Die Inzidenz und Prävalenz von Krebserkrankungen präsentiert sich in den vergangenen Jahren ungebrochen hoch. Durch die stetige Optimierung der Versorgung werden Betroffenen neuartige Optionen offeriert. Moderne Onkotherapie zeichnet sich durch sektorenübergreifende Kooperation aus. Diese komplexen Versorgungskonzepte können durch innovative Technologien simplifiziert werden. Vorliegende Arbeit erörtert die Frage nach der Umsetzbarkeit Tablet-gestützter Screenings in der Routine der Strahlenmedizin. Die Erfassung der ESAS-Items und des Unterstützungsbedarfs ermöglichte nach dem Vorbild kanadischer Versorgungskonzepte definierte Aussagen zur Qualität der medizinischen Versorgung. Im Rahmen der Studie erhielten Tumorpatienten vor der perkutanen Radiotherapie (T1) ein Tablet-gestütztes Symptom-Screening. Das Tablet-Screening wurde von den Teilnehmern bezüglich Bedienung und Nutzerfreundlichkeit evaluiert. Nach Abschluss der Radiotherapie erfolgte eine telefonische Nachbefragung der Teilnehmer (T2). Insgesamt partizipierten 332 Krebspatienten am Tablet-Screening. 79 potentielle Studienprobanden nahmen nicht teil. Als Hauptursachen zeigten sich fehlende Zeit (21,5%), die Teilnahme an sonstigen Studien (20,3%) und zu hohe psychische Belastungen (17,7%). Der Anteil der Screening-Teilnehmer mit fundierten Vorkenntnissen im Umgang mit Tablet-PCs (15,7%) war gering. Probanden mit Tablet-Vorerfahrungen waren signifikant jünger als Unerfahrene. Anwendung und Nutzerfreundlichkeit erlangte hohe Zustimmung. Die wenigen (21,7%) Befürworter konventioneller Stift-Papier-Fragebögen waren signifikant älter. 219 Screening-Teilnehmer stellten ihre ausgewerteten Symptom-Fragebögen weiteren Auswertungen zur Verfügung. Der Performance-Status wurde von Patient und Mediziner eher divergent bewertet (ĸ=0,254). Von T1 zu T2 nahm der Anteil positiv gescreenter Probanden ab. Kurativpatienten markierten bei den ESAS-Items Müdigkeit, Kurzatmigkeit und Sonstiges signifikante Symptomverbesserungen. Bei Palliativpatienten zeigte Kurzatmigkeit signifikante Verbesserung, Depressionen hingegen signifikante Verschlechterung. Der schwächste Unterstützungsbedarf (23,3%) wurde beim ,,Bedarf an Informationen beim Erstellen von Patientenverfügungen‘‘ registriert. Die BUKA-Studie konnte die Chancen Tablet-gestützter Befragungen in der Routine der Radioonkologie darstellen. Das Screening markierte durchgängig positive Bewertungen sowie große Akzeptanz. Die positiven Ergebnisse deckten sich mit denen anderer Studien bezüglich EDV-gestützter Datenerhebung. Die oftmals nicht ausreichendende Zeit zur Studienteilnahme war jedoch nicht auf eine zu zeitintensive Bedienung von Tablet-PCs zurückzuführen. Die Anzahl der Screening-Items sollte der kurzen Wartezeit der Strahlenambulanz angepasst werden. EDV-Screenings sollten darüber hinaus zukünftig bereits von zuhause absolviert werden. Die zunehmende Technisierung des Alltags lässt den Anteil PC-erfahrener Patienten weiter ansteigen. Die Einführung EDV-gestützter Versionen bietet eine effektive Möglichkeit des Patienten-Monitoring als Grundlage multidisziplinärer onkologischer Versorgung. Infolge der zunehmenden PC-gestützten Verarbeitung hochsensibler Patientendaten ist die Gewährleistung vollkommener Datensicherheit dringend notwendig. Im Gegensatz zu anderen Arbeiten präsentierte das Studienkollektiv überwiegend Kurativpatienten mit gutem Allgemeinzustand. Trotz geringerer Symptombelastung konnten auch hier die positiven Effekte der Radiotherapie dargestellt werden. Der hohe Unterstützungsbedarf erschien oftmals dem mangelnden medizinischen Verständnis der Betroffenen geschuldet. Kurativpatienten äußerten deutlich mehr Interesse aktiv an der Therapie teilzuhaben. Palliativpatienten erschienen durch das Übermaß an Therapien entkräftet. / In recent years the incidence and