Web version of the protocol of the orofacial myofunctional evaluation with scores: usability and learning / Versão para Web do protocolo de avaliação miofuncional com escores: usabilidade e aprendizado

ABSTRACT Purpose The Orofacial Myofunctional Evaluation with Scores (OMES) protocol has been validated and used in clinical practice and research. The goals of this study were to develop, analyze and improve a version of OMES for the Web and to investigate the relationship between the usability judgments and the prior experience of the evaluators and whether using the interface promotes learning, as shown by the task completion time (TCT). Methods Study steps: 1) inspection of the prototype by the team; 2) evaluation of usability by three experienced speech-language pathologists (SLPs); and 3) evaluation of its usability by 12 SLPs with varying levels of experience in the use of OMES. Participants answered the Heuristic evaluation (HE), the Computer System Usability Questionnaire (CSUQ), and expressed free comments. The TCT was recorded. Results The OMES-Web reached excellent usability levels, and the participants were highly satisfied. The correlations between the participants' experience and the HE and CSUQ scores were not significant. The TCT decreased significantly throughout the tasks. Conclusion OMES-Web meets the usability criteria, and participants feel satisfied with the system regardless of their level of experience. The fact that it is easy to learn favors its adoption by professionals.

RESUMO Objetivo O Protocolo de Avaliação Miofuncional Orofacial com Escores (AMIOFE) é validado e usado na prática clínica e pesquisas. Os objetivos deste estudo foram desenvolver, analisar e aprimorar a versão do AMIOFE para a Web e investigar a relação entre os julgamentos de usabilidade e a prévia experiência dos avaliadores, e se o manuseio da interface promove o aprendizado, baseado no tempo para completar a tarefa (TCT). Método Passos do estudo: 1) inspeção do protótipo pela equipe; 2) avaliação de usabilidade por três fonoaudiólogos experientes; e 3) avaliação de usabilidade por 12 fonoaudiólogos com variados níveis de experiência no uso do AMIOFE. Avaliação heurística (HE), Computer System Usability Questionnaire (CSUQ) e livre expressão dos participantes foram realizadas. O TCT foi registrado. Resultados O AMIOFE-Web atingiu ótimos níveis de usabilidade e os participantes mostram-se altamente satisfeitos (Escala geral do CSUQ; Média= 1,31, DP= 0,31). A relação da experiência dos participantes e a HE e o CSUQ não foi significativa. O TCT decresceu significantemente ao longo das tarefas, mostrando que o sistema é fácil de aprender e usar. Conclusão O AMIOFE-Web atende os critérios de usabilidade e os participantes sentiram-se satisfeitos com o sistema, independentemente de seus níveis de experiência. O fato de ser de fácil aprendizado é um fator favorável para a sua adoção por profissionais.

Development of a teledentistry system for the elderly in the context of the covid-19 pandemic: 3d diagnostic models integration in a web platform / Desarrollo de un sistema de teleodontología para adultos mayores en el contexto de la pandemia de covid-19: integración de modelos de diagnóstico 3d en una plataforma web

Objective: To recognize the usefulness of incorporating Three-Dimensional models of standardized humans in electronic health records, in the context of the development of a teledentistry web platform designed for the attention of the elderly population in COVID-19 pandemic context. Material and Methods: A teledentistry web platform designed with different modules for clinical records. Through a new user-computer interface with a standardized virtual 3D phantom, an extraoral physical examination, an intraoral examination section was modeled. A label-associated marker is allowed to record descriptive aspects of the findings. A 3D odontogram represents multiple patient's conditions for each of the 32 dental positions. Results: From a total of 135 patients registered on the platform, 51 markers and 33 photographs associated with the surface of the virtual 3D phantoms were recorded. For the Location parameter: Hard palate 27.6%, inserted gingiva 15.7%, tongue 15.6%. For the Type of lesion parameter (according to the information entered in the pathology selector): unidentified 35.3%, sub-prosthetic stomatitis 23.5%, irritative fibroma 9.8%. Through the registration of the exact location of the finding in the virtual phantom by a 3D marker, the 3D modeling of the oral pathologies contributed to a better diagnosis, improving the remote communication between the attending dentist and specialists. Conclusion: The combination of the 3D modeling and anatomical-referencing in a teledentistry platform can become a powerful tool for the dental practice, due to their utility and specificity.

Objetivo: Reconocer la utilidad de incorporar modelos tridimensionales de humanos estandarizados en registros electrónicos de salud, en el contexto del desarrollo de una plataforma web de teleodontología diseñada para la atención de la población adulta mayor en contexto de pandemia por COVID-19. Material y Métodos: Una plataforma web de teleodontología diseñada con diferentes módulos para historias clínicas. A través de una nueva interfaz usuario-computadora con un fantoma 3D virtual estandarizado, se modeló un examen físico extraoral, una sección de examen intraoral. Se permite un marcador asociado a la etiqueta para registrar aspectos descriptivos de los hallazgos. Un odontograma 3D representa múltiples condiciones del paciente para cada una de las 32 posiciones dentales.Resultados: De un total de 135 pacientes registrados en la plataforma, se registraron 51 marcadores y 33 fotografías asociadas a la superficie de los fantomas virtuales 3D. Para el parámetro Ubicación: Paladar duro 27,6%, encía insertada 15,7%, lengua 15,6%. Para el parámetro Tipo de lesión (según la información ingresada en el selector de patología): no identificado 35,3%, estomatitis subprotésica 23,5%, fibroma irritativo 9,8%. A través del registro de la ubicación exacta del hallazgo en el fantoma virtual mediante un marcador 3D, el modelado 3D de las patologías orales contribuyó a un mejor diagnóstico, mejorando la comunicación remota entre el odontólogo tratante y los especialistas. Conclusión: La combinación del modelado 3D y la referenciación anatómica en una plataforma de teleodontología puede convertirse en una poderosa herramienta para la práctica odontológica, debido a su utilidad y especificidad.

