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3.
Multimedia | Recursos Multimedia | ID: multimedia-9561

RESUMEN

Durante esta sesión, el equipo directivo de la RECAINSA, compartió las principales actividades realizadas durante el 2021 así como los resultados obtenidos, las lecciones aprendidas y las proyecciones de trabajo del 2022 de la Red.


Asunto(s)
Informática Médica , Estrategias de eSalud , Telemedicina
4.
Boîte à Outils de Transformation Numérique;Outils de ConnaissanceOPS/EIH/IS/21-023.
Monografía en Francés | PAHO-IRIS | ID: phr-55634

RESUMEN

La gestion des données est actuellement une exigence de base pour disposer de preuves pour éclairer la prise de décision dans le domaine de la santé. Par conséquent, il est nécessaire de concevoir des stratégies qui dominent le lexique spécialisé afin que les informations cliniques stockées dans les systèmes informatiques puissent être utilisées à des fins multiples, ce qui est réalisé grâce à la représentation des données de santé. Cette capsule de connaissances explique ce concept et d'autres, ainsi que l'importance des outils de codage terminologique et leur relation avec la transformation numérique de la santé publique.


Asunto(s)
Sistemas de Salud , Sistemas de Información , Sistemas de Información en Salud , Telemedicina , Interoperabilidad de la Información en Salud , Toma de Decisiones , Sistemas de Computación , Codificación Clínica , Américas
5.
J Med Internet Res ; 24(1): e30379, 2022 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-34994706

RESUMEN

BACKGROUND: People are now connected in a borderless web-based world. The modern public, especially the younger generation, relies heavily on the internet as the main source of health-related information. In health care, patients can use social media for more tailored uses such as telemedicine, finding a provider, and for peer support. OBJECTIVE: The aim of this narrative review is to discuss how social media has been used in the health care industry from the perspective of patients and describe the main issues surrounding its use in health care. METHODS: Between March and June 2020, a review of the literature was conducted on PubMed, Google Scholar, and Web of Science for English studies that were published since 2007 and discussed the use of social media in health care. In addition to only English publications that discussed the use of social media by patients, publications pertaining to ethical and legal considerations in the use of social media were included. The studies were then categorized as health information, telemedicine, finding a health care provider, peer support and sharing experiences, and influencing positive health behavior. In addition, two more sections were added to the review: issues pertaining to social media use in health care and ethical considerations. RESULTS: Initially, 75 studies were included. As the study proceeded, more studies were included, and a total of 91 studies were reviewed, complemented by 1 textbook chapter and 13 web references. Approximately half of the studies were reviews. The first study was published in 2009, and the last was published in 2021, with more than half of the studies published in the last 5 years. The studies were mostly from the United States (n=40), followed by Europe (n=13), and the least from India (n=1). WhatsApp or WeChat was the most investigated social media platform. CONCLUSIONS: Social media can be used by the public and patients to improve their health and knowledge. However, due diligence must be practiced to assess the credibility of the information obtained and its source. Health care providers, patients, and the public need not forget the risks associated with the use of social media. The limitations and shortcomings of the use of social media by patients should be understood.


Asunto(s)
Medios de Comunicación Sociales , Telemedicina , Terapia Conductista , Atención a la Salud , Personal de Salud , Humanos
6.
Sensors (Basel) ; 22(1)2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-35009878

