scholarly journals A Sensor-Based mHealth Platform for Remote Monitoring and Intervention of Frailty Patients at Home

2021 ◽  
Vol 18 (21) ◽  
pp. 11730
Author(s):  
Jorge Calvillo-Arbizu ◽  
David Naranjo-Hernández ◽  
Gerardo Barbarov-Rostán ◽  
Alejandro Talaminos-Barroso ◽  
Laura M. Roa-Romero ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Independent Risk Factor ◽  
Clinical Validation ◽  
Frailty Syndrome ◽  
Validation Process ◽  
Frail Patients ◽  
Sensor Devices ◽  
Technical Validation ◽  
The Impact ◽  
At Home

Frailty syndrome is an independent risk factor for serious health episodes, disability, hospitalization, falls, loss of mobility, and cardiovascular disease. Its high reversibility demands personalized interventions among which exercise programs are highly efficient to contribute to its delay. Information technology-based solutions to support frailty have been recently approached, but most of them are focused on assessment and not on intervention. This paper describes a sensor-based mHealth platform integrated in a service-based architecture inside the FRAIL project towards the remote monitoring and intervention of pre-frail and frail patients at home. The aim of this platform is constituting an efficient and scalable system for reducing both the impact of aging and the advance of frailty syndrome. Among the results of this work are: (1) the development of elderly-focused sensors and platform; (2) a technical validation process of the sensor devices and the mHealth platform with young adults; and (3) an assessment of usability and acceptability of the devices with a set of pre-frail and frail patients. After the promising results obtained, future steps of this work involve performing a clinical validation in order to quantify the impact of the platform on health outcomes of frail patients.

scholarly journals 45 Implementing A Frailty at the Front Door Service in the Emergency Department

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i11-i13
Author(s):  
B McGurn ◽  
J McDicken ◽  
H McKee ◽  
D Docharty ◽  
A Duffty ◽  
...  
Keyword(s):  
Emergency Department ◽  
Nurse Practitioners ◽  
Admission Rate ◽  
The Elderly ◽  
Medical Specialties ◽  
Front Door ◽  
Frail Patients ◽  
The Right ◽  
The Impact ◽  
At Home

Abstract Background University Hospital Hairmyres is a small District General Hospital in Lanarkshire Scotland. We have an active Care of the Elderly Department with a well-established Acute Care of the Elderly (ACE) team of Advanced Nurse Practitioners, supported by Consultants. This team delivers Comprehensive Geriatric Assessment (CGA) to frail older people in acute medical receiving as well as offering liaison to medical, surgical and orthopaedic wards. Local problem and intervention: Our patients were not always being managed by the correct professionals in a timely manner, leading to delays especially in the Emergency Department (ED). We set up a Frailty at the Front Door (FAFD) service to address this, commencing July 2018. Supported by additional consultant sessions, we re-focused the ACE team on assessing and managing frail patients in the ED. The aim was to get the right patient to the right place at the right time and to manage acutely ill people at home where this was safe. Where admission was required we aimed to admit directly to a specialty bed, bypassing acute receiving wards. Methods We routinely collect important data including number of frail patients, %patients receiving CGA within 24 hours, number of discharges. To assess the impact of our change we analysed the data by plotting on run charts and statistical process control charts. In addition we assessed the effect on referrals from medical specialties and the number of direct-to-specialty admissions. Results After the 22 July 2018 we noticed a significant increase in patients screened for frailty, and a significant increase in discharges. We were able to reliably sustain over 95% of frail patients getting CGA within 24 hrs. There was an increased use of hospital at home. There was a reduction in referrals from medical wards (median = 10/week before, 5/week after intervention). Between August 2018 and May 2019 we were able to admit 163 patients directly to specialty beds. There was no change in re-admission rate. Conclusions We successfully changed our service to have consultant delivered Frailty at the Front Door, assessing more frail patients. Most importantly, we have an improved patient pathway, both managing more people at home but also reducing ward moves by achieving direct to specialty admissions. CGA can be safely delivered in the ED.

Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

2020 ◽  
Author(s):  
Ahmed Youssef Kada
Keyword(s):  
Case Fatality Rate ◽  
Doubling Time ◽  
Case Fatality ◽  
World Health ◽  
Fatality Rate ◽  
Therapeutic Protocol ◽  
First Case ◽  
The World ◽  
The Impact ◽  
At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

scholarly journals A global analysis of the impact of COVID-19 stay-at-home restrictions on crime

2021 ◽  
Author(s):  
Amy E. Nivette ◽  
Renee Zahnow ◽  
Raul Aguilar ◽  
Andri Ahven ◽  
Shai Amram ◽  
...  
Keyword(s):  
Public Space ◽  
Global Analysis ◽  
Sudden Change ◽  
Interrupted Time Series ◽  
Urban Crime ◽  
Substantial Variation ◽  
Different Types ◽  
Time Series Analyses ◽  
The Impact ◽  
At Home

