Digital Health and Telemedicine: Their Contribution to Personalized and Precision Medicine

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 54344

Special Issue Editors


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Guest Editor
Telemedicine and Telepharmacy Center, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy
Interests: human–computer interaction; neuro sciences; telemedicine; remote consultation; pharmacology

E-Mail Website
Guest Editor
Telemedicine and Telepharmacy Center, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy
Interests: artificial intelligence; e-health; machine learning; medical informatics; Python; tele-healthcare; tele-robotics

Special Issue Information

Dear Colleagues,

Digital health and telemedicine are main applications of Information and Communication Technology (ICT) in healthcare and are playing an increasingly important role for health systems. These technologies are considered as strategic objectives of innovation, growth and employment plans. A cultural commitment resulting in the widespread use of these technologies in daily practice is important for enlarging their applications in health care, such as telehealth and digital telemedicine.

In recent years, there has been growing interest in the development of personalized and precision medicine approaches in the prevention and treatment of several pathologies with the purpose to offer patients “the right treatment, to the right patient, at the right time.” Digital health and telemedicine, if properly used, may offer advantages for both patients and health professionals in the delivery of medical services, where distance is a basic factor. Thanks to these technologies, all medical care experts can use ICT for the exchange of adequate information for treatment, diagnosis and avoidance of illness and wounds, exploration and assessment and for the proceeding with the instruction of medical care suppliers with the purpose of strengthening individuals’ health and their networks.

Personalized medicine via telemedicine can offer personal medications or treatment that can be suggested over video or phone conversations with a pill dispenser at hand. Family members or friends (from different locations) can participate in these conversations and understand expert suggestions for improving the health literacy of the entire family.

The proposed Special Issue collects the most recent insights into basic and clinical research on this topic, opening new perspectives towards modern approaches in personalized and precision medicine primarily for the advantage of people that for any reasons may have difficulties in accessing high quality medical assistance. 

Prof. Dr. Francesco Amenta
Dr. Gopi Battineni
Guest Editors

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Keywords

  • digital health
  • telemedicine
  • remote medical diagnosis
  • digital transmission of medical care
  • ICT systems in medicine
  • precision care
  • second and third opinion teleconsultations

Published Papers (23 papers)

