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At least 271 records · Page 15Linked to original sources

PubMedDate not supplied

Using telecommunication technology to manage children with diabetes: the Computer-Linked Outpatient Clinic (CLOC) Study.

The purpose of this study was to evaluate the efficacy of using a telecommunication system to assist in the outpatient management of pediatric patients with insulin-dependent diabetes. Metabolic control, patients' psychosocial status, family functioning, perceived quality of life, patterns of parental/child responsibility for daily diabetes maintenance, and nursing time-on-task were evaluated. One hundred six pediatric patients (mean age = 13.3 years) were randomly assigned to an experimental or control outpatient clinic for 1 year. Experimental subjects transmitted self-monitoring blood glucose data by modem to the hospital every 2 weeks. Transmitted data were reviewed by nurse practitioners who telephoned subjects to discuss regimen adjustments. Control subjects received standard care with regimen adjustments made by physicians. There were no significant between-group differences for metabolic control, rates of hospitalization or emergency-room visits, psychological status, general family functioning, quality of life, or parent-child responsibility. A significant decrease was noted in nursing time-on-task for experimental subjects.

Adolescent↗

PubMed2003

History of North American donor milk banking: one hundred years of progress.

Over the past 100 years, North American milk banking has evolved from an idea to a sophisticated process. The early history of establishment of North American banks, including screening processes undertaken, provides the basis for current procedures in modern banks. Increased research and technological improvements have also dramatically changed modern screening procedures. Human milk banks have waxed and waned through the years due to concerns of safety, lack of information, and assertive marketing of infant formula. With increasing awareness of the benefits of human milk and the safety of the optimal product provided through modem milk banks, demand is increasing, leading to greater interest in establishing additional banks.

Canada↗

PubMed2001

The development of a new model for community telemedicine services.

Two trials of a telemedicine monitoring system were conducted in the UK. The SAFE21 system records the patient's physiological data, which are transmitted via a modem to the health service provider. The first trial was conducted on nine muscular dystrophy patients under 18 years of age. Eight of the patients felt that the monitoring system was reliable and were happy with it, as it avoided the need to go to hospital for monitoring. The second trial was carried out on 14 patients suffering from respiratory illness. Thirteen of these patients felt that the service was useful and 12 reported satisfaction with the system. The SAFE21 telemedicine monitoring system appears to be an acceptable means of delivering care.

Adolescent↗

PubMed2002

A feasibility study of remote monitoring of asthmatic patients.

We assessed the feasibility of a remote monitoring system for asthmatic patients to use in their own homes. Eighty-four patients were invited to participate following discharge from hospital after an acute exacerbation of their asthma. We remotely monitored 33 patients from two hospitals for two weeks. Their mean age was 34 years (range 17-50 years). Patient compliance with monitoring was 80% (range 45-231%) and compliance with transmitting the results using a modem was 52% (range 0-100%). The average time spent teaching patients how to perform measurements was 16 min (range 2-55 min) and time spent providing asthma education was 39 min (range 5-135 min). Ninety-six per cent of patients found the equipment easy or very easy to use and 92% said they would use the equipment again in the future. Medical intervention occurred in 48% of patients during the study period, which suggests that the use of remote monitoring could be important in reducing asthma morbidity and improving treatment outcomes.

Adolescent↗

PubMed2004

Distributed network imaging and electrical impedance tomography of minimally invasive surgery.

