Home Use Research Articles

Biocompatible Native Hyaluronan Nanofibers Fabricated via Aqueous PEO-Assisted Electrospinning and Heat-Quench Process.

Hyaluronan (HA) is widely used in cosmetic and biomedical applications due to its excellent biocompatibility and potential to promote wound healing. Nanofibrous HA, mimicking the extracellular matrix (ECM), is considered promising for therapeutic and cosmetic applications. However, the electrospinning process of HA often necessitates cytotoxic solvents and chemical modifications, compromising its biocompatibility and advantageous properties. In this study, poly(ethylene oxide) (PEO) was added to an aqueous solution of natural HA to improve its spinnability, enabling HA to be electrospun into fibers. The HA was rendered water-insoluble by treatment with an acidic solution, and the amorphized PEO, achieved by heat-quenching, was removed through water washing. This method distinguishes it from previous reports of fibers blended with PEO or other water-soluble polymers. Consequently, the resulting HA gel fibers demonstrated suitability for mesenchymal stem cell adhesion due to the exposure of HA on the fiber surface. Additionally, HA fibers were successfully applied directly onto the skin using a hand-held electrospinning device, indicating the potential for point-of-care and home use applications.

Effect of a soft exosuit on daily life gait performance in people with incomplete spinal cord injury: study protocol for a randomized controlled trial

BackgroundPeople with incomplete spinal cord injury (iSCI) often have gait impairments that negatively affect daily life gait performance (i.e., ambulation in the home and community setting) and quality of life. They may benefit from light-weight lower extremity exosuits that assist in walking, such as the Myosuit (MyoSwiss AG, Zurich, Switzerland). A previous pilot study showed that participants with various gait disorders increased their gait speed with the Myosuit in a standardized environment. However, the effect of a soft exosuit on daily life gait performance in people with iSCI has not yet been evaluated.ObjectiveThe primary study objective is to test the effect of a soft exosuit (Myosuit) on daily life gait performance in people with iSCI. Second, the effect of Myosuit use on gait capacity and the usability of the Myosuit in the home and community setting will be investigated. Finally, short-term impact on both costs and effects will be evaluated.MethodsThis is a two-armed, open label, randomized controlled trial (RCT). Participants will be randomized (1:1) to the intervention group (receiving the Myosuit program) or control group (initially receiving the conventional program). Thirty-four people with chronic iSCI will be included. The Myosuit program consists of five gait training sessions with the Myosuit at the Sint Maartenskliniek. Thereafter, participants will have access to the Myosuit for home use during 6 weeks. The conventional program consists of four gait training sessions, followed by a 6-week home period. After completing the conventional program, participants in the control group will subsequently receive the Myosuit program. The primary outcome is walking time per day as assessed with an activity monitor at baseline and during the first, third, and sixth week of the home periods. Secondary outcomes are gait capacity (10MWT, 6MWT, and SCI-FAP), usability (D-SUS and D-QUEST questionnaires), and costs and effects (EQ-5D-5L).DiscussionThis is the first RCT to investigate the effect of the Myosuit on daily life gait performance in people with iSCI.Trial registrationClinicaltrials.gov NCT05605912. Registered on November 2, 2022.

Exoskeletal-Assisted Walking in Veterans With Paralysis: A Randomized Clinical Trial.

