Noemi Bitterman - Academia.edu (original) (raw)

Papers by Noemi Bitterman

Disaster Medicine and Public Health Preparedness, May 19, 2022

Gestire l'emergenza. Il contributo della ricerca interdisciplinare, 2019

The Israel Medical Association journal : IMAJ, 2005

In light of changes in the medical profession, the different requirements placed on physicians an... more In light of changes in the medical profession, the different requirements placed on physicians and the evolving needs of the healthcare system, the need arose to examine the medical education curriculum in Israel. This survey, conducted by the Samuel Neaman Institute for Science and Technology, summarizes 20 years of medical education in Israel's four medical schools, as the first stage in mapping the existing state of medical education in Israel and providing a basis for decision-making on future medical education programs. To characterize the academic background of graduates, evaluate their attitudes towards current and alternative medical education programs, and examine subgroups among graduates according to gender, medical school, high school education, etc. The survey included graduates from all four Israeli medical schools who graduated between the years 1981 and 2000 in a sample of 1:3. A questionnaire and stamped return envelope were sent to every third graduate; the que...

Introduction: Natural and man-made disasters are becoming global concerns. Natural disasters appe... more Introduction: Natural and man-made disasters are becoming global concerns. Natural disasters appear to be growing in number and intensity due to global warming, population explosion, increased travel, and overcrowding of cities. In addition, man-made disasters do not seem to be diminishing. At disaster sites, an immediate response is needed. National and international organizations ; nongovernmental, military, and commercial organizations; and even private donors enlist to provide humanitarian and medical support and to send supplies, shelters, and temporary health care facilities to disaster zones. Problem: The literature is sparse regarding the design of portable health care facilities intended for disaster zones and their adaptability to the tasks required and site areas. Methods: Data were collected from peer-reviewed literature, scientific reports, magazines, and websites regarding health care facilities at rescue and salvage situations. Information was grouped according to categories of structure and properties, and relative strengths and weaknesses. Next, suggestions were made for future directions. Results: Permanent structures and temporary constructed facilities were the two primary categories of health care facilities functioning at disaster zones. Permanent hospitals were independent functioning medical units that were moved or transported to and from disaster zones as complete units, as needed. These facilities included floating hospitals, flying (airborne) hospitals, or terrestrial mobile facilities. Thus, these hospitals self-powered and contained mobility aids within their structure using water, air, or land as transporting media. Temporary health care facilities were transported to disaster zones as separate, non-functioning elements that were constructed or assembled on site and were subsequently taken apart. These facilities included the classical soft-type tents and solid containers that were organized later as hospitals in camp configurations. The strengths and weaknesses of the diverse hospital options are discussed. Conclusions: Future directions include the use of innovative materials, advanced working methods, and integrated transportation systems. In addition, a holistic approach should be developed to improve the performance, accessibility, time required to function, sustainability , flexibility, and modularity of portable health care facilities.

236 w w w . g e r o n t e c h j o u r n a l . n e t O c t o b e r 2 0 0 7 , V o l 6 , N o 4 S t u... more 236 w w w . g e r o n t e c h j o u r n a l . n e t O c t o b e r 2 0 0 7 , V o l 6 , N o 4 S t u d e n t p a p e r

Commercial air travel is widespread, with close to 2 billion people traveling each year. The asso... more Commercial air travel is widespread, with close to 2 billion people traveling each year. The association between venous thromboembolism (VTE) and confined sitting has been established and a correlation between the distance traveled and its incidence had been documented. Most studies underscore stasis caused by immobility as the cause of VTE and ignore the possible contribution of additional factors including coagulation and the blood vessel wall. Recent studies indicate that hypobaric hypoxia may contribute to blood vessel wall alteration and activation of coagulation. We suggest that air travel associated hypobaric hypoxia may lead to endothelial injury and initiation of a procoagulatory response, effects which are augmented by the reoxygenation upon landing, thus culminating in thrombosis. Prevention of air travel associated hypoxia and reoxygenation injury may decrease the incidence of flight associated VTE.

Recreational diving has developed extensively over the years as a popular leisure and sports acti... more Recreational diving has developed extensively over the years as a popular leisure and sports activity, attracting millions of practitioners around the world. The number of female divers of all ages has increased over the years and they constitute approximately one third of worldwide recreational divers.

