Search Results (11)

Objectives: To summarize the impact of various telerehabilitation interventions on motor function, balance, gait, activities of daily living (ADLs), and quality of life (QoL) among patients with stroke and to determine the existing telerehabilitation interventions for delivering physiotherapy sessions in clinical practice. Methods: Six electronic databases were searched to identify relevant quantitative systematic reviews (SRs). Due to substantial heterogeneity, the data were analysed narratively. Results: A total of 28 systematic reviews (n = 245 primary studies) were included that examined various telerehabilitation interventions after stroke. Motor function was the most studied outcome domain across the reviews (20 SRs), followed by ADL (18 SRs), and balance (14 SRs) domains. For primary outcomes, our findings highlight moderate- to high-quality evidence showing either a significant effect or no significant difference between telerehabilitation and other interventions. There was insufficient evidence to draw a conclusion regarding feasibility outcomes, including participant satisfaction, adherence to treatment, and cost. Most reviews under this umbrella included patients with stroke in the subacute or chronic phase (12 SRs). Simple and complex telerehabilitation interventions such as telephone calls, videoconferencing, smartphone- or tablet-based mobile health applications, messaging, virtual reality, robot-assisted devices, and 3D animation videos, either alone or in combination with other interventions, were included across reviews. Conclusions: Various telerehabilitation interventions have shown either a significant effect or no significant difference compared to other interventions in improving upper and lower limb motor function, balance, gait, ADLs, and QoL, regardless of whether simple or complex approaches were used. Further research is needed to support the delivery of rehabilitation services through telerehabilitation intervention following a stroke. Full article

Helping people with intellectual and visual disabilities engage in activity and mobility is considered crucially important to promote constructive occupation and a basic form of physical exercise (i.e., objectives that are essential for the individuals’ wellbeing and in line with their rights). This study assessed two new programs aimed at helping eight participants with intellectual and visual disabilities (four in each program) to independently move through specific indoor destinations, collect and transport objects, and access stimulation events (e.g., music) with the support of technology systems involving a smartphone linked to mini cameras and speakers. The second program was more advanced than the first and (a) required the participants to discriminate the objects used and transport two (rather than one) of them before any stimulation event, and (b) included telephone calls to and stories from preferred communication partners among the stimulation events. Each program was implemented using a single-case research design (i.e., a non-concurrent multiple baseline design across participants). The results showed that both programs were effective in enabling the participants to collect, transport, and put away objects and access stimulation independently during 20-min sessions. Based on the results, both programs might be considered useful tools to help people with intellectual and visual disabilities manage independent activity and mobility. Full article

Research of novel biosignal modalities with application to remote patient monitoring is a subject of state-of-the-art developments. This study is focused on sonified ECG modality, which can be transmitted as an acoustic wave and received by GSM (Global System for Mobile Communications) microphones. Thus, the wireless connection between the patient module and the cloud server can be provided over an audio channel, such as a standard telephone call or audio message. Patients, especially the elderly or visually impaired, can benefit from ECG sonification because the wireless interface is readily available, facilitating the communication and transmission of secure ECG data from the patient monitoring device to the remote server. The aim of this study is to develop an AI-driven algorithm for 12-lead ECG sonification to support diagnostic reliability in the signal processing chain of the audio ECG stream. Our methods present the design of two algorithms: (1) a transformer (ECG-to-Audio) based on the frequency modulation (FM) of eight independent ECG leads in the very low frequency band (300–2700 Hz); and (2) a transformer (Audio-to-ECG) based on a four-layer 1D convolutional neural network (CNN) to decode the audio ECG stream (10 s @ 11 kHz) to the original eight-lead ECG (10 s @ 250 Hz). The CNN model is trained in unsupervised regression mode, searching for the minimum error between the transformed and original ECG signals. The results are reported using the PTB-XL 12-lead ECG database (21,837 recordings), split 50:50 for training and test. The quality of FM-modulated ECG audio is monitored by short-time Fourier transform, and examples are illustrated in this paper and supplementary audio files. The errors of the reconstructed ECG are estimated by a popular ECG diagnostic toolbox. They are substantially low in all ECG leads: amplitude error (quartile range RMSE = 3–7 μV, PRD = 2–5.2%), QRS detector (Se, PPV > 99.7%), P-QRS-T fiducial points’ time deviation (<2 ms). Low errors generalized across diverse patients and arrhythmias are a testament to the efficacy of the developments. They support 12-lead ECG sonification as a wireless interface to provide reliable data for diagnostic measurements by automated tools or medical experts. Full article