Robotic exoskeletons leverage technology that assists people with spinal cord injury (SCI) to walk. The efficacy of home and community exoskeletal use has not been studied in a randomized clinical trial (RCT). To examine whether use of a wheelchair plus an exoskeleton compared with use of only a wheelchair led to clinically meaningful net improvements in patient-reported outcomes for mental and physical health. This RCT of veterans with SCI was conducted at 15 Veterans Affairs medical centers in the US from September 6, 2016, to September 27, 2021. Data analysis was performed from March 10, 2022, to June 20, 2024. Participants were randomized (1:1) to standard of care (SOC) wheelchair use or SOC plus at-will use of a US Food and Drug Administration (FDA)-cleared exoskeletal-assisted walking (EAW) device for 4 months in the home and community. Two primary outcomes were studied: 4.0-point or greater improvement in the mental component summary score on the Veterans RAND 36-Item Health Survey (MCS/VR-36) and 10% improvement in the total T score of the Spinal Cord Injury-Quality of Life (SCI-QOL) physical and medical health domain and reported as the proportion who achieved clinically meaningful changes. The primary outcomes were measured at baseline, post randomization after advanced EAW training sessions, and at 2 months and 4 months (primary end point) in the intervention period. Device usage, reasons for not using, and adverse events were collected. A total of 161 veterans with SCI were randomized to the EAW (n = 78) or SOC (n = 83) group; 151 (94%) were male, the median age was 47 (IQR, 35-56) years, and median time since SCI was 7.3 (IQR, 0.5 to 46.5) years. The difference in proportion of successes between the EAW and SOC groups on the MCS/VR-36 (12 of 78 [15.4%] vs 14 of 83 [16.9%]; relative risk, 0.91; 95% CI, 0.45-1.85) and SCI-QOL physical and medical health domain (10 of 78 [12.8%] vs 11 of 83 [13.3%]; relative risk, 0.97; 95% CI, 0.44-2.15) was not statistically different. Device use was lower than expected (mean [SD] distance, 1.53 [0.02] miles per month), primarily due to the FDA-mandated companion being unavailable 43.9% of the time (177 of 403 instances). Two EAW-related foot fractures and 9 unrelated fractures (mostly during wheelchair transfers) were reported. In this RCT of veterans with SCI, the lack of improved outcomes with EAW device use may have been related to the relatively low device usage. Solutions for companion requirements and user-friendly technological adaptations should be considered for improved personal use of these devices. ClinicalTrials.gov Identifier: NCT02658656.

PHASOR ANALYSIS OF DECENTRALIZED GRID-CONNECTED RESIDENTIAL SOLAR FARM: ADDRESSING NIGERIA ELECTRICITY CAPACITY ISSUES

Addressing Nigeria’s energy capacity issues, this paper presents a Phasor-evaluation of a simulation comparing the feasibility of using a Photovoltaic (PV) system with backup power for home use at a large-scale solar farm with a Residential Energy Storage System (RESS) in Nigeria. The Hydro-Québec Research Institute (IREQ) designed a standard power operation system for the simulation, which is essential. The findings, displayed in phasor mode, aim to assess energy storage and solar intensity, potentially revolutionizing the energy landscape for Nigeria’s rural and urban residents.

Multidisciplinary Delphi Panel on Rehabilitation Approaches and Unmet Needs for Chronic Stroke Walking Impairment and the Role of Rhythmic Auditory Stimulation.

Walking or gait impairment is a common consequence of stroke that persists into the chronic phase of recovery for many stroke survivors. The goals of this work were to obtain consensus from a multidisciplinary panel on current practice patterns and treatment options for walking impairment after stroke, to better understand the unmet needs for rehabilitation in the chronic phase of recovery and to explore opportunities to address them, and to discuss the potential role of rhythmic auditory stimulation (RAS) in gait rehabilitation. A panel of eight experts specializing in neurology, physical therapy, and physiatry participated in this three-part, modified Delphi study. Survey 1 focused on gathering information to develop statements that were discussed and polled during Survey 2 (interactive session), after which revised and new statements were polled in Survey 3. Consensus was defined as ≥75% (6/8 of panelists) agreement or disagreement with a statement. Consensus agreement was ultimately reached on all 24 statements created and polled during this process. The panelists agreed that individuals with gait or walking impairment in the chronic phase of stroke recovery can achieve meaningful improvement in walking by utilizing various evidence-based interventions. Barriers to treatment included cost, access, participation in long-term treatment, and safety. Consensus was achieved for interventions that have the following features challenging, personalized, accessible, and engaging. Improvement of gait speed and quality, durability of effect, safety, affordability, and ability for home or community use also emerged as important treatment features. In addition to conventional treatments (e.g., physical therapy, including mobility-task training and walking/exercise therapy), RAS was recognized as a potentially valuable treatment modality. Discussion: This panel highlighted limitations of current treatments and opportunities to improve access, participation, and outcomes through a consideration of newer treatment strategies and patient/healthcare provider education and engagement.

