http://www.hindawi.comThe latest articles from Hindawi Publishing Corporation© 2012, Hindawi Publishing Corporation. All rights reserved.http://www.hindawi.com/journals/ijta/2012/271758/Multiprotocol medical imaging communication through the Internet is more flexible than the tight DICOM transfers. This paper introduces a modular multiprotocol teleradiology architecture that integrates DICOM and common Internet services (based on web, FTP, and E-mail) into a unique operational domain. The extended WADO service (a web extension of DICOM) and the other proposed services allow access to all levels of the DICOM information hierarchy as opposed to solely Object level. A lightweight client site is considered adequate, because the server site of the architecture provides clients with service interfaces through the web as well as invulnerable space for temporary storage, called as User Domains, so that users fulfill their applications' tasks. The proposed teleradiology architecture is pilot implemented using mainly Java-based technologies and is evaluated by engineers in collaboration with doctors. The new architecture ensures flexibility in access, user mobility, and enhanced data security.George V. Koutelakis, George K. Anastassopoulos, and Dimitrios K. LymberopoulosCopyright © 2012 George V. Koutelakis et al. All rights reserved.http://www.hindawi.com/journals/ijta/2012/696324/Objective. Current generation smartphones' video camera technologies enable photoplethysmographic (PPG) acquisition and heart rate (HR) measurement. The study objective was to develop an Android application and compare HRs derived from a Motorola Droid to electrocardiograph (ECG) and Nonin 9560BT pulse oximeter readings during various movement-free tasks. Materials and Methods. HRs were collected simultaneously from 14 subjects, ages 20 to 58, healthy or with clinical conditions, using the 3 devices during 5-minute periods while at rest, reading aloud under observation, and playing a video game. Correlation between the 3 devices was determined, and Bland-Altman plots for all possible pairs of devices across all conditions assessed agreement. Results. Across conditions, all device pairs showed high correlations. Bland-Altman plots further revealed the Droid as a valid measure for HR acquisition. Across all conditions, the Droid compared to ECG, 95% of the data points (differences between devices) fell within the limits of agreement. Conclusion. The Android application provides valid HRs at varying levels of movement free mental/perceptual motor exertion. Lack of electrode patches or wireless sensor telemetric straps make it advantageous for use in mobile-cell-phone-delivered health promotion and wellness programs. Further validation is needed to determine its applicability while engaging in physical movement-related activities.Mathew J. Gregoski, Martina Mueller, Alexey Vertegel, Aleksey Shaporev, Brenda B. Jackson, Ronja M. Frenzel, Sara M. Sprehn, and Frank A. TreiberCopyright © 2012 Mathew J. Gregoski et al. All rights reserved.http://www.hindawi.com/journals/ijta/2011/523161/Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.Ken Russell CoelhoCopyright © 2011 Ken Russell Coelho. All rights reserved.http://www.hindawi.com/journals/ijta/2011/540138/Background. Hospitalization accounts for 70% of heart failure (HF) costs; readmission rates at 30 days are 24% and rise to 50% by 90 days. Agencies anticipate that telehomecare will provide the close monitoring necessary to prevent HF readmissions. Methods and Results. Randomized controlled trial to compare a telehomecare intervention for patients 55 and older following hospital discharge for HF to usual skilled home care. Primary endpoints were 30- and 60-day all-cause and HF readmission, hospital days, and time to readmission or death. Secondary outcomes were access to care, emergency department (ED) use, and satisfaction with care. All-cause readmissions at 30 days (16% versus 19%) and over six months (46% versus 52%) were lower in the telehomecare group but were not statistically significant. Access to care and satisfaction were significantly higher for the telehomecare patients, including the number of in-person visits and days in home care. Conclusions. Patient acceptance of the technology and current home care policies and processes of care were barriers to gaining clinical effectiveness and efficiency.Kathryn H. Bowles, Alexandra L. Hanlon, Henry A. Glick, Mary D. Naylor, Melissa O'Connor, Barbara Riegel, Nai-Wei Shih, and Mark G. WeinerCopyright © 2011 Kathryn H. Bowles et al. All rights reserved.http://www.hindawi.com/journals/ijta/2011/721654/Diabetes is classified as the world's fastest-growing chronic illness that affects millions of people. It is a very serious disease, but the