WorldWideScience

Sample records for care assessment platform

  1. A mobile phone-based care model for outpatient cardiac rehabilitation: the care assessment platform (CAP

    Directory of Open Access Journals (Sweden)

    Francis Rebecca

    2010-01-01

    Full Text Available Abstract Background Cardiac rehabilitation programs offer effective means to prevent recurrence of a cardiac event, but poor uptake of current programs have been reported globally. Home based models are considered as a feasible alternative to avoid various barriers related to care centre based programs. This paper sets out the study design for a clinical trial seeking to test the hypothesis that these programs can be better and more efficiently supported with novel Information and Communication Technologies (ICT. Methods/Design We have integrated mobile phones and web services into a comprehensive home- based care model for outpatient cardiac rehabilitation. Mobile phones with a built-in accelerometer sensor are used to measure physical exercise and WellnessDiary software is used to collect information on patients' physiological risk factors and other health information. Video and teleconferencing are used for mentoring sessions aiming at behavioural modifications through goal setting. The mentors use web-portal to facilitate personal goal setting and to assess the progress of each patient in the program. Educational multimedia content are stored or transferred via messaging systems to the patients phone to be viewed on demand. We have designed a randomised controlled trial to compare the health outcomes and cost efficiency of the proposed model with a traditional community based rehabilitation program. The main outcome measure is adherence to physical exercise guidelines. Discussion The study will provide evidence on using mobile phones and web services for mentoring and self management in a home-based care model targeting sustainable behavioural modifications in cardiac rehabilitation patients. Trial registration The trial has been registered in the Australian New Zealand Clinical Trials Registry (ANZCTR with number ACTRN12609000251224.

  2. Net4Care platform

    DEFF Research Database (Denmark)

    2012-01-01

    , that in turn enables general practitioners and clinical staff to view observations. Use the menus above to explore the site's information resources. To get started, follow the short Hello, World! tutorial. The Net4Care project is funded by The Central Denmark Region and EU via Caretech Innovation....

  3. Care platforms: a basic building block for care delivery.

    Science.gov (United States)

    Bohmer, Richard M J; Lawrence, David M

    2008-01-01

    Without significant operational reform within the nation's health care delivery organizations, new financing models, payment systems, or structures are unlikely to realize their promise. Adapting insights from high-performing companies in other high-risk, high-cost, science- and technology-based industries, we propose the "care platform" as an organizing framework for internal operations in diversified provider organizations to increase the quality, reliability, and efficiency of care delivery. A care platform organizes "care production" around similar work, rather than organs or specialties; integrates standard and custom care processes; and surrounds them with specifically configured information and business systems. Such organizational designs imply new roles for physicians. PMID:18780920

  4. Smart home care platforms: Where is the added value?

    OpenAIRE

    Vannieuwenborg, Frederic; Van Auwermeulen, Thomas; Van Ooteghem, Jan; Jacobs, An; Verbrugge, Sofie; Colle, Didier; Pickavet, Mario

    2014-01-01

    Due to changes in the demographic situation of most Western European countries, interest in ICT supported care services grows fast. eCare services that foster a better care information exchange, social involvement, lifestyle monitoring services, etc., offered via smart care platforms integrated in the homes of the elderly are believed to be cost-effective and could lead to an increased quality of life of both care receiver and (in)formal care giver. Currently adoption and integration of these...

  5. Common Ambient Assisted Living Home Platform for Seamless Care

    DEFF Research Database (Denmark)

    Wagner, Stefan Rahr; Stenner, Rene; Memon, Mukhtiar;

    The CareStore project is investigating the feasibility of creating an open and flexible infrastructure for facilitating seamless deployment of assisted living devices and applications on heterogeneous platforms. The Common Ambient Assisted Living Home Platform (CAALHP) is intended to be the main...... user interface for patients and healthcare staff in the CareStore eco system. The aim of this abstract is to demonstrate the currently implemented features and outline relevant perspectives and future work in the CareStore project....

  6. Deliverable 3.3.1 - Assessment Methodology on ISISEMD platform

    DEFF Research Database (Denmark)

    Peterson, Carrie Beth

    2009-01-01

    The overall goal of the ISISEMD project is to offer innovative ICT services to improve the quality of life of elderly persons with cognitive problems or mild dementia and their informal and formal caregivers who provide every day care for them. This will be done via the ISISEMD platform – a...... platform of intelligent scalable ICT services which will be tested for a period of 12 months under realistic conditions with end-users. In order to analyse the impact and the outcome from introducing these services, after the one year of pilot operation, overall assessment will be carried out by the...

  7. Health care technology assessment

    Science.gov (United States)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  8. Biobjective Performance Assessment with the COCO Platform

    OpenAIRE

    Brockhoff, Dimo; Tušar, Tea; Tušar, Dejan; Wagner, Tobias; Hansen, Nikolaus; Auger, Anne

    2016-01-01

    This document details the rationales behind assessing the performance of numerical black-box optimizers on multi-objective problems within the COCO platform and in particular on the biobjective test suite bbob-biobj. The evaluation is based on a hypervolume of all non-dominated solutions in the archive of candidate solutions and measures the runtime until the hypervolume value succeeds prescribed target values.

  9. Cross-platform digital assessment forms for evaluating surgical skills

    Directory of Open Access Journals (Sweden)

    Steven Arild Wuyts Andersen

    2015-04-01

    Full Text Available A variety of structured assessment tools for use in surgical training have been reported, but extant assessment tools often employ paper-based rating forms. Digital assessment forms for evaluating surgical skills could potentially offer advantages over paper-based forms, especially in complex assessment situations. In this paper, we report on the development of cross-platform digital assessment forms for use with multiple raters in order to facilitate the automatic processing of surgical skills assessments that include structured ratings. The FileMaker 13 platform was used to create a database containing the digital assessment forms, because this software has cross-platform functionality on both desktop computers and handheld devices. The database is hosted online, and the rating forms can therefore also be accessed through most modern web browsers. Cross-platform digital assessment forms were developed for the rating of surgical skills. The database platform used in this study was reasonably priced, intuitive for the user, and flexible. The forms have been provided online as free downloads that may serve as the basis for further development or as inspiration for future efforts. In conclusion, digital assessment forms can be used for the structured rating of surgical skills and have the potential to be especially useful in complex assessment situations with multiple raters, repeated assessments in various times and locations, and situations requiring substantial subsequent data processing or complex score calculations.

  10. Instruments to assess integrated care

    DEFF Research Database (Denmark)

    Lyngsø, Anne Marie; Godtfredsen, Nina Skavlan; Høst, Dorte;

    2014-01-01

    measure the level of integration across health-care sectors and to assess and evaluate the organisational elements within the instruments identified. METHODS: An extensive, systematic literature review in PubMed, CINAHL, PsycINFO, Cochrane Library, Web of Science for the years 1980-2011. Selected...... and six include cultural aspects; 14 explicitly stated using a theoretical framework. CONCLUSION AND DISCUSSION: This review did not identify any measurement instrument covering all aspects of integrated care. Further, a lack of uniform use of the eight organisational elements across the studies was...

  11. Wikis as Platforms for Authentic Assessment

    Science.gov (United States)

    Eddy, Pamela L.; Lawrence, April

    2013-01-01

    Calls for accountability focus attention on assessment of student learning. Authentic assessment involves evaluating student learning as students perform real world tasks. We present a four-stage conceptual framework for authentic assessment. We argue first that evaluation is a process rather than a static one-time event. Second, authentic…

  12. Design and Assessment of an Intelligent Activity Monitoring Platform

    Directory of Open Access Journals (Sweden)

    Monique Thonnat

    2005-08-01

    Full Text Available We are interested in designing a reusable and robust activity monitoring platform. We propose three good properties that an activity monitoring platform should have to enable its reusability for different applications and to insure performance quality: (1 modularity and flexibility of the architecture, (2 separation between the algorithms and the a priori knowledge they use, and (3 automatic evaluation of algorithm results. We then propose a development methodology to fulfill the last two properties. The methodology consists in the interaction between end-users and developers during the whole development of a specific monitoring system. To validate our approach, we present a platform used to generate activity monitoring systems dedicated to specific applications, we also describe in details the technical validation and the end-user assessment of an automatic metro monitoring system built with the platform and briefly the validation results for bank agency monitoring and building access control.

  13. PROPOSED PROCEDURE FOR ASSESSMENT OF EXISTING PLATFORMS IN INDONESIA

    OpenAIRE

    Ricky L. Tawekal

    2005-01-01

    Off-shore platforms were built since the 1970âs in Indonesia, but there is no local code or recommended practice for their design or assessment procedure. The common practice is to use the recommended practice issued by the American Petroleum Institute, API RP2A. The off-shore platforms built in the 1970âs must be re-qualified due to exceedance of the design life. This paper discuss the assessment procedure given in the API RP2A WSD 21th edition, API RP2A LRFD, dan ISO 19902 (draft E â 2001)....

  14. Development of an E- Assessment Platform for Nigerian Universities

    OpenAIRE

    O. Akinsanmi

    2010-01-01

    This paper presents the development of an e-assessment platform for application in Nigerianuniversities. Ahmadu Bello University, Zaria, Nigeria was used as a testing ground in 2008. In the age ofdigitalization that we live in, it has become imperative that a reliable means of assessing students using internetbasedtechnologies be developed. This paper seeks to solve a part of that problem by designing and developinga web application where tests in multiple choice formats will be taken online ...

  15. Offshore Platform Hydrocarbon Risk Assessment – OPHRA: Feasibility

    DEFF Research Database (Denmark)

    Duijm, Nijs Jan; Kozine, Igor; Markert, Frank

    and data needed for the risk assessment framework, and provides specific suggestions for some of those models. Some preliminary calculations with the DES model have been performed to illustrate type of results that can be obtained and to provide some insight in the accuracy and computational efforts......This report describes the feasibility demonstration of a new method to perform risk assessments for offshore platforms. This method simulates the following phenomena as concurrent sequences of events using the Arena® Discrete Event Simulation (DES) software (version 14.50.00): • Release, ignition....... Finally, further work is identified in order to develop an operational risk assessment tool....

  16. Practical assessment of Biba integrity for TCG-enabled platforms

    OpenAIRE

    Lioy, Antonio; Ramunno, Gianluca; Sassu, Roberto

    2014-01-01

    Checking the integrity of an application is necessary to determine if the latter will behave as expected. The method defined by the Trusted Computing Group consists in evaluating the fingerprints of the platform hardware and software components required for the proper functioning of the application to be assessed. However, this only ensures that a process was working correctly at load-time but not for its whole life-cycle. Policy-Reduced Integrity Measurement Architecture (PRIMA) addresses th...

  17. Platform for Assessing Strategic Alignment Using Enterprise Architecture: Application to E-Government Process Assessment

    CERN Document Server

    Elhari, Kaoutar

    2011-01-01

    This paper presents an overview of S2AEA (v2) (Strategic Alignment Assessment based on Enterprise Architecture (version2)), a platform for modelling enterprise architecture and for assessing strategic alignment based on internal enterprise architecture metrics. The idea of the platform is based on the fact that enterprise architecture provides a structure for business processes and information systems that supports them. This structure can be used to measure the degree of consistency between business strategies and information systems. In that sense, this paper presents a platform illustrating the role of enterprise architecture in the strategic alignment assessment. This assessment can be used in auditing information systems. The platform is applied to assess an e-government process.

  18. Platform for Assessing Strategic Alignment Using Enterprise Architecture: Application to E-Government Process Assessment

    Directory of Open Access Journals (Sweden)

    Kaoutar Elhari

    2011-01-01

    Full Text Available This paper presents an overview of S2AEA (v2 (Strategic Alignment Assessment based on Enterprise Architecture (version2, a platform for modelling enterprise architecture and for assessing strategic alignment based on internal enterprise architecture metrics. The idea of the platform is based on the fact that enterprise architecture provides a structure for business processes and information systems that supports them. This structure can be used to measure the degree of consistency between business strategies and information systems. In that sense, this paper presents a platform illustrating the role of enterprise architecture in the strategic alignment assessment. This assessment can be used in auditing information systems. The platform is applied to assess an e-government process.

  19. System Reliability Assessment of Existing Jacket Platforms in Malaysian Waters

    Directory of Open Access Journals (Sweden)

    V.J. Kurian

    2014-12-01

    Full Text Available Reliability of offshore platforms has become a very important issue in the Malaysian Oil and Gas Industry as, majority of the jacket platforms in Malaysian waters to date, have exceeded their design life. Reliability of a jacket platform can be assessed through reliability index and probability of failure. Conventional metocean consideration uses 100 year return period wave height associated with 100 year return period current velocity and wind speed. However, recent study shows that for Malaysian waters, the proposed metocean consideration should be 100 year return period wave height associated with 10 year return period current velocity and wind speed. Hence, this research investigated the effect of different metocean consideration, to system-based reliability of jacket platforms in Malaysian waters. Prior to that, the effect of different metocean consideration to the pushover analysis has also been studied. Besides, the significance of Pile Soil Interaction (PSI, wave direction and platform geometry were analyzed in a sensitivity study. Pushover analysis was performed on three jacket platforms representing three water regions in Malaysia to obtain Reserve Strength Ratio (RSR as an indicator of the reliability of the jackets. Utilizing sensitivity study parameters mentioned above, seven different case studies were undertaken to study their significance on RSR. The RSR values of each case study were compared and incorporated as resistance model of reliability analysis. Besides, platform specific response model of each jacket has been generated using response surface technique which was later incorporated into the limit state function for reliability analysis. Reliability analysis using First Order Reliability Method (FORM has been conducted in MATLAB to obtain the reliability index and probability of failure. Results from the reliability analysis were compared to analyze the effect of different metocean consideration. In this study, an updated

  20. Platform for Assessing Strategic Alignment Using Enterprise Architecture: Application to E-Government Process Assessment

    OpenAIRE

    Kaoutar Elhari; Bouchaib Bounabat

    2011-01-01

    This paper presents an overview of S2AEA (v2) (Strategic Alignment Assessment based on Enterprise Architecture (version2)), a platform for modelling enterprise architecture and for assessing strategic alignment based on internal enterprise architecture metrics. The idea of the platform is based on the fact that enterprise architecture provides a structure for business processes and information systems that supports them. This structure can be used to measure the degree of consistency between ...

  1. Quality Assessment in the Primary care

    OpenAIRE

    Muharrem Ak

    2013-01-01

    -Quality Assessment in the Primary care Dear Editor; I have read the article titled as “Implementation of Rogi Kalyan Samiti (RKS) at Primary Health Centre Durvesh” with great interest. Shrivastava et all concluded that assessment mechanism for the achievement of objectives for the suggested RKS model was not successful (1). Hereby I would like to emphasize the importance of quality assessment (QA) especially in the era of newly established primary care implementations in our coun...

  2. Evaluation of a novel home skin care platform.

    Science.gov (United States)

    Reich, Hilary C; Wallander, Irmina; Schulte, Lacie; Shulte, Lacie; Frickman, Hilary; Flickenger, Suzanne; Zelickson, Brian

    2015-04-01

    The home beauty device market is rapidly growing, having more than tripled in the last four years. This study evaluates several specific attachment heads using a novel home skincare platform (HSP). By incorporating multiple treatment heads for cleansing, skin smoothing, and skin infusion, this device has the potential to address many potential treatment goals. The first subset of this study is a blinded, randomized split-face study evaluating the efficacy of the HSP device with a standard brush head for make-up removal and compares the HSP device to a currently marketed home cleansing device. The results show that the HSP cleansing head was comparable to the leading home skin cleansing device on the market. The HSP's skin smoothing head showed statistically significant improvement in erythema and dryness over baseline levels with significant histologic changes including normalization of epidermal thickness in only 10 days of use. This is comparable to and exceeds many well-studied antiaging treatments after weeks and months of therapy. Finally, the infusion head demonstrated improvement in skin hydration over baseline levels. PMID:25844614

  3. PLINIUS-2. A new versatile platform for severe accident assessments

    International Nuclear Information System (INIS)

    The current PLINIUS platform at CEA Cadarache is a coherent set of experimental facilities devoted to knowledge improvements on corium behavior in severe accident conditions, model developments and code validation in view of performing reactor case calculations. In the frame of recent National and International Programs it provided numerous experimental results used for generation 2 and 3 reactors concerning major phenomena occurring during severe accident like Fuel Coolant Interaction (FCI) and Molten Corium Concrete Interaction (MCCI) as well as new data for thermophysical and thermochemical properties of the molten corium. One specific characteristic of this experimental platform is to produce significant masses of prototypical material (containing depleted uranium) molten at temperatures above 3000K and to carry out experiments with pools containing both metals and oxides, simulating most of the phenomena occurring in case of severe accident, except the non-thermal effects of radioactive decay. Moreover, specific measurements techniques have been developed giving a high level of accuracy of the results and allowing the assessment of analytical models like the fragmentation of the corium in the water. The mass of usable corium is limited to about 50 kg with the current furnaces and, even though some corium interaction experiments are already carried out in PLINIUS platform for generation 4 sodium fast reactors, sodium cannot be used in the current facility. Therefore, CEA has decided the building of a new large scale prototypic corium facility to extend its current PLINIUS corium platform. This new versatile facility, called PLINIUS 2, shall be devoted to both water and sodium-cooled reactor severe accident experimental simulation. This corium platform will cover all the R and D needs of the existing reactors, of new light water reactor designs and of the ASTRID project. It will be composed of a furnace able to melt 200 to 500 kg of corium including nuclear fuel

  4. Health-Care Technology Assessment in Radiology

    Directory of Open Access Journals (Sweden)

    Arash Deljou

    2010-05-01

    Full Text Available Health-care service provision and procurement is increasingly subject to policy decisions, managed more than ever before. Becoming more international, collaboration is increasing as the health professions, research and industry all work across borders. Differing health-care systems across the countries result from national and regional policy developments and priorities."nIn health-care, all interventions and procedures are basically technologies-including radiology and sur-gery, and technology assessment is mandatory to meet the national and professional goals in this sec-tor. "nHealth-care technology assessment (HTA is a systematic, broad-ranging evaluation of the implications of using technologies within a particular health-care system. Structured and evidence-based input are its aim for policymaking in order to inform the formulation of safe and effective health policies that are patient-focused and seek to achieve the best value in all health-care sectors, more specifically in the radiology department. The following headlines are the topics in our study:"n•Decisions Related to Health Technologies"n•Appraisal Entities and Corresponding As-sessment Units"n•Assessment, Appraisal and Decision-Making Institutions"n•HTA Agencies and Units in Radiology"n•Model of a Policy Process in Radiology"n•Factors that Influence Radiology Policy-Making"n•HTA Process"n•Different Levels of Health-Care Technolo-gies/Intervention

  5. Quality Assessment in the Primary care

    Directory of Open Access Journals (Sweden)

    Muharrem Ak

    2013-04-01

    Full Text Available -Quality Assessment in the Primary care Dear Editor; I have read the article titled as “Implementation of Rogi Kalyan Samiti (RKS at Primary Health Centre Durvesh” with great interest. Shrivastava et all concluded that assessment mechanism for the achievement of objectives for the suggested RKS model was not successful (1. Hereby I would like to emphasize the importance of quality assessment (QA especially in the era of newly established primary care implementations in our country. Promotion of quality has been fundamental part of primary care health services. Nevertheless variations in quality of care exist even in the developed countries. Accomplishment of quality in the primary care has some barriers like administration and directorial factors, absence of evidence-based medicine practice lack of continuous medical education. Quality of health care is no doubt multifaceted model that covers all components of health structures and processes of care. Quality in the primary care set up includes patient physician relationship, immunization, maternal, adolescent, adult and geriatric health care, referral, non-communicable disease management and prescribing (2. Most countries are recently beginning the implementation of quality assessments in all walks of healthcare. Organizations like European society for quality and safety in family practice (EQuiP endeavor to accomplish quality by collaboration. There are reported developments and experiments related to the methodology, processes and outcomes of quality assessments of health care. Quality assessments will not only contribute the accomplishment of the program / project but also detect the areas where obstacles also exist. In order to speed up the adoption of QA and to circumvent the occurrence of mistakes, health policy makers and family physicians from different parts of the world should share their experiences. Consensus on quality in preventive medicine implementations can help to yield

  6. PROPOSED PROCEDURE FOR ASSESSMENT OF EXISTING PLATFORMS IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Ricky L. Tawekal

    2005-01-01

    Full Text Available Off-shore platforms were built since the 1970’s in Indonesia, but there is no local code or recommended practice for their design or assessment procedure. The common practice is to use the recommended practice issued by the American Petroleum Institute, API RP2A. The off-shore platforms built in the 1970’s must be re-qualified due to exceedance of the design life. This paper discuss the assessment procedure given in the API RP2A WSD 21th edition, API RP2A LRFD, dan ISO 19902 (draft E – 2001. Problems usually arise due to the fact that the original design was based on API RP2A 10th edition and assessment is done using the new edition which is the 21th edition. Abstract in Bahasa Indonesia : Sejak tahun 1970-an di Indonesia terdapat banyak anjungan lepas pantai, tetapi sampai saat ini belum ada peraturan atau tata cara untuk perencanaan dan penelaahannya. Anjungan lepas pantai biasanya direncanakan berdasarkan Recommended Practice yang diterbitkan oleh American Petroleum Institute, API RP2A. Pada saat ini dirasakan adanya kebutuhan untuk melakukan penelaahan kelayakan struktur anjungan lepas pantai yang telah dibangun sejak tahun 1970-an tersebut. Makalah ini membahas prosedur cara penelaahan anjungan lepas pantai yang diatur dalam API RP2A WSD edisi 21, API RP2A LRFD, dan ISO 19902 (draft E – 2001. Masalah biasanya akan timbul karena perencanaan didasarkan kepada API RP2A edisi 10 sedangkan penelaahan kelayakan didasarkan kepada edisi yang terbaru (edisi 21

  7. Synthetic biology and microbioreactor platforms for programmable production of biologics at the point-of-care

    Science.gov (United States)

    Perez-Pinera, Pablo; Han, Ningren; Cleto, Sara; Cao, Jicong; Purcell, Oliver; Shah, Kartik A.; Lee, Kevin; Ram, Rajeev; Lu, Timothy K.

    2016-01-01

    Current biopharmaceutical manufacturing systems are not compatible with portable or distributed production of biologics, as they typically require the development of single biologic-producing cell lines followed by their cultivation at very large scales. Therefore, it remains challenging to treat patients in short time frames, especially in remote locations with limited infrastructure. To overcome these barriers, we developed a platform using genetically engineered Pichia pastoris strains designed to secrete multiple proteins on programmable cues in an integrated, benchtop, millilitre-scale microfluidic device. We use this platform for rapid and switchable production of two biologics from a single yeast strain as specified by the operator. Our results demonstrate selectable and near-single-dose production of these biologics in system with analytical, purification and polishing technologies could lead to a small-scale, portable and fully integrated personal biomanufacturing platform that could advance disease treatment at point-of-care. PMID:27470089

  8. Health Technology Assessment of Integrated Home Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

    Background: The fragmented delivery of healthcare and social services as advanced by WHO 2002. Objectives: This project of international collaboration assesses integrated home care (IHC) for frail elder somatic patients as compared to usual hospital care. Methods: The HTA follows the special......-up: Stroke: A meta-analysis including 14 randomized trials (N=2139) demonstrate a significant reduction (p< 0.001) in the risk being dead or dependent compared with conventional care with OR=0.75 (CI95%: 0.61-0.92). HF: 3 RCT (N=568) demonstrate each a significant reduction of all-cause readmissions. A meta...

  9. Picoliter droplet microfluidic immunosorbent platform for point-of-care diagnostics of tetanus

    International Nuclear Information System (INIS)

    We have developed a sensitive, specific, rapid and low cost picoliter microsphere-based platform for bioanalyte detection and quantification. In this method, a biological sample, biosensing microspheres, and fluorescently labeled detection (secondary) antibodies are co-encapsulated to capture the analyte (here: human anti-tetanus immunoglobulin G) on the surface of the microsphere in microfluidic pL-sized droplets. The absorption of the analyte and detecting antibodies on the microsphere concentrate the fluorescent signal in correlation with analyte concentration. Using our platform and commercially available antibodies, we were able to quantify anti-tetanus antibodies in human serum. In comparison to standard bulk immunosorbent assays, the microfluidic droplet platform presented here reduces the reagent volume by four orders of magnitude, while fast reagent mixing reduces the detection time from hours to minutes. We consider this platform to be a major leap forward in the miniaturization of immunosorbent assays and to provide a rapid and low cost tool for global point-of-care. (author)

  10. Assessing the Quality of Diabetic Patients Care

    Directory of Open Access Journals (Sweden)

    Belkis Vicente Sánchez

    2012-12-01

    Full Text Available Background: to improve the efficiency and effectiveness of the actions of family doctors and nurses in this area is an indispensable requisite in order to achieve a comprehensive health care. Objective: to assess the quality of health care provided to diabetic patients by the family doctor in Abreus health area. Methods: a descriptive and observational study based on the application of tools to assess the performance of family doctors in the treatment of diabetes mellitus in the five family doctors consultation in Abreus health area from January to July 2011 was conducted. The five doctors working in these consultations, as well as the 172 diabetic patients were included in the study. At the same time, 172 randomly selected medical records were also revised. Through observation, the existence of some necessary material resources and the quality of their performance as well as the quality of medical records were evaluated. Patient criteria served to assess the quality of the health care provided. Results: scientific and technical training on diabetes mellitus has been insufficient; the necessary equipment for the appropriate care and monitoring of patients with diabetes is available; in 2.9% of medical records reviewed, interrogation appears in its complete form including the complete physical examination in 12 of them and the complete medical indications in 26. Conclusions: the quality of comprehensive medical care to diabetic patients included in the study is compromised. Doctors interviewed recognized the need to be trained in the diagnosis and treatment of diabetes in order to improve their professional performance and enhance the quality of the health care provided to these patients.

  11. Exploring valid and reliable assessment methods for care management education.

    Science.gov (United States)

    Gennissen, Lokke; Stammen, Lorette; Bueno-de-Mesquita, Jolien; Wieringa, Sietse; Busari, Jamiu

    2016-07-01

    Purpose It is assumed that the use of valid and reliable assessment methods can facilitate the development of medical residents' management and leadership competencies. To justify this assertion, the perceptions of an expert panel of health care leaders were explored on assessment methods used for evaluating care management (CM) development in Dutch residency programs. This paper aims to investigate how assessors and trainees value these methods and examine for any inherent benefits or shortcomings when they are applied in practice. Design/methodology/approach A Delphi survey was conducted among members of the platform for medical leadership in The Netherlands. This panel of experts was made up of clinical educators, practitioners and residents interested in CM education. Findings Of the respondents, 40 (55.6 per cent) and 31 (43 per cent) participated in the first and second rounds of the Delphi survey, respectively. The respondents agreed that assessment methods currently being used to measure residents' CM competencies were weak, though feasible for use in many residency programs. Multi-source feedback (MSF, 92.1 per cent), portfolio/e-portfolio (86.8 per cent) and knowledge testing (76.3 per cent) were identified as the most commonly known assessment methods with familiarity rates exceeding 75 per cent. Practical implications The findings suggested that an "assessment framework" comprising MSF, portfolios, individual process improvement projects or self-reflections and observations in clinical practice should be used to measure CM competencies in residents. Originality/value This study reaffirms the need for objective methods to assess CM skills in post-graduate medical education, as there was not a single assessment method that stood out as the best instrument. PMID:27397747

  12. Modular development of a prototype point of care molecular diagnostic platform for sexually transmitted infections.

    Science.gov (United States)

    Branavan, Manoharanehru; Mackay, Ruth E; Craw, Pascal; Naveenathayalan, Angel; Ahern, Jeremy C; Sivanesan, Tulasi; Hudson, Chris; Stead, Thomas; Kremer, Jessica; Garg, Neha; Baker, Mark; Sadiq, Syed T; Balachandran, Wamadeva

    2016-08-01

    This paper presents the design of a modular point of care test platform that integrates a proprietary sample collection device directly with a microfluidic cartridge. Cell lysis, within the cartridge, is conducted using a chemical method and nucleic acid purification is done on an activated cellulose membrane. The microfluidic device incorporates passive mixing of the lysis-binding buffers and sample using a serpentine channel. Results have shown extraction efficiencies for this new membrane of 69% and 57% compared to the commercial Qiagen extraction method of 85% and 59.4% for 0.1ng/µL and 100ng/µL salmon sperm DNA respectively spiked in phosphate buffered solution. Extraction experiments using the serpentine passive mixer cartridges incorporating lysis and nucleic acid purification showed extraction efficiency around 80% of the commercial Qiagen kit. Isothermal amplification was conducted using thermophillic helicase dependant amplification and recombinase polymerase amplification. A low cost benchtop real-time isothermal amplification platform has been developed capable of running six amplifications simultaneously. Results show that the platform is capable of detecting 1.32×10(6) of sample DNA through thermophillic helicase dependant amplification and 1×10(5) copy numbers Chlamydia trachomatis genomic DNA within 10min through recombinase polymerase nucleic acid amplification tests. PMID:27238759

  13. Practice innovation: the need for nimble data platforms to implement precision oncology care.

    Science.gov (United States)

    Elfiky, Aymen; Zhang, Dongyang; Krishnan Nair, Hari K

    2015-01-01

    Given the drive toward personalized, value-based, and coordinated cancer care delivery, modern knowledge-based practice is being shaped within the context of an increasingly technology-driven healthcare landscape. The ultimate promise of 'precision medicine' is predicated on taking advantage of the range of new capabilities for integrating disease- and individual-specific data to define new taxonomies as part of a systems-based knowledge network. Specifically, with cancer being a constantly evolving complex disease process, proper care of an individual will require the ability to seamlessly integrate multi-dimensional 'omic' and clinical data. Importantly, however, the challenges of curating knowledge from multiple dynamic data sources and translating to practice at the point-of-care highlight parallel needs. As patients, caregivers, and their environments become more proactive in clinical care and management, practical success of precision medicine is equally dependent on the development of proper infrastructures for evolving data integration, platforms for knowledge representation in a clinically-relevant context, and implementation within a provider's work-life and workflow. PMID:26321084

  14. Clinical risk assessment in intensive care unit

    Directory of Open Access Journals (Sweden)

    Saeed Asefzadeh

    2013-01-01

    Full Text Available Background: Clinical risk management focuses on improving the quality and safety of health care services by identifying the circumstances and opportunities that put patients at risk of harm and acting to prevent or control those risks. The goal of this study is to identify and assess the failure modes in the ICU of Qazvin′s Social Security Hospital (Razi Hospital through Failure Mode and Effect Analysis (FMEA. Methods: This was a qualitative-quantitative research by Focus Discussion Group (FDG performed in Qazvin Province, Iran during 2011. The study population included all individuals and owners who are familiar with the process in ICU. Sampling method was purposeful and the FDG group members were selected by the researcher. The research instrument was standard worksheet that has been used by several researchers. Data was analyzed by FMEA technique. Results: Forty eight clinical errors and failure modes identified, results showed that the highest risk probability number (RPN was in respiratory care "Ventilator′s alarm malfunction (no alarm" with the score 288, and the lowest was in gastrointestinal "not washing the NG-Tube" with the score 8. Conclusions: Many of the identified errors can be prevented by group members. Clinical risk assessment and management is the key to delivery of effective health care.

  15. Leveraging HIV platforms to work toward comprehensive primary care in rural Malawi: the Integrated Chronic Care Clinic.

    Science.gov (United States)

    Wroe, Emily B; Kalanga, Noel; Mailosi, Bright; Mwalwanda, Stanley; Kachimanga, Chiyembekezo; Nyangulu, Kondwani; Dunbar, Elizabeth; Kerr, Lila; Nazimera, Lawrence; Dullie, Luckson

    2015-12-01

    This case study describes an integrated chronic care clinic that utilizes a robust HIV program as a platform for NCD screening and treatment. A unique model, the integrated chronic care clinic provides longitudinal care for patients with an array of chronic diseases including HIV and common NCDs, allowing for a single visit for all of a patient's conditions. Set in Malawi's remote Neno District, this clinic structure aims to (1) increase access to care for NCD patients, (2) maximize efficiency given the severe human resource shortages, and (3) replicate strong HIV outcomes for patients with other chronic conditions. The goal is to increase the number of health facilities in Neno capable of fully delivering Malawi's Essential Health Package, the set of cost-effective interventions endorsed by Malawi MOH to reduce burden of disease and leading causes of death. While implementation is ongoing and processes are evolving, this model of healthcare delivery has already improved the accessibility of NCD care by allowing patients to have all of their chronic conditions treated on the same day at their nearest health facility, notably without additional investment of human and financial resources. Currently, 6781 patients on antiretroviral therapy and 721 patients with NCDs are benefitting, including 379 with hypertension, 187 with asthma, 144 with epilepsy, and 76 with diabetes. Among the NCD patient population, 15.1% are HIV-positive. Success hinged largely on several factors, including clear leadership and staff ownership of their specific duties, and a well-defined and uniform patient flow process. Furthermore, deliberate and regular conversations about challenges allowed for constant iteration and improvement of processes. Moving forward, several tasks remain. We are refining the data management process to further consolidate medical records, along with integrating our tracking processes for clients who miss appointments. Additionally, we are exploring opportunities for

  16. Cross-platform digital assessment forms for evaluating surgical skills

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts

    2015-01-01

    developed for the rating of surgical skills. The database platform used in this study was reasonably priced, intuitive for the user, and flexible. The forms have been provided online as free downloads that may serve as the basis for further development or as inspiration for future efforts. In conclusion...

  17. Evolvable Smartphone-Based Platforms for Point-of-Care In-Vitro Diagnostics Applications

    Directory of Open Access Journals (Sweden)

    François Patou

    2016-09-01

    Full Text Available The association of smart mobile devices and lab-on-chip technologies offers unprecedented opportunities for the emergence of direct-to-consumer in vitro medical diagnostics applications. Despite their clear transformative potential, obstacles remain to the large-scale disruption and long-lasting success of these systems in the consumer market. For instance, the increasing level of complexity of instrumented lab-on-chip devices, coupled to the sporadic nature of point-of-care testing, threatens the viability of a business model mainly relying on disposable/consumable lab-on-chips. We argued recently that system evolvability, defined as the design characteristic that facilitates more manageable transitions between system generations via the modification of an inherited design, can help remedy these limitations. In this paper, we discuss how platform-based design can constitute a formal entry point to the design and implementation of evolvable smart device/lab-on-chip systems. We present both a hardware/software design framework and the implementation details of a platform prototype enabling at this stage the interfacing of several lab-on-chip variants relying on current- or impedance-based biosensors. Our findings suggest that several change-enabling mechanisms implemented in the higher abstraction software layers of the system can promote evolvability, together with the design of change-absorbing hardware/software interfaces. Our platform architecture is based on a mobile software application programming interface coupled to a modular hardware accessory. It allows the specification of lab-on-chip operation and post-analytic functions at the mobile software layer. We demonstrate its potential by operating a simple lab-on-chip to carry out the detection of dopamine using various electroanalytical methods.

  18. Evolvable Smartphone-Based Platforms for Point-of-Care In-Vitro Diagnostics Applications.

    Science.gov (United States)

    Patou, François; AlZahra'a Alatraktchi, Fatima; Kjægaard, Claus; Dimaki, Maria; Madsen, Jan; Svendsen, Winnie E

    2016-01-01

    The association of smart mobile devices and lab-on-chip technologies offers unprecedented opportunities for the emergence of direct-to-consumer in vitro medical diagnostics applications. Despite their clear transformative potential, obstacles remain to the large-scale disruption and long-lasting success of these systems in the consumer market. For instance, the increasing level of complexity of instrumented lab-on-chip devices, coupled to the sporadic nature of point-of-care testing, threatens the viability of a business model mainly relying on disposable/consumable lab-on-chips. We argued recently that system evolvability, defined as the design characteristic that facilitates more manageable transitions between system generations via the modification of an inherited design, can help remedy these limitations. In this paper, we discuss how platform-based design can constitute a formal entry point to the design and implementation of evolvable smart device/lab-on-chip systems. We present both a hardware/software design framework and the implementation details of a platform prototype enabling at this stage the interfacing of several lab-on-chip variants relying on current- or impedance-based biosensors. Our findings suggest that several change-enabling mechanisms implemented in the higher abstraction software layers of the system can promote evolvability, together with the design of change-absorbing hardware/software interfaces. Our platform architecture is based on a mobile software application programming interface coupled to a modular hardware accessory. It allows the specification of lab-on-chip operation and post-analytic functions at the mobile software layer. We demonstrate its potential by operating a simple lab-on-chip to carry out the detection of dopamine using various electroanalytical methods. PMID:27598208

  19. Optimization of a Cell Counting Algorithm for Mobile Point-of-Care Testing Platforms

    Directory of Open Access Journals (Sweden)

    DaeHan Ahn

    2014-08-01

    Full Text Available In a point-of-care (POC setting, it is critically important to reliably count the number of specific cells in a blood sample. Software-based cell counting, which is far faster than manual counting, while much cheaper than hardware-based counting, has emerged as an attractive solution potentially applicable to mobile POC testing. However, the existing software-based algorithm based on the normalized cross-correlation (NCC method is too time- and, thus, energy-consuming to be deployed for battery-powered mobile POC testing platforms. In this paper, we identify inefficiencies in the NCC-based algorithm and propose two synergistic optimization techniques that can considerably reduce the runtime and, thus, energy consumption of the original algorithm with negligible impact on counting accuracy. We demonstrate that an AndroidTM smart phone running the optimized algorithm consumes 11.5× less runtime than the original algorithm.

  20. Designing the RiverCare knowledge base and web-collaborative platform to exchange knowledge in river management

    Science.gov (United States)

    Cortes Arevalo, Juliette; den Haan, Robert-Jan; van der Voort, Mascha; Hulscher, Suzanne

    2016-04-01

    Effective communication strategies are necessary between different scientific disciplines, practitioners and non-experts for a shared understanding and better implementation of river management measures. In that context, the RiverCare program aims to get a better understanding of riverine measures that are being implemented towards self-sustaining multifunctional rivers in the Netherlands. During the RiverCare program, user committees are organized between the researchers and practitioners to discuss the aim and value of RiverCare outputs, related assumptions and uncertainties behind scientific results. Beyond the RiverCare program end, knowledge about river interventions, integrated effects, management and self-sustaining applications will be available to experts and non-experts by means of River Care communication tools: A web-collaborative platform and a serious gaming environment. As part of the communication project of RiverCare, we are designing the RiverCare web-collaborative platform and the knowledge-base behind that platform. We aim at promoting collaborative efforts and knowledge exchange in river management. However, knowledge exchange does not magically happen. Consultation and discussion of RiverCare outputs as well as elicitation of perspectives and preferences from different actors about the effects of riverine measures has to be facilitated. During the RiverCare research activities, the platform will support the user committees or collaborative sessions that are regularly held with the organizations directly benefiting from our research, at project level or in study areas. The design process of the collaborative platform follows an user centred approach to identify user requirements, co-create a conceptual design and iterative develop and evaluate prototypes of the platform. The envisioned web-collaborative platform opens with an explanation and visualisation of the RiverCare outputs that are available in the knowledge base. Collaborative sessions

  1. WCDMA Uplink Interference Assessment from Multiple High Altitude Platform Configurations

    Directory of Open Access Journals (Sweden)

    A. Mohammed

    2008-06-01

    Full Text Available We investigate the possibility of multiple high altitude platform (HAP coverage of a common cell area using a wideband code division multiple access (WCDMA system. In particular, we study the uplink system performance of the system. The results show that depending on the traffic demand and the type of service used, there is a possibility of deploying 3–6 HAPs covering the same cell area. The results also show the effect of cell radius on performance and the position of the multiple HAP base stations which give the worst performance.

  2. Intelligent platforms for disease assessment: novel approaches in functional echocardiography.

    Science.gov (United States)

    Sengupta, Partho P

    2013-11-01

    Accelerating trends in the dynamic digital era (from 2004 onward) has resulted in the emergence of novel parametric imaging tools that allow easy and accurate extraction of quantitative information from cardiac images. This review principally attempts to heighten the awareness of newer emerging paradigms that may advance acquisition, visualization and interpretation of the large functional data sets obtained during cardiac ultrasound imaging. Incorporation of innovative cognitive software that allow advanced pattern recognition and disease forecasting will likely transform the human-machine interface and interpretation process to achieve a more efficient and effective work environment. Novel technologies for automation and big data analytics that are already active in other fields need to be rapidly adapted to the health care environment with new academic-industry collaborations to enrich and accelerate the delivery of newer decision making tools for enhancing patient care. PMID:24229773

  3. Construction of the Chinese Veteran Clinical Research (CVCR) Platform for the assessment of non-communicable diseases

    Institute of Scientific and Technical Information of China (English)

    Tan Jiping; Li Nan; Gao Jing; Guo Yuhe; Hu Wei; Yang Jinsheng; Yu Baocheng

    2014-01-01

    Background Based on the excellent medical care and management system for Chinese veterans,as well as the detailed medical documentation available,we aim to construct a Chinese Veteran Clinical Research (CVCR) platform on noncommunicable diseases (NCDs) and carry out studies of the primary disabling NCDs.Methods The Geriatric Neurology Department of Chinese People's Liberation Army General Hospital and veterans' hospitals serve as the leading and participating units in the platform construction.The fundamental constituents of the platform are veteran communities.Stratified typical cluster sampling is adopted to recruit veteran communities.A cross-sectional study of mental,neurological,and substance use (MNS) disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment,followed by systematic neuropsychological assessments to make clinical diagnoses,evaluated disease awareness and care situation.Results A total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform,yielding a response rate of 83.86%.8 812 subjects complete the MNS subproject screening and total response rate is 91.70%.The average participant age is (82.01±4.61) years,69.47% of veterans are 80 years or older.Most participants are male (94.01%),83.36% of subjects have at least a junior high school degree.The overall health status of veterans is good and stable.The most common NCD are cardiovascular disorders (86.44%),urinary and genital diseases (73.14%),eye and ear problems (66.25%),endocrine (56.56%) and neuro-psychiatric disturbances (50.78%).Conclusion We first construct a veterans' comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans.The good and stable health condition of the

  4. Probabilistic Reliability Assessment of Truss Construction in Matlab Software Platform

    OpenAIRE

    Vašek Jakub; Krejsa Martin

    2014-01-01

    This paper deals with the use of probabilistic methods in assessing the reliability of the planar truss support structure. Classical Monte Carlo simulation technique was chosen for calculation of failure probability in structural elements and the entire support system under assessment. Numerical calculation was applied in MATLAB software system using the random number generator and parallelization using multi-core processors. The aim of the study was to analyze the usability of MATLAB for pro...

  5. ERMHAN: A Context-Aware Service Platform to Support Continuous Care Networks for Home-Based Assistance

    Directory of Open Access Journals (Sweden)

    Federica Paganelli

    2008-01-01

    Full Text Available Continuous care models for chronic diseases pose several technology-oriented challenges for home-based continuous care, where assistance services rely on a close collaboration among different stakeholders such as health operators, patient relatives, and social community members. Here we describe Emilia Romagna Mobile Health Assistance Network (ERMHAN a multichannel context-aware service platform designed to support care networks in cooperating and sharing information with the goal of improving patient quality of life. In order to meet extensibility and flexibility requirements, this platform has been developed through ontology-based context-aware computing and a service oriented approach. We also provide some preliminary results of performance analysis and user survey activity.

  6. An integrated platform for assessing biologics (Conference Presentation)

    Science.gov (United States)

    Schein, Perry; O'Dell, Dakota; Erickson, David

    2016-04-01

    Protein therapeutics are a rapidly growing portion of the pharmaceuticals market and have many significant advantages over traditional small molecule drugs. As this market expands, however, critical regulatory and quality control issues remain, most notably the problem of protein aggregation. Individual target proteins often aggregate into larger masses which trigger an immune response in the body, which can reduce the efficacy of the drug for its intended purpose, or cause serious anaphylactic side-effects. Although detecting and minimizing aggregate formation is critical to ensure an effective product, aggregation dynamics are often highly complicated and there is little hope of reliable prediction and prevention from first principles. This problem is compounded for aggregates in the subvisible range of 100 nm to 10 micrometers where traditional techniques for detecting aggregates have significant limitations. Here, we present an integrated optofluidic platform for detecting nanoscale protein aggregates and characterizing interactions between these aggregates and a reference surface. By delivering light to a solution of proteins with an optical waveguide, scattered light from individual protein aggregates can be detected and analyzed to determine the force profile between each particle and the waveguide surface. Unlike existing methods which only determine size or charge, our label-free screening technique can directly measure the surface interaction forces between single aggregates and the glass substrate. This direct measurement capability may allow for better empirical predictions of the stability of protein aggregates during drug manufacturing and storage.

  7. Obstetrics Patients' Assessment of Medical Students' Role in Their Care.

    Science.gov (United States)

    Magrane, Diane

    1988-01-01

    Obstetric patients rated the skills and assessed the roles of students caring for them during a clinical clerkship. They rated skills and attitudes high, generally, with lower ratings for their ability to answer questions and preparation to participate in care. Most felt students improved their care, primarily in supportive ways. (Author/MSE)

  8. Technology assessment for an integrated PC-based platform for three telemedicine applications

    Science.gov (United States)

    Tohme, Walid G.; Hayes, Wendelin S.; Dai, Hailei L.; Komo, Darmadi; Pahira, John J.; Abernethy, Darrell R.; Rennert, Wolfgang; Kuehl, Karen S.; Hauser, Gabriel J.; Mun, Seong K.

    1996-05-01

    This paper investigates the design and technical efficacy of an integrated PC based platform for three different medical applications. The technical efficacy of such a telemedicine platform has not been evaluated in the literature and optimal technical requirements have not been developed. The first application, with the Department of Surgery, Division of Urology, tests the utility of a telemedicine platform including radiology images for a surgical stone disease consultation service from an off site location in West Virginia. The second application, with the Department of Internal Medicine, Division of Clinical Pharmacology, investigates the usefulness of telemedicine when used for a clinical pharmacology consultation service from an off-site location. The third application, with the Department of Pediatrics, will test telemedicine for trauma care triage service first within an off-site location in Virginia and then from there to Georgetown University Medical Center.

  9. Programmable Bio-nanochip Platform: A Point-of-Care Biosensor System with the Capacity To Learn.

    Science.gov (United States)

    McRae, Michael P; Simmons, Glennon; Wong, Jorge; McDevitt, John T

    2016-07-19

    The combination of point-of-care (POC) medical microdevices and machine learning has the potential transform the practice of medicine. In this area, scalable lab-on-a-chip (LOC) devices have many advantages over standard laboratory methods, including faster analysis, reduced cost, lower power consumption, and higher levels of integration and automation. Despite significant advances in LOC technologies over the years, several remaining obstacles are preventing clinical implementation and market penetration of these novel medical microdevices. Similarly, while machine learning has seen explosive growth in recent years and promises to shift the practice of medicine toward data-intensive and evidence-based decision making, its uptake has been hindered due to the lack of integration between clinical measurements and disease determinations. In this Account, we describe recent developments in the programmable bio-nanochip (p-BNC) system, a biosensor platform with the capacity for learning. The p-BNC is a "platform to digitize biology" in which small quantities of patient sample generate immunofluorescent signal on agarose bead sensors that is optically extracted and converted to antigen concentrations. The platform comprises disposable microfluidic cartridges, a portable analyzer, automated data analysis software, and intuitive mobile health interfaces. The single-use cartridges are fully integrated, self-contained microfluidic devices containing aqueous buffers conveniently embedded for POC use. A novel fluid delivery method was developed to provide accurate and repeatable flow rates via actuation of the cartridge's blister packs. A portable analyzer instrument was designed to integrate fluid delivery, optical detection, image analysis, and user interface, representing a universal system for acquiring, processing, and managing clinical data while overcoming many of the challenges facing the widespread clinical adoption of LOC technologies. We demonstrate the p

  10. System Change: Quality Assessment and Improvement for Medicaid Managed Care

    OpenAIRE

    Smith, Wally R.; Cotter, J. James; Louis F Rossiter

    1996-01-01

    Rising Medicaid health expenditures have hastened the development of State managed care programs. Methods to monitor and improve health care under Medicaid are changing. Under fee-for-service (FFS), the primary concern was to avoid overutilization. Under managed care, it is to avoid underutilization. Quality enhancement thus moves from addressing inefficiency to addressing insufficiency of care. This article presents a case study of Virginia's redesign of Quality Assessment and Improvement (Q...

  11. Health-Care Technology Assessment in Radiology

    OpenAIRE

    Arash Deljou

    2010-01-01

    Health-care service provision and procurement is increasingly subject to policy decisions, managed more than ever before. Becoming more international, collaboration is increasing as the health professions, research and industry all work across borders. Differing health-care systems across the countries result from national and regional policy developments and priorities."nIn health-care, all interventions and procedures are basically technologies-including radiology and sur-gery, and tec...

  12. Construction of life cycle assessment software system platform

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ya-ping; ZUO Yu-hui

    2007-01-01

    There has not been life cycle assessment (LCA) software applicable to China's products. To faciliate the develop-ment of LCA software system in China, we built an object-oriented LCA software system plantform based on LCA international standards ISO 14040 to ISO 14043 and the commonness of diverse products. The system includes six modules: disassembly module, data collection module, arithmetic module, drawing module, database module and control module. It evaluates all economic and environmental impacts during the whole life cycle of a product. The integrated life cycle inventory database system allows dynamic expansion, which makes the effort required for data collection reduce with the increase of the system's application. With the improvement of human environmental-awareness, the demand of environment-friendly products is increasing, and ecological design of products has become a critical part in products development. Consummation of the LCA software system will provide a powerful tool for designing and developing Chinese ecological products.

  13. A Global Refiability Assessment Method on Aging Offshore Platforms with Corrosion and Cracks

    Institute of Scientific and Technical Information of China (English)

    JI Chun-yan; LI Shan-shan; CHEN Ming-lu

    2009-01-01

    Corrosion and fatigue cracks are major threats to the structural integrity of aging offshore platforms.For the rational estimation of the safety levels of aging platforms,a global reliability assessment approach for aging offshore platforms with corrosion and fatigue cracks is presented in this paper.The base shear capacity is taken as the global ultimate strength of the offshore plaffoms,it is modeled as a random process that decreases with time in the presence of corrosion and fatigue crack propagation.And the corrosion and fatigue crack growth rates in the main members and key joints are modeled as random variables.A simulation method of the extreme wave loads which are applied to the structures of offshore platforms is proposed too.Furthermore,the statistics of global base shear capacity and extreme wave loads are obtained by Monte Carlo simulation method.On the basis of the limit state equation of global failure mode,the instantaneous reliability and time dependent reliability assessment methods are both presented in this paper.Finally the instantaueous reliability index and time dependent failure probability of a jacket platform are estimated with different ages in the demonstration example.

  14. Thermo-economic assessment of the integration of steam cycles on offshore platforms

    DEFF Research Database (Denmark)

    Nguyen, Tuong-Van; Tock, Laurence; Breuhaus, Peter;

    2014-01-01

    The integration of steam bottoming cycles on oil platforms is often seen as a possible route to mitigate the CO2-emissions offshore. In this paper, a North Sea platform and its energy requirements are systematically analysed. The site-scale integration of steam networks is assessed by using...... thermodynamic and economic performance indicators. The results illustrate the benefits of converting the gas turbines into a combined cycle. Using seawater results in smaller power generation and greater CO2-emissions than using process water, as the additional power generation in the combined cycle is...

  15. An implementation and test platform for wide area stability assessment methods

    DEFF Research Database (Denmark)

    Wittrock, Martin Lindholm; Jóhannsson, Hjörtur

    2013-01-01

    This paper presents a software platform developed in MatLab with the purpose of supporting research, Development and testing of wide area algorithms for stability assessment and control. The development and testing process of algorithms exploiting real time wide area data from Phasor Measurement...... Units (PMU) can be very time consuming, especially if the testing procedure is not carried out in a systematic and automatic manner. The test platform overcomes this problem by automatically importing system model parameters, topology and simulation output from a time domain simulation of an instability...

  16. GeoProMT: A Collaborative Platform Supporting Natural Hazards Project Management From Assessment to Resilience

    Science.gov (United States)

    Renschler, C.; Sheridan, M. F.; Patra, A. K.

    2008-05-01

    The impact and consequences of extreme geophysical events (hurricanes, floods, wildfires, volcanic flows, mudflows, etc.) on properties and processes should be continuously assessed by a well-coordinated interdisciplinary research and outreach approach addressing risk assessment and resilience. Communication between various involved disciplines and stakeholders is the key to a successful implementation of an integrated risk management plan. These issues become apparent at the level of decision support tools for extreme events/disaster management in natural and managed environments. The Geospatial Project Management Tool (GeoProMT) is a collaborative platform for research and training to document and communicate the fundamental steps in transforming information for extreme events at various scales for analysis and management. GeoProMT is an internet-based interface for the management of shared geo-spatial and multi-temporal information such as measurements, remotely sensed images, and other GIS data. This tool enhances collaborative research activities and the ability to assimilate data from diverse sources by integrating information management. This facilitates a better understanding of natural processes and enhances the integrated assessment of resilience against both the slow and fast onset of hazard risks. Fundamental to understanding and communicating complex natural processes are: (a) representation of spatiotemporal variability, extremes, and uncertainty of environmental properties and processes in the digital domain, (b) transformation of their spatiotemporal representation across scales (e.g. interpolation, aggregation, disaggregation.) during data processing and modeling in the digital domain, and designing and developing tools for (c) geo-spatial data management, and (d) geo-spatial process modeling and effective implementation, and (e) supporting decision- and policy-making in natural resources and hazard management at various spatial and temporal scales

  17. Use of the NetBeans Platform for NASA Robotic Conjunction Assessment Risk Analysis

    Science.gov (United States)

    Sabey, Nickolas J.

    2014-01-01

    The latest Java and JavaFX technologies are very attractive software platforms for customers involved in space mission operations such as those of NASA and the US Air Force. For NASA Robotic Conjunction Assessment Risk Analysis (CARA), the NetBeans platform provided an environment in which scalable software solutions could be developed quickly and efficiently. Both Java 8 and the NetBeans platform are in the process of simplifying CARA development in secure environments by providing a significant amount of capability in a single accredited package, where accreditation alone can account for 6-8 months for each library or software application. Capabilities either in use or being investigated by CARA include: 2D and 3D displays with JavaFX, parallelization with the new Streams API, and scalability through the NetBeans plugin architecture.

  18. Instruments to assess integrated care:a systematic review

    OpenAIRE

    Lyngsø, Anne Marie; Skavlan, Nina; Høst, Dorte; Frølich, Anne

    2014-01-01

    INTRODUCTION: Although several measurement instruments have been developed to measure the level of integrated health care delivery, no standardised, validated instrument exists covering all aspects of integrated care. The purpose of this review is to identify the instruments concerning how to measure the level of integration across health-care sectors and to assess and evaluate the organisational elements within the instruments identified.METHODS: An extensive, systematic literature review in...

  19. Palliative care in India: Situation assessment and future scope

    OpenAIRE

    S S Kar; Subitha, L.; S Iswarya

    2015-01-01

    Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through prevention and relief of suffering by means of early identification, assessment and treatment of pain, and other problems – physical, psychosocial, and spiritual. It is estimated that in India the total number of people who need palliative care is likely to be 5.4 million people a year. Though palliative care services have been i...

  20. Developing and implementing an oral care policy and assessment tool.

    LENUS (Irish Health Repository)

    Stout, Michelle

    2012-01-09

    Oral hygiene is an essential aspect of nursing care. Poor oral care results in patients experiencing pain and discomfort, puts individuals at risk of nutritional deficiency and infection, and has an adverse effect on quality of life. This article describes how an oral care policy and assessment tool were updated to ensure the implementation of evidence-based practice at one hospital in the Republic of Ireland.

  1. Racial and ethnic differences in parents' assessments of pediatric care in Medicaid managed care.

    OpenAIRE

    Weech-Maldonado, R; Morales, L. S.; Spritzer, K; Elliott, M.; Hays, R D

    2001-01-01

    OBJECTIVE: This study examines whether parents' reports and ratings of pediatric health care vary by race/ethnicity and language in Medicaid managed care. DATA SOURCES: The data analyzed are from the National Consumer Assessment of Health Plans (CAHPS) Benchmarking Database 1.0 and consist of 9,540 children enrolled in Medicaid managed care plans in Arkansas, Kansas, Minnesota, Oklahoma, Vermont, and Washington state from 1997 to 1998. DATA COLLECTION: The data were collected by telephone and...

  2. Genetic Assessment of Breast Cancer Risk in Primary Care Practice

    OpenAIRE

    Burke, Wylie; Culver, Julie; Pinsky, Linda; Hall, Sarah; Reynolds, Susan E; Yasui, Yutaka; Press, Nancy

    2009-01-01

    Family history is increasingly important in primary care as a means to detect candidates for genetic testing or tailored prevention programs. We evaluated primary care physicians’ skills in assessing family history for breast cancer risk, using unannounced standardized patient visits to 86 general internists and family medicine practitioners in King County, WA. Transcripts of clinical encounters were coded to determine ascertainment of family history, risk assessment, and clinical follow-up. ...

  3. Palliative care in India: Situation assessment and future scope

    Directory of Open Access Journals (Sweden)

    S S Kar

    2015-01-01

    Full Text Available Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through prevention and relief of suffering by means of early identification, assessment and treatment of pain, and other problems – physical, psychosocial, and spiritual. It is estimated that in India the total number of people who need palliative care is likely to be 5.4 million people a year. Though palliative care services have been in existence for many years, India ranks at the bottom of the Quality of Death index in overall score. However there has been steady progress in the past few years through community-owned palliative care services. One of the key objectives of the National Programme for prevention and control of cancer, diabetes, cardiovascular diseases, and stroke is to establish and develop capacity for palliative and rehabilitative care. Community models for the provision of home-based palliative care is possible by involving community caregivers and volunteers supervised by nurses trained in palliative care. Training of medical officers and health care professionals, and sensitization of the public through awareness campaigns are vital to improve the scope and coverage of palliative care. Process of translating palliative care plan into action requires strong leadership, competent management, political support and integration across all levels of care.

  4. Assessment of genetic variation in Bulgarian tomato (Solanum lycopersicum L.) genotypes, using fluorescent SSR genotyping platform

    OpenAIRE

    TODOROVSKA, Elena; IVANOVA, Albena; Daniela GANEVA; Galina PEVICHAROVA; Molle, Emil; Bojinov, Bojin; Radkova, Mariana; Danailov, Zhivko

    2014-01-01

    Genetic variability in modern crops is limited due to domestication and selection processes. Genetic variation in eight Bulgarian tomato varieties and breeding lines (variety Plovdivska karotina, variety IZK Alya, L21β, L53β, L1140, L1116, L975, L984) differing in their morphological and biochemical composition was assessed using a highly efficient and low-cost fluorescent simple sequence repeat (SSR) genotyping platform. Genotyping was conducted with 165 publicly available microsatellite mar...

  5. An integrated telemedicine platform for the assessment of affective physiological states

    OpenAIRE

    Ganiatsas George; Katsis Christos D; Fotiadis Dimitrios I

    2006-01-01

    Abstract AUBADE is an integrated platform built for the affective assessment of individuals. The system performs evaluation of the emotional state by classifying vectors of features extracted from: facial Electromyogram, Respiration, Electrodermal Activity and Electrocardiogram. The AUBADE system consists of: (a) a multisensorial wearable, (b) a data acquisition and wireless communication module, (c) a feature extraction module, (d) a 3D facial animation module which is used for the projectio...

  6. USGS National Assessment of Oil and Gas Project - Cherokee Platform Province Assessment Units

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Assessment Unit is the fundamental unit used in the National Assessment Project for the assessment of undiscovered oil and gas resources. The Assessment Unit is...

  7. A flexible mobile-device biosensing instrumentation platform for point-of-care medical diagnostics applications

    DEFF Research Database (Denmark)

    Patou, François; Pfreundt, Andrea; Zulfiqar, Azeem;

    2014-01-01

    The early diagnosis and monitoring of chronic diseases still constitutes today one of the major healthcare challenges in our society. Advances in nanotechnology and microfluidics have been increasingly empowering researchers and engineers with tools to develop integrated biosensing solutions...... for this work. We present a mobile-device based, PoC biosensing instrumentation platform, designed for multiplexed high-impedance sensing and the electrochemical detection of biological species on a LoC. The proposed system is thus designed as a flexible, user-friendly hardware and software platform allowing...... programmable electrical readout from LoCs potentially comprehending varied transducers addressing different targeted biological markers. A smart-phone/tablet docking-station embeds the hardware interface necessary for the implementation of a smart-phone digital lock-in amplifier. The platform is tested...

