The e-Health Implementation Toolkit: qualitative evaluation across four European countries.

Background: Implementation researchers have attempted to overcome the research-practice gap in e-health by developing tools that summarize and synthesize research evidence of factors that impede or facilitate implementation of innovation in healthcare settings. The e-Health Implementation Toolkit (e-HIT) is an example of such a tool that was designed within the context of the United Kingdom National Health Service to promote implementation of e-health services. Its utility in international settings is unknown.

National questionnaire study on clinical ICT systems proofs: physicians suffer from poor usability.

Objective: In the health informatics field, usability studies typically focus on evaluating a single information system and involve a rather small group of end-users. However, little is known about the usability of clinical information and communication technology (ICT) environment in which healthcare professionals work daily. This paper aims at contributing to usability research and user-oriented development of healthcare technologies with three objectives: inform researchers and practitioners about the current state of usability of clinical ICT systems, increase the understanding of usability aspects specific for clinical context, and encourage a more holistic approach on studying usability issues in health informatics field.

What is found positive in healthcare information and communication technology implementation?-the results of a nationwide survey in Finland.

Objective: Considerable expectations have been placed on information and communication technology (ICT) in improving the processes and quality of healthcare. Our purpose was to find out which element is found positive in healthcare ICT implementation.

Materials And Methods: An online questionnaire on e-Health implementation submitted to all Finnish public health service providers and a sample from the private sector included an open question about which the electronic working methods, systems, or applications have most positively influenced the fluency or quality of service processes.

Transnational comparison: A retrospective study on e-health in sparsely populated areas of the northern periphery.

Healthcare delivery in the northern periphery of Europe is challenged by dispersed populations, geographical complexities (including mountainous terrain and inhabited islands), ageing populations, and rising patient expectations. It is challenged further by variations in transport networks and information communication technology infrastructure. This article provides an overview of e-health development across the northern periphery areas of four northern European countries (Finland, Sweden, Norway, and Scotland) by summarizing the outcomes of a mixed methods e-health mapping exercise and subsequently identifying service needs and gaps.

Hereditary isolated metatarsophalangeal arthritis.

Objective: To describe a family with 13 members in four generations affected by early-onset isolated painful arthritis limited to the first metatarsophalangeal (MTP) joint but without evidence of generalized joint disease at follow-up.

Methods: A complete family pedigree was constructed and radiographs from the affected family members and their offspring were taken. Laboratory tests including serum measurements of C-reactive protein (CRP), urate, and rheumatoid factor (RF) were performed to exclude gout and rheumatoid arthritis from the diagnosis.

The Pyhäjärvi Cataract Study II. Criteria for cataract surgery.

Purpose: It is necessary to develop tools for patient selection to target cataract surgery to patients with the best expected outcomes. We used visual acuity, visual functioning 14 (VF-14) test, the 15-dimension health-related quality-of-life questionnaire (15D) and the New Zealand priority criteria to evaluate the criteria for cataract surgery in a post hoc setting.

Material And Methods: Ninety-three consecutive patients living in a defined rural area in Finland had cataract surgery as a part of the Pyhäjärvi Cataract Study in 2003.

The use of videoconferencing for mental health services in Finland.

The utilization of telemental health (TMH) services in Finland was surveyed in 2006. In total, 135 health-care units provided responses. Eighty-four responses were received from primary care units (health-care centres and clinics) and eight from other clinics, in all hospital districts.

Current status of national eHealth and telemedicine development in Finland.

This eHealth paper shows the results of a survey produced by FinnTelemedicum, Centre of Excellence for Telehealth at the University of Oulu and STAKES (National Research and Development Centre for Welfare and Health development in Finland) under assignment of the Finnish Ministry of Social Affairs and Health. The survey shows the status and trends of the usage of eHealth applications in the Finnish health care in 2005. The results are compared to an earlier survey made in 2003.

Comparison of low-complexity fall detection algorithms for body attached accelerometers.

The elderly population is growing rapidly. Fall related injuries are a central problem for this population. Elderly people desire to live at home, and thus, new technologies, such as automated fall detectors, are needed to support their independence and security.

The Pyhäjärvi Cataract Study. I. Study design, baseline characteristics and the demand for cataract surgery.

Purpose: The Pyhäjärvi Cataract Study aims to study demand for cataract surgery in the population of a rural town in Finland.