bright side is that it is treatable and can be managed. Proper education in this view is necessary to achieve essential control and prevent the aggregation of this chronic sickness. We have developed a healthcare social network that provides methods for distance learning; opportunities for creation of virtual self-help groups where patients can get information and establish interactions among each other in order to exchange important healthcare-related information; discussion forums; patient-to-healthcare specialist communication. The mission of our virtual community is to increase the independence of people with diabetes, self-management, empower them to take care of themselves, make their everyday activities easier, enrich their medical knowledge, and improve their health condition, make them more productive, and improve their communication with other patients with similar diagnoses. The ultimate goal is to enhance the quality of their life.Ivan Chorbev, Marija Sotirovska, and Dragan MihajlovCopyright © 2011 Ivan Chorbev et al. All rights reserved.http://www.hindawi.com/journals/ijta/2011/804254/The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference) with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children) with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six cases were managed during a five-year period (2006 to 2010). The most common reasons for using Family-Link were related to the logistical challenges of traveling to and from the hospital—principally due to distance, time, family commitments, and/or personal cost. We conclude that videoconferencing provides a solution to some barriers that may limit family presence and participation in care for hospitalized patients, and as a patient-centered innovation is likely to enhance patient and family satisfaction.Kourosh Parsapour, Alexander A. Kon, Madan Dharmar, Amy K. McCarthy, Hsuan-Hui Yang, Anthony C. Smith, Janice Carpenter, Candace K. Sadorra, Aron D. Farbstein, Nayla M. Hojman, Gary L. Wold, and James P. MarcinCopyright © 2011 Kourosh Parsapour et al. All rights reserved.http://www.hindawi.com/journals/ijta/2011/353405/With its huge population and vast territory, China faces a great challenge in providing modern advanced health care services to all parts of the country. The advances of information communication technologies (ICTs) and the advent of internet have revolutionised the means in the delivery of healthcare via telemedicine to remote and underserved populations, which to a certain extent has been very well exploited in China, especially where 70% peasants residing in the rural areas. This paper reviews the latest development in telemedicine infrastructure in China with the focus on the development of teleneurosurgery, drawing from the results gained from a 3-year networking project between Europe and China on telemedicine (TIME, 2005–2007) funded by European Commission under Asia ICT programme, with an aim to shape up envisages of future medical care in China. Comparison with its counterparts in Europe is also addressed.Xiaohong GaoCopyright © 2011 Xiaohong Gao. All rights reserved.http://www.hindawi.com/journals/ijta/2011/549282/The need for high-quality out-of-hospital healthcare is a known socioeconomic problem. Exploiting ICT's evolution, ad-hoc telemedicine solutions have been proposed in the past. Integrating such ad-hoc solutions in order to cost-effectively support the entire healthcare cycle is still a research challenge. In order to handle the heterogeneity of relevant information and to overcome the fragmentation of out-of-hospital instrumentation in person-centric healthcare systems, a shared and open source interoperability component can be adopted, which is ontology driven and based on the semantic web data model. The feasibility and the advantages of the proposed approach are demonstrated by presenting the use case of real-time monitoring of patients' health and their environmental context.Fabio Vergari, Tullio Salmon Cinotti, Alfredo D'Elia, Luca Roffia, Guido Zamagni, and Claudio LambertiCopyright © 2011 Fabio Vergari et al. All rights reserved.http://www.hindawi.com/journals/ijta/2011/342582/With significant declines in cardiovascular disease (CVD) mortality, attention has shifted to patient management. Programs designed to manage CVD require the involvement of health professionals for comanagement and patients' self-management. However, these programs are commonly limited to large urban centers, resulting in limited access for rural patients. The use of telehealth potentially overcomes geographical barriers and can improve access to care for patients. The current research explores how an Internet-based platform might facilitate collaboration among healthcare providers comanaging patients and enhance