Design and Evaluation of a Novel Venturi-Based Spirometer for Home Respiratory Monitoring.

The high cost and limited availability of home spirometers pose a significant barrier to effective respiratory disease management and monitoring. To address this challenge, this paper introduces a novel Venturi-based spirometer designed for home use, leveraging the Bernoulli principle. The device features a 3D-printed Venturi tube that narrows to create a pressure differential, which is measured by a differential pressure sensor and converted into airflow rate. The airflow is then integrated over time to calculate parameters such as the Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1). The system also includes a bacterial filter for hygienic use and a circuit board for data acquisition and streaming. Evaluation with eight healthy individuals demonstrated excellent test-retest reliability, with intraclass correlation coefficients (ICCs) of 0.955 for FVC and 0.853 for FEV1. Furthermore, when compared to standard Pulmonary Function Test (PFT) equipment, the spirometer exhibited strong correlation, with Pearson correlation coefficients of 0.992 for FVC and 0.968 for FEV1, and high reliability, with ICCs of 0.987 for FVC and 0.907 for FEV1. These findings suggest that the Venturi-based spirometer could significantly enhance access to spirometry at home. However, further large-scale validation and reliability studies are necessary to confirm its efficacy and reliability for widespread use.

Validation of combiomed hipermax-BF model A7101 automatic oscillometric upper-arm sphygmomanometer in general population: AAMI/ESH/ISO universal standard (ISO 81060-2:2018/Amd 1:2020).

This study evaluates the accuracy of the Hipermax-BF model A7101 (Combiomed, Havana, Cuba) automatic oscillometric upper-arm sphygmomanometer for office and home use in general population as part of the HEARTS in the Americas initiative. The research was developed according to the Universal Standard AAMI/ESH/ISO ISO 81060-2:2018/Amd 1:2020. The subjects were recruited according to the requirements of age, gender, blood pressure values and upper-arm circumference. The same upper-arm sequential blood pressure measurement method was used. For measurements with the device under test, the 2-piece cuff from 22-44 cm limb circumference range was used. 92 subjects were recruited and 85 were analyzed. Mean age was 44.8 ± 14.7 years, mean upper-arm circumference was 32.3 ± 6.2, and 56.5% were female. For Validation Criterion 1, the mean value ± standard deviation of the differences in readings between the device under test and the reference device was 1.2 ± 4.9/0.8 ± 4.9 mmHg (systolic/diastolic). For both pressures, in criterion 1 the standard requires a mean value of the differences ≤ ± 5 mmHg and a standard deviation ≤ ± 8 mmHg. For Validation Criterion 2, the standard deviation of the mean blood pressure differences per subject was 4.2/4.2 mmHg (systolic/diastolic). According to Table 1 of criterion 2, for the mean values of 1.2/0.8 mmHg (systolic/diastolic), the maximum allowable standard deviation had to be < 6.84 for systolic and < 6.89 for diastolic pressure. The Combiomed Hipermax-BF A7101 automatic sphygmomanometer meets the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018/Amd 1:2020) in the general population.

