ORCID Profile
0000-0002-7810-6388
Current Organisations
Linköping University
,
University of Wollongong
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Data Format | Computation Theory And Mathematics Not Elsewhere Classified | Data Format not elsewhere classified | Data Security | Computer System Security | Data Encryption | Discrete Mathematics
Communication services not elsewhere classified | Information services not elsewhere classified | Computer software and services not elsewhere classified | Communication Networks and Services not elsewhere classified | Application Tools and System Utilities | Information and Communication Services not elsewhere classified |
Publisher: Elsevier BV
Date: 2019
Publisher: Informa UK Limited
Date: 17-01-2023
Publisher: Inderscience Publishers
Date: 2007
Publisher: JMIR Publications Inc.
Date: 19-01-2023
DOI: 10.2196/37716
Abstract: Overweight and obesity have been linked to several serious health problems and medical conditions. With more than a quarter of the young population having weight problems, the impacts of overweight and obesity on this age group are particularly critical. Mobile health (mHealth) apps that support and encourage positive health behaviors have the potential to achieve better health outcomes. These apps represent a unique opportunity for young people (age range 10-24 years), for whom mobile phones are an indispensable part of their everyday living. However, despite the potential of mHealth apps for improved engagement in health interventions, user adherence to these health interventions in the long term is low. The aims of this research were to (1) review and analyze mHealth apps targeting obesity and overweight and (2) propose guidelines for the inclusion of user interface design patterns (UIDPs) in the development of mHealth apps for obese young people that maximizes the impact and retention of behavior change techniques (BCTs). A search for apps was conducted in Google Play Store using the following search string: [“best weight loss app for obese teens 2020”] OR [“obesity applications for teens”] OR [“popular weight loss applications”]. The most popular apps available in both Google Play and Apple App Store that fulfilled the requirements within the inclusion criteria were selected for further analysis. The designs of 17 mHealth apps were analyzed for the inclusion of BCTs supported by various UIDPs. Based on the results of the analysis, BCT-UI design guidelines were developed. The usability of the guidelines was presented using a prototype app. The results of our analysis showed that only half of the BCTs are implemented in the reviewed apps, with a subset of those BCTs being supported by UIDPs. Based on these findings, we propose design guidelines that associate the BCTs with UIDPs. The focus of our guidelines is the implementation of BCTs using design patterns that are impactful for the young people demographics. The UIDPs are classified into 6 categories, with each BCT having one or more design patterns appropriate for its implementation. The applicability of the proposed guidelines is presented by mock-ups of the mHealth app “Morphe,” intended for young people (age range 10-24 years). The presented use cases showcase the 5 main functionalities of Morphe: learn, challenge, statistics, social interaction, and settings. The app analysis results showed that the implementation of BCTs using UIDPs is underutilized. The purposed guidelines will help developers in designing mHealth apps for young people that are easy to use and support behavior change. Future steps involve the development and deployment of the Morphe app and the validation of its usability and effectiveness.
Publisher: Informa UK Limited
Date: 22-04-2013
DOI: 10.3109/17435390.2013.788748
Abstract: In order to study the effects of nanoparticles (NPs) with different physicochemical properties on cellular viability and structure, Saccharomyces cerevisiae were exposed to different concentrations of TiO2-NPs (1-3 nm), ZnO-NPs (<100 nm), CuO-NPs (<50 nm), their bulk forms, Ag-NPs (10 nm) and single-walled carbon nanotubes (SWCNTs). The GreenScreen assay was used to measure cyto- and genotoxicity, and transmission electron microscopy (TEM) used to assess ultrastructure. CuO-NPs were highly cytotoxic, reducing the cell density by 80% at 9 cm(2)/ml, and inducing lipid droplet formation. Cells exposed to Ag-NPs (19 cm(2)/ml) and TiO2-NPs (147 cm(2)/ml) contained dark deposits in intracellular vacuoles, the cell wall and vesicles, and reduced cell density (40 and 30%, respectively). ZnO-NPs (8 cm(2)/ml) caused an increase in the size of intracellular vacuoles, despite not being cytotoxic. SWCNTs did not cause cytotoxicity or significant alterations in ultrastructure, despite high oxidative potential. Two genotoxicity assays, GreenScreen and the comet assay, produced different results and the authors discuss the reasons for this discrepancy. Classical assays of toxicity may not be the most suitable for studying the effects of NPs in cellular systems, and the simultaneous assessment of other measures of the state of cells, such as TEM are highly recommended.
Publisher: Springer Science and Business Media LLC
Date: 16-12-2021
DOI: 10.1007/S12028-021-01400-3
Abstract: Trauma-induced coagulopathy in traumatic brain injury (TBI) remains associated with high rates of complications, unfavorable outcomes, and mortality. The underlying mechanisms are largely unknown. Embedded in the prospective multinational Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, coagulation profiles beyond standard conventional coagulation assays were assessed in patients with isolated TBI within the very early hours of injury. Results from blood s les (citrate/EDTA) obtained on hospital admission were matched with clinical and routine laboratory data of patients with TBI captured in the CENTER-TBI central database. To minimize confounding factors, patients with strictly isolated TBI (iTBI) ( n = 88) were selected and stratified for coagulopathy by routine international normalized ratio (INR): (1) INR 1.2 and (2) INR ≥ 1.2. An INR 1.2 has been well adopted over time as a threshold to define trauma-related coagulopathy in general trauma populations. The following parameters were evaluated: quick’s value, activated partial thromboplastin time, fibrinogen, thrombin time, antithrombin, coagulation factor activity of factors V, VIII, IX, and XIII, protein C and S, plasminogen, D-dimer, fibrinolysis-regulating parameters (thrombin activatable fibrinolysis inhibitor, plasminogen activator inhibitor 1, antiplasmin), thrombin generation, and fibrin monomers. Patients with iTBI with INR ≥ 1.2 ( n = 16) had a high incidence of progressive intracranial hemorrhage associated with increased mortality and unfavorable outcome compared with patients with INR 1.2 ( n = 72). Activity of coagulation factors V, VIII, IX, and XIII dropped on average by 15–20% between the groups whereas protein C and S levels dropped by 20%. With an elevated INR, thrombin generation decreased, as reflected by lower peak height and endogenous thrombin potential (ETP), whereas the amount of fibrin monomers increased. Plasminogen activity significantly decreased from 89% in patients with INR 1.2 to 76% in patients with INR ≥ 1.2. Moreover, D-dimer levels significantly increased from a mean of 943 mg/L in patients with INR 1.2 to 1,301 mg/L in patients with INR ≥ 1.2. This more in-depth analysis beyond routine conventional coagulation assays suggests a counterbalanced regulation of coagulation and fibrinolysis in patients with iTBI with hemostatic abnormalities. We observed distinct patterns involving key pathways of the highly complex and dynamic coagulation system that offer windows of opportunity for further research. Whether the changes observed on factor levels may be relevant and explain the worse outcome or the more severe brain injuries by themselves remains speculative.
Publisher: Inderscience Publishers
Date: 2010
Publisher: Inderscience Publishers
Date: 2008
Publisher: Springer Science and Business Media LLC
Date: 23-03-2007
DOI: 10.1007/S10916-006-9035-Y
Abstract: The objective of this study is to discover how to maximise the use of health research data without breaching the patient's confidentiality. To achieve this, we have examined available options identified in enhancing information security of health research data. It has been noted that there are gaps in information security for health research data. Our novel approach, searching through encrypted data is discussed in this paper.
Publisher: Elsevier BV
Date: 08-2021
Publisher: JMIR Publications Inc.
