scholarly journals Bionic for Training: Smart Framework Design for Multisensor Mechatronic Platform Validation

Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 249
Author(s):  
Ruben Foresti ◽  
Rosario Statello ◽  
Nicola Delmonte ◽  
Francesco Paolo Lo Muzio ◽  
Giacomo Rozzi ◽  
...  
Keyword(s):  
Mobile Application ◽  
Healthcare Professionals ◽  
Home Monitoring ◽  
External Noise ◽  
Multiple Sources ◽  
Infrared Sensors ◽  
Body Postures ◽  
Framework Design ◽  
Life Threatening ◽  
Neonatal Apnea

Home monitoring supports the continuous improvement of the therapy by sharing data with healthcare professionals. It is required when life-threatening events can still occur after hospital discharge such as neonatal apnea. However, multiple sources of external noise could affect data quality and/or increase the misdetection rate. In this study, we developed a mechatronic platform for sensor characterizations and a framework to manage data in the context of neonatal apnea. The platform can simulate the movement of the abdomen in different plausible newborn positions by merging data acquired simultaneously from three-axis accelerometers and infrared sensors. We simulated nine apnea conditions combining three different linear displacements and body postures in the presence of self-generated external noise, showing how it is possible to reduce errors near to zero in phenomena detection. Finally, the development of a smart 8Ws-based software and a customizable mobile application were proposed to facilitate data management and interpretation, classifying the alerts to guarantee the correct information sharing without specialized skills.

Consultation with the Specialist

1996 ◽  
Vol 17 (7) ◽  
pp. 257-259
Author(s):  
John G. Brooks
Keyword(s):  
Color Change ◽  
Muscle Tone ◽  
Close Association ◽  
Prognostic Significance ◽  
Home Monitoring ◽  
Marked Change ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Diagnostic Management ◽  
Life Threatening

Infants who experience apparent life-threatening events (ALTEs) usually generate enormous anxiety among family members and other caretakers and present diagnostic, management, and counseling challenges for the pediatrician. Important considerations for the primary care provider include the following: 1. What is the prognostic significance of the frightening event, particularly in relation to sudden infant death syndrome (SIDS)? 2. Which mechanisms and specific diagnoses should be considered as possible causes of ALTEs? 3. Which infants who present after an ALTE require hospitalization, and what diagnostic evaluation is appropriate? 4. What is the role for home cardiorespiratory monitors, and what is appropriate follow-up for infants who have suffered an ALTE? Definition ALTE should be considered a chief complaint rather than a specific diagnosis. In the standard established in 1986 by the National Institutes of Health (NIH) Consensus Development Conference on Infantile Apnea and Home Monitoring, ALTE is defined as "an episode that is frightening to the observer and is characterized by some combination of apnea (central or occasionally obstructive), color change (usually cyanotic or pallid but occasionally erythematous or plethoric), marked change in muscle tone (usually marked limpness), choking, or gagging. In some cases the observer fears that the infant has died." Previously used terminology, such as "aborted crib death" or "nearmiss SIDS," should be abandoned because it implies a possibly misleading close association between this type of event and SIDS.

scholarly journals Medical Ethics during the COVID-19 Pandemic

Acta Medica ◽  
2021 ◽  
pp. 1-10
Author(s):  
Sevim Coşkun ◽  
Nüket Örnek Büken
Keyword(s):  
Healthcare Professionals ◽  
Human Life ◽  
Action Plan ◽  
Disaster Medicine ◽  
Ethical Principles ◽  
Duty Of Care ◽  
Protective Measures ◽  
Life Threatening ◽  
Correct Application ◽  
Difficult Situations

WHO states five ethical principles for the care of patients with COVID-19: Equal moral respect, duty of care, non-abandonment, protection of the community, and confidentiality. Healthcare professionals might have to make difficult decisions such as selecting patients and withholding or withdrawing mechanical ventilation of critically ill patients. In such difficult situations, a well-prepared action plan which considers ethical principles and prioritizes both public health and the safety of healthcare professionals, can help them. In this case, the development of an effective pandemic action plan, together with a triage plan based on emergency and disaster medicine is necessary. The only parameter of selection in this plan must be the correct application of triage, which respects every human life and depends on the criteria of clinical suitability. In this context, the fundamental ethical principles and human rights must be considered when allocating resources and prioritizing patients. Additionally, all protective measures for healthcare professionals must be taken, including all necessary equipment being adequately provided. If healthcare professionals become infected or face a life-threatening risk, then their obligations will be limited. Therefore, it is necessary to realize these limitations which may arise while providing appropriate health services.