Objective: Our aim was to evaluate visualization methods for specific tasks performed with person... more Objective: Our aim was to evaluate visualization methods for specific tasks performed with personal healthcare e-record systems for lay adults and older patients. We investigated common visualization methods for data entry and follow-up of personal and clinical information for self-control of blood coagulation functions. Methods: Twenty-five old (72.2 – 5.5 years) and 25 young (30.4 – 4.9 years) participants completed tasks based on common scenarios, on experimental Web sites with hidden tracking programs. Functional parameters (time, accuracy), subjective parameters (preference, satisfaction), and physiological parameters (heart rate, skin temperature , sweat, respiratory rate, and muscle tension) monitored with miniature sensors were used. Results: Total time for data entry and information follow-up were significantly longer for older compared with younger participants, with no significant differences in accuracy (errors), in stress-related physiological parameters, in preferences, or in satisfaction between age group. The Menu display was the significantly preferred configuration for data entry in both age groups, based on functional, physiological, and subjective criteria (p < 0.05, Duncan test). The Calendar configuration was significantly preferred for mixed tasks of follow-up and information retrieval, in both age groups, based on functional, physiological, and subjective criteria (p < 0.05, Duncan test). Conclusions: Our study supports equal capabilities of old and young people to use interactive healthcare systems for management of chronic diseases and further encourages using physiological, functional, and subjective methods for evaluating personal healthcare records.

Smart homes are residences equipped innovative technologies: sensors, wired and wireless networks... more Smart homes are residences equipped innovative technologies: sensors, wired and wireless networks, actuators and intelligent systems. The smart home concept has developed rapidly since the early 1990s. Yet, after almost more than two decades, the prevalence of smart homes is still limited and has not taken off on a large scale even though many people consider it to constitute 'future living'. This review article aims to bridge the knowledge gap between the disciplines of computing, architecture and health care, in order to provide architects, designers and planners with an integrative overview of the smart home, its technologies, objectives, problems and obstacles, including suggestions for overcoming these obstacles and the possible implications on our future living.

Hyperbaric therapeutic chambers are pressure vessels capable of accommodating one or more persons... more Hyperbaric therapeutic chambers are pressure vessels capable of accommodating one or more persons with the purpose of providing medical treatment. Therapeutic hyperbaric chambers have been in use from the mid-20 th century, yet apparently their design has not reached their full potential and they are not compatible with current healthcare facilities design. This paper will present therapeutic hyperbaric chambers from a human-environment-machine perspective in order to highlight their specifi c problems and requirements, and suggest design concepts that may improve patient satisfaction, quality of treatment, and functionality of the staff . Data were collected from a literature review, a market survey and personal observations. Main design solutions include personal space and privacy, stressand anxiety-reducing environments, hazard mitigation, rearrangement of seating, and personalized (user-tailored) entertainment systems. It is suggested that adopting a user-centered design rather than an engineering focus will increase satisfaction and overall 'user experience' of the patients, alleviate psychological issues, and lessen workload and improve functionality of the staff . This study could be applicable and easily adapted to other confi ned therapeutic environments in which patients are restrained for several hours on a regular basis in receiving treatment, such as dialysis or chemotherapy rooms, and for confi ned nonmedical situations such as aircrafts and rapid trains. KEYWORDS: confi ned atmosphere , healthcare facilities , hyperbaric oxygen therapy , medical design , user-centered design . Bitterman N, Bonen A. Design and human factors of therapeutic hyperbaric chambers . Aerosp Med Hum Perform. 2016; 87(4): 1 -9 .

