Remote physiological monitoring in an austere environment: a future for battlefield care provision?

2018 ◽  
Vol 164 (6) ◽  
pp. 410-413
Author(s):  
Matthew J Smyth ◽  
J A Round ◽  
A J Mellor
Keyword(s):  
Remote Monitoring ◽  
Global Market ◽  
Physiological Status ◽  
Care Provision ◽  
Self Monitoring ◽  
Austere Environment ◽  
Military Command ◽  
Monitoring Technologies ◽  
User Friendly ◽  
The Military

Wearable technologies are making considerable advances into the mainstream as they become smaller and more user friendly. The global market for such devices is forecasted to be worth over US$5 billion in 2018, with one in six people owning a device. Many professional sporting teams use self-monitoring to assess physiological parameters and work rate on the pitch, highlighting the potential utility for military command chains. As size of device reduces and sensitivity improves, coupled with remote connectivity technology, integration into the military environment could be relatively seamless. Remote monitoring of personnel on the ground, giving live updates on their physiological status, would allow commanders or medical officers the ability to manage their soldiers appropriately and improve combat effectiveness. This paper explores a proof of concept for the use of a self-monitoring system in the austere high altitude environment of the Nepalese Himalayas, akin to those experienced by modern militaries fighting in remote locations. It also reviews, in part, the historical development of remote monitoring technologies. The system allowed for physiological recordings, plotted against GPS position, to be remotely monitored in Italy. Examples of the data recorded are given and the performance of the system is discussed, including limitations, potential areas of development and how systems like this one could be integrated into the military environment.

RELATIONSHIPS BETWEEN COMMAND, MANAGEMENT, AND COMMUNICATIONS. TO CONTINUE IN DIFFERENT DIRECTIONS OR TO REMAIN IN SAME FIELD

2018 ◽  
Vol 28 (6) ◽  
pp. 1887-1891
Author(s):  
Todor Kalinov
Keyword(s):  
Data Exchange ◽  
Content Management ◽  
System Structure ◽  
Power Comparison ◽  
Long Distance ◽  
Military Alliances ◽  
Military Systems ◽  
Military Command ◽  
And Control ◽  
The Military

Management and Command253 are two different words and terms, but military structures use them as synonyms. Military commanders’ authorities are almost equal in meaning to civilian managers’ privileges and power. Comparison between military command and the civilian management system structure, organization, and way of work shows almost full identity and overlapping. The highest in scale and size military systems are national ministries of defense and multinational military alliances and coalitions. Military systems at this level combine military command structures with civilian political leadership and support elements. Therefore, they incorporate both military command and civilian management organizations without any complications, because their nature originated from same source and have similar framework and content. Management of organizations requires communication in order to plan, coordinate, lead, control, and conduct all routine or extraordinary activities. Immediate long-distance communications originated from telegraphy, which was firstly applied in 19th century. Later, long-distance communications included telephony, aerial transmitting, satellite, and last but not least internet data exchange. They allowed immediate exchange of letters, voice and images, bringing to new capabilities of the managers. Their sophisticated technical base brought to new area of the military command and civilian management structures. These area covered technical and operational parts of communications, and created engineer sub-field of science, that has become one of the most popular educations, worldwide. Communications were excluded from the military command and moved to separate field, named Computers and Communications. A historic overview and analysis of the command and management structures and requirements shows their relationships, common origin, and mission. They have significant differences: management and control are based on humanities, natural and social sciences, while communications are mainly based on engineering and technology. These differences do not create enough conditions for defragmentation of communications from the management structures. They exist together in symbiosis and management structures need communications in order to exist and multiply their effectiveness and efficiency. Future defragmentation between military command and communications will bring risks of worse coordination, need for more human resources, and worse end states. These risks are extremely negative for nations and should be avoided by wide appliance of the education and science among nowadays and future leaders, managers, and commanders.

scholarly journals Remote monitoring technologies in Alzheimer’s disease: design of the RADAR-AD study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Marijn Muurling ◽  
◽  
Casper de Boer ◽  
Rouba Kozak ◽  
Dorota Religa ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Remote Monitoring ◽  
Rating Scales ◽  
Functional Decline ◽  
Cognitive Domain ◽  
Subjective Rating ◽  
Functional Domain ◽  
Smartphone Applications ◽  
Monitoring Technologies

