The diagnostic accuracy of telegeriatrics for the diagnosis of dementia via video conferencing

Introduction The suitability of video conferencing (VC) technology for clinical purposes relevant to geriatric medicine is still being established. This project aimed to determine the validity of the diagnosis of dementia via VC. Methods This was a multisite, noninferiority, prospective cohort study. Patients, aged 50 years and older, referred by their primary care physician for cognitive assessment, were assessed at 4 memory disorder clinics. All patients were assessed independently by 2 specialist physicians. They were allocated one face-to-face (FTF) assessment (Reference standard – usual clinical practice) and an additional assessment (either usual FTF assessment or a VC assessment) on the same day. Each specialist physician had access to the patient chart and the results of a battery of standardized cognitive assessments administered FTF by the clinic nurse. Percentage agreement (P0) and the weighted kappa statistic with linear weight (Kw) were used to assess inter-rater reliability across the 2 study groups on the diagnosis of dementia (cognition normal, impaired, or demented). Results The 205 patients were allocated to group: Videoconference (n = 100) or Standard practice (n = 105); 106 were men. The average age was 76 (SD 9, 51–95) and the average Standardized Mini-Mental State Examination Score was 23.9 (SD 4.7, 9–30). Agreement for the Videoconference group (P0= 0.71; Kw = 0.52; P < .0001) and agreement for the Standard Practice group (P0= 0.70; Kw = 0.50; P < .0001) were both statistically significant (P < .05). The summary kappa statistic of 0.51 (P = .84) indicated that VC was not inferior to FTF assessment. Conclusions Previous studies have shown that preliminary standardized assessment tools can be reliably administered and scored via VC. This study focused on the geriatric assessment component of the interview (interpretation of standardized assessments, taking a history and formulating a diagnosis by medical specialist) and identified high levels of agreement for diagnosing dementia. A model of service incorporating either local or remote administered standardized assessments, and remote specialist assessment, is a reliable process for enabling the diagnosis of dementia for isolated older adults.

Going live : building academic capacity in blended learning using web-conferencing technologies

This paper reports on a current initiative at Queensland University of Technology to provide timely, flexible and sustainable training and support to academic staff in blended learning and associated techno-pedagogies via a web-conferencing classroom and collaboration tool, Elluminate Live!. This technology was first introduced to QUT in 2008 as part of the university‘s ongoing commitment to meeting the learning needs of diverse student cohorts. The centralised Learning Design team, in collaboration with the university‘s department of eLearning Services, was given the task of providing training and support to academic staff in the effective use of the technology for teaching and learning, as part of the team‘s ongoing brief to support and enhance the provision of blended learning throughout the university. The resulting program, ―Learning Design Live‖ (LDL) is informed by Rogers‘ theory of innovation and diffusion (2003) and structured according to Wilson‘s framework for faculty development (2007). This paper discusses the program‘s design and structure, considers the program‘s impact on academic capacity in blended learning within the institution, and reflects on future directions for the program and emerging insights into blended learning and participant engagement for both staff and students.

A Scalable Architecture for VoIP Conferencing

Real-Time services are traditionally supported on circuit switched network. However, there is a need to port these services on packet switched network. Architecture for audio conferencing application over the Internet in the light of ITU-T H.323 recommendations is considered. In a conference, considering packets only from a set of selected clients can reduce speech quality degradation because mixing packets from all clients can lead to lack of speech clarity. A distributed algorithm and architecture for selecting clients for mixing is suggested here based on a new quantifier of the voice activity called “Loudness Number” (LN). The proposed system distributes the computation load and reduces the load on client terminals. The highlights of this architecture are scalability, bandwidth saving and speech quality enhancement. Client selection for playing out tries to mimic a physical conference where the most vocal participants attract more attention. The contributions of the paper are expected to aid H.323 recommendations implementations for Multipoint Processors (MP). A working prototype based on the proposed architecture is already functional.

Towards an Example-Based Image Compression Architecture for Video-Conferencing

This paper consists of two major parts. First, we present the outline of a simple approach to very-low bandwidth video-conferencing system relying on an example-based hierarchical image compression scheme. In particular, we discuss the use of example images as a model, the number of required examples, faces as a class of semi-rigid objects, a hierarchical model based on decomposition into different time-scales, and the decomposition of face images into patches of interest. In the second part, we present several algorithms for image processing and animation as well as experimental evaluations. Among the original contributions of this paper is an automatic algorithm for pose estimation and normalization. We also review and compare different algorithms for finding the nearest neighbors in a database for a new input as well as a generalized algorithm for blending patches of interest in order to synthesize new images. Finally, we outline the possible integration of several algorithms to illustrate a simple model-based video-conference system.

Restorative justice conferencing for reducing recidivism in young offenders (aged 7 to 21)

Background
Restorative justice is “a process whereby parties with a stake in a specific offence resolve collectively how to deal with the aftermath of the offence and its implications for the future” (Marshall 2003). Despite the increasing use of restorative justice programmes as an alternative to court proceedings, no systematic review has been undertaken of the available evidence on the effectiveness of these programmes with young offenders. Recidivism in young offenders is a particularly worrying problem, as recent surveys have indicated
the frequency of re-offences for young offenders has ranged from 40.2% in 2000 to 37.8% in 2007 (Ministry of Justice 2009)

Objectives
To evaluate the effects of restorative justice conferencing programmes for reducing recidivism in young offenders.

