A systematic review of successes and failures in home telehealth: preliminary results

We conducted a systematic review of the literature to identify studies in home telehealth that compared a home telehealth intervention with a non-telehealth standard/usual care alternative in terms of administrative changes, patient management decisions, patient outcomes, caregiver outcomes, economic impact or social impact on patients. A search of various databases produced 6643 references. Of these 769 papers were selected for more detailed investigation. These papers, combined with hand searching of relevant telehealth journals and cross-referencing of citations in identified publications, resulted in 138 papers referring to 130 projects for review. In this preliminary analysis we used a quality appraisal approach that took into account the study design. An additional analysis of patient numbers was then used to calculate a net evidence score. A large proportion of studies (80%) were randomised controlled trials. Only 22 projects (17%) reported economic data deemed to be sufficient for appraisal. Evidence exists for the clinical effectiveness of home telehealth in diabetes, the general area of mental health, high risk pregnancy monitoring, heart failure and cardiac disease.

Evidence about tele-oncology applications and associated benefits for patients and their families

We conducted a systematic review of evidence on the ability of tele-oncology applications to improve access to care closer to home for adult rural patients affected by cancer. From 269 publications identified in the literature search, 54 studies met our inclusion criteria. Forty two were clinical studies (32 quantitative, eight qualitative and two that included both quantitative and qualitative methodology). Strength of evidence from quantitative clinical studies was assessed using an approach that takes account of both study design and study quality. Qualitative studies were appraised by giving scores for six areas of interest. In terms of the continuum of cancer care, the most common study area was psychosocial and supportive care. While there were a number of high quality studies, overall the evidence of benefit from tele-oncology was limited and few investigations had proceeded beyond the stage of establishing feasibility. The literature suggests some useful possibilities for new services to cancer patients in rural areas but it seems likely that these would need validation with suitable local studies.

Using integrated metamodeling to define OO design patterns with object-z and UML

Three important goals in describing software design patterns are: generality, precision, and understandability. To address these goals, this paper presents an integrated approach to specifying patterns using Object-Z and UML. To achieve the generality goal, we adopt a role-based metamodeling approach to define patterns. With this approach, each pattern is defined as a pattern role model. To achieve precision, we formalize role concepts using Object-Z (a role metamodel) and use these concepts to define patterns (pattern role models). To achieve understandability, we represent the role metamodel and pattern role models visually using UML. Our pattern role models provide a precise basis for pattern-based model transformations or refactoring approaches.

An inverse methodology for high frequency RF head coil design with pre-emphasized B1 field in MRI

An inverse methodology to assist in the design of radio-frequency (RF) head coils for high field MRI application is described in this work. Free space time-harmonic electromagnetic Green's functions and preemphasized B1 field are used to calculate the current density on the coil cylinder. With B1 field preemphasized and lowered in the middle of the RF transverse plane, the calculated current distribution can generate an internal magnetic field that can reduce the EM field/tissue interactions at high frequencies. The current distribution of a head coil operating at 4 T is calculated using inverse methodology with preemphasized B1 fields. FDTD is employed to calculate B1 field and signal intensity inside a homogenous cylindrical phantom and human head. A comparison with conventional RF birdcage coil is reported here and demonstrated that inverse-method designed coil with preemphasized B1 field can help in decreasing the notorious bright region caused by EM field/tissue interactions in the human head images at 4 T.

Architectural design in object-z

We present a process for introducing an object-oriented architecture into an abstract functional specification written in Object-Z. Since the design is derived from the specification, correctness concerns are addressed as pan of the design process. We base our approach on refactoring rules that apply to class structure, and use the rules to implement design patterns. As a motivating example, we introduce a user-interface design that follows the model-view-controller paradigm into an existing specification.