Uso de WhatsApp en curso sobre la atención estomatológica en tiempos de COVID-19 / The use of WhatsApp in the course on Dentistry Care in times of COVID-19

RESUMEN Fundamento: dotar a los profesionales de Estomatología de conocimientos para su actuación frente a la pandemia de la COVID-19 es una necesidad; realizarlo en un ambiente virtual, un desafío. Objetivo: describir el uso de la aplicación WhatsApp en un curso sobre la atención estomatológica en tiempos de la COVID-19. Métodos: se realizó una investigación descriptiva en los meses de mayo a junio de 2020 en el Hospital Militar Universitario "Manuel Fajardo Rivero" de Santa Clara, Villa Clara. Se utilizaron métodos teóricos: análisis-síntesis y enfoque sistémico; empíricos: revisión bibliográfica para la selección y fundamentación de contenidos del curso, técnica de lo positivo, negativo e interesante y el criterio de especialistas para la valoración del producto diseñado. Resultados: el curso estuvo estructurado en cuatro temas, con sus objetivos, contenidos, orientaciones metodológicas, tareas docentes y bibliografía básica. Concluido su diseño, fue valorado por especialistas e implementado en un ambiente virtual (WhatsApp) durante un mes. Se destacaron sus aspectos: positivo, la aplicabilidad de los contenidos impartidos; negativo, la limitación de la tecnología por carencias de teléfonos móviles; e interesante, la actualización permanente de los temas en consonancia con los artículos publicados en línea. Conclusiones: la aplicación WhatsApp se propone como una herramienta para promover la participación e interacción durante el curso y como un recurso didáctico que potenció el aprendizaje desde la educación a distancia.

ABSTRACT Background: providing dental professionals with knowledge for their performance while facing the COVID-19 pandemic is a necessity; doing it in a virtual environment is really a challenge. Objective: to describe the use of the WhatsApp application in a course on dental care in times of COVID-19. Methods: a descriptive research was carried out from May to June 2020 at the "Manuel Fajardo Rivero" Army University Hospital in Santa Clara, Villa Clara. Theoretical methods were used: analysis-synthesis and systemic approach; empirical ones: bibliographic review for the selection and foundation of course content, positive, negative and interesting technique and the criteria of specialists for the evaluation of the designed product. Results: the course was structured in four topics, with their objectives, contents, methodological guidelines, teaching tasks and basic bibliography. Once its design was completed, it was evaluated by specialists and implemented in a virtual environment (WhatsApp) for a month. Its aspects were highlighted: positive, the applicability of the contents taught; negative, the limitation of technology due to lack of mobile phones; and interesting, the steady updating of the topics in line with the articles published online. Conclusions: the WhatsApp application is proposed as a tool to promote participation and interaction during the course and as a didactic resource that promoted learning from distance learning.

Usability of free software used for visualization and measurement of digital orthodontic models

The aim of this study was to evaluate the usability of the free software available that allow visualization and measurement of orthodontic digital models. 80 graduate students of orthodontics were asked to perform pre-defined tasks in a digital model through 3D Viewer ® and 3D-Tool ® software. The success in accomplishing the tasks and the time spent were recorded. To end, each participant answered a questionnaire to express their satisfaction regarding the software. There were no statistically significant difference between the software when compared to the accomplishment rates of tasks and the time spent by participants on each one. The software were evaluated as "slightly satisfactory" in several criteria. There is scope for optimization of orthodontic software by manufacturers since lack of their interface usability can discourage orthodontists' adherence to new resources that could provide benefits to their daily routine, even if they are freely available.

Validity and reliability of a trigonometry-based method for the measurement of tooth movement on digital models

ABSTRACT Objective: The objectives of the present study were to develop a method for longitudinally measuring tooth rotation, inclination and angulation on digital models, and to test the method validity and reliability. Methods: The initial and final planned models of 14 patients treated with Invisalign® (386 teeth) were exported from ClinCheck®. The rotation, inclination and angulation values were assessed for the incisors, canines, premolars and molars, in both models, using trigonometry. An application was developed in Python 2.7 to automate the measurements. The ∆planned (variation in the position between the initial and final planned models) was obtained for each tooth and each type of movement. To test the validity, the degree of agreement between the ∆planned and the values available in the Invisalign® Table of Movements was assessed using the Intraclass Correlation Coefficient (ICC) and Bland-Altman analysis. For intra and inter-rater reliabilities, the ∆planned was obtained again. Results: Excellent ICCs (> 0.9) and limits of agreement with narrow and clinically acceptable discrepancies were obtained for the rotation of all teeth (except maxillary canines, which had broader limits: -3.47 - 5.43) and for the inclination of premolars and molars. The inclination of anterior teeth and angulation of all teeth had ICCs and limits that were not indicative of great agreement. The reliability was high for the three movements (discrepancy <2°). Conclusions: The method developed is reliable and suitable for longitudinally measuring inclination (posterior teeth) and rotation (except maxillary canines). It has limited value for the other movements measurements.

