30 research outputs found

    Evaluation of mHealth apps for women of reproductive age: generating evidence to inform best practice

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    Background Preconception and antenatal care are crucial to improving outcomes. Women of childbearing age use various strategies to receive information including mHealth. It is unknown what works in terms of apps that promote positive behaviour changes; how women access such information; what information women want; and what are the best mHealth apps available in Australia. Aim To generate evidence to inform the development and utilisation of preconception and pregnancy-specific mHealth behaviour change interventions. Methods Five studies were conducted. Firstly, a systematic review was undertaken to compare the effectiveness of mHealh apps verse standard care in promoting positive behaviour changes preconception. Secondly, a survey of women of reproductive age was done to explore the knowledge, attitudes, beliefs, and preferences for information about preconception and pregnancy care. Thirdly, a qualitative study was conducted to explore how women access pregnancy information. Fourthly, a study was undertaken to identify and review pregnancy mHealth apps available in Australia. Finally, we retrospectively mapped a high-quality app to examine the important components. Findings The systematic review showed no clear benefit in using mHealth apps compared to usual care in promoting positive behaviour changes for women before they are pregnant. The survey showed that women both prior to and during pregnancy access many sources for reproductive health information. The most popular freely available apps for pregnancy in Australia are generally of low quality and are not underpinned by behaviour change theory. The analysis of the development of the UK app Baby Buddy showed that using a behavioural change framework to guide design of mHealth apps is beneficial. Conclusion Given that women prefer to receive information from healthcare professionals and access mHealth often, new health strategies must be co-designed with women and clinicians to meet current and future needs

    The Integration of Clinical Decision Support Systems Into Telemedicine for Patients With Multimorbidity in Primary Care Settings: Scoping Review

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    BACKGROUND: Multimorbidity, the presence of more than one condition in a single individual, is a global health issue in primary care. Multimorbid patients tend to have a poor quality of life and suffer from a complicated care process. Clinical decision support systems (CDSSs) and telemedicine are the common information and communication technologies that have been used to reduce the complexity of patient management. However, each element of telemedicine and CDSSs is often examined separately and with great variability. Telemedicine has been used for simple patient education as well as more complex consultations and case management. For CDSSs, there is variability in data inputs, intended users, and outputs. Thus, there are several gaps in knowledge about how to integrate CDSSs into telemedicine and to what extent these integrated technological interventions can help improve patient outcomes for those with multimorbidity. OBJECTIVE: Our aims were to (1) broadly review system designs for CDSSs that have been integrated into each function of telemedicine for multimorbid patients in primary care, (2) summarize the effectiveness of the interventions, and (3) identify gaps in the literature. METHODS: An online search for literature was conducted up to November 2021 on PubMed, Embase, CINAHL, and Cochrane. Searching from the reference lists was done to find additional potential studies. The eligibility criterion was that the study focused on the use of CDSSs in telemedicine for patients with multimorbidity in primary care. The system design for the CDSS was extracted based on its software and hardware, source of input, input, tasks, output, and users. Each component was grouped by telemedicine functions: telemonitoring, teleconsultation, tele-case management, and tele-education. RESULTS: Seven experimental studies were included in this review: 3 randomized controlled trials (RCTs) and 4 non-RCTs. The interventions were designed to manage patients with diabetes mellitus, hypertension, polypharmacy, and gestational diabetes mellitus. CDSSs can be used for various telemedicine functions: telemonitoring (eg, feedback), teleconsultation (eg, guideline suggestions, advisory material provisions, and responses to simple queries), tele-case management (eg, sharing information across facilities and teams), and tele-education (eg, patient self-management). However, the structure of CDSSs, such as data input, tasks, output, and intended users or decision-makers, varied. With limited studies examining varying clinical outcomes, there was inconsistent evidence of the clinical effectiveness of the interventions. CONCLUSIONS: Telemedicine and CDSSs have a role in supporting patients with multimorbidity. CDSSs can likely be integrated into telehealth services to improve the quality and accessibility of care. However, issues surrounding such interventions need to be further explored. These issues include expanding the spectrum of medical conditions examined; examining tasks of CDSSs, particularly for screening and diagnosis of multiple conditions; and exploring the role of the patient as the direct user of the CDSS