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Research

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18 pages, 3803 KiB  
Article
Lessons Learned from the COVID-19 Pandemic: A Survey-Based Study on a Sample of Italian Physicians’ Opinions on Telemedicine
by Pamela Tozzo, Arianna Delicati, Beatrice Marcante, Dolores Catelan and Luciana Caenazzo
J. Pers. Med. 2023, 13(8), 1267; https://doi.org/10.3390/jpm13081267 - 16 Aug 2023
Viewed by 812
Abstract
Telemedicine was born out of the need to ensure clinical evaluation and personal care regardless of the physical presence of the healthcare professional nearby. Information technologies have been vital during the COVID-19 pandemic to ensure medical care and avoid the contagion between patients [...] Read more.
Telemedicine was born out of the need to ensure clinical evaluation and personal care regardless of the physical presence of the healthcare professional nearby. Information technologies have been vital during the COVID-19 pandemic to ensure medical care and avoid the contagion between patients and clinicians. Accordingly, telecare services multiplied worldwide and gained paramount importance. The present work aims to collect field-based opinions about Telemedicine and ethics among Italian physicians. We developed a web-based questionnaire that was administered to Italian physicians from 1 May to 15 June 2022. The questionnaire was distributed as a link to Google Forms via social networks/instant messaging applications to groups of graduated and qualified physicians. A total of 180 physicians answered the questionnaire (with an age range from 25 to 68 years old). Physicians belonging to the medical area of expertise appear to more frequently use new technologies in comparison to other specialties. The vast majority believe that it is appropriate to use Telemedicine for monitoring and follow-up but not for evaluating a new patient. Concerns about changes in the physician–patient relationship, informed consent, digital barrier, and privacy and data protection also emerged. Finally, telehealth is thought to be a potential useful tool for the future by the majority of respondents but proper training for physicians is therefore needed. Full article
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7 pages, 245 KiB  
Communication
Clinician Perspectives on Clinical Decision Support for Familial Hypercholesterolemia
by Hana Bangash, Omar Elsekaily, Seyedmohammad Saadatagah, Joseph Sutton, Paul Johnsen, Justin H. Gundelach, Arailym Kamzabek, Robert Freimuth, Pedro J. Caraballo and Iftikhar J. Kullo
J. Pers. Med. 2023, 13(6), 929; https://doi.org/10.3390/jpm13060929 - 31 May 2023
Cited by 2 | Viewed by 1076
Abstract
Familial Hypercholesterolemia (FH) is underdiagnosed in the United States. Clinical decision support (CDS) could increase FH detection once implemented in clinical workflows. We deployed CDS for FH at an academic medical center and sought clinician insights using an implementation survey. In November 2020, [...] Read more.
Familial Hypercholesterolemia (FH) is underdiagnosed in the United States. Clinical decision support (CDS) could increase FH detection once implemented in clinical workflows. We deployed CDS for FH at an academic medical center and sought clinician insights using an implementation survey. In November 2020, the FH CDS was deployed in the electronic health record at all Mayo Clinic sites in two formats: a best practice advisory (BPA) and an in-basket alert. Over three months, 104 clinicians participated in the survey (response rate 11.1%). Most clinicians (81%) agreed that CDS implementation was a good option for identifying FH patients; 78% recognized the importance of implementing the tool in practice, and 72% agreed it would improve early diagnosis of FH. In comparing the two alert formats, clinicians found the in-basket alert more acceptable (p = 0.036) and more feasible (p = 0.042) than the BPA. Overall, clinicians favored implementing the FH CDS in clinical practice and provided feedback that led to iterative refinement of the tool. Such a tool can potentially increase FH detection and optimize patient management. Full article
14 pages, 1282 KiB  
Article
Personal Health Record for Personalizing Research and Care Trajectories: A Proof of Concept Pilot with Diet in Inflammatory Bowel Diseases
by Reinder Broekstra, Marjo J. E. Campmans-Kuijpers, Gerard Dijkstra, Adelita V. Ranchor and Elisabeth W. H. M. Eijdems
J. Pers. Med. 2023, 13(4), 601; https://doi.org/10.3390/jpm13040601 - 29 Mar 2023
Viewed by 1465
Abstract
Combinations of health-related research data and clinical data generated, e.g., from wearables, can increasingly provide new insights about a person’s health. Combining these data in a personal health record (PHR), which is managed by citizens themselves, can enhance research and enable both personalized [...] Read more.
Combinations of health-related research data and clinical data generated, e.g., from wearables, can increasingly provide new insights about a person’s health. Combining these data in a personal health record (PHR), which is managed by citizens themselves, can enhance research and enable both personalized care and prevention. We piloted a hybrid PHR using it for scientific research and the concomitant return of individual findings for clinical information and prevention purposes. The obtained information on the quality of daily dietary intake allowed researchers to further investigate the association between diet and inflammatory bowel diseases (IBDs). Additionally, the feedback enabled participants to adjust their food intake to improve the quality and prevent nutritional deficiency, thereby increasing their health. Our results showed that a PHR including a Research Connection can be successfully used for both purposes but requires a good embedding in both research and healthcare processes with the cooperation of healthcare professionals and researchers. Addressing these challenges is key in the pursuit of delivering personalized medicine and building learning health systems with PHRs. Full article
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11 pages, 3133 KiB  
Article
mHealth App Barriers, Usability, and Personalization: A Cross-Sectional Study from Egypt and Saudi Arabia
by Ahmed Arafa, Zahraa M. Mostafa, Haytham A. Sheerah, Fahad Alzahrani, Yasir Almuzaini, Shaimaa Senosy and Radwa Ibrahim Ali Hassan
J. Pers. Med. 2022, 12(12), 2038; https://doi.org/10.3390/jpm12122038 - 09 Dec 2022
Cited by 1 | Viewed by 1375
Abstract
Mobile health (mHealth) has emerged as a substantial segment of eHealth. Herein, we conducted a cross-sectional study to investigate mHealth app barriers, usability, and personalization in Egypt and Saudi Arabia. We used a Google survey to recruit participants from both countries between the [...] Read more.