RESUMO Objetivo: Os objetivos do presente estudo foram desenvolver um método para medir longitudinalmente a rotação, inclinação e angulação dentárias em modelos digitais, e testar sua validade e reprodutibilidade. Material e Métodos: Os modelos inicial e final planejado de 14 pacientes tratados com Invisalign® (386 dentes) foram exportados do ClinCheck®. Os valores de rotação, inclinação e angulação foram calculados para incisivos, caninos, pré-molares e molares, em ambos os modelos, por meio de trigonometria. Um aplicativo desenvolvido em Python 2.7 foi utilizado para automatização das medidas. O ∆planejado (variação na posição entre os modelos inicial e final planejado) foi obtido para os movimentos descritos, nos diferentes grupos de dentes. A validade do método foi verificada pelo grau de concordância entre o ∆planejado e os valores disponíveis na Tabela de Movimentos do Invisalign®, utilizando-se o Coeficiente de Correlação Intraclasse (ICC) e a análise de Bland-Altman. O ∆planejado foi novamente calculado para análise da reprodutibilidade intra e interexaminadores. Resultados: Excelentes ICCs (> 0,9) e limites de concordância com discrepâncias reduzidas e clinicamente aceitáveis foram obtidos para a rotação de todos os dentes (exceto os caninos superiores, que expressaram limites mais amplos: -3,47 - 5,43) e para a inclinação de pré-molares e molares. A inclinação dos dentes anteriores e a angulação de todos os dentes apresentaram ICCs e limites não representativos de boa concordância. A reprodutibilidade foi alta para os três movimentos (discrepância < 2°). Conclusões: O método desenvolvido é reprodutível e se mostrou adequado para mensuração longitudinal da inclinação de dentes posteriores e rotação de todos os dentes, exceto caninos superiores. Apresenta valor limitado para as demais mensurações.

Ventajas, desventajas y ocho recomendaciones para la educación médica virtual en tiempos de COVID-19 / Benefits, disadvantages and eight recommendations for virtual medical education in times of COVID-19

Resumen La pandemia de COVID-19 ha llevado a la implementación del aislamiento preventivo como medida de salud pública y con esto, se presentan nuevos retos para las instituciones de educación superior y en especial para carreras con alto contenido presencial. Se realizó una revisión de la literatura en Pubmed en conjunto con textos de referencia en educación virtual, educación médica, opiniones de expertos y artículos derivados de estos por método bola de nieve. Las ventajas de la educación médica virtual hacen alusión, en su mayoría, a la flexibilidad en tiempo, espacios, oportunidades y recursos desde un enfoque individualizado. Las desventajas, por su parte, dependen de la falta de preparación en infraestructura, así como por parte de docentes y estudiantes para las nuevas modalidades. Las recomendaciones se basan en un cambio de estrategia en el que el estudiante pueda abordar los contenidos de forma amigable y resumida previo a las clases en-vivo y que estas últimas tengan un enfoque dirigido a la complementación y resolución de dudas. Se presentan recomendaciones para los docentes que actualmente dictan sus contenidos de manera virtual para favorecer el aprendizaje y cumplimiento de objetivos. Se incluye un anexo con herramientas para el desarrollo de clases y otros contenidos útiles para el estudio de temas en distintas áreas.

Abstract The COVID-19 pandemic has led to the implementation of preventive isolation as a public health measure and with these new challenges are presented for higher education institutions and especially for careers with high attendance content. A literature review was conducted in Pubmed in conjunction with reference texts in virtual education, medical education, expert opinions and articles derived from these by the snowball method. The advantages of virtual medical education mostly refer to flexibility in time, space, opportunities and resources from an individualized approach. The disadvantages, on the other hand, depend on the lack of preparation in infrastructure, as well as by teachers and students for the new modalities. The recommendations are based on a change of strategy in which the student can approach the contents in a friendly and summarized way prior to the live classes and that the latter have a focus directed to the complementation and resolution of doubts. Recommendations are presented for teachers who currently teach their contents in a virtual way to favour learning and the fulfilment of objectives. An annex is included with tools for the development of classes and other useful content for the study of topics in different areas.

Veinte años de un proyecto de avanzada: la Universidad Virtual de la Salud de Villa Clara / Twenty years of a cutting-edge project: the Virtual Health University of Villa Clara

RESUMEN La educación superior experimentó una transformación con la integración de las Tecnologías de la Información y la Comunicación en las propuestas curriculares. Con su implementación se hizo necesario ofrecer al alumno un conocimiento específico de los nuevos modos y herramientas de comunicación. Para ello, la red de salud cubana Infomed, cuenta con dos proyectos principales: la Biblioteca Virtual de la Salud y la Universidad Virtual de la Salud. En el año 1999 surgió la Cátedra de Universidad Virtual en la Universidad de Ciencias Médicas de Villa Clara. Hasta el momento se han realizado tres actualizaciones de este sitio, lo cual ha permitido la capacitación de cientos de profesionales. Se puede afirmar que el proyecto Universidad Virtual de la Salud de Villa Clara, en sus veinte años de servicio, ha evolucionado satisfactoriamente y se encuentra al servicio de todos los profesionales de la salud.