Date: 09-12-2019
Abstract: upporting women to initiate and continue breastfeeding is a global challenge. A range of breastfeeding interventions employing electronic technologies (e-technologies) are being developed, which offer different delivery modes and features over the internet however, the impact of internet-based e-technologies on breastfeeding outcomes remains unclear. his study aimed to identify the characteristics of current internet-based breastfeeding interventions employing e-technologies and investigate the effects of internet-based e-technologies on breastfeeding outcomes. systematic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in the following databases: Scopus, Web of Science, the Cochrane Database of Systematic Reviews, ScienceDirect, Google Scholar, the Association for Computing Machinery, SpringerLink, and Institute of Electrical and Electronics Engineers Xplore. his systematic review included 16 studies published between 2007 and 2018, with 4018 women in 8 countries. The characteristics of the interventions were grouped based on (1) mode of delivery (web-based, mobile phone apps, and computer kiosk), (2) purpose of the interventions (education and support), and (3) key strategies (monitoring and breastfeeding tracking, personalization, online discussion forum, web-based consultation, and breastfeeding station locators). Combining educational activities with web-based personalized support through discussion forums appeared to be the most effective way to improve breastfeeding outcomes and long-term exclusive breastfeeding rates. Monitoring and breastfeeding trackers appeared to be the least effective ways. his study demonstrated a variety of internet-based e-technologies that professionals can use to promote, educate, and support breastfeeding women. Future internet-based breastfeeding interventions employing e-technologies might consider improving interaction with mothers and personalizing the content of the proposed interventions.
Publisher: JMIR Publications Inc.
Date: 07-08-2023
DOI: 10.2196/46839
Abstract: The Australian Dietary Guidelines (ADG) translate the best available evidence in nutrition into food choice recommendations. However, adherence to the ADG is poor in Australia. Given that following a healthy diet can be a potentially cost-effective strategy for lowering the risk of chronic diseases, there is an urgent need to develop novel technologies for in iduals to improve their adherence to the ADG. This study describes the development process and design of a prototype mobile app for personalized dietary advice based on the ADG for adults in Australia, with the aim of exploring the usability of the prototype. The goal of the prototype was to provide personalized, evidence-based support for self-managing food choices in real time. The guidelines of the design science paradigm were applied to guide the design, development, and evaluation of a progressive web app using Amazon Web Services Elastic Compute Cloud services via iterations. The food layer of the Nutrition Care Process, the strategies of cognitive behavioral theory, and the ADG were translated into prototype features guided by the Persuasive Systems Design model. A gain-framed approach was adopted to promote positive behavior changes. A cross-modal image-to-recipe retrieval model under an Apache 2.0 license was deployed for dietary assessment. A survey using the Mobile Application Rating Scale and semistructured in-depth interviews were conducted to explore the usability of the prototype through convenience s ling (N=15). The prominent features of the prototype included the use of image-based dietary assessment, food choice tracking with immediate feedback leveraging gamification principles, personal goal setting for food choices, and the provision of recipe ideas and information on the ADG. The overall prototype quality score was “acceptable,” with a median of 3.46 (IQR 2.78-3.81) out of 5 points. The median score of the perceived impact of the prototype on healthy eating based on the ADG was 3.83 (IQR 2.75-4.08) out of 5 points. In-depth interviews identified the use of gamification for tracking food choices and innovation in the image-based dietary assessment as the main drivers of the positive user experience of using the prototype. A novel evidence-based prototype mobile app was successfully developed by leveraging a cross-disciplinary collaboration. A detailed description of the development process and design of the prototype enhances its transparency and provides detailed insights into its creation. This study provides a valuable ex le of the development of a novel, evidence-based app for personalized dietary advice on food choices using recent advancements in computer vision. A revised version of this prototype is currently under development.
Publisher: Hawaii International Conference on System Sciences
Date: 2017
Publisher: Springer Science and Business Media LLC
Date: 23-03-2007
Publisher: IEEE
Date: 06-2007
Publisher: Springer Science and Business Media LLC
Date: 02-06-2010
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.IJMEDINF.2022.104775
Abstract: The use of the teleconsultation system has increased in recent years, which enabled healthcare providers and patients to share, communicate and transfer information in real-time via different types of telemedicine services and applications. However, there is a lack of studies that underpin factors that motivate patients to use teleconsultation systems. This study aimed to identify factors that influence consumers' motivation to use teleconsultation systems by developing a theoretical framework and empirically testing the developed framework with a real-world teleconsultation system. A cross-sectional study was used for this research to empirically validate the proposed model. The online survey consisted of 51 items, which were developed by the researchers. Partial least squares structural equation modelling (PLS-SEM) was used to analyze the measurement model and structural model. 485 participants completed the online survey, 471 of which were included in the model analysis. The measurement analysis indicated that convergent validity was achieved as all items' outer lording were well above the threshold of 0.70, all indicators reliability and AVEs were well above the threshold of 0.50. Also, the measurement analysis indicated that discriminate validity was achieved as the Heterotrait-Monotrait ratio of correlations for all constructs were below the threshold of 0.90. In the structural model analysis, the inner constructs of the model, autonomy, competence and relatedness explained 60.1% of the variance in users' motivation toward the use of the teleconsultation system. The outer constructs of the model, subjective norm, external and internal facilitating conditions, explained 67.3% of the variance in users' autonomy, whereas attitude, performance expectancy, external and internal facilitating conditions explained 51.9% of the variance in the users' competence, and subjective norm explained 25.6% of the variance in the users' relatedness. The developed framework can explain why consumers are motivated to use teleconsultation systems for online medical consultations. The model indicated that a variety of internal and external factors can positively or negatively influence consumers' perceived autonomy, competence and relatedness, which can impact their motivation toward the use of teleconsultation systems.
Publisher: Informa UK Limited
Date: 23-10-2019
Publisher: Springer International Publishing
Date: 28-11-2020
Publisher: American Medical Association (AMA)
Date: 11-11-2021
Publisher: Springer Nature Switzerland
Date: 2023
Publisher: IEEE
Date: 2009
DOI: 10.1109/ISPA.2009.14
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.CMPB.2017.12.011
Abstract: Breast cancer is the most common cancer affecting females worldwide. Breast cancer survivability prediction is challenging and a complex research task. Existing approaches engage statistical methods or supervised machine learning to assess redict the survival prospects of patients. The main objectives of this paper is to develop a robust data analytical model which can assist in (i) a better understanding of breast cancer survivability in presence of missing data, (ii) providing better insights into factors associated with patient survivability, and (iii) establishing cohorts of patients that share similar properties. Unsupervised data mining methods viz. the self-organising map (SOM) and density-based spatial clustering of applications with noise (DBSCAN) is used to create patient cohort clusters. These clusters, with associated patterns, were used to train multilayer perceptron (MLP) model for improved patient survivability analysis. A large dataset available from SEER program is used in this study to identify patterns associated with the survivability of breast cancer patients. Information gain was computed for the purpose of variable selection. All of these methods are data-driven and require little (if any) input from users or experts. SOM consolidated patients into cohorts of patients with similar properties. From this, DBSCAN identified and extracted nine cohorts (clusters). It is found that patients in each of the nine clusters have different survivability time. The separation of patients into clusters improved the overall survival prediction accuracy based on MLP and revealed intricate conditions that affect the accuracy of a prediction. A new, entirely data driven approach based on unsupervised learning methods improves understanding and helps identify patterns associated with the survivability of patient. The results of the analysis can be used to segment the historical patient data into clusters or subsets, which share common variable values and survivability. The survivability prediction accuracy of a MLP is improved by using identified patient cohorts as opposed to using raw historical data. Analysis of variable values in each cohort provide better insights into survivability of a particular subgroup of breast cancer patients.
Publisher: Australian Journal of Information Systems
Date: 11-05-2020
Abstract: The information systems community plays a significant role in providing theories for guiding the creation of more effective information systems. This is nowadays most prominent in supporting the ongoing evolution of Artificial Intelligence (AI) and decision-making systems. As these systems are becoming increasingly reliable, and supplanting the presence of humans, the question of accountability and trust in these systems is increasingly coming to the fore. This editorial positions and showcases a collection of papers from the 2018 Australasian Conference on Information Systems within this context.
