An integrated model for cognitive behavioural therapy for mobile diabetes self-management system.

There is increasing clinical evidence that behavioural change theories can help diabetic patients with their diabetic management in providing better education and a healthy lifestyle. In recent years, Cognitive Behavioural Therapy (CBT) has been increasingly used as a key psychological method for studies of behavioural changes for diabetes patients. However, to date, there is no extensive study that addresses the challenges and opportunities on applying CBT models within the mobile diabetes management cycle of care. In this paper, we present a review of the current status of CBT in diabetes management and propose a model for the implementation of CBT Therapy into a mobile diabetes management system by using smart mobile phone technologies.

Dynamic subframe allocation for mobile broadband m-health using IEEE 802.16j mobile multihop relay networks.

The concept of 4G health will be one of the key focus areas of future m-health research and enterprise activities in the coming years. WiMAX technology is one of the constituent 4G wireless technologies that provides broadband wireless access (BWA). Despite the fact that WiMAX is able to provide a high data rate in a relatively large coverage; this technology has specific limitations such as: coverage, signal attenuation problems due to shadowing or path loss, and limited available spectrum. The IEEE 802.16j mobile multihop relay (MMR) technology is a pragmatic solution designed to overcome these limitations. The aim of IEEE 802.16j MMR is to expand the IEEE 802.16e's capabilities with multihop features. In particular, the uplink (UL) and downlink (DL) subframe allocation in WiMAX network is usually fixed. However, dynamic frame allocation is a useful mechanism to optimize uplink and downlink subframe size dynamically based on the traffic conditions through real-time traffic monitoring. This particular mechanism is important for future WiMAX based m-health applications as it allows the tradeoff in both UL and DL channels. In this paper, we address the dynamic frame allocation issue in IEEE 802.16j MMR network for m-health applications. A comparative performance analysis of the proposed approach is validated using the OPNET Modeler(®). The simulation results have shown an improved performance of resource allocation and end-to-end delay performance for typical medical video streaming application.

Mapping of multiple parameter m-health scenarios to mobile WiMAX QoS variables.

Multiparameter m-health scenarios with bandwidth demanding requirements will be one of key applications in future 4 G mobile communication systems. These applications will potentially require specific spectrum allocations with higher quality of service requirements. Furthermore, one of the key 4 G technologies targeting m-health will be medical applications based on WiMAX systems. Hence, it is timely to evaluate such multiple parametric m-health scenarios over mobile WiMAX networks. In this paper, we address the preliminary performance analysis of mobile WiMAX network for multiparametric telemedical scenarios. In particular, we map the medical QoS to typical WiMAX QoS parameters to optimise the performance of these parameters in typical m-health scenario. Preliminary performance analyses of the proposed multiparametric scenarios are evaluated to provide essential information for future medical QoS requirements and constraints in these telemedical network environments.

The potential of Internet of m-health Things "m-IoT" for non-invasive glucose level sensing.

An amalgamated concept of Internet of m-health Things (m-IoT) has been introduced recently and defined as a new concept that matches the functionalities of m-health and IoT for a new and innovative future (4G health) applications. It is well know that diabetes is a major chronic disease problem worldwide with major economic and social impact. To-date there have not been any studies that address the potential of m-IoT for non-invasive glucose level sensing with advanced opto-physiological assessment technique and diabetes management. In this paper we address the potential benefits of using m-IoT in non-invasive glucose level sensing and the potential m-IoT based architecture for diabetes management. We expect to achieve intelligent identification and management in a heterogeneous connectivity environment from the mobile healthcare perspective. Furthermore this technology will enable new communication connectivity routes between mobile patients and care services through innovative IP based networking architectures.

A feasibility study of a personalized, internet-based compliance system for chronic disease management.

This paper describes a feasibility study on an Internet-based compliance system to provide personalized care for patients suffering from chronic diseases. Relevant medical trials from three different European countries provided preliminary evidence of the feasibility of the system and its efficacy in helping patients to manage their diseases at home. The study discusses further improvements not only for the C-Monitor system, but also for other Internet-based health-care services.

