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Results for “Computers, Handheld”

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At least 217 records · Page 12Linked to original sources

PubMed1999

Blood glucose awareness training and epinephrine responses to hypoglycemia during intensive treatment in type 1 diabetes.

OBJECTIVE: To determine the effect of blood glucose awareness training (BGAT) on epinephrine and symptom responses to hypoglycemia in patients with type 1 diabetes enrolled in an intensive diabetes treatment (IDT) program. RESEARCH DESIGN AND METHODS: A total of 47 subjects with uncomplicated diabetes (duration 9 +/- 3 years: HbA1c 9.0 +/- 1.2%; reference range 4-6%) enrolled in a 4-month outpatient IDT program were randomized to classes in BGAT (n = 25) (BGAT group) or cholesterol awareness (n = 22) (control group). Subjects underwent stepped hypoglycemic clamp studies before and at completion of IDT. Plasma glucose was lowered from 6.7 mmol/l (baseline) to 4.4, 3.9, 3.3, 2.8, and 2.2 mmol/l over 190 min. Symptoms, counterregulatory hormones, and ability of the subject to estimate their glucose level were assessed at each plateau. At home, subjects used a handheld computer to first estimate and then measure and record blood glucose levels for 70 trials over a 4-week period immediately before IDT and again immediately following the educational intervention. RESULTS: HbA1c decreased in both BGAT group (9.1 +/- 1.4 to 7.9 +/- 1.1%; P < 0.001) and control group (9.0 +/- 1.1 to 7.8 +/- 0.8%; P < 0.001) (NS between groups). Frequency of hypoglycemia (< 3.9 mmol/l) increased in both groups, from 0.45 +/- 0.06 to 0.69 +/- 0.07 episodes per day (P < 0.001) in the BGAT group and from 0.50 +/- 0.08 to 0.68 +/- 0.06 episodes per day (P < 0.05) in the control group NS between groups). Epinephrine responses after IDT were greater in the BGAT group (repeated measure analysis of variance [ANOVA], F = 3.5, P < 0.05). A separate analysis of subjects n = 26) most at risk for hypoglycemia (HbA1c after IDT < 7.8% or an HbA1c improvement of > 2 percentage points) showed that frequency of hypoglycemia increased in both the groups: from 0.50 +/- 0.09 to 0.80 +/- 0.11 episodes per day (P < 0.01) in the BGAT group (n = 14) and from 0.43 +/- 0.11 to 0.75 +/- 0.07 episodes per day (P < 0.05) in the control group (n = 12) (NS between groups). However, the epinephrine response in control subjects decreased with IDT while the response in the BGAT subjects was preserved (repeated measure ANOVA, F = 4.4, P < 0.02). CONCLUSIONS: BGAT is a useful intervention to decrease blunting of counterregulatory responses associated with improved glycemic control and may modify the severity of hypoglycemia associated with improved glycemic control in type 1 diabetes.

Adrenocorticotropic Hormone↗

PubMed2001

Blood glucose awareness training (BGAT-2): long-term benefits.

OBJECTIVE: Blood glucose awareness training (BGAT) has been shown to improve awareness of blood glucose (BG) fluctuations among adults with type 1 diabetes. This study investigates the long-term (12-month) benefits of BGAT-2. RESEARCH DESIGN AND METHODS: A total of 73 adults with type 1 diabetes participated in a 6-month repeated baseline design with a 12-month follow-up. At 6 months and 1 month before BGAT-2 and at 1,6, and 12 months after BGAT-2, subjects used a handheld computer for 50 trials and completed psychological tests. Throughout assessment, subjects completed diaries, recording occurrences of diabetic ketoacidosis, severe hypoglycemia, and motor vehicle violations During follow-up, 50% of the subjects received booster training. RESULTS: During the first and last halves of both the baseline period and the follow-up period, dependent variables were generally stable. However, from baseline to follow-up, BGAT-2 led to 1) improved detection of hypoglycemia and hyperglycemia; 2) improved judgment regarding when to lower high BG, raise low BG, and not drive while hypoglycemic; 3) reduction in occurrence of diabetic ketoacidosis, severe hypoglycemia, and motor vehicle violations; and 4) improvement in terms of worry about hypoglycemia, quality of life, and diabetes knowledge. Reduction in severe hypoglycemia was not associated with a worsening of metabolic control (HbA1). The presence or absence of booster training did not differentially affect these benefits. CONCLUSION: BGAT has sustained broad-ranging benefits, independent of booster intervention.

