Preliminary results from the Northern Ireland arms of the UK Multicentre Teledermatology Trial: is clinical management by realtime teledermatology possible?

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 3-5 ◽  
Author(s):  
M A Loane ◽  
H E Gore ◽  
S E Bloomer ◽  
R Corbett ◽  
D J Eedy ◽  
...  
Keyword(s):  
Northern Ireland ◽  
Clinical Management ◽  
Low Cost ◽  
Treatment Plan ◽  
Phase 1 ◽  
Management Plan ◽  
Management Tool ◽  
Dermatological Disease ◽  
Video Link ◽  
The Uk

Results from phase 1 of the UK Multicentre Teledermatology Trial demonstrated the diagnostic accuracy of realtime teledermatology using low-cost equipment. Phase 2 of the trial aimed to assess its effectiveness as a management tool for dermatological disease. Teledermatology consultations were organized between two health centres and two hospitals in Northern Ireland using low-cost videoconferencing equipment. For 205 patients seen by a dermatologist over the video-link a diagnosis and management plan were recorded. A subsequent face-to-face consultation was arranged on the same day to confirm the diagnosis and treatment regime. A comparison of these management plans revealed that the same plan was recommended in 64% of cases; the teledermatologist was unable to advocate a suitable management plan in 19% of cases; a suboptimal treatment plan was suggested by the teledermatologist in 6% of cases; and in 11% of cases, the teledermatologist suggested an inappropriate treatment plan. These findings indicate that appropriate clinical management was possible in approximately two-thirds of dermatology consultations via the video-link.

Diagnostic accuracy and clinical management by realtime teledermatology. Results from the Northern Ireland arms of the UK Multicentre Teledermatology Trial

1998 ◽  
Vol 4 (2) ◽  
pp. 95-100 ◽  
Author(s):  
M A Loane ◽  
R Corbett ◽  
S E Bloomer ◽  
D J Eedy ◽  
H E Gore ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Management ◽  
Low Cost ◽  
Treatment Plan ◽  
Management Plan ◽  
Face To Face ◽  
Management Plans ◽  
Video Link ◽  
The Uk ◽  
Management Recommendations

Diagnostic accuracy and management recommendations of realtime teledermatology consultations using low-cost telemedicine equipment were evaluated. Patients were seen by a dermatologist over a video-link and a diagnosis and treatment plan were recorded. This was followed by a face-to-face consultation on the same day to confirm the earlier diagnosis and management plan. A total of 351 patients with 427 diagnoses participated. Sixty-seven per cent of the diagnoses made over the video-link agreed with the face-to-face diagnosis. Clinical management plans were recorded for 214 patients with 252 diagnoses. For this cohort, 44 of the patients were seen by the same dermatologist at both consultations, while 56 were seen by a different dermatologist. In 64 of cases the same management plan was recommended at both consultations; a sub-optimum treatment plan was recommended in 8 of cases; and in 9 of cases the video-link management plans were judged to be inappropriate. In 20 of cases the dermatologist was unable to recommend a suitable management plan by video-link. There were significant differences in the ability to recommend an optimum management plan by video-link when a different dermatologist made the reference management plan. The results indicate that a high proportion of dermatological conditions can be successfully managed by realtime teledermatology.

scholarly journals The King’s College London Coronavirus Health and Experiences of Colleagues at King’s Study: SARS-CoV-2 antibody response in a higher education sample

2021 ◽  
Author(s):  
Daniel Leightley ◽  
Valentina Vitiello ◽  
Alice Wickersham ◽  
Katrina A.S. Davis ◽  
Gabriella Bergin-Cartwright ◽  
...  
Keyword(s):  
Higher Education ◽  
Low Cost ◽  
Phase 1 ◽  
Phase 2 ◽  
Antibody Testing ◽  
Face To Face ◽  
King's College ◽  
Positive Antibody ◽  
The Uk ◽  
Test Result