Publisher: Springer Nature Switzerland
Date: 2023
Publisher: Elsevier BV
Date: 2022
Publisher: BMJ
Date: 16-12-2021
DOI: 10.1136/EMERMED-2020-209471
Abstract: There is substantial interest in blood biomarkers as fast and objective diagnostic tools for traumatic brain injury (TBI) in the acute setting. Adult patients (≥18) with TBI of any severity and indications for CT scanning and orthopaedic injury controls were prospectively recruited during 2011–2013 at Turku University Hospital, Finland. The severity of TBI was classified with GCS: GCS 13–15 was classified as mild (mTBI) GCS 9–12 as moderate (moTBI) and GCS 3–8 as severe (sTBI). Serum s les were collected within 24 hours of admission and biomarker levels analysed with high-performance kits. The ability of biomarkers to distinguish between severity of TBI and CT-positive and CT-negative patients was assessed. Among 189 patients recruited, neurofilament light (NF-L) was obtained from 175 patients with TBI and 40 controls. S100 calcium-binding protein B (S100B), heart fatty-acid binding protein (H-FABP) and interleukin-10 (IL-10) were analysed for 184 patients with TBI and 39 controls. There were statistically significant differences between levels of all biomarkers between the severity classes, but none of the biomarkers distinguished patients with moTBI from patients with sTBI. Patients with mTBI discharged from the ED had lower levels of IL-10 (0.26, IQR=0.21, 0.39 pg/mL), H-FABP (4.15, IQR=2.72, 5.83 ng/mL) and NF-L (8.6, IQR=6.35, 15.98 pg/mL) compared with those admitted to the neurosurgical ward, IL-10 (0.55, IQR=0.31, 1.42 pg/mL), H-FABP (6.022, IQR=4.19, 20.72 ng/mL) and NF-L (13.95, IQR=8.33, 19.93 pg/mL). We observed higher levels of H-FABP and NF-L in older patients with mTBI. None of the biomarkers or their combinations was able to distinguish CT-positive (n=36) or CT-negative (n=58) patients with mTBI from controls. S100B, H-FABP, NF-L and IL-10 levels in patients with mTBI were significantly lower than in patients with moTBI and sTBI but alone or in combination, were unable to distinguish patients with mTBI from orthopaedic controls. This suggests these biomarkers cannot be used alone to diagnose mTBI in trauma patients in the acute setting.
Publisher: Springer New York
Date: 20-08-2014
Publisher: Inderscience Publishers
Date: 2014
Publisher: Public Library of Science (PLoS)
Date: 22-04-2015
Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
Date: 05-2021
Abstract: The aim of this paper was to evaluate the prevalence of postconcussive symptoms and their relation to health-related quality of life (HRQOL) in pediatric and adolescent patients with mild traumatic brain injury (mTBI) who received head CT imaging during initial assessment. Patients aged between 5 and 21 years with mTBI (Glasgow Coma Scale scores 13–15) and available Rivermead Post Concussion Questionnaire (RPQ) at 6 months of follow-up in the multicenter, prospectively collected CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) study were included. The prevalence of postconcussive symptoms was assessed, and the occurrence of postconcussive syndrome (PSC) based on the ICD-10 criteria, was analyzed. HRQOL was compared in patients with and without PCS using the Quality of Life after Brain Injury (QOLIBRI) questionnaire. A total of 196 adolescent or pediatric mTBI patients requiring head CT imaging were included. High-energy trauma was prevalent in more than half of cases (54%), abnormalities on head CT scans were detected in 41%, and admission to the regular ward or intensive care unit was necessary in 78%. Six months postinjury, 36% of included patients had experienced at least one moderate or severe symptom on the RPQ. PCS was present in 13% of adolescents and children when considering symptoms of at least moderate severity, and those patients had significantly lower QOLIBRI total scores, indicating lower HRQOL, compared with young patients without PCS (57 vs 83 points, p 0.001). Adolescent and pediatric mTBI patients requiring head CT imaging show signs of increased trauma severity. Postconcussive symptoms are present in up to one-third of those patients, and PCS can be diagnosed in 13% 6 months after injury. Moreover, PCS is significantly associated with decreased HRQOL.
Publisher: Elsevier BV
Date: 10-2022
Publisher: Springer Science and Business Media LLC
Date: 13-04-2012
Publisher: Elsevier BV
Date: 2014
DOI: 10.2139/SSRN.2461113
Publisher: Mary Ann Liebert Inc
Date: 21-06-2023
Publisher: Elsevier BV
Date: 08-2023
Publisher: Oxford University Press (OUP)
Date: 06-2022
Abstract: There is substantial interest in the potential for traumatic brain injury to result in progressive neurological deterioration. While blood biomarkers such as glial fibrillary acid protein (GFAP) and neurofilament light have been widely explored in characterizing acute traumatic brain injury (TBI), their use in the chronic phase is limited. Given increasing evidence that these proteins may be markers of ongoing neurodegeneration in a range of diseases, we examined their relationship to imaging changes and functional outcome in the months to years following TBI. Two-hundred and three patients were recruited in two separate cohorts 6 months post-injury (n = 165) and >5 years post-injury (n = 38 12 of whom also provided data ∼8 months post-TBI). Subjects underwent blood biomarker s ling (n = 199) and MRI (n = 172 including diffusion tensor imaging). Data from patient cohorts were compared to 59 healthy volunteers and 21 non-brain injury trauma controls. Mean diffusivity and fractional anisotropy were calculated in cortical grey matter, deep grey matter and whole brain white matter. Accelerated brain ageing was calculated at a whole brain level as the predicted age difference defined using T1-weighted images, and at a voxel-based level as the annualized Jacobian determinants in white matter and grey matter, referenced to a population of 652 healthy control subjects. Serum neurofilament light concentrations were elevated in the early chronic phase. While GFAP values were within the normal range at ∼8 months, many patients showed a secondary and temporally distinct elevations up to >5 years after injury. Biomarker elevation at 6 months was significantly related to metrics of microstructural injury on diffusion tensor imaging. Biomarker levels at ∼8 months predicted white matter volume loss at >5 years, and annualized brain volume loss between ∼8 months and 5 years. Patients who worsened functionally between ∼8 months and >5 years showed higher than predicted brain age and elevated neurofilament light levels. GFAP and neurofilament light levels can remain elevated months to years after TBI, and show distinct temporal profiles. These elevations correlate closely with microstructural injury in both grey and white matter on contemporaneous quantitative diffusion tensor imaging. Neurofilament light elevations at ∼8 months may predict ongoing white matter and brain volume loss over >5 years of follow-up. If confirmed, these findings suggest that blood biomarker levels at late time points could be used to identify TBI survivors who are at high risk of progressive neurological damage.
Publisher: Inderscience Publishers
Date: 2016
Publisher: Elsevier BV
Date: 05-2015
Publisher: Springer Science and Business Media LLC
Date: 10-05-2022
DOI: 10.1038/S41467-022-30227-5
Abstract: Complex metabolic disruption is a crucial aspect of the pathophysiology of traumatic brain injury (TBI). Associations between this and systemic metabolism and their potential prognostic value are poorly understood. Here, we aimed to describe the serum metabolome (including lipidome) associated with acute TBI within 24 h post-injury, and its relationship to severity of injury and patient outcome. We performed a comprehensive metabolomics study in a cohort of 716 patients with TBI and non-TBI reference patients (orthopedic, internal medicine, and other neurological patients) from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) cohort. We identified panels of metabolites specifically associated with TBI severity and patient outcomes. Choline phospholipids (lysophosphatidylcholines, ether phosphatidylcholines and sphingomyelins) were inversely associated with TBI severity and were among the strongest predictors of TBI patient outcomes, which was further confirmed in a separate validation dataset of 558 patients. The observed metabolic patterns may reflect different pathophysiological mechanisms, including protective changes of systemic lipid metabolism aiming to maintain lipid homeostasis in the brain.
Publisher: Inderscience Publishers
Date: 2007
Publisher: IEEE
Date: 25-01-2022
Publisher: ACM
Date: 24-11-2009
Publisher: IGI Global
Date: 2013
DOI: 10.4018/978-1-4666-2919-6.CH048
Abstract: Protecting the confidentiality of a patient’s information in a shared care environment could become a complex task. Correct identification of users, assigning of access permissions, and resolution of conflict rise as main points of interest in providing solutions for data exchange among health care providers. Traditional approaches such as Mandatory Access Control, Discretionary Access control and Role-Based Access Control policies do not always provide a suitable solution for health care settings, especially for shared care environments. The core of this contribution consists in the description of an approach which uses attribute-based encryption to protect the confidentiality of patients’ information during the exchange of electronic health records among healthcare providers. Attribute-based encryption allows the reinforcing of access policies and reduces the risk of unauthorized access to sensitive information it also provides a set of functionalities which are described using a case study. Attribute-based encryption provides an answer to restrictions presented by traditional approaches and facilitate the reinforcing of existing security policies over the transmitted data.