Anxiety↗

PubMed2000

Binge antecedents in obese women with and without binge eating disorder.

In this study, women with binge eating disorder (BED; n = 41) and weight- and age-matched comparison women without BED (NBED; n = 38) monitored their eating for 6 days, using handheld computers to measure mood, appetite, and setting at all eating episodes and comparison noneating episodes. Poor mood, low alertness, feelings of poor eating control, and craving sweets all preceded binge episodes for the BED group. An unanticipated finding was the frequent report of binge episodes in the comparison group; only feelings of poor eating control and craving sweets predicted binge episodes in this group. Binge eating NBED women tended to experience worse mood, less control, and more craving than other NBED women, contributing to evidence of the close relationship of binge eating and decrements in emotional and appetitive functioning.

Adult↗

PubMed2001

2000 200-city survey. Operational & clinical EMS trends in large, urban areas.

The year's survey illustrated ongoing stability with respect to providers and operational approaches, and explored relationships that could provide opportunities for improvement. The continued use of hot response to every request for service is a high-risk response strategy. Today's EMD protocol systems can enable systems to safely prioritize requests for service. Response time performance reported by measure interval and averaged response time, while appearing to follow a rational model for transportation providers, fell short with respect to first responder response times which appeared to have no correlation with response clock start times. A possible explanation for this difference is the lower percentage of first responder agencies that are subject to external response-time performance review. The medical direction results suggest an investment in a full-time medical director could reduce online medical control requirements. The use of handheld computing technology could serve as a vehicle for building accurate clinical databases, as well as a means to deliver DS technology to the patient's bedside. Use of this technology could also improve reimburesment through more accurate reporting. The future of EMS has enormous challenges that must be overcome, especially in light of reduced health-care insurance reimbursements. However, these challenges also present an opportunity for EMS to reinvent itself. The capture and analysis of operational and clinical data by EMS systems will prove essential to understanding what changes can be made to enable them to meet future demands.

Data Collection↗

PubMed2001

Emerging technologies in health care and the patient encounter of the future.

In the last five years, the Web has changed the way information is disseminated, knowledge is gained, and health care is provided. Even though the health care industry has yet to fully realize the potential of the Internet, the Web is only the beginning. Several emerging technologies will be changing the rules again. With new forms of network connectivity and faster, new wireless technologies, the adoption rate of mobile, handheld computers in health care will grow feverishly. Intelligent, autonomous software agents that guide the patient through the continuum of care will extend the reach of health care providers to all places at all times. The author discusses these new concepts, how they might be applied in health care, and the doctor-patient health care transaction.

Diffusion of Innovation↗

PubMedDate not supplied

E-prescribing hits the medical world: what physicians need to know to get the right technology.

Electronic prescribing is an emerging technology that allows physicians to write appropriate, legible, and safe prescriptions quickly and easily, using a handheld computer unit linked to their office computer. The early physician adapters using this innovation had little objective information upon which to base their choice, so cost was their main criterion. Now, a variety of vendors and options are available, so the discriminating physician is able to select the electronic prescribing system most complementary to his or her practice's needs and unique style.

Clinical Pharmacy Information Systems↗

PubMed2002

Point and click. (If only it were that easy.).

