PURPOSE: The telemedicine systems for both timely decision of patient transfer and accurate direction of patient treatment through remote consultation are required for better patient care in emergency situation. In this paper, we present noble design methods to implement the emergency telemedicine system suitable for emergency consultation. METHODS: The prototype system designed can encompass multimedia components including radiological images, medical record, biological signals, video conferencing and full-quality video, as well as can transmit changing data in real-time. In the first stage, experimental tests at the local networks analyzed the technical aspects of designed systems, and optimize the parameters subjectively to run them with affordable error. In the Second stage, two medical emergency cases were examined between two hospitals, the first was advanced airway management, and second was the management a patient with cardiac problem. RESULTS: Experimental tests at the local networks, all multimedia components can be represented to both terminals without any problems. Two cases of clinical experiment have performed to demonstrate the clinical usefullness. Orotracheal Intubation was done successfully by local hospital physician who was directed by specialist at distant hospital. The second case, a patient with cardiac problem was good managed by specialist via this telemedicine system without any problems. CONCLUSION: Inter-hospital experiments demonstrate the feasibility to be effectively used at emergency department.
Airway Management ; Emergencies* ; Emergency Service, Hospital ; Humans ; Intubation ; Medical Records ; Multimedia* ; Patient Care ; Patient Transfer ; Remote Consultation ; Specialization ; Telemedicine*

Pelvic sarcomas are rare malignancies that can result in extensive surgeries involving bone and soft tissue resection, which can greatly improve with rehabilitation. However, due to the restrictions brought about by the COVID-19 pandemic, the rehabilitation of patients with pelvic sarcomas was affected. Limited information is also presented in the literature regarding the rehabilitation of patients with lower extremity surgeries undergoing telerehabilitation and during a pandemic. This study presents the rehabilitation process of a 43-year-old woman diagnosed with pelvic round cell sarcoma of the right gluteal area during the COVID-19 pandemic. The patient underwent wide excision, buttockectomy and internal hemipelvectomy, and we measured outcomes using the Tinetti assessment tool (TAT) and Lower Extremity Functional Scale (LEFS). A decreased risk of falls and improved functional performance were recorded using the TAT and LEFS respectively. Telerehabilitation was noted to have a good satisfaction rate among the patient and health workers. Telerehabilitation may be an effective alternative to face-to-face therapy during the COVID-19 pandemic. More studies are needed to look into the conduct of telerehabilitation intervention among patients with bone and soft tissue surgeries.
Telerehabilitation

BACKGROUND: Filipino speech-language pathologists (SLPs) can reach more persons with disabilities across 7,107 Philippine islands through telerehabilitation (also known as teletherapy, telepractice). This study described the feasibility of telerehabilitation for speech-language pathology in community-based rehabilitation in terms of appropriate information and communication technologies (ICT), stakeholder perspectives, and facilitators and barriers. METHODS: A qualitative descriptive design was employed. Participants were purposely selected as telerehabilitation stakeholders. One metropolitan-based SLP conducted remote and synchronous therapy sessions to two persons with voice disorders (52 and 65 years old) in their homes, assisted by one primary caregiver each and one community-based rehabilitation worker (CBRW). ICT observations were logged as field notes. Stakeholder perspectives were obtained through participant journals and interviews, thematically analyzed using NVIVO, and validated by participants. Facilitators and barriers were derived from data triangulation of field notes, journals, and interviews. RESULTS: The best ICT comprised of fastest wireless internet available (7.2 Mbps), MacBook™ laptop, and FaceTime™ videoconferencing application. Stakeholders had varied yet positive perspectives. The SLP focused on ICT requirements and intervention conduct. The families saw telerehabilitation benefits of cost-effectiveness and intervention effectiveness. Both SLP and the families were satisfied as telerehabilitation providers and consumers. CBRW appreciated intervention effectivity. The only barrier to telerehabilitation was low internet bandwidth. Facilitators to telerehabilitation were stronger CBR policies and SLP capacity development. CONCLUSION Telerehabilitation is feasible in speech-language pathology within communitybased rehabilitation in the Philippines, given community-appropriate ICT and positive experiences of stakeholders. It can flourish with faster internet, stronger community health policies, and empowering stakeholders.
Telerehabilitation

BACKGROUND: The emergence of Telerehabilitation in managing hypertension showed positive outcomes as an alternative approach to deliver healthcare services. With the ongoing COVID-19 pandemic which necessitates less physical contact, the study aims to determine the effectiveness of Telerehabilitation versus the usual care in hypertension management among adults in communities, especially in rural settings. METHODS: A comprehensive electronic search was conducted in the following databases: ProQuest, EBSCOhost, AHA Journals, PubMed, Google Scholar, Scopus, HERDIN, Web of Science, JSTOR, and ScienceDirect in March 2022 and was updated in August 2022. Inclusion criteria are randomized controlled trial studies that involve participants aged ≥ 18 years old with hypertension or baseline blood pressure of >140/90 mmHg and the use of technologies and digital services to address hypertension versus non-Telerehabilitation approaches in rural communities or through community- based rehabilitation. Exclusion criteria are non-randomized controlled trials, qualitative studies, unfinished and article type records. The revised Cochrane Collaboration Risk of Bias tool will be used to evaluate the content for risk of bias, quality, and internal validity. An electronic data collection form and Raxter will be utilized to extract and to organize the following: demographics, objectives, design, settings, interventions, outcome measures, and significant findings. Review Manager (RevMan) version 5.4 will be used to perform quantitative synthesis of the pooled data if homogeneity is observed in the outcomes. EXPECTED RESULTS The study will determine the effectiveness of Telerehabilitation in managing hypertension and aiding in its implementation in response to the global trend of urbanization in rural areas.
Telerehabilitation