Publisher: IEEE
Date: 2015
Publisher: Springer Science and Business Media LLC
Date: 23-02-2021
DOI: 10.1186/S13054-020-03370-Y
Abstract: To study variation in, and clinical impact of high Therapy Intensity Level (TIL) treatments for elevated intracranial pressure (ICP) in patients with traumatic brain injury (TBI) across European Intensive Care Units (ICUs). We studied high TIL treatments (metabolic suppression, hypothermia ( 35 °C), intensive hyperventilation (PaCO 2 4 kPa), and secondary decompressive craniectomy) in patients receiving ICP monitoring in the ICU stratum of the CENTER-TBI study. A random effect logistic regression model was used to determine between-centre variation in their use. A propensity score-matched model was used to study the impact on outcome (6-months Glasgow Outcome Score-extended (GOSE)), whilst adjusting for case-mix severity, signs of brain herniation on imaging, and ICP. 313 of 758 patients from 52 European centres (41%) received at least one high TIL treatment with significant variation between centres (median odds ratio = 2.26). Patients often transiently received high TIL therapies without escalation from lower tier treatments. 38% of patients with high TIL treatment had favourable outcomes (GOSE ≥ 5). The use of high TIL treatment was not significantly associated with worse outcome (285 matched pairs, OR 1.4, 95% CI [1.0–2.0]). However, a sensitivity analysis excluding high TIL treatments at day 1 or use of metabolic suppression at any day did reveal a statistically significant association with worse outcome. Substantial between-centre variation in use of high TIL treatments for TBI was found and treatment escalation to higher TIL treatments were often not preceded by more conventional lower TIL treatments. The significant association between high TIL treatments after day 1 and worse outcomes may reflect aggressive use or unmeasured confounders or inappropriate escalation strategies. Substantial variation was found in the use of highly intensive ICP-lowering treatments across European ICUs and a stepwise escalation strategy from lower to higher intensity level therapy is often lacking. Further research is necessary to study the impact of high therapy intensity treatments. The core study was registered with ClinicalTrials.gov, number NCT02210221, registered 08/06/2014, t2/show/NCT02210221?id=NCT02210221& draw=1& rank=1 and with Resource Identification Portal (RRID: SCR_015582).
Publisher: JMIR Publications Inc.
Date: 20-02-2020
DOI: 10.2196/16407
Abstract: Health care providers are adopting information and communication technologies (ICTs) to enhance their services. Telemedicine is one of the services that rely heavily on ICTs to enable remote patients to communicate with health care professionals in this case, the patient communicates with the health care professional for a follow-up or for a consultation about his or her health condition. This communication process is referred to as an e-consultation. In this paper, telemedicine services refer to health care services that use ICTs, which enable patients to share, transfer, and communicate data or information in real time (ie, synchronous) from their home with a care provider—normally a physician—at a clinical site. However, the use of e-consultation services can be positively or negatively influenced by external or internal factors. External factors refer to the environment surrounding the system as well as the system itself, while internal factors refer to user behavior and motivation. This review aims to investigate the barriers and the facilitators that influence the use of home consultation systems in the health care context. This review also aims to identify the effectiveness of Home Online Health Consultation (HOHC) systems in improving patients’ health as well as their satisfaction with the systems. We conducted a systematic literature review to search for articles—empirical studies—about online health consultation in four digital libraries: Scopus, Association for Computing Machinery, PubMed, and Web of Science. The database search yielded 2518 articles after applying the inclusion and exclusion criteria, the number of included articles for the final review was 45. A qualitative content analysis was performed to identify barriers and facilitators to HOHC systems, their effectiveness, and patients’ satisfaction with them. The systematic literature review identified several external and internal facilitators and barriers to HOHC systems that were used in the creation of a HOHC framework. The framework consists of four requirements the framework also consists of 17 facilitators and eight barriers, which were further categorized as internal and external influencers on HOHC. Patients from different age groups and with different health conditions benefited from remote health services. HOHC via video conferencing was effective in delivering online treatment and was well-accepted by patients, as it simulated in-person, face-to-face consultation. Acceptance by patients increased as a result of online consultation facilitators that promoted effective and convenient remote treatment. However, some patients preferred face-to-face consultation and showed resistance to online consultation. Resistance to online consultation was influenced by some of the identified barriers. Overall, the framework identified the facilitators and barriers that positively and negatively influenced the uptake of HOHC systems, respectively.
Publisher: IGI Global
Date: 2008
DOI: 10.4018/978-1-60566-050-9.CH147
Abstract: Access to mobile data and messages is essential in healthcare environment as patients and healthcare providers are mobile. This is inline with the need of ubiquitous computing in everyday life. Mobile and wireless devices can assist in ensuring patient’s safety by providing easy availability of the data at the point of care. Portability and accessibility of these devices enhances use of them in healthcare environment. However, data integrity and confidentiality of information in them need to be ensured to provide safe, effective and efficient healthcare. Mobile healthcare involves conducting healthcare related activities through using mobile devices such as a smart phone, Personal digital assistant (PDA), wireless enabled computer, iPod and so on. Mobile computing is suitable for healthcare as healthcare providers are mobile. These would be suitable for conducting patient’s healthcare activities in emergencies, ward rounds, homecare, chronic disease management, conducting clinical trials, and so on. There are various projects using mobile devices to enhance patient’s care. With the advancement of medical informatics, telemedicine and information technology, mobile data devices play an enormous role in healthcare system. In this chapter, we outline the need of mobile devices in healthcare, usage of these devices, underlying technology and applications, importance of security of these devices, securing mobile data communication in healthcare through different security models and case ex les of applications that we have developed, in particular (1) iPathology tool on iPod, (2) securing healthcare information using Pocket PC 2003, and (3) securing information on handheld devices. There were several incidents in the past due to the insecurity of mobile devices that can leak information to anyone who does not have access to the information. In this chapter, we will illustrate several techniques that we have developed to protect these malicious activities and how these are applicable for securing mobile data computing in healthcare.
