mHealth

mHealth (also written as m-health or mobile health) is a term used for the practice of medicine and public health, supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones, tablet computers and PDAs, for health services and information, but also to affect emotional states.[1] The mHealth field has emerged as a sub-segment of eHealth, the use of information and communication technology (ICT), such as computers, mobile phones, communications satellite, patient monitors, etc., for health services and information.[2] mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery of healthcare information to practitioners, researchers, and patients, real-time monitoring of patient vital signs, and direct provision of care (via mobile telemedicine).[3]

While mHealth certainly has application for industrialized nations, the field has emerged in recent years as largely an application for developing countries, stemming from the rapid rise of mobile phone penetration in low-income nations. The field, then, largely emerges as a means of providing greater access to larger segments of a population in developing countries, as well as improving the capacity of health systems in such countries to provide quality healthcare.

Within the mHealth space, projects operate with a variety of objectives, including increased access to healthcare and health-related information (particularly for hard-to-reach populations); improved ability to diagnose and track diseases; timelier, more actionable public health information; and expanded access to ongoing medical education and training for health workers.[2]

According to the analyst firm Berg Insight, around 2.8 million patients worldwide were using a home monitoring service based on equipment with integrated connectivity at the end of 2012. The figure does not include patients that use monitoring devices connected to a PC or mobile phone. It only includes systems that rely on monitors with integrated connectivity or systems that use monitoring hubs with integrated cellular or fixed-line modems. Berg Insight forecasts that the number of home monitoring systems with integrated communication capabilities will grow at a compound annual growth rate (CAGR) of 26.9 percent between 2011 and 2017 reaching 9.4 million connections globally by the end of the forecast period. The number of these devices that have integrated cellular connectivity increased from 0.73 million in 2011 to about 1.03 million in 2012, and is projected to grow at a CAGR of 46.3 percent to 7.10 million in 2017.[4]

Massachusetts, where many of the more than 260 victims live, mandates residents have health insurance. But even those with coverage could face major out-of-pocket costs.

Massachusetts, where many of the more than 260victims live, mandates residents have health insurance. But even those with coverage could face major out-of-pocket costs.

http://money.cnn.com/2013/04/30/pf/boston-victims-medical-bills/index.html?hpt=hp_t2

Big news:

CLEVELAND, Ohio — Scientists at Case Western Reserve University School of Medicine have developed a technique in mice models to convert skin cells to the types of brain cells that are found damaged in patients with cerebral palsy and multiple sclerosis.

The next step, said Dr. Paul Tesar, the lead investigator in the study, is to see if the technique can be applied to human cells.

Since skin cells are abundant, the process, called “cellular reprogramming,” has the potential to provide researchers with a plentiful supply of converted cells to work with in the search to find ways to treat people with myelin disorders, said Tesar.

Millions of people worldwide suffer from myelin disorders, which include multiple sclerosis in adults and cerebral palsy and inherited degenerative brain disorders in children.

In myelin disorders, myelinating cells are destroyed and cannot be replaced by the body. These cells are important because they provide an insulation that protects neurons and enables the brain to deliver messages to the rest of the body.

The study by Tesar’s team was published Sunday in the online edition of the journal Nature Biotechnology.

Tesar’s research with animal models is relevant, said Dr. Bruce Trapp, chairman of the department of neurosciences at the Lerner Research Institute.

“This is a significant step forward in trying to generate cells that could be transplanted in the brain to repair and replace damaged myelinating cells,” said Trapp, who was not involved in the study.

Cells have a particular genetic code, with some genes turned on and some turned off, Tesar said. Researchers found a way to manipulate the genetic code to turn skin cells into cells that functioned like brain cells.

“It’s a cellular alchemy, the ability to control and direct a cell to become something else,” said Tesar, assistant professor of genetics and genome sciences at CWRU.

The new technique involves reprogramming three naturally occurring proteins to change firoblasts (abundant structural cells present in the skin) into oligodendrocytes (cells responsible for myelinating, or insulating, the neurons of the brain).

A cure for these diseases would require the myelin coating to be regenerated by the oligodendrocytes, Tesar said. In the study, researchers generated billions of the reprogrammed cells and showed that they could produce new myelin coatings around nerves after being transplanted into mice.

Currently, fetal tissue and some types of stem cells are the only sources of oligodendrocytes, Tesar said.

The hope is that cells from a patient’s skin eventually could be transformed and then transplanted to a region of the brain or spinal cord for possible regeneration of damaged or dead cells, he said.

Dr. Brian Popko, professor of neurological disorders at the University of Chicago, called the work by Tesar’s team “an exciting development.”

