BACKGROUND The existing literature indicates that psychotherapeutic treatment,especially exposure and response prevention(ERP)is efficacious in treating obsessivecompulsive disorder(OCD).The coronavirus disease 2019 p...BACKGROUND The existing literature indicates that psychotherapeutic treatment,especially exposure and response prevention(ERP)is efficacious in treating obsessivecompulsive disorder(OCD).The coronavirus disease 2019 pandemic adversely impacted many patients with OCD and disrupted their usual treatment.Moreover,the pandemic forced a global switch to telemental health(TMH)services to maintain the standards and continuity of care.Consequently,clinicians are increasingly using TMH-based psychotherapeutic treatments to treat OCD.However,several challenges have made it difficult for them to implement these treatments in the changed circumstances imposed by the pandemic.AIM To describe the formulation,implementation,feasibility,and usefulness of videoconferencing-based ERP(VC-ERP)treatment for OCD during the coronavirus disease 2019 pandemic.METHODS This prospective,observational study was conducted in the psychiatric unit of a multi-specialty hospital in north India over 12 mo(July 2020-June 2021).All patients with OCD were assessed using the home-based TMH services of the department.The VC-ERP protocol for OCD was the outcome of weekly Zoom meetings with a group of clinicians involved in administering the treatment.After a systematic evaluation of the available treatment options,an initial protocol for delivering VC-ERP was developed.Guidelines for clinicians and educational materials for patients and their families were prepared.The protocol was implemented among patients with OCD attending the TMH services,and their progress was monitored.The weekly meetings were used to upgrade the protocol to meet the needs of all stakeholders.Feasibility and efficacy outcomes were examined.RESULTS All patients were diagnosed with OCD as a primary or a comorbid condition according to the International Classification of Diseases,10th version criteria.Out of 115 patients who attended the services during the study period,37 were excluded from the final analysis.Of the remaining 78 patients,VC-ERP was initiated in 43 patients.Six patients dropped out,and three were hospitalized for inpatient ERP.Eleven patients have completed the full VC-ERP treatment.One patient completed the psychoeducation part of the protocol.VC-ERP is ongoing in 22 patients.The protocol for VC-ERP treatment was developed and upgraded online.A large proportion of the eligible patients(n=34/43;79%)actively engaged in the VC-ERP treatment.Drop-out rates were low(n=6/43;14%).Satisfaction with the treatment was adequate among patients,caregivers,and clinicians.Apart from hospitalization in 3 patients,there were no other adverse events.Hybrid care and stepped care approaches could be incorporated into the VC-ERP protocol.Therefore,the feasibility of VC-ERP treatment in terms of operational viability,service utilization,service engagement,need for additional in-person services,frequency of adverse events,and user satisfaction was adequate.The VC-ERP treatment was found to be efficacious in the 11 patients who had completed the full treatment.Significant reductions in symptoms and maintenance of treatment gains on follow-up were observed.CONCLUSION This study provided preliminary evidence for the feasibility and usefulness of VC-ERP in the treatment of OCD.The results suggest that VC-ERP can be a useful option in resource-constrained settings.展开更多
Telepsychiatry, i.e., the use of information and communication technologies to provide psychiatric services from a distance, has been around for more than half a century now. Research over this period has shown that v...Telepsychiatry, i.e., the use of information and communication technologies to provide psychiatric services from a distance, has been around for more than half a century now. Research over this period has shown that videoconferencing-based telepsychiatry is an enabling and empowering form of service delivery, which promotes equality of access, and high levels of satisfaction among patients. The range of services offered by videoconferencing-based telepsychiatry, potential users and points of delivery of such services are theoretically limitless. Telepsychiatry has both clinical utility and non-clinical uses such as administrative, learning and research applications. A large body of accumulated evidence indicates that videoconferencingbased telepsychiatric assessments are reliable, and clinical outcomes of telepsychiatric interventions are comparable to conventional treatment among diverse patient populations, ages and diagnostic groups, and on a wide range of measures. However, on many aspects of effectiveness, the evidence base is still relatively limited and often compromised by methodological problems. The lack of cost-effectiveness data in particular, is a major hindrance, raising doubts about the continued viability of telepsychiatric services. Added to this are the vagaries of technology, negative views among clinicians, poor uptake by providers, and several legal, ethical and administrative barriers. These hamper the widespread implementation of telepsychiatry and its integration with routine care. Though further advances in technology and research are expected to solve many of these problems, the way forward would be to promote telepsychiatry as an adjunct to conventional care, and to develop hybrid models, which incorporate both traditional and telepsychiatric forms of mental health-care.展开更多
We describe a system for multipoint videoconferencing that offers extremely low end-to-end delay, low cost and complexity, and high scalability, alongside standard features associated with high-end solutions such as r...We describe a system for multipoint videoconferencing that offers extremely low end-to-end delay, low cost and complexity, and high scalability, alongside standard features associated with high-end solutions such as rate matching and per- sonal video layout. The system accommodates heterogeneous receivers and networks based on the Internet Protocol and relies on scalable video coding to provide a coded representation of a source video signal at multiple temporal and spatial resolutions as well as quality levels. These are represented by distinct bitstream components which are created at each end-user encoder. Depending on the specific conferencing environment, some or all of these components are transmitted to a Scalable Video Conferencing Server (SVCS). The SVCS redirects these components to one or more recipients depending on, e.g., the available network con- ditions and user preferences. The scalable aspect of the video coding technique allows the system to adapt to different network conditions, and also accommodates different end-user requirements (e.g., a user may elect to view another user at a high or low spatial resolution). Performance results concerning flexibility, video quality and delay of the system are presented using the Joint Scalable Video Model (JSVM) of the forthcoming SVC (H.264 Annex G) standard, demonstrating that scalable coding outper- forms existing state-of-the-art systems and offers the right platform for building next-generation multipoint videoconferencing systems.展开更多
