scholarly journals Open Issues and Practical Suggestions for Telemedicine in Chronic Pain

2021 ◽  
Vol 18 (23) ◽  
pp. 12416
Author(s):  
Marco Cascella ◽  
Franco Marinangeli ◽  
Alessandro Vittori ◽  
Cristina Scala ◽  
Massimo Piccinini ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cost Effective ◽  
Medical Intervention ◽  
Assessment Tools ◽  
Face To Face ◽  
Open Questions ◽  
Adherence Assessment ◽  
The Right ◽  
Monitoring Treatment ◽  
Open Issues

Telemedicine represents a major opportunity to facilitate continued assistance for patients with chronic pain and improve their access to care. Preliminary data show that an improvement can be expected of the monitoring, treatment adherence, assessment of treatment effect including the emotional distress associated with pain. Moreover, this approach seems to be convenient and cost-effective, and particularly suitable for personalized treatment. Nevertheless, several open issues must be highlighted such as identification of assessment tools, implementation of monitoring instruments, and ability to evaluate personal needs and expectations. Open questions exist, such as how to evaluate the need for medical intervention and interventional procedures, and how to define when a clinical examination is required for certain conditions. In this context, it is necessary to establish dynamic protocols that provide the right balance between face-to-face visits and telemedicine. Useful tips are provided to start an efficient experience. More data are needed to develop precise operating procedures. In the meantime, the first experiences from such settings can pave the way to initiate effective care pathways in chronic pain.

When to Take a Gesture Seriously: On How We Use and Prioritize Communicative Cues

2017 ◽  
Vol 29 (8) ◽  
pp. 1355-1367 ◽  
Author(s):  
Thomas C. Gunter ◽  
J. E. Douglas Weinbrenner
Keyword(s):  
Classical Literature ◽  
Reference Tracking ◽  
Face To Face ◽  
Cue Validity ◽  
Open Questions ◽  
Brain Responses ◽  
Pointing Gestures ◽  
The Right ◽  
Accumulated Error ◽  
Pointing Gesture

When people talk, their speech is often accompanied by gestures. Although it is known that co-speech gestures can influence face-to-face communication, it is currently unclear to what extent they are actively used and under which premises they are prioritized to facilitate communication. We investigated these open questions in two experiments that varied how pointing gestures disambiguate the utterances of an interlocutor. Participants, whose event-related brain responses were measured, watched a video, where an actress was interviewed about, for instance, classical literature (e.g., Goethe and Shakespeare). While responding, the actress pointed systematically to the left side to refer to, for example, Goethe, or to the right to refer to Shakespeare. Her final statement was ambiguous and combined with a pointing gesture. The P600 pattern found in Experiment 1 revealed that, when pointing was unreliable, gestures were only monitored for their cue validity and not used for reference tracking related to the ambiguity. However, when pointing was a valid cue (Experiment 2), it was used for reference tracking, as indicated by a reduced N400 for pointing. In summary, these findings suggest that a general prioritization mechanism is in use that constantly monitors and evaluates the use of communicative cues against communicative priors on the basis of accumulated error information.

Extended Routine Follow-up of Primary Uncomplicated Hip and Knee Arthroplasty is not Necessary

2019 ◽  
Vol 13 (1) ◽  
pp. 266-271
Author(s):  
Georgina Kakra Wartemberg ◽  
Thomas Goff ◽  
Simon Jones ◽  
James Newman
Keyword(s):  
Aseptic Loosening ◽  
Revision Surgery ◽  
Revision Arthroplasty ◽  
Cost Effective ◽  
Face To Face ◽  
Primary Surgery ◽  
Effective System ◽  
Knee Revision Surgery ◽  
Knee Revision

