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Towards a Telehealth Service Planning and Implementation: A Research about the Requirements, Barriers, Benefits and Risks
https://journals.ukzn.ac.za/index.php/JISfTeH/article/view/162/550 ; The implementation of telehealth service is a complex task with many requirements and issues to accomplish. The global opinion is that it can provide many benefits. The objective of this paper is to identify the main requirements that must be accomplish to implement a telehealth service in order to increase the healthcare services quality and economic sustainability. The dimensions have different aspects including citizens themselves, social, healthcare providers, politics makers, academic institutions, normalization organizations and industry. To narrow the study, these dimensions were merged to the following domains: Quality of the processes of the healthcare organization; Economic and financial resources; Workforce planning, healthcare planning, and responsibilities; Infrastructure and facilities resources for telehealth services; Adoption of new Information Architectures capable to share information and knowledge; Adoption of new technology resources to permit the telehealth services; Education and training. The study was conducted in Portugal and the used methodology was a systematic literature review about published norms, guidelines and technical reports, followed by the gathering of secondary data and interviews to the decision makers. The existent education and training courses across Europe were also considered. The conclusions are a set of requirements considering healthcare processes and workforce planning, infrastructures facilities, education and training of the professionals, adoption of normalized information architectures, implementation of different processes of quality management and the expected outcomes are improvements quality and on health economy. Some potential and possible metrics are also proposed.
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Light Aviation And Flight Safety: Monitoring System For Unpressurised Cabins. Flight And Physiological Data Acquisition
The majority of light aviation aircrafts cabins are unpressurised and this may pose risks for the safety of both pilots and passengers. As altitude increases partial oxygen pressure decreases and this situation may lead to early stages of hypoxia affecting pilot's capabilities to perform simple tasks. These factors combined in several ways may affect significantly the capability of a pilot to conduct a safe flight. Some work has been developed in this area and results show that even small changes in altitude can decrease pilot's oxygen level significantly. Thus, as pilot's behaviour and flying capabilities are affected, flight safety is compromise too. This work is generally focused on the acquisition and study of flight operational and physiological data that may affect pilot's capabilities and thus flight safety. To perform such objectives data acquired from the aircraft contains several items such as geographic coordinates, attitude, altitude, speed, g-load, heading, absolute pressure and temperature inside the cabin; also data acquired from the pilot contains several parameters such as cerebral oximetry, electroencephalography (EEG) and electrocardiography (ECG). As pilot's own safety and comfort are important issues we developed a portable system that may be installed and operated in a safe and ergonomic way inside any light (small) aircraft cabin. Also this equipment is flexible enough so that it may be used inside a hypobaric chamber or in a flight simulator to test, prior a real flight, some specific pilot's reactions to different flight scenarios. The specific objective of this paper is to report the acquisition, processing and monitoring of flight data collected directly and in real time from both the aircraft and the pilot, so it may be analysed to determine pilot's major physiological changes facing different flight scenarios and the consequents alterations of his flying capabilities. Legislation for pilot licensing is quite similar all over Europe, and in practice it is not capable to prevent such in-flight individual performance problems. Taking in account the results of this work we also sustain the basis for a revision of the actual European legislation for pilot licensing, thus improving flight safety.
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Light Aviation And Flight Safety: Monitoring System For Unpressurised Cabins. Physiological Parameters Monitorization
Light aviation pilots are exposed to many different environmental situations due to non-pressurized aircraft cabins. Those variations can push the human body to some limits, which associated with psychological factors may culminate in incidents or even fatalities. Really, a literature review on this theme suggests that a significant part of the incidents and fatalities within the light aviation that uses non-pressurized aircraft cabins are related to the human factor. This analysis might bring up a concealed but significant and worrying phenomenon in terms of flight safety: changes of pilot performance in the amendment of physiological parameters concerning to different pressure variations during the various flight stages. Flying is a reality that, although being used mostly for fast passenger and cargo transportation, also it is requested for leisure purposes by a very heterogeneous pool of pilots. This may be a concerning situation due to the disparity of human body (individual) reactions to flight conditions. Nature, both of environmental factors (like as pressure, temperature and humidity) or of human physiological behavior during different flight phases, is unpredictable. Therefore, it is very difficult to establish safety boundaries in this specific context. This work main objective is to analyze the influence of flight environmental conditions on pilot's physiological parameters and thus on tasks performance during different flight situations (or scenarios). In order to perform this analysis a portable and ergonomic monitoring system was built. This equipment records both the cerebral oximetry to study the phenomenon of hypoxia and its importance, and electrocardiography (ECG) and electroencephalography (EEG) parameters in order to establish a correlation among pressure variations, amount of mental workload, and several individual physiological parameters during different flight stages. The specific purpose of this study is how to define physiological limits for each pilot, calibrated through simulation tests contemplating different flight scenarios, in order to create in the next future a on board alert system to prevent possible incidents and fatalities. Also we suggest potential restrictions on European pilots licensing legislation for light aviation, based on some physiological boundaries, as a positive contribution to a safer flight environment.
