Realtime telemedicine for paediatric otolaryngology pre-admission screening

We conducted a feasibility study to examine whether a paediatric patient at a regional hospital could be assessed by an ear, nose and throat (ENT) specialist via videoconference, therefore saving at least one journey to the tertiary hospital for a pre-admission appointment. A video-otoscope was used with standard videoconference equipment, and realtime images were transmitted at a bandwidth of 384 kbit/s. In all, 13 telepaediatric ENT clinics were conducted between November 2003 and April 2005, and 98 consultations were facilitated for 64 patients. The main reasons for referral were recurrent tonsillitis (25%) and obstructive sleep apnoea (23%). Of the 64 patients examined by telemedicine, 42 (66%) were recommended for surgery and placed on the surgical waiting list. About 12 patients (19%) required travel to the tertiary centre for further investigations and tests not available locally, while four patients (6%) were reviewed via videoconference during a scheduled clinic. Six patients (9%) required no further follow-up after their initial telepaedliatric consultation. Videoconferencing is an effective method of assessing ENT conditions of paediatric patients and for pre-screening potential surgical admissions to a tertiary hospital. Careful consideration of a number of economic and logistical factors needs to be made before large investments are made to expand the service.

A randomised controlled trial of a tele-based lifestyle intervention for colorectal cancer survivors ('CanChange') : Study protocol

Background Colorectal cancer survivors may suffer from a range of ongoing psychosocial and physical problems that negatively impact on quality of life. This paper presents the study protocol for a novel telephone-delivered intervention to improve lifestyle factors and health outcomes for colorectal cancer survivors. Methods/Design Approximately 350 recently diagnosed colorectal cancer survivors will be recruited through the Queensland Cancer Registry and randomised to the intervention or control condition. The intervention focuses on symptom management, lifestyle and psychosocial support to assist participants to make improvements in lifestyle factors (physical activity, healthy diet, weight management, and smoking cessation) and health outcomes. Participants will receive up to 11 telephone-delivered sessions over a 6 month period from a qualified health professional or 'health coach'. Data collection will occur at baseline (Time 1), post-intervention or six months follow-up (Time 2), and at 12 months follow-up for longer term effects (Time 3). Primary outcome measures will include physical activity, cancer-related fatigue and quality of life. A cost-effective analysis of the costs and outcomes for survivors in the intervention and control conditions will be conducted from the perspective of health care costs to the government. Discussion The study will provide valuable information about an innovative intervention to improve lifestyle factors and health outcomes for colorectal cancer survivors.

A Novel Approach to Haptic Tele-operation of Aerial Robot Vehicles

We present a novel, simple and effective approach for tele-operation of aerial robotic vehicles with haptic feedback. Such feedback provides the remote pilot with an intuitive feel of the robot’s state and perceived local environment that will ensure simple and safe operation in cluttered 3D environments common in inspection and surveillance tasks. Our approach is based on energetic considerations and uses the concepts of network theory and port-Hamiltonian systems. We provide a general framework for addressing problems such as mapping the limited stroke of a ‘master’ joystick to the infinite stroke of a ‘slave’ vehicle, while preserving passivity of the closed-loop system in the face of potential time delays in communications links and limited sensor data

Moving tele-monitoring and tele-treatment from promise to practice : a business model approach for a chronic lower back pain application

The availability of new information and communication technologies creates opportunities for new, mobile tele-health services. While many promising tele-health projects deliver working R&D prototypes, they often do not result in actual deployment. We aim to identify critical issues than can increase our understanding and enhance the viability of the mobile tele-health services beyond the R&D phase by developing a business model. The present study describes the systematic development and evaluation of a service-oriented business model for tele-monitoring and -treatment of chronic lower back pain patients based on a mobile technology prototype. We address challenges of multi-sector collaboration and disruptive innovation.