Mobile health (mHealth) has emerged as a substantial segment of eHealth. Herein, we conducted a cross-sectional study to investigate mHealth app barriers, usability, and personalization in Egypt and Saudi Arabia. We used a Google survey to recruit participants from both countries between the 15th of September and the 15th of October 2022. Among 299 participants (247 from Egypt and 52 from Saudi Arabia), aged ≥ 18 years, 27.4% reported mHealth app use. In the age-, sex-, and country-adjusted regression models, age > 25 years: OR (95% CI) = 1.98 (1.11, 3.54), residing in Saudi Arabia: OR (95% CI) = 4.33 (2.22, 8.48), and physical activity: OR (95% CI) = 2.53 (1.44, 4.44) were associated with mHealth app use. The main mHealth app purposes were lifestyle promotion (35.4%), diet and nutrition (30.5%), and administrative services (13.4%). On a scale from 20 to 100, mHealth app usability scores were 46.3% (20–40), 7.3% (41–60), 31.7% (61–80), and 14.7% (81–100). According to 93.9% of users, mHealth app features were modifiable to meet personal health goals, while 37% stated that mHealth apps helped them set new personal health goals. In conclusion, age, residing in Saudi Arabia (compared to Egypt), and physical activity were positively associated with mHealth app use. mHealth app feature personalization and helping users set new personal health goals were largely reported, suggesting that mHealth has the potential to help put personalized healthcare into practice. Full article
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12 pages, 762 KiB  
Article
Perception about Health Applications (Apps) in Smartphones towards Telemedicine during COVID-19: A Cross-Sectional Study
by Lingala Kalyan Viswanath Reddy, Pallavi Madithati, Bayapa Reddy Narapureddy, Sahithya Ravali Ravula, Sunil Kumar Vaddamanu, Fahad Hussain Alhamoudi, Giuseppe Minervini and Saurabh Chaturvedi
J. Pers. Med. 2022, 12(11), 1920; https://doi.org/10.3390/jpm12111920 - 17 Nov 2022
Cited by 52 | Viewed by 3112
Abstract
Background: The use of health applications (apps) in smartphones increased exponentially during COVID-19. This study was conducted the with the aim to understand the factors that determine the consumer’s perception of health apps in smartphones towards telemedicine during COVID-19 and to test any [...] Read more.
Background: The use of health applications (apps) in smartphones increased exponentially during COVID-19. This study was conducted the with the aim to understand the factors that determine the consumer’s perception of health apps in smartphones towards telemedicine during COVID-19 and to test any relation between these factors and consumers towards Telemedicine in India. Methods: This questionnaire-based cross-sectional study was conducted from July 2021 to December 2021 in India. Out of 600 selected participants, 594 responded and in that 535 valid questionnaires were measured. The questionnaire consists of close-ended responses, with the first part consisting of demographic information, the second part consisting of questions associated with consumers’ perceptions and the third part kept for suggestions and complaints. The questionnaire was distributed using digital platforms via WhatsApp or email. A 5-point Likert scale, ranging from strongly agree’ (5) to strongly disagree (1) was used to record responses. Results: Results revealed a high response rate of 90%. The highest score was obtained for the question assessing the satisfaction of the users towards health apps [1175 = 500 (agree-4) + 675 (Strongly agree-5)]. The interface of the app scored very low, showing disagreement (514) with app functionality, and was the most common disadvantage as perceived by patients. The mean scores of reliabilities and vicinity of health services; efficacy and comprehensive health information; development and improvement of health apps and telemedicine (3.24, 3.18, 3.62, 3.49), respectively, show the difference in attraction existing between groups. There is a strong positive correlation between the variables except for efficacy and comprehensive information about health and Telemedicine (−0.249), development and improvement of health apps, and reliability and vicinity of health services (−0.344) which have a negative correlation. Conclusions: The findings of this survey reveal a positive outlook of health apps toward telemedicine. This research also found a strong forecaster of the consumer’s perception of health apps in smartphones towards telemedicine. In the broad spectrum, the future of health app affiliates for telemedicine is better affected by the consumer’s perception of health app efficacy. This study suggests that health app marketers develop more innovative apps to increase usage and help consumers. Full article
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13 pages, 2810 KiB  
Article
Evaluation of Tele-Dentistry and Face-to-Face Appointments during the Provision of Dental Services in Poland
by Klaudia Migas, Remigiusz Kozłowski, Aleksandra Sierocka and Michał Marczak
J. Pers. Med. 2022, 12(10), 1640; https://doi.org/10.3390/jpm12101640 - 03 Oct 2022
Cited by 3 | Viewed by 1629
Abstract
Tele-dentistry is a rapidly growing field, especially in the era of the COVID-19 pandemic. Due to the COVID-19 pandemic, remote services are of increasing interest to both patients and dental personnel. They allow for reduced person-to-person contact and thus a reduced risk of [...] Read more.
Tele-dentistry is a rapidly growing field, especially in the era of the COVID-19 pandemic. Due to the COVID-19 pandemic, remote services are of increasing interest to both patients and dental personnel. They allow for reduced person-to-person contact and thus a reduced risk of transmission of the SARS-CoV2 virus. The COVID-19 pandemic has affected the functioning of all areas of life, including dental treatment. The aim of the study was to assess the possibility of using tele-dentistry for dental services and analyse the attitudes of patients and dentists towards this solution. The period analysed was between March 2019 and February 2021 in five healthcare entities in Cracow in Central Europe. The study’s retrospective analysis shows a positive attitude of patients towards tele-dentistry at every stage of treatment, from diagnosis through postoperative care, and a significant reluctance of dentists in the majority of dental specialties towards tele-dentistry. Consequently, a significant percentage of patients were invited to dental offices for a face-to-face appointment during the COVID-19 pandemic. The negative attitude of dental personnel towards tele-dentistry compared with the positive attitude of patients towards tele-dentistry is somewhat worrying in view of the possibility of a further pandemic. At the same time, it provides important information about the need to educate and support dental personnel in tele-dental solutions and improve solutions for the future. Taking into account the potential reduction in dental care costs for patients and countries after the implementation of tele-dentistry solutions, this is an important topic, while current studies do not comprehensively address the attitudes of patients and dental personnel towards tele-dentistry. In other parts of the world, a similar approach to tele-dentistry is used by patients and dentists. Full article
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10 pages, 1708 KiB  
Article
Application and Validation of LUXIE: A Newly Developed Virtual Reality Perimetry Software
by Yen-Ting Chen, Po-Han Yeh, Yu-Chun Cheng, Wei-Wen Su, Yih-Shiou Hwang, Henry Shen-Lih Chen, Yung-Sung Lee and Su-Chin Shen
J. Pers. Med. 2022, 12(10), 1560; https://doi.org/10.3390/jpm12101560 - 22 Sep 2022
Cited by 3 | Viewed by 1604
Abstract
Purpose: To report the application of LUXIE and validate its reliability by comparing the test results with those of Humphrey Field Analyzer 3 (HFA3). Methods: In this pilot study, we prospectively recruited participants who had received HFA3 SITA standard 30-2 perimetry and tested [...] Read more.