  8. DNA-Aptamer optical biosensors based on a LPG-SPR optical fiber platform for point-of-care diagnostic

    Science.gov (United States)

    Coelho, L.; Queirós, R. B.; Santos, J. L.; Martins, M. Cristina L.; Viegas, D.; Jorge, P. A. S.

    2014-03-01

    Surface Plasmon Resonance (SPR) is the base for some of the most sensitive label free optical fiber biosensors. However, most solutions presented to date require the use of fragile fiber optic structure such as adiabatic tapers or side polished fibers. On the other hand, long-period fiber gratings (LPG) present themselves as an interesting solution to attain an evanescent wave refractive index sensor platform while preserving the optical fiber integrity. The combination of these two approaches constitute a powerful platform that can potentially reach the highest sensitivities as it was recently demonstrated by detailed theoretical study [1, 2]. In this work, a LPG-SPR platform is explored in different configurations (metal coating between two LPG - symmetric and asymmetric) operating in the telecom band (around 1550 nm). For this purpose LPGs with period of 396 μm are combined with tailor made metallic thin films. In particular, the sensing regions were coated with 2 nm of chromium to improve the adhesion to the fiber and 16 nm of gold followed by a 100 nm thick layer of TiO2 dielectric material strategically chosen to attain plasmon resonance in the desired wavelength range. The obtained refractometric platforms were then validated as a biosensor. For this purpose the detection of thrombin using an aptamer based probe was used as a model system for protein detection. The surface of the sensing fibers were cleaned with isopropanol and dried with N2 and then the aminated thrombin aptamer (5'-[NH2]- GGTTGGTGTGGTTGG-3') was immobilized by physisorption using Poly-L-Lysine (PLL) as cationic polymer. Preliminary results indicate the viability of the LPFG-SPR-APTAMER as a flexible platforms point of care diagnostic biosensors.

  9. Beyond satisfaction: Using the Dynamics of Care assessment to better understand patients' experiences in care

    Directory of Open Access Journals (Sweden)

    Kahalas Wendy

    2008-03-01

    Full Text Available Abstract Background Patient perceptions of and satisfaction with care have become important indicators of the quality of services and the relationship of services to treatment outcomes. However, assessment of these indicators continues to be plagued by measurement problems, particularly the lack of variance in satisfaction data. In this article, we present a new approach to better capture patient perceptions of experiences in care, the Dynamics of Care (DoC assessment. It is an in-depth approach to defining and assessing patients' perspectives at different junctures in care, including their decisions about whether and where to seek care, the barriers encountered, and the treatments and services received. Methods The purpose of this article is to describe, validate, and discuss the benefits and limitations of the DoC, which was administered as part of a longitudinal study to evaluate the New York State HIV Special Needs Plan (SNP, a Medicaid managed care model for people living with HIV/AIDS. Data are from 426 study respondents across two time points. Results The results demonstrate the validity and value of the DoC. Help seeking decisions and satisfaction with care appear to be situation-specific, rather than person-specific. However, barriers to care appear to be more cross-situational for respondents, and may be associated with clients' living situations or care arrangements. Inventories in this assessment that were designed to identify potential deterrents to help seeking and difficulties encountered in care demonstrated clear principal component structures, and helped to explain satisfaction with care. The problem resolution index was found to be independent from satisfaction with care and the data were more normally distributed. DoC data were also associated with subsequent utilization and change in quality of life. Conclusion The DoC was designed to be a flexible, integrated measure to determine individuals' salient service needs, help

  10. SYMBIOSE: A modeling and simulation platform for environmental chemical risk assessment

    International Nuclear Information System (INIS)

    Environmental systems are considered among the most complex ones because they involve a large number of diverse components, interactions, scale issues, spatial heterogeneity and significant sources of uncertainty. An Environmental Chemical Risk Assessment (ECRA) require therefore the integration of a wide range of data and modeling approaches, while accounting for sources and propagation of uncertainties in the system. Further, the level of detail to be achieved in an assessment depends mainly on environmental management objectives and the difficulty of adequately describing exposure, toxicity and other properties of the chemicals with site-specific data. This can range from simplistic conservative analyses to more realistic spatiotemporal modeling approaches. As a consequence, there is a pressing need for integrated, flexible (and user-friendly) tools that could adapt to this shifting and expanding assessment context. The SYMBIOSE project aims at developing such a modeling and simulation platform, for assessing the fate, transport and effects of chemicals - radionuclides and heavy metals, mainly - on humans and biota, in a multi-media environment. The various aspects of an environmental chemical risk assessment process, and existing relationships between them, are first revisited in a comprehensive way with emphasis on valuable modeling techniques. The modeling approach that will be implemented in the platform is then described through keystone aspects such as conceptual, mathematical and spatial modeling aspects. Finally, some key ideas about the object-oriented software architecture that is foreseen are presented. (author)

  11. Integrated numerical platforms for environmental dose assessments of large tritium inventory facilities

    International Nuclear Information System (INIS)

    Related with a prospected new scenario of large inventory tritium facilities [KATRIN at TLK, CANDUs, ITER, EAST, other coming] the prescribed dosimetric limits by ICRP-60 for tritium committed-doses are under discussion requiring, in parallel, to surmount the highly conservative assessments by increasing the refinement of dosimetric-assessments in many aspects. Precise Lagrangian-computations of dosimetric cloud-evolution after standardized (normal/incidental/SBO) tritium cloud emissions are today numerically open to the perfect match of real-time meteorological-data, and patterns data at diverse scales for prompt/early and chronic tritium dose assessments. The trends towards integrated-numerical-platforms for environmental-dose assessments of large tritium inventory facilities under development.

  12. Exergetic assessment of energy systems on North Sea oil and gas platforms

    DEFF Research Database (Denmark)

    Nguyen, Tuong-Van; Pierobon, Leonardo; Elmegaard, Brian;

    2013-01-01

    -temperature gases from the utility and flaring systems is the major contributor to the exergy losses. These findings suggest to focus efforts on a better use of the waste heat contained in the exhaust gases and on the ways in which the gas compression performance can be improved. © 2013 Elsevier Ltd. All rights...... offshore system is described: its thermodynamic performance is assessed by performing an exergy accounting and rules of thumb for oil and gas platforms are derived. Simulations are built and conducted with the tools Aspen Plus_, Dynamic Network Analysis and Aspen HYSYS_. 62e65% of the total exergy...... destruction of an offshore platform is attributable to the power generation and waste heat recovery system, and 35 e38% to the oil and gas processing. The variability of the feed composition has little effect on the split of the thermodynamic irreversibilities between both plants. The rejection of high...

  13. An eHealth Platform to Manage Chronic Disease in Primary Care: An Innovative Approach.

    Science.gov (United States)

    Talboom-Kamp, Esther Pwa; Verdijk, Noortje A; Harmans, Lara M; Numans, Mattijs E; Chavannes, Niels H

    2016-01-01

    The number of individuals with chronic illness and multimorbidity is growing due to the rapid ageing of the population and the greater longevity of individuals. This causes an increasing workload in care, which results in a growing need for structural changes of the health care system. In recent years this led to a strong focus on promoting "self-management" in chronically ill patients. Research showed that patients who understand more about their disease, health, and lifestyle have better experiences and health outcomes, and often use less health care resources; the effect is even more when these patients are empowered to and responsible for managing their health and disease. In addition to the skills of patients, health care professionals need to shift to a role of teacher, partner, and professional supervisor of their patients. One way of supervising patients is by the use of electronic health (eHealth), which helps patients manage and control their disease. The application of eHealth solutions can provide chronically ill patients high-quality care, to the satisfaction of both patients and health care professionals, alongside a reduction in health care consumption and costs. PMID:26860333

  14. Assessment of the real-time PCR and different digital PCR platforms for DNA quantification.

    Science.gov (United States)

    Pavšič, Jernej; Žel, Jana; Milavec, Mojca

    2016-01-01

    Digital PCR (dPCR) is beginning to supersede real-time PCR (qPCR) for quantification of nucleic acids in many different applications. Several analytical properties of the two most commonly used dPCR platforms, namely the QX100 system (Bio-Rad) and the 12.765 array of the Biomark system (Fluidigm), have already been evaluated and compared with those of qPCR. However, to the best of our knowledge, direct comparison between the three of these platforms using the same DNA material has not been done, and the 37 K array on the Biomark system has also not been evaluated in terms of linearity, analytical sensitivity and limit of quantification. Here, a first assessment of qPCR, the QX100 system and both arrays of the Biomark system was performed with plasmid and genomic DNA from human cytomegalovirus. With use of PCR components that alter the efficiency of qPCR, each dPCR platform demonstrated consistent copy-number estimations, which indicates the high resilience of dPCR. Two approaches, one considering the total reaction volume and the other considering the effective reaction size, were used to assess linearity, analytical sensitivity and variability. When the total reaction volume was considered, the best performance was observed with qPCR, followed by the QX100 system and the Biomark system. In contrast, when the effective reaction size was considered, all three platforms showed almost equal limits of detection and variability. Although dPCR might not always be more appropriate than qPCR for quantification of low copy numbers, dPCR is a suitable method for robust and reproducible quantification of viral DNA, and a promising technology for the higher-order reference measurement method. PMID:26521179

  15. Monitoring and Detection Platform to Prevent Anomalous Situations in Home Care

    OpenAIRE

    Gabriel Villarrubia; Javier Bajo; Juan F. DE PAZ; Juan M. Corchado

    2014-01-01

    Monitoring and tracking people at home usually requires high cost hardware installations, which implies they are not affordable in many situations. This study/paper proposes a monitoring and tracking system for people with medical problems. A virtual organization of agents based on the PANGEA platform, which allows the easy integration of different devices, was created for this study. In this case, a virtual organization was implemented to track and monitor patients carrying a Holter monitor....

  16. Assessing Quality in Mental Health Care

    OpenAIRE

    Ian Shaw

    1997-01-01

    Quality assessment in mental health services is undergoing change in the United Kingdom following the introduction of market reforms. Traditionally, service quality was monitored by professional practitioners with reference to user satisfaction. This became formalized, and the two main forms of quality assurance currently used are outlined. However, the government is concerned that this may be inadequate for the monitoring of quality standards, specified in contracts between service purchaser...

  17. A Model for Risk Assessment in Health Care.

    Science.gov (United States)

    Prijatelj, Vesna; Rajkovič, Vladislav; Šušteršič, Olga

    2016-01-01

    The purpose of our research is to reduce risks and hence prevent errors in the health care process. The aim is to design an organizational information model using error prevention methods for risk assessment in a clinical setting. The model is based on selected indicators of quality nursing care, resulting from the world-known theoretical and practical models combined with experience in the Slovenian health care. The proposed organizational information model and software solution has a significant impact on the professional attention, communication and information, critical thinking, experience and knowledge. PMID:27332383

  18. The TRIPOD e-learning Platform for the Training of Earthquake Safety Assessment

    Science.gov (United States)

    Coppari, S.; Di Pasquale, G.; Goretti, A.; Papa, F.; Papa, S.; Paoli, G.; Pizza, A. G.; Severino, M.

    2008-07-01

    The paper summarizes the results of the in progress EU Project titled TRIPOD (Training Civil Engineers on Post-Earthquake Safety Assessment of Damaged Buildings), funded under the Leonardo Da Vinci program. The main theme of the project is the development of a methodology and a learning platform for the training of technicians involved in post-earthquake building safety inspections. In the event of a catastrophic earthquake, emergency building inspections constitute a major undertaking with severe social impact. Given the inevitable chaotic conditions and the urgent need of a great number of specialized individuals to carry out inspections, past experience indicates that inspection teams are often formed in an adhoc manner, under stressful conditions, at a varying levels of technical expertise and experience, sometime impairing the reliability and consistency of the inspection results. Furthermore each Country has its own building damage and safety assessment methodology, developed according to its experience, laws, building technology and seismicity. This holds also for the partners participating to the project (Greece, Italy, Turkey, Cyprus), that all come from seismically sensitive Mediterranean countries. The project aims at alleviating the above shortcomings by designing and developing a training methodology and e-platform, forming a complete training program targeted at inspection engineers, specialized personnel and civil protection agencies. The e-learning platform will provide flexible and friendly authoring mechanisms, self-teaching and assessment capabilities, course and trainee management, etc. Courses will be also made available as stand-alone multimedia applications on CD and in the form of a complete pocket handbook. Moreover the project will offer the possibility of upgrading different experiences and practices: a first step towards the harmonization of methodologies and tools of different Countries sharing similar problems. Finally, through wide

  19. The TRIPOD e-learning Platform for the Training of Earthquake Safety Assessment

    International Nuclear Information System (INIS)

    The paper summarizes the results of the in progress EU Project titled TRIPOD (Training Civil Engineers on Post-Earthquake Safety Assessment of Damaged Buildings), funded under the Leonardo Da Vinci program. The main theme of the project is the development of a methodology and a learning platform for the training of technicians involved in post-earthquake building safety inspections. In the event of a catastrophic earthquake, emergency building inspections constitute a major undertaking with severe social impact. Given the inevitable chaotic conditions and the urgent need of a great number of specialized individuals to carry out inspections, past experience indicates that inspection teams are often formed in an adhoc manner, under stressful conditions, at a varying levels of technical expertise and experience, sometime impairing the reliability and consistency of the inspection results. Furthermore each Country has its own building damage and safety assessment methodology, developed according to its experience, laws, building technology and seismicity. This holds also for the partners participating to the project (Greece, Italy, Turkey, Cyprus), that all come from seismically sensitive Mediterranean countries. The project aims at alleviating the above shortcomings by designing and developing a training methodology and e-platform, forming a complete training program targeted at inspection engineers, specialized personnel and civil protection agencies. The e-learning platform will provide flexible and friendly authoring mechanisms, self-teaching and assessment capabilities, course and trainee management, etc. Courses will be also made available as stand-alone multimedia applications on CD and in the form of a complete pocket handbook. Moreover the project will offer the possibility of upgrading different experiences and practices: a first step towards the harmonization of methodologies and tools of different Countries sharing similar problems. Finally, through wide

  20. Integrated Modelling Platform for Dynamic Performance Assessment of Floating Wind Turbines

    OpenAIRE

    Endegnanew, Atsede Gualu; Satertro, Kristian; Gjerde, Sverre Skalleberg; Svendsen, Harald Georg; Anaya-Lara, Olimpo; Tande, John Olav Giæver; Uhlen, Kjetil; Gjolmesli, Svein

    2015-01-01

    The paper presents an integrated modelling platform that can be used to assess the dynamic performance of an offshore wind turbine mounted on a spar-buoy type floater. Sub-models of generator and converter controllers and the power network are combined with a state-of-the-art numerical simulation of the hydro-, aero- and structural dynamic behavior of the floating wind turbine, using FEDEM Windpower software. The aim is to provide a tool that allows analyzing response of floating turbines to ...

  1. Challenges of Assessing Maltreated Children Coming into Foster Care.

    Science.gov (United States)

    Pritchett, Rachel; Hockaday, Harriet; Anderson, Beatrice; Davidson, Claire; Gillberg, Christopher; Minnis, Helen

    2016-01-01

    Children who have experienced early adversity have been known to be at risk of developing cognitive, attachment, and mental health problems; therefore, it is crucial that children entering foster care can be properly assessed as early as possible. There are known difficulties in assessing children in foster care, for example, in finding a reliable informant. An ongoing randomised controlled trial in Glasgow, Scotland, recruiting infants entering foster care, provides a unique opportunity to explore some of the issues which need to be considered when assessing these children. The assessment data of 70 infants entering care is described while exploring the reliability of foster carers as informants and the importance of infant engagement with tasks. This group of infants was shown to be having more problems than children from the general population. While correlations were found between a carer's level of concern about a child and the severity of a child's problem, there were still a number of children displaying worrying problem scores whom foster carers did not report concern. The child's engagement in the cognitive task showed associations with the child's attainment on the task. Findings emphasise the importance of a holistic assessment for these children and all should be considered as potential cases with Maltreatment-Associated Psychiatric Problems (MAPP). PMID:26881270

  2. Challenges of Assessing Maltreated Children Coming into Foster Care

    Directory of Open Access Journals (Sweden)

    Rachel Pritchett

    2016-01-01

    Full Text Available Children who have experienced early adversity have been known to be at risk of developing cognitive, attachment, and mental health problems; therefore, it is crucial that children entering foster care can be properly assessed as early as possible. There are known difficulties in assessing children in foster care, for example, in finding a reliable informant. An ongoing randomised controlled trial in Glasgow, Scotland, recruiting infants entering foster care, provides a unique opportunity to explore some of the issues which need to be considered when assessing these children. The assessment data of 70 infants entering care is described while exploring the reliability of foster carers as informants and the importance of infant engagement with tasks. This group of infants was shown to be having more problems than children from the general population. While correlations were found between a carer’s level of concern about a child and the severity of a child’s problem, there were still a number of children displaying worrying problem scores whom foster carers did not report concern. The child’s engagement in the cognitive task showed associations with the child’s attainment on the task. Findings emphasise the importance of a holistic assessment for these children and all should be considered as potential cases with Maltreatment-Associated Psychiatric Problems (MAPP.

  3. Tile-in-ONE: A web platform which integrates Tile Calorimeter data quality and calibration assessment

    Science.gov (United States)

    Sivolella, A.; Ferreira, F.; Maidantchik, C.; Solans, C.; Solodkov, A.; Burghgrave, B.; Smirnov, Y.

    2015-12-01

    The ATLAS Tile Calorimeter collaboration assesses the quality of calibration data in order to ensure its proper operation. A number of tasks is then performed by executing several tools and accessing web systems, which were independently developed to meet distinct collaboration's requirements and do not necessarily are connected with each other. Thus, to attend the collaboration needs, several programs are usually implemented without a global perspective of the detector, requiring basic software features. In addition, functionalities may overlap in their objectives and frequently replicate resources retrieval mechanisms. Tile-in-ONE is a designed and implemented platform that assembles various web systems used by the calorimeter community through a single framework and a standard technology. It provides an infrastructure to support the code implementation, avoiding duplication of work while integrating with an overall view of the detector status. Database connectors smooth the process of information access since developers do not need to be aware of where records are placed and how to extract them. Within the environment, a dashboard stands for a particular Tile operation aspect and gets together plug-ins, i.e. software components that add specific features to an existing application. A server contains the platform core, which represents the basic environment to deal with the configuration, manage user settings and load plug-ins at runtime. A web middleware assists users to develop their own plug-ins, perform tests and integrate them into the platform as a whole. Backends are employed to allow that any type of application is interpreted and displayed in a uniform way. This paper describes Tile-in-ONE web platform.

  4. Exergetic assessment of energy systems on North Sea oil and gas platforms

    International Nuclear Information System (INIS)

    Oil and gas platforms in the North Sea region are associated with high power consumption and large CO2-emissions, as the processing and utility plants suffer from significant changes in production rates and performance losses over the field lifespan. In this paper, a generic model of the overall offshore system is described: its thermodynamic performance is assessed by performing an exergy accounting and rules of thumb for oil and gas platforms are derived. Simulations are built and conducted with the tools Aspen Plus®, Dynamic Network Analysis and Aspen HYSYS®. 62–65% of the total exergy destruction of an offshore platform is attributable to the power generation and waste heat recovery system, and 35–38% to the oil and gas processing. The variability of the feed composition has little effect on the split of the thermodynamic irreversibilities between both plants. The rejection of high-temperature gases from the utility and flaring systems is the major contributor to the exergy losses. These findings suggest to focus efforts on a better use of the waste heat contained in the exhaust gases and on the ways in which the gas compression performance can be improved. - Highlights: • North Sea oil and gas platforms are investigated and a generic model is developed. • Exergy analysis of these offshore facilities is performed. • Most of the total exergy destruction is attributable to the utility systems producing the electrical power required onsite. • Rejection of the exhaust gases from the utility systems is the major exergy loss of this system. • The highest thermodynamic performance is reached with low well-fluid content of water and gas

  5. Quality assessment of child care services in primary health care settings of Central Karnataka (Davangere District

    Directory of Open Access Journals (Sweden)

    Rashmi

    2010-01-01

    Full Text Available Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert′s scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother′s education andoutreach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers′ knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average.

  6. Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: strategies for delivery and integration of evidence-based interventions

    OpenAIRE

    Shidhaye, Rahul; Lund, Crick; Chisholm, Dan

    2015-01-01

    This paper outlines the main elements and features of a mental health care delivery platform and its delivery channels. These include evidence-based interventions that can be delivered via this platform as well as broader health system strengthening strategies for more effective and efficient delivery of services. The focus is broadly on health systems perspective rather than strictly disorder-oriented intervention analysis. A set of evidence-based interventions within the WHO pyramid framewo...

  7. Reliability of medical audit in quality assessment of medical care

    Directory of Open Access Journals (Sweden)

    Camacho Luiz Antonio Bastos

    1996-01-01

    Full Text Available Medical audit of hospital records has been a major component of quality of care assessment, although physician judgment is known to have low reliability. We estimated interrater agreement of quality assessment in a sample of patients with cardiac conditions admitted to an American teaching hospital. Physician-reviewers used structured review methods designed to improve quality assessment based on judgment. Chance-corrected agreement for the items considered more relevant to process and outcome of care ranged from low to moderate (0.2 to 0.6, depending on the review item and the principal diagnoses and procedures the patients underwent. Results from several studies seem to converge on this point. Comparisons among different settings should be made with caution, given the sensitivity of agreement measurements to prevalence rates. Reliability of review methods in their current stage could be improved by combining the assessment of two or more reviewers, and by emphasizing outcome-oriented events.

  8. Workplace-based assessment in a primary-care setting.

    Science.gov (United States)

    Hecker, Kent G; Norris, Jill; Coe, Jason B

    2012-01-01

    Workplace-based assessment (WBA) is the process of directly observing students' work within a clinical setting, assessing their performance, and providing specific, goal oriented feedback. Assessment methods used for workplace-based assessment include tools developed for clinical interaction (e.g., the mini clinical evaluation exercise [mini-CEX]), for procedural or technical skills (e.g., the direct observation of procedural skills [DOPS]), and multi-source feedback tools to assess interpersonal and technical skills. While several of these assessment methods are being adopted by veterinary schools to evaluate students' progress through their clinical rotations, there is little reported at this time about their utility and effectiveness within the veterinary context. This article provides an introduction to the use of these tools and offers guidance in selecting appropriate methods for assessment in the primary health care setting. PMID:22951458

  9. OpenQuake, a platform for collaborative seismic hazard and risk assessment

    Science.gov (United States)

    Henshaw, Paul; Burton, Christopher; Butler, Lars; Crowley, Helen; Danciu, Laurentiu; Nastasi, Matteo; Monelli, Damiano; Pagani, Marco; Panzeri, Luigi; Simionato, Michele; Silva, Vitor; Vallarelli, Giuseppe; Weatherill, Graeme; Wyss, Ben

    2013-04-01

    Sharing of data and risk information, best practices, and approaches across the globe is key to assessing risk more effectively. Through global projects, open-source IT development and collaborations with more than 10 regions, leading experts are collaboratively developing unique global datasets, best practice, tools and models for global seismic hazard and risk assessment, within the context of the Global Earthquake Model (GEM). Guided by the needs and experiences of governments, companies and international organisations, all contributions are being integrated into OpenQuake: a web-based platform that - together with other resources - will become accessible in 2014. With OpenQuake, stakeholders worldwide will be able to calculate, visualize and investigate earthquake hazard and risk, capture new data and share findings for joint learning. The platform is envisaged as a collaborative hub for earthquake risk assessment, used at global and local scales, around which an active network of users has formed. OpenQuake will comprise both online and offline tools, many of which can also be used independently. One of the first steps in OpenQuake development was the creation of open-source software for advanced seismic hazard and risk calculations at any scale, the OpenQuake Engine. Although in continuous development, a command-line version of the software is already being test-driven and used by hundreds worldwide; from non-profits in Central Asia, seismologists in sub-Saharan Africa and companies in South Asia to the European seismic hazard harmonization programme (SHARE). In addition, several technical trainings were organized with scientists from different regions of the world (sub-Saharan Africa, Central Asia, Asia-Pacific) to introduce the engine and other OpenQuake tools to the community, something that will continue to happen over the coming years. Other tools that are being developed of direct interest to the hazard community are: • OpenQuake Modeller; fundamental

  10. Tile-ippokratis: the experience of an ehealth platform for the provision of health care services in the island of chios and cyprus.

    Science.gov (United States)

    Papadopoulos, Homer

    2010-01-01

    Tile-Ippokratis proposed an integrated platform for the provision of low-cost ehealth services to citizens in southeast Mediterranean area (Island of Chios and Cyprus). The aim of the paper is to present the architecture, the design, and the evaluation results of this platform. The platform based on already evaluated state-of-the-art mobile ehealth systems and using wireless and terrestrial telecommunication networks is able to provide the following health care services: (i) telecollaboration and teleconsultation services between health care personnel and between health care personnel and patients and (ii) ehealth services for "at risk" citizens such as elderly and patients with chronic diseases (Island of Chios) and postsurgery patients (Cyprus). The ehealth systems supported capabilities for vital signal measurements (ECG 1 lead, SPO2, HR, BP, weight, and temperature), an Electronic Patient Record (EPR) infrastructure, and video conference, along with communication gateways for data transmission over ADSL, GPRS, and WLAN networks. PMID:20871664

  11. Self-assessment in cancer patients referred to palliative care

    DEFF Research Database (Denmark)

    Strömgren, Annette S; Goldschmidt, Dorthe; Groenvold, Mogens;

    2002-01-01

    -based study using the European Organization for Research and Treatment of Cancer quality-of-life instrument EORTC QLQ-C30, the Edmonton Symptom Assessment System (ESAS), and the Hospital Anxiety and Depression Scale (HADS) in cancer patients who were receiving palliative care. This report describes the......-based study of symptomatology in consecutive cancer patients in palliative care, achieving rather complete data from the participants. The symptomatology in these patients was very pronounced. The questionnaires were able to detect clinically important differences between places of service.......BACKGROUND: Research in palliative care is considered difficult due to the poor health of patients. However, patient-provided data are essential for a thorough description of patient symptomatology and for the evaluation of care. METHODS: The authors examined the feasibility of a questionnaire...

  12. Evaluating the Child Care Director: The Collaborative Professional Assessment Process.

    Science.gov (United States)

    Freeman, Nancy K.; Brown, Mac H.

    2000-01-01

    Describes the Collaborative Professional Assessment Process (CPAP) to guide the evaluation of the director of early childhood programs. Examines the assumptions upon which the CPAP is based. Lists the management skills and leadership abilities of successful child care directors. Includes the Director Self-Evaluation form and a program evaluation…

  13. Laboratory Evaluation of a Dual-Path Platform Assay for Rapid Point-of-Care HIV and Syphilis Testing.

    Science.gov (United States)

    Leon, S R; Ramos, L B; Vargas, S K; Kojima, N; Perez, D G; Caceres, C F; Klausner, J D

    2016-02-01

    We assessed the laboratory performance of the Chembio dual-path platform HIV-syphilis rapid immunodiagnostic test and electronic reader for detection of HIV and Treponema pallidum antibodies in 450 previously characterized serum specimens. For visual or electronic reader HIV antibody detection, the sensitivity was 100% and the specificity was 98.7%. For visual T. pallidum antibody detection, the test sensitivity was 94.7% and the specificity was 100.0%; with the electronic reader, the sensitivity was 94.7% and the specificity was 99.7%. PMID:26659215

  14. Microchip screening platform for single cell assessment of NK cell cytotoxicity

    Directory of Open Access Journals (Sweden)

    Karolin eGuldevall

    2016-04-01

    Full Text Available Here we report a screening platform for assessment of the cytotoxic potential of individual natural killer (NK cells within larger populations. Human primary NK cells were distributed across a silicon-glass microchip containing 32 400 individual microwells loaded with target cells. Through fluorescence screening and automated image analysis the numbers of NK and live or dead target cells in each well could be assessed at different time points after initial mixing. Cytotoxicity was also studied by time-lapse live-cell imaging in microwells quantifying the killing potential of individual NK cells. Although most resting NK cells (≈75% were non-cytotoxic against the leukemia cell line K562, some NK cells were able to kill several (≥3 target cells within the 12 hours long experiment. In addition, the screening approach was adapted to increase the chance to find and evaluate serial killing NK cells. Even if the cytotoxic potential varied between donors it was evident that a small fraction of highly cytotoxic NK cells were responsible for a substantial portion of the killing. We demonstrate multiple assays where our platform can be used to enumerate and characterize cytotoxic cells, such as NK or T cells. This approach could find use in clinical applications, e.g. in the selection of donors for stem cell transplantation or generation of highly specific and cytotoxic cells for adoptive immunotherapy.

  15. Monitoring and detection platform to prevent anomalous situations in home care.

    Science.gov (United States)

    Villarrubia, Gabriel; Bajo, Javier; De Paz, Juan F; Corchado, Juan M

    2014-01-01

    Monitoring and tracking people at home usually requires high cost hardware installations, which implies they are not affordable in many situations. This study/paper proposes a monitoring and tracking system for people with medical problems. A virtual organization of agents based on the PANGEA platform, which allows the easy integration of different devices, was created for this study. In this case, a virtual organization was implemented to track and monitor patients carrying a Holter monitor. The system includes the hardware and software required to perform: ECG measurements, monitoring through accelerometers and WiFi networks. Furthermore, the use of interactive television can moderate interactivity with the user. The system makes it possible to merge the information and facilitates patient tracking efficiently with low cost. PMID:24905853

  16. Monitoring and Detection Platform to Prevent Anomalous Situations in Home Care

    Directory of Open Access Journals (Sweden)

    Gabriel Villarrubia

    2014-06-01

    Full Text Available Monitoring and tracking people at home usually requires high cost hardware installations, which implies they are not affordable in many situations. This study/paper proposes a monitoring and tracking system for people with medical problems. A virtual organization of agents based on the PANGEA platform, which allows the easy integration of different devices, was created for this study. In this case, a virtual organization was implemented to track and monitor patients carrying a Holter monitor. The system includes the hardware and software required to perform: ECG measurements, monitoring through accelerometers and WiFi networks. Furthermore, the use of interactive television can moderate interactivity with the user. The system makes it possible to merge the information and facilitates patient tracking efficiently with low cost.

  17. Real-Time Processing of Continuous Physiological Signals in a Neurocritical Care Unit on a Stream Data Analytics Platform.

    Science.gov (United States)

    Bai, Yong; Sow, Daby; Vespa, Paul; Hu, Xiao

    2016-01-01

    Continuous high-volume and high-frequency brain signals such as intracranial pressure (ICP) and electroencephalographic (EEG) waveforms are commonly collected by bedside monitors in neurocritical care. While such signals often carry early signs of neurological deterioration, detecting these signs in real time with conventional data processing methods mainly designed for retrospective analysis has been extremely challenging. Such methods are not designed to handle the large volumes of waveform data produced by bedside monitors. In this pilot study, we address this challenge by building a prototype system using the IBM InfoSphere Streams platform, a scalable stream computing platform, to detect unstable ICP dynamics in real time. The system continuously receives electrocardiographic and ICP signals and analyzes ICP pulse morphology looking for deviations from a steady state. We also designed a Web interface to display in real time the result of this analysis in a Web browser. With this interface, physicians are able to ubiquitously check on the status of their patients and gain direct insight into and interpretation of the patient's state in real time. The prototype system has been successfully tested prospectively on live hospitalized patients. PMID:27165881

  18. An instrument assessing patient satisfaction with day care in hospitals

    Directory of Open Access Journals (Sweden)

    Kleefstra SM

    2012-05-01

    Full Text Available Abstract Background Patient satisfaction is an important indicator of quality of care in hospitals. Reliable and valid instruments to measure clinical and outpatient satisfaction already exist. Recently hospitals have increasingly provided day care, i.e., admitting patients for one day without an overnight stay. This article describes the adaption of the ‘Core questionnaire for the assessment of Patient Satisfaction’ (COPS for general Day care (COPS-D, and the subsequent validation of the COPS-D. Methods The clinical COPS was supplemented with items to cover two new dimensions: Pre-admission visit and Operation Room. It was sent to a sample of day care patients of five general Dutch hospitals to investigate dimensionality, acceptability, reliability, construct and external validity. Construct validity was established by correlating the dimensions of the COPS-D with patients’ overall satisfaction. Results The COPS-D was returned by 3802 patients (response 46%. Factor analysis confirmed its’ structure: Pre-intake visit, Admission, Operation room, Nursing care, Medical care, Information, Autonomy and Discharge and aftercare (extraction communality 0.63-0.90. The internal consistency of the eight dimensions was good (α = 0.82-0.90; the item internal consistency corrected for overlap was satisfactory (>0.40; all inter-item correlations were higher than 0.45 but not too high (Information dimension had the strongest correlation with overall day care satisfaction. Conclusions The COPS-D is a reliable and valid instrument for measuring satisfaction with day care. It complements the model of measuring patient satisfaction with clinical and outpatient care given in hospitals. It also fulfils the conditions made while developing the clinical and outpatient COPS: a short, core instrument to screen patient satisfaction.

  19. The GenePOC Platform, a Rational Solution for Extreme Point-of-Care Testing

    OpenAIRE

    Luc Bissonnette; Bergeron, Michel G.

    2016-01-01

    Extreme point-of-care (POC) testing for infections, as performed (endured) in low-resource settings, developing countries, tropical areas, or in conditions following emergency crises or natural disasters, must be undertaken under environmental, logistic, and societal conditions which impose a significant deal of stress on local human populations and healthcare providers. For disease diagnostics or management, simple and robust biomedical equipment and reagents are required and needed. This ch...

  20. Comparison of Unmanned Aerial Vehicle Platforms for Assessing Vegetation Cover in Sagebrush Steppe Ecosystems

    Energy Technology Data Exchange (ETDEWEB)

    Robert P. Breckenridge; Maxine Dakins; Stephen Bunting; Jerry Harbour; Sera White

    2011-09-01

    In this study, the use of unmanned aerial vehicles (UAVs) as a quick and safe method for monitoring biotic resources was evaluated. Vegetation cover and the amount of bare ground are important factors in understanding the sustainability of many ecosystems and assessment of rangeland health. Methods that improve speed and cost efficiency could greatly improve how biotic resources are monitored on western lands. Sagebrush steppe ecosystems provide important habitat for a variety of species (including sage grouse and pygmy rabbit). Improved methods are needed to support monitoring these habitats because there are not enough resource specialists or funds available for comprehensive ground evaluations. In this project, two UAV platforms, fixed wing and helicopter, were used to collect still-frame imagery to assess vegetation cover in sagebrush steppe ecosystems. This paper discusses the process for collecting and analyzing imagery from the UAVs to (1) estimate percent cover for six different vegetation types (shrub, dead shrub, grass, forb, litter, and bare ground) and (2) locate sage grouse using representative decoys. The field plots were located on the Idaho National Engineering (INL) site west of Idaho Falls, Idaho, in areas with varying amounts and types of vegetation cover. A software program called SamplePoint was used along with visual inspection to evaluate percent cover for the six cover types. Results were compared against standard field measurements to assess accuracy. The comparison of fixed-wing and helicopter UAV technology against field estimates shows good agreement for the measurement of bare ground. This study shows that if a high degree of detail and data accuracy is desired, then a helicopter UAV may be a good platform to use. If the data collection objective is to assess broad-scale landscape level changes, then the collection of imagery with a fixed-wing system is probably more appropriate.

  1. The touchscreen operant platform for assessing cognitive functions in a rat model of depression.

    Science.gov (United States)

    Tran, Thao Phuong; Christensen, Helle Lyng; Bertelsen, Freja Cecilia Brandt; Bouzinova, Elena; Møller, Arne; Wiborg, Ove

    2016-07-01

    In the present study we assessed alterations in cognitive functions in a chronic mild stress (CMS) rat model of depression. Cognitive functions were assessed in two different tasks applying the translational operant platform touchscreen technology; the visual discrimination/acquisition task was used to assess the ability to perceive and distinguish visual stimuli and to assess associative stimulus-reward learning. The visual discrimination/reversal learning task was used to assess functional brain plasticity or reprogramming of previously acquired stimulus-reward associations. These tasks permit the dissociation of multiple cognitive domains. The CMS model is a validated depression model with the useful feature that rats upon stress exposure show a graduated, individual stress response allowing the segregation of rats into different phenotypes including stress-resilient and anhedonic-like subgroups. Anhedonic-like rats are less likely to acquire the pairwise discrimination task, and they have a slower acquisition rate than controls. In the reversal learning task, resilient rats performed significantly better than anhedonic-like rats over time and 50% passed criterion as opposed to 25% for controls and only 14% for anhedonic-like rats. This indicates that resilient rats have higher cognitive flexibility than anhedonic-like rats. Thus they perform better in learning a novel task, which at the same time potentially implies an increased ability to inhibit previously rewarded behavior. PMID:27083126

  2. Health-care technology assessment: a clinical perspective.

    Science.gov (United States)

    Chantler, Cyril

    2004-01-01

    Health technology assessment needs to relate to contemporary questions which concern public health-care systems: how to keep people healthy, how to focus on the needs of those with chronic disabilities and integrate care between the hospital and the community, how to encourage and audit effective teamwork, and how to establish a consensus about what is effective and affordable. Clinicians have an ethical responsibility to practice efficiently and economically, for profligacy in the care of one patient may mean that another is treated inadequately. For similar reasons, clinicians need to play a full role in the management of services. Advice from health technology assessment is vital and needs to be accurate, relevant, timely, clear, and accessible. As well as being concerned about what works, we need also to eliminate from practice what does not. Regular audit and appraisal of practice against the evidence base should be useful in this respect. Alternative approaches to management, such as the provision of care as opposed to aggressive treatments, need to be evaluated, and health technology assessment needs to consider how services are delivered, not just specific treatments. PMID:15176183

  3. GlobAllomeTree: international platform for tree allometric equations to support volume, biomass and carbon assessment

    OpenAIRE

    Henry M; Bombelli A; Trotta C,; Alessandrini A; Birigazzi L; Sola G; Vieilledent G; Santenoise P; Longuetaud F; Valentini R; Picard N; Saint-André L

    2013-01-01

    GlobAllomeTree is an international platform for tree allometric equations. It is the first worldwide web platform designed to facilitate the access of the tree allometric equation and to facilitate the assessment of the tree biometric characteristics for commercial volume, bio-energy or carbon cycling. The webplatform presents a database containing tree allometric equations, a software called Fantallomatrik, to facilitate the comparison and selection of the equations, and documentation to fac...

  4. Product Platform Performance

    DEFF Research Database (Denmark)

    Munk, Lone

    experienced representatives from the different life systems phase systems of the platform products. The effects are estimated and modeled within different scenarios, taking into account financial and real option aspects. The model illustrates and supports estimation and quantification of internal platform....... These reasons are mentioned in literature, but only the two latter are addressed in platform assessment criteria. Hence a new platform assessment criterion is introduced, the platform user incentive criterion. Alongside with the introduction and recommendation of a platform user incentive criterion...

  5. I want what you've got: Cross platform portabiity and human-robot interaction assessment.

    Energy Technology Data Exchange (ETDEWEB)

    Julie L. Marble, Ph.D.*.; Douglas A. Few; David J. Bruemmer

    2005-08-01

    Human-robot interaction is a subtle, yet critical aspect of design that must be assessed during the development of both the human-robot interface and robot behaviors if the human-robot team is to effectively meet the complexities of the task environment. Testing not only ensures that the system can successfully achieve the tasks for which it was designed, but more importantly, usability testing allows the designers to understand how humans and robots can, will, and should work together to optimize workload distribution. A lack of human-centered robot interface design, the rigidity of sensor configuration, and the platform-specific nature of research robot development environments are a few factors preventing robotic solutions from reaching functional utility in real word environments. Often the difficult engineering challenge of implementing adroit reactive behavior, reliable communication, trustworthy autonomy that combines with system transparency and usable interfaces is overlooked in favor of other research aims. The result is that many robotic systems never reach a level of functional utility necessary even to evaluate the efficacy of the basic system, much less result in a system that can be used in a critical, real-world environment. Further, because control architectures and interfaces are often platform specific, it is difficult or even impossible to make usability comparisons between them. This paper discusses the challenges inherent to the conduct of human factors testing of variable autonomy control architectures and across platforms within a complex, real-world environment. It discusses the need to compare behaviors, architectures, and interfaces within a structured environment that contains challenging real-world tasks, and the implications for system acceptance and trust of autonomous robotic systems for how humans and robots interact in true interactive teams.

  6. Petroleum resource assessment, Paleozoic successions of the St. Lawrence Platform and Appalachians of eastern Canada

    Energy Technology Data Exchange (ETDEWEB)

    Lavoie, D.; Pinet, N.; Dietrich, J.; Hannigan, P; Castonguay, S.; Hamblin, A.P.; Giles, P.

    2009-07-01

    This paper provided an assessment of the petroleum resource found in the Paleozoic successions of the St. Lawrence Platform and the Appalachians of eastern Canada. The Cambrian-Permian successions in eastern Canada belong to 3 tectonostratigraphic domains, each with its own unique source rock, reservoir units, and trap types. All the basins contain producing or discovered hydrocarbon fields, but their ultimate oil and gas resource potential had not been evaluated recently. In the Palaeozoic strata, 15 conventional petroleum plays and 3 unconventional gas plays have been recognized, but a large number of the conventional and all the unconventional plays cannot be quantitatively assessed. For this reason, the total resource presented in the paper is a minimum potential, as evidence for hydrocarbon charge is compelling in most of the qualitatively assessed plays. The assessment results enhance the understanding of the energy resource endowment of Paleozoic basins in eastern Canada. The large gas potential of Carboniferous basins was found to be much higher than previously estimated. refs., tabs., figs.

  7. Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: strategies for delivery and integration of evidence-based interventions.

    Science.gov (United States)

    Shidhaye, Rahul; Lund, Crick; Chisholm, Dan

    2015-01-01

    This paper outlines the main elements and features of a mental health care delivery platform and its delivery channels. These include evidence-based interventions that can be delivered via this platform as well as broader health system strengthening strategies for more effective and efficient delivery of services. The focus is broadly on health systems perspective rather than strictly disorder-oriented intervention analysis. A set of evidence-based interventions within the WHO pyramid framework of self-care, primary care, and specialist care have been identified; the main challenge lies in the translation of that evidence into practice. The delivery of these interventions requires an approach that puts into practice key principles of public health, adopts systems thinking, promotes whole-of-government involvement and is focused on quality improvement. Key strategies for effective translation of evidence into action include collaborative stepped care, strengthening human resources, and integrating mental health into general health care. In order to pursue these principles and strategies using a platform-wide approach, policy makers need to engage with a wide range of stakeholders and make use of the best available evidence in a transparent manner. PMID:26719762

  8. Creation of complexity assessment tool for patients receiving home care

    Directory of Open Access Journals (Sweden)

    Maria Leopoldina de Castro Villas Bôas

    2016-06-01

    Full Text Available Abstract OBJECTIVE To create and validate a complexity assessment tool for patients receiving home care from a public health service. METHOD A diagnostic accuracy study, with estimates for the tool's validity and reliability. Measurements of sensitivity and specificity were considered when producing validity estimates. The resulting tool was used for testing. Assessment by a specialized team of home care professionals was used as the gold standard. In the tool's reliability study, the authors used the Kappa statistic. The tool's sensitivity and specificity were analyzed using various cut-off points. RESULTS On the best cut-off point-21-with the gold standard, a sensitivity of 75.5% was obtained, with the limits of confidence interval (95% at 68.3% and 82.8% and specificity of 53.2%, with the limits of confidence interval (95% at 43.8% and 62.7%. CONCLUSION The tool presented evidence of validity and reliability, possibly helping in service organization at patient admission, care type change, or support during the creation of care plans.

  9. Rapid assessment methods in eye care: An overview

    Directory of Open Access Journals (Sweden)

    Srinivas Marmamula

    2012-01-01

    Full Text Available Reliable information is required for the planning and management of eye care services. While classical research methods provide reliable estimates, they are prohibitively expensive and resource intensive. Rapid assessment (RA methods are indispensable tools in situations where data are needed quickly and where time- or cost-related factors prohibit the use of classical epidemiological surveys. These methods have been developed and field tested, and can be applied across almost the entire gamut of health care. The 1990s witnessed the emergence of RA methods in eye care for cataract, onchocerciasis, and trachoma and, more recently, the main causes of avoidable blindness and visual impairment. The important features of RA methods include the use of local resources, simplified sampling methodology, and a simple examination protocol/data collection method that can be performed by locally available personnel. The analysis is quick and easy to interpret. The entire process is inexpensive, so the survey may be repeated once every 5-10 years to assess the changing trends in disease burden. RA survey methods are typically linked with an intervention. This article provides an overview of the RA methods commonly used in eye care, and emphasizes the selection of appropriate methods based on the local need and context.

  10. Tile-in-ONE: A web platform which integrates Tile Calorimeter data quality and calibration assessment

    CERN Document Server

    Sivolella Gomes, Andressa; The ATLAS collaboration; Maidantchik, Carmen; Solans, Carlos; Burghgrave, Blake; Solodkov, Alexander

    2015-01-01

    The ATLAS Tile Calorimeter assesses the quality of data in order to ensure its proper operation. A number of tasks are then performed by running several tools and systems, which were independently developed to meet distinct collaboration’s requirements and do not necessarily builds an effective connection among them. Thus, a program is usually implemented without a global perspective of the detector, requiring basic software features. In addition, functionalities may overlap in their objectives and frequently replicate resources retrieval mechanisms. Tile-in-ONE is a unique platform that assembles various web systems used by the calorimeter community through a single framework and a standard technology. It provides an infrastructure to support the code implementation, avoiding duplication of work while integrating with an overall view of the detector status. Database connectors smooth the process of information access since developers do not need to be aware of where records are placed and how to extract th...

  11. Palau assessment for a continuing health care professional development program.

    Science.gov (United States)

    Chen, Tai-Ho; Dever, Gregory; Kuartei, Stevenson; Maskarinec, Gregory G

    2007-03-01

    In 2003, the University of Hawai'i Department of Family Medicine and Community Health entered a 4-year cooperative agreement with the U.S. Health Resources and Services Administration to establish the "Pacific Association for Clinical Training" (PACT). PACT's goal is to develop effective distance education methods to improve the education and skills of health care professionals in the U.S.-Affiliated Pacific Island nations. To determine the situation existing in 2004, one of PACT's first projects was to perform site visits to each jurisdiction, conducting needs assessments through interviews with key health care professionals, hospital administrators and government officials. This article highlights findings of PACT's Palau assessment. Meant to establish a baseline for future reference, all data were collected in 2004-2005 and have not been updated. PMID:19772140

  12. Age, gender, socioeconomic, and ethnic differences in patients' assessments of primary health care

    OpenAIRE

    Campbell, J.; Ramsay, J.; Green, J.

    2001-01-01

    Background—Patients' evaluations are an important means of measuring aspects of primary care quality such as communication and interpersonal care. This study aims to examine variations in assessments of primary care according to age, gender, socioeconomic, and ethnicity variables.

  13. The SAMCO Web-platform for resilience assessment in mountainous valleys impacted by landslide risks.

    Science.gov (United States)

    Grandjean, Gilles; Thomas, Loic; Bernardie, Severine

    2016-04-01

    The ANR-SAMCO project aims to develop a proactive resilience framework enhancing the overall resilience of societies on the impacts of mountain risks. The project aims to elaborate methodological tools to characterize and measure ecosystem and societal resilience from an operative perspective on three mountain representative case studies. To achieve this objective, the methodology is split in several points: (1) the definition of the potential impacts of global environmental changes (climate system, ecosystem e.g. land use, socio-economic system) on landslide hazards, (2) the analysis of these consequences in terms of vulnerability (e.g. changes in the location and characteristics of the impacted areas and level of their perturbation) and (3) the implementation of a methodology for quantitatively investigating and mapping indicators of mountain slope vulnerability exposed to several hazard types, and the development of a GIS-based demonstration platform available on the web. The strength and originality of the SAMCO project lies in the combination of different techniques, methodologies and models (multi-hazard assessment, risk evolution in time, vulnerability functional analysis, and governance strategies) that are implemented in a user-oriented web-platform, currently in development. We present the first results of this development task, architecture and functions of the web-tools, the case studies database showing the multi-hazard maps and the stakes at risks. Risk assessment over several area of interest in Alpine or Pyrenean valleys are still in progress, but the first analyses are presented for current and future periods for which climate change and land-use (economical, geographical and social aspects) scenarios are taken into account. This tool, dedicated to stakeholders, should be finally used to evaluate resilience of mountainous regions since multiple scenarios can be tested and compared.

  14. MOSFET assessment of radiation dose delivered to mice using the Small Animal Radiation Research Platform (SARRP).

    Science.gov (United States)

    Ngwa, Wilfred; Korideck, Houari; Chin, Lee M; Makrigiorgos, G Mike; Berbeco, Ross I

    2011-12-01

    The Small Animal Radiation Research Platform (SARRP) is a novel isocentric irradiation system that enables state-of-the-art image-guided radiotherapy research to be performed with animal models. This paper reports the results obtained from investigations assessing the radiation dose delivered by the SARRP to different anatomical target volumes in mice. Surgically implanted metal oxide semiconductor field effect transistors (MOSFET) dosimeters were employed for the dose assessment. The results reveal differences between the calculated and measured dose of -3.5 to 0.5%, -5.2 to -0.7%, -3.9 to 0.5%, -5.9 to 2.5%, -5.5 to 0.5%, and -4.3 to 0% for the left kidney, liver, pancreas, prostate, left lung, and brain, respectively. Overall, the findings show less than 6% difference between the delivered and calculated dose, without tissue heterogeneity corrections. These results provide a useful assessment of the need for tissue heterogeneity corrections in SARRP dose calculations for clinically relevant tumor model sites. PMID:21962005

  15. A Multiplexed Diagnostic Platform for Point-of-Care Pathogen Detection

    Energy Technology Data Exchange (ETDEWEB)

    Regan, J F; Letant, S E; Adams, K L; Mahnke, R C; Nguyen, N T; Dzenitis, J M; Hindson, B J; Hadley, D R; Makarewicz, T J; Henderer, B D; Breneman, J W; Tammero, L F; Ortiz, J I; Derlet, R W; Cohen, S; Colston, W W; McBride, M T; Birch, J M

    2008-02-04

    We developed an automated point-of-care diagnostic instrument that is capable of analyzing nasal swab samples for the presence of respiratory diseases. This robust instrument, called FluIDx, performs autonomous multiplexed RT-PCR reactions that are analyzed by microsphere xMAP technology. We evaluated the performance of FluIDx, in comparison rapid tests specific for influenza and respiratory syncytial virus, in a clinical study performed at the UC Davis Medical Center. The clinical study included samples positive for RSV (n = 71), influenza A (n = 16), influenza B (n = 4), adenovirus (n = 5), parainfluenza virus (n = 2), and 44 negative samples, according to a composite reference method. FluIDx and the rapid tests detected 85.9% and 62.0% of the RSV positive samples, respectively. Similar sensitivities were recorded for the influenza B samples; whereas the influenza A samples were poorly detected, likely due to the utilization of an influenza A signature that did not accurately match currently circulating influenza A strains. Data for all pathogens were compiled and indicate that FluIDx is more sensitive than the rapid tests, detecting 74.2% (95% C.I. of 64.7-81.9%) of the positive samples in comparison to 53.6% (95% C.I. of 43.7-63.2%) for the rapid tests. The higher sensitivity of FluIDx was partially offset by a lower specificity, 77.3% versus 100.0%. Overall, these data suggest automated flow-through PCR-based instruments that perform multiplexed assays can successfully screen clinical samples for infectious diseases.

  16. The EnerGEO Platform of Integrated Assessment (PIA). Environmental assessment of scenarios as a web service

    International Nuclear Information System (INIS)

    With the International Energy Agency estimating that global energy demand will increase between 40 and 50 percent by 2030 (compared to 2003), scientists and policymakers are concerned about the sustainability of the current energy system and what environmental pressures might result from the development of future energy systems. EnerGEO is an ongoing FP7 Project (2009-2013) which assesses the current and future impact of energy use on the environment by linking environmental observation systems with the processes involved in exploiting energy resources. The idea of this European project is to determine how low carbon scenarios, and in particular scenarios with a high share of renewable electricity, affect emissions of air pollutants and greenhouse gases (GHG) and contribute to mitigation of negative energy system impacts on human health and ecosystems. A Platform of Integrated Assessment (PIA) has been elaborated to provide impact results for a selection of scenarios via a set of models (large-scale energy models, Life Cycle Assessment models,..). This PIA is currently available through a web service. The concept of the PIA is detailed and to illustrate its interest, a set of results is given with the use of the simulation mode of the European version of GAINS for a selection of scenarios. (orig.)

  17. The Seamless Transfer-of-Care Protocol: a randomized controlled trial assessing the efficacy of an electronic transfer-of-care communication tool

    Directory of Open Access Journals (Sweden)

    Okoniewska Barbara M

    2012-11-01

    Full Text Available Abstract Background The transition between acute care and community care represents a vulnerable period in health care delivery. The vulnerability of this period has been attributed to changes to patients’ medication regimens during hospitalization, failure to reconcile discrepancies between admission and discharge and the burdening of patients/families to take over care responsibilities at discharge and to relay important information to the primary care physician. Electronic communication platforms can provide an immediate link between acute care and community care physicians (and other community providers, designed to ensure consistent information transfer. This study examines whether a transfer-of-care (TOC communication tool is efficacious and cost-effective for reducing hospital readmission, adverse events and adverse drug events as well as reducing death. Methods A randomized controlled trial conducted on the Medical Teaching Unit of a Canadian tertiary care centre will evaluate the efficacy and cost-effectiveness of a TOC communication tool. Medical in-patients admitted to the unit will be considered for this study. Data will be collected upon admission, and a total of 1400 patients will be randomized. The control group’s acute care stay will be summarized using a traditional dictated summary, while the intervention group will have a summary generated using the TOC communication tool. The primary outcome will be a composite, at 3 months, of death or readmission to any Alberta acute-care hospital. Secondary outcomes will be the occurrence of post-discharge adverse events and adverse drug events at 1 month post discharge. Patients with adverse outcomes will have their cases reviewed by two Royal College certified internists or College-certified family physicians, blinded to patients’ group assignments, to determine the type, severity, preventability and ameliorability of all detected adverse outcomes. An accompanying economic

  18. Assessing methods for measurement of clinical outcomes and quality of care in primary care practices

    Directory of Open Access Journals (Sweden)

    Green Michael E

    2012-07-01

    Full Text Available Abstract Purpose To evaluate the appropriateness of potential data sources for the population of performance indicators for primary care (PC practices. Methods This project was a cross sectional study of 7 multidisciplinary primary care teams in Ontario, Canada. Practices were recruited and 5-7 physicians per practice agreed to participate in the study. Patients of participating physicians (20-30 were recruited sequentially as they presented to attend a visit. Data collection included patient, provider and practice surveys, chart abstraction and linkage to administrative data sets. Matched pairs analysis was used to examine the differences in the observed results for each indicator obtained using multiple data sources. Results Seven teams, 41 physicians, 94 associated staff and 998 patients were recruited. The survey response rate was 81% for patients, 93% for physicians and 83% for associated staff. Chart audits were successfully completed on all but 1 patient and linkage to administrative data was successful for all subjects. There were significant differences noted between the data collection methods for many measures. No single method of data collection was best for all outcomes. For most measures of technical quality of care chart audit was the most accurate method of data collection. Patient surveys were more accurate for immunizations, chronic disease advice/information dispensed, some general health promotion items and possibly for medication use. Administrative data appears useful for indicators including chronic disease diagnosis and osteoporosis/ breast screening. Conclusions Multiple data collection methods are required for a comprehensive assessment of performance in primary care practices. The choice of which methods are best for any one particular study or quality improvement initiative requires careful consideration of the biases that each method might introduce into the results. In this study, both patients and providers were

  19. Assessment of nursing care using indicators generated by software

    Directory of Open Access Journals (Sweden)

    Ana Paula Souza Lima

    2015-04-01

    Full Text Available OBJECTIVE: to analyze the efficacy of the Nursing Process in an Intensive Care Unit using indicators generated by software. METHOD: cross-sectional study using data collected for four months. RNs and students daily registered patients, took history (at admission, performed physical assessments, and established nursing diagnoses, nursing plans/prescriptions, and assessed care delivered to 17 patients using software. Indicators concerning the incidence and prevalence of nursing diagnoses, rate of effectiveness, risk diagnoses, and rate of effective prevention of complications were computed. RESULTS: the Risk for imbalanced body temperature was the most frequent diagnosis (23.53%, while the least frequent was Risk for constipation (0%. The Risk for Impaired skin integrity was prevalent in 100% of the patients, while Risk for acute confusion was the least prevalent (11.76%. Risk for constipation and Risk for impaired skin integrity obtained a rate of risk diagnostic effectiveness of 100%. The rate of effective prevention of acute confusion and falls was 100%. CONCLUSION: the efficacy of the Nursing Process using indicators was analyzed because these indicators reveal how nurses have identified patients' risks and conditions, and planned care in a systematized manner.

  20. Seismic hazard and risk assessment for large Romanian dams situated in the Moldavian Platform

    Science.gov (United States)

    Moldovan, Iren-Adelina; Popescu, Emilia; Otilia Placinta, Anica; Petruta Constantin, Angela; Toma Danila, Dragos; Borleanu, Felix; Emilian Toader, Victorin; Moldoveanu, Traian

    2016-04-01

    Besides periodical technical inspections, the monitoring and the surveillance of dams' related structures and infrastructures, there are some more seismic specific requirements towards dams' safety. The most important one is the seismic risk assessment that can be accomplished by rating the dams into seismic risk classes using the theory of Bureau and Ballentine (2002), and Bureau (2003), taking into account the maximum expected peak ground motions at the dams site - values obtained using probabilistic hazard assessment approaches (Moldovan et al., 2008), the structures vulnerability and the downstream risk characteristics (human, economical, historic and cultural heritage, etc) in the areas that might be flooded in the case of a dam failure. Probabilistic seismic hazard (PSH), vulnerability and risk studies for dams situated in the Moldavian Platform, starting from Izvorul Muntelui Dam, down on Bistrita and following on Siret River and theirs affluent will be realized. The most vulnerable dams will be studied in detail and flooding maps will be drawn to find the most exposed downstream localities both for risk assessment studies and warnings. GIS maps that clearly indicate areas that are potentially flooded are enough for these studies, thus giving information on the number of inhabitants and goods that may be destroyed. Geospatial servers included topography is sufficient to achieve them, all other further studies are not necessary for downstream risk assessment. The results will consist of local and regional seismic information, dams specific characteristics and locations, seismic hazard maps and risk classes, for all dams sites (for more than 30 dams), inundation maps (for the most vulnerable dams from the region) and possible affected localities. The studies realized in this paper have as final goal to provide the local emergency services with warnings of a potential dam failure and ensuing flood as a result of an large earthquake occurrence, allowing further

  1. Assessing effective care in normal labor: the Bologna score.

    Science.gov (United States)

    Chalmers, B; Porter, R

    2001-06-01

    The intention of the "Bologna score" is to quantify, both in an individual labor and in a wider population, the extent to which labors have been managed as if they are normal as opposed to complicated. In this way it may be possible to assess both attitudes and practices within a maternity service toward the effective care of normal labor. A scoring system for normal labor was proposed at the World Health Organization (Regional Office for Europe) Task Force Meeting on Monitoring and Evaluation of Perinatal Care, held in Bologna in January 2000. This paper describes conceptual development of the scale. Recommendations for future evaluation of the Bologna score's validity and potential include field testing globally, comparison with the Apgar score, and evaluation of the relative weight contributed by each of the five measures comprising the Bologna score. PMID:11380378

  2. Accuracy Assessment of Direct Georeferencing for Photogrammetric Applications on Small Unmanned Aerial Platforms

    Science.gov (United States)

    Mian, O.; Lutes, J.; Lipa, G.; Hutton, J. J.; Gavelle, E.; Borghini, S.