AbstractObjectiveTo assess the feasibility of home antibody testing as part of large-scale study, the King’s College London Coronavirus Health and Experiences of Colleagues at King’s (KCL CHECK).MethodsParticipants of the KCL CHECK study were sent a SureScreen Diagnostics COVID-19 IgG/IgM Rapid Test Cassette to complete at home in June 2020 (phase 1) and September 2020 (phase 2). Participants were asked to upload a test result image to a study website. Test result images and sociodemographic information were analysed by the research team.ResultsA total of n=2716 participants enrolled in the KCL CHECK study, with n=2003 (73.7%) and n=1825 (69.3%) consenting and responding to phase 1 and 2. Of these, n=1882 (93.9%; phase 1) and n=1675 (91.8%; phase 2) returned a valid result. n=123 (6.5%; phase 1) and n=91 (5.4%; phase 2) tested positive for SARS-CoV-2 antibodies. A total of n=1488 participants provided a result in both phases, with n=57 (3.8%) testing positive for SARS- CoV-2 antibodies across both phases, suggesting a reduction in the number of positive antibody results over time. Initial comparisons showed variation by age group, gender and clinical role.ConclusionsOur study highlights the feasibility of rapid, repeated and low-cost SARS-CoV-2 serological testing without the need for face-to-face contact.What is already known about this subject?Higher education institutions have a duty of care to minimise the spread and transmission of COVID-19 in its campuses, and among staff and students. The reopening of higher education buildings and campuses has brought about a mass movement of students, academics and support staff from across the UK. Serological antibody studies can assist by highlighting groups of people and behaviours associated with high risk of COVID-19.What are the new findings?We report a framework for SARS-CoV-2 serological antibody testing in an occupational group of postgraduate research students and current members of staff at King’s College London. Over two phases of data collection, 6.5% (phase 1) and 5.4% (phase 2) tested positive for SARS-CoV-2 antibodies, with only 3.8% testing positive for antibodies in both phases, suggesting a reduction in positive antibody results over time.How might this impact on policy or clinical practice in the foreseeable future?Our study highlights the feasibility of rapidly deploying low-cost and repeatable SARS-CoV-2 serological testing, without the need for face-to-face contact, to support the higher education system of the UK.

Effect of camera performance on diagnostic accuracy: preliminary results from the Northern Ireland arms of the UK Multicentre Teledermatology Trial

1997 ◽  
Vol 3 (2) ◽  
pp. 83-88 ◽  
Author(s):  
M A Loane ◽  
H E Gore ◽  
R Corbett ◽  
K Steele ◽  
C Mathews ◽  
...  
Keyword(s):  
Northern Ireland ◽  
Diagnostic Accuracy ◽  
Low Cost ◽  
Single Chip ◽  
Face To Face ◽  
Video Cameras ◽  
Dermatology Clinic ◽  
The Uk ◽  
Missed Diagnoses ◽  
Made In

The diagnostic accuracy of realtime teledermatology was measured using two different video cameras. One camera was a relatively low-cost, single-chip device camera 1 , while the other was a more expensive, three-chip camera camera 2 . The diagnosis obtained via the videolink was compared with the diagnosis made in person. Sixty-five new patients referred to a dermatology clinic were examined using camera 1 followed by a standard face-to-face consultation on the same day. A further 65 patients were examined using camera 2 and the same procedure implemented. Seventy-six per cent of conditions were correctly diagnosed by telemedicine using camera 2 compared with 62 using camera 1. A working differential diagnosis was obtained in 12 of cases using camera 2 compared with 14 using camera 1. The percentage of `no diagnosis`, wrong and missed diagnoses was halved using camera 2 compared with camera 1. These results suggest that the performance of the more expensive camera was superior for realtime teledermatology.