Phthalate and DINCH metabolites in the urine of Hungarian schoolchildren: Cumulative risk assessment and exposure determinants

A human biomonitoring study was conducted to assess the exposure of Hungarian children aged 8–11 years to ten phthalate esters (PEs) and DINCH between 2017 and 2018. In addition to collecting urine samples from 262 participants, a questionnaire was completed by the parents or legal guardians to identify potential determinants of exposure.The highest geometric mean concentration was observed for MiBP, followed by MBP, cx- MEHP, OH-MEHP and MEP. Three out of the four DINCH metabolites were detected in more than 90% of the samples. The comparison of the urinary concentrations measured in this study with those observed in the DEMOCOPHES study revealed a significant decreasing trend in all PE metabolites investigated in both studies between 2011/2012 and 2017/2018. Different approaches were used to assess the health risks associated with the exposure to PEs and DINCH. Our results highlighted that the hazard index (HI) values were higher than 1 in 17.6% of the children when the human biomonitoring guidance values were applied. In contrast, less than 3% of the children had HI values exceeding 1 when other sources of reference values were used. By applying a safety factor of 10 for the risk assessment, 17.6–91.6% of the children were characterized by HI values higher than 0.1, indicating the need for risk reduction measures. Overall, DnBP, DiBP and DEHP were identified as the main drivers of the mixture risk. Although PEs and DINCH are ubiquitous contaminants, there are still inconsistencies and gaps in our understanding of the determinants of exposure. The results of the multivariate regression analysis showed significant associations between PE or DINCH metabolite concentrations and certain individual characteristics, use of personal care products, home and school environment and food and beverages consumption 24 h prior to sample collection.

Cleansing efficacy of the electric toothbrush Oral-B® iO™ compared to conventional oscillating-rotating technology: a randomized-controlled study

ObjectivesThis study aimed to compare the cleansing efficacy of the Oral-B® iO™ electric toothbrush incorporating oscillating-rotating technology with microvibrations - with a traditional oscillating-rotating toothbrush.Materials and methodsThirty adult participants were randomly assigned to use the iO™ electric toothbrush with the brush head iO™ Ultimate Clean or the traditional oscillating-rotating toothbrush Oral-B® Genius® with the Cross-Action brush head. Oral hygiene indices (Rustogi Modified Navy Plaque Index and Gingival Bleeding Index) were assessed before and after 28 days of home use of the assigned product. Participants were instructed to refrain from interdental hygiene during the study period. After a 2-week washout period, the clinical investigation was repeated in a crossover design.ResultsAll 30 participants completed the study with no dropouts. After 28 days of use, the iO™ showed statistically significantly lower plaque levels than the conventional oscillating-rotating toothbrush (25.09% vs. 30.60%, p = 0.029). This difference was particularly noticeable in marginal and approximal areas. There were no significant distinctions in gingival bleeding indices.ConclusionsThe Oral-B® iO™ electric toothbrush displayed enhanced plaque removal efficiency compared to a conventional oscillating-rotating technology.Clinical relevanceThis study highlights the potential benefits of advanced toothbrush technologies for plaque reduction and encourages further research.

Exploring the Parental Perspectives and Experiences With the Use of a Home Mechanical Insufflation-Exsufflation Device.

A mechanical insufflation-exsufflation (MI-E) device is a commonly used tool for airway clearance in children with an ineffective cough. Whereas the device has been shown to have multiple benefits, limited evidence exists regarding parents' experiences with its home use in the Canadian context. This study's objective was to explore the perspectives and experiences of parents who receive service through the IWK Health Centre and use an MI-E device at home with their child. The study used an interpretive description design. Semi-structured interviews, conducted with 9 participants, were audio recorded and transcribed verbatim. Transcripts were analyzed using a reflective thematic process. Seven mothers and 2 fathers were interviewed. Following analysis, 3 themes were identified: (1) Learning about the MI-E device described participants' journey from becoming aware of the device to acquiring knowledge and skills about its use; (2) using the device detailed the integral role the MI-E device played in their lives, including decisions around use, and parental role; and (3) changing lives outlined the physical, emotional, and social benefits the device provided to the child and their family. Participants provided detailed descriptions of their journey from learning to integrating the MI-E device into their child's daily routine and family life. Its multiple associated benefits improved the child's and their family's quality of life. However, better education on its use was highlighted as a need for both parents and the health care professionals who work with them.

