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- Item[6/6 How to stay a good driver?].(2005-08-29) ,
- ItemAcceptability to patients, carers and clinicians of an mHealth platform for the management of Parkinson's disease (PD_Manager): study protocol for a pilot randomised controlled trial.(0000-00-00) Antonini, Angelo; Gentile, Giovanni; Giglio, Manuela; Marcante, Andrea; Gage, Heather; Touray, Morro M L; Fotiadis, Dimitrios I; Gatsios, Dimitris; Konitsiotis, Spyridon; Timotijevic, Lada; Egan, Bernadette; Hodgkins, Charo; Biundo, Roberta; Pellicano, Clelia; ,BACKGROUND Parkinson s disease is a degenerative neurological condition causing multiple motor and non motor symptoms that have a serious adverse effect on quality of life Management is problematic due to the variable and fluctuating nature of symptoms often hourly and daily The PD Manager mHealth platform aims to provide a continuous feed of data on symptoms to improve clinical understanding of the status of any individual patient and inform care planning The objectives of this trial are to 1 assess patient and family carer perspectives of PD Manager regarding comfort acceptability and ease of use 2 assess clinician views about the utility of the data generated by PD Manager for clinical decision making and the acceptability of the system in clinical practice METHODS DESIGN This trial is an unblinded parallel two group randomised controlled pilot study A total of 200 persons with Parkinson s disease Hoehn and Yahr stage 3 experiencing motor fluctuations at least 2 h per day with primary family carers in three countries 110 Rome 50 Venice Italy 20 each in Ioannina Greece and Surrey England will be recruited Following informed consent baseline information will be gathered including the following age gender education attitudes to technology patient and carer time since Parkinson s diagnosis symptom status and comorbidities patient only Randomisation will assign participants 1 1 in each country to PD Manager vs control stratifying by age 1 70 1 70 and gender 60 M 40 F The PD Manager system captures continuous data on motor symptoms sleep activity speech quality and emotional state using wearable devices wristband insoles and a smartphone with apps for storing and transmitting the information Control group participants will be asked to keep a symptom diary covering the same elements as PD Manager records After a minimum of two weeks each participant will attend a consultation with a specialist doctor for review of the data gathered by either means and changes to management will be initiated as indicated Patients carers and clinicians will be asked for feedback on the acceptability and utility of the data collection methods The PD Manager intervention compared to a symptom diary will be evaluated in a cost consequences framework DISCUSSION Information gathered will inform further development of the PD Manager system and a larger effectiveness trial TRIAL REGISTRATION ISRCTN Registry ISRCTN17396879 Registered on 15 March 2017
- ItemAccurate data collection for head injury monitoring studies: a data validation methodology.(2006-02-08) Barnes, J; Chambers, I; Piper, I; Citerio, G; Contant, C; Enblad, P; Fiddes, H; Howells, T; Kiening, K; Nilsson, P; Yau, Y H; ,BACKGROUND BrainIT is a multi centre European project to collect high quality continuous data from severely head injured patients using a previously defined 6 core data set This includes minute by minute physiological data and simultaneous treatment and management information It is crucial that the data is correctly collected and validated METHODS Minute by minute physiological monitoring data is collected from the bedside monitors Demographic and clinical information intensive care management and secondary insult management data are collected using a handheld computer Data is transferred from the handheld device to a local computer where it is reviewed and anonymised before being sent electronically with the physiological data to the central database in Glasgow Automated computer tools highlight missing or ambiguous data A request is then sent to the contributing centre where the data is amended and returned to Glasgow Of the required data elements 20 are randomly selected for validation against original documentation along with the actual number of specific episodic events during a known period This will determine accuracy and the percentage of missing data for each record CONCLUSION Advances in patient care require an improved evidence base For accurate consistent and repeatable data collection robust mechanisms are required which should enhance the reliability of clinical trials assessment of management protocols and equipment evaluations
