Computer-generated reminders delivered on paper to healthcare professionals; effects on professional practice and health care outcomes.

BACKGROUND: Clinical practice does not always reflect best practice and evidence, partly because of unconscious acts of omission, information overload, or inaccessible information. Reminders may help clinicians overcome these problems by prompting the doctor to recall information that they already know or would be expected to know and by providing information or guidance in a more accessible and relevant format, at a particularly appropriate time. OBJECTIVES: To evaluate the effects of reminders automatically generated through a computerized system and delivered on paper to healthcare professionals on processes of care (related to healthcare professionals' practice) and outcomes of care (related to patients' health condition). SEARCH METHODS: For this update the EPOC Trials Search Co-ordinator searched the following databases between June 11-19, 2012: The Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Library (Economics, Methods, and Health Technology Assessment sections), Issue 6, 2012; MEDLINE, OVID (1946- ), Daily Update, and In-process; EMBASE, Ovid (1947- ); CINAHL, EbscoHost (1980- ); EPOC Specialised Register, Reference Manager, and INSPEC, Engineering Village. The authors reviewed reference lists of related reviews and studies.  SELECTION CRITERIA: We included individual or cluster-randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) that evaluated the impact of computer-generated reminders delivered on paper to healthcare professionals on processes and/or outcomes of care. DATA COLLECTION AND ANALYSIS: Review authors working in pairs independently screened studies for eligibility and abstracted data. We contacted authors to obtain important missing information for studies that were published within the last 10 years. For each study, we extracted the primary outcome when it was defined or calculated the median effect size across all reported outcomes. We then calculated the median absolute improvement and interquartile range (IQR) in process adherence across included studies using the primary outcome or median outcome as representative outcome. MAIN RESULTS: In the 32 included studies, computer-generated reminders delivered on paper to healthcare professionals achieved moderate improvement in professional practices, with a median improvement of processes of care of 7.0% (IQR: 3.9% to 16.4%). Implementing reminders alone improved care by 11.2% (IQR 6.5% to 19.6%) compared with usual care, while implementing reminders in addition to another intervention improved care by 4.0% only (IQR 3.0% to 6.0%) compared with the other intervention. The quality of evidence for these comparisons was rated as moderate according to the GRADE approach. Two reminder features were associated with larger effect sizes: providing space on the reminder for provider to enter a response (median 13.7% versus 4.3% for no response, P value = 0.01) and providing an explanation of the content or advice on the reminder (median 12.0% versus 4.2% for no explanation, P value = 0.02). Median improvement in processes of care also differed according to the behaviour the reminder targeted: for instance, reminders to vaccinate improved processes of care by 13.1% (IQR 12.2% to 20.7%) compared with other targeted behaviours. In the only study that had sufficient power to detect a clinically significant effect on outcomes of care, reminders were not associated with significant improvements. AUTHORS' CONCLUSIONS: There is moderate quality evidence that computer-generated reminders delivered on paper to healthcare professionals achieve moderate improvement in process of care. Two characteristics emerged as significant predictors of improvement: providing space on the reminder for a response from the clinician and providing an explanation of the reminder's content or advice. The heterogeneity of the reminder interventions included in this review also suggests that reminders can improve care in various settings under various conditions.

Producing computer-generated tailored written information for stroke patients and their carers: System development and preliminary evaluation

Purpose: The aim of this project was to design and evaluate a system that would produce tailored information for stroke patients and their carers, customised according to their informational needs, and facilitate communication between the patient and, health professional. Method: A human factors development approach was used to develop a computer system, which dynamically compiles stroke education booklets for patients and carers. Patients and carers are able to select the topics about which they wish to receive information, the amount of information they want, and the font size of the printed booklet. The system is designed so that the health professional interacts with it, thereby providing opportunities for communication between the health professional and patient/carer at a number of points in time. Results: Preliminary evaluation of the system by health professionals, patients and carers was positive. A randomised controlled trial that examines the effect of the system on patient and carer outcomes is underway. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

