Computer-based Technology Research Articles

Dynamic adaptation process to implement an evidence-based child maltreatment intervention

BackgroundAdaptations are often made to evidence-based practices (EBPs) by systems, organizations, and/or service providers in the implementation process. The degree to which core elements of an EBP can be maintained while allowing for local adaptation is unclear. In addition, adaptations may also be needed at the system, policy, or organizational levels to facilitate EBP implementation and sustainment. This paper describes a study of the feasibility and acceptability of an implementation approach, the Dynamic Adaptation Process (DAP), designed to allow for EBP adaptation and system and organizational adaptations in a planned and considered, rather than ad hoc, way. The DAP involves identifying core elements and adaptable characteristics of an EBP, then supporting implementation with specific training on allowable adaptations to the model, fidelity monitoring and support, and identifying the need for and solutions to system and organizational adaptations. In addition, this study addresses a secondary concern, that of improving EBP model fidelity assessment and feedback in real-world settings.MethodsThis project examines the feasibility, acceptability, and utility of the DAP; tests the degree to which fidelity can be maintained using the DAP compared to implementation as usual (IAU); and examines the feasibility of using automated phone or internet-enabled, computer-based technology to assess intervention fidelity and client satisfaction. The study design incorporates mixed methods in order to describe processes and factors associated with variations in both how the DAP itself is implemented and how the DAP impacts fidelity, drift, and adaptation. The DAP model is to be examined by assigning six regions in California (USA) to either the DAP (n = 3) or IAU (n = 3) to implement an EBP to prevent child neglect.DiscussionThe DAP represents a data-informed, collaborative, multiple stakeholder approach to maintain intervention fidelity during the implementation of EBPs in the field by providing support for intervention, system, and organizational adaptation and intervention fidelity to meet local needs. This study is designed to address the real-world implications of EBP implementation in public sector service systems and is relevant for national, state, and local service systems and organizations.

A new paradigm for the development of future medical software systems

In many areas of human life, computer-based Information Technology (IT) has prevailed and become essential for the coordinated and efficient organization of workflows. Especially in the field of health care, interaction between human beings and IT is a sensitive subject. Inevitably, people working in the field of health care will have to make use of the potentials of IT in order to meet the enormous demands on e.g. patient management. When we look at the situation of current medical software systems, we can find major advances in the performance capacities of modern software systems, but must also note their rapid penetration into almost every facet of the daily hospital routine. Today medical software systems can be characterized as a vast number of (networked) software which each fulfills specific functions (e.g., hospital information system, Picture Archiving and Communication System) and which is used by different user groups (e.g., physicians, nurses, medical secretaries) with diverse user tasks [4]. Yet, for almost two decades, graphical user interfaces have dominated the interaction of medical software systems in most cases. In the future, a broader range of paradigms will emerge, allowing for multi-modal interaction. But also the growing number of heterogeneous platforms (operating systems, graphical libraries) and devices utilized complementarily (e.g., PC, Toughbook, Smartphone, PDA) demand for the development of congeneric user interfaces for a plethora of target platforms. Especially "mobile healthcare computing devices (MHCDs) are rapidly becoming an integral part of hospital information systems. Deployment of these devices is becoming an important IT strategy designed to assist in improving quality of care, enhancing patient services, increasing productivity, lowering costs, improving cash flow, as well as facilitating other critical delivery processes" [3]. For MHCDs aspects like getting the right information at the right time in the right place (context sensitivity) is important. To be able to cope with requirements like interoperability, context-sensitivity and device-independent usage a model-based approach for the development of user interfaces (MBUID) appears to be favourable [2].

A systematic review of emergency department technology-based behavioral health interventions.

