Linda E. Moody, Ph.D., MPH, FAAN, BC, Cheryl Dee, Ph.D., Ara Rogers, Ph.D.

ABSTRACT

E-health Internet portals provide health information resources and services in the home for those with chronic illness or consumer health questions. Yet, these resources remain mostly an untapped resource among the elderly. This descriptive study identified needs, preferences, and uses of Internet based health resources and healthcare services among older adults in Southwest Florida. In addition, the study measured seniors’ ratings of their perceived self-efficacy with computer and related e-technology. The convenience sample of older adults in a Senior Net program comprised 60 females (59.4%) and 43 males (40.6 %). Mean age was 71.18 (sd 7.20) and age range was 56 to 84. Ethnic and racial distribution of the sample was 86 % white, 3% African American, 1 % Hispanic, and 9% Other. The majority, 53%, reported a college-level degree. Of the 103 respondents, 55% reported daily Internet use; 75% had 1> chronic conditions; and, 78% indicated preference for web-based resources to help manage medications and chronic diseases. The self-efficacy scale was assessed to have high reliability: Cronbach’s coefficient alpha (r = .93). Men reported a greater degree of self-efficacy than women did in learning to use new devices and new software. Results are consistent with previous studies indicating that baby-boomers will demand more Internet-based healthcare services than the current generation of seniors. Findings may inform the design of future customized web portals to increase self-management and coping skills of seniors with chronic diseases.
 

Rajiv Raman, M.S., Sheshadri Mahajan, M.S., Padmaja Kumari Rani, M.S., Swati Agarwal, M.S., P. Gnanamoorthy, M.Sc., Pradeep G. Paul, B.S.M.S., M.S., MS Krishna, Govindasamy Kumara-manickavel, M.D., Tarun Sharma, M.D., FRCSEd.

ABSTRACT

This study was done to evaluate the efficacy of telehealth programme for diabetic retinopathy and estimate the grading-agreement between digital fundus photography and indirect Ophthalmoscopy observations. The data were obtained from 511 diabetics examined at the six screening camps organized in rural south India. Topcon TRC NW 100 non-mydriatic camera was used to get digital single 450 fundus photographs (with dilated pupil) centered midway between the center of the macula and the disc. A retinal specialist in the base hospital evaluated the images.. Patients with sight threatening diabetic retinopathy were re-examined in the base hospital, and their fundus findings based on indirect ophthalmoscopy were compared with those obtained by digital fundus photography. Of the 1013 images, 22 (2.2%) could not be graded due to poor image quality. Of the remaining 991 images, the fundus was graded normal in 802 and abnormal with evidence of any diabetic retinopathy in 189 (19.1%). Of the 189 eyes with diabetic retinopathy, non-proliferative DR was evident in 159 (84.1%), proliferative DR in 30 (15.9%); macular edema was evident in 52 (27.5%) eyes. The grading-agreement of DR between digital photograph and indirect ophthalmoscope was good for any retinopathy versus no retinopathy (kappa value=0.79, 95%CI: 0.68-0.88). Similarly, grading-agreement between sight-threatening DR and no sight-threatening DR, as determined by ICC, was 0.76 (95% CI, 0.63-0.85).Telehealth programme is an effective tool of early detection of sight threatening complications of diabetic retinopathy. Its use can be extended for mass screening of patients in rural settings where availability of health care professionals is inadequate.
 

Dr. Peter Drury.

ABSTRACT

This paper proposes a model, or framework for analysis, to inform the development of eHealth in developing countries. The framework has five components – the 5Cs. Firstly there is the Context of poverty, meeting the Millennium Development Goals and the role ICT can play to support health workers. Then, there is the Content of health information provided to health workers and how it can be migrated from being paper-based to a digital format. Providing wireless Connectivity within and between health facilities that supports the transmission of health knowledge and management information provides an entry-level health information infrastructure. Over such a health facility-based wireless infrastructure it then becomes possible to build workforce Capacity as well as support Community development, via the delivery of information to enable better individual and community decision-making in health and other development issues.
 

K.E.Burn-Thornton, Tim Burman

ABSTRACT

In this paper we present the results of an investigation into the efficiency (recovery rate of clients) of the provision of different frequencies of counselling sessions by different counsellors.

This research demonstrates that, counselling sessions occurring more frequently than once every 10-11 days may hamper the recovery of clients. Reducing the frequency of sessions to once every 3 weeks does not appear to affect the recovery rate.

The results of these investigations have significant implications regarding the potential costing savings which can be made in the provision of therapeutic intervention and, hence, the opportunity for serving more clients for the same funding.

These findings may be timely given the recent extension in drinking hours in the United Kingdom and their expected impact upon increased alcohol addiction.
 

Dr. Aijaz Qadir Patoli, MBBS, MBA, DSM

ABSTRACT

This paper reviews the role of telemedicine in disaster management, in the context of the October, 2005 earthquake in Pakistan.

Disaster is a catastrophe, either natural or man-made. Typically, it causes loss of life, property, and paralyses daily life for the time being, and it may leave behind permanent socio-economic and ecological changes.

Disaster Management encompasses the preparedness to minimize loss to life and destruction of property; to aid relief operations, and rehabilitation of the effected population and daily activities. The core issue in disaster management is human safety where telemedicine is significant, due to expected damages in the local healthcare infrastructure on one hand, and the capabilities of electronic information and communications technologies to provide health care when distance separates the participants.

In this context, telemedicine has two basic functions. In the preparedness phase, telemedicine applications can be used in continuing medical education, knowledge based expert systems and resource databases. During relief operations, it includes tele-monitored procedures/surgery, telediagnostics and second opinion; and in the rehabilitation phase, teleconsultation, complex problem interpretation, and epidemiological surveillance.
In a developing country like Pakistan, promotion of telemedicine services to play role in disaster management requires planning and development at every social organizational level. The constraints in affordable technological access should be minimized and public/private partnerships should be promoted.
 

Giselle Ricur, M.D., María Gabriela Batiz, IT Eng, Roberto Zaldivar, M.D.