AbstractThe stay-at-home restrictions to control the spread of COVID-19 led to unparalleled sudden change in daily life, but it is unclear how they affected urban crime globally. We collected data on daily counts of crime in 27 cities across 23 countries in the Americas, Europe, the Middle East and Asia. We conducted interrupted time series analyses to assess the impact of stay-at-home restrictions on different types of crime in each city. Our findings show that the stay-at-home policies were associated with a considerable drop in urban crime, but with substantial variation across cities and types of crime. Meta-regression results showed that more stringent restrictions over movement in public space were predictive of larger declines in crime.

Using an App to monitor postoperative pain at home in pediatric patients

2021 ◽  
pp. 136749352091931
Author(s):  
Emanuela Tiozzo ◽  
Valentina Biagioli ◽  
Matilde Brancaccio ◽  
Riccardo Ricci ◽  
Anna Marchetti ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Health Professionals ◽  
Pediatric Patients ◽  
Pain Scale ◽  
Factors Associated ◽  
Prospective Comparative Study ◽  
Paper And Pencil ◽  
The Impact ◽  
At Home

A prospective comparative study was conducted in 487 pediatric patients (69% male, mean age = 6.4 ± 4.0) to evaluate (a) the incidence, intensity, and characteristics of pain in pediatric patients at home during the first 24 hours and 5 days after surgery and (b) the factors associated with higher pain intensity, including the impact of an application (App) compared to the paper-and-pencil approach. Postoperative pain was assessed by patients or their parents at home using the ‘Bambino Gesù’ Children’s Hospital (Ospedale Pediatrico Bambino Gesù, OPBG) tool for participants aged 4–17 years or the Faces, Legs, Arms, Cry, and Consolability scale for participants less than four years old. Participants were assigned to two groups: those who used the paper-and-pencil version of the pain scale and those who used the App. Overall, 209 of the 472 (44%) participants reported pain during the first 24 hours, and 92 of the 420 (22%) reported pain between one and five days after surgery. Higher pain intensity scores were associated with being in the App group, directly assessing own pain, and using the OPBG tool. The App was effective in facilitating pain assessment. Health professionals could empower pediatric patients and their parents in assessing pain at home through a dedicated App.

scholarly journals Abstract No. 550 The impact of stay-at-home orders on code stroke activations and mechanical thrombectomy

2021 ◽  
Vol 32 (5) ◽  
pp. S151
Author(s):  
A. Hines ◽  
J. Rhoten ◽  
D. Strong ◽  
T. Prasad ◽  
E. Wang
Keyword(s):  
Mechanical Thrombectomy ◽  
The Impact ◽  
At Home

scholarly journals Quit Experiences among Primary Care Patients Enrolled in a Smoking Cessation Pilot RCT Early in the COVID-19 Pandemic

2021 ◽  
Vol 18 (3) ◽  
pp. 1011
Author(s):  
Andrea A. Joyce ◽  
Grace M. Styklunas ◽  
Nancy A. Rigotti ◽  
Jordan M. Neil ◽  
Elyse R. Park ◽  
...  
Keyword(s):  
Primary Care ◽  
Text Messaging ◽  
Risk Perceptions ◽  
Environmental Changes ◽  
Age Groups ◽  
Text Messages ◽  
Increased Risk ◽  
Primary Care Patients ◽  
The Impact ◽  
At Home

The impact of the COVID-19 pandemic on US adults’ smoking and quitting behaviors is unclear. We explored the impact of COVID-19 on smoking behaviors, risk perceptions, and reactions to text messages during a statewide stay-at-home advisory among primary care patients who were trying to quit. From May–June 2020, we interviewed smokers enrolled in a 12-week, pilot cessation trial providing text messaging and mailed nicotine replacement medication (NCT04020718). Twenty-two individuals (82% white, mean age 55 years), representing 88% of trial participants during the stay-at-home advisory, completed exit interviews; four (18%) of them reported abstinence. Interviews were thematically analyzed by two coders. COVID-19-induced environmental changes had mixed effects, facilitating quitting for some and impeding quitting for others. While stress increased for many, those who quit found ways to cope with stress. Generally, participants felt at risk for COVID-19 complications but not at increased risk of becoming infected. Reactions to COVID-19 and quitting behaviors differed across age groups, older participants reported difficulties coping with isolation (e.g., feeling disappointed when a text message came from the study and not a live person). Findings suggest that cessation interventions addressing stress and boredom are needed during COVID-19, while smokers experiencing isolation may benefit from live-person supports.

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