    2016-03-01

    Microdrones md4-1000 quad-rotor VTOL UAV. The Sony A7R and each lens combination were focused and calibrated terrestrially using the Applanix camera calibration facility, and then integrated with the APX-15 GNSS-Inertial system using a custom mount specifically designed for UAV applications. The mount is constructed in such a way as to maintain the stability of both the interior orientation and IMU boresight calibration over shock and vibration, thus turning the Sony A7R into a metric imaging solution. In July and August 2015, Applanix and Avyon carried out a series of test flights of this system. The goal of these test flights was to assess the performance of DMS APX-15 direct georeferencing system under various scenarios. Furthermore, an examination of how DMS APX-15 can be used to produce accurate map products without the use of ground control points and with reduced sidelap was also carried out. Reducing the side lap for survey missions performed by small UAVs can significantly increase the mapping productivity of these platforms. The area mapped during the first flight campaign was a 250m x 300m block and a 775m long railway corridor in a rural setting in Ontario, Canada. The second area mapped was a 450m long corridor over a dam known as Fryer Dam (over Richelieu River in Quebec, Canada). Several ground control points were distributed within both test areas. The flight over the block area included 8 North-South lines and 1 cross strip flown at 80m AGL, resulting in a ~1cm GSD. The flight over the railway corridor included 2 North-South lines also flown at 80m AGL. Similarly, the flight over the dam corridor included 2 North-South lines flown at 50m AGL. The focus of this paper was to analyse the results obtained from the two corridors. Test results from both areas were processed using Direct Georeferencing techniques, and then compared for accuracy against the known positions of ground control points in each test area. The GNSS-Inertial data collected by the APX-15 was

  3. Assessment of undiscovered oil and gas resources in the Cherokee Platform Province area of Kansas, Oklahoma, and Missouri, 2015

    Science.gov (United States)

    Drake II, Ronald M.; Hatch, Joseph R.; Schenk, Christopher J.; Charpentier, Ronald R.; Klett, Timothy R.; Le, Phuong A.; Leathers, Heidi M.; Brownfield, Michael E.; Gaswirth, Stephanie B.; Marra, Kristen R.; Pitman, Janet K.; Potter, Christopher J.; Tennyson, Marilyn E.

    2015-01-01

    Using a geology-based assessment methodology, the U.S. Geological Survey estimated mean volumes of undiscovered, technically recoverable resources of 463 million barrels of oil, 11.2 trillion cubic feet of gas, and 35 million barrels of natural gas liquids in the Cherokee Platform Province area of Kansas, Oklahoma, and Missouri.

  4. Comprehensive risk assessment for rail transportation of dangerous goods: a validated platform for decision support

    International Nuclear Information System (INIS)

    Currently, the most advanced and well documented risk assessments for the transportation of dangerous goods by railway take into account:(i)statistics-based loss of containment frequencies, (ii) specification of potential consequences for a given release situations using event tree methodology as an organisational tool and (iii) consequence calculation models to determine a risk figure known as CCDF (Complementary Cumulative Distribution Function). Such procedures for the risk assessment (including for example decision-making on preventive measures) may offer only a limited insight into the causes and sequences leading to an accident and do not allow for any kind of predictive analysis. The present work introduces an enhanced solution, and a related software platform, which attempts to integrate loss of containment causes and consequences with system's infrastructure and its environment. The solution features:(i)the use of a detailed Master Logical Diagram, including fault/event tree analysis to determine a loss of containment frequency based on different initiating events, scenarios and specific basic data, (ii) the characterization of a resulting source term following a release situation, and (iii) the calculation of various potential impacts on the neighbouring site. Results are wrapped into a CCDF format for each selected traffic segment. The risk-related results are integrated on a software platform, structured as a decision support system using intelligent maps and a variety of GIS (Geographical Information System) data processing procedures. The introduction of the hot spot approach, allows us to focus on the most risk-relevant areas and to use information on various railway infrastructure elements (e.g. points, tunnels), are the basis of the new models employed. The software is applicable to any railway transportation system, comprising its technical infrastructure, rolling stock, human actions, regulation and management procedures. It provides the

  5. Interdisciplinary expert consultation via a teleradiology platform. Influence on therapeutic decision-making and patient referral rates to an academic tertiary care center

    International Nuclear Information System (INIS)

    In addition to teleradiological reporting as a nighthawking or a regular service, teleradiological communication can be used for interdisciplinary expert consultation. We intended to evaluate an interdisciplinary consultation system based on a teleradiology platform with regard to its impact on therapeutic decision-making, directed patient referrals to an academic tertiary care center and the economic benefit for the hospital providing the service. Therefore, consultations from five secondary care centers and consecutive admissions to an academic tertiary care center were prospectively evaluated over a time period of six months. A total of 69 interdisciplinary expert consultations were performed. In 54% of the cases the patients were consecutively referred to the university hospital for further treatment. In all acutely life-threatening emergencies (n=9), fast and focused treatment by referral to the academic tertiary care center was achieved (average time to treat 130 min). The admissions to the academic tertiary care center led to improved utilization of its facilities with additional revenue of more than 1 000 000 Euro p.a. An interdisciplinary expert consultation via a teleradiology platform enables fast and efficient expert care with improved and accelerated patient management and improved utilization of the service providing hospital. (orig.)

  6. Research and Application of Pre-hospital Care Information Platform Based on VPDN%基于VPDN的院前急救信息平台研究与应用

    Institute of Scientific and Technical Information of China (English)

    李爱勤; 胡外光; 陈敏莲; 卢秀兰; 胡珊珊

    2015-01-01

    In order to cover the shortage of the current pre-hospital care system in the mobile data collection, analysis, early warning and closed-loop management, use of VPDN technology and Internet technology are used to set up the pre-hospital care information platform. With the method of statistical analysis of big data, the traditional pre-hospital care system is expanded into the PDCA closed-loop emergency information platform with risk assessment and early warning, field first aid, data integration and referral and other functions, so as to guide the hospital emergency and reduce the transfer risk.%为解决目前院前急救体系在移动数据采集、分析、预警和闭环管理方面的不足,运用VPDN和物联网技术搭建院前急救信息平台,利用大数据统计分析方法把传统的院前急救系统拓展为拥有风险评估与预警、现场急救、数据整合与转诊等多个功能的PDCA闭环急救信息平台,从而用来指导医院急救,降低转运风险。

  7. Patients’ Needs for Care in Public Mental Health: Unity and Diversity of Self-Assessed Needs for Care

    OpenAIRE

    Bellier-Teichmann, Tanja; Golay, Philippe; Bonsack, Charles; Pomini, Valentino

    2016-01-01

    Purpose Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients’ needs are organized. This study investigates both general and specific dimensions of patients’ needs for care. Methods Patients’ needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients...

  8. Evaluation of Optical Detection Platforms for Multiplexed Detection of Proteins and the Need for Point-of-Care Biosensors for Clinical Use

    Directory of Open Access Journals (Sweden)

    Samantha Spindel

    2014-11-01

    Full Text Available This review investigates optical sensor platforms for protein multiplexing, the ability to analyze multiple analytes simultaneously. Multiplexing is becoming increasingly important for clinical needs because disease and therapeutic response often involve the interplay between a variety of complex biological networks encompassing multiple, rather than single, proteins. Multiplexing is generally achieved through one of two routes, either through spatial separation on a surface (different wells or spots or with the use of unique identifiers/labels (such as spectral separation—different colored dyes, or unique beads—size or color. The strengths and weaknesses of conventional platforms such as immunoassays and new platforms involving protein arrays and lab-on-a-chip technology, including commercially-available devices, are discussed. Three major public health concerns are identified whereby detecting medically-relevant markers using Point-of-Care (POC multiplex assays could potentially allow for a more efficient diagnosis and treatment of diseases.

  9. An integrated telemedicine platform for the assessment of affective physiological states

    Directory of Open Access Journals (Sweden)

    Ganiatsas George

    2006-08-01

    Full Text Available Abstract AUBADE is an integrated platform built for the affective assessment of individuals. The system performs evaluation of the emotional state by classifying vectors of features extracted from: facial Electromyogram, Respiration, Electrodermal Activity and Electrocardiogram. The AUBADE system consists of: (a a multisensorial wearable, (b a data acquisition and wireless communication module, (c a feature extraction module, (d a 3D facial animation module which is used for the projection of the obtained data through a generic 3D face model; whereas the end-user will be able to view the facial expression of the subject in real time, (e an intelligent emotion recognition module, and (f the AUBADE databases where the acquired signals along with the subject's animation videos are saved. The system is designed to be applied to human subjects operating under extreme stress conditions, in particular car racing drivers, and also to patients suffering from neurological and psychological disorders. AUBADE's classification accuracy into five predefined emotional classes (high stress, low stress, disappointment, euphoria and neutral face is 86.0%. The pilot system applications and components are being tested and evaluated on Maserati's car. racing drivers.

  10. Development of a Micro-UAV Hyperspectral Imaging Platform for Assessing Hydrogeological Hazards

    Science.gov (United States)

    Chen, Z.; Alabsi, M.

    2015-12-01

    The exacerbating global weather changes have cast significant impacts upon the proportion of water supplied to agriculture. Therefore, one of the 21stCentury Grant Challenges faced by global population is securing water for food. However, the soil-water behavior in an agricultural environment is complex; among others, one of the key properties we recognize is water repellence or hydrophobicity, which affects many hydrogeological and hazardous conditions such as excessive water infiltration, runoff, and soil erosion. Under a US-Israel research program funded by USDA and BARD at Israel, we have proposed the development of a novel micro-unmanned aerial vehicle (micro-UAV or drone) based hyperspectral imaging platform for identifying and assessing soil repellence at low altitudes with enhanced flexibility, much reduced cost, and ultimately easy use. This aerial imaging system consists of a generic micro-UAV, hyperspectral sensor aided by GPS/IMU, on-board computing units, and a ground station. The target benefits of this system include: (1) programmable waypoint navigation and robotic control for multi-view imaging; (2) ability of two- or three-dimensional scene reconstruction for complex terrains; and (3) fusion with other sensors to realize real-time diagnosis (e.g., humidity and solar irradiation that may affect soil-water sensing). In this talk we present our methodology and processes in integration of hyperspectral imaging, on-board sensing and computing, hyperspectral data modeling, and preliminary field demonstration and verification of the developed prototype.

  11. A Colorimetric Enzyme-Linked Immunosorbent Assay (ELISA Detection Platform for a Point-of-Care Dengue Detection System on a Lab-on-Compact-Disc

    Directory of Open Access Journals (Sweden)

    Aung Thiha

    2015-05-01

    Full Text Available The enzyme-linked Immunosorbent Assay (ELISA is the gold standard clinical diagnostic tool for the detection and quantification of protein biomarkers. However, conventional ELISA tests have drawbacks in their requirement of time, expensive equipment and expertise for operation. Hence, for the purpose of rapid, high throughput screening and point-of-care diagnosis, researchers are miniaturizing sandwich ELISA procedures on Lab-on-a-Chip and Lab-on-Compact Disc (LOCD platforms. This paper presents a novel integrated device to detect and interpret the ELISA test results on a LOCD platform. The system applies absorption spectrophotometry to measure the absorbance (optical density of the sample using a monochromatic light source and optical sensor. The device performs automated analysis of the results and presents absorbance values and diagnostic test results via a graphical display or via Bluetooth to a smartphone platform which also acts as controller of the device. The efficacy of the device was evaluated by performing dengue antibody IgG ELISA on 64 hospitalized patients suspected of dengue. The results demonstrate high accuracy of the device, with 95% sensitivity and 100% specificity in detection when compared with gold standard commercial ELISA microplate readers. This sensor platform represents a significant step towards establishing ELISA as a rapid, inexpensive and automatic testing method for the purpose of point-of-care-testing (POCT in resource-limited settings.

  12. Programmable bio-nano-chip system: a flexible point-of-care platform for bioscience and clinical measurements.

    Science.gov (United States)

    McRae, Michael P; Simmons, Glennon W; Wong, Jorge; Shadfan, Basil; Gopalkrishnan, Sanjiv; Christodoulides, Nicolaos; McDevitt, John T

    2015-10-21

    The development of integrated instrumentation for universal bioassay systems serves as a key goal for the lab-on-a-chip community. The programmable bio-nano-chip (p-BNC) system is a versatile multiplexed and multiclass chemical- and bio-sensing system for bioscience and clinical measurements. The system is comprised of two main components, a disposable cartridge and a portable analyzer. The customizable single-use plastic cartridges, which now can be manufactured in high volumes using injection molding, are designed for analytical performance, ease of use, reproducibility, and low cost. These labcard devices implement high surface area nano-structured biomarker capture elements that enable high performance signaling and are index-matched to real-world biological specimens. This detection modality, along with the convenience of on-chip fluid storage in blisters and self-contained waste, represents a standard process to digitize biological signatures at the point-of-care. A companion portable analyzer prototype has been developed to integrate fluid motivation, optical detection, and automated data analysis, and it serves as the human interface for complete assay automation. In this report, we provide a systems-level perspective of the p-BNC universal biosensing platform with an emphasis on flow control, device integration, and automation. To demonstrate the flexibility of the p-BNC, we distinguish diseased and non-case patients across three significant disease applications: prostate cancer, ovarian cancer, and acute myocardial infarction. Progress towards developing a rapid 7 minute myoglobin assay is presented using the fully automated p-BNC system. PMID:26308851

  13. Validity Assessment of Referral Decisions at a VA Health Care System Polytrauma System of Care.

    Science.gov (United States)

    Chung, Joyce; Aguila, Fatima; Harris, Odette

    2015-01-01

    There has been intensive interest to ensure equitable and appropriate access to the specialized rehabilitative services of the VA Polytrauma System of Care (PSC) for patients sustaining polytrauma and traumatic brain injuries (TBI). A retrospective cohort study with prospective data acquisition was conducted to assess validity and objectivity of the acceptance decision algorithm to the VA Palo Alto Health Care System (VAPAHCS) PSC. Our hypotheses are (1) VAPAHCS PSC referral decisions were appropriate and without bias and (2) the identified needs of redirected referrals were addressed. This analysis included 1,025 referrals (906 patients); 813 patients (89.7%) were accepted, and 93 (10.3%) were redirected. Redirected cases were older, were more often active duty service members, and were not from the West Coast. There were more females redirected due to concomitant spinal cord injury. These are rationale differences. In redirected patients, the most commonly identified rehabilitation needs were psychological support, mobility/physical therapy, and communication/speech services; >75% of patients had these services offered elsewhere outside of the PSC resources. While balancing financial stewardship and meeting our mission to provide outstanding rehabilitative care to veterans and service members, we demonstrated that acceptance decisions were valid and without bias, and redirected patients received appropriate alternate resources. PMID:26180664

  14. The Global Mental Health Assessment Tool - Primary Care Version (GMHAT/PC). Development, reliability and validity

    OpenAIRE

    Sharma, Vimal K; Lepping, Peter; Cummins, Anthony GP; Copeland, John RM; Parhee, Rashmi; Mottram, Patricia

    2004-01-01

    The Global Mental Health Assessment Tool – Primary Care Version (GMHAT/PC) is a computerised clinical assessment tool developed to assess and identify a wide range of mental health problems in primary care. It generates a computer diagnosis, a symptom rating, a self-harm risk assessment, and a referral letter. Patients from primary care and community psychiatric outpatient clinics and a small sample of inpatients were interviewed for a period of two months using the GMHAT/PC...

  15. Assessment of quality of care in acute postoperative pain management

    Directory of Open Access Journals (Sweden)

    Milutinović Dragana

    2009-01-01

    Full Text Available Background/Aim. Managing of acute postoperative pain should be of great interest for all hospital institutions, as one of the key components of patients satisfaction, which indicates quality, as well as the outcome of treatment. The aim of this study was to assess the quality of nursing care in managing acute postoperative pain and to establish factors which influence patients assessment of the same. Method. The investigation was conducted on the sample of 135 patients hospitalized in surgical clinics of the Clinical Centre of Vojvodina in Novi Sad in the form of cross-sectional study, by interviewing patients during the second postoperative day and collecting sociodemographic variables, type of surgical procedure and applied analgesic therapy which were taken from their medical documentation. The modified questionnaire of the Strategic and Clinical Quality Indicators in Postoperative Pain Management (SCQIPP was used as the instrument of the investigation. The data were processed with suitable mathematical statistics methods such as multivariate analyses of variance (MANOVA, discriminative and other parametric procedures and methods. Roy's test, Pearson's coefficient contingency (χ, multiple correlation coefficient (R were conducted amongst other invariant procedures. Results. The mean score for the individual items of SCQIPP questionnaire was between 2.0 and 4.7 (scale range 1-5 and the percentage of patients answers 'strongly agree' ranged from 4.4 to 77%. The smallest number of positive answers were given by the patients for the item 'In order to assess pain intensity, some of the staff asked me at least once in the morning, in the afternoon and in the evening to show the number from 0-10'. Most of the patients (57% evaluated severe pain during the previous 24 hours, as moderate pain, which represents significantly greater number of patients which complain of severe pain and mild pain (p < 0.001. The analysis of patients evaluation (MANOVA p

  16. Towards Supporting Climate Scientists and Impact Assessment Analysts with the Big Data Europe Platform

    Science.gov (United States)

    Klampanos, Iraklis; Vlachogiannis, Diamando; Andronopoulos, Spyros; Cofiño, Antonio; Charalambidis, Angelos; Lokers, Rob; Konstantopoulos, Stasinos; Karkaletsis, Vangelis

    2016-04-01

    The EU, Horizon 2020, project Big Data Europe (BDE) aims to support European companies and institutions in effectively managing and making use of big data in activities critical to their progress and success. BDE focuses on seven areas of societal impact: Health, Food and Agriculture, Energy, Transport, Climate, Social Sciences and Security. By reaching out to partners and stakeholders, BDE aims to elicit data-intensive requirements for, and deliver an ICT platform to cover aspects of publishing and consuming semantically interoperable, large-scale, multi-lingual data assets and knowledge. In this presentation we will describe the first BDE pilot for Climate, focusing on SemaGrow, its core component, which provides data querying and management based on data semantics. Over the last few decades, extended scientific effort in understanding climate change has resulted in a huge volume of model and observational data. Large international global and regional model inter-comparison projects have focused on creating a framework in support of climate model diagnosis, validation, documentation and data access. The application of climate model ensembles, a system consisting of different possible realisations of a climate model, has further significantly increased the amount of climate and weather data generated. The provision of such models satisfies the crucial objective of assessing potential impacts of climate change on well-being for adaptation, prevention and mitigation. One of the methodologies applied by the climate research and impact assessment communities is that of dynamical downscaling. This calculates values of atmospheric variables in smaller spatial and temporal scales, given a global model. On the company or institution level, this process can be greatly improved in terms of querying, data ingestion from various sources and formats, automatic data mapping, etc. The first Climate BDE pilot will facilitate the process of dynamical downscaling by providing a

  17. Tennessee Star-Quality Child Care Program: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Tennessee's Star-Quality Child Care Program prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  18. Primary Care Fall Risk Assessment for Elderly West Virginians.

    Science.gov (United States)

    Minkemeyer, Vivian M; Meriweather, Matt; Shuler, Franklin D; Mehta, Saurabh P; Qazi, Zain N

    2015-01-01

    West Virginia is ranked second nationally for the percent of its population 65 years of age. The elderly are especially susceptible to falls with fall risk increasing as age increases. Because falls are the number one cause of injury-related morbidity and mortality in the West Virginia elderly, evaluation of fall risk is a critical component of the patient evaluation in the primary care setting. We therefore highlight fall risk assessments that require no specialized equipment or training and can easily be completed at an established office visit. High quality clinical practice guidelines supported by the American Geriatric Society recommend yearly fall risk evaluation in the elderly. Those seniors at greatest risk of falls will benefit from the standardized therapy protocols outlined and referral to a balance treatment center. Patients with low-to-moderate fall risk attributed to muscle weakness or fatigue should be prescribed lower extremity strengthening exercises, such as kitchen counter exercises, to improve strength and balance. PMID:26665892

  19. Assessment of the Effectiveness of Internet-Based Distance Learning through the VClass e-Education Platform

    OpenAIRE

    Chadchadaporn Pukkaew

    2013-01-01

    This study assesses the effectiveness of internet-based distance learning (IBDL) through the VClass live e-education platform. The research examines (1) the effectiveness of IBDL for regular and distance students and (2) the distance students’ experience of VClass in the IBDL course entitled Computer Programming 1. The study employed the common definitions of evaluation to attain useful statistical results. The measurement instruments used were test scores and questionnaires. The sample consi...

  20. Physical Therapy Observation and Assessment in the Neonatal Intensive Care Unit

    Science.gov (United States)

    Byrne, Eilish; Campbell, Suzann K.

    2013-01-01

    This article presents the elements of the Observation and Assessment section of the Infant Care Path for Physical Therapy in the Neonatal Intensive Care Unit (NICU). The types of physical therapy assessments presented in this path are evidence-based and the suggested timing of these assessments is primarily based on practice knowledge from expert…

  1. Assessment of Environmental Sustainability in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    María Carmen Carnero

    2015-06-01

    Full Text Available Healthcare organizations should set a standard in corporate social responsibility and encourage environmental sustainability, since protection of the environment implies the development of preventive measures in healthcare. Environmental concern has traditionally focused on manufacturing plants. However, a Health Care Organization (HCO is the only type of company which generates all existing classes of waste, and 20% is dangerous, being infectious, toxic or radioactive in nature. Despite the extensive literature analysing environmental matters, there is no objective model for assessing the environmental sustainability of HCOs in such a way that the results may be compared over time for an organization, and between different organizations, to give a comparison or benchmarking tool for HCOs. This paper presents a Multi-Criteria Decision Analysis model integrating a Fuzzy Analytic Hierarchy Process and utility theory, to evaluate environmental sustainability in HCOs. The model uses criteria assessed as a function of the number of annual treatments undertaken. The model has been tested in two HCOs of very different sizes.

  2. Mandates for Collaboration: Health Care and Child Welfare Policy and Practice Reforms Create the Platform for Improved Health for Children in Foster Care.

    Science.gov (United States)

    Zlotnik, Sarah; Wilson, Leigh; Scribano, Philip; Wood, Joanne N; Noonan, Kathleen

    2015-10-01

    Improving the health of children in foster care requires close collaboration between pediatrics and the child welfare system. Propelled by recent health care and child welfare policy reforms, there is a strong foundation for more accountable, collaborative models of care. Over the last 2 decades health care reforms have driven greater accountability in outcomes, access to care, and integrated services for children in foster care. Concurrently, changes in child welfare legislation have expanded the responsibility of child welfare agencies in ensuring child health. Bolstered by federal legislation, numerous jurisdictions are developing innovative cross-system workforce and payment strategies to improve health care delivery and health care outcomes for children in foster care, including: (1) hiring child welfare medical directors, (2) embedding nurses in child welfare agencies, (3) establishing specialized health care clinics, and (4) developing tailored child welfare managed care organizations. As pediatricians engage in cross-system efforts, they should keep in mind the following common elements to enhance their impact: embed staff with health expertise within child welfare settings, identify long-term sustainable funding mechanisms, and implement models for effective information sharing. Now is an opportune time for pediatricians to help strengthen health care provision for children involved with child welfare. PMID:26403650

  3. Assessment of the real-time PCR and different digital PCR platforms for DNA quantification

    OpenAIRE

    Pavšič, Jernej; Žel, Jana; Milavec, Mojca

    2015-01-01

    Digital PCR (dPCR) is beginning to supersede real-time PCR (qPCR) for quantification of nucleic acids in many different applications. Several analytical properties of the two most commonly used dPCR platforms, namely the QX100 system (Bio-Rad) and the 12.765 array of the Biomark system (Fluidigm), have already been evaluated and compared with those of qPCR. However, to the best of our knowledge, direct comparison between the three of these platforms using the same DNA material has not been do...

  4. Hybrid causal methodology and software platform for probabilistic risk assessment and safety monitoring of socio-technical systems

    International Nuclear Information System (INIS)

    This paper introduces an integrated framework and software platform for probabilistic risk assessment (PRA) and safety monitoring of complex socio-technical systems. An overview of the three-layer hybrid causal logic (HCL) modeling approach and corresponding algorithms, implemented in the Trilith software platform, are provided. The HCL approach enhances typical PRA methods by quantitatively including the influence of soft causal factors introduced by human and organizational aspects of a system. The framework allows different modeling techniques to be used for different aspects of the socio-technical system. The HCL approach combines the power of traditional event sequence diagram (ESD)event tree (ET) and fault tree (FT) techniques for modeling deterministic causal paths, with the flexibility of Bayesian belief networks for modeling non-deterministic cause-effect relationships among system elements (suitable for modeling human and organizational influences). Trilith enables analysts to construct HCL models and perform quantitative risk assessment and management of complex systems. The risk management capabilities included are HCL-based risk importance measures, hazard identification and ranking, precursor analysis, safety indicator monitoring, and root cause analysis. This paper describes the capabilities of the Trilith platform and power of the HCL algorithm by use of example risk models for a type of aviation accident (aircraft taking off from the wrong runway).

  5. Social impact assessment: identification, management and follow-up of community concerns associated with construction of the Hibernia offshore platform

    International Nuclear Information System (INIS)

    Social impact Assessment (SIA) is the systematic analysis, in advance of the likely impacts of a proposed action, that considers 'all social and cultural consequences to human populations of any public or private actions that alter the ways in which people live, work, play, relate to one another, organize to meet their needs, and generally cope as members of society' (US Department of Commerce 1994). Through the SIA for the construction of the Hibernia offshore oil platform concern, and values of local area residents were identified and a management strategy designed to minimise social disruption associated with the project. Monitoring studies showed that the strategy was effective and that few negative social impacts occurred. The Hibernia offshore oil field, was discovered on the Grand Banks, east of the island of Newfoundland, in 1979. The distance from shore (315 km), its isolation, the periodic presence of sea ice, icebergs and fog, and frequently severe wave and wind conditions, make these waters an extremely hostile work environment. Primarily to maximize human safety, the final engineering design chosen for the project was a fixed, gravity base system (GBS). The platform functions as the main drilling and production unit, the first stage processing facility, oil storage and accommodations base for the offshore crews. The concrete base of the platform, one of the five super-modules that make up the top-sides of the platform and eight of tile smaller top-sides-mounted modules, were fabricated in Newfoundland and the entire platform assembled at Bull Arm, Trinity Bay. (author)

  6. Comparison of two pain assessment tools in nonverbal critical care patients.

    Science.gov (United States)

    Paulson-Conger, Melissa; Leske, Jane; Maidl, Carolyn; Hanson, Andrew; Dziadulewicz, Laurel

    2011-12-01

    It is recommended that patient's self-report of pain should be obtained as often as possible as the "gold standard." Unfortunately in critical care, many factors can alter verbal communication with patients, making pain assessment more difficult. Scientific advances in understanding pain mechanisms, multidimensional methods of pain assessment, and analgesic pharmacology have improved pain management strategies. However, pain assessment for nonverbal patients in critical care continues to present a challenge for clinicians and researchers. The purpose of this study was to compare the Pain Assessment in Advanced Dementia (PAINAD) and the Critical-Care Pain Observation Tool (CPOT) scores for assessment in nonverbal critical care patients. A descriptive, comparative, prospective design was used in this study. A convenience sample of 100 critical care, nonverbal, adult patients of varying medical diagnoses who required pain evaluation were assessed with the PAINAD and CPOT scales. Data were collected over a 6-month period in all critical care areas. Observations of pain assessments for nonverbal patients who required pain evaluation were recorded on the PAINAD and the CPOT successively. Internal consistency reliability for the PAINAD was 0.80 and for the CPOT 0.72. Limits of agreement indicated that there was no difference in PAINAD and CPOT scores for assessing pain in nonverbal patients in critical care. Further research in the area of pain assessment for nonverbal patients in critical care is needed. PMID:22117753

  7. Construction and operation of the wound care technology platform%创口治疗技术平台的建设及运作

    Institute of Scientific and Technical Information of China (English)

    胡大海; 周琴; 韩军涛

    2011-01-01

    Chronic wounds are a major healthcare problem costing billions of dollars a year over the world. However, it is regrettable that a large number of chronic wounds are still treated simply by conventional dressing change in local clinics,lacking of definite diagnosis and personalized care. This situation results in a low wound healing rate, unsatisfied life quality of the patients, and higher medical cost for the prolonged promiscuous care. We should not only emphasize the importance of wound care in clinical practice, but also emphasize the importance of establishing wound care centers. With the experience of our practice in wound care center, the construction of wound care technology platform is strongly suggested. This platform could act as an education base to train more professional wound care doctors, nurses, and care workers, as well as resolve many technical difficulties involved in the treatment of many complicated chronic wounds.%社会经济及科学技术的快速发展,不仅直接影响着人们的工作和日常生活,也使疾病谱发生了明显改变。高血压、冠心病、糖尿病等慢性病逐年增多,交通伤、工伤等意外伤害明显增加,与此相对应的,是临床各类伤口特别是复杂、难治性创面逐年递增。解决这一问题,首先要考虑创面治疗中心的建设与运作[1]。1 平台建设的必要性据报道,全世界每年有超过1000万患者存在慢性创口类疾患,而且随着人口老龄化的不断发展,这一数据仍在持续上升[2-3]。以美国为例,其医疗技术及医疗体系均处于世界领先水平,但2007年的调查结果显示,638家医疗机构中压疮患者的发病率为13.7%,院内压疮患病率为6.1%[4]。

  8. Assessment of a pharmacist-driven point-of-care spirometry clinic within a primary care physicians office

    OpenAIRE

    Cawley MJ; Pacitti R; Warning W

    2011-01-01

    Objective: To assess value-added service of a pharmacist-driven point-of-care spirometry clinic to quantify respiratory disease abnormalities within a primary care physicians officeMethods: This retrospective, cohort study was an analysis of physician referred patients who attended our spirometry clinic during 2008-2010 due to pulmonary symptoms or disease. After spirometry testing, data was collected retrospectively to include patient demographics, spirometry results, and pulmonary pharmaceu...

  9. Developmentally supportive neonatal care : A study of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) in a Swedish environment

    OpenAIRE

    Westrup, Björn

    2003-01-01

    A family-centred, developmentally supportive approach to newborn intensive care, referred to as the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has attracted considerable interest in recent years. Studies performed in North America have reported that NIDCAP improves short-term growth, decreases the need for respiratory support, decreases the length and cost of hospitalisation, and improves neurodevelopment. The aim of the present study was to ch...

  10. Development of a trauma care assessment instrument for emergency nurses in West Africa

    OpenAIRE

    Sue Anne Bell, MSN FNP-BC; Victoria Bam, RN PhD; Sarah Rominski, MPH; Nee-Kofi Mould-Millman, MD; Petra Brysiewicz, PhD RN

    2014-01-01

    Background: Strengthening the provision of emergency health services, including the nursing workforce, is progress towards decreasing the burden of injury in sub-Saharan Africa. The WHO Essential Trauma Care Guidelines provide minimum knowledge and skills to ensure quality in-hospital trauma care. Our aim was to develop an emergency nursing trauma care knowledge, attitudes, and skills minimum competency assessment instrument with WHO guidelines for African emergency care settings. Methods:...

  11. Assessing the Overall Quality of Health Care in Persons Living with HIV in an Urban Environment

    OpenAIRE

    KELLER, Sara C.; Yehia, Baligh R.; Momplaisir, Florence O.; Eberhart, Michael G.; Share, Amanda; Brady, Kathleen A.

    2014-01-01

    Ensuring high quality primary care for people living with HIV (PLWH) is important. We studied factors associated with meeting Health Resources and Services Administration-identified HIV performance measures, among a population-based sample of 376 PLWH in care at 24 Philadelphia clinics. Quality of care was assessed by a patient-level composite of 15 performance measures, focusing on HIV-specific care, vaccinations, and co-morbid condition screening. Adjusted incidence rate ratios (IRR) demons...

  12. Training needs assessment of health care professionals in a developing country: the example of Saint Lucia

    OpenAIRE

    Gaspard, Janice; Yang, Che-Ming

    2016-01-01

    Background Continuing education (CE) is crucial for quality improvement in health care. The needs assessment of CE helps ensure effectiveness. However, such an assessment necessitates certain techniques that are unfamiliar to health care communities in developing countries. This study identifies the needs of providing CE to health care personnel in Saint Lucia. Methods This study was designed as a questionnaire survey to investigate the demographics, training needs, and preferred approaches t...

  13. Assessment of patient satisfaction with acute pain management service: Monitoring quality of care in clinical setting

    OpenAIRE

    Farooq, Fizzah; Khan, Robyna; Ahmed, Aliya

    2016-01-01

    Background and Aims: Assessment of patient satisfaction is an important tool for monitoring the quality of care in hospitals. The aim of this survey was to develop a reliable tool to assess patient satisfaction with acute pain management service (APMS) and identify variables affecting this so that care can be improved. Methods: A questionnaire was developed and administered to patients after being discharged from APMS care by an unbiased person. Data collected from record included patient dem...

  14. Assessment of patient satisfaction with acute pain management service: Monitoring quality of care in clinical setting

    OpenAIRE

    Fizzah Farooq; Robyna Khan; Aliya Ahmed

    2016-01-01

    Background and Aims: Assessment of patient satisfaction is an important tool for monitoring the quality of care in hospitals. The aim of this survey was to develop a reliable tool to assess patient satisfaction with acute pain management service (APMS) and identify variables affecting this so that care can be improved. Methods: A questionnaire was developed and administered to  patients after being discharged from APMS care by an unbiased person. Data collected from record included patient de...

  15. An assessment of antenatal care among Syrian refugees in Lebanon

    OpenAIRE

    Benage, Matthew; Greenough, P Gregg; Vinck, Patrick; Omeira, Nada; Pham, Phuong

    2015-01-01

    Background After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and famil...

  16. An assessment of antenatal care among Syrian refugees in Lebanon

    OpenAIRE

    Benage, Matthew; Greenough, P Gregg; Vinck, Patrick; Omeira, Nada; Pham, Phuong

    2015-01-01

    Background: After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and fami...

  17. Current Issues in Assessment in Early Childhood Care and Education in Japan

    Science.gov (United States)

    Kitano, Sachiko

    2011-01-01

    This paper introduces the characteristics of early childhood care and education (ECCE) assessment and identifies current challenges and changes in the assessment of ECCE in Japan. There are differences in assessment between ECCE and elementary school education. Assessment in ECCE is used to focus on making better plans, improving the understanding…

  18. Needs Assessment for Health Care Management Education in Russia

    Science.gov (United States)

    Rekhter, Natalia; Togunov, Igor A.

    2006-01-01

    Introduction: For more than 70 years, health care management in the Soviet Union reflected a centralized directive style familiar to the Soviet political system. Market-oriented reform in post-Soviet Russia is pushing practicing physicians and physician-executives to acquire new information and skills regarding health care management. To assist…

  19. Telemedicine: The Assessment of an Evolving Health Care Technology.

    Science.gov (United States)

    Reich, Joel J.

    Telemedicine, the use of bidirectional telecommunications systems for the delivery of health care at a distance, could create a more equitable distribution of medical care. Many medical tasks can be performed at a distance although some require the presence of a physician's assistant. Cost-benefit analysis of this service is difficult and requires…

  20. Assessment of Anxiety in Older Home Care Recipients

    Science.gov (United States)

    Diefenbach, Gretchen J.; Tolin, David F.; Meunier, Suzanne A.; Gilliam, Christina M.

    2009-01-01

    Purpose: This study determined the psychometric properties of a variety of anxiety measures administered to older adults receiving home care services. Design and Methods: Data were collected from 66 adults aged 65 years and older who were receiving home care services. Participants completed self-report and clinician-rated measures of anxiety and…

  1. Assessing Health Literacy in Diverse Primary Care Settings

    Science.gov (United States)

    McCune, Renee L.

    2010-01-01

    Patient health literacy skills are critical to effective healthcare communication and safe care delivery in primary care settings. Methods and strategies to identify patient health literacy (HL) capabilities and provider/staff knowledge, attitudes and beliefs (KAB) regarding HL must be known before addressing provider/staff communication skills.…

  2. The Dutch health care performance report: seven years of health care performance assessment in the Netherlands

    OpenAIRE

    van den Berg, Michael J.; Kringos, Dionne S; Marks, Lisanne K; Klazinga, Niek S

    2014-01-01

    In 2006, the first edition of a monitoring tool for the performance of the Dutch health care system was released: the Dutch Health Care Performance Report (DHCPR). The Netherlands was among the first countries in the world developing such a comprehensive tool for reporting performance on quality, access, and affordability of health care. The tool contains 125 performance indicators; the choice for specific indicators resulted from a dialogue between researchers and policy makers. In the ‘poli...

  3. The Homeless Child Health Care Inventory: assessing the efficacy of linkages to primary care.

    OpenAIRE

    Redlener, I.; Karich, K. M.

    1994-01-01

    Each year, the New York City homeless family shelter system provides transitional housing for nearly 20,000 homeless children. While the health care needs of these children are substantial, there is currently no system-wide mechanism for ensuring that they have access to appropriate medical care. This report analyzes information from the Homeless Child Health Care Inventory, a survey conducted by Montefiore Medical Center's Division of Community Pediatrics, to examine the adequacy of health c...

  4. Wearable textile platform for assessing stroke patient treatment in daily life conditions

    Directory of Open Access Journals (Sweden)

    Federico eLorussi

    2016-03-01

    Full Text Available Monitoring physical activities during post-stroke rehabilitation in daily life may help physicians to optimize and tailor the training program for patients. The European research project INTERACTION (FP7-ICT-2011-7-287351 evaluated motor capabilities in stroke patients during the recovery treatment period. We developed wearable sensing platform based on the sensor fusion among inertial, knitted piezoresistive sensors and textile EMG electrodes . The device was conceived in modular form and consists of a separate shirt, trousers, glove and shoe. Thanks to the novel fusion approach it has been possible to develop a model for the shoulder taking into account the scapulo-thoracic joint of the scapular girdle, considerably improving the estimation of the hand position in reaching activities. In order to minimize the sensor set used to monitor gait, a single inertial sensor fused with a textile goniometer proved to reconstruct the orientation of all the body segments of the leg. Finally, the sensing glove, endowed with three textile goniometers and three force sensors showed good capabilities in the reconstruction of grasping activities and evaluating the interaction of the hand with the environment, according to the project specifications. This paper reports on the design and the technical evaluation of the performance of the sensing platform, tested on healthy subjects.

  5. Wearable Textile Platform for Assessing Stroke Patient Treatment in Daily Life Conditions.

    Science.gov (United States)

    Lorussi, Federico; Carbonaro, Nicola; De Rossi, Danilo; Paradiso, Rita; Veltink, Peter; Tognetti, Alessandro

    2016-01-01

    Monitoring physical activities during post-stroke rehabilitation in daily life may help physicians to optimize and tailor the training program for patients. The European research project INTERACTION (FP7-ICT-2011-7-287351) evaluated motor capabilities in stroke patients during the recovery treatment period. We developed wearable sensing platform based on the sensor fusion among inertial, knitted piezoresistive sensors and textile EMG electrodes. The device was conceived in modular form and consists of a separate shirt, trousers, glove, and shoe. Thanks to the novel fusion approach it has been possible to develop a model for the shoulder taking into account the scapulo-thoracic joint of the scapular girdle, considerably improving the estimation of the hand position in reaching activities. In order to minimize the sensor set used to monitor gait, a single inertial sensor fused with a textile goniometer proved to reconstruct the orientation of all the body segments of the leg. Finally, the sensing glove, endowed with three textile goniometers and three force sensors showed good capabilities in the reconstruction of grasping activities and evaluating the interaction of the hand with the environment, according to the project specifications. This paper reports on the design and the technical evaluation of the performance of the sensing platform, tested on healthy subjects. PMID:27047939

  6. Multiple platform assessment of the EGF dependent transcriptome by microarray and deep tag sequencing analysis

    Directory of Open Access Journals (Sweden)

    Iraola Susana

    2011-06-01

    Full Text Available Abstract Background Epidermal Growth Factor (EGF is a key regulatory growth factor activating many processes relevant to normal development and disease, affecting cell proliferation and survival. Here we use a combined approach to study the EGF dependent transcriptome of HeLa cells by using multiple long oligonucleotide based microarray platforms (from Agilent, Operon, and Illumina in combination with digital gene expression profiling (DGE with the Illumina Genome Analyzer. Results By applying a procedure for cross-platform data meta-analysis based on RankProd and GlobalAncova tests, we establish a well validated gene set with transcript levels altered after EGF treatment. We use this robust gene list to build higher order networks of gene interaction by interconnecting associated networks, supporting and extending the important role of the EGF signaling pathway in cancer. In addition, we find an entirely new set of genes previously unrelated to the currently accepted EGF associated cellular functions. Conclusions We propose that the use of global genomic cross-validation derived from high content technologies (microarrays or deep sequencing can be used to generate more reliable datasets. This approach should help to improve the confidence of downstream in silico functional inference analyses based on high content data.

  7. Assessing Patient-Centered Communication in Cancer Care: Stakeholder Perspectives

    OpenAIRE

    Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.

    2013-01-01

    Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices.

  8. Psychiatric Issues in Palliative Care: Assessing Mental Capacity

    OpenAIRE

    Itoro Udo; Zeid Mohammed; Amanda Gash

    2013-01-01

    Issues surrounding capacity to consent to or refuse treatment are increasingly receiving clinical and legal attention. Through the use of 3 case vignettes that involve different aspects of mental health care in palliative care settings, mental capacity issues are discussed. The vignettes tackle capacity in a patient with newly developed mental illness consequent to physical illness, capacity in a patient with mental illness but without delirium and capacity in a patient with known impairment ...

  9. Sharing clinical information across care settings: the birth of an integrated assessment system

    Directory of Open Access Journals (Sweden)

    Henrard Jean-Claude

    2009-04-01

    Full Text Available Abstract Background Population ageing, the emergence of chronic illness, and the shift away from institutional care challenge conventional approaches to assessment systems which traditionally are problem and setting specific. Methods From 2002, the interRAI research collaborative undertook development of a suite of assessment tools to support assessment and care planning of persons with chronic illness, frailty, disability, or mental health problems across care settings. The suite constitutes an early example of a "third generation" assessment system. Results The rationale and development strategy for the suite is described, together with a description of potential applications. To date, ten instruments comprise the suite, each comprising "core" items shared among the majority of instruments and "optional" items that are specific to particular care settings or situations. Conclusion This comprehensive suite offers the opportunity for integrated multi-domain assessment, enabling electronic clinical records, data transfer, ease of interpretation and streamlined training.

  10. The Tox21 robotic platform for the assessment of environmental chemicals--from vision to reality.

    Science.gov (United States)

    Attene-Ramos, Matias S; Miller, Nicole; Huang, Ruili; Michael, Sam; Itkin, Misha; Kavlock, Robert J; Austin, Christopher P; Shinn, Paul; Simeonov, Anton; Tice, Raymond R; Xia, Menghang

    2013-08-01

    Since its establishment in 2008, the US Tox21 inter-agency collaboration has made great progress in developing and evaluating cellular models for the evaluation of environmental chemicals as a proof of principle. Currently, the program has entered its production phase (Tox21 Phase II) focusing initially on the areas of modulation of nuclear receptors and stress response pathways. During Tox21 Phase II, the set of chemicals to be tested has been expanded to nearly 10,000 (10K) compounds and a fully automated screening platform has been implemented. The Tox21 robotic system combined with informatics efforts is capable of screening and profiling the collection of 10K environmental chemicals in triplicate in a week. In this article, we describe the Tox21 screening process, compound library preparation, data processing, and robotic system validation. PMID:23732176

  11. Inter-laboratory evaluation of instrument platforms and experimental workflows for quantitative accuracy and reproducibility assessment

    Directory of Open Access Journals (Sweden)

    Andrew J. Percy

    2015-09-01

    Full Text Available The reproducibility of plasma protein quantitation between laboratories and between instrument types was examined in a large-scale international study involving 16 laboratories and 19 LC–MS/MS platforms, using two kits designed to evaluate instrument performance and one kit designed to evaluate the entire bottom-up workflow. There was little effect of instrument type on the quality of the results, demonstrating the robustness of LC/MRM-MS with isotopically labeled standards. Technician skill was a factor, as errors in sample preparation and sub-optimal LC–MS performance were evident. This highlights the importance of proper training and routine quality control before quantitation is done on patient samples.

  12. Developing a social media platform for nurses.

    Science.gov (United States)

    Jackson, Jennifer; Kennedy, Maggie

    2015-11-18

    Social media tools provide opportunities for nurses to connect with colleagues and patients and to advance personally and professionally. This article describes the process of developing an innovative social media platform at a large, multi-centre teaching hospital, The Ottawa Hospital, Canada, and its benefits for nurses. The platform, TOH Nurses, was developed using a nursing process approach, involving assessment, planning, implementation and evaluation. The aim of this initiative was to address the barriers to communication inherent in the large number of nurses employed by the organisation, the physical size of the multi-centre hospital and the shift-work nature of nursing. The platform was used to provide educational materials for clinical nurses, and to share information about professional practice. The implications of using a social media platform in a healthcare setting were considered carefully during its development and implementation, including concerns regarding privacy and confidentiality. PMID:26576914

  13. Health needs assessment in primary care: the evolution of a practical public health approach.

    Science.gov (United States)

    Kilduff, A; McKeown, K; Crowther, A

    1998-05-01

    The purpose of the paper is to place health needs assessment in its primary care context. This is a dynamic context where changes in policies, staff roles and patient expectations have all to be considered. Given this complexity and the variations between practices, it is necessary to help primary health care teams (PHCTs) to understand their stage of development and how this will directly affect any health needs assessment. The technical and methodological aspects of health needs assessment have been explored and described by others, and that work will not be duplicated here. This paper reviews the health needs assessment (HNA) work of the Ribblesdale Total Purchasing Project (RTPP) and then sets this review against the political, organisational, professional and practical pressures that currently confront primary care. Out of this analysis emerges a diagnostic and development tool which links together, and emphasises the intimate relationships between, five stages of development needed for effective primary care-oriented health needs assessment work. The emphasis is on understanding the place of health needs assessment within the general processes and systems of the primary health care team. The paper concludes by suggesting ways in which public health practitioners and specialists might approach the task of supporting and influencing the evolution of the recently proposed Primary Care Groups and Primary Care Trusts. The overall intention of the article is to stimulate debate and action. PMID:9629025

  14. Assessing the skills of home care workers in helping older people take their prescribed medications.

    Science.gov (United States)

    Smyth, Elizabeth E J

    2015-08-01

    The Southern Health and Social Care Trust in Northern Ireland applied a modified version of the Objective Structured Clinical Examination (OSCE) to assess the skills of home care workers in assisting older people taking prescribed medications. In Northern Ireland, home care workers are care workers employed by health and social care trusts or private agencies. The application of the model has developed the skills of this staff group, improved the relationship between the commissioner and provider, significantly reduced the time spent by community nurses in individual training and assessment, and enhanced the patient experience for those taking medication. Overall, the application of this model has provided assurances to the Trust board, the executive director of nursing, and operational directors that home care workers are competent in assisting older people in this high-risk activity. PMID:26252238

  15. A tool for assessing continuity of care across care levels: an extended psychometric validation of the CCAENA questionnaire

    Directory of Open Access Journals (Sweden)

    Marta Beatriz Aller

    2013-12-01

    Full Text Available Background: The CCAENA questionnaire was developed to assess care continuity across levels from the patients’ perspective. The aim is to provide additional evidence on the psychometric properties of the scales of this questionnaire. Methods: Cross-sectional study by means of a survey of a random sample of 1500 patients attended in primary and secondary care in three healthcare areas of the Catalan healthcare system. Data were collected in 2010 using the CCAENA questionnaire. To assess psychometric properties, an exploratory factor analysis was performed (construct validity and the item-rest correlations and Cronbach’s alpha were calculated (internal consistency. Spearman correlation coefficients were calculated (multidimensionality and the ability to discriminate between groups was tested. Results: The factor analysis resulted in 21 items grouped into three factors: patient-primary care provider relationship, patient-secondary care provider relationship and continuity across care levels. Cronbach’s alpha indicated good internal consistency (0.97, 0.93, 0.80 and the correlation coefficients indicated that dimensions can be interpreted as separated scales. Scales discriminated patients according to healthcare area, age and educational level. Conclusion: The CCAENA questionnaire has proved to be a valid and reliable tool for measuring patients’ perceptions of continuity. Providers and researchers could apply the questionnaire to identify areas for healthcare improvement. 

  16. Pinellas Plant: Child Care/Partnership School safety assessment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1989-11-01

    The Albuquerque Operations Office through the Pinellas Plant Area Office is involved in a joint venture to establish a Partnership School and a Day Care Facility at the Plant. The venture is unique in that it is based on a partnership with the local county school system. The county school system will provide the teachers, supplies and classroom furnishings for the operation of the school for pre-kindergarten, kindergarten, first and second grade during regular school hours. The Government will provide the facility and its normal operating and maintenance costs. A Day Care Facility will also be available for children from infancy through the second grade for outside school hours. The day care will be operated as a non-profit corporation. Fees paid by parents with children in the day care center will cove the cost of staff, food, supplies and liability insurance. Again, the government will provide the facility and its normal operating and maintenance costs. Between 75 and 90 children are expected in the first year of operation. The Partnership School will consist of one class each for pre-kindergarten, kindergarten and first grade. Second grade will be added in 1990. The total estimated number of children for both the Child Care and Partnership School should not exceed 200 children. Expected benefits include reduced absenteeism, tardiness and turnover and thus increased productivity. The program will be an asset in recruiting and retaining the best workforce. Other benefits include improved education for the children.

  17. Validation of the Danish version of the Patient Assessment of Care for Chronic Conditions questionnaire (PACIC)

    DEFF Research Database (Denmark)

    Sokolowski, Ineta; Maindal, Helle Terkildsen; Vedsted, Peter

    Objective: To evaluate the level of chronic care patients must be involved. The Danish version of the 20-item Patient Assessment of Care for Chronic Conditions PACIC questionnaire consisting of 5 scales and an overall summary score measuring patient reported assessment of structured chronic care...... has not been evaluated with regard to psychometric properties. This study aims to assess data quality and internal consistency and to validate the proposed factorial structure. Materials and methods: Setting: Diabetes population receiving chronic care in Denmark. Subjects: A total of 624 patients aged...... same questionnaire is constructed and applied to different countries with diverse cultural backgrounds and health care systems. It is decisive, that translated questionnaires are validated in country they are used....

  18. Hemodynamic Assessment and Monitoring in the Intensive Care Unit: an Overview

    OpenAIRE

    Adler, Adam C.; Ramakant Sharma; Thomas Higgins; McGee, William T

    2014-01-01

    The goal of hemodynamic monitoring in intensive care is to assess the adequacy of perfusion, specifically with regard to maintaining sufficient perfusion pressures and oxygen delivery. Precise volume management of peri-operative and critical care patients is crucial as under or over resuscitation is associated with adverse outcomes. Hemodynamic monitoring allows care to be individualized based on specific patient response to therapy and can provide early warning of impending perfusion deficit...

  19. Assessment of distress with physical and psychological symptoms of patients in german palliative care services.

    OpenAIRE

    Neuwöhner, Karl; Lindena, Gabriele

    2011-01-01

    BACKGROUND: Within the framework of the nationwide Hospice and Palliative Care Evaluation (HOPE), the German Basic Documentation for Psycho-oncology (PO-Bado) was used from 2004 to 2006 as an optional module in most participating palliative care services to investigate how patient distress due to symptom burdens in different palliative care settings should be assessed and how professional interventions could be derived. PATIENTS AND METHODS: The distress scores of 3,317 PO-Bado records o...

  20. Assessment of patient safety culture in primary care setting, Al-Mukala, Yemen

    OpenAIRE

    Webair, Hana H; Al-assani, Salwa S.; Al-haddad, Reema H.; Al-Shaeeb, Wafa H.; Bin Selm, Manal A.; Alyamani, Abdulla S.

    2015-01-01

    Background Patient safety culture in primary care is the first step to achieve high quality health care. This study aims to provide a baseline assessment of patient safety culture in primary care settings in Al-Mukala, Yemen as a first published study from a least developed country. Methods A survey was conducted in primary healthcare centres and units in Al-Mukala District, Yemen. A comprehensive sample from the available 16 centres was included. An Arabic version of the Medical Office Surve...

  1. A novel testing platform for assessing knee joint mechanics: a parallel robotic system combined with an instrumented spatial linkage.

    Science.gov (United States)

    Atarod, Mohammad; Rosvold, Joshua M; Frank, Cyril B; Shrive, Nigel G

    2014-05-01

    Assessing joint function following trauma and its inter-relation with degenerative changes requires an understanding of the normal state of structural loading in the joint. Very few studies have attempted to reproduce joint specific in vivo motions in vitro to quantify the actual loads carried by different tissues within the knee joint. The most significant challenge in this area is the very high sensitivity of the loads in joint structures to motion reproduction accuracy. A novel testing platform for assessing knee joint mechanics is described, comprised of a highly accurate (0.3 ± 0.1 mm, 0.3 ± 0.1°) six-degree-of-freedom (6-DOF) instrumented spatial linkage (ISL) for in vivo joint kinematic assessments and a unique 6-DOF parallel robotic manipulator. A position feedback system (ISL and position controller) is used for accurate reproduction of in vivo joint motions and estimation of "in situ" joint/tissue loads. The parallel robotic manipulator provides excellent stiffness and repeatability in reproducing physiological motions in 6-DOF, compared to the commonly used serial robots. The position feedback system provides real-time feedback data to the robot to reproduce in vivo motions and significantly enhances motion reproduction accuracy by adjusting for robot end-effector movements. Using this combined robot-ISL system, in vivo motions can be reproduced in vitro with very high accuracy (0.1 mm, 0.1°). Our results indicate that this level of accuracy is essential for meaningful estimation of tissue loads during gait. Using this novel testing platform, we have determined the normal load-carrying characteristics of different tissues within the ovine knee joint. The application of this testing system will continue to increase our understanding of normal and pathological joint states. PMID:24519725

  2. The validity and reliability of an instrument to assess nursing competencies in spiritual care

    NARCIS (Netherlands)

    van Leeuwen, Rene; Tiesinga, Lucas J.; Middel, Berrie; Post, Doeke; Jochemsen, Henk

    2009-01-01

    Aim. This study contributes to the development of a valid and reliable instrument, the spiritual care competence scale, as an instrument to assess nurses' competencies in providing spiritual care. Background. Measuring these competencies and their development is important and the construction of a r

  3. The validity and reliability of an instrument to assess nursing competencies in spiritual care

    NARCIS (Netherlands)

    Leeuwen, R.R.; Tiesinga, L.J.; Middel, L.J.; Post, D.; Jochemsen, H.

    2009-01-01

    Aim. This study contributes to the development of a valid and reliable instrument, the spiritual care competence scale, as an instrument to assess nurses’ competencies in providing spiritual care. Background. Measuring these competencies and their development is important and the construction of a r

  4. Vermont STep Ahead Recognition System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Vermont's STep Ahead Recognition System (STARS) prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for All Child Care Programs;…

  5. GlobAllomeTree: international platform for tree allometric equations to support volume, biomass and carbon assessment

    Directory of Open Access Journals (Sweden)

    Henry M

    2013-07-01

    Full Text Available GlobAllomeTree is an international platform for tree allometric equations. It is the first worldwide web platform designed to facilitate the access of the tree allometric equation and to facilitate the assessment of the tree biometric characteristics for commercial volume, bio-energy or carbon cycling. The webplatform presents a database containing tree allometric equations, a software called Fantallomatrik, to facilitate the comparison and selection of the equations, and documentation to facilitate the development of new tree allometric models, improve the evaluation of tree and forest resources and improve knowledge on tree allometric equations. In the Fantallometrik software, equations can be selected by country, ecological zones, input parameters, tree species, statistic parameters and outputs. The continuously updated database currently contains over 5000 tree allometric equations classified according to 73 fields. The software Fantallometrik can be also used to compare equations, insert new data and estimate the selected output variables using field inventory. The GlobAllomeTree products are freely available at the URL: http://globallometree.org for a range of users including foresters, project developers, scientist, student and government staff.

  6. Assessment of Systems for Paying Health Care Providers in Mongolia

    OpenAIRE

    Joint Learning Network; Mongolia Ministry of Health; World Bank; World Health Organization,

    2015-01-01

    Achieving access to basic health services for the entire population without risk of financial hardship or impoverishment from out-of-pocket expenditures (‘universal health coverage’ or UHC) is a challenge that continues to confront most low- and middle-income countries. As coverage expands in these countries, issues of financial sustainability, efficiency, and quality of care quickly rise ...

  7. Fish survey, fishing duration, shellfish resource assessment, and other data from the COMMANDO and other platforms as part of Outer Continental Shelf Environmental Assessment Program (OCSEAP) from 21 May 1976 to 16 September 1976 (NODC Accession 7700432)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Fish survey, fishing duration, shellfish resource assessment, and other data were collected from the COMMANDO and other platforms from 21 May 1976 to 16 September...

  8. Design of an Integrated Sensor Platform for Vital Sign Monitoring of Newborn Infants at Neonatal Intensive Care Units

    OpenAIRE

    Chen, Wei; Bambang Oetomo, Sidarto; Feijs, Loe; Bouwstra, Sibrecht; Ayoola, Idowu; Dols, Sietse

    2010-01-01

    Continuous health status monitoring and advances in medical treatments have resulted in a significant increase of survival rate in critically ill infants admitted into Neonatal Intensive Care Units (NICUs). The quality of life and long-term health prospects of the neonates depend increasingly on the reliability and comfort of the monitoring systems. In this paper, we present the design work of a smart jacket for vital sign monitoring of neonates at a NICU. The design represents a unique integ...

  9. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    OpenAIRE

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David

    2016-01-01

    Objectives Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to ela...

  10. Assessment of linkages from HIV testing to enrolment and retention in HIV care in Central Mozambique

    OpenAIRE

    Celso Azarias Inguane; Stephen Gloyd; João Luis Manuel; Charlene Brown; Vincent Wong; Orvalho Augusto; Wisal Mustafa Hassan; Lúcia Vieira; Pires Afonso; Mehol Jamnadás; Jama Joy Bernard; James Cowan; Samuel Kalibala; James Pfeiffer

    2016-01-01

    Introduction: Effectiveness of the rapid expansion of antiretroviral therapy (ART) throughout sub-Saharan Africa is highly dependent on adequate enrolment and retention in HIV care. However, the measurement of both has been challenging in these settings. This study aimed to assess enrolment and retention in HIV care (pre-ART and ART) among HIV-positive adults in Central Mozambique, including identification of barriers and facilitators. Methods: We assessed linkages to and retention in HIV car...

  11. Human health impacts for renewable energy scenarios from the EnerGEO Platform of Integrated Assessment (PIA)

    International Nuclear Information System (INIS)

    This article reports impact results from running the EnerGEO Platform of Integrated Assessment (PIA) related to human health for different scenarios in Europe. The scenarios were prepared within the EnerGEO project. The idea of this European project is to determine how low carbon scenarios, and in particular scenarios with a high share of renewable energy, affect concentrations of air pollutants and as a consequence affect human health. PM2.5 concentrations were estimated with the IIASA Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model on a time horizon up to the year 2050 for different scenarios. We analyse here the estimation of the Loss of Life Expectancy due to PM2.5 concentrations for the Baseline scenario taken as a reference and the Maximum renewable power scenario. (orig.)

  12. DEVELOPMENT OF AN INSPECTION PLATFORM AND A SUITE OF SENSORS FOR ASSESSING CORROSION AND MECHANICAL DAMAGE ON UNPIGGABLE TRANSMISSION MAINS

    Energy Technology Data Exchange (ETDEWEB)

    George C. Vradis

    2003-05-01

    The present report summarizes the accomplishments of the project during its second three-month period (from January 2003 through March 2003). The project was initiated with delay in February 2003 due to contractual issues that emerged between the NGA and Foster-Miller, Inc. The two organizations are working diligently to maintain the program's pace so that it is completed in time. The efforts of the project focused during this period in the assessment of the tether technology that is intended to be used as the means of communication between robot and operator. Preliminary results indicate that tether is a viable option under certain pipeline operating conditions but not all. The exact range of operating conditions that are viable for tether use are being determined as the study progresses. Work was also initiated regarding the design of the robotic platform.

  13. Cancer Risk Assessment for the Primary Care Physician

    OpenAIRE

    Korde, Larissa A; Gadalla, Shahinaz M.

    2009-01-01

    Cancer is the second leading cause of death in the United States. Cancer risk assessment can be divided into two major categories: assessment of familial or genetic risk and assessment of environmental factors that may be causally related to cancer. Identification of individuals with a suspected heritable cancer syndrome can lead to additional evaluation and to interventions that can substantially decrease cancer risk. Special attention should also be paid to potentially modifiable cancer ris...