ABSTRACT Higher education underwent a transformation with the integration of Information and Communication Technologies in curricular proposals. Offering the student a specific knowledge of the new ways and tools of communication became necessary with its implementation. To this end, the health information network of Cuba (INFOMED) has two main projects: the Virtual Health Library and the Virtual Health University. The Virtual University Professorship was created at the University of Medical Sciences of Villa Clara in 1999. So far three updates have been made to this site, which has allowed the training of hundreds of professionals. We can state that the Virtual Health University project in Villa Clara, in its twenty years of service, has evolved satisfactorily and is at the service of all health professionals.

Evaluation of User Experience of New Defense Medical Information System / 대한의료정보학회지

OBJECTIVES: This study aimed to investigate the user experience (UX) of the New Defense Medical Information System (N-DEMIS), which was introduced in 2012 as part of an effort to improve the old system of armed forces hospitals and ultimately bring their standards up to those of civilian hospitals. METHODS: In this study, the dependent variable was the UX of N-DEMIS and was composed of usability, affect, and user value. The questionnaire comprised 41 questions: nine on general characteristics, 20 on usability, four on affect, and eight on user value. The data collection period was from April 15 to April 30, 2018. Overall, 85 responses were received; of these, three insincere responses were excluded, and the remaining 82 responses were used in the analysis. RESULTS: The overall value of Cronbach's alpha was 0.917, indicating an overall high-reliability. There was a significant difference between user value and usability, but there was no significant differences between the other pairs. We observed a significant effect on UX for length of time working in an armed forces hospital and employment type. CONCLUSIONS: The results of our survey showed an even distribution of scores across the three elements of UX, showing that no particular aspect of N-DEMIS is superior to the others in terms of user satisfaction. However, the overall UX score of around 60% indicates the need for future improvements. Rather than focusing improvements on a specific area, improvements should be spread across usability, affect, and user value.

Visual and Auditory Reaction Times of Patients with Opioid Use Disorder

OBJECTIVE: Reaction time is defined as the time from the start of a stimulus to the start of the voluntary movement. Time plays an important role in undertaking daily living activities. Reaction time is an important factor in respect of both quality of life and of capabilities demonstrated in the work environment. Alcohol and some addictive substances have effect on RT. The aim of this study was to compare the visual and auditory reaction times of patients with opioid use disorder with healthy control subjects. METHODS: The study was applied to two groups as the opioid use disorder group and the control group. A Sociodemographic and Clinical Data Form was prepared for each patient including age, gender, marital status and education level. Using a computer program the response to visual screen color change (red/blue) and to an auditory ‘beep’ sound of the computer system were recorded. The Student’s t-test was applied as a statistical method. RESULTS: The results showed longer reaction times in the patients with opioid use disorder. CONCLUSION: To add improving reaction time approaches in opioid use disorder treatment may contribute to treatment by increasing quality of life and work performance.

Two new virtual reality tasks for the assessment of spatial orientation: preliminary results of tolerability, sense of presence and usability / Duas novas tarefas de realidade virtual para avaliação da orientação espacial: resultados preliminares de tolerabilidade, sensação de presença e usabilidade

Abstract Spatial orientation is a cognitive domain frequently impaired in Alzheimer's Disease and can be one of its earliest symptoms. Objective: This paper describes the results of tolerability, sense of presence and usability of two immersive virtual reality tasks for the assessment of spatial orientation, using VR headset in adults. Methods: 31 healthy adults recruited from university and the local community performed two experimental immersive virtual reality tasks of spatial orientation: the SOIVET-Maze for the assessment of allocentric to egocentric spatial abilities and the SOIVET-Route for the assessment of spatial memory and landmark recognition. Participants completed questionnaires about sense of presence, cybersickness symptoms, technology use profile and motion sickness history. Usability measures were assessed by spontaneous feedback from participants. Results: All participants were able to understand the task instructions and how to interact with the system. Both tasks seemed to induce a strong sense of presence, as assessed by the Witmer and Singer Presence Questionnaires (M=128 and 143 for SOIVET-Maze and SOIVET-Route, respectively). The SOIVET-Route had a small numeric advantage over the SOIVET-Maze tolerability scores assessed by the Cybersickness Questionnaire (M=4.19, SD=5.576 and M=3.52, SD=6.418 for SOIVET-Maze and SOIVET-Route respectively). Also, there were no drop-outs on the SOIVET-Route due to tolerability issues, unlike the SOIVET-Maze, which had two drop-outs. However, this difference was not statistically significant (Z= -.901, p= 0.368, Wilcoxon signed-rank test).

Resumo A orientação espacial é um domínio cognitivo freqüentemente comprometido na doença de Alzheimer e pode ser um dos primeiros sintomas manifestados. Objetivo: Este artigo descreve os resultados de tolerabilidade, sensação de presença e usabilidade de duas tarefas imersivas de realidade virtual para avaliação da orientação espacial, utilizando óculos de RV em adultos. Métodos: 31 adultos saudáveis, ​​recrutados entre estudantes universitários e da comunidade local, realizaram duas tarefas de realidade virtual imersiva para avaliação da orientação espacial: A tarefa SOIVET-Maze para avaliação da capacidade de transposição da orientação alocêntrica para egocêntrica e a tarefa SOIVET-Route para avaliação da memória espacial e reconhecimento de pontos de referência. Os participantes também responderam questionários sobre Sensação de Presença, Sintomas de cybersickness, Perfil de Uso de Tecnologia e Histórico de cinetose. Feedback espontâneo dos participantes foi utilizado como medida de usabilidade. Resultados: Todos os participantes conseguiram compreender as instruções da tarefa e como interagir com o sistema. Ambas tarefas parecem induzir forte sensação de presença, avaliada pelo Questionário de Presença de Witmer e Singer (M=128 e 143 para SOIVET-Maze e SOIVET-Route, respectivamente). A tarefa SOIVET-Route teve uma pequena vantagem numérica em relação à tarefa SOIVET-Maze na pontuação de tolerabilidade avaliada pelo Questionário de Cybersickness (M=4,19, SD=5,576 e M=3,52, SD=6,418 para SOIVET-Maze e SOIVET-Route respectivamente). Além disso, não houve desistências na SOIVET-Route devido a problemas de tolerabilidade, ao contrário da SOIVET-Maze, que teve dois drop-outs. No entanto, essa diferença não foi estatisticamente significativa (Z= -901, p=0,368, teste de postos sinalizados de Wilcoxon)