This systematic review evaluated the evidence for use of computer technologies to assess and reduce high-risk health behaviors in emergency department (ED) patients. A systematic search was conducted of electronic databases, references, key journals, and conference proceedings. Studies were included if they evaluated the use of computer-based technologies for ED-based screening, interventions, or referrals for high-risk health behaviors (e.g., unsafe sex, partner violence, substance abuse, depression); were published since 1990; and were in English, French, or Spanish. Study selection and assessment of methodologic quality were performed by two independent reviewers. Data extraction was performed by one reviewer and then independently checked for completeness and accuracy by a second reviewer. Of 17,744 unique articles identified by database search, 66 underwent full-text review, and 20 met inclusion criteria. The greatest number of studies targeted alcohol/substance use (n = 8, 40%), followed by intentional or unintentional injury (n = 7, 35%) and then mental health (n = 4, 20%). Ten of the studies (50%) were randomized controlled trials; the remainder were observational or feasibility studies. Overall, studies showed high acceptability and feasibility of individual computer innovations, although study quality varied greatly. Evidence for clinical efficacy across health behaviors was modest, with few studies addressing meaningful clinical outcomes. Future research should aim to establish the efficacy of computer-based technology for meaningful health outcomes and to ensure that effective interventions are both disseminable and sustainable. The number of studies identified in this review reflects recent enthusiasm about the potential of computers to overcome barriers to behavioral health screening, interventions, and referrals to treatment in the ED. The available literature suggests that these types of tools will be feasible and acceptable to patients and staff.

4SPPIces: A case study of factors in a scripted collaborative-learning blended course across spatial locations

Computer-Supported Collaborative Blended Learning (CSCBL) scripts are complex learning situations in which formal and informal activities conducted at different spatial locations are coordinated and integrated into one unique learning setting through the use of technology. We define a conceptual model identifying four factors to be considered when addressing the design of these CSCBL scripts and of the technological system for supporting their enactment: the space, the pedagogical method, the participants and the history (4SPPIces factors). This paper presents and evaluates a CSCBL script designed according to the 4SPPIces factors. The script is proposed for extending the learning of geographic fieldwork in a geography course at a high school. In this script, students reflect about the urbanism and the socio-geographic characteristics of a Barcelona neighborhood. The script blends individual and collaborative activities supported by mobile and computer-based technologies conducted in the classroom, home and city. The script is evaluated in a case study involving thirty-four students and two teachers. The case study reports: (1) the CSCBL script designed with the teachers, considering the 4SPPIces factors and the associated technological environment and (2) the results of enacting the script in the actual learning context and analysing whether it fulfils the targeted learning objectives. The results from this case study show the impact of considering the 4SPPIces factors to enhance a real practice providing new learning and motivational benefits. The CSCBL script presented is an example that can encourage other practitioners and researchers to adopt the 4SPPices factors in similar educational situations.

Supply Chain Management in Textiles and Apparel

Supply chain management (SCM) is a crucial part of modern textiles and apparel business [1]. In addition to the traditional concepts on improving the production efficiency, quality control, and product design, supply chain management focuses on enhancing the collaboration and cooperation among all companies in the supply chain with a goal of satisfying what market wants. With the advance of technologies, both in terms of computer-based information technology and materials-science related production technology, many timely research issues emerge in supply chain management of textiles and apparel. Based on a recently published edited research handbook on fashion supply chain management [1] and the recent development of the textiles and apparel industry, the following research issues are outlined and discussed.

Patterns of Beliefs, Attitudes, and Characteristics of Teachers That Influence Computer Integration

Despite continued acceleration of computer access in elementary and secondary schools, computer integration is not necessarily given as an everyday learning tool. A heterogeneous sample of 185 elementary and 204 secondary teachers was asked to respond to open-ended survey questions in order to understand why integration of computer-based technologies does or does not fit with their teaching philosophy, what factors impact planning to use computer technologies in the classroom, and what characteristics define excellent teachers who integrate technology. Qualitative analysis of open-ended questions indicated that, overall, educators are supportive of computer integration describing the potential of technology using constructivist language, such as “authentic tasks” and “self-regulated learning.” Responses from “high” and “low” integrating teachers were compared across themes. The diversity of the themes and the emerging patterns of those themes from “high and low integrators” indicate that the integration of computer technology is a complex concern that requires sensitivity to individual and contextual variables.

Learning style and learning strategies

Two important factors need attention when contemplating how and where to use the new computer-based learning technologies. Firstly, in order to select the right kind of software, it is necessary to have a clear picture of the desired outcomes of a particular learning situation. There are many varieties of interactive multimedia available, and matching the tool to the job should be an early consideration. Of equal, if not greater importance, is the question of whether, for a particular learner, interactive multimedia is the most appropriate learning tool. If there is too great a mismatch between the learning styles and strategies of a particular learner and the given learning environment, learning may be inhibited rather than enhanced.DOI:10.1080/0968776950030103

Developing cross-cultural communicative competence via computer-assisted language learning: the case of pre-service ESL/EFL teachers

