BACKGROUND

Mobile clinics offer crucial healthcare services, including X-ray examinations, to underserved communities. Minimizing image repeats in this setting is vital due to radiation exposure, patient inconvenience, and cost implications.

This study investigated the prevalence and causes of image repeat in conventional radiography performed within mobile clinics in the Philippines.

A retrospective review analyzed data from five mobile clinics located in two highly urbanized cities in the Philippines from July to December 2023). Radiology staff assessed image quality, with suboptimal images requiring retakes. Reasons for rejection were categorized.

Out of 871 radiographs taken, 118 (13.55%) were repeated. Vertebrae and pelvic girdle images had the highest repeat rates (33.33%). Positioning errors were the most common cause (44.07%), followed by underexposure and overexposure.

This study identified a concerning repeat rate (13.55%) for mobile X-rays, primarily due to improper patient positioning, particularly for specific body parts. Targeted training programs and stricter protocols for mobile clinic staff are needed. Radiography education should also emphasize these skills, potentially through collaboration with mobile clinic operators to ensure graduates are prepared for the unique challenges of this environment.

BACKGROUND

Mobile clinics offer crucial healthcare services, including X-ray examinations, to underserved communities. Minimizing image repeats in this setting is vital due to radiation exposure, patient inconvenience, and cost implications.

This study investigated the prevalence and causes of image repeat in conventional radiography performed within mobile clinics in the Philippines.

A retrospective review analyzed data from five mobile clinics located in two highly urbanized cities in the Philippines from July to December 2023). Radiology staff assessed image quality, with suboptimal images requiring retakes. Reasons for rejection were categorized.

Out of 871 radiographs taken, 118 (13.55%) were repeated. Vertebrae and pelvic girdle images had the highest repeat rates (33.33%). Positioning errors were the most common cause (44.07%), followed by underexposure and overexposure.

This study identified a concerning repeat rate (13.55%) for mobile X-rays, primarily due to improper patient positioning, particularly for specific body parts. Targeted training programs and stricter protocols for mobile clinic staff are needed. Radiography education should also emphasize these skills, potentially through collaboration with mobile clinic operators to ensure graduates are prepared for the unique challenges of this environment.

OBJECTIVES: This study developed a diabetes self-management mobile application based on the information-motivation-behavioral skills (IMB) model, evidence extracted from clinical practice guidelines, and requirements identified through focus group interviews (FGIs) with diabetes patients. METHODS: We developed a diabetes self-management (DSM) app in accordance with the following four stages of the system development life cycle. The functional and knowledge requirements of the users were extracted through FGIs with 19 diabetes patients. A system diagram, data models, a database, an algorithm, screens, and menus were designed. An Android app and server with an SSL protocol were developed. The DSM app algorithm and heuristics, as well as the usability of the DSM app were evaluated, and then the DSM app was modified based on heuristics and usability evaluation. RESULTS: A total of 11 requirement themes were identified through the FGIs. Sixteen functions and 49 knowledge rules were extracted. The system diagram consisted of a client part and server part, 78 data models, a database with 10 tables, an algorithm, and a menu structure with 6 main menus, and 40 user screens were developed. The DSM app was Android version 4.4 or higher for Bluetooth connectivity. The proficiency and efficiency scores of the algorithm were 90.96% and 92.39%, respectively. Fifteen issues were revealed through the heuristic evaluation, and the app was modified to address three of these issues. It was also modified to address five comments received by the researchers through the usability evaluation. CONCLUSIONS: The DSM app was developed based on behavioral change theory through IMB models. It was designed to be evidence-based, user-centered, and effective. It remains necessary to fully evaluate the effect of the DSM app on the DSM behavior changes of diabetes patients.
Blood Glucose Self-Monitoring ; Diabetes Mellitus ; Focus Groups ; Heuristics ; Humans ; Life Cycle Stages ; Methyltestosterone ; Mobile Applications* ; Mobile Health Units ; Self Care* ; Telemedicine