Publisher: IEEE
Date: 2009
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-10-2020
DOI: 10.1097/CCM.0000000000004673
Abstract: Acute kidney injury is frequent in polytrauma patients, and it is associated with increased mortality and extended hospital length of stay. However, the specific prevalence of acute kidney injury after traumatic brain injury is less recognized. The present study aims to describe the occurrence rate, risk factors, timing, and association with outcome of acute kidney injury in a large cohort of traumatic brain injury patients. The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury is a multicenter, prospective observational, longitudinal, cohort study. Sixty-five ICUs across Europe. For the present study, we selected 4,509 traumatic brain injury patients with an ICU length of stay greater than 72 hours and with at least two serum creatinine values during the first 7 days of ICU stay. We classified acute kidney injury in three stages according to the Kidney Disease Improving Global Outcome criteria: acute kidney injury stage 1 equals to serum creatinine × 1.5–1.9 times from baseline or an increase greater than or equal to 0.3 mg/dL in 48 hours acute kidney injury stage 2 equals to serum creatinine × 2–2.9 times baseline acute kidney injury stage 3 equals to serum creatinine × three times baseline or greater than or equal to 4 mg/dL or need for renal replacement therapy. Standard reporting techniques were used to report incidences. A multivariable Cox regression analysis was performed to model the cause-specific hazard of acute kidney injury and its association with the long-term outcome. We included a total of 1,262 patients. The occurrence rate of acute kidney injury during the first week was as follows: acute kidney injury stage 1 equals to 8% ( n = 100), acute kidney injury stage 2 equals to 1% ( n = 14), and acute kidney injury stage 3 equals to 3% ( n = 36). Acute kidney injury occurred early after ICU admission, with a median of 2 days (interquartile range 1–4 d). Renal history (hazard ratio = 2.48 95% CI, 1.39–4.43 p = 0.002), insulin-dependent diabetes (hazard ratio = 2.52 95% CI, 1.22–5.197 p = 0.012), hypernatremia (hazard ratio = 1.88 95% CI, 1.31–2.71 p = 0.001), and osmotic therapy administration (hazard ratio = 2.08 95% CI, 1.45–2.99 p 0.001) were significantly associated with the risk of developing acute kidney injury. Acute kidney injury was also associated with an increased ICU length of stay and with a higher probability of 6 months unfavorable Extended Glasgow Outcome Scale and mortality. Acute kidney injury after traumatic brain injury is an early phenomenon, affecting about one in 10 patients. Its occurrence negatively impacts mortality and neurologic outcome at 6 months. Osmotic therapy use during ICU stay could be a modifiable risk factor.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Elsevier BV
Date: 2023
DOI: 10.1016/J.IJMEDINF.2022.104903
Abstract: Alongside the promise of improving clinical work, advances in healthcare artificial intelligence (AI) raise concerns about the risk of deskilling clinicians. This purpose of this study is to examine the issue of deskilling from the perspective of erse group of professional stakeholders with knowledge and/or experiences in the development, deployment and regulation of healthcare AI. We conducted qualitative, semi-structured interviews with 72 professionals with AI expertise and/or professional or clinical expertise who were involved in development, deployment and/or regulation of healthcare AI. Data analysis using combined constructivist grounded theory and framework approach was performed concurrently with data collection. Our analysis showed participants had erse views on three contentious issues regarding AI and deskilling. The first involved competing views about the proper extent of AI-enabled automation in healthcare work, and which clinical tasks should or should not be automated. We identified a cluster of characteristics of tasks that were considered more suitable for automation. The second involved expectations about the impact of AI on clinical skills, and whether AI-enabled automation would lead to worse or better quality of healthcare. The third tension implicitly contrasted two models of healthcare work: a human-centric model and a technology-centric model. These models assumed different values and priorities for healthcare work and its relationship to AI-enabled automation. Our study shows that a erse group of professional stakeholders involved in healthcare AI development, acquisition, deployment and regulation are attentive to the potential impact of healthcare AI on clinical skills, but have different views about the nature and valence (positive or negative) of this impact. Detailed engagement with different types of professional stakeholders allowed us to identify relevant concepts and values that could guide decisions about AI algorithm development and deployment.
Publisher: JMIR Publications Inc.
Date: 27-02-2023
Abstract: he Australian Dietary Guidelines (ADG) translate the best available evidence in nutrition into food choice recommendations. However, adherence to the ADG is poor in Australia. Given that following a healthy diet can be a potentially cost-effective strategy for lowering the risk of chronic diseases, there is an urgent need to develop novel technologies for in iduals to improve their adherence to the ADG. his study describes the development process and design of a prototype mobile app for personalized dietary advice based on the ADG for adults in Australia, with the aim of exploring the usability of the prototype. The goal of the prototype was to provide personalized, evidence-based support for self-managing food choices in real time. he guidelines of the design science paradigm were applied to guide the design, development, and evaluation of a progressive web app using Amazon Web Services Elastic Compute Cloud services via iterations. The food layer of the Nutrition Care Process, the strategies of cognitive behavioral theory, and the ADG were translated into prototype features guided by the Persuasive Systems Design model. A gain-framed approach was adopted to promote positive behavior changes. A cross-modal image-to-recipe retrieval model under an Apache 2.0 license was deployed for dietary assessment. A survey using the Mobile Application Rating Scale and semistructured in-depth interviews were conducted to explore the usability of the prototype through convenience s ling (N=15). he prominent features of the prototype included the use of image-based dietary assessment, food choice tracking with immediate feedback leveraging gamification principles, personal goal setting for food choices, and the provision of recipe ideas and information on the ADG. The overall prototype quality score was “acceptable,” with a median of 3.46 (IQR 2.78-3.81) out of 5 points. The median score of the perceived impact of the prototype on healthy eating based on the ADG was 3.83 (IQR 2.75-4.08) out of 5 points. In-depth interviews identified the use of gamification for tracking food choices and innovation in the image-based dietary assessment as the main drivers of the positive user experience of using the prototype. novel evidence-based prototype mobile app was successfully developed by leveraging a cross-disciplinary collaboration. A detailed description of the development process and design of the prototype enhances its transparency and provides detailed insights into its creation. This study provides a valuable ex le of the development of a novel, evidence-based app for personalized dietary advice on food choices using recent advancements in computer vision. A revised version of this prototype is currently under development.
Publisher: Mary Ann Liebert Inc
Date: 03-2022
Abstract: We investigated the topology of structural brain connectivity networks and its association with outcome after mild traumatic brain injury, a major cause of permanent disability. Eighty-five patients with mild traumatic brain injury underwent magnetic resonance imaging (MRI) twice, about three weeks and eight months after injury, and 30 age-matched orthopedic trauma control subjects were scanned. Outcome was assessed with Extended Glasgow Outcome Scale on average eight months after injury. We performed constrained spherical deconvolution-based probabilistic streamlines tractography on diffusion MRI data and parcellated cortical and subcortical gray matter into 84 regions based on T1-weighted data to reconstruct structural brain connectivity networks weighted by the number of streamlines. Graph theoretical methods were employed to measure network properties in both patients and controls, and correlations between these properties and outcome were calculated. We found no global differences in the network properties between patients with mild traumatic brain injury and orthopedic control subjects at either stage. We found significantly increased betweenness centrality of the right pars opercularis in the chronic stage compared with control subjects, however. Further, both global and local network properties correlated significantly with outcome. Higher normalized global efficiency, degree, and strength as well as lower small-worldness were associated with better outcome. Correlations between the outcome and the local network properties were the most prominent in the left putamen and the left postcentral gyrus. Our results indicate that both global and local network properties provide valuable information about the outcome already in the acute/subacute stage and, therefore, are promising biomarkers for prognostic purposes in mild traumatic brain injury.
Publisher: MDPI AG
Date: 24-03-2018
DOI: 10.3390/INFO9040069
Publisher: Wiley
Date: 28-09-2011
DOI: 10.1111/J.1537-2995.2010.02887.X
Abstract: Data from prior health scares suggest that an avian influenza outbreak will impact on people's intention to donate blood however, research exploring this is scarce. Using an augmented theory of planned behavior (TPB), incorporating threat perceptions alongside the rational decision-making components of the TPB, the current study sought to identify predictors of blood donors' intentions to donate during two phases of an avian influenza outbreak. Blood donors (n = 172) completed an on-line survey assessing the standard TPB predictors as well as measures of threat perceptions from the health belief model (i.e., perceived susceptibility and severity). Path analyses examined the utility of the augmented TPB to predict donors' intentions to donate during a low- and high-risk phase of an avian influenza outbreak. In both phases, the model provided a good fit to the data explaining 69% (low risk) and 72% (high risk) of the variance in intentions. Attitude, subjective norm, and perceived susceptibility significantly predicted donor intentions in both phases. Within the low-risk phase, sex was an additional significant predictor of intention, while in the high-risk phase, perceived behavioral control was significantly related to intentions. An augmented TPB model can be used to predict donors' intentions to donate blood in a low-risk and a high-risk phase of an outbreak of avian influenza. As such, the results provide important insights into donors' decision-making that can be used by blood agencies to maintain the blood supply in the context of an avian influenza outbreak.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Elsevier BV
Date: 03-2021
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.IJMEDINF.2021.104618
Abstract: Healthcare providers have improved consumer access to healthcare services by the adoption of information communication technology and the use of telemedicine. With the current COVID-19 pandemic, consumers are shifting to remote teleconsultation. There are several studies regarding consumers' acceptance and satisfaction with telemedicine among healthcare providers and a few among patients at healthcare facilities. However, studies about patients' motivation toward the use of teleconsultation systems are very few. The aim of this study was to validate an instrument of a newly developed framework to identify factors that motivate patients to use a teleconsultation system. This study used a modified eDelphi method incorporating content validity index and content validity ratio procedures to validate the instrument among fifteen experts from different disciplines. The eDelphi consisted of three rounds to review each item's relevance, clarity, importance and the overall validity of the instrument. The result showed a significant level of agreement among experts for in idual items' relevance, clarity and importance. For relevance, all items had excellent I-CVI above 0.889, except one item with I-CVI = 0.78, which is still acceptable. For clarity, all items had an excellent I-CVI > 0.889, except one with I-CVI = 0.667. For importance, most items had CVR above the threshold value of 0.778, except 5 items. Also, the result showed moderate to high content validity of the overall instrument (S-CVI/UA = 0.694 S-CVI/Ave = 0.996). These findings support the validity and reliability of the developed instrument, which can be used to identify factors that motivated patients to use a teleconsultation system. Future testing of the instrument should be conducted with a larger population that uses a teleconsultation system. An instrument was developed to identify factors that motivated consumers to use teleconsultation, using a modified eDelphi method among experts. The eDelphi method consisted of three rounds and the results showed that the instrument is a valid and reliable tool.