  14. Assessment of cisplatin-induced kidney injury using an integrated rodent platform

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yafei [Global Safety Assessment, AstraZeneca R and D Waltham, MA 02451 (United States); Brott, David [Patient Safety, AstraZeneca R and D Wilmington, DE 19850 (United States); Luo, Wenli [Discovery Statistics, AstraZeneca R and D Waltham, MA 02451 (United States); Gangl, Eric [DMPK, AstraZeneca R and D Waltham, MA 02451 (United States); Kamendi, Harriet; Barthlow, Herbert; Lengel, David; Fikes, James; Kinter, Lewis [Global Safety Assessment, AstraZeneca R and D Waltham, MA 02451 (United States); Valentin, Jean-Pierre [Global Safety Assessment, AstraZeneca R and D Alderley Park, Macclesfield, SK10 4TG (United Kingdom); Bialecki, Russell, E-mail: russell.bialecki@astrazeneca.com [Global Safety Assessment, AstraZeneca R and D Waltham, MA 02451 (United States)

    2013-05-01

    Current diagnosis of drug-induced kidney injury (DIKI) primarily relies on detection of elevated plasma creatinine (Cr) or blood urea nitrogen (BUN) levels; however, both are indices of overall kidney function and changes are delayed with respect to onset of nephron injury. Our aim was to investigate whether early changes in new urinary DIKI biomarkers predict plasma Cr, BUN, renal hemodynamic and kidney morphological changes associated with kidney injury following a single dose of cisplatin (CDDP) using an integrated platform in rodent. Conscious surgically prepared male Han Wistar rats were given a single intraperitoneal dose of CDDP (15 mg/kg). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), urinalysis, DIKI biomarkers, CDDP pharmacokinetics, blood pressures, heart rate, body temperature and electroencephalogram (EEG) were measured in the same vehicle- or CDDP-treated animals over 72 h. Plasma chemistry (including Cr and BUN) and renal tissues were examined at study termination. Cisplatin caused progressive reductions of GFR, ERPF, heart rate and body temperature from day 1 (0–24 h). DIKI biomarkers including alpha-glutathione S-transferase (α-GST) significantly increased as early as 6 h post-dose, which preceded significant declines of GFR and ERPF (24 h), increased plasma Cr and BUN (72 h), and associated with renal acute tubular necrosis at 72 h post-dose. The present study adds to the current understanding of CDDP action by demonstrating that early increases in urinary excretion of α-GST predict DIKI risk following acute exposure to CDDP in rats, before changes in traditional DIKI markers are evident. - Highlights: ► CDDP causes direct damage to kidneys without affecting EEG or CVS function. ► α-GST and albumin detect DIKI earlier when compared with traditional indices. ► Integrated “cardiovascular-EEG-renal” model to better understand DIKI mechanisms ► Promotes 3R's principles in drug discovery and development.

  15. Assessment of cisplatin-induced kidney injury using an integrated rodent platform

    International Nuclear Information System (INIS)

    Current diagnosis of drug-induced kidney injury (DIKI) primarily relies on detection of elevated plasma creatinine (Cr) or blood urea nitrogen (BUN) levels; however, both are indices of overall kidney function and changes are delayed with respect to onset of nephron injury. Our aim was to investigate whether early changes in new urinary DIKI biomarkers predict plasma Cr, BUN, renal hemodynamic and kidney morphological changes associated with kidney injury following a single dose of cisplatin (CDDP) using an integrated platform in rodent. Conscious surgically prepared male Han Wistar rats were given a single intraperitoneal dose of CDDP (15 mg/kg). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), urinalysis, DIKI biomarkers, CDDP pharmacokinetics, blood pressures, heart rate, body temperature and electroencephalogram (EEG) were measured in the same vehicle- or CDDP-treated animals over 72 h. Plasma chemistry (including Cr and BUN) and renal tissues were examined at study termination. Cisplatin caused progressive reductions of GFR, ERPF, heart rate and body temperature from day 1 (0–24 h). DIKI biomarkers including alpha-glutathione S-transferase (α-GST) significantly increased as early as 6 h post-dose, which preceded significant declines of GFR and ERPF (24 h), increased plasma Cr and BUN (72 h), and associated with renal acute tubular necrosis at 72 h post-dose. The present study adds to the current understanding of CDDP action by demonstrating that early increases in urinary excretion of α-GST predict DIKI risk following acute exposure to CDDP in rats, before changes in traditional DIKI markers are evident. - Highlights: ► CDDP causes direct damage to kidneys without affecting EEG or CVS function. ► α-GST and albumin detect DIKI earlier when compared with traditional indices. ► Integrated “cardiovascular-EEG-renal” model to better understand DIKI mechanisms ► Promotes 3R's principles in drug discovery and development

  16. Symptom severity of patients with advanced cancer in palliative care unit: longitudinal assessments of symptoms improvement

    OpenAIRE

    Tai, Shu-Yu; Lee, Chung-Yin; Wu, Chien-Yi; Hsieh, Hui-ya; Huang, Joh-Jong; Huang, Chia-Tsuan; Chien, Chen-Yu

    2016-01-01

    Background This study assessed the symptom severity of patients with advanced cancer in a palliative care unit and explored the factors associated with symptom improvement. Methods This study was conducted in a palliative care unit in Taiwan between October 2004 and December 2009. Symptom intensity was measured by the “Symptom Reporting Form”, and graded on a scale of 0 to 4 (0 = none, and 4 = extreme). These measures were assessed on the 1st, 3rd, 5th, and 7th Day in the palliative care unit...

  17. CLINICAL PSYCHOLOGICAL ASSESSMENT IN LITHUANIAN HEALTH CARE INSTITUTIONS: OPINION ANALYSIS OF PROFESSIONALS

    OpenAIRE

    Augustinas Rotomskis

    2015-01-01

    Purpose – to investigate the state of clinical psychological assessment in the Lithuanian health care system: 1) what kind of tests are used in clinical practice and what are clinicians opinions about them; 2) what kind of psychological functions are assessed in clinical practice and what is the opinion of clinicians about the assessment of these psychological functions; 3) what kind of issues are the most pressing in clinical assessment. Design/methodology/approach – 101 clinical psychol...

  18. The Development and Evaluation of Delirium Assessment and Nursing Care Decision-Making Assistant Mobile Application for Intensive Care Unit.

    Science.gov (United States)

    Yang, Fangyu; Ji, Meihua; Ding, Shu; Wu, Ying; Chang, Polun; Lin, Chiawei; Yang, Xin

    2016-01-01

    Delirium is a common complication among patients in ICU settings. Although it has been repeatedly confirmed that Confusion Assessment Model for Intensive Care Unit (CAM-ICU), one of the most commonly used ICU delirium assessment tool, is highly accurate in validation studies, it's sensitivity and specificity is relatively low during routine practice among bedside nurses. The aim of this study is to develop a mobile application (app) to detect delirium and to test its reliability and validity both by research nurses and among ICU bedside nurses. The app was programmed with Java and installed on a mobile device with Android system. After completion of reliability and validity testing, the app will be integrated into the existing Hospital Information System in order to automatically retrieve essential information for risk factor identification and formulation of care plan accordingly to prevent or manage ICU delirium. PMID:27332299

  19. Assessment of Environmental Sustainability in Health Care Organizations

    OpenAIRE

    María Carmen Carnero

    2015-01-01

    Healthcare organizations should set a standard in corporate social responsibility and encourage environmental sustainability, since protection of the environment implies the development of preventive measures in healthcare. Environmental concern has traditionally focused on manufacturing plants. However, a Health Care Organization (HCO) is the only type of company which generates all existing classes of waste, and 20% is dangerous, being infectious, toxic or radioactive in nature. Despite th...

  20. CLINICAL PSYCHOLOGICAL ASSESSMENT IN LITHUANIAN HEALTH CARE INSTITUTIONS: OPINION ANALYSIS OF PROFESSIONALS

    Directory of Open Access Journals (Sweden)

    Augustinas Rotomskis

    2015-07-01

    Full Text Available Purpose – to investigate the state of clinical psychological assessment in the Lithuanian health care system: 1 what kind of tests are used in clinical practice and what are clinicians opinions about them; 2 what kind of psychological functions are assessed in clinical practice and what is the opinion of clinicians about the assessment of these psychological functions; 3 what kind of issues are the most pressing in clinical assessment. Design/methodology/approach – 101 clinical psychologists, who work in Lithuanian health care institutions, completed a questionnaire about their opinion on clinical psychological assessment. Findings – Attention, memory, executive functions, intelligence and emotions are the most important and frequently assessed psychological functions in clinical practice. Neuropsychogical assessment of attention, memory, executive functions, are viewed as the most problematic fields of assessment. The adaptation, standartization and revision of the various neuropsychological tests is suggested. The most pressing issues in clinical practice are: 1 the assessment of specific psychological functions (neuropsychological and psychosocial functioning; 2 the assessment of specific disorders (schizophrenia spectrum disorders and autism spectrum disorders; 3 the asessment of specific stages of development (children and teenagers. Research limitations/implications – 32 percent of health care institutions (30 out of 95 identified institutions, which provide mental health care, did not participate in the study. The majority of these institutions are from the provinces. Practical implications – psychological assessment plays a key role in the practice of a clinical psychologist. This study investigated and pinpointed the most pressing issues and needs of psychologists in clinical practice. According to the study results, recommendations ascertaining to the adaptation and revision of tests and preparation of clinical psychologists

  1. C-HUB: a communication and network platform targeting the Generation Plus and their social and care networks

    DEFF Research Database (Denmark)

    Asboe, Mark; Fernandes, Joao; Grönvall, Erik

    2010-01-01

    This paper presents an ongoing project that focuses on improving the quality of life for senior citizens by developing IT support for independent living in their homes. We introduce a concept that explores and supports coordination within a social and care community targeting elderly people. The...... paper reports on early project findings such as how elderly perceive a touch screen based interface and why a touch screen based interface might be favorable for this category of users in respect to a standard PC. Furthermore, This paper contributes to the societal debate on how IT may support ageing in...

  2. The psychosocial oncology learning assessment: a province-wide survey of cancer care providers' learning needs.

    Science.gov (United States)

    Rennie, Heather; Mackenzie, Gina

    2010-06-01

    A psychosocial oncology learning needs assessment was developed and offered online to cancer care providers in a variety of settings across all health regions in British Columbia. The purpose was to better understand the psychosocial learning needs of cancer care providers and to use this knowledge to shape continuing education priorities. Respondents' preferred learning formats, access to technology and barriers to accessing psychosocial learning opportunities were also assessed. Cancer care providers including radiation therapists, social workers, dieticians, pharmacists, physicians and nurses in both community and agency settings were surveyed. Two hundred and sixty-seven people completed the survey. Key learning needs identified included cultural aspects of care, symptom management, treating the anxious patient, self-care for the professional, care of elderly patients, basic cancer-related medical issues surrounding care and ethics. Community respondents indicated more needs than agency respondents. On-site training was the most preferred learning format, and time constraints were the biggest barrier to accessing learning opportunities. Participants had access to technology. Next steps include conducting key informant and focus group interviews to determine if interest in a learning need is the same as a relevant knowledge and practice gap. This research suggests that cancer care providers are interested in learning more about the psychosocial issues related to cancer care. PMID:20361284

  3. Platform Performance and Challenges - using Platforms in Lego Company

    DEFF Research Database (Denmark)

    Munk, Lone; Mortensen, Niels Henrik

    2009-01-01

    needs focus on the incentive of using the platform. This problem lacks attention in literature, as well as industry, where assessment criteria do not cover this aspect. Therefore, we recommend including user incentive in platform assessment criteria to these challenges. Concrete solution elements...... ensuring user incentive in platforms is an object for future research...

  4. NutriPhone: a mobile platform for low-cost point-of-care quantification of vitamin B12 concentrations.

    Science.gov (United States)

    Lee, Seoho; O'Dell, Dakota; Hohenstein, Jess; Colt, Susannah; Mehta, Saurabh; Erickson, David

    2016-01-01

    Vitamin B12 is necessary for formation of red blood cells, DNA synthesis, neural myelination, brain development, and growth. Vitamin B12 deficiency is often asymptomatic early in its course; however, once it manifests, particularly with neurological symptoms, reversal by dietary changes or supplementation becomes less effective. Access to easy, low cost, and personalized nutritional diagnostics could enable individuals to better understand their own deficiencies as well as track the effects of dietary changes. In this work, we present the NutriPhone, a mobile platform for the analysis of blood vitamin B12 levels in 15 minutes. The NutriPhone technology comprises of a smartphone accessory, an app, and a competitive-type lateral flow test strip that quantifies vitamin B12 levels. To achieve the detection of sub-nmol/L physiological levels of vitamin B12, our assay incorporates an innovative "spacer pad" for increasing the duration of the key competitive binding reaction and uses silver amplification of the initial signal. We demonstrate the efficacy of our NutriPhone system by quantifying physiologically relevant levels of vitamin B12 and performing human trials where it was used to accurately evaluate blood vitamin B12 status of 12 participants from just a drop (~40 μl) of finger prick blood. PMID:27301282

  5. NutriPhone: a mobile platform for low-cost point-of-care quantification of vitamin B12 concentrations

    Science.gov (United States)

    Lee, Seoho; O’Dell, Dakota; Hohenstein, Jess; Colt, Susannah; Mehta, Saurabh; Erickson, David

    2016-01-01

    Vitamin B12 is necessary for formation of red blood cells, DNA synthesis, neural myelination, brain development, and growth. Vitamin B12 deficiency is often asymptomatic early in its course; however, once it manifests, particularly with neurological symptoms, reversal by dietary changes or supplementation becomes less effective. Access to easy, low cost, and personalized nutritional diagnostics could enable individuals to better understand their own deficiencies as well as track the effects of dietary changes. In this work, we present the NutriPhone, a mobile platform for the analysis of blood vitamin B12 levels in 15 minutes. The NutriPhone technology comprises of a smartphone accessory, an app, and a competitive-type lateral flow test strip that quantifies vitamin B12 levels. To achieve the detection of sub-nmol/L physiological levels of vitamin B12, our assay incorporates an innovative “spacer pad” for increasing the duration of the key competitive binding reaction and uses silver amplification of the initial signal. We demonstrate the efficacy of our NutriPhone system by quantifying physiologically relevant levels of vitamin B12 and performing human trials where it was used to accurately evaluate blood vitamin B12 status of 12 participants from just a drop (~40 μl) of finger prick blood. PMID:27301282

  6. Assessing the acceptability of community pharmacy based pharmaceutical care services in Karachi

    Directory of Open Access Journals (Sweden)

    Muhammad Amir, B.Pharmacy, MSc. MBA, Assistant Professor/Clinical Pharmacist

    2011-01-01

    Full Text Available Provision of pharmaceutical care services in community pharmacies is a new trend in pharmacy practice worldwide. Published literature from developed countries is available showing benefits of pharmaceutical care services provided in community pharmacies. However, relatively little published literature is available from developing countries in which unique market environments are encountered. This study was conducted to assess the acceptability of community pharmacy based pharmaceutical care services in Karachi. Pharmaceutical care services were developed and offered to pharmacy customers for a period of two months. Acceptability was evaluated with respect to enrollment of participants in the program, discontinuation, and complaints registered. The findings provide a better understanding of pharmaceutical care marketing strategies and are discussed within the context of the health care environment in Karachi.

  7. The PRIMA-PIETRA Project: A Web-Based Platform for Early Autism Risk Assessment

    OpenAIRE

    Ruta, Liliana; Siracusano, Rosamaria; Tortorella, Gaetano; Boncoddo, Maria; Colombi, Costanza; Crifaci, Giulia; Billeci, Lucia; Tartarisco, Gennaro; Ferro, Marcello; Narzisi, Antonio; Muratori, Filippo; Pioggia, Giovanni

    2013-01-01

    It is well recognized that the best outcomes in autism spectrum disorders (ASD) are achieved through early diagnosis and early intervention. ASD symptoms may occur as early as 12-18 months and different instruments have been developed for early autism risk assessment under the age of 2 years. The Modified Checklist for Autism in Children (M-CHAT) is a developmental surveillance-screening instrument administered during 18- to 36-month well-child visits that was demonstrated to improve early id...

  8. A human pluripotent stem cell platform for assessing developmental neural toxicity screening

    OpenAIRE

    Hou, Zhonggang; Zhang, Jue; Schwartz, Michael P.; Stewart, Ron; Page, C David; Murphy, William L.; Thomson, James A

    2013-01-01

    A lack of affordable and effective testing and screening procedures mean surprisingly little is known about the health hazards of many of the tens of thousands of chemicals in use in the world today. The recent rise in the number of children affected by neurological disorders such as autism has stirred valuable debate about the role chemicals play in our daily life, highlighting the need for improved methods of assessing chemicals for developmental neural toxicity. Current methods of testing ...

  9. CO2CARE - Site Closure Assessment Research - Recent Results

    Science.gov (United States)

    Wipki, Mario; Liebscher, Axel; Kühn, Michael; Lüth, Stefan; Durucan, Sevket; Deflandre, Jean-Pierre; Wollenweber, Jens; Chadwick, Andy; Böhm, Gualtiero

    2013-04-01

    The EU project CO2CARE, which started in January 2011, supports the large scale demonstration of CCS technology by addressing requirements of operators and regulators face in terms of CO2 storage site abandonment. The CO2CARE consortium, consisting of 24 project partners from universities, research institutes, and the industry, investigate technologies and procedures for abandonment and post-closure safety, satisfying the regulatory requirements for the transfer of responsibility. Nine key injections sites in Europe, USA, Japan, and Australia, each with a specific (hydro) geological and environmental character, were selected for investigations. These sites can be divided into the CO2 storage types on-shore, off-shore, natural CO2 reservoir, depleted gas reservoirs, and saline aquifers. The project mainly focuses on three key areas: - well abandonment and long-term integrity; - reservoir management and prediction from closure to the long-term; - risk management methodologies for long-term safety. These key areas are in turn closely linked to the three high-level requirements of the EU Directive 2009/31/EC, Article 18 for CO2 storage which are: (i) absence of any detectable leakage, (ii) conformity of actual behaviour of the injected CO2 with the modeled behaviour, and (iii) the storage site is evolving towards a situation of long-term stability. The identification of criteria and the development of site abandonment procedures and technologies, which guarantee the fulfillment of the high-level requirements, are the major objectives in CO2CARE. These criteria have to be fulfilled prior to subsequent transfer of responsibility to the competent authorities, typically 20 or 30 years after site closure. Finally, the essential results of the different working groups in CO2CARE will feed into overall guidelines for regulatory compliance and "Best Practice" for site abandonment. Dissemination of the results will show policy makers and the general public how site abandonment

  10. Assessment of brain death in the neurocritical care unit.

    Science.gov (United States)

    Hwang, David Y; Gilmore, Emily J; Greer, David M

    2013-07-01

    This article reviews current guidelines for death by neurologic criteria and addresses topics relevant to the determination of brain death in the intensive care unit. The history of brain death as a concept leads into a discussion of the evolution of practice parameters, focusing on the most recent 2010 update from the American Academy of Neurology and the practice variability that exists worldwide. Proper transition from brain death determination to possible organ donation is reviewed. This review concludes with a discussion regarding ethical and religious concerns and suggestions on how families of patients who may be brain dead might be optimally approached. PMID:23809039

  11. Sequential organ failure assessment score as prognostic marker in critically ill patients in a tertiary care intensive care unit

    Directory of Open Access Journals (Sweden)

    Charan Bale

    2013-07-01

    Full Text Available Introduction: Sepsis is one of the most important causes of mortality in the intensive care setting. An effective predictor of prognosis of sepsis is required to assess morbidity and mortality of this condition. In this study, sepsis in the intensive care unit (ICU of a tertiary care hospital was evaluated, with specific reference to clinical features and causative organisms. The sequential organ failure assessment (SOFA score was calculated to assess the severity of sepsis and multi-organ failure at presentation and after 48 h. The correlation of SOFA and mean SOFA scores with outcome was studied. Materials and Methods: This was a prospective, observational, cohort study carried out in a tertiary care teaching hospital. Forty consecutive cases of septicemia were studied. Detailed history, clinical features, and SOFA score was recorded to assess the disease severity at the time of presentation and after 48 h. Inclusion of patients in the study was performed using the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM definition of sepsis. Two sample t-test and 95% confidence interval (CI for difference of mean was applied. Results: When the SOFA score was <7, the mortality was 56%. It increased to 70% when the score was 8-15 (P = 0.0989, t value: 1.69, Mean difference: 2.12, 95% CI: 0.41-4.665. Patients with SOFA score <7 after 48 h had 52% mortality and it increased to 88% when the score was 8-15. The mean SOFA score at 48 h was 6.96 in patients who died and 2.5 in those who improved (P < 0.001, t value: 4.332, mean difference: 4.39, 95% CI: 2.34-6.44. Hence, the predictive value for mortality of SOFA score was better at 48 h than at presentation. Conclusions: Sequential assessment of organ dysfunction in ICU at presentation and at 48 h is a good indicator of prognosis. Both mean and highest SOFA scores are particularly useful predictors of outcome, independent of the initial score. A high SOFA score at 48 h of

  12. Positional Quality Assessment of Orthophotos Obtained from Sensors Onboard Multi-Rotor UAV Platforms

    Science.gov (United States)

    Mesas-Carrascosa, Francisco Javier; Rumbao, Inmaculada Clavero; Berrocal, Juan Alberto Barrera; Porras, Alfonso García-Ferrer

    2014-01-01

    In this study we explored the positional quality of orthophotos obtained by an unmanned aerial vehicle (UAV). A multi-rotor UAV was used to obtain images using a vertically mounted digital camera. The flight was processed taking into account the photogrammetry workflow: perform the aerial triangulation, generate a digital surface model, orthorectify individual images and finally obtain a mosaic image or final orthophoto. The UAV orthophotos were assessed with various spatial quality tests used by national mapping agencies (NMAs). Results showed that the orthophotos satisfactorily passed the spatial quality tests and are therefore a useful tool for NMAs in their production flowchart. PMID:25587877

  13. Positional Quality Assessment of Orthophotos Obtained from Sensors Onboard Multi-Rotor UAV Platforms

    Directory of Open Access Journals (Sweden)

    Francisco Javier Mesas-Carrascosa

    2014-11-01

    Full Text Available In this study we explored the positional quality of orthophotos obtained by an unmanned aerial vehicle (UAV. A multi-rotor UAV was used to obtain images using a vertically mounted digital camera. The flight was processed taking into account the photogrammetry workflow: perform the aerial triangulation, generate a digital surface model, orthorectify individual images and finally obtain a mosaic image or final orthophoto. The UAV orthophotos were assessed with various spatial quality tests used by national mapping agencies (NMAs. Results showed that the orthophotos satisfactorily passed the spatial quality tests and are therefore a useful tool for NMAs in their production flowchart.

  14. Positional quality assessment of orthophotos obtained from sensors onboard multi-rotor UAV platforms.

    Science.gov (United States)

    Mesas-Carrascosa, Francisco Javier; Rumbao, Inmaculada Clavero; Berrocal, Juan Alberto Barrera; Porras, Alfonso García-Ferrer

    2014-01-01

    In this study we explored the positional quality of orthophotos obtained by an unmanned aerial vehicle (UAV). A multi-rotor UAV was used to obtain images using a vertically mounted digital camera. The flight was processed taking into account the photogrammetry workflow: perform the aerial triangulation, generate a digital surface model, orthorectify individual images and finally obtain a mosaic image or final orthophoto. The UAV orthophotos were assessed with various spatial quality tests used by national mapping agencies (NMAs). Results showed that the orthophotos satisfactorily passed the spatial quality tests and are therefore a useful tool for NMAs in their production flowchart. PMID:25587877

  15. Assessing emergency medical care in low income countries: A pilot study from Pakistan

    Directory of Open Access Journals (Sweden)

    Akhtar Tasleem

    2008-07-01

    Full Text Available Abstract Background Emergency Medical Care is an important component of health care system. Unfortunately it is however, ignored in many low income countries. We assessed the availability and quality of facility-based emergency medical care in the government health care system at district level in a low income country – Pakistan. Methods We did a quantitative pilot study of a convenience sample of 22 rural and 20 urban health facilities in 2 districts – Faisalabad and Peshawar – in Pakistan. The study consisted of three separate cross-sectional assessments of selected community leaders, health care providers, and health care facilities. Three data collection instruments were created with input from existing models for facility assessment such as those used by the Joint Commission of Accreditation of Hospitals and the National Center for Health Statistics in USA and the Medical Research Council in Pakistan. Results The majority of respondents 43/44(98%, in community survey were not satisfied with the emergency care provided. Most participants 36/44(82% mentioned that they will not call an ambulance in health related emergency because it does not function properly in the government system. The expenses on emergency care for the last experience were reported to be less than 5,000 Pakistani Rupees (equivalent to US$ 83 for 19/29(66% respondents. Most health care providers 43/44(98% were of the opinion that their facilities were inadequately equipped to treat emergencies. The majority of facilities 31/42(74% had no budget allocated for emergency care. A review of medications and equipment available showed that many critical supplies needed in an emergency were not found in these facilities. Conclusion Assessment of emergency care should be part of health systems analysis in Pakistan. Multiple deficiencies in emergency care at the district level in Pakistan were noted in our study. Priority should be given to make emergency care responsive to

  16. The health-care system: an assessment and reform agenda.

    Science.gov (United States)

    Mataria, Awad; Khatib, Rana; Donaldson, Cam; Bossert, Thomas; Hunter, David J; Alsayed, Fahed; Moatti, Jean-Paul

    2009-04-01

    Attempts to establish a health plan for the occupied Palestinian territory were made before the 1993 Oslo Accords. However, the first official national health plan was published in 1994 and aimed to regulate the health sector and integrate the activities of the four main health-care providers: the Palestinian Ministry of Health, Palestinian non-governmental organisations, the UN Relief and Works Agency, and a cautiously developing private sector. However, a decade and a half later, attempts to create an effective, efficient, and equitable system remain unsuccessful. This failure results from arrangements for health care established by the Israeli military government between 1967 and 1994, the nature of the Palestinian National Authority, which has little authority in practice and has been burdened by inefficiency, cronyism, corruption, and the inappropriate priorities repeatedly set to satisfy the preferences of foreign aid donors. Although similar problems exist elsewhere, in the occupied Palestinian territory they are exacerbated and perpetuated under conditions of military occupation. Developmental approaches integrated with responses to emergencies should be advanced to create a more effective, efficient, and equitable health system, but this process would be difficult under military occupation. PMID:19268349

  17. An assessment of burn care professionals' attitudes to major burn.

    LENUS (Irish Health Repository)

    Murphy, A D

    2008-06-01

    The resuscitation of severe burn remains a controversial area within the burn care profession. There is ongoing debate as to what percentage burn is associated with a sufficient quality of life to support initial resuscitation efforts. We conducted a survey of delegates at the 39th Annual Meeting of the British Burns Association (2005), regarding attitudes towards resuscitation following major burns. Respondents were asked the maximum percentage total body surface area (TBSA) burn beyond which they would not wish to be resuscitated. They were also asked what maximum TBSA they perceived to be commensurate with an acceptable quality of life (QOL). One hundred and forty three of 300 delegates responded to the questionnaire. Thirty three percent of respondents would not wish to be resuscitated with 50-75% TBSA burns or greater. A further 35% would not wish to have life-sustaining intervention with 75-95% TBSA burns or greater. The remaining 32% indicated that they would not want resuscitation with TBSA burns>95%. Regardless of TBSA affected, 16% would not wish resuscitation if they had full thickness facial burns, a further 10% did not want resuscitation if both their hands and faces were affected. Our survey demonstrates the diversity of personal preference amongst burn care professionals. This would suggest that a unifying philosophy regarding the resuscitation of extensive burns will remain elusive.

  18. Assessing and Enhancing Health Care Providers’ Response to Domestic Violence

    Directory of Open Access Journals (Sweden)

    Tuija Leppäkoski

    2014-01-01

    Full Text Available This study aimed to examine possible changes from 2008 to 2012 in the skills of health care staff in identifying and intervening in domestic violence (DV. A longitudinal descriptive study design with volunteer samples (baseline; n=68, follow-up; n=100 was used to acquire information regarding the present state and needs of the staff in practices related to DV. The results of the baseline survey were used as a basis for planning two interventions: staff training and drafting practical guidelines. Information was collected by questionnaires from nurses, physicians, and social workers and supplemented by responses from the interviews. The data were analysed using both quantitative and qualitative methods. A chi-square test was used to test the statistical significance of the data sets. In addition, participants’ quotes are used to describe specific phenomena or issues. The comparison showed that overall a small positive change had taken place between the study periods. However, the participants were aware of their own shortcomings in identifying and intervening in DV. Changes happen slowly, and administrative support is needed to sustain such changes. Therefore, this paper offers recommendations to improve health care providers’ response to DV. Moreover, there is a great need for evaluating the training programme used.

  19. A Delay Vector Variance based Marker for an Output-Only Assessment of Structural Changes in Tension Leg Platforms

    Science.gov (United States)

    Jaksic, V.; Wright, C.; Mandic, D. P.; Murphy, J.; Pakrashi, V.

    2015-07-01

    Although aspects of power generation of many offshore renewable devices are well understood, their dynamic responses under high wind and wave conditions are still to be investigated to a great detail. Output only statistical markers are important for these offshore devices, since access to the device is limited and information about the exposure conditions and the true behaviour of the devices are generally partial, limited, and vague or even absent. The markers can summarise and characterise the behaviour of these devices from their dynamic response available as time series data. The behaviour may be linear or nonlinear and consequently a marker that can track the changes in structural situations can be quite important. These markers can then be helpful in assessing the current condition of the structure and can indicate possible intervention, monitoring or assessment. This paper considers a Delay Vector Variance based marker for changes in a tension leg platform tested in an ocean wave basin for structural changes brought about by single column dampers. The approach is based on dynamic outputs of the device alone and is based on the estimation of the nonlinearity of the output signal. The advantages of the selected marker and its response with changing structural properties are discussed. The marker is observed to be important for monitoring the as- deployed structural condition and is sensitive to changes in such conditions. Influence of exposure conditions of wave loading is also discussed in this study based only on experimental data.

  20. Quality Assessment of Roof Planes Extracted from Height Data for Solar Energy Systems by the EAGLE Platform

    Directory of Open Access Journals (Sweden)

    Simon Schuffert

    2015-12-01

    Full Text Available Due to the increasing scarcity of fossil fuels and the upwards trend in energy costs over time, many countries—especially in Europe—have begun to modify their energy policies aiming to increase that percentage obtained from renewable energies. The EAGLE (FP7 program, European Commission has developed a web-based platform to promote renewable energy systems (RES in the public and private sectors, and to deliver a comprehensive information source for all interested users. In this paper, a comprehensive quality assessment of extracted roof planes suitable for solar energy installations (photovoltaic, solar thermal from height data derived automatically from both LiDAR (Light Detection and Ranging and aerial images will be presented. A shadow analysis is performed regarding the daily path of the sun including the shading effects of nearby objects (chimneys, dormers, vegetation, buildings, topography, etc.. A quality assessment was carried out for both LiDAR and aerial images of the same test sites in UK and Germany concerning building outline accuracy, extraction rate of roof planes and the accuracy of their geometric parameters (inclination and aspect angle, size. The benefit is an optimized system to extract roof planes for RES with a high level of detail, accuracy and flexibility (concerning different commonly available data sources including an estimation of quality of the results which is important for individual house owners as well as for regional applications by governments or solar energy companies to judge their usefulness.

  1. Clinical undergraduate training and assessment in primary health care: Experiences gained from Crete, Greece

    Directory of Open Access Journals (Sweden)

    Fioretos Michael

    2005-05-01

    Full Text Available Abstract Background Primary Health Care (PHC is increasingly being introduced into undergraduate medical education. In Greece, the Faculty of Medicine of the University of Crete was the first to introduce a 4-week long training in primary health care. This paper presents the experiences gained from the initial implementation of the teaching of practice-based primary care in rural Crete and reports on the assessment scale that was developed. Methods 284 students' case write-ups from the 6 primary care units (PCUs where they were allocated for the period 1990 to 1994 were analysed. The demographic data of the students and patients and the number of home visits were studied. Content analysis of the students' write-ups was carried out, using an assessment scale consisting of 10 dichotomous variables, in order to quantify eight (8 primary qualitative criteria. Results Internal reliability was estimated by the index KR20 = 0.67. Face and content validity was found to conform to the standards set for the course, while logistic linear regression analysis showed that the quality criteria could be used as an assessment scale. The number of home visits carried out varied between the various different PCUs (p Conclusion The primary health care course achieved the objectives of introducing students to comprehensive, community oriented care, although there was variation between the PCUs. The assessment scale that was developed to analyse the case-write ups of the students provided data that can be used to evaluate the course.

  2. How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Cousens Simon

    2011-09-01

    Full Text Available Abstract Background Many women in Sub-Saharan African countries do not receive key recommended interventions during routine antenatal care (ANC including information on pregnancy, related complications, and importance of skilled delivery attendance. We undertook a process evaluation of a successful cluster randomized trial testing the effectiveness of birth plans in increasing utilization of skilled delivery and postnatal care in Ngorongoro district, rural Tanzania, to document the time spent by health care providers on providing the recommended components of ANC. Methods The study was conducted in 16 health units (eight units in each arm of the trial. We observed, timed, and audio-recorded ANC consultations to assess the total time providers spent with each woman and the time spent for the delivery of each component of care. T-test statistics were used to compare the total time and time spent for the various components of ANC in the two arms of the trial. We also identified the topics discussed during the counselling and health education sessions, and examined the quality of the provider-woman interaction. Results The mean total duration for initial ANC consultations was 40.1 minutes (range 33-47 in the intervention arm versus 19.9 (range 12-32 in the control arm p Conclusion Although the implementation of birth plans in the intervention health units improved provider-women dialogue on skilled delivery attendance, most recommended topics critical to improving maternal and newborn survival were rarely covered.

  3. Reliable and Valid Assessment of Point-of-care Ultrasonography

    DEFF Research Database (Denmark)

    Todsen, Tobias; Tolsgaard, Martin Grønnebæk; Olsen, Beth Härstedt;

    2015-01-01

    surgical patient cases in a controlled set-up. All ultrasound examinations were video-recorded and assessed by 2 blinded radiologists using OSAUS. Reliability was examined using generalizability theory. Construct validity was examined by comparing performance scores between the groups and by correlating...

  4. Design of an Integrated Sensor Platform for Vital Sign Monitoring of Newborn Infants at Neonatal Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2010-01-01

    Full Text Available Continuous health status monitoring and advances in medical treatments have resulted in a significant increase of survival rate in critically ill infants admitted into Neonatal Intensive Care Units (NICUs. The quality of life and long-term health prospects of the neonates depend increasingly on the reliability and comfort of the monitoring systems. In this paper, we present the design work of a smart jacket for vital sign monitoring of neonates at a NICU. The design represents a unique integration of sensor technology, user focus and design aspects. Textile sensors, a reflectance pulse oximeter and a wearable temperature sensor were proposed to be embedded into the smart jacket. Location of the sensor, materials and appearance were designed to optimize the functionality, patient comfort and the possibilities for aesthetic features. Prototypes were built for demonstrating the design concept and experimental results were obtained from tests on premature babies at the NICU of M�xima Medical Centre (MMC in Veldhoven, the Netherlands.

  5. Developing a pressure ulcer risk assessment scale for patients in long-term care.

    Science.gov (United States)

    Lepisto, Mervi; Eriksson, Elina; Hietanen, Helvi; Lepisto, Jyri; Lauri, Sirkka

    2006-02-01

    Previous pressure ulcer risk assessment scales appear to have relied on opinions about risk factors and are based on care setting rather than research evidence. Utilizing 21 existing risk assessment scales and relevant risk factor literature, an instrument was developed by Finnish researchers that takes into account individual patient risk factors, devices and methods applied in nursing care, and organizational characteristics. The instrument underwent two pilot tests to assess the relevance and clarity of the instrument: the first involved 43 nurses and six patients; the second involved 50 nurses with expertise in wound care. Changes to questionnaire items deemed necessary as a result of descriptive analysis and agreement percentages were completed. After pilot testing, the final instrument addressed the following issues: 1) patient risks: activity, mobility in bed, mental status, nutrition, urinary incontinence, fecal incontinence, sensory perception, and skin condition; 2) devices and methods used in patient care: technical devices, bed type, mattress, overlay, seat cushions, and care methods; and 3) staff number and structure, maximum number of beds, and beds in use (the last group of questions were included to ensure participants understood the items; results were not analyzed). The phases of the study provided an expeditious means of data collection and a suitable opportunity to assess how the instrument would function in practice. Instrument reliability and validity were improved as a result of the pilot testing and can be enhanced further with continued use and assessment. PMID:16464993

  6. Nurses' Knowledge and Responsibility toward Nutritional Assessment for Patients in Intensive Care Units

    OpenAIRE

    Mahmoud Al Kalaldeh; Mahmoud Shahein

    2014-01-01

    Introduction: Nutritional assessment is a prerequisite for nutritional delivery. Patients in intensive care suffer from under-nutrition and nutritional failure due to poor assessment. Nursing ability to early detect nutritional failure is the key for minimizing imparities in practice and attaining nutritional goals. Aim of this article is to examine the ability of Jordanian ICU nurses to assess the nutritional status of critically ill patients, considering biophysical and biochemical measures...

  7. An adaptable mesocosm platform for performing integrated assessments of nanomaterial risk in complex environmental systems

    Science.gov (United States)

    Auffan, Mélanie; Tella, Marie; Santaella, Catherine; Brousset, Lenka; Paillès, Christine; Barakat, Mohamed; Espinasse, Benjamin; Artells, Ester; Issartel, Julien; Masion, Armand; Rose, Jérôme; Wiesner, Mark R.; Achouak, Wafa; Thiéry, Alain; Bottero, Jean-Yves

    2014-07-01

    Physical-chemists, (micro)biologists, and ecologists need to conduct meaningful experiments to study the environmental risk of engineered nanomaterials with access to relevant mechanistic data across several spatial and temporal scales. Indoor aquatic mesocosms (60L) that can be tailored to virtually mimic any ecosystem appear as a particularly well-suited device. Here, this concept is illustrated by a pilot study aimed at assessing the distribution of a CeO2-based nanomaterial within our system at low concentration (1.5 mg/L). Physico-chemical as well as microbiological parameters took two weeks to equilibrate. These parameters were found to be reproducible across the 9-mesocosm setup over a 45-day period of time. Recovery mass balances of 115 +/- 18% and 60 +/- 30% of the Ce were obtained for the pulse dosing and the chronic dosing, respectively. This demonstrated the relevance of our experimental approach that allows for adequately monitoring the fate and impact of a given nanomaterial.

  8. Instrument for assessing the quality of mobile emergency pre-hospital care: content validation.

    Science.gov (United States)

    Dantas, Rodrigo Assis Neves; Torres, Gilson de Vasconcelos; Salvetti, Marina de Góes; Dantas, Daniele Vieira; Mendonça, Ana Elza Oliveira de

    2015-01-01

    OBJECTIVES To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K) and Content Validity Index (CVI), considering K> 0.80 and CVI ≥ 0.80. RESULTS Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. CONCLUSION The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services. PMID:26107697

  9. Assessing Patient Attitudes to Computerized Screening in Primary Care: Psychometric Properties of the Computerized Lifestyle Assessment Scale

    OpenAIRE

    Ahmad, Farah; Hogg-Johnson, Sheilah; Skinner, Harvey A

    2008-01-01

    Background Computer-based health-risk assessments are electronic surveys which can be completed by patients privately, for example during their waiting time in a clinic, generating a risk report for the clinician and a recommendation sheet for the patient at the point of care. Despite increasing popularity of such computer-based health-risk assessments, patient attitudes toward such tools are rarely evaluated by reliable and valid scales. The lack of psychometric appraisal of appropriate scal...

  10. A primary care-based health needs assessment in inner city Dublin.

    LENUS (Irish Health Repository)

    O'Kelly, C M

    2012-02-01

    BACKGROUND: In 2001, a primary care-based health needs assessment (HNA) in South Inner City of Dublin identified high levels of morbidity and widespread and frequent use of primary care and specialist hospital services as particular concerns. AIMS: This study aims to determine the primary care health needs of a local community, from the perspective of service users and service providers. METHODS: A similar methodology to our 2001 HNA was adopted, involving semi-structured interviews with a convenience sample of patients attending two general practices and key informants regarding local health issues and health service utilisation. RESULTS: High levels of morbidity and chronic illness were found. A correlation between the local environment and ill-health was identified, as well as high utilisation of primary care services in the area. CONCLUSION: The establishment of a Primary Care Team would begin to address the health needs of the community.

  11. How to systematically assess serious games applied to health care.

    Science.gov (United States)

    Graafland, Maurits; Dankbaar, Mary; Mert, Agali; Lagro, Joep; De Wit-Zuurendonk, Laura; Schuit, Stephanie; Schaafstal, Alma; Schijven, Marlies

    2014-01-01

    The usefulness and effectiveness of specific serious games in the medical domain is often unclear. This is caused by a lack of supporting evidence on validity of individual games, as well as a lack of publicly available information. Moreover, insufficient understanding of design principles among the individuals and institutions that develop or apply a medical serious game compromises their use. This article provides the first consensus-based framework for the assessment of specific medical serious games. The framework provides 62 items in 5 main themes, aimed at assessing a serious game's rationale, functionality, validity, and data safety. This will allow caregivers and educators to make balanced choices when applying a serious game for healthcare purposes. Furthermore, the framework provides game manufacturers with standards for the development of new, valid serious games. PMID:25654163

  12. Computerised Genetic Risk Assessment and Decision Support in Primary Care

    OpenAIRE

    Andrew Coulson; David Glasspool; John Fox; Jon Emery

    2000-01-01

    Public awareness of the availability of genetic testing threatens to put severe strain upon genetics clinics in the near future. General practitioners (GPs) could help avert this problem by making an initial genetic risk assessment and acting as gatekeepers to specialist services. However, studies in the United Kingdom suggest that few GPs feel they have the requisite skills for taking family history details and making an appropriate referral decision. They are also poorly served by compute...

  13. Ventilator assessment of respiratory mechanics in paediatric intensive care

    OpenAIRE

    Harikumar, Gopinathannair; Greenough, Anne; Rafferty, Gerrard F.

    2007-01-01

    Many modern “paediatric” mechanical ventilators have in-built features for estimation of respiratory mechanics which could be useful in the management of ventilated infants and children. The aim of this study was to determine if such measurements were reproducible and accurate. Ventilator (Draeger Evita 4) displayed compliance (Cvent) and resistance (Rvent) values were assessed and compared to the results of respiratory system mechanics (respiratory system compliance (Crs) and resistance (Rrs...

  14. Surplus Appropriation from R&D and Health Care Technology Assessment Procedures

    OpenAIRE

    Philipson, Tomas J.; Jena, Anupam B.

    2006-01-01

    Given the rapid growth in health care spending that is often attributed to technological change, many private and public institutions are grappling with how to best assess and adopt new health care technologies. The leading technology adoption criteria proposed in theory and used in practice involve so called "cost-effectiveness" measures. However, little is known about the dynamic efficiency implications of such criteria, in particular how they influence the R&D investments that make technol...

  15. The validity and reliability of an instrument to assess nursing competencies in spiritual care

    OpenAIRE

    van Leeuwen, Rene; Tiesinga, Lucas J.; Middel, Berrie; Post, Doeke; Jochemsen, Henk

    2009-01-01

    Aim. This study contributes to the development of a valid and reliable instrument, the spiritual care competence scale, as an instrument to assess nurses' competencies in providing spiritual care. Background. Measuring these competencies and their development is important and the construction of a reliable and valid instrument is recommended in the literature. Design. Survey. Method. The participants were students from Bachelor-level nursing schools in the Netherlands (n = 197) participating ...

  16. Assessment of health care quality among penitentiary employees with hypertension in the Saratov region

    OpenAIRE

    Balashov S.V.; Balashova M.E.; Popova Yu.V.

    2015-01-01

    The aim of the study is to assess the quality of health care among penitentiary employees with hypertension in the Saratov region from 2003 to 2013. Material and Methods. The data from 62 employees with hypertension (43 men and 19 women) who followed up in the dispensary of Branch of Center of Medical and Social Rehabilitation of Medical Unit no.64 of Russian Federal Penitentiary Service in 2013 were evaluated. We analyzed retrospectively the quality of health care in every calendar year from...

  17. Quality along the continuum: a health facility assessment of intrapartum and postnatal care in Ghana.

    Directory of Open Access Journals (Sweden)

    Robin C Nesbitt

    Full Text Available To evaluate quality of routine and emergency intrapartum and postnatal care using a health facility assessment, and to estimate "effective coverage" of skilled attendance in Brong Ahafo, Ghana.We conducted an assessment of all 86 health facilities in seven districts in Brong Ahafo. Using performance of key signal functions and the availability of relevant drugs, equipment and trained health professionals, we created composite quality categories in four dimensions: routine delivery care, emergency obstetric care (EmOC, emergency newborn care (EmNC and non-medical quality. Linking the health facility assessment to surveillance data we estimated "effective coverage" of skilled attendance as the proportion of births in facilities of high quality.Delivery care was offered in 64/86 facilities; only 3-13% fulfilled our requirements for the highest quality category in any dimension. Quality was lowest in the emergency care dimensions, with 63% and 58% of facilities categorized as "low" or "substandard" for EmOC and EmNC, respectively. This implies performing less than four EmOC or three EmNC signal functions, and/or employing less than two skilled health professionals, and/or that no health professionals were present during our visit. Routine delivery care was "low" or "substandard" in 39% of facilities, meaning 25/64 facilities performed less than six routine signal functions and/or had less than two skilled health professionals and/or less than one midwife. While 68% of births were in health facilities, only 18% were in facilities with "high" or "highest" quality in all dimensions.Our comprehensive facility assessment showed that quality of routine and emergency intrapartum and postnatal care was generally low in the study region. While coverage with facility delivery was 68%, we estimated "effective coverage" of skilled attendance at 18%, thus revealing a large "quality gap." Effective coverage could be a meaningful indicator of progress towards

  18. [Assessment of the spiritual needs of patients in palliative care].

    Science.gov (United States)

    Hajnová Fukasová, E; Bužgová, R; Feltl, D

    2015-01-01

    The appraisal and the right diagnostics of all needs and problems of patients, including the spiritual needs, are unavoidable for increase of the quality of the all-embracing nursing care. In the case of satisfying of the needs of the patients, it is important to have view the person as a unity of thebody and the soul. Identification and satisfying of the spiritual needs are not uncomplicated; moreover, spirituality does not have a target--ed and clear definition. In the palliative care, the solution and saturation of spiritual needs have a great priority, and it can be the key aspect of psychological activity. Also, medical experts are becoming aware of the meaning of spirituality as the part of psychological contentment more and more. Smaller importance is attached to measurement of spiritual needs, and in many medical institutions ends at the case history with the questions: "Are you a believer?", "Do you have any spiritual needs?". Spirituality and religion are very personal matters of every human. Many patients turn to religion to find answers to difficult questions while others find support through the spiritual beliefs outside the scope of organized religion. Mistaking of meanings of the spirituality and religionism can lead to many misunderstandings. The basic condition for the right diagnostics and satisfaction of spiritual needs are the definition of the used terms and using of standardized measurement devices in the clinical praxis. The target of summarizing study was to define the term of spirituality, to describe a lot of measurement devices these are suitable for the evaluation of human spiritual needs. For methodology for acquiring of the results of research works that are concerned with the questions of spiritual needs in case of the incurable patients, the following databases were used (2005-2013): EBSCO, Bibliographia Medica Čechoslovaca, Google Scholar, Solen - www.solen.cz, Profese on-line as the source of the data. The choice of studies were

  19. Patients’ needs for care in public mental health: unity and diversity of self-assessed needs for care

    Directory of Open Access Journals (Sweden)

    Tanja eBellier-Teichmann

    2016-02-01

    Full Text Available Purpose. Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients’ needs are organized. This study investigates both general and specific dimensions of patients’ needs for care. Methods. Patients’ needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients’ perceptions. A patient-centered psychiatric practice facilitates empowerment as it is based on the patients’ personal motivations, needs and wants. 471 patients’ profiles were analyzed through exploratory factor analysis. Results. A four-factor bi-factor model, including one general factor and three specific factors of needs was most adequate. Specific factors were: (a ‘finances’ and ‘administrative tasks’; (b ‘transports’, ‘public places’, ‘self-care’, ‘housework’ and ‘food’; (c ‘family’, ‘children’, ‘intimate relationships’ and ‘friendship’.Conclusions. As revealed by the general factor, patients expressing urgent needs in some domains are also more susceptible to report urgent needs in several other domains. This general factor relates to high versus low utilizers of public mental healthcare. Patients also present specific needs in life domains, which are organized in three dimensions: management; functional disabilities; familial and interpersonal relationships. These dimensions relate to the different types of existing social support described in the literature.

  20. Framework for assessing quality of care for inflammatory bowel disease in Sweden

    Institute of Scientific and Technical Information of China (English)

    Martin Rejler; J(o)rgen Tholstrup; Mattias Elg; Anna Sp(a)ngéus; Boel Andersson G(a)re

    2012-01-01

    AIM:To create and apply a framework for quality assessment and improvement in care for inflammatory bowel disease (IBD) patients.METHODS A framework for quality assessment and improvement was created for IBD based on two generally acknowledged quality models.The model of Donabedian (Df) offers a logistical and productive perspective and the Clinical Value Compass (CVC) model adds a management and service perspective.The framework creates a pedagogical tool to understand the balance between the dimensions of clinical care (CVC) and the components of clinical outcome (Df).The merged models create a framework of the care process dimensions as a whole,reflecting important parts of the IBD care delivery system in a local setting.Clinical and organizational quality measures were adopted from clinical experience and the literature and were integrated into the framework.Data were collected at the yearly check-up for 481 IBD patients during 2008.The application of the quality assessment framework was tested and evaluated in a local clinical IBD care setting in J(o)nk(o)ping County,Sweden.RESULTS:The main outcome was the presentation of how locally-selected clinical quality measures,integrated into two complementary models to develop a framework,could be instrumental in assessing the quality of care delivered to patients with IBD.The selected quality measures of the framework noted less anemia in the population than previously reported,provided information about hospitalization rates and the few surgical procedures reported,and noted good access to the clinic.CONCLUSION:The applied local quality framework was feasible and useful for assessing the quality of care delivered to IBD patients in a local setting.

  1. The perception of midwives regarding psychosocial risk assessment during antenatal care

    Directory of Open Access Journals (Sweden)

    Johanna M. Mathibe-Neke

    2014-05-01

    Full Text Available Background: The physiological and psychological changes caused by pregnancy may increase a woman’s vulnerability to depression, which may in turn have adverse effects on both maternal and foetal wellbeing. Inadequate psychosocial risk assessment of women by midwives may lead to lack of psychosocial support during pregnancy and childbirth. Pregnant women who lack psychosocial support may experience stress, anxiety and depression that could possibly affect foetal wellbeing. Objective:The objective of this study was toexplore and describe the perception of psychosocial risk assessment and psychosocial care by midwives providing antenatal care to pregnant women. Method: An interpretive and descriptive qualitative approach was adopted. Three focus group interviews were conducted with midwives working in three Maternal Obstetric Units in Gauteng Province, using a semi-structured interview guide. The constant comparison data analysis approach was used. Results:Findings revealed that midwives are aware of and have encountered a high prevalence of psychosocial problems in pregnant women. Furthermore, they acknowledged the importance of psychosocial care for pregnant women although they stated that they were not equipped adequately to offer psychosocial assessment and psychosocial care. Conclusion:The findings provided a basis for incorporation of psychosocial care into routine antenatal care.

  2. Primary care assessment of capillaroscopy abnormalities in patients with Raynaud's phenomenon.

    Science.gov (United States)

    Overbury, Rebecca; Murtaugh, Maureen A; Fischer, Aryeh; Frech, Tracy M

    2015-12-01

    Raynaud's phenomenon is a clinical symptom that can commonly present to a primary care provider or generalist. Proper identification of an underlying connective tissue disease in a patient with Raynaud's could allow for the prevention of possible critical digital ischemia. Capillaroscopy is a tool which can identify abnormalities associated with connective tissue disease. Patients presenting with a complaint of Raynaud's phenomenon were assessed with capillaroscopy. In twenty consecutive Raynaud patients, 8 digits were assessed by a ×200 magnification dermatoscope and an image was obtained. Each image was assessed for the following abnormalities: drop-out (skill that could assist primary care providers and generalists in identifying and qualifying changes associated with the common presentation of Raynaud's disease. However, formal training is needed to ensure accuracy and reproducibility. Furthermore, training and scoring systems should address time constraints of busy primary care practitioners. PMID:26400642

  3. Hemophilia and von Willebrand's disease: 1. Diagnosis, comprehensive care and assessment. Association of Hemophilia Clinic Directors of Canada.

    OpenAIRE

    1995-01-01

    OBJECTIVE: To present current strategies for the assessment and comprehensive care of patients with hemophilia and von Willebrand's disease. OPTIONS: Hospital care, home care, single-provider care and multidisciplinary care. OUTCOMES: Morbidity and quality of life associated with bleeding and treatment. EVIDENCE: Relevant clinical studies and reports published from 1974 to 1994 were examined. A search was conducted of own reprint files, MEDLINE, citations in the articles reviewed and referenc...

  4. Patient satisfaction is biased by renovations to the interior of a primary care office: a pretest-posttest assessment

    OpenAIRE

    Tièche, Raphaël; da Costa, Bruno R; Streit, Sven

    2016-01-01

    Abstract Background Measuring quality of care is essential to improve primary care. Quality of primary care for patients is usually assessed by patient satisfaction questionnaires. However, patients may not be able to judge quality of care without also reflecting their perception of the environment. We determined the effect that redesigning a primary care office had on patient satisfaction. We hypothesized that renovating the interior would make patients more satisfied with the qualit...

  5. Effects of a Late Life Suicide Risk Assessment Training on Multidisciplinary Health Care Providers

    Science.gov (United States)

    Huh, J.W. Terri; Weaver, Christopher M.; Martin, Jennifer L.; Caskey, Nicholas H.; O’Riley, Alisa; Kramer, B. Josea

    2016-01-01

    Older adults are among the highest at risk group for completing suicide, and they are more likely to seek mental health services from providers outside of traditional mental healthcare. However, providers across the spectrum of care have limited training in suicide risk assessment and management and particularly lack training in suicide prevention for older adults. An educational program was developed to increase awareness and improve suicide risk assessment and management training for a range of health care providers who may see older adults in their care settings. One hundred and thirty two participants from two VA Medical Centers participated in a 6.5 hour long workshop in the assessment and management of suicide risk among older adults. Participants were asked to complete pre- and- post workshop case notes and report on subjective changes in knowledge, attitude, and confidence in assessment and managing suicide risk in older adults. Participants included social workers, nurses, physicians, psychologists, and occupational therapists coming from a variety of care settings including outpatient and inpatient medical, outpatient and inpatient mental health, specialty clinics, and home and community. Following the workshop, participants demonstrated improvement in the overall quality of case notes (p<.01), increased ability to recognize important conceptual suicide risk categories (p<.05), and reported heightened awareness of the importance of late life suicide. Results suggested that educational training may have beneficial impact on multidisciplinary care providers’ ability to identify and manage suicide risk in the elderly. PMID:22288717

  6. DEVELOPMENT OF AN INSPECTION PLATFORM AND A SUITE OF SENSORS FOR ASSESSING CORROSION AND MECHANICAL DAMAGE ON UNPIGGABLE TRANSMISSION MAINS

    Energy Technology Data Exchange (ETDEWEB)

    George C. Vradis

    2003-07-01

    This development program is a joint effort among the Northeast Gas Association (formerly New York Gas Group), Foster-Miller, Inc., and the US Department of Energy (DOE) through the National Energy Technology Laboratory (NETL). The DOE's contribution to this project is $572,525 out of a total of $772,525. The present report summarizes the accomplishments of the project during its third three-month period (from April 2003 through June 2003). The project was initiated with delay in February 2003 due to contractual issues that emerged between NGA and Foster-Miller, Inc. The two organizations are working diligently to maintain the program's pace and expect to complete it in time. The efforts of the project focused during this period in finalizing the assessment of the tether technology, which is intended to be used as the means of communication between robot and operator. Results indicate that the tether is a viable option under certain pipeline operating conditions, but not all. Concerns also exist regarding the abrasion resistance of the tether, this issue being the last studied. Substantial work was also conducted on the design of the robotic platform, which has progressed very well. Finally, work on the MFL sensor, able to negotiate all pipeline obstacles (including plug valves), was initiated by PII following the successful completion of the subcontract negotiations between Foster-Miller and PII. The sensor design is at this point the critical path in the project's timetable.

  7. Evaluating medical residents as managers of care: a critical appraisal of assessment methods

    Directory of Open Access Journals (Sweden)

    Busari JO

    2014-02-01

    Full Text Available Jamiu O Busari,1,2 Lorette A Stammen,2 Lokke M Gennissen,2 Rob M Moonen1 1Department of Pediatrics, Atrium Medical Center, Henri Dunantstraat 5, 6401 CX Heerlen, the Netherlands; 2Faculty of Health, Medicine and Life Sciences, University of Maastricht, the Netherlands Introduction: The increasing demands for effective and efficient health care delivery systems worldwide have resulted in an expansion of the desired competencies that physicians need to possess upon graduation. Presently, medical residents require additional professional competencies that can prepare them to practice adequately in a continuously changing health care environment. Recent studies show that despite the importance of competency-based training, the development and evaluation of management competencies in residents during residency training is inadequate. The aim of this literature review was to find out which assessment methods are currently being used to evaluate trainees' management competencies and which, if any, of these methods make use of valid and reliable instruments. Methods: In September 2012, a thorough search of the literature was performed using the PubMed, Cochrane, Embase®, MEDLINE®, and ERIC databases. Additional searches included scanning the references of relevant articles and sifting through the “related topics” displayed by the databases. Results: A total of 25 out of 178 articles were selected for final review. Four broad categories emerged after analysis that best reflected their content: 1 measurement tools used to evaluate the effect of implemented curricular interventions; 2 measurement tools based on recommendations from consensus surveys or conventions; 3 measurement tools for assessing general competencies, which included care-management; and 4 measurement tools focusing exclusively on care-management competencies. Conclusion: Little information was found about (validated assessment tools being used to measure care-management competence

  8. SW-platform for R&D in Applications of Synchrophasor Measurements for Wide-Area Assessment, Control and Visualization in Real-Time

    DEFF Research Database (Denmark)

    Jóhannsson, Hjörtur; Morais, Hugo; Pedersen, Allan Henning Birger;

    2014-01-01

    operation when a critical operation has been identified. An important part of the SOSPO project is the development of a SW - platform that enables testing and demonstrations of the various methods for wide - area assessment, control and visualization the project delivers. In order to test the methods under......The Danish research project “Secure Operation of Sustainable Power Systems (SOSPO)” is currently being conducted in a collaboration by a group of partners from academia and industry. The focus of the project is on how to achieve secure operation of the power grid as large scale thermal power plants...... realistic conditions, the future system scenarios are represented in a real time grid simulator that is an integrated part of the platform. The SW - platform provides structured access to any model parameter as well as access to real - time phasor measurement unit (PMU) and remote terminal unit (RTU...

  9. Music therapy for the Assessment of Parental Competencies for Children in need of Care

    DEFF Research Database (Denmark)

    Jacobsen, Stine; Wigram, Tony

    2007-01-01

    The assessment for parenting competencies for parents of children potentially in need of care involves an evaluation of their relationship with their child, and the interaction that underpins that relationship. The "Assessment of Parenting Competences" (APC) music therapy assessment provides a...... structured series of interactional exercises that allow the therapist to explore the nature of the relationship both as a tool in every day clinical work and as a research method. The method of the assessment involves free improvisation, turn-taking exercises, and following leading exercises and is evaluated...

