Thesis (M.S.)--West Virginia University, 2000. / Title from document title page. Document formatted into pages; contains vi, 94 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 92-93).

Thesis (M.Eng.)--Memorial University of Newfoundland, 1999. / Bibliography: leaves 117-128.

Thesis (MScIng)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: Primary health care telemedicine services require the acquisition and transmission of patient data including high quality still and video images via telecommunication networks. The objective of this thesis is to investigate the implementation of a generalpurpose medical camera as an alternative to the complex and costly CCD based cameras generally in use at present. The design is based on FillFactory’s SXGA (1280 ×1024) CMOS image sensor. A low-cost Altera Cyclone FPGA is used for signal interfacing, filtering and colour processing to enhance image quality. A Cypress USB 2.0 interface chip is employed to isochronously transfer video data up to a maximum rate of 23.04 MBytes per second to the PC. A detailed design and video image results are presented and discussed; however the camera will need repackaging and an approval for medical application by medical specialists and concerned bodies before releasing it as full-fledged product. / AFRIKAANSE OPSOMMING: Primêre gesondheidssorg telemedisyne dienste moet hoëkwaliteit televisiebeelde van hul pasiënte verkry deur van telekommunikasienetwerke gebruik te maak. Die doel van hierdie tesis is om die toepassing van n meerdoelige mediese kamera te ondersoek as n alternatief tot duur, komplekse CCD-gebaseerde kameras wat huidiglik gebruik word. Die ontwerp is gebaseer op n hoëkwaliteit CMOS beeldsensor. n Goedkoop Altera Cyclone FPGA word gebruik vir seinkoppelvlak, filtering en kleurprosessering om die kwaliteit van die beeld te verhoog. n Hoëspoed USB 2.0 poort word gebruik om die data teen die nodige spoed te versend. n Gedetailleerde ontwerp, en die beeldresultate word voorgelê en bespreek. Die kamera moet egter eers deur mediese spesialiste en relevante beheerliggame goedgekeur word voordat dit as n volledige produk vrygestel kan word.

New wireless communication technology standards are being released every year. Wireless technologies merely differ from one another by their range and speed and can each be selected according to the type of application in use. Mobility and ubiquity are the main benefits that can be extracted by using those technologies. On the other hand, telemedicine is the use of communication technologies to provide medical care and thus avoid the usual face-to-face, physician-to-patient scenario. With telemedicine, a physician can treat a patient located at a remote site. Early telemedicine systems used technologies that were available at the time, such as the telephone. Integrating wireless technologies into telemedicine systems would surely provide a huge boost to the improvement of the delivery of healthcare. However, telemedicine and wireless technologies are both emerging scientific concepts. Scientific concepts always have to face challenges prior to popularisation. The more important barriers to the adoption of wireless telemedicine are security and privacy. Medical practitioners are doing their best to preserve the privacy of their patients. Disclosure of patients’ health information may lead to severe legal sanctions. Security flaws in a wireless telemedicine system would lead to privacy breaches. Patient privacy, which physicians have tried so hard to protect, would consequently be out of their control. This dissertation will achieve two goals. The first goal is to show how different wireless technologies could be integrated into telemedicine to provide different applications. The second goal is to design a fully wireless telemedicine system where the information of patients will flow securely. The model described in this dissertation shows a possible wireless telemedicine scenario using different types of wireless technologies. The model also proposes a solution to allow the secure flow of medical information in order to protect the privacy of patients. / Dr. E. Marais

Magister Scientiae - MSc / Most rural areas of developing countries are faced with problems like shortage of doctors in hospitals, illiteracy and poor power supply. Because of these issues, Information and Communication Technology (ICT) is often sees as a useful solution for these areas. Unfortunately, the social environment is often ignored. This leads to inappropriate systems being developed for these areas. The aims of this thesis were firstly, to learn how a communication system can be built for a rural telehealth environment in a developing country, secondly to learn how users can be supported to use such a system. / South Africa

Regardless of the reason, many patients/clients do not have access to face-to-face medical, neuropsychological, or mental health consultation, assessment, or treatment (Cowain, 2001). The term Remote Neuropsychological Assessment (RNA) has been proposed by Browndyke to denote the general use of telecommunication and Internet-based technologies in neuropsychological assessment and practice (as cited in Schatz & Browndyke, 2002). RNA (Telemedicine) offers a plausible, potentially cost-effective solution to individuals in need of medical, neuropsychological, or mental health consultation, assessment, or treatment that are located in geographical areas away from the specialist (Armstrong, 2006; Berman, 2005; Cowain, 2001; Jacobsen, Sprenger, Andersson, & Krogstad, 2003). The purpose of this study was to examine if test performance for RNA administration of the Cognistat is comparable to test performance for the pencil-paper administration. A one-way repeated measures multivariate analysis of variance (MANOVA) was used to analyze the data. The main effect for administration modality was not significant, F(9, 126) = .375, p = .945. The present study demonstrated the utility of a widely used neurobehavioral screening test that provides a differentiated profile of cognitive status can now reliably be used through a video-conferencing administration. The importance of this finding is that a more comprehensive detection of deficits in multiple domains of cognitive functioning for screening purposes is now possible remotely.

