Self-Management Maintenance Inhalation Therapy With eHealth (SELFIE): Observational Study on the Use of an Electronic Monitoring Device in Respiratory Patient Care and Research.

BACKGROUND: Electronic inhalation monitoring devices (EIMDs) are available to remind patients with respiratory diseases to take their medication and register inhalations for feedback to patients and health care providers as well as for data collection in research settings. OBJECTIVE: This study aimed to assess the validity as well as the patient-reported usability and acceptability of an EIMD. METHODS: This observational study planned to include 21 community pharmacies in the Netherlands. Patient-reported inhalations were collected and compared to EIMD registrations to evaluate the positive predictive value of these registrations as actual patient inhalations. Patients received questionnaires on their experiences and acceptance. RESULTS: A convenience sample of 32 patients was included from across 18 pharmacies, and 932 medication doses were validated. Of these, 796 registrations matched with patient-reported use (true-positive, 85.4%), and 33 inhalation registrations did not match with patient-reported use (false-positive, 3.5%). The positive predictive value was 96.0%, and 103 patient-reported inhalations were not recorded in the database (false-negative, 11.1%). Overall, patients considered the EIMD to be acceptable and easy to use, but many hesitated to continue its use. Reminders and motivational messages were not appreciated by all users, and more user-tailored features in the app were desired. CONCLUSIONS: Patients' interaction with the device in real-world settings is critical for objective measurement of medication adherence. The positive predictive value of this EIMD was found to be acceptable. However, patients reported false-negative registrations and a desire to include more user-tailored features to increase the usability and acceptability of the EIMD.

Positive Impacts of Electronic hand-off systems designs on Nurses' communication effectiveness.

AIM: Different designs of electronic hand-off systems might have different levels of effectiveness; this study validated the effectiveness of systems with an Identify, Situation, Background, Assessment and Recommendation (ISBAR) design to one without such a design. BACKGROUND: Adverse consequences in hospital commonly occur when there are breakdowns in the transmission of information between team members. To ensure information accuracy and consistency, some Taiwan hospitals implemented electronic hand-off systems. However, the effectiveness of such systems was not investigated. METHODS: A quasi-experiment was conducted to the nurses of two Taiwan case hospitals, one with ISBAR and the other with non-ISBAR design systems and 200 questionnaires were used to collect data. RESULTS: The respondent rate was 72%. Using system with ISBAR design, nurses can enhance their communication effectiveness and further increase their individual benefits at hand-off. Using a non-ISBAR hand-off system, communication effectiveness depends solely on the nurses' individual cognitive and expressive ability. CONCLUSION: System with ISBAR design can ensure effective information transmission among nurses for care continuity and prevention of adverse events. IMPLICATIONS FOR NURSING MANAGEMENT: Ensuring the design of electronic systems is adequate, nursing managers can save nurses' time and effort while using the system to perform their regular work effectively and gain competitive advantage.

Smart medical beds in patient-care environments of the twenty-first century: a state-of-art survey.

BACKGROUND: Recent scientific achievements and technological advances have brought forward a massive display of new or updated medical devices, enabled with highly-developed embedded-control functions and interactivity. From the final decade of the twentieth century, medical beds have particularly been affected by this surge, taking on new forms and functions, while accommodating to established properties that have become well-known for these devices. The past fifteen years have also brought forward changes to conceptual frameworks, concerning the product design and manufacturing processes (standards), as well as the patient (perspectives on patient-care environments and accessibility). This work presents a state-of-art survey on electric medical beds, representing what is defined as the time of "smart beds", as part of an increasingly comprehensive patient-care environment. METHODS: A survey and assessment of market trends, research efforts and standards related to smart medical beds was performed, covering a wide range of public records of intellectual property, models and related healthcare solutions, as well as relevant research efforts in the field between 2000 and 2016. Contextual topics, necessary for the understanding of this subject, on novel technologies, disability and the reach of healthcare systems, were also researched and interpreted. RESULTS: The new generation of electric medical beds is defined, with the final stage of the proposed timeline for these devices being covered. Functional, aesthetic and interactive features are presented, and the current global market for medical beds and related standards are also assessed. Finally, discussions concerning rising challenges and opportunities for these systems are explored, with the potential for adding further monitoring and assistive implementations into medical devices and environments being highlighted. CONCLUSIONS: Smart medical beds are integrated solutions for patient care, assistance and monitoring, based on a comprehensive, multidisciplinary design approach. Research in this field is critical in a context of global ageing, and powered by a surge in opportunities for accessibility solutions. Smart beds, seamlessly integrated into the healthcare system, have a unique opportunity in enabling more efficient efforts for caregivers, and more responsive environments for patients.

Safety of Electro-Medical Equipment in Floods in Austere Environment.

Pakistan is prone to floods. In 2010, floods in North-Western Pakistan caused devastation in wide areas. Electro-medical equipment is very expensive and without proper equipment adequate surgery is not possible. We retrospectively analyzed how expensive electro-medical equipment got damaged during floods of 2010 at a district-level hospital in North-Western Pakistan and how we could have saved this equipment or reduced the damage to the minimum. The article provides the lessons learned and recommendations aimed to prevent or minimize damage to the valuable and expensive equipment in the areas prone to floods. (Disaster Med Public Health Preparedness. 2018;12:803-805).

Forecasting electric vehicles sales with univariate and multivariate time series models: The case of China.

The market demand for electric vehicles (EVs) has increased in recent years. Suitable models are necessary to understand and forecast EV sales. This study presents a singular spectrum analysis (SSA) as a univariate time-series model and vector autoregressive model (VAR) as a multivariate model. Empirical results suggest that SSA satisfactorily indicates the evolving trend and provides reasonable results. The VAR model, which comprised exogenous parameters related to the market on a monthly basis, can significantly improve the prediction accuracy. The EV sales in China, which are categorized into battery and plug-in EVs, are predicted in both short term (up to December 2017) and long term (up to 2020), as statistical proofs of the growth of the Chinese EV industry.

Rise in electronic cigarette use among adolescents in Poland.

PURPOSE: Despite the potential negative health effects of electronic cigarettes (e-cigarettes), these devices are increasing in popularity worldwide, especially among youth. METHODS: We compared data from two cross-sectional studies conducted in Poland among students aged 15-19 years in 2010-2011 and 2013-2014. We tested differences between samples in the prevalence of e-cigarette use, tobacco cigarette smoking, and simultaneous use of both tobacco and e-cigarettes ("dual use") using a multilevel linear mixed model regression. RESULTS: We found that the current use of e-cigarettes among adolescents in Poland was significantly higher in the 2013-2014 sample than the 2010-2011 sample (29.9% vs. 5.5%, respectively; p < .05). Dual use of tobacco and e-cigarettes was also significantly higher (21.8% vs. 3.6%, respectively; p < .05). Interestingly, the prevalence of smoking tobacco cigarettes also increased (from 23.9% in 2010-2011 to 38.0% in 2013-2014; p < .05). CONCLUSIONS: Observed parallel increase in e-cigarette use and smoking prevalence does not support the idea that e-cigarettes are displacing tobacco cigarettes in this population.

Sparking controversy. Rise in e-cigarette use has public health experts questioning their safety, effectiveness as harm-reduction device.

The rise of e-cigarettes in the past decade has been accompanied by a debate over the public health consequences of using the devices. Many see them as beneficial. "T'his is basically what I would call a harm-reduction strategy," says Dr. Michael Siegel, a professor of community health sciences at Boston University, comparing e-cigarette use to how methadone is prescribed to heroin addicts.