  10. Helicobacter pylori infection in children: should it be carefully assessed?

    Science.gov (United States)

    Ortiz-Princz, D; Daoud, G; Salgado-Sabel, A; Cavazza, M E

    2016-05-01

    The prevalence of H. pylori infection, mainly acquired during childhood and may be persisting throughout life, has been found high in developing countries; this high prevalence is related to low socioeconomic status. The persistence of bacterium exposure is related to gastritis and other severe complications including peptic ulcer, lymphoma MALT and gastric cancer, which are rarely present in the pediatric age due to a lower inflammatory and immunological response. Virulence factors, host gastric mucosal factors, and the natural environment of patients are associated with the clinical outcome of H. pylori infection. The main bacterial virulence factors include adhesins (BabA, SabA), vacuolating cytotoxin VacA, and the products of the cag pathogenicity island (cag PAI). There are geographic differences between cagA, vacA status and H. pylori related diseases. The main criteria to evaluate H. pylori infection in children are gastrointestinal and extra gastrointestinal manifestations related to H. pylori infection, familial history of gastric cancer, peptic ulcer, lymphoma MALT, symptomatic children living in high prevalence regions, and immigrant or adopted children in developed countries. Early detection of H. pylori and its virulence factors, in addition to effective methods of eradication associated with prevention programs, may lead to the decrease of H. pylori incidence and gastritis, especially in endemic high-risk regions. The early assessment in children may prevent further severe complications in adulthood. PMID:27212173

  11. Development and Validation of a Questionnaire to Assess Multimorbidity in Primary Care: An Indian Experience

    Directory of Open Access Journals (Sweden)

    Sanghamitra Pati

    2016-01-01

    Full Text Available Multimorbidity remains an underexplored domain in Indian primary care. We undertook a study to assess the prevalence, correlates, and outcomes of multimorbidity in primary care settings in India. This paper describes the process of development and validation of our data collection tool “Multimorbidity Assessment Questionnaire for Primary Care (MAQ-PC.” An iterative process comprising desk review, chart review, and expert consultations was undertaken to generate the questionnaire. The MAQ-PC contained items on chronic conditions, health care utilization, health related quality of life, disease severity, and sociodemographics. It was first tested with twelve adults for comprehensibility followed by test-retest reliability with 103 patients from four primary care practices. For interrater reliability, two interviewers separately administered the questionnaire to sixteen patients. MAQ-PC displayed strong internal consistency (Cronbach’s alpha: 0.69, interrater reliability (Cohen’s Kappa: 0.78–1, and test-retest reliability (ICC: 0.970–0.741. Substantial concordance between self-report and physician diagnosis (Scott Kappa: 0.59–1.0 was observed for listed chronic conditions indicating strong concurrent validity. Nearly 54% had one chronic condition and 23.3% had multimorbidity. Our findings demonstrate MAQ-PC to be a valid and reliable measure of multimorbidity in primary care practice and suggest its potential utility in multimorbidity research in India.

  12. Knowledge, Skills, and Attitudes in Caring for Older Adults With Advanced Illness Among Staff Members of Long-Term Care and Assisted Living Facilities: An Educational Needs Assessment.

    Science.gov (United States)

    Cimino, Nina M; Lockman, Kashelle; Grant, Marian; McPherson, Mary Lynn

    2016-05-01

    In long-term care and assisted living facilities, many groups of health care professionals contribute to the work of the health care team. These staff members perform essential, direct patient care activities. An educational needs assessment was conducted to determine the learning needs and preferences of staff members related to providing care for patients with life-limiting illnesses. Staff members placed importance on understanding topics such as principles of palliative care, pain assessment, pain management, and nonpain symptom management. The majority of survey respondents were also interested in learning more about these topics. The results of this educational needs analysis suggest staff members would benefit from a course tailored to these identified educational needs and designed to overcome previously identified educational barriers. PMID:25473091

  13. Validation of the Spanish Translation of the Patient Assessment of Chronic Illness Care (PACIC Survey

    Directory of Open Access Journals (Sweden)

    Abraham Aragones, MD, MSCI

    2008-10-01

    Full Text Available IntroductionThe Patient Assessment of Chronic Illness Care (PACIC survey is a patient-centered instrument for evaluating the quality and patient-centeredness of chronic illness care received according to the Chronic Care Model paradigm. This study validates the Spanish translation of the PACIC in an urban, Spanish-speaking population.MethodsOne hundred Spanish-speaking patients with diabetes completed the translated PACIC and sociodemographic and cultural questionnaires. Test-retest reliability was assessed in a subset of 20 patients who completed the questionnaire 2 to 4 months later. Internal consistency was evaluated with Cronbach α. PACIC score and subscale associations with sociodemographic characteristics were examined.ResultsTest-retest reliability for the overall translated PACIC scale was 0.77. Scores were not associated with patient sociodemographic characteristics, including age, country of birth, years living in the United States, or education level (P >.05.ConclusionThe Spanish translation of the PACIC survey demonstrated high reliability, internal consistency, and test-retest reliability. Scores showed no association with sociodemographic or cultural characteristics. The Spanish version can reliably be used to assess care delivered according to the Chronic Care Model in a heterogeneous Spanish-speaking population.

  14. Cold plasma treatment in wound care: efficacy and risk assessment

    Science.gov (United States)

    Stoffels, Eva

    2007-10-01

    Cold atmospheric plasma is an ideal medium for non-destructive modification of vulnerable surfaces. One of the most promising medical applications of cold plasma treatment is wound healing. Potential advantages in wound healing have been demonstrated in vitro: the plasma does not necrotize the cells and does not affect the extracellular matrix [1], has clear bactericidal or bacteriostatic effects [2], and stimulates fibroblast cells towards faster attachment and proliferation [3]. However, safety issues, such as the potential cytotoxicity of the plasma must be clarified prior to clinical implementation. This work comprises the recent facts on sub-lethal plasma effects on mammalian cells, as well as studies on apoptosis induction and quantitative assessment of DNA damage. Fibroblast, smooth muscle and endothelial cells were treated using the standard cold plasma needle [1,2]; intra- and extracellular oxidant levels as well as the influence of the plasma on intracellular antioxidant balance were monitored using appropriate fluorescent markers [1]. We have studied long-term cellular damage was monitored using flow cytometry to determine the DNA profiles in treated cells. Dose-response curves were obtained: increased proliferation as well as apoptosis were visualized under different treatment conditions. The results from the in vitro studies are satisfying. [1] I.E. Kieft, ``Plasma needle: exploring biomedical applications of non-thermal plasmas'', PhD Thesis, Eindhoven University of Technology (2005). [2] R.E.J. Sladek, ``Plasma needle: non-thermal atmospheric plasmas in dentistry'' PhD Thesis, Eindhoven University of Technology (2006). [3] I.E. Kieft, D. Darios, A.J.M. Roks, E. Stoffels, IEEE Trans. Plasma Sci. 34(4), 2006, pp. 1331-1336.

  15. The German version of the Individualized Care Scale – assessing validity and reliability

    Science.gov (United States)

    Köberich, Stefan; Suhonen, Riitta; Feuchtinger, Johanna; Farin, Erik

    2015-01-01

    Aim To assess validity and reliability of the German version of the Individualized Care Scale (ICS). Background Individualized nursing care plays a pivotal role in establishing patient-centered care. To assess individualized nursing care and to compare it in different settings and countries, valid and reliable instruments are needed. No psychometric-tested instrument for comparing individualized nursing care with other countries is available in Germany. Design Cross-sectional study. Methods Data were collected between September 2013 and June 2014 from 606 patients in 20 wards in five hospitals across Germany. Unidimensionality of the ICS scales ICSA (patients’ views on how individuality is supported through nursing interventions) and ICSB (patients’ perceptions of individualized nursing care) was analyzed by confirmatory factor analysis. Internal consistency was assessed by calculating Cronbach’s alpha. The Smoliner Scale (patients’ perceptions of the decision-making process in nursing care) and results from participating hospitals’ assessment of the nursing care delivery systems were used to assess known-groups validity and concurrent validity. Results Fit indices of confirmatory factor analysis indicate unidimensionality of the ICSA (Comparative Fit Index: 0.92; Tucker-Lewis Index: 0.902; root mean square error of approximation: 0.09; standardized root mean square residual: 0.05) and the ICSB (Comparative Fit Index: 0.91; Tucker-Lewis Index: 0.89; root mean square error of approximation: 0.09; standardized root mean square residual: 0.05). Internal consistency using Cronbach’s alpha was 0.95 (95% confidence interval: 0.94–0.95) for ICSA and 0.93 (95% confidence interval: 0.92–0.94) for the ICSB. Concurrent validity was established by a significant relationship between the Smoliner Scale and ICSA (r=0.66; P<0.01) and ICSB (r=0.72; P<0.01). Known-groups validity was approved by ICSA/ICSB score differences related to nursing care delivery systems and

  16. Mining care trajectories using health administrative information systems: the use of state sequence analysis to assess disparities in prenatal care consumption

    OpenAIRE

    Meur, Nolwenn Le; Gao, Fei; Bayat, Sahar

    2015-01-01

    Background Pregnant women are a vulnerable population. Although regular follow-ups are recommended during pregnancy, not all pregnant women seek care. This pilot study wanted to assess whether the integration of data from administrative health information systems and socio-economic features allows identifying disparities in prenatal care trajectories. Methods Prenatal care trajectories were extracted from the permanent sample of the French health insurance information system linked to the hos...

  17. Relationship between adductor pollicis muscle thickness and subjective global assessment in a cardiac intensive care unit

    OpenAIRE

    Karst, Fernanda Pickrodt; Vieira, Renata Monteiro; Barbiero, Sandra

    2015-01-01

    Objective To verify the relationship between the adductor pollicis muscle thickness test and the subjective global assessment and to correlate it with other anthropometric methods. Methods This observational cross-sectional study was conducted in the intensive care unit of a cardiology hospital in the state of Rio Grande do Sul, Brazil. The hospitalized patients underwent subjective global assessment and adductor pollicis muscle thickness tests on both hands, along with measurement of the rig...

  18. Primary care physicians' use of family history for cancer risk assessment

    OpenAIRE

    Stockdale Alan; Ashikaga Takamaru; Wood Marie E; Flynn Brian S; Dana Greg S; Naud Shelly

    2010-01-01

    Abstract Background Family history (FH) assessment is useful in identifying and managing patients at increased risk for cancer. This study assessed reported FH quality and associations with physician perceptions. Methods Primary care physicians practicing in two northeastern U.S. states were surveyed (n = 880; 70% response rate). Outcome measures of FH quality were extent of FH taken and ascertaining age at cancer diagnosis for affected family members. Predictors of quality measured in this s...

  19. Standardizing Assessment of Competences and Competencies of Oncology Nurses Working in Ambulatory Care.

    Science.gov (United States)

    Beaver, Clara; Magnan, Morris A; Henderson, Denise; DeRose, Patricia; Carolin, Kathleen; Bepler, Gerold

    2016-01-01

    A nursing quality consortium standardized nursing practice across 17 independently functioning ambulatory oncology sites. Programs were developed to validate both competences and competencies. One program assessed nine competences needed to develop systems of care to detect and treat treatment-related side effects. A second program was developed to assess competencies needed to prevent harm to oncology patients. This manuscript describes a successful approach to standardizing nursing practice across geographically distant academic and community sites. PMID:26985750

  20. Assessment of COPD wellness tools for use in primary care: an IPCRG initiative

    Directory of Open Access Journals (Sweden)

    Cave AJ

    2012-07-01

    Full Text Available Andrew J Cave,1 Lana Atkinson,1 Ioanna G Tsiligianni,2,3 Alan G Kaplan41Department of Family Medicine, University of Alberta, Edmonton, Canada; 2Department of General Practice, University Medical Centre of Groningen, Groningen, Netherlands; 3Agia Barbara Health Care Centre, Heraklion, Greece; 4Family Physician Airways Group of Canada, North York, CanadaAbstract: COPD is considered a complex disease and global problem that is predicted to be the third most common cause of death by 2030. While managing this chronic condition, primary health care practitioners are faced with the ongoing challenge of achieving good quality of life and overall "wellness" for those affected. As such, a practical tool for monitoring quality of life in a clinical setting is required. However, due to the wide variety of general and disease-specific tools from which to choose, primary health care practitioners are given minimal guidance as to which tool may be most appropriate. To address these challenges, the International Primary Care Respiratory Group (IPCRG proposed the creation of a user's guide for primary health care practitioners to assess "wellness" in COPD patients in an everyday clinical setting. This short report outlines the process by which the IPCRG Users' Guide to COPD "Wellness" Tools was developed. It also describes why this guide has the potential to be of great value in guiding primary health care practitioners to improve patient wellness.Keywords: wellness, quality of life, primary care, instrument

  1. Assessment of a primary and tertiary care integrated management model for chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Peiro Meritxell

    2009-02-01

    Full Text Available Abstract Background The diagnosis and treatment of patients with chronic obstructive pulmonary disease (COPD in Spain continues to present challenges, and problems are exacerbated when there is a lack of coordinated follow-up between levels of care. This paper sets out the protocol for assessing the impact of an integrated management model for the care of patients with COPD. The new model will be evaluated in terms of 1 improvement in the rational utilization of health-care services and 2 benefits reflected in improved health status and quality of life for patients. Methods/Design A quasi-experimental study of the effectiveness of a COPD management model called COPD PROCESS. The patients in the study cohorts will be residents of neighborhoods served by two referral hospitals in Barcelona, Spain. One area comprises the intervention group (n = 32,248 patients and the other the control group (n = 32,114 patients. The study will include pre- and post-intervention assessment 18 months after the program goes into effect. Analyses will be on two datasets: clinical and administrative data available for all patients, and clinical assessment information for a cohort of 440 patients sampled randomly from the intervention and control areas. The main endpoints will be the hospitalization rates in the two health-care areas and quality-of-life measures in the two cohorts. Discussion The COPD PROCESS model foresees the integrated multidisciplinary management of interventions at different levels of the health-care system through coordinated routine clinical practice. It will put into practice diagnostic and treatment procedures that are based on current evidence, multidisciplinary consensus, and efficient use of available resources. Care pathways in this model are defined in terms of patient characteristics, level of disease severity and the presence or absence of exacerbation. The protocol covers the full range of care from primary prevention to treatment of

  2. Kentucky STARS for KIDS NOW: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Kentucky's STARS for KIDS NOW prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…

  3. Pennsylvania Keystone STARS: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Pennsylvania's Keystone STARS prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…

  4. North Carolina Star Rated License System: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of North Carolina's Star Rated License System prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  5. Virginia Star Quality Initiative: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Virginia's Star Quality Initiative prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators…

  6. Delaware Stars for Early Success. QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Delaware's Stars for Early Success prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators…

  7. Developing a new assessment procedure of social information processing in adolescents within secure residential care

    NARCIS (Netherlands)

    van Rest, Maaike M.; van Bokhoven, Irene; van Nieuwenhuijzen, Maroesjka; Embregts, Petri J. C. M.; Vriens, Aart; Matthys, Walter

    2014-01-01

    The purpose of the present study was to develop a new assessment procedure of social information processing (SIP) for adolescents, to explore its validity and to examine whether it differentiated between IQ groups. Ninety-four adolescents within secure residential care were administered the SIP inst

  8. Palm Beach Quality Counts: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of Palm Beach's Quality Counts prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4) Indicators for…

  9. Food Sanitation and Safety Self-assessment Instrument for Family Day-Care Homes.

    Science.gov (United States)

    1990

    This self-assessment instrument for family day care providers is designed to help caregivers provide safe food to children. The eight sections of the instrument, presented in checklist format, concern: (1) personal hygiene; (2) purchasing and inspecting of food; (3) food storage; (4) kitchen equipment; (5) food preparation; (6) infant food…

  10. Food Sanitation and Safety Self-assessment Instrument for Child Care Centers.

    Science.gov (United States)

    1990

    This self-assessment instrument for day care center staff is designed to help caregivers provide safe food to children. The nine sections of the instrument, presented in checklist format, concern: (1) personal hygiene; (2) purchasing, receiving, and inspecting of food; (3) food storage; (4) food service equipment; (5) food preparation; (6) infant…

  11. Applicability of the assessment of chronic illness care (ACIC instrument in Germany resulting in a new questionnaire: questionnaire of chronic illness care in primary care

    Directory of Open Access Journals (Sweden)

    Campbell Stephen

    2011-07-01

    Full Text Available Abstract Background The Chronic Care Model (CCM is an evidence based, population based approach to improve care for people with chronic conditions. The Assessment of Chronic Illness Care (ACIC instrument is widely used to measure to what extent within a healthcare system the CCM is implemented. The aim of this study was to translate and culturally adapt the ACIC Instrument for the German healthcare system. Methods For translating the ACIC instrument, principles of Good Practice for the Translation and Cultural Adaptation Process by the ISPOR Task Force were followed. Focus groups were additionally conducted with general practitioners to adapt the items culturally. Results The ACIC instrument can not be used in the German healthcare system easily due to a multifaceted understanding of words, different levels of knowledge of the CCM and fundamental differences between health systems. Conclusions As following the CCM leads to benefits for patients with chronic illnesses, measuring to which extent it is implemented is of major interest. A new questionnaire using the CCM as its theoretical basis, sensitive to the healthcare systems of the host country has to be created. Knowledge transfer between countries by using an instrument from a different healthcare system can lead to a completely new questionnaire.

  12. Development of a Self-Assessment Tool to Facilitate Decision-Making in Choosing a Long Term Care Administration Major

    Science.gov (United States)

    Johs-Artisensi, Jennifer L.; Olson, Douglas M.; Nahm, Abraham Y.

    2016-01-01

    Long term care administrators need a broad base of knowledge, skills, and interests to provide leadership and be successful in managing a fiscally responsible, quality long term care organization. Researchers developed a tool to help students assess whether a long term care administration major is a compatible fit. With input from professionals in…

  13. DEVELOPMENT OF AN INSPECTION PLATFORM AND A SUITE OF SENSORS FOR ASSESSING CORROSION AND MECHANICAL DAMAGE ON UNPIGGABLE TRANSMISSION MAINS

    Energy Technology Data Exchange (ETDEWEB)

    George C. Vradis; Bill Leary

    2004-01-14

    This development program is a joint effort among the Northeast Gas Association (formerly New York Gas Group), Foster-Miller, Inc., and the US Department of Energy (DOE) through the National Energy Technology Laboratory (NETL). The total cost of the project is $772,525, with the National Energy Technology Laboratory of the US Department of Energy contributing $572,525, and the Northeast Gas Association contributing $200,000. The present report summarizes the accomplishments of the project during its fourth three-month period (from July 2003 through September 2003). The efforts of the project focused during this period in completing the assessment of the tether technology, which is intended to be used as the means of communication between robot and operator, in designing the MFL sensor module, in completing the kinematic studies, and in initiating tractor design. In addition, work on the ovality sensor progressed significantly, while work on system integration was initiated focusing at this point in time on module coupling. Results to date indicate that the robotic system under design will be able to meet most of the design specifications initially specified. Earlier concerns regarding the portability of the system are shown to be a non-issue, with new more detailed analysis showing that from a locomotor point of view an inspection of a 16 inch-24 inch pipe size range with a single platform is most likely possible However, the limitations imposed by the sensor are more restrictive, preliminary results indicating an inspection range of 16 inch-20 inch pipe sizes. In addition, tether use will most likely have to be limited to medium and low flow conditions in order to preserve tether integrity.

  14. DEVELOPMENT OF AN INSPECTION PLATFORM AND A SUITE OR SENSORS FOR ASSESSING CORROSION AND MECHANICAL DAMAGE ON UNPIGGABLE TRANSMISSION MAINS

    Energy Technology Data Exchange (ETDEWEB)

    George C. Vradis

    2004-02-01

    This development program is a joint effort among the Northeast Gas Association (formerly New York Gas Group), Foster-Miller, Inc., GE Oil & Gas (PII), and the US Department of Energy (DOE) through the National Energy Technology Laboratory (NETL). The total cost of the project is $772,525, with the National Energy Technology Laboratory of the US Department of Energy contributing $572,525, and the Northeast Gas Association contributing $200,000. The present report summarizes the accomplishments of the project during its fifth three-month period (from October 2003 through December 2003). The efforts of the project focused during this period in completing the assessment of the tether technology, which is intended to be used as the means of communication between robot and operator, in completing the design of the MFL sensor modules, and in completing the kinematic studies and tractor design. In addition, work on the ovality sensor has been completed, while work on system integration is nearly complete. Results to date indicate that the robotic system under design will be able to meet most of the design specifications initially prescribed. The kinematic analysis shows that from a locomotor point of view an inspection of a 16 inch-24 inch pipe size range with a single platform is most likely possible. However, the limitations imposed by the sensor are more restrictive, final preliminary design results showing that in order to cover this pipe range, two different sensor systems will be needed; one for the 16 inch-20 inch pipe size range and one for the 20 inch-24 inch range. Finally, the analysis has shown that tether operation will be limited to flows of less than 30 ft/sec; these results will have to be confirmed experimentally during the next phase of work.

  15. Primary care physicians’ perspectives on computer-based health risk assessment tools for chronic diseases: a mixed methods study

    OpenAIRE

    Teja Voruganti; Mary Ann O'Brien; Straus, Sharon E; McLaughlin, John R.; Eva Grunfeld

    2015-01-01

    Background Health risk assessment tools compute an individual’s risk of developing a disease. Routine use of such tools by primary care physicians (PCPs) is potentially useful in chronic disease prevention. We sought physicians’ awareness and perceptions of the usefulness, usability and feasibility of performing assessments with computer-based risk assessment tools in primary care settings.Methods Focus groups and usability testing with a computer-based risk assessment tool were conducted wit...

  16. The Design of Old Man Health Care Service Platform%老人健康关怀服务平台设计

    Institute of Scientific and Technical Information of China (English)

    刘航; 聂开; 王珏辉

    2016-01-01

    我国的老龄化速度明显加快。空巢家庭老人、高龄老人、独居老人、失能老人和残疾老人数量逐年增加。有些老人家中虽有子女,但子女不能每天24小时陪伴,老人不得不长期独处。如在家中或者出外发生跌倒、有心脑血管意外等,随时有生命危险,这样的例子举不胜举。虽然国家提供120,110等急救服务,但老人们如何联系国家紧急救助机构是个大问题,搭建一套老人健康关怀服务平台非常重要。%The population aging in China was accelerated signiifcantly. Empty nest old man, the very old man, the old people who lived alone, disability and disabled old man, and have children at home, but children can't accompany them 24 hours a day, If old man lived alone, suddenly fell down at home or go out, or suffered heart attack and cerebrovascular accident, the old man may lose their lives anytime, such examples are too numerous to mention. Although our countries provide the emergency call 120, 110 and other ifrst-aid services for them, in this case there is still a big problem that how to contact the national emergency aid agencies, so it’s very important to set up a platform of the old people health care service .

  17. Assessment of a prototype for the Systemization of Nursing Care on a mobile device

    Directory of Open Access Journals (Sweden)

    Laura Cristhiane Mendonça Rezende

    2016-01-01

    Full Text Available Abstract Objectives: assess a prototype for use on mobile devices that permits registering data for the Systemization of Nursing Care at a Neonatal Intensive Care Unit. Method: an exploratory and descriptive study was undertaken, characterized as an applied methodological research, developed at a teaching hospital. Results: the mobile technology the nurses at the Neonatal Intensive Care Unit use was positive, although some reported they faced difficulties to manage it, while others with experience in using mobile devices did not face problems to use it. The application has the functions needed for the Systematization of Nursing Care at the unit, but changes were suggested in the interface of the screens, some data collection terms and parameters the application offers. The main contributions of the software were: agility in the development and documentation of the systemization, freedom to move, standardization of infant assessment, optimization of time to develop bureaucratic activities, possibilities to recover information and reduction of physical space the registers occupy. Conclusion: prototype software for the Systemization of Nursing Care with mobile technology permits flexibility for the nurses to register their activities, as the data can be collected at the bedside.

  18. Assessment in Kinship Foster Care: A New Tool to Evaluate the Strengths and Weaknesses

    Directory of Open Access Journals (Sweden)

    Nuria Fuentes-Peláez

    2014-12-01

    Full Text Available Placement in kinship family has existed informally throughout time. There are many countries in which kinship family care is the most common measure used for child protection. However, it is a subject of continuous debate. One of the major issues is that kinship foster care is relied upon without carrying out an evaluation study of the family; often the child is placed directly with grandparents and uncles simply because they are direct family. This article presents an assessment tool to evaluate extended families in order to ensure the welfare of the child. The tool was created as a result of the cooperative research of 126 professionals from seven regions of Spain. The tool can identify the strengths and weaknesses of families by considering six factors: personal characteristics, the coverage of basic needs, collaboration with professionals, the family structure and dynamics, the relationship between family, child, and biological family, and, finally, the attitude towards the placement. The assessment tool is innovative and introduces the opportunity to consider the skills of the kinship foster care family, the needs of support, and which families are unfit to take care of the child. To conclude, the tool tries to overcome one of the principal disadvantages of kinship foster care: the lack of knowledge about the kinship family.

  19. Patient-Assessed Chronic Illness Care (PACIC) scenario in an Indian homeopathic hospital.

    Science.gov (United States)

    Koley, Munmun; Saha, Subhranil; Ghosh, Shubhamoy; Nag, Goutam; Kundu, Monojit; Mondal, Ramkumar; Purkait, Rajib; Patra, Supratim; Ali, Seikh Swaif

    2016-01-01

    Homeopathy research has focused on chronic conditions; however, the extent to which current homeopathic care is compliant with the Chronic Care Model (CCM) has been sparsely shown. As the Bengali Patient-Assessed Chronic Illness Care (PACIC)-20 was not available, the English questionnaire was translated and evaluated in a government homeopathic hospital in West Bengal, India. The translation was done in six steps, and approved by an expert committee. Face validity was tested by 15 people for comprehension. Test/retest reliability (reproducibility) was tested on 30 patients with chronic conditions. Internal consistency was tested in 377 patients suffering from various chronic conditions. The questionnaire showed acceptable test/retest reliability [intraclass correlation coefficient (ICC) 0.57-0.75; positive to strong positive correlations; p  0.05); however, monthly household income had a significant influence (p < 0.05) on the subscales except for "delivery system or practice design." Overall, chronic illness care appeared to be quite promising and CCM-compliant. The psychometric properties of the Bengali PACIC-20 were satisfactory, rendering it a valid and reliable instrument for assessing chronic illness care among the patients attending a homeopathic hospital. PMID:26933640

  20. Perspectives and strategies of alternative methods used in the risk assessment of personal care products.

    Science.gov (United States)

    Quantin, P; Thélu, A; Catoire, S; Ficheux, H

    2015-11-01

    Risk assessment for personal care products requires the use of alternative methods since animal testing is now totally banned. Some of these methods are effective and have been validated by the "European Union Reference Laboratory for alternatives to animal testing"; but there is still a need for development and implementation of methods for specific endpoints. In this review, we have focused on dermal risk assessment because it is the prime route of absorption and main target organ for personal care products. Within this field, various areas must be assessed: irritation, sensitisation and toxicokinetic. Personal care product behaviour after use by the consumer and potential effects on the environment are also discussed. The purpose of this review is to show evolution and the prospects of alternative methods for safety dermal assessment. Assessment strategies must be adapted to the different chemical classes of substances studied but also to the way in which they are used. Finally, experimental and theoretical technical parameters that may impact on measured effects have been identified and discussed. PMID:26184446

  1. Personality Assessment Screener, Childhood Abuse, and Adult Partner Violence in African American Women Using Primary Care.

    Science.gov (United States)

    Porcerelli, John H; Hurrell, Kristen; Cogan, Rosemary; Jeffries, Keturah; Markova, Tsveti

    2015-12-01

    This study assessed the relationship between psychopathology with the Personality Assessment Screener (PAS) and childhood physical and sexual abuse and adult physical and sexual partner violence in a primary care sample of 98 urban-dwelling African American women. Patients completed the PAS, the Childhood Trauma Questionnaire, and the Conflict Tactics Scale. The PAS total score significantly correlated with all measures of childhood and adult abuse. Stepwise regression analyses revealed that PAS element scores of Suicidal Thinking and Hostile Control significantly predicted a history of childhood physical abuse; Suicidal Thinking, Hostile Control, and Acting Out significantly predicted a history of childhood sexual abuse; Suicidal Thinking, Negative Affect, and Alienation significantly predicted current adult partner physical violence; and Psychotic Features, Alcohol Problems, and Anger Control significantly predicted current adult sexual partner violence. The PAS appears to be a useful measure for fast-paced primary care settings for identifying patients who need a more thorough assessment for abuse. PMID:26374084

  2. An assessment of dedicated energy crops in Europe under the EU Energy Reference Scenario 2013. Application of the LUISA modelling platform - Updated Configuration 2014

    OpenAIRE

    PERPIÑA CASTILLO CAROLINA; BARANZELLI CLAUDIA; MAES JOACHIM; ZULIAN GRAZIA; LOPES BARBOSA ANA LUISA; VANDECASTEELE INE; MARI RIVERO INES; VALLECILLO RODRIGUEZ SARA; BATISTA E SILVA FILIPE; JACOBS CHRISTIAAN; Lavalle, Carlo

    2015-01-01

    This report presents a comprehensive analysis of dedicated energy crops (ENCR) performed with the LUISA (Land Use-based Integrated Sustainability Assessment) modelling platform across Europe between 2020 and 2050. LUISA is configured in compliance with the “EU Energy, Transport and GHG emissions trends until 2050” document in order to ensure that the EU meet its climate and energy targets up to 2050 (EU Reference Scenario 2013, updated LUISA configuration 2014). The spatial modelling of ENCR ...

  3. Hemodynamic Assessment and Monitoring in the Intensive Care Unit: an Overview

    Directory of Open Access Journals (Sweden)

    Adam C. Adler

    2014-08-01

    Full Text Available The goal of hemodynamic monitoring in intensive care is to assess the adequacy of perfusion, specifically with regard to maintaining sufficient perfusion pressures and oxygen delivery. Precise volume management of peri-operative and critical care patients is crucial as under or over resuscitation is associated with adverse outcomes. Hemodynamic monitoring allows care to be individualized based on specific patient response to therapy and can provide early warning of impending perfusion deficits or instability. Physiologic monitoring aids determination of appropriate therapy. Methods for obtaining accurate and continuous measurements in the critically ill patient have evolved from surgical and anesthetic techniques dating back more than a century. These techniques transitioned from the operating room to early intensive care units as necessitated by the polio epidemics of the 1950s. The advantages of cohorting critically ill patients led to specialized intensive care and later cardiac care units. Telemetry developed to monitor astronauts and miniaturization of electronics made possible by substituting transistors for vacuum tubes helped create the first generation of intensive care monitors in the 1960s. Transcutaneous oxygen sensors, end-tidal measurement of carbon dioxide, and pulse oximetry took monitoring to a new level by the 1980s. Monitors became more sophisticated and capable of calculating derived variables such as oxygen delivery and consumption as computer processing became routine. These data sets were useful to clinicians using fluids and vasoactive agents primarily to manipulate oxygen delivery in hemodynamically unstable patients. Recently, simply monitoring vascular pressures has given way to dynamic monitoring where physiologic changes with respiration can be used to derive additional parameters such as pulse pressure variation (PPV and stroke volume variation (SVV. Today’s clinician has a wealth of information available at the

  4. Assessing the prognoses on Health care in the information society 2013--thirteen years after.

    Science.gov (United States)

    Knaup, Petra; Ammenwerth, Elske; Dujat, Carl; Grant, Andrew; Hasman, Arie; Hein, Andreas; Hochlehnert, Achim; Kulikowski, Casimir; Mantas, John; Maojo, Victor; Marschollek, Michael; Moura, Lincoln; Plischke, Maik; Röhrig, Rainer; Stausberg, Jürgen; Takabayashi, Katsuhiko; Uckert, Frank; Winter, Alfred; Wolf, Klaus-Hendrik; Haux, Reinhold

    2014-07-01

    Health care and information technology in health care is advancing at tremendous speed. We analysed whether the prognoses by Haux et al. - first presented in 2000 and published in 2002 - have been fulfilled in 2013 and which might be the reasons for match or mismatch. Twenty international experts in biomedical and health informatics met in May 2013 in a workshop to discuss match or mismatch of each of the 71 prognoses. After this meeting a web-based survey among workshop participants took place. Thirty-three prognoses were assessed matching; they reflect e.g. that there is good progress in storing patient data electronically in health care institutions. Twenty-three prognoses were assessed mismatching; they reflect e.g. that telemedicine and home monitoring as well as electronic exchange of patient data between institutions is not established as widespread as expected. Fifteen prognoses were assessed neither matching nor mismatching. ICT tools have considerably influenced health care in the last decade, but in many cases not as far as it was expected by Haux et al. in 2002. In most cases this is not a matter of the availability of technical solutions but of organizational and ethical issues. We need innovative and modern information system architectures which support multiple use of data for patient care as well as for research and reporting and which are able to integrate data from home monitoring into a patient centered health record. Since innovative technology is available the efficient and wide-spread use in health care has to be enabled by systematic information management. PMID:24952606

  5. Many quality measurements, but few quality measures assessing the quality of breast cancer care in women: A systematic review

    OpenAIRE

    Zhang Li; Morrison Andra; Sampson Margaret; Brouwers Melissa; Graham Ian D; Lewin Gabriela; Mamaladze Vasil; Schachter Howard M; O'Blenis Peter; Garritty Chantelle

    2006-01-01

    Abstract Background Breast cancer in women is increasingly frequent, and care is complex, onerous and expensive, all of which lend urgency to improvements in care. Quality measurement is essential to monitor effectiveness and to guide improvements in healthcare. Methods Ten databases, including Medline, were searched electronically to identify measures assessing the quality of breast cancer care in women (diagnosis, treatment, followup, documentation of care). Eligible studies measured adhere...

  6. Personal Care Product Use in Pregnancy and the Postpartum Period: Implications for Exposure Assessment

    Science.gov (United States)

    Lang, Carly; Fisher, Mandy; Neisa, Angelica; MacKinnon, Leona; Kuchta, Sandra; MacPherson, Susan; Probert, Adam; Arbuckle, Tye E.

    2016-01-01

    Concern regarding the potential for developmental health risks associated with certain chemicals (e.g., phthalates, antibacterials) used in personal care products is well documented; however, current exposure data for pregnant women are limited. The objective of this study was to describe the pattern of personal care product use in pregnancy and the post-partum period. Usage patterns of personal care products were collected at six different time points during pregnancy and once in the postpartum period for a cohort of 80 pregnant women in Ottawa, Canada. The pattern of use was then described and groups of personal care product groups commonly used together were identified using hierarchical cluster analysis. The results showed that product use varied by income and country of birth. General hygiene products were the most commonly used products and were consistently used over time while cosmetic product use declined with advancing pregnancy and post-delivery. Hand soaps and baby products were reported as used more frequently after birth. This study is the first to track personal care product use across pregnancy and into the postpartum period, and suggests that pregnant populations may be a unique group of personal care product users. This information will be useful for exposure assessments. PMID:26751460

  7. Unraveling care integration: Assessing its dimensions and antecedents in the Italian Health System.

    Science.gov (United States)

    Calciolari, Stefano; Ilinca, Stefania

    2016-01-01

    In recent decades, consensus has grown on the need to organize health systems around the concept of care integration to better confront the challenges associated with demographic trends and financial sustainability. However, care integration remains an imprecise umbrella term in both the academic and policy arenas. In addition, little substantive knowledge exists on the success factors for integration initiatives. We propose a composite measure of care integration and a conceptual framework suggesting its relationships with three types of antecedents: contextual, cultural, and organizational factors. Our framework was tested using data from the Italian National Health System (NHS). We administered an ad-hoc questionnaire to all Italian local health units (LHUs), with a 60.4% response rate, and used structural equation modeling to assess the relationships between the relevant latent constructs. The results validated our measure of care integration and supported the hypothesized relationships. In particular, integration was found to be fostered by results-oriented institutional settings, a professional culture conducive to inclusiveness and shared goals, and organizational arrangements promoting clear expectations among providers. Thus, integration improves care and mediates the effects of specific operating means on care enhancement. PMID:26725643

  8. Personal Care Product Use in Pregnancy and the Postpartum Period: Implications for Exposure Assessment

    Directory of Open Access Journals (Sweden)

    Carly Lang

    2016-01-01

    Full Text Available Concern regarding the potential for developmental health risks associated with certain chemicals (e.g., phthalates, antibacterials used in personal care products is well documented; however, current exposure data for pregnant women are limited. The objective of this study was to describe the pattern of personal care product use in pregnancy and the post-partum period. Usage patterns of personal care products were collected at six different time points during pregnancy and once in the postpartum period for a cohort of 80 pregnant women in Ottawa, Canada. The pattern of use was then described and groups of personal care product groups commonly used together were identified using hierarchical cluster analysis. The results showed that product use varied by income and country of birth. General hygiene products were the most commonly used products and were consistently used over time while cosmetic product use declined with advancing pregnancy and post-delivery. Hand soaps and baby products were reported as used more frequently after birth. This study is the first to track personal care product use across pregnancy and into the postpartum period, and suggests that pregnant populations may be a unique group of personal care product users. This information will be useful for exposure assessments.

  9. Getting on with your computer is associated with job satisfaction in primary care: entrants to primary care should be assessed for their competency with electronic patient record systems

    Directory of Open Access Journals (Sweden)

    Simon de Lusignan

    2014-02-01

    Full Text Available Job satisfaction in primary care is associated with getting on with your computer. Many primary care professionals spend longer interacting with their computer than anything else in their day. However, the computer often makes demands rather than be an aid or supporter that has learned its user’s preferences. The use of electronic patient record (EPR systems is underrepresented in the assessment of entrants to primary care, and in definitions of the core competencies of a family physician/general practitioner. We call for this to be put right: for the use of the EPR to support direct patient care and clinical governance to be given greater prominence in training and assessment. In parallel, policy makers should ensure that the EPR system use is orientated to ensuring patients receive evidence-based care, and EPR system suppliers should explore how their systems might better support their clinician users, in particular learning their preferences.

  10. Getting on with your computer is associated with job satisfaction in primary care: entrants to primary care should be assessed for their competency with electronic patient record systems.

    Science.gov (United States)

    de Lusignan, Simon; Pearce, Christopher; Munro, Neil

    2013-01-01

    Job satisfaction in primary care is associated with getting on with your computer. Many primary care professionals spend longer interacting with their computer than anything else in their day. However, the computer often makes demands rather than be an aid or supporter that has learned its user's preferences. The use of electronic patient record (EPR) systems is underrepresented in the assessment of entrants to primary care, and in definitions of the core competencies of a family physician/general practitioner. We call for this to be put right: for the use of the EPR to support direct patient care and clinical governance to be given greater prominence in training and assessment. In parallel, policy makers should ensure that the EPR system use is orientated to ensuring patients receive evidence-based care, and EPR system suppliers should explore how their systems might better support their clinician users, in particular learning their preferences. PMID:24629650

  11. Assessment of linkages from HIV testing to enrolment and retention in HIV care in Central Mozambique

    Science.gov (United States)

    Inguane, Celso Azarias; Gloyd, Stephen; Manuel, João Luis; Brown, Charlene; Wong, Vincent; Augusto, Orvalho; Hassan, Wisal Mustafa; Vieira, Lúcia; Afonso, Pires; Jamnadás, Mehol; Bernard, Jama Joy; Cowan, James; Kalibala, Samuel; Pfeiffer, James

    2016-01-01

    Introduction Effectiveness of the rapid expansion of antiretroviral therapy (ART) throughout sub-Saharan Africa is highly dependent on adequate enrolment and retention in HIV care. However, the measurement of both has been challenging in these settings. This study aimed to assess enrolment and retention in HIV care (pre-ART and ART) among HIV-positive adults in Central Mozambique, including identification of barriers and facilitators. Methods We assessed linkages to and retention in HIV care using a mixed quantitative and qualitative approach in six districts of Manica and Sofala provinces. We analyzed routine district and health facility monthly reports and HIV care registries from April 2012 to March 2013 and used single imputation and trimmed means to adjust for missing values. In eight health facilities in the same districts and period, we assessed retention in HIV care among 795 randomly selected adult patient charts (15 years and older). We also conducted 25 focus group discussions and 53 in-depth interviews with HIV-positive adults, healthcare providers and community members to identify facilitators and barriers to enrolment and retention in HIV care. Results Overall, 46% of the monthly HIV testing reports expected at the district level were missing, compared to 6.4% of the pre-ART registry reports. After adjustment for missing values, we estimated that the aggregate numbers of adults registered in pre-ART was 75% of the number of persons tested HIV-positive in the six districts. In the eight health facilities, 40% of the patient charts for adults enrolled in pre-ART and 44% in ART were missing. Of those on ART for whom charts were found, retention in treatment within 90 and 60 days prior to the study team visit was 34 and 25%, respectively. Combining these multiple data sources, the overall estimated retention was 18% in our sample. Individual-level factors were perceived to be key influences to enrolment in HIV care, while health facility and structural

  12. Improving adjustments for older age in pre-hospital assessment and care

    Directory of Open Access Journals (Sweden)

    Rehn Marius

    2013-01-01

    Full Text Available Abstract Population estimates projects a significant increase in the geriatric population making elderly trauma patients more common. The geriatric trauma patients experience higher incidence of pre-existing medical conditions, impaired age-dependent physiologic reserve, use potent drugs and suffer from trauma system related shortcomings that influence outcomes. To improve adjustments for older age in pre-hospital assessment and care, several initiatives should be implemented. Decision-makers should make system revisions and introduce advanced point-of-care initiatives to improve outcome after trauma for the elderly.

  13. Assessment and Availability of Trauma Care Services in a District Hospital of South India; A Field Observational Study

    OpenAIRE

    Pallavi Sarji Uthkarsh; Gopalkrishna Gururaj; Sai Sabharish Reddy; Mandya Siddalingaiah Rajanna

    2016-01-01

    Objective: To assess the availability of trauma care services in a district referral hospital of Southern India. Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed speciality hospital which is an apex referral hospital in the public health system using a check list based on WHO guidelines for evaluation of essential trauma care services, along with in-d...

  14. Model documentation of assessment and nursing diagnosis in the practice of nursing care management for nursing students

    OpenAIRE

    A. Aziz Alimul Hidayat; M. Kes

    2015-01-01

    Model documentation of assessment and nursing diagnosis in the practice of nursing care management is an integration model in nursing care records, especially records nursing assessment and diagnosis in one format. This model can reduce the duration of the recording in nursing care, and make it easier for students to understand the nursing diagnosis, so that nursing interventions more effective. The purpose of this paper was to describes the form integration documentation of nursing assessmen...

  15. Quality of care assessment in geriatric evaluation and management units: construction of a chart review tool for a tracer condition

    OpenAIRE

    Latour Judith; Leduc Nicole; Leclerc Bernard-Simon; Kergoat Marie-Jeanne; Berg Katherine; Bolduc Aline

    2009-01-01

    Abstract Background The number of elderly people requiring hospital care is growing, so, quality and assessment of care for elders are emerging and complex areas of research. Very few validated and reliable instruments exist for the assessment of quality of acute care in this field. This study's objective was to create such a tool for Geriatric Evaluation and Management Units (GEMUs). Methods The methodology involved a reliability and feasibility study of a retrospective chart review on 934 o...

  16. An assessment of routine primary care health information system data quality in Sofala Province, Mozambique

    Directory of Open Access Journals (Sweden)

    Cuembelo Fatima

    2011-05-01

    Full Text Available Abstract Background Primary health care is recognized as a main driver of equitable health service delivery. For it to function optimally, routine health information systems (HIS are necessary to ensure adequate provision of health care and the development of appropriate health policies. Concerns about the quality of routine administrative data have undermined their use in resource-limited settings. This evaluation was designed to describe the availability, reliability, and validity of a sample of primary health care HIS data from nine health facilities across three districts in Sofala Province, Mozambique. HIS data were also compared with results from large community-based surveys. Methodology We used a methodology similar to the Global Fund to Fight AIDS, Tuberculosis and Malaria data verification bottom-up audit to assess primary health care HIS data availability and reliability. The quality of HIS data was validated by comparing three key indicators (antenatal care, institutional birth, and third diptheria, pertussis, and tetanus [DPT] immunization with population-level surveys over time. Results and discussion The data concordance from facility clinical registries to monthly facility reports on five key indicators--the number of first antenatal care visits, institutional births, third DPT immunization, HIV testing, and outpatient consults--was good (80%. When two sites were excluded from the analysis, the concordance was markedly better (92%. Of monthly facility reports for immunization and maternity services, 98% were available in paper form at district health departments and 98% of immunization and maternity services monthly facility reports matched the Ministry of Health electronic database. Population-level health survey and HIS data were strongly correlated (R = 0.73, for institutional birth, first antenatal care visit, and third DPT immunization. Conclusions Our results suggest that in this setting, HIS data are both reliable and

  17. Application of Donabedian quality-of-care framework to assess the outcomes of preconception care in urban health centers, Mashhad, Iran in 2012

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    Fatemeh Ghaffari

    2013-12-01

    Full Text Available Background and aim: Improving patient health status is the primary goal of healthcare system. and planning to improve the health care services without taking into account the views of care receivers is not possible .In this regard, Donabedian Model as an appropriate framework in assessing the quality of health care, has particular attention to the issue of "outcomes", which are sometimes seen as the most important indicators of quality. This study therefore aimed to assess the outcomes of preconception care including changes to health knowledge as well as patient satisfaction in urban health centers, Mashhad, Iran in 2012. Methods: In this descriptive study, 350 women of reproductive age who received preconception care in urban health centers of Mashhad, Iran, were selected using a two stage sampling design. Demographic and obstetric data were collected through a self-structured questionnaire.  Outcomes of preconception care including health knowledge as well as patient satisfaction were measured using a questionnaire adopted from Donabedian Model. Data were analyzed with SPSS Software version 16 and statistical tests such as ANOVA, Chi-square and Pearson correlation coefficient. Findings: The mean age of women was 22.5 ± 26.93 and the mean score of their marriage years was 6.32±4.77.  67.4% of subjects experienced between one and six pregnancies. The mean score of health knowledge of preconception care was 53.4 ± 8.14 and the highest score of its subdomains was related to the personal hygiene. The mean score of patients' satisfaction of preconception care was 84.11 ± 56.75 and its highest score was in relation to counseling and provided care. Conclusion: According to the results, planning to provide better education services for clients, raising public awareness regarding preconception care and more emphasis on preconception care importance in continuous education of health care providers are recommended.  

  18. Patient Assessment of Chronic Illness Care (PACIC) in Type 2 Diabetes: A Longitudinal Study.

    Science.gov (United States)

    Aung, Eindra; Ostini, Remo; Dower, Jo; Donald, Maria; Coll, Joseph R; Williams, Gail M; Doi, Suhail A R

    2016-06-01

    The Patient Assessment of Chronic Illness Care (PACIC) was designed to measure care congruent with several elements of the chronic care model (CCM), including self-management support and delivery system design. However, support for the a priori 5-subscale structure of the PACIC in previous research has been conflicting. Thus, we aim to investigate psychometric characteristics of the PACIC including the content and stability of its construct over time. A population-based prospective cohort study of patients with type 2 diabetes was conducted in Queensland, Australia, from 2008 (N = 3,761) to 2010 (N = 3,040). Participants completed annually the 20-item PACIC as well as measures of providers' adherence to guideline-recommended self-management support activities. We used exploratory factor analysis to determine its factor structure and examined internal consistency as well as agreement between the PACIC at baseline with repeated measurements at follow-up after 1 and 2 years. We also determined a criterion-related validity using multinomial logistic regression to explore PACIC's association with providers' self-management support. A one-factor structure was deemed optimal according to our findings. High internal consistency and moderate agreement within the scales over time were observed. Higher PACIC scores predicted better providers' self-management support. In conclusion, the PACIC is a reliable, valid, and reproducible instrument for assessment of diabetes care, and we recommend its promotion and use as a single scale rather than subscales as originally proposed. PMID:25380699

  19. Assessment of primary care nursing in relation to adolescent health behaviour by means of trigger films.

    Science.gov (United States)

    Eshed, H; Epstein, L

    1991-01-01

    The patterns of adolescents' behaviour place them at a risk from developing health and social pathology. In order to assess whether primary care nursing meets adolescents' health needs, the reported performance of 306 registered nurses working in different primary health care settings was studied. The research tool developed especially for the study was a video-taped trigger film. Demographic, education and work-related variables were studied by means of a questionnaire. The behaviour patterns studied were smoking, sexual activity, alcohol and drug consumption, and eating habits. The clinical issues were hypertension, obesity and anorexia nervosa. Reported performance was low--35% of the total possible score--with the lowest scores in the areas of preventive care, data gathering and recording, and somewhat higher in the areas of curative care and follow-up. The video-taped trigger films were considered to have face validity; they were found to be reliable, with an ability to assess the nurses' reported performance and to differentiate between the nurses in the three different work settings. This is the first study of its kind in Israel. The results show that primary health nursing of adolescents is insufficient, and that teenagers should get higher priority as a target population from the nursing profession in order to achieve WHO's aims of 'health for all by the year 2000'. PMID:2005286

  20. Instrument for assessing the quality of mobile emergency pre-hospital care: content validation

    Directory of Open Access Journals (Sweden)

    Rodrigo Assis Neves Dantas

    2015-06-01

    Full Text Available OBJECTIVES To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K and Content Validity Index (CVI, considering K> 0.80 and CVI ≥ 0.80. RESULTS Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. CONCLUSION The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services.

  1. Assessing the context of health care utilization in Ecuador: A spatial and multilevel analysis

    Directory of Open Access Journals (Sweden)

    Chi Chunhuei

    2010-03-01

    Full Text Available Abstract Background There are few studies that have analyzed the context of health care utilization, particularly in Latin America. This study examines the context of utilization of health services in Ecuador; focusing on the relationship between provision of services and use of both preventive and curative services. Methods This study is cross-sectional and analyzes data from the 2004 National Demographic and Maternal & Child Health dataset. Provider variables come from the Ecuadorian System of Social Indicators (SIISE. Global Moran's I statistic is used to assess spatial autocorrelation of the provider variables. Multilevel modeling is used for the simultaneous analysis of provision of services at the province-level with use of services at the individual level. Results Spatial analysis indicates no significant differences in the density of health care providers among Ecuadorian provinces. After adjusting for various predisposing, enabling, need factors and interaction terms, density of public practice health personnel was positively associated with use of preventive care, particularly among rural households. On the other hand, density of private practice physicians was positively associated with use of curative care, particularly among urban households. Conclusions There are significant public/private, urban/rural gaps in provision of services in Ecuador; which in turn affect people's use of services. It is necessary to strengthen the public health care delivery system (which includes addressing distribution of health workers and national health information systems. These efforts could improve access to health care, and inform the civil society and policymakers on the advances of health care reform.

  2. Driving Care Quality: Aligning Trainee Assessment and Supervision Through Practical Application of Entrustable Professional Activities, Competencies, and Milestones.

    Science.gov (United States)

    Carraccio, Carol; Englander, Robert; Holmboe, Eric S; Kogan, Jennifer R

    2016-02-01

    To address the long-standing challenge of meaningful trainee assessment, the authors reviewed and expanded on the Accountable Assessment for Quality Care and Supervision (AAQCS) equation. The equation proposes that care quality is the product of the interaction between trainee performance (measured by workplace assessment) and supervision (required level of intervention to ensure care quality) in the context of the environment where the care occurs: Trainee performance × Appropriate supervision = Safe, effective patient-centered care. Assessing trainee performance and matching that performance to "appropriate" supervision, however, is fraught with challenges. The authors suggest a unifying framework that integrates entrustable professional activities (EPAs), competencies, and milestones to inform trainee assessment and supervision, thereby enabling the practical application of the AAQCS equation in the workplace. Because the unit of measure for an EPA is the outcome of whether the trainee can safely and effectively perform the professional activity without supervision, the proposed unifying framework directly aligns with the dependent variable in the AAQCS equation: care quality.The value of applying a unifying framework that integrates EPAs, competencies, and milestones to the AAQCS equation in the clinical learning environment lies in its ability to provide supervisors with a shared mental model of performance expectations for trainees, reducing unwanted variability and improving assessment accuracy; guidance for aligning performance milestones of trainees with the needed level of supervisor intervention to ensure care quality; and substrate for specific feedback to improve the trainee's professional development as a way to ensure future care quality. PMID:26509601

  3. Stress assessment by anaesthesiologists and nurses working in paediatric intensive care units

    OpenAIRE

    Grzeskowiak, Malgorzata; Bartkowska-Sniatkowska, Alicja; Rosada-Kurasinska, Jowita; Kielbasiewicz-Drozdowska, Iwona; Janicki, Piotr K

    2013-01-01

      Abstract. Paediatric intensive care units (PICU) play a special role in the therapy of critically ill children. The physicians (anaesthesiologists) and nurses are at a particular risk of job-related stress because continuous work stress can lead to psychological and physical disturbances. The aim of the study was to assess the stress level among the anaesthesiologists and nurses in the PICU. The anaesthesiologists and nurses (104), recruited from five university hospital centres in Poland, ...

  4. Practical aspects of conducting a pragmatic randomised trial in primary care: patient recruitment and outcome assessment.

    OpenAIRE

    2000-01-01

    BACKGROUND: Conducting a pragmatic randomised trial in primary care is often accompanied by practical problems. Such problems are seldom reported and may constitute useful lessons for researchers planning future trials. AIM: To address the difficulties involved in patient recruitment and to present measures to minimise bias during outcome assessment. METHOD: A recently conducted trial comparing the effects of corticosteroid injections and physiotherapy for painful stiff shoulder was used to i...

  5. Using Diffusion of Innovations Theory to implement the confusion assessment method for the intensive care unit.

    Science.gov (United States)

    Bowen, Constance Mary; Stanton, Marietta; Manno, Martin

    2012-01-01

    Routine screening of mechanically ventilated patients for delirium is essential for prompt recognition and management; however, this represents a change in practice. Rogers' Diffusion of Innovations Theory can be useful as a strategy to facilitate adoption of a practice change. This case study describes the effectiveness of identifying barriers to a change in practice and developing strategies, specific to Rogers' innovation decision process, for implementing the Confusion Assessment Method for the intensive care unit. PMID:22367153

  6. Antenatal Care Strengthening in Jimma, Ethiopia: A Mixed-Method Needs Assessment

    OpenAIRE

    Sarah Fredsted Villadsen; Britt Pinkowski Tersbøl; Dereje Negussie; Abebe GebreMariam; Abebech Tilahun; Henrik Friis; Vibeke Rasch

    2014-01-01

    Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC) strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content of ANC and to identify the predictors of low ANC satisfaction. Further, a qualitative approach was applied to understand perceptions, practices, and policies of ANC. Results. There were no national...

  7. Improving adjustments for older age in pre-hospital assessment and care

    OpenAIRE

    Rehn Marius

    2013-01-01

    Abstract Population estimates projects a significant increase in the geriatric population making elderly trauma patients more common. The geriatric trauma patients experience higher incidence of pre-existing medical conditions, impaired age-dependent physiologic reserve, use potent drugs and suffer from trauma system related shortcomings that influence outcomes. To improve adjustments for older age in pre-hospital assessment and care, several initiatives should be implemented. Decision-makers...

  8. Pulmonary Edema Assessed by Ultrasound: Impact in Cardiology and Intensive Care Practice.

    Science.gov (United States)

    Blanco, Pablo A; Cianciulli, Tomás F

    2016-05-01

    Pulmonary edema is a frequent condition found in adult patients hospitalized in cardiology wards and intensive care units. Ultrasonography is a diagnostic modality with a high sensitivity for the detection of extravascular lung water, visualized as B lines, and usually caused by cardiogenic or noncardiogenic pulmonary edema. This paper highlights a simple method for the assessment of patients with pulmonary edema, which allows for a differential diagnosis of its possible mechanism and contributes to therapeutic intervention guiding and monitoring. PMID:26841270

  9. Instrument for assessing the quality of mobile emergency pre-hospital care: content validation

    OpenAIRE

    2015-01-01

    OBJECTIVES To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K) and Content Validity Index (CVI), considering K> 0.80 and CVI ≥ 0.80. RESULTS Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes a...

  10. Assessment of the breath alcohol concentration in emergency care patients with different level of consciousness

    OpenAIRE

    Kaisdotter Andersson, Annika; Kron, Josefin; Castren, Maaret; Muntlin Athlin, Åsa; Hök, Bertil; Wiklund, Lars

    2015-01-01

    Background Many patients seeking emergency care are under the influence of alcohol, which in many cases implies a differential diagnostic problem. For this reason early objective alcohol screening is of importance not to falsely assign the medical condition to intake of alcohol and thus secure a correct medical assessment. Objective At two emergency departments, demonstrate the feasibility of accurate breath alcohol testing in emergency patients with different levels of cooperation. Method As...

  11. An approach to sexuality from primary care nursing, what to assess?

    Directory of Open Access Journals (Sweden)

    Laura Figueroa-Martín

    2015-08-01

    Full Text Available This study analyzes the content validity and criterion of different parts of the interview relationed with the sexuality pattern and studies the clinimetric and psychometric characteristics of the selected instruments in the review of literature -scoping review-.. By the inclusions criteria, 28 items have been selected; of which seven questionnaires assess sexuality in women and men. The contribution of this study to nursing care is to provide suitable tools for valuation of sexuality, raising awareness on the need to conclude in important areas of exploration and develop effective tools for the assessment of this pattern in children, adolescents and elderly.

  12. Assessment of the structural and process aspects of pharmaceutical care at a university hospital in Ethiopia

    Directory of Open Access Journals (Sweden)

    Abdrrahman Shemsu Surur

    2015-01-01

    Full Text Available Objective: To assess the structural and process components of the pharmaceutical care at Gondar University Referral Hospital (GURH. Materials and Methods: An institution-based cross-sectional study was conducted on all the four pharmacies at GURH from October 1 to December 31, 2013. By adopting data collection instruments from a previously done study, the structural aspects of the pharmacies were assessed using an observation checklist and the process of pharmaceutical care delivery using a self-administered questionnaire. The data collected was entered to and analyzed using Statistical Packages for Social Sciences (SPSS version 16.0. Results: none of the pharmacies had a private counseling room, fire extinguisher and meeting area. None of the pharmacy stores were equipped with fan and air ventilation system and had no cross aisles. The mean values for documentation, patient assessment and implementation of therapeutic objective were 12.14, 14.03 and 5.64 respectively. Many pharmacists (64.29% did not participate in ward rotation with physicians. The overall pharmacy professionals′ level of job satisfaction was found to be 2.77. Conclusion: There were gaps in the structure and the process of the provision of pharmaceutical care in GURH.

  13. A conceptual model for assessing quality of care for patients boarding in the emergency department: structure-process-outcome.

    Science.gov (United States)

    Liu, Shan W; Singer, Sara J; Sun, Benjamin C; Camargo, Carlos A

    2011-04-01

    Many believe that the "boarding" of emergency department (ED) patients awaiting inpatient beds compromises quality of care. To better study the quality of care of boarded patients, one should identify and understand the mechanisms accounting for any potential differences in care. This paper presents a conceptual boarding "structure-process-outcome" model to help assess quality of care provided to boarded patients and to aid in recognizing potential solutions to improve that quality, if it is deficient. The goal of the conceptual model is to create a practical framework on which a research and policy agenda can be based to measure and improve quality of care for boarded patients. PMID:21496148

  14. Towards allele-level human leucocyte antigens genotyping - assessing two next-generation sequencing platforms: Ion Torrent Personal Genome Machine and Illumina MiSeq.

    Science.gov (United States)

    Duke, J L; Lind, C; Mackiewicz, K; Ferriola, D; Papazoglou, A; Derbeneva, O; Wallace, D; Monos, D S

    2015-10-01

    Human leucocyte antigens (HLA) typing has been a challenge due to extreme polymorphism of the HLA genes and limitations of the current technologies and protocols used for their characterization. Recently, next-generation sequencing techniques have been shown to be a well-suited technology for the complete characterization of the HLA genes. However, a comprehensive assessment of the different platforms for HLA typing, describing the limitations and advantages of each of them, has not been presented. We have compared the Ion Torrent Personal Genome Machine (PGM) and Illumina MiSeq, currently the two most frequently used platforms for diagnostic applications, for a number of metrics including total output, quality score per position across the reads and error rates after alignment which can all affect the accuracy of HLA genotyping. For this purpose, we have used one homozygous and three heterozygous well-characterized samples, at HLA-A, HLA-B, HLA-C, HLA-DRB1 and HLA-DQB1. The total output of bases produced by the MiSeq was higher, and they have higher quality scores and a lower overall error rate than the PGM. The MiSeq also has a higher fidelity when sequencing through homopolymer regions up to 9 bp in length. The need to set phase between distant polymorphic sites was more readily achieved with MiSeq using paired-end sequencing of fragments that are longer than those obtained with PGM. Additionally, we have assessed the workflows of the different platforms for complexity of sample preparation, sequencer operation and turnaround time. The effects of data quality and quantity can impact the genotyping results; having an adequate amount of good quality data to analyse will be imperative for confident HLA genotyping. The overall turnaround time can be very comparable between the two platforms; however, the complexity of sample preparation is higher with PGM, while the actual sequencing time is longer with MiSeq. PMID:26119888

  15. Payment Platform

    DEFF Research Database (Denmark)

    Hjelholt, Morten; Damsgaard, Jan

    2012-01-01

    Payment transactions through the use of physical coins, bank notes or credit cards have for centuries been the standard formats of exchanging money. Recently online and mobile digital payment platforms has entered the stage as contenders to this position and possibly could penetrate societies...... applies a co-evolutionary multilevel perspective to model the interplay and processes between technology and society wherein digital payment platforms potentially will substitute other payment platforms just like the credit card negated the check. On this basis this paper formulate a multilevel conceptual...

