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Telehealth has significantly enhanced various medical sectors, notably in postpartum care, by increasing breastfeeding rates and reducing postpartum depression. However, issues in patient management and triage, particularly in high-demand telehealth lactation consultations, lead to LC burnout, unnecessary costs and diagnostic delays. To address these challenges, this study introduces a pain assessment tool for telehealth lactation consultations, enhancing patient-provider communication through momentary assessment and AI mediation. It features a user interface with image quality assessment and condition classification algorithms, aiding remote diagnosis and triage. The tool guides patients and uses a severity-based feedback system, helping LCs prioritize cases. This method boosts tele-lactation service efficiency, streamlines LC workload, and serves as a model for specialized healthcare triaging. Future work includes refining the feedback system and evaluating the tool in clinical settings to standardize symptom severity grading and estimate its impact, potentially improving expert patient triaging in remote healthcare settings.

One of the biggest challenges for the medical professionals is spotting cardiovascular issues in the earliest stages. Around the world, Cardiovascular Diseases (CVD) are a major cause of death for almost 18 million people each year. Heart disease is therefore a serious concern that needs to be treated. The numerous elements that affect health, such as excessive blood pressure, elevated cholesterol, aberrant pulse rate, and many other factors, might make it challenging to detect heart disease. Consequently, early disease detection and the development of effective treatments can benefit greatly from the field of artificial intelligence. The purpose of this work is to develop a new IoT based healthcare monitoring framework for the prediction of CVD using machine learning algorithm. Here, the data preprocessing has been performed to create the normalized dataset for improving classification. Then, an Artificial Gorilla Troop Optimization (AGTO) algorithm is deployed to choose the most pertinent features from the normalized dataset. Moreover, the Multi-Linear Regression Classification (MLRC) model is also implemented for accurately categorizing the medical information as whether healthy or CVD affected. The results of the proposed AGTO-MLRC mechanism is validated and compared using the popular benchmarking datasets. [ABSTRACT FROM AUTHOR]

High prevalence and low control rate of hypertension have brought a significant disease burden globally. In order to improve the level of hypertension prevention and treatment, remote healthcare and digital medicine have been rapidly developed and widely used worldwide. Currently, there are no relevant regulations in China for these technologies. In 2023, the Italian Society of Arterial Hypertension issued a position statement to guide the development, validation, and clinical use of remote medicine and digital healthcare. This article will interpret this position paper, focusing on the forms of application of telemedicine and digital healthcare in managing hypertension and its related cardiovascular diseases, key research evidence, existing advantages, as well as current opportunities and challenges. The aim is to guide general practitioners in China on how to utilize these technologies in managing hypertension and related cardiovascular conditions.

Over the past few decades, wearable sensor technology has played a pivotal role in patient information acquisition. A new paradigm for unconstrained medical data collection emerged with noncontact sensors such as Kinect and industrial-grade RGB cameras. These innovations have enhanced patient experiences and offer vast potential for long-term monitoring, telemedicine, and remote healthcare in underserved areas. However, while many research efforts have zeroed in on specific components, such as sensor development or algorithm design, this has occasionally led to noncontact systems' reliability, accuracy, and connectivity challenges. Consequently, there is a pressing need for research that adopts a more holistic approach, ensuring the optimal integration of sensors and algorithms. In this study, we introduce a method of constructing a noncontact diagnostic system powered by deep learning vision algorithms that showcase strong resilience against viewpoint changes and obstructions in human motion identification and assessment. Using four RGB cameras, we capture human dynamics and leverage a pose estimator to generate comprehensive 3D human postures. Afterward, these postures are refined to aid in subsequent behavior prediction. Our multitask-trained model significantly bolsters the system's adaptability to posture discrepancies. Notably, this noncontact diagnostic system thrives in challenging environments, such as 360-degree surveillance, intricate situations, and low-light settings where traditional sensors often falter. In addition, we have assembled a multiview autism behavior dataset. Through it, our embedded deep learning algorithm showcases exemplary action category recognition (reaching up to 95.09%), highlighting further its practical implications. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health & Nursing Management / Sağlık ve Hemşirelik Yönetimi Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Telerehabilitation has emerged as a promising approach to address the challenges posed by chronic obstructive pulmonary disease (COPD) management. This article provides a comprehensive review of telerehabilitation’s characteristics,components, efficacy, patient experiences, and the implications for COPD patients. Telerehabilitation involves the use of telecommunication technologies to remotely deliver rehabilitation services, including exercise training, education, and monitoring, to individuals with COPD. It addresses barriers such as geographical distance and limited access to specialized facilities, making rehabilitation accessible from home. Telerehabilitation encompasses various approaches, including telemonitoring, teleconsultation, and tele-education. Several studies have indicated positive outcomes in exercise capacity, dyspnea, and quality of life when comparing telerehabilitation interventions to standard care or traditional rehabilitation programs. However, challenges related to technology access, digital literacy, and privacy need to be addressed for equitable implementation. Interdisciplinary collaboration among healthcare professionals is essential for the successful delivery of telerehabilitation. Future research should focus on refining the interventions, standardizing the protocols, and evaluating the long-term maintenance effects. By integrating patient-centered approaches and leveraging advancements in digital technologies, telerehabilitation can revolutionize COPD management strategies, enhancing patient outcomes in the modern healthcare landscape.