Publisher: Royal Society of Chemistry (RSC)
Date: 2017
DOI: 10.1039/C6NH00162A
Abstract: Engineered nanoparticles for biomedical applications require increasing effectiveness in targeting specific cells while preserving non-target cells safety.
Publisher: American Medical Association (AMA)
Date: 09-2021
Publisher: Springer Science and Business Media LLC
Date: 04-02-2016
DOI: 10.1007/S10916-016-0438-0
Abstract: Patient education plays an important role in chronic disease management. The aim of this study is to identify patients' preferences in regard to the design features of effective online patient education (OPE) and the benefits. A review of the existing literature was conducted in order to identify the benefits of OPE and its essential design features. These design features were empirically tested by conducting survey with patients and caregivers. Reliability analysis, construct validity and regression analysis were performed for data analysis. The results identified patient-tailored information, interactivity, content credibility, clear presentation of content, use of multimedia and interpretability as the essential design features of online patient education websites for chronic disease management.
Publisher: Wiley
Date: 25-02-2019
Abstract: The large interactive surfaces of nanoparticles (NPs) increase the opportunities to develop NPs for vascular targeting. Proteomic analysis of endothelial cells exposed to NPs reveals the cellular response and turns the focus into the impairment of the endothelial permeability. Here, quantitative proteomics and transcriptome sequencing are combined to evaluate the effects of exposure to sub-lethal concentrations of TiO
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2019
Publisher: Springer Berlin Heidelberg
Date: 2008
Publisher: Springer Science and Business Media LLC
Date: 22-03-2016
Publisher: American Medical Association (AMA)
Date: 18-03-2021
Publisher: IEEE
Date: 11-2019
Publisher: Mary Ann Liebert Inc
Date: 12-2021
Abstract: Men and women differ in outcomes following mild traumatic brain injury (TBI). In the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, we previously found that women had worse 6-month functional outcome (Glasgow Outcome Score Extended [GOSE]), health-related quality of life (HRQoL), and mental health following mild TBI. The aim of this study was to investigate whether those differences were mediated by psychiatric history, gender-related sociodemographic variables, or by care pathways. We analyzed sex/gender differences in 6-month GOSE, generic and TBI-specific HRQoL, and post-concussion and mental health symptoms using three sets of mediators: psychiatric history, sociodemographic variables (living alone, living with children, education and employment status/job category), and care-pathways (referral to study hospital and discharge destination after emergency department) while controlling for a substantial number of potential confounders (pre-injury health and injury-related characteristics). We included 1842 men and 1022 women (16+) with a Glasgow Coma Score 13-15, among whom 83% had GOSE available and about 60% other 6-month outcomes. We used natural effects models to decompose the total effect of sex/gender on the outcomes into indirect effects that passed through the specified mediators and the remaining direct effects. In our study population, women had worse outcomes and these were only partly explained by psychiatric history, and not considerably explained by sociodemographic variables nor by care pathways. Factors other than differences in specified variables seem to underlie observed differences between men and women in outcomes after mild TBI. Future studies should explore more aspects of gender roles and identity and biological factors underpinning sex and gender differences in TBI outcomes.
Publisher: Springer Science and Business Media LLC
Date: 24-07-2021
Publisher: Springer Science and Business Media LLC
Date: 23-01-2019
DOI: 10.1007/S10916-019-1159-Y
Abstract: Persuasion Support Systems (PSS) for health behavior change can play an important role in promoting health and well-being through physical activity. It is an emerging application at the crossroad between information systems, persuasion, and healthcare. We propose an ontology to systematically and systemically describe the construct of PSS for health behavior change. The ontology deconstructs the construct into its constituent dimensions and elements, and assembles them into a complete, parsimonious description of the same. We then map the corpus of literature on PSS for health behavior change through physical activity onto the ontology. The resulting ontological map highlights the research topics that are highly- and lightly-emphasized, as well as those with little or no emphasis. It illuminates the landscape of research in the corpus it highlights biases in emphases that can help and hinder the advancement of the corpus. It can be used to develop a roadmap for future research.
Publisher: SAGE Publications
Date: 03-10-2018
Abstract: Electronic medical records are increasingly used for research with limited external validation of their data. This study investigates the validity of electronic medical data (EMD) for estimating diabetes prevalence in general practitioner (GP) patients by comparing EMD with national Bettering the Evaluation and Care of Health (BEACH) data. A “decision tree” was created using inclusion/exclusion of pre-agreed variables to determine the probability of diabetes in absence of diagnostic label, including diagnoses (coded/free-text diabetes, polycystic ovarian syndrome, impaired glucose tolerance, impaired fasting glucose), diabetic annual cycle of care (DACC), glycated haemoglobin (HbA1c) 6.5%, and prescription (metformin, other diabetes medications). Via SQL query, cases were identified in EMD of five Illawarra and Southern Practice Network practices (30,007 active patients from 2 years to January 2015). Patient-based Supplementary Analysis of Nominated Data (SAND) sub-studies from BEACH investigating diabetes prevalence (1172 GPs 35,162 patients November 2012 to February 2015) were comparison data. SAND results were adjusted for number of GP encounters per year, per patient, and then age–sex standardised to match age–sex distribution of EMD patients. Cluster-adjusted 95% confidence intervals (CIs) were calculated for both datasets. EMD diabetes prevalence (T1 and/or T2) was 6.5% (95% CI: 4.1–8.9). Following age–sex standardisation, SAND prevalence, not significantly different, was 6.7% (95% CI: 6.3–7.1). Extracting only coded diagnosis missed 13.0% of probable cases, subsequently identified through the presence of metformin/other diabetes medications (*without other indicator variables) (6.1%), free-text diabetes label (3.8%), HbA1c result* (1.6%), DACC* (1.3%), and diabetes medications* (0.2%). While complex, proxy variables can improve usefulness of EMD for research. Without their consideration, EMD results should be interpreted with caution. Enforceable, transparent data linkages in EMRs would resolve many problems with identification of diagnoses. Ongoing data quality improvement remains essential.
Publisher: Wiley
Date: 10-05-2018
DOI: 10.1111/OPN.12198
Abstract: The purpose of the study was to evaluate the usefulness of the "Managing Medicines for People with Dementia" (www.dementiameds.com) website for informal carers. The management of medications for in iduals living with a dementia by informal carers is a neglected area of care. We know that informal carers find it difficult accessing reliable and comprehensive information about medications. We also know that the Internet is a contemporary and growing medium through which consumers access health information. This study was unique in that it brought these two elements together through an interdisciplinary study about the usefulness of a new website providing information on medication management. Data collection consisted of focus groups with informal carers of in iduals living with a dementia. Data were analysed through content analysis. Four themes were generated from the data to explain the evaluation of the website by informal carers: (1) Suitability of the website (2) Presentation of the website (3) Unexpected benefits of the website content (4) Future enhancements for website. Participants overwhelmingly agreed the content of the website filled a gap in information needs about medication management for in iduals living with a dementia. This qualitative evaluation demonstrated the value of the website as a resource for informal carers of in iduals living with a dementia. The resource could also be used by community nurses and other healthcare practitioners to help informal carers better manage the medication regimes of in iduals living with a dementia. The resource has the potential to reduce complications associated with mismanagement of medications and contribute to new policies for implementing safe medication practices.
