Tablet Platforms Research Articles

Diabetes Management Using Modern Information and Communication Technologies and New Care Models

BackgroundDiabetes, a metabolic disorder, has reached epidemic proportions in developed countries. The disease has two main forms: type 1 and type 2. Disease management entails administration of insulin in combination with careful blood glucose monitoring (type 1) or involves the adjustment of diet and exercise level, the use of oral anti-diabetic drugs, and insulin administration to control blood sugar (type 2).ObjectiveState-of-the-art technologies have the potential to assist healthcare professionals, patients, and informal carers to better manage diabetes insulin therapy, help patients understand their disease, support self-management, and provide a safe environment by monitoring adverse and potentially life-threatening situations with appropriate crisis management.MethodsNew care models incorporating advanced information and communication technologies have the potential to provide service platforms able to improve health care, personalization, inclusion, and empowerment of the patient, and to support diverse user preferences and needs in different countries. The REACTION project proposes to create a service-oriented architectural platform based on numerous individual services and implementing novel care models that can be deployed in different settings to perform patient monitoring, distributed decision support, health care workflow management, and clinical feedback provision.ResultsThis paper presents the work performed in the context of the REACTION project focusing on the development of a health care service platform able to support diabetes management in different healthcare regimes, through clinical applications, such as monitoring of vital signs, feedback provision to the point of care, integrative risk assessment, and event and alarm handling. While moving towards the full implementation of the platform, three major areas of research and development have been identified and consequently approached: the first one is related to the glucose sensor technology and wearability, the second is related to the platform architecture, and the third to the implementation of the end-user services. The Glucose Management System, already developed within the REACTION project, is able to monitor a range of parameters from various sources including glucose levels, nutritional intakes, administered drugs, and patient’s insulin sensitivity, offering decision support for insulin dosing to professional caregivers on a mobile tablet platform that fulfills the need of the users and supports medical workflow procedures in compliance with the Medical Device Directive requirements.ConclusionsGood control of diabetes, as well as increased emphasis on control of lifestyle factors, may reduce the risk profile of most complications and contribute to health improvement. The REACTION project aims to respond to these challenges by providing integrated, professional, management, and therapy services to diabetic patients in different health care regimes across Europe in an interoperable communication platform.

Real-Time Droplet DNA Amplification with a New Tablet Platform

We present a novel droplet-based tablet platform for temporal polymerase chain reaction (PCR) in microliter droplets. The simple design of the device does not require extensive processing or external equipment, which allows for greater ease of use and integration as a point-of-care diagnostic. We demonstrate its functionality to perform both PCR and reverse-transcription PCR for λ phage DNA and H3 influenza RNA with ramp rates and cycle times consistent with traditional PCR thermal cyclers. We additionally investigate the effect of performing PCR in small volumes on the reaction performance by specifically examining adsorption of reagents at the oil/water interface. We determined that adsorption of Taq polymerase at the biphasic interface reduces yield and impairs reaction performance at standard concentrations. Thus, microdroplet PCR reactions require additional polymerase to achieve sufficient amplification and we project for applications utilizing nanodroplets or picodroplets like digital applications, even greater concentrations of polymerase are required to achieve desired results. Following the adsorption investigation, we evaluated the sensitivity of λ phage PCR on our platform to be less than 2.0 copies/μL with an efficiency of 104.4% and similar sensitivity for reverse-transcription PCR for influenza H3 RNA.

The rabbit dies and new initiatives are born

A strategic editorial retreat with the theme “Reimagining the Journal” was held (in collaboration with our publisher, Lippincott Williams & Wilkins) March 16–18 in Boston, Massachusetts, to discuss the creation of a more relevant journal that will meet the evolving needs of physicians of the future. Our guest consultants, from online network development groups and prominent scientific journals, guided interactive sessions. Topics included expectations for digital devices, models for spin-off journals, data visualization, new features being invented for journals, and improvements to make Neurology ® more readable. Some of the many ideas discussed are already bearing fruit and are described in the following paragraphs. We plan to implement others in the coming months and years. ### e-Publication of all articles ahead of print. In recent years, articles that the editors judged to have the most influence on practice—and therefore were published online ahead of print—were so identified by a rabbit icon on the journal cover. With this issue of Neurology , the hare icon has disappeared: the bunny is now no longer meaningful because all of our peer-reviewed articles will be published ahead of print. This innovation will allow readers to access articles earlier for use in practice and will make our content available earlier for citation by authors of other articles. ### QR Codes. In this issue, we introduce Quick Response (QR) Codes, matrix barcodes showing a dark pattern on a square white background. These increasingly used tools will link article pages to online features, such as videos and other items, for viewing on smartphones and other mobile devices. To use a QR Code, you will need to install a QR Code Reader application (available free) on your smartphone or tablet platform; launch this app and point your device's camera to a QR Code to scan it. The phone will interpret the code and load the data on your device's …

Abstract 1817: A computer-tailored intervention increases patient-provider discussion and appointment making for colorectal cancer screening

Abstract BACKGROUND: Colorectal cancer (CRC) will affect more than 142,000 Americans and almost 52,000 will die from this disease this year. Approximately half of these deaths could be prevented if CRC screening were consistently implemented. Both CRC incidence and mortality rates are highest among African Americans compared to all other racial groups due, in part, to suboptimal screening rates. Interactive health communication, defined as “computer technology designed to access or transmit tailored health information or receive tailored guidance and support on a health-related issue”, can be efficacious in changing individual behavior. PURPOSE: Our objective was to determine if a tailored, interactive computer-based intervention (ICI) on CRC would increase screening discussions between African American patients and their primary care providers. Applying Health Belief Model constructs, we developed an ICI which featured CRC-risk based screening recommendations as well as individually tailored and culturally appropriate messages. The program operated on a user-friendly tablet platform and required an average of 17 minutes to complete. METHODS: We enrolled 556 African Americans who were due for CRC screening in a randomized clinical trial. The sample was predominantly low income (58% < $15,000 annual income) and 50% male with a mean age of 58 years (sd = 6.3). Demographics did not vary significantly between the two treatment arms. Prior to meeting with primary care providers in the clinic, 273 (49%) patients used the ICI. The remaining 283 (51%) patients received a “usual care” intervention – a non-tailored, CRC screening informational brochure developed by the American Cancer Society. Follow-up telephone interviews were conducted within one week of the clinic visit. RESULTS: Patients in the ICI group were significantly more likely to report talking with their doctor about having a colon screening test (ICI group = 63%, brochure group = 49%, p = 0.001). Colonoscopy was reported as the most frequently discussed test (ICI group = 54%, brochure group = 45%, p = 0.06). Importantly, 30% of the ICI group further reported having an appointment scheduled for a colonoscopy, compared to 21% of the brochure group (p = 0.02). Fecal occult blood test was reportedly discussed by less than one third of patients in both groups (ICI group = 32%, brochure group = 27%, p = 0.15). Few patients reported discussing sigmoidoscopy (ICI group = 9%, brochure group = 7%, p = 0.29). CONCLUSION: Tailored interactive health communications can prompt patient-provider dialogue on CRC screening and colonoscopy appointment making. Future analyses will determine if discussions translate into completion of these preventive tests which, in turn, can decrease cancer incidence and mortality. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1817. doi:10.1158/1538-7445.AM2011-1817