Purpose: To report the application of LUXIE and validate its reliability by comparing the test results with those of Humphrey Field Analyzer 3 (HFA3). Methods: In this pilot study, we prospectively recruited participants who had received HFA3 SITA standard 30-2 perimetry and tested them with LUXIE on the same day. LUXIE is a software designed for visual field testing cooperating with HTC Vive Pro Eye, a head-mounted virtual reality device with an eye-tracking system. The test stimuli were synchronized with eye movements captured by the eye-tracking system to eliminate fixation loss. The global, hemifields, quadrants, glaucoma hemifield test (GHT) sectors, and point-by-point retinal sensitivities were compared between LUXIE and HFA3. All participants were asked to fill out a post-test user survey. Results: Thirty-eight participants with 65 eyes were enrolled. LUXIE demonstrated good correlations with HFA3 in global (r = 0.81), superior hemifield (r = 0.77), superonasal, superotemporal, and inferonasal quadrants (r = 0.80, 0.78, 0.80). The user survey showed that participants were more satisfied with LUXIE in operating difficulty, comfortability, time perception, concentration, and overall satisfaction. Conclusions: LUXIE demonstrated good correlations with HFA3. Fixation loss could be eliminated in LUXIE with the eye-tracking system. The application of virtual reality devices such as the HTC Vive Pro Eye makes telemedicine and even home-based self-screening visual field tests possible. Key Messages: 1. Virtual reality perimetry is a developing technology that has the potential in telemedicine, and home self-screening visual field tests. 2. LUXIE demonstrated good correlations with Humphrey Field Analyzer 3 in visual field retinal sensitivities. Full article
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10 pages, 838 KiB  
Article
Management of the Two-Week Wait Pathway for Skin Cancer Patients, before and during the Pandemic: Is Virtual Consultation an Option?
by Maria-Roxana Chiru, Sandip Hindocha, Ekaterina Burova, Gabriel-Cristian Bejan, Laura-Maria Manea and Liviu-Nicolae Ghilencea
J. Pers. Med. 2022, 12(8), 1258; https://doi.org/10.3390/jpm12081258 - 30 Jul 2022
Viewed by 1783
Abstract
Background: Although telemedicine emerged more than 100 years ago, the recent pandemic underlined the role of remote assessment of different diseases. The diagnoses of cutaneous conditions, especially malignant lesions, have placed significant stress on the fast-track pathway for general practitioners (GPs), dermatologists, and [...] Read more.
Background: Although telemedicine emerged more than 100 years ago, the recent pandemic underlined the role of remote assessment of different diseases. The diagnoses of cutaneous conditions, especially malignant lesions, have placed significant stress on the fast-track pathway for general practitioners (GPs), dermatologists, and plastic surgeons. The aim of the study was to compare (pre- and during the pandemic) the ability of professionals to face the challenge. Methods: The study was composed of 1943 consecutive patients (mean age 61.9 ± 18.3, 53.8% female) assessed by GPs, face-to-face (988 patients, 50.8%, between October 2019 and March 2020) and by virtual (video/photo) visits (955 patients, 49.2%, between March 2020 and October 2020) for skin lesions, and referred to secondary care via the two-week wait pathway for suspected skin malignancy. Results: The two groups had similar primary skin malignancies identification rates (24.3% vs. 22.1%, p = 0.25). The virtual visits identified squamous cell carcinoma (SCC) better than face-to-face consultations (p = 0.04), but identified basal cell carcinoma less-well (BCC, p = 0.02), whereas malignant melanoma (MM) was equally identified in the two groups (p = 0.13). There was no difference in the median breach time (days) of the two-week wait pathway (12, IQR = 6 vs. 12, IQR = 5, p = 0.16) in the two groups. Virtual assessments (by GPs) of skin lesions suspected of malignancy, and referred via the two-week wait pathway, increased the probability of diagnosing SCC by 42.9% (p = 0.03), while for malignant melanomas, face-to-face and virtual consultations were alike (p = 0.12). Conclusions: The equivalent outcomes in the management of skin cancers (SCC, MM) via the two-week pathway through virtual consultations and face-to-face appointments underline the role of telemedicine as a reliable alternative to face-to-face assessments. Full article
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12 pages, 1672 KiB  
Article
The COVID-19 Pandemic as an Impulse for the Development of Telemedicine in Primary Care in Poland
by Kamila Furlepa, Andrzej Śliwczyński, Karolina Kamecka, Remigiusz Kozłowski, Izabela Gołębiak, Dominika Cichońska-Rzeźnicka, Michał Marczak and Wojciech Michał Glinkowski
J. Pers. Med. 2022, 12(7), 1165; https://doi.org/10.3390/jpm12071165 - 18 Jul 2022
Cited by 10 | Viewed by 2727
Abstract
Telemedicine gives a safe and effective way of providing healthcare. During the COVID-19 pandemic, it was possible to offer teleconsultations in primary care (Primary Care Teleconsultation-PCT). The study aimed to present an analysis of the PCTs served in the years 2020–2021 in the [...] Read more.
Telemedicine gives a safe and effective way of providing healthcare. During the COVID-19 pandemic, it was possible to offer teleconsultations in primary care (Primary Care Teleconsultation-PCT). The study aimed to present an analysis of the PCTs served in the years 2020–2021 in the field of primary care in Poland to determine how the COVID-19 pandemic contributed to the development of telemedicine in primary care in Poland. The database, containing a list of medical services provided remotely obtained from the National Health Fund, was analyzed. Economic and tax indicators obtained from the Ministry of Finance were also analyzed. Personal Income Tax (PIT) value was used as an indicator of household wealth, and the Corporate Income Tax (CIT) was used as an indicator of economic activity in individual counties for 2019. Along with the COVID-19 pandemic, patients as healthcare beneficiaries can take advantage of previously unserved telemedicine services as part of primary care. The data analysis showed that, along with the introduced recommendations and restrictions in connection with the pandemic, the number of teleconsultations in 2021 increased compared to 2020. In response to the pandemic, an educational campaign targeted older patients. These indicate the most significant percentage of PCTs among patients aged 70 and older. The study shows that the awareness barrier in implementing services for the elderly population decreased significantly. There was a clear correlation between the increase in PCTs and patient age. Full article
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13 pages, 1373 KiB  
Article
Demographic Patterns of MS Patients Using BRISA: An MS-Specific App in Germany
by Preetha Balakrishnan, Jannis Groenberg, Elizabeth Jacyshyn-Owen, Markus Eberl, Benjamin Friedrich, Natalie Joschko and Tjalf Ziemssen
J. Pers. Med. 2022, 12(7), 1100; https://doi.org/10.3390/jpm12071100 - 01 Jul 2022
Cited by 4 | Viewed by 1942
Abstract
Background: Multiple sclerosis (MS) is a chronic, progressive neurological autoimmune disease impacting quality of life. BRISA is an app designed to help MS patients in Germany track their disease course by symptom-monitoring. This study aimed to understand demographic and health-related characteristics of BRISA [...] Read more.