Infant Apnea: Polygraphic Studies and Follow-up Monitoring

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 731-736 ◽  
Author(s):  
Carol Lynn Rosen ◽  
James D. Frost ◽  
Gunyon M. Harrison
Keyword(s):  
Ph Monitoring ◽  
Home Monitoring ◽  
Seizure Disorders ◽  
Eeg Abnormalities ◽  
Subsequent Episode ◽  
Life Threatening ◽  
History Of ◽  
Polygraphic Recordings ◽  
Prolonged Apnea ◽  
The One

Twenty-six infants with unexplained and apparently life-threatening apnea were evaluated clinically, underwent eight- or 12-hour polygraphic recordings during sleep, and were then observed on home monitors. The one exception was an infant who was treated with theophylline and not monitored at home. Clinical evaluation revealed a history of vomiting in 19 infants, gastroesophageal reflux (GER) on esophagram in 19, and subtle neurologic abnormalities in ten. Polygraphic studies revealed questionable EEG abnormalities in nine infants, abnormal rapid eye movement (REM) time in four, prolonged apnea in one, and increased frequency of brief mixed (central and obstructive) and obstructive apneas in five. Of the 11 infants who underwent pH monitoring during their polygraphic sleep studies, seven had at least one recorded episode of GER, but the episodes were not accompanied by apnea or bradycardia. Thirteen infants had a subsequent episode of apnea that required stimulation, and in eight infants, cardiopulmonary resuscitation was given. There was two deaths. Two infants subsequently developed seizure disorders. Three of the five infants who underwent surgical fundoplication had recurrent apneic episodes. GER commonly occurred in these infant apnea patients but did not correlate with the clinical outcome. Although subtle abnormalities may be detected by sophisticated polygraphic monitoring studies, they are not predictive of recurrent apnea or death. Home monitoring may be useful in detecting the infant at risk for recurrent life-threatening apnea and in providing some safeguard for that infant.

Anorexia nervosa and the gastrointestinal tract

2021 ◽  
pp. flgastro-2021-101857
Author(s):  
Wisam Jafar ◽  
James Morgan
Keyword(s):  
Anorexia Nervosa ◽  
Healthcare Professionals ◽  
Signs And Symptoms ◽  
Nutritional Therapy ◽  
Nutrition Support ◽  
Multidisciplinary Teams ◽  
High Morbidity ◽  
Support Teams ◽  
Life Threatening ◽  
Acute Admissions

Anorexia nervosa (AN) is a complex eating disorder associated with a high morbidity and mortality, however, there is a lack of dedicated training for healthcare professionals outside of mental health specialities. There has been a reported increase in acute admissions of patients with AN, which may have been precipitated by the isolation and loss of support networks created by the COVID-19 pandemic. The purpose of this review is to highlight that AN can present with a wide variety of signs and symptoms relating to both the hollow and solid organs of the gastrointestinal (GI) tract some of which may even be life threatening. The overlap of symptoms with several other functional and organic GI diseases makes diagnosis challenging. Gastroenterologists and allied healthcare professionals need to be aware of the wide array of possible GI manifestations not only to help rationalise investigations but to also facilitate early involvement of the relevant multidisciplinary teams. Many of the GI manifestations of AN can be reversed with careful nutritional therapy under the guidance of nutrition support teams.