Thesis (MPhil)--University of Stellenbosch, 2006. / ENGLISH ABSTRACT: The study reported on here was conducted between December 2003 and April 2004. The aim of the study was to assess the use of Health Channel Broadcast Multimedia (HCBM) in order to maximise its success. The HCBM is an Information Technology method that was used to disseminate health information in public health facilities. HCBM was installed in health facilities and was used as an education tool. This was done by further developing the clinical skills of the health care workers (HCWs) and to inform the patients, including the community members on HIV/AIDS and related communicable diseases. The study was conducted in eight health facilities in seven provinces where HCBM was piloted. Facilities and forty-nine health professionals (HCWs) were selected conveniently and one hundred and twenty-eight patients were sampled using a systematic random method. The convenient sampling method was relevant since these were key facilities with HCBM. There were very few HCWs who did view HCBM and they were drawn into the study. HCBM used programmes disseminating messages in Afrikaans, English, sePedi, seSotho, siSwati, isiXhosa and isiZulu. The Rapid Assessment Response (RAR) approach was used to give a quick appraisal of the study. The report focuses on the cross-sectional reporting of the quantitative technique of the RAR. Of the HCWs, 86% had viewed the broadcast content, 70% were satisfied with the broadcast mode of service delivery; 56% indicated that the messages were good and added educational value to their professional work, while 52% chose to use the IP box content with HIV/AIDS topics. Ninety-two percent of HCWs stated that HCBM targeted patients and young people, 48% said HCBM had the ability to convey information and 48% said it was capable of addressing health problem. When HCBM was being set up, 62% HCWs engaged in decision making. Patients mentioned that HCBM as a method of information dissemination was educative (62%) and informative (52%). They reported that they did hear messages on HIV/AIDS telling them that medication was available for free to treat within 72 hours after being raped (72%); they had the right to say no to unsafe sex (92%); and 76% said the broadcast had the ability to change people’s behaviour. Respondents reported that the messages were easily understood (44%). The conclusion is that the findings will be useful to inform the government and managers of HCBM programmes on how to maximise the success of HCBM, especially at the implementation phase. / AFRIKAANSE OPSOMMING: Hierdie verslag doen verslag oor die resultate van ’n ondersoek wat tussen Desember 2003 en April 2004 onderneem is. Die doel van die verslag is om die doeltreffendheid van die gebruik van ’n multimedia gesondheidsuitsendingkanaal, Health Channel Broadcast Multimedia (HCBM) te bepaal. Hierdie is nuwe tegnologie wat gebruik word om gesondheidsinligting slegs in die openbare gesondheidsektor te versprei. Die studie is by agt openbare gesondheidsfasiliteite in sewe provinsies waar die HCBM volledig gevestig was, onderneem. Nege-en-veertig gesondheidskundiges (HPW’s) is volgens ’n gerieflikheidsteekproef geselekteer, en 128 pasiënte is met behulp van ’n sistematiese ewekansige steekproef geselekteer. Die HCBM het programme gebruik wat boodskappe in Afrikaans, Engels, sePedi, seSotho, siSwati, isiXhosa en isiZulu uitgesaai het. ’n Benadering bekend as die Rapid Assessment Response (RAR) is gebruik om ’n vinnige evaluering van die studie te maak. Die verslag konsentreer op die deursneerapportering van die kwantitatiewe tegniek van die RAR. Van die HPW’s het 85% na die inhoud van die uitsending gekyk, 70% was tevrede met die uitsendingmodus van dienslewering, 56% het aangedui dat die boodskappe goed was en van opvoedkundige waarde in hulle professionele werk, terwyl 52% verkies het om die Internet Platform-inhoud met MIV/Vigs-temas te gebruik. Twee-en-negentig persent van die HPW’s het te kenne gegee die HCBM is gerig op pasiënte en die jeug, 48% het gesê HCBM het die vermoë om inligting oor te dra, en 48% het gesê dit is geskik om na die gesondheidsprobleem om te sien. Tydens die instelling van die HCBM het 62% HPW’s aan besluitneming deelgeneem. Van die pasiënte met grade 0–6 as opvoedingspeil het 75% verkies om brosjures te gebruik bo enige ander massamedia, en 72% mans en 67% vrouens het na boodskappe oor die behandeling van MIV/Vigs-simptome geluister. Inligting oor vrywillige berading en toetsing voor swangerskap is deur 66% van die vrouens gehoor. Meer as 90% van hulle was bewus van die reg om nee te sê vir seks of onveilige seks. Pasiënte oor die hele residensiële gebied was dit eens dat die taalgebruik in die uitsendings maklik verstaanbaar was. Oor al die opvoedkundige grade heen is saamgestem dat die HCBM die voorgenome boodskap oorgedra het. Die gevolgtrekking is dat die bevindings waardevol is om die regering en bestuurders van die uitsendingsprogram in te lig oor hoe om die ander fases te verbeter. Dit sluit Fase 2 in, wat die uitvoering van die HCBM behels.

