Current Issue : January - March Volume : 2019 Issue Number : 1 Articles : 6 Articles
Background: Though internet based cognitive behaviour therapy is proven to\nbe effective, e-health is applied only in a minority of treatments in specialised\nmental health care. The low application rates are associated with therapistsâ??\nattitudes towards e-health. One of the major concerns is limitations in the\ntherapeutic relation and communication between patient and therapist. Since\ntherapist involvement is important in an effective e-health treatment, negative\nattitudes towards e-health can be a risk for effective e-health application.\nAims: This study aimed to examine the relationship between patientsâ?? e-health\nusage as well as patientsâ?? attitudes towards e-health and the therapeutic alliance.\nThe possible influence of therapistsâ?? attitudes on patientsâ?? e-health usage\nis also examined. Method: In an outpatient mental health setting, patients attended\na blended treatment program for major depressive disorder and completed\nquestionnaires on attitudes towards e-health and the therapeutic alliance.\nTherapists completed an alliance and attitude questionnaire as well.\nResults: Patients with more positive attitudes used the e-health application\nmore intensively. Higher work alliance rates were related to sharing digital\nhomework assignments and seeking contact with their therapist. Also, when\ntreated by therapists with more positive attitudes towards e-health, patients\nshared more assignments with their therapist. Patients with high symptom\nrates at start, had more negative attitude rates and tended to use the e-health\napplication less frequently. Conclusions: In a treatment cohesion in which\ntherapists are positive about blended e-health, patientsâ?? attitudes are positively\nrelated to e-health usage and therefore a factor of interest in improvement\nof effective e-health application. Patients with severe symptoms may need extra\nattention like active support and iteration to promote adherence to the\ne-health program....
Objective. To evaluate the impact of telephone follow-up service on clinical outcomes in patients on warfarin when discharged\nfrom hospital. Methods. This randomized controlled trial was conducted at a general hospital in Thailand. Patients aged ...years who were prescribed warfarin when discharged were eligible to participate in this study. They were randomly allocated,\nusing a computer generated random number, to receive either telephone follow-up intervention or usual care. Participants in the\nintervention group received telephone follow-up by hospital pharmacists for three months.During each telephone call, pharmacists\nperformed medicine use reviews and addressed any problems identified. Key Findings. A total of..patients participated in this\nstudy.The proportion of international normalized ratio (INR) values in the target range for the telephone follow-up group (............)was higher than that in the usual care group (.........).... The mean time in the therapeutic range (TTR) in the\ntelephone follow-up group was also higher than that in the usual care group (.....versus....) All patients\nin the usual care group experienced one or more out-of-range INR values (.......)compared to .. out of ..(..) in the\ntelephone follow-up group, .............................There was no difference between the two groups in the incidence of complications or adverse\nevents associated with warfarin. Conclusions.The telephone follow-up service in recently discharged patients helps them achieve\nand maintain their INR target. This anticoagulant supportive service should be promoted to patients receiving warfarin therapy\nafter discharge.This trial is registered with .....................(Thai Clinical Trials Registry)....
eHealth systems provide medical support to users and contribute to the development\nof mobile and quality health care. They also provide results on the prevention and follow-up of\ndiseases by monitoring health-status indicators and methodical data gathering in patients. Telematic\nmanagement of health services by means of the Internet of Things provides immediate support and it\nis cheaper than conventional physical presence methods. Currently, wireless communications and\nsensor networks allow a person or group to be monitored remotely. The aim of this paper is to develop\nand assess a system for monitoring physiological parameters to be applied in different scenarios,\nsuch as health or sports. This system is based on a distributed architecture, where physiological data\nof a person are collected by several sensors; next, a Raspberry Pi joins the information and makes\na standardization process; then, these data are sent to the Cloud to be processed. Our Cloud system\nstores the received data and makes a data fusion process in order to indicate the athleteâ??s fatigue\nstatus at every moment. This system has been tested in collaboration with a small group of voluntary\ntri-athletes. A network simulation has been performed to plan a monitoring network for a bigger\ngroup of athletes. Finally, we have found that this system is useful for medium-term monitoring of\nthe sports activities....