prevalence of carcinosis remained unchanged high. The continous improvement of patient centred care offers unknown possibilities. Modern cancer therapy is distinguished by overlapping cooperation. These extensive treatment options can be simplified by innovative technology. The study in hand investigates the implementabilitiy of a tablet screening in the field of radiooncology. Aquiring data on the ESAS Items and on the individual request of support as done in the Canadian cancer support system enables us to give evidence. In the present study tumor patients were screened before receiving percutane radiotherapy (T1) on a special symptom screening scale via tablet. The participants also evaluated the tablet screening on handling and usability. After the radiotheray the participants were questioned again via phone interview. In total 332 cancer patients took part in the tablet screening. 79 potential participants didn’t participate. The main reasons were the lack of time (21,5%), the participation in other studies (20,3%), and the high psychic strain (17,7%). The the number of participants with a previous knowledge in the use of tablet-computer was low (15,7%). Furthermore, they were significantly younger than the participants with that hat no previous knowledge in the use of a tablet. Handling and usabilityshowed high acceptance. The few supporters of conventional paper-pencil -quetionnaires were significantly older. In total 219 screening patients did consent the further evaluation and analysis of their screening results. Patients and physicians showed divergent results in theassessment of the patient’s performance status (k=0,254). The rate of participants with positive screening results decreased from T1 to T2. In the ESAS items fatigue, dyspnoea and other problems curative patients showed significant symptom improvement. Patients with palliative treatment also represented with significant improvemet in dyspnoea whereas the rate on depression increased significantly. Patients showed the lowest interest in the provision on information on making an advance health care directive (23,3%). The BUKA study was able to represent the opportunities of tablet screening in the routine of radiooncology. The tablet screening did resilt in an overall positive feedback and demonstrated high rate of acceptance. Similar positive results were also showen in several previous studies concerning the use computerized questionnaires. The participants complaints on the lack of time did not refer to the use of the computerized questionnaire itself but on the provided amount of time for the questionaire itself. In the future, the amount of screening items should be adjusted to the amount of waiting time in the ambulance of the radiooncology. Furthermore, computerized screening should be considered to be already done at home. The upcoming computerization in the daily routine will increase rate people with previous knowledge on computerized systems and applications even further. The implementation of computerized systems provides the opportunity of a very effective patient monitoring as a foundation vor multidisciplinary oncological treatment. As a result of the increasing digitalization of patient data the data protection is extremely important and future challenge but must be basic prerequisite. In contrast to other studies our patients predominantly represented a good performance status. Despite the low symptom stress the positive effects of a radiotherapy could be illustrated here as well. The high demand of support seemed to be due to the lack of understanding of medical information. Curative patients showed significantly more interest in taking actively part in their therapy whereas patients with palliative treatment seemed to be rather exhausted with the excess of palliative treatment options.