Optimisation Issues of High Throughput Medical Data and Video Streaming Traffic in 3G Wireless Environments.

In this paper we describe some of the optimisation issues relevant to the requirements of high throughput of medical data and video streaming traffic in 3G wireless environments. In particular we present a challenging 3G mobile health care application that requires a demanding 3G medical data throughput. We also describe the 3G QoS requirement of mObile Tele-Echography ultra-Light rObot system (OTELO that is designed to provide seamless 3G connectivity for real-time ultrasound medical video streams and diagnosis from a remote site (robotic and patient station) manipulated by an expert side (specialists) that is controlling the robotic scanning operation and presenting a real-time feedback diagnosis using 3G wireless communication links.

Advances in robotic tele-echography services--the OTELO system.

This paper presents some of the recent advances in mobile robotic tele-echography systems. It discussed the feasibility of a reliable remote ultrasound examination using such robotic systems in wireless environments. That is to say, to make use emerging wireless communications to provide a medical expert or consultant the ability to examine a remote patient. A critical issue of such systems is the accurate interactivity between both remote sides. The paper presents a robotic teleoperated OTELO (mobile tele-echography using an ultra-light robot) system for such purposes. The paper presents an overview of the system and some of preliminary tests and the use of wireless communication in this e-health application.

Atherosclerotic carotid plaque segmentation.

Atherosclerosis is the major cause of heart attack and stroke in the western world. In this paper we present a computerized method for segmenting the athrerosclerotic carotid plaque from ultrasound images. The method uses the blood flow image first to detect the initial contour of the plaque, and then despeckle filtering and snakes to deform the initial contour for best fit of plaque boundaries. The accuracy and reproducibility of this method was tested using 35 longitudinal ultrasound images of carotid arteries and the results were compared with the manual delineations of an expert. The comparison showed that the computerized method gives satisfactory results with no manual correction needed in most of the cases. The true positive fraction, TPF, true negative fraction, TNF, false negative fraction, FNF and false positive fraction, FPF, were 86.44%, 84.03%, 8.5%, and 7% respectively.

Effect of wavelet compression on data transmission in a multipurpose wireless telemedicine system.

We have developed a novel emergency telemedicine system which allows the transmission of physiological data (electrocardiogram, oximetry, blood pressure and temperature) and still images of the patient. The transmission is performed through wireless links using either GSM mobile phones or satellite. Because of the low bandwidth available through these links, data compression is required to allow realtime transmission of electrocardiographic (ECG) data. A new integrated design approach for an optimal zonal wavelet compression (OZWC) method was implemented for the ECG data. The performance of the mobile system with compressed ECG data segments was evaluated in terms of the percentage root-mean-square difference and visual inspection. The optimum wavelet algorithm achieved a maximum compression ratio of 18:1 with low distortion.

ECG data compression using wavelets and higher order statistics methods.

This paper evaluates the compression performance and characteristics of two wavelet coding compression schemes of electrocardiogram (ECG) signals suitable for real-time telemedical applications. The two proposed methods, namely the optimal zonal wavelet coding (OZWC) method and the wavelet transform higher order statistics-based coding (WHOSC) method, are used to assess the ECG compression issues. The WHOSC method employs higher order statistics (HOS) and uses multirate processing with the autoregressive HOS model technique to provide increasing robustness to the coding scheme. The OZWC algorithm used is based on the optimal wavelet-based zonal coding method developed for the class of discrete "Lipschitizian" signals. Both methodologies were evaluated using the normalized rms error (NRMSE) and the average compression ratio (CR) and bits per sample criteria, applied on abnormal clinical ECG data samples selected from the MIT-BIH database and the Creighton University Cardiac Center database. Simulation results illustrate that both methods can contribute to and enhance the medical data compression performance suitable for a hybrid mobile telemedical system that integrates these algorithmic approaches for real-time ECG data transmission scenarios with high CRs and low NRMSE ratios, especially in low bandwidth mobile systems.

