Current Issue : October-December Volume : 2024 Issue Number : 4 Articles : 5 Articles
Purpose Exercise-based cancer rehabilitation via digital technologies can provide a promising alternative to centrebased exercise training, but data for cancer patients and survivors are limited. We conducted a meta-analysis examining the effect of telehealth exercise-based cancer rehabilitation in cancer survivors on cardiorespiratory fitness, physical activity, muscle strength, health-related quality of life, and self-reported symptoms. Methods PubMed, Web of Science, and reference lists of articles related to the aim were searched up to March 2023. Randomized controlled clinical trials were included comparing the effect of telehealth exercise-based cancer rehabilitation with guideline-based usual care in adult cancer survivors. The primary result was cardiorespiratory fitness expressed by peak oxygen consumption. Results A total of 1510 participants were identified, and ten randomized controlled trials (n = 855) were included in the meta-analysis. The study sample was 85% female, and the mean age was 52.7 years. Meta-analysis indicated that telehealth exercise-based cancer rehabilitation significantly improved cardiorespiratory fitness (SMD = 0.34, 95% CI 0.20, 0.49, I2 = 42%, p < 0.001) and physical activity (SMD = 0.34, 95% CI, 0.17, 0.51, I2 = 71%, p < 0.001). It was uncertain whether telehealth exercise-based cancer rehabilitation, compared with guideline-based usual care, improved the quality of life (SMD = 0.23, 95%CI, -0.07, 0.52, I2 = 67%, p = 0.14) body mass index (MD = 0.46, 95% CI, -1.19, 2.12, I2 = 60%, p = 0.58) and muscle strength (SMD = 0.07, 95% CI, -0.14, 0.28, I2 = 37%, p = 0.51). Conclusion This meta-analysis showed that telehealth exercise cancer rehabilitation could significantly increase cardiorespiratory fitness and physical activity levels and decrease fatigue. It is uncertain whether these interventions improve quality of life and muscle strength. High-quality and robust studies are needed to investigate specific homebased exercise regimens in different cancer subgroups to increase the certainty of the evidence....
The NeoCare home monitoring system aims to detect falls and other events using artificial intelligence. This study evaluated NeoCare’s accuracy and explored user perceptions through a 12- week in-home trial with 18 households of adults aged 65+ years old at risk of falls (mean age: 75.3 years old; 67% female). Participants logged events that were cross-referenced with NeoCare logs to calculate sensitivity and specificity for fall detection and response. Qualitative interviews gathered in-depth user feedback. During the trial, 28 falls/events were documented, with 12 eligible for analysis as others occurred outside the home or when devices were offline. NeoCare was activated 4939 times—4930 by everyday household sounds and 9 by actual falls. Fall detection sensitivity was 75.00% and specificity 6.80%. For responding to falls, sensitivity was 62.50% and specificity 17.28%. Users felt more secure with NeoCare but identified needs for further calibration to improve accuracy. Advantages included avoiding wearables, while key challenges were misinterpreting noises and occasional technical issues like going offline. Suggested improvements were visual indicators, trigger words, and outdoor capability. The study demonstrated NeoCare’s potential with modifications. Users found it beneficial, but highlighted areas for improvement. Real-world evaluations and user-centered design are crucial for healthcare technology development....