We tested the effect of moderate food or water deprivation and a combination of the two on sensit... more We tested the effect of moderate food or water deprivation and a combination of the two on sensitivity to hyperoxia-induced seizures
in rats. Seventy rats with chronic cortical electrodes were exposed to seven experimental protocols: starvation, dehydration or a
combination of both for 24 or 36 h, prior to exposure to 0.5 MpaO2. Blood glucose and hematocrit were measured before and after
exposure to hyperbaric oxygen HBO.. Starvation and dehydration significantly prolonged the latent period to the onset of hyperoxia-in-
duced seizures P-0.05 in the Tukey test., in a dose-related manner. Our results suggest that deprivation of food or water, prior to
exposure to HBO, may postpone the development of hyperoxia-induced seizures

We tested the effect of caffeine, on hyperoxia-induced seizures. Thirty-seven rats with chronic c... more We tested the effect of caffeine, on hyperoxia-induced seizures. Thirty-seven rats with chronic cortical electrodes were injected i.p.
with caffeine (1.25, 2.5, and 10 mg/kg) or vehicle before exposure to 0.5 MPa oxygen and 17 rats to oxygen with 5% CO 2 at 0.5 MPa.
EEG monitoring and spectral analysis of EEG activity were carried out. Caffeine significantly prolonged the latent period to the onset of
seizures (P < 0.05 in ANOVA), in a dose-related manner. Our results suggest that caffeine may be used in low doses for protection
against hyperoxia-induced seizures.

Recent advances in technology have led to the introduction of a variety of innovative devices, ea... more Recent advances in technology have led to the introduction
of a variety of innovative devices, each with their
own platform for data display, into the operating room (OR).
While these innovative applications are expanding the traditional
boundaries of the surgical space and enhancing treatment capabilities,
the introduction of additional screens and displays is placing
an ever-increasing load on the OR team.
This review describes the main data display platforms currently
available in ORs: computer monitors with CRT (cathode ray
tube) or LCD (liquid crystal display) screens, suspended imaging
displays, wearable computers (WC), auditory displays and tactile
(haptic) displays. The different display platforms are evaluated
according to their compatibility with the characteristics of the
working environment (OR), the monitoring task, and the users
(the surgical team).
No single display configuration provides an ultimate solution
for presenting patient data in the OR. A multi-sensory data display
including visual, acoustic and haptic manipulation is suggested
as a promising configuration for data display in the OR.

Health care services are moving out to the community and into the home; e-health services, remote... more Health care services are moving out to the community and into the home; e-health services, remote
monitoring technology and self-management are replacing hospitalization and visits to medical clinics and
custom-tailored medicines are making inroads into normative treatment. These developments have great
implications for the scope and design of home health care equipment.
The paper discusses the unique nature of home medical devices, from a human–environment–machine
perspective, focusing on the nature of users, environment and tasks performed.
We call for increased awareness and active continuous involvement of health care personnel together with
bioengineers, human factors experts, architects, designers and end users—patients and caregivers—in defining
the objectives of health care devices and services at home in terms of “all family” use, integrated into the
overall surroundings (“smart home”), and as part of a collaborative patient–physician disease management
team.

Equipment congestion and a disarray of wires, tubes and lines (the spaghetti syndrome) is a commo... more Equipment congestion and a disarray of wires, tubes and lines (the spaghetti syndrome) is a common
scenario in operating theatres. The radial arrangement of input and output signals and their
interconnecting lines has been identified as the main source of clutter and congestion in this
environment. Our aim was to present a comprehensive design concept for reducing electrical and
physical clutter in the operating theatre. Data were collected from different operating theatres,
including identification and sorting of equipment, cables, tubes and lines according to the direction
and the features of the transmitted information and materials. We suggest a concept of a selfcontained,
‘built-in’ operating table as a design solution for avoiding the clutter and congestion
caused by the radial configuration. The operating table will function as a central integrated unit for
management of the entire process of patient flow and control of supply systems and environmental
conditions.

The sea and its depths have captivated human imagination from time immemorial. People have looked... more The sea and its depths have captivated human imagination from time immemorial.
People have looked to the sea for adventure and beauty, and gone into it in search of
unique and different experiences. The underwater world, however, is mainly
accessible only to divers. We look for ways to extend it to non-divers, making it a
family experience. Submerged tourism, a fledgling industry, is set to take shape in the
form of restaurants, hotel entertainment halls and more – operating beneath the
surface of the water. The article reviews existing one-atmosphere underwater
structures and discusses their unique problems and challenges, offering suggestions
for the future development of submerged tourism.

Disaster Medicine and Public Health Preparedness, May 19, 2022

Gestire l'emergenza. Il contributo della ricerca interdisciplinare, 2019

The Israel Medical Association journal : IMAJ, 2005