- ItemAcoustic neuroma risk in relation to mobile telephone use: results of the INTERPHONE international case-control study.(2011-09-20) ,The rapid increase in mobile telephone use has generated concern about possible health risks of radiofrequency electromagnetic fields from these devices
- ItemAcquisition and analysis of cardiovascular signals on smartphones: potential, pitfalls and perspectives: by the Task Force of the e-Cardiology Working Group of European Society of Cardiology.(2014-10-30) Bruining, Nico; Caiani, Enrico; Chronaki, Catherine; Guzik, Przemyslaw; van der Velde, Enno; ,Smartphones mobile applications apps social media analytics and the cloud are profoundly changing the practice of medicine and the way health decisions are made With the constant progress of technology the measurement of vital signals becomes easier cheaper and practically a standard approach in clinical practice The interest in measuring vital signals goes beyond medical professionals to the general public patients informal caregivers and healthy individuals who frequently lack any formal medical training On smartphone platforms such as iOS and Android a proliferation of health or medical apps acquire and analyse a variety of vital signs through embedded sensors interconnected devices or peripherals utilising on occasion analytics and social media Smartphone vendors compete with traditional medical device manufacturers in the grey area between health care wellness and fitness as US and EU regulatory bodies are setting and revising rules for these new technologies On the other hand in the absence of robust validation results clinicians are hesitant to trust measurements by apps or recommend specific apps to their patients partly also due to lack of a cost reimbursement policy This review focuses on the acquisition and analysis on smartphones of three important vital signs in the cardiovascular and respiratory field as well as in rehabilitation i e heart or pulse rate blood pressure and blood oxygenation The potential pitfalls and perspectives on mobile devices and smartphone apps for health management by patients and healthy individuals are discussed
- ItemACRRM: practice analysis.(2003-12-03) ,
- ItemAdherence to antiretroviral treatment in HIV-positive patients in the Cameroon context: promoting the use of medication reminder methods.(2011-08-22) Roux, Perrine; Kouanfack, Charles; Cohen, Julien; Marcellin, Fabienne; Boyer, Sylvie; Delaporte, Eric; Carrieri, Patrizia; Laurent, Christian; Spire, Bruno; ,OBJECTIVES Antiretroviral treatment ART scale up in sub Saharan Africa has made it possible to investigate the maintenance of adherence to HIV medications We describe here adherence to ART and identify its correlates in the Cameroonian context DESIGN Prospective cohort study in 9 rural district hospitals METHODS A mixed logistic regression model was used to identify factors associated with adherence to ART in 401 patients with data prospectively collected on adherence RESULTS Although 73 of patients were adherent after the first month on ART this proportion decreased to 61 after 24 months After adjustment for known factors of adherence to ART such as knowledge motivation and side effects patients who reported willingness to start ART before initiation those who were satisfied with information provided by their physicians and those who implemented reminder methods for ART intake eg using an alarm clock mobile phone or watch odds ratio 95 confidence interval 2 45 1 58 to 3 79 but also the help of a relative to remind them or other methods were more likely to be adherent to ART CONCLUSIONS Besides highlighting some correlates already known to have an impact on adherence to ART our findings also underline the need to reinforce the counseling component of follow up through innovative methods Accordingly training and implementation research should encourage the use of medication reminder methods such as mobile phones to assure adherence over time and improve long term response to ART