  16. Implementing Geriatric Resources for Assessment and Care of Elders Team Care in a Veterans Affairs Medical Center: Lessons Learned and Effects Observed.

    Science.gov (United States)

    Schubert, Cathy C; Myers, Laura J; Allen, Katie; Counsell, Steven R

    2016-07-01

    In a randomized clinical trial, Geriatric Resources for Assessment and Care of Elders (GRACE), a model of care that works in collaboration with primary care providers (PCPs) and patient-centered medical homes to provide home-based geriatric care management focusing on geriatric syndromes and psychosocial problems commonly found in older adults, improved care quality and reduced acute care use for high-risk, low-income older adults. To assess the effect of GRACE at a Veterans Affairs (VA) Medical Center (VAMC), veterans aged 65 and older from Marion County, Indiana, with PCPs from four of five VAMC clinics who were not on hospice or dialysis were enrolled in GRACE after discharge home from an acute hospitalization. After an initial home-based transition visit to GRACE enrollees, the GRACE team returned to conduct a geriatric assessment. Guided by 12 protocols and input from an interdisciplinary panel and the PCP, the GRACE team developed and implemented a veteran-centric care plan. Hospitalized veterans from the fifth clinic, who otherwise met enrollment criteria, served as a usual-care comparison group. Demographic, comorbidity, and usage data were drawn from VA databases. The GRACE and comparison groups were similar in age, sex, and burden of comorbidity, although predicted risk of 1-year mortality in GRACE veterans was higher. Even so, GRACE enrollment was associated with 7.1% fewer emergency department visits, 14.8% fewer 30-day readmissions, 37.9% fewer hospital admissions, and 28.5% fewer total bed days of care, saving the VAMC an estimated $200,000 per year after program costs during the study for the 179 veterans enrolled in GRACE. Having engaged, enthusiastic VA leadership and GRACE staff; aligning closely with the medical home; and accommodating patient acuity were among the important lessons learned during implementation. PMID:27305428

  17. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    OpenAIRE

    Leppert, Wojciech; Majkowicz, Mikolaj; Forycka, Maria; Mess, Eleonora; Zdun-Ryzewska, Agata

    2014-01-01

    Aim of the study To assess quality of life (QoL) in cancer patients treated at home, at an in-patient palliative care unit (PCU), and at a day care center (DCC). Patients and methods QoL was assessed in advanced cancer patients at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL), the Edmonton Symptom Assessment System (ESAS), and the Karnofsky Perfor...

  18. Certification of health care organisations, assessment of professional practices and external radiotherapy

    International Nuclear Information System (INIS)

    In France, accreditation of health care organisations (HCOs) is mandatory every 4 years. It is based on a systemic approach and, since 2004, includes professional practice appraisal (EPP) against good practice guidelines. However, following an incident in Epinal, a new quality assurance criterion was introduced in 2007 for external radiotherapy (ERT) on top of the annual inspection of patient radiation protection by the Nuclear Safety Authority. In the accreditation procedure starting January 2010, ERT work organisation will come under 'high-risk activity' (criterion 26b) and radio-vigilance will be included in the adverse events reporting system (8i). In addition, ERT will have to comply with many generic criteria on quality and safety improvement. For example, practice appraisal of all clinical activities will become routine. Thus, besides self-assessment against criteria 26b and 8i, ERT professionals will have report the impact of their quality improvement actions on patient care. They will be able to freely choose the area for improvement, as long as it is in line with the HCO's overall quality and safety plan. In oncology, multidisciplinary team meetings for deciding on the treatment plan, as well as mortality and morbidity meetings providing feedback, are compulsory (28a). Appraisal of appropriateness of care (28b) and indicator-based practice appraisal (28c) complete the process. In conclusion, the generic practice appraisal approach that is part of the French HCO accreditation procedure can contribute toward improving health care and education, but it has not been designed for in-depth assessment of complex, multidisciplinary clinical practice such as ERT. Such assessment requires a specific clinical audit and specialized auditors. (authors)

  19. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Directory of Open Access Journals (Sweden)

    Marion McNabb

    Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  20. Downlink Coexistence Performance Assessment and Techniques for WiMAX Services from High Altitude Platform and Terrestrial Deployments

    OpenAIRE

    Grace D; Yang Z.; Mohammed A; Hult T

    2008-01-01

    Abstract We investigate the performance and coexistence techniques for worldwide interoperability for microwave access (WiMAX) delivered from high altitude platforms (HAPs) and terrestrial systems in shared 3.5 GHz frequency bands. The paper shows that it is possible to provide WiMAX services from individual HAP systems. The coexistence performance is evaluated by appropriate choice of parameters, which include the HAP deployment spacing radius, directive antenna beamwidths based on ado...

  1. Foster care assessment: A study of the placement decision process in Flanders.

    Science.gov (United States)

    Vanderfaeillie, Johan; Pijnenburg, Huub; Damen, Harm; Van Holen, Frank

    2015-11-01

    Family foster care placement decision-making has a weak scientific underpinning. Mostly a 'variable-oriented approach' is taken, which requires a lot of information that is not always available. The identification of clusters of foster children with similar characteristics may be a more viable decision strategy. In this study we investigated if foster children could indeed be clustered, which problems were identified at the time of placement, and the influence of placement history. It proved possible to group foster children into two clusters: (1) young children with familial problems and few behavioral problems, and (2) older children with prominent child problems and behavioral problems. For foster children with and without placement history, problems associated with placement proved identical. Considering that a foster care placement did not result in fundamental change in the problems present at time of placement, the importance is stressed of approaching foster care assessment as part of a decision making process which looks back as well as forward. Placement decisions should be based on an appraisal of the appropriateness of foster placement as a solution for the child. In conjunction with this appraisal a decision is required on how parents can be supported toward reunification. Or--if this is not an option--whether long term foster care is the best option for the child and if so, what conditions need to be met. PMID:25913381

  2. Report to Congress: Summary Report of the Assessment of Current State Practices in Title XX Funded Day Care Programs.

    Science.gov (United States)

    Administration for Children, Youth, and Families (DHHS), Washington, DC.

    In 1980 the federal government mandated that assistance be given states to conduct systematic assessment of current practices in Title XX funded day care programs and that a summary report of this assessment be provided to Congress. Assessment findings are given in this document. Overall, provider practices exceeded state licensing standards and…

  3. A study assessing patient satisfaction in a tertiary care hospital in India: the changing healthcare scenario.

    Science.gov (United States)

    Agarwal, Aashima; Garg, Shalini; Pareek, Udai

    2009-06-01

    The healthcare service scenario in India is expected to evolve into a more developed stage. More emphasis has been given on patient satisfaction as this is an important consideration for the assessment of the hospital services. The concept of patient satisfaction is also rapidly changing and the hospitals are using variety of techniques to improve patient care and organizational efficiency. Patient satisfaction questionnaire is a validated instrument to assess the level of the satisfaction of adult patients. The questionnaire was administered on those patients who were admitted in hospital for at least three days. In our study 88% patients were satisfied with treatment and medical care they had received. About 86% patients found that the hospital services were excellent. However, it is felt that patient values and culture should be explored for further improving patient doctor communication. There is hence a scope for improvement in meeting patient's needs and preferences and rendering hospital services. This can be achieved by some feedback system which could be available to the patients and later worked upon by the management, to improve the patient care by bridging the gap between senior management and patients. PMID:22010498

  4. The PERS(2) ON score for systemic assessment of symptomatology in palliative care: a pilot study.

    Science.gov (United States)

    Masel, E K; Berghoff, A S; Schur, S; Maehr, B; Schrank, B; Simanek, R; Preusser, M; Marosi, C; Watzke, H H

    2016-07-01

    The comprehensive assessment of symptoms is the basis for effective, individualised palliative treatment. Established scoring systems provide in-depth information but are often lengthy and hence unsuitable. We introduce the PERS(2) ON score as a short and practically feasible score to evaluate symptom burden. Fifty patients admitted to a Palliative Care Unit rated seven items, i.e. pain, eating (loss of appetite/weight loss), rehabilitation (physical impairment), social situation (possibility for home care), suffering (anxiety/burden of disease/depression), O2 (dyspnoea) and nausea/emesis, on a scale ranging from 0 (absence) to 10 (worst imaginable), resulting in a score ranging from 0 to 70. Assessments were performed at admission, 7 days after admission and at the day of discharge. Symptom intensity scores were calculated, and change over time was evaluated. A significant improvement was observed from the PERS²ON score between admission and 7 days (P evaluation to evaluation on the day of discharge was observed (P = 0.001; paired t-test). This study provides initial evidence that the PERS²ON score is both feasible and sensitive to changes of the most prominent symptoms in palliative care. It may be useful in clinical practice to direct palliative treatment strategies and provide targeted symptom management. PMID:26564404

  5. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    OpenAIRE

    Leppert, Wojciech

    2014-01-01

    Wojciech Leppert,1 Mikolaj Majkowicz,2 Maria Forycka,1 Eleonora Mess,3 Agata Zdun-Ryzewska2 1Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland; 2Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland; 3Palliative Care Nursing Department, Wroclaw Medical University, Wroclaw, Poland Aim of the study: To assess quality of life (QoL) in cancer patients treated at home, at an in-patient palliative care unit (PCU), and at a day care...

  6. Complex health care interventions: Characteristics relevant for ethical analysis in health technology assessment

    Directory of Open Access Journals (Sweden)

    Lysdahl, Kristin Bakke

    2016-03-01

    Full Text Available Complexity entails methodological challenges in assessing health care interventions. In order to address these challenges, a series of characteristics of complexity have been identified in the Health Technology Assessment (HTA literature. These characteristics are primarily identified and developed to facilitate effectiveness, safety, and cost-effectiveness analysis. However, ethics is also a constitutive part of HTA, and it is not given that the conceptions of complexity that appears relevant for effectiveness, safety, and cost-effectiveness analysis are also relevant and directly applicable for ethical analysis in HTA. The objective of this article is therefore to identify and elaborate a set of key characteristics of complex health care interventions relevant for addressing ethical aspects in HTA. We start by investigating the relevance of the characteristics of complex interventions, as defined in the HTA literature. Most aspects of complexity found to be important when assessing effectiveness, safety, and efficiency turn out also to be relevant when assessing ethical issues of a given health technology. However, the importance and relevance of the complexity characteristics may differ when addressing ethical issues rather than effectiveness. Moreover, the moral challenges of a health care intervention may themselves contribute to the complexity. After identifying and analysing existing conceptions of complexity, we synthesise a set of five key characteristics of complexity for addressing ethical aspects in HTA: 1 multiple and changing perspectives, 2 indeterminate phenomena, 3 uncertain causality, 4 unpredictable outcome, and 5 ethical complexity. This may serve as an analytic tool in addressing ethical issues in HTA of complex interventions.

  7. Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

    Directory of Open Access Journals (Sweden)

    Murphy Kathy

    2011-03-01

    Full Text Available Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups' ability to identify body weight status in both adults and children. The health professional groups are: (a community related public health nurses; (b school public health nurses; (c GPs and practice nurses (primary care; and (d occupational health nurses (workplace from both Northern Ireland and the Republic of Ireland. Methods/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based - to determine the attitudes, current practices/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

  8. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    Science.gov (United States)

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-01-01

    Objectives Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. Settings The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). Participants Responsible teams for regional data management in the five ACT regions. Primary and secondary outcome measures We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. Results There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. Conclusions The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches

  9. Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

    LENUS (Irish Health Repository)

    Moorhead, Anne

    2011-03-31

    Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices\\/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups\\' ability to identify body weight status in both adults and children. The health professional groups are: (a) community related public health nurses; (b) school public health nurses; (c) GPs and practice nurses (primary care); and (d) occupational health nurses (workplace) from both Northern Ireland and the Republic of Ireland. Methods\\/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based) - to determine the attitudes, current practices\\/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals\\' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices\\/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

  10. Parental Stress and Child Behavior and Temperament in the First Year after the Newborn Individualized Developmental Care and Assessment Program

    Science.gov (United States)

    van der Pal, Sylvia; Maguire, Celeste M.; Le Cessie, Saskia; Veen, Sylvia; Wit, Jan M.; Walther, Frans J.; Bruil, Jeanet

    2008-01-01

    A randomized controlled trial involving 128 infants born prematurely compared basic developmental care (nests and incubator covers) and the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) intervention (behavior observations and guidance by a trained developmental specialist) in relation to effects on parental stress and…

  11. Primary care units in Emilia-Romagna, Italy: an assessment of organizational culture.

    Science.gov (United States)

    Pracilio, Valerie P; Keith, Scott W; McAna, John; Rossi, Giuseppina; Brianti, Ettore; Fabi, Massimo; Maio, Vittorio

    2014-01-01

    This study investigates the organizational culture and associated characteristics of the newly established primary care units (PCUs)-collaborative teams of general practitioners (GPs) who provide patients with integrated health care services-in the Emilia-Romagna Region (RER), Italy. A survey instrument covering 6 cultural dimensions was administered to all 301 GPs in 21 PCUs in the Local Health Authority (LHA) of Parma, RER; the response rate was 79.1%. Management style, organizational trust, and collegiality proved to be more important aspects of PCU organizational culture than information sharing, quality, and cohesiveness. Cultural dimension scores were positively associated with certain characteristics of the PCUs including larger PCU size and greater proportion of older GPs. The presence of female GPs in the PCUs had a negative impact on collegiality, organizational trust, and quality. Feedback collected through this assessment will be useful to the RER and LHAs for evaluating and guiding improvements in the PCUs. PMID:24006025

  12. Environmental and ventilation assessment in Child Day Care Centers in Porto: the ENVIRH Project.

    Science.gov (United States)

    Mendes, Ana; Aelenei, Daniel; Papoila, Ana Luísa; Carreiro-Martins, Pedro; Aguiar, Lívia; Pereira, Cristiana; Neves, Paula; Azevedo, Susana; Cano, Manuela; Proença, Carmo; Viegas, João; Silva, Susana; Mendes, Diana; Neuparth, Nuno; Teixeira, João Paulo

    2014-01-01

    Children attending day care centers (CDCC) have been reported to be more prone to infectious diseases when compared with those cared for at home, and are exposed to conditions that may increase the risk of allergies and asthma. Several studies revealed that consequences of poor ventilation conditions include high levels of carbon dioxide (CO2) and many other indoor pollutants commonly detected in schools. Nine child day care centers were selected randomly to participate in this study. Fifty-two classrooms were assessed for chemical, biological, physical, and allergen parameters in spring and winter seasons in these nine CDCC located in Porto, Portugal. Outdoor measurements were also conducted for comparison. Our results indicated that (i) particulate matter (PM10) median levels were above the national reference levels, both by classroom type and by season; (ii) TVOC kindergarten peak values may raise some concern; (iii) CO2 was present at high median and maximum levels during spring and winter assessment in both nurseries and kindergartens classrooms; (iv) total bacteria concentrations were 57- and 52-fold higher in the nursery and kindergarten than outdoors, respectively, for the spring season; (v) winter and spring median predicted mean vote (PMV) indices were between "neutral" (0) and "slightly cool" (≤ -1) in the thermal sensation scale for comfort situations (-2 to 2) for both types of classrooms; (vi) there were significant differences for both PMV and predicted percentage of dissatisfied (PPD) indices by season; and (vii) CO2, total bacteria, and gram-negative bacteria were associated with low airflow rates. These data will help to evaluate the effectiveness of current building operation practices in child day care centers regarding indoor air quality and respiratory health. PMID:25072725

  13. A rapid assessment of the availability and use of obstetric care in Nigerian healthcare facilities.

    Directory of Open Access Journals (Sweden)

    Daniel O Erim

    Full Text Available BACKGROUND: As part of efforts to reduce maternal deaths in Nigeria, pregnant women are being encouraged to give birth in healthcare facilities. However, little is known about whether or not available healthcare facilities can cope with an increasing demand for obstetric care. We thus carried out this survey as a rapid and tactical assessment of facility quality. We visited 121 healthcare facilities, and used the opportunity to interview over 700 women seeking care at these facilities. FINDINGS: Most of the primary healthcare facilities we visited were unable to provide all basic Emergency Obstetric Care (bEmOC services. In general, they lack clinical staff needed to dispense maternal and neonatal care services, ambulances and uninterrupted electricity supply whenever there were obstetric emergencies. Secondary healthcare facilities fared better, but, like their primary counterparts, lack neonatal care infrastructure. Among patients, most lived within 30 minutes of the visited facilities and still reported some difficulty getting there. Of those who had had two or more childbirths, the conditional probability of a delivery occurring in a healthcare facility was 0.91 if the previous delivery occurred in a healthcare facility, and 0.24 if it occurred at home. The crude risk of an adverse neonatal outcome did not significantly vary by delivery site or birth attendant, and the occurrence of such an outcome during an in-facility delivery may influence the mother to have her next delivery outside. Such an outcome during a home delivery may not prompt a subsequent in-facility delivery. CONCLUSIONS: In conclusion, reducing maternal deaths in Nigeria will require attention to both increasing the number of facilities with high-quality EmOC capability and also assuring Nigerian women have access to these facilities regardless of where they live.

  14. Assessment of the Quality of Delivered Care for Iranian patients with Rheumatoid Arthritis by Using Comprehensive Quality Measurement Model in Health Care (CQMH

    Directory of Open Access Journals (Sweden)

    Saeed Karimi

    2015-12-01

    Full Text Available Introduction: Quality of care has become increasingly critical in the evaluation of healthcare and healthcare services. The aim of this study was to assess quality of delivered care among patients with rheumatoid arthritis using a model of Comprehensive Quality Measurement in Health Care (CQMH. Methods: This cross-sectional study was conducted on 172 patients with rheumatoid arthritis (RA who were received care from private clinics of Isfahan University of medical sciences in 2013. CQMH questionnaires were used for assessing the quality of care. Data were analyzed using SPSS for Windows. Results: The mean scores of Quality Index, Service Quality (SQ, Technical Quality (TQ, and Costumer Quality (CQ were 72.70, 79.09, 68.54 and 70.25 out of 100, respectively. For CQ only 19.8% of participations staying the course of action even under stress and financial constraints, there is a significant gap between what RA care they received with what was recommended in the guideline for TQ. Scores of service quality was low in majority of aspects especially in "availability of support group" section. Conclusion: Study shows paradoxical findings and expresses that quality scores of service delivery for patients with arthritis rheumatoid from patient's perspective is relatively low. Therefore, for fixing this paradoxical problem, improving the participation of patients and their family and empowering them for self-management and decision should be regarded by health systems.

  15. Nurses' Knowledge and Responsibility toward Nutritional Assessment for Patients in Intensive Care Units

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    Mahmoud Al Kalaldeh

    2014-09-01

    Full Text Available Introduction: Nutritional assessment is a prerequisite for nutritional delivery. Patients in intensive care suffer from under-nutrition and nutritional failure due to poor assessment. Nursing ability to early detect nutritional failure is the key for minimizing imparities in practice and attaining nutritional goals. Aim of this article is to examine the ability of Jordanian ICU nurses to assess the nutritional status of critically ill patients, considering biophysical and biochemical measures.Methods: This cross sectional study recruited nurses from different health sectors in Jordan. ICU nurses from the governmental sector (two hospitals and private sectors (two hospitals were surveyed using a self-administered questionnaire. Nurses' knowledge and responsibility towards nutritional assessment were examined.Results: A total of 220 nurses from both sectors have completed the questionnaire. Nurses were consistent in regard to knowledge, responsibility, and documentation of nutritional assessment. Nurses in the governmental hospitals inappropriately perceived the application of aspiration reduction measures. However, they scored higher in applying physical examination and anthropometric assessment.  Although both nurses claimed higher use of biochemical measurements, biophysical measurements were less frequently used. Older nurses with longer clinical experience exhibited better adherence to biophysical measurement than younger nurses.Conclusion: Nursing nutritional assessment is still suboptimal to attain nutritional goals. Assessment of body weight, history of nutrition intake, severity of illness, and function of gastrointestinal tract should be considered over measuring albumin and pre-albumin levels.  A well-defined evidence-based protocol as well as a multidisciplinary nutritional team for nutritional assessment is the best to minimize episodes of under-nutrition.

  16. Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service

    Directory of Open Access Journals (Sweden)

    Bath B

    2011-12-01

    Full Text Available Brenna Bath1, Bonnie Janzen21School of Physical Therapy, College of Medicine, University of Saskatchewan, 2Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaPurpose: To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons.Methods: People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding.Results: A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were “very satisfied” with the service and 55% were “very satisfied” with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were “very satisfied” with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction, negative (ie, lack of detail, time to follow-up, cost and neutral related to the triage service, and an “other” category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.Conclusion: The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given

  17. Review of Dublin Institute of Technology's E-Learning Platform for Effective Teaching Fromative Assessment and Feedback

    OpenAIRE

    Kehily, Dermot

    2011-01-01

    This paper investigates Dublin Institute of Technology’s (DIT) ‘webcourses.dit.ie’ created for DIT with Blackboard Learning System software as an effective e-learning tool on a module in the School of Real Estate and Construction Economics in DIT. Webcourses.dit.ie is an e-learning platform providing support and assistance to both lecturers and students as part of their daily teaching and learning experience. Webcourses as it is known in DIT is both a course management system for lecturers an...

  18. The Patient Centered Assessment Method (PCAM: integrating the social dimensions of health into primary care

    Directory of Open Access Journals (Sweden)

    Rebekah Pratt

    2015-07-01

    Full Text Available Background: Social dimensions of health are known to contribute to what is often termed “patient complexity”, which is particularly common among patients with multimorbidity. Health-care professionals require tools to help them identify and manage these aspects of patient needs. Objectives: To examine: (i the Patient Centered Assessment Method (PCAM, a tool for assessing patient complexity in ways that are sensitive to the biopsychosocial dimensions of health, in primary care settings in Scotland; (ii the impact of the PCAM on referral patterns and its perceived value; and (iii the PCAM’s perceived applicability for use in a complex patient population. Design: Two studies are described: (i a mixed-methods prospective cohort study of the implementation of the PCAM in primary care clinics; and (ii a qualitative exploratory study that evaluated the value of the PCAM in a complex patient population. Results: Use of the PCAM did not impact patient satisfaction or perception of practitioners’ empathy, but it did increase both the number of onward referrals per referred patient (9–12% and the proportion of referrals to non-medical services addressing psychological, social, and lifestyle needs. Nurses valued the PCAM, particularly its ability to help them address psychological and social domains of patients’ lives, and found it to be highly relevant for use in populations with known high complexity. Conclusions: The PCAM represents a feasible approach for assessing patient needs with consideration to the social dimensions of health, and allows practitioners to refer patients to a broader range of services to address patient complexity.

  19. Development of scales to assess patients' perception of physicians' cultural competence in health care interactions.

    Science.gov (United States)

    Ahmed, Rukhsana; Bates, Benjamin R

    2012-07-01

    This study describes the development of scales to measure patients' perception of physicians' cultural competence in health care interactions and thus contributes to promoting awareness of physician-patient intercultural interaction processes. Surveys were administrated to a total of 682 participants. Exploratory factor analyses were employed to assess emergent scales and subscales to develop reliable instruments. The first two phases were devoted to formative research and pilot study. The third phase was devoted to scale development, which resulted in a five-factor solution to measure patient perception of physicians' cultural competence for patient satisfaction. PMID:22477717

  20. Assessing the relative health care spending needs of the UK’s devolved territories: a Scottish perspective

    OpenAIRE

    Rob Ball; David King; David Eiser

    2012-01-01

    This paper applies Scotland’s health allocation formula to Primary Care Trusts (PCTs) in England, Health Boards in Wales, and Health and Social Care Trusts in Northern Ireland in order to assess the relative health care expenditure needs of the countries. According to the Scottish formula, England’s per capita health care expenditure need is around 10% lower than Scotland’s, while Wales’ per capita expenditure need is around 2% lower than Scotland’s, and Northern Ireland’s is around 7% lower ...

  1. Biomimicry 3D gastrointestinal spheroid platform for the assessment of toxicity and inflammatory effects of zinc oxide nanoparticles.

    Science.gov (United States)

    Chia, Sing Ling; Tay, Chor Yong; Setyawati, Magdiel I; Leong, David T

    2015-02-11

    Our current mechanistic understanding on the effects of engineered nanoparticles (NPs) on cellular physiology is derived mainly from 2D cell culture studies. However, conventional monolayer cell culture may not accurately model the mass transfer gradient that is expected in 3D tissue physiology and thus may lead to artifactual experimental conclusions. Herein, using a micropatterned agarose hydrogel platform, the effects of ZnO NPs (25 nm) on 3D colon cell spheroids of well-defined sizes are examined. The findings show that cell dimensionality plays a critical role in governing the spatiotemporal cellular outcomes like inflammatory response and cytotoxicity in response to ZnO NPs treatment. More importantly, ZnO NPs can induce different modes of cell death in 2D and 3D cell culture systems. Interestingly, the outer few layers of cells in 3D model could only protect the inner core of cells for a limited time and periodically slough off from the spheroids surface. These findings suggest that toxicological conclusions made from 2D cell models might overestimate the toxicity of ZnO NPs. This 3D cell spheroid model can serve as a reproducible platform to better reflect the actual cell response to NPs and to study a more realistic mechanism of nanoparticle-induced toxicity. PMID:25331163

  2. Assessing pediatric patient's risk of distress during health-care encounters: The psychometric properties of the Psychosocial Risk Assessment in Pediatrics.

    Science.gov (United States)

    Staab, Jennifer H; Klayman, Gail Jean; Lin, Li

    2014-12-01

    The aim of this study was to examine the psychometric properties of the Psychosocial Risk Assessment in Pediatrics (PRAP). PRAP is a screening tool designed to assess pediatric patients who are at risk of experiencing elevated distress during health-care encounters. A cross-sectional observational study was conducted with 200 pediatric patients. Patient's distress levels were observed during their health-care encounter using the Children's Emotional Manifestation Scale (CEMS). Health-care staff and parents were asked to rate the patient's level of cooperation and stress. Exploratory factor analysis supported a single latent factor structure of the PRAP tool. Cronbach's α for internal reliability was .83. PRAP score was strongly correlated with CEMS score with r = .82 (p < .0001). The PRAP is a standardized, reliable, and valid method for health-care providers to assess a patient's risk of experiencing significant distress during treatment or testing. PMID:23939720

  3. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G.; Williams, Grant R.; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L.; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M.; Hurria, Arti

    2016-01-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. “GA with management” is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, “Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer,” a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  4. Genomic sequencing: assessing the health care system, policy, and big-data implications.

    Science.gov (United States)

    Phillips, Kathryn A; Trosman, Julia R; Kelley, Robin K; Pletcher, Mark J; Douglas, Michael P; Weldon, Christine B

    2014-07-01

    New genomic sequencing technologies enable the high-speed analysis of multiple genes simultaneously, including all of those in a person's genome. Sequencing is a prominent example of a "big data" technology because of the massive amount of information it produces and its complexity, diversity, and timeliness. Our objective in this article is to provide a policy primer on sequencing and illustrate how it can affect health care system and policy issues. Toward this end, we developed an easily applied classification of sequencing based on inputs, methods, and outputs. We used it to examine the implications of sequencing for three health care system and policy issues: making care more patient-centered, developing coverage and reimbursement policies, and assessing economic value. We conclude that sequencing has great promise but that policy challenges include how to optimize patient engagement as well as privacy, develop coverage policies that distinguish research from clinical uses and account for bioinformatics costs, and determine the economic value of sequencing through complex economic models that take into account multiple findings and downstream costs. PMID:25006153

  5. Antenatal Care Strengthening in Jimma, Ethiopia: A Mixed-Method Needs Assessment

    Directory of Open Access Journals (Sweden)

    Sarah Fredsted Villadsen

    2014-01-01

    Full Text Available Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content of ANC and to identify the predictors of low ANC satisfaction. Further, a qualitative approach was applied to understand perceptions, practices, and policies of ANC. Results. There were no national guidelines for ANC in Ethiopia. Within the health system, the teaching of health professional students was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health education, and lack of training of health professionals. Conclusions. Health system trials are needed to study the feasibility of ANC strengthening in the study area. Nationally and internationally, the leadership needs to be strengthened with supportive supervision geared towards building trust and mutual respect to protect maternal and infant health.

  6. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research.

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G; Williams, Grant R; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M; Hurria, Arti

    2016-07-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. "GA with management" is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, "Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer," a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  7. Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa

    Directory of Open Access Journals (Sweden)

    Mosa Moshabela

    2015-12-01

    Full Text Available Background: Community care workers (CCWs in rural South Africa provide medical, personal, household, educational, and social care services to their clients. However, little understanding exists on how provision of services is approached within a household, taking into account available social support networks. Objective: The aim of this study was to generate an understanding of the processes that underpin the provision of care by CCWs in rural households and their engagement with clients, primary caregivers (PCGs, and other members of the social support network. Design: We analysed in-depth interviews conducted in a triad of participants involved in a home-based care (HBC encounter – 32 clients, 32 PCGs, and 17 CCWs. For each triad, a purposefully selected CCW was linked with a purposefully selected client and the corresponding PCG using maximum variation sampling. Three coders used an inductive content analysis method to describe participants’ references to the nuances of processes followed by CCWs in servicing HBC clients. Written informed consent was obtained from all participants. Findings: The results suggest that, by intuition and prior knowledge, CCWs treated each household uniquely, depending on the clients’ care needs, cooperation, availability of a social network, and the reliability and resilience of the social support system for the client. Four distinct processes took place in rural households: needs assessment for care, rationing of care, appraisal of care, and reinforcement of a social support system. However, there was no particular order or sequence established for these processes, and caregivers followed no prescribed or shared standards. Conclusions: CCWs bring a basket of services to a household, but engage in a constant, dynamic, and cyclical process of weighing needs against services provided. The service package is uniquely crafted and tailored for each household, depending on the absorptive capacity of the social

  8. Platform computing

    CERN Multimedia

    2002-01-01

    "Platform Computing releases first grid-enabled workload management solution for IBM eServer Intel and UNIX high performance computing clusters. This Out-of-the-box solution maximizes the performance and capability of applications on IBM HPC clusters" (1/2 page) .

  9. ASSESSING THE IMPORTANCE OF BREAST SELF EXAMINATION AND BREAST CANCER AWARENESS AMONG HEALTH CARE PROFESSIONALS

    Directory of Open Access Journals (Sweden)

    Tejaswi Vittal

    2015-07-01

    Full Text Available INTRODUCTION: Breast cancer appears to be a disease of both developing and developed country. Breast cancer is now the most common cancer in most cities in India, and 2nd most common in the rural areas. OBJECTIVES: 1. To assess the knowledge, attitude and practice of self breast examination am ong health care professionals. 2. To assess breast cancer awareness among health care professionals. METHODOLOGY : A questionnaire based cross sectional study in which 133 women belonging to various medical and allied specialties were included. RESULTS: It was found that most (91% respondents were aware of BSE. The electronic media were the major sources of information followed by information from co - health workers. The attitude of health professionals on BSE was positive, with a fairly high degree of accep tability of the idea. Despite the positive attitude to BSE, its practice was low (73.7%. CONCLUSION: BSE is a cost effective screening modality. In view of worldwide rising trends in the incidence of breast cancer rates, importance of BSE should be popula rised through mass media.

  10. Primary care physicians' use of family history for cancer risk assessment

    Directory of Open Access Journals (Sweden)

    Stockdale Alan

    2010-06-01

    Full Text Available Abstract Background Family history (FH assessment is useful in identifying and managing patients at increased risk for cancer. This study assessed reported FH quality and associations with physician perceptions. Methods Primary care physicians practicing in two northeastern U.S. states were surveyed (n = 880; 70% response rate. Outcome measures of FH quality were extent of FH taken and ascertaining age at cancer diagnosis for affected family members. Predictors of quality measured in this survey included: perceived advantages and disadvantages of collecting FH information, knowledge of management options, access to supportive resources, and confidence in ability to interpret FH. Results Reported collection of information regarding second degree blood relatives and age of diagnosis among affected relatives was low. All hypothesized predictors were associated with measures of FH quality, but not all were consistent independent predictors. Perceived advantages of taking a family history, access to supportive resources, and confidence in ability to identify and manage higher risk patients were independent predictors of both FH quality measures. Perceived disadvantages of taking a family history was independently associated one measure of FH quality. Knowledge of management options was not independently associated with either quality measure. Conclusions Modifiable perception and resource factors were independently associated with quality of FH taking in a large and diverse sample of primary care physicians. Improving FH quality for identification of high risk individuals will require multi-faceted interventions.

  11. Comprehensive Care Plan Development Using Resident Assessment Instrument Framework: Past, Present, and Future Practices

    Directory of Open Access Journals (Sweden)

    Mary Ellen Dellefield

    2015-10-01

    Full Text Available Development of the comprehensive care plan (CCP is a requirement for nursing homes participating in the federal Medicare and Medicaid programs, referred to as skilled nursing facilities. The plan must be developed within the context of the comprehensive interdisciplinary assessment framework—the Resident Assessment Instrument (RAI. Consistent compliance with this requirement has been difficult to achieve. To improve the quality of CCP development within this framework, an increased understanding of complex factors contributing to inconsistent compliance is required. In this commentary, we examine the history of the comprehensive care plan; its development within the RAI framework; linkages between the RAI and registered nurse staffing; empirical evidence of the CCP’s efficacy; and the limitations of extant standards of practices in CCP development. Because of the registered nurse’s educational preparation, professional practice standards, and licensure obligations, the essential contributions of professional nurses in CCP development are emphasized. Recommendations for evidence-based micro and macro level practice changes with the potential to improve the quality of CCP development and regulatory compliance are presented. Suggestions for future research are given.

  12. DEVELOPMENT OF AN INSPECTION PLATFORM AND A SUITE OF SENSORS FOR ASSESSING CORROSION AND MECHANICAL DAMAGE ON UNPIGGABLE TRANSMISSION MAINS

    Energy Technology Data Exchange (ETDEWEB)

    George C. Vradis; William Leary

    2004-03-01

    The National Energy Technology Laboratory of the US Department of Energy (under Award DE-FC26-02NT41645) and the NYSEARCH Committee of the Northeast Gas Association (previous the New York Gas Group), have sponsored research to develop a robotic pipeline inspection system capable of navigation through the typical physical and operational obstacles that make transmission and distribution pipelines unpiggable. The research contractors, Foster-Miller and GE Oil & Gas (PII North America) have performed an engineering study and developed a conceptual design that meets all the requirements for navigating and inspecting unpiggable transmission pipelines. Based on Foster-Miller's previous efforts developing the Pipe Mouse robot, the RoboScan inspection robot (Figure ES-1) meets the navigational and physical challenges of unpiggable pipelines through an innovative modular platform design, segmented MFL inspection modules and improvements to the inter-module coupling design.

  13. P-D Effects on the Reliability of Oil Offshore Jacket Platforms in Mexico

    Directory of Open Access Journals (Sweden)

    De León-Escobedo D.

    2012-07-01

    Full Text Available Given the important economic consequences of an oil platform failure, all the aspects of its structural behavior and safety issues need to be carefully considered. In particular, P-Δ effects on the deck legs of marine offshore jacket platforms may be relevant when the deck height and the vertical load are significant. In this paper, the impact of the moment amplification, due to slenderness of the deck legs, on the platform safety is examined and appraised from the viewpoint of the structural reliability. The formulation is applied to a typical tall deck marine platform under the environmental loading at the Bay of Campeche, Mexico, and its reliability index is calculated with and without the P-Δeffect. The results presented herein may be used to improve the current practice in the design and assessment of offshore marine platforms in Mexico and to update the current version of the code.

  14. A five-year assessment of the affordable care act: market forces still trump the common good in U.S. Health care.

    Science.gov (United States)

    Geyman, John P

    2015-01-01

    The Affordable Care Act (ACA) was enacted in 2010 as the signature domestic achievement of the Obama presidency. It was intended to contain costs and achieve near-universal access to affordable health care of improved quality. Now, five years later, it is time to assess its track record. This article compares the goals and claims of the ACA with its actual experience in the areas of access, costs, affordability, and quality of care. Based on the evidence, one has to conclude that containment of health care costs is nowhere in sight, that more than 37 million Americans will still be uninsured when the ACA is fully implemented in 2019, that many more millions will be underinsured, and that profiteering will still dominate the culture of U.S. health care. More fundamental reform will be needed. The country still needs to confront the challenge that our for-profit health insurance industry, together with enormous bureaucratic waste and widespread investor ownership throughout our market-based system, are themselves barriers to health care reform. Here we consider the lessons we can take away from the ACA's first five years and lay out the economic, social/political, and moral arguments for replacing it with single-payer national health insurance. PMID:25674797

  15. Establishing diagnostic platform for environmental biosafety assessment of genetically modified plants based on the decision-tree method

    OpenAIRE

    Lei Wang; Chao Yang; Bao-Rong Lu

    2010-01-01

    Transgenic biotechnology and its products provide important solutions for the great challenge of global food security. Biosafety assessment of genetically modified organisms (GMOs) including their food and environmental safety is a prerequisite for the commercialization and safe application of transgenic biotechnologyproducts. However, existing methodologies cannot meet the urgent requirements for rapid biosafety assessment of the increasing number of new and sophisticated GMOs. Therefore, a ...

  16. Focus group reflections on the current and future state of cognitive assessment tools in geriatric health care

    Directory of Open Access Journals (Sweden)

    Whitehead JC

    2015-06-01

    Full Text Available Jocelyne C Whitehead,1 Sara A Gambino,1 Jeffrey D Richter,2 Jennifer D Ryan1,3,41Rotman Research Institute, Baycrest, 2Independent Human Factors Consultant, Toronto, ON, Canada; 3Department of Psychology, 4Department of Psychiatry, University of Toronto, Toronto, ON, CanadaObjective: This study provides insight into the thoughts and opinions of geriatric health-care professionals toward cognitive assessments and the use of emerging technologies, such as eye-tracking, to supplement current tools.Methods: Two focus group sessions were conducted with nurses and physicians who routinely administer neurocognitive assessments to geriatric populations. Video recordings of the focus group sessions were transcribed and a thematic analysis was performed.Results: Participants reported the need for assessment and diagnostic tools that are accessible and efficient, and that are capable of accommodating the rapid growth in the aging population. The prevalence of more complex ailments experienced by older adults has had repercussions in the quality of care that the clients receive, and has contributed to lengthy wait times and resource shortages. Health-care professionals stated that they are hampered by the disjointed structure of the health-care system and that they would benefit from a more efficient allocation of responsibilities made possible through tools that did not require extensive training or certification. Eyetracking-based cognitive assessments were thought to strongly complement this system, yet it was thought that difficulty would be faced in gaining the support and increased uptake by health-care professionals due to the nonintuitive relationship between eyetracking and cognition.Conclusion: The findings suggest that health-care professionals are receptive to the use of eyetracking technology to assess for cognitive health as it would conserve resources by allowing frontline staff to administer assessments with minimal training

  17. Spiritual Assessment within Clinical Interventions Focused on Quality of Life Assessment in Palliative Care: A Secondary Analysis of a Systematic Review

    Directory of Open Access Journals (Sweden)

    Gianluca Catania

    2016-03-01

    Full Text Available One of the most crucial palliative care challenges is in determining how patients’ needs are defined and assessed. Although physical and psychological needs are commonly documented in patient’s charts, spiritual needs are less frequently reported. The aim of this review was to determine which explicit, longitudinal documentation of spiritual concerns would sufficiently affect clinical care to alleviate spiritual distress or promote spiritual wellbeing. A secondary analysis of a systematic review originally aimed at appraising the effectiveness of complex interventions focused on quality of life in palliative care was conducted. Five databases were searched for articles reporting interventions focused on QoL including at least two or more QoL dimensions. A narrative synthesis was performed to synthesize findings. In total, 10 studies were included. Only three studies included spiritual wellbeing assessment. Spirituality tools used to assess spiritual wellbeing were different between studies: Hospital QoL Index 14; Spiritual Needs Inventory; Missoula-Vitas QoL Index; and the Needs Assessment Tool: Progressive Disease-Cancer. Only one study reported a healthcare professional’s session training in the use of the QoL tool. Two out of three studies showed in participants an improvement in spiritual wellbeing, but changes in spiritual wellbeing scores were not significant. Overall patients receiving interventions focused on QoL assessment experienced both improvements in their QoL and in their spiritual needs. Although spiritual changes were not significant, the results provide evidence that a spiritual need exists and that spiritual care should be appropriately planned and delivered. Spiritual needs assessment precedes spiritual caring. It is essential that interventions focused on QoL assessment in palliative care include training on how to conduct a spiritual assessment and appropriate interventions to be offered to patients to address their

  18. Translation and validation of the Korean confusion assessment method for the intensive care unit

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    Han Sung

    2011-05-01

    Full Text Available Abstract Background Delirium is a common problem and associated with poor outcomes in intensive care unit (ICU patients. Diagnosis of delirium in ICU patients is limited and usually underdiagnosed by physicians. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU is one of the most widely used screening methods for detection of ICU delirium. Our goal was to translate and validate the CAM-ICU for use in the Korean ICU setting. Methods Translation of the CAM-ICU was done according to the guidelines suggested by the Translation and Cultural Adaptation Group. For validation and interrater reliability assessment of the Korean CAM-ICU, two nurses independently assessed delirium in ICU patients and the results were compared with the reference evaluation, which was done by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV. Results Twenty-two patients were evaluated by two nurses and one psychiatrist expert independently. During the study period, we have continuously educated study nurses. Based on DSM-IV criteria, 16 out of 22 (72.7% patients developed delirium. The sensitivities of the two nurses' evaluations using the Korean CAM-ICU were 89.80% for nurse 1 and 77.40% for nurse 2. Their specificities were 72.40% and 75.80% and their overall accuracy was 83.33% and 88.37% respectively. The Korean CAM-ICU was done with reasonable interrater reliability between nurse 1 and nurse 2 (κ = 0.81, p Conclusions The Korean CAM-ICU showed good validity and could be incorporated into clinical practice in Korean ICUs. Trial registration ISRCTN: ISRCTN50265663

  19. Applications of life cycle assessment and cost analysis in health care waste management

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Sebastiao Roberto, E-mail: soares@ens.ufsc.br [Department of Sanitary Engineering, Federal University of Santa Catarina, UFSC, Campus Universitario, Centro Tecnologico, Trindade, PO Box 476, Florianopolis, SC 88040-970 (Brazil); Finotti, Alexandra Rodrigues, E-mail: finotti@ens.ufsc.br [Department of Sanitary Engineering, Federal University of Santa Catarina, UFSC, Campus Universitario, Centro Tecnologico, Trindade, PO Box 476, Florianopolis, SC 88040-970 (Brazil); Prudencio da Silva, Vamilson, E-mail: vamilson@epagri.sc.gov.br [Department of Sanitary Engineering, Federal University of Santa Catarina, UFSC, Campus Universitario, Centro Tecnologico, Trindade, PO Box 476, Florianopolis, SC 88040-970 (Brazil); EPAGRI, Rod. Admar Gonzaga 1347, Itacorubi, Florianopolis, Santa Catarina 88034-901 (Brazil); Alvarenga, Rodrigo A.F., E-mail: alvarenga.raf@gmail.com [Department of Sanitary Engineering, Federal University of Santa Catarina, UFSC, Campus Universitario, Centro Tecnologico, Trindade, PO Box 476, Florianopolis, SC 88040-970 (Brazil); Ghent University, Department of Sustainable Organic Chemistry and Technology, Coupure Links 653/9000 Gent (Belgium)

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer Three Health Care Waste (HCW) scenarios were assessed through environmental and cost analysis. Black-Right-Pointing-Pointer HCW treatment using microwave oven had the lowest environmental impacts and costs in comparison with autoclave and lime. Black-Right-Pointing-Pointer Lime had the worst environmental and economic results for HCW treatment, in comparison with autoclave and microwave. - Abstract: The establishment of rules to manage Health Care Waste (HCW) is a challenge for the public sector. Regulatory agencies must ensure the safety of waste management alternatives for two very different profiles of generators: (1) hospitals, which concentrate the production of HCW and (2) small establishments, such as clinics, pharmacies and other sources, that generate dispersed quantities of HCW and are scattered throughout the city. To assist in developing sector regulations for the small generators, we evaluated three management scenarios using decision-making tools. They consisted of a disinfection technique (microwave, autoclave and lime) followed by landfilling, where transportation was also included. The microwave, autoclave and lime techniques were tested at the laboratory to establish the operating parameters to ensure their efficiency in disinfection. Using a life cycle assessment (LCA) and cost analysis, the decision-making tools aimed to determine the technique with the best environmental performance. This consisted of evaluating the eco-efficiency of each scenario. Based on the life cycle assessment, microwaving had the lowest environmental impact (12.64 Pt) followed by autoclaving (48.46 Pt). The cost analyses indicated values of US$ 0.12 kg{sup -1} for the waste treated with microwaves, US$ 1.10 kg{sup -1} for the waste treated by the autoclave and US$ 1.53 kg{sup -1} for the waste treated with lime. The microwave disinfection presented the best eco-efficiency performance among those studied and provided a feasible

  20. Applications of life cycle assessment and cost analysis in health care waste management

    International Nuclear Information System (INIS)

    Highlights: ► Three Health Care Waste (HCW) scenarios were assessed through environmental and cost analysis. ► HCW treatment using microwave oven had the lowest environmental impacts and costs in comparison with autoclave and lime. ► Lime had the worst environmental and economic results for HCW treatment, in comparison with autoclave and microwave. - Abstract: The establishment of rules to manage Health Care Waste (HCW) is a challenge for the public sector. Regulatory agencies must ensure the safety of waste management alternatives for two very different profiles of generators: (1) hospitals, which concentrate the production of HCW and (2) small establishments, such as clinics, pharmacies and other sources, that generate dispersed quantities of HCW and are scattered throughout the city. To assist in developing sector regulations for the small generators, we evaluated three management scenarios using decision-making tools. They consisted of a disinfection technique (microwave, autoclave and lime) followed by landfilling, where transportation was also included. The microwave, autoclave and lime techniques were tested at the laboratory to establish the operating parameters to ensure their efficiency in disinfection. Using a life cycle assessment (LCA) and cost analysis, the decision-making tools aimed to determine the technique with the best environmental performance. This consisted of evaluating the eco-efficiency of each scenario. Based on the life cycle assessment, microwaving had the lowest environmental impact (12.64 Pt) followed by autoclaving (48.46 Pt). The cost analyses indicated values of US$ 0.12 kg−1 for the waste treated with microwaves, US$ 1.10 kg−1 for the waste treated by the autoclave and US$ 1.53 kg−1 for the waste treated with lime. The microwave disinfection presented the best eco-efficiency performance among those studied and provided a feasible alternative to subsidize the formulation of the policy for small generators of HCW.

  1. Assessing the Extent of Adherence to the Recommended Antenatal Care Content in Malaysia: Room for Improvement.

    Directory of Open Access Journals (Sweden)

    Ping Ling Yeoh

    Full Text Available Recent papers on monitoring of health services affirmed that while antenatal care (ANC is an effective measure, quality is still a problem. Quality in maternal services "…involves providing a minimum level of care to all pregnant women…" Yet adherence to a minimum level of recommended ANC content appears to be unmet. Comprehensive review of ANC content rendered in environments with rapid changes in demographic, socio-economic, lifestyle and morbidity was sparse. Malaysia is such a country that has undergone these transitions with tremendous progress in health. However, recent progress in pregnancy outcomes is stagnating. This study aims to analyse adherence to recommended ANC; specifically, to examine the extent of adherence to recommended ANC content and to determine the factors influencing ANC content score.A retrospective cohort study of 522 randomly selected women who used ANC was conducted. Data were extracted from individual records. The study examined adherence to essential ANC guidelines using weighted scoring for physical examination, health screening, case management, and health education. GLM Univariate analysis procedure was used to determine the factors associated with ANC content score. Binary logistic regression was used to assess ANC content level and pregnancy outcomes, controlled for ANC utilisation.Around half of the women had <80% of recommended ANC content documented. Health education had the lowest mean score, at around 35%. The low-risk pregnancies had a higher ANC content score than the high-risk pregnancies (78% vs. 75%; P = 0.002. The smallest clinics had a higher ANC content score than the bigger clinics (78% vs. 74-76%; P<0.001. ANC content score among the women with "adequate" ANC utilisation, as defined by the modified Adequacy of Prenatal Care Utilisation Index, was lower than the women with "adequate-plus" ANC utilisation (75% vs. 78%, P<0.001. Assessment of symphysis-fundal height, foetal presentation and

  2. Orthopaedic surgeries - assessment of ionising radiations exposure in health care workers

    International Nuclear Information System (INIS)

    Full text of publication follows: 1. Objectives: The health care workers are exposed to ionizing radiations during their activities. In the operating rooms, the ionizing radiations are used in orthopaedic surgery and the dose depends on some factors, like the characteristics of the equipment. This study aims to: Estimate the occupational dose of ionizing radiations exposure of the orthopaedic doctors and nurses during the orthopaedic surgeries, in a Portuguese operating room; Sensitize the health care workers to use the individual dosimeter and to adopt radiation preventive measures. 2. Population and methods The study was conducted on nine Orthopaedic doctors and two nurses of an operating room of a hospital in Lisbon neighborhoods. We made a risk evaluating concerning: the radiations dose in different points, corresponding to gonads, hands and crystalline lens levels of all the professionals, during the surgeries; the average period of radiation in the orthopaedic surgeries; the number of annual orthopaedic surgeries, looking for that in the surgeries registers, to estimate the annual ionizing radiations dose of each orthopaedic doctor and nurse. 3. Results The annual doses estimated at different levels for orthopaedic doctors were the following: gonads: between 20,63 and 68,75 mGy; hands: 4,95 16,50 mGy; crystalline lens: 8,25 27,50 mGy). For the orthopaedic nurses: gonads: 130,63 151,25 mGy; hands: 31,35 36,30 mGy; crystalline lens 52,25 60,25 mGy. 4. Conclusions Although the location and positions of health care workers are not the same during the different surgeries and the equipment has an automatic control of the X ray emission, the annual ionizing radiations dose exposure for health care workers is an important one. The risk rating justifies the use of individual dosimeters for better individual dose assessment as part of an ionizing radiations prevention program. As a matter of fact preventive measures begin with a good quantitative risk assessment of

  3. Orthopaedic surgeries - assessment of ionising radiations exposure in health care workers

    Energy Technology Data Exchange (ETDEWEB)

    Leite, E.S.; Uva, A.S. [Lisbon Univ., National School of Public Health/New (Portugal)

    2006-07-01

    Full text of publication follows: 1. Objectives: The health care workers are exposed to ionizing radiations during their activities. In the operating rooms, the ionizing radiations are used in orthopaedic surgery and the dose depends on some factors, like the characteristics of the equipment. This study aims to: Estimate the occupational dose of ionizing radiations exposure of the orthopaedic doctors and nurses during the orthopaedic surgeries, in a Portuguese operating room; Sensitize the health care workers to use the individual dosimeter and to adopt radiation preventive measures. 2. Population and methods The study was conducted on nine Orthopaedic doctors and two nurses of an operating room of a hospital in Lisbon neighborhoods. We made a risk evaluating concerning: the radiations dose in different points, corresponding to gonads, hands and crystalline lens levels of all the professionals, during the surgeries; the average period of radiation in the orthopaedic surgeries; the number of annual orthopaedic surgeries, looking for that in the surgeries registers, to estimate the annual ionizing radiations dose of each orthopaedic doctor and nurse. 3. Results The annual doses estimated at different levels for orthopaedic doctors were the following: gonads: between 20,63 and 68,75 mGy; hands: 4,95 16,50 mGy; crystalline lens: 8,25 27,50 mGy). For the orthopaedic nurses: gonads: 130,63 151,25 mGy; hands: 31,35 36,30 mGy; crystalline lens 52,25 60,25 mGy. 4. Conclusions Although the location and positions of health care workers are not the same during the different surgeries and the equipment has an automatic control of the X ray emission, the annual ionizing radiations dose exposure for health care workers is an important one. The risk rating justifies the use of individual dosimeters for better individual dose assessment as part of an ionizing radiations prevention program. As a matter of fact preventive measures begin with a good quantitative risk assessment of

  4. ITS Platform

    DEFF Research Database (Denmark)

    Tøfting, Svend; Lahrmann, Harry; Agerholm, Niels;

    2014-01-01

    Aalborg University and two local companies have over the past four years developed and tested an ITS Platform, which can be used for communication with cars and for providing a number of services to the drivers. The purpose has been to perform a technological test of the possible use of a hidden...... GPS box with data connection to a backend server. The ITS Platform project has had a budget of DKK 33 million (app € 4.4) and it has demonstrated that boxes which register the position of the cars can be helpful to drivers in many ways. Establishing dynamic traffic information and support systems for...... safer and more economic driving is technologically possible. Big Data from the system can provide traffic authorities with a better basis for decision for their traffic planning. Last, but not least, it is possible to establish payment systems. The project has also shown that the boxes in the cars do...

  5. Measuring the quality of patient-centered care: why patient-reported measures are critical to reliable assessment

    Directory of Open Access Journals (Sweden)

    Tzelepis F

    2015-06-01

    Full Text Available Flora Tzelepis, Robert W Sanson-Fisher, Alison C Zucca, Elizabeth A FradgleyPriority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, AustraliaPurpose: The Institute of Medicine (IOM identified patient-centeredness as crucial to quality health care. The IOM endorsed six patient-centeredness dimensions that stipulated that care must be: respectful to patients’ values, preferences, and expressed needs; coordinated and integrated; provide information, communication, and education; ensure physical comfort; provide emotional support; and involve family and friends. Patient-reported measures examine the patient’s perspective and are essential to the accurate assessment of patient-centered care. This article’s objectives are to: 1 use the six IOM-endorsed patient-centeredness dimensions as a framework to outline why patient-reported measures are crucial to the reliable measurement of patient-centered care; and 2 to identify existing patient-reported measures that assess each patient-centered care dimension.Methods: For each IOM-endorsed patient-centeredness dimension, the published literature was searched to highlight the essential role of patients in assessing patient-centered care and informing quality improvement efforts. Existing literature was also searched to identify examples of patient-reported measures that assess each patient-centeredness dimension.Conclusion: Patient-reported measures are arguably the best way to measure patient-centeredness. For instance, patients are best positioned to determine whether care aligns with patient values, preferences, and needs and the Measure of Patient Preferences is an example of a patient-reported measure that does so. Furthermore, only the patient knows whether they received the level of information desired, and if information was understood and can be recalled. Patient-reported measures that examine information provision include

  6. Assessing screening practices among health care workers at a tertiary-care hospital in Sao Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Ana Claudia Gonçalves-Silva

    2010-01-01

    Full Text Available OBJECTIVE: To ascertain the extent to which screening procedures (with and without evidence of effectiveness are practiced among health care workers at a tertiary-care hospital in Sao Paulo, Brazil. METHODS: From February 2001 to September 2003, a cross-sectional study involving physicians, nurses and nursing assistants (aged 40 to 69 years was carried out at a tertiary-care hospital in the city of Sao Paulo, Brazil. Subjects were interviewed using a questionnaire that addresses 17 procedures with grades of recommendation of A, B, C, D or E, in accordance with the 1996 United States Preventive Services Task Force guidelines for routine screening. RESULTS: Of the 333 health care workers included, 228 (68.5% were female. The mean age was 48.8 (SD 6.6 years. Most subjects had undergone screening for hypertension (blood pressure measurement and lipid abnormalities (cholesterol testing. Screening for breast and cervical cancer was common among females. Resting electrocardiography, serum glucose testing, urine tests, chest X-rays and serum prostate-specific antigen testing were also quite common. However, only 6 (1.8% of the subjects had undergone screening for colorectal cancer (fecal occult blood test or sigmoidoscopy. CONCLUSIONS: A sizeable proportion of health care workers underwent screening procedures that are not recommended or for which there was insufficient evidence of a benefit. Conversely, certain recommended procedures were performed on a small proportion of such workers. These results indicate that the Brazilian National Ministry of Health must develop nationwide evidence-based screening recommendations and disseminate such recommendations among health care professionals in Brazil.

  7. Assessing coverage, equity and quality gaps in maternal and neonatal care in sub-saharan Africa: an integrated approach.

    Directory of Open Access Journals (Sweden)

    Calistus Wilunda

    Full Text Available Gaps in coverage, equity and quality of health services hinder the achievement of the Millennium Development Goals 4 and 5 in most countries of sub-Saharan Africa as well as in other high-burden countries, yet few studies attempt to assess all these dimensions as part of the situation analysis. We present the base-line data of a project aimed at simultaneously addressing coverage, equity and quality issues in maternal and neonatal health care in five districts belonging to three African countries.Data were collected in cross-sectional studies with three types of tools. Coverage was assessed in three hospitals and 19 health centres (HCs utilising emergency obstetric and newborn care needs assessment tools developed by the Averting Maternal Death and Disability program. Emergency obstetrics care (EmOC indicators were calculated. Equity was assessed in three hospitals and 13 HCs by means of proxy wealth indices and women delivering in health facilities were compared with those in the general population to identify inequities. Quality was assessed in three hospitals using the World Health Organization's maternal and neonatal quality of hospital care assessment tool which evaluates the whole range of aspects of obstetric and neonatal care and produces an average score for each main area of care.All the three hospitals qualified as comprehensive EmOC facilities but none of the HCs qualified for basic EmOC. None of the districts met the minimum requisites for EmOC indicators. In two out of three hospitals, there were major quality gaps which were generally greater in neonatal care, management of emergency and complicated cases and monitoring. Higher access to care was coupled by low quality and good quality by very low access. Stark inequities in utilisation of institutional delivery care were present in all districts and across all health facilities, especially at hospital level.Our findings confirm the existence of serious issues regarding coverage

  8. The Professional Nurse Self-Assessment Scale: Psychometric testing in Norwegian long term and home care contexts

    OpenAIRE

    Finnbakk, Elisabeth; Wangensteen, Sigrid; Skovdahl, Kirsti; Fagerström, Lisbeth

    2015-01-01

    Background Nurses’ clinical competence is vital to ensure safe and high quality care, and the continuous assessment of nurses’ clinical competence is of major concern. A validated instrument for the self-assessment of nurses’ clinical competence at different educational levels across specialties and countries is lacking. The aim of this study was to test the reliability and construct validity of the new Professional Nurse Self-Assessment Scale (ProffNurse SAS) questionnaire in long term and h...

  9. An integrated assessment of the catchment-scale energy and water balance using a terrestrial systems modeling platform and observations

    Science.gov (United States)

    Sulis, Mauro; Shrestha, Prabhakar; Keune, Jessica; Steinke, Sandra; Diederich, Malte; Schween, Jan; Crewell, Susanne; Simmer, Clemens; Kollet, Stefan

    2016-04-01

    Fully coupled hydrological models close the water and energy cycles while accounting for the dynamic feedbacks between the subsurface, land surface, and atmosphere compartments of terrestrial systems. Diagnoses of their predictive capabilities require spatio-temporal coherent data sets including states and fluxes across the soil-vegetation-atmosphere continuum. This study presents an extensive comparison between numerical simulations carried out using a novel integrated hydrological modeling platform (TerrSysMP) and a suite of cross-compartmental observations obtained from intensive field campaigns and continuous monitoring over the Rur catchment in western Germany during the HOPE experiment (April-May 2013). The observations encompass amongst others rainfall estimates from several X-band radars, atmospheric integrated water vapor estimates from microwave radiometers, radiation and turbulent fluxes at the land surface, and soil moisture retrieval from cosmic-ray probes. A detailed analysis of the radiation components indicates that TerrSysMP systematically overestimates incoming shortwave due to a cloudiness effect, but underestimates incoming longwave due to a lower simulated atmospheric water vapor content. Screening of observed and simulated data for clear sky conditions also reveals mismatches between surface albedo at certain locations within the catchment. Moreover, a preliminary cross-comparison of precipitation and soil moisture suggests that overall the model is able to reproduce catchment dynamics reasonably well while pronounced discrepancies between model and observations were observed in the mountainous region due to the lack of detailed soil parameterization (i.e., soil organic content) and the underestimation of some rainfall events.