Safety and Usability Guidelines of Clinical Information Systems Integrating Clinical Workflow: A Systematic Review / 대한의료정보학회지

OBJECTIVES: The usability of clinical information systems (CISs) is known to be an essential consideration in ensuring patient safety as well as integrating clinical flow. This study aimed to determine how usability and safety guidelines of CIS consider clinical workflow through a systematic review in terms of the target systems, methodology, and guideline components of relevant articles. METHODS: A literature search was conducted for articles published from 2000 to 2015 in PubMed, Cochrane, EMBASE, Web of Science, and CINAHL. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement method was employed. Articles containing recommendations, principles, and evaluation items for CIS usability and safety were included. The selected articles were classified according to article type, methodology, and target systems. Taking clinical workflow into consideration, the components of guidelines were extracted and classified. RESULTS: A total of 7,401 articles were identified by keyword search. From the 76 articles remaining after abstract screening, 15 were selected through full-text review. Literature review (n = 7) was the most common methodology, followed by expert opinions (n = 6). Computerized physician order entry (n = 6) was the most frequent system. Four articles considered the entire process of clinical tasks, and two articles considered the principles of the entire process of user interface affecting clinical workflow. Only two articles performed heuristic evaluations of CISs. CONCLUSIONS: The usability and safety guidelines of CISs need improvement in guideline development methodology and with consideration of clinical workflow.

Objetos virtuales para el aprendizaje autorregulado de estudiantes de terapia ocupacional / Virtual objects for self-regulated learning of occupational therapy students

RESUMEN Objetivos Identificar las relaciones entre las características de los estudiantes, su ambiente de aprendizaje, su ocupación, y los objetos virtuales para el aprendizaje autorregulado a través de la observación participante. Aspectos importantes para la formación de profesionales de la salud. Métodos Estudio cualitativo aplicado a estudiantes que participaron en la asignatura Educación y Terapia Ocupacional. Se emplearon dos herramientas: Cuestionario Objetos Virtuales para el aprendizaje en el campo educativo y Observación participante. Al primer instrumento se le realizó pilotaje y revisión por experto. Resultados El estudio dio cuenta de datos demográficos y antecedentes de educación media similares, con relación a: procedencia, acceso al computador y exclusividad para estudiar; así como desarrollo de estudios de educación media en Bogotá y en instituciones privadas. En los ambientes de aprendizaje hay una tendencia a evidenciar que están de acuerdo con el programa de la asignatura: en cumplimiento de objetivos explícitos escogidos para el estudio en un 75 % e implícitos en un 60 %. En la ocupación, se encontró que el objeto virtual permitió profundizar sobre el tema que desarrollaron los estudiantes y poner en práctica conocimientos previos sobre tecnologías de la información y la comunicación. La observación participante arrojó particularidades en los elementos motivación, eficacia y aprendizaje autorregulado. Conclusiones La implementación de los Objetos Virtuales de Aprendizaje favorece en los estudiantes la motivación, el aprendizaje autorregulado y la apropiación de conceptos y conocimientos relacionados con la asignatura; por lo que se propone como estrategia de aprendizaje.(AU)

ABSTRACT Objective To identify the relationship between the characteristics of students, their learning environment, their occupation, and the virtual objects for self-regulated learning. In addition, to establish connections with participant's observation. Important aspects for the training of health professionals. Methods A qualitative study was applied to students who participated in the Education and Occupational Therapy subject. Two tools were used: virtual Objects Questionnaire for the educational field learning and Participant Observation. The first instrument was piloted and reviewed by experts. Results The study reported similar demographic data and background of similar education in relation to: origin, access to the computer and exclusivity to study; as well as the development of secondary education studies in Bogotá and in private institutions. In the learning environments, there is a tendency to show that they agree with the program of the subject in fulfillment of explicit objectives chosen for the study in 75 % and implicit in 60 %. With regards to the occupation, it was found that the virtual object allowed to deepen on the subject that the students developed and put into practice previous knowledge on communication technologies. The Participant Observation tool found particularities in the elements of motivation, efficacy and self-regulated learning. Conclusions The implementation of the Virtual Learning Objects favor the students' motivation, self-regulated learning and their appropriation of concepts and knowledge related to the subject; therefore, it is proposed as a learning strategy.(AU)

Virtual Reality simulator for dental anesthesia training in the inferior alveolar nerve block