Background: Multiple sclerosis (MS) is a chronic, progressive neurological autoimmune disease impacting quality of life. BRISA is an app designed to help MS patients in Germany track their disease course by symptom-monitoring. This study aimed to understand demographic and health-related characteristics of BRISA users. Methods: Demographic data provided by 2095 users were analyzed to describe characteristics such as sex, age, type of MS, and medication. The distribution of tracked symptoms based on age and time since diagnosis were studied. Furthermore, the covariance of specific symptom pairs was analyzed. Results: BRISA users are predominantly female and between 26 and 55 years old. Relapsing–remitting MS was the most prevalent form of MS. First-line category 1 drugs were most frequently used, followed by high-efficacy category 3 drugs (e.g., monoclonal antibodies). The relative frequencies of use of category 1 and category 2 drugs (e.g., spingosine-1-phosphate-receptor modulators) significantly altered with time since diagnosis. Fatigue, concentration disorders, tingling, forgetfulness, and pain were the top five symptoms affecting users. Conclusion: The results highlight the diversity among MS patients and the need for extensive cohort characterization in the real-world scenario. In-depth analysis could help in identifying novel insights that could aid in disease management. Full article
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11 pages, 5218 KiB  
Article
Maritime Telemedicine: Design and Development of an Advanced Healthcare System Called Marine Doctor
by Gopi Battineni, Nalini Chintalapudi and Francesco Amenta
J. Pers. Med. 2022, 12(5), 832; https://doi.org/10.3390/jpm12050832 - 20 May 2022
Cited by 5 | Viewed by 2637
Abstract
Background: The availability of better healthcare services is critical for onboard seafarers. The development of expert systems can help ships with limited medical facilities, which allow the shipside doctors to properly refer symptoms to remote doctors. This allows clinicians to make a correct [...] Read more.
Background: The availability of better healthcare services is critical for onboard seafarers. The development of expert systems can help ships with limited medical facilities, which allow the shipside doctors to properly refer symptoms to remote doctors. This allows clinicians to make a correct diagnosis from there, which leads to proper treatment. A software named Marine Doctor (M Doc) has been developed by incorporating computing technologies to address this objective. Methods: With the help of Information and Communication Technology (ICT) this application can support the provision of appropriate medical assistance to seafarers. The system was developed with Python Tkinter (frontend) and PHP (backend) languages. MySQL was used as a server database. Results: Seafarers can use M Doc to benefit from medical advice that can reduce complications due to misdiagnosis and help doctors to make better-informed decisions. By automatically collecting appropriate sequences of symptoms, doctors will be able to generate proper information for referral of patient symptoms and subsequent advice based on the data. Conclusions: Technology that supports experts on board ships in better interacting with Telemedical Maritime Assistance Services (TMAS) could define the future of medical assistance at sea. Full article
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11 pages, 696 KiB  
Article
Reliability Study of Inertial Sensors LIS2DH12 Compared to ActiGraph GT9X: Based on Free Code
by Jaime Martín-Martín, Ariadna Jiménez-Partinen, Irene De-Torres, Adrian Escriche-Escuder, Manuel González-Sánchez, Antonio Muro-Culebras, Cristina Roldán-Jiménez, María Ruiz-Muñoz, Fermín Mayoral-Cleries, Attila Biró, Wen Tang, Borjanka Nikolova, Alfredo Salvatore and Antonio I. Cuesta-Vargas
J. Pers. Med. 2022, 12(5), 749; https://doi.org/10.3390/jpm12050749 - 05 May 2022
Cited by 5 | Viewed by 2245
Abstract
The study’s purpose was to assess the reliability of the LIS2DH12 in two different positions, using the commercial sensor Actigraph GT9X as a reference instrument. Five participants completed two gait tests on a treadmill. Firstly, both sensors were worn on the wrist and [...] Read more.
The study’s purpose was to assess the reliability of the LIS2DH12 in two different positions, using the commercial sensor Actigraph GT9X as a reference instrument. Five participants completed two gait tests on a treadmill. Firstly, both sensors were worn on the wrist and around the thigh. Each test consisted of a 1 min walk for participants to become accustomed to the treadmill, followed by a 2 min trial at ten pre-set speeds. Data from both sensors were collected in real-time. Intraclass correlation coefficient (ICC) was used to evaluate the equality of characteristics obtained by both sensors: maximum peaks, minimum peaks, and the mean of the complete signal (sequence of acceleration values along the time) by each axis and speed were extracted to evaluate the equality of characteristics obtained with LIS2DH12 compared to Actigraph. Intraclass correlation coefficient (ICC) was extracted, and a standard deviation of the mean was obtained from the data. Our results show that LIS2DH12 measurements present more reliability than Actigraph GT9X, ICC > 0.8 at three axes. This study concludes that LIS2DH12 is as reliable and accurate as Actigraph GT9X Link and, therefore, would be a suitable tool for future kinematic studies. Full article
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10 pages, 612 KiB  
Article
Efficacy of Telemedicine and At-Home Telemonitoring following Hospital Discharge in Patients with COVID-19
by Roi Suárez-Gil, Emilio Casariego-Vales, Rosa Blanco-López, Fernando Santos-Guerra, Cristina Pedrosa-Fraga, Álvaro Fernández-Rial, Iria Íñiguez-Vázquez, María Mar Abad-García, Mercedes Bal-Alvaredo and on behalf of the members of the Lugo TELEA-COVID Team
J. Pers. Med. 2022, 12(4), 609; https://doi.org/10.3390/jpm12040609 - 10 Apr 2022
Cited by 6 | Viewed by 2019
Abstract
Aim: This work aims to evaluate the safety and utility of an at-home telemedicine with telemonitoring program for discharged COVID-19 patients. Methods: This is a retrospective cohort study of all patients discharged home in Galicia between 6 March 2020 and 15 February 2021. [...] Read more.
Aim: This work aims to evaluate the safety and utility of an at-home telemedicine with telemonitoring program for discharged COVID-19 patients. Methods: This is a retrospective cohort study of all patients discharged home in Galicia between 6 March 2020 and 15 February 2021. We evaluated a structured, proactive monitoring program conducted by the ASLAM (Área Sanitaria de Lugo, A Mariña y Monforte de Lemos) Healthcare Area team compared to patients discharged in the rest of the Autonomous Community of Galicia. Results: During the study period, 10,517 patients were hospitalized for COVID-19 and 8601 (81.8%) were discharged. Of them, 738 (8.6%) were discharged in ASLAM and 7863 (91.4%) were discharged in the rest of Galicia. Of those discharged in ASLAM, 475 (64.4%) patients were monitored. Compared to patients in the rest of Galicia, the group monitored via telemedicine had a significantly shorter first hospital stay (p < 0.0001), a lower readmission rate (p = 0.05), and a shorter second hospital stay (p = 0.04), with no differences in emergency department visits or 90-day all-cause mortality. Conclusion: A structured, proactive telemedicine with telemonitoring program for discharged COVID-19 patients is a safe, useful tool that reduces the mean length of hospital stay and readmissions. Full article
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Review