- ItemAdherence to treatment in allergic rhinitis using mobile technology. the mask study.(0000-00-00) Menditto, E; Costa, E; Midão, L; Bosnic-Anticevich, S; Novellino, E; Bialek, S; Briedis, V; Mair, A; Rajabian-Soderlund, R; Arnavielhe, S; Bedbrook, A; Czarlewski, W; Annesi-Maesano, I; Anto, J M; Devillier, P; De Vries, G; Keil, T; Sheikh, A; Orlando, V; Larenas-Linnemann, D; Cecchi, L; De Feo, G; Illario, M; Stellato, C; Fonseca, J; Malva, J; Morais-Almeida, M; Pereira, A M; Todo-Bom, A; Kvedariene, V; Valiulis, A; Bergmann, K C; Klimek, L; Mösges, R; Pfaar, O; Zuberbier, T; Cardona, V; Mullol, J; Papadopoulos, N G; Prokopakis, E P; Bewick, M; Ryan, D; Roller-Wirnsberger, R E; Tomazic, P V; Cruz, A A; Kuna, P; Samolinski, B; Fokkens, W J; Reitsma, S; Bosse, I; Fontaine, J F; Laune, D; Haahtela, T; Toppila-Salmi, S; Bachert, C; Hellings, P W; Melén, E; Wickman, M; Bindslev-Jensen, C; Eller, E; O'Hehir, R E; Cingi, C; Gemicioglu, B; Kalayci, O; Ivancevich, J C; Bousquet, J; ,BACKGROUND Mobile technology may help to better understand the adherence to treatment MASK rhinitis Mobile Airways Sentinel NetworK for allergic rhinitis is a patient centered ICT system A mobile phone app the Allergy Diary central to MASK is available in 22 countries OBJECTIVES To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App METHODS An observational cross sectional study was carried out on all users who filled in the Allergy Diary from January 1 2016 to August 1 2017 Secondary adherence was assessed by using the modified Medication Possession Ratio MPR and the Proportion of days covered PDC approach RESULTS 12 143 users were registered 6 949 users reported at least one VAS data recording Among them 1 887 users reported 7 VAS data 1 195 subjects were included in the analysis of adherence 136 11 28 users were adherent MPR 70 and PDC 1 25 51 4 23 were partly adherent MPR 70 and PDC 1 50 and 176 14 60 were switchers On the other hand 832 69 05 users were non adherent to medications MPRUnder70 Of those the largest group was non adherent to medications and the time interval was increased in 442 36 68 users CONCLUSION AND CLINICAL RELEVANCE Adherence to treatment is low The relative efficacy of continuous versus on demand treatment for AR symptoms is still a matter of debate This study shows an approach for measuring retrospective adherence based on a mobile app This represent a novel approach also for analyzing medication taking behavior in a real world setting This article is protected by copyright All rights reserved
- ItemAIR Louisville: Addressing Asthma With Technology, Crowdsourcing, Cross-Sector Collaboration, And Policy.(0000-00-00) Barrett, Meredith; Combs, Veronica; Su, Jason G; Henderson, Kelly; Tuffli, Michael; ,Cross sector partnerships benefit public health by leveraging ideas resources and expertise from a wide range of partners In this study we documented the process and impact of AIR Louisville a collaboration forged among the Louisville Metro Government a nonprofit institute and a technology company in successfully tackling a complex public health challenge asthma We enrolled residents of Louisville Kentucky with asthma and used electronic inhaler sensors to monitor where and when they used medication We found that the use of the digital health platform achieved positive clinical outcomes including a 78 percent reduction in rescue inhaler use and a 48 percent improvement in symptom free days Moreover the crowdsourced real world data on inhaler use combined with environmental data led to policy recommendations including enhancing tree canopy tree removal mitigation zoning for air pollution emission buffers recommended truck routes and developing a community asthma notification system AIR Louisville represents a model that can be replicated to address many public health challenges by simultaneously guiding individual clinical and policy decisions