Background: CHIVID is a telemedicine solution developed under tight time constraints that assists Thai healthcare practitioners in monitoring non-severe COVID-19 patients in isolation programs during crises. It assesses patient health and notifies healthcare practitioners of high-risk scenarios through a chatbot. The system was designed to integrate with the famous Thai messaging app LINE, reducing development time and enhancing user-friendliness, and the system allowed patients to upload a pulse oximeter image automatically processed by the PACMAN function to extract oxygen saturation and heart rate values to reduce patient input errors. Methods: This article describes the proposed system and presents a mixed-methods study that evaluated the system’s performance by collecting survey responses from 70 healthcare practitioners and analyzing 14,817 patient records. Results: Approximately 71.4% of healthcare practitioners use the system more than twice daily, with the majority managing 1–10 patients, while 11.4% handle over 101 patients. The progress note is a function that healthcare practitioners most frequently use and are satisfied with. Regarding patient data, 58.9%(8,724/14,817) are male, and 49.7%(7,367/14,817) within the 18 to 34 age range. The average length of isolation was 7.6 days, and patients submitted progress notes twice daily on average. Notably, individuals aged 18 to 34 demonstrated the highest utilization rates for the PACMAN function. Furthermore, most patients, totaling over 95.52%(14,153/14,817), were discharged normally. Conclusion: The findings indicate that CHIVID could be one of the telemedicine solutions for hospitals with patient overflow and healthcare practitioners unfamiliar with telemedicine technology to improve patient care during a critical crisis. Clinical and Translational Impact Statement— CHIVID’s success arises from seamlessly integrating telemedicine into third-party application within a limited timeframe and effectively using clinical decision support systems to address challenges during the COVID-19 crisis.

Introduction: The transition towards remote healthcare has been rapidly accelerated in recent years due to a number of factors, including the COVID-19 pandemic, however, few studies have explored service users' views of remote mental healthcare, particularly in community mental health settings. Methods: As part of a larger study concerned with the development of a remotely delivered psychosocial intervention, a survey was conducted with service users with psychosis (N = 200) from six NHS trusts across England to gain cross-sectional data about service users' opinions and attitudes towards remote interventions and explore how digital access varies across different demographic groups and geographical localities. Results: The majority of service users had access to technological devices and a quiet space to receive care. Age was a key factor in motivation to engage with remote care as older participants had less access to technological devices and the internet, and reported less confidence to learn how to use new technologies compared to younger participants. Differences in access and attitudes towards remote care were found across the different geographical localities. Over half of the participants (53.1%) preferred a hybrid model (i.e., mixture of face-to-face and remotely delivered treatment), with only 4.5% preferring remote treatment exclusively. Factors that both encourage and deter service users from engaging with remote care were identified. Conclusions: The findings of this study provide important information about the environmental and clinical barriers that prevent, or limit, the uptake of remotely delivered care for people with psychotic disorders. Although service users often have the ability and capacity to receive remote care, providers need to be cognisant of factors which may exacerbate digital exclusion and negatively impact the therapeutic alliance. [ABSTRACT FROM AUTHOR]

Purpose of the Study: The purpose of this study is to review and analyze the intersection of Internet of Things (IoT) and Machine Learning (ML) technologies in remote healthcare monitoring. It aims to highlight how these technologies are transforming patient care by improving early detection of health issues, enhancing personalized healthcare, and fostering patient independence, particularly in the context of an aging population. Methodology: This study employs a comprehensive state-of-the-art review methodology, synthesizing existing literature on the application of IoT and ML in healthcare. It explores various use cases and technological advancements that facilitate the continuous collection and analysis of patient data through wearable sensors and remote monitoring devices. Results: The study finds that the convergence of IoT and ML has significantly advanced remote healthcare monitoring by enabling real-time data collection and intelligent data analysis. This integration allows for early detection of health issues, improved personalized healthcare services, and increased autonomy for patients, especially the elderly. Implication of the Study: The implications of this study are substantial for both healthcare providers and technology developers. It provides insights into the potential of IoT and ML to revolutionize patient monitoring systems, reduce the strain on healthcare facilities, and improve patient outcomes. The study also highlights the importance of adopting these technologies for addressing the growing demand for personalized, data-driven healthcare. Novelty: This study uniquely synthesizes the state-of-the-art developments at the intersection of IoT and ML within the healthcare sector. It contributes to the field by offering a comprehensive overview of the ways these technologies are collectively enhancing remote healthcare monitoring and shaping future trends in healthcare innovation. [ABSTRACT FROM AUTHOR]

Background: This study focuses on evaluating the perceptions, competencies, and acceptance of remote healthcare monitoring technology among healthcare professionals in developing countries, specifically India and Bhutan, with an emphasis on sustainability as a crucial factor. The study aims to understand the impact of perceived ease of use, usefulness, and sustainability on the adoption of such technologies. Methods: This research utilized the TAM framework to analyze the responses of 44 healthcare professionals, primarily doctors, from developing countries. The study examined participants' attitudes towards the ease of use and effectiveness of remote healthcare technologies, their intentions to use such technologies, and their perceptions of sustainable design in these technologies. Results: The findings indicate a generally favorable stance towards the utility and ease of use of remote monitoring technologies in telemedicine among healthcare professionals. Participants showed positive intentions toward adopting remote healthcare technologies and acknowledged the role of technology in enhancing remote monitoring. The preference for sustainably designed technologies suggests that sustainability principles can positively influence technology acceptance. However, concerns regarding security, privacy, and network coverage emerged as significant barriers to technology adoption. Conclusion: The study underscores the potential of remote healthcare monitoring technologies to improve healthcare access, especially in remote and underserved areas of developing countries. It highlights the importance of addressing security, privacy, and network infrastructure issues to enhance technology adoption. Furthermore, incorporating sustainability into the TAM provides a broader understanding of the factors influencing the acceptance and use of remote healthcare technologies among healthcare professionals. [ABSTRACT FROM AUTHOR]