Passive Wireless Porous Biopolymer Sensors for At-Home Monitoring of Oil and Fatty Acid Nutrition.

Dietary oils─rich in omega-3, -6, and -9 fatty acids─exhibit critical impacts on health parameters such as cardiovascular function, bodily inflammation, and neurological development. There has emerged a need for low-cost, accessible method to assess dietary oil consumption and its health implications. Existing methods typically require specialized, complex equipment and extensive sample preparation steps, rendering them unsuitable for home use. Addressing this gap, herein, we study passive wireless, biocompatible biosensors that can be used to monitor dietary oils directly from foods either prepared or cooked in oil. This design uses broad-coupled split ring resonators interceded with porous silk fibroin biopolymer (requiring only food-safe materials, such as aluminum foil and biopolymer). These porous biopolymer films absorb oils at rates proportional to their viscosity/fatty acid composition and whose response can be measured wirelessly without any microelectronic components touching food. The engineering and mechanism of such sensors are explored, alongside their ability to measure the oil presence and fatty acid content directly from foods. Its simplicity, portability, and inexpensiveness are ideal for emerging needs in precision nutrition─such sensors may empower individuals to make informed dietary decisions based on direct-from-food measurements.

A feasibility study on the use of glycerol as a solution to waste renewable energy storage in the United Kingdom

This study has analysed to feasibility of incorporating a biologically derived liquid organic hydrogen carrier (LOHC) into the energy grid as a method of reducing waste renewable energy.With this goal in mind, a scenario has been devised in using glycerol to transport hydrogen for release at domestic homes for use in PEM fuel cells. Through this, a packed bed reactor can fulfil the average load with a glycerol conversion of 94 %. The peak load can be fulfilled by using 3 of these reactors at each home and reducing the temperature to decrease conversion when the energy is not needed. Through the dehydrogenation, many side products are formed, including methanol and ethanol which can be used to regenerate glycerol in a transesterification reaction. For a target conversion of 98 %, a 7.08 m3 reactor vessel would be required to handle the alcohol output of 100 houses.After these simulations, an economic analysis and life cycle assessment was performed. The economic showed operating costs to be around 76.5 $/h, and the capital cost per home to be $33,000. 60% of this investment is the cost of the catalyst used in the dehydrogenation of glycerol. An alternative catalyst is required to reduce this total cost. The life cycle assessment showed very high effectiveness in reducing carbon missions, however, the other pollutants severely damper its viability.

An Interactive Error-correcting Approach for IoT-sourced Event Logs

Although Internet of Things (IoT) systems are widely used in various industries, they are prone to data collection errors due to device limitations and environmental factors. These errors can significantly degrade the quality of collected data and the event log extracted from raw sensor readings, impact data analysis and lead to inaccurate or distorted results. This article emphasizes the importance of evaluating data quality and errors before proceeding with analysis. The effectiveness of three error correction methods, a rule-based method and a Process Mining (PM)-based method which are adjusted for a smart home use case, and their combination was also investigated in resolving log errors. The study found that understanding different types and sources of errors, and adapting the error correction algorithm based on this knowledge of error sources, can greatly improve the algorithm’s efficiency in addressing various error types.

Virtual reality as a treatment for chronic musculoskeletal pain syndromes

Chronic musculoskeletal pain syndromes, including fibromyalgia, are often resistant to conventional medications and invasive therapies. Central hypersensitization, neurotransmitter dysregulation, and autonomic nervous system abnormalities are key pathomechanisms, frequently resulting in widespread pain and a variety of psychosomatic symptoms. Virtual Reality (VR) applications have demonstrated effectiveness in reducing pain, both during and after interventions, and in chronic conditions such as fibromyalgia and back pain. The proposed mechanisms behind VR's effectiveness include distraction and immersion, coupled with cognitive behavioral therapy, which promote neuroplasticity and alter pain perceptions. Functional MRI studies have shown the impact of VR interventions on specific brain regions. Advances in hardware and software, potentially combined with treatments like biofeedback, could enhance VR's role in managing chronic pain. Currently, VR for musculoskeletal pain syndromes is primarily used within multimodal programs, but it is also available for home use as a standalone health application. Future research should focus on the ‘drug-like’ effects of VR, requiring controlled trials with comparable study populations and appropriate sham interventions.

