Development of an evaluation framework for publicly funded R&D projects: The case of Korea's Next Generation Network.

For decades, efforts have been made globally to measure the performance of large-scale public projects and to develop a framework to perform such measurements due to the complexity and dynamics of R&D and stakeholder interests. Still, limitations such as the use of a simply modified model and the lack of a comprehensive viewpoint are prevalent in existing approaches. In light of these research gaps, this study suggests a practical model to evaluate the performance of large-scale and publicly funded projects. The proposed model suggests a standard matrix framework of indices that evaluates the performance of particular elements in an industrial ecosystem in vertical categories and the economic and technological outcomes of those elements in horizontal categories. Based on the application of a balanced scorecard, this study uses mixed methodologies such as social network analysis, inter-industry analysis, and the analytic hierarchy process. Finally, the model evaluates the performance of Korea's Next Generation Network project as a case study.

The cost of developing a computerized tailored interactive multimedia intervention vs. a print based Photonovella intervention for HPV vaccine education.

Mobile technology is opening new avenues for healthcare providers to create and implement tailored and personalized health education programs. We estimate and compare the cost of developing an i-Pad based tailored interactive multimedia intervention (TIMI) and a print based (Photonovella) intervention to increase human papillomavirus (HPV) immunization. The development costs of the interventions were calculated using a societal perspective. Direct cost included the cost of planning the study, conducting focus groups, and developing the intervention materials by the research staff. Costs also included the amount paid to the vendors who produced the TIMI and Photonovella. Micro cost data on the staff time and materials were recorded in logs for tracking personnel time, meeting time, supplies and software purchases. The costs were adjusted for inflation and reported in 2015 USD. The total cost of developing the Photonovella was $66,468 and the cost of developing the TIMI was $135,978. The amortized annual cost for the interventions calculated at a 3% discount rate and over a 7-year period was $10,669 per year for the Photonovella and $21,825 per year for the TIMI intervention. The results would inform decision makers when planning and investing in the development of interactive multimedia health interventions.

Expectativas y experiencias de uso de las mujeres gitanas mayores ante los servicios sanitarios de atención primaria / Expectations and user experiences of older Roma women with health services in primary care

OBJETIVO: Conocer las expectativas y las experiencias de uso de las mujeres gitanas mayores ante los servicios sanitarios de atención primaria (AP). DISEÑO: Estudio cualitativo fenomenológico. Uso de grupos focales (4-9 mujeres/grupo) y entrevistas semiestructuradas. Registradas en audio. Realizadas entre marzo y noviembre de 2011. Emplazamiento: Estudio realizado en Úbeda y Linares (España). Participantes y contexto: Mujeres gitanas de más de 50 años. Muestreo intencional con criterio de segmentación de edad y zona de residencia. Captación a través de líderes comunitarias. MÉTODO: Proceso de análisis cualitativo de contenido: codificación, triangulación, obtención y verificación de RESULTADOS: Apoyado con el software Nvivo 8. RESULTADOS: Se realizaron 3 grupos focales y 4 entrevistas, incluyéndose 23 mujeres. Las expectativas ante la AP se dirigen exclusivamente a su médico, siendo invisibles otros profesionales. Quieren una relación con su médico basada en la confianza. En sus experiencias de uso de la AP conviven 3 tipos de uso: acuden a sus citas, demandan atención solo ante patología aguda y no acuden a citas y revisiones. Existen elementos socioculturales relacionados con la accesibilidad. CONCLUSIONES: Las mujeres gitanas mayores plantean sus expectativas y experiencias en los servicios de AP alrededor del binomio enfermedad/médico. Esperan una atención basada en la confianza y con una alta instrumentalización. Se observa un discurso con signos de cambio dirigidos hacia una participación más activa y reivindicativa en los servicios de AP

OBJECTIVE: To know the expectations and user experiences of older Roma women with health services in primary care (PC). DESIGN: Phenomenological qualitative study. Using focus groups (4-9 women/group) and semistructured interviews. Audio recorded from March to November 2011. LOCATION: Performed in Úbeda and Linares (Spain). Participants and SETTING: Roma women over 50 years. A purposive sample stratified by age and area of residence was carried out. Woman were recruited through community leaders. Method: Process of qualitative content analysis: coding, triangulation, obtain and verify RESULTS: Supported whit the software Nvivo 8. RESULTS: Three focus groups and four interviews were conducted, including 23 women. The expectations for the PC are focus exclusively on their physician, being invisible other professionals. They look for a relationship with their physician based on trust. In their user experience with the PC coexist three types of user: who goes to their appointments, demands attention only in acute disease and does not attend appointments and reviews. There are socio-cultural factors related to accessibility. CONCLUSIONS: Older Roma women set their expectations and experiences with health service in PC around the binomial disease/physician. Expect attention based on trust and a high instrumentalization. A speech with signs of change directed towards a more active and demanding participation in PC services is observed

Game-theoretic pricing for video streaming in mobile networks.