A review of the relevant literature strongly suggests that many, if not most, English as a Second or Foreign Language (ESL/EFL) teacher education programmes typically utilize concepts of culture and strategies for teaching and learning that are open to some cogent, but constructive, critiques from the perspective of critical educational theory. In addition, according to Wise (1995), throughout the last ten years the National Council for Accreditation of Teacher Education has required that colleges of teacher education must integrate technology into their curricula. In fact, ESL/EFL teacher education programmes are increasingly incorporating computer-based technologies and software into their curricula. However, this integration is often done in ways that seem to leave unquestioned the potential cultural and hegemonic ramifications of such technology (see, for example, Bowers, 1988; Jones, 1995; Morton, 1996; Murray, 1997; Sehlaoui, 1999).DOI:10.1080/0968776010090306

Differences in examination characteristics of pigmented skin lesions: Results of an eye tracking study

To use computer-based eye tracking technology to record and evaluate examination characteristics of the diagnosis of pigmented skin lesions. 16 study participants with varying levels of diagnostic expertise (little, intermediate, superior) were recorded while diagnosing a series of 28 digital images of pigmented skin lesions, obtained by non-invasive digital dermatoscopy, on a computer screen. Eye tracking hardware recorded the gaze track and fixations of the physicians while they examined the lesion images. Analysis of variance was used to test for differences in examination characteristics between physicians grouped according to expertise. There were no significant differences between physicians with little and intermediate levels of expertise in terms of average time until diagnosis (6.61 vs. 6.19s), gaze track length (6.65 vs. 6.15 kilopixels), number of fixations (23.1 vs. 19.1), and time in fixations (4.91 vs. 4.17s). The experts were significantly different with 3.17s time until diagnosis, 4.53 kilopixels gaze track length, 9.9 fixations, and 1.74s in fixations, respectively. Differentiation between benign and malignant lesions had no effect on examination measurements. The results show that experience level has a significant impact on the way in which lesion images are examined. This finding can be used to construct decision support systems that employ important diagnostic features identified by experts, and to optimize teaching for less experienced physicians.

Affording Mechanisms: An Integrated View of Coordination and Knowledge Management

In this paper we question the separation between technologies that support information and handle the ordered flow of work and technologies that support knowledge management. On the basis of observational studies and initiatives of participatory prototype design that we performed in the hospital domain and other cooperative work settings, the paper proposes a unified view of these high-level functionalities through the notion of Affording Mechanism. In order to clarify the implications for design, the paper discusses the relationships between knowledge and representations; the role of artifacts that are used in activities where knowledge is allegedly "produced, shared and consumed"; and finally the notion of affordance and its dynamics. In very general terms, an AM consists of an artifact and of dynamic relationships between the context of use and the artifact's affordances, expressed in terms of simple if-then constructs. The affordances conveyed through and by the artifact are modulated in order to evoke a "positive" reaction in the actors who use these augmented artifacts and to support knowledgeable behaviors apt to the situation. Moreover, the paper illustrates a prototypical technology through examples derived from the studies mentioned above, and discusses the kind of support this application provides in the light of an unusual interpretation of what it might mean to "manage" knowledge through computer-based technology.

Current Challenges in Integrating Educational Technology into Elementary and Middle School Mathematics Education

Developing curriculum and instruction for mathematics education and designing technologically enhanced learning environments are often pursued separately, but may need to be addressed together to effectively link the strengths of technology to performance in mathematics and conceptual understanding. This paper addresses current challenges with educational technology in elementary and middle school mathematics education, as well as technology’s influence on curriculum, instruction, and student performance. Three properties of computer-based technology are described; these properties determine technology’s unique value for elementary and middle school mathematics: engagement and motivation, informative feedback, and visualization. Three computer-based math applications, Doodle Math, Puzzle Me, and GeoShape, are introduced as examples that combine effective learning resources and technology.