Minimally invasive surgery has become highly dependent on imaging. For instance, the effectiveness of cryosurgery in treating cancer is dependent on knowledge of freezing extent, and relies on real-time imaging techniques for monitoring. However, medical imaging is often very expensive and therefore not available to most of the world population. Here we propose the concept of distributed network imaging (DNI) which could make medical imaging and minimally invasive surgery available to all who need these advanced medical modalities. We demonstrate the concept through electrical impedance tomography (EIT) of cryosurgery. The central idea is to develop an inexpensive measurend (data collection hardware) at a remote site and then to connect the measurend apparatus to an advanced image reconstruction server, which can serve a large number of distributed measurends at remote sites, using existing communication conduits (Ethernet, telephone, satellite, etc.). These conduits transfer the raw data from the measurend to the server and the reconstructed image from the server to the measurend. Electrical impedance tomography (EIT) is an imaging modality which utilizes tissue impedance variation to construct an image. The EIT measurend which consists of electrodes, a power supply, and means to measure voltage is inexpensive, and therefore suitable for DNI. EIT is also very well-suited to imaging cryosurgery since frozen tissue impedance is much higher than that of unfrozen tissue. In this study, we first develop numerical models to illustrate the theoretical ability of EIT to image cryosurgery. We begin with a simplified two dimensional model, and then extend the study to the more appropriate three dimensional model. Our simulated finite element phantoms and pixel-based Newton-Raphson reconstruction algorithms were able to produce easily identifiable images of frozen regions within tissue. Then, we demonstrate the feasibility of the DNI concept though a case study using EIT to image an in vitro liver cryosurgery procedure through a modem. We find that the acquired raw data packets are less than 5KB per image and the images, using compression, do not exceed 50KB per image.

Algorithms↗

PubMed1996

Challenges and opportunities of the Internet for medical oncology.

PURPOSE: The internet, and in particular the world wide web (www), has a rapidly increasing potential to provide information for oncologists and their patients about cancer biology and treatment. A brief overview of this environment is given along with examples of how easily the information is accessed as a means of introducing the web page of the American Society of Clinical Oncology (ASCO), ASCO OnLine. METHODS: Oncology information sources on the www were accessed from the author's home using a 14.4 kbs modem, Netscape browser (Netscape communications Corp, Mountain View, CA), and the locations recorded for tabulation and discussion. RESULTS: Overwhelming amounts of oncology-related information are now available via the Internet. CONCLUSION: Oncology as a subspecialty is ideally suited to apply the newest information technology to traditional needs in areas of education, research, and patient care. Oncologists will increasingly act as information guides rather than information resources for patients and their families with cancer.

Computer Communication Networks↗

PubMed1997

Connectionism, parallel constraint satisfaction processes, and gestalt principles: (re) introducing cognitive dynamics to social psychology.

We argue that recent work in connectionist modeling, in particular the parallel constraint satisfaction processes that are central to many of these models, has great importance for understanding issues of both historical and current concern for social psychologists. We first provide a brief description of connectionist modeling, with particular emphasis on parallel constraint satisfaction processes. Second, we examine the tremendous similarities between parallel constraint satisfaction processes and the Gestalt principles that were the foundation for much of modem social psychology. We propose that parallel constraint satisfaction processes provide a computational implementation of the principles of Gestalt psychology that were central to the work of such seminal social psychologists as Asch, Festinger, Heider, and Lewin. Third, we then describe how parallel constraint satisfaction processes have been applied to three areas that were key to the beginnings of modern social psychology and remain central today: impression formation and causal reasoning, cognitive consistency (balance and cognitive dissonance), and goal-directed behavior. We conclude by discussing implications of parallel constraint satisfaction principles for a number of broader issues in social psychology, such as the dynamics of social thought and the integration of social information within the narrow time frame of social interaction.

Journal Article↗

PubMed1988

NeuroSIG: the computer network of the Congress of Neurological Surgeons.

A sophisticated computer network has been developed specifically for use by the Congress of Neurological Surgeons. This network provides a variety of communication and information features. These include public and private message transmission, teleconferencing, numerous data libraries, programs that may be downloaded and executed on the user's own computer, high resolution color graphics image transmission, an extensive neurosurgical database, and extensive on-line "help" features. The system can be accessed using almost any personal computer and a telephone modem.

Computer Communication Networks↗

PubMed2000

Telemedicine in the control of intra-ocular pressure.