scholarly journals Recognition and response to life-threatening situations among women with perinatal mental illness: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025872 ◽  
Author(s):  
Abigail Easter ◽  
Louise Michelle Howard ◽  
Jane Sandall
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Qualitative Study ◽  
Service Provision ◽  
Healthcare Professionals ◽  
Perinatal Period ◽  
Professional Culture ◽  
Near Miss ◽  
Prescribe Medication ◽  
Life Threatening

ObjectiveMental illness has persistently been found to be a leading cause of death during pregnancy and the year after birth (the perinatal period). This study aims to explore barriers to detection, response and escalation of mental health-related life-threatening near miss events among women with perinatal mental illness.DesignQualitative study.ParticipantsHealthcare professionals (HCP) working in psychiatry, maternity and primary care (n=15) across community and hospital maternity and perinatal services within the UK.MethodsIn-depth semistructured interviews were conducted with a range of healthcare professionals working with women during the perinatal period. An iterative process of inductive and deductive thematic analysis, informed by systems theories of healthcare and the Three Delays model, was employed to analyse the data.ResultsThree overarching themes were identified: recognition of severity, communication of risk and service provision and access to treatment. Differing perspectives of mental illness severity influenced how life-threatening situations among women with perinatal mental illness were described, recognised and communicated between teams. Under-resourced mental health service provision, particularly within emergency and specialist perinatal mental health services, unclear thresholds for escalating care and poor infrastructure for sharing information all contributed to delays in a timely response to crisis situations. Reluctance to prescribe medication or admit women to psychiatric hospital, stigma and missed appointments created further delays.ConclusionsResponse and escalation of care for life threatening near miss events among women with mental illness is strongly influenced by professional culture and understandings of mental illness embedded within different healthcare disciplines. Focusing on how differences in organisational and professional culture contribute to the recognition of severe mental illness and interdisciplinary communication may help facilitate clearer co-ordination between teams.

Pulse oximetry home monitoring in infants with single-ventricle physiology and a surgical shunt as the only source of pulmonary blood flow

2012 ◽  
Vol 23 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Annika Öhman ◽  
Eva Strömvall-Larsson ◽  
Boris Nilsson ◽  
Mats Mellander
Keyword(s):  
Oxygen Saturation ◽  
Single Ventricle ◽  
Home Monitoring ◽  
Shunt Complication ◽  
Single Ventricle Physiology ◽  
Life Saving ◽  
Shunt Occlusion ◽  
Life Threatening ◽  
Shunt Dysfunction ◽  
At Home

AbstractBackgroundShunt occlusion is a major cause of death in children with single ventricle. We evaluated whether one daily measurement of oxygen saturation at home could detect life-threatening shunt dysfunction.MethodsA total of 28 infants were included. Parents were instructed to measure saturation once daily and if less than or equal to 70% repeat the measurement. Home monitoring was defined as positive when a patient was admitted to Queen Silvia Children's Hospital because of saturation less than or equal to 70% on repeated measurement at home. A shunt complication was defined as arterial desaturation and a narrowing of the shunt that resulted in an intervention to relieve the obstruction or in death. Parents’ attitude towards the method was investigated using a questionnaire.ResultsA shunt complication occurred out of hospital eight times in eight patients. Home monitoring was positive in five out of eight patients. In two patients, home monitoring was probably life saving; in one of them, the shunt was replaced the same day and the other had an emergency balloon dilatation of the shunt. In three out of eight patients, home monitoring was negative; one had an earlier stage II and survived, but two died suddenly at home from thrombotic shunt occlusion. On seven occasions in three patients home monitoring was positive but there was no shunt complication. The method was well accepted by the parents according to the results of the questionnaire.ConclusionHome monitoring of oxygen saturation has the potential to detect some of the life-threatening shunt obstructions between stages I and II in infants with single-ventricle physiology.

scholarly journals Understanding care when cure is not likely for young adults who face cancer: a realist analysis of data from patients, families and healthcare professionals

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024397 ◽  
Author(s):  
Charlotte Kenten ◽  
Nothando Ngwenya ◽  
Faith Gibson ◽  
Mary Flatley ◽  
Louise Jones ◽  
...  
Keyword(s):  
Young Adults ◽  
Healthcare Professionals ◽  
Care Delivery ◽  
Family Members ◽  
Family Carers ◽  
Structured Interviews ◽  
Multiple Sources ◽  
Programme Theory ◽  
Realist Analysis ◽  
Palliative Care Services