Design of a telemedicine system using a mobile telephone.

This paper describes the design of a prototype integrated mobile telemedicine system that is compatible with existing mobile telecommunications networks and upgradable for use with third-generation networks. The system, when fully developed, will enable a doctor to monitor remotely a patient who is free to move around for sports medicine and for emergency situations.

Telemedicine in Armenia.

Telemedicine in Armenia began with the US Telemedicine Space Bridge programme, which was introduced following the disastrous earthquake in 1988. More recently educational programmes have been established between the School of Medicine at Boston University and the Emergency Hospital in Yerevan. There are also telemedicine activities involving the Internet, for example at the Diagnostica Medical Centre in Yerevan. The future integration of telemedicine and telehealth services within the health services in Armenia will produce significant benefits. Current telemedicine activities in Armenia represent models for collaborative projects in other former Soviet republics with the aim of providing greater access to health-care at higher quality and lower cost.

UNWIRED E-MED: the next generation of wireless and internet telemedicine systems.

The movement of telemedicine to wireless and mobile Internet applications is imminent in the next few years. This migration from desktop platforms to wireless and mobile configurations will have a significant impact on future healthcare delivery systems and their globalization. Recent telecommunications and biomedical computing advances will significantly enhance the current methodologies of telemedicine and telecare systems. This editorial will present some of the evolutionary issues and important aspects that have to be considered in developing technologies for the next generation of Internet and third generation of mobile systems geared for future telemedical applications. These will provide new dimensions to existing medical services and areas of outreach that are not possible with the current generation that will have tremendous impact on how healthcare delivery will be shaped for the 21st century.

Optimal zonal wavelet-based ECG data compression for a mobile telecardiology system.

A new integrated design approach for an optimal zonal wavelet-based ECG data compression (OZWC) method for a mobile telecardiology model is presented. The hybrid implementation issues of this wavelet method with a GSM-based mobile telecardiology system are also introduced. The performance of the mobile system with compressed ECG data segments selected from the MIT-BIH arrhythmia data base is evaluated in terms of bit error rate (BER), percent rms difference (PRD), and visual clinical inspection. The compression performance analysis of the OZWC is compared with another wavelet-based (Discrete Symmetric Wavelet Compression) approach. The optimal wavelet algorithm achieved a maximum compression ratio of 18: 1 with low PRD ratios. The mobile telemedical simulation results show the successful compressed ECG transmission at speeds of 100 (km/h) with BER rates of less than 10(-15), providing a 73% reduction in total mobile transmission time with clinically acceptable reconstruction of the received signals. This approach will provide a framework for the design and functionality issues of GSM-based wireless telemedicine systems with wavelet compression techniques and their future integration for the next generation of mobile telecardiology systems.

Telemedicine in the United Kingdom: current status and future prospects.

The objective of this correspondence is to present an overview of some of the current development and some of the ongoing telemedicine programs in the United Kingdom. The issues of the future integration of telemedicine activities within the National Health Service that promises better access to healthcare with higher efficiency, mobility, and lower cost are also discussed.

Microcontroller-based underwater acoustic ECG telemetry system.

This paper presents a microcontroller-based underwater acoustic telemetry system for digital transmission of the electrocardiogram (ECG). The system is designed for the real time, through-water transmission of data representing any parameter, and it was used initially for transmitting in multiplexed format the heart rate, breathing rate and depth of a diver using self-contained underwater breathing apparatus (SCUBA). Here, it is used to monitor cardiovascular reflexes during diving and swimming. The programmable capability of the system provides an effective solution to the problem of transmitting data in the presence of multipath interference. An important feature of the paper is a comparative performance analysis of two encoding methods, Pulse Code Modulation (PCM) and Pulse Position Modulation (PPM).