- ItemAmbivalence in digital health: Co-designing an mHealth platform for HIV care.(0000-00-00) Marent, Benjamin; Henwood, Flis; Darking, Mary; ,In reaction to polarised views on the benefits or drawbacks of digital health the notion of ambivalence has recently been proposed as a means to grasp the nuances and complexities at play when digital technologies are embedded within practices of care This article responds to this proposal by demonstrating how ambivalence can work as a reflexive approach to evaluate the potential implications of digital health We first outline current theoretical advances in sociology and organisation science and define ambivalence as a relational and multidimensional concept that can increase reflexivity within innovation processes We then introduce our empirical case and highlight how we engaged with the HIV community to facilitate a co design space where 97 patients across five European clinical sites Antwerp Barcelona Brighton Lisbon Zagreb were encouraged to lay out their approaches imaginations and anticipations towards a prospective mHealth platform for HIV care Our analysis shows how patients navigated ambivalence within three dimensions of digital health quantification connectivity and instantaneity We provide examples of how potential tensions arising through remote access to quantified data new connections with care providers or instant health alerts were distinctly approached alongside embodied conditions e g undetectable viral load and embedded socio material environments such as stigma or unemployment We conclude that ambivalence can counterbalance fatalistic and optimistic accounts of technology and can support social scientists in taking up their critical role within the configuration of digital health interventions
- ItemAmerican Association of Cardiovascular and Pulmonary Rehabilitation telemedicine position statement.(2001-10-09) Shaw, D K; Heggestad-Hereford, J R; Southard, D R; Sparks, K E; ,
- ItemAngina on the Palm: randomized controlled pilot trial of Palm PDA software for referrals for cardiac testing.(2006-08-23) Greiver, Michelle; Drummond, Neil; White, David; Weshler, Jason; Moineddin, Rahim; ,OBJECTIVE Personal digital assistants PDAs are popular with physicians in 2003 33 of Canadian doctors reported using them in their practices We do not know however whether using a PDA changes the behaviour of practising physicians We studied the effectiveness of a PDA software application to help family physicians diagnose angina among patients with chest pain DESIGN Prospective randomized controlled pilot trial using a cluster design SETTING Primary care practices in the Toronto area PARTICIPANTS Eighteen family physicians belonging to the North Toronto Primary Care Research Network Nortren or recruited from a local hospital INTERVENTIONS We randomized physicians to receive a Palm PDA which included the angina diagnosis software or to continue conventional care Physicians prospectively recorded the process of care for patients aged 30 to 75 presenting with suspected angina over 7 months MAIN OUTCOME MEASURES Did the process of care for patients with suspected angina improve when their physicians had PDAs and software The primary outcomes we looked at were frequency of cardiac stress test orders for suspected angina and the appropriateness of referral for cardiac stress testing at presentation and for nuclear cardiology testing after cardiac stress testing Secondary outcome was referrals to cardiologists RESULTS The software led to more overall use of cardiac stress testing 81 vs 50 The absolute increase was 31 P 007 95 confidence interval CI 8 to 58 There was a trend toward more appropriate use of stress testing 48 6 with the PDA vs 28 6 control an increase of 20 P 284 95 CI 11 54 to 51 4 There was also a trend toward more appropriate use of nuclear cardiology following cardiac stress testing 63 0 vs 45 5 an absolute increase of 17 5 P 400 95 CI 13 9 to 48 9 Referrals to cardiologists did not increase 38 2 with the PDA vs 40 9 P 869 CONCLUSION A PDA based software application can lead to improved care for patients with suspected angina seen in family practices this finding requires confirmation in a larger study
- ItemAntihypertensive effect of zofenopril plus hydrochlorothiazide versus zofenopril monotherapy in patients with essential hypertension according to their cardiovascular risk level: A post hoc analysis.(2014-04-02) Malacco, Ettore; Omboni, Stefano; ,International guidelines recommend the use of angiotensin converting enzyme inhibitors possibly in combination with other antihypertensive drugs to treat hypertension with associated risk factors