Methods: A random, population-based sample of 881 persons aged > or = 60 years were interviewed by telephone to obtain a Visual Function-14 (VF-14) score. A total of 294 persons were invited for an ophthalmic examination based on three categories of VF-14 score.

Determination of simple thresholds for accelerometry-based parameters for fall detection.

The increasing population of elderly people is mainly living in a home-dwelling environment and needs applications to support their independency and safety. Falls are one of the major health risks that affect the quality of life among older adults. Body attached accelerometers have been used to detect falls.

Videoconferencing in child and adolescent psychiatry in Finland--an inadequately exploited resource.

To assess the current role of videoconferencing and the purposes for which it has been used in child and adolescent psychiatry in Finland, we sent a 16-item questionnaire to all providers of child and adolescent psychiatry services in specialised health care in Finland, i.e. the 42 child and adolescent units in 21 hospital districts.

Videoconferencing in child and adolescent telepsychiatry: a systematic review of the literature.

A systematic review of child and adolescent telepsychiatry was conducted. It was based on a search of the electronic databases MEDLINE and PsycINFO covering the period 1966 to June 2003. Studies were selected for review if they concerned videoconferencing for patient care or consultation, evaluated a clinical service or education, or assessed satisfaction with videoconferences.

Videoconferencing for orthopaedic outpatients: one-year follow-up.

We studied whether consultations via videoconferencing and traditional outpatient clinic visits differ in terms of the implementation of the patient management plan during a one-year follow-up. First-admission and follow-up orthopaedic patients were randomly allocated to an outpatient visit at the surgical department of Oulu University Hospital or to videoconferencing at a health centre in Pyhäjärvi. In a prospective one-year study, there were 145 consecutive orthopaedic patients who met the inclusion criteria: 84 referred for their first visit to a specialist and 61 of them for follow-up.

A cost-minimization analysis of orthopaedic consultations using videoconferencing in comparison with conventional consulting.

We compared the costs of conventional outpatient visits to the surgical department of the University Hospital of Oulu with those of videoconferencing between the primary care centre in Pyhäjärvi and the University Hospital (separated by 160 km). The cost data were obtained from a randomized controlled trial that included 145 first-admission and follow-up orthopaedic patients. In the telemedicine group the annual fixed costs were 6074 in the hospital and 3910 in the primary care centre.

Prevalence of disability in three birth cohorts at old age over time spans of 10 and 20 years.

The prevalence of disability at the age of 75+ measured by the Katz Index of Activities of Daily Living (ADL) was compared among three birth cohorts: those born < or = 1903 (n = 348), those born < or = 1913 (n = 586), and those born < or = 1923 (n = 758). Significant risk factors for disability were female sex and age; the cohort effect was not significant. The prevalence rates of disability were 29.

The feasibility of telemedicine for orthopaedic outpatient clinics--a randomized controlled trial.

We investigated the use of videoconferencing in the examination of orthopaedic outpatients. A consecutive sample of orthopaedic outpatients was randomized to examination either via videoconferencing (n = 76) while attending a primary-care unit or at a conventional hospital outpatient clinic 160 km away (n = 69). Videoconferencing was found to be feasible and the equipment functioned well technically.

New speech-in-noise test in different types of hearing impairment.

A new test was developed to assess speech recognition in noise. The test was designed to be run in a personal computer supplied with a sound card. One thousand disyllabic test words and noise were stored in digitized form on the hard disk of the computer.

A short DSM-III-R-based diagnostic instrument for screening mental disorders in geriatric institutions.

A screening instrument based on the DSM-III-R was developed in order to differentiate aged persons with or without a DSM-III-R mental disorder. The usefulness of this instrument was investigated in six geriatric institutions with 171 residents aged 65 to 93 years in Finland. The nursing staff independently rated the mental status of residents; researchers (a psychiatrist and general practitioner) made a diagnosis based on DSM-III-R criteria.

A thirteen-year follow-up of respiratory effects of acute exposure to sulfur dioxide.

Objectives: In 1977, nine men were accidentally exposed to sulfur dioxide in an explosion in a pyrite mine. The lung function of seven men was followed after the accident. A four-year follow-up has been published previously.

Quantitative assessment of life span of the aged persons--a preliminary study.

The life span is a concept with increasing interest in gerontology, but how to visualize it? We developed the life span assessment scale, where the participants scored their concepts on their different life periods, using a visual analogue scale. A smoothed curve line was fitted through the means of each period. The final results of this procedure resembled an arch or span, like the original metaphor.