The human mind is a churning engine, processing all forms of sensory input. Information that reaches these senses is powerful, facilitating and deepening understanding. Animations access sight. They provide a rich visual model that portrays not only information about the system graphically, but they also present information about the relationships and interactions in that model over time. However, the complexity of today's software for constructing animations limits their use and isolates animations to a small set of scenarios. One such eliminated scenario is being able to create and manipulate animations in real time, while a conversation takes place. The human mind comprehends from manipulation, trial, and error. Animations are productions. Instructors cannot manipulate and recreate animations within the time constraints of a classroom. Developers cannot recreate animations within the time constraints of a meeting. This thesis explores the engineering of a modeling environment prototype for creating animated models. By building an environment designed to leverage the capabilities of Microsoft's Tablet PC operating system, this thesis contributes a new approach to creating animations and visualizations. This prototype demonstrates a pen-based user interface that decreases the time and effort required to create an animation by enabling users to create an animation by simply drawing a model and animating it. The Tablet PC hardware and software provide developers with the capabilities necessary to create software that works as naturally as the pen and paper. With the Tablet PC's Ink technology, users can draw models and simply draw the paths where the objects in that model should follow. This thesis explores the design of the environment, the research prototype named Model Pad, and explores its importance, its contribution, and its unique design based on the capabilities of the Tablet PC. As mobile computers become increasingly central to the workplace, the ability to create animations quickly and easily while talking with others, while presenting in front of an audience or a class, or while working with a team of engineers allows animation to become a natural part of the way we visually communicate information. The Model Pad environment is merely a first step in the direction of creating fully pen-based modeling and animation tools. The concepts it builds form the foundation of understanding how to express animations that are more complex. This thesis and the Model Pad environment provide the initial framework for building pen-based animation tools on the Tablet PC, allowing simple models to be expressed in methods as simple as using a pen and paper. This solution enables people to construct simple models in real time, enabling a rebirth of the power of animation for education and engineering design. / Master of Science / The human mind is a churning engine, processing all forms of sensory input. Information that reaches these senses is powerful, facilitating and deepening understanding. Animations access sight. They provide a rich visual model that portrays not only information about the system graphically, but they also present information about the relationships and interactions in that model over time. However, today’s software tools for constructing animations are complex, unnatural and limiting to for Students, Instructors, and Developers. This thesis explores the engineering of a modeling environment prototype for creating animated models with a natural form of input, a pen. By building an environment designed to leverage the capabilities of Microsoft’s Tablet PC, a personal computer designed with a built-in interactive screen that enables users to draw on the screen to interact with it directly, this thesis contributes a new approach to creating animations and visualizations. This prototype demonstrates a pen-based user interface that decreases the time and effort required to create an animation by enabling users to create an animation by merely drawing a model and animating it. The Tablet PC hardware and software provide developers with the capabilities necessary to develop software that works as naturally as the pen and paper. With the Tablet PC’s Ink technology, users can draw models and merely draw the paths where the objects in that model should follow. This thesis explores the design of the environment, the research prototype named Model Pad, and explores its importance, its contribution, and its unique design based on the capabilities of the Tablet PC. As mobile computers become increasingly central to the workplace, the ability to create animations quickly and efficiently while talking with others, while presenting in front of an audience or a class, or while working with a team of engineers allows the animation to become a natural part of the way we visually communicate information. The Model Pad environment is merely a first step in the direction of creating fully pen-based modeling and animation tools. The concepts it builds form the foundation of understanding how to express animations that are more complex. This thesis and the Model Pad environment provide the interaction primitives for building penbased animation tools on the Tablet PC, allowing simple models to be expressed in methods as simple as using a pen and paper. This solution enables people to construct simple models in real time, enabling a rebirth of the power of animation for education and engineering design.