Patient satisfaction with realtime teledermatology in Northern Ireland

1998 ◽  
Vol 4 (1) ◽  
pp. 36-40 ◽  
Author(s):  
M. A. Loane ◽  
S. E. Bloomer ◽  
R. Corbett ◽  
D. J. Eedy ◽  
H. E. Gore ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Northern Ireland ◽  
Low Cost ◽  
Technical Aspects ◽  
Item Questionnaire ◽  
Personal Experiences ◽  
Health Centres ◽  
Video Link ◽  
A Prospective Study

Teledermatology consultations were organized between two health centres and two hospitals in Northern Ireland using low-cost videoconferencing equipment. A prospective study of patient satisfaction was carried out. Following each teleconsultation, patients were asked to complete a questionnaire assessing their satisfaction with the service. Over 22 months, 334 patients were seen by a dermatologist over the video-link, and 292 patients 87 completed the 16-item questionnaire. Patients reported universal satisfaction with the technical aspects of teledermatology. The quality of both the audio and the display was highly acceptable to patients. Personal experiences of the teledermatology consultation were also favourable: 85 felt comfortable using the video-link. The benefits of teledermatology were generally recognized: 88 of patients thought that a teleconsultation could save time. Patients found the teledermatology consultation to be as acceptable as the conventional dermatology consultation. These findings suggest overall patient satisfaction with realtime teledermatology.

scholarly journals The BabySaver: Design of a New Device for Neonatal Resuscitation at Birth with Intact Placental Circulation

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 526
Author(s):  
James Ditai ◽  
Aisling Barry ◽  
Kathy Burgoine ◽  
Anthony K. Mbonye ◽  
Julius N. Wandabwa ◽  
...  
Keyword(s):  
Low Cost ◽  
Neonatal Resuscitation ◽  
Sub Saharan Africa ◽  
Skilled Birth Attendants ◽  
New Device ◽  
Birth Attendants ◽  
Premature Babies ◽  
Sub Saharan ◽  
The Uk ◽  
The University

The initial bedside care of premature babies with an intact cord has been shown to reduce mortality; there is evidence that resuscitation of term babies with an intact cord may also improve outcomes. This process has been facilitated by the development of bedside resuscitation surfaces. These new devices are unaffordable, however, in most of sub-Saharan Africa, where 42% of the world’s 2.4 million annual newborn deaths occur. This paper describes the rationale and design of BabySaver, an innovative low-cost mobile resuscitation unit, which was developed iteratively over five years in a collaboration between the Sanyu Africa Research Institute (SAfRI) in Uganda and the University of Liverpool in the UK. The final BabySaver design comprises two compartments; a tray to provide a firm resuscitation surface, and a base to store resuscitation equipment. The design was formed while considering contextual factors, using the views of individual women from the community served by the local hospitals, medical staff, and skilled birth attendants in both Uganda and the UK.

scholarly journals Implementation of a Six-Layer Smart Factory Architecture with Special Focus on Transdisciplinary Engineering Education

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 2944
Author(s):  
Benjamin James Ralph ◽  
Marcel Sorger ◽  
Benjamin Schödinger ◽  
Hans-Jörg Schmölzer ◽  
Karin Hartl ◽  
...  
Keyword(s):  
Open Source ◽  
User Interfaces ◽  
Industrial Revolution ◽  
Low Cost ◽  
Material Behavior ◽  
Sensor Data ◽  
Management Tool ◽  
Special Focus ◽  
Programming Environments ◽  
Metal Processing

Smart factories are an integral element of the manufacturing infrastructure in the context of the fourth industrial revolution. Nevertheless, there is frequently a deficiency of adequate training facilities for future engineering experts in the academic environment. For this reason, this paper describes the development and implementation of two different layer architectures for the metal processing environment. The first architecture is based on low-cost but resilient devices, allowing interested parties to work with mostly open-source interfaces and standard back-end programming environments. Additionally, one proprietary and two open-source graphical user interfaces (GUIs) were developed. Those interfaces can be adapted front-end as well as back-end, ensuring a holistic comprehension of their capabilities and limits. As a result, a six-layer architecture, from digitization to an interactive project management tool, was designed and implemented in the practical workflow at the academic institution. To take the complexity of thermo-mechanical processing in the metal processing field into account, an alternative layer, connected with the thermo-mechanical treatment simulator Gleeble 3800, was designed. This framework is capable of transferring sensor data with high frequency, enabling data collection for the numerical simulation of complex material behavior under high temperature processing. Finally, the possibility of connecting both systems by using open-source software packages is demonstrated.