RESUMEN

The ever-growing ecosystem of the Internet of Things (IoT) integrating with the ever-evolving wireless communication technology paves the way for adopting new applications in a smart society. The core concept of smart society emphasizes utilizing information and communication technology (ICT) infrastructure to improve every aspect of life. Among the variety of smart services, eHealth is at the forefront of these promises. eHealth is rapidly gaining popularity to overcome the insufficient healthcare services and provide patient-centric treatment for the rising aging population with chronic diseases. Keeping in view the sensitivity of medical data, this interfacing between healthcare and technology has raised many security concerns. Among the many contemporary solutions, attribute-based encryption (ABE) is the dominant technology because of its inherent support for one-to-many transfer and fine-grained access control mechanisms to confidential medical data. ABE uses costly bilinear pairing operations, which are too heavy for eHealth's tiny wireless body area network (WBAN) devices despite its proper functionality. We present an efficient and secure ABE architecture with outsourcing intense encryption and decryption operations in this work. For practical realization, our scheme uses elliptic curve scalar point multiplication as the underlying technology of ABE instead of costly pairing operations. In addition, it provides support for attribute/users revocation and verifiability of outsourced medical data. Using the selective-set security model, the proposed scheme is secure under the elliptic curve decisional Diffie-Hellman (ECDDH) assumption. The performance assessment and top-ranked value via the help of fuzzy logic's evaluation based on distance from average solution (EDAS) method show that the proposed scheme is efficient and suitable for access control in eHealth smart societies.


Asunto(s)
Seguridad Computacional , Telemedicina , Anciano , Confidencialidad , Ecosistema , Humanos , Tecnología Inalámbrica
7.
Clin Interv Aging ; 17: 1-13, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35023909

RESUMEN

In light of the increasing life expectancy of Europe's population and the rising significance of active and healthy ageing relating thereto, an integrated approach of nutritional care within primary health care is gaining importance. The aim of the review was to summarize evidence on the effectiveness of nutritional interventions in primary health care. The scoping review is based upon a comprehensive literature search of relevant literature published between January 2010 and August 2021 in PubMed, CINAHL, Cochrane Database of Systematic Reviews, Embase and Medline databases. Overall, 15 studies were included for evidence synthesis and interventions were basically clustered according to their type, into 1) eHealth and tele-medical interventions; 2) targeted single interventions; and 3) comprehensive, multi-faceted interventions. The review presents diverging evidence regarding the efficacy and effectiveness of interventions for nutritional care in primary health care, however, demonstrates encouraging outcomes. eHealth and tele-medical interventions partly show a careful positive tendency. Likewise, manifold single interventions on patient level present significant improvements in patient health outcomes. Multifaceted and comprehensive interventions found in the literature also partly demonstrate significant changes in intervention groups. Primary health care represents a critical setting for the care of older citizens and patients with complex health needs. This scoping review provides an overview of current nutrition care practices in primary health care and results reinforce the need to strengthen implementation of multi-faceted interventions carried out by the inter-disciplinary primary care team for advanced nutritional care.


Asunto(s)
Atención Primaria de Salud , Telemedicina , Anciano , Humanos , Apoyo Nutricional , Revisiones Sistemáticas como Asunto
8.
Rev Esp Salud Publica ; 962022 Jan 14.
Artículo en Español | MEDLINE | ID: mdl-35027527

RESUMEN

OBJECTIVE: The daily use of mobile healthcare applications is already a reality around the world. Their supply and demand forecasts continue to increase exponentially due to the multiple facilities and improvements that they can offer to health management and patient-centered care, especially for the chronically ill. However, this exponential growth in the offer confuses when choosing the best mobile application to use due to the lack of scientific evidence on whether they meet the safety criteria for patients and professionals. The objective of this work was to analyze mobile applications to record and monitor the adverse effects of Available Oral Antineoplastic Treatments, to have a guide on which of these applications could be recommended with certainty by health professionals to cancer patients. METHODS: A search of mobile applications was carried out on the Android and iOS platforms in Spanish and English. Subsequently, each application is analyzed according to the accreditation criteria of the iSYSCore (Internet Health and Society) and the Tic Salut Social Foundation. RESULTS: Twelve applications were found for monitoring the adverse effects of ANEOs, eight of which could be safely recommended by healthcare professionals where the scores of the Tic Salut Social Foundation range from 31 to 32 points out of 40 and those of iSYSCore from 31 to 36 points out of 47. CONCLUSIONS: The e-Onco Salud® application stands out for its ability to improve health management and empower patients in the management of their disease.