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Strabismic amblyopia disrupts the hemispheric asymmetry for spatial stimuli in cortical visual processing
In: British journal of visual impairment: BJVI, Band 34, Heft 2, S. 141-150
ISSN: 1744-5809
Hemispheric asymmetry in processing visual stimuli was assessed in anisometropic and strabismic amblyopia and control subjects. Measurements of contrast sensitivity for low and high spatial frequencies were performed psychophysically and tested under functional magnetic resonance imaging (fMRI) using a stimulus configuration that generates measurements for each temporal and nasal hemifield. The fMRI and the psychophysics results showed a marked hemispheric asymmetry in processing spatial frequencies for normal and anisometropic adults, in which low spatial frequencies were mainly processed in the left visual field – right hemisphere (LVF-RH: 0.3 cycles per degree [cpd]; F = 12.548; p = .002) and the high spatial frequencies were predominating processed in the right visual field – left hemisphere (RVF-LH: 2.0 cpd; F = 4.582; p = .021 and 8.3 cpd; F = 8.561; p = .001). No asymmetry was present in the amblyopic and the fellow eye of the strabismic amblyopia subjects. We conclude that the developmental organization of visual cortex in strabismic amblyopia is impaired differently from what happens in the anisometropic amblyopia and support the impairment of high-level visual-related functions observed in strabismic children.
Sexual dimorphism of the adult human retina assessed by optical coherence tomography
In: Health and Technology, Band 10, Heft 4, S. 913-924
ISSN: 2190-7196
Neurobiological Correlates of Psychological Treatments for Insomnia: A Review
In: European psychologist, Band 21, Heft 3, S. 195-205
ISSN: 1878-531X
Abstract. Sleep disorders and sleep disturbances are considered nowadays a major public health problem. Within sleep problems, insomnia is the most common health complaint. The maintenance of insomnia symptoms may lead to a clinical disorder – Insomnia Disorder (ID). A significant amount of literature has shown the efficacy and effectiveness of psychological treatments for ID. Often, the evaluation of therapeutic processes and outcomes focuses on subjective measures such as sleep diaries. In this work, we review the few published studies that evaluate modifications in neurobiological domain related to evidence-based psychological interventions, namely cognitive-behavioral therapy for insomnia (CBT-I). The search was carried out consulting Scopus, PubMed, and ISI Web of Knowledge databases. Only 12 studies were found. From the reviewed papers it was observed that the results are diverse, perhaps due to significant differences pertaining to the methodologies used. However, one interesting finding emerged: daytime experiments on insomnia comprising mainly cognitive tasks denoted hypofunction in ID patients, whereas nighttime experiments mainly associated with affective/emotional tasks denoted hyperarousal. We suggest that the study of the neural changes prompted by CBT-I is a major topic in the domain of psychotherapy and sleep medicine. Despite the scarce studies on neurobiological mechanisms of CBT-I, the results achieved until now are promising and should be taken into account in the future. Nonetheless, more research on this topic is needed.
The neural bases of sport fan reactions to teams: Evidence from a neuroimaging study
In: Journal of consumer behaviour, Band 23, Heft 2, S. 842-854
ISSN: 1479-1838
AbstractThis study uses neuroimaging methods to identify patterns of brain activation among sport fans in reaction to team stimuli. In a whole‐brain analysis without selected regions in advance, the purposes were to identify the structures involved when fans are exposed to positive, neutral, and negative events and to learn what events activate more limbic networks. A total of 53 individuals participated in and functional magnetic resonance imaging experiment involving the presentation of videos in various situations. Findings indicate the activation of the cingulate gyrus and other structures of the limbic system, as the hippocampus and parahippocampus. We also found involvement of the ventral tegmental area of the reward system. Additionally, brain activity in emotional regulation and memory areas were more influenced by positive than neutral and negative videos. It was also found the involvement of other areas not directly included in the limbic or reward systems. This study provides the neural basis of fan reactions to team‐related stimuli. Sport clubs should be aware that negative content seems to be suppressed from emotional memory and positive videos trigger more emotion and memory areas than neutral and negative videos.
Characterization of the retinal changes of the 3×Tg-AD mouse model of Alzheimer's disease
In: Health and Technology, Band 10, Heft 4, S. 875-883
ISSN: 2190-7196
AbstractAlzheimer's disease (AD) is a progressive neurodegenerative disorder whose diagnosis remains a notable challenge. The literature suggests that cerebral changes precede AD symptoms by over two decades, implying a significantly advanced stage of AD by the time it is usually diagnosed. In the study herein, texture analysis was applied to computed optical coherence tomography ocular fundus images to identify differences between a group of the transgenic mouse model of the Alzheimer's disease (3×Tg-AD) and a group of wild-type mice, at the ages of one and two-months-old. A substantial difference between groups was found at both time-points across all neuroretina's layers. Here, the inner nuclear layer stands out both in the level of statistically significant differences and on the extension of these differences which span through the imaged area. Also, the progression of AD is suggested to be spotted by texture analysis as demonstrated by the significant difference found in the inner plexiform and the outer nuclear layers from the age of one to the age of two-months-old. These findings demonstrate the potential of the use of the retina and texture analysis to the diagnosis of AD and monitor AD progression. Besides, the differences between groups found in this study suggest that the 3×Tg-AD model may be inappropriate to study early changes associated with the AD and other animal models should be tested following the same path and rationale. Moreover, these results also suggest that the human genes present in these transgenic mice may have an impact on the neurodevelopment of offspring which would justify the significant changes found at the age of one-month-old.
Neurofeedback Training of Executive Function in Autism Spectrum Disorder: Distinct Effects on Brain Activity Levels and Compensatory Connectivity Changes
In: NICL-22-1382
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