of our study is on two policy issues: (1) did the Brazilian system of indexing of interest rates, the exchange rate, and wages make inflation so dependent on its own past values that it created a significant feedback process and inertia in the behaviour of inflation in and (2) was the feedback effect of past inf1ation upon itself so strong that dominated the effect of monetary/fiscal variables upon current inflation? This paper develops a simple model designed to capture several "stylized facts" of Brazi1ian indexing po1icy. Separate ru1es of "backward indexing" for interest rates, the exchange rate, and wages, reflecting the evolution of po1icy changes in Brazil, are incorporated in a two-sector model of industrial and agricultural prices. A transfer function derived irom this mode1 shows inflation depending on three factors: (1) past values of inflation, (2) monetary and fiscal variables, and (3) supply- .shock variables. The indexing rules for interest rates, the exchange rate, and wages place restrictions on the coefficients of the transfer function. Variations in the policy-determined parameters of the indexing rules imply changes in the coefficients of the transfer function for inflation. One implication of this model, in contrast to previous results derived in analytically simpler models of indexing, is that a higher degree of indexing does not make current inflation more responsive to current monetary shocks. The empirical section of this paper studies the central hypotheses of this model through estimation of the inflation transfer function with time-varying parameters. The results show a systematic non-random variation of the transfer function coefficients closely synchronized with changes in the observed values of the wage-indexing parameters. Non-parametric tests show the variation of the transfer function coefficients to be statistically significant at the time of the changes in wage indexing rules in Brazil. As the degree of indexing increased, the inflation feadback coefficients increased, while the effect of external price and agricultura shocs progressively increased and monetary effects progressively decreased.

Captura e visualização de video 3d em tempo real

Vídeos são dos principais meios de difusão de conhecimento, informação e entretenimento existentes. Todavia, apesar da boa qualidade e da boa aceitação do público, os vídeos atuais ainda restringem o espectador a um único ponto de vista. Atualmente, alguns estudos estão sendo desenvolvidos visando oferecer ao espectador maior liberdade para decidir de onde ele gostaria de assistir a cena. O tipo de vídeo a ser produzido por essas iniciativas tem sido chamado genericamente de vídeo 3D. Esse trabalho propõe uma arquitetura para captura e exibição de vídeos 3D em tempo real utilizando as informações de cor e profundidade da cena, capturadas para cada pixel de cada quadro do vídeo. A informação de profundidade pode ser obtida utilizando-se câmeras 3D, algoritmos de extração de disparidade a partir de estéreo, ou com auxílio de luz estruturada. A partir da informação de profundidade é possível calcular novos pontos de vista da cena utilizando um algoritmo de warping 3D. Devido a não disponibilidade de câmeras 3D durante a realização deste trabalho, a arquitetura proposta foi validada utilizando um ambiente sintético construído usando técnicas de computação gráfica. Este protótipo também foi utilizado para analisar diversos algoritmos de visão computacional que utilizam imagens estereoscópias para a extração da profundidade de cenas em tempo real. O uso de um ambiente controlado permitiu uma análise bastante criteriosa da qualidade dos mapas de profundidade produzidos por estes algoritmos, nos levando a concluir que eles ainda não são apropriados para uso de aplicações que necessitem da captura de vídeo 3D em tempo real.

Indexing stock portfolios in Brazil: tracking the IBOVESPA and the FGV 100

Indexing is a passive investment strategy in which the investor weights bis portfolio to match the performance of a broad-based indexo Since severaI studies showed that indexed portfolios have consistently outperformed active management strategies over the last decades, an increasing number of investors has become interested in indexing portfolios IateIy. Brazilian financiaI institutions do not offer indexed portfolios to their clients at this point in time. In this work we propose the use of indexed portfolios to track the performance oftwo ofthe most important Brazilian stock indexes: the mOVESPA and the FGVIOO. We test the tracking performance of our modeI by a historical simulation. We applied several statistical tests to the data to verify how many stocks should be used to controI the portfolio tracking error within user specified bounds.

Inexpensive solution for real-time video and image stitching

Image stitching is the process of joining several images to obtain a bigger view of a scene. It is used, for example, in tourism to transmit to the viewer the sensation of being in another place. I am presenting an inexpensive solution for automatic real time video and image stitching with two web cameras as the video/image sources. The proposed solution relies on the usage of several markers in the scene as reference points for the stitching algorithm. The implemented algorithm is divided in four main steps, the marker detection, camera pose determination (in reference to the markers), video/image size and 3d transformation, and image translation. Wii remote controllers are used to support several steps in the process. The built‐in IR camera provides clean marker detection, which facilitates the camera pose determination. The only restriction in the algorithm is that markers have to be in the field of view when capturing the scene. Several tests where made to evaluate the final algorithm. The algorithm is able to perform video stitching with a frame rate between 8 and 13 fps. The joining of the two videos/images is good with minor misalignments in objects at the same depth of the marker,misalignments in the background and foreground are bigger. The capture process is simple enough so anyone can perform a stitching with a very short explanation. Although real‐time video stitching can be achieved by this affordable approach, there are few shortcomings in current version. For example, contrast inconsistency along the stitching line could be reduced by applying a color correction algorithm to every source videos. In addition, the misalignments in stitched images due to camera lens distortion could be eased by optical correction algorithm. The work was developed in Apple’s Quartz Composer, a visual programming environment. A library of extended functions was developed using Xcode tools also from Apple.