OBJETIVO: El uso cotidiano de las aplicaciones sanitarias móviles es ya una realidad en todo el mundo. Las previsiones de su oferta y demanda siguen aumentando exponencialmente debido a las múltiples facilidades y mejoras que pueden ofrecer en la gestión de la salud y a la atención centrada en el paciente, especialmente para los enfermos crónicos. No obstante, este crecimiento exponencial de la oferta confunde a la hora de elegir la mejor aplicación móvil a utilizar debido a la falta de evidencia científica sobre si cumplen los criterios de seguridad para pacientes y profesionales. El objetivo de este trabajo fue analizar aplicaciones móviles para registrar y monitorizar los efectos adversos de los tratamientos antineoplásicos orales (ANEOs) disponibles, para tener una guía sobre cuáles de estas aplicaciones podrían ser recomendadas con certeza por los profesionales de la salud a los pacientes con cáncer. METODOS: Se realizó una búsqueda de las aplicaciones móviles en las plataformas Android y iOS en lengua castellana y en inglés. Posteriormente, se analizó cada aplicación de acuerdo con los criterios de acreditación del iSYSCore (Internet Salud y Sociedad) y de la Fundación "Tic Salut Social". RESULTADOS: Se encontraron doce aplicaciones para el seguimiento de los efectos adversos de los ANEOs, siendo ocho las que podrían ser recomendadas con seguridad por los profesionales sanitarios donde las puntuaciones de la Fundación "Tic Salut Social" oscilan de 31 a 32 puntos de 40 y las de iSYSCore de 31 a 36 puntos de 47. CONCLUSIONES: Se destaca la aplicación e-Onco Salud® por su capacidad para mejorar la gestión sanitaria y empoderar a los pacientes en el manejo de su enfermedad.


Asunto(s)
Antineoplásicos , Aplicaciones Móviles , Telemedicina , Tics , Antineoplásicos/efectos adversos , Atención a la Salud , Humanos , España
9.
Trials ; 23(1): 5, 2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-34980212

RESUMEN

BACKGROUND: Breastfeeding offers many medical and neurodevelopmental advantages for birthing parents and infants; however, the majority of parents stop breastfeeding before it is recommended. Professional lactation support by the International Board Certified Lactation Consultants (IBCLCs) increases breastfeeding rates; however, many communities lack access to IBCLCs. Black and Latinx parents have lower breastfeeding rates, and limited access to professional lactation support may contribute to this disparity. Virtual "telelactation" consults that use two-way video have the potential to increase access to IBCLCs among disadvantaged populations. We present a protocol for the digital Tele-MILC trial, which uses mixed methods to evaluate the impact of telelactation services on breastfeeding outcomes. The objective of this pragmatic, parallel design randomized controlled trial is to assess the impact of telelactation on breastfeeding duration and exclusivity and explore how acceptability of and experiences with telelactation vary across Latinx, Black, and non-Black and non-Latinx parents to guide future improvement of these services. METHODS: 2400 primiparous, pregnant individuals age > 18 who intend to breastfeed and live in the USA underserved by IBCLCs will be recruited. Recruitment will occur via Ovia, a pregnancy tracker mobile phone application (app) used by over one million pregnant individuals in the USA annually. Participants will be randomized to (1) on-demand telelactation video calls on personal devices or (2) ebook on infant care/usual care. Breastfeeding outcomes will be captured via surveys and interviews and compared across racial and ethnic groups. This study will track participants for 8 months (including 6 months postpartum). Primary outcomes include breastfeeding duration and breastfeeding exclusivity. We will quantify differences in these outcomes across racial and ethnic groups. Both intention-to-treat and as-treated (using instrumental variable methods) analyses will be performed. This study will also generate qualitative data on the experiences of different subgroups of parents with the telelactation intervention, including barriers to use, satisfaction, and strengths and limitations of this delivery model. DISCUSSION: This is the first randomized study evaluating the impact of telelactation on breastfeeding outcomes. It will inform the design and implementation of future digital trials among pregnant and postpartum people, including Black and Latinx populations which are historically underrepresented in clinical trials. TRIAL REGISTRATION: ClinicalTrials.gov NCT04856163. Registered on April 23, 2021.


