Study methods: Mixed-method study design was used to investigate feasibility of implementing a mobile-phone based behavioural intervention to reduce CVD risk factors among the Chinese population. Patients, who were 45-79 years old, fair English literacy, had access to a JAVA enabled mobile phone and had no mental health problems, cognitive impairment or severe illness, were eligible to the study. Intervention: Patients recruited from three settings (1 GP, 1 specialist and 1 public clinics) had the study software installed to their phone. The software enabled patients to access their CVD risk profiles (including weight, BP, HbA1c, and lipoprotein profile), 10-year CVD risk prediction (based on Framingham Cardiac Risk Score), and pre-set behavioural recommendations. Patients’ CVD risk profiles were updated at 1-month and 3-month follow-up when their test results were available. Patients were alerted with healthy behaviours recommendations. Outcomes: Outcomes were measured at baseline and 3-month follow-up. Clinical outcomes included Cardiac Risk Factor Score and its components (BMI, Systolic & Diastolic BP, total cholesterol, HDL and HbA1c). Two sets of questionnaires were used to measure knowledge, risk reduction behaviour and attitude toward usefulness of medical records (pre-intervention) and perceived ease of use, usefulness, satisfaction and utilisation of the software (post-intervention). Results and Discussion: 19 patients were recruited at baseline. 75% (14) aged 45-55 years, 58% (11) were male, 79% (15) had secondary or lower education, 63% (12) were married, and 95% (18) never smoked. Patients’ understanding about CVD risk factors and risk reduction behaviour was moderate. Patients’ attitude toward electronic medical record was positive. Overall patients’ perception of usefulness, ease of use and satisfaction with the software was satisfactory. Post-intervention, a decreasing trend was observed in patients’ CVD risk profiles i.e. weight, BMI, SBP&DBP, HbA1c and Lipoprotein profile. Focus group discussions revealed that there was a mismatch between physicians and patients perspectives about the use of mobile phone in a behavioural intervention. Physicians tended to express their concern about the quality of records, security of technology, and patients’ actual benefit, while patients showed little concern about security and great excitement about further use of mobile phone technology in assisting their disease self-management. The public sector physicians admitted that their patients were passive in term of seeking information about their health. Patients were willing to use this software for future care if it could provide more real-time data, tailored recommendations for behavioural change, and an interactive communication tool with their physicians. Physicians would like to try the software if it could ease patient-management process, especially enhance patient-physician communication, and be a decision support system to help them keep track with changes that their patients made. Conclusion: This pilot study has provided preliminary evidence of the feasibility, acceptability, and utility of an e-platform in primary interventions for CVD in Hong Kong. / published_or_final_version / Community Medicine / Master / Master of Philosophy

Thesis (Ph.D.)--Victoria University (Melbourne, Vic.), 2008.

Thesis (M. Eng.), Memorial University of Newfoundland, 1999. / Bibliography: p. 130-134.

Internet use is considered a lever for empowering patients, levelling inequalities and reducing healthcare expenditure. However, with digital inclusion, health provision quality and health system efficiency high on the UK and EU policy agendas, we need to better understand the relationship between Internet use and health outcomes to assess potential benefits and adverse effects. This research addresses the question of how Internet use influences individuals' health service use and their perceived health in the context of England. Focusing on health information-seeking, it analyses variations across different kinds of users, mechanisms between Internet use and both health outcomes, and the role of individual and contextual factors in this relationship. To answer this question, this research uses a mixed methods approach. Quantitative data from the Oxford Internet Surveys (OxIS), the English census and Hospital Episode Statistics (HES) was connected through spatial microsimulation based on output areas. Qualitative data was collected through semi-structured, face-to-face interviews, primarily with former OxIS participants from output areas in the quantitative strand. The quantitative data was revisited based on emerging interview themes. The results indicate that Internet use influences perceived health and health service use via various mechanisms based on the Internet's content, mediation and connection affordances. However, the boundaries between users and non-users are blurry and outcomes vary for different types of individuals, classified here as learners, pragmatists, sceptics, worriers, delegators and adigitals. Age, education, socioeconomic status, long-term health conditions, and geographic context influence Internet use and health outcomes separately, while the social context shapes their relationship too. These findings advance the theoretical understanding of Internet-based health outcomes, and provide practical implications for health professionals and policymakers with insights down to the local level. Moreover, this research demonstrates how novel insights for public wellbeing can be derived from qualitatively enriched secondary data in privacy-preserving and cost-effective ways.