Along with tight reimbursement and confounding regulations, any list of big headaches for health care leaders includes information technology. We've been promised so much from IT for so long, and have been disappointed so many times, who can blame us for being skeptical, if not downright cynical? When is the last time an investment in information technology actually improved your bottom line? But we know we can't dismiss IT altogether. At the end of the rainbow there really is efficiency, security and better care for patients. So how close are we? In this issue, H&HN takes a hard look at technology--what it can do for us today and tomorrow. We look at return on investment, examining whether hospitals are measuring what they get back against what they put in; a budding effort to bring a common platform to health care IT; handheld computers; electronic medical records; and computerized physician order entry. The technology is out there, but it's fair to ask: is it really clicking yet?

Computer Communication Networks↗

PubMed2003

Detection of speaking with a new respiratory inductive plethysmography system.

The LifeShirt system, a garment with integrated sensors connected to a handheld computer, allows recording of a wide variety of clinically important cardiorespiratory data continuously for extended periods outside the laboratory or clinic. The device includes sensors for assessment of physical activity and posture since both can affect physiological activation and need to be controlled. Speaking is another potential confounding factor in the interpretation of physiological data. Auditory speech recording is problematic because it can pick up sources other than the person's voice (external microphone) or is obtrusive (throat microphone). The abdominal and thoracic calibrated respiratory inductive plethysmography (RIP) sensors integrated in the LifeShirt system might be an adequate alternative for detecting speech. In a laboratory experiment we determined respiratory parameters indicative of speech. Eighteen subjects were instructed to sit quietly, write, and speak continuously, for 4 min each. Nine parameters were derived from the RIP signals and averaged over each minute. In addition, nine variability parameters were computed as their coefficients of breath-by-breath variation. Inspiratory/expiratory time (IE-ratio) best distinguished speaking from writing with 98% correct classification at a cutoff criterion of 0.52. This criterion was equally successful in distinguishing speaking from sitting quietly. Discriminant analyses indicated that linear combinations of IE-ratio and a variety of other parameters did not reliably improve classification accuracy across tasks and replications. These results demonstrate the high efficacy of RIP-derived IE-ratio for speech detection and suggest that auditory recording is not necessary for detection of speech in ambulatory assessment.

Adult↗

PubMedDate not supplied

Immunization education among family practice residency programs.

BACKGROUND AND OBJECTIVES: The dynamic nature of immunization schedules, shortages, and administration techniques makes keeping up to date with current national recommendations difficult and necessitates periodic evaluation of immunization teaching resources. METHODS: This study surveyed family practice residency program directors in 1998 to assess their satisfaction with immunization teaching resources and interest in new resources. Subsequently, with funding from the Centers for Disease Control and Prevention, the Society of Teachers of Family Medicine Group on Immunization Education developed a series of educational materials devoted to educating family physicians about immunizations. In 2001, residency directors were surveyed again to evaluate the educational resources. RESULTS: Most program directors reported satisfaction with resources currently available to them for teaching residents about childhood immunizations, but about half (41% in 1998 versus 55% in 2001) agreed that keeping up to date on childhood immunizations was difficult. The corresponding figures for adult immunizations were 27% in 1998 and 36% in 2001. Pocket-size immunization schedules were ranked highly important (53% in 1998 versus 45% in 2001). Many would use handheld computer immunization schedules (53%). Although satisfaction with available resources did not increase following introduction of a newly developed journal supplement and Web site, the limited response received was favorable. CONCLUSIONS: Immunization teaching materials developed by family physicians, especially those that make use of evolving technologies, can be useful resources for individuals teaching family practice residents and for keeping up to date on recommendations for immunizations.

Family Practice↗

PubMed2003

Wireless application for complex wound management.

This project was to develop a web based wireless system to be used by community care nurses. Wound care constitutes approximately one half of home health care nursing visits. The system was implemented with a digital camera and a handheld computer with a wireless connection to a web based server. A database was used to control access to the clinical cases and to serve as a data repository. When new images were uploaded to the server a wound expert was notified via pager. The images and data could be viewed from any computer with an internet connection.