Face-to-face Videoconferencing is a popular option for many large organizations because it minimizes the need for travel. Instead of continually paying for traveling expenses, a company can either pay to set up a high...Face-to-face Videoconferencing is a popular option for many large organizations because it minimizes the need for travel. Instead of continually paying for traveling expenses, a company can either pay to set up a high speed network which has many usages (including videoconferencing) or they can rent time on an existing network. Employees will also no longer be burdened with the need to travel. While face-to-face videoconferencing performance is heavily influenced by the underlying hardware and software, a good video compression scheme can help make the best use of videoconferencing and provide a high quality picture. H.263 standard is now widely used for real-time video communications over a range of networks including the Internet. A frame work for better understanding the H.263 including the implementation of encoder and decoder for face-to-face videoconferencing is presented. This software was written in C++ language, running under the Microsoft Windows operating system.展开更多
We consider a face-to-face videoconferencing system that uses a Kinect camera at each end of the link for 3D modeling and an ordinary2 D display for output. The Kinect camera allows a 3D model of each participant to b...We consider a face-to-face videoconferencing system that uses a Kinect camera at each end of the link for 3D modeling and an ordinary2 D display for output. The Kinect camera allows a 3D model of each participant to be transmitted;the(assumed static) background is sent separately.Furthermore, the Kinect tracks the receiver's head,allowing our system to render a view of the sender depending on the receiver's viewpoint. The resulting motion parallax gives the receivers a strong impression of 3D viewing as they move, yet the system only needs an ordinary 2D display. This is cheaper than a full3 D system, and avoids disadvantages such as the need to wear shutter glasses, VR headsets, or to sit in a particular position required by an autostereo display.Perceptual studies show that users experience a greater sensation of depth with our system compared to a typical 2D videoconferencing system.展开更多
文摘BACKGROUND The existing literature indicates that psychotherapeutic treatment,especially exposure and response prevention(ERP)is efficacious in treating obsessivecompulsive disorder(OCD).The coronavirus disease 2019 pandemic adversely impacted many patients with OCD and disrupted their usual treatment.Moreover,the pandemic forced a global switch to telemental health(TMH)services to maintain the standards and continuity of care.Consequently,clinicians are increasingly using TMH-based psychotherapeutic treatments to treat OCD.However,several challenges have made it difficult for them to implement these treatments in the changed circumstances imposed by the pandemic.AIM To describe the formulation,implementation,feasibility,and usefulness of videoconferencing-based ERP(VC-ERP)treatment for OCD during the coronavirus disease 2019 pandemic.METHODS This prospective,observational study was conducted in the psychiatric unit of a multi-specialty hospital in north India over 12 mo(July 2020-June 2021).All patients with OCD were assessed using the home-based TMH services of the department.The VC-ERP protocol for OCD was the outcome of weekly Zoom meetings with a group of clinicians involved in administering the treatment.After a systematic evaluation of the available treatment options,an initial protocol for delivering VC-ERP was developed.Guidelines for clinicians and educational materials for patients and their families were prepared.The protocol was implemented among patients with OCD attending the TMH services,and their progress was monitored.The weekly meetings were used to upgrade the protocol to meet the needs of all stakeholders.Feasibility and efficacy outcomes were examined.RESULTS All patients were diagnosed with OCD as a primary or a comorbid condition according to the International Classification of Diseases,10th version criteria.Out of 115 patients who attended the services during the study period,37 were excluded from the final analysis.Of the remaining 78 patients,VC-ERP was initiated in 43 patients.Six patients dropped out,and three were hospitalized for inpatient ERP.Eleven patients have completed the full VC-ERP treatment.One patient completed the psychoeducation part of the protocol.VC-ERP is ongoing in 22 patients.The protocol for VC-ERP treatment was developed and upgraded online.A large proportion of the eligible patients(n=34/43;79%)actively engaged in the VC-ERP treatment.Drop-out rates were low(n=6/43;14%).Satisfaction with the treatment was adequate among patients,caregivers,and clinicians.Apart from hospitalization in 3 patients,there were no other adverse events.Hybrid care and stepped care approaches could be incorporated into the VC-ERP protocol.Therefore,the feasibility of VC-ERP treatment in terms of operational viability,service utilization,service engagement,need for additional in-person services,frequency of adverse events,and user satisfaction was adequate.The VC-ERP treatment was found to be efficacious in the 11 patients who had completed the full treatment.Significant reductions in symptoms and maintenance of treatment gains on follow-up were observed.CONCLUSION This study provided preliminary evidence for the feasibility and usefulness of VC-ERP in the treatment of OCD.The results suggest that VC-ERP can be a useful option in resource-constrained settings.