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The use of technology as an effective educational tool has been an elusive goal in the past. Specifically, previous attempts at using small personal computers in the classroom to aid students as collaborative and note-taking tools have been met with lukewarm responses. Many of these past attempts were hampered by inferior hardware and the lack of an efficient and user-friendly interface. With the recent introduction of Tablet PC products on the market, however, the limitations imposed on software developers for mobile computing systems have been dramatically lowered. We present a collaborative annotation system that allows students equipped with tablet computers to work cooperatively in either an ad-hoc or a structured wireless classroom setting. / Singapore-MIT Alliance (SMA)

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A Tablet PC is a portable computing device which combines a regular notebook computer with a digitizing screen that interacts with a complementary electronic pen stylus. The pen allows the user to input data by writing on or by tapping the screen. Like a regular notebook computer, the user can also perform tasks using the mouse and keyboard. A Tablet PC gives the users all the features of a regular notebook computer along with the support to recognize, process, and store electronic/digital ink, enabling a user to make and save hand-written notes or data. In institutions of teaching and learning, instructors often use computer-based materials like web pages, PowerPoint® slides, etc., to explain subject matter. The ability to annotate on presentation information using the electronic stylus of a Tablet PC has attracted the attention of the academic community to use the Tablet PC as a potential tool for increasing the effectiveness of presentations in teaching and learning. Tablet PC-based applications such as OneNote®, WindowsJournal® and Classroom Presenter have been developed to enhance note-taking in classrooms based on the fact that a pen stylus is a more natural form of input device for making notes on the computer as compared to the regular keyboard and mouse. Although tools like OneNote®, WindowsJournal® enhanced the note-taking process on the Tablet PC, they lacked the ability to allow the user to directly annotate on the lecture content. Classroom Presenter provides the ability to integrate classroom notes and the presentation material by allowing the instructors and students to annotate over the lecture material. However, all the above tools lacked the ability to allow a user to take notes over the output window of an arbitrary application like Excel, an active simulator or a movies players output. The Tablet PC based tool, WriteOn, developed at Virginia Tech, addresses this drawback. WriteOn, when deployed on the Tablet PC in a classroom environment, allows the instructor to utilize electronic ink to annotate on top of any application window visible on the Tablet PC display screen, including those that play active content like a movie or simulation. WriteOn facilitates a user to annotate over a dynamic application window by activating its virtual transparency surface called the eVellum (electronic vellum). The user can view a movie or an active simulation running in the eVellum background because of its transparent color. The user can deactivate the eVellum to make it invisible by "piercing" it if he/she wishes to access the desktop or an application window under the vellum window. WriteOn provides the instructor with the ability to broadcast a composite of the dynamic lecture content and ink annotations to the students in real-time. The term dynamic lecture contents is meant to indicate that the content being annotated need not be static words on a background, but may also be window contents that are changing in time. Using WriteOn, the students can make their own notes by writing on the eVellum enabled on top of the lecture stream window without losing visibility of the lecture. The instructor/student can save the ink annotations along with base lecture material as a movie file. The ability of WriteOn to improve classroom presentation and student note-taking as shown by initial tests, were pedagogically very useful. However, in order to deploy WriteOn on large scale in classrooms as an active and effective teaching tool of choice, several aspects of the application had to be improved. One aspect of the application that needed improvement was the user interface. The primitive Graphical User Interface (GUI) of the WriteOn tool was not easily usable by instructors and students from non-computer science backgrounds. The second aspect needing improvement was the operational performance of the application in terms of its CPU resource utilization. The WriteOn tool has shown to have operational performance issues during the screen capture process. This research therefore aims to address improvements in the GUI to make it more user friendly and increase the operational performance to the point where the user does not notice degradation of a base lecture application. Incorporation of these improvements has led us to rename the application as WriteOn1.0. WriteOn1.0 implements a picture-based GUI that comprises of two forms: a main form that appears shortly after WriteOn1.0 starts and a toolbar. The WriteOn1.0 toolbar appears in the center of the top edge of the display as soon as the user initiates a task like a screen recording session, by clicking on the appropriate menu button on the main form. The toolbar provides the user, accessibility to perform all the desired activities like annotating, screen recording, presentation broadcast, and piercing of the eVellum by a single-click of the appropriate menu