ABSTRACT
Background: Remote areas of Taiwan lack routine and specialized ophthalmology services. This study aimed to analyze feasibility of teleophthalmology service for diseases diagnosis and referral in remote areas of Taiwan. Methods: A retrospective study of medical records from 11 remote teleophthalmology clinics in the Taitung area of Taiwan was conducted from May 2020 to December 2021. Vision and intraocular pressure were checked. Ophthalmic imaging was performed by local trained nurses using a hand-held ophthalmoscope and slit lamp biomicroscope. The images were transmitted by telemedicine system to a medical center. Consultation was conducted via face-to-face real-time video calls. Ophthalmologists in the medical center provided diagnosis and treatment advice based on the real-time images and interactive history taking via the telemedicine system. All the images and data were collected and well-reviewed by ophthalmologists in the medical center, and disease prevalence and referral were analyzed for the program. A small-scale satisfaction questionnaire survey was conducted for efficacy evaluation of the program. Results: A total of 1,401 medical records from 1,094 patients were collected and screened. Patients' ages ranged from 9 months to 94 years, with a mean age of 57.27 (standard deviation ±20.47) years. The most frequent ophthalmologic diagnosis was dry eye disease (20.2%), followed by conjunctivitis (12.4%). Among 322 patients with underlying diseases of diabetes mellitus, 59 patients (18.3%) were diagnosed with diabetic retinopathy. Major diagnosis was made in 102 patients (7.3%) and referral to hospital for further management was suggested. This program had high overall satisfaction score of 89% (mean 4.43 ± 0.52 points) in satisfaction questionnaire survey. Conclusion: Teleophthalmology provides an alternative tool for ocular disease diagnosis and screening for patients in remote areas, especially during the COVID-19 pandemic. This service helps to detect major but undiagnosed diseases and promotes health care accessibility and availability in remote areas that lack specialists.
ABSTRACT
BACKGROUND: The global coronavirus disease pandemic (COVID-19) has had a considerable impact on athletic competition and team sports training. Athletes have been forced to train alone at home. However, the isolation training model effects are still unknown. PURPOSE: This study compared the effects of personal isolation training (PIT) and detraining (DT) on specific sport performances (flexibility, power, reaction time, acceleration, and aerobic capacity) and body composition in elite taekwondo athletes. METHODS: Eleven elite taekwondo athletes were recruited as voluntary subjects. Athletes were randomly paired by weight into the personal isolation training group (PIT group: N = 5, age: 21.2 ± 0.4 years, BMI: 22.2 ± 0.8 kg/m2) or detraining group (DT group: N = 6, age: 19.8 ± 0.3 years, BMI: 23.1 ± 1.0 kg/m2). All subjects performed the same training content prior to the pre-test (T1). When the pre-test was completed, all subjects underwent 12 weeks of PIT or DT. Athletes were then administrated the post-test (T2). The athlete's sport performances and body composition were measured to compare the differences between the two groups (PIT and DT) and two phases (T1 and T2). RESULTS: There were no significant differences in kicking reaction time and flexibility in both groups (p > 0.05). The PIT showed significant improvements in 10 m (10M) sprint performance (p < 0.05), and displayed a progress trend in Abalakov jump performance. In addition, the PIT resulted in a better change response in 10M sprint performance (PIT: -4.2%, DT: +2.1%), aerobic endurance performance (PIT: -10.2%, DT: -18.4%), right arm muscle mass (PIT: +2.9%, DT: -3.8%), and trunk muscle mass (PIT: +2.2%, DT: -1.9%) than DT (p < 0.05). The fat mass percentage showed a negative change from T1 to T2 in both groups (p < 0.05). CONCLUSIONS: PIT showed a trend toward better body composition (arm and trunk muscle) and sport performances (10M sprint and aerobic capacity) compared to DT. This finding may provide information on the effectiveness of a personal isolation training model for optimal preparation for taekwondo athletes and coaches. It may also serve as a useful and safe guideline for training recommendations during the coronavirus disease (COVID-19).