behavioural change in patients. Forty-eight participants were interviewed including: (a) patients (n=12), (b) physicians (n=11), (c) nurses (n=13), and (d) allied health professionals (n=10). The results were organized and analyzed in three central themes: (1) role of technology for CVD management, (2) challenges to technology adoption, and (3) incentives for technology adoption. Health care providers and patients supported future implementation of Internet-based technology support for CVD management.Sandra Jarvis-Selinger, Joanna Bates, Yuriko Araki, and Scott A. LearCopyright © 2011 Sandra Jarvis-Selinger et al. All rights reserved.http://www.hindawi.com/journals/ijta/2011/631848/Recent technical development focused on real-time heart rate monitoring instead of postexercise evaluation of recorded data. There are several systems on the market that allow direct and real-time monitoring of several individuals at the same time. The present study compared the systems of Polar, Acentas, Activio, and Suunto in a field test with twelve subjects regarding failure quota, operating distance, and ECG validity. Moreover, the installation and use of software and hardware were evaluated with a quality rating system. Chest belts were evaluated with a questionnaire, too. Overall the system of Acentas reached the best mark of all systems, but detailed results showed that every system has its advantages and disadvantages depending on using purpose, location, and weather. So this evaluation cannot recommend a single system but rather shows strength and weakness of all systems and additionally can be used for further system improvements.Martin Schönfelder, Georg Hinterseher, Philipp Peter, and Peter SpitzenpfeilCopyright © 2011 Martin Schönfelder et al. All rights reserved.http://www.hindawi.com/journals/ijta/2011/860549/A telemedicine system using communication and information technology to deliver medical signals such as ECG, EEG for long distance medical services has become reality. In either the urgent treatment or ordinary healthcare, it is necessary to compress these signals for the efficient use of bandwidth. This paper discusses a quality on demand compression of EEG signals using neural network predictors for telemedicine applications. The objective is to obtain a greater compression gains at a low bit rate while preserving the clinical information content. A two-stage compression scheme with a predictor and an entropy encoder is used. The residue signals obtained after prediction is first thresholded using various levels of thresholds and are further quantized and then encoded using an arithmetic encoder. Three neural network models, single-layer and multi-layer perceptrons and Elman network are used and the results are compared with linear predictors such as FIR filters and AR modeling. The fidelity of the reconstructed EEG signal is assessed quantitatively using parameters such as PRD, SNR, cross correlation and power spectral density. It is found from the results that the quality of the reconstructed signal is preserved at a low PRD thereby yielding better compression results compared to results obtained using lossless scheme.N. SriraamCopyright © 2011 N. Sriraam. All rights reserved.http://www.hindawi.com/journals/ijta/2011/505426/Following the implementation of electronic nursing records in a psychogeriatric ward, we examined nursing staff's attitudes and perceptions to the implementation of an electronic handover routine. A web-based anonymous and secure questionnaire was distributed by e-mail to all nursing staff at a psychogeriatric ward at a university hospital. Most respondents were satisfied with the electronic handover, and they believed they managed to keep informed by the new routine. The simultaneous introduction of a morning meeting, to ensure a forum for oral professional discussion, was a success. A minority of staff did not fully trust the information conveyed in the electronic handover, and a significant proportion expressed a need for guidance in using the system. Staff that had a high level of trust in written reports believed these saved time, had little trouble finding time and a place to read the reports, and were more positive to the new handover routine.Torbjørg Meum, Gro Wangensteen, Karen S. Soleng, and Rolf WynnCopyright © 2011 Torbjørg Meum et al. All rights reserved.http://www.hindawi.com/journals/ijta/2011/671040/An assessment of a sensor designed for monitoring energy expenditure, activity, and sleep was conducted in the context of a research project which develops a weight management application. The overall goal of this project is to affect sustainable behavioural change with respect to diet and exercise in order to improve health and wellbeing. This paper reports results of a pretrial