Aims: To create a more effective system to identify patients in need of revision surgery. Background: There are over 160,000 total hip and knee replacements performed per year in England and Wales. Currently, most trusts review patients for up to 10 years or more. When we consider the cost of prolonged reviews, we cannot justify the expenditure within a limited budget. Study Design & Methods: We reviewed all patients' notes that underwent primary hip and knee revision surgery at our institution, noting age, gender, symptoms at presentation, referral source, details of the surgery, reason for revision and follow up history from primary surgery. Results: There were 145 revision arthroplasties (60 THR and 85 TKR) that met our inclusion criteria. Within the hip arthroplasty group, indications for revision included aseptic loosening (37), dislocation (10), and infection (3), periprosthetic fracture, acetabular liner wear and implant failure. All thirty-seven patients with aseptic loosening presented with pain. Twenty-five were referred from general practice with new symptoms. The remaining were clinic follow-ups. The most common reason for knee revision was aseptic loosening (37), followed by infection (21) and then progressive osteoarthritis (8). Most were referred from GP as a new referral or were clinic follow-ups. All patients were symptomatic. Conclusion: All the patients that underwent revision arthroplasty were symptomatic. Rather than yearly follow up, we recommend a cost-effective system. We are implementing a 'non face-to-face' system. Patients would be directly sent a questionnaire and x-ray form. The radiographs and forms will be reviewed by an experienced arthroplasty surgeon. The concerning cases will be seen urgently in a face-to-face clinic.

The Role of Economic Evaluation in Dissemination and Implementation Research

2017 ◽  
Author(s):  
Ramesh Raghavan
Keyword(s):  
Service Providers ◽  
Implementation Strategies ◽  
Cost Effective ◽  
Point Of View ◽  
Dissemination And Implementation ◽  
Economic Point ◽  
Open Questions ◽  
Public Health Organizations ◽  
Quality Health ◽  
Dissemination And Implementation Research

This chapter presents an overview of how D&I research can be evaluated from an economic point of view. Dissemination and implementation imposes costs upon knowledge purveyors, provider organizations, public health organizations, and payers (including governments). However, whether these added costs will result in improved service delivery and, perhaps more importantly, client outcomes and improvements in population health remain as open questions. If emerging studies reveal that defined implementation strategies are more cost effective than “usual” implementation, then policymakers and service providers will need to resource these added costs of implementation in order to assure the success and sustainability of high-quality health services over the long term.

scholarly journals Implementation of podiatry telephone appointments for people with rheumatic and musculoskeletal diseases

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
J. L. Palmer ◽  
H. J. Siddle ◽  
A. C. Redmond ◽  
B. Alcacer-Pitarch
Keyword(s):  
Musculoskeletal Diseases ◽  
Cost Effective ◽  
Time Frame ◽  
Teaching Hospitals ◽  
Potential Cost ◽  
Foot Health ◽  
Telephone Consultation ◽  
Face To Face ◽  
Initial Intervention

Abstract Background Foot health problems are common in the general population, and particularly so in people with rheumatic and musculoskeletal disorders (RMD). Several clinical guidelines state that people with RMDs should have access to foot health services, although service capacity is often limited. The current COVID-19 pandemic has increased the need for alternative ways to provide patient care. The aim of this clinical audit was to review a newly implemented telephone follow-up appointment service conducted within the Rheumatology Podiatry Department in Leeds, UK. Methods Fifty-eight patients attending the Rheumatology Podiatry Department at Leeds Teaching Hospitals NHS Trust were contacted by telephone approximately 6–8 weeks following initial intervention. During the telephone consultation, all patients were asked pre-defined questions relating to their symptoms, intervention efficacy, the need for further appointments and their preference for the type of consultation. To assess the cost of the telephone consultation the number of attempts needed in order to make successful contact, the duration of the call and the number of telephone follow-up appointments completed in a working day were also recorded. Results Twenty-five patients (43%) were successfully contacted within the 6–8 weeks stipulated time frame and were included in the analysis. Of the 25 contacted, twelve (48%) patients were successfully contacted on the first attempt. Ten (40%) were successfully contacted on the second attempt. The remaining three patients (12%) required 3 or more attempts to make successful contact. Telephone consultations were estimated not to last longer than 10 min, including notes screening and documentation. Eleven patients (44%) reported an improvement in their symptoms, thirteen (52%) reported no change and one patient (4%) reported their symptoms to be worse. Conclusion Telephone follow-up consultations may be a potentially cost-effective alternative to face-to-face appointments when implemented in a Rheumatology Podiatry Department, and provide an alternative way of providing care, especially when capacity for face-to-face contact is limited. The potential cost saving and efficiency benefits of this service are likely to be enhanced when telephone consultations are pre-arranged with patients.

scholarly journals Assessing Riparian Areas of Greece—An Overview

2020 ◽  
Vol 13 (1) ◽  
pp. 309
Author(s):  
George N. Zaimes ◽  
Valasia Iakovoglou
Keyword(s):  
Sustainable Management ◽  
Stream Flow ◽  
Vegetation Indices ◽  
Cost Effective ◽  
Assessment Tools ◽  
Land Uses ◽  
Riparian Areas ◽  
Spatial And Temporal Scales ◽  
Management Plans ◽  
Of Greece

