scholarly journals Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension

Hypertension ◽  
2020 ◽  
Vol 76 (5) ◽  
pp. 1368-1383 ◽  
Author(s):  
Stefano Omboni ◽  
Richard J. McManus ◽  
Hayden B. Bosworth ◽  
Lucy C. Chappell ◽  
Beverly B. Green ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Vital Signs ◽  
Healthcare Services ◽  
Hypertension Management ◽  
Team Physician ◽  
Video Consultation ◽  
Ideal Approach ◽  
Healthcare Model ◽  
Automated Feedback ◽  
The Ideal

Telemedicine allows the remote exchange of medical data between patients and healthcare professionals. It is used to increase patients’ access to care and provide effective healthcare services at a distance. During the recent coronavirus disease 2019 (COVID-19) pandemic, telemedicine has thrived and emerged worldwide as an indispensable resource to improve the management of isolated patients due to lockdown or shielding, including those with hypertension. The best proposed healthcare model for telemedicine in hypertension management should include remote monitoring and transmission of vital signs (notably blood pressure) and medication adherence plus education on lifestyle and risk factors, with video consultation as an option. The use of mixed automated feedback services with supervision of a multidisciplinary clinical team (physician, nurse, or pharmacist) is the ideal approach. The indications include screening for suspected hypertension, management of older adults, medically underserved people, high-risk hypertensive patients, patients with multiple diseases, and those isolated due to pandemics or national emergencies.

Intranasal dexmedetomidine: the ideal drug for sedation in the pediatric echo lab?

2021 ◽  
pp. 1-5
Author(s):  
David E Saudek ◽  
Deborah Walbergh ◽  
Peter Bartz ◽  
Sara Shreve ◽  
Amy Schaal ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Disease ◽  
Chart Review ◽  
Chloral Hydrate ◽  
Vital Signs ◽  
Cyanotic Heart Disease ◽  
Historical Cohort ◽  
Safety And Efficacy ◽  
Attractive Option ◽  
The Ideal

Abstract Background: Intranasal dexmedetomidine is an attractive option for procedural sedation in pediatrics due to ease of administration and its relatively short half-life. This study sought to compare the safety and efficacy of intranasal dexmedetomidine to a historical cohort of pediatric patients sedated using chloral hydrate in a pediatric echo lab. Methods: Chart review was performed to compare patients sedated between September, 2017 and October, 2019 using chloral hydrate and intranasal dexmedetomidine. Vital signs, time to sedation, duration of sedation, need for second dose of medication, rate of failed sedation, and impact on vital signs were compared between groups. Subgroup analysis was performed for those with complex and cyanotic heart disease. Results: Chloral hydrate was used in 356 patients and intranasal dexmedetomidine in 376. Patient age, complexity of heart disease, and duration of sedation were similar. Rates of failed sedation were very low and similar. Average heart rate and minimum heart rate were lower for those receiving intranasal dexmedetomidine than chloral hydrate. Impact on vital signs was similar for those with complex and cyanotic heart disease. No adverse events occurred in either group. Conclusions: Sedation with intranasal dexmedetomidine is comparable to chloral hydrate in regards to safety and efficacy for children requiring echocardiography. Consistent with the mechanism of action, patients receiving intranasal dexmedetomidine have a lower heart rate without morbidity.

The Ideal approach for casing leak repairs in Old wells

2017 ◽  
Author(s):  
Abdulla Faleh Al-Dossary ◽  
Abdulasalm Al-warthan ◽  
Mohammed Al-Badran ◽  
Ibrahim S. Al-Ghamdi ◽  
Wessam Mutawaa
Keyword(s):  
Ideal Approach ◽  
The Ideal

scholarly journals Remote Monitoring of Patients with COVID-19 after Hospital Discharge with Connected Health Platform: Outcomes and Quality of Life

2020 ◽  
pp. 1-5
Author(s):  
César Morcillo Serra ◽  
César Morcillo Serra ◽  
Domingo Marzal Martín ◽  
Jorge Velázquez Moro ◽  
José Francisco Tomás Martínez
Keyword(s):  
Quality Of Life ◽  
Oxygen Saturation ◽  
Hospital Discharge ◽  
Remote Monitoring ◽  
Vital Signs ◽  
Medical Team ◽  
Mobile Phone Application ◽  
Connected Health ◽  
Video Consultation