For 60 years, human presence in Antarctica has required particularly demanding medical skills. Nevertheless, the preparation of physicians working in this extreme environment remains unknown and deserves clarification. This study aimed to summarise data on the surgical training given to physicians by different countries. In April 2020, we conducted a questionnaire-based study of 14 countries wintering in Antarctica. Responses were descriptively analysed. Regarding the profiles of physicians recruited by the wintering countries, 30% to 55% were non-surgeon doctors compared with 45% to 70% for surgeons depending on the year. Of the 13 countries answering the questionnaire, nine organised practical surgical training and six used theoretical material. All countries reported practical training for dental surgery, while only five countries provided training in four other surgical specialities (orthopaedic, digestive, thoracic, and ear, throat, and nose). All 13 countries reported using a telemedicine system. These results revealed heterogeneous training strategies among the recruited physicians, reflecting the difficulties of practice on this extreme continent. Future work may assess the effectiveness of each strategy. A better understanding of surgical epidemiology and a detailed referencing of the equipment available at the bases would help better define the contours of surgical care in Antarctica. [ABSTRACT FROM AUTHOR]

Injury in Antarctica can have a significant impact when considering transfer timelines of several weeks. Medical support to the British Antarctic Territory (BAT) is provided by deployed healthcare professionals and the utilisation of "reach-back" with telemedicine. This is paired with robust training and familiarisation with a system of modularised deployed equipment. This paper examines the current telemedicine strategy, infrastructure modularisation, and influence from military practice by the British Antarctic Survey Medical Unit (BASMU) for medical care at extreme reach. Current telemedicine practices and utilisation, as well as modular equipment capabilities across the BAT were reviewed to provide an outline of care delivery. Requests varied from expert advice to remote supervision of clinical procedures. Integration of commercially available solutions enabled real-time display of patient physiology. The deployment of modular resources has improved equipment availability and greater standardisation between sites. The sending of case notes and digital x-rays has been generally sufficient but, when greater supervision was required, limited data transfer bandwidth was a challenge. An ongoing review of deployed equipment capabilities may also enhance the ease with which remote support can be offered but an uplift in telemedicine capability will likely require infrastructure upgrades to maintain data transfer from 8000 miles away. [ABSTRACT FROM AUTHOR]

Telemedicine, the provision of remote healthcare, has gained prominence, accelerated by the COVID-19 pandemic. It has the potential to replace routine in-person follow-up visits for patients with chronic inflammatory skin conditions. However, it remains unclear whether telemedicine can effectively substitute in-person consultations for this patient group. This systematic review assessed the effectiveness and safety of telemedicine compared with traditional in-person care for chronic inflammatory skin diseases. A comprehensive search in various databases identified 11 articles, including 5 randomized controlled trials (RCTs) and 1 clinical controlled trial (CCT). These studies evaluated telemedicine’s impact on patients with psoriasis and atopic dermatitis, with varying methods like video consultations and digital platforms. The findings tentatively suggest that telemedicine does not seem to be inferior compared with in-person care, particularly in terms of condition severity and quality of life for patients with chronic inflammatory skin diseases. However, these results should be interpreted with caution due to the inherent uncertainties in the evidence. There are indications that telemedicine can offer benefits such as cost-effectiveness, time savings, and reduced travel distances, but it is important to recognize these findings as preliminary, necessitating further validation through more extensive research.

Abstract Background The COVID-19 pandemic disrupted maternal and newborn health services in Bangladesh, exacerbating the large gaps in service utilization that existed prior to the pandemic. As part of its response, Bangladesh initiated remote antenatal and postnatal care telemedicine services led by midwives in 36 sub-district hospitals across five of Bangladesh’s 64 districts. Gender-based violence screening and referral were integrated into the service to address a reported rise in violence following the country’s pandemic lockdown. Methods Mixed-methods implementation research was used to develop an intrinsic case study describing the design and implementation of the telemedicine program. Qualitative analysis comprised document review, key informant interviews, and focus group discussions. Quantitative analysis employed an interrupted time series analysis with segmented multi-variate regression to compare maternity care service use trends before and after implementation. Poisson regression analysis was used to examine the trend in number of gender-based violence remote screenings, sessions held, and cases identified. Results A statistically significant change in trend for onsite antenatal and postpartum care as well as women seeking care at the hospital as a result of postpartum hemorrhage arising in the community was observed following the introduction of telemedicine. Facility births and cases of eclampsia appropriately identified and managed also had significant increases. In addition, over 6917 women were screened for GBV, 223 received counseling and 34 referrals were made, showing a statistically significant increase in frequency over time following the implementation of the telemedicine program. Challenges included that not all midwives adopted GBV screening, some women were reluctant to discuss GBV, there was an unanticipated need to introduce a patient visit scheduling system in all intervention hospitals, and many women were not reachable by phone due to lack of access or network coverage. Conclusions Maternal health and gender-based violence telemedicine led by midwives was an effective, low-cost intervention in Bangladesh for addressing pandemic and pre-pandemic gaps in service use. Other low and middle-income countries planning to implement remote maternal health interventions via midwives should consider whether a patient visit scheduling system needs to be introduced, as well as limitations around mobile phone access and connectivity. Future research should include care quality oversight and improvement, and a more well-informed strategy for facilitating effective GBV screening.