  10. Relationship between cognitive impairment and nutritional assessment on functional status in Calabrian long-term-care

    Directory of Open Access Journals (Sweden)

    Malara A

    2014-01-01

    Full Text Available Alba Malara, Giovanni Sgrò, Chiara Caruso, Francesco Ceravolo, Giuseppe Curinga, Grazia Francesca Renda, Fausto Spadea, Michele Garo, Vincenzo RispoliScientific Committee of the National Association of Third Age Structures (ANASTE Calabria, ItalyObjective: The interaction between dementia and nutritional state is very complex and not yet fully understood. The aim of the present study was to assess the interaction between cognitive impairment and nutritional state in a cohort of residential elderly in relationship with functional condition of patients and their load of assistance in long-term-care facilities of the National Association of Third Age Structures (ANASTE Calabria.Methods: One hundred seventy-four subjects (122 female and 52 male were admitted to the long-term-care ANASTE Calabria study. All patients underwent multidimensional geriatric assessment. Nutritional state was assessed with the Mini Nutritional Assessment (MNA, whereas cognitive performance was evaluated by the Mini-Mental State Examination (MMSE. The functional state was assessed by Barthel Index (BI and Activity Daily Living (ADL. The following nutritional biochemical parameters were also evaluated: albumin, cholesterol, iron, and hemoglobin. All patients were reassessed 180 days later.Results: A severe cognitive impairment in MMSE performance was displayed in 49.7% patients, while 39.8% showed a moderate deficit; 6.9% had a slight deficit; and 3.4% evidenced no cognitive impairment. In MNA, 30% of patients exhibited an impairment of nutritional state; 56% were at risk of malnutrition; and 14% showed no nutritional problems. Malnutrition was present in 42% of patients with severe cognitive impairment, but only 4% of malnourished patients showed moderate cognitive deficit. The statistical analysis displayed a significant correlation between MNA and MMSE (P<0.001, as did MMSE correlated with Activity Daily Living (P<0.001 and BI (P<0.05. MNA correlated with BI (P<0.001 and

  11. Construction of a Questionnaire to Assess Parental Stress in Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    haydeh heidari

    2015-09-01

    Full Text Available Background: Once an infant is hospitalized in the Neonatal Intensive Care Unit (NICU, the entire family dynamics is disrupted due to stressors such as interruption in maternal-infant bonding, abandonment of other siblings and financial burdens. Combination of multiple stressors often ends in divorce or other devastating results. In this study, a novel survey questionnaire has been developed to assess the level of parental stress in NICU and identify the warning signs, in order to provide assistance to young couples in need of help. Methods: Qualitative content analysis was performed to survey 13couplesrecruited from various teaching hospitals in Isfahan, Iran. Results: The initial part of the questionnaire was designed to assess parents’ stress level with an expected content validity index of 0.78 or above and to measure face validity of the questionnaire, all the items received a mean impact score of 1.5 or above, and the Cronbach’s alpha reliability of the 12-item questionnaire equaled to 0.904.Based on the factor analysis, the items with a correlation coefficient of less than 0.4 were excluded (one item was omitted. Conclusion: Most survey questionnaires found in the existing literature have investigated the types of stressors experienced by parents with an infant in NICU. In this study, researchers offer a novel 11-item questionnaire designed to assess the level of stress among parents with a hospitalized infant in NICU.

  12. Acute medical assessment units: an efficient alternative to in-hospital acute medical care.

    LENUS (Irish Health Repository)

    Watts, M

    2011-02-01

    Acute Medical Assessment Units (AMAUs) are being proposed as an alternative to congested Emergency Departments (EDs for the assessment of patients with a range of acute medical problems. We retrospectively reviewed the discharge destination of patients referred to a newly established AMAU during a six-month period. During the same period we contrasted activity in the ED for a similar group of patients. 1,562 patients were assessed in the AMAU. 196 (12.5%) were admitted to an in-patient bed and 1,148 (73.5%) were entered into specific diagnosis-driven out-patient pathways. 1,465 patients attended the ED and 635 (43.3%) were admitted. Out-patient alternatives to expensive in-patient care need to be provided at the \\'coal face" of acute referral. The AMAU provides this, and as a consequence admission rates are relatively low. This is achieved by directly communicating with GPs, accessing senior clinical decision makers, and providing immediate access to diagnostically driven outpatient pathways.

  13. Assessment of food, nutrition, and physical activity practices in Oklahoma child-care centers.

    Science.gov (United States)

    Sisson, Susan B; Campbell, Janis E; May, Kellie B; Brittain, Danielle R; Monroe, Lisa A; Guss, Shannon H; Ladner, Jennifer L

    2012-08-01

    The purpose of the current study was to determine the obesogenic practices in all-day child-care centers caring for preschool-aged children. This study used a cross-sectional, self-reported survey mailed to centers across Oklahoma (n=314). Frequency of responses and χ(2) were calculated comparing region and star rating. Items where the majority of centers frequently report best practices include: daily fruits served (76%), daily nonfried vegetables served (71%), rarely/never served sugary drinks (92%), rarely/never used food to encourage good behaviors (88%), staff join children at table most of the time (81%), staff rarely eat different foods in view of children (69%), visible self-serve or request availability of water (93%), regular informal communication about healthy eating (86%), opportunities for outdoor play (95%), not withholding activity for punishment (91%), accessible play equipment (59% to 80% for different types of equipment), and minimization of extended sitting time (78%). Practices where centers can improve include increasing variety of vegetables (18%), reducing frequency of high-fat meats served (74% serve more than once per week), increasing high-fiber and whole-grain foods (35% offer daily), serving style of "seconds" (28% help kids determine whether they are still hungry), nonfood holiday celebrations (44% use nonfood treats), having toys and books that encourage healthy eating (27%) and physical activity (25%) in all rooms in the center, a standard nutrition (21%) and physical education (50%) curriculum, and following a written physical activity policy (43%). Practitioners can use these data to develop benchmarks and interventions, as this was the first study to assess statewide obesogenic practices in child care. PMID:22818731

  14. Assessment of hand hygiene compliance after hand hygiene education among health care workers in Cambodia.

    Science.gov (United States)

    Sansam, Sim; Yamamoto, Eiko; Srun, Sok; Sinath, Yin; Moniborin, Mey; Bun Sim, Kheang; Reyer, Joshua A; Yoshida, Yoshitoku; Hamajima, Nobuyuki

    2016-05-01

    Health care-associated infection (HCAI) is the most frequent adverse event for hospitalized patients. Hand hygiene is a simple and effective solution to protect patients from HCAI. This study aimed to introduce hand hygiene to health care workers based on the World Health Organization guideline for reducing HCAI in Cambodia and to assess their behavioral patterns on hand hygiene. All health care workers at Kampong Cham provincial hospital had lectures and practice on hand hygiene in January 2012. The surveys for hand hygiene compliance (HHC) were performed after 6 months, 1 year and 2 years, respectively. The number of surgical site infections (SSI) was counted in 2011 and 2014. Our analysis used the data of 58 workers, who were observed at all three points, although 139 workers were observed during the study period. The average of HHC at 6 months, 1 year and 2 years were 62.37%, 85.76% and 80.36%, respectively. The improved group (HHC 2 years/1 year≧1) had 32 workers, whereas the worsened group (HHC 2 years/1 yearsex, age or occupations. The improved group had more workers of General (31.2% vs. 19.2%), Surgical (25.0% vs. 11.5%) and Infection (21.9% vs. 11.5%) categories compared to the worsened group. The incidence of SSI was improved from 32.26% in 2011 to 0.97% in 2014. Our results suggest that the education and the survey on hand hygiene are effective for reducing HCAI in Cambodia. PMID:27303102

  15. Implementation of TeleCare services: benefit assessment and organisational models.

    Science.gov (United States)

    Stroetmann, Karl A; Stroetmann, Veli N; Westerteicher, Chris

    2003-01-01

    All industrial societies are ageing. This has profound socio-economic and health sector implications. Innovative services based on Information Society Technologies (IST), like telehomecare are regarded as promising avenues to follow both to allow (national) health systems to cope with these challenges and to improve the quality of life of chronically ill and frail older citizens. The aim of the TEN-HMS project is to convincingly prove that telemonitoring of congestive heart failure (CHF) patients at home can improve medical outcome for these patients as well as their quality of life and the efficiency of healthcare delivery processes. But this will not (yet) be enough for the sustained success of such a service. Unless it takes into account the interests of the various players in the health care arena and a long-term Business Case can be proven, it will be very difficult to integrate such services into routine health care delivery processes. Before developing concrete delivery models for such a telemonitoring service, the "players" directly involved in such a service need to be identified--customers/patients, health services providers, IT services suppliers, and public/private insurance funds as payers--and their assessment perspectives considered. Then four concrete telemonitoring delivery models and their probability of success are discussed. Our analysis suggests that telemonitoring will presently only be successful if the service delivery model applied reflects national health system idiosyncrasies, takes into account established organisational boundaries and adapts to patient quality of life and health professional preferences. In the longer term, the new paradigm of seamless, patient-centred care will, however, require new, more efficient service delivery models integrating all aspects of the health services value chain. PMID:15537237

  16. Assessment of surfactant use in preterm infants as a marker of neonatal intensive care unit quality

    Directory of Open Access Journals (Sweden)

    Lorch Scott A

    2011-01-01

    Full Text Available Abstract Background Proposed neonatal quality measures have included structural measures such as average daily census, and outcome measures such as mortality and rates of complications of prematurity. However, process measures have remained largely unexamined. The objective of this research was to examine variation in surfactant use as a possible process measure of neonatal quality. Methods We obtained data on infants 30 to 34 weeks gestation admitted with respiratory distress syndrome (RDS within 48 hours of birth to 16 hospitals participating in the Pediatric Health Information Systems database from 2001-2006. Models were developed to describe hospital variation in surfactant use and identify patient and hospital predictors of use. Another cohort of all infants admitted within 24 hours of birth was used to obtain adjusted neonatal intensive care unit (NICU mortality rates. To assess the construct validity of surfactant use as a quality metric, adjusted hospital rates of mortality and surfactant use were compared using Kendall's tau. Results Of 3,633 infants, 46% received surfactant. For individual hospitals, the adjusted odds of surfactant use varied from 2.2 times greater to 5.9 times less than the hospital with the median adjusted odds of surfactant use. Increased annual admissions of extremely low birth weight infants to the NICU were associated with greater surfactant use (OR 1.80, 95% CI 1.02-3.19. The correlation between adjusted hospital rates of surfactant use and in-hospital mortality was 0.37 (Kendall's tau p = 0.051. Conclusions Though results were encouraging, efforts to examine surfactant use in infants with RDS as a process measure reflecting quality of care revealed significant challenges. Difficulties related to adequate measurement including defining RDS using administrative data, accounting for care received prior to transfer, and adjusting for severity of illness will need to be addressed to improve the utility of this

  17. Workshop: health technology assessment of integrated home care for frial elder somatic patients

    Science.gov (United States)

    Larsen, Torben; Santana, Silvina

    2012-01-01

    Background The fragmented delivery of healthcare and social services as advanced by WHO 2002. Objectives This project of international collaboration assesses integrated home care (IHC) for frail elder somatic patients as compared to usual hospital care. Methods The HTA follows the special application for Tele-medicine (MAST). An introductory literature review identified stroke, heart failure (HF) and COPD as prototypes of IHC. Pre-existing evidence has been complemented by additional trials and surveys. Results 1. Definition/organization of IHC: Is carried out by a multidisciplinary team visiting the home Considers effectiveness, quality, access and user satisfaction in an economic way and uses Tele-facilities as far as they serve these goals Has finance across organizational settings. 2. Clinical effectiveness of IHC for moderately disabled patients by 6–12 months follow-up: Stroke: In 14 randomized trials (n=2139) intervention patients were by meta-analysis significantly less likely (p=0.001) to be dead or dependent compared with conventional care. HF: 2 RCT (n=386) demonstrate each a significant reduction of all-cause readmissions (p=0.003 and p=0.001). COPD: 5 studies (2 RCT, 2 cohorts and 1 CT) (n=1249) demonstrate each a significant reduction in readmissions/total admission days (p<0.05). 3. Health economic evaluation: For each selected condition the first year benefit surmounts the costs of intervention using the Dutch Standardization by Oostenbrink as a common price catalogue across resources/trials/countries. 4. Patient satisfaction: Focus group interviews confirm literature findings of very good satisfaction by IHC both among patients/carers and health professionals. Discussion Calculated net savings of 1450€ per patient in IHC are not supposed to materialize in ‘cool’- cash but enables local negotiation of adapted solutions with a minimum of national legislation/finance (Meso-strategy of dissemination). Implications IHC is an approach to clinical

  18. Assessing the HIV Care Continuum in Latin America: progress in clinical retention, cART use and viral suppression

    OpenAIRE

    Rebeiro, Peter F.; Carina Cesar; Shepherd, Bryan E.; Raquel B De Boni; Cortés, Claudia P.; Fernanda Rodriguez; Pablo Belaunzarán-Zamudio; Pape, Jean W; Denis Padgett; Daniel Hoces; McGowan, Catherine C; Pedro Cahn

    2016-01-01

    Introduction: We assessed trends in HIV Care Continuum outcomes associated with delayed disease progression and reduced transmission within a large Latin American cohort over a decade: clinical retention, combination antiretroviral therapy (cART) use and viral suppression (VS). Methods: Adults from Caribbean, Central and South America network for HIV epidemiology clinical cohorts in seven countries contributed data between 2003 and 2012. Retention was defined as two or more HIV care visits an...

  19. Assessment of oral self-care in patients with periodontitis: a pilot study in a dental school clinic in Japan

    OpenAIRE

    Masuda Hitomi; Hayakawa Hiroki; Matsumoto Shinya; Ueshima Fumie; Kikuchi Momomi; Saito Atsushi; Makiishi Takemi

    2009-01-01

    Abstract Background Oral hygiene education is central to every stage of periodontal treatment. Successful management of periodontal disease depends on the patient's capacity for oral self-care. In the present study, the oral self-care and perceptions of patients attending a dental school clinic in Japan were assessed using a short questionnaire referring to existing oral health models. Methods A cross-sectional study design was used. The study population consisted of sixty-five patients (age ...

  20. Construct validity of the Chelsea critical care physical assessment tool: an observational study of recovery from critical illness

    OpenAIRE

    Corner, Evelyn J; Soni, Neil; Handy, Jonathan M.; Stephen J Brett

    2014-01-01

    Introduction Intensive care unit-acquired weakness (ICU-AW) is common in survivors of critical illness, resulting in global weakness and functional deficit. Although ICU-AW is well described subjectively in the literature, the value of objective measures has yet to be established. This project aimed to evaluate the construct validity of the Chelsea Critical Care Physical Assessment tool (CPAx) by analyzing the association between CPAx scores and hospital-discharge location, as a measure of fu...

  1. Assessing predictors of delayed antenatal care visits in Rwanda: a secondary analysis of Rwanda demographic and health survey 2010

    OpenAIRE

    Manzi, Anatole; Munyaneza, Fabien; Mujawase, Francisca; Banamwana, Leonidas; Sayinzoga, Felix; Thomson, Dana R; Ntaganira, Joseph; Hedt-Gauthier, Bethany L

    2014-01-01

    Background Early initiation of antenatal care (ANC) can reduce common maternal complications and maternal and perinatal mortality. Though Rwanda demonstrated a remarkable decline in maternal mortality and 98% of Rwandan women receive antenatal care from a skilled provider, only 38% of women have an ANC visit in their first three months of pregnancy. This study assessed factors associated with delayed ANC in Rwanda. Methods This is a cross-sectional study using data collected during the 2010 R...

  2. Assessing predictors of delayed antenatal care visits in Rwanda: a secondary analysis of Rwanda demographic and health survey 2010

    OpenAIRE

    Manzi, Anatole; Munyaneza, Fabien; Mujawase, Francisca; Banamwana, Leonidas; Sayinzoga, Felix; Thomson, Dana R; Ntaganira, Joseph; Hedt-Gauthier, Bethany L

    2014-01-01

    Background: Early initiation of antenatal care (ANC) can reduce common maternal complications and maternal and perinatal mortality. Though Rwanda demonstrated a remarkable decline in maternal mortality and 98% of Rwandan women receive antenatal care from a skilled provider, only 38% of women have an ANC visit in their first three months of pregnancy. This study assessed factors associated with delayed ANC in Rwanda. Methods: This is a cross-sectional study using data collected during the 2010...

  3. Cost-effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery

    OpenAIRE

    Khan, Ashiya; Amitava, Abadan Khan; Rizvi, Syed Ali Raza; Siddiqui, Ziya; Kumari, Namita; Grover, Shivani

    2015-01-01

    Context: Cost-effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery. Aims: To compare the cost effectiveness of phacoemulsification (PE) versus manual small-incision cataract surgery (MSICS). Settings and Design: Prospective randomized controlled trial. Tertiary care hospital setting. Subjects and Methods: A total of 52 consenting patients with age-related cataracts, were prospectively recruited, and block r...

  4. Cost-effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery

    OpenAIRE

    Ashiya Khan; Abadan Khan Amitava; Syed Ali Raza Rizvi; Ziya Siddiqui; Namita Kumari; Shivani Grover

    2015-01-01

    Context : Cost-effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery. Aims: To compare the cost effectiveness of phacoemulsification (PE) versus manual small-incision cataract surgery (MSICS). Settings and Design: Prospective randomized controlled trial. Tertiary care hospital setting. Subjects and Methods: A total of 52 consenting patients with age-related cataracts, were prospectively recruited, and block ...

  5. A comprehensive approach to assess Arabidopsis survival phenotype in water-limited condition using a non-invasive high-throughput phenomics platform

    Directory of Open Access Journals (Sweden)

    Emilio eVello

    2015-12-01

    Full Text Available With the rapid rise in global population and the challenges caused by climate changes, the maximization of plant productivity and the development of sustainable agriculture strategies are vital for food security. One of the resources more affected in this new environment will be the limitation of water.In this study, we describe the use of non-invasive technologies exploiting sensors for visible, fluorescent and near-infrared lights to accurately screen survival phenotypes in Arabidopsis thaliana exposed to water-limited conditions. We implemented two drought protocols and a robust analysis methodology that enabled us to clearly assess the wilting or dryness status of the plants at different time points using a phenomics platform. In conclusion, our approach has shown to be very accurate and suitable for experiments where hundred of samples have to be screened making a manual evaluation unthinkable. This approach can be used not only in functional genomics studies but also in agricultural applications.

  6. Local prioritisation work in health care--assessment of an implementation process.

    Science.gov (United States)

    Waldau, Susanne

    2007-05-01

    Political, horizontal prioritisation requires knowledge on local health care resource use on unit or patient group level. This in turn requires unit level structures (meeting forums) and processes for creation of knowledge and continuous, open decision-making on prioritisation. Ideally, for decisions to be legitimate, such procedures should meet the "Accountability for reasonableness"-criteria of Daniels and Sabin [Daniels N. Accountability for reasonableness. Establishing a fair process for priority setting is easier than agreeing on principles. British Medical Journal 2000;321:1300-1]. A strategy, aiming at shaping such an organisational culture, was developed and set to work within a regional health care organisation, responsible for around 250000 inhabitants. This pilot study regarding topic and methodology assesses the changes of knowledge in open prioritisation as well as structures, processes for and results of such work on unit level in that organisation 1998 through early 2005. Initial interviews and two consecutive surveys were analysed. Results indicate that only early adopters respond to the surveys and among them a growing knowledge in priority setting, acceptance of personal leadership for local priority setting work and recognition of a need for adequate structures and processes. Among respondents, one could note a development: A tentative model expressing different positions towards prioritisation was developed. PMID:16824642

  7. Assessment of the Efficiency of Tobacco Cessation Counseling in Primary Care.

    Science.gov (United States)

    El-Shahawy, Omar; Shires, Deirdre A; Elston Lafata, Jennifer

    2016-09-01

    Clinical Practice Guidelines for Treating Tobacco Use and Dependence advocate for using counseling targeted at tobacco users' motivation to quit during each office visit. We evaluate tobacco use screening and counseling interventions delivered during routine periodic health examinations by 44 adult primary care physicians practicing in 22 clinics of a large health system in southeast Michigan. 484 office visits were audio-recorded and transcribed. For this study, current tobacco users (N = 91) were identified using pre-visit surveys and audio-recordings. Transcripts were coded for the delivery of tobacco-related counseling interventions. The extent to which counseling interventions were used and/or targeted to the patients' readiness to quit was the main outcome measure. The majority of tobacco users (n = 77) had their tobacco use status assessed, and most received some sort of tobacco-related counseling (n = 74). However, only 15% received the recommended counseling targeted to their readiness to quit. On the other hand, 19% received less counseling than recommended given their readiness to quit, 7% received only nonindicated counseling, and 59% received nonindicated counseling in addition to indicated counseling. Results illustrate physicians' commitment to cessation counseling and also identify potential opportunities to improve the efficiency of tobacco-related counseling in primary care. PMID:26290271

  8. Point-of-care outcome assessment in the cancer clinic: Audit of data quality

    International Nuclear Information System (INIS)

    Background and purpose: To assess the completeness and accuracy of stage and outcome data in the Anthology of Outcomes (AOs), a prospective point-of-care physician-collected electronic data system for patients at Princess Margaret Hospital. Material and methods: A random sample of 10% of the AO cases registered between July 2003 and December 2005 was drawn. An audit was conducted of the AO data compared with chart review and cancer registry. Results: The AO system was applied first to a head and neck (HN) cancer patient cohort. From 1152 HN cases, 120 were audited. TNM stage was recorded in all cases. Discrepancy was found between the AO and primary data sources in 3-13% of cases. Physician review showed a 3% error rate in overall stage recorded in the AO. Sixty-two outcomes in 43 patients were found on chart review. No outcomes were incorrectly recorded in the AO. Nineteen (31%) outcomes in 17 patients were missed in the AO. Conclusions: Our experience has demonstrated the feasibility of real-time outcome recording at point-of-care. New processes needed to improve the completeness of capture of patient outcomes in the AO have more recently been introduced. This successful system has been expanded to other disease sites.

  9. Assessment of Patient Safety Culture in Primary Health Care Settings in Kuwait

    Directory of Open Access Journals (Sweden)

    Maha Mohamed Ghobashi

    2014-01-01

    Full Text Available Background Patient safety is critical component of health care quality. We aimed to assess the awareness of primary healthcare staff members about patient safety culture and explore the areas of deficiency and opportunities for improvement concerning this issue.Methods: This descriptive cross sectional study surveyed 369 staff members in four primary healthcare centers in Kuwait using self-administered “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of respondents was 276 participants (response rate = 74.79%.Results: Five safety dimensions with lowest positivity (less than 50% were identified and these are; the non – punitive response to errors, frequency of event reporting, staffing, communication openness, center handoffs and transitions with the following percentages of positivity 24%, 32%, 41%, 45% and 47% respectively. The dimensions of highest positivity were teamwork within the center’s units (82% and organizational learning (75%.Conclusion: Patient safety culture in primary healthcare settings in Kuwait is not as strong as improvements for the provision of safe health care. Well-designed patient safety initiatives are needed to be integrated with organizational policies, particularly the pressing need to address the bioethical component of medical errors and their disclosure, communication openness and emotional issues related to them and investing the bright areas of skillful organizational learning and strong team working attitudes.    

  10. Assessment Of Nurses Performance During Cardiopulmonary Resuscitation In Intensive Care Unit And Cardiac Care Unit At The Alexandria Main University Hospital.

    Directory of Open Access Journals (Sweden)

    Dr. Nagla Hamdi Kamal Khalil El- Meanawi

    2015-08-01

    Full Text Available Abstract Background Cardiopulmonary resuscitation one of the most emergency management the nurse has a pivotal role and should be highly qualified in performing these procedures. The aim of the study is to assess performance of nurses during Cardio pulmonary resuscitation for patient with cardiac arrest In Intensive Care Unit and Cardiac Care Unit at the Alexandria main university hospital. To answer the question what are the most common area of satisfactory and area of neglection in nurses performance during Cardio Pulmonary Resuscitation. The sample consists of 53 staff nurses working in Intensive care unit amp cardiac care unit at Alexandria main university hospital. The tools of data collection were structured of questionnaire sheet and observational cheek list. The results showed that unsatisfactory performance between nurses in both units. The study concluded that all nurses need to improve their performance during cardiopulmonary resuscitation for patient with cardiac arrest it is crucial for nursing staff to participate in CPR courses in order to refresh and update their theoretical knowledge and performance skills and consequently to improve the safety and effectiveness of care. The study recommended that continuous evaluation of nurses knowledge and performance is essential the optimal frequency with which CPR training should be implemented at least every 6 months in order to avoid deterioration in nurses CPR knowledge and skills.

  11. Assessment of biomedical waste management practices in a tertiary care teaching hospital in Ludhiana

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    Savan Sara Mathew

    2011-08-01

    Full Text Available Biomedical waste (BMW is waste generated during diagnosis, treatment or immunization of human beings or animals, or in research activities pertaining thereto, or in the production and testing of biologicals, and is contaminated with human fluids.1 Though 75-80% of wastes generated from hospitals are non-infectious, 20-25% is hazardous.2 It is a potential health hazard to health workers, public, flora and fauna of the area.3 The Government of India has given specifications for hospital waste management under the Environment (Protection Act Biomedical Waste (Management and Handling Rules 1998.4 The present study was undertaken to assess the knowledge and practices regarding BMW management amongst staff of a large tertiary care teaching hospital in Ludhiana, with about 700 beds which, according to its Chief Maintenance Officer, generates about 70 kg biomedical waste per day.

  12. Pilot study: Assessing repeatability of the EcoWalk platform resistive pressure sensors to measure plantar pressure during barefoot standing

    International Nuclear Information System (INIS)

    Plantar pressure provides useful information to assess the feet's condition. These systems have emerged as popular tools in clinical environment. These systems present errors and no compensation information is presented by the manufacturer, leading to uncertainty in the measurements. Ten healthy subjects, 5 females and 5 males, were recruited. Lateral load distribution, antero-posterior load distribution, average pressure, contact area, and force were recorded. The aims of this study were to assess repeatability of the EcoWalk system and identify the range of pressure values observed in the normal foot. The coefficient of repeatability was less than 4% for all parameters considered.

  13. Can Health Technology Assessment (HTA) provide a solution to tackle the increasing health-care expenditure in India?

    Science.gov (United States)

    Dang, Amit; Vallish, B N

    2016-01-01

    The private health-care system in India is effective but expensive. Due to the absence of a comprehensive and well-penetrated insurance scheme that caters to the majority of the Indian population, most of the private health care consultations are out-of-pocket (OOP), and this is pushing many people to poverty. In this article, we describe the concept of health technology assessment (HTA), and review its possible role in improving the health-care system in India. We additionally comment on its present status and possible role of its implementation in the Indian context. PMID:27350708

  14. Nano-CeO2 decorated graphene based chitosan nanocomposites as enzymatic biosensing platform: fabrication and cellular biocompatibility assessment.

    Science.gov (United States)

    De, Sriparna; Mohanty, Smita; Nayak, Sanjay Kumar

    2015-09-01

    The present study summarizes the designing of a green transducer phase based on nano-cerium oxide (CeO2) decorated reduced graphene oxide (RGO) reinforced chitosan nanocomposites as an effective enzyme immobilizer and bio-sensing matrix for glucose analyte. Also, it scrutinizes the biocompatibility and cell viability of the synthesized nanohybrid with human fibroblastic macrophage cell line. CeO2 nanoparticles (NPs) were successfully grown on graphene nanosheet in the presence of cationic surfactant followed by facile hydrothermal treatment. The eventual growth of synthesized CeO2 nanocrystals on the graphene layer was confirmed from X-ray diffraction (XRD), transmission electron microscopy (TEM) and Raman analysis. The biocompatibility of the synthesized nanohybrid was also evident from the MTT assay. Glucose oxidase (GOx) was employed on the green polymer nanocomposites modified FTO electrode to fabricate an enzymatic bioelectrode. The electroanalytical response of the GOx/nano-CeO2/RGO/CS/FTO bioelectrode towards electrooxidation of glucose analyte was investigated by electrochemical impedance (EIS) and cyclic voltammetry (CV) study. The resulting biosensor exhibited a good electrochemical response to glucose within the linear detection range of 0.05-6.5 mM with a low detection limit of 2 μM and a sensitivity of 7.198 μA mM(-1) cm(-2). The bioelectrode also showed good shelf life (~10 weeks) and negligible interfering ability under controlled environment. The obtained results indicate that nano-CeO2/RGO nanohybrid based chitosan nanocomposites achieve a biocompatible biosensing platform for effective enzyme immobilization due to the excellent synergistic effects between the CeO2 nanoparticles and graphene sheet. PMID:25980384

  15. Data analysis methods for assessing palliative care interventions in one-group pre–post studies

    Science.gov (United States)

    Ioroi, Takeshi; Kakuma, Tatsuyuki; Sakashita, Akihiro; Miki, Yuki; Ohtagaki, Kanako; Fujiwara, Yuka; Utsubo, Yuko; Nishimura, Yoshihiro; Hirai, Midori

    2015-01-01

    Objectives: Studies of palliative care are often performed using single-arm pre–post study designs that lack causal inference. Thus, in this study, we propose a novel data analysis approach that incorporates risk factors from single-arm studies instead of using paired t-tests to assess intervention effects. Methods: Physical, psychological and social evaluations of eligible cancer inpatients were conducted by a hospital-based palliative care team. Quality of life was assessed at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer QLQ-C15-PAL. Among 35 patients, 9 were discharged within 1 week and 26 were included in analyses. Structural equation models with observed measurements were applied to estimate direct and indirect intervention effects and simultaneously consider risk factors. Results: Parameters were estimated using full models that included associations among covariates and reduced models that excluded covariates with small effects. The total effect was calculated as the sum of intervention and covariate effects and was equal to the mean of the difference (0.513) between pre- and post-intervention quality of life (reduced model intervention effect, 14.749; 95% confidence intervals, −4.407 and 33.905; p = 0.131; covariate effect, −14.236; 95% confidence interval, −33.708 and 5.236; p = 0.152). Conclusion: Using the present analytical method for single-arm pre–post study designs, factors that modulate effects of interventions were modelled, and intervention and covariate effects were distinguished based on structural equation model. PMID:27092261

  16. Quality of care assessment in geriatric evaluation and management units: construction of a chart review tool for a tracer condition

    Directory of Open Access Journals (Sweden)

    Latour Judith

    2009-07-01

    Full Text Available Abstract Background The number of elderly people requiring hospital care is growing, so, quality and assessment of care for elders are emerging and complex areas of research. Very few validated and reliable instruments exist for the assessment of quality of acute care in this field. This study's objective was to create such a tool for Geriatric Evaluation and Management Units (GEMUs. Methods The methodology involved a reliability and feasibility study of a retrospective chart review on 934 older inpatients admitted in 49 GEMUs during the year 2002–2003 for fall-related trauma as a tracer condition. Pertinent indicators for a chart abstraction tool, the Geriatric Care Tool (GCT, were developed and validated according to five dimensions: access to care, comprehensiveness, continuity of care, patient-centred care and appropriateness. Consensus methods were used to develop the content. Participants were experts representing eight main health care professions involved in GEMUs from 19 different sites. Items associated with high quality of care at each step of the multidisciplinary management of patients admitted due to falls were identified. The GCT was tested for intra- and inter-rater reliability using 30 medical charts reviewed by each of three independent and blinded trained nurses. Kappa and agreement measures between pairs of chart reviewers were computed on an item-by-item basis. Results Three quarters of 169 items identifying the process of care, from the case history to discharge planning, demonstrated good agreement (kappa greater than 0.40 and agreement over 70%. Indicators for the appropriateness of care showed less reliability. Conclusion Content validity and reliability results, as well as the feasibility of the process, suggest that the chart abstraction tool can gather standardized and pertinent clinical information for further evaluating quality of care in GEMU using admission due to falls as a tracer condition. However, the GCT

  17. Environmental data for the planning of off-shore wind parks from the EnerGEO Platform of Integrated Assessment (PIA)

    International Nuclear Information System (INIS)

    The EU-sponsored EnerGEO project aims at providing decision makers with a modelling platform to assess the environmental impacts of different sources of renewable energy. One of the pillars of the project is the Wind Energy Pilot, addressing the effects of offshore wind parks on air pollution and energy use. The methods used in the pilot and the underlying environmental databases are integrated into a WebGIS client tool and made available to the public. This paper is dedicated to describing the environmental databases and supporting data incorporated in the client tool. A 27-km resolution, 11-year wind database is created using the WRF model. The wind database is used to assess the wind climate in the north-west Atlantic region and to derive the potential power output from offshore wind parks. Auxiliary data concerning water depth, distance to shore and distance to the nearest suitable port are created to aid the planning and maintenance phases. Seasonal workability conditions are assessed using a 20-year wave database. The distance at which future wind parks should be placed to exhibit different wind climates is investigated. (orig.)

  18. Assessment of Patients that Request Prescription by Primary Care Physicians' Views

    Directory of Open Access Journals (Sweden)

    Sebahat Gucuk

    2011-04-01

    Full Text Available Objective: In this study it was aimed to assess the request of patients that admitted for prescription and to determine the situation regarding to the effect of present health system on primary care services. Materials and Methods: Patients admitted to Van Mother-Child Health and Family Planning center for prescription in 5 workdays between 1 and 8 February 2010 were included into the cross-sectional study. A questionnaire was performed to the participants, including information about the health insurance, residence, time to come to the last control of the patient that request prescription, by whom and when the medication was recommended, demand of health insurance abuse, number of medications, whether information about the medication prescribed was given by the physician or not. Results: A total of 441 participants, 41.5’% of them were admitted for prescription of their own medications, 45.8% for prescription of their first-degree relatives’ medication. The 79.4% of them were from urban, 20.6% from rural areas, and 58.5% of them were examined at secondary care unit, 32% at private hospitals. Health insurance of patients whose medications were prescribed at the last three days was green card with a rate of 86.5%. The 65.3% of medications requested were Rx drugs, 34.7% were over the counter. The 15.6% of the participants requested the medication to be prescribed over the health insurance of the people other than the patient that use medication. The 68.4% of participants that requested Rx drugs were informed by the physician. A significant association was found with those who requested Rx drugs and over the counter drugs regarding to be informed about medications (p=0.0001. Conclusion: The low socioeconomic level and education level, society and the multiplicity of health problems in our region, increase the burden on health care facilities especially on primary care units [TAF Prev Med Bull 2011; 10(2.000: 149-154

  19. Development of the dementia assessment sheet for community-based integrated care system.

    Science.gov (United States)

    Awata, Shuichi; Sugiyama, Mika; Ito, Kae; Ura, Chiaki; Miyamae, Fumiko; Sakuma, Naoko; Niikawa, Hirotoshi; Okamura, Tsuyoshi; Inagaki, Hiroki; Ijuin, Mutsuo

    2016-03-01

    A series of our studies on the development of the Dementia Assessment Sheet for Community-based Integrated Care System 21-items (DASC-21) were reviewed. Study 1: to examine the distribution of scores and internal reliability of DASC-21, trained nurses and researchers visited the homes of 1341 participants aged 65 years and older and living in the community. The nurses interviewed the participants and, when possible, their family members, to complete the DASC-21. Then, the Mini-Mental State Examination was carried out to select the participants of study 2. Study 2: to examine the concurrent and discriminant validity, experienced psychiatrists and psychologists, who were blind to the findings of study 1, visited the homes of 131 subjects who were selected from the participants of study 1 and completed the Clinical Dementia Rating (CDR), the Mini-Mental State Examination and the Frontal Assessment Battery (FAB). Cronbach's coefficient alpha of the DASC-21 was 0.808-0.950. Scores of the DASC-21 significantly correlated with CDR total and box scores, Mini-Mental State Examination and Frontal Assessment Battery. In an analysis of variance, CDR had the main effect on the score of the DASC-21. Receiver operating characteristic analysis showed that the DASC-21 had sufficient discriminatory ability between dementia (CDR1+) and non-dementia (CDR0 or CDR0.5; area under the curve = 0.804-0.895). When using a cut-off point of 30/31, sensitivity was 83.3-94.1% and specificity was 77.3-86.4%. The DASC-21 has sufficient reliability and validity as a tool to evaluate impairments in daily functioning and in cognitive functions, to detect dementia, and to assess the severity of dementia in the community. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 123-131. PMID:27018290

  20. The online Prescriptive Index platform for the assessment of managerial competencies and coaching needs: development and initial validation of the experience sampling Mood Wheel and the Manager-Rational and Irrational Beliefs Scale

    OpenAIRE

    David, O.A.

    2013-01-01

    The Prescriptive Index platform is dedicated to the appraisal and development of managerial competencies, and it is comprised of such measures as the multi-rater Freeman-Gavita Prescriptive Executive Coaching (PEC) Assessment for assessing core managerial skills, and the multi-rater Managerial Coaching Assessment System (MCAS) for the evaluation of coaching competencies in managers. The aim of this research was to present the development and psychometric properties of new tools, part of the P...

  1. Assessment of knowledge attitude and practice towards hepatitis B among health care workers in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Farhana Siraj

    2016-01-01

    Results: This cross sectional prospective study was conducted in the Department of Obstetrics and Gynecology Govt. Medical College Srinagar from January to June 2015. 150 health care professionals were taken for the study. Knowledge regarding disease and transmission was fairly good. Regarding vaccination status 42.02% of medical and 29.60% of paramedical staff was fully vaccinated, the most common reason for non compliance being ignorance of importance of vaccination. Awareness of patients' vaccination status was also low. Conclusions: Due to low vaccine-compliance, Health care workers (HCW continue to be at the risk of occupational HBV infection. Regular Health education highlighting occupational risk of HBV, accessibility of vaccine, and mandatory vaccination of HCW is recommended to prevent Hepatitis B infection. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 58-61

  2. Assessment and Availability of Trauma Care Services in a District Hospital of South India; A Field Observational Study

    Directory of Open Access Journals (Sweden)

    Pallavi Sarji Uthkarsh

    2016-04-01

    Full Text Available Objective: To assess the availability of trauma care services in a district referral hospital of Southern India. Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed speciality hospital which is an apex referral hospital in the public health system using a check list based on WHO guidelines for evaluation of essential trauma care services, along with in-depth interviews of hospital stake holders and key informants. Results: The hospital had physical infrastructure in terms of emergency room, inpatient wards, operation theatres, intensive care unit and blood bank facilities. The recently constructed designated building for trauma care services was not operational and existing facilities were used beyond capacity. A designated trauma team was lacking and speciality services for managing polytrauma were deficient and thus, existing personnel were performing multiple tasks. Neurosurgeons and rehabilitative nursing staff were unavailable, and a radiographer was not available on a 24/7 basis. Existing nursing personnel had not received any formal training in trauma care and standard operating protocols were not available for trauma care. Resources for acute resuscitation were partially adequate. The hospital lacked adequate resources to manage head, abdomen, chest and spine injuries, and most of the polytrauma cases were referred to nearby city hospitals. Conclusion: District hospital, the only referral hospital in public health system for trauma victims of that region, had inadequate resources to manage trauma victims, which was probably responsible for delay in trauma care, improper referrals, high cost of care and poor outcomes.

  3. Xurography as a Rapid Fabrication Alternative for Point-of-Care Devices: Assessment of Passive Micromixers

    Science.gov (United States)

    Martínez-López, J. Israel; Mojica, Mauricio; Rodríguez, Ciro A.; Siller, Héctor R.

    2016-01-01

    Despite the copious amount of research on the design and operation of micromixers, there are few works regarding manufacture technology aimed at implementation beyond academic environments. This work evaluates the viability of xurography as a rapid fabrication tool for the development of ultra-low cost microfluidic technology for extreme Point-of-Care (POC) micromixing devices. By eschewing photolithographic processes and the bulkiness of pumping and enclosure systems for rapid fabrication and passively driven operation, xurography is introduced as a manufacturing alternative for asymmetric split and recombine (ASAR) micromixers. A T-micromixer design was used as a reference to assess the effects of different cutting conditions and materials on the geometric features of the resulting microdevices. Inspection by stereographic and confocal microscopy showed that it is possible to manufacture devices with less than 8% absolute dimensional error. Implementation of the manufacturing methodology in modified circular shape- based SAR microdevices (balanced and unbalanced configurations) showed that, despite the precision limitations of the xurographic process, it is possible to implement this methodology to produce functional micromixing devices. Mixing efficiency was evaluated numerically and experimentally at the outlet of the microdevices with performances up to 40%. Overall, the assessment encourages further research of xurography for the development of POC micromixers. PMID:27196904

  4. E-assessment of prior learning : a pilot study of interactive assessment of staff with no formal education who are working in Swedish elderly care

    OpenAIRE

    Nilsson, Annika; Andren, Marianne; Engström, Maria

    2014-01-01

    Background The current paper presents a pilot study of interactive assessment using information and communication technology (ICT) to evaluate the knowledge, skills and abilities of staff with no formal education who are working in Swedish elderly care. Methods Theoretical and practical assessment methods were developed and used with simulated patients and computer-based tests to identify strengths and areas for personal development among staff with no formal education. Results Of the 157 sta...

  5. A Long-Term Care—Comprehensive Geriatric Assessment (LTC-CGA) Tool: Improving Care for Frail Older Adults?

    Science.gov (United States)

    Marshall, Emily G.; Clarke, Barry S.; Varatharasan, Nirupa; Andrew, Melissa K.

    2015-01-01

    Background Most older adults living in long-term care facilities (LTCF) are frail and have complex care needs. Holistic understanding of residents’ health status is key to providing good care. Comprehensive Geriatric Assessment (CGA) is a valid assessment method which aims to embrace complexity. Here we aimed to study a CGA that has been modified for use in long-term care (the LTC-CGA) and to investigate its acceptability and usefulness to stakeholders and users. Methods This mixed methods study, conducted in 10 LTCFs in Halifax, Nova Scotia, reviewed 598 resident charts from pre- and post-implementation of the LTC-CGA. Qualitative methods explored stakeholder perspectives (physicians, nurses, paramedics, administrators, residents and families) though focus groups. Results The LTC-CGA was present in 78% of LTCF charts in the post -implementation, period though it did not appear in acute care charts of transferred residents, despite the intention that it accompany residents between care sites. Some items had suboptimal completion rates (e.g., Advance Directives at 56.4%), though these were located in other sections of the LTCF chart (98.2%). Nevertheless, qualitative findings suggest the LTC-CGA describes a clinical baseline health status which enabled timely and informed clinical decision-making. Conclusions The LTC-CGA is a useful resource whose full capacity may not yet have been realized. PMID:25825606

  6. Physical activity assessed in routine care predicts mortality after a COPD hospitalisation

    Directory of Open Access Journals (Sweden)

    Marilyn L. Moy

    2016-03-01

    Full Text Available The independent relationship between physical inactivity and risk of death after an index chronic obstructive pulmonary disease (COPD hospitalisation is unknown. We conducted a retrospective cohort study in a large integrated healthcare system. Patients were included if they were hospitalised for COPD between January 1, 2011 and December 31, 2011. All-cause mortality in the 12 months after discharge was the primary outcome. Physical activity, expressed as self-reported minutes of moderate to vigorous physical activity (MVPA, was routinely assessed at outpatient visits prior to hospitalisation. 1727 (73% patients were inactive (0 min of MVPA per week, 412 (17% were insufficiently active (1–149 min of MVPA per week and 231 (10% were active (≥150 min of MVPA per week. Adjusted Cox regression models assessed risk of death across the MVPA categories. Among 2370 patients (55% females and mean age 73±11 years, there were 464 (20% deaths. Patients who were insufficiently active or active had a 28% (adjusted HR 0.72 (95% CI 0.54–0.97, p=0.03 and 47% (adjusted HR 0.53 (95% CI 0.34–0.84, p<0.01 lower risk of death, respectively, in the 12 months following an index COPD hospitalisation compared to inactive patients. Any level of MVPA is associated with lower risk of all-cause mortality after a COPD hospitalisation. Routine assessment of physical activity in clinical care would identify persons at high risk for dying after COPD hospitalisation.

  7. Assessment of adverse drug reactions based on spontaneous signals at secondary care public hospital

    Directory of Open Access Journals (Sweden)

    S Ponnusankar

    2015-01-01

    Full Text Available Adverse drug reactions are considered to be among the leading causes of morbidity and mortality. Approximately 5-25% of hospital admissions are due to adverse drug reactions and 6-15% of hospitalized patients experience serious adverse drug reactions, causing significant prolongation of hospital stay. Thus this study was aimed at determining adverse drug reactions by conducting spontaneous reporting in secondary care Govt. District Head Quarters Hospital at Ooty. A prospective Spontaneous Adverse Drug Reaction reporting study was conducted over a period of 12 months from July 2012 to June 2013. The assessment, categorization, causality, severity and preventability were assessed using standard criteria. A total of 47 suspected adverse drug reactions were reported during the study period. Over all incidences was 1.29% among the study population. Antibiotics (31.91% were the class of drug most commonly involved, while ciprofloxacin (14.89% was the most frequently reported. Type H (Hypersensitivity reactions (51.06% accounted for majority of the reports and a greater share of the adverse drug reactions are probable (89.36% based on causality assessment. Mild reactions accounted 82.97% based on modified Hartwig and Siegel severity scale. In 76.59% of the reports, the reaction was considered to be preventable based on Schumock and Thornton preventability scale. The implementation of monitoring based on spontaneous reporting will be useful for the detection and evaluation is associated with increase in morbidity and duration of hospitalization. This study also has established the vital role of clinical pharmacist in the adverse drug reaction monitoring program.

  8. 基于AHP的应急平台信息安全风险评估%ASSESSING INFORMATION SECURITY RISK OF THE EMERGENCY PLATFORM BASED ON AHP

    Institute of Scientific and Technical Information of China (English)

    张永妹; 王瑛; 李树仁; 党德鹏; 武建军

    2009-01-01

    Assessing information security risk of the emergency platform is a key task for its construction in China. Various risk values are determined by analyzing information security risk elements, applying AHP and constructing risk Hierarchy structure model, combining with constructed risk assessment math model. It is very important to avoid, reduce and transfer the security risk and strengthen security.%应急平台信息安全风险评估是我国应急平台建设工作重点任务之一.分析了应急平台信息安全风险要素,运用层次分析法,构建风险层次结构模型,结合构造的风险评估数学模型,最终确定了应急平台所面临的各类风险值.根据分析结果对应急平台安全风险进行规避,降低,转移,对加强应急平台安全具有重要意义.

  9. Assessing undergraduate nursing students' knowledge, attitudes, and cultural competence in caring for lesbian, gay, bisexual, and transgender patients.

    Science.gov (United States)

    Strong, Kristy L; Folse, Victoria N

    2015-01-01

    Lesbian, gay, bisexual, and transgender (LGBT) patients experience barriers to health care that include fear of discrimination, as well as insensitivity and lack of knowledge about LGBT-specific health needs among providers. This study examined the effectiveness of an educational intervention designed to improve knowledge and attitudes of baccalaureate nursing students regarding LGBT patient care. Education focused on key terminology, health disparities, medical needs of transgender patients, and culturally sensitive communication skills for competent LGBT patient care. Knowledge level and attitudes were evaluated before and after the intervention using a survey based on a modified Attitudes Toward Lesbians and Gay Men Scale and two assessment tools developed for this study. A statistically significant increase in positive attitudes and knowledge level was found immediately after the intervention. Findings from this study support the inclusion of education related to LGBT patient health care in undergraduate nursing curricula to promote cultural competence and sensitivity. PMID:25535762

  10. Exploring the Utility of Ultra-Brief Delirium Assessments in a Nonintensive Care Geriatric Population: The GEM Study

    OpenAIRE

    Powers, James S.; Doering, Tracey; Gordon, Sharon; Svetlana K Eden; Shintani, Ayumi; Schnelle, John

    2012-01-01

    Objective: To determine how an ultra-brief structured tool that would require usually less than a minute for delirium assessment compares with a clinical assessment based on Diagnostic and Statistical Manual-IV (DSM-IV) in a geriatric postacute care (PAC) rehabilitation unit. Design: Prospective observational cohort study. Setting: Postacute geriatric hospital ward of a Veteran’s Affairs hospital. Participants: Consecutively admitted patients between 50 and 100 years old for inpatient postacu...

  11. Risk assessment of parents' concerns at 18 months in preventive child health care predicted child abuse and neglect

    OpenAIRE

    Staal, I.I.E.; Hermanns, J.M.A.; Schrijvers, A.J.P.; Stel, van, H.F.

    2013-01-01

    Objective: As child maltreatment has a major impact, prevention and early detection of parenting problems are of great importance. We have developed a structured interview which uses parents’ concerns for a joint needs assessment by parents and a child health care nurse, followed by a professional judgment on the risk level of future parenting and developmental problems: the Structured Problem Analysis of Raising Kids (SPARK). Previous results have shown that the risk assessment of the SPARK ...

  12. ASSESSMENT OF COMPLIANCE TO TREATMENT AMONG AMBULATORY ASTHMATIC PATIENTS IN A SECONDARY HEALTH CARE FACILITY IN NIGERIA

    OpenAIRE

    S. J. Showande et al.

    2012-01-01

    This study assessed the level of compliance using three different methods: pill count, self report and peak expiratory flow rate, in asthmatic patients attending a secondary health care facility. Self report (using a pre-tested structured questionnaire), peak expiratory flow rate and pill count were used to assess patient’s compliance and identify the factors which may be responsible for non compliance. Measurement of peak expiratory flow rate and the pill count were done at two different occ...

  13. Surveying Consumer Satisfaction to Assess Managed-Care Quality: Current Practices

    OpenAIRE

    Gold, Marsha; Wooldridge, Judith

    1995-01-01

    Growing interest in using consumer satisfaction information to enhance quality of care and promote informed consumer choice has accompanied recent expansions in managed care. This article synthesizes information about consumer satisfaction surveys conducted by managed-care plans, government and other agencies, community groups, and purchasers of care. We discuss survey content, methods, and use of consumer survey information. Differences in the use of consumer surveys preclude one instrument ...

  14. Assessing the role and effectiveness of prenatal care: history, challenges, and directions for future research.

    OpenAIRE

    Alexander, G R; Kotelchuck, M

    2001-01-01

    Despite the widespread use of prenatal care, the evidence for its effectiveness remains equivocal and its primary purpose and effects continue to be a subject of debate. To provide some perspective on why the effectiveness and organization of prenatal care continue to be debated, the authors (a) briefly review the history of the development of prenatal care in the US; (b) attempt to conceptually define prenatal care in terms of its utilization, content, and quality; and, (c) highlight some of...

  15. Prenatal care in the primary health care network in FortalezaCE: an assessment of the structure, process and results

    Directory of Open Access Journals (Sweden)

    Rebeca Silveira Rocha

    2012-09-01

    Full Text Available Objective: To evaluate the prenatal care assistance in the primary health care network in Fortaleza-CE, considering the structure, process and results. Methods: A cross sectional descriptive study, of quantitative approach, performed between October 2009 and February 2011, in 30 Health Units randomly selected, keeping the ratio for each Regional Executive Secretary. For analysis of the structure, the information obtained was scored and classified as: excellent, satisfactory, precarious or insufficient. The form used was submitted to four experts for validation. In evaluating the process and results, data was available by the Municipal Health Secretary of Fortaleza for obtainance of the indicators recommended by the Ministry of Health. Results: There was, in general, a satisfactory structure. As for the process and result, we obtained: pregnant women who had, at least, six prenatal visits (7.6%; pregnant women who received tetanus immunization (22.8%; newborns with congenital syphilis (1.4%; newborns with neonatal tetanus (0%; maternal mortality rate (78.5% in 2008 and 51% in 2009 and total neonatal mortality rate (10.1% in 2008 and 11.2% in 2009. Conclusions: Despite good results with regard to the structure, the reflections on the process and outcome indicators were not positive, with low rates compared to those expected by the World Health Organization or the Ministry of Health, or in comparison with other regions.

  16. Platform christened

    International Nuclear Information System (INIS)

    On Friday May 9, 1997, a ceremony took place in which the Hibernia platform was officially christened by Aline Chretien, the wife of the Prime Minister of Canada. The ceremony highlighted the successful completion of Hibernia and the tremendous accomplishment of this offshore structure which will be towed out of Bull Arm, Newfoundland, in June 1997 to its offshore location. Drilling for the first well will begin in August with first oil expected by December 1997. Other guests at the ceremony included Hibernia owner companies Mobil Oil, Chevron, Petro-Canada, Canada Hibernia Holding Corp., Murphy Oil and Norsk Hydro. The Hibernia project paves the way for other offshore ventures and employment opportunities in Newfoundland

  17. Algorithms and Care Pathways for Assessment and Counseling for Domestic Violence.

    Science.gov (United States)

    Miller, Thomas W.; Veltkamp, Lane J.

    Health care providers recognize the importance of standards of care and standardized models of evaluation and intervention on cases of domestic violence. Examined are algorithms and care pathways being utilized to assure consistency in the evaluation and interventions offered where the spectrum symptoms of domestic violence are identified in the…

  18. The Development of an ICF-Oriented, Adaptive Physician Assessment Instrument of Mobility, Self-care, and Domestic Life

    Science.gov (United States)

    Farin, Erik; Fleitz, Annette

    2009-01-01

    The objective of this study was development and psychometric testing of an adaptive, International Classification of Functioning, Disability, and Health (ICF)-oriented questionnaire to be processed by the rehabilitation physician that aids in assessing mobility, self-care, and domestic life (Moses-Physician). The intent is to develop a physician…

  19. Validation and Evaluation of Two Observational Pain Assessment Tools in a Trauma and Neurosurgical Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Jane Topolovec-Vranic

    2013-01-01

    Full Text Available BACKGROUND: Studies have demonstrated that patients in the intensive care unit experience high levels of pain. While many of these patients are nonverbal at some point during their stay, there are few valid tools available to assess pain in this group.

  20. New Mexico Look for the STARS--AIM HIGH: QRS Profile. The Child Care Quality Rating System (QRS) Assessment

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

    This paper presents a profile of New Mexico's Look for the STARS--AIM HIGH prepared as part of the Child Care Quality Rating System (QRS) Assessment Study. The profile consists of several sections and their corresponding descriptions including: (1) Program Information; (2) Rating Details; (3) Quality Indicators for Center-Based Programs; (4)…

  1. Risk assessment of parents' concerns at 18 months in preventive child health care predicted child abuse and neglect

    NARCIS (Netherlands)

    I.I.E. Staal; J.M.A. Hermanns; A.J.P. Schrijvers; H.F. van Stel

    2013-01-01

    Objective: As child maltreatment has a major impact, prevention and early detection of parenting problems are of great importance. We have developed a structured interview which uses parents’ concerns for a joint needs assessment by parents and a child health care nurse, followed by a professional j

  2. Assessment of oral self-care in patients with periodontitis: a pilot study in a dental school clinic in Japan

    Directory of Open Access Journals (Sweden)

    Masuda Hitomi

    2009-10-01

    Full Text Available Abstract Background Oral hygiene education is central to every stage of periodontal treatment. Successful management of periodontal disease depends on the patient's capacity for oral self-care. In the present study, the oral self-care and perceptions of patients attending a dental school clinic in Japan were assessed using a short questionnaire referring to existing oral health models. Methods A cross-sectional study design was used. The study population consisted of sixty-five patients (age range 23-77 with chronic periodontitis. The pre-tested 19-item questionnaire comprised 3 domains; 1 oral hygiene, 2 dietary habits and 3 perception of oral condition. The questionnaire was used as a part of the comprehensive assessment. Results Analyses of the assessment data revealed no major problems with the respondents' perceived oral hygiene habits, although their actual plaque control levels were not entirely adequate. Most of the respondents acknowledged the importance of prevention of dental caries and periodontal diseases, but less than one third of them were regular users of the dental care system. Twenty-five percent of the respondents were considered to be reluctant to change their daily routines, and 29% had doubts about the impact of their own actions on oral health. Analyzing the relationships between patient responses and oral hygiene status, factors like 'frequency of tooth brushing', 'approximal cleaning', 'dental check-up' and 'compliance with self-care advice' showed statistically significant associations (P Conclusion The clinical utilization of the present questionnaire facilitates the inclusion of multiple aspects of patient information, before initiation of periodontal treatment. The significant associations that were found between some of the self-care behaviors and oral hygiene levels document the important role of patient-centered oral health assessment in periodontal care.

  3. Primary care assessment instruments for patients at risk of, or with, persistent pain: opportunistic findings from a systematic literature review

    Directory of Open Access Journals (Sweden)

    Karen Grimmer-Somers

    2009-06-01

    Full Text Available Karen Grimmer-Somers1, Saravana Kumar1, Nic Vipond2, Gillian Hall21Centre for Allied Health Evidence, University of South Australia, Australia; 2Accident Compensation Corporation, Wellington, New ZealandBackground: Early identification in primary care settings of individuals with, or at-risk of, developing persistent pain, is important to limit development of disability. There is little information to assist primary care providers to choose or deliver relevant, efficient, and soundly constructed assessment instruments for this purpose.Objective: We recently published the findings of a literature review, which produced a compendium of assessment instruments to identify adults with, or at-risk of developing, persistent pain of noncancer origin. This paper reports on instruments opportunistically identified during this review which may be appropriate to primary health care settings for early identification of such patients.Results: One hundred sixteen potentially useful instruments were initially identified in the review, measuring pain severity, psychological distress, functional capacity, quality of life or multidimensional constructs of persistent pain. Following a series of steps, 45 instruments were shortlisted, with sound clinical utility and strong psychometric properties. Of these, 16 instruments were appropriate to primary health care settings because of simple wording, brief items, short administration time, and ease of scoring.Conclusion: No one assessment instrument captured all constructs of persistent pain. The 16 instruments provide a broad choice for primary care clinicians to assist with early identification of adults at risk of, or with persistent pain.Keywords: adults with persistent pain, primary health care assessment, early identification

  4. Assessing the impact of common forensic presumptive tests on the ability to obtain results using a novel rapid DNA platform.

    Science.gov (United States)

    Donachie, Gillian E; Dawnay, Nick; Ahmed, Romana; Naif, Sarah; Duxbury, Nicola J; Tribble, Nicholas D

    2015-07-01

    The rise of DNA evidence to the forefront of forensic science has led to high sample numbers being submitted for profiling by investigators to casework laboratories: bottleneck effects are often seen resulting in slow turnaround times and sample backlog. The ParaDNA(®) Screening and Intelligence Tests have been designed to guide investigators on the viability of potential sources of DNA allowing them to determine which samples should be sent for full DNA analysis. Both tests are designed to augment the arsenal of available forensic tests for end users and be used concurrently to those commonly available. Therefore, assessing the impact that common forensic tests have on such novel technology is important to measure. The systems were tested against various potential inhibitors to which samples may be exposed as part of the investigative process. Presumptive test agents for biological materials (blood, semen and saliva) and those used as fingerprint enhancement agents were both used. The Screening Test showed a drop in performance following application of aluminium powder and cyanoacrylate (CNA) on fingerprints samples; however this drop in performance was not replicated with high template DNA. No significant effect was observed for any agent using the Intelligence Test. Therefore, both tests stand up well to the chemical agents applied and can be used by investigators with confidence that system performance will be maintained. PMID:25864157

  5. Home and community based care program assessment for people living with HIV/AIDS in Arba Minch, Southern Ethiopia

    Directory of Open Access Journals (Sweden)

    Zerfu Taddese

    2012-06-01

    Full Text Available Abstract Background People Living with HIV/AIDS (PLWHA require significant care and support; however, most care needs are still unmet. To our knowledge, no studies have described the activities and challenges of care services in Ethiopia. Our objective was to assess the status, shortcomings and prospects of care and support services provided to PLWHA in the town of Arba Minch, Ethiopia, and surrounding areas. Methods A cross-sectional quantitative study combined with qualitative methods was conducted in Southern Ethiopia among 226 randomly selected PLWHAs and 10 service providers who were purposively selected. Data was collected using a pre-tested structured interview questionnaire and in-depth interview guideline. Quantitative data was analyzed using SPSS windows based statistical software while qualitative data was analyzed manually using thematic framework analysis. Results A total of 226 PLWHAs were interviewed. Socio-economic support (material and income generating activities was being received by 108 (47.8% of the respondents, counseling services (e.g. psychological support were being received 128(56.6%, 144 (63.7% alleviation of stigma and discrimination as human right and legal support for study participants. Inadequate external financial support, lack of proper referral systems between different care providers were among the reasons identified for the low quality and redundancy of care and support activities. Nonetheless, many opportunities and prospects, including easily accessible care receivers (PLWHA, good political and societal will were also implicated. Conclusion Care and support services provided to PLWHAs in the study area are by far lower in terms of coverage and quantity. Strategies for improvement could be facilitated given the observed political will, social support and access to care givers.