Abstract Background Functional decline in Alzheimer’s disease (AD) is typically measured using single-time point subjective rating scales, which rely on direct observation or (caregiver) recall. Remote monitoring technologies (RMTs), such as smartphone applications, wearables, and home-based sensors, can change these periodic subjective assessments to more frequent, or even continuous, objective monitoring. The aim of the RADAR-AD study is to assess the accuracy and validity of RMTs in measuring functional decline in a real-world environment across preclinical-to-moderate stages of AD compared to standard clinical rating scales. Methods This study includes three tiers. For the main study, we will include participants (n = 220) with preclinical AD, prodromal AD, mild-to-moderate AD, and healthy controls, classified by MMSE and CDR score, from clinical sites equally distributed over 13 European countries. Participants will undergo extensive neuropsychological testing and physical examination. The RMT assessments, performed over an 8-week period, include walk tests, financial management tasks, an augmented reality game, two activity trackers, and two smartphone applications installed on the participants’ phone. In the first sub-study, fixed sensors will be installed in the homes of a representative sub-sample of 40 participants. In the second sub-study, 10 participants will stay in a smart home for 1 week. The primary outcome of this study is the difference in functional domain profiles assessed using RMTs between the four study groups. The four participant groups will be compared for each RMT outcome measure separately. Each RMT outcome will be compared to a standard clinical test which measures the same functional or cognitive domain. Finally, multivariate prediction models will be developed. Data collection and privacy are important aspects of the project, which will be managed using the RADAR-base data platform running on specifically designed biomedical research computing infrastructure. Results First results are expected to be disseminated in 2022. Conclusion Our study is well placed to evaluate the clinical utility of RMT assessments. Leveraging modern-day technology may deliver new and improved methods for accurately monitoring functional decline in all stages of AD. It is greatly anticipated that these methods could lead to objective and real-life functional endpoints with increased sensitivity to pharmacological agent signal detection.

scholarly journals Enhancing Safety During a Pandemic Using Virtual Care Remote Monitoring Technologies and UML Modeling

2021 ◽  
Author(s):  
Elizabeth M. Borycki ◽  
Andre W. Kushniruk ◽  
Ryan Kletke ◽  
Vivian Vimarlund ◽  
Yalini Senathirajah ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Virus Disease ◽  
Grey Literature ◽  
Object Oriented ◽  
Signs And Symptoms ◽  
Use Cases ◽  
Virtual Care ◽  
The Future ◽  
Government Websites ◽  
Monitoring Technologies

Objectives: This paper describes a methodology for gathering requirements and early design of remote monitoring technology (RMT) for enhancing patient safety during pandemics using virtual care technologies. As pandemics such as COrona VIrus Disease (COVID-19) progress there is an increasing need for effective virtual care and RMT to support patient care while they are at home. Methods: The authors describe their work in conducting literature reviews by searching PubMed.gov and the grey literature for articles, and government websites with guidelines describing the signs and symptoms of COVID-19, as well as the progression of the disease. The reviews focused on identifying gaps where RMT could be applied in novel ways and formed the basis for the subsequent modelling of use cases for applying RMT described in this paper. Results: The work was conducted in the context of a new Home of the Future laboratory which has been set up at the University of Victoria. The literature review led to the development of a number of object-oriented models for deploying RMT. This modeling is being used for a number of purposes, including for education of students in health infomatics as well as testing of new use cases for RMT with industrial collaborators and projects within the smart home of the future laboratory. Conclusions: Object-oriented modeling, based on analysis of gaps in the literature, was found to be a useful approach for describing, communicating and teaching about potential new uses of RMT.

scholarly journals Remote monitoring in heart failure: current and emerging technologies in the context of the pandemic

Heart ◽  
2021 ◽  
Vol 107 (5) ◽  
pp. 366-372
Author(s):  
Donya Mohebali ◽  
Michelle M Kittleson
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Remote Monitoring ◽  
Reliable Method ◽  
Healthcare Delivery ◽  
Rapid Expansion ◽  
Monitoring Technology ◽  
Remote Healthcare ◽  
Monitoring Technologies

The incidence of heart failure (HF) remains high and patients with HF are at risk for frequent hospitalisations. Remote monitoring technologies may provide early indications of HF decompensation and potentially allow for optimisation of therapy to prevent HF hospitalisations. The need for reliable remote monitoring technology has never been greater as the COVID-19 pandemic has led to the rapid expansion of a new mode of healthcare delivery: the virtual visit. With the convergence of remote monitoring technologies and reliable method of remote healthcare delivery, an understanding of the role of both in the management of patients with HF is critical. In this review, we outline the evidence on current remote monitoring technologies in patients with HF and highlight how these advances may benefit patients in the context of the current pandemic.