icon. Tool tips that appear when the user points the mouse over a picture icon on the toolbar, explain the task that shall be performed when he/she clicks on the underlying menu icon. WriteOn1.0 introduces a window-like resizable and movable eVellum called the scalable eVellum that it activates in the area of interest specified by the user. Unlike the first implementation of the eVellum which had a fixed location and spanned the entirety of the user's desktop window, the instructor/student define the dimensions of the scalable eVellum and can choose to re-dimension, relocate and pierce through it at any point of time during a session. WriteOn1.0 also introduces the transparent mode of operation wherein the instructor/student, without having to deactivate the scalable eVellum can access any underlying window by a right-click of the mouse on the eVellum surface while the ink annotations are intact on the foreground. WriteOn1.0 addresses the operational performance issues observed during a screen capture session in WriteOn by capturing the activities only in the area of interest of the user for recording and broadcasting. By combining this scheme with a with a lossless screen capture codec called the MSU screen capture codec that has a high-compression ratio and that is optimized for speed for data compression, WriteOn1.0 greatly improves the operational CPU performance of the tool. WriteOn1.0 employs various technologies to implement its features. The improvements to operational performance are implemented by using the MSU screen codec from Moscow State University's Graphics and Media Lab. Microsoft®'s Video for Windows Framework (VfW) and WindowsMedia Player API's are used to realize the module that records the screen activities to an AVI file while DirectShow of DirectX and ConferenceXP API's are used for streaming presentations over a network. WriteOn1.0, with its features like its scalable eVellum, good operational performance and picture-based GUI is aimed at potentially making it a teaching tool of choice across classrooms and changing the method of classroom instruction of courses involving dynamic content. / Master of Science

This thesis provides an introduction to an advance in technology-aided instruction. Most of the research in this area has focused on PowerPoint® based applications or white board-centered electronic ink applications with the capability of broadcasting slides, ink annotations and so forth, used for presentation or classroom lectures. But these tools lack the capability of annotating on any kind of applications with active content playing (a movie or a simulation, for instance) in the background. Additional useful, but currently unavailable functionality would include the capability of broadcasting the presentation information, which can further consist of lecture slides, ink annotations, video of the desktop screen activity, or any other application program that might be used to demonstrate a concept or illuminate an idea. Therefore, the current research attempts to provide these facilities with a new tool, WriteOn. WriteOn improves both the presentation of information and the interactivity in classroom instruction, because it gives the instructor the ability to ink annotate on any application by using a virtual transparency surface, called electronic vellum or simply eVellum, which in effect resides on top of all desktop window applications. The instructor can enable the vellum at any point during the lecture and write on it to draw diagrams, make notes, emphasize points, or otherwise elucidate the presentation content. The instructor can also pierce the eVellum in order to switch to different applications, modify an applications parameters or operating values, or otherwise manipulate an operating program as part of a classroom demonstration or discussion. These features allow the instructor to demonstrate the dynamic operation of any application, which is an improvement on a static PowerPoint display of a program's operation. With WriteOn, the instructor can save the ink annotations along with desktop screen activity over an interval of time as a movie file and later make this file available to students. Alternatively, the instructor can transmit to the students the presentation information along with ink annotations in real-time so that the students can make their own notes on top of information being produced by the instructor. Thus the tool can be used to enhance the interactive lecturing process and help students to develop good note-taking processes and habits. WriteOn is also capable of saving the voice of the instructor, provided there is an audio device attached to the instructor's Tablet PC. However, broadcasting the instructor's voice is not yet fully supported. The WriteOn tool was developed using Microsoft's technologies: Windows Media Encoder® and DirectShow of DirectX®, as well as Microsoft's ConferenceXP API to achieve streaming of the presentation information. The first chapter explains the need for computer tools used for effective teaching purposes. The second chapter presents the architectural and technical details of WriteOn. Chapter three describes the architecture of the WriteOn tool. Chapters four through six explain the major software components of the system and also give the pros and cons of the DirectShow and Windows Media Encoder technologies. The seventh chapter provides an explanation of the usage of the tool by instructors and students. The eighth chapter presents the experiences of the instructors and students using the WriteOn tool in the classroom and concludes with a discussion of future work in this area. The Appendix V provides a developers guide for those who might like to expand on this open source code. / Master of Science