Upscaling telemonitoring in Dutch University Medical Centres: A baseline measurement.

INTRODUCTION AND OBJECTIVE: The Dutch university medical centres (UMC's) are on the forefront when it comes to validation, implementation and research of telemonitoring. To aid the UMC's in their effort, the Dutch Government has supported the UMC's by fostering the 'Citrien eHealth program'. This program aims at nationwide implementation and upscaling of telemonitoring via a collaborative network. To quantify the success of this program, this study aims to provide insights into the current adoption of telemonitoring by health care professionals (HCP) within Dutch UMC's. METHODS: Based on the evaluation framework as adapted from the Normalization Process Theory (NPT) a cross-sectional study was conducted in all Dutch UMC's. Thirty healthcare professionals (HCPs) per UMC were invited to complete the 23-item Normalization MeAsure Development (NoMAD) questionnaire, a tool to assess the degree of normalisation of telemonitoring. RESULTS: The over-all response rate was 52.4% (124/240). Over 80% of respondents agreed or strongly agreed that they understand how telemonitoring affects the nature of their work, with a mean score of 1.49 (N = 117, SD 0.74). HCPs reported to believe telemonitoring will become a normal part of their work in the near future (N = 124, mean = 8.67, SD = 1.38). Using the Wilcoxon signed-rank test, the difference between current practise and future use of telemonitoring predicts to be statistically significant (Z =  - 7.505, p ≤ 0.001). Mean scores for appropriate training and sufficient resources are relatively low (2.39 and 2.70 respectively), indicating a barrier for collective action. CONCLUSION: This is the first study to assess the implementation of telemonitoring as standard practise across Dutch UMCs. The HCPs in this study are the frontrunners, believing that telemonitoring will become standard practise in the future despite the fact that it is currently not. Based on the results of this study, both educational and implementation strategies including practical skills training are highly recommended in order to scale up telemonitoring widely.

Assessing the influence of operational factors on the perceived structure of real-world scenes viewed during low-altitude, high-speed flight.

Previous research indicates that pilots of most jet-fighter aircraft attend to similar elements of the natural flight environment when flying at low altitudes. However, some evidence suggests that differences may exist for pilots of certain specific types of aircraft. The present experiment examined the influence of operational factors on the perceived structure of real-world scenes viewed during low-altitude flight. Multidimensional scaling analyses with stimuli consisting of videotape segments of low-altitude flight over a variety of real-world terrains revealed differences in perceived environmental structure for pilots assigned to different types of jet-fighter aircraft. These results provide evidence that perceptual learning evolves differently under different operational conditions and suggests that training programs should be designed to reflect those differences.

Visual scene properties relevant for simulating low-altitude flight: a multidimensional scaling approach.

In the present experiments I sought to identify the properties of visual scenes relevant for simulating low-altitude flight. The approach was first to identify the relevant properties of real-world scenes. The stimuli were videotape segments or still photographs of real-world scenes exhibiting a variety of scene properties. Ratings of similarity between stimulus pairs were submitted to multidimensional scaling analyses. Results using videotape segments provided consistent evidence for two relevant scene properties: variation in terrain shape and variation in object size or spacing. Results using still photographs were less interpretable, supporting the argument that motion information is important. Results suggest that designers of flight simulator visual scenes should focus specifically on rendering elements of terrain shape and objects in scenes.

Effects of three types of flight simulator visual scene detail on detection of altitude change.

The effects of three types of flight simulator visual scene detail on detection of altitude change were evaluated in three experiments. Across all experiments and with a variety of tasks and display conditions, speed and accuracy of detecting altitude change improved with increases in the density of vertical objects in scenes. Adding detail to individual objects to increase their natural appearance produced no consistent effects on performance. In Experiment 3 complex texture distributed globally on terrain surfaces improved detection of altitude change but did not alleviate the need for high object density. These results indicate that available computer image generator processing capacity would be used more effectively by increasing the density of objects in scenes, rather than by increasing the complexity and detail of individual objects. Complex texture is used more effectively when distributed globally on terrain surfaces, rather than when allocated to individual objects.

Locus and persistence of capacity limitations in visual information processing.

Although there is considerable evidence that stimuli such as digits and letters are extensively processed in parallel and without capacity limitations, recent data suggest that only the features of stimuli are processed in parallel. In an attempt to reconcile this discrepancy, we used the simultaneous/successive detection paradigm with stimuli from experiments indicating parallel processing and with stimuli from experiments indicating that only features can be processed in parallel. In Experiment 1, large differences between simultaneous and successive presentations were obtained with an R target among P and Q distractors and among P and B distractors, but not with digit targets among letter distractors. As predicted by the feature integration theory of attention, false-alarm rates in the simultaneous condition were much higher than in the successive condition with the R/PQ stimuli. In Experiment 2, the possibility that attention is required for any difficult discrimination was ruled out as an explanation of the discrepancy between the digit/letter results and the R/PQ and R/PB results. Experiment 3A replicated the R/PQ and R/PB results of Experiment 1, and Experiment 3B extended these findings to a new set of stimuli. In Experiment 4, we found that large amounts of consistent practice did not generally eliminate capacity limitations. From this series of experiments we strongly conclude that the notion of capacity-free letter perception has limited generality.