Through the Declaration of Montevideo in 2011, the World Medical Association suggested that doctors worldwide should be trained in basic disaster response regardless of their specialty. The Haiti earthquake in 2010, which had the highest number of foreign medical team dispatched from all over the world, proved that untrained and disorganized team only brought confusion. This event led the World Health Organization to develop the ‘Classification and Minimum Standards for Foreign Medical Teams in Sudden Onset Disasters ’ in 2013. This guideline will become the standard for organizing an international emergency medical team. We should be able to provide high standard of care through field hospital set up and continuous training of disaster medicine specialists.
Disaster Medicine* ; Disasters* ; Earthquakes ; Emergencies* ; Haiti ; Mobile Health Units ; Specialization ; Standard of Care ; World Health Organization

Voiding dysfunction is a common disease that contributes to a lower quality of life and has an increased prevalence in the elderly population. Noninvasive and objective methods such as uroflowmetry (UFM) and voiding diaries (VDs) are essential for exact diagnosis and effective treatment of this condition because patients with different causes of voiding dysfunction can complain of the same lower urinary tract symptoms. Further, different treatment options can be determined based on the diagnosis made from these symptoms. In order to improve the quality of UFM and VDs and to provide a convenient testing environment, several advances have been made by previous investigators. In this study, we investigate the history and technological mechanisms of UFM and VDs. We also aim to review UFM from the viewpoint of clinical and at-home uses, including the recently proposed toilet-shaped UFM and electronic VDs.
Aged ; Diagnosis ; Humans ; Lower Urinary Tract Symptoms ; Mobile Health Units ; Monitoring, Ambulatory ; Prevalence ; Quality of Life ; Research Personnel

Since 2015, the Support Project for Obstetrically Underserved Areas has been operating a total of 31 obstetric clinics, including 12 delivery clinics, 14 outpatient clinics, and 31 mobile clinics. However, the effectiveness of the project is being questioned due to the low birth rate in some of the hospitals that received delivery clinics through the project. Despite the support project, the number of obstetrically underserved areas is increasing as clinics ceasing their business or at least give up maternal care. This has led to the need for a discussion regarding the limits of obstetrics clinics in underserved areas that are operated by the support project itself and the direction of future improvements. The increasing number of obstetrically underserved areas that lack delivery clinics within a one-hour drive range can have grave consequences, which are not limited to maternal medical systems alone, but also towards the general deterioration of the community. Thus, it has been determined that existing problems should be addressed and the project should continue operating with the Support Project for Obstetrically Underserved Areas Act as the foundation and minimal measures for strengthening the social security system, which is essential. Additionally, aggressive policymaking by the government is thought to be needed for the sake of expanding the extremely weakened obstetric infrastructure.
Ambulatory Care Facilities ; Birth Rate ; Commerce ; Mobile Health Units ; Obstetrics ; Social Security

OBJECTIVETo investigate the Western Area Surge (WAS) program in the Ebola outbreak of Sierra Leone, and to analyze its implementing effect.

METHODSThe subject of this study was 3,813 laboratory confirmed Ebola hemorrhagic fever (EHF) cases reported in Sierra Leone from November 19, 2014 through January 27, 2015, a period before and after the implementation of the WAS program. To analyze and make conclusions according to the working experience of China Mobile Laboratory Reponses Team in the fight of Ebola outbreak, using WHO published EHF case definition to make diagnosis and compare the number of bed numbers, confirmed EHF cases, samples tested, and positive rates before and after implementation of WAS program.