in which three volunteers wore the sensor for a total of 11 days. The aim was to gain experience with the sensor and determine if it would be suitable for incorporation into the ICT system developed by the project to be trialled later on a larger population. In this paper we focus mainly on activity monitoring and user experience. Data and results including visualizations and reports are presented and discussed. User experience proved positive in most respects. Exercise levels and sleep patterns correspond to user logs relating to exercise sessions and sleep patterns. Issues raised relate to accuracy, one source of possible interference, the desirability of enhancing the system with real-time data transmission, and analysis to enable real-time feedback. It is argued that automatic activity classification is needed to properly analyse and interpret physical activity data captured by accelerometry.Val Jones, Richard Bults, Rene de Wijk, Ing Widya, Ricardo Batista, and Hermie HermensCopyright © 2011 Val Jones et al. All rights reserved.http://www.hindawi.com/journals/ijta/2011/230670/Purpose. The estimated new cancer patient load in the Indian state of Uttar Pradesh is 0.1–0.12 million per year. Approximately two thirds of these require treatment by a radiation oncologist. Radiation oncologists: cancer patient ratio in this state is 1 : 2000 as compared to the recommended 1 : 250. This problem is compounded by the poor infrastructure of radiation oncology departments in the state which is suboptimal for teaching, training of resident doctors, and treatment in most barring a few departments. To bridge some gap in the sociodemographics stated above and enhancement of training of residents, we submitted a project for establishment of a telemedicine facility in our department to the Department of Science and Technology, Government of India. We present the design, implementation, and a two-year audit of our tele-education activities. Materials and Methods. After the sanction of the project, we established telemedicine linkage with another medical institute in the city located 25 kms away in 2007. After implementation of the project, academic sessions designed for trainee residents in our department were shared with the remote end. A record of these activities and a feedback of the activities were audited at the end of 2 years of implementation of this project. Results. Regular videoconferencing sessions comprising of lectures on clinical oncology, medical physics, and radiobiology were held. Feedback from the users revealed satisfaction with the content of the academic sessions for the purpose of MD training. Conclusions. Distance education in radiation oncology is an important tool for training of the trainee residents.Sushma Agrawal, Anil Kumar Maurya, Kirti Shrivastava, Shaleen Kumar, M. C. Pant, and Saroj Kant MishraCopyright © 2011 Sushma Agrawal et al. All rights reserved.http://www.hindawi.com/journals/ijta/2010/563903/Wireless telemetry is crucial for long-term implantable neural recording systems. RF-encoded neurological signals often require high data-rates to transmit information from multiple electrodes with a sufficient sampling frequency and resolution. In this work, we quantify the effects of interferers and tissue attenuation on a wireless link for optimal design of future systems. The wireless link consists of an external receiver capable of demodulating FSK/OOK transmission at speeds up to 8 Mbps, with <1e-5 bit-error rate (BER) without error correction, and a fully implanted transmitter consuming about 1.05 mW. The external receiver is tested with the transmitter in vivo to show demodulation efficacy of the transcutaneous link at high data-rates. Transmitter/Receiver link BER is quantified in typical and controlled RF environments for ex vivo and in vivo performance.A. R. Kahn, E. Y. Chow, O. Abdel-Latief, and P. P. IrazoquiCopyright © 2010 A. R. Kahn et al. All rights reserved.http://www.hindawi.com/journals/ijta/2010/870959/Remote monitoring (RM) of homebound heart failure (HF) patients has previously been shown to reduce hospital admissions. We conducted a pilot trial of ambulatory, non-homebound patients recently hospitalized for HF to determine whether RM could be successfully implemented in the ambulatory setting. Eligible patients from Massachusetts General Hospital (n=150) were randomized to a control group (n=68) or to a group that was offered RM (n=82). The participants transmitted vital signs data to a nurse who coordinated care with the physician over the course of the 6-month study. Participants in the RM program had a lower all-cause per person readmission rate (mean=0.64, SD±0.87) compared to the usual care group (mean=0.73, SD±1.51; P-value=.75) although the difference was not