A CUSTOMIZED AND PORTABLE COMPONENT-BASED FRAMEWORK FOR INTELLIGENT HOMECARE SYSTEM DESIGN WITH VIDEO AND PHYSIOLOGICAL MONITORING MACHINERIES

2011 ◽  
Vol 23 (05) ◽  
pp. 325-348
Author(s):  
Yen-Lin Chen ◽  
Chuan-Yen Chiang ◽  
Chao-Wei Yu ◽  
Shyan-Ming Yuan ◽  
Zeng-Wei Hong
Keyword(s):  
Mobile Devices ◽  
Communication Networks ◽  
Treatment Plan ◽  
Physiological State ◽  
Healthcare Systems ◽  
Home Healthcare ◽  
Physiological Data ◽  
Reusable Component ◽  
Treatment Plans ◽  
Functional Components

This study proposes a customized and reusable component-based design framework based on the UML modeling process for intelligent home healthcare systems. All the proposed functional components are reusable, replaceable, and extensible for the system developers to implement customized home healthcare systems addressing different demands of patients and caregivers from healthcare monitoring aspects. The prototype design of the intelligent healthcare system based on these proposed components can provide the following features: (1) monitoring and recording videos of rehabilitation situations and patient behavior using multiple CCD cameras, which can be stored accordingly in an archive; (2) recording the patient's physiological data and corresponding treatment plan, which can be stored in an XML archiving database for caregivers' review; (3) automatically alerting patients to remind them of medication schedules or treatment plans, while recording the patient's treatment situations; (4) caregivers monitoring videos and physiological records of the patient's rehabilitation using handheld mobile devices via the Internet or wireless communication networks; and (5) caregivers and patients establishing alert mechanisms for the patients' physiological warning states. If the patient's physiological state suddenly deteriorates, the module would immediately alert caregivers by sending notification messages to their remote mobile devices or web browsers.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

scholarly journals Multicriterial CNN based beam generation for robotic radiosurgery of the prostate

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Stefan Gerlach ◽  
Christoph Fürweger ◽  
Theresa Hofmann ◽  
Alexander Schlaefer
Keyword(s):  
Deep Learning ◽  
Treatment Planning ◽  
Treatment Plan ◽  
Plan Quality ◽  
New Approach ◽  
Beam Generation ◽  
Radiological Features ◽  
Improve Treatment ◽  
Robotic Radiosurgery ◽  
Treatment Plans

AbstractAlthough robotic radiosurgery offers a flexible arrangement of treatment beams, generating treatment plans is computationally challenging and a time consuming process for the planner. Furthermore, different clinical goals have to be considered during planning and generally different sets of beams correspond to different clinical goals. Typically, candidate beams sampled from a randomized heuristic form the basis for treatment planning. We propose a new approach to generate candidate beams based on deep learning using radiological features as well as the desired constraints. We demonstrate that candidate beams generated for specific clinical goals can improve treatment plan quality. Furthermore, we compare two approaches to include information about constraints in the prediction. Our results show that CNN generated beams can improve treatment plan quality for different clinical goals, increasing coverage from 91.2 to 96.8% for 3,000 candidate beams on average. When including the clinical goal in the training, coverage is improved by 1.1% points.

scholarly journals Outcomes of Peer Review for Radiotherapy Treatment Plans With Palliative Intent

2018 ◽  
Vol 14 (12) ◽  
pp. e794-e800
Author(s):  
Dina Thompson ◽  
Kimberly Cox ◽  
James Loudon ◽  
Ivan Yeung ◽  
Woodrow Wells
Keyword(s):  
Peer Review ◽  
Treatment Plan ◽  
Palliative Radiotherapy ◽  
Cancer Center ◽  
Palliative Intent ◽  
Treatment Plans ◽  
Important Quality ◽  
Radiation Medicine ◽  
Radiotherapy Treatment

Purpose: Peer review of a proposed treatment plan is increasingly recognized as an important quality activity in radiation medicine. Although peer review has been emphasized in the curative setting, applying peer review for treatment plans that have palliative intent is receiving increased attention. This study reports peer review outcomes for a regional cancer center that applied routine interprofessional peer review as a standard practice for palliative radiotherapy. Methods and Materials: Peer review outcomes for palliative radiotherapy plans were recorded prospectively for patients who began radiotherapy between October 1, 2015, and September 30, 2017. Recommended and implemented changes were recorded. The content of detailed discussions was recorded to gain insight into the complexities of palliative treatment plans considered during peer review. Results: Peer review outcomes were reviewed for 1,413 treatment plans with palliative intent. The proportions of detailed discussions and changes recommended were found to be 139 (9.8%) and 29 (2.1%), respectively. The content of detailed discussions and changes recommended was categorized. Major changes represented 75.9% of recommended changes, of which 84.2% were implemented clinically. Conclusion: Many complexities exist that are specific to palliative radiotherapy. Interprofessional peer review provides a forum for these complexities to be openly discussed and is an important activity to optimize the quality of care for patients with treatment plans that have palliative intent.