RESULTSFrom the implementation of WAS program on 17th December 2014 to half a month later, the total numbers of Ebola holding and treatment centers increased from 640 to 960, six additional laboratories were established. On January, 2015, another two laboratories from America and The Netherlands were established. The numbers of samples tested one month before and after WAS program were 7,891 and 9,783, respectively, with an increase of 24.0 percent, while the positive rate of Ebola virus decreased from 22.2% (1,752/7,891) to 11.0% (1,077/9,783). The positive rate of blood samples decreased from 39.6% (248/626) in the month before WAS program to 27.4% (131/478) (χ2=17.93, P<0.001) in the mother after WAS program, the positive rate of blood samples 22.7% (103/454) to 10% (62/609) (χ2=31.03, P<0.001), accordingly. After 3 weeks of WAS program, in addition to Western Area, another four hotspots in Sierra Leone had also reported a significant decrease of the numbers of confirmed EVD cases. Forty-two days after implementation of WAS program, the daily number of laboratory confirmed EHF cases decreased from 63 to 10.

CONCLUSIONWAS program played a vital role in controlling the EHF outbreak rapidly in Sierra Leone. It could also provide guidance for the control similar large infectious diseases outbreak in the future.

OBJECTIVES: The factors affecting the acceptance of mobile obesity-management applications (apps) by the public were analyzed using a mobile healthcare system (MHS) technology acceptance model (TAM). METHODS: The subjects who participated in this study were Android smartphone users who had an intent to manage their weight. They used the obesity-management app for two weeks, and then completed an 18-item survey designed to determine the factors influencing the acceptance of the app. Three questions were asked pertaining to each of the following six factors: compatibility, self-efficacy, technical support and training, perceived usefulness, perceived ease of use, and behavior regarding intention to use. Cronbach's alpha was used to assess the reliability of the scales. Pathway analysis was also performed to evaluate the MHS acceptance model. RESULTS: A total of 94 subjects participated in this study. The results indicate that compatibility, perceived usefulness, and perceived ease of use significantly affected the behavioral intention to use the mobile obesity-management app. Technical support and training also significantly affected the perceived ease of use; however, the hypotheses that self-efficacy affects perceived usefulness and perceived ease of use were not supported in this study. CONCLUSIONS: This is the first attempt to analyze the factors influencing mobile obesity-management app acceptance using a TAM. Further studies should cover not only obesity but also other chronic diseases and should analyze the factors affecting the acceptance of apps among healthcare consumers in general.
Chronic Disease ; Delivery of Health Care ; Factor Analysis, Statistical ; Intention ; Mobile Health Units ; Obesity* ; Telemedicine ; Weight Loss ; Weights and Measures

OBJECTIVES: The purpose of the study was to develop and evaluate a clinical-guideline-based smartphone application ('app') for obesity management. METHODS: Obesity-related knowledge and functional requirements were extracted from clinical practice guidelines, a literature review, and consultations with experts. The extracted knowledge was used to design obesity-management algorithms, and the functions of the developed app are presented through a use case diagram and activity diagrams. The database and user interface were designed and then an app was developed. The proficiency and efficiency of the algorithm were evaluated using scenarios, while the user interface was assessed using a mobile heuristics evaluation tool, with its usability determined using the Post-Study System Usability Questionnaire. RESULTS: In total, 131 obesity-related knowledge statements and 11 functions for the app were extracted, and 5 algorithms (comprising 1 main algorithm and 4 subalgorithms) were developed. The database comprised 11 tables and 41 screens. The app was developed using the Android SDK platform 4.0.3, JDK 1.7.0, and Eclipse. The overall proficiency and efficiency scores of the algorithm were 88.0 and 69.1, respectively. In heuristics tests, 57 comments were made, and the mean usability score was 3.47 out of 5. Thirteen usability problems were identified by the heuristics and usability evaluations. CONCLUSIONS: The app developed in this study might be helpful for weight management because it can provide high-quality health information and intervention without spatial or temporal constraints. However, the clinical effectiveness of this app still requires further investigation.
Mobile Health Units ; Obesity* ; Referral and Consultation ; Telemedicine ; Weight Loss ; Surveys and Questionnaires

A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital.
Electronic Health Records ; Information Management ; methods ; Mobile Health Units ; Operating Rooms