IntroductionThe transition towards remote healthcare has been rapidly accelerated in recent years due to a number of factors, including the COVID-19 pandemic, however, few studies have explored service users' views of remote mental healthcare, particularly in community mental health settings.MethodsAs part of a larger study concerned with the development of a remotely delivered psychosocial intervention, a survey was conducted with service users with psychosis (N = 200) from six NHS trusts across England to gain cross-sectional data about service users' opinions and attitudes towards remote interventions and explore how digital access varies across different demographic groups and geographical localities.ResultsThe majority of service users had access to technological devices and a quiet space to receive care. Age was a key factor in motivation to engage with remote care as older participants had less access to technological devices and the internet, and reported less confidence to learn how to use new technologies compared to younger participants. Differences in access and attitudes towards remote care were found across the different geographical localities. Over half of the participants (53.1%) preferred a hybrid model (i.e., mixture of face-to-face and remotely delivered treatment), with only 4.5% preferring remote treatment exclusively. Factors that both encourage and deter service users from engaging with remote care were identified.ConclusionsThe findings of this study provide important information about the environmental and clinical barriers that prevent, or limit, the uptake of remotely delivered care for people with psychotic disorders. Although service users often have the ability and capacity to receive remote care, providers need to be cognisant of factors which may exacerbate digital exclusion and negatively impact the therapeutic alliance.

ABSTRACTFor 60 years, human presence in Antarctica has required particularly demanding medical skills. Nevertheless, the preparation of physicians working in this extreme environment remains unknown and deserves clarification. This study aimed to summarise data on the surgical training given to physicians by different countries. In April 2020, we conducted a questionnaire-based study of 14 countries wintering in Antarctica. Responses were descriptively analysed. Regarding the profiles of physicians recruited by the wintering countries, 30% to 55% were non-surgeon doctors compared with 45% to 70% for surgeons depending on the year. Of the 13 countries answering the questionnaire, nine organised practical surgical training and six used theoretical material. All countries reported practical training for dental surgery, while only five countries provided training in four other surgical specialities (orthopaedic, digestive, thoracic, and ear, throat, and nose). All 13 countries reported using a telemedicine system. These results revealed heterogeneous training strategies among the recruited physicians, reflecting the difficulties of practice on this extreme continent. Future work may assess the effectiveness of each strategy. A better understanding of surgical epidemiology and a detailed referencing of the equipment available at the bases would help better define the contours of surgical care in Antarctica.

ABSTRACTInjury in Antarctica can have a significant impact when considering transfer timelines of several weeks. Medical support to the British Antarctic Territory (BAT) is provided by deployed healthcare professionals and the utilisation of “reach-back” with telemedicine. This is paired with robust training and familiarisation with a system of modularised deployed equipment.This paper examines the current telemedicine strategy, infrastructure modularisation, and influence from military practice by the British Antarctic Survey Medical Unit (BASMU) for medical care at extreme reach. Current telemedicine practices and utilisation, as well as modular equipment capabilities across the BAT were reviewed to provide an outline of care delivery.Requests varied from expert advice to remote supervision of clinical procedures. Integration of commercially available solutions enabled real-time display of patient physiology. The deployment of modular resources has improved equipment availability and greater standardisation between sites. The sending of case notes and digital x-rays has been generally sufficient but, when greater supervision was required, limited data transfer bandwidth was a challenge.An ongoing review of deployed equipment capabilities may also enhance the ease with which remote support can be offered but an uplift in telemedicine capability will likely require infrastructure upgrades to maintain data transfer from 8000 miles away.

Background: The COVID-19 pandemic disrupted maternal and newborn health services in Bangladesh, exacerbating the large gaps in service utilization that existed prior to the pandemic. As part of its response, Bangladesh initiated remote antenatal and postnatal care telemedicine services led by midwives in 36 sub-district hospitals across five of Bangladesh's 64 districts. Gender-based violence screening and referral were integrated into the service to address a reported rise in violence following the country's pandemic lockdown. Methods: Mixed-methods implementation research was used to develop an intrinsic case study describing the design and implementation of the telemedicine program. Qualitative analysis comprised document review, key informant interviews, and focus group discussions. Quantitative analysis employed an interrupted time series analysis with segmented multi-variate regression to compare maternity care service use trends before and after implementation. Poisson regression analysis was used to examine the trend in number of gender-based violence remote screenings, sessions held, and cases identified. Results: A statistically significant change in trend for onsite antenatal and postpartum care as well as women seeking care at the hospital as a result of postpartum hemorrhage arising in the community was observed following the introduction of telemedicine. Facility births and cases of eclampsia appropriately identified and managed also had significant increases. In addition, over 6917 women were screened for GBV, 223 received counseling and 34 referrals were made, showing a statistically significant increase in frequency over time following the implementation of the telemedicine program. Challenges included that not all midwives adopted GBV screening, some women were reluctant to discuss GBV, there was an unanticipated need to introduce a patient visit scheduling system in all intervention hospitals, and many women were not reachable by phone due to lack of access or network coverage. Conclusions: Maternal health and gender-based violence telemedicine led by midwives was an effective, low-cost intervention in Bangladesh for addressing pandemic and pre-pandemic gaps in service use. Other low and middle-income countries planning to implement remote maternal health interventions via midwives should consider whether a patient visit scheduling system needs to be introduced, as well as limitations around mobile phone access and connectivity. Future research should include care quality oversight and improvement, and a more well-informed strategy for facilitating effective GBV screening. Plain language summary: To support the continuation of sexual and reproductive health services following pandemic lockdowns, Bangladesh introduced a midwife-led telemedicine program. Through the program, midwives who were already employed within the health system delivered remote antenatal and postnatal care, including gender-based violence screening and referral. The program operated in 36 sub-district hospitals across five of Bangladesh's 64 districts. Intrinsic implementation research was used to develop a case study describing the design and implementation of the telemedicine program. Qualitative and quantitative methods comprised document review, key informant interviews, focus group discussions, and service use trends. Analysis of the data identified a statistically significant trend increase for most maternity care services. Although they did increase significantly over time, referrals for GBV were less than expected, which may have been related to some midwives not screening for GBV, and/or that many women were reluctant to discuss GBV. In addition, there was an unanticipated need to introduce a patient visit scheduling system in all intervention hospitals, and many women were not reachable by phone due to lack of access or network coverage. In spite of this, 6197 women were screened for GBV. Of those, 223 received counseling and 34 received referrals. Overall, telemedicine led by midwives was an effective, low-cost intervention for maternal health, and a step toward stronger GBV response in Bangladesh. Other low and middle-income countries planning to implement remote maternal health interventions via midwives should consider what is needed to facilitate comfort for both providers and women as related to GBV screening, as well as practical issues regarding introducing scheduling systems and limitations of mobile phone access and connectivity. [ABSTRACT FROM AUTHOR]