Background: Thyroid nodules are common and fine needle aspiration (FNA)\nor surgery is used to assess for malignancy. Thyroid Imaging, Reporting and\nData System (TI-RADS) use ultrasound for non-invasive risk stratification of\nthyroid nodules and reduce unnecessary biopsies. This project used an online\ncalculator and education to facilitate the application of TI-RADS in clinical\npractice. Methods: Retrospective review defined the baseline reporting of\nthyroid nodule ultrasound features. Web-based resource and presentation\nwere used to integrate TI-RADS in reporting thyroid ultrasounds and measure\nthe improvements in comprehensive reporting of thyroid nodules and\nguiding management. Results: The percentage of thyroid ultrasound reporting\nusing TI-RADS within six months increased from 0% to 27% during the\nproject period. Reports with TI-RADS provided twice as many recommendations\ncompared to reports without TI-RADS. Conclusion: Online TI-RADS\ncalculator and education have successfully facilitated the integration of\nTI-RADS in thyroid ultrasound reporting to provide more accurate and\ncomprehensive reports and guide management....
Background. Lifestyle interventions have shown to be effective when continuous personal support was provided. However, there is\nlack of knowledge whether a telemedical-approach with personal coaching contributes to long-term weight losses in overweight\nemployees. We, therefore, tested the hypothesis that telemedical-based lifestyle interventions accompanied with telemedical\ncoaching lead to larger weight losses in overweight persons in an occupational health care setting. Methods. Overweight employees\n(n=180) with a body mass index (BMI) of >27 kg/m2 were randomized into either a telemedical (TM) group (n=61), a telemedical\ncoaching (TMC) group (n=58), or a control group (n=61). Both intervention groups were equipped with scales and pedometers\nautomatically transferring the data into a personalized online portal, which could be monitored from participants and coaches.\nParticipants of the TMC group received additionally one motivational care call per week by mental coaches to discuss the current\ndata (current weight and steps) and achieving goals such as a healthy lifestyle or weight reduction. The control group remained\nin routine care. Clinical and anthropometric data were determined after the 12-week intervention. Additionally, weight change\nwas followed up after 12 months. Results. Participants of TMC (-3.1 ± 4.8 kg, p<0.0001) and TM group (-1.9 ± 4.0 kg; p=0.0012)\nsignificantly reduced weight and sustained it during the 1-year follow-up, while the control group showed no change. Compared\nto the control group only weight loss in the TMC group was significantly different (p<0.001) after 12 months. TMC and TM group\nalso reduced BMI, waist circumference, and LDL cholesterol. Moreover, TMC group improved additionally systolic and diastolic\nblood pressure, total cholesterol, HDL cholesterol, and HbA1c. Conclusions. Telemedical devices in combination with telemedical\ncoaching lead to significant long-term weight reductions in overweight persons in an occupational health care setting. This study\nis registered with NCT01868763, Clinical Trials.gov....
The development of connected health devices has allowed for a more accurate assessment\nof a personâ??s state under free-living conditions. In this work, we use two mobile sensing devices and\ninvestigate the correlation between individualâ??s resting metabolic rate (RMR) and volatile organic\ncompounds (VOCs) exposure levels. A total of 17 healthy, young, and sedentary office workers were\nrecruited, measured for RMR with a mobile indirect calorimetry (IC) device, and compared with their\ncorresponding predicted RMR values from the Academy of Nutrition and Dieteticsâ?? recommended\nepidemiological equation, the Mifflinâ??St Jeor equation (MSJE). Individual differences in the RMR\nvalues from the IC device and the epidemiological equation were found, and the subjectsâ?? RMRs\nwere classified as normal, high, or low based on a cut-off of ±200 kcal/day difference with respect to\nthe predicted value. To study the cause of the difference, VOCs exposure levels of each participantâ??s\ndaytime working environment and nighttime resting environment were assessed using a second\nmobile sensing device for VOCs exposure detection. The results showed that all sedentary office\nworkers had a low VOCs exposure level (<2 ppmC), and there was no obvious correlation between\nVOCs exposure and the RMR difference. However, an additional participant who was a worker in an\nauto repair shop, showed high VOCs exposure with respect to the sedentary office worker population\nand a significant difference between measured and predicted RMR, with a low RMR of 500 kcal/day\ndifference. The mobile sensing devices have been demonstrated to be suitable for the assessment of\ndirect information of human healthâ??environment interactions at free-living conditions....
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