statistically significant. HF-related readmission rate was similarly reduced in participants. This pilot study demonstrates that RM can be successfully implemented in non-homebound HF patients and may reduce readmission rates.Ambar Kulshreshtha, Joseph C. Kvedar, Abhinav Goyal, Elkan F. Halpern, and Alice J. WatsonCopyright © 2010 Ambar Kulshreshtha et al. All rights reserved.http://www.hindawi.com/journals/ijta/2010/536237/A typical telemedicine system involves a small set of hospitals providing remote healthcare services to a small section of the society using dedicated nodal centers. However, in developing nations like India where majority live in rural areas that lack specialist care, we envision the need for much larger Internet-based telemedicine systems that would enable a large pool of doctors and hospitals to collectively provide healthcare services to entire populations. We propose a scalable, Internet-based P2P architecture for telemedicine integrating multiple hospitals, mobile medical specialists, and rural mobile units. This system, based on the store and forward model, features a distributed context-aware scheduler for providing timely and location-aware telemedicine services. Other features like zone-based overlay structure and persistent object space abstraction make the system efficient and easy to use. Lastly, the system uses the existing internet infrastructure and supports mobility at doctor and patient ends.Sriram Kailasam, Santosh Kumar, and Janakiram DharanipragadaCopyright © 2010 Sriram Kailasam et al. All rights reserved.http://www.hindawi.com/journals/ijta/2010/920704/Battery-operated medical implants—such as pacemakers or cardioverter-defibrillators—have already been widely used in practical telemedicine and telecare applications. However, no solution has yet been found to mitigate the effect of the fading that the in-body to off-body communication channel is subject to. In this paper, we reveal and assess the potential of cooperative diversity to combat fading—hence to improve system performance—in medical implant communication systems. In the particular cooperative communication scenario we consider, multiple cooperating receiver units are installed across the room accommodating the patient with a medical implant inside his/her body. Our investigations have shown that the application of cooperative diversity is a promising approach to enhance the performance of medical implant communication systems in various aspects such as implant lifetime and communication link reliability.Barnabás Hegyi and János LevendovszkyCopyright © 2010 Barnabás Hegyi and János Levendovszky . All rights reserved.http://www.hindawi.com/journals/ijta/2009/740712/The ability to obtain information about the structure of tissue without taking a sample for pathology has opened the way for new diagnostic techniques. The present paper reviews all currently available techniques capable of producing an optical biopsy, with or without morphological images. Most of these techniques are carried out by physicians who are not specialized in pathology and therefore not trained to interpret the results as a pathologist would. In these cases, the use of telepathology or distant consultation techniques is essential.Olga Ferrer-RocaCopyright © 2009 Olga Ferrer-Roca. All rights reserved.http://www.hindawi.com/journals/ijta/2009/859232/A mobile monitoring system utilizing Bluetooth and mobile messaging services (MMS/SMSs) with low-cost hardware equipment is proposed. A proof of concept prototype has been developed and implemented to enable transmission of an Electrocardiogram (ECG) signal and body temperature of a patient, which can be expanded to include other vital signs. Communication between a mobile smart-phone and the ECG and temperature acquisition apparatus is implemented using the popular personal area network standard specification Bluetooth. When utilizing MMS for transmission, the mobile phone plots the received ECG signal and displays the temperature using special application software running on the client mobile phone itself, where the plot can be captured and saved as an image before transmission. Alternatively, SMS can be selected as a transmission means, where in this scenario, dedicated application software is required at the receiving device. The experimental setup can be operated for monitoring from anywhere in the globe covered by a cellular network that offers data services.Ashraf A. TahatCopyright © 2009 Ashraf A. Tahat. All rights reserved.http://www.hindawi.com/journals/ijta/2009/435849/Remote surgery information requires quick and reliable transmission between the surgeon and the patient site. However, the networks that interconnect the surgeon and patient sites are usually time varying and lossy which