Workers in the oil and gas industry are exposed to numerous health risks, ranging from poor health behaviours to the possibility of life-threatening injuries. Determining the most appropriate models of healthcare for the oil and gas industry is difficult, as strategies must be acceptable to multiple stakeholders, including employees, employers, and local communities. The purpose of this review was to broadly explore the health status and needs of workers in the oil and gas industry and healthcare delivery models relating to primary care and emergency responses. Database searches of PubMed, EMBASE, CINAHL, PsycINFO, and Scopus were conducted, as well as grey literature searches of Google, Google Scholar, and the International Association of Oil and Gas Producers website. Resource-sector workers, particularly those in 'fly-in fly-out' roles, are susceptible to poor health behaviours and a higher prevalence of mental health concerns than the general population. Evidence is generally supportive of organisation-led behaviour change and mental health-related interventions. Deficiencies in primary care received while on-site may lead workers to inappropriately use local health services. For the provision of emergency medical care, telehealth and telemedicine lead to favourable outcomes by improving patient health status and satisfaction and reducing the frequency of medical evacuations. [ABSTRACT FROM AUTHOR]

Background: Missed sexual healthcare appointments lead to inefficiencies and wasted resources, longer waiting times and poorer outcomes. The aim of this research was to identify factors influencing non-attendance at sexual healthcare appointments and to make recommendations for interventions. Methods: Semi-structured interviews were carried out with UK-based sexual health service-users with experience of booking and missing appointments and sexual health professionals (n = 28). Interviews were analysed using a thematic framework approach. Results: Perceptual, practical, and organisational factors were found to influence missed appointments. Perceptual factors included beliefs about the outcomes of attending; sense of responsibility to attend; and concerns about privacy and security. Practical factors included competing demands and disruption to daily life; ability to attend; and forgetting. Organisational factors included mode of appointment delivery and availability of appointments. Conclusions: Interventions should combine strategies shown to be effective for overcoming practical barriers to attendance (e.g. reminder systems) with novel strategies communicating the benefits of attending and risks of missed appointments (e.g. behaviourally informed messaging). Text reminders containing behaviourally informed messages may be an efficient intervention for targeting perceptual and practical factors associated with missed appointments. Offering appointment modalities to suit individual preference and enabling service-users to remotely cancel/reschedule appointments maight further support a reduction in missed appointments. Missed sexual healthcare appointments lead to wasted resources, long waiting times and poorer health for individuals who maight not receive the treatment they need. This research aimed to find out what makes it easy or difficult to attend a sexual healthcare appointment. Barriers to attendance included beliefs about what will happen, sense of responsibility, concerns about privacy, ability to attend, appointment availability and forgetting. Text message reminders with behaviour change messaging may be an efficient way to address these barriers. [ABSTRACT FROM AUTHOR]

Seniors face many challenges as they age, such as dementia, cognitive and memory disorders, vision and hearing impairment, among others. Although most of them would like to stay in their own homes, as they feel comfortable and safe, in some cases, older people are taken to special institutions, such as nursing homes. In order to provide serious and quality care to elderly people at home, continuous remote monitoring is perceived as a solution to keep them connected to healthcare service providers. The new trend in medical health services, in general, is to move from 'hospital-centric' services to 'home-centric' services with the aim of reducing the costs of medical treatments and improving the recovery experience of patients, among other benefits for both patients and medical centers. Smart energy data captured from electrical home appliance sensors open a new opportunity for remote healthcare monitoring, linking the patient's health-state/health-condition with routine behaviors and activities over time. It is known that deviation from the normal routine can indicate abnormal conditions such as sleep disturbance, confusion, or memory problems. This work proposes the development and deployment of a smart energy data with activity recognition (SEDAR) system that uses machine learning (ML) techniques to identify appliance usage and behavior patterns oriented to older people living alone. The proposed system opens the door to a range of applications that go beyond healthcare, such as energy management strategies, load balancing techniques, and appliance-specific optimizations. This solution impacts on the massive adoption of telehealth in third-world economies where access to smart meters is still limited. [ABSTRACT FROM AUTHOR]

