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At least 1,081 records · Page 60Linked to original sources
PubMed2001

Comparison of lip incompetence by remote video surveillance and clinical observation in children with and without cerebral palsy.

This study aimed to compare two methods of assessing lip position so that an appropriate method could be used to assess whether a relationship existed between lip position and drooling in children with cerebral palsy. This investigation compared the use of a new, remote video surveillance (RVS) technique with direct clinical assessment of lip position by determination of intra- and inter-examiner agreement. Lip position was assessed in both techniques using the Jackson lip classification. Two groups of school children took part: one group suffered from cerebral palsy (CP), but the second group consisted of unaffected individuals. Based on Kappa statistics, intra- and inter-examiner agreements were generally found to be moderate for the individual methods (kappa = 0.48-0.54), whilst agreement between the two methods was found to be good (kappa = 0.68). The results showed moderately good examiner-agreement in the assessment of lip position, using either method and the Jackson lip classification. Consequently, lip position can be assessed by either RVS or direct clinical assessment, the choice depending on the physical circumstances surrounding the assessor and operator preference. However, RVS may offer a more unobtrusive approach.

Adolescent↗
PubMed2003

Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study.

PURPOSE: We determine the main outcome effects of a 12-month computer-mediated automated interactive voice response (IVR) intervention designed to assist family caregivers managing persons with disruptive behaviors related to Alzheimer's disease (AD). DESIGN AND METHODS: We conducted a randomized controlled study of 100 caregivers, 51 in the usual care control group and 49 in the technology intervention group, who received yearlong access to an IVR-mediated system. The system provided caregiver stress monitoring and counseling information, personal voice-mail linkage to AD experts, a voice-mail telephone support group, and a distraction call for care recipients. We conducted analyses by using a repeated measures approach for longitudinal data and an intention-to-treat analytic approach. Outcomes included the caregiver's appraisal of the bothersome nature of caregiving, anxiety, depression, and mastery at baseline, 6, 12, and 18 months. RESULTS: There was a significant intervention effect as hypothesized for participants with lower mastery at baseline on all three outcomes: bother (p =.04), anxiety (p =.01), and depression (p =.007). Additionally, wives exhibited a significant intervention effect in the reduction of the bothersome nature of caregiving (p =.02). IMPLICATIONS: Wives who exhibited low mastery and high anxiety benefited the most from the automated telecare intervention. Findings suggest that, to optimize outcome effects, similar interventions should be tailored to match the users' characteristics and preferences.

Aged↗
PubMed1997

Telephone medical care administered by internal medicine residents: concerns of program directors and implications for residency training.

The objective of this study was to determine the need for telephone medicine curricula and to help define important content for internal medicine residencies using scales that measure program director attitudes toward telephone medicine. Data were collected by surveying all 416 program directors of accredited internal medicine residencies in the United States. We applied factor analysis to develop reliable attitudinal scales and employed regression models to identify predictors of these attitudes. Response rate was 60%. Formal training for telephone medicine was available in only 6% of programs. The factor analysis showed three attitudinal concepts; all described marked program director discomfort with aspects of resident telephone prescription. Predictors of improved program director comfort included more frequent documentation of resident telephone calls, chart availability, and clear definition of resident roles pertaining to telephone interactions with patients (P < 0.02 for all predictor variables). These results identify a need for telephone curricula and suggest components that might alleviate program director discomfort with resident telephone practices.

Attitude of Health Personnel↗
PubMed2001

A preliminary report of the virtual craniofacial center: development of Internet-/Intranet-based care coordination of pediatric craniofacial patients.

The authors present preliminary information regarding the development of an Internet-based Virtual Craniofacial Center that provides access to a patient database with visual and textual data. Patients are photographed by digital camera with standardized images. Through a Web site linked to a remote database, patient demographics, management data, reports, and acquired digital photographic images are stored and retrieved. The database can be used to sort and to present data as desired by multiple specialists. Confidentiality is maintained by unique identification numbers and password access to the server for craniofacial team members. The current system uses economical equipment (i.e., digital camera, personal computer with modem, and access to a remote Windows NT-based server), using data that can be entered in a variety of cross-platform personal computer systems and transmitted on a wide range of bandwidths-from a relatively low-bandwidth (28.8 KB per second) modem to a high-speed T-3 line connection. Long-term goals include archival data storage and analysis, as well as the development of multicenter telemedicine links for active craniofacial centers.

Child↗
PubMed2002

Digital photography as a means of enhancing interconsultant communication in oncological cutaneous surgery.

Plastic surgeons have associated themselves closely with photography almost since the inception of medical photography. Photographs are used for documentation of medical records and comparison of pre- and postoperative status. Digital photography allows instant picture viewing and printing as well as Web-based mailing and, as a result, it facilitates interconsultant communication between the dermatologist, surgeon, and pathologist during the surgical treatment of cutaneous neoplasms. Moreover, it enhances patient monitoring during long-term follow-up.

Humans↗
PubMed1998

Digital echocardiography.

Continued improvement in the computer price-to-performance ratio and the adoption of international standards have enhanced the feasibility of completely digital echocardiographic laboratories that were initially described more than a decade ago. Digital archival has distinct advantages over analog recording, including improved laboratory efficiency, capability of side-by-side comparison of current and historical studies, streamlined image storage, and enhanced interinstitution image transfer. Studies have demonstrated that clinical and electronic image compression allows efficient storage of data, without affecting diagnostic accuracy. Finally, digital echocardiography has important telemedicine applications.

Echocardiography↗
PubMed1999

Exploring indicators of telephone nursing quality.

To explore whether documentation, use of clinical guidelines, and nurse competency are the best indicators of quality telephone nursing, this study examined the relationship between these commonly cited indicators and the characteristics of a telephone nursing call. This study, done at a large health maintenance organization (HMO), found: accompanying symptoms played a major role in telephone nursing assessment; call length was related to documentation process and to number of visits to a health care facility after a call; nurses' interpersonal skills and ability to determine urgency of a call are related to the documentation process but not to outcomes of the call; time of a call is related to disposition; and disposition is related to number of visits after a call.

Clinical Competence↗
PubMedDate not supplied

Effects of an Internet-based intervention on plasma glucose levels in patients with type 2 diabetes.

This study applied a 12-week educational intervention that used both the cellular phone and the Internet to send short message service. Forty-two diabetic patients were asked to access a Web site by using a cellular phone or wire Internet and input their blood glucose levels every day. Patients were sent the optimal recommendations by both the cellular phone and the Internet. After 12 weeks, the patients had a mean decrease of 28.6 mg/dL in fasting plasma glucose and 78.4 mg/dL in 2-hour postprandial blood sugar levels and a mean increase in the care satisfaction score.

Adolescent↗
PubMedDate not supplied

Impact of a nurse short message service intervention for patients with diabetes.

The purpose of this study was to investigate the effect of a nurse short message service by cellular phone and the Internet on glycosylated hemoglobin (HbA1c) levels and adherence to diabetes control recommendations. The patients with diabetes were asked to input their blood glucose levels every day by cellular phone or the Internet. Optimal recommendations were sent weekly to each patient by short message service. After 12 weeks, the patients had a mean decrease of 1.1% in HbA1c level and an increase in diabetic medication taking, 30 minutes of physical exercise, and foot care adherence.

Adult↗