Demand-Responsive Transport (DRT) is one of the most valid solutions to tackle the problems affecting public transport today, both in urban and rural areas. Despite its undoubted advantages, it still remains underdeveloped compared to its great potential. The purpose of this paper is to understand the role that on-demand transport plays in the strategic choices of public transport authorities (PTAs): to this end, this study examined the DRT services of three geographically distant European cities, in order to test different social, cultural and regulatory backgrounds, examining their main characteristics. Tampere, Braunschweig and Genoa were selected for the purposes of this work; data and information were collected by viewing the official websites of public transport companies and by direct contact via mail/telephone with the managers responsible for on-call transport. The data collected were then analyzed based on specific Key Performance Indicators (KPIs) identified in academic literature. The results of this paper show that the role of on-call service in the strategic decisions of PTAs depends on the cultural context of reference; some cities focus more on urban services, others on rural transport. In all three case studies examined, on-demand transport is an important aspect of local mobility and with wide room for growth. Full article

Creating social and physical environments that promote good health is a key component of a social determinants approach. For the parents of young children, a smartphone offers opportunities for social networking, photography and multi-tasking. Understanding the relationship between supervision, mobile phone use and injury in the playground setting is essential. This research explored parent mobile device use (MDU), parent–child interaction in the playground, parent attitudes and perceptions towards MDU and strategies used to limit MDU in the playground. A mixed-methods approach collected naturalistic observations of parents of children aged 0–5 (n = 85) and intercept interviews (n = 20) at four metropolitan playgrounds in Perth, Western Australia. Most frequently observed MDU was scrolling (75.5%) and telephone calls (13.9%). Increased duration of MDU resulted in a reduction in supervision, parent–child play and increased child injury potential. The camera function offered the most benefits. Strategies to prevent MDU included turning to silent mode, wearing a watch and environmental cues. MDU was found to contribute to reduced supervision of children, which is a risk factor for injury. This is an emerging area of injury prevention indicating a need for broader strategies addressing the complex interplay between the social determinants and the developmental younger years. Full article

Mobile telephony has developed exponentially, offering a multitude of services that could be optimal for the educational field of physical and sports activity (PSA). The objective of this research was to analyze the use of smartphone by 40 Spanish teenagers and assess the degree of satisfaction of the Polar Beat application within the subject of physical education in high school. The instruments used were two quantitative questionnaires and the data were analyzed with the statistical package SPSS 24.0. The teenagers recognized that they use the smartphone for instant messaging, telephone calls and downloads of games and tunes. The Polar Beat application in physical education classes has allowed them a better understanding of the content developed; the students affirmed that their motivation towards PSA increased with the knowledge and use of the Polar Beat app and that smartphones are innovative and effective tools. With all this, the mobile phone could be an educational tool that awakens interest in teenagers and teachers. Full article

Community pharmacists (CPs) continue to have an important role in improving public health, however, advances in telehealth and digital technology mean that the methods by which they support their customers and patients are changing. The primary aim of this study was to identify which telehealth and digital technology tools are used by CPs for public health purposes and determine if these have a positive impact on public health outcomes. A systematic review was carried out using databases including PubMed and ScienceDirect, covering a time period from April 2005 until April 2020. The search criteria were the following: randomized controlled trials, published in English, investigating the delivery of public health services by community pharmacists using a telehealth or digital tool. Thirteen studies were included out of 719 initially identified. Nine studies detailed the use of telephone prompts or calls, one study detailed the use of a mobile health application, two studies detailed the use of a remote monitoring device, and one study detailed the use of photo-aging software. Public health topics that were addressed included vaccination uptake (n = 2), smoking cessation (n = 1), hypertension management (n = 2), and medication adherence and counseling (n = 8). More studies are needed to demonstrate whether or not the use of novel technology by CPs can improve public health. Full article