Thesis (DTech (Electrical engineering))--Cape Peninsula University of Technology, Cape Town, 2007 / Telemedicine has been identified as a tool to distnllUte medical expertise to medically underserved rural community. However, due to the underdeveloped or non-existent telecommunication infrastructure, which is needed as the platform for telemedicine, the full benefits of telemedicine are yet to be realized in most parts of South Africa and Africa as a whole. This study aims to explore ways on how to provide lP-based lCI system that can be used as a communication platform for telemedicine in rural areas. In order to emulate the onsite face-to-face consultation experience, the rural telemedicine system must be able to provide quality video transmission. Quality video is also important in order for the physician at the distant end to be able to make correct diagnosis. Hence the main focus of this study is on ways ofproviding quality video over lP-based multiservice network. A conceptual model of a rural area network that can be used for rural telemedicine has been deVeloped, and different access technologies that can be used for rural areas are presented. Techniques for compesating IP best effort datagram delivery are provided. Factors that can affect the quality of video transmission on an lP-based packet network are identified, and a holistic approach to mitigate them is proposed. That includes adopting coding techniques that will provide coding efficiency, high quality video that is consistent at high and low bit rates, resilience to transmission errors, scalability, and network friendliness, which will result in perceived quality improvement, highcompression efficiency, and possibility of transportation over different networks. Secondly, it also includes mechanisms to compensate for packet networks idiosyncrasy, especially JP best-effort debilities, in order to meet the latency and jitter requirements of real-time video traffic. For video coding, H.264 is proposed as it meets most of the encoding requirements listed above, and for prioritising and protecting.video traffic from JP network's best-effort debilities a combination of differential services (DiflServ) and multi-protocol label switching (MPLS) have been adopted, where DiflServ is used for traffic classification and MPLS is used for traffic engineering and fast-rerouting in the event of route failure. To verify and validate the proposed solutions, modelling and simulation has been used, where the Network Simulator (NS-2.93) has been used to simulate network functions, and PSNR, VQM score and double stimulus impairment scale (DSIS) have been used for evaluating video quality.

Health care organisations operate in a eld that is driven by patient, business and legislative demands. Now, Information Technology (IT) is starting to exert its powers on this eld. A revolution is taking place in the health care eld, and IT is playing an increasingly important role. This study originated from realising that medical staff were using technology to help them receive patient studies and do a diagnosis. Health care professionals are very dependent on the availability of the computer systems and on the accuracy of the data that is stored. While health care records may contain information that is of utmost sensitivity, this information is only useful if it is shared with the health care providers and the system under which the patient receives his/her care. The latter trend marks an ever-growing need to protect the confidentiality and integrity of health care information, while at the same time ensuring its availability to authorised health care providers. It has to be acknowledged that a complete protection of data is, in practice, infeasible and impossible. Many systems are not secure, making them vulnerable to attacks. Health care facilities have a challenge of keeping up-to-date with the legal requirements that apply to patient records in order to protect the condentiality, integrity and availability of patient data. This study is aimed at examining the information security of the data in a teleradiology system that is used by a health care facility, and to provide recommendations on how the security can be improved. / Prof. S.H. von Solms

Digital Health relates to “health information systems which enable the merging of social-care and healthcare systems. This would impact on the organisation, service delivery as well as the technological infrastructure” (Herselman & Botha, 2016, p.10). However, with relatively sparse research publications emanating from within the Namibian Health domain, and the concept of Namibian Digital Health as an emergent phenomenon, a Namibian Digital Health Innovation Ecosystem Framework would provide a start to conceptualising, developing and implementing such an ecosystem for Namibia and thus unlocking the potential of Digital Health in this country. The purpose of this study is to develop a Namibian Digital Health Innovation Ecosystem Framework based on literature reviews and the feedback from knowledgeable professionals (KPs) in Namibia, as well as global experts. The methodology which was applied in this study to address the purpose, and to answer the research questions, was Design Science Research Methodology and the Design Science Research Methodology (DSRM) process of Peffers, Tuunanen, Rothenberger and Chatterjee (2008), was adopted. Pragmatism is the overall philosophy guiding the study, as proposed by Ackoff’s theory regarding the hierarchy of human understanding (1989) and Shneiderman’s visual information seeking mantra (1996). During Phases 2 and 3 of the study interpretivism and positivism were applied as philosophies, guided by hermeneutics and triangulation, towards understanding the feedback of Knowledgeable Professionals (KPs) in Namibia, as well as the global experts. The study was divided into three phases. The first phase entailed a literature study which identified the components of Digital Health, Innovation and Digital Ecosystems as well as related research of Digital health, Innovation and Digital Ecosystems in developed and developing countries. This process led to the compilation of the initial Namibian Digital Health Innovation Ecosystem Framework using a conceptual approach. In the second phase of the study, the initial Namibian Digital Health Innovation Ecosystem was evaluated by KPs in Namibia using the Delphi method and interviews. Phase 2 adopted both quantitative and qualitative approaches. The findings from Phase 2 resulted in the development of the intermediate Namibian Digital Health Innovation Ecosystem Framework. In Phase 3 of the study, the intermediate framework was validated by global experts. Feedback was collected from global experts through questionnaires which were analysed through qualitative content analysis. The findings, from Phase 3 led to the development of the final Namibian Digital Health Innovation Ecosystems Framework. The guidelines, which can be used by the Namibian government to implement the suggested digital health innovation ecosystem framework, were also provided. / Information Science / D. Litt. et Phil. (Information Systems)