Abstract 18150: Prediction of Imminent Deterioration of Children after Stage I Palliation Using Real-Time Processing of Physiological Data

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Craig G Rusin ◽  
Sebastian I Acosta ◽  
Eric L Vu ◽  
Risa B Myers ◽  
Kenneth M Brady ◽  
...  
Keyword(s):  
Early Life ◽  
Physiological State ◽  
Vital Signs ◽  
Clinical Deterioration ◽  
Physiological Data ◽  
Real Time Processing ◽  
Life Saving ◽  
St Segment ◽  
The Hours ◽  
Roc Area

Patients after stage 1 palliation (S1P) for hypoplastic left heart syndrome (HLHS) and related lesions are at risk of life threatening deterioration resulting in shock, cardiac arrest, & hypoxemia. We hypothesize that these sudden deteriorations may be forecast by subtle, previously unidentified changes in cardiorespiratory dynamics. Identification of these precursors may provide an opportunity for early, life-saving intervention. We created complete high-resolution physiological recordings for all patients who had a primary admission of S1P after Jan. 1, 2013. We used the SickbayTM system (Medical Informatics Corp, Houston, TX) to collect high frequency physiological waveforms including EKG, ABP, LAP, SpO2 and Chest Impedance (60Hz - 240Hz), as well as HR, RR, Temp. and ST segment vital signs (0.5 Hz) during the patient’s interstage hospitalization. A logistic regression model was constructed to discriminate between physiological characteristics observed in the hours prior to deterioration from the characteristics observed >24 hours prior to or >96 hours after a clinical deterioration. Model validation was done using a standard bagging approach with a REPtree classifier and 10 fold cross validation. Twenty five patients were included in the study. Of these, 15 (60%) were found to have one or more deterioration events (arrest, CPR, unplanned intubation), with 24 total events observed during the interstage period. Characteristics associated with imminent deterioration were low SpO2 and depressed ST segment. Changes in physiological dynamics could be detected 1-2 hours before overt deterioration occurs (ROC area = 0.89) (Figure 1). This altered physiological state remains for ~96 hours after deterioration. In conclusion, it is possible to identify clinical deterioration in HLHS patients during their interstage period ~1-2 hours before overt deterioration occurs, providing an opportunity for early, life-saving intervention to be administered.

Willingness to Travel for Cellular Therapy: The Influence of Follow-Up Care Location, Oncologist Continuity, and Race

2021 ◽  
pp. OP.21.00312
Author(s):  
Zachary A. K. Frosch ◽  
Esin C. Namoglu ◽  
Nandita Mitra ◽  
Daniel J. Landsburg ◽  
Sunita D. Nasta ◽  
...  
Keyword(s):  
Travel Time ◽  
Cellular Therapy ◽  
Treatment Plan ◽  
Admission Rate ◽  
B Cell Lymphoma ◽  
Travel Times ◽  
Importance Weights ◽  
Follow Up Care ◽  
Treatment Plans

PURPOSE Patients weigh competing priorities when deciding whether to travel to a cellular therapy center for treatment. We conducted a choice-based conjoint analysis to determine the relative value they place on clinical factors, oncologist continuity, and travel time under different post-treatment follow-up arrangements. We also evaluated for differences in preferences by sociodemographic factors. METHODS We administered a survey in which patients with diffuse large B-cell lymphoma selected treatment plans between pairs of hypothetical options that varied in travel time, follow-up arrangement, oncologist continuity, 2-year overall survival, and intensive care unit admission rate. We determined importance weights (which represent attributes' value to participants) using generalized estimating equations. RESULTS Three hundred and two patients (62%) responded. When all follow-up care was at the center providing treatment, plans requiring longer travel times were less attractive ( v 30 minutes, importance weights [95% CI] of –0.54 [–0.80 to –0.27], –0.57 [–0.84 to –0.29], and –0.17 [–0.49 to 0.14] for 60, 90, and 120 minutes). However, the negative impact of travel on treatment plan choice was mitigated by offering shared follow-up (importance weights [95% CI] of 0.63 [0.33 to 0.93], 0.32 [0.08 to 0.57], and 0.26 [0.04 to 0.47] at 60, 90, and 120 minutes). Black participants were less likely to choose plans requiring longer travel, regardless of follow-up arrangement, as indicated by lower value importance weights for longer travel times. CONCLUSION Reducing travel burden through shared follow-up may increase patients' willingness to travel to receive cellular therapies, but additional measures are required to facilitate equitable access.