Comparison between Digital Blood Pressure Monitors for Home Use (Wrist) and (Arm) with a Mercury Sphygmomanometer

Blood pressure disease (BP) is one of the major public health problems around the world. There are many digital BP devices used at home. Doubts are usually raised about these devices. This study aimed to compare home (wrist) and (arm) digital blood pressure monitors with a mercury sphygmomanometer. This study was conducted at the University of Tabuk, comparing a digital BP meter (arm) and (wrist) with a properly calibrated mercury BP. A total of 100 randomly selected students aged 18 to 39 years were enrolled. Two blood pressure measurements for each person were recorded by all devices, and the values were recorded taking into account the environment of a person. The data were entered into MS Excel and analysis was done by using Social Sciences version 23.0. The normality of data was performed by the Shapiro-Wilk test and it was normally distributed. The mean and standard deviation were calculated for quantitative variables, while frequencies and percentages were provided for qualitative variables. Paired sample t-test was used to compare the mean values of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Digital arm devices had sensitivity and specificity of 62.5% and 63%, respectively, compared to digital wrist devices, which had sensitivity and specificity of 75% and 56%, respectively. The readings of the digital blood pressure monitors were comparable to the readings of the mercury blood pressure monitor. Both devices could be considered indispensable tools for detecting hypertension at home and thus useful for early diagnosis.

Navigating artificial intelligence in care homes: Competing stakeholder views of trust and logics of care

The COVID-19 pandemic shed light on systemic issues plaguing care (nursing) homes, from staff shortages to substandard healthcare. Artificial Intelligence (AI) technologies, including robots and chatbots, have been proposed as solutions to such issues. Yet, socio-ethical concerns about the implications of AI for health and care practices have also been growing among researchers and practitioners. At a time of AI promise and concern, it is critical to understand how those who develop and implement these technologies perceive their use and impact in care homes. Combining a sociological approach to trust with Annemarie Mol's logic of care and Jeanette Pol's concept of fitting, we draw on 18 semi-structured interviews with care staff, advocates, and AI developers to explore notions of human-AI care. Our findings show positive perceptions and experiences of AI in care homes, but also ambivalence. While integrative care incorporating humans and technology was salient across interviewees, we also identified experiential, contextual, and knowledge divides between AI developers and care staff. For example, developers lacked experiential knowledge of care homes' daily functioning and constraints, influencing how they designed AI. Care staff demonstrated limited experiential knowledge of AI or more critical views about contexts of use, affecting their trust in these technologies. Different understandings of ‘good care’ were evident, too: ‘warm’ care was sometimes linked to human care and ‘cold’ care to technology. In conclusion, understandings and experiences of AI are marked by different logics of sociotechnical care and related levels of trust in these sensitive settings.

Nasal High-Flow Oxygen Therapy in Chronic Respiratory Failure for Homecare Applications-A Feasibility Study.

Background: While high-flow nasal cannulas (HFNCs) represent the standard of care in the intensive care unit for patients with severe hypoxemia, its use in homecare settings is uncommon despite its potential. The potential benefits and challenges of the high-flow nasal cannula (HFNC) in homecare settings compared to standard long-term oxygen via nasal low-flow therapy are unclear. Methods: We conducted a prospective monocentric feasibility study at the Department of Respiratory Medicine, University Hospital, Goethe University Frankfurt, Germany. Patients with interstitial lung disease or severe bronchiectasis (including cystic fibrosis) were enrolled into the study. The HFNC was introduced during hospitalization. The patients' compliance with home use advice and arterial blood gas results were evaluated at a 4-6-week follow-up. Results: A total of 12 patients were analyzed. HFNC initiation did not result in a significant improvement of the pO2/fiO2 (p/f) ratio. Only 8 out of 12 (66.6%) patients used the HFNC at home after the initial in-hospital initiation. Only 7 of the total 12 patients were using the therapy at a follow-up 3-6 weeks after HFNC onset. Two patients died during the observation, resulting in a surveillance mortality rate of 16.7%. Conclusions: The feasibility data showed low adherence to the HFNC at home. The lack of any positive effect on the p/f ratio may be due to low airflow rates and overall mild hypoxemia compared to patients with severe respiratory failure in the ICU.