In this present paper, the current situation and the main features in acupuncture-moxibustion clinic are analyzed. The preliminary conclusion is that acupuncture-moxibustion research should proceed from the actual situation, take the treatment as the carrier, be scientifically designed and study in a deep-going way according to the methods of medical science for the acupuncture-moxibustion treatment with obvious clinical effect and specific action, then can get the scientific data and conclusion to illustrate the clinical problem and increase the therapeutic effect with important instruction significance for clinical practice. Clinical practice of acupuncture and moxibustion is the basis of all acupuncture-moxibustion research.
Acupuncture Therapy ; Humans ; Moxibustion ; Practice Patterns, Physicians'

Purpose: Filipino speech-language pathologists (SLPs) face challenges in applying evidence-based practice (EBP) due to lack of training, exposure, and experience. Without EBP being embedded in the educational curricula and clinical practice guidelines (CPGs), SLPs will continue to face barriers in providing evidencebased services. This study aimed to map the practice patterns of SLPs on voice disorders and benchmark these practices with international evidence-based practice guidelines. Methodology: A cross-sectional descriptive survey design was used. Seventeen out of 61 (28%) Filipino SLPs with clinical experience in voice disorders responded to an online survey form. The form was composed of these sections: (1) Practice Profile, (2) Etiologies of Voice Disorders, (3) Case Study, and (4) Clinical Practice Perspectives. The quantitative and qualitative data sets were analyzed to obtain the practice profiles of SLPs and identify gaps in relation to established evidence-based practice patterns. Results: The study revealed that 70% (n=12) of clinicians fall within five years of practice and work at hospitals. Majority of their clients are adults between 26 to 80 years old. On average, clinicians see one to two clients with voice disorders every week and hold around seven to nine voice therapy sessions prior to discharge. Structural pathologies were the most frequent etiology reported. Content analysis revealed that clinicians rely on the use of clinical experience and patient values for assessment and intervention of voice disorders. Conclusion The findings suggest that Filipino SLPs managing voice disorders predominantly rely on clinical experience and patient values for clinical decision-making. They sparsely use external evidence in assessment, differential diagnosis, and intervention which might compromise the quality of care. To ensure the best patient care, EBP needs to be incorporated in undergraduate education, professional development, and regulatory requirements of the Philippine Association of Speech Pathologists.
Practice Patterns, Physicians' ; ; Voice Disorders

BACKGROUND: To assess the current level of development of emergency medicine (EM) systems in Asia. METHOD: Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. RESULTS: 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. CONCLUSION: Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.
Asia ; Asian Continental Ancestry Group* ; Surveys and Questionnaires ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Financial Management ; Humans ; Internship and Residency ; Intubation ; Patient Care ; Patient Transfer ; Peer Review ; Triage ; Ultrasonography

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.
Chronic Disease ; Humans ; Hypertension ; Information Systems ; Patient Care Management ; Physicians, Primary Care ; Quality Improvement ; Referral and Consultation ; Transitional Care

Chinese medicine practitioners apply the differentiation reasoning for decision-making. The wide scope of Chinese medicine intervention provides coverage of methods and techniques with applications to primary, secondary and tertiary levels of prevention. The rapid evolution of mathematical and computational techniques allowed the implementation of several models for pattern differentiation that were tested for several physiologic systems. Concurrently, it is argued that pattern differentiation might improve the efficacy of either traditional or conventional medical interventions. This article reviewed the influence of pattern differentiation into clinical practice organized by medical field: general pattern differentiation; genitourinary (recurrent cystitis); cardiovascular (coronary heart disease; arterial hypertension; angina pectoris); neurology (stroke); surgery; metabolic (diabetes mellitus); hepatic (cirrhosis); gastrointestinal (chronic superficial gastritis); orthopedic (low back pain; rheumatoid arthritis; cervical spondylosis; elbow arthritis); oncology (gastric mucosal dysplasia; lung cancer); gynecologic and obstetric manifestations (nausea and vomiting). The reviewed studies presented achievements that have contributed to the integration of Chinese medicine and evidence-based medicine in the treatment of many mild and severe diseases. Target diseases considered as major public health problems were also investigated and the results are promising regarding the possibility to treat guided by pattern differentiation.
Disease ; Humans ; Medicine, Chinese Traditional ; methods ; Practice Patterns, Physicians'

Humans ; Ophthalmology ; Practice Patterns, Physicians' ; Retinal Diseases ; therapy ; Singapore