Remote Wireless Network Monitoring Application System

2012 ◽  
Vol 433-440 ◽  
pp. 7024-7028
Author(s):  
Hui Fu ◽  
Bin Jin ◽  
Lin Han ◽  
Zuo Tang Tao
Keyword(s):  
Wireless Network ◽  
Remote Monitoring ◽  
Rapid Development ◽  
Self Monitoring ◽  
Information Display ◽  
Remote Monitoring System ◽  
Encrypt Data ◽  
And Control ◽  
Embedded Applications ◽  
Monitoring Application

With computer technology, communication technology and the rapid development of electronic technology, remote monitoring technology will be more widely used for data transmission requirements and more stringent. GPRS-based remote monitoring system, which is based in communications equipment, through the server to PC, as the remote control platform, embedded applications, network programming and other technology, the remote information display and control. Throughout the system, users can allow each terminal in the case of permission to accept the data on the changes and settings. Wireless network communication is important that the network transmission of data security and consistency, to solve this problem this thesis, performance of network communications software technology to achieve self-monitoring and self-recovery, while use of end to end encryption to encrypt data on the transmission , which can guarantee data reliability, completeness, real time and security.

II. Caspian Energy: Oil and Gas Resources and the Global Market

2003 ◽  
Vol 2 (3) ◽  
pp. 391-406
Author(s):  
Mehdi Parvizi Amineh ◽  
Henk Houweling
Keyword(s):  
World War Ii ◽  
Property Rights ◽  
Oil And Gas ◽  
International System ◽  
Global Market ◽  
Energy Resources ◽  
Survival Strategies ◽  
The Us ◽  
Oil And Gas Resources ◽  
The Military

AbstractThis article develops several concepts of critical geopolitics and relates them to the energy resources of the Caspian Region. Energy resources beyond borders may be accessed by trade, respectively by conquest, domination and changing property rights. These are the survival strategies of human groups in the international system. The article differentiates between demand-induced scarcity, supply-induced scarcity, structural scarcity and the creation, respectively, transfer of property rights. Together, the behaviors referred to by these concepts create a field of social forces that cross state borders involving state and a variety of non-state actors. During World War II, the US began to separate the military borders of the country from its legal-territorial borders. By dominating the world's oceans, the Anglo-Saxon power presided over the capacity to induce scarcity by interdicting maritime supplies to allies and enemies alike. Today, overland transport increasingly connects economies and energy supplies on the Eurasian continent. The US has therefore to go on land in order to pre-empt the land-based powers from unifying their economies and energy supplies.

scholarly journals Implications of remote monitoring Technology in Optimizing Traditional Self-Monitoring of blood glucose in adults with T2DM in primary care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alex R. Montero ◽  
David Toro-Tobon ◽  
Kelly Gann ◽  
Carine M. Nassar ◽  
Gretchen A. Youssef ◽  
...  
Keyword(s):  
Primary Care ◽  
Blood Glucose ◽  
Diabetes Care ◽  
Remote Monitoring ◽  
Secondary Analysis ◽  
Time Of Day ◽  
Trial Registration ◽  
Blood Glucose Monitoring ◽  
Self Monitoring ◽  
The Impact

Abstract Background Self-monitoring of blood glucose (SMBG) has been shown to reduce hemoglobin A1C (HbA1C). Accordingly, guidelines recommend SMBG up to 4–10 times daily for adults with type 2 diabetes (T2DM) on insulin. For persons not on insulin, recommendations are equivocal. Newer technology-enabled blood glucose monitoring (BGM) devices can facilitate remote monitoring of glycemic data. New evidence generated by remote BGM may help to guide best practices for frequency and timing of finger-stick blood glucose (FSBG) monitoring in uncontrolled T2DM patients managed in primary care settings. This study aims to evaluate the impact of SMBG utility and frequency on glycemic outcomes using a novel BGM system which auto-transfers near real-time FSBG data to a cloud-based dashboard using cellular networks. Methods Secondary analysis of the intervention arm of a comparative non-randomized trial with propensity-matched chart controls. Adults with T2DM and HbA1C > 9% receiving care in five primary care practices in a healthcare system participated in a 3-month diabetes boot camp (DBC) using telemedicine and a novel BGM to support comprehensive diabetes care management. The primary independent variable was frequency of FSBG. Secondary outcomes included frequency of FSBG by insulin status, distribution of FSBG checks by time of day, and hypoglycemia rates. Results 48,111 FSBGs were transmitted by 359 DBC completers. Participants performed 1.5 FSBG checks/day; with 1.6 checks/day for those on basal/bolus insulin. Higher FSBG frequency was associated with greater improvement in HbA1C independent of insulin treatment status (p = 0.0003). FSBG frequency was higher in patients treated with insulin (p = 0.003). FSBG checks were most common pre-breakfast and post-dinner. Hypoglycemia was rare (1.2% < 70 mg/dL). Conclusions Adults with uncontrolled T2DM achieved significant HbA1C improvement performing just 1.5 FSBGs daily during a technology-enabled diabetes care intervention. Among the 40% taking insulin, this improvement was achieved with a lower FSBG frequency than guidelines recommend. For those not on insulin, despite a lower frequency of FSBG, they achieved a greater reduction in A1C compared to patients on insulin. Low frequency FSBG monitoring pre-breakfast and post-dinner can potentially support optimization of glycemic control regardless of insulin status in the primary care setting. Trial registration Trial registration number:NCT02925312 (10/19/2016).