Abstract Objectives This study shows the development and validation of a dental anesthesia-training simulator, specifically for the inferior alveolar nerve block (IANB). The system developed provides the tactile sensation of inserting a real needle in a human patient, using Virtual Reality (VR) techniques and a haptic device that can provide a perceived force feedback in the needle insertion task during the anesthesia procedure. Material and Methods To simulate a realistic anesthesia procedure, a Carpule syringe was coupled to a haptic device. The Volere method was used to elicit requirements from users in the Dentistry area; Repeated Measures Two-Way ANOVA (Analysis of Variance), Tukey post-hoc test and averages for the results' analysis. A questionnaire-based subjective evaluation method was applied to collect information about the simulator, and 26 people participated in the experiments (12 beginners, 12 at intermediate level, and 2 experts). The questionnaire included profile, preferences (number of viewpoints, texture of the objects, and haptic device handler), as well as visual (appearance, scale, and position of objects) and haptic aspects (motion space, tactile sensation, and motion reproduction). Results The visual aspect was considered appropriate and the haptic feedback must be improved, which the users can do by calibrating the virtual tissues' resistance. The evaluation of visual aspects was influenced by the participants' experience, according to ANOVA test (F=15.6, p=0.0002, with p<0.01). The user preferences were the simulator with two viewpoints, objects with texture based on images and the device with a syringe coupled to it. Conclusion The simulation was considered thoroughly satisfactory for the anesthesia training, considering the needle insertion task, which includes the correct insertion point and depth, as well as the perception of tissues resistances during the insertion.

DIPLOPED: una alternativa de educación a distancia para la preparación pedagógica de docentes / DIPLOPED: an alternative of distance learning for the pedagogical preparation of teachers

Fundamento: es necesario fortalecer la preparación pedagógica de los docentes desde la superación posgraduada utilizando la educación a distancia. Objetivo: diseñar un curso virtual como alternativa de la educación a distancia para la preparación pedagógica de los docentes. Métodos: se realizó una investigación descriptiva transversal, en la Filial "Lidia Doce Sánchez" de Sagua la Grande, durante el período septiembre 2013 a abril 2014. Se utilizaron diferentes métodos teóricos y empíricos para la búsqueda y procesamiento de la información y el criterio de especialistas para la valoración del producto elaborado. Resultados: se constató que la mayoría de los docentes son licenciados en especialidades no pedagógicas; tienen poca experiencia y entre ellos predominan los asistentes. Según la prueba pedagógica aplicada casi todos presentan necesidades de aprendizaje en aspectos relacionados con la pedagogía, determinado por el nivel bajo en las calificaciones obtenidas, por lo que se diseñó un curso de posgrado de educación a distancia, cuyo soporte digital lo constituye un CD-ROM que contiene todos sus elementos incluyendo una amplia bibliografía sobre los numerosos temas que aborda. Conclusiones: fue valorado por criterios de especialistas como pertinente y con adecuado tratamiento científico-metodológico, porque favorece el perfeccionamiento de las habilidades instructivas y educativas en la práctica docente.

Background: it is necessary to strengthen the pedagogical preparation of teachers through postgraduate studies using distance learning. Objective: to design a virtual course for distance learning for the pedagogical preparation of teachers. Methods: a descriptive cross-sectional investigation was carried out at "Lidia Doce Sánchez" university site from September 2013 to April 2014. Different theoretical and empirical methods were used for the search and processing of information and the criterion of specialists for the evaluation of the elaborated product. Results: it was verified that the majority of the teachers are bachelors in non-pedagogical specialties; they have little experience and the assistant teaching rank is predominant among them. According to the applied pedagogical test almost all of them present learning needs in aspects related to pedagogy, determined by the low marking level they got, reason why a postgraduate course in distance learning was designed, whose digital support comprises a CD- ROM containing all its elements including an extensive bibliography on the many topics it addresses. Conclusions: it was evaluated by specialists as pertinent and with adequate scientific-methodological treatment, because it favors the improvement of instructional and educational skills in teaching practice.

Curso virtual sobre la lengua de señas cubana para los estudiantes de Medicina / Virtual course on the Cuban sign language for Medicine students

Fundamento: a las instituciones de salud acuden con frecuencias pacientes y/o familiares sordos, que no siempre van acompañados por intérpretes de lenguajes de señas que puedan explicar su padecimiento. Objetivo: diseñar un curso virtual sobre lengua de señas cubana dirigido a estudiantes de Medicina para favorecer la comunicación con los pacientes y/o familiares con necesidades auditivas. Métodos: se realizó un estudio descriptivo transversal en la Filial de Ciencias Médicas de Sagua la Grande, en el período septiembre 2013 a abril 2014. Se utilizaron métodos teóricos: análisis-síntesis e inductivo-deductivo y empíricos: encuesta en forma de cuestionario, grupo nominal y el criterio de especialistas para valorar el producto diseñado. Resultados: predominó desconocimiento en los estudiantes sobre la lengua de señas cubana y la necesidad de conocerla para comunicarse con los pacientes y/o familiares con estas limitaciones. Se diseñó un curso de acuerdo a los requerimientos del entorno virtual. Conclusiones: los especialistas lo consideraron pertinente y factible porque favorece la comunicación con los pacientes y/o familiares sordos con los que interactuarán estos estudiantes durante su profesión médica, en correspondencia con la aplicación del método clínico.

