Virtual Trauma Team

The clinical motivation for Virtual Trauma Team is to improve quality of care in trauma care in the vital first "golden hour" where correct intervention can greatly improve likely health outcome. The motivation for Virtual Homecare Team is to improve quality of life and independence for patients by supporting care at home. The economic motivation is to replace expensive hospital-based care with homecare using wireless technology to support the patient and the carers. Results will be applied by international partners in healthcare service

Healthcare PANs: Personal Area Networks for trauma care and home care

The first hour following the trauma is of crucial importance in trauma care. The sooner treatment begins, the better the ultimate outcome for the patient. Generally the initial treatment is handled by paramedical personnel arriving at the site of the accident with an ambulance. There is evidence to show that if the expertise of the on-site paramedic team can be supported by immediate and continuous access to and communication with the expert medical team at the hospital, patient outcomes can be improved. After care also influences the ultimate recovery of the patient. After-treatment follow up often occurs in-hospital in spite of the fact that care at home can offer more advantages and can accelerate recovery. Based on emerging and future wireless communication technologies, in a previous paper [1] we presented an initial vision of two future healthcare settings, supported by applications which we call Virtual Trauma Team and Virtual Homecare Team. The Virtual Trauma Team application involves high quality wireless multimedia communications between ambulance paramedics and the hospital facilitated by paramedic Body Area Networks (BANs) [2] and an ambulance-based Vehicle Area Network (VAN). The VAN supports bi-directional streaming audio and video communication between the ambulance and the hospital even when moving at speed. The clinical motivation for Virtual Trauma Team is to increase survival rates in trauma care. The Virtual Homecare Team application enables homecare coordinated by home nursing services and supported by the patient's PAN which consists of a patient BAN in combination with an ambient intelligent home environment. The homecare PAN provides intelligent monitoring and support functions and the possibility to ad hoc network to the visiting health professionals’ own BANs as well as high quality multimedia communication links to remote members of the virtual team. The motivation for Virtual Homecare Team is to improve quality of life and independence for patients by supporting care at home; the economic motivation is to replace expensive hospital-based care with homecare by virtual teams using wireless technology to support the patient and the carers. In this paper we develop the vision further and focus in particular on the concepts of personal and body area networks

Future challenges and recommendations

Rapid advances in information technology and telecommunications, and in particular mobile and wireless communications, converge towards the emergence of a new type of “infostructure” that has the potential of supporting a large spectrum of advanced services for healthcare and health. Currently the ICT community produces a great effort to drill down from the vision and the promises of wireless and mobile technologies and provide practical application solutions. Research and development include data gathering and omni-directional transfer of vital information, integration of human machine interface technology into handheld devices and personal applications, security and interoperability of date and integration with hospital legacy systems and electronic patient record. The ongoing evolution of wireless technology and mobile device capabilities is changing the way healthcare providers interact with information technologies. The growth and acceptance of mobile information technology at the point of care, coupled with the promise and convenience of data on demand, creates opportunities for enhanced patient care and safety. The developments presented in this section demonstrate clearly the innovation aspects and trends towards user oriented applications

A context-aware adaptive feedback agent for activity monitoring and coaching

A focus in treatment of chronic diseases is optimizing levels of physical activity. At Roessingh Research and Development, a system was developed, consisting of a Smartphone and an activity sensor, that can measure a patient’s daily activity behavior and provide motivational feedback messages. We are currently looking into ways of increasing the effectiveness of motivational messages that aim to stimulate sustainable behavioral change, by adapting its timing and content to individual patients in their current context of use

Service Orchestration for Collaboration Patterns

This article describes a structuring of groupware services that allows end users to orchestrate the provided services in order to match their collaboration patterns. Our approach is based on the notion that different forms of collaboration require different combinations of groupware services, and that these provided services are the most important aspect of a groupware system for its users. Based on an analysis of a series of high-level collaboration patterns from the healthcare domain we illustrate where flexibility in groupware service design is needed. The resulting structuring has been evaluated by experts using scenarios and has been implemented in a proof-of-concept demonstrator

Mobihealth: mobile health services based on body area networks

In this chapter we describe the concept of MobiHealth and the approach developed during the MobiHealth project (MobiHealth, 2002). The concept was to bring together the technologies of Body Area Networks (BANs), wireless broadband communications and wearable medical devices to provide mobile healthcare services for patients and health professionals. These technologies enable remote patient care services such as management of chronic conditions and detection of health emergencies. Because the patient is free to move anywhere whilst wearing the MobiHealth BAN, patient mobility is maximised. The vision is that patients can enjoy enhanced freedom and quality of life through avoidance or reduction of hospital stays. For the health services it means that pressure on overstretched hospital services can be alleviated

Biosignal and context monitoring: Distributed multimedia applications of body area networks in healthcare

We are investigating the use of Body Area Networks (BANs), wearable sensors and wireless communications for measuring, processing, transmission, interpretation and display of biosignals. The goal is to provide telemonitoring and teletreatment services for patients. The remote health professional can view a multimedia display which includes graphical and numerical representation of patients’ biosignals. Addition of feedback-control enables teletreatment services; teletreatment can be delivered to the patient via multiple modalities including tactile, text, auditory and visual. We describe the health BAN and a generic mobile health service platform and two context aware applications. The epilepsy application illustrates processing and interpretation of multi-source, multimedia BAN data. The chronic pain application illustrates multi-modal feedback and treatment, with patients able to view their own biosignals on their handheld device

Shear Bond Strength of Composite to Dentin after Various Drying Techniques and Its Micro Morphological Analysis under SEM - An In-vitro Study

Aim: The present in-vitro study compared the shear bond strength of composite to dentin after various methods to remove excess water from the dentin. Materials and Methods: Sixty extracted human molars were used for the study that were randomly divided into 6 groups with 4 experimental (three-way syringe, cotton pellet, mini sponge, tissue paper)  and 2 control groups (over dry, over wet). The exposed dentin surfaces were acid etched with 37% phosphoric acid for 20 seconds followed by thorough rinsing with water for 15 seconds. The teeth were kept visibly moist in all the experimental groups. Adhesive agent was applied on all specimens and restored with composite resin. The specimens were then subjected to shear bond strength tests and one specimen from each group was randomly selected for micro-morphological analysis of dentin. Results and Conclusion: Statistical analysis was done and data were tabulated to determine average shear bond strength for each group.  The results indicated that the mean values in the group using tissue paper were significantly higher than the mean values in all the other experimental groups and control groups