scholarly journals P63 Improving cervical smear uptake through an Automated Voice Messages Reminder

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Francesca Bladt ◽  
Felyx Wong ◽  
Francesca Bladt
Keyword(s):  
Cervical Cancer ◽  
Low Cost ◽  
Cervical Screening ◽  
Telephone Triage ◽  
Cervical Smear ◽  
Screening Programs ◽  
Smear Test ◽  
Voice Message ◽  
The Uk ◽  
Busy Schedule

Abstract National cervical screening programs have played a pivotal role in the prevention of cervical cancer. However, practices across the UK have reached an all-time low in cervical screening uptake. This study aimed to assess the efficacy of implementing an automated voice message reminder within the local general practice (GP) telephone triage system and explore the reasons which deter eligible patients away from cervical screening. A 20-second voice-message reminder in the telephone queue was played, addressing key risk factors along with a message from a child who lost his mother to cervical cancer. From the anonymised GP database, weekly new smear test bookings were monitored from 4 weeks prior until 2 weeks after the intervention was implemented. To qualitatively assess factors which deter patients away from screening, female patients were randomly sampled to fill in an anonymous questionnaire. The use of a low-cost 20 second voice message in the telephone queue across UK GP practices could be an effective method to increase cervical smear test coverage towards the national target of 80%. 35 questionnaire responses were received, main themes reported for not attending screening include embarrassment(37%), busy schedule(32%) and cultural differences(24%). In the week following the intervention, cervical smear tests increased more than 2-fold, from an average of 12 to 26 smears per week. This could be partly due to the convenient timing of voice recording, reminding them to book both appointments simultaneously and the child’s emotive message.

scholarly journals Brexit and Territorial Preferences: Evidence from Scotland and Northern Ireland

2021 ◽  
Vol 51 (2) ◽  
pp. 186-211
Author(s):  
Lesley-Ann Daniels ◽  
Alexander Kuo
Keyword(s):  
Northern Ireland ◽  
Religious Background ◽  
Scottish Independence ◽  
The Uk ◽  
The Eu

Abstract Has the UK referendum to leave the EU (Brexit) affected territorial preferences within the UK? We draw on comparative theories of such preferences to address this question, as Brexit can be seen as a shock to a political unit. We test hypotheses in two key regions, Scotland and Northern Ireland, with original surveys fielded at a unique time (September 2019). We randomize making salient different Brexit scenarios and measure support for Scottish independence and unification with Ireland within each region. We find in Scotland the prospect of leaving the EU increases support for independence. This effect is pronounced among those who support the UK remaining in the EU. In Northern Ireland, religious background correlates highly with territorial views, and we find little evidence of Brexit or border-scenario effects. Our results contribute to the literature on decentralization processes and the EU, and provide evidence of when negative shocks affect such preferences.

scholarly journals P071 Survey of rheumatology patient satisfaction with telephone consultations during the COVID-19 pandemic

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Mia Rodziewicz ◽  
Terence O'Neill ◽  
Audrey Low
Keyword(s):  
Patient Satisfaction ◽  
Physical Examination ◽  
Management Plan ◽  
Service Development ◽  
Telephone Consultation ◽  
Face To Face ◽  
Communication Difficulties ◽  
Strongly Agree ◽  
The Uk