scholarly journals A Creature Called CIH: From a Quantum Explanation of Psychological Disorders to a Classical Limit of Behavior

2017 ◽  
Author(s):  
Saeideh Mohseni Nezhad
Keyword(s):  
Impulse Control ◽  
Classical Limit ◽  
Treatment Plan ◽  
Psychological Disorders ◽  
Conduct Disorders ◽  
Quantum Limit ◽  
Quantum Model ◽  
Quantum Field Theories ◽  
Treatment Plans ◽  
Suitable Treatment

The objective of this study is to present a Quantum Model for designing and predicting suitable treatment plans for different psychological disorders. The theory has been extracted from Quantum Field Theories and is modeled on a Conceptual Isolated Human (CIH), which is a totally abstract idea. The Quantum limit of the model explains the way disorders are formed, and its classical limit forecasts the observable CIH behavior. Then, a pattern has been presented for treatment plans based on the CIH Quantum Model, which is named ‘Systematic Balancing’. Finally, Systematic Balancing is presented in this article in order to explain and predict the treatment plan for the category of 'Disruptive, Impulse-Control, and Conduct Disorders in DSM-5'.

scholarly journals Self-organizing topology for energy-efficient ad-hoc communication networks of mobile devices

2020 ◽  
Author(s):  
Indushree Banerjee ◽  
Martijn Warnier ◽  
Frances M. T Brazier
Keyword(s):  
Communication Network ◽  
Mobile Devices ◽  
Communication Networks ◽  
Energy Efficient ◽  
Ad Hoc ◽  
Preferential Attachment ◽  
Scale Free ◽  
Simulated Environment ◽  
Adaptive Topology ◽  
Hoc Networks

Abstract When physical communication network infrastructures fail, infrastructure-less communication networks such as mobile ad-hoc networks (MANET), can provide an alternative. This, however, requires MANETs to be adaptable to dynamic contexts characterized by the changing density and mobility of devices and availability of energy sources. To address this challenge, this paper proposes a decentralized context-adaptive topology control protocol. The protocol consists of three algorithms and uses preferential attachment based on the energy availability of devices to form a loop-free scale-free adaptive topology for an ad-hoc communication network. The proposed protocol has a number of advantages. First, it is adaptive to the environment, hence applicable in scenarios where the number of participating mobile devices and their availability of energy resources is always changing. Second, it is energy-efficient through changes in the topology. This means it can be flexibly be combined with different routing protocols. Third, the protocol requires no changes on the hardware level. This means it can be implemented on all current phones, without any recalls or investments in hardware changes. The evaluation of the protocol in a simulated environment confirms the feasibility of creating and maintaining a self-adaptive ad-hoc communication network, consisting of multitudes of mobile devices for reliable communication in a dynamic context.

scholarly journals Assessment of the capacity of future Dentists to elaborate treatment plans for dental trauma

2020 ◽  
Vol 9 (8) ◽  
pp. e255985718
Author(s):  
Daniela Atili Brandini ◽  
Denise Pedrini ◽  
Caio Vinicius Lourenço Debortoli ◽  
Luiza Monzoli Côvre ◽  
Marina Fuzette Amaral
Keyword(s):  
Treatment Plan ◽  
Dental Trauma ◽  
Great Difficulty ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Root Fracture ◽  
Occlusal Adjustment ◽  
Treatment Plans ◽  
Dentoalveolar Trauma ◽  
Systemic Condition