Publisher: Elsevier BV
Date: 02-2020
Publisher: Elsevier BV
Date: 07-2021
Publisher: IEEE
Date: 2016
Publisher: Cambridge University Press (CUP)
Date: 10-2010
DOI: 10.1017/S0266462310001121
Abstract: Objectives: The aim of this study was to examine open-source electronic health record (EHR) software to determine their level of functionalities according to the International Organization for Standardization (ISO) standards. Methods: ISO standards were used as a guideline to determine and describe the reference architecture and functionalities of a standard electronic health record system as well the environmental context for which the software has been built. Twelve open-source EHR systems were selected and evaluated according to two-dimensional criteria based on ISO/TS 18308:2004 functional requirements and ISO/TR 20514:2005 context of the EHR system. Results: Open EHR software programs mostly fulfill structural, procedural, evolutional, and medicolegal requirements at the minimal and full functionality levels. Communication, privacy, and security requirements are accomplished in less than 23 percent of the cases, mainly at minimal functional level. Ethical, cultural, and consumer requirements still need to be fulfilled by free and open-source EHR applications. Conclusions: Most analyzed systems had several functional limitations. Nevertheless, especially for clinicians and decision makers in developing countries, open-source EHR systems are an option. The limited functionalities are likely to become requirements for further releases of open-source EHR systems.
Publisher: JMIR Publications Inc.
Date: 25-09-2019
Abstract: ealthCare providers are adopting information communication technologies (ICT) to enhance their services. Telemedicine is one of the services that rely heavily on ICT technologies to enable remote patients to communicate with their health professional. The patient communicates with the health professional for a follow-up or for a consultation about his/her health condition. This communication process is referred to as an electronic consultation (e-consultation). However, the usage of e-consultation can be influenced positively or negatively by external or internal factors. External factors refer to the environment surrounding the system and the system itself, while internal factors refer to user behaviour and motivation. his review aims to (1) investigate the barriers and the facilitators that influence the use of home consultation systems in the healthcare context. Further, it aims to (2) identify the effectiveness of Home Online Health Consultation (HOHC) systems in improving patients’ health and (3) patients’ satisfaction with it. he researchers conducted a systematic literature review to search for articles (empirical studies) about online health consultation in three digitals libraries: Scopus, Association for Computing Machinery (ACM) and Web of Science. The search on the databases yielded 1016 articles and after following the Inclusion and Exclusion criteria, the number of included articles for the final review was 44. A qualitative content analysis was performed to identify barriers and facilitators to HOHC, its effectiveness and patients’ satisfaction with it. he systematic literature review identified several external and internal facilitators and barriers to HOHC systems that were used in the creation of a HOHC framework. The framework consists of four requirements, 17 facilitators and eight barriers, categorized as internal and external influences on HOHC. atients from different age groups and different health conditions benefited from remote health services. OHC via video conferencing was effective in delivering online treatment and was well accepted by patients as it simulated in-person face-to-face consultation. Acceptance by patients was assisted by online consultation facilitators that promoted effective and convenient remote treatment. However, some patients preferred face-to-face consultation showing resistance to the online consultation. Resistance to online consultations was influenced by a few of the identified barriers. Overall, the framework identified the facilitators and barriers that positively and negatively influence the uptake of HOHC.
Publisher: Mary Ann Liebert Inc
Date: 07-2021
Abstract: In medical research, missing data is common. In acute diseases, such as traumatic brain injury (TBI), even well-conducted prospective studies may suffer from missing data in baseline characteristics and outcomes. Statistical models may simply drop patients with any missing values, potentially leaving a selected subset of the original cohort. Imputation is widely accepted by methodologists as an appropriate way to deal with missing data. We aim to provide practical guidance on handling missing data for prediction modeling. We hereto propose a five-step approach, centered around single and multiple imputation: 1) explore the missing data patterns 2) choose a method of imputation 3) perform imputation 4) assess diagnostics of the imputation and 5) analyze the imputed data sets. We illustrate these five steps with the estimation and validation of the IMPACT (International Mission on Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury) prognostic model in 1375 patients from the CENTER-TBI database, included in 53 centers across 17 countries, with moderate or severe TBI in the prospective European CENTER-TBI study. Future prediction modeling studies in acute diseases may benefit from following the suggested five steps for optimal statistical analysis and interpretation, after maximal effort has been made to minimize missing data.
Publisher: Elsevier BV
Date: 06-2018
Publisher: Springer Science and Business Media LLC
Date: 28-06-2006
DOI: 10.1007/S10916-006-9019-Y
Abstract: The objective of this study is to analyze the security protection of personal health record systems. To achieve this we have investigated different personal health record systems, their security functions, and security issues. We have noted that current security mechanisms are not adequate and we have proposed some security mechanisms to tackle these problems.
Publisher: IEEE
Date: 07-2008
Publisher: IGI Global
Date: 2006
DOI: 10.4018/978-1-59140-866-6.CH036
Abstract: Access to mobile data and messages is essential in healthcare environment as patients and healthcare providers are mobile. This is inline with the need of ubiquitous computing in everyday life. Mobile and wireless devices can assist in ensuring patient’s safety by providing easy availability of the data at the point of care. Portability and accessibility of these devices enhances use of them in healthcare environment. However, data integrity and confidentiality of information in them need to be ensured to provide safe, effective and efficient healthcare. Mobile healthcare involves conducting healthcare related activities through using mobile devices such as a smart phone, Personal digital assistant (PDA), wireless enabled computer, iPod and so on. Mobile computing is suitable for healthcare as healthcare providers are mobile. These would be suitable for conducting patient’s healthcare activities in emergencies, ward rounds, homecare, chronic disease management, conducting clinical trials, and so on. There are various projects using mobile devices to enhance patient’s care. With the advancement of medical informatics, telemedicine and information technology, mobile data devices play an enormous role in healthcare system. In this chapter, we outline the need of mobile devices in healthcare, usage of these devices, underlying technology and applications, importance of security of these devices, securing mobile data communication in healthcare through different security models and case ex les of applications that we have developed, in particular (1) iPathology tool on iPod, (2) securing healthcare information using Pocket PC 2003, and (3) securing information on handheld devices. There were several incidents in the past due to the insecurity of mobile devices that can leak information to anyone who does not have access to the information. In this chapter, we will illustrate several techniques that we have developed to protect these malicious activities and how these are applicable for securing mobile data computing in healthcare.
Publisher: Springer Singapore
Date: 2019
Publisher: IGI Global
Date: 2013
DOI: 10.4018/978-1-4666-2770-3.CH070
Abstract: Protecting the confidentiality of a patient’s information in a shared care environment could become a complex task. Correct identification of users, assigning of access permissions, and resolution of conflict rise as main points of interest in providing solutions for data exchange among health care providers. Traditional approaches such as Mandatory Access Control, Discretionary Access control and Role-Based Access Control policies do not always provide a suitable solution for health care settings, especially for shared care environments. The core of this contribution consists in the description of an approach which uses attribute-based encryption to protect the confidentiality of patients’ information during the exchange of electronic health records among healthcare providers. Attribute-based encryption allows the reinforcing of access policies and reduces the risk of unauthorized access to sensitive information it also provides a set of functionalities which are described using a case study. Attribute-based encryption provides an answer to restrictions presented by traditional approaches and facilitate the reinforcing of existing security policies over the transmitted data.
Publisher: Springer International Publishing
Date: 2019
Publisher: Elsevier BV
Date: 2022
Publisher: Elsevier BV
Date: 12-2020
Publisher: Elsevier BV
Date: 09-2018
Publisher: Springer New York
Date: 06-11-2012
Publisher: Informa UK Limited
Date: 04-05-2018
Publisher: JMIR Publications Inc.