Asunto(s)
Lactancia Materna , Telemedicina , Adulto , Femenino , Humanos , Lactante , Persona de Mediana Edad , Padres , Atención Posnatal , Periodo Posparto , Embarazo , Ensayos Clínicos Controlados Aleatorios como Asunto
10.
BMC Health Serv Res ; 22(1): 24, 2022 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-34983501

RESUMEN

BACKGROUND: Mobile health applications (mHealth apps) have created innovative service channels for patients with chronic diseases. These innovative service channels require physicians to actively use mHealth apps. However, few studies investigate physicians' participation in mHealth apps. OBJECTIVE: This study aims to empirically explore factors affecting physicians' usage behaviors of mHealth apps. Based on the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) and mHealth apps features, we propose a research model including altruism, cognitive trust, and online ratings. METHODS: We collected data from physicians who have used mHealth apps and conducted a factor analysis to verify the convergence and discriminative effects. We used a hierarchical regression method to test the path coefficients and statistical significance of our research model. In addition, we adopted bootstrapping approach and further analyzed the mediating effects of behavioral intention between all antecedent variables and physicians' usage behavior. Finally, we conducted three robustness analyses to test the validity of results and tested the constructs to verify the common method bias. RESULTS: Our results support the effects of performance expectancy, effort expectancy, social influence, and altruism on the behavioral intentions of physicians using mHealth apps. Moreover, facilitating conditions and habits positively affect physicians using mHealth apps through the mediating effort of behavioral intention. Physicians' cognitive trust and online rating have significant effects on their usage behaviors through the mediating efforts of behavioral intention. CONCLUSIONS: This study contributes to the existing literature on UTAUT2 extension of physicians' acceptance of mHealth apps by adding altruism, cognitive trust, and online ratings. The results of this study provide a novel perspective in understanding the factors affecting physicians' usage behaviors on mHealth apps in China and provide such apps' managers with an insight into the promotion of physicians' active acceptance and usage behaviors.


Asunto(s)
Aplicaciones Móviles , Médicos , Telemedicina , Investigación Empírica , Humanos , Intención
11.
Trials ; 23(1): 12, 2022 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-34983621

RESUMEN

BACKGROUND: Men with localized prostate cancer often experience urinary, sexual, bowel, and hormonal symptoms; general distress; pain; fatigue; and sleep disturbance. For men in an intimate relationship, these symptoms disrupt couples' relationships and intimacy. The symptoms also reduce quality of life for both men and their partners, who are often their primary caregivers. Management of the negative effects of cancer and its treatment is a significantly under-addressed supportive care need for these men and their intimate partners. To address these unmet supportive care needs, our interdisciplinary team developed and pilot tested the usability and feasibility of an evidence-based, couple-focused, tailored eHealth intervention, "Prostate Cancer Education & Resources for Couples" (PERC). Based on the adapted stress and coping theoretical framework and developed with stakeholder involvement, PERC aims to improve quality of life for both men and their partners by enhancing their positive appraisals, self-efficacy, social support, and healthy behaviors for symptom management. METHODS: We will test the efficacy of PERC using a population-based, geographically and demographically diverse cohort in a randomized controlled trial. Primary aim: Assess if patients and partners receiving PERC will report greater improvement in their cancer-related quality of life scores than those in the control group (usual care plus the National Cancer Institute prostate cancer website) at 4, 8, and 12 months post-baseline. Secondary aim: Test if patients and partners in PERC will report significantly more positive appraisals and higher levels of coping resources at follow-ups than those in the control group. Exploratory aim: Determine if patient race and ethnicity, education, type of treatment, or couples' relationship quality moderate the effects of PERC on patient and partner QOL at follow-ups. DISCUSSION: This study will provide a novel model for self-managing chronic illness symptoms that impact couples' relationships, intimacy, and quality of life. It addresses the National Institute of Nursing Research's goal to develop and test new strategies for symptom self-management to help patients and caregivers better manage their illness and improve quality of life. It also responds to calls for programs from the Institute of Medicine and American Cancer Society to address treatment-related effects and improve survivors' QOL. TRIAL REGISTRATION: CT.gov NCT03489057.