Riparian areas, especially in the Mediterranean, offer many ecosystem services for the welfare of society benefits from their sustainable management. This study presents different tools used to assess riparian areas of Greece and their results. Riparian areas with different land-uses/vegetation covers along streams or torrents were assessed. The assessment tools were visual protocols, bioindicators, geographic information systems (GIS), vegetation indices, and a model. These tools differ in scale, accuracy, and difficulty of implementation. The riparian areas had Low and Moderate quality in Greece because of agricultural activities and hydrologic alterations. Vegetation appeared more important for the integrity of riparian areas than stream flow (perennial or intermittent). In addition, territorial variables (distance from dam and sea) were more influential compared to climatic variables. Visual protocols and GIS were effective for preliminary assessments. GIS can be applied at a greater scale but was less accurate than the protocols. Bioindicators can provide more cost-effective monitoring than physicochemical water variables. Finally, vegetation indices and models can be used for larger spatial and temporal scales, but require specialized personnel. Overall, riparian areas of Greece seem to be degraded, and monitoring would contribute to the development of a database on riparian areas that should form the basis for sustainable management plans in Greece.

scholarly journals Online Assessment of Cognitive Functioning: A Reliable Alternative to Laboratory Testing?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 576-577
Author(s):  
Maximilian Haas ◽  
Sascha Zuber ◽  
David Framorando ◽  
Elissa El Khawli ◽  
Susanne Scheibe ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Cognitive Abilities ◽  
Rapid Assessment ◽  
Cognitive Disorders ◽  
Assessment Tools ◽  
Adult Lifespan ◽  
Face To Face ◽  
Age Related ◽  
Online Tools

Abstract As the population ages, risks for cognitive decline threaten independence and quality of life for older adults. Classically, psychological assessment tools to evaluate cognitive functioning are administered in face-to-face laboratory sessions, which is time- and resource-consuming. With the aim of reducing such costs, the present study set out to develop and validate two new online tools, allowing a rapid assessment of general cognitive abilities and of prospective memory. We collected data from 250 participants equally spread across the adult lifespan (aged 18 – 86). Results suggest that performance assessed via these newly developed online tools is comparable to performance in face-to-face laboratory settings. Our findings thereby indicate that these online tools can reliably measure cognitive functioning across the lifespan at a reduced cost, which may help detect individuals at risk of developing age-related cognitive disorders.

scholarly journals ERP benefits capability framework: orchestration theory perspective

2018 ◽  
Vol 24 (1) ◽  
pp. 266-294 ◽  
Author(s):  
Amgad Badewi ◽  
Essam Shehab ◽  
Jing Zeng ◽  
Mostafa Mohamad
Keyword(s):  
Cost Effective ◽  
Organizational Capabilities ◽  
Erp Implementation ◽  
Content Type ◽  
Quantitative Studies ◽  
Financial Perspective ◽  
Complementary Resources ◽  
Benefits Realization ◽  
Research Questions ◽  
The Right

Purpose The purpose of this paper is to answer two research questions: what are the ERP resources and organizational complementary resources (OCRs) required to achieve each group of benefits? And on the basis of its resources, when should an organization invest more in ERP resources and/or OCRs so that the potential value of its ERP is realised? Design/methodology/approach Studying 12 organizations in different countries and validating the results with 8 consultants. Findings ERP benefits realization capability framework is developed; it shows that each group of benefits requires ERP resources (classified into features, attached technologies and information technology department competences) and OCRs (classified into practices, attitudes, culture, skills and organizational characteristics) and that leaping ahead to gain innovation benefits before being mature enough in realising a firm’s planning and automation capabilities could be a waste of time and effort. Research limitations/implications It is qualitative study. It needs to be backed by quantitative studies to test the results. Practical implications Although the “P” in ERP stands for planning, many academics and practitioners still believe that ERP applies to automation only. This research spotlights that the ability to invest in ERP can increase the innovation and planning capabilities of the organization only if it is extended and grown at the right time and if it is supported by OCRs. It is not cost effective to push an organization to achieve all the benefits at the same time; rather, it is clear that an organization would not be able to enjoy a higher level of benefits until it achieves a significant number of lower-level benefits. Thus, investing in higher-level benefit assets directly after an ERP implementation, when there are no organizational capabilities available to use these assets, could be inefficient. Moreover, it could be stressful to users when they see plenty of new ERP resources without the ability to use them. Although it could be of slight benefit to introduce, for example, business intelligence to employees in the “stabilizing period” (Badewi et al., 2013), from the financial perspective, it is a waste of money since the benefits would not be realised as expected. Therefore, orchestrating ERP assets with the development of organizational capabilities is important for achieving the greatest effectiveness and efficiency of the resources available to the organization. This research can be used as a benchmark for designing the various blueprints required to achieve different groups of benefits from ERP investments. Originality/value This research addresses two novel questions: RQ1: what are the ERP resources and OCRs required to achieve the different kinds of ERP benefits? RQ2: when, and on what basis, should an organization deploy more resources to leverage the ERP business value?