Abstract Background The World Health Organization announced the outbreak of the Coronavirus disease as a global pandemic on March 11, 2020. Since then, rapid implementation of telehealth approaches into the healthcare system have been evident. The pandemic has drastically impacted the lives of many around the globe and has detrimentally affected our healthcare systems, specifically with the delivery of healthcare. This has had many implications on rehabilitation services such as, occupational therapy, physiotherapy, and speech therapy. The delivery of mental health services remotely may be referred to as teletherapy, telemental health, telepsychiatry, and telepsychology. Telerehabilitation has become a necessity over the course of the pandemic due to safety concerns with COVID-19 transmission. The primary aim of this systematic review protocol is to evaluate the literature on the effect of telerehabilitation on patient outcomes and propose directives for future research based on the evidence reviewed. Methods A systematic review and meta-analysis will be conducted to examine the literature on the effect of telerehabilitation on patient outcomes following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA, 2015). The systematic review will use the following databases to examine the literature on telerehabilitation and patient outcomes: APA PsychINFO, Embase (Ovid), MEDLINE (Ovid), CINAHL, and Scopus. Discussion The utilization of telerehabilitation and similar telehealth treatments has increased throughout the COVID-19 pandemic. However, much is still unclear regarding the effectiveness of these methods in the delivery and service of healthcare, and their effect on health outcomes. This review will identify and address the knowledge gaps in the literature, which will provide further directions for future research. Trial registration This systematic review has been registered with PROSPERO under registration number CRD42022297849.

Introduction: Virtual clinics have emerged as a viable alternative to traditional face-to-face medical consultations, particularly during the COVID-19 pandemic. This study aims to evaluate the efficiency of virtual clinics by examining the satisfaction of patients and healthcare providers and their opinions of the virtual clinic service. Method: Data were collected using two separate questionnaires—one distributed to patients and the other to healthcare providers, between January 2023 and October 2023. Results: The analysis revealed that patients, regardless of their demographics, preferred virtual clinics due to reduced waiting times (43.9%), easy access to healthcare professionals (36.7%), and the convenience of receiving medical advice from home (19.8%). Healthcare providers also favoured virtual clinics as they reduced workloads and improved accessibility to health services. However, concerns were identified regarding the limitations of telemedicine in conducting physical examinations and technological barriers for physicians and patients. Conclusion: Based on the findings, it is recommended that healthcare providers and patients be encouraged to maximise the use of telemedicine services. Efforts should be made to address barriers, such as technological challenges, and to ensure that appropriate measures are taken to overcome limitations related to physical examinations. By embracing virtual clinics and removing barriers, healthcare delivery can be improved, leading to increased patient satisfaction and reduced provider workload.

Background: The telemedicine clinic for follow up after minor surgical procedures in general surgery is now ubiquitously considered a standard of care. However, this method of consultation is not the mainstay for preoperative assessment and counselling of patients for common surgical procedures such as laparoscopic cholecystectomy. The aim of this study was to evaluate the safety of assessing and counselling patients in the telemedicine clinic without a physical encounter for laparoscopic cholecystectomy. Methods: We conducted a retrospective analysis of patients who were booked for laparoscopic cholecystectomy for benign gallbladder disease via general surgery telemedicine clinics from March 2020 to November 2021. The primary outcome was the cancellation rate on the day of surgery. The secondary outcomes were complication and readmission rates, with Clavein-Dindo grade III or greater deemed clinically significant. We performed a subgroup analysis on the cases cancelled on the day of surgery in an attempt to identify key reasons for cancellation following virtual clinic assessment. Results: We identified 206 cases booked for laparoscopic cholecystectomy from telemedicine clinics. 7% of patients had a cancellation on the day of surgery. Only one such cancellation was deemed avoidable as it may have been prevented by a face-to-face assessment. Severe postoperative adverse events (equal to or greater than Clavien-Dindo grade III) were observed in 1% of patients, and required re-intervention. 30-day readmission rate was 11%. Conclusions: Our series showed that it is safe and feasible to assess and counsel patients for laparoscopic cholecystectomy remotely with a minimal cancellation rate on the day of operation. Further work is needed to understand the effect of remote consultations on patient satisfaction, its environmental impact, and possible benefits to healthcare economics to support its routine use in general surgery. [ABSTRACT FROM AUTHOR]

With the present situation in the world, proper monitoring of health has become one of the important and critical parts of our day-to-day life. With increasing work pressure and improper eating habit in day-to-day life, diabetes has become a common disease among the people. The early prediction of diabetes is a major tool to diagnose diabetes in its early stage. With the development of cloud computing and fog computing, a nature-based algorithm can be used to create a framework which can predict the diabetes in its early phase. The early prediction of disease will allow immediate treatment and hence patient's life can be saved. Cloud computing and fog computing have provided mobility and has facilitated that the patients' data can be collected and is monitored properly by the healthcare professionals at any time. In this paper, a fog-based diabetes prediction model is proposed where the patient data are acquired from the sensors that are present in remote. Fog computing is used for gathering and processing the data at the device end and communicating immediately. The processed data is transferred to the cloud layer for the analysis. In the cloud layer, the proposed hybrid ANFIS-PSO-WOA algorithm is used for the detection of diabetes level. The collected data is stored in fog layer and is used for further analysis by the healthcare professionals. Based on the analysis, the healthcare professional will treat the patient. The nature-based algorithm helps to provide good accuracy. The proposed framework has experimented with diabetes data obtained from the UCI repository and the result obtained with high accuracy of 92% by comparing with other existing algorithms such as SVM, ANN, and ANFIS. The proposed algorithm-based framework can be used to detect diabetes more efficiently and accurately as compared to other nature-based frameworks and will help healthcare professionals to diagnose the disease in its early phase. [ABSTRACT FROM AUTHOR]

