Health services in remote and austere settings are challenged by limited resources and geographic distance. Lack of investigative tools or local specialist care may impede timely diagnoses or focused treatment. Teleultrasound is an effective tool to overcome these obstacles, permitting trained experts to provide guidance to isolated environments. This paper reports on the many applications of teleultrasound and recent developments in the field.

Keywords: teleultrasound, remote, austere, mobile

Background: In rural areas, a considerable lack of therapy and self-help facilities has been described with regard to drug dependence treatment. Mobile technologies are supposed to bridge geographical distances and improve access to healthcare.

Aim: The paper therefore aims to compare conventional vs. mHealth supported delivery processes in drug dependence treatment.

Methods: We use BPMN process modelling to compare usual vs. mHealth assisted treatment pathways for drug addiction. The details of mHealth support (mHealth configuration, monitoring, interventions, information processing) are also demonstrated.

Results: The paper shows (1) that the medical treatment gap mainly occurs at the interface between inpatient and outpatient care and (2) that mHealth support eliminates this interface problem. mHealth effectively supports drug dependence treatment in rural areas.

Conclusion: The paper demonstrates an mHealth based optimization of a complex treatment process. Our approach is also expected to improve theoretical and practical knowledge in mHealth service engineering.

Keywords: patient-therapist collaboration, mHealth, clinical pathway, drug addiction, BPMN, interface

Background: A 2017 study by Giles-Smith et al examining nurse use of and attitudes towards mobile devices at the bedside revealed nurses were reluctant to use mobile devices due to concerns patients would view such device use negatively.

Aims: To explore whether the concerns expressed in the 2017 study regarding mobile device use by healthcare professionals were valid, a qualitative study was conducted to determine patient attitudes towards healthcare professionals’ use of mobile devices at the bedside.

Methods: Short interviews were conducted with 30 inpatients on medical and surgical units at a community hospital in Winnipeg, MB, Canada. Questions captured the inpatients’ socio-demographic data, experiences with healthcare providers using mobile devices during their current stay, and opinions on the use of mobile devices by healthcare providers. The qualitative responses were analysed and coded to determine themes.

Results: Thirty (30) inpatients completed the interviews. Few inpatients reported observing mobile devices use during their current hospital stay. Participants were supportive of the idea of mobile device use in the hospital setting but felt use should be restricted to professional purposes. Results showed a high degree of confidence among patients in the professionalism of their healthcare professionals.

Conclusion: Patients expressed an acceptance of mobile device use in hospitals as a natural extension of the increasing prevalence of technology in modern society. As mobile device use in hospitals increases, healthcare policies that outline acceptable use and protect patient privacy will be necessary. Education will play an important role in improving patient understanding of how mobile devices are used at the bedside.

Keywords: Inpatients, attitude, qualitative research, surveys and questionnaires, mobile devices

Background: Accelerometric assessment of balance is typically conducted from lower back locations approximating the center of mass (COM).

Aims: Because placement of accelerometers at the approximate COM may not always be practical, the purpose of this study was to determine if significant differences exist between acceleration measures recorded from the mid-sternum, COM, and center of pressure (COP).

Methods: Data were collected from 25 subjects (13 male; 22.4 ± 3.3 years) as they performed 30 sec trials of bipedal standing and single leg standing. Accelerations were simultaneously recorded via­ tri-axial accelerometers attached at the mid-sternum and approximate COM (i.e., over L3), and by force plate. Signals were tilt corrected and root mean squared (RMS) values of the accelerations were calculated. Repeated measures ANOVA were performed to determine if differences exist between accelerometer measurement locations as a function of stance and accelerometer location.

Results: No significant differences in mean RMS acceleration between the accelerometer locations were observed during bipedal standing in the anterior-posterior (p = 0.140), medial-lateral (p=0.170), or vertical directions (p = 0.270). For the single leg stance, significant differences were observed between measurement locations in the anterior-posterior (p < 0.001), medial-lateral (p = 0.002), and vertical directions (p < 0.001).

Conclusion: Trunk accelerations recorded from above the center of mass may provide useful measures for identifying those with reduced postural control.

Keywords: balance, accelerometers, force plate, center of mass, postural control