Current Issue : January - March Volume : 2017 Issue Number : 1 Articles : 5 Articles
In the last few years, telerehabilitation and telecare have become important topics in\nhealthcare since they enable people to remain independent in their own homes by providing\nperson-centered technologies to support the individual. These technologies allows elderly people to\nbe assisted in their home, instead of traveling to a clinic, providing them wellbeing and personalized\nhealth care. The literature shows a great number of interesting proposals to address telerehabilitation\nand telecare scenarios, which may be mainly categorized into two broad groups, namely wearable\ndevices and context-aware systems. However, we believe that these apparently different scenarios\nmay be addressed by a single context-aware approach, concretely a vision-based system that can\noperate automatically in a non-intrusive way for the elderly, and this is the goal of this paper.\nWe present a general approach based on 3D cameras and neural network algorithms that offers\nan efficient solution for two different scenarios of telerehabilitation and telecare for elderly people.\nOur empirical analysis reveals the effectiveness and accuracy of the algorithms presented in our\napproach and provides more than promising results when the neural network parameters are\nproperly adjusted....
Background: Proximal humerus fractures can be treated surgically (eg: pinning, plate and screws) or conservatively\nby wearing a splint or a cast. Following both of these approaches, rehabilitation has proven effective to prevent\nfunctional limitations and to re-establish normal shoulder function. However, access to these rehabilitation services\nand compliance tends to be limited in elderly patients due to travelling difficulties caused by their precarious health\nstatus and, in some cases, social and marital status. Since the majority of patients with a proximal humerus fracture are\nelderly, it becomes relevant to find a new way to offer quick, simple and suitable rehabilitation service. Thus, the use of\npromising alternative approaches, as in-home telerehabilitation, can enhance access to rehabilitation services for such\npopulation. The main objective of the study is to compare the clinical effects of the innovative telerehabilitation\napproach (TELE group) compared to face-to-face visits to a clinic (CLINIC group) for patients treated for a proximal\nhumerus fracture.\nMethods/Design: In this randomized controlled trial, individuals who have had a proximal humerus fracture treated\nconservatively at the Centre int�©gr�© universitaire de sant�© et de services sociaux de lâ��Estrie - Centre hospitalier universitaire\nde Sherbrooke (CIUSSS de lâ��Estrie CHUS), and who are returning home will be included. Participants will be recruited\nduring their visit to the emergency ward or outpatient clinic by the medical or research team and will then sign the\ninformed consent form if they are interested to participate in the study. We expect to recruit 52 participants (26 per\ngroup). Randomization will be done by a random number generator with sealed envelopes. Each patient will be\nevaluated before the beginning of the rehabilitation (T1), and immediately after the 2-month intervention (T2). The\nfollowing outcomes will be measured: 1) upper extremity function (Constant Shoulder Score and Disability of the Arm,\nShoulder and Hand questionnaire [DASH]); 2) range of motion (conventional goniometer); 3) user satisfaction (Health\nCare Satisfaction questionnaire); and 4) cost of services to the public healthcare system.\nThe difference between the two groups will be compared using a t-test or a chi-squared test, and through a costeffectiveness\neconomic analysis....
This work deals with the development and characterization of a potentially implantable\nblood pressure telemetry system, based on an active Radio-Frequency IDentification (RFID) tag,\nInternational Organization for Standardization (ISO) 15693 compliant. This approach aims to\ncontinuously measure the average, systolic and diastolic blood pressure of the small/medium\nanimals. The measured pressure wave undergoes embedded processing and results are stored\nonboard in a non-volatile memory, providing the data under interrogation by an external RFID\nreader. In order to extend battery lifetime, RFID energy harvesting has been investigated. The paper\npresents the experimental characterization in a laboratory and preliminary in-vivo tests. The device\nis a prototype mainly intended, in a future engineered version, for monitoring freely moving test\nanimals for pharmaceutical research and drug safety assessment purposes, but it could have multiple\nuses in environmental and industrial applications....
Objective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low cost\nscreening telemammography. We compared computed radiography, film printed images, and digitized films produced with\na specialized film digitizer and a digital camera. Material and Methods. The ethics committee of our institution approved this\nstudy. We assessed the equivalence of the clinical performance of observers for cancer detection.The factorial design included 70\nscreening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations.\nThe variables evaluated were the positive predictive value (PPV), accuracy, sensitivity, specificity, and the area under the receiver\noperating characteristic curves (AUC). Result.The mean values for the observed variables were as follows: accuracy ranged from\n0.77 to 0.82, the PPV ranged from 0.67 to 0.68, sensitivity ranged from 0.64 to 0.74, specificity ranged from 0.87 to 0.90, and the AUC\nranged from 0.87 to 0.90. At a difference of 0.1 to claim equivalence, all alternatives were equivalent for all variables. Conclusion.\nOur findings suggest that telemammography screening programs may be provided to underserved populations at a low cost, using\na film digitizer or a digital camera....
Background: Decentralised services using outreach clinics or modern technology are methods to reduce both\npatient transports and costs to the healthcare system. Telemedicine consultations via videoconference are one such\nmodality. Before new technologies are implemented, it is important to investigate both the quality of care given\nand the economic impact from the use of this new technology. The aim of this clinical trial was to study the quality\nof planned remote orthopaedic consultations by help of videoconference.\nMethod: We performed a randomised controlled trial (RCT) with two parallel groups: video-assisted remote\nconsultations at a regional medical centre (RMC) as an intervention versus standard consultation in the orthopaedic\noutpatient clinic at the University Hospital of North Norway (UNN) as a control. The participants were patients\nreferred to or scheduled for a consultation at the orthopaedic outpatient clinic. The orthopaedic surgeons\nevaluated each consultation they performed by completing a questionnaire. The primary outcome measurement\nwas the difference in the sum score calculated from this questionnaire, which was evaluated by the non-inferiority\nof the intervention group. The study design was based on the intention to treat principle. Ancillary analyses\nregarding complications, the number of consultations per patient, operations, patients who were referred again and\nthe duration of consultations were performed.\nResults: Four-hundred patients were web-based randomised. Of these, 199 (98 %) underwent remote consultation\nand 190 (95 %) underwent standard consultation. The primary outcome, the sum score of the specialist evaluation,\nwas significantly lower (i.e. ââ?¬Ë?betterââ?¬â?¢) at UNN compared to RMC (1.72 versus 1.82, p = 0.0030). The 90 % confidence\ninterval (CI) for the difference in score (0.05, 0.17) was within the non-inferiority margin. The orthopaedic surgeons\ninvolved evaluated 98 % of the video-assisted consultations as ââ?¬Ë?goodââ?¬â?¢ or ââ?¬Ë?very goodââ?¬â?¢. In the ancillary analyses, there\nwas no significant difference between the two groups.\nConclusions: This study supports the argument that it is safe to offer video-assisted consultations for selected\northopaedic patients. We did not find any serious events related to the mode of consultation. Further assessments\nof the economic aspects and patient satisfaction are needed before we can recommend its wider application....
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