Mobile phones are among the most popular consumer devices, and the recent developments of 3G networks and smart phones enable users to watch video programs by subscribing data plans from service providers. Due to the ubiquity of mobile phones and phone-to-phone communication technologies, data-plan subscribers can redistribute the video content to nonsubscribers. Such a redistribution mechanism is a potential competitor for the mobile service provider and is very difficult to trace given users' high mobility. The service provider has to set a reasonable price for the data plan to prevent such unauthorized redistribution behavior to protect or maximize his/her own profit. In this paper, we analyze the optimal price setting for the service provider by investigating the equilibrium between the subscribers and the secondary buyers in the content-redistribution network. We model the behavior between the subscribers and the secondary buyers as a noncooperative game and find the optimal price and quantity for both groups of users. Based on the behavior of users in the redistribution network, we investigate the evolutionarily stable ratio of mobile users who decide to subscribe to the data plan. Such an analysis can help the service provider preserve his/her profit under the threat of the redistribution networks and can improve the quality of service for end users.

The multimedia computer for office-based patient education: a systematic review.

Use of the multimedia computer for education is widespread in schools and businesses, and yet computer-assisted patient education is rare. In order to explore the potential use of computer-assisted patient education in the office setting, we performed a systematic review of randomized controlled trials (search date April 2004 using MEDLINE and Cochrane databases). Of the 26 trials identified, outcome measures included clinical indicators (12/26, 46.1%), knowledge retention (12/26, 46.1%), health attitudes (15/26, 57.7%), level of shared decision-making (5/26, 19.2%), health services utilization (4/26, 17.6%), and costs (5/26, 19.2%), respectively. Four trials targeted patients with breast cancer, but the clinical issues were otherwise diverse. Reporting of the testing of randomization (76.9%) and appropriate analysis of main effect variables (70.6%) were more common than reporting of a reliable randomization process (35.3%), blinding of outcomes assessment (17.6%), or sample size definition (29.4%). We concluded that the potential for improving the efficiency of the office through computer-assisted patient education has been demonstrated, but better proof of the impact on clinical outcomes is warranted before this strategy is accepted in the office setting.

Estimating software development costs for a patient multimedia education project.

The authors compare alternative methods of cost estimation for a patient multimedia education (PME) program, using a computerized weight-reduction PME project as an example. Data from the project planning and budgeting process and actual costs of the completed project are analyzed retrospectively to calculate three different estimates-pre-work, post-work, and actual work. Three traditional methods of estimating the cost of computer programs (the lines-of-code, function point, and task ratio analyses) underestimate costs in this example. A commercial program (Cost Xpert) that calculates the cost of developing a graphical user interface provided a better estimate, as did a tally reflecting the complexity and quality of media material in the project.

The clinical display of radiologic information as an interactive multimedia report.

We regard the delivery of radiological information as an interactive multimedia report. We use a multimedia report model based on Extensible Markup Language (XML), rather than a traditional workstation model. Others have suggested a similar document-based approach. This display presentation includes image-related and text-based information and may contain interactive components (e.g., window, level and zoom). Using XML as a foundation for this multimedia presentation, we achieve flexibility and platform independence at a lower cost. XML allows for the separation of content and form. Content information, defined as elements (e.g., images, radiologic reports, and demographic information), is treated as independent information objects. The behavior of the elements can be changed for different users and tasks. In addition, by separating format detail from content, the appearance of the elements within the report can be modified. XML does not replace existing standards (i.e., Digital Imaging and Communications in Medicine [DICOM], Transmission Control Protocol/Internet Protocol [TCP/IP]). Instead, it provides a powerful framework that is used in combination with existing standards to allow system designers to modify display characteristics based on user need. We describe our application of XML to the clinical display of radiologic information.

Virtual reality--current multimedia--the world of virtual reality for children.

Some people go as far to say that the invention of virtual technology is comparable to Columbus' discovery of the American continent. Nowadays, computers are regarded as essential tools for children to explore their new world. It will be interesting to observe and guide the growth of these children who have entered into such a world filled with many possibilities.