ObjectivesTo understand the experiences of young adults with cancer for whom cure is not likely, in particular what may be specific for people aged 16–40 years and how this might affect care.DesignWe used data from multiple sources (semi-structured interviews with people with cancer, nominated family members and healthcare professionals, and workshops) informed by a preliminary programme theory: realist analysis of data within these themes enabled revision of our theory. A realist logic of analysis explored contexts and mechanisms affecting outcomes of care.SettingThree cancer centres and associated palliative care services across England.ParticipantsWe aimed for a purposive sample of 45 people with cancer from two groups: those aged 16–24 years for whom there may be specialist cancer centres and those 16–40 years cared for through general adult services; each could nominate for interview one family member and one healthcare professional. We interviewed three people aged 16–24 years and 30 people 25–40 years diagnosed with cancer (carcinomas; blood cancers; sarcoma; central nervous system tumours) with a clinician-estimated prognosis of <12 months along with nominated family carers and healthcare professionals. 19 bereaved family members and 47 healthcare professionals participated in workshops.ResultsData were available from 69 interviews (33 people with cancer, 14 family carers, 22 healthcare professionals) and six workshops. Qualitative analysis revealed seven key themes: loss of control; maintenance of normal life; continuity of care; support for professionals; support for families; importance of language chosen by professionals; and financial concerns.ConclusionsCurrent care towards end of life for young adults with cancer and their families does not meet needs and expectations. We identified challenges specific to those aged 16–40 years. The burden that care delivery imposes on healthcare professionals must be recognised. These findings can inform recommendations for measures to be incorporated into services.

scholarly journals Using mHealth for the management of hypertension in UK primary care: an embedded qualitative study of the TASMINH4 randomised controlled trial

2019 ◽  
Vol 69 (686) ◽  
pp. e612-e620 ◽  
Author(s):  
Sabrina Grant ◽  
James Hodgkinson ◽  
Claire Schwartz ◽  
Peter Bradburn ◽  
Marloes Franssen ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomised Controlled Trial ◽  
Healthcare Professionals ◽  
Controlled Trial ◽  
Home Monitoring ◽  
Data Communication ◽  
Free Text ◽  
Self Monitoring ◽  
Structured Care ◽  
Randomised Controlled

BackgroundSelf-monitoring of blood pressure is common but how telemonitoring with a mobile healthcare (mHealth) solution in the management of hypertension can be implemented by patients and healthcare professionals (HCPs) is currently unclear.AimEvaluation of facilitators and barriers to self- and telemonitoring interventions for hypertension within the Telemonitoring and Self-monitoring in Hypertension (TASMINH4) trial.Design and settingAn embedded process evaluation of the TASMINH4 randomised controlled trial (RCT), in the West Midlands, in UK primary care, conducted between March 2015 and September 2016.MethodA total of 40 participants comprising 23 patients were randomised to one of two arms: mHealth (self-monitoring by free text/short message service [SMS]) and self-monitoring without mHealth (self-monitoring using paper diaries). There were also15 healthcare professionals (HCPs) and two patient caregivers.ResultsFour key implementation priority areas concerned: acceptability of self- and telemonitoring to patients and HCPs; managing data; communication; and integrating self-monitoring into hypertension management (structured care). Structured home monitoring engaged and empowered patients to self-monitor regardless of the use of mHealth, whereas telemonitoring potentially facilitated more rapid communication between HCPs and patients. Paper-based recording integrated better into current workflows but required additional staff input.ConclusionAlthough telemonitoring by mHealth facilitates easier communication and convenience, the realities of current UK general practice meant that a paper-based approach to self-monitoring could be integrated into existing workflows with greater ease. Self-monitoring should be offered to all patients with hypertension. Telemonitoring appears to give additional benefits to practices over and above self-monitoring but both need to be offered to ensure generalisability.

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