Date: 29-05-2020
DOI: 10.2196/17361
Abstract: Supporting women to initiate and continue breastfeeding is a global challenge. A range of breastfeeding interventions employing electronic technologies (e-technologies) are being developed, which offer different delivery modes and features over the internet however, the impact of internet-based e-technologies on breastfeeding outcomes remains unclear. This study aimed to identify the characteristics of current internet-based breastfeeding interventions employing e-technologies and investigate the effects of internet-based e-technologies on breastfeeding outcomes. A systematic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in the following databases: Scopus, Web of Science, the Cochrane Database of Systematic Reviews, ScienceDirect, Google Scholar, the Association for Computing Machinery, SpringerLink, and Institute of Electrical and Electronics Engineers Xplore. This systematic review included 16 studies published between 2007 and 2018, with 4018 women in 8 countries. The characteristics of the interventions were grouped based on (1) mode of delivery (web-based, mobile phone apps, and computer kiosk), (2) purpose of the interventions (education and support), and (3) key strategies (monitoring and breastfeeding tracking, personalization, online discussion forum, web-based consultation, and breastfeeding station locators). Combining educational activities with web-based personalized support through discussion forums appeared to be the most effective way to improve breastfeeding outcomes and long-term exclusive breastfeeding rates. Monitoring and breastfeeding trackers appeared to be the least effective ways. This study demonstrated a variety of internet-based e-technologies that professionals can use to promote, educate, and support breastfeeding women. Future internet-based breastfeeding interventions employing e-technologies might consider improving interaction with mothers and personalizing the content of the proposed interventions.
Publisher: IEEE
Date: 2009
Publisher: SAGE Publications
Date: 09-2004
DOI: 10.1177/183335830403300205
Abstract: This article discusses the risk assessment of a health information system. A case study was conducted at the South Western Sydney Area Health Service to examine the potential risks of the Maternal and Infant Network (MINET) health information system using Failure Mode Effect Analysis (FMEA). FMEA was conducted by utilising safety attributes identified by the authors. Potential failure modes of the system were identified by the study. From this study, it can be concluded that FMEA is an appropriate risk-assessment method for MINET.
Publisher: SAGE Publications
Date: 09-2004
DOI: 10.1177/183335830403300204
Abstract: In November 1997, the South Western Sydney Area Health Service launched the Mother and Infant Network (MINET). The key objective of MINET is to develop an integrated clinical data network which has the capacity to inform and support a continuum of care for the population of all mothers, infants and children. The MINET data network integrates in-patient services, ambulatory services, and community-based services. The focus of this article is the development and implementation of MINET with reference to the crucial role of data linkage and health informatics in health outcomes/health services research.
Publisher: IEEE
Date: 2010
Publisher: IEEE
Date: 2010
Publisher: IEEE
Date: 2013
Publisher: IGI Global
Date: 2010
DOI: 10.4018/978-1-61692-895-7.CH001
Abstract: Protecting the confidentiality of a patient‘s information in a shared care environment could become a complex task. Correct identification of users, assigning of access permissions, and resolution of conflict rise as main points of interest in providing solutions for data exchange among health care providers. Traditional approaches such as Mandatory Access Control, Discretionary Access control and Role-Based Access Control policies do not always provide a suitable solution for health care settings, especially for shared care environments. The core of this contribution consists in the description of an approach which uses attribute-based encryption to protect the confidentiality of patients’ information during the exchange of electronic health records among healthcare providers. Attribute-based encryption allows the reinforcing of access policies and reduces the risk of unauthorized access to sensitive information it also provides a set of functionalities which are described using a case study. Attribute-based encryption provides an answer to restrictions presented by traditional approaches and facilitate the reinforcing of existing security policies over the transmitted data.
Publisher: IEEE
Date: 29-12-2021
Publisher: Australian Journal of Information Systems
Date: 12-02-2019
Abstract: Telehealth interventions are designed to facilitate the remote exchange of information and data between patients and health care providers, improving the quality and safety of the patients and increasing efficiency and cost-effectiveness of health care providers. The development of telecommunications and virtual technology allowed a number of telehealth systems to be applied in different health care areas. These technologies can provide an alternative monitoring and solutions for decreasing the hospital readmission rates for patients with congestive heart failure (CHF). In this paper, a systematic literature review regarding tele-monitoring and its use in the management of patients with CHF is conducted. The result indicated that a standardized tele-monitoring design would reduce a length of hospitalization and re-hospitalization rate. The other factors that moderate the effectiveness of the tele-monitoring intervention include quality of life, mortality rate, and disease-specific knowledge (health literacy). All these factors align with the consumer-centred principle of The Australian Safety and Quality Framework for Health Care.
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.IJMEDINF.2022.104789
Abstract: Persuasive design principles are increasingly employed in mHealth apps for motivating users and promoting healthy behaviours among in iduals. However, how the persuasive design principles are perceived by the mHealth app users remains unclear. To develop and validate the content validity of an instrument designed to measure the user's perceptions of the persuasive design principles assimilated in a breastfeeding mHealth app. A critical review of the literature guided the development of the research instrument. The developed instrument was refined and validated through a two-round modified Delphi process. Ten experts drawn from academic and clinical settings evaluated the items through two content validity indicators, relevance, and clarity and provided narrative feedback. The content validity of the instrument was determined by calculating the Content Validity Index (CVI). Content validity indicators at the scale-level (S-CVI) and item-level (I-CVI) were calculated. The results demonstrated high content validity index of in idual items in the instrument. All items in the instrument reached an excellent I-CVI ≥ 0.78 for both relevance and clarity except one item. The overall content validity index of the instrument using the average approach was moderate to high (S-CVI/Ave was 0.89 and 0.92 for relevance and clarity, respectively). The developed research instrument is composed of 5 constructs representing 24 items: (1) primary task support, (2) dialogue support, (3) system credibility support, (4) social support and (5) perceived persuasiveness. Using a modified Delphi approach, the development and validation of the research instrument demonstrated moderate to high content validity for measuring users' perceptions of the persuasive design principles assimilated in a breastfeeding mHealth app. The evidence from this study supports that the research instrument is valid, relevant, and clear.
Publisher: Springer International Publishing
Date: 2019
Publisher: Springer New York
Date: 06-11-2013
Publisher: Springer Science and Business Media LLC
Date: 11-02-2015
DOI: 10.1007/S10916-015-0224-4
Abstract: With the advancement in technology and availability of the Internet, online health education could become one of the media for health education. As health education is to persuade patients on health behavioural change, understanding perceived benefits of online health education is an important aspect to explore. The aim of this study is to explore consumers and health professionals opinion on online health education. Literature review was conducted and identified the benefits of online health education (OHE). Survey was conducted to health consumers and health professionals. Descriptive analyses were performed using SPSS Version 19.0. The analysis of the literature has identified a set of 12 potential benefits of OHE which had been used to understand the perceptions of the effectiveness of OPE sites and these have been validated in the study. This study has the practical implication as the study identified OHE effectiveness, which definitely can assist health practitioners on health education, which can lead to better health outcome.
Publisher: Springer Science and Business Media LLC
Date: 09-01-2016
DOI: 10.1007/S10916-015-0425-X
Abstract: Persuasive technology in mobile applications can be used to influence the behaviour of users. A framework known as the Persuasive Systems Design model has been developed for designing and evaluating systems that influence the attitudes or behaviours of users. This paper reviews the current state of mobile applications for health behavioural change with an emphasis on applications that promote physical activity. The inbuilt persuasive features of mobile applications were evaluated using the Persuasive Systems Design model. A database search was conducted to identify relevant articles. Articles were then reviewed using the Persuasive Systems Design model as a framework for analysis. Primary task support, dialogue support, and social support were found to be moderately represented in the selected articles. However, system credibility support was found to have only low levels of representation as a persuasive systems design feature in mobile applications for supporting physical activity. To ensure that available mobile technology resources are best used to improve the wellbeing of people, it is important that the design principles that influence the effectiveness of persuasive technology be understood.
Start Date: 2012
End Date: 2015
Funder: Australian Research Council
View Funded ActivityStart Date: 2006
End Date: 2008
Funder: Australian Research Council
View Funded ActivityStart Date: 2020
End Date: 2022
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2006
End Date: 12-2009
Amount: $229,608.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2013
End Date: 12-2016
Amount: $105,000.00
Funder: Australian Research Council
View Funded Activity