Search Results (10)

Background: Telemedicine can improve early symptom detection using medical devices and applications. It can also help identify barriers to patient adherence and enhance communication with healthcare professionals. This study aimed to evaluate the applicability, usability, and patient satisfaction with telemonitoring devices and apps for individuals with heart failure and type 2 diabetes. Methods: In a randomized study, patients in the Intervention Group received six months of nursing teleassistance and telemonitoring using a wearable electrocardiograph, a step tracker, and an App for recording clinical information and conducting video calls. Usability was measured using the System Usability Scale (SUS) and satisfaction with a six-item questionnaire. Results: A total of 43 patients (71 ± 8 years) were enrolled in the intervention group. A total of 41 (95%) of patients utilized the App daily, entering 13,048 information, 53 ± 59 per patient. The nurses performed 896 video-calls, 22 ± 21 per patient. The mean number of walking sessions recorded was 6.1 ± 0.9 per week (159 ± 24 per patient). Thirty-five patients (81%) used a 3-lead ECG and recorded 942 traces, 27 ± 14 per patient. At the end, 40 SUS were collected from patients: 15 (38%, 71 ± 7 years) considered the system excellent or good, 20 (50%, 71 ± 8 years) thought it fair, and 5 (13%, 74 ± 7 years) considered the system offered poor. The overall assessment of patient satisfaction with the service was 22 ± 3.3. Conclusions: This study provides evidence that, although technology can be complex for older adults, it is broadly accepted by most patients, especially when the benefits are understood. The support offered by nurses is essential for significantly enhancing the overall patient experience. Full article

Background. Few studies have evaluated physical fitness (PF) and physical activity (PA) in individuals with heart failure and type 2 diabetes mellitus and the possibility that some telemedicine programs (TMPs) may impact them. This post hoc subgroup analysis of an RCT study aimed to describe PF and PA in this population before and after a TMP. Methods. We evaluated (a) PF as distance, assessed via the 6-Minute Walking Test (6MWT), and PA as daily step count in this population before and after a TMP; (b) their relationship; and (c) the patient characteristics that influence PF and PA. Results. Fifty-eight patients (aged 71.31 ± 7.92 years old, 84% male, BMI 28.01 ± 4.70 Kg/m², ejection fraction 48.64 ± 10.64%) were enrolled between August 2022 and September 2024. All patients received a six-month TMP (nurse teleassistance, telemonitoring, a dedicated app, and PA evaluation using a tracker bracelet and step count goals). The 6MWT improved (from 418 ± 113 to 439 ± 120 m, p < 0.001), while PA remained unchanged after the TMP (from 7181 ± 4149 to 7229 ± 4947 steps/day, p = 0.92). The PA and PF association ranged from moderate at baseline (rho = 0.4958, p < 0.001) to strong at the end of the study (rho = 0.6807, p < 0.001). The regression model shows that following the TMP, PA(y) was associated with baseline 6MWT [β= 8.5, 95%IC −0.31; 17.24], age (β = −144.0, 95%IC −262.14; −25.90)), baseline daily steps (β = 0.5967, 95%IC 0.37; 0.82), and HDL cholesterol (β = 119.7, 95%IC 39.07; 200.31) (R²= 0.6580, F(4.53) = 25.49, p < 0.001), while PF(y) was associated with BMI (β= −2.04, 95%IC −4.30; 0.22)), age (β= 0.90, 95%IC −4.4; 1.32), and baseline 6MWT (β = 0.90, 95%IC 0.79; 1.00) (R² = 0.9007, F(3.54) = 163.29, p < 0.001). Conclusions. Our TMP led to a statistically significant but clinically modest improvement in PF but did not impact PA despite there being variability among patients. PA and PF appear to be interdependent. PF, age, HDL cholesterol, and baseline PA were key predictors of PA, while BMI, age, and baseline 6MWT impacted PF at the end of the TMP. Full article