Computer-based assistive technology and changes in daily living after stroke

The aim of this study was to examine in depth how computer-based assistive technology (AT) for cognitive support influenced the everyday lives of both persons who had had a stroke and their significant others. Method: Four participants, who had experienced cognitive limitations after a stroke, and their significant others were included in the study. The study included an intervention with a specific type of computer-based AT that was installed in the homes of the four participants for a 6-month period. Semistructured interviews were conducted before the installation to learn about the participants needs and repeated interviews took place after the installation. All collected data were analyzed based on qualitative methodology. Results: The findings illustrated how routines developed with support from the AT influenced the participants towards increased control of their everyday life, and also created daily structure and helped them regain social contacts. The findings demonstrated how the spouses also benefitted and could reduce their reminding and checking responsibilities. Conclusion: Computer-based AT has the potential to bring about changes in the everyday life for people with cognitive limitations by supporting the development of routines and by introducing, maintaining, reinforcing or regaining valuable activities.Implication for RehabilitationThere are several reasons for health professionals to consider computerized support for persons with cognitive impairments. There are especially two implications for rehabilitation that this study addresses:One implication from the study relates to the need of easing the burden for family members. Especially spouses often have to serve as an external “memory-support” that provides guidance and reminders to the person who has had a stroke. Computer-based AT can be of help in recreating new habits and a new structure in everyday living by reminding and encouraging the user and by doing so ease the burden of being a care provider.In this study, personalized reminders from computer-based AT were seen as supportive by those users who wanted to regain or maintain contact with family and friends. Such social contacts are of great importance and do often decrease after a stroke. The findings in this study represent a promising example of much needed technology to maintain a social role.

Virtual articulator for the analysis of dental occlusion: An update

The future of dental practice is closely linked to the utilization of computer-based technology, specifically virtual reality, which allows the dental surgeon to simulate true life situations in patients. The virtual articulator has been designed for the exhaustive analysis of static and dynamic occlusion, with the purpose of substituting mechanical articulators and avoiding their errors. These tools will help both odontologists and dental prosthetists to provide the best individualized treatment for each patient. The present review analyzes the studies published in the literature on the design, functioning and applications of virtual articulators. A Medline-PubMed search was made of dental journals, with the identification of 137 articles, of which 16 were finally selected. The virtual articulator can simulate the specific masticatory movement of the patient. During mandibular animation, the program calculates the sites where the opposing teeth come into contact. The studies made to assess the reliability of the virtual articulator show good correspondence in visualization of the number and position of the dynamic contacts. The virtual articulator is a precise tool for the full analysis of occlusion in a real patient. Key words: Virtual articulator, dental occlusion, dental articulator.

Selective laser sintering and its application in biomedical engineering

Abstract

Towards mainstreaming of biodiversity data publishing: recommendations of the GBIF Data Publishing Framework Task Group

BackgroundData are the evidentiary basis for scientific hypotheses, analyses and publication, for policy formation and for decision-making. They are essential to the evaluation and testing of results by peer scientists both present and future. There is broad consensus in the scientific and conservation communities that data should be freely, openly available in a sustained, persistent and secure way, and thus standards for 'free' and 'open' access to data have become well developed in recent years. The question of effective access to data remains highly problematic.DiscussionSpecifically with respect to scientific publishing, the ability to critically evaluate a published scientific hypothesis or scientific report is contingent on the examination, analysis, evaluation - and if feasible - on the re-generation of data on which conclusions are based. It is not coincidental that in the recent 'climategate' controversies, the quality and integrity of data and their analytical treatment were central to the debate. There is recent evidence that even when scientific data are requested for evaluation they may not be available. The history of dissemination of scientific results has been marked by paradigm shifts driven by the emergence of new technologies. In recent decades, the advance of computer-based technology linked to global communications networks has created the potential for broader and more consistent dissemination of scientific information and data. Yet, in this digital era, scientists and conservationists, organizations and institutions have often been slow to make data available. Community studies suggest that the withholding of data can be attributed to a lack of awareness, to a lack of technical capacity, to concerns that data should be withheld for reasons of perceived personal or organizational self interest, or to lack of adequate mechanisms for attribution.ConclusionsThere is a clear need for institutionalization of a 'data publishing framework' that can address sociocultural, technical-infrastructural, policy, political and legal constraints, as well as addressing issues of sustainability and financial support. To address these aspects of a data publishing framework - a systematic, standard approach to the formal definition and public disclosure of data - in the context of biodiversity data, the Global Biodiversity Information Facility (GBIF, the single inter-governmental body most clearly mandated to undertake such an effort) convened a Data Publishing Framework Task Group. We conceive this data publishing framework as an environment conducive to ensure free and open access to world's biodiversity data. Here, we present the recommendations of that Task Group, which are intended to encourage free and open access to the worlds' biodiversity data.