Community Health Nursing↗

PubMed2005

Blood glucose awareness training in Dutch type 1 diabetes patients: one-year follow-up.

BACKGROUND: American studies have shown positive effects of Blood Glucose Awareness Training (BGAT) on the recognition of hypoglycaemia. We evaluated the effects of BGAT among Dutch patients, and compared individual training with training in the original group format. METHODS: Fifty-nine type 1 diabetes patients participated in BGAT in either a group (n = 37) or an individual (n = 22) setting. Before and one year after training they performed up to 70 measurements, two to four a day, at home on a handheld computer. During each measurement they estimated their blood glucose (BG), indicated whether they would be participating in traffic and raised their BG on the basis of their estimation, and then measured their BG. The incidence of severe hypoglycaemia and traffic accidents was also assessed. RESULTS: BGAT had positive effects on hypoglycaemic awareness, decisions not to drive and to raise the blood glucose during hypoglycaemia, severe hypoglycaemic episodes and traffic accidents. The accuracy of BG estimations only improved after group training, while after individual training patients tended to measure more or more extremely high BG values. CONCLUSION: The training improved awareness of hypoglycaemia, and seems worthy of implementation in The Netherlands.

Adult↗

PubMed2005

Factors to weigh when considering electronic data collection.

Researchers are increasingly considering the adoption of electronic data-collection methods--which entail the use of the Web, e-mail, and desktop and handheld computers--for surveys, diaries, research instruments, and focus groups. Based on prior research findings on electronic data collection, the authors delineate the key factors, which incorporate population, data, and resource characteristics, that guide researchers in selecting the data-collection method most appropriate for their research question. Population factors to consider in data-collection decisions are age, gender, socio-economic status, and access to technology. Key data factors influencing the selection of collection method include sensitivity of the topic, time sensitivity, longitudinal data, and contextual data. Data-collection decisions are also based on financial, time, and technological resources. Technology and demographics will continue to change and affect data-collection methods and possibilities. By examining these key factors, however, researchers will be able to reach data-collection decisions that are appropriate for each project.

Computer Simulation↗

PubMed2005

The eHealth agenda for developing countries.

Delivering eHealth in developing countries faces different health and socio-economic challenges to the developed one. But, if a global health infrastructure is to evolve, then developing countries need to play their part. So, whilst the context may differ, the localization-globalization of content issues needs to be jointly addressed. In providing robust and affordable connectivity, particularly to rural areas, developing countries can fully exploit the potential of handheld computers and wireless connectivity. Over such an infrastructure new ways of building capacity, both locally and globally, can be supported. Finally, an eHealth infrastructure can support the delivery of healthcare in communities, thereby supporting individuals and community development.

Developing Countries↗

PubMed2005

Information infrastructure for emergency medical services.

The pre-hospital emergency medical and public safety information environment is nearing a threshold of significant change. The change is driven in part by several emerging technologies such as secure, high-speed wireless communication in the local and wide area networks (wLAN, 3G), Geographic Information Systems (GIS), Global Positioning Systems (GPS), and powerful handheld computing and communication services, that are of sufficient utility to be more widely adopted. We propose a conceptual model to enable improved clinical decision making in the pre-hospital environment using these change agents.

Emergency Medical Services↗

PubMedDate not supplied

Medical information systems of the future.

The coming years promise great advances in the storing, recording, and communication of medical data. Handheld computers may make bedside terminals obsolete. CD-ROM's storage capacity will eliminate data retention problems as well as provide for storage images. Doctors should be able to access computers merely by talking. Home monitoring equipment that the physician can access by telephone should reduce hospital stays. Computerized decision support, neurocomputing, cost-cutting through automation: all these concepts are at the cutting edge of medical information technology.

Decision Making, Computer-Assisted↗

PubMedDate not supplied

A method of mixed dentition analysis in the mandible.

