Nurses' and community support workers' experience of telehealth: A longitudinal case study

Copyright © 2014 Sharma and Clarke; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.This article has been made available through the Brunel Open Access Publishing Fund.Background - Introduction of telehealth into the healthcare setting has been recognised as a service that might be experienced as disruptive. This paper explores how this disruption is experienced. Methods - In a longitudinal qualitative study, we conducted focus group discussions prior to and semi structured interviews post introduction of a telehealth service in Nottingham, U.K. with the community matrons, congestive heart failure nurses, chronic obstructive pulmonary disease nurses and community support workers that would be involved in order to elicit their preconceptions and reactions to the implementation. Results - Users experienced disruption due to the implementation of telehealth as threatening. Three main factors add to the experience of threat and affect the decision to use the technology: change in clinical routines and increased workload; change in interactions with patients and fundamentals of face-to-face nursing work; and change in skills required with marginalisation of clinical expertise. Conclusion - Since the introduction of telehealth can be experienced as threatening, managers and service providers should aim at minimising the disruption caused by taking the above factors on board. This can be achieved by employing simple yet effective measures such as: providing timely, appropriate and context specific training; provision of adequate technical support; and procedures that allow a balance between the use of telehealth and personal visit by nurses delivering care to their patients

Left-invariant evolutions of wavelet transforms on the Similitude Group

Enhancement of multiple-scale elongated structures in noisy image data is relevant for many biomedical applications but commonly used PDE-based enhancement techniques often fail at crossings in an image. To get an overview of how an image is composed of local multiple-scale elongated structures we construct a multiple scale orientation score, which is a continuous wavelet transform on the similitude group, SIM(2). Our unitary transform maps the space of images onto a reproducing kernel space defined on SIM(2), allowing us to robustly relate Euclidean (and scaling) invariant operators on images to left-invariant operators on the corresponding continuous wavelet transform. Rather than often used wavelet (soft-)thresholding techniques, we employ the group structure in the wavelet domain to arrive at left-invariant evolutions and flows (diffusion), for contextual crossing preserving enhancement of multiple scale elongated structures in noisy images. We present experiments that display benefits of our work compared to recent PDE techniques acting directly on the images and to our previous work on left-invariant diffusions on orientation scores defined on Euclidean motion group.Comment: 40 page

Clinical users' perspective on telemonitoring of patients with long term conditions: Understood through concepts of Giddens's structuration theory & consequence of modernity

This is the post-print version of the article - Copyright @ 2010 IOS.This study involves conducting focus group discussions with clinical users (nurses and technicians) prior to the launch of telehealth service in Nottingham, UK, to elicit their initial perceptions about the service. It describes the findings from preliminary phase of otherwise a larger longitudinal study. Using Giddens’s concepts from structuration theory and con-sequence of modernity, we were able to acknowledge trust and sense of security as two very salient aspects that govern adop-tion of new technological innovation. Unattended, these as-pects contribute to arousal of conflict and contradiction within a system. In order for successful telehealth implementa-tions in health care setting, providers of the service, need to focus on ways in which clinical users’ trust can be gained and sense of security can be promoted while using the telehealth service and technology.Funding was obained from MATCH (Multidisciplinary Assessment of Technologies Centre for Healthcare)

Electric and Magnetic fields due to Dirac particles in FRW spacetime

Some solutions of the Maxwell equations with Dirac particles for the source in FRW spacetime are discussed. The Green's function of the equation for the radial component of the Maxwell fields, F_{r\eta} and F_{\theta\phi} is solved. Green's function is found to reduce to that of Minkowskian spacetime in the appropriate limit. Also, the Lienard-Wiechert type solution is derived. Also, the solutions with the Dirac particle current is also presented. It is found that the F_{r\eta} is composed of even angular momentum states while the odd states constitue F_{\theta\phi} .Comment: 8 pages including 2 figure