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12 pages, 957 KiB  
Review
The Use of Radio and Telemedicine by TMAS Centers in Provision of Medical Care to Seafarers: A Systematic Review
by Gopi Battineni, Nalini Chintalapudi, Giulio Gagliardi and Francesco Amenta
J. Pers. Med. 2023, 13(7), 1171; https://doi.org/10.3390/jpm13071171 - 22 Jul 2023
Cited by 1 | Viewed by 1398
Abstract
Objective: From medicine via radio to telemedicine, personalized medical care at sea has improved significantly over the years. Currently, very little research has been conducted on telemedicine services and tools at sea. This study aims to review real-time case studies of seafarers’ [...] Read more.
Objective: From medicine via radio to telemedicine, personalized medical care at sea has improved significantly over the years. Currently, very little research has been conducted on telemedicine services and tools at sea. This study aims to review real-time case studies of seafarers’ personalized treatment via telemedical devices published in medical journals. Methods: A literature search was conducted using three libraries such as PubMed (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), BioMed Central, and Google Scholar. The Medical Subject Headings (MeSH) were used for information retrieval and document selection was conducted based on the guidelines of preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 flowchart. Selected articles were subjected to quality checks using the Newcastle–Ottawa scale (NOS). Results: The literature search produced 785 papers and documents. The selection was conducted in three stages such as selection, screening, and inclusion. After applying predefined inclusion and exclusion criteria, only three articles on real-time medical assistance with telemedical tools were identified. It is reported that medical attention is delivered to seafarers in real time thanks to advancements in telemedicine, satellite technology, and video conferencing. Conclusions: By improving the quality of medical care and reducing response times for medical emergencies at sea, lives have been saved. There are still several gaps despite these advancements. Medical assistance at sea should therefore be improved to address many of the still unsolved issues. Full article
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11 pages, 737 KiB  
Review
Telemedicine and Its Application in Cystic Fibrosis
by Valentina Fainardi, Gaia Capoferri, Marco Tornesello, Giovanna Pisi and Susanna Esposito
J. Pers. Med. 2023, 13(7), 1041; https://doi.org/10.3390/jpm13071041 - 25 Jun 2023
Cited by 2 | Viewed by 1565
Abstract
The care of cystic fibrosis (CF) traditionally consists of regular visits to the clinic where a multidisciplinary team can visit the patient, adjust treatments and monitor the disease. During the COVID-19 pandemic when access to hospitals and medical environments was very limited, the [...] Read more.
The care of cystic fibrosis (CF) traditionally consists of regular visits to the clinic where a multidisciplinary team can visit the patient, adjust treatments and monitor the disease. During the COVID-19 pandemic when access to hospitals and medical environments was very limited, the role of telemedicine was crucial to keep in touch with patients with chronic diseases such as CF. Increasing evidence demonstrates that electronic health can successfully support healthcare professionals in the management of people with CF. The use of devices connected to digital platforms or smartphones results in a continuous flow of data that can be shared with the clinician and the team in order to improve the knowledge of patients’ diseases and the level of care needed. This narrative review aims to describe the application of telemedicine in CF disease with pros and cons. A literature analysis showed that telemedicine has several advantages in the management of patients with CF. With the evolving support of digital technology, telemedicine can promote clinical visits, adherence to daily treatment, including respiratory physiotherapy and physical exercise, early identification of pulmonary exacerbations and management of psychological issues. The main disadvantages are missed physical exam findings, lack of physical contact that can prevent conversation on sensitive topics, lack of access to technology and lack of technological skills. Furthermore, healthcare operators need appropriate training for telemedicine systems and need time to organise and analyse data generated remotely, which may increase the burden of daily work. Hybrid personalised care models that marge telemedicine and traditional care can be an ideal solution. Full article
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17 pages, 2901 KiB  
Review
The Magnitude of Cardiovascular Disease Risk Factors in Seafarers from 1994 to 2021: A Systematic Review and Meta-Analysis
by Getu Gamo Sagaro, Ulrico Angeloni, Claudia Marotta, Giulio Nittari, Giovanni Rezza, Andrea Silenzi, Gopi Battineni and Francesco Amenta
J. Pers. Med. 2023, 13(5), 861; https://doi.org/10.3390/jpm13050861 - 20 May 2023
Cited by 1 | Viewed by 1552
Abstract
Objectives: The incidence of acute cardiac events is one of the main reasons for medical consultation, disembarkation, repatriation, and death among seafarers at sea. Managing cardiovascular risk factors, particularly those that can be modified, is the key to preventing cardiovascular disease. Therefore, this [...] Read more.
Objectives: The incidence of acute cardiac events is one of the main reasons for medical consultation, disembarkation, repatriation, and death among seafarers at sea. Managing cardiovascular risk factors, particularly those that can be modified, is the key to preventing cardiovascular disease. Therefore, this review estimates the pooled prevalence of major CVD risk factors among seafarers. Methods: We conducted a comprehensive search of studies published between 1994 and December 2021 in four international databases, namely PubMed/Medline, Scopus, Google Scholar, and Web of Science (WOS). Each study was evaluated for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tool for prevalence studies. The DerSimonian–Laird random-effects model with logit transformations was used to estimate the pooled prevalence of major CVD risk factors. The results were reported in accordance with the Preferred Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Results: Out of all 1484 studies reviewed, 21 studies with 145,913 study participants met the eligibility criteria and were included in the meta-analysis. In the pooled analysis, the prevalence of smoking was found to be 40.14% (95% CI: 34.29 to 46.29%) with heterogeneity between studies (I2 = 98%, p < 0.01). The prevalence of hypertension, overweight, obesity, diabetes mellitus, and alcohol consumption was 45.32%, 41.67%, 18.60%, 12.70%, and 38.58%, respectively. However, the sensitivity analysis after excluding studies showed a pooled prevalence of hypertension, overweight, obesity, and diabetes mellitus of 44.86%, 41.87%, 15.99%, and 16.84%, respectively. The subgroup analysis demonstrated that smoking prevalence among seafarers had decreased significantly after 2013. Conclusion: This study demonstrated that CVD risk factors, particularly hypertension, overweight, smoking, alcohol consumption, and obesity, are prevalent among seafarers. These findings may serve as a guide for shipping companies and other responsible bodies in order to prevent CVD risk factors among seafarers. PROSPERO Registration: CRD42022300993. Full article
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19 pages, 345 KiB  
Review
Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)