Background: to health institutions frequently attend deaf patient and/or family who aren't always accompanied by sign language interpreters that can explain about their medical problem. Objective: to design a virtual course on Cuban sign language for Medicine students to favor the communication with the patients and/or family with auditory necessities. Methods: it was carried out a cross-sectional descriptive study in Sagua la Grande Medical Sciences university site, from September 2013 to April 2014. Theoretical methods were used: analysis-synthesis and inductive-deductive and empiric ones: an interview in questionnaire form, nominal group and specialists´ criteria to value the designed product. Results: ignorance prevailed in the students about the Cuban sign language and the necessity of knowing it to communicate with the patients and/or family with these limitations. A course was designed according to the requirements of the virtual environment. Conclusions: the specialists considered it pertinent and feasible because it favors the communication with the deaf patients and/or family, whom the medical students could interact in their profession, while applying the clinical method.

Applicability of a motor rehabilitation system in stroke victims / Aplicabilidade de um sistema de reabilitação motora em pacientes pós-acidente vascular encefálico

Abstract Introduction: The recovery of stroke patients is long and boring due to the repetitive nature of the exercises used and the length of treatment. Thus, we started using virtual reality as an alternative and, because of its advantages, health professionals are adapting video games for physical therapy. However, there are some limitations, such as the fact that games are designed for entertainment and not for therapeutic purposes. Objective: In order to mitigate gaps in assistive devices for physical therapy, this study describes the development and applicability of a computer support system for motor rehabilitation - Ikapp - in stroke victims. Methods: Twenty-seven stroke patients filled out a socioeconomic questionnaire, tested Ikapp during five minutes and answered a usability and satisfaction questionnaire about handling the tool. The chi-square test was used to analyze any association between sociodemographic factors and the features of the system. Results: The Ikapp system can be an excellent device to assist neurological rehabilitation of stroke patients, as participants questionnaires showed that 85.2% were satisfied in regard to motivation and inclusion of Ikapp in physiotherapy and 77.8% relative to ease of interaction with the tool. Conclusion: The Ikapp system proved to be an easy-to-use and accessible computer support system for patients with functional limitations.

Resumo Introdução: A recuperação de indivíduos pós-Acidente Vascular Encefálico (AVE) tem se mostrado longa e monótona devido ao caráter repetitivo dos exercícios utilizados na clínica e aos anos de tratamento. Logo, tem-se utilizado a Realidade Virtual (RV) como uma alternativa e diante de suas vantagens, profissionais de saúde vêm adaptando vídeo games à fisioterapia. No entanto, existem algumas limitações, como a do fato de estes vídeo games terem sido desenvolvidos para diversão e não serem apropriados para uso terapêutico. Objetivo: Em busca de atenuar lacunas existentes em dispositivos adaptados à fisioterapia, este estudo descreve o desenvolvimento e a aplicabilidade de um sistema computacional de suporte a reabilitação motora - Ikapp - em pacientes pós-AVE. Métodos: 27 pacientes pós-AVE preencheram um questionário socioeconômico, testaram o Ikapp durante 5 min e responderam a um questionário de usabilidade e satisfação sobre o manuseio da ferramenta. Para analisar a associação de fatores sociodemográficos com funcionalidades do sistema, o teste qui quadrado (Exato de Fisher) foi utilizado. Resultados: O Ikapp pode ser uma excelente ferramenta de auxílio à reabilitação neurológica de pacientes pós-AVE, visto que seus testes evidenciaram 85,2% de satisfação no que diz respeito à motivação e inclusão no processo fisioterápico e 77,8% em relação à facilidade de interação com a ferramenta. Conclusão: O Ikapp mostrou ser um sistema computacional de fácil aplicação e acessível a pacientes com diferentes limitações funcionais.

Peeled and piled volume models of the stomach made from a cadaver's sectioned images / Modelos de volumen descortezados y apilados del estómago producidos a partir de imágenes seccionales de un cadáver

Diagnosing and treating stomach diseases requires as many of the related anatomy details as possible. The objective of this study based on the sectioned images of cadaver was to offer interested clinicians anatomical knowledge about the stomach and its neighbors from the new viewpoint. For the raw data, sectioned images of a male cadaver without stomach pathology were used. By manual segmentation and automatic interpolation, a high-quality volume model of the stomach was reconstructed. The model was continuously peeled and piled to synthetically reveal the inside and outside of the stomach. The anterior, posterior, right, and left views of the models were compared with a chosen sectioned image. The numerous stomach images were then put into user-friendly browsing software. Some advantages of this study are that the sectioned images reveal real stomach color with high resolution; the peeled and piled volume models result in new features of the stomach and surroundings; and the processed models can be conveniently browsed in the presented software. These image data and tutorial software are expected to be helpful in acquiring supplementary morphologic information on the stomach and related structures.

El diagnóstico y el tratamiento de enfermedades del estómago requieren del conocimiento del mayor número de detalles posible sobre su anatomía. El objetivo de este estudio, basado en secciones de imágenes de cadáver, es ofrecer a los médicos la anatomía del estómago y sus estructuras vecinas desde un nuevo punto de vista. Se utilizaron imágenes de secciones de un cadáver, de sexo masculino, sin patología del estómago. Por segmentación manual y automática de interpolación, se reconstruyó un modelo de volumen de alta calidad del estómago. El modelo fue descortezado y apilado para revelar sintéticamente el interior y exterior del estómago. Se compararon los puntos de vista anterior, posterior, derecho e izquierdo de los modelos en una sección elegida. Las numerosas imágenes del estómago luego fueron puestas en el software de navegación de fácil uso para el profesional. Algunas de las ventajas de este estudio son que las imágenes seccionadas revelan el color real del estómago con alta resolución; los modelos de volumen descortezados y apilados dan lugar a nuevas funciones del estómago y sus estructuras circundantes; y los modelos procesados pueden ser convenientemente navegados en el software presentado. Se espera que estos datos de imagen y el tutorial del programa sean de utilidad para la adquisición de información morfológica complementaria sobre el estómago y las estructuras relacionadas.

