Introduction The low quality of life in heart failure patients is related to low self-care and treatment adherence. Consequently, innovative strategies are needed to improve them. The objective of this work is to determine the effectiveness of the use of a home telemonitoring system to improve the self-care and treatment adherence of heart failure patients. Methods A randomized clinical trial that compares the efficacy of a home telemonitoring system –intervention group versus usual care control group – among heart failure outpatients over a 90-day monitoring period was carried out. The home telemonitoring system consists of an application that collects measurements of different parameters on a daily basis and provides health education to patients. The home telemonitoring system processes data gathered and generates an alert if a risky situation arises. The outcomes observed were significant changes in patients’ self-care (European Heart Failure Self-care Behaviour Scale), treatment adherence (Morisky Modified Scale) and re-hospitalizations over the follow-up period. Results 104 heart failure patients were screened; 40 met the inclusion criteria; only 30 completed the study. After the follow-up, intragroup analysis of the control group indicated a decrease in treatment adherence ( p = 0.02). The mean European Heart Failure Self-care Behaviour Scale overall score indicated an improved self-care in the intervention group patients ( p = 0.03) and a worsened self-care in the control group ( p = 0.04) with a p value of 0.004 in the intergroup analysis. Thanks to the home telemonitoring system alerts, two re-hospitalizations were avoided. Discussion This study demonstrated that the proposed home telemonitoring system improves patient self-care when compared to usual care and has the potential to avoid re-hospitalizations, even considering patients with low literacy levels. Trial Registration: Home Telemonitoring System for Patients with Heart Failure. clinicaltrials.gov Identifier: NCT04071093
Applying haptic control to mobile hydraulic equipment presents a practical yet challenging application. One criticism of newer electro-hydraulic system is a lack of “feel.” To a haptics researcher this sounds like a call for haptic feedback in the human-machine interface. However, for an operator the “feel” of the system likely has more to do with how the actual system responds to forces or higher work port pressures. At some point, the high pressures slow down the system or naturally redirect flow to lower pressure circuits in a hydro-mechanical system. How this is done plays a large part in the “feel” of the system. In this paper, a paradigm is presented that tries to merge these two concepts of “feel.” Instead of trying to make the system transparent, the goal is to make the system react to forces acting on the system then use haptic feedback to help alert the operator to these forces. This is done by shaping this impedance so that the system provides a response or “feel” that is closer to a typical excavator. A haptic interface is used to enhance the haptic feel. Performance is evaluated using data from human-in-the-loop testing.
Pressure sensors are valuable transducers that are necessary in a huge number of medical application. However, the state of the art of compact and lightweight pressure sensors with the capability of measuring the contact pressure between two surfaces (contact pressure sensors) is very poor. In this work, several types of wearable contact pressure sensors are fabricated using different conductive textile materials and piezo-resistive films. The fabricated sensors differ in size, the textile conductor used and/or the number of layers of the sandwiched piezo-resistive film. The intention is to study, through the obtaining of their calibration curves, their metrological properties (repeatability, sensitivity and range) and determine which physical characteristics improve their ability for measuring contact pressures. It has been found that it is possible to obtain wearable contact pressure sensors through the proposed fabrication process with satisfactory repeatability, range and sensitivity; and that some of these properties can be improved by the physical characteristics of the sensors.
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