A New Multidisciplinary Home Care Telemedicine System to Monitor Stable Chronic Human Immunodeficiency Virus-Infected Patients: A Randomized Study

BACKGROUND: Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. METHODOLOGY: We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. FINDINGS: Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels >90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. CONCLUSIONS: Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection. TRIAL REGISTRATION: Clinical-Trials.gov: NCT01117675.

Freeform Optical Surfaces: Report from OSA's First Incubator Meeting

Just as business incubator programs are designed to support the development of fledgling companies, OSA?s new incubator meeting series is structured to encourage the growth of exciting new areas within optics. The first one was devoted to the topic of freeform optics-a field that is actively evolving due to recent technological advances.

Neighborhood mobility: A Long-Gone Pardigm? Approaching proximity and land use mix using data from home based surveys.

El WCTR es un congreso de reconocido prestigio internacional en el ámbito de la investigación del transporte y aunque las actas publicadas están en formato digital y sin ISSN ni ISBN, lo consideramos lo suficientemente importante como para que se considere en los indicadores. Policies trying to increase walking within urban mobility modal split usually highlight the importance of the functional patterns and the environmental quality of the urban space as major drivers of citizens modal choices. Functional characteristics would be mainly associated to an appropriate mix of land uses within neighbourhoods, whereas environmental quality would be associated to the characteristics of urban spaces. The purpose of this research is threefold: first, to identify relevant proxy indicators, which could characterize pedestrian-friendly land use mix and environmental quality. Second, to assess, for both traits, existing disparities among neighbourhoods in a major metropolitan area. And finally, to explore the association between both indicators and children mobility patterns: according to their built environment, which neighbourhoods have a greater proportion of children and, how is their mobility? Using data from the 2004 household mobility survey in the 128 neighbourhoods of the municipality of Madrid, this paper concludes that potentially favourable conditions at the neighbourhood level seem to have only a modest influence in,mobility patterns , in terms of both, selection of closer destinations and a higher share of walking within modal split. The citys policy choices, with intensive investment in road and public transport infrastructure may explain why short-distance mobility is not as important as it could have been expected in those neighbourhoods with more pedestrian-friendly conditions. The metropolitan transport system is providing mobility conditions, which make far-away destinations attractive to most citizens.

Neighbourhood mobility: a longgone Paradigm? Approaching "proximity" and "land use mix" using data from home-based surveys

Policies trying to increase walking within urban mobility modal split usually highlight the importance of the functional patterns and the environmental quality of the urban space as major drivers of citizens modal choices. Functional characteristics would be mainly associated to an appropriate mix of land uses within neighbourhoods, whereas environmental quality would be associated to the characteristics of urban spaces. The purpose of this research is threefold: first, to identify relevant proxy indicators, which could characterize pedestrian-friendly land use mix and environmental quality. Second, to assess, for both traits, existing disparities among neighbourhoods in a major metropolitan area. And finally, to explore the association between both indicators and children mobility patterns: according to their built environment, which neighbourhoods have a greater proportion of children and, how is their mobility? Using data from the 2004 household mobility survey in the 128 neighbourhoods of the municipality of Madrid, this paper concludes that potentially favourable conditions at the neighbourhood level seem to have only a modest influence in,mobility patterns , in terms of both, selection of closer destinations and a higher share of walking within modal split. The city s policy choices, with intensive investment in road and public transport infrastructure may explain why short-distance mobility is not as important as it could have been expected in those neighbourhoods with more pedestrian-friendly conditions. The metropolitan transport system is providing mobility conditions, which make far-away destinations attractive to most citizens.