Considering the increasing need for oral and dental care in the elderly, teledentistry has been proposed to improve the education of elderly patients in oral health maintenance and risk factor control, identify patients’ concerns in advance, facilitate monitoring, and save time and money. The present cross-sectional analysis of Google search data through real-time surveillance with Google Trends aimed to determine Google users’ interest in oral and dental needs and teledentistry applications in the elderly, and to compare search volumes before and after the COVID-19 outbreak. Extracted CVS data were qualitatively analyzed. Pearson and Spearman correlation analyses were performed between searches for “elderly” and “teledentistry”, and all the oral and dental needs and teledentistry applications. The Mann–Whitney U test compared search volumes in the 36 months before and after the beginning of the COVID-19 pandemic. Google users’ interest in the elderly and related oral and dental needs was diffusely medium–high, while teledentistry and its applications were of lower interest. Interest in teledentistry and its applications was strongly related to interest in the older population, which is consistent with the assumption that older adults represent the population segment that could benefit most from these tools. A positive correlation was also found between searches for “Elderly” and searches for almost all oral and dental needs typical of the geriatric population. Search volumes increased significantly after the outbreak of the COVID-19 pandemic. More information about teledentistry should be disseminated to increase knowledge and awareness, especially among older patients, about its indications, applications, and advantages. Full article

Smart glasses (SG) could be a breakthrough in emergency situations, so the aim of this work was to assess the potential benefits of teleassistance with smart glasses (SG) from a midwife to a lifeguard in a simulated, unplanned, out-of-hospital birth (OHB). Thirty-eight lifeguards were randomized into SG and control (CG) groups. All participants were required to act in a simulated imminent childbirth with a maternal–fetal simulator (PROMPT Flex, Laerdal, Norway). The CG acted autonomously, while the SG group was video-assisted by a midwife through SG (Vuzix Blade, New York, NY, USA). The video assistance was based on the OHB protocol, speaking and receiving images on the SG. The performance time, compliance with the protocol steps, and perceived performance with the SG were evaluated. The midwife’s video assistance with SG allowed 35% of the SG participants to perform the complete OHB protocol. No CG participant was able to perform it (p = 0.005). All OHB protocol variables were significantly better in the SG group than in the CG (p < 0.05). Telemedicine through video assistance with SG is feasible so that a lifeguard with no knowledge of childbirth care can act according to the recommendations in a simulated, unplanned, uncomplicated OHB. Communication with the midwife by speaking and sending images to the SG is perceived as an important benefit to the performance. Full article

Heart failure is the most common disease among elderly people, and the risk increases with age. The use of smart Internet of Things (IoT) systems for monitoring patients with chronic heart failure (CHF) in a non-intrusive manner can result in better control of the disease, improving proactive healthcare through real-time and historical patient’s data, promoting self-care in patients, reducing unneeded interaction between patients and doctors, reducing the number of hospitalizations and saving healthcare costs. This work presents an active assisted living (AAL) solution based on the IoT to provide a tele-assistance platform for CHF patients from the public health service of the region of Murcia in Spain, with formal and informal caregivers and health professionals also as key actors. In this article, we have detailed the methodology, results, and conclusions of the prevalidation phase for the set of IoT technologies to be integrated in the AAL platform, the first mandatory step before the deployment of a large-scale pilot that will lead to improving the innovation of the system from its current technology readiness level to the market. The work presented, in the framework of the H2020 Pharaon project, aims to serve as inspiration to the R&D community for the design, development, and deployment of AAL solutions based on heterogeneous IoT technologies, or similar approaches, for smart healthcare solutions in real healthcare institutions. Full article

In the field of autism intervention, a large amount of evidence has demonstrated that parent-mediated interventions are effective in promoting a child’s learning and parent caring skills. Furthermore, remote delivery treatments are feasible and can represent a promising opportunity to reach families at distance with positive results. Recently, the sudden outbreak of COVID-19 dramatically disrupted intervention services for autism and forced an immediate reorganization of the territory services toward tele-assisted intervention programs, according to professional and local resources. Our study aimed to conduct a retrospective pilot exploratory investigation on parental compliance, participation, and satisfaction in relation to three different telehealth intervention modalities, such as video feedback, live streaming, and psychoeducation, implemented in the context of a public community setting delivering early autism intervention during the COVID-19 emergency. We found that parents who attended video feedback expressed the highest rate of compliance and participation, while parental psychoeducation showed significantly lower compliance and the highest drop-out rate. Regardless of the tele-assistance modality, all the participants expressed satisfaction with the telehealth experience, finding it useful and effective. Potential benefits and advantages of different remote modalities with reference to parent involvement and effectiveness are important aspects to be taken into account and should be further investigated in future studies. Full article