The prognosis of dental trauma depends on professionals with solid and updated knowledge. The objective was to evaluate the ability of undergraduate dentistry students to develop treatment plans for dental trauma. This cross-sectional, observational, quantitative  study had a sample of 242 participants. A clinical case involving avulsion of tooth 11 and complex coronary root fracture of tooth 21 was selected. All data relating to the patient's exams were added to a clinical record, which was delivered to students in the final year of the undergraduate dentistry course for three years consecutive. The students were instructed to develop a treatment plan for this case. The factors most considered in avulsion treatment plans were: how, when and where the trauma occurred, the patient's age and systemic condition. Of the students, 39.7% developed an adequate treatment plan, the main mistake being the lack of occlusal adjustment. In addition, 9,9% of students had an adequate treatment plan for coronary artery fracture. The recovery of periodontal biological space and the indication of intraradicular retainers were the main difficulties. It is concluded that undergraduate dentistry students had great difficulty in formulating treatment plans suitable for more severe cases of dentoalveolar trauma involving several specialties.

scholarly journals A review of documents assessing capacity and treatment needs to safeguard adults with incapacity

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S82-S82
Author(s):  
Tereza Hoggard ◽  
Robin Holliday ◽  
Everett Julyan
Keyword(s):  
Treatment Plan ◽  
Healthcare Team ◽  
Treatment Needs ◽  
Legal Documents ◽  
Legal Standards ◽  
Vulnerable Patients ◽  
Legal Competence ◽  
Treatment Plans ◽  
Old Age Psychiatry ◽  
Clear Information

AimsTo audit the completion of Adults with Incapacity (AWI) documents (Assessment of Capacity, Section 47 Certificate of Incapacity and Treatment Plan) to ensure they met the legal standards required. We hypothesised that the forms were not all completed comprehensively, particularly with regards to the Treatment Plans.MethodIn addition to being legal documents, AWI documents provide an important framework to guide clinicians when giving treatment and balancing patient safety with patient autonomy. Correctly completed documents help provide vulnerable patients with ethical and lawful treatment that allows them to be treated with respect and dignity.An audit was conducted across two Old Age Psychiatry wards at Ayrshire Central Hospital during October 2020. We assessed all AWI documents available on the wards (n = 20) using criteria based on the standards set by the Mental Welfare Commission for Scotland to ensure legal competence.Result95% of the forms were signed and dated, and the nature of the incapacity was given in 100% of the documents. On the other hand, 35% of the forms gave no indication of the presence or absence of a guardian. Only one of those identified as having a guardian was consulted with regards to the treatment plan. Another member of staff was consulted on the Treatment Plan in 45% of cases. 30% of the Treatment Plans were not precisely worded enough to be considered justifiable for treatment. In the Certificate of Incapacity, two out-of-date certificates were found, and staff were notified immediately. 45% of certificates were considered over-generalised with regards to the description under medical treatment.ConclusionOverall, the forms were mostly signed and dated, with the nature of incapacity given. The two areas that appeared to be the most problematic were the issue of identifying and discussing plans with a guardian, and the specification of treatment covered by both the Certificate of Incapacity and the Treatment Plan.Discussion with members of the healthcare team found some confusion over how to complete the forms and many cited a lack of formal training as the main reason for their uncertainty. In addition, accessing clear information online or on the wards on how to complete the forms was challenging. We intend to improve the completion of these documents by implementing teaching and a guidance poster, based on the areas that we identified as being problematic, and completing the audit cycle.

Integrating Play Therapy and Mental Health Consultation

2017 ◽  
pp. 232-248
Author(s):  
Krystal Vaughn ◽  
Erin Dugan
Keyword(s):  
Mental Health ◽  
Play Therapy ◽  
Treatment Plan ◽  
Challenging Behaviors ◽  
American Psychological Association ◽  
Mental Health Consultation ◽  
American Psychological ◽  
Health Consultation ◽  
Consultation Model ◽  
Treatment Plans

Many parents and teachers are often confounded when it comes to figuring out a child's presenting issues. Mental health consultants are able to note the frequency, proximity, duration and intensity of and in which the behavior(s) occur (American Psychological Association, 2013; Henderson & Martin, 2014). These professionals are equipped with the tools, education, and experience and are able to gather information, observe, and assess the challenging behaviors or presenting issues in order to formulate and conceptualize a treatment plan for the child, their parent(s), and/or the school/center based setting. Additionally, mental health consultants may offer valuable feedback; increase of knowledge, skills and awareness; development of treatment plans; and implementation of the necessary interventions. This chapter seeks to provide professionals with the definitions, differences, structure, and implementation of a mental health consultation model.

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