With the increasing demands of rising medical costs in combination with a boom in elderly patients in need of quality patient care medical practices are being stressed. Patient to nurse ratios are increasing and government spending in the medical domain is at an all-time high threatening the futures of government medical programs such as Medicare and Medicaid. In this thesis we propose a framework for the monitoring of a patient's vital statistics in a home-based setting using a mobile smart device. We believe that in taking advantage of the wireless sensor technology which is readily available today we can provide a solution that is both economically and socially viable offering a solid quality of healthcare in a comfortable and familiar environment. Our framework exposes both 802.11 and Bluetooth wireless protocol transmitting medical sensor devices using an Android platform device as a monitoring hub. / by Mark Conaster. / Thesis (M.S.C.S.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

An estimated 15 million individuals in the United States have been formally diagnosed with dysphagia, defined as swallowing dysfunction -- the fifth leading cause of death in Americans over the age of 65. Statistical findings indicate that at least 50% of these individuals have limited access to treatment. However, despite the rapid expansion of telepractice (defined as the use of telecommunications technology to provide services at a distance) as a statistically valid online method for the provision of medical and clinical intervention to those without access, telepractice has yet to consistently incorporate online dysphagia service delivery (referred to as tele-dysphagia) into its clinical scope. This investigation compared the outcomes of traditional face-to-face intervention to online tele-dysphagia intervention by measuring the correct and incorrect responses to visual and auditory cues presented by a clinician during dysphagia intervention sessions. Data analysis conducted via t-test indicated that there was no significant difference in the mean scores from tele-dysphagia method (M = 9.67, SD = 3.74) as compared to face-to-face method (M = 9.00, SD = 2.70), t (28) = - 0.56, p = 0.580. Additionally, inter-rater reliability scores were obtained by determining a Cohen’s kappa coefficient in order to measure the degree of agreement between the two raters. Findings indicated a kappa statistic of k=1 for all items, given a 100% agreement for all trials. Additionally, results of a mixed-design analysis of variance suggested a significant within-subject effect with the use of cues, but there were no significant main effects of between-subject factors (gender, delivery type, etiology, or age) on the patients’ responses. Given that there was no significant statistical difference between the two delivery methods and inter-rater reliability scores demonstrated perfect agreement, we can suggest that the online tele-dysphagia method can potentially yield clinical outcomes similar to a traditional face-to-face method. Results from a mixed-design analysis of variance additionally suggested that there is a significant within-subject effect given the use of cues (F (1, 29)=14.99, p = .001) on patients’ responses. However, there were no significant main effects of between-subject factors (gender, delivery type, etiology, or age) on the patients’ responses. It is hoped that the results of this study will lend validity and direction to future attempts to provide much-needed dysphagia intervention via online service methods. Such attempts, in turn, would have the potential to promote increased longevity and quality of life in those populations currently unable to access such services.

Background: The use of telemedicine was gaining momentum. Although the strength of the therapeutic alliance (TA) correlated with treatment outcomes, there was no research exploring the skills, attitudes and behaviours that enhanced the TA during Skype consultations in palliative care. Aims: This study identified the skills, attitudes and behaviours that affected the TA between palliative care patients and health care professionals during Skype consultations and identified strategies that enhanced the TA. Study Design: Two cycles of action research engaged the participants in self-reflective inquiry and encouraged the identification of strategies that enhanced the TA and the Skype experience. Participants: Six health professionals and nine patients were recruited from a Hospice out patient service in one Health Authority in England. Data Collection: Data from the audio-recorded consultation were managed quantitatively and the TA was measured using the Working Alliance Inventory (S). Qualitative data were collected from participant interviews and focus groups attended by the professionals. Data Analysis: The analysis ran in parallel with the data collection, started after the first consultation and all sources of data were cross-referenced. Thematic analysis was used to sequentially code the qualitative data to help identify, examine and record patterns within the data set. Findings: The findings suggested that it was possible to establish and a positive therapeutic alliance between health professionals and palliative care patients when using Skype. There was a shift in perception for those health professionals who had reservations about their ability to establish a therapeutic alliance (TA) via a computer link. It was demonstrated that advanced communication skills were transferrable between face to face and video consultations. No additional communication skills training was needed to enable a strong TA when using Skype. Including some social talk, working with the patient’s as opposed to the professional’s agenda and actively offering solutions improved the Skype experience for the patients. The strategies that health professionals promoted to enhance the TA included using Skype with appropriately selected patients to complement the existing Service. Mandatory training in the effective use of Skype was recommended even for those health professionals who used Skype socially. Clarification to address the challenge of clinical governance was recommended. In keeping with an action research design the change impacted on both the health professionals own practice and the Organisation’s approach to telemedicine. The potential for using action research to engage nurses and doctors in critical self-reflective inquiry and to empower them to be change facilitators was demonstrated. Conclusion: Although a small sample size, this study identified strategies that enhanced the TA during Skype consultations. The findings were significant because they added to the current body of knowledge about using Skype to facilitate consultations within the palliative care population. Additionally, the findings may be transferable to different populations and healthcare contexts.