Wireless capsule endoscopy is a fast-growing technology in healthcare systems. Due to using battery for powering the camera, light source, wireless communication, and other electronics, it has substantial limitations with the image quality, frame rate, and operating time. In this work, we propose a wireless passive video transmission system for capsule endoscopy, in which the power consumption is reduced by using analog camera sensor, and implementing an innovative radar technique for remote reading of the analog video signal using radio frequency backscattering. The power consumption of the capsule communication system tends to zero. The communication electronics system is minimized to a single Varactor diode with appropriate matching circuits and the image sensor power consumption is reduced by eliminating the camera sensor’s analog to digital converter. With these improvements the capsule system can operate for a longer period of time which enables the feasibility of continuous video streaming during the gastric tract screening. The design feasibility is demonstrated in a phantom experiment, and validated in an animal experiment for depths 6–11 cm using a bi-static radar system at 400 MHz, implemented using software defined radio platform.

Background: The World Health Organization announced the outbreak of the Coronavirus disease as a global pandemic on March 11, 2020. Since then, rapid implementation of telehealth approaches into the healthcare system have been evident. The pandemic has drastically impacted the lives of many around the globe and has detrimentally affected our healthcare systems, specifically with the delivery of healthcare. This has had many implications on rehabilitation services such as, occupational therapy, physiotherapy, and speech therapy. The delivery of mental health services remotely may be referred to as teletherapy, telemental health, telepsychiatry, and telepsychology. Telerehabilitation has become a necessity over the course of the pandemic due to safety concerns with COVID-19 transmission. The primary aim of this systematic review protocol is to evaluate the literature on the effect of telerehabilitation on patient outcomes and propose directives for future research based on the evidence reviewed. Methods: A systematic review and meta-analysis will be conducted to examine the literature on the effect of telerehabilitation on patient outcomes following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA, 2015). The systematic review will use the following databases to examine the literature on telerehabilitation and patient outcomes: APA PsychINFO, Embase (Ovid), MEDLINE (Ovid), CINAHL, and Scopus. Discussion: The utilization of telerehabilitation and similar telehealth treatments has increased throughout the COVID-19 pandemic. However, much is still unclear regarding the effectiveness of these methods in the delivery and service of healthcare, and their effect on health outcomes. This review will identify and address the knowledge gaps in the literature, which will provide further directions for future research. Trial registration: This systematic review has been registered with PROSPERO under registration number CRD42022297849. [ABSTRACT FROM AUTHOR]

Photoplethysmography (PPG) signals have been widely used in evaluating cardiovascular biomarkers, however, there is a lack of in-depth understanding of the remote usage of this technology and its viability for underdeveloped countries. This study aims to quantitatively evaluate the performance of a low-cost wireless PPG device in detecting ultra-short-term time-domain pulse rate variability (PRV) parameters in different postures and breathing patterns. A total of 30 healthy subjects were recruited. ECG and PPG signals were simultaneously recorded in 3 min using miniaturized wearable sensors. Four heart rate variability (HRV) and PRV parameters were extracted from ECG and PPG signals, respectively, and compared using analysis of variance (ANOVA) or Scheirer–Ray–Hare test with post hoc analysis. In addition, the data loss was calculated as the percentage of missing sampling points. Posture did not present statistical differences across the PRV parameters but a statistical difference between indicators was found. Strong variation was found for the RMSSD indicator in the standing posture. The sitting position in both breathing patterns demonstrated the lowest data loss (1.0 ± 0.6 and 1.0 ± 0.7) and the lowest percentage of different factors for all indicators. The usage of commercial PPG and BLE devices can allow the reliable extraction of the PPG signal and PRV indicators in real time. [ABSTRACT FROM AUTHOR]

Aerospace research has a long history of developing technologies with industry-changing applications and recent history is no exception. The expansion of commercial spaceflight and the upcoming exploration-class missions to the Moon and Mars are expected to accelerate this process even more. The resulting portable, wearable, contactless, and regenerable medical technologies are not only the future of healthcare in deep space but also the future of healthcare here on Earth. These multi-dimensional and integrative technologies are non-invasive, easily-deployable, low-footprint devices that have the ability to facilitate rapid detection, diagnosis, monitoring, and treatment of a variety of conditions, and to provide decision-making and performance support. Therefore, they are primed for applications in low-resource and remote environments, facilitating the extension of quality care delivery to all patients in all communities and empowering non-specialists to intervene early and safely in order to optimize patient-centered outcomes. Additionally, these technologies have the potential to advance care delivery in tertiary care centers by improving transitions of care, providing holistic patient data, and supporting clinician wellness and performance. The requirements of space exploration have created a number of paradigm-altering medical technologies that are primed to revitalize and elevate our standard of care here on Earth.

Home health monitoring can facilitate patient monitoring remotely for diabetes and blood pressure patients. Early detection of hypertension and diabetes is extremely important, as these chronic diseases often result in life-threatening complications when found at a later stage. This work proposes a smart home health monitoring system that helps to analyze the patient’s blood pressure and glucose readings at home and notifies the healthcare provider in case of any abnormality detected. A combination of conditional decision-making and machine-learning approaches is used to predict hypertension and diabetes status, respectively. The goal is to predict the hypertension and diabetes status using the patient’s glucose and blood pressure readings. Using supervised machine learning classification algorithms, herein a system is trained to predict the patient’s diabetes and hypertension status. After analyzing all the classification algorithms, support vector machine classification algorithm was found to be most accurate and thus chosen to train the model. This proposed work develops an application for a home health monitoring system with a user-friendly easy-to-use graphical user interface to diagnose blood pressure and diabetes status of patients along with sending categorized alerts and real-time notifications to their registered physician or clinic all from home.