When Promotoras and Technology Meet

Computer-based multimedia technologies can be used to tailor health messages, but promotoras (Spanish-speaking community health workers) rarely use these tools. Promotoras delivered health messages about colorectal cancer screening to medically underserved Latinos in South Texas using two small media formats: a "low-tech" format (flipchart and video) and a "high-tech" format consisting of a tailored, interactive computer program delivered on a tablet computer. Using qualitative methods, the authors observed promotora training and intervention delivery and conducted interviews with five promotoras to compare and contrast program implementation of both formats. The authors discuss the ways each format aided or challenged promotoras' intervention delivery. Findings reveal that some aspects of both formats enhanced intervention delivery by tapping into Latino health communication preferences and facilitating interpersonal communication, whereas other aspects hindered intervention delivery. This study contributes to our understanding of how community health workers use low- and high-tech small media formats when delivering health messages to Latinos.

Iterative design and testing of a hand-held, non-contact wound measurement device

A variety of wound measurement techniques are available to clinicians. Options range from relatively simple and inexpensive to complex, expensive devices.An iterative design approach was used to evaluate and improve performance and clinical utility of a new wound measurement device (WMD). The design was based upon a commercially available Smartphone. Accuracy was assessed using bench testing and reliability of area measurements was determined using multiple evaluators. Clinical utility was investigated by deploying the WMD during wound rounds in a rehabilitation hospital.Accuracy testing revealed an average error <2% at 0° or skew and an average error of 4.28% at 10° of skew. The intra-rater reliability exceeded 0.975 for all raters and inter-rater reliability was 0.966. Clinical utility testing provided the opportunity to address several usability concerns including the software interface and computation times.The accuracy and reliability of a new, non-contact wound measurement device exceeded that of other manual techniques and were, at least, equivocal to other computer-based technologies. Some limitations of using a Smartphone were identified by the clinicians that can be addressed by the more advanced processing power of newer technology. Overall, the WMD was shown to have the potential as a useful clinical tool.

Basic Information Processing Effects from Perceptual Learning in Complex, Real-World Domains

Basic Information Processing Effects from Perceptual Learning in Complex, Real-World Domains Khanh-Phuong Thai (kpthai@ucla.edu) Everett Mettler (mettler@ucla.edu) Philip J. Kellman (kellman@psych.ucla.edu) Department of Psychology, 405 Hilgard Avenue, Los Angeles, CA 90095 USA Abstract mathematics and science (e.g., Goldstone, Landy & Son, 2008; Kellman et al., 2008). In recent research, Kellman and colleagues have shown that PL can be systematically engineered and accelerated using appropriate computer-based technology (e.g., Kellman, Massey & Son, 2010). Their approach to PL methods takes the form of perceptual learning modules (PLMs). Rather than focusing on memorization of instances, PLMs employ unique instances and systematic variations in the learning set to promote the learning of invariant or diagnostic structures characterizing a category or concept. Learners engage in short, interactive episodes focused on discrimination or classification. Because specific instances seldom or never repeat in PLMs, learners pick up structural invariance and can generalize it to new instances (Kellman et al., 2010). Recent work suggests that relatively brief PLM interventions can produce dramatic learning gains in challenging mathematical domains, such as fraction learning and algebra problem solving (Kellman et al., 2008; Kellman et al., 2010). Recent research indicates that perceptual learning (PL) interventions in real-world domains (i.e., mathematics, science) can produce strong learning gains, transfer, and fluency. Although results on domain-relevant assessments suggest characteristic PL effects, seldom have real-world PL interventions been explicitly tested for their effects on basic information extraction. We trained participants to classify Chinese characters, based on either (1) overall configurations (structures), (2) featural relations (components), or (3) non- relational information (stroke-count control). Before and after training, we tested for changes in information extraction using a visual search task. Search displays contained all novel exemplars, involved manipulations of target-distractor similarity using structures and components, and included heterogeneous and homogeneous distractors. We found robust improvements in visual search for structure and component PL training relative to the control. High-level PL interventions produce changes in basic information extraction, and sensitivity induced by PL for both relational structure and specific components transfers to novel structural categories. Purpose of Current Work Keywords: perceptual learning; educational technology; visual search; categorization. In applying PL to complex, symbolic, real-world learning domains, a critical question arises - how do we tell that the driver in these effects is really PL? Kellman, Massey & Son (2010) set out characteristic design features of perceptual learning interventions and some signature effects that implicate PL. Yet, realistic learning domains are complex and involve synergies between conceptual knowledge and perception of structure. Here we sought evidence of PL effects in a high-level, realistic learning domain, by explicitly testing after PLM use for basic changes in information extraction. We trained PL for complex patterns in Chinese characters using a paradigm similar to that used to train PL in math and science learning (Kellman et al., 2010). Since Chinese characters are logographic and have both local and global structure, we were able to train participants to recognize characters at 3 different levels of hierarchical organization: stroke, component, and structure. Participants in two PL conditions matched characters by component (featural relations) or overall structure (global configuration). Importantly, in the case of matching by structure, local components were free to vary. Other studies have shown that an expert’s ability to use relevant ‘chunks’ based on components and configural structure has to be nourished by literacy development and cannot be obtained solely through Introduction Research on expertise has shown that experts effortlessly attend to relevant features and relations (Gibson, 1969), that experts extract larger “chunks” of information, discover higher-order invariance, and do so with low attentional load (Gibson, 1969; Schneider & Shiffrin, 1977). Such changes in information extraction as a result of experience constitute perceptual learning (Gibson, 1969; for a recent review, see Kellman & Garrigan, 2009). Much contemporary research on perceptual learning (PL) has focused on basic sensory discriminations; however, PL effects are not confined to low-level tasks (Garrigan & Kellman, 2008; Kellman & Garrigan, 2009). In fact, the natural function of PL is to improve the extraction of information from complex objects and events (Kellman & Garrigan, 2009). PL also likely involves discovery of abstract relational structures. Such high-level PL is a crucial component of expertise in many domains including reading (Baron, 1978; Yeh et al., 2003), chess (Chase & Simon, 1973), and X-ray interpretation (Chi, Feltovich & Glaser, 1981). In addition, recent research indicates an important role for PL in high-level symbolic domains, such as