Asunto(s)
Neoplasias de la Próstata , Automanejo , Telemedicina , Humanos , Masculino , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/terapia , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Esposos
12.
Health Res Policy Syst ; 20(1): 2, 2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-34980156

RESUMEN

BACKGROUND: Careful development of interventions using principles of co-production is now recognized as an important step for clinical trial development, but practical guidance on how to do this in practice is lacking. This paper aims (1) provide practical guidance for researchers to co-produce interventions ready for clinical trial by describing the 4-stage process we followed, the challenges experienced and practical tips for researchers wanting to co-produce an intervention for a clinical trial; (2) describe, as an exemplar, the development of our intervention package. METHOD: We used an Integrated Knowledge Translation (IKT) approach to co-produce a telehealth-delivered exercise program for people with stroke. The 4-stage process comprised of (1) a start-up planning phase with the co-production team. (2) Content development with knowledge user informants. (3) Design of an intervention protocol. (4) Protocol refinement. RESULTS AND REFLECTIONS: The four stages of intervention development involved an 11-member co-production team and 32 knowledge user informants. Challenges faced included balancing conflicting demands of different knowledge user informant groups, achieving shared power and collaborative decision making, and optimising knowledge user input. Components incorporated into the telehealth-delivered exercise program through working with knowledge user informants included: increased training for intervention therapists; increased options to tailor the intervention to participant's needs and preferences; and re-naming of the program. Key practical tips include ways to minimise the power differential between researchers and consumers, and ensure adequate preparation of the co-production team. CONCLUSION: Careful planning and a structured process can facilitate co-production of complex interventions ready for clinical trial.


Asunto(s)
Accidente Cerebrovascular , Telemedicina , Atención a la Salud , Terapia por Ejercicio , Humanos , Accidente Cerebrovascular/terapia
15.
Rev Neurol ; 74(2): 55-60, 2022 01 16.
Artículo en Español | MEDLINE | ID: mdl-35014020

RESUMEN

INTRODUCTION: The SARS-CoV-2 pandemic has given rise to a major change in healthcare and brought teleconsultation to the forefront. In neurology, headaches are the most frequent reason for visits. AIM: To assess the impact of the COVID-19 pandemic on the structure of headache units in Andalusia and the adaptations made to healthcare that are potentially useful innovations that can continue to be developed when the pandemic is over. MATERIALS AND METHODS: Cross-sectional observational study using an online survey of neurologists responsible for headache units and specialised consultations in Andalusia. RESULTS: During the state of alarm, all respondents used teleconsultation. The vast majority (92.8%) maintained some face-to-face activity, mostly for invasive techniques and new patients, using individual protection measures and as a way to avoid crowds. Half of them (50%) maintained botulinum toxin administrations at the scheduled times and 78.6% continued to prescribe monoclonal antibodies against calcitonin gene-related peptide. Altogether 78.5% are generally satisfied with the use of teleconsultation and 57.1% think it could be quite useful in the future. The main advantages reported were avoiding the need for the patient to travel and time savings; the disadvantages were the absence of physical examinations and difficulties in communicating. The most frequently expressed need for improvement was the use of video-calls. CONCLUSIONS: Some of the changes adopted during this time could continue to be useful in the future and, in the case of headaches, teleconsultation could be used as an option for following up patients who have already been diagnosed and do not require any invasive techniques.