can cause packet loss and delay jitter. In this paper we propose SURGNET, a telesurgery system for which we developed the architecture, algorithms and implemented it on a testbed. The algorithms include adaptive packet prediction and buffer time adjustment techniques which reduce the negative effects caused by the lossy and time varying networks. To evaluate the proposed SURGNET system, at the therapist site, we implemented a therapist panel which controls the force feedback device movements and provides image analysis functionality. At the patient site we controlled a virtual reality applet built in Matlab. The varying network conditions were emulated using NISTNet emulator. Our results show that even for severe packet loss and variable delay jitter, the proposed integrated synchronization techniques significantly improve SURGNET performance.Sriram Natarajan and Aura GanzCopyright © 2009 Sriram Natarajan and Aura Ganz. All rights reserved.http://www.hindawi.com/journals/ijta/2009/406753/In real-time remote diagnosis of emergency medical events, mobility can be enabled by wireless video communications. However, clinical use of this potential advance will depend on definitive and compelling demonstrations of the reliability of diagnostic quality video. Because the medical domain has its own fidelity criteria, it is important to incorporate diagnostic video quality criteria into any video compression system design. To this end, we used flexible algorithms for region-of-interest (ROI) video compression and obtained feedback from medical experts to develop criteria for diagnostically lossless (DL) quality. The design of the system occurred in three steps-measurement of bit rate at which DL quality is achieved through evaluation of videos by medical experts, incorporation of that information into a flexible video encoder through the notion of encoder states, and an encoder state update option based on a built-in quality criterion. Medical experts then evaluated our system for the diagnostic quality of the video, allowing us to verify that it is possible to realize DL quality in the ROI at practical communication data transfer rates, enabling mobile medical assessment over bit-rate limited wireless channels. This work lays the scientific foundation for additional validation through prototyped technology, field testing, and clinical trials.Sira P. Rao, Nikil S. Jayant, Max E. Stachura, Elena Astapova, and Anthony Pearson-ShaverCopyright © 2009 Sira P. Rao et al. All rights reserved.http://www.hindawi.com/journals/ijta/2009/627625/Temporal matching is applied in the frame of the formation of high-level entities in remote-controlled robotic surgery. The objective is to track tumor boundaries over time to improve the segmentation stage in each image of the sequence to facilitate the tracking and localization of the tumor. It makes use of an attributed string matching technique to find the correspondence between tumor boundaries over time. Relationships are then exploited to reconstitute the tumor boundaries and remove the inconsistencies coming from the detection errors. Input data are free form shapes of different length representing the tumor boundary, extracted at a previous stage.Jia Gu, Rolf Wolters, and Ulf GustafssonCopyright © 2009 Jia Gu et al. All rights reserved.http://www.hindawi.com/journals/ijta/2008/210471/This paper presents a method to reconstruct and to calculate geometric invariants on brain tumors. The geometric invariants considered in the paper are the volume, the area, the discrete Gauss curvature, and the discrete mean curvature. The volume of a tumor is an important aspect that helps doctors to make a medical diagnosis. And as doctors seek a stable calculation, we propose to prove the stability of some invariants. Finally, we study the evolution of brain tumor as a function of time in two or three years depending on patients with MR images every three or six months.K. Tawbe, F. Cotton, and L. VuillonCopyright © 2008 K. Tawbe et al. All rights reserved.http://www.hindawi.com/journals/ijta/2008/417870/The present paper studies the prospective and the performance of a forthcoming high-speed third generation (3.5G) networking technology, called enhanced uplink, for delivering mobile health (m-health) applications. The performance of 3.5G networks is a critical factor for successful development of m-health services perceived by end users. In this paper, we propose a methodology for performance assessment based on the joint uplink transmission of voice, real-time video, biological data (such as electrocardiogram, vital signals, and heart sounds), and healthcare records file transfer. Various scenarios were concerned in terms of real-time, nonreal-time, and emergency applications in random locations, where