Tingkat Pemahaman Siswa dalam Pembelajaran Daring dan Tatap Muka Langsung dalam Masa Pandemi Covid-19 Terhadap Bimbingan TIK Menggunakan Metode Backpropagation

2021 ◽  
pp. 95-101
Author(s):  
S Salmiati ◽  
Yuhandri Yunus ◽  
S Sumijan
Keyword(s):  
Student Learning ◽  
Learning Outcomes ◽  
Predictive Accuracy ◽  
Cognitive Learning ◽  
Student Learning Outcomes ◽  
Face To Face ◽  
Backpropagation Method ◽  
Face To Face Learning ◽  
Level Of Understanding ◽  
The Right

The Covid-19 pandemic has a major impact on the world of education. Government policies to implement Distance Learning (PJJ) have an impact on learning in schools. Increasing ICT competence is needed to support the smooth running of PJJ. One of them is through ICT guidance activities during the Covid-19 Pandemic. SMP Negeri 1 Lengayang carried out online and face-to-face ICT guidance activities during the Covid-19 Pandemic. However, student learning outcomes in online and face-to-face learning have not shown maximum results. Various obstacles arise that affect student learning outcomes. Teachers have difficulty measuring the level of students' understanding of ICT guidance. Predicting the level of understanding of students is important as a measure of learning success during the Covid-19 Pandemic. This study aims to predict the level of understanding of students in online and face-to-face learning during the Covid-19 period, so that it can also help schools to take the right policies to improve the quality of learning for the future. This study uses the Backpropagation method of Artificial Neural Network (ANN). ANN is a part of artificial intelligence that can be used to predict. The data that is managed is a recap of the value of student cognitive learning outcomes during ICT guidance in online and face-to-face learning during the Covid-19 Pandemic. The results of calculations using the Backpropagation method with the Matlab application produce a percentage value for the level of student understanding, so that the accuracy value in prediction is obtained. With the results of testing the predictive accuracy of the level of understanding online and face-to-face with the 3-10-1 pattern, the best accuracy value is 95%. The prediction results can measure the level of students' understanding of learning during the Covid 19 Pandemic towards ICT guidance.

Penggunaan Permainan Edukasi pada Pembelajaran Daring Mata Pelajaran Geografi Kelas XII di MA PPPI Miftahussalam Banyumas

2021 ◽  
Vol 1 ◽  
pp. 20-22
Author(s):  
Faris Salman Faza
Keyword(s):  
Online Learning ◽  
Teaching And Learning ◽  
Educational Games ◽  
Learning Activities ◽  
Qualitative Description ◽  
Learning Goals ◽  
Face To Face ◽  
Average Value ◽  
Geography Teaching ◽  
The Right

The existence of the COVID-19 outbreak has an impact on all sectors of life, one of which is in the education sector, many schools are forced to dismiss their students and teaching and learning activities are carried out online. the transition of Geography teaching and learning activities at MA PPPI Miftahussalam Banyumas from face to face to online creates new problems in learning so that a special strategy is needed in this learning. Although online learning is not effective for achieving learning goals, the teacher must be able to make new innovations so that learning objectives can be achieved. This study uses a qualitative description method by observing the behavior of students when online learning takes place. Learning online Geography class XII at MA PPPI Miftahussalam Banyumas uses educational games. This study aims to find out the right media in learning Geography class XII during the COVID-19 pandemic at MA PPPI Miftahussalam Banyumas. The results of this study showed that 76 students of class XII MA PPPI Miftahussalam Banyumas who had taken the test showed an average value> 8.00. This shows satisfactory results.

Sign in / Sign up

Export Citation Format

Share Document