- ItemApplicability of telemedicine in the screening of diabetic retinopathy (DR): The first multicentre study in Italy. The No Blind Study.(0000-00-00) Sasso, Ferdinando Carlo; Pafundi, Pia Clara; Gelso, Aldo; Bono, Valeria; Costagliola, Ciro; Marfella, Raffaele; Sardu, Celestino; Rinaldi, Luca; Galiero, Raffaele; Acierno, Carlo; de Sio, Chiara; Adinolfi, Luigi Elio; ,AIMS Diabetic retinopathy DR represents the main cause of blindness among adults in the industrialized Countries Use of telemedicine could offer an easy smart specialist fundus oculi examination as well as putting in a screening program many patients who otherwise would be excluded MATERIALS AND METHODS The NO Blind is a transversal multicentre observational study Its pilot phase involved nine public outpatient clinics for six months As endpoint of the study we assessed the prevalence of DR by retinography in a subset of the Italian population Patients fundus oculi photos were performed by trained diabetologists through a digital smart ophthalmoscope RESULTS According to our endpoint in the final study population n 1461 obtained excluding patients for whom retinography was not able to provide any diagnosis DR prevalence was equal to 15 5 According to the ROC Curve performed we can observe how retinography appears a highly accurate method to detect DR AUROC 0 971 95 C I 0 954 0 989 with a specificity of the 100 and a sensitivity of the 94 3 CONCLUSIONS Our findings in an Italian setting confirm main data in the literature about DR prevalence Hence telemedicine could represent an accurate fast and cheap method for screening of DR
- ItemApproaches to the prevention and management of childhood obesity: the role of social networks and the use of social media and related electronic technologies: a scientific statement from the American Heart...(2013-01-15) Li, Jennifer S; Barnett, Tracie A; Goodman, Elizabeth; Wasserman, Richard C; Kemper, Alex R; ,
- ItemArchitecture for remote training of home telemedicine patients.(2006-06-16) Lai, Albert M; Starren, Justin B; Shea, Steven; ,In spite of efforts to develop easy to use devices patients may require multiple training sessions to achieve mastery of advanced telehealth devices especially those incorporating web access In geographically distributed projects such repeat training can be costly A software architecture for simultaneous voice conferencing and remote device control over a single telephone line is presented Evaluation of the pilot implementation is favorable
- ItemASGE Technology Status Evaluation Report: wireless capsule endoscopy.(2006-03-27) Mishkin, Daniel S; Chuttani, Ram; Croffie, Joseph; Disario, James; Liu, Julia; Shah, Raj; Somogyi, Lehel; Tierney, William; Song, Louis M Wong Kee; Petersen, Bret T; ,
- ItemAssessment of obstetric and neonatal health services in developing country health facilities.(2013-09-16) Manasyan, Albert; Saleem, Sarah; Koso-Thomas, Marion; Althabe, Fernando; Pasha, Omrana; Chomba, Elwyn; Goudar, Shivaprasad S; Patel, Archana; Esamai, Fabian; Garces, Ana; Kodkany, Bhala; Belizan, Jose; McClure, Elizabeth M; Derman, Richard J; Hibberd, Patricia; Liechty, Edward A; Hambidge, K Michael; Carlo, Waldemar A; Buekens, Pierre; Moore, Janet; Wright, Linda L; Goldenberg, Robert L; ,To describe the staffing and availability of medical equipment and medications and the performance of procedures at health facilities providing maternal and neonatal care at African Asian and Latin American sites participating in a multicenter trial to improve emergency obstetric neonatal care in communities with high maternal and perinatal mortality
- ItemAssessment of prehospital chest pain using telecardiology.(2002-09-09) Scalvini, Simonetta; Zanelli, Emanuela; Conti, Claudia; Volterrani, Maurizio; Pollina, Riccardo; Giordano, Amerigo; Glisenti, Fulvio; ,Two hundred general practitioners were equipped with a portable electrocardiograph which could transmit a 12 lead electrocardiogram ECG via a telephone line A cardiologist was available 24 h a day for an interactive teleconsultation In a 13 month period there were 5073 calls to the telecardiology service and 952 subjects with chest pain were identified The telecardiology service allowed the general practitioners to manage 700 cases 74 themselves further diagnostic tests were requested for 162 patients 17 and 83 patients 9 were sent to the hospital emergency department In the last group a cardiological diagnosis was confirmed in 60 patients and refuted in 23 Seven patients in whom the telecardiology service failed to detect a cardiac problem were hospitalized in the subsequent 48 h The telecardiology service showed a sensitivity of 97 4 a specificity of 89 5 and a diagnostic accuracy of 86 9 for chest pain Telemedicine could be a useful tool in the diagnosis of chest pain in primary care