Background: Telemonitoring with applications and connected devices facilitates a more accessible and efficient attention. Its implementation has been accelerated thanks to the pandemic by COVID-19, where they have allowed the continuity of care. Objective: To evaluate the efficacy of a remote monitoring platform for the outpatient follow-up after hospital discharge by COVID-19. Methods: Prospective observational study of patients discharged from the hospital with COVID-19 infection between March 23 and May 25, 2020, who were followed for one month with the Connected Health telemonitoring platform. The mobile phone application connected to a pulse oximeter, allowed to measure vital signs and answer health questionnaires (EQ5D3L and CAT) daily, and alert the medical team that could be contacted by video consultation. Results: 95 patients (64% male) with a mean age of 54 (SD 26-81) years were included. The application allowed the detection of alerts for pain (80% of patients) and a decrease in oxygen saturation (12%). No patient required hospital readmission or presented complications. The application allowed strict monitoring of symptoms and quality of life. The main symptom was severe pain (59% of patients) followed by anxiety or depression (25%). The average state of health was 65 (SD 20-100). COVID-19 caused a low impact on the quality of life of 62% of the patients, although 8% reported a significant limitation, due to shortness of breath and leaving the house. Conclusion: telemonitoring allows a safe remote monitoring of patients after hospital discharge by COVID-19. The Connected Health application has allowed the measurement of oxygen saturation, symptoms and quality of life, and the detection and management of alerts by the medical team through video consultation.

scholarly journals IoT-Based Applications in Healthcare Devices

2021 ◽  
Vol 2021 ◽  
pp. 1-18
Author(s):  
Bikash Pradhan ◽  
Saugat Bhattacharyya ◽  
Kunal Pal
Keyword(s):  
Medical Devices ◽  
Healthcare Costs ◽  
Healthcare Professionals ◽  
Healthcare Services ◽  
The Internet ◽  
Healthcare Industry ◽  
Healthcare Applications ◽  
Source Of Information ◽  
The Internet Of Things ◽  
Insight Into

The last decade has witnessed extensive research in the field of healthcare services and their technological upgradation. To be more specific, the Internet of Things (IoT) has shown potential application in connecting various medical devices, sensors, and healthcare professionals to provide quality medical services in a remote location. This has improved patient safety, reduced healthcare costs, enhanced the accessibility of healthcare services, and increased operational efficiency in the healthcare industry. The current study gives an up-to-date summary of the potential healthcare applications of IoT- (HIoT-) based technologies. Herein, the advancement of the application of the HIoT has been reported from the perspective of enabling technologies, healthcare services, and applications in solving various healthcare issues. Moreover, potential challenges and issues in the HIoT system are also discussed. In sum, the current study provides a comprehensive source of information regarding the different fields of application of HIoT intending to help future researchers, who have the interest to work and make advancements in the field to gain insight into the topic.

scholarly journals Compliance of Healthcare Professionals with Safety Measures for Control of Hepatitis Viruses in Hemodialysis Centers: An Experience from Southeast Iran

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Sodaif Darvish Moghaddam ◽  
Mohammad Javad Zahedi ◽  
Mahdieh Dalili ◽  
Mostafa Shokoohi
Keyword(s):  
Infection Control ◽  
Healthcare Professionals ◽  
Compliance Rate ◽  
Healthcare Services ◽  
Control Measures ◽  
Hepatitis Viruses ◽  
Safety Measures ◽  
Infection Control Measures ◽  
Periodic Monitoring ◽  
Single Use

Introduction. Noncompliance with the recommended infection control measures by the healthcare professionals (HCPs) plays a major role in transmission of hepatitis B (HBV) and hepatitis C (HCV) viruses in hemodialysis (HD) wards. This study aimed to determine the compliance rate of the HCP with safety measures in the HD wards in southeast Iran. Patients and Methods. A total of 208 patients were enrolled. Adherence of HCPs with standard infection control measures was assessed. Results. Sixty-one HCPs with a mean age of 32.4 ± 11.2 years old were responsible for healthcare services. Compliance with the following items was weak: not sharing medications trolley (29.8%), disinfecting the shared instruments (46.2%), using single use materials for many patients (52.4%), carrying used materials in disposable containers (51.9%), not returning of unused materials to the clean room (55.3%), and adherence to hand washing (58.7%). Periodic monitoring for HBV and HCV was performed on 100% and 69.7% of the patients, respectively. Less than 2/3 of HCPs participated in the retraining courses. Conclusion. Compliance of HCPs with safety measures for viral hepatitis prevention was partly inadequate in HD wards. Emphasis on retraining of HCPs and official supervision would be effective steps in the reduction of viral dissemination.