TITLE: Adaptación de las unidades de cefalea de Andalucía a la pandemia por COVID-19. Análisis del Grupo de Estudio de Cefaleas de la Sociedad Andaluza de Neurología.Introducción. La pandemia por SARS-CoV-2 ha supuesto un gran cambio en la atención sanitaria y ha dado protagonismo a la teleconsulta. En neurología, las cefaleas constituyen el motivo más frecuente de consulta. Objetivo. Evaluar el impacto de la pandemia por COVID-19 en la estructura de las unidades de cefaleas de Andalucía y las adaptaciones asistenciales potencialmente útiles tras ella. Materiales y métodos. Estudio observacional transversal mediante encuesta en línea a los neurólogos responsables de las unidades y consultas monográficas de cefaleas de Andalucía. Resultados. Durante el estado de alarma, todos los encuestados usaron teleconsulta. El 92,8% mantuvo alguna actividad presencial, fundamentalmente para técnicas invasivas y pacientes nuevos, utilizando medidas de protección individual y para evitar aglomeraciones. El 50% mantuvo las administraciones de toxina botulínica en los tiempos adecuados y el 78,6% siguió prescribiendo anticuerpos monoclonales frente al péptido relacionado con el gen de la calcitonina. El 78,5% se encuentra globalmente satisfecho con el uso de la teleconsulta y el 57,1% considera que podría ser bastante útil de cara al futuro. Las principales ventajas expresadas fueron evitar el desplazamiento de los pacientes y el ahorro de tiempo; los inconvenientes, la ausencia de exploración física y la dificultad de comunicación. La necesidad de mejora más expresada fue el uso de videollamada. Conclusiones. Algunos de los cambios adoptados en este tiempo podrían seguir siendo útiles en el futuro y, en el caso de las cefaleas, la teleconsulta se podría emplear como opción para el seguimiento de pacientes ya diagnosticados y que no requieran técnicas invasivas.


Asunto(s)
COVID-19/epidemiología , Cefalea , Unidades Hospitalarias/organización & administración , Hospitales Universitarios/organización & administración , Neurología/organización & administración , Pandemias , SARS-CoV-2 , Telemedicina/tendencias , Anticuerpos Monoclonales/uso terapéutico , Actitud del Personal de Salud , Toxinas Botulínicas Tipo A/uso terapéutico , Estudios Transversales , Cefalea/epidemiología , Cefalea/terapia , Encuestas de Atención de la Salud , Unidades Hospitalarias/estadística & datos numéricos , Humanos , Neurólogos/psicología , Neurología/métodos , Satisfacción Personal , Utilización de Procedimientos y Técnicas , España/epidemiología , Telemedicina/estadística & datos numéricos , Factores de Tiempo
16.
Health Res Policy Syst ; 20(1): 9, 2022 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-35033107

RESUMEN

BACKGROUND: Adaptive models of healthcare delivery, such as telehealth consultations, have rapidly been adopted to ensure ongoing delivery of essential healthcare services during the COVID-19 pandemic. However, there remain gaps in our understanding of how clinicians have adapted to telehealth. This study aims to explore the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region, and general practitioners (GP), including barriers, enablers and opportunities. METHODS: An interpretative qualitative study involving in-depth interviews explored the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region of Australia, and GPs, including barriers, enablers and opportunities. Data were analysed using an inductive thematic approach with constant comparison. RESULTS: Individual interviews were conducted with 10 specialists and five GPs. Key themes were identified: (1) transition to telehealth has been valuable but challenging; (2) persisting telehealth process barriers need to be addressed; (3) establishing when face-to-face consults are essential; (4) changes in workload pressures and potential for double-up; (5) essential modification of work practices; and (6) exploring what is needed going forward. CONCLUSIONS: While there is a need to rationalize and optimize health access during a pandemic, we suggest that more needs to be done to improve telehealth going forward. Our results have important policy implications. Specifically, there is a need to effectively train clinicians to competently utilize and be confident using this telehealth and to educate patients on necessary skills and etiquette.