Glaucoma is one of the most common causes of blindness in the Western world and a major risk factor is increased intra-ocular pressure. We therefore used telemedicine in its control. Patients measured their intra-ocular pressure several times a day with a portable instrument and the values were then entered into a portable digital assistant. These data were transmitted by a modem to a central server. If the intra-ocular pressure was pathologically high, an email message was automatically sent to the ophthalmologist. The pressure curve, including a statistical analysis, was displayed in an easily readable chart format. Ten patients with glaucoma participated in a trial. Self-tonometry with telemedicine enabled continuous evaluation of the patient by the ophthalmologist. This approach offered the advantage of controlling the treatment remotely. Advantages for the patient were that the measurements were easily done at home under normal conditions, and the patient could control when the measurement and data transmission would be performed. Telemedicine is a cost-effective technique enabling the early diagnosis of pathologically increased intra-ocular pressure.

Glaucoma↗

PubMed2000

Technical evaluation of a low-bandwidth, Internet-based system for teleconsultations.

A low-bandwidth telemedicine system was evaluated in eight community hospitals connected to a central hospital via the Internet. PCs were used with videoconferencing software and modem connections to the telephone network. The average data connection rates, still-image transfer times and live-video transmission rates were determined. The time to send 640 x 480, 320 x 240 and 160 x 120 pixel, 24-bit still images ranged from 29 s to 411 s. The average file transfer times for a 10 s MPEG video-clip was 8.6 min. The average live video frame rate was 1 frame/s (at the best image quality), with an average latency of 3 s. The results suggest that Internet-based videoconferencing is acceptable for certain telemedicine applications.

Canada↗

PubMed2001

Improvement in diabetes control with a monitoring system based on a hand-held, touch-screen electronic diary.

We conducted a six-month prospective interventional crossover study examining a computerized diabetes monitoring system (DMS) that conveyed dietary information. The objectives were to compare glycaemic control between intervention and control periods, and to assess patients' acceptance of the DMS. Nineteen patients were randomized into two groups, each using the DMS for three months and serving as the control group for another three months. The patients recorded information about their meal portions and blood glucose readings in a hand-held electronic diary. After transmitting the data to the DMS through a telephone modem, the patients received immediate feedback about the carbohydrate, protein and fat content of the meal, as well as the calorie content. A significant improvement in glycaemic control was achieved during intervention compared with control periods (mean HbA1C reduction of 0.825%). The DMS was also highly acceptable: 95% patients found it easy to operate while 63% found it useful. The DMS was thus a feasible model of telemedicine in diabetes care and a larger study is warranted to examine its cost-effectiveness.

Adult↗

PubMed2001

Low-bandwidth, Internet-based videoconferencing for physical rehabilitation consultations.

Low-bandwidth, Internet-based videoconferencing was used to provide physical rehabilitation consultation services for eight community hospitals. Videoconferencing and file transmission used a PC and modem. A separate telephone line was used for voice. Over 21 months, 47 physical rehabilitation consultations were completed for communication disorders, foot care, gait problems, orthotics, prosthetics, arm weakness and wheelchair prescription. Consultations were approximately 40 min long. Clinician questionnaires were completed by 47 individuals. While more than 80% of the questionnaire responses supported the telemedicine approach, remote clinicians rated their satisfaction higher than did the specialists. Client questionnaires were completed by 24 individuals (a response rate of 51%). All clients were comfortable with and had confidence in the teleconsultations.

Attitude of Health Personnel↗

PubMed2001

A study of Internet use by doctors and patients in Poland.

We evaluated Internet use in Poland in the field of obstetrics and gynaecology. Questionnaires were sent to 33 hospital departments of obstetrics and gynaecology; 25 replied (76%). The 25 departments contained a total of 275 doctors, 70% of whom (n=193) returned the questionnaire. We also invited 3054 people visiting a gynaecological Website for patients to complete an online form; 161 replied, a response rate of 5.3%. While 84% of the 102 doctors using the Internet were satisfied with Internet medical resources, only 24% of patients were. Patients searched for medical information less frequently than professionals and were younger. About half of the doctors and patients had only modem access to the Internet. The most popular services for professionals were databases and information services; patients were most interested in information on pregnancy, contraceptives, physiology and general female health. Most of the 45% of patients who said that they did not receive sufficient information from doctors could not usually find it on the Internet either.

Adolescent↗

PubMed2002

Integrated regional services: are working process changes desirable and achievable?