Providing Patient Centered Care for Adolescents with Chronic Conditions

2016 ◽  
Vol 6 (1) ◽  
pp. 22-29
Author(s):  
Nabeel Al-Yateem
Keyword(s):  
Young Adults ◽  
Healthcare Professionals ◽  
Transition Process ◽  
Healthcare Services ◽  
Adolescents And Young Adults ◽  
Study Phase ◽  
Patient Centered ◽  
Centered Care ◽  
Group Interviews ◽  
Depth Interviews

Background: It is well acknowledged that clear, structured healthcare services that are mutually developed between the patient and the healthcare professionals are likely to be of high quality, desirable, and effective. Such service should address the complexity of the illness-health experience in terms of the factors that influence it as well as the physical and psychosocial consequences on the patient. The required focus should be on treating the patient rather than just treating the disease.Objectives: To develop relevant and feasible care guidelines that may inform more competent and patient centered services for adolescents and young adults with chronic conditions.Methodology: A sequential exploratory mixed method design guided this study. The first qualitative phase employed in-depth interviews to explore the experiences of adolescents and young adults about the health services they were receiving. This was followed by focus group interviews with healthcare professionals to discuss the patients’ reported needs and to suggest interventions that would address them. Finally, a second quantitative phase was carried out through a survey to explore the views of a larger sample of service stakeholders about the relevance and feasibility of the suggested guidelines for clinical practice.Results: The in-depth interviews revealed four main themes, as follows: a current amorphous service, sharing knowledge, the need to be at the center of service, and easing the transition process to adulthood. The second study phase yielded 32 proposed guidelines that may contribute to more competent and patient centered health care.

Restoration of Environment Through Phytoremediation

2015 ◽  
pp. 172-195 ◽  
Author(s):  
Arezoo Dadrasnia ◽  
Chijioke U Emenike ◽  
Salmah binti Ismail
Keyword(s):  
Soil Water ◽  
Biological Process ◽  
Time Constraints ◽  
Environmental Restoration ◽  
Future Directions ◽  
Environmental Media ◽  
Original State ◽  
Ideal Approach ◽  
The Future ◽  
The Ideal

Environmental restoration is a phenomenon required to keep the ecosystem intact, or enhance the rejuvenation of impaired environmental media; soil, water and air. Various methods of remediation exist, yet restoring the environment to the proximal or original state appear elusive to most methods. Interestingly, phytoremediation which is a biological process does not only restore environment in a greener way, but also can adopt diverse mechanisms such phytoextraction, phytodegradation, rhizodegrdation, phytostabilization and phytovolatization, to achieve the desired outcome. The chapter also unlined the merits and a few demerits of this principle, while the identification of sustainable plants and the mitigation of time constraints were the future directions mentioned for the projection of phytoremediation as the ideal approach for the restoration of the environment.

Business Ethics and the Greek Healthcare System

2018 ◽  
pp. 100-127 ◽  
Author(s):  
Vaitsa Giannouli
Keyword(s):  
Business Ethics ◽  
Healthcare System ◽  
Healthcare Professionals ◽  
Maslach Burnout Inventory ◽  
Healthcare Services ◽  
Ethical Values ◽  
Structured Interviews ◽  
Future Directions ◽  
Emotional Aspects ◽  
Job Affect

This chapter provides a review not only of classic literature on healthcare business and ethics, but also an introduction to the legal changes in the Greek healthcare system with ethical values on focus. A study examining in both a quantitative and qualitative way what the Greek healthcare experts think and feel about ethics and healthcare services presents the factors that shape attitudes towards ethical values from the viewpoint of the healthcare professionals. For this reason, 34 semi-structured interviews, accompanied by the administration of perceived cohesion scale, generalized immediacy scale, job affect scale, state anxiety inventory, Maslach burnout inventory, and the attitude towards business ethics questionnaire revealed that healthcare professionals do have knowledge of ethical values and moral responsibility, but no clear connections with specific emotional aspects were found. The chapter concludes with future directions on how business ethics can be further examined and applied.

