This chapter describes the growing influence of point-of-care diagnostics (POCD) on the daily lives of citizens, their immediate families, and healthcare providers. With a view to the future, the most important contemporary developments in this field are discussed, such as noninvasive sensor technology in the diagnostic process, practical examples of point-of-care diagnostics (POCD), including the quantify-self movement and infrared technology. Cost-effectiveness, adoption of POCD, and the contribution of POCD innovations to self-management and health literacy are also discussed. Developments in which deep learning and artificial intelligence are used to make the diagnostic results more reliable are also conferred, such as the development of point-of-care Internet diagnostics. The discussion of professional advice dilemma’s in POCD, the patient’s appreciation of POCD, and ethical and philosophical considerations conclude this chapter.
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Common methods to detect phlebitis may not be sufficient for patients in the intensive care unit (ICU). The goal of this study was to investigate the feasibility of infrared (IR) thermography to objectively detect phlebitis in adult ICU patients. We included a total of 128 adult ICU-patients in a pilot and subsequent validation study. Median [interquartile range] age was 62 [54-71] years and 88 (69%) patients were male. Severity of phlebitis was scored using the visual infusion phlebitis (VIP)-score, ranging from 0 (no phlebitis) to 5 (thrombophlebitis). The temperature difference (ΔT) between the insertion site and a proximal reference point was measured with IR thermography. In 78 (34%) catheters early phlebitis and onset of moderate phlebitis was observed (VIP-score of 1-3). In both the pilot and the validation study groups ΔT was significantly higher when the VIP-score was ≥1 compared to a VIP-score of 0 (p<0.01 and p<0.001, respectively). Multivariate analysis identified ΔT (p<0.001) and peripheral venous catheter (PVC) dwell time (p = 0.001) as significantly associated with phlebitis. IR thermography may be a promising technique to identify phlebitis in the ICU. An increased ΔT as determined with thermography may be a risk factor for phlebitis.
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Dealing with and maintaining high-quality standards in the design and construction phases is challenging, especially for on-site construction. Issues like improper implementation of building components and poor communication can widen the gap between design specifications and actual conditions. To prevent this, particularly for energy-efficient buildings, it is vital to develop resilient, sustainable strategies. These should optimize resource use, minimize environmental impact, and enhance livability, contributing to carbon neutrality by 2050 and climate change mitigation. Traditional post-occupancy evaluations, which identify defects after construction, are impractical for addressing energy performance gaps. A new, real-time inspection approach is necessary throughout the construction process. This paper suggests an innovative guideline for prefabricated buildings, emphasizing digital ‘self-instruction’ and ‘self-inspection’. These procedures ensure activities impacting quality adhere to specific instructions, drawings, and 3D models, incorporating the relevant acceptance criteria to verify completion. This methodology, promoting alignment with planned energy-efficient features, is supported by BIM-based software and Augmented Reality (AR) tools, embodying Industry 4.0 principles. BIM (Building Information Modeling) and AR bridge the gap between virtual design and actual construction, improving stakeholder communication and enabling real-time monitoring and adjustments. This integration fosters accuracy and efficiency, which are key for energy-efficient and nearly zero-energy buildings, marking a shift towards a more precise, collaborative, and environmentally sensible construction industry.
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