A 3-arm randomised controlled trial implemented in 2017, recruited participants from four Local Health Districts (LHDs) in New South Wales (NSW) to test an early obesity prevention program delivered via telephone calls (telephone) or text messages (SMS). This sub-study explored participants’ experience and satisfaction with the program. A multimethod design was used. Quantitative satisfaction questions were completed by participants when their child was six-months old. A purposive sample of participants with varying satisfaction levels was invited for in-depth qualitative interviews. Data were analysed using Excel (quantitative) and inductive thematic analysis (qualitative). Of the 1155 participants recruited: 947 (293 telephone; 338 SMS; 316 control) completed the six-month survey; 34 (14 telephone; 13 SMS; 7 control) were interviewed. Participants’ overall program satisfaction was 100% (telephone) and 85% (SMS). Participants’ qualitative responses demonstrated appreciation of: personalised stage-based information; opportunity to communicate with health professionals (telephone); linked Healthy Beginnings booklets and SMS mostly as nudges (SMS). There is a clear need for stage-based information, and supplemented modes of delivery i.e., text messages along with telephone calls; with text messages solely seen as nudges or reminders. However, individual preferences vary according to information needs at any given time, time constraints on new mothers and hence, multiple modes of information provision are recommended in order to reach a wider population and for better engagement. Choice and flexibility in mode of delivery has the potential to provide equitable access to information, empowering women with infants to practice recommended health behaviours for infant obesity prevention. Full article

Over the years, the cellular mobile network has evolved from a wireless plain telephone system to a very complex system providing telephone service, Internet connectivity and many interworking capabilities with other networks. Its air interface performance has increased drastically over time, leading to high throughput and low latency. Changes to the core network, however, have been slow and incremental, with increased complexity worsened by the necessity of backwards-compatibility with older-generation systems such as the Global System for Mobile communication (GSM). In this paper, a new virtualized Peer-to-Peer (P2P) core network architecture is presented. The key idea of our approach is that each user is assigned a private virtualized copy of the whole core network. This enables a higher degree of security and novel services that are not possible in today’s architecture. We describe the new architecture, focusing on its main elements, IP addressing, message flows, mobility management, and scalability. Furthermore, we will show some significant advantages this new architecture introduces. Finally, we investigate the performance of our architecture by analyzing voice-call traffic available in a database of a large U.S. cellular network provider. Full article

The aim of this study was to assess the effect of the quality of the coronal restoration and the root filling on the success of endodontic treatment. Patients treated at Kuwait University Dental Clinics (KUDC) from 2003 to 2014 were contacted by telephone calls. Demographic data and clinical records of patients, including age, gender, the tooth number, and medical history were recorded. Each patient received clinical examination for all teeth, including assessment of the coronal filling (type, quality), root- and/or coronal fracture, and the periodontal condition around the tooth (e.g., probing depth, gingival recession); percussion and mobility tests. A periapical radiograph of the endodontic treated tooth was taken to determine the health of the periapical tissues using the periapical index. The quality of the root filling was assessed by length and density of the root filling. The mean follow-up period was 4.8 years. The overall success rate of endodontic treatment was 86%; teeth without any initial periapical lesion had a success of 93%, whereas those with such lesion had a success rate of 80%. Periapical healing was not significantly associated with either the length of root filling (p = 0.40) or the density of root filling (p = 0.099), but was statistically significantly associated with the presence of coronal filling defects (p = 0.001). This study demonstrated that inadequate coronal filling but not the quality of root filling was associated with a higher prevalence of periapical lesions. Full article

Older people had a high incidence of hospitalisation during the 2009 heat wave in South Australia. We sought to explore resilience, behaviours, health risk factors and health outcomes during recent heat waves for a representative sample of independently living residents. A telephone survey of 499 people aged 65 years and over was conducted, and included both metropolitan and rural residences. A variety of adaptive strategies were reported, with 75% maintaining regular appointments and activities during the heat. However, 74% took medication for chronic disease and 25% assessed their health status to be fair to poor. In a multivariate model, factors associated with heat health outcomes included medication for mental health, heart failure, diabetes or respiratory health, reporting a reduced health status, use of mobility aids and being female. Compared with younger participants, those over 75 had more check-up calls and visits by family, friends and neighbours. However, confidence to call on support was associated with indicators of social isolation. The study indicates that older people are generally resilient, but interventions addressing multi-morbidity and medication interactions and social isolation should be developed. Full article