Abstract Background/Aims  Rheumatology departments were required to switch rapidly from face-to-face (F2F) to remote consultations during the COVID-19 pandemic in the UK. We conducted a patient satisfaction survey on the switch to inform future service development. Methods  All patients [new (NP), follow-up (FU)] were identified between 1st to 5th June 2020. Patients who attended or did not attend (DNA) a pre-booked F2F consultation or cancelled were excluded. Of the remainder, half the patients was surveyed by phone using a standardised questionnaire and the other half was posted the same questionnaire. Both groups were offered the opportunity to complete the survey online. Patients were surveyed on the organisation and content of the consultation, whether they were offered a subsequent F2F appointment and future consultation preference. Results  233 consultations were scheduled during the study period. After 53 exclusions (34 pre-booked F2F, 16 DNA, 3 cancellations), 180 eligible consultations were surveyed (85 via mailshot, 95 by telephone). 75/180 patients (42%) responded within 1 month of the telephone consultation (20 NP, 47 FU, 8 missing). The organisation of the switch was positively perceived (Table). Patients were highly satisfied with 4 of the 5 consultation domains but were undecided whether a physical assessment would have changed the outcome of the consultation (Table). After the initial phone consultation, 7 of 20 NP and 19 of 47 FU were not offered subsequent F2F appointments at the clinicians’ discretion. Of those not offered subsequent F2F appointments, proportionally more NP (3/7, 43%) would have liked one, compared to FU (5/19, 26%). Reasons included communication difficulties and a desire for a definitive diagnosis. 48/75 (64%) would be happy for future routine FU to be conducted by phone “most of the time" or "always”; citing patient convenience and disease stability. Caveats were if physical examination was required or if more serious issues (as perceived by the patient) needed F2F discussion. Conclusion  Patients were generally satisfied with telephone consultations and most were happy to be reviewed again this way. NPs should be offered F2F appointments for first visits to maximise patient satisfaction and time efficiency. P071 Table 1:Median age, yearsFemale; n (%)Follow-up; n (%)All eligible for survey; n = 18056122 (68)133 (74)Sent mailshot; n = 855459 (69)65 (76)Surveyed by phone; n = 955663 (66)68 (72)Responder by mail; n = 166911 (69)13 (82)Responder by phone; n = 525437 (71)34 (65)Responder by e-survey; n = 7495 (71)UnknownOrganisation of the telephone consultation, N = 75Yes, n (%)No, n (%)Missing, n (%)Were you informed beforehand about the phone consultation?63 (84)11 (15)1 (1)Were you called within 1-2 hours of the appointed date and time?66 (88)6 (8)3 (4)Domains of the consultation, N = 75Strongly disagree, n (%)Disagree, n (%)Neutral, n (%)Agree, n (%)Strongly agree, n (%)Missing, n (%)During the call, I felt the clinician understood my problem3 (4)1 (1)1 (1)20 (27)49 (65)1 (1)During the call, I had the opportunity to ask questions regarding my clinical care1 (1)02 (3)16 (21)55 (73)1 (1)A physical examination would have changed the outcome of the consultation16 (21)18 (24)20 (27)11 (15)10 (13)0The clinician answered my questions to my satisfaction2 (3)06 (8)18 (24)49 (65)0At the end of the consultation, the clinician agreed a management plan with me3 (4)2 (3)6 (8)24 (32)39 (52)1 (1)Future consultations, N = 75Never, n (%)Sometimes, n (%)Most of the time, n (%)Always, n (%)Missing, n, (%)In the future, would you be happy for routine FU to be conducted by phone?5 (7)20 (27)16 (21)32 (43)2 (3) Disclosure  M. Rodziewicz: None. T. O'Neill: None. A. Low: None.

Introduction: How the British-exit is Impacting the European Union?

2021 ◽  
Vol 58 (2) ◽  
pp. 133-149
Author(s):  
Emmanuel Brunet-Jailly
Keyword(s):  
European Union ◽  
Northern Ireland ◽  
International Studies ◽  
The European Union ◽  
Special Issue ◽  
The Uk

This special issue of International Studies focuses on ‘how the British-exit is impacting the European Union’. This introduction is a review of the context, costs and institutional repercussions, as well as the very recent the UK/European Union trade deal and implications for customs borders. Eight articles then detail consequences for European Union policies and important trading relationships: Immigration, Citizenship, Gender, Northern Ireland, Trade and impacts on India, Canada and Japan.

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