A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare')

Background Coronary heart disease (CHD) and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI) and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL), decrease medication adherence and appropriate utilisation of health services, lead to increased morbidity and suicide risk, and is associated with poorer CHD risk factor profiles and reduced survival. We aim to determine the feasibility of conducting a randomised, multi-centre trial designed to compare a tele-health program (MoodCare) for depression and CHD secondary prevention, with Usual Care (UC). Methods Over 1600 patients admitted after index admission for Acute Coronary Syndrome (ACS) are being screened for depression at six metropolitan hospitals in the Australian states of Victoria and Queensland. Consenting participants are then contacted at two weeks post-discharge for baseline assessment. One hundred eligible participants are to be randomised to an intervention or a usual medical care control group (50 per group). The intervention consists of up to 10 × 30-40 minute structured telephone sessions, delivered by registered psychologists, commencing within two weeks of baseline screening. The intervention focuses on depression management, lifestyle factors (physical activity, healthy eating, smoking cessation, alcohol intake), medication adherence and managing co-morbidities. Data collection occurs at baseline (Time 1), 6 months (post-intervention) (Time 2), 12 months (Time 3) and 24 months follow-up for longer term effects (Time 4). We are comparing depression (Cardiac Depression Scale [CDS]) and HRQOL (Short Form-12 [SF-12]) scores between treatment and UC groups, assessing the feasibility of the program through patient acceptability and exploring long term maintenance effects. A cost-effectiveness analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the government. Discussion This manuscript presents the protocol for a randomised, multi-centre trial to evaluate the feasibility of a tele-based depression management and CHD secondary prevention program for ACS patients. The results of this trial will provide valuable new information about potential psychological and wellbeing benefits, cost-effectiveness and acceptability of an innovative tele-based depression management and secondary prevention program for CHD patients experiencing depression.

Challenges in improving chronic disease survivorship outcomes using tele-health and self-managed online solutions

The advances in modern information and communication (ICT) technology continue to address the challenges and improve` health outcomes for the survivors of chronic disease such as prostate cancer. The management of survivorship is increasingly becoming an important need for the survivors to manage their chronic conditions. The technology interventions such as tele-health as well as self-managed technology applications have shown a potential to improve survivorship outcomes. However, the application of these tools should be supported by strong health economics evidence. This work discusses the challenges of technology led survivorship care models and presents an integrated approach to address these challenges.

Efficacy and feasibility of a tele-health intervention for acute coronary syndrome patients with depression: Results of the 'MoodCare' randomized controlled trial

Background Depression is common after a cardiac event, yet there remain few approaches to management that are both effective and scalable. Purpose We aimed to evaluate the 6-month efficacy and feasibility of a tele-health program (MoodCare) that integrates depression management into a cardiovascular disease risk reduction program for acute coronary syndrome patients with low mood. Methods A two-arm, parallel, randomized design was used comprising 121 patients admitted to one of six hospitals for acute coronary syndrome. Results Significant treatment effects were observed for Patient Health Questionnaire 9 (PHQ9) depression (mean difference [change] = −1.8; p = 0.025; effect size: d = 0.36) for the overall sample, when compared with usual medical care. Results were more pronounced effects for those with a history of depression (mean difference [change] = −2.7; p = 0.043; effect size: d = 0.65). Conclusions MoodCare was effective for improving depression in acute coronary syndrome patients, producing effect sizes exceeding those of some face-to-face psychotherapeutic interventions and pharmacotherapy. (Trial Registration Number: ACTRN1260900038623.)

A Compliant End-Effector to Passively Limit the Force in Tele-Operated Tissue-Cutting

This paper presents a compliant end-effector that cuts soft tissues and senses the cutting forces. The end-effector is designed to have an upper threshold on cutting forces to facilitate safe handling of tissue during automated cutting. This is demonstrated with nonlinear finite element analysis and experimental results obtained by cutting inhomogeneous phantom tissue. The cutting forces are estimated using a vision-based technique that uses amplified elastic deformation of the compliant end-effector. We also demonstrate an immersive tele-operated tissue-cutting system together with a haptic device that gives real-time force feedback to the user. DOI: 10.1115/1.4007638]