by Susanna Esposito, Cristiano Rosafio, Francesco Antodaro, Alberto Argentiero, Marta Bassi, Paolo Becherucci, Fabio Bonsanto, Andrea Cagliero, Giulia Cannata, Fabio Capello, Fabio Cardinale, Tiziana Chiriaco, Alessandro Consolaro, Angelica Dessì, Giuseppe Di Mauro, Valentina Fainardi, Vassilios Fanos, Alfredo Guarino, Giada Li Calzi, Elisa Lodi, Mohamad Maghnie, Luca Manfredini, Emanuela Malorgio, Nicola Minuto, Maria Grazia Modena, Rossano Montori, Andrea Moscatelli, Elisa Patrone, Elena Pescio, Marco Poeta, Angelo Ravelli, Maddalena Spelta, Agnese Suppiej, Sergio Vai, Luca Villa, Rinaldo Zanini, Renato Botti and Antonio Vittorino Gaddiadd Show full author list remove Hide full author list
J. Pers. Med. 2023, 13(2), 235; https://doi.org/10.3390/jpm13020235 - 28 Jan 2023
Cited by 8 | Viewed by 2628
Abstract
Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the [...] Read more.
Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the improvement of treatments has allowed survival for them into adulthood, telemedicine and remote assistance are today considered effective and convenient solutions both for the chronic patient, who thus receives personalized and timely assistance, and for the doctors, who reduce the need for direct intervention, hospitalizations and consequent management costs. This Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, has the objectives to propose an organizational model based on the relationships between the actors who participate in the provision of a telemedicine service aimed at minors with chronic pathologies, identifying specific project links between the areas of telemedicine in the developmental age from the first 1000 days of life to the age adult. The future scenario will have to be able to integrate digital innovation in order to offer the best care to patients and citizens. It will have to be able to provide the involvement of patients from the very beginning of the design of any care pathway, increasing where possible the proximity of the health service to citizens. Full article
15 pages, 307 KiB  
Review
Use of Telemedicine Healthcare Systems in Pediatric Assistance at Territorial Level: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)
by Susanna Esposito, Cristiano Rosafio, Francesco Antodaro, Alberto Argentiero, Marta Bassi, Paolo Becherucci, Fabio Bonsanto, Andrea Cagliero, Giulia Cannata, Fabio Capello, Fabio Cardinale, Tiziana Chiriaco, Alessandro Consolaro, Angelica Dessì, Giuseppe Di Mauro, Valentina Fainardi, Vassilios Fanos, Alfredo Guarino, Giada Li Calzi, Elisa Lodi, Mohamad Maghnie, Luca Manfredini, Emanuela Malorgio, Nicola Minuto, Maria Grazia Modena, Rossano Montori, Andrea Moscatelli, Elisa Patrone, Elena Pescio, Marco Poeta, Angelo Ravelli, Maddalena Spelta, Agnese Suppiej, Sergio Vai, Luca Villa, Rinaldo Zanini, Renato Botti and Antonio Vittorino Gaddiadd Show full author list remove Hide full author list
J. Pers. Med. 2023, 13(2), 198; https://doi.org/10.3390/jpm13020198 - 22 Jan 2023
Cited by 5 | Viewed by 1943
Abstract
Technological innovation can contribute to a reorganization of healthcare, particularly by supporting the shift in the focus of care from the hospital to the territory, through innovative citizen-centered models, and facilitating access to services in the territory. Health and social care delivery modalities, [...] Read more.
Technological innovation can contribute to a reorganization of healthcare, particularly by supporting the shift in the focus of care from the hospital to the territory, through innovative citizen-centered models, and facilitating access to services in the territory. Health and social care delivery modalities, enabled by telemedicine, are crucial in this regard. The objective of this Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, is to define a standard for its use at the territorial level in various declinations in the pediatric field; this paper also identifies priority areas for its application and the types of services that most require intervention and investment. The changes that are underway in digital transformation in all sectors are unstoppable, and for the digital transformation to take place in a productive sense, the contribution of not only all health professionals, but also of patients, is necessary. From this perspective, authors from different backgrounds were involved in the drafting of this Consensus and, in the future, other figures, primarily patients, are expected to be involved. In fact, this belongs to the vision of connected care, in which the citizen/patient actively participates in the treatment path so that they are assisted in a personalized, predictive and preventive way. The future scenario must be able to provide for the involvement of patients from the initial stages of planning any treatment path, even in the pediatric age, and increasing, where possible, the proximity of the health service to the families. Full article
17 pages, 1273 KiB  
Review
A Review of Digital Health and Biotelemetry: Modern Approaches towards Personalized Medicine and Remote Health Assessment
by Ștefan Sebastian Busnatu, Adelina-Gabriela Niculescu, Alexandra Bolocan, Octavian Andronic, Anca Mihaela Pantea Stoian, Alexandru Scafa-Udriște, Ana Maria Alexandra Stănescu, Dan Nicolae Păduraru, Mihnea Ioan Nicolescu, Alexandru Mihai Grumezescu and Viorel Jinga
J. Pers. Med. 2022, 12(10), 1656; https://doi.org/10.3390/jpm12101656 - 05 Oct 2022
Cited by 8 | Viewed by 2612
Abstract
With the prevalence of digitalization in all aspects of modern society, health assessment is becoming digital too. Taking advantage of the most recent technological advances and approaching medicine from an interdisciplinary perspective has allowed for important progress in healthcare services. Digital health technologies [...] Read more.
With the prevalence of digitalization in all aspects of modern society, health assessment is becoming digital too. Taking advantage of the most recent technological advances and approaching medicine from an interdisciplinary perspective has allowed for important progress in healthcare services. Digital health technologies and biotelemetry devices have been more extensively employed for preventing, detecting, diagnosing, monitoring, and predicting the evolution of various diseases, without requiring wires, invasive procedures, or face-to-face interaction with medical personnel. This paper aims to review the concepts correlated to digital health, classify and describe biotelemetry devices, and present the potential of digitalization for remote health assessment, the transition to personalized medicine, and the streamlining of clinical trials. Full article
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16 pages, 5026 KiB  
Review
A Scoping Review on Accentuating the Pragmatism in the Implication of Mobile Health (mHealth) Technology for Tuberculosis Management in India
by Jyotsna Needamangalam Balaji, Sreenidhi Prakash, Youngmok Park, Joon Sang Baek, Jaeyong Shin, Vasuki Rajaguru and Krishna Mohan Surapaneni
J. Pers. Med. 2022, 12(10), 1599; https://doi.org/10.3390/jpm12101599 - 28 Sep 2022
Cited by 5 | Viewed by 2289
Abstract
Background: India continues to share a colossal count of the global tuberculosis load, with a perturbing 19% spring in the reported cases in 2021. With the National Tuberculosis Elimination Program (NTEP) consolidated to bring this epidemic to an end by 2025, the [...] Read more.
