Using three-channel video to evaluate the impact of the use of the computer on the patient-centredness of the general practice consultation

The aim of this study was to assess the feasibility of using three-channel video to explore the impact of the computer on general practitioner (GP) consultations. A previous study had highlighted the limitations of using single-channel video: firstly, there was a lack of information about exactly how the computer was being used, and secondly difficulty in interpreting the body language of the consulting clinician. More information was needed to understand the impact of the computer on the consultation, and in this pilot three-channel video was used to overcome these constraints. Four doctors consulted, with the patient's role played by an actor with a preset script and preloaded personal and family history record programmed into the computer. The output was analysed using the Roter Interaction Analysis System (RIAS) and observational methods were used to explore the effect of computers on aspects of verbal and non-verbal behaviour and the completeness of the computer data record. Three-channel video proved to be a feasible and valuable technique for the analysis of primary care GP consultations, with advantages over single-channel video. Interesting differences in non-verbal and verbal behaviour became apparent with different types of computer use during the consultation. Implications for the three-channel video technique for training, monitoring GP competence and providing feedback are discussed

The feasibility of using pattern recognition software to measure the influence of computer use on the consultation

BACKGROUND: A key feature of a good general practice consultation is that it is patient-centred. A number of verbal and non-verbal behaviours have been identified as important to establish a good relationship with the patient. However, the use of the computer detracts the doctor's attention away from the patient, compromising these essential elements of the consultation. Current methods to assess the consultation and the influence of the computer on them are time consuming and subjective. If it were possible to measure these quantitatively, it could provide the basis for the first truly objective way of studying the influence of the computer on the consultation. The aim was to assess whether pattern recognition software could be used to measure the influence and pattern of computer use in the consultation. If this proved possible it would provide, for the first time, an objective quantitative measure of computer use and a measure of the attention and responsiveness of the general practitioner towards the patient. METHODS: A feasibility study using pattern recognition software to analyse a consultation was conducted. A web camera, linked to a data-gathering node was used to film a simulated consultation in a standard office. Members of the research team enacted the role of the doctor and the patient, using pattern recognition software to try and capture patient-centred, non-verbal behaviour. As this was a feasibility study detailed results of the analysis are not presented. RESULTS: It was revealed that pattern recognition software could be used to analyse certain aspects of a simulated consultation. For example, trigger lines enabled the number of times the clinician's hand covered the keyboard to be counted and wrapping recorded the number of times the clinician nodded his head. It was also possible to measure time sequences and whether the movement was brief or lingering. CONCLUSION: Pattern recognition software enables movements associated with patient-centredness to be recorded. Pattern recognition software has the potential to provide an objective, quantitative measure of the influence of the computer on the consultation

Reviews and bibliographical notices

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Coconut lethal yellowing diseases: a phytoplasma threat to palms of global economic and social significance

The recent discovery of Bogia coconut syndrome in Papua New Guinea (PNG) is the first report of a lethal yellowing disease (LYD) in Oceania. Numerous outbreaks of LYDs of coconut have been recorded in the Caribbean and Africa since the late Nineteenth century and have caused the death of millions of palms across several continents during the Twentieth century. Despite the severity of economic losses, it was only in the 1970s that the causes of LYDs were identified as phytoplasmas, a group of insect-transmitted bacteria associated with diseases in many other economically important crop species. Since the development of polymerase chain reaction (PCR) technology, knowledge of LYDs epidemiology, ecology and vectors has grown rapidly. There is no economically viable treatment for LYDs and vector-based management is hampered by the fact that vectors have been positively identified in very few cases despite many attempted transmission trials. Some varieties and hybrids of coconut palm are known to be less susceptible to LYD but none are completely resistant. Optimal and current management of LYD is through strict quarantine, prompt detection and destruction of symptomatic palms, and replanting with less susceptible varieties or crop species. Advances in technology such as loop mediated isothermal amplification (LAMP) for detection and tracking of phytoplasma DNA in plants and insects, remote sensing for identifying symptomatic palms, and the advent of clustered regularly interspaced short palindromic repeats (CRISPR)-based tools for gene editing and plant breeding are likely to allow rapid progress in taxonomy as well as understanding and managing LYD phytoplasma pathosystems

A first principles investigation on the interaction of oxomolybdenum porphyrin with Q2 - Oxomolybdenum porphyrin as a catalyst for oxygen reduction

We investigated the interaction of oxomolybdenum porpyhrin (MoO(por)) with 0% by using first principles calculations. Our calculations indicate that the adsorbed O2 on MoO(por) does not take an end-on configuration, but a side-on configuration to become more stable. These results can be understood from the differences in the molecular orbital energies and the valence electron densities. The geometric parameters of MoO(por) and MoO(por) (O2) with a side-on configuration of O2 are in good, agreement with experimental results. © 2006 The Surface Science Society of Japan

Data from: Movements of four native Hawaiian birds across a naturally fragmented landscape

Animals often increase their fitness by moving across space in response to temporal variation in habitat quality and resource availability, and as a result of intra and inter-specific interactions. The long-term persistence of populations and even whole species depends on the collective patterns of individual movements, yet animal movements have been poorly studied at the landscape level. We quantified movement behavior within four native species of Hawaiian forest birds in a complex lava-fragmented landscape: Hawai‛i ‘Amakihi (Chlorodrepanis virens), ‘Oma‘o (Myadestes obscurus), ‘Apapane (Himatione sanguinea), and ‘I‘iwi (Drepanis coccinea). We evaluated the relative importance of six potential intrinsic and extrinsic drivers of movement behavior and patch fidelity: 1) forest fragment size, 2) the presence or absence of invasive rats (Rattus sp.), 3) season, 4) species, 5) age, and 6) sex. The study was conducted across a landscape of 34 forest fragments varying in size from 0.07 to 12.37 ha, of which 16 had rats removed using a treatment-control design. We found the largest movements in the nectivorous ‘Apapane and ‘I‘iwi, intermediate levels in the generalist Hawai‛i ‘Amakihi, and shortest average movement for the ‘Oma‘o, a frugivore. We found evidence for larger patch sizes increasing patch fidelity only in the ‘Oma‘o, and an effect of rat-removal increasing patch fidelity of Hawai‛i ‘Amakihi only after two years of rat-removal. Greater movement during the non-breeding season was observed in all species, and season was an important factor in explaining higher patch fidelity in the breeding season for ‘Apapane and ‘I‘iwi. Sex was important in explaining patch fidelity in ‘Oma‘o only, with males showing higher patch fidelity. Our results provide new insights into how these native Hawaiian species will respond to a changing environment, including habitat fragmentation and changing distribution of threats from climate change