Physical therapy options for knee osteoarthritis: A review.

In recent years, osteoarthritis of the knee, a common degenerative joint disease, often occurs in the elderly population. This disease has a significant impact on the quality of life of patients. For treating knee osteoarthritis, physical therapy is highly regarded as a very effective treatment method. This article delves deeply into commonly used physical therapy methods and analyzes their therapeutic effects, cost-effectiveness, and applicability, aiming to find treatments with broader applicability and better cost-effectiveness. The goal is to help a large number of patients effectively alleviate the discomfort caused by knee osteoarthritis, enhance the clinical therapeutic effects, and introduce home treatment methods to reduce financial burdens. The article also compares various physical therapy methods and finds that moxibustion and electrotherapy are more suitable for home use. Other treatment methods provide a reliable scientific basis for patient treatment.

The economic burden of bipolar disorder: a case study in Southern Iran

BackgroundBipolar Disorder (BD) imposes considerable economic and social burdens on the community. Therefore, the present study aimed to determine the economic burden of bipolar disorder in patients referred to single-specialty psychiatric hospitals at the secondary and tertiary care level in 2022.MethodsThis partial economic evaluation was conducted as a cross-sectional study in the south of Iran in 2022, and 916 patients were selected through the census method. The prevalence-based and bottom-up approaches were used to collect cost information and calculate the costs, respectively. The data on Direct Medical Costs (DMC), Direct Non-Medical Costs (DNMC), and Indirect costs (IC) were obtained using the information from the patients’ medical records and bills as well as the self-reports by the patients or their companions. The human capital approach was also used to calculate IC.Findings: The results showed that in 2022, the annual cost of bipolar disorder was $4,227 per patient. The largest share of the costs was that of DMC (77.66%), with hoteling and ordinary beds accounting for the highest expenses (55.40%). The shares of DNMC and IC were 6.37% and 15.97%, respectively, and the economic burden of the disease in the country was estimated at $2,799,787,266 as well.ConclusionIn general, the costs of bipolar disorder treatment could impose a heavy economic burden on the community, the health system, the insurance system, and the patients themselves. Considering the high costs of hoteling and ordinary beds, it is suggested that hospitalization of BD patients be reduced by managing treatment solutions along with prevention methods to reduce the economic burden of this disease. Furthermore, in order to reduce the costs, proper and fair distribution of psychiatrists and psychiatric beds as well as expansion of home care services and use of the Internet and virtual technologies to follow up the treatment of these patients are recommended.

Impact of the ambulatory surgery system on the usability of a home medical device for post-operative follow-up: a mixed-method study in simulation

Usability of home use medical devices is complex, multidimensional and multifactorial. The design of such devices must accommodate a range of users, including patients, caregivers, and hospital staff, as well as the potential impact of human-human interaction through the device. In this study, we analyse the impact of the hospital context on the usability of a medical device used for post-ambulatory monitoring. We enrolled 28 patients and 20 student physicians in an ambulatory surgery system simulation. After the simulation, we conducted both focus groups and interviews to gather both quantitative and qualitative data to measure the usability of the medical device. The results show that exchanges during the consultation with the anaesthetist have a definite impact on the device’s usability by modifying the user’s perceived risk. Even if the device is intuitive to use, its usability is dependent on the context of use and the projection of the users.