Background: India continues to share a colossal count of the global tuberculosis load, with a perturbing 19% spring in the reported cases in 2021. With the National Tuberculosis Elimination Program (NTEP) consolidated to bring this epidemic to an end by 2025, the rapidly growing mobile health technologies can be utilized to offer promising results. Even though the implementation of this novel strategy is escalating around the globe, its triumph is still sub optimal in India. Objectives: This scoping review intends to explore the available mobile health (mHealth) technologies and analyse the effectiveness of the same for tuberculosis management in India. Methods: An elaborate search in electronic databases, such as PubMed and Google scholar, using the key terms and focussing from the year 2015, provided very broad results focussing on mHealth interventions and their utilisation in TB management in India. Further selection of the inclusive publications was carried out based upon the eligibility requirements as formulated for this review, pertaining to the objective of this study. Results: The collaborate search yielded a total of 858 scientific research papers. After the filtering of the obtained results, a total of 45 articles were selected to be analysed for this review. Published manuscripts, articles in peer review and abstracts from reliable databases were included to obtain vast range of information. Conclusion: The extensive literature search showed a preponderance of mHealth intervention studies focusing on TB treatment and drug monitoring. There exists a paucity of mHealth applications targeted to educate the public and intercept this infectious disease. The scientific articles reviewed and analysed in this scoping review strongly recommend the demployment of mHealth applications to achieve the target of eradicating TB by 2025 in India. Full article
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27 pages, 894 KiB  
Review
Potential and Pitfalls of Mobile Mental Health Apps in Traditional Treatment: An Umbrella Review
by Jerica Koh, Germaine Y. Q. Tng and Andree Hartanto
J. Pers. Med. 2022, 12(9), 1376; https://doi.org/10.3390/jpm12091376 - 25 Aug 2022
Cited by 20 | Viewed by 5623
Abstract
While the rapid growth of mobile mental health applications has offered an avenue of support unbridled by physical distance, time, and cost, the digitalization of traditional interventions has also triggered doubts surrounding their effectiveness and safety. Given the need for a more comprehensive [...] Read more.
While the rapid growth of mobile mental health applications has offered an avenue of support unbridled by physical distance, time, and cost, the digitalization of traditional interventions has also triggered doubts surrounding their effectiveness and safety. Given the need for a more comprehensive and up-to-date understanding of mobile mental health apps in traditional treatment, this umbrella review provides a holistic summary of their key potential and pitfalls. A total of 36 reviews published between 2014 and 2022—including systematic reviews, meta-analyses, scoping reviews, and literature reviews—were identified from the Cochrane library, Medline (via PubMed Central), and Scopus databases. The majority of results supported the key potential of apps in helping to (1) provide timely support, (2) ease the costs of mental healthcare, (3) combat stigma in help-seeking, and (4) enhance therapeutic outcomes. Our results also identified common themes of apps’ pitfalls (i.e., challenges faced by app users), including (1) user engagement issues, (2) safety issues in emergencies, (3) privacy and confidentiality breaches, and (4) the utilization of non-evidence-based approaches. We synthesize the potential and pitfalls of mental health apps provided by the reviews and outline critical avenues for future research. Full article
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18 pages, 7570 KiB  
Review
Effectiveness of Digital Cognitive Behavioral Therapy for Insomnia in Young People: Preliminary Findings from Systematic Review and Meta-Analysis
by Hsin-Jung Tsai, Albert C. Yang, Jun-Ding Zhu, Yu-Yun Hsu, Teh-Fu Hsu and Shih-Jen Tsai
J. Pers. Med. 2022, 12(3), 481; https://doi.org/10.3390/jpm12030481 - 16 Mar 2022
Cited by 13 | Viewed by 4888
Abstract
Various forms of cognitive behavioral therapy for insomnia (CBT-i) have been developed to improve its scalability and accessibility for insomnia management in young people, but the efficacy of digitally-delivered cognitive behavioral therapy for insomnia (dCBT-i) remains uncertain. This study systematically reviewed and evaluated [...] Read more.
Various forms of cognitive behavioral therapy for insomnia (CBT-i) have been developed to improve its scalability and accessibility for insomnia management in young people, but the efficacy of digitally-delivered cognitive behavioral therapy for insomnia (dCBT-i) remains uncertain. This study systematically reviewed and evaluated the effectiveness of dCBT-i among young individuals with insomnia. We conducted comprehensive searches using four electronic databases (PubMed, Cochrane Library, PsycINFO, and Embase; until October 2021) and examined eligible records. The search strategy comprised the following three main concepts: (1) participants were adolescents or active college students; (2) dCBT-I was employed; (3) standardized tools were used for outcome measurement. Four randomized controlled trials qualified for meta-analysis. A significant improvement in self-reported sleep quality with a medium-to-large effect size after treatment (Hedges’s g = −0.58~−0.80) was noted. However, a limited effect was detected regarding objective sleep quality improvement (total sleep time and sleep efficiency measured using actigraphy). These preliminary findings from the meta-analysis suggest that dCBT-i is a moderately effective treatment in managing insomnia in younger age groups, and CBT-i delivered through the web or a mobile application is an acceptable approach for promoting sleep health in young people. Full article
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12 pages, 1081 KiB  
Case Report
A Telerehabilitation Approach to Chronic Facial Paralysis in the COVID-19 Pandemic Scenario: What Role for Electromyography Assessment?
by Alessandro de Sire, Nicola Marotta, Francesco Agostini, Vera Drago Ferrante, Andrea Demeco, Martina Ferrillo, Maria Teresa Inzitari, Raffaello Pellegrino, Ilaria Russo, Ozden Ozyemisci Taskiran, Andrea Bernetti and Antonio Ammendolia
J. Pers. Med. 2022, 12(3), 497; https://doi.org/10.3390/jpm12030497 - 19 Mar 2022
Cited by 23 | Viewed by 2889
Abstract
There is a lack of data on patient and diagnostic factors for prognostication of complete recovery in patients with peripheral facial palsy. Thus, the aim of this study was to evaluate the role of a telerehabilitave enhancement through the description of a case [...] Read more.
There is a lack of data on patient and diagnostic factors for prognostication of complete recovery in patients with peripheral facial palsy. Thus, the aim of this study was to evaluate the role of a telerehabilitave enhancement through the description of a case report with the use of short-wave diathermy and neuromuscular electrical stimulation combined to facial proprioceptive neuromuscular facilitation (PNF) rehabilitation in unrecovered facial palsy, in a COVID-19 pandemic scenario describing a paradigmatic telerehabilitation report. A 43-year-old woman underwent a facial rehabilitation plan consisting of a synergistic treatment with facial PNF rehabilitation, short-wave diathermy, and neuromuscular electrical stimulation (12 sessions lasting 45 min, three sessions/week for 4 weeks). Concerning the surface electromyography evaluation of frontal and orbicularis oris muscles, the calculated ratio between amplitude of the palsy side and normal side showed an improvement in terms of movement symmetry. At the end of the outpatient treatment, a daily telerehabilitation protocol with video and teleconsultation was provided, showing a further improvement in the functioning of a woman suffering from unresolved facial paralysis. Therefore, an adequate telerehabilitation follow-up seems to play a fundamental role in the management of patients with facial palsy. Full article
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