“The study is a real tour de force with significant implications for human demyelinating diseases,” Popko said.

Future of organs? Synthetic tissue built with 3-D printer

By Amina Khan

April 4, 2013, 1:24 p.m.

Scientists have built a 3-D printer that creates material resembling human tissues. The novel substance, a deceptively simple network of water droplets coated in lipids, could one day be used to deliver drugs to the body — or perhaps even to replace damaged tissue in living organs.

The creation, described in the journal Science, consists of lipid bilayers separating droplets of water — rather like cell membranes, whose double layers allow the body’s cells to mesh with their watery environments while still protecting their contents.

“The great thing about these droplets is that they use pretty much exclusively biological materials,” said study co-author and University of Oxford researcher Gabriel Villar, making them ideal for medical uses.

Lipid bilayers are formed by two rows of molecules that each have a hydrophobic, water-repelling side and a hydrophilic, water-loving side. They’re crucial to the existence of cells: In cell membranes, the hydrophobic tails of each layer face inward, creating the inner layer of the cell membrane, and the water-loving heads point outward.

Scientists had been creating lipid layers by inserting droplets into lipid-filled oil, causing the lipids to collect around the water droplets’ surface, and then pushing them together. The lipid ends would attract to one another and pull the monolayers together, creating a lipid bilayer.

But doing this by hand was a laborious process. So Villar built a 3-D printer that would use a micropipette to squeeze out droplets in exact orders, speeding up the process. They created networks of up to 35,000 droplets. And in the process, they began to look at the material they were creating differently.

“What we didn’t really expect was that once we could print these droplets out and eject them en masse and assemble them into different geometries, the collection of droplets behaved not just as a loose aggregate of objects but really as a cohesive material, and that kind of changed our thinking throughout the work,” Villar said.

The lipid bilayers surround droplets 50 microns across — about five times bigger than living cells — but they’re biocompatible, and scientists think that if protein channels can be inserted into the layers, they can act as nerve pathways through the system.

Villar also showed that the material could be triggered into contracting like a muscle — folding up into unprintable, flower-like shapes. They were even able to send electrical signals after building a conductive pathway through some of the tissue — like a rudimentary nerve.

Any potential medical uses were far out on the horizon, Villar said — but the faux-tissue could be used to graft onto organs to replace damaged parts, employed as scaffolding on which to grow more cells, or could be inserted into the body to release medication at given times, in certain spots, with specific triggers.

Follow me on Twitter @aminawrite.

LINK: http://www.latimes.com/news/science/sciencenow/la-sci-sn-faux-synthetic-tissue-3d-printer-self-assembling-20130404,0,6286611.story

Hospital uses iPads to connect mothers and newborns with ‘BabyTime’ initiative

Hospital uses iPads to connect mothers and newborns with ‘BabyTime’ initiative
By AppleInsider Staff
Cedars-Sinai hospital announced last week a new program it’s calling “BabyTime,” which uses Apple’s iPad to help mothers stay connected to their newborns, even if they aren’t able to move after giving birth.

BabyTime, a play on Apple’s FaceTime, leverages the video messaging service to create a remote presence link between a new mother’s room and the hospital’s Neonatal Intensive Care Unit, reports TUAW.

Source: Cedars-Sinai

As noted by Cedars-Sinai, the program allows moms who are non-ambulatory to “visit” the NICU, where babies are usually taken after a cesarean section is performed or other complications require strict monitoring.

According to chair of the Cedars-Sinai Department of Pediatrics and Ruth and Harry Roman Chair in Neonatology Charles F. Simmons Jr., MD, some 20 to 30 percent of mothers who undergo C-sections are not capable of traveling to the NICU during the first 24 to 48 hours after giving birth, an important time in mother-child bonding.

The system works by placing one iPad near a baby’s incubator, while another is given to the mother. The portable video and audio platform grants a level of interaction never before possible in such an environment, and lets parents see and hear their newborn even though they are floors away.

Mothers can access BabyTime twice a day, remotely interacting with their baby and nurses over a secured internet connection.

“BabyTime will help bridge communication with the family and the baby’s medical team and is an excellent use of technology to help new mothers bond with their babies, even when they cannot be physically at their babies’ bedside,” Simmons said. “When doctors and nurses are treating a newborn in the NICU, mom can be right there asking questions and getting updates, even if she’s on a different floor.”

The Cedars-Sinai initiative is just one example of how the iPad is slowly integrating with the medical field. It was reported last year that some hospitals were using the Apple tablet as visitor and patient kiosks, while the U.S. Food and Drug Administration cleared the device and an iOS app for mobile diagnoses.

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