3D surface point and wireframe reconstruction from multiview photographic images

This paper describes a new method for reconstructing 3D surface points and a wireframe on the surface of a freeform object using a small number, e.g. 10, of 2D photographic images. The images are taken at different viewing directions by a perspective camera with full prior knowledge of the camera configurations. The reconstructed surface points are frontier points and the wireframe is a network of contour generators. Both of them are reconstructed by pairing apparent contours in the 2D images. Unlike previous works, we empirically demonstrate that if the viewing directions are uniformly distributed around the object's viewing sphere, then the reconstructed 3D points automatically cluster closely on a highly curved part of the surface and are widely spread on smooth or flat parts. The advantage of this property is that the reconstructed points along a surface or a contour generator are not under-sampled or under-represented because surfaces or contours should be sampled or represented with more densely points where their curvatures are high. The more complex the contour's shape, the greater is the number of points required, but the greater the number of points is automatically generated by the proposed method. Given that the viewing directions are uniformly distributed, the number and distribution of the reconstructed points depend on the shape or the curvature of the surface regardless of the size of the surface or the size of the object. The unique pattern of the reconstructed points and contours may be used in 31) object recognition and measurement without computationally intensive full surface reconstruction. The results are obtained from both computer-generated and real objects. (C) 2007 Elsevier B.V. All rights reserved.

Queue-based agent communication architecture for intelligent human-like computer interfaces

Human-like computer interaction systems requires far more than just simple speech input/output. Such a system should communicate with the user verbally, using a conversational style language. It should be aware of its surroundings and use this context for any decisions it makes. As a synthetic character, it should have a computer generated human-like appearance. This, in turn, should be used to convey emotions, expressions and gestures. Finally, and perhaps most important of all, the system should interact with the user in real time, in a fluent and believable manner.

The foundations of computer assisted surgery

Using navigation systems in general orthopaedic surgery and, in particular, knee replacement is becoming more and more accepted. This paper describes the basic technological concepts of modern computer assisted surgical systems. It explains the variation in currently available systems and outlines research activities that will potentially influence future products. In general, each navigation system is defined by three components: (1) the therapeutic object is the anatomical structure that is operated on using the navigation system, (2) the virtual object represents an image of the therapeutic object, with radiological images or computer generated models potentially being used, and (3) last but not least, the navigator acquires the spatial position and orientation of instruments and anatomy thus providing the necessary data to replay surgical action in real-time on the navigation system's screen.

Modelling tribology of slider and disk in a computer hard drive system

Issues of wear and tribology are increasingly important in computer hard drives as slider flying heights are becoming lower and disk protective coatings thinner to minimise spacing loss and allow higher areal density. Friction, stiction and wear between the slider and disk in a hard drive were studied using Accelerated Friction Test (AFT) apparatus. Contact Start Stop (CSS) and constant speed drag tests were performed using commercial rigid disks and two different air bearing slider types. Friction and stiction were captured during testing by a set of strain gauges. System parameters were varied to investigate their effect on tribology at the head/disk interface. Chosen parameters were disk spinning velocity, slider fly height, temperature, humidity and intercycle pause. The effect of different disk texturing methods was also studied. Models were proposed to explain the influence of these parameters on tribology. Atomic Force Microscopy (AFM) and Scanning Electron Microscopy (SEM) were used to study head and disk topography at various test stages and to provide physical parameters to verify the models. X-ray Photoelectron Spectroscopy (XPS) was employed to identify surface composition and determine if any chemical changes had occurred as a result of testing. The parameters most likely to influence the interface were identified for both CSS and drag testing. Neural Network modelling was used to substantiate results. Topographical AFM scans of disk and slider were exported numerically to file and explored extensively. Techniques were developed which improved line and area analysis. A method for detecting surface contacts was also deduced, results supported and explained observed AFT behaviour. Finally surfaces were computer generated to simulate real disk scans, this allowed contact analysis of many types of surface to be performed. Conclusions were drawn about what disk characteristics most affected contacts and hence friction, stiction and wear.

Computer aided design and manufacture of form-rolls

Cold roll forming of thin-walled sections is a very useful process in the sheet metal industry. However, the conventional method for the design and manufacture of form-rolls, the special tooling used in the cold roll forming process, is a very time consuming and skill demanding exercise. This thesis describes the establishment of a stand-alone minicomputer based CAD/CAM system for assisting the design and manufacture of form-rolls. The work was undertaken in collaboration with a leading manufacturer of thin-walled sections. A package of computer programs have been developed to provide computer aids for every aspect of work in form-roll design and manufacture. The programs have been successfully implemented, as an integrated CAD/CAM software system, on the ICL PERQ minicomputer with graphics facilities. Thus, the developed CAD/CAM system is a single-user workstation, with software facilities to help the user to perform the conventional roll design activities including the design of the finished section, the flower pattern, and the form-rolls. A roll editor program can then be used to modify, if required, the computer generated roll profiles. As far as manufacturing is concerned, a special-purpose roll machining program and postprocessor can be used in conjunction to generate the NC control part-programs for the production of form-rolls by NC turning. Graphics facilities have been incorporated into the CAD/CAM software programs to display drawings interactively on the computer screen throughout all stages of execution of the CAD/CAM software. It has been found that computerisation can shorten the lead time in all activities dealing with the design and manufacture of form-rolls, and small or medium size manufacturing companies can gain benefits from the CAD/CM! technology by developing, according to its own specification, a tailor-made CAD/CAM software system on a low cost minicomputer.