Workers in the oil and gas industry are exposed to numerous health risks, ranging from poor health behaviours to the possibility of life-threatening injuries. Determining the most appropriate models of healthcare for the oil and gas industry is difficult, as strategies must be acceptable to multiple stakeholders, including employees, employers, and local communities. The purpose of this review was to broadly explore the health status and needs of workers in the oil and gas industry and healthcare delivery models relating to primary care and emergency responses. Database searches of PubMed, EMBASE, CINAHL, PsycINFO, and Scopus were conducted, as well as grey literature searches of Google, Google Scholar, and the International Association of Oil and Gas Producers website. Resource-sector workers, particularly those in ‘fly-in fly-out’ roles, are susceptible to poor health behaviours and a higher prevalence of mental health concerns than the general population. Evidence is generally supportive of organisation-led behaviour change and mental health-related interventions. Deficiencies in primary care received while on-site may lead workers to inappropriately use local health services. For the provision of emergency medical care, telehealth and telemedicine lead to favourable outcomes by improving patient health status and satisfaction and reducing the frequency of medical evacuations.

Seniors face many challenges as they age, such as dementia, cognitive and memory disorders, vision and hearing impairment, among others. Although most of them would like to stay in their own homes, as they feel comfortable and safe, in some cases, older people are taken to special institutions, such as nursing homes. In order to provide serious and quality care to elderly people at home, continuous remote monitoring is perceived as a solution to keep them connected to healthcare service providers. The new trend in medical health services, in general, is to move from ’hospital-centric’ services to ’home-centric’ services with the aim of reducing the costs of medical treatments and improving the recovery experience of patients, among other benefits for both patients and medical centers. Smart energy data captured from electrical home appliance sensors open a new opportunity for remote healthcare monitoring, linking the patient’s health-state/health-condition with routine behaviors and activities over time. It is known that deviation from the normal routine can indicate abnormal conditions such as sleep disturbance, confusion, or memory problems. This work proposes the development and deployment of a smart energy data with activity recognition (SEDAR) system that uses machine learning (ML) techniques to identify appliance usage and behavior patterns oriented to older people living alone. The proposed system opens the door to a range of applications that go beyond healthcare, such as energy management strategies, load balancing techniques, and appliance-specific optimizations. This solution impacts on the massive adoption of telehealth in third-world economies where access to smart meters is still limited.

Medical robots with audio-video-haptic streams, as indispensable devices for remote healthcare, are playing ever-increasing roles in mitigating the spread of infectious diseases. However, existing medical robots are far from precise and efficient because of the following two technical challenges, including i) how to ensure the haptic fidelity for precise manipulation, and ii) how to alleviate the impact of haptic streams on the quality of visual navigation for efficient operation. To this end, this work explores the benefits of edge-based cross-modal communications (CMCs), which take full advantage of potential correlations among different modalities’ streams, to realize high reliability and throughput. Specifically, to compensate for the reliability loss caused by wireless transmission, a semantic-aided cross-modal reconstruction framework is firstly designed at edge nodes for high haptic fidelity. Then, a user experience-driven stream scheduling strategy is developed to enhance the visual quality by fully leveraging edge computing and network slicing. In particular, different from traditionally interrupting audio/video stream transmission to prioritize haptic streams, we jointly schedule resources to different modalities’ streams via estimating haptic arrival time. Finally, as a classical case study, we independently construct a remote throat swab sampling platform based on CMCs to evaluate practical performance, and numerical results indicate the significant improvements in terms of various metrics. [ABSTRACT FROM AUTHOR]

Background: In-person, evidence-based, peer-facilitated chronic disease self-management programs have been shown to be effective for individuals from a variety of backgrounds, including rural and minority populations and those with lower socioeconomic status. Based in social learning theory, these programs use group processes to help participants better manage their chronic disease symptoms and improve their quality of life. During the pandemic, these in-person programs were forced to rapidly transition to remote delivery platforms, and it was unclear whether doing so increased disparities within our rural population. Objective: The objectives of this analysis were to ascertain self-management program enrollment and completion characteristics between 2 remote delivery platforms, as well as determine the individual level characteristics that drove enrollment and completion across delivery modes. Methods: We analyzed enrollment and completion characteristics of 183 individuals who either enrolled in a self-management workshop delivered through a web-based videoconference (VC) system or through a traditional, audio-only conference call (CC) offered by our health care network between April and December 2020. Chi-square tests of association were used to describe the characteristics of and differences between groups. Logistic regression analysis was used to determine significant predictors of enrollment and completion. Results: Those who enrolled in the VC platform were significantly likelier to be younger and college educated than those who enrolled in the CC platform. Those who completed a program, regardless of delivery mode, were likelier to be older and college educated than those who did not complete a program. Multivariate analyses indicated that of those enrolled in the CC platform, completers were likelier to not be enrolled in Medicaid. Among those enrolled in the VC platform, completers were older, college graduates, female, and likelier to have reported poorer health than those who did not complete the program. Conclusions: The transition of self-management programs to remote delivery modes, particularly to those that rely on VC platforms, revealed that certain demographic groups may no longer be able or willing to access the service. Efforts need to be made to increase engagement in remote self-management workshops. In addition, equivalent quality services that do not rely on a digital platform must continue to be offered in order to promote health equity. [ABSTRACT FROM AUTHOR]