Search methods
We searched the following databases up to May 2012: CENTRAL, 2012 Issue 5, MEDLINE (1978 to current), Bibliography of Nordic Criminology (1999 to current), Index to Theses (1716 to current), PsycINFO (1887 to current), Social Sciences Citation Index (1970 to current), Sociological Abstracts (1952 to current), Social Care Online (1985 to current), Restorative Justice Online (1975 to current), Scopus (1823 to current), Science Direct (1823 to current), LILACS (1982 to current), ERIC (1966 to current), Restorative Justice Online (4May 2012),WorldCat (9May 2012), ClinicalTrials.gov (19May 2012) and ICTRP (19May 2012). ASSIA,National Criminal Justice Reference Service and Social Services Abstracts were searched up to May 2011. Relevant bibliographies, conference programmes and journals were also searched.

Selection criteria
Randomised controlled trials (RCTs) or quasi-RCTs of restorative justice conferencing versus management as usual, in young offenders.

Data collection and analysis
Two authors independently assessed the risk of bias of included trials and extracted the data. Where necessary, original investigators were contacted to obtain missing information.

Main results
Four trials including a total of 1447 young offenders were included in the review. Results failed to find a significant effect for restorative justice conferencing over normal court procedures for any of the main analyses, including number re-arrested (odds ratio (OR) 1.00, 95% confidence interval (CI) 0.59 to 1.71; P = 0.99), monthly rate of reoffending (standardised mean difference (SMD) -0.06, 95% CI -0.28 to 0.16; P = 0.61), young person’s remorse following conference (OR 1.73, 95% CI 0.97 to 3.10; P = 0.06), young person’s recognition of wrongdoing following conference (OR 1.97, 95% CI 0.81 to 4.80; P = 0.14), young person’s self-perception following conference (OR 0.95, 95% CI 0.55 to 1.63; P = 0.85), young person’s satisfaction following conference (OR 0.42, 95% CI 0.04 to 4.07; P = 0.45) and victim’s satisfaction following conference (OR 4.05, 95%CI 0.56 to 29.04; P = 0.16). A small number of sensitivity analyses did indicate significant effects, although all are to be interpreted with caution.

Authors’ conclusions
There is currently a lack of high quality evidence regarding the effectiveness of restorative justice conferencing for young offenders. Caution is urged in interpreting the results of this review considering the small number of included studies, subsequent low power and high risk of bias. The effects may potentially be more evident for victims than offenders. The need for further research in this area is highlighted.

Video Conferencing podcast

presented by Trevor Kettle and James Wilson

Teaching Intercultural Communication in Foreign Language Education through Video Conferencing

Since 1980s, Western linguists and specialists on second language acquisition have emphasized the importance of enhancing students’ intercultural communication competence in foreign language education. At the same time, the demand for intercultural communicative competence increased along with the advances of communication technology with its increasingly global reach and the process of globalization itself.In the field of distance language education, these changes have resulted in a shift of focus from the production and distribution of learning materials towards communication and learning as a social process, facilitated by various internet-based platforms. The current focus on learners interacting and communicating synchronously trough videoconferencing is known as the fourth generation of distance language education. Despite the fact that teaching of Chinese as a foreign language (CFL) faces the same or even greater challenges as teaching other languages, the intercultural communication perspective is still quite a new trend in CFL and its implementation and evaluation are still under development. Moreover, the advocates of the new trends in CFL have so far focused almost exclusively on classroom-based courses, neglecting the distance mode of CFL and leaving it as an open field for others to explore. In this under-researched context, Dalarna University (Sweden), where I currently work, started to provide web-based courses of the Chinese language in 2007. Since 2010, the Chinese language courses have been available only in the distance form, using the same teaching materials as the previous campus-based courses. The textbooks used in both settings basically followed the functional nationalism approach. However, in order to catch up with the main trend of foreign-language education, we felt a need to implement the cross-cultural dimension into the distance courses as well. Therefore in 2010, a pilot study has been carried out to explore opportunities and challenges for implementing a cross-cultural perspective into existing courses and evaluating the effectiveness of this implementation based on the feedback of the students and on the experience of the teacher/researcher.

Enabling electronic medicine at Kiwicare : the case of video conferencing adoption for psychiatry in New Zealand

Telemedicine emerges as a viable solution to New Zealand health providers in reaching out to rural patients, in offering medical services and conducting administrative meetings and training. No research exists about adoption of telemedicine in New Zealand. The purpose of this case study was to explain factors influencing adoption of telemedicine utilizing video conferencing technology (TMVC) within a New Zealand hospital known as KiwiCare. Since TMVC is part of IT, tackling it from within technological innovation literature may assist in providing an insight into its adoption within KiwiCare and into the literature. Findings indicate weak presence of critical assessment into technological innovation factors prior to the adoption decision, thereby leading to its weak utilization. Factors like complexity, compatibility and trialability were not assessed extensively by KiwiCare and would have hindered TMVC adoption. TMVC was mainly assessed according to its relative advantage and to its cost effectiveness along with other facilitating and accelerating factors. This is essential but should be alongside technological and other influencing factors highlighted in the literature.