no other system but 3.5G is available. The accomplishment of quality of service (QoS) was explored through a step-by-step improvement of enhanced uplink system's parameters, attributing the network system for the best performance in the context of the desired m-health services.Dimitris Komnakos, Demosthenes Vouyioukas, Ilias Maglogiannis, and Philip ConstantinouCopyright © 2008 Dimitris Komnakos et al. All rights reserved.http://www.hindawi.com/journals/ijta/2008/405796/Daisuke Takahashi, Yang Xiao, Fei Hu, and Michael LewisCopyright © 2008 Daisuke Takahashi et al. All rights reserved.http://www.hindawi.com/journals/ijta/2008/753064/Patients suffering from chronic respiratory disease need to follow a rehabilitative exercise programme, in order to self-manage their illness and improve quality of life. Adherence to the programme is highly dependent on professional support from a physiotherapist and hence declines when patients seek to self-manage in the home. A number of requirements were identified for a Smartphone-based application in which patients are supported remotely and given automatic feedback during exercise. An application is described which will improve adherence during pulmonary rehabilitation.A. Marshall, O. Medvedev, and A. AntonovCopyright © 2008 A. Marshall et al. All rights reserved.http://www.hindawi.com/journals/ijta/2008/459185/New wireless technologies, such as wireless LAN and sensor networks, for telecardiology purposes give new possibilities for monitoring vital parameters with wearable biomedical sensors, and give patients the freedom to be mobile and still be under continuous monitoring and thereby better quality of patient care. This paper will detail the architecture and quality-of-service (QoS) characteristics in integrated wireless telecardiology platforms. It will also discuss the current promising hardware/software platforms for wireless cardiac monitoring. The design methodology and challenges are provided for realistic implementation.Sunil Kumar, Kashyap Kambhatla, Fei Hu, Mark Lifson, and Yang XiaoCopyright © 2008 Sunil Kumar et al. All rights reserved.http://www.hindawi.com/journals/ijta/2008/739385/We survey blood glucose control schemes for insulin-dependent diabetes therapies and systems. These schemes largely rely on mathematical models of the insulin-glucose relations, and these models are typically derived in an empirical or fundamental way. In an empirical way, the experimental insulin inputs and resulting blood-glucose outputs are used to generate a mathematical model, which includes a couple of equations approximating a very complex system. On the other hand, the insulin-glucose relation is also explained from the well-known facts of other biological mechanisms. Since these mechanisms are more or less related with each other, a mathematical model of the insulin-glucose system can be derived from these surrounding relations. This kind of method of the mathematical model derivation is called a fundamental method. Along with several mathematical models, researchers develop autonomous systems whether they involve medical devices or not to compensate metabolic disorders and these autonomous systems employ their own control methods. Basically, in insulin-dependent diabetes therapies, control methods are classified into three categories: open-loop, closed-loop, and partially closed-loop controls. The main difference among these methods is how much the systems are open to the outside people.Daisuke Takahashi, Yang Xiao, and Fei HuCopyright © 2008 Daisuke Takahashi et al. All rights reserved.http://www.hindawi.com/journals/ijta/2008/132890/The aim of this study was to investigate whether video consultations in the home can support a viable alternative to visits to the hospital outpatient clinic for patients with diabetic foot ulcers. And furthermore whether patients, relatives, visiting nurses, and experts at the hospital will experience satisfaction and increased confidence with this new course of treatment. Participatory design methods were applied as well as field observations, semistructured interviews, focus groups, and qualitative analysis of transcriptions of telemedical consultations conducted during a pilot test. This study shows that it is possible for experts at the hospital to conduct clinical examinations and decision making at a distance, in close cooperation with the visiting nurse and the patient. The visiting nurse experienced increased confidence with the treatment of the foot ulcer and characterized the consultations as a learning situation. All patients expressed satisfaction and felt confidence with this new way of working.Jane Clemensen, Simon B. Larsen, Marit Kirkevold, and Niels EjskjaerCopyright © 2008 Jane Clemensen et al. All rights reserved.