Background Telemedicine use increased with the Covid-19 pandemic. The impact of telemedicine on resource use in pulmonary clinics is unknown. Methods This retrospective cohort study identified adults with pulmonary clinic visits at the University of Miami Hospital and Clinics (January 2018-December 2021). The primary exposure was telemedicine versus in-person visits. Standard statistics were used to describe the cohort and compare patients stratified by visit type. Multivariable logistic regression models evaluated the association of telemedicine with resource use (primarily, computed tomography [CT] orders placed within 7 days of visit). Results 21,744 clinic visits were included: 5,480 (25.2%) telemedicine and 16,264 (74.8%) in-person. In both, the majority were < 65-years-old, female, and identified as Hispanic white. Patients seen with telemedicine had increased odds of having CT scans ordered within 7 days (adjusted odds ratio [aOR] 1.34, [95% confidence interval 1.04–1.74]); and decreased odds of chest x-rays (aOR 0.37 [0.23–0.57]). Telemedicine increased odds of contact of any kind with our healthcare system within 30-days (aOR 1.56 [1.29–1.88]) and 90-days (aOR 1.39 [1.17–1.64]). Specifically, telemedicine visits had decreased odds of emergency department visits and hospitalizations (30 days: aOR 0.54 [0.38– 0.76]; 90 days: aOR 0.68 [0.52–0.89]), but increased odds of phone calls and electronic health record inbox messages (30 days: aOR 3.44 [2.73–4.35]; 90 days: aOR 3.58 [2.95–4.35]). Conclusions Telemedicine was associated with an increased odds of chest CT order with a concomitant decreased odds of chest x-ray order. Increased contact with the healthcare system with telemedicine may represent a larger time burden for outpatient clinicians....
Objective Our aim is to explore the common challenges encountered by neurologists in telemedicine. Methods We performed a cross-sectional study via an anonymous survey to explore neurologists’ experiences with telemedicine. A survey was sent to randomly selected 200 participants from academic institutions in the United States. We performed descriptive statistics, reported as percentages for each survey question. Results One hunderd and ten neurologists completed the survey. Fifty-one percent of neurologists stated that they experienced technological issues in (1%–20%) of telemedicine visits and 57% needed technical assistance from informational technology ( support. Thirty-four percent of neurologists agree that the inability to perform physical examination make them feel worried that they are providing a sub-optimal care for their patients and 55% recommended a subsequent in-person visit for further evaluation in (1%–20%) of telemedicine visits. Most Neurologists (95%) rated patients’ technological challenges in setting up a telemedicine visit as the most common issue encountered and 37% rated both patient’s cognitive/mental disability and the limited availability of interpreter services for non-English speaking patients to be the other common challenges encountered during telemedicine visits. Neurologists rated improving administrative support (39%), integrating EMR with video and telephone calls (37%), and allotment of sufficient time to complete telemedicine visits (27%) to be the most important issues to be addressed to facilitate using telemedicine in neurology. Significance Potential opportunities to improve neurologists’ experiences with telemedicine include improving technological support, integrating virtual platforms within EMR and providing adequate administrative support. Patients with cognitive and or physical disabilities may need additional support to engage in the healthcare system via telemedicine....
Background and Aim: Previous research points to a growth rate of 17% for veterinary telemedicine. This study aimed to analyze pet owners’ attitudes, feasibility, and socioeconomic impacts of introducing this growth technique to a particular demographic. Materials and Methods: Five hundred population-representative respondents were utilized in the study. The ages ranged from 18 to 68 years. At the Russian State Agrarian University’s veterinary hospital, respondents (pet owners) made contact (either in person or remotely). The survey inquired about participants’ personal information, their pets, and veterinary telemedicine. Russia uses the ruble, issued by the Bank of Russia, as its currency. The required sample size of 385 for this study was determined using the Q test to ensure feasibility. Results: 79.2% of the participants had a positive outlook on telemedicine. Every fifth applicant turned down telemedicine, opting instead for personal vet appointments. 53.8% of respondents with prices under $14 were willing to pay for the service, whereas 17.8% (89 people) outright rejected it, and 93.8% of the paid customers belonged to the age group of 18–28. Pet owners with chronically ill animals merit special consideration. Conclusion: Pet owners are generally open to veterinary telemedicine, but it remains underutilized. The study reveals directions for optimizing veterinary telemedicine and enhancing client and patient satisfaction. Despite limitations (less access to respondents/telemedicine), future approach is to investigate variables and invariable factors affecting this process....
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