In the hospital district of Helsinki and Uusimaa, 32 municipalities with one or more health centres provide primary care to their residents. Legal and organizational barriers between primary care and hospital care impede the continuity of patient care. Integrating primary and secondary care with the aid of information technology may facilitate a virtual electronic patient record, in which the viewing of images and other patient data is possible regardless of the organization that produced them. For example, in one trial, diabetic patients sent their home blood glucose measurements by modem to their health centre. Preliminary observations suggest that they could increase their glucose testing largely because they were able to transmit the results to the database and receive teleconsultations. Also, a picture archiving and communication system (PACS) has been in operation in two clinics of the Helsinki University Central Hospital for over two years and seven hospitals had become filmless by the end of 2001. A regional PACS is planned to be completed by the year 2004.

Journal Article↗

PubMed2004

Nurse and patient communication via low- and high-bandwidth home telecare systems.

We examined nurse-patient communication on two videoconferencing systems: a video-phone (PSTN video) and a PC-based system (IP video). The former used data transmission via a modem at 33.6 kbit/s and the latter via a local-area network at up to 512 kbit/s. Twenty-six nurses and 18 volunteers (simulated patients) participated. On each video system nurse-patient dyads completed scripted interactions; they then completed questionnaires to assess communication. Of the participants, 84% (n=37) preferred IP video and 14% (n=6) preferred PSTN video (one expressed no preference). IP video was rated significantly higher in all communication quality areas except self-consciousness/embarrassment. Although participants' overall ratings were higher for the IP video system, two important advantages of the PSTN video system were identified by both nurses and patients: first, it provided superior visualization of the medication bottle, insulin syringe and the patient's skin; and second, it was easier to use. Video quality and audio quality are important determinants of patient and provider perceptions, but ease of use, clinical appropriateness, and the need for training and support must not be forgotten.

Adult↗

PubMed1996

Digital transmission of 12-lead electrocardiograms and duplex speech in the telephone bandwidth.

A system was developed which allowed the simultaneous communication of digitized, full duplex speech and electrocardiography (ECG) signals in realtime. A single band-limited channel was used over a standard telephone line providing 3 kHz bandwidth. The full duplex speech was compressed to 2400 bit/s using linear predictive coding, while multiple ECG signals were processed by a novel ECG compression technique. Extensive use of digital signal processing reduced the combined bit rate to less than 9600 bit/s, allowing the use of low-cost commercial modems. The ECG communications system was tested in clinical trials. It enabled a hospital-based clinician to provide diagnostic and treatment advice to a remote location over the standard telephone network.

Analog-Digital Conversion↗

PubMed1998

The clinical and economic advantages of remote, community-based physiological assessment.

A prospective study documented the nutritional intakes of a large cohort of pregnant women living in Portsmouth and investigated the independent relationships of smoking, dietary intake and other maternal socio-economic factors on outcome and cardiorespiratory function of the child during sleep at home at three weeks and three months of age. Unattended overnight cardiorespiratory recording was performed and the data stored in local memory before transmission on demand via modem to Oxford next morning. The telemetry of the physiological data, entirely managed by part-time community nurses in Portsmouth, was very successful. Despite some losses, which included transmission failures, electrode or lead disconnection, and monitor malfunction, 92% of the physiological data were analysed at Oxford. Personalized physiological monitoring in the community provides an opportunity for new evidence bases that will enable a new level of individualized care.

Female↗

PubMed1989

Analysis of non-urban end users' MEDLINE training.

The University of Oklahoma Health Sciences Center (OUHSC) Library mailed a MEDLINE End User Practice Survey Form to 310 health professionals who had attended MEDLINE seminars supported by a two-year NLM grant. The survey sought to determine how many respondents had obtained NLM codes, reasons for not obtaining a code, searching time done since the seminar, differences in the use of information since taking the seminar, factors helpful in successful searching, and factors contributing to frustrations. The most prevalent reasons for not obtaining a code were lack of a microcomputer and modem, infrequent use of MEDLINE, cost, lack of time, complications, and ability to obtain free searches.

Computer User Training↗