Background: For the past two and half years, dentists all across the world, along with their patients, have faced numerous challenges. In this context, the aim of this integrative review was to assess if dentists’ and patients’ attitudes regarding teledentistry (TD) have changed since the COVID-19 outbreak, and if the use of TD will continue to rise, even in the post-pandemic period; (2) Methods: A literature search was performed between August 2021 and January 2022. The PubMed, Scopus, and Science Direct databases were searched for articles published between 2012 and 2022 using a combination of the following Mesh terms: “COVID-19”, “pandemic”, “oral telemedicine”, “teledentistry”; (3) Results: Among the 52 included papers, nine papers were published between 2011 and 2019, and 43 articles were published after 2020 (12 were published in 2020, 29 papers were published in 2021, and two in 2022). Among the articles published before 2020, seven out of nine included papers were reviews, and two were original research. Among the 43 papers published after 2020, 18 were reviews and 25 original research. (4) Conclusions: Based on the results of this integrative review, there is clear evidence that the interest in teledentistry and teleassistance in the dental field has increased rapidly, especially in the context of the COVID-19 pandemic. Therefore, while dental practitioners should be encouraged to keep themselves updated about new technologies, patients should also be constantly informed about their options for receiving special oral health care. Full article

Background: Telehealth is useful for both autism spectrum disorder (ASD) diagnosis and treatment, but studies with a direct comparison between teletherapy and traditional in-person therapy are limited. Methods: This randomized control trial—ISRCTN (International Standard Randomised Controlled Trial Number) primary clinical trial registry ID ISRCTN15312724—was aimed at comparing the effect of a tele-assisted and in-person intervention based on a behavioral intervention protocol for families with children affected by ASDs. Forty-two parents with children with autism (30 months to 10 years old) were randomly assigned to 12 sessions of an applied behavioral analysis (ABA) intervention implemented in an individual and group setting, either with or without the inclusion of tele-assistance. Pre- and postintervention assessments were conducted using the Home Situation Questionnaire (HSQ-ASD) and the Parental Stress Index (PSI/SF). Results: Substantial improvements in the perception and management of children’s behavior by parents, as well as in the influence of a reduction in parent stress levels on said children’s behavior through the use of a tele-assisted intervention, were obtained. Conclusions: This randomized controlled trial demonstrates the evidence-based potential for telehealth to improve treatment of ASDs. Full article

Background: COVID-2019 spread rapidly throughout the world from China. This infection is highly contagiousness, has a high morbidity, and is capable of evolving into a potentially lethal form of interstitial pneumonia. Numerous countries shut-down various activities that were considered “not essential.” Dental treatment was in this category and, at the time of writing, only non-deferrable emergencies are still allowed in many countries. Therefore, follow-up visits of ongoing active therapies (e.g., orthodontic treatment) must be handled taking special precautions. This literature review aims at reducing in-office appointments by providing an overview of the technologies available and their reliability in the long-distance monitoring of patients, i.e., teledentistry. Methods: A literature review was made according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. Randomized clinical trials, cross sectional, observational, and case-control studies were evaluated with the Mixed Methods Appraisal Tool for quality assessment and study limitations. Results: A primary search found 80 articles, 69/80 were excluded as non-relevant on the basis of: the abstract, title, study design, bias, and/or lack of relevance. Twelve articles were included in the qualitative analysis. Conclusions: Teleorthodontics can manage most emergencies, reassuring and following patients remotely. The aim set by dental teleassistance was met as it reduced patients’ office visits whilst maintaining regular monitoring, without compromising the results. Although our preliminary findings should be further investigated to objectively evaluate the efficacy, cost-effectiveness, and long-term results, we are confident that teleassistance in orthodontics will have a role to play in the near future. Full article

Collaborative virtual environments (CVEs) present ways for human users to work together on a task. Research efforts of CVEs have mainly focused on the factors that affect the task performance of the users, such as awareness, communication, and presence. Furthermore, the users involved normally have the same task experience or knowledge background. In this paper, we examined the effect of interactive strategies for human/human interaction, which involves human users with different levels of expertise. Within a CVE for an expert and a novice, we deployed three interactive strategies—Tele-Operation, Tele-Assistance3, and Tele-Assistance7—to give the three degrees of autonomy to the novice. Focusing on the performance of the novice, our findings revealed that each interactive strategy has a different effect on the task performance of the novice. These findings could aid in choosing an optimal interactive strategy for performing a collaborative task between an expert and a novice. Full article