Design and development of a multimedia database for emergency telemedicine.

Recent studies conclude that early and specialised pre-hospital patient management contributes to emergency cases survival. Recent developments in telecommunication and medical informatics by means of telemedicine can be extremely useful to accomplish such tasks in a cost-effective manner. Along that direction, we have designed a portable device for emergency telemedicine. This device is able to telematically "bring" the expert doctor at the emergency site, have him perform an accurate diagnosis, and subsequently direct the Emergency Medical Technicians on how to treat the patient until he arrives to the hospital. The need for storing and archiving all data being interchanged during the telemedicine sessions is very crucial for clinical, legal and administrative purposes. For this, we have developed a multimedia database able to store and manage the data collected by the AMBULANCE system. The database was equipped with a user-friendly graphical interface to enable use from computer naive users. Furthermore, the database has the possibility to display, in an standard way, ECG's, X-ray, CT and MRI images. The application is password protected with a three-level hierarchy access for users with different privileges. The scope of this application is to enhance the capabilities of the doctor on duty for a more precise and prompt diagnosis. The application has the ability to store audio files related to each emergency case and still images of the scene. Finally, this database can become a useful multimedia tool which will work together with the AMBULANCE portable device, the HIS and the PACS of the hospital. The system has been validated in selected non-critical cases and proved to be functional and successful in enhancing the ability of the doctor's on duty for prompt and accurate diagnosis and specialised pre-hospital treatment.

Development of interactive patient-based multimedia computer programs in veterinary orthopedic radiology.

Three computerized multimedia programs on large and small animal veterinary orthopedic radiology were developed and implemented for the radiology curriculum as an alternative to traditional film-based laboratory learning. Programs utilized "hot words" (colored text words that displayed an overlaid image label that highlighted lesions) and interactive quizzes which responded appropriately to selected answers. "Hot words" helped students develop confidence in accurate lesion detection and the interactive quizzes transformed learning from a passive to an active process. Multiple examples were provided for reinforcement and concepts were incorporated from other clinical disciplines for curriculum integration. Programs were written using a presentation software program, Toolbook for DOS based platform, and contained radiographic images made by laser-scanning digitization. Multiple students could simultaneously access the programs through a network server. These pilot programs were implemented successfully and computerized multimedia presentation proved to be well suited to teaching radiology. Development of the programs required attention to a number of hardware, software, time and cost factors.

Educational benefits and cost savings from an interactive multimedia "best practice".

BACKGROUND: Developing and deploying "clinical practice guidelines" and "best practices" is a major strategic goal of our organization. We developed and evaluated a novel way of educating our colleagues on the office management of shoulder pain, using an interactive multimedia computer program to allow rapid access to user-selected audiovisual educational materials through a simple point and click interface. METHODS: Pre- and post-testing of 30 practicing primary care providers was conducted to assess ability to evaluate and manage patients who present with shoulder pain, and a post-use survey was administered to assess clinician acceptance and confidence, ability to use as a just-in-time tool, and changes in utilization of medical resources. RESULTS: Pre- and post-testing demonstrated that clinicians used this tool to improve their scores in a wide variety of clinical areas including history, physical examination, diagnosis, and management of conditions causing painful shoulder above their scores using textbooks and other traditional educational materials alone. The post-use survey showed outstanding acceptance by clinicians and their reported increased confidence as well as the potential for their increased abilities to translate into significant cost savings through more focused use of radiographic studies, orthopedic consultations, and physical therapy treatments. CONCLUSIONS: It was concluded that "The Multimedia Reference for Office Management of Shoulder Pain" is an effective and valuable learning resource for practicing clinicians, and demonstrates the potential to use an interactive multimedia tool to augment clinical skills and promote cost effective management of patients with this common clinical problem.

Multimedia instruction of cardiac auscultation.

The cardiac physical examination is in itself a multimedia experience. It is an amalgamation of visible, palpable, and audible sensations, preceded by the collection of an appropriate historical context in which to place these multiple sensations. It is unlikely that any electronic media could ever replace the real life experience of admitting, examining, diagnosing, and effectively treating a patient with mitral stenosis who has decompensated because of the onset of atrial fibrillation with rapid ventricular response, or a patient with sudden, severe aortic regurgitation due to endocarditis. These potentially fatal conditions can be effectively treated only if the suspicion of their presence is seriously raised. Although there is no substitute for first-hand experience, attempts to provide an effective surrogate experience are worth pursuing.