Use of ICT in school: a comparison between students with and without physical disabilities

The aim of this study was to determine the information and communication technologies use in school activities of two groups of students with physical disabilities, comprised of those who did and those who did not use a computer-based assistive technology device (ATD) and to make a comparison with students from the general population. In addition, positive factors associated with in-school computer use are identified for students with physical disabilities. The method adopted was a cross-sectional survey about computer-based activities in school among students with physical disabilities (n = 287); including those who used (n = 127) and those who did not use (n = 160) a computer-based ATD in school (mean age 13 years 6 months). Group comparisons were made with students from the general population (n = 940). The results showed that the most frequent computer users were students with physical disabilities, who used a computer-based ATD daily. However, when considered as a group, students with physical disabilities used the computer for less varied educational activities than the reference group. Four factors had a positive association to ‘participation in computer activities in school’ for students with physical disabilities: attending a mainstream school, the students’ age (notably, being 16–18 years old), using a computer often in school, and the teachers using a computer frequently in teaching. The present study concludes that, regardless of whether they use a computer-based ATD or not, students with a physical disability have restricted participation in some computer-based educational activities in comparison to students from the general population. An individual plan could be beneficial for each student to: focus on the aim of the computer use; examine the students’ needs in terms of computer-based ATDs and their inclusion in education; and ensure that the students’ digital skills are fully utilised.

Documenting the Use of Computers in Swedish Health Care up to 1980

This paper describes a documentation project to create, collect and preserve previously unavailable sources on informatics in Sweden (including health care as one of 16 subgroups), and making them available on the Web. Time was critical as the personal documentation and artifacts of early pioneers could be irretrievably lost. The criteria for participation were that a person had developed a system in a clinical environment which was used by others prior to 1980. Participants were interviewed and asked for early documentation such as notes, minutes from meetings, drawings, test results and early models - together with related artifacts. The approach included traditional oral history interviews, collection of autobiographies and new self-structuring and time saving methods, such as witness seminars and an Internet-based repository of their recollections (the Writers' Web). The combination of methods obtained new information on system errors, and challenges in reaching the goals due partly to inadequacies of the early technology, and partly to the insufficient understanding of the complexity of the many problems which needed to be solved before a useful electronic patient record could be realized. A very important result was the development of a method to collect information in an easier, faster and much less expensive way than using the traditional scientific method, and still reach results that are qualitative and quantitative for the purpose of documenting the early period of computer-based health care technology. The witness seminars and the Writers' Web yielded especially large amounts of hitherto-unknown information. With all material in one database available to everyone on the Web, it is accessed very frequently - especially by students, researchers, journalists and teachers. Study of the materials explains and clarifies the reasons behind the delays and difficulties that have been encountered in developing electronic patient records, as described in an article [3] published in the IMIA Yearbook 2006.