Tele-Supervised FES-Assisted Exercise for Hemiplegic Upper Limb

Stroke survivors often have upper limb (UL) hemiparesis, limiting their ability to perform activities of daily life (ADLs). Intensive, task-oriented exercise therapy (ET) can improve UL function, but motivation to perform sufficient ET is difficult to maintain. Here we report on a trial in which a workstation was deployed in the homes of chronic stroke survivors to enable tele-coaching of ET in the guise of computer games. Participants performed 6 weeks of 1 hour/day, 5 days/week ET. Hand opening and grasp were assisted with functional electrical stimulation (FES). The primary outcome measure was the Action Research Arm Test (ARAT). Secondary outcome measures included a quantitative test of UL function performed on the workstation, grasp force measurements and transcranial magnetic stimulation (TMS). Improvements were seen in the functional tests, but surprisingly, not in the TMS responses. An important finding was that participants commencing with intermediate functional scores improved the most.

CONCLUSIONS: 1) Daily, tele-supervised FES-ET in chronic stroke survivors is feasible with commercially-available technology. 2) The intervention can significantly improve UL function, particularly in people who start with an intermediate level of function. 3) Significant improvements in UL function can occur in the absence of changes in TMS responses.

Advancements and Challenges towards a Collaborative Framework for 3D Tele-Immersive Social Networking

Social experiences realized through teleconferencing systems are still quite different from face to face meetings. The awareness that we are online and in a, to some extent, lesser real world are preventing us from really engaging and enjoying the event. Several reasons account for these differences and have been identified. We think it is now time to bridge these gaps and propose inspiring and innovative solutions in order to provide realistic, believable and engaging online experiences. We present a distributed and scalable framework named REVERIE that faces these challenges and provides a mix of these solutions. Applications built on top of the framework will be able to provide interactive, truly immersive, photo-realistic experiences to a multitude of users that for them will feel much more similar to having face to face meetings than the experience offered by conventional teleconferencing systems.

Tele-experimentação de técnicas de monitorização via internet com aplicações em agricultura e energia solar (TeleAgriSol)

Tele-experimentação detécnicas de monitorização via Internet com aplicações em agricultura e energia solar.

­Viva la tele que me parió!

Los últimos informes sobre audiencia televisiva indican que los españoles hemos batido nuestro record histórico en consumo televisivo, en 2008, pasamos frente a la pantalla cada día tres horas y cuarenta y siete minutos. Por otra parte, ver la televisión se ha convertido en la primera alternativa de ocio infantil. Además, inquieta el hecho de que los niños y niñas hayan dejado de consumir sólo los productos infantiles elaborados y dirigidos específicamente a ellos, ampliando su territorio a horarios y franjas de programación de adultos. Éstos y otros datos analizados, permiten al autor reflexionar sobre el papel que la televisión ejerce sobre la conducta de los alumnos. La televisión no tiene en sí, intrínsicamente, nada perverso, despreciable o menor. Todo lo contrario, la televisión reúne en un solo medio buena parte de las mejores características que tienen los demás medios de comunicación, potenciadas al máximo, pero puede contribuir al fracaso escolar si no se utiliza adecuadamente. TeleYo y TeleNosotros son los modelos que el autor nos presenta para utilizar la televisión como recurso educativo. Una propuesta que se basa en las indicaciones recogidas por RTVE a través del Foro Nacional 'Entorno Familiar, Menores, Educación y Televisión' difundidas en un tríptico titulado 'Aprender a ver la tele sin perder de vista el cole'. Una forma distinta de visionar la programación televisiva en el ámbito familiar y en la escuela, colegio e instituto.

Metodología para la evaluación de un servicio de tele-educación multimedia.

Resumen tomado del autor. Esta investigación ha sido financiada por el operador global de comunicaciones Telecable de Asturias SAU en el entorno de los proyectos NuevaMedia, Telemedia y ModelMedia

ISMAEL : un agente BDI como cerebro de una plataforma de tele-educación

Resumen tomado del autor