Construcción de escenarios pseudo-perspectivos mediante la creación y modificación de gráficos tridimensionales utilizados en el trecento

Este estudio forma parte de una investigación más amplia que trata de la capacidad expresiva de los sistemas perspectivos1. Bajo esta premisa hemos reflexionado sobre los métodos utilizados por los artistas del trecento italiano para representar la tercera dimensión. Hemos analizado un amplio número de obras, con un doble objetivo: El primero, obtener datos que otorguen consistencia y fiabilidad a una clasificación que nos ayuda a tipificar el espacio perspectivo en esta etapa predecesora de la perspectiva «correcta» (lineal o cónica). El segundo, extrapolar sus características a la construcción de escenarios pseudo-perspectivos mediante la modificación y creación de gráficos tridimensionales por computadora. Este proceso se ha utilizado para extraer los esquemas que nos sirven como herramienta para explorar nuevos caminos en la representación perspectiva, alejados de la lógica euclidiana. Con este propósito se aportan esquemas formales de representaciones clasificadas en diferentes tipos, que posteriormente se transforman para efectuar la construcción volumétrica de los escenarios.

Moedor de Pixels : interfaces, interações e audiovisual

Dissertação (mestrado)—Universidade de Brasília, Instituto de Artes, Programa de Pós-Graduação em Arte, 2016.

Diffractive phase-shift lithography photomask operating in proximity printing mode

A phase shift proximity printing lithographic mask is designed, manufactured and tested. Its design is based on a Fresnel computer-generated hologram, employing the scalar diffraction theory. The obtained amplitude and phase distributions were mapped into discrete levels. In addition, a coding scheme using sub-cells structure was employed in order to increase the number of discrete levels, thus increasing the degree of freedom in the resulting mask. The mask is fabricated on a fused silica substrate and an amorphous hydrogenated carbon (a:C-H) thin film which act as amplitude modulation agent. The lithographic image is projected onto a resist coated silicon wafer, placed at a distance of 50 mu m behind the mask. The results show a improvement of the achieved resolution - linewidth as good as 1.5 mu m - what is impossible to obtain with traditional binary masks in proximity printing mode. Such achieved dimensions can be used in the fabrication of MEMS and MOEMS devices. These results are obtained with a UV laser but also with a small arc lamp light source exploring the partial coherence of this source. (C) 2010 Optical Society of America

Diffraction gratings fabricated in DLC thin films

This work presents the fabrication of two-dimensional diffraction gratings in diamond-like carbon (DLC) thin films, with applications in computer-generated holography and micro optics. In order to achieve high diffraction efficiency and to have a very simple manufacturing process, the device is designed to modulate only the phase of an incoming coherent monochromatic laser beam (632.8 nm, HeNe laser). This modulation is obtained by implementing a binary microrelief in the DLC film, responsible for generating a localized optical path difference of half a wavelength. This microrelief is obtained by anisotropic reactive ion etching of the DLC surface in an oxygen based plasma. The DLC layer was grown by reactive magnetron sputtering, using a methane-based plasma chemistry. AFM measurements show a low-level surface roughness of less than 1% of the operation wavelength, and optical characterization shows a good quality of the reconstructed diffraction patterns. (C) 2010 Elsevier B.V. All rights reserved.

Methods of Fourier optics in digital holographic microscopy

In this paper, processing methods of Fourier optics implemented in a digital holographic microscopy system are presented. The proposed methodology is based on the possibility of the digital holography in carrying out the whole reconstruction of the recorded wave front and consequently, the determination of the phase and intensity distribution in any arbitrary plane located between the object and the recording plane. In this way, in digital holographic microscopy the field produced by the objective lens can be reconstructed along its propagation, allowing the reconstruction of the back focal plane of the lens, so that the complex amplitudes of the Fraunhofer diffraction, or equivalently the Fourier transform, of the light distribution across the object can be known. The manipulation of Fourier transform plane makes possible the design of digital methods of optical processing and image analysis. The proposed method has a great practical utility and represents a powerful tool in image analysis and data processing. The theoretical aspects of the method are presented, and its validity has been demonstrated using computer generated holograms and images simulations of microscopic objects. (c) 2007 Elsevier B.V. All rights reserved.