scholarly journals Patient perspectives on hypertension management in health system of Sri Lanka: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031773
Author(s):  
Manuja Perera ◽  
Chamini Kanatiwela de Silva ◽  
Saeideh Tavajoh ◽  
Anuradhani Kasturiratne ◽  
Nathathasa Vihangi Luke ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Health Services ◽  
Low Income ◽  
Rural Areas ◽  
Healthcare Professionals ◽  
Public Awareness ◽  
Uncontrolled Hypertension ◽  
Hypertension Management ◽  
Antihypertensive Medications ◽  
Patient Pathways

IntroductionUncontrolled hypertension is the leading risk factor for mortality globally, including low-income and middle-income countries (LMICs). However, pathways for seeking hypertension care and patients’ experience with the utilisation of health services for hypertension in LMICs are not well understood.ObjectivesThis study aimed to explore patients’ perspectives on different dimensions of accessibility and availability of healthcare for the management of uncontrolled hypertension in Sri Lanka.SettingPrimary care in rural areas in Sri Lanka.Participants20 patients with hypertension were purposively sampled from an ongoing study of Control of Blood Pressure and Risk Attenuation in rural Bangladesh, Pakistan, Sri Lanka.MethodWe conducted in-depth interviews with patients. Interviews were audio-recorded and transcribed into local language (Sinhala) and translated to English. Thematic analysis was used and patient pathways on their experiences accessing care from government and private clinics are mapped out.ResultsOverall, most patients alluded to the fact that their hypertension was diagnosed accidentally in an unrelated visit to a healthcare provider and revealed lack of adherence and consuming alternatives as barriers to control hypertension. Referring to the theme ‘Accessibility and availability of hypertension care’, patients complained of distance to the hospitals, long waiting time and shortage of medicine supplies at government clinics as the main barriers to accessing health services. They often resorted to private physicians and paid out of pocket when they experienced acute symptoms attributable to hypertension. Considering the theme ‘Approachability and ability to perceive’, the majority of patients mentioned increasing public awareness, training healthcare professionals for effective communication as areas of improvement. Under the theme ‘Appropriateness and ability to engage’, few patients were aware of the names or purpose of their medications and reportedly missed doses frequently. Reminders from family members were considered a major facilitator to adherence to antihypertensive medications. Patients welcomed the idea of outreach services for hypertension and health education closer to home in the theme ‘Things the patients reported to improve the system’.ConclusionPatients identified several barriers to accessing hypertension care in Sri Lanka. Measures recommended improving hypertension management in Sri Lanka including public education on hypertension, better communication between healthcare professionals and patients, and efforts to improve access and understanding of antihypertensive medications.Trial registration numberNCT02657746.

scholarly journals Increase in Video Consultations During the COVID-19 Pandemic: Healthcare Professionals’ Perceptions about Their Implementation and Adequate Management

2020 ◽  
Vol 17 (14) ◽  
pp. 5112 ◽  
Author(s):  
Diana Jiménez-Rodríguez ◽  
Azucena Santillán García ◽  
Jesús Montoro Robles ◽  
María del Mar Rodríguez Salvador ◽  
Francisco José Muñoz Ronda ◽  
...  
Keyword(s):  
Health Care ◽  
Healthcare Professionals ◽  
New Technologies ◽  
Technical Skills ◽  
Clinical Settings ◽  
Social Emotional ◽  
Phone Calls ◽  
Video Consultation ◽  
Access And Quality ◽  
Adequate Management

In response to the COVID-19 pandemic, health care modalities such as video consultations have been rapidly developed to provide safe health care and to minimize the risk of spread. The purpose of our study is to explore Spanish healthcare professionals’ perceptions about the implementation of video consultations. Based on the testimonies of 53 professionals, different categories emerged related to the four identified themes: benefits of video consultations (for professionals, patients, and the health system, and compared to phone calls), negative aspects (inherent to new technologies and the risk of a perceived distancing from the professional), difficulties associated with the implementation of video consultations (technological difficulties, lack of technical skills and refusal to use video consultation among professionals and patients), and the need for training (technological, nontechnical, and social-emotional skills, and adaptation of technical skills). Additionally, the interviewees indicated that this new modality of health care may be extended to a broader variety of patients and clinical settings. Therefore, since video consultations are becoming more widespread, it would be advisable for health policies and systems to support this modality of health care, promoting their implementation and guaranteeing their operability, equal access and quality.

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