Research report submitted to the School of Economic and Business Sciences, University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Commerce (Information Systems) by coursework and research, 2 November 2017 / Mobile health applications are fast becoming an influential source of information for pregnant women. Studies have shown that pregnant women download 3 such apps on average on their cellphones. These mobile technologies have been shown to help women monitor their progress during their pregnancy and personalise healthcare to suit their needs. To date, llimited research has been directed towards understanding usage behaviours with these apps. Various authors have argued that there is a need to expand the scope of research from simple usage behaviour to deeper levels as technology becomes more sophisticated and easily available. M-health technologies are increasingly becoming more varied and sophisticated and as such this study aims to explore post-adoption usage specifically of mobile health pregnancy applications in the South African context. This study specifically looked at post adoption usage behaviours and used Hsieh and Zmud’s (2006) framework as a basis of understanding these behaviours. The potential influences on these behaviours were sourced from various studies done on pregnant women usage of ICT in general. These influences were then investigated to see whether they were relevant in the context of m-health pregnancy support applications. The primary method of data collection was open ended semi structured interviews with twelve pregnant women. Data analysis was done using the iterative model for qualitative data analysis proposed by Miles and Huberman (1994). The findings revealed that pregnant women displayed post adoption usage behaviours of routine use and IS continuance. With regards to the infusion stage, the study found that pregnant women engaged in the first set of post adoption usage behaviours i.e. extended usage and deep usage. They did not engage in second stage behaviours namely emergent use, feature extension or intention to explore behaviours. The influences identified in the literature were found to be relevant in the context of m-health applications and additional influences such as cost of seeing gynaecologist, number of features on the app and social structures were found to have an influence on usage of the apps. This study provides unique insights into the views of pregnant women’s experiences with m-health apps. Specifically, by using interpretive research it uncovers the subjective meanings around post adoption usage behaviours, understanding how pregnant women engage in these behaviours and subsequently how these behaviours are sustained during their pregnancy. The study recognises m-health pregnancy support apps as important tools in the pregnancy journey. It highlights how pregnant women value these apps and view them as huge information sources, reassurance and comfort during their pregnancy. It is argued that medical professionals cannot distance themselves away from these apps and need to work in conjunction with them to provide robust maternity care to their patients. 5 Theoretically, this study adds to our understanding of post adoption usage behaviours specifically in the context of m-health pregnancy apps. Limited studies have been done in this field specifically in the South African context and the study provides a foundation for further research. Further research can be done to understand how these apps are changing the relationship between pregnant women and medical professionals and furthermore, whether the information received from these apps is reliable and credible. / GR2018

Video is the most demanding modality from the viewpoints of bandwidth, computational complexity, and resolution. Thus, there has been limited progress in the field of mobile video technology. In the research, the focus is on elastic wireless video technology, and its adaptation to diagnostic application requirements in real-time clinical assessment. It is important and timely to apply wireless video technology to real-time remote diagnosis of emergent medical events. This premise comes from initial successes in telehealth based on wired networks. The enablement of mobility (for the physician and/or the patient) by wireless communication will be a next major step, but this advance will depend on definitive and compelling demonstrations of reliability. Thus, an important goal of the research is to develop a complete methodology that will be embraced by physicians. Acute pediatric asthma has been identified as a domain where this new capability will be highly welcome. The research uses flexible and interactive algorithms for Region-of-Interest (ROI) processing. ROI processing is a useful approach to achieve the optimal balance in the quality-bandwidth tradeoff characteristic of visual communication services. The notion of ROI has been traditionally used mostly for foreground-background separation in scene rendering and manipulation, and only more recently for variably quality compression. Even when the latter goal is considered, quality criteria have been ad-hoc and at best useful for video conferencing, given that the medical domain has its own fidelity criteria. The research thus focuses on the design of an elastic ROI-based compression paradigm with medical diagnosis as a central criterion. The research describes the methodology to achieve elasticity through rate control algorithms at the encoder. An elastic non-parametric approach is proposed that uses a priori user-specified video quality information, quantifies this information, and incorporates this into the encoder in the form of region-quality mappings. This method is compared to a parametric bit allocation approach that is based on region-features and a set of tuning weights. A number of videos of actual patients were filmed and used as the video database for the developed algorithms. In testing the elastic non-parametric and parametric algorithms, both objective measures in the form of Peak Signal to Noise Ratio (PSNR), and subjective evaluations were used. Thus, in this work, the focus is on domain relevance of the algorithms developed, as opposed to network related issues such as packet losses. This is justified in that these may have broader value with other applications, and continuation of this work will include realistic network conditions. To summarize, the research shows the usefulness of ROI processing as a means of achieving a gain (in a bits per pixel sense) over uniform compression at the same bitrate. It also shows how quantifying a notion of functionally lossless video quality diagnostically lossless video quality in a video-based telehealth system, in a bits per pixel sense is useful from an applications and bitrate perspective. Finally, a combination of these two concepts is advantageous i.e. diagnostically lossless ROI video quality is achievable over bitrate limited channels.

Thesis (M. S.)--Electrical and Computer Engineering, Georgia Institute of Technology, 2009. / Committee Chair: Jayant, Nikil; Committee Member: Altunbasak, Yucel; Committee Member: Sivakumar, Raghupathy. Part of the SMARTech Electronic Thesis and Dissertation Collection.