文摘Telepsychiatry, i.e., the use of information and communication technologies to provide psychiatric services from a distance, has been around for more than half a century now. Research over this period has shown that videoconferencing-based telepsychiatry is an enabling and empowering form of service delivery, which promotes equality of access, and high levels of satisfaction among patients. The range of services offered by videoconferencing-based telepsychiatry, potential users and points of delivery of such services are theoretically limitless. Telepsychiatry has both clinical utility and non-clinical uses such as administrative, learning and research applications. A large body of accumulated evidence indicates that videoconferencingbased telepsychiatric assessments are reliable, and clinical outcomes of telepsychiatric interventions are comparable to conventional treatment among diverse patient populations, ages and diagnostic groups, and on a wide range of measures. However, on many aspects of effectiveness, the evidence base is still relatively limited and often compromised by methodological problems. The lack of cost-effectiveness data in particular, is a major hindrance, raising doubts about the continued viability of telepsychiatric services. Added to this are the vagaries of technology, negative views among clinicians, poor uptake by providers, and several legal, ethical and administrative barriers. These hamper the widespread implementation of telepsychiatry and its integration with routine care. Though further advances in technology and research are expected to solve many of these problems, the way forward would be to promote telepsychiatry as an adjunct to conventional care, and to develop hybrid models, which incorporate both traditional and telepsychiatric forms of mental health-care.
文摘We describe a system for multipoint videoconferencing that offers extremely low end-to-end delay, low cost and complexity, and high scalability, alongside standard features associated with high-end solutions such as rate matching and per- sonal video layout. The system accommodates heterogeneous receivers and networks based on the Internet Protocol and relies on scalable video coding to provide a coded representation of a source video signal at multiple temporal and spatial resolutions as well as quality levels. These are represented by distinct bitstream components which are created at each end-user encoder. Depending on the specific conferencing environment, some or all of these components are transmitted to a Scalable Video Conferencing Server (SVCS). The SVCS redirects these components to one or more recipients depending on, e.g., the available network con- ditions and user preferences. The scalable aspect of the video coding technique allows the system to adapt to different network conditions, and also accommodates different end-user requirements (e.g., a user may elect to view another user at a high or low spatial resolution). Performance results concerning flexibility, video quality and delay of the system are presented using the Joint Scalable Video Model (JSVM) of the forthcoming SVC (H.264 Annex G) standard, demonstrating that scalable coding outper- forms existing state-of-the-art systems and offers the right platform for building next-generation multipoint videoconferencing systems.
文摘Face-to-face Videoconferencing is a popular option for many large organizations because it minimizes the need for travel. Instead of continually paying for traveling expenses, a company can either pay to set up a high speed network which has many usages (including videoconferencing) or they can rent time on an existing network. Employees will also no longer be burdened with the need to travel. While face-to-face videoconferencing performance is heavily influenced by the underlying hardware and software, a good video compression scheme can help make the best use of videoconferencing and provide a high quality picture. H.263 standard is now widely used for real-time video communications over a range of networks including the Internet. A frame work for better understanding the H.263 including the implementation of encoder and decoder for face-to-face videoconferencing is presented. This software was written in C++ language, running under the Microsoft Windows operating system.
基金supported by the National Hightech R&D Program of China (Project No. 2013AA013903)the National Natural Science Foundation of China (Project Nos. 61133008 and 61272226)+1 种基金Research Grant of Beijing Higher Institution Engineering Research Center, an EPSRC Travel Grantthe Research and Enterprise Investment Fund of Cardiff Metropolitan University
文摘We consider a face-to-face videoconferencing system that uses a Kinect camera at each end of the link for 3D modeling and an ordinary2 D display for output. The Kinect camera allows a 3D model of each participant to be transmitted;the(assumed static) background is sent separately.Furthermore, the Kinect tracks the receiver's head,allowing our system to render a view of the sender depending on the receiver's viewpoint. The resulting motion parallax gives the receivers a strong impression of 3D viewing as they move, yet the system only needs an ordinary 2D display. This is cheaper than a full3 D system, and avoids disadvantages such as the need to wear shutter glasses, VR headsets, or to sit in a particular position required by an autostereo display.Perceptual studies show that users experience a greater sensation of depth with our system compared to a typical 2D videoconferencing system.