Asunto(s)
COVID-19 , Telemedicina , Australia , Atención a la Salud , Humanos , Pandemias , Políticas , SARS-CoV-2
17.
BMC Health Serv Res ; 22(1): 81, 2022 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-35034647

RESUMEN

BACKGROUND: Many professional services were pressed to adopt telepractice in response to the global coronavirus SARS-CoV-2 (COVID-19) pandemic. The need to adopt a new service delivery approach quickly created different implementation challenges. This study explored the lived experiences of frontline clinicians who successfully transitioned their in-person speech-language therapy services to telepractice through an implementation science lens. METHODS: The study was conducted in partnership with one publicly funded program in Ontario, Canada that offers services to preschoolers with speech, language and communication disorders. Sixteen frontline speech-language pathologists and assistants at this organization shared their lived experience transitioning to telepractice during the pandemic during videoconference interviews. A narrative inquiry approach was used to analyze interview transcripts to identify the processes (or steps) this program took to implement telepractice and to understand the facilitators and barriers to telepractice implementation during the pandemic. RESULTS: The following six stages were identified from clinicians' narratives: abrupt lockdown; weeks of uncertainty; telepractice emerged as an option; preparation for telepractice; telepractice trials; and finally, full implementation of telepractice. The stages of events offered significant insights into how government public health measures influenced clinicians' decisions and their processes of adopting telepractice. In terms of barriers, clinicians reported a lack of knowledge, skills and experience with telepractice and a lack of technological support. The organization's learning climate and team approach to transitioning services were identified as the main facilitator of implementation. CONCLUSIONS: Findings suggest a need for better coordination of public health measures and professional services, which would have eased clinicians' stress and facilitated an earlier transition to telepractice. Fostering an organization's learning climate may improve organization's resilience in response to emergency situations.


Asunto(s)
COVID-19 , Trastornos de la Comunicación , Patología del Habla y Lenguaje , Telemedicina , Preescolar , Control de Enfermedades Transmisibles , Humanos , Ontario/epidemiología , Pandemias/prevención & control , Patólogos , SARS-CoV-2 , Habla
18.
Medicina (B Aires) ; 82(1): 99-103, 2022.
Artículo en Español | MEDLINE | ID: mdl-35037867

RESUMEN

Diabetic retinopathy is one of the major problems public health is facing in the 21st century. The worldwide prevalence is increasing; however, little is known about the frequency of this disease in Argentina. Tele-ophthalmology programs have helped to face and to better understand this disease, mainly in rural areas. The aim of this study was to estimate the prevalence of diabetic retinopathy in the province of La Pampa. A cross-sectional observational study was carried out, evaluating the characteristics of the population assisted by a tele-ophthalmology program in a rural area of the province. The images, taken with a non-mydriatic retinal camera, the intraocular pressure and general characteristics of the population were evaluated. A disease prevalence of 21.5% was estimated and 14.1% of them had a vision-threatening diabetic retinopathy. In addition, it was observed that 5.0% had glaucoma, 63.4% hypertension and 42.6% dyslipidemia. These findings are similar to those reported in other countries around the world. These data are fundamental to understand the details of the epidemiological situation in this region and to be able to develop health strategies to deal with this disease.


La retinopatía diabética es uno de los grandes problemas que enfrenta la salud pública en el siglo XXI. La prevalencia mundial se encuentra en constante aumento; sin embargo, poco se conoce sobre la frecuencia de esta enfermedad en la Argentina. Los programas de tele-oftalmología han ayudado a combatir y a comprender mejor esta enfermedad, principalmente en áreas rurales. El objetivo del siguiente trabajo fue estimar la prevalencia de la retinopatía diabética en la provincia de La Pampa. Se realizó un estudio observacional de corte transversal, evaluando las características de la población asistida por un programa de tele-oftalmología en la zona rural de la provincia. Se evaluaron imágenes de retina obtenidas con un retinógrafo no midriático, la presión intraocular y características generales de la población. Se estimó una prevalencia del 21.5% y un 14.1% de estas personas tenían una amenaza visual grave. Además, se observó que el 5.0% tenían glaucoma, 63.4% hipertensión arterial y 42.6% dislipemia. Estos resultados son similares a los presentados en otros países del mundo. Son datos fundamentales para comprender detalles de la situación epidemiológica en esta región y poder armar estrategias sanitarias para enfrentar a esta enfermedad.