Carteira de vacinação virtual / Virtual vaccination card

Apesar do constante crescimento do uso da tecnologia nas diversas áreas, ainda existem processos não informatizados, dependendo exclusivamente do uso da caneta e do papel, exemplo disso é a carteira de vacinação no Brasil. Em vários postos de saúde, os processos de registro da vacinação, desde o registro de quantas vacinas chegaram ao posto até o controle de quantas vacinas foram aplicadas diária e mensalmente são realizados através de fichas preenchidas manualmente pelos colaboradores destes postos. Esses procedimentos geram: inconsistência e perda de informações, difícil acesso a informações, dentre outros. Este artigo propõe um protótipo de carteira de vacinação virtual com o objetivo de propiciar o acesso ágil às informações registradas, armazenar informações de forma centralizada e organizada, permitindo a consistência e integridade de dados. Para isso, utiliza-se um cartão inteligente combinado a um ambiente web proporcionando acesso imediato e integral ao registro do histórico de vacinação de todo cidadão.

Despite the steady growth in the use of technology in different areas, there are still not computerized procedures, depending exclusively the use of pen and paper, example is the vaccination card in Brazil. In several health centers, all of vaccination registration processes, since the registration of all vaccines reached the post until track ofhow many vaccines were applied daily and monthly are performed through bookmarks manually filled by employees of these stations. These procedures create: inconsistency and loss of information, difficult access to information, among others. This paper purposes a prototype a virtual vaccination card in order to provide an agile access to recorded information, store information in a centralized and organized manner, allowing consistency and data integrity. For this,we use a combined smart card to web environment providing immediate and full access to the record of the vaccination history of all citizens.

Development of Child-Teen Obesity Treatment Service Platform / 대한의료정보학회지

OBJECTIVES: This study aimed to develop an effective and efficient obesity treatment and management service platform for obese children/teenagers. METHODS: The integrated smart platform was planned and established through cooperation with service providers such as hospitals and public health centers, obese children/teenagers who constitute the service's user base, and IT development and policy institutions and companies focusing on child-teen obesity management and treatment. RESULTS: Based on guidelines on intervention strategies to manage child-teen obesity, we developed two patient/parent mobile applications, one web-monitoring service for medical staff, one mobile application for food-craving endurance, and one mobile application for medical examinations. CONCLUSIONS: The establishment of the integrated service platform was successfully completed; however, this study was restrictively to the hospital where the pilot program took place. The effectiveness of the proposed platform will be verified in the future in tests involving other organizations.

Portable Document Format File Containing the Surface Models to Learn the Stereoscopic Shape of Foot Muscles / Archivos en Formato de Documento Portátil con Modelos de Superficie para Aprender la Forma Estereoscópica de los Músculos del Pié

We intended to present a portable document format (PDF) file containing stereoscopic surface models of the foot. While other surface models are subjectively drawn based on anatomical knowledge, our models are reconstructed from high quality sectioned images. Unlike other models, ours in the complimentary PDF file can also be saved on individual user computers to be manipulated off-line. The skin, 27 bones, 24 muscles, and 19 ligaments in the foot were delineated on a male cadaver's sectioned images from the Visible Korean project. After stacking the outlines of the structures, other than those of the ligaments, surface reconstruction was performed. The resultant surface models were placed in a PDF file, in which the models could be superimposed on either the corresponding sectioned images or the color-filled outline images. PDF bookmarks were established to exhibit the groups of foot muscles conveniently. The PDF file prepared in this research is likely to be very useful for comprehension of the topographic anatomy of the foot muscles. The models it contains can be extracted by other researchers for their own virtual dissection or surgery visualization of foot as desired.

El objetivo de este estudio fue un archivo en formato de documento portátil (PDF) que contiene modelos de superficie estereoscópicas del pie. Mientras que otros modelos de superficie se dibujan subjetivamente sobre la base de los conocimientos anatómicos, nuestros modelos seccionados se reconstruyen a partir de imágenes de alta calidad. A diferencia de otros modelos, nuestro modelo en el archivo PDF también se puede guardar en los computadores de los usuarios individuales para ser manipulados fuera de línea. Se delineó la piel, 27 huesos, 24 músculos, y 19 ligamentos en los pies de un cadáver de sexo masculino del proyecto Visible Korean. Después de apilar los contornos de las estructuras, que no fuera las de los ligamentos, se llevó a cabo la reconstrucción de las superficies. Los modelos de superficie resultantes se colocan en un archivo PDF, en el que los modelos podrían ser superpuestos en cualquiera de las correspondientes imágenes seccionadas o las imágenes de contorno a color. Se establecieron marcadores de PDF para exhibir los grupos de músculos del pie cómodamente. El archivo PDF preparado de esta investigación probablemente sea muy útil para la comprensión de la anatomía topográfica de los músculos del pie. Los modelos que contiene pueden ser extraídos por otros investigadores para la disección o cirugía de visualización virtual de los pies.