We developed a method of space analysis based on the fact that the measurement between the distal surfaces of the mandibular permanent lateral incisors was approximately equal to that of the combined widths of the mandibular permanent canine and premolars. This method is referred to as Interlateral Incisor Width (I.L.I.W.) Analysis. One hundred and nineteen Japanese children, without malocclusion, were selected for the study. Various measurements of teeth were taken in their mouths with a modified, fine-tipped, electrical, digital caliper and recorded in a Handheld Computer by connecting it to the caliper. Statistical analyses were conducted to compare the accuracy of the I.L.I.W., Ono, Moyers, and Ballard and Wylie analyses in the mandibular arch. The summary of the results were: Correlation coefficients for the sum of the actual mesiodistal dimensions of the canine and premolars with their predicted values obtained by each of the four analyses revealed r = 0.63 for I.L.I.W., r = 0.55 for Ono, r = 0.57 for Moyers, and r - 0.55 for Ballard and Wylie. Our I.L.I.W. method presented the best correlation of the four analyses, although each indicated a relatively low correlation. This method does appear to be clinically valid, since it is simple enough to enable the practitioner to estimate the combined dimension of the unerupted canine and premolars by measurement, in the mouth, of the distance between the distal surfaces of both mandibular permanent lateral incisors, instead of on study casts. It is recommended that a radiographic method be used in conjunction with our method to obtain a more accurate estimate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1985

[Monitoring kidney function in abdominal infection].

In ICU patients suffering from abdominal sepsis acute renal failure (ARF) is a common (50% incidence) and often lethal (more than 80% mortality) complication. Continuous monitoring of renal function is necessary for both adequate fluid replacement and early detection of ARF. Using a programmable handheld computer the following parameters are calculated at least daily: creatinine, osmolal and free water clearance, fractional excretion of sodium and potassium and non-saline loss. The clearance values are corrected to 1.73 m2 body surface area. Free water clearance proved to be a particularly valuable guide for fluid therapy as well as for early diagnosis of ARF. In all septic patients renal function is impaired to some degree, since despite increased cardiac output creatinine clearance is only normal or even decreased. More than 50% of our patients with abdominal sepsis develop ARF, resulting in a dramatic increase in mortality. Goal of renal monitoring in sepsis is to detect ARF as early as possible and to differentiate between extrarenal and septic origin to enable immediate surgical treatment.

Acute Kidney Injury↗

PubMed2002

Nuclear cardiology patient tracking using a palm-based device: methods and clinician satisfaction.

Handheld personal computers are popular, easy to use, inexpensive, portable, and can share data among different operating systems. In our institution, nuclear cardiology testing is performed in the nuclear medicine department and jointly reported by radiologists and cardiologists. The objective of this article is to describe a system for recording nuclear cardiology data and to assess clinician satisfaction using handheld computers with the Palm Operating System. We devised a Palm-based relational database/ using commercially available software (HanDBase) that requires minimal computer expertise to implement and maintain. Data are collected by the cardiologist and synchronized to a single central relational database compatible with Microsoft Access. We assessed cardiologists' satisfaction with this system. Cardiologists unanimously agreed that this system had a positive impact on patient management and cardiology fellow education. They were satisfied with ease of data input, sharing, retrieval, and clarity of data display. The cardiologist with the least experience in using the software took longer to input data and thought that it prolonged the nuclear cardiology rounds. The idea to develop this software was to ease data entry using shortcuts and lists, limiting data stored to that essential for patient management and also to transmit data easily between staff. The cardiologist with the most experience in using the software felt more comfortable and satisfied with it. This was perhaps due to his continuous involvement in the development of this system. Like any new system, there is a learning curve in using this software. The software was easy to customize, and support and tutorials were found on the manufacturer's Web site. The system of collecting data using handheld computers with the Palm Operating System is easy to use, relatively inexpensive, accurate, and secure. The user-friendly system provides prompt, complete, and accurate data, enhancing the education of fellows while facilitating the job of cardiologists.

Attitude of Health Personnel↗