Asunto(s)
Diabetes Mellitus , Retinopatía Diabética , Telemedicina , Argentina/epidemiología , Estudios Transversales , Retinopatía Diabética/diagnóstico , Retinopatía Diabética/epidemiología , Humanos , Tamizaje Masivo , Prevalencia
19.
Workplace Health Saf ; 70(1): 43-49, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35037513

RESUMEN

This case study draws attention to the psychosocial difficulties that emerged in the context of the coronavirus disease 2019 (COVID-19) outbreak in relation to the remote management of subjects with psychiatric vulnerabilities following exposure to prolonged quarantine. The case involves a 56-year-old hospital nurse, followed by the Occupational Health Department of a major university hospital in central Italy for mood instability in the context of a cyclothymic temperament. She was quarantined for occupationally acquired COVID-19 and remained positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via swab test for more than 2 months between March and May 2020. In this case study, we discuss the challenges presented by the risk of a prolonged quarantine in a psychologically vulnerable employee, the need for occupational medicine to provide adequate health surveillance of all health care workers during the COVID-19 pandemic, the effectiveness of telepsychiatry, and the difficulties in formulating a proper treatment strategy.


Asunto(s)
COVID-19 , Medicina del Trabajo , Psiquiatría , Telemedicina , Femenino , Personal de Salud , Humanos , Salud Mental , Persona de Mediana Edad , Pandemias , Cuarentena , SARS-CoV-2
20.
Matern Child Health J ; 26(1): 58-64, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34978018

RESUMEN

PURPOSE:  In March 2020, many state, local, and national governments declared various states of emergencies in response to the COVID-19 pandemic. In Massachusetts, where our multidisciplinary pediatric feeding clinic is located, the governor declared of a state of emergency encouraging social distancing, and simultaneously signed an order establishing reimbursement parity for telehealth visits to in-office traditional visits by both commercial and state health insurers. This presented a challenge and an opportunity for our multidisciplinary program for children with pediatric feeding disorders embedded in a large academic children's hospital. In this paper we aim to provide a roadmap for rapid implementation of telehealth practice without a reliance on in-person care in a multidisciplinary pediatric feeding clinic. Description: Within a week, the program pivoted from solely in-person care to 100% telehealth services for both new and established patients. Through this transition, the program encountered several challenges with technology, scheduling, licensing, and concerns for reinforcing pre-existing healthcare disparities. ASSESSMENT:  The program quickly overcame many of these challenges and found telehealth to offer benefits to patients such as improved coordination of care with other agencies, reduced appointment times, and reduced travel time and travel cost. Even with a reduction in the number of patients seen per clinic due to the manner in which telehealth was implemented, there was an increase in the number of visits completed with a slight reduction in the no-show rate. Additionally, providers in the program are better able to evaluate feeding practices in the home and understand many of the barriers families may face in implementing interventions. While telehealth does have some challenges, it can help to improve access, communication, and may increase patient satisfaction for children who require multidisciplinary care for their pediatric feeding disorder. CONCLUSION:  Our hope is that billing parity for telehealth will continue to be supported by insurance companies and state governments throughout the remainder of this pandemic, and far beyond.


Asunto(s)
COVID-19 , Telemedicina , Instituciones de Atención Ambulatoria , Niño , Femenino , Humanos , Pandemias , Embarazo , SARS-CoV-2
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