    5G Outlook – Innovations and Applications

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    5G Outlook - Innovations and Applications is a collection of the recent research and development in the area of the Fifth Generation Mobile Technology (5G), the future of wireless communications. Plenty of novel ideas and knowledge of the 5G are presented in this book as well as divers applications from health science to business modeling. The authors of different chapters contributed from various countries and organizations. The chapters have also been presented at the 5th IEEE 5G Summit held in Aalborg on July 1, 2016. The book starts with a comprehensive introduction on 5G and its need and requirement. Then millimeter waves as a promising spectrum to 5G technology is discussed. The book continues with the novel and inspiring ideas for the future wireless communication usage and network. Further, some technical issues in signal processing and network design for 5G are presented. Finally, the book ends up with different applications of 5G in distinct areas. Topics widely covered in this book are: • 5G technology from past to present to the future• Millimeter- waves and their characteristics• Signal processing and network design issues for 5G• Applications, business modeling and several novel ideas for the future of 5

    Acta Cybernetica : Volume 25. Number 2.

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    A patient agent controlled customized blockchain based framework for internet of things

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    Although Blockchain implementations have emerged as revolutionary technologies for various industrial applications including cryptocurrencies, they have not been widely deployed to store data streaming from sensors to remote servers in architectures known as Internet of Things. New Blockchain for the Internet of Things models promise secure solutions for eHealth, smart cities, and other applications. These models pave the way for continuous monitoring of patient’s physiological signs with wearable sensors to augment traditional medical practice without recourse to storing data with a trusted authority. However, existing Blockchain algorithms cannot accommodate the huge volumes, security, and privacy requirements of health data. In this thesis, our first contribution is an End-to-End secure eHealth architecture that introduces an intelligent Patient Centric Agent. The Patient Centric Agent executing on dedicated hardware manages the storage and access of streams of sensors generated health data, into a customized Blockchain and other less secure repositories. As IoT devices cannot host Blockchain technology due to their limited memory, power, and computational resources, the Patient Centric Agent coordinates and communicates with a private customized Blockchain on behalf of the wearable devices. While the adoption of a Patient Centric Agent offers solutions for addressing continuous monitoring of patients’ health, dealing with storage, data privacy and network security issues, the architecture is vulnerable to Denial of Services(DoS) and single point of failure attacks. To address this issue, we advance a second contribution; a decentralised eHealth system in which the Patient Centric Agent is replicated at three levels: Sensing Layer, NEAR Processing Layer and FAR Processing Layer. The functionalities of the Patient Centric Agent are customized to manage the tasks of the three levels. Simulations confirm protection of the architecture against DoS attacks. Few patients require all their health data to be stored in Blockchain repositories but instead need to select an appropriate storage medium for each chunk of data by matching their personal needs and preferences with features of candidate storage mediums. Motivated by this context, we advance third contribution; a recommendation model for health data storage that can accommodate patient preferences and make storage decisions rapidly, in real-time, even with streamed data. The mapping between health data features and characteristics of each repository is learned using machine learning. The Blockchain’s capacity to make transactions and store records without central oversight enables its application for IoT networks outside health such as underwater IoT networks where the unattended nature of the nodes threatens their security and privacy. However, underwater IoT differs from ground IoT as acoustics signals are the communication media leading to high propagation delays, high error rates exacerbated by turbulent water currents. Our fourth contribution is a customized Blockchain leveraged framework with the model of Patient-Centric Agent renamed as Smart Agent for securely monitoring underwater IoT. Finally, the smart Agent has been investigated in developing an IoT smart home or cities monitoring framework. The key algorithms underpinning to each contribution have been implemented and analysed using simulators.Doctor of Philosoph
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