scholarly journals An Evaluation of Digital Health Tools for Diabetes Self-Management in Hispanic Adults: Exploratory Study (Preprint)

2018 ◽  
Author(s):  
Leah Yingling ◽  
Nancy A Allen ◽  
Michelle L Litchman ◽  
Vanessa Colicchio ◽  
Bryan S Gibson
Keyword(s):  
Blood Glucose ◽  
Low Income ◽  
Digital Health ◽  
Wearable Sensors ◽  
Self Management ◽  
Food Diary ◽  
Self Monitoring ◽  
Hispanic Adults ◽  
Monitoring Technologies ◽  
Potential Integration

BACKGROUND Although multiple self-monitoring technologies for type 2 diabetes mellitus (T2DM) show promise for improving T2DM self-care behaviors and clinical outcomes, they have been understudied in Hispanic adult populations who suffer disproportionately from T2DM. OBJECTIVE The objective of this study was to evaluate the acceptability, feasibility, and potential integration of wearable sensors for diabetes self-monitoring among Hispanic adults with self-reported T2DM. METHODS We conducted a pilot study of T2DM self-monitoring technologies among Hispanic adults with self-reported T2DM. Participants (n=21) received a real-time continuous glucose monitor (RT-CGM), a wrist-worn physical activity (PA) tracker, and a tablet-based digital food diary to self-monitor blood glucose, PA, and food intake, respectively, for 1 week. The RT-CGM captured viewable blood glucose concentration (mg/dL) and PA trackers collected accelerometer-based data, viewable on the device or an associated tablet app. After 1 week of use, we conducted a semistructured interview with each participant to understand experiences and thoughts on integration of the data from the devices into a technology-facilitated T2DM self-management intervention. We also conducted a brief written questionnaire to understand participants’ self-reported T2DM history and past experience using digital health tools for T2DM self-management. Feasibility was measured by device utilization and objective RT-CGM, PA tracker, and diet logging data. Acceptability and potential integration were evaluated through thematic analysis of verbatim interview transcripts. RESULTS Participants (n=21, 76% female, 50.4 [SD 11] years) had a mean self-reported hemoglobin A1c of 7.4 [SD 1.8] mg/dL and had been diagnosed with T2DM for 7.4 [SD 5.2] years (range: 1-16 years). Most (89%) were treated with oral medications, whereas the others self-managed through diet and exercise. Nearly all participants (n=20) used both the RT-CGM and PA tracker, and 52% (11/21) logged at least one meal, with 33% (7/21) logging meals for 4 or more days. Of the 8 possible days, PA data were recorded for 7.1 [SD 1.8] days (range: 2-8), and participants averaged 7822 [SD 3984] steps per day. Interview transcripts revealed that participants felt most positive about the RT-CGM as it unveiled previously unknown relationships between lifestyle and health and contributed to changes in T2DM-related thoughts and behaviors. Participants felt generally positive about incorporating the wearable sensors and mobile apps into a future intervention if support were provided by a health coach or health care provider, device training were provided, apps were tailored to their language and culture, and content were both actionable and delivered on a single platform. CONCLUSIONS Sensor-based tools for facilitating T2DM self-monitoring appear to be a feasible and acceptable technology among low-income Hispanic adults. We identified barriers to acceptability and highlighted preferences for wearable sensor integration in a community-based intervention. These findings have implications for the design of T2DM interventions targeting Hispanic adults.

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