  6. Occurrence, fate and risk assessment of personal care products in river-groundwater interface.

    Science.gov (United States)

    Serra-Roig, Maria Pau; Jurado, Anna; Díaz-Cruz, M Silvia; Vázquez-Suñé, Enric; Pujades, Estanislao; Barceló, Damià

    2016-10-15

    This work presents the occurrence and fate of selected personal care products (PCPs) in the urban river-groundwater interface. To this end, urban river and groundwater samples were collected in Sant Adrià del Besòs (NE of Spain) and a total of 16 PCPs were analyzed including benzophenone derivatives, camphor derivatives, p-aminobenzoic acid derivatives, triazoles and parabens in three different campaigns (from May 2010 to July 2014). These compounds reach the aquifer through the recharge of Besòs River that receives large amounts of effluents from waste water treatment plants. Results have shown that most of the compounds were not or barely detected (maximum concentrations around 200ng/L) in groundwater samples during the different sampling campaigns. Only two triazoles, namely benzotriazole (BZT) and methyl benzotriazol (MeBZT) were found at high concentrations in groundwater samples (maximum concentration around 2000ng/L). The fate of PCPs in the aquifer was assessed using mixing analysis considering the seasonal variability of the Besòs River. Overall, measured groundwater concentrations were significantly much lower than those estimated by the mixing of the river water. This observation suggested that most of the PCPs are naturally removed when river water infiltrates the aquifer. However, some compounds were more persistent in the aquifer. These compounds were in descending order: the triazoles BZT and MeBZT followed by the camphor derivative 4MBC and the paraben MePB. The measured concentrations allowed us to assess the environmental risk posed by the selected UV-filters and parabens in the river and groundwater samples. Hazard Quotients (HQs) for different aquatic species were calculated in order to characterize the ecotoxicity potential of the studied compounds in the river-groundwater interface. HQ values were always below 1 indicating that at the concentrations observed in the surface or aquifer water of Besòs River these compounds pose no risk to

  7. Cardiac Risk Assessment, Morbidity Prediction, and Outcome in the Vascular Intensive Care Unit.

    LENUS (Irish Health Repository)

    Dover, Mary

    2013-09-17

    Objectives: The aim of this study is to examine the predictive value of the Lee revised cardiac risk index (RCRI) for a standard vascular intensive care unit (ICU) population as well as assessing the utility of transthoracic echocardiography and the impact of prior coronary artery disease (CAD) and coronary revascularization on patient outcome. Design: This is a retrospective review of prospectively maintained Vascubase and prospectively collected ICU data. Materials and Methods: Data from 363 consecutive vascular ICU admissions were collected. Findings were used to calculate the RCRI, which was then correlated with patient outcomes. All patients were on optimal medical therapy (OMT) in the form of cardioselective β-blocker, aspirin, statin, and folic acid. Results: There was no relationship found between a reduced ejection fraction and patient outcome. Mortality was significantly increased for patients with left ventricular hypertrophy (LVH) as identified on echo (14.9% vs 6.5%, P = .028). The overall complication rates were significantly elevated for patients with valvular dysfunction. Discrimination for the RCRI on receiver-operating characteristic analysis was poor, with an area under the receiver-operating characteristic curve of .621. Model calibration was reasonable with an Hosmer-Lemeshow Ĉ statistic of 2.726 (P = .256). Of those with known CAD, 41.22% of the patients receiving best medical treatment developed acute myocardial infarction (AMI) compared to 35.3% of those who previously underwent percutaneous cardiac intervention and 23.5% of those who had undergone coronary artery bypass grafting. There was 3-fold increase in major adverse clinical events in patients with troponin rise and LVH. Conclusions: The RCRI\\'s discriminatory capacity is low, and this raises difficulties in assessing cardiac risk in patients undergoing vascular intervention. The AMI is highest in the OMT group without prior cardiac intervention, which mandates protocols to

  8. Building better systems of care for Aboriginal and Torres Strait Islander people: findings from the Kanyini health systems assessment

    Directory of Open Access Journals (Sweden)

    Peiris David

    2012-10-01

    Full Text Available Abstract Background Australian federal and jurisdictional governments are implementing ambitious policy initiatives intended to improve health care access and outcomes for Aboriginal and Torres Strait Islander people. In this qualitative study we explored Aboriginal Medical Service (AMS staff views on factors needed to improve chronic care systems and assessed their relevance to the new policy environment. Methods Two theories informed the study: (1 ‘candidacy’, which explores “the ways in which people’s eligibility for care is jointly negotiated between individuals and health services”; and (2 kanyini or ‘holding’, a Central Australian philosophy which describes the principle and obligations of nurturing and protecting others. A structured health systems assessment, locally adapted from Chronic Care Model domains, was administered via group interviews with 37 health staff in six AMSs and one government Indigenous-led health service. Data were thematically analysed. Results Staff emphasised AMS health care was different to private general practices. Consistent with kanyini, community governance and leadership, community representation among staff, and commitment to community development were important organisational features to retain and nurture both staff and patients. This was undermined, however, by constant fear of government funding for AMSs being withheld. Staff resourcing, information systems and high-level leadership were perceived to be key drivers of health care quality. On-site specialist services, managed by AMS staff, were considered an enabling strategy to increase specialist access. Candidacy theory suggests the above factors influence whether a service is ‘tractable’ and ‘navigable’ to its users. Staff also described entrenched patient discrimination in hospitals and the need to expend considerable effort to reinstate care. This suggests that Aboriginal and Torres Strait Islander people are still

  9. Assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran

    Directory of Open Access Journals (Sweden)

    Simin Taghavi

    2015-06-01

    Full Text Available Introduction: Patients satisfaction includes the assessment of healthcare which she/he received. This study aims at assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran. Methods: In an analytic-descriptive cross-sectional study, 1000 female patients who admitted in educational-medical centers of Northwest were studied during a 2 years period (2010-2012. They asked to fill a 34-item closed-answer questionnaire (ranking from very unsatisfied to very satisfied responses following their discharge. Validity of the questionnaire was improved by gynecologist’s experts comments, and reliability of the questionnaire were assessed by test-retest methods (α = 0.946. Results: The satisfaction score (satisfied or very satisfied responses were 61.2, 55.8, 61.8 and 59.5 percent for admitting process, primary care services, treatments and therapeutic interventions and overall, respectively. The satisfaction score for access to doctors was highest in the morning and lowest at the night shifts. The satisfaction score about the personnel’s behavior was lowest during the night shifts. The satisfaction score about the residents’ behavior was highest for the morning shifts. There was no significant difference between the three working shifts regarding psychological feelings, humanitarian respect, and issues like nutrition and private and public hygiene. There was a significant direct correlation between the mean score of satisfaction and patients’ age (Spearman’s rho = 0.117, P < 0.001. Conclusion: The satisfaction level of patients hospitalized in Northwest of Iran's Hospitals was intermediate. Planning new strategies in this regard with emphasis on the main limitations may improve the satisfaction rate in the future.

  10. Quality of Care for Patients with Type 2 Diabetes Mellitus in Dubai: A HEDIS-Like Assessment

    Directory of Open Access Journals (Sweden)

    Shelagh M. Szabo

    2015-01-01

    Full Text Available Objective. As little data are available on the quality of type 2 diabetes mellitus (T2DM care in the Arabian Gulf States, we estimated the proportion of patients receiving recommended monitoring at the Dubai Hospital for T2DM over one year. Methods. Charts from 150 adults with T2DM were systematically sampled and quality of care was assessed during one calendar year, using a Healthcare Effectiveness Data and Information Set- (HEDIS- like assessment. Screening for glycosylated haemoglobin (HbA1c, low-density lipoprotein (LDL, blood pressure, retinopathy, and nephropathy was considered. Patients were classified based on their most recent test in the period, and predictors of receiving quality care were examined. Results. Mean age was 58 years (standard deviation (SD: 12.4 years and 33% were males. Over the year, 98% underwent HbA1c screening (50% had control and 28% displayed poor control; 91% underwent LDL screening (65% had control; 55% had blood pressure control; 30% had retinopathy screening; and 22% received attention for nephropathy. No individual characteristics examined predicted receiving quality care. Conclusion. Some guideline monitoring was conducted for most patients; and rates of monitoring for selected measures were comparable to benchmarks from the United States. Greater understanding of factors leading to high adherence would be useful for other areas of preventive care and other jurisdictions.

  11. The online Prescriptive Index platform for the assessment of managerial competencies and coaching needs: development and initial validation of the experience sampling Mood Wheel and the Manager-Rational and Irrational Beliefs Scale

    Directory of Open Access Journals (Sweden)

    David, O.A.

    2013-12-01

    Full Text Available The Prescriptive Index platform is dedicated to the appraisal and development of managerial competencies, and it is comprised of such measures as the multi-rater Freeman-Gavita Prescriptive Executive Coaching (PEC Assessment for assessing core managerial skills, and the multi-rater Managerial Coaching Assessment System (MCAS for the evaluation of coaching competencies in managers. The aim of this research was to present the development and psychometric properties of new tools, part of the Prescriptive Index platform, for the assessment of managerial emotional competencies: the web and mobile based Mood Wheel measure using experience sampling procedures, for the assessment of current/previous distress and positive emotions; and the self-report Manager Rational and Irrational Beliefs Scale (M-RIBS for the assessment of managerial attitudes involved in emotion-regulation processes. Results obtained show that both instruments integrated in the Prescriptive Index platform have adequate initial psychometric support and predictive validity. Practical implications of our findings are discussed in the light of the importance of enabling organizations to accurately identify managerial competencies and coaching needs.

  12. An assessment of the quality of care for children in eighteen randomly selected district and sub-district hospitals in Bangladesh

    OpenAIRE

    Hoque Dewan ME; Rahman Muntasirur; Billah Sk Masum; Savic Michael; Karim AQM Rezaul; Chowdhury Enayet K; Hossain Altaf; Musa SAJ Md; Kumar Harish; Malhotra Sudhansh; Matin Ziaul; Raina Neena; Weber Martin W.; El Arifeen Shams

    2012-01-01

    Abstract Background Quality hospital care is important in ensuring that the needs of severely ill children are met to avert child mortality. However, the quality of hospital care for children in developing countries has often been found poor. As the first step of a country road map for improving hospital care for children, we assessed the baseline situation with respect to the quality of care provided to children under-five years age in district and sub-district level hospitals in Bangladesh....

  13. The Patients Assessment Chronic Illness Care (PACIC questionnaire in The Netherlands: a validation study in rural general practice

    Directory of Open Access Journals (Sweden)

    Hermsen Jan

    2008-09-01

    Full Text Available Abstract Background Many patients with chronic illness receive health care in primary care settings, so a challenge is to provide well-structured chronic care in these settings. Our aim was to develop and test a Dutch version of the PACIC questionnaire, a measure for patient reported structured chronic care. Methods Observational study in 165 patients with diabetes or COPD from four general practices (72% response rate. Patients completed a written questionnaire, which included instruments for assessing chronic illness care (PACIC, evaluations of general practice (Europep, enablement (PEI, and individual characteristics. Results The patients had a mean age of 68.0 years and 47% comprised of women. Twenty-two to 35% of responding patients did not provide answers to specific items in the PACIC. In 11 items the lowest answering category was used by 30% or more of the responders and in 6 items the highest answering category was used by this number of responders. Principal factor analysis identified the previously defined five domains reasonably well. Cronbach's alpha per domain varied from 0.71 to 0.83, and the intraclass coefficient from 0.66 to 0.91. Diabetes patients reported higher presence of structured chronic care for 14 out of the 20 PACIC items. The effect of patient evaluations of general practice on the PACIC score was positive (b = 0.72, p Conclusion A translated and validated Dutch version of the PACIC questionnaire is now available. Further research on its validity is recommended.

  14. Safety assessment of personal care products/cosmetics and their ingredients

    International Nuclear Information System (INIS)

    We attempt to review the safety assessment of personal care products (PCP) and ingredients that are representative and pose complex safety issues. PCP are generally applied to human skin and mainly produce local exposure, although skin penetration or use in the oral cavity, on the face, lips, eyes and mucosa may also produce human systemic exposure. In the EU, US and Japan, the safety of PCP is regulated under cosmetic and/or drug regulations. Oxidative hair dyes contain arylamines, the most chemically reactive ingredients of PCP. Although arylamines have an allergic potential, taking into account the high number of consumers exposed, the incidence and prevalence of hair dye allergy appears to be low and stable. A recent (2001) epidemiology study suggested an association of oxidative hair dye use and increased bladder cancer risk in consumers, although this was not confirmed by subsequent or previous epidemiologic investigations. The results of genetic toxicity, carcinogenicity and reproductive toxicity studies suggest that modern hair dyes and their ingredients pose no genotoxic, carcinogenic or reproductive risk. Recent reports suggest that arylamines contained in oxidative hair dyes are N-acetylated in human or mammalian skin resulting in systemic exposure to traces of detoxified, i.e. non-genotoxic, metabolites, whereas human hepatocytes were unable to transform hair dye arylamines to potentially carcinogenic metabolites. An expert panel of the International Agency on Research of Cancer (IARC) concluded that there is no evidence for a causal association of hair dye exposure with an elevated cancer risk in consumers. Ultraviolet filters have important benefits by protecting the consumer against adverse effects of UV radiation; these substances undergo a stringent safety evaluation under current international regulations prior to their marketing. Concerns were also raised about the safety of solid nanoparticles in PCP, mainly TiO2 and ZnO in sunscreens. However

  15. Safety assessment of personal care products/cosmetics and their ingredients.

    Science.gov (United States)

    Nohynek, Gerhard J; Antignac, Eric; Re, Thomas; Toutain, Herve

    2010-03-01

    We attempt to review the safety assessment of personal care products (PCP) and ingredients that are representative and pose complex safety issues. PCP are generally applied to human skin and mainly produce local exposure, although skin penetration or use in the oral cavity, on the face, lips, eyes and mucosa may also produce human systemic exposure. In the EU, US and Japan, the safety of PCP is regulated under cosmetic and/or drug regulations. Oxidative hair dyes contain arylamines, the most chemically reactive ingredients of PCP. Although arylamines have an allergic potential, taking into account the high number of consumers exposed, the incidence and prevalence of hair dye allergy appears to be low and stable. A recent (2001) epidemiology study suggested an association of oxidative hair dye use and increased bladder cancer risk in consumers, although this was not confirmed by subsequent or previous epidemiologic investigations. The results of genetic toxicity, carcinogenicity and reproductive toxicity studies suggest that modern hair dyes and their ingredients pose no genotoxic, carcinogenic or reproductive risk. Recent reports suggest that arylamines contained in oxidative hair dyes are N-acetylated in human or mammalian skin resulting in systemic exposure to traces of detoxified, i.e. non-genotoxic, metabolites, whereas human hepatocytes were unable to transform hair dye arylamines to potentially carcinogenic metabolites. An expert panel of the International Agency on Research of Cancer (IARC) concluded that there is no evidence for a causal association of hair dye exposure with an elevated cancer risk in consumers. Ultraviolet filters have important benefits by protecting the consumer against adverse effects of UV radiation; these substances undergo a stringent safety evaluation under current international regulations prior to their marketing. Concerns were also raised about the safety of solid nanoparticles in PCP, mainly TiO(2) and ZnO in sunscreens. However

  16. Improvements in the quality of co-ordination of nursing care following implementation of the Resident Assessment Instrument in Dutch nursing homes.

    NARCIS (Netherlands)

    Achterberg, W.P.; Holtkamp, C.C.M.; Kerkstra, A.; Pot, A.M.; Ooms, M.E.; Ribbe, M.W.

    2001-01-01

    Aim: To study the effect of implementation of the Resident Assessment Instrument (RAI) on the quality of co-ordination of nursing care in Dutch nursing homes. Background: The Resident Assessment Instrument (RAI) was designed to improve the quality of care and quality of life in nursing homes. Until

  17. The Staffordshire Arthritis, Musculoskeletal, and Back Assessment (SAMBA) Study: a prospective observational study of patient outcome following referral to a primary-secondary care musculoskeletal interface service

    OpenAIRE

    Jordan Kelvin P; Hider Samantha L; Dawes Peter; Zwierska Irena; Roddy Edward; Packham Jon; Stevenson Kay; Hay Elaine

    2010-01-01

    Abstract Background Recent healthcare policy has shifted the management of musculoskeletal conditions in the UK away from secondary care towards Clinical Assessment and Treatment Services at the primary-secondary care interface. However, little is known about the outcome of patients with musculoskeletal conditions referred from primary care to Clinical Assessment and Treatment Services or how best to identify those patients at high risk of poor outcome in this setting. We describe the protoco...

  18. Geriatric pain competencies and knowledge assessment for nurses in long term care settings

    OpenAIRE

    Swafford, Kristen L.; Miller, Lois L.; Herr, Keela; Forcucci, Chris; Kelly, Anne Marie L.; Bakerjian, Debra

    2014-01-01

    Pain in older adults is a prevalent problem that affects quality of life and challenges nurses, particularly those caring for older adults living in long term care settings. Despite the national priority of pain management, insufficient knowledge of nurses about geriatric pain is a documented barrier to effective geriatric pain management in all long term care settings. To address this knowledge gap, a website (GeriatricPain.org) was developed by the National Geriatric Pain Collaborative with...

  19. Wait Times for Sleep Apnea Care in Ontario: A Multidisciplinary Assessment

    OpenAIRE

    Rotenberg, Brian W; George, Charles F.; Sullivan, Kevin M; Eric Wong

    2010-01-01

    BACKGROUND: Obstructive sleep apnea (OSA) is a highly prevalent disorder that is associated with significant patient morbidity and societal burden. In general, wait times for health care in Ontario are believed to be lengthy; however, many diseases lack specific corroborative wait time data.OBJECTIVE: To characterize wait times for OSA care in Ontario.METHODS: Cross-sectional survey. A survey tool was designed and validated to question physicians involved in OSA care about the length of the w...

  20. Validation of a New Instrument for Self-Assessment of Nurses’ Core Competencies in Palliative Care

    OpenAIRE

    Kari Slåtten; Ove Hatlevik; Lisbeth Fagerström

    2014-01-01

    Competence can be seen as a prerequisite for high quality nursing in clinical settings. Few research studies have focused on nurses’ core competencies in clinical palliative care and few measurement tools have been developed to explore these core competencies. The purpose of this study was to test and validate the nurses’ core competence in palliative care (NCPC) instrument. A total of 122 clinical nurse specialists who had completed a postbachelor program in palliative care at two university...

  1. Assessment and determinants of airborne bacterial and fungal concentrations in different indoor environments: Homes, child day-care centres, primary schools and elderly care centres

    Science.gov (United States)

    Madureira, Joana; Paciência, Inês; Rufo, João Cavaleiro; Pereira, Cristiana; Teixeira, João Paulo; de Oliveira Fernandes, Eduardo

    2015-05-01

    Until now the influence of risk factors resulting from exposure to biological agents in indoor air has been far less studied than outdoor pollution; therefore the uncertainty of health risks, and how to effectively prevent these, remains. This study aimed (i) to quantify airborne cultivable bacterial and fungal concentrations in four different types of indoor environment as well as to identify the recovered fungi; (ii) to assess the impact of outdoor bacterial and fungal concentrations on indoor air; (iii) to investigate the influence of carbon dioxide (CO2), temperature and relative humidity on bacterial and fungal concentrations; and (iv) to estimate bacterial and fungal dose rate for children (3-5 years old and 8-10 years old) in comparison with the elderly. Air samples were collected in 68 homes, 9 child day-care centres, 20 primary schools and 22 elderly care centres, in a total of 264 rooms with a microbiological air sampler and using tryptic soy agar and malt extract agar culture media for bacteria and fungi growth, respectively. For each building, one outdoor representative location were identified and simultaneously studied. The results showed that child day-care centres were the indoor microenvironment with the highest median bacterial and fungal concentrations (3870 CFU/m3 and 415 CFU/m3, respectively), whereas the lowest median concentrations were observed in elderly care centres (222 CFU/m3 and 180 CFU/m3, respectively). Indoor bacterial concentrations were significantly higher than outdoor concentrations (p < 0.05); whereas the indoor/outdoor ratios for the obtained fungal concentrations were approximately around the unit. Indoor CO2 levels were associated with the bacterial concentration, probably due to occupancy and insufficient ventilation. Penicillium and Cladosporium were the most frequently occurring fungi. Children's had two times higher dose rate to biological pollutants when compared to adult individuals. Thus, due to children

  2. [Development of a Conceptual Framework for the Assessment of Chronic Care in the Spanish National Health System].

    Science.gov (United States)

    Espallargues, Mireia; Serra-Sutton, Vicky; Solans-Domènech, Maite; Torrente, Elena; Moharra, Montse; Benítez, Dolors; Robles, Noemí; Domíngo, Laia; Escarrabill Sanglas, Joan

    2016-01-01

    The aim was to develop a conceptual framework for the assessment of new healthcare initiatives on chronic diseases within the Spanish National Health System. A comprehensive literature review between 2002 and 2013, including systematic reviews, meta-analysis, and reports with evaluation frameworks and/or assessment of initiatives was carried out; integrated care initiatives established in Catalonia were studied and described; and semistructured interviews with key stakeholders were performed. The scope and conceptual framework were defined by using the brainstorming approach.Of 910 abstracts identified, a total of 116 studies were included. They referred to several conceptual frameworks and/or assessment indicators at a national and international level. An overall of 24 established chronic care initiatives were identified (9 integrated care initiatives); 10 in-depth interviews were carried out. The proposed conceptual framework envisages: 1)the target population according to complexity levels; 2)an evaluation approach of the structure, processes, and outcomes considering the health status achieved, the recovery process and the maintenance of health; and 3)the dimensions or attributes to be assessed. The proposed conceptual framework will be helpful has been useful to develop indicators and implement them with a community-based and result-oriented approach and a territorial or population-based perspective within the Spanish Health System. This will be essential to know which are the most effective strategies, what are the key elements that determine greater success and what are the groups of patients who can most benefit. PMID:27382930

  3. "Yeah, I Like It!" Assessing What Children Think of Child Care

    Science.gov (United States)

    Godfrey, Michael; Cemore, Joanna

    2005-01-01

    Children behave differently when they spend the day in child care and knowing their ideas about care is vital to understanding their happiness, continued development and learning. In this article, the authors share their methods and acquired wisdom about surveying young children, as well as the results of their study--what children think about…

  4. License-Exempt Child Care Providers: A Needs Assessment for Designing an Implementation Model

    Science.gov (United States)

    Roseburr, Linda Joyce

    2008-01-01

    Many children from low-income families appear to be not receiving quality child care from their license-exempt subsidized child-care providers. The purpose of this qualitative case study was to obtain data from a sample of license-exempt providers/caregivers and parents from a mailed self-administered survey and telephone interview. Four research…

  5. Assessing Indigent Health Care Needs and Use of County Health Services.

    Science.gov (United States)

    Brown, E. Richard; Cousineau, Michael R.

    In 1982 California eliminated 250,000 "medically indigent adults" (MIAs) from the Medi-Cal program and transferred responsibility for their care to the counties, along with about 70% of what the state would have spent on their care had they remained in the Medi-Cal program. There is far greater variability among the counties in benefits,…

  6. An Instrument to Assess the Obesogenic Environment of Child Care Centers

    Science.gov (United States)

    Ward, Dianne; Hales, Derek; Haverly, Katie; Marks, Julie; Benjamin, Sara; Ball, Sarah; Trost, Stewart

    2008-01-01

    Objectives: To describe protocol and interobserver agreements of an instrument to evaluate nutrition and physical activity environments at child care. Methods: Interobserver data were collected from 9 child care centers, through direct observation and document review (17 observer pairs). Results: Mean agreement between observer pairs was 87.26%…

  7. Cancer survivors and their partners: the assessment of unmet supportive care needs

    International Nuclear Information System (INIS)

    Our understanding of unmet supportive care needs of cancer survivors and their partners is limited. Most studies have focused on needs of patients undergoing treatment and on Quality of life or patient satisfaction. For the purpose of this research, cancer survivors are defined as persons who received a cancer diagnosis at least one year previously and are disease free. The aim of this study is to develop measures to assess unmet needs in survivors and their partners. After developing the questionnaire items it was piloted for validity in a wide sample of cancer patients from the radiation oncology department. 105 patients, all women, 101 with breast cancer and 40 partners participated. Psychological morbidity of depression and anxiety was recorded and was low. Quality of life for both survivors and partners was close to the US population mean. For patients top 4 unmet needs was 1. Anxiety about cancer returning (35%), current information (21%), understandable information (28%), ongoing case manager (25%). Unmet needs for partners were 1. Need to know all the doctors were communication (3.2%), need for local health services (2.8%), current information (2.1%) and help with managing concerns about the cancer returning (2.1%). 73% of partners reported at least one positive outcome from their partner's experience, significantly more than the survivors. In conclusion, interim analysis of the questionnaire reveals validity. Survivors report ongoing high levels of unmet needs 3-9 years after cancer diagnosis ( 30%). Less than 4% of partners report such unmet needs. There is significant correlation between needs of partners and survivors, many of which relate to issues of ongoing support and information delivery

  8. Assessment of spontaneous pneumothorax in adults in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Aparup Dhua

    2015-01-01

    Full Text Available Context: Pneumothorax continues to be a major cause of morbidity and mortality among respiratory patients, but there is a paucity of data regarding etiology, clinical profile, management, and outcome of spontaneous pneumothorax (SP, from this part of the world. Aims: To assess the patients of spontaneous pneumothorax in adults with special reference to the etiology, clinical presentation, management, and outcome of SP. Settings and Design: Prospective, observational study conducted in a tertiary care institution over a period of one year. Materials and Methods: All adult patients of SP attending the department of pulmonary medicine in a tertiary hospital were studied and detailed clinical, radiological, and management data were recorded and analyzed. Results: Sixty consecutive patients, who satisfied the inclusion criteria were included in the study. Among them 10 had primary spontaneous pneumothorax (PSP and 50 had secondary spontaneous pneumothorax (SSP. The overall male to female ratio was 4:1. The mean age of the PSP patients was 26.3 ± 2.19 years, whereas, that of the SSP patients was 53.42 ± 2.07 years (P < 0.0001. Seventy percent of the patients were smokers. The most common clinical manifestation of PSP was chest pain (80% in contrast to dyspnea in SSP (96%. The most common cause of SSP (42% was found to be chronic obstructive pulmonary disease (COPD followed by pulmonary tuberculosis (30%. The cases were managed with intercostal tube drainage (85%, simple aspiration (8.33%, and observation (6.67%. Full expansion of the lung was noted in 91.67% of the cases. Conclusion: Spontaneous pneumothorax was more common in men. SSP was far more common in this study, and the predominant underlying cause of SSP was COPD, which surpassed tuberculosis as the leading cause of SSP. This is in contrast to the results from previous studies done in our country. Intercostal tube drainage was the mainstay of treatment and the response was good.

  9. Infection control in delivery care units, Gujarat state, India: A needs assessment

    Directory of Open Access Journals (Sweden)

    Ramani KV

    2011-05-01

    Full Text Available Abstract Background Increasingly, women in India attend health facilities for childbirth, partly due to incentives paid under government programs. Increased use of health facilities can alleviate the risks of infections contracted in unhygienic home deliveries, but poor infection control practices in labour and delivery units also cause puerperal sepsis and other infections of childbirth. A needs assessment was conducted to provide information on procedures and practices related to infection control in labour and delivery units in Gujarat state, India. Methods Twenty health care facilities, including private and public primary health centres and referral hospitals, were sampled from two districts in Gujarat state, India. Three pre-tested tools for interviewing and for observation were used. Data collection was based on existing infection control guidelines for clean practices, clean equipment, clean environment and availability of diagnostics and treatment. The study was carried out from April to May 2009. Results Seventy percent of respondents said that standard infection control procedures were followed, but a written procedure was only available in 5% of facilities. Alcohol rubs were not used for hand cleaning and surgical gloves were reused in over 70% of facilities, especially for vaginal examinations in the labour room. Most types of equipment and supplies were available but a third of facilities did not have wash basins with "hands-free" taps. Only 15% of facilities reported that wiping of surfaces was done immediately after each delivery in labour rooms. Blood culture services were available in 25% of facilities and antibiotics are widely given to women after normal delivery. A few facilities had data on infections and reported rates of 3% to 5%. Conclusions This study of current infection control procedures and practices during labour and delivery in health facilities in Gujarat revealed a need for improved information systems

  10. Knowledge based ranking algorithm for comparative assessment of post-closure care needs of closed landfills

    International Nuclear Information System (INIS)

    Post-closure care (PCC) activities at landfills include cap maintenance; water quality monitoring; maintenance and monitoring of the gas collection/control system, leachate collection system, groundwater monitoring wells, and surface water management system; and general site maintenance. The objective of this study was to develop an integrated data and knowledge based decision making tool for preliminary estimation of PCC needs at closed landfills. To develop the decision making tool, 11 categories of parameters were identified as critical areas which could affect future PCC needs. Each category was further analyzed by detailed questions which could be answered with limited data and knowledge about the site, its history, location, and site specific characteristics. Depending on the existing knowledge base, a score was assigned to each question (on a scale 1-10, as 1 being the best and 10 being the worst). Each category was also assigned a weight based on its relative importance on the site conditions and PCC needs. The overall landfill score was obtained from the total weighted sum attained. Based on the overall score, landfill conditions could be categorized as critical, acceptable, or good. Critical condition indicates that the landfill may be a threat to the human health and the environment and necessary steps should be taken. Acceptable condition indicates that the landfill is currently stable and the monitoring should be continued. Good condition indicates that the landfill is stable and the monitoring activities can be reduced in the future. The knowledge base algorithm was applied to two case study landfills for preliminary assessment of PCC performance.

  11. The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies

    OpenAIRE

    Gusmao-Flores, Dimitri; Salluh, Jorge Ibrain Figueira; Chalhub, Ricardo Ávila; Lucas C Quarantini

    2012-01-01

    Introduction Delirium is a frequent form of acute brain dysfunction in critically ill patients, and several detection tools for it have been developed for use in the Intensive Care Unit (ICU). The objective of this study is to evaluate the current evidence on the accuracy of the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for the diagnosis of delirium in critically ill patients. Methods A systematic review was condu...

  12. Distraction: an assessment of smartphone usage in health care work settings

    Directory of Open Access Journals (Sweden)

    Gill PS

    2012-08-01

    Full Text Available Preetinder S Gill,1 Ashwini Kamath,2 Tejkaran S Gill31College of Technology, Eastern Michigan University, Ypsilanti, MI, USA; 2School of Information, University of Texas, Austin, TX, USA; 3College of Engineering, University of Michigan, Ann Arbor, MI, USAAbstract: Smartphone use in health care work settings presents both opportunities and challenges. The benefits could be severely undermined if abuse and overuse are not kept in check. This practice-focused research paper examines the current panorama of health software applications. Findings from existing research are consolidated to elucidate the level and effects of distraction in health care work settings due to smartphone use. A conceptual framework for crafting guidelines to regulate the use of smartphones in health care work settings is then presented. Finally, specific guidelines are delineated to assist in creating policies for the use of smartphones in a health care workplace.Keywords: smartphone, health care, distraction, workplace, mobile apps, health informatics

  13. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    Directory of Open Access Journals (Sweden)

    Leppert W

    2014-05-01

    Full Text Available Wojciech Leppert,1 Mikolaj Majkowicz,2 Maria Forycka,1 Eleonora Mess,3 Agata Zdun-Ryzewska2 1Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland; 2Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland; 3Palliative Care Nursing Department, Wroclaw Medical University, Wroclaw, Poland Aim of the study: To assess quality of life (QoL in cancer patients treated at home, at an in-patient palliative care unit (PCU, and at a day care center (DCC. Patients and methods: QoL was assessed in advanced cancer patients at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL, the Edmonton Symptom Assessment System (ESAS, and the Karnofsky Performance Status (KPS scale. Results: A total of 129 patients completed the study, with 51 patients treated at home, 51 patients treated at the PCU, and 27 patients at DCC. In the EORTC QLQ-C15-PAL, improvement in functional and symptom scales was observed except in physical functioning and fatigue levels; patients at DCC had a better physical functioning, global QoL, appetite, and fatigue levels. In the ESAS, improvement in all items was found except for drowsiness levels, which was stable in patients treated at DCC and deteriorated in home and PCU patients. Higher activity, better appetite and well-being, and less drowsiness were observed in patients treated at DCC. KPS was better in DCC patients compared to those treated at home and at the PCU; the latter group deteriorated. Conclusions: QoL improved in all patient groups, with better results in DCC patients and similar scores in those staying at home and at the PCU. Along with clinical assessment, baseline age, KPS, physical and emotional functioning may be considered when assigning patients to care at a DCC, PCU, or at home. Keywords: oncology, patient care

  14. Obstetric care providers are able to assess psychosocial risks, identify and refer high-risk pregnant women: validation of a short assessment tool – the KINDEX Greek version

    OpenAIRE

    Spyridou, Andria; Schauer, Maggie; Ruf-Leuschner, Martina

    2015-01-01

    Background Prenatal assessment for psychosocial risk factors and prevention and intervention is scarce and, in most cases, nonexistent in obstetrical care. In this study we aimed to evaluate if the KINDEX, a short instrument developed in Germany, is a useful tool in the hands of non-trained medical staff, in order to identify and refer women in psychosocial risk to the adequate mental health and social services. We also examined the criterion-related concurrent validity of the tool through a ...

  15. Assessing fun in platform games

    OpenAIRE

    Diogo Ferreira Pinela

    2015-01-01

    Os jogos de plataformas são um dos géneros mais antigos de videojogos, e têm ganho popularidade recentemente devido às suas mecânicas simples. No entanto, podem tornar-se repetitivos depois de terminados, pelo que podem beneficiar significativamente do uso de geração procedimental de conteúdos, estendendo a sua duração sem aborrecer o jogador. Há vários métodos para gerar níveis procedimentalmente; alguns juntam componentes de baixo nível diretamente, enquanto outros baseiam as suas construçõ...

  16. Patient Experience Assessment is a Requisite for Quality Evaluation: A Discussion of the In-Center Hemodialysis Consumer Assessment of Health Care Providers and Systems (ICH CAHPS) Survey.

    Science.gov (United States)

    Cavanaugh, Kerri L

    2016-03-01

    Patient experience surveys provide a critical and unique perspective on the quality of patient-centered healthcare delivery. These surveys provide a mechanism to systematically express patients' voice on topics valued by patients to make decisions about choices in care. They also provide an assessment to healthcare organizations about their service that cannot be obtained from any other source. Regulatory agencies have mandated the assessment of patients' experience as part of healthcare value based purchasing programs and weighted the results to account for up to 30% of the total scoring. This is a testimony to the accepted importance of this metric as a fundamental assessment of quality. After more than a decade of rigorous research, there is a significant body of growing evidence supporting specifically the validity and use of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, including a version specific to in-center hemodialysis (ICH CAHPS). This review will focus on the ICH CAHPS survey including a review of its development, content, administration, and also a discussion of common criticisms. Although it is suggested that the survey assesses activities and experiences that are not modifiable by the healthcare organization (or the dialysis facility in our case) emerging evidence suggests otherwise. Dialysis providers have an exclusive opportunity to lead the advancement of understanding the implications and serviceability of the evaluation of the patient experience in health care. PMID:26858008

  17. Primary care physicians’ perspectives on computer-based health risk assessment tools for chronic diseases: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Teja Voruganti

    2015-09-01

    Full Text Available Background Health risk assessment tools compute an individual’s risk of developing a disease. Routine use of such tools by primary care physicians (PCPs is potentially useful in chronic disease prevention. We sought physicians’ awareness and perceptions of the usefulness, usability and feasibility of performing assessments with computer-based risk assessment tools in primary care settings.Methods Focus groups and usability testing with a computer-based risk assessment tool were conducted with PCPs from both university-affiliated and community-based practices. Analysis was derived from grounded theory methodology.Results PCPs (n = 30 were aware of several risk assessment tools although only select tools were used routinely. The decision to use a tool depended on how use impacted practice workflow and whether the tool had credibility. Participants felt that embedding tools in the electronic medical records (EMRs system might allow for health information from the medical record to auto-populate into the tool. User comprehension of risk could also be improved with computer-based interfaces that present risk in different formats.Conclusions In this study, PCPs chose to use certain tools more regularly because of usability and credibility. Despite there being differences in the particular tools a clinical practice used, there was general appreciation for the usefulness of tools for different clinical situations. Participants characterised particular features of an ideal tool, feeling strongly that embedding risk assessment tools in the EMR would maximise accessibility and use of the tool for chronic disease management. However, appropriate practice workflow integration and features that facilitate patient understanding at point-of-care are also essential. 

  18. Creating archetypes for patient assessment with nurses to facilitate shared patient centred care in the older person

    OpenAIRE

    Hussey, Pamela

    2010-01-01

    The process of what information is captured in documenting patient care assessment and how it is summarised, communicated and interpreted by nurses across different healthcare services is the main focus of this thesis. Currently in Ireland, systems within the domain of healthcare are undergoing transformation. Existing practices where health information is collected at one local health organisation level and often duplicated across differing services will not support the strategic goals of th...

  19. Assessment of knowledge on causes and care of neonatal jaundice at the Nigerian primary and secondary health institutions

    OpenAIRE

    Olusegun Joseph Adebami

    2015-01-01

    Background: Neonatal jaundice is the most common condition that requires medical attention in new-borns. However, missed diagnosis of jaundice, poor monitoring, and prescriptions of wrong and ineffective medications by the health workers for jaundice are known to be responsible for the persistence of acute bilirubin encephalopathy in the sub region. Therefore, the aim of the present study was therefore to assess the knowledge in the care of neonatal jaundice at the primary and secondary heal...

  20. Improving Pathways to Assessment and Care for Infants of Substance Abusing Mothers: Are We Getting It Right?

    OpenAIRE

    Joanna Alexander; Shanti Raman; Terence Yoong; Belinda Mawhinney

    2015-01-01

    There is documented correlation between parental substance abuse, child maltreatment, and poor outcomes. In two health districts in Sydney, Australia (Site A and B), specialised clinics were established to provide comprehensive assessments for infants of substance abusing mothers (ISAM). We aimed to determine whether there was a difference in outcomes between infants who attended clinic versus those who did not; and to identify differences in the pathways to care between sites. We analysed ch...

  1. Assessing the Effectiveness of an Educational Program on Compliance with Hand Hygiene in a Pediatric Intensive Care Unit

    OpenAIRE

    Charalampia Nteli; Petros Galanis; Despoina Koumpagioti; Georgios Poursanidis; Eleni Panagiotopoulou; Vasiliki Matziou

    2014-01-01

    Objective. To identify the impact of an educational intervention on compliance of health professionals with hand hygiene. Method. The survey involved nurses, doctors, and physiotherapists who work in pediatric intensive care unit of a pediatric hospital. A multifaceted hand hygiene educational program was introduced with compliance assessed during successive observational surveys. Results. The total healthcare professionals’ compliance increased from 31.8% in the baseline period to 51.5% imme...

  2. Assessment of the health care waste generation rates and its management system in hospitals of Addis Ababa, Ethiopia, 2011

    OpenAIRE

    Debere Mesfin Kote; Gelaye Kassahun Alemu; Alamdo Andamlak Gizaw; Trifa Zemedu Mehamed

    2013-01-01

    Abstract Background Healthcare waste management options are varying in Ethiopia. One of the first critical steps in the process of developing a reliable waste management plan requires a widespread understanding of the amount and the management system. This study aimed to assess the health care waste generation rate and its management system in some selected hospitals located in Addis Ababa, Ethiopia. Methods Six hospitals in Addis Ababa, (three private and three public), were selected using s...

  3. Focus group reflections on the current and future state of cognitive assessment tools in geriatric health care

    OpenAIRE

    Whitehead JC; Gambino SA; Richter JD; Ryan JD

    2015-01-01

    Jocelyne C Whitehead,1 Sara A Gambino,1 Jeffrey D Richter,2 Jennifer D Ryan1,3,41Rotman Research Institute, Baycrest, 2Independent Human Factors Consultant, Toronto, ON, Canada; 3Department of Psychology, 4Department of Psychiatry, University of Toronto, Toronto, ON, CanadaObjective: This study provides insight into the thoughts and opinions of geriatric health-care professionals toward cognitive assessments and the use of emerging technologies, such as eye-tracking, to supplement current too...

  4. Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya

    OpenAIRE

    Burke, Thomas F.; Hines, Rosemary; Ahn, Roy; Walters, Michelle; Young, David; Anderson, Rachel Eleanor; Tom, Sabrina M; Clark, Rachel; Obita, Walter; Nelson, Brett D

    2014-01-01

    Objective: Injuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting. Methods: We conducted an assessment within all 30 primary and secondary hospitals an...

  5. Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya

    OpenAIRE

    Burke, Thomas F.; Hines, Rosemary; Ahn, Roy; Walters, Michelle; Young, David; Anderson, Rachel Eleanor; Tom, Sabrina M; Clark, Rachel; Obita, Walter; Nelson, Brett D

    2014-01-01

    Objective Injuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting. Methods We conducted an assessment within all 30 primary and secondary hospitals and ...

  6. Patient safety and patient assessment in pre-hospital care: a study protocol

    OpenAIRE

    Andersson Hagiwara, Magnus; Nilsson, Lena; Stromsoe, Anneli; Axelsson, Christer; Kangstrom, Anna; Herlitz, Johan

    2016-01-01

    Background: Patient safety issues in pre-hospital care are poorly investigated. The aim of the planned study is to survey patient safety problems in pre-hospital care in Sweden. Methods/Design: The study is a retro-perspective structured medical record review based on the use of 11 screening criteria. Two instruments for structured medical record review are used: a trigger tool instrument designed for pre-hospital care and a newly development instrument designed to compare the pre-hospital as...

  7. Self-reported leisure time physical activity: a useful assessment tool in everyday health care

    Directory of Open Access Journals (Sweden)

    Rödjer Lars

    2012-08-01

    .94-4.35 and for reporting stress (men OR 3.59, 95 % CI: 2.34-5.49; women OR 1.25, 95% CI: 0.79-1.98, compared to the most active individuals, but also showed increased OR for most other risk factors analyzed above. Conclusion The self-reported PA-level according to the modernized Saltin-Grimby Physical Activity Level Scale, SGPALS, is associated with the presence of many cardiovascular risk factors, with the most inactive individuals having the highest risk factor profile, including self-reported stress. We propose that the present SGPALS may be used as an additional, simple tool in a routine risk assessment in e.g. primary care, to identify inactive individuals, with a higher risk profile.

  8. Deep Assessment: A Novel Framework for Improving the Care of People with Very Advanced Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Gordon Lyons

    2015-01-01

    Full Text Available Best practice in understanding and caring for people with advanced Alzheimer’s disease presents extraordinary challenges. Their severe and deteriorating cognitive impairments are such that carers find progressive difficulty in authentically ascertaining and responding to interests, preferences, and needs. Deep assessment, a novel multifaceted framework drawn from research into the experiences of others with severe cognitive impairments, has potential to empower carers and other support professionals to develop an enhanced understanding of people with advanced Alzheimer’s disease and so deliver better calibrated care in attempts to maximize quality of life. Deep assessment uses a combination of techniques, namely, Behaviour State Observation, Triangulated Proxy Reporting, and Startle Reflex Modulation Measurement, to deliver a comprehensive and deep assessment of the inner states (awareness, preferences, likes, and dislikes of people who cannot reliably self-report. This paper explains deep assessment and its current applications. It then suggests how it can be applied to people with advanced Alzheimer’s disease to develop others’ understanding of their inner states and to help improve their quality of life. An illustrative hypothetical vignette is used to amplify this framework. We discuss the potential utility and efficacy of this technique for this population and we also propose other human conditions that may benefit from research using a deep assessment approach.

  9. Validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU

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    Pipanmekaporn T

    2014-05-01

    Full Text Available Tanyong Pipanmekaporn,1 Nahathai Wongpakaran,2 Sirirat Mueankwan,3 Piyawat Dendumrongkul,2 Kaweesak Chittawatanarat,3 Nantiya Khongpheng,3 Nongnut Duangsoy31Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Division of Surgical Critical Care and Trauma, Department of Surgery, Chiang Mai University Hospital, Chiang Mai, ThailandPurpose: The purpose of this study was to determine the validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU, when compared to the diagnoses made by delirium experts.Patients and methods: This was a cross-sectional study conducted in both surgical intensive care and subintensive care units in Thailand between February–June 2011. Seventy patients aged 60 years or older who had been admitted to the units were enrolled into the study within the first 48 hours of admission. Each patient was randomly assessed as to whether they had delirium by a nurse using the Thai version of the CAM-ICU algorithm (Thai CAM-ICU or by a delirium expert using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.Results: The prevalence of delirium was found to be 18.6% (n=13 by the delirium experts. The sensitivity of the Thai CAM-ICU’s algorithms was found to be 92.3% (95% confidence interval [CI] =64.0%-99.8%, while the specificity was 94.7% (95% CI =85.4%-98.9%. The instrument displayed good interrater reliability (Cohen’s κ=0.81; 95% CI =0.64-0.99. The time taken to complete the Thai CAM-ICU was 1 minute (interquatile range, 1-2 minutes.Conclusion: The Thai CAM-ICU demonstrated good validity, reliability, and ease of use when diagnosing delirium in a surgical intensive care unit setting. The use of this diagnostic tool should be encouraged for daily, routine use, so as to promote the early detection

  10. Google Search and the Law on Dominance in the EU: An Assessment of the Compatibility of Current Methodology with Multi-Sided Platforms in Online Search

    OpenAIRE

    Herz, Martin

    2014-01-01

    Business platforms that utilise, or are based upon, internet technology are omnipresent in consumers daily lives. Since the dawn of the World Wide Web, the amount of web content has increased greatly. Simultaneously, business interests have sparked, meeting the arisen demand for particular online services. As a consequence, economists have defined a novel market in these sectors, namely that of multi-sided platform markets. To an important extent, these markets experience network effects, whi...

  11. An Early Assessment of Accountable Care Organizations' Efforts to Engage Patients and Their Families.

    Science.gov (United States)

    Shortell, Stephen M; Sehgal, Neil J; Bibi, Salma; Ramsay, Patricia P; Neuhauser, Linda; Colla, Carrie H; Lewis, Valerie A

    2015-10-01

    Accountable care organizations (ACOs) have incentives to meet quality and cost targets to share in any resulting savings. Achieving these goals will require ACOs to engage more actively with patients and their families. The extent to which ACOs do so is currently unknown. Using mixed methods, including a national survey, phone interviews, and site-visits, we examine the extent to which ACOs actively engage patients and their families, explore challenges involved, and consider approaches for dealing with those challenges. Results indicate that greater ACO use of patient activation and engagement (PAE) activities at the point-of-care may be related to positive perceptions among ACO leaders of the impact of PAE investments on ACO costs, quality, and outcomes of care. We identify a number of important practices associated with greater PAE, including high-level leadership commitment, goal-setting supported by adequate resources, extensive provider training, use of interdisciplinary care teams, and frequent monitoring and reporting on progress. PMID:26038349

  12. QUALITY ASSESSEMENT OF ANTE-NATAL CARE USING THE METHOD OF LOT QUALITY ASSURANCE SAMPLING

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    Sh. Salarilak

    1999-08-01

    Full Text Available To determine the coverage rate, timeliness and quality of ante-natal care in rural areas under the coverage of Health Houses in West Azerbaijan province, 30 Health Houses (HH were randomly selected out of 731 HH in the province. In each HH, using the method of Lot Quality Assurance Sampling (LQAS 28 women having recently born babies was selected. Data were collected using check-list for facilities, and questionnaires and forms to be completed from the files by interview. The study showed that the method of LQAS is quite effective for evaluation of this service at HH level. The weighted total coverage of ante-natal care was 46.2%. Quality of care was acceptable for 53.9% of mothers. The weighted average of time lines of care was 49.8%. Availability of facilities in delivery of this service was 100%, showing there was no short coming in this respect.

  13. Paediatric trainees and end-of-life care: a needs assessment for a formal educational intervention

    OpenAIRE

    Arzuaga, Bonnie H; Caldarelli, Leslie

    2015-01-01

    Background: Literature suggests a paucity of formal training in end-of-life care in contemporary American medical education. Similar to trainees in adult medicine, paediatric trainees are frequently involved in end-of-life cases. Objective: To determine current experience and comfort levels among paediatric trainees when caring for dying patients with the hypothesis that more clinical experience alone would not improve comfort. Methods: Paediatric residents, subspeciality fellows and programm...

  14. Assessing general practitioners' care of adult patients with learning disability: case-control study.

    OpenAIRE

    Whitfield, M.; Langan, J; Russell, O

    1996-01-01

    OBJECTIVE--To compare general practitioners' care of adult patients with learning disability with that of control patients in the same practice. DESIGN--Case-control study of patients and controls by a structured interview study of general practitioners. SETTING--Avon. PATIENTS--78 adult patients with learning disability and 78 age and sex matched controls--cared for by 62 general practitioners. MAIN MEASURES--Number and content of consultations and opinions of the general practitioners. RESU...

  15. Development of a Clinician Report Measure to Assess Psychotherapy for Depression in Usual Care Settings

    OpenAIRE

    Hepner, Kimberly A.; Azocar, Francisca; Greenwood, Gregory L.; Miranda, Jeanne; Burnam, M. Audrey

    2010-01-01

    Although mental health policy initiatives have called for quality improvement in depression care, practical tools to describe the quality of psychotherapy for depression are not available. We developed a clinician-report measure of adherence to three types of psychotherapy for depression—cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy. A total of 727 clinicians from a large, national managed behavioral health care organization responded to a mail survey. The mea...

  16. Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation

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    Thomas Hadjistavropoulos

    2016-01-01

    Full Text Available Background. Although feasible protocols for pain assessment and management in long-term care (LTC have been developed, these have not been implemented on a large-scale basis. Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so. Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted. Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain. Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices. Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

  17. Neonatal Mortality Risk Assessment in a Neonatal Intensive Care Unit (NICU

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    Babak Eshrati

    2007-09-01

    Full Text Available Objective: This study aims to assess the utility of a scoring system as predictor of neonatal mortality rate among the neonates admitted within one year to the neonatal intensive care unit (NICU of the Childrens Medical Center in Tehran, Iran.Material & Methods: Data were gathered from 213 newborns admitted to the NICU from September 2003 to August 2004. In addition to demographic data, Apgar scores at 1 minute and 5 minutes, history and duration of previous hospitalization, initial diagnosis and final diagnosis, and scoring system by using the score for the neonatal acute physiology-perinatal extension II (SNAP-PE II were carried out within 12 hours after admission to the NICU. All of the parameters were prospectively applied to the admitted newborns. The exclusion criteria were discharge or death in less than 24 hours after NICU admission.Findings: 198 newborn infants met the inclusion criteria. The mean and standard deviation (SD of the variables including postnatal age, birth weight, SNAP, and finally Apgar scores at 1 minute and 5 minutes of neonates under this study were 7.6 (0.5 days, 2479.8 (29.4 grams, 21.6 (1.1, 7.47 0.08(, and 7.71 (0.06, respectively. Twenty five of the 198 patients died (12.6%. Gestational age (P=0.03, birth weight (P=0.02, Apgar score at 5 minutes (0.001, and SNAP-PE II (P=0.04 were significantly related to the mortality rate. By Analyzing through logistic regression to evaluate the predictive value of these variables in relation to the risk of mortality, it was shown that only SNAP-PE II and Apgar score at 5 minutes could significantly predict the neonatal mortality.Conclusion: According to this study SNAP-PE II and Apgar score at 5 minutes can be used to predict mortality among the NICU patients. SNAP-PE II score had the best performance in predicting mortality in this study. More studies with larger samples are suggested to evaluate all of the above-mentioned parameters among neonates who are admitted to NICUs

  18. Assessing the accessibility of HIV care packages among tuberculosis patients in the Northwest Region, Cameroon

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    Miguel San

    2010-03-01

    Full Text Available Abstract Background Tuberculosis (TB and human immunodeficiency virus (HIV co-infection is a major source of morbidity and mortality globally. The World Health Organization (WHO has recommended that HIV counselling and testing be offered routinely to TB patients in order to increase access to HIV care packages. We assessed the uptake of provider-initiated testing and counselling (PITC, antiretroviral (ART and co-trimoxazole preventive therapies (CPT among TB patients in the Northwest Region, Cameroon. Methods A retrospective cohort study using TB registers in 4 TB/HIV treatment centres (1 public and 3 faith-based for patients diagnosed with TB between January 2006 and December 2007 to identify predictors of the outcomes; HIV testing/serostatus, ART and CPT enrolment and factors that influenced their enrolment between public and faith-based hospitals. Results A total of 2270 TB patients were registered and offered pre-HIV test counselling; 2150 (94.7% accepted the offer of a test. The rate of acceptance was significantly higher among patients in the public hospital compared to those in the faith-based hospitals (crude OR 1.97; 95% CI 1.33 - 2.92 and (adjusted OR 1.92; 95% CI 1.24 - 2.97. HIV prevalence was 68.5% (1473/2150. Independent predictors of HIV-seropositivity emerged as: females, age groups 15-29, 30-44 and 45-59 years, rural residence, previously treated TB and smear-negative pulmonary TB. ART uptake was 50.3% (614/1220 with 17.2% (253/1473 of missing records. Independent predictors of ART uptake were: previously treated TB and extra pulmonary TB. Finally, CPT uptake was 47.0% (524/1114 with 24% (590/1114 of missing records. Independent predictors of CPT uptake were: faith-based hospitals and female sex. Conclusion PITC services are apparently well integrated into the TB programme as demonstrated by the high testing rate. The main challenges include improving access to ART and CPT among TB patients and proper reporting and monitoring of

  19. Utility of routine data sources for feedback on the quality of cancer care: an assessment based on clinical practice guidelines

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    Baade Peter

    2009-05-01

    Full Text Available Abstract Background Not all cancer patients receive state-of-the-art care and providing regular feedback to clinicians might reduce this problem. The purpose of this study was to assess the utility of various data sources in providing feedback on the quality of cancer care. Methods Published clinical practice guidelines were used to obtain a list of processes-of-care of interest to clinicians. These were assigned to one of four data categories according to their availability and the marginal cost of using them for feedback. Results Only 8 (3% of 243 processes-of-care could be measured using population-based registry or administrative inpatient data (lowest cost. A further 119 (49% could be measured using a core clinical registry, which contains information on important prognostic factors (e.g., clinical stage, physiological reserve, hormone-receptor status. Another 88 (36% required an expanded clinical registry or medical record review; mainly because they concerned long-term management of disease progression (recurrences and metastases and 28 (11.5% required patient interview or audio-taping of consultations because they involved information sharing between clinician and patient. Conclusion The advantages of population-based cancer registries and administrative inpatient data are wide coverage and low cost. The disadvantage is that they currently contain information on only a few processes-of-care. In most jurisdictions, clinical cancer registries, which can be used to report on many more processes-of-care, do not cover smaller hospitals. If we are to provide feedback about all patients, not just those in larger academic hospitals with the most developed data systems, then we need to develop sustainable population-based data systems that capture information on prognostic factors at the time of initial diagnosis and information on management of disease progression.

  20. Assessment of Children’s Health and Indoor Air Contaminants of Day Care Centre in Industrial Area

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    Tezara CIONITA

    2015-10-01

    Full Text Available Background: Carbon dioxide (CO2 is one of the most commonly used indicators of indoor air quality (IAQ in industrial area. The higher concentration level of CO2 and particulate matter (PM10 in day care centre could affect children’s health. The objective of this study was to assess children’s health symptom, and measure the CO2 and PM10 concentration level as IAQ parameters in different locations of day care centres near the industrial area at Kuala Lumpur, Selangor and Hulu Langat as urban, suburban and rural areas respectively.Methods: The data of children’s health symptom were collected from the distributed questionnaire.Results: The day care centres (DCC in Kuala Lumpur has the highest number of children’s illness frequency of more than four times annually (11%, followed by the highest number of children who experienced asthma (5.3%, wheezing (3.3% and coughing (10%. The results of data collection of day care centres in Kuala Lumpur, Selangor and Hulu Langat ranged between 629-830 ppm, 587-823 ppm and 600-830 ppm for CO2 level, and 60.80-78.60 mg/m3, 56.90-80.50 mg/m3 and 59.90-79.10 mg/m3 for PM10 level. The statistical analysis for CO2 level between areas was significantly different (P<0.05.Conclusion: Day care centers in Kuala Lumpur have the highest mean rate of CO2 and PM10 as well as frequency of children’ illness which could identify traffic congestion and less greenery of a densely populated city. Keywords: Day care centre (DCC, IAQ, CO2, PM10, Health symptoms

  1. Adaptation and cross-cultural validationof the United States Primary Care Assessment Tool (expanded version for use in South Africa

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    Graham Bresick

    2015-02-01

    Full Text Available Background: Measuring primary care is important for health sector reform. The Primary Care Assessment Tool (PCAT measures performance of elements essential for cost-effective care. Following minor adaptations prior to use in Cape Town in 2011, a few findings indicated a need to improve the contentand cross-cultural validity for wider use in South Africa (SA.Aim: This study aimed to validate the United States of America-developed PCAT before being used in a baseline measure of primary care performance prior to major reform.Setting: Public sector primary care clinics, users, practitioners and managers in urban and rural districtsin the Western Cape Province.Methods: Face value evaluation of item phrasing and a combination of Delphi and Nominal Group Technique (NGT methods with an expert panel and user focus group were used to obtain consensus on content relevant to SA. Original and new domains and items with > = 70% agreement were included in the South African version – ZA PCAT.Results: All original PCAT domains achieved consensus on inclusion. One new domain, the primary healthcare (PHC team, was added. Three of 95 original items achieved < 70% agreement, that is consensus to exclude as not relevant to SA; 19 new items were added. A few items needed minor rephrasing with local healthcare jargon. The demographic section was adapted to local socio-economic conditions. The adult PCAT was translated into isiXhosa and Afrikaans.Conclusion: The PCAT is a valid measure of primary care performance in SA. The PHC team domainis an important addition, given its emphasis in PHC re-engineering. A combination of Delphi and NGT methods succeeded in obtaining consensus on a multi-domain, multi-item instrument in a resource-constrained environment.

  2. Assessing Asthma control in UK primary care: Use of routinely collected prospective observational consultation data to determine appropriateness of a variety of control assessment models

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    Norman Paul D

    2011-09-01

    Full Text Available Abstract Background Assessing asthma control using standardised questionnaires is recommended as good clinical practice but there is little evidence validating their use within primary care. There is however, strong empirical evidence to indicate that age, weight, gender, smoking, symptom pattern, medication use, health service resource use, geographical location, deprivation, and organisational issues, are factors strongly associated with asthma control. A good control measure is therefore one whose variation is most explained by these factors. Method Eight binary (Yes = poor control, No = good control models of asthma control were constructed from a large UK primary care dataset: the Royal College of Physicians 3-Questions (RCP-3Qs; the Jones Morbidity Index; three composite measures; three single component models. Accounting for practice clustering of patients, we investigated the effects of each model for assessing control. The binary models were assessed for goodness-of-fit statistics using Pseudo R-squared and Akaikes Information Criteria (AIC, and for performance using Area Under the Receiver Operator Characteristic (AUROC. In addition, an expanded RCP-3Q control scale (0-9 was derived and assessed with linear modelling. The analysis identified which model was best explained by the independent variables and thus could be considered a good model of control assessment. Results 1,205 practices provided information on 64,929 patients aged 13+ years. The RCP-3Q model provided the best fit statistically, with a Pseudo R-squared of 18%, and an AUROC of 0.79. By contrast, the composite model based on the GINA definition of controlled asthma had a higher AIC, an AUROC of 0.72, and only 10% variability explained. In addition, although the Peak Expiratory Flow Rate (PEFR model had the lowest AIC, it had an AUROC of 71% and only 6% of variability explained. However, compared with the RCP-3Qs binary model, the linear RCP-3Q Total Score Model (Scale 0

  3. A Comparative Study on Hardware Platforms for Wireless Sensor Networks

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    Thang Vu Chien

    2012-01-01

    Full Text Available Recently, Wireless Sensor Networks (WSNs attract a great deal of research attention, and are envisioned to support a variety of applications, including building monitoring, environment control, wild-life habitat monitoring, forest fire detection, industry automation, military, security, and health-care. Over the years, we have seen a variety of hardware platforms for WSNs to facilitate developing WSN applications. In this paper, we provide a comprehensive review of existing hardware platforms for WSNs. We first present the hardware architecture of a wireless sensor node. We then survey the major hardware platforms for WSNs and present a comparison of these hardware platforms. Finally we present some recommendations from the perspectives of hardware platform developers and hardware platform users. The authors hope that making information about existing hardware platforms will assist researchers working in this area to appreciate the diversity of platforms available to them and to help them select the most appropriate platform for their purposes.

  4. SNMP management of MASIF platforms

    OpenAIRE

    Lopes, Rui Pedro; Oliveira, José Luís

    2001-01-01

    In this paper we describe the architecture, the development and the assessment results of an SNMP agent that allows MASIF compliant platforms to be managed through SNMP. The major outcome of this work is a simple integration of mobile agent technology with any well-established commercial network management system.

  5. Assessing the accessibility and degree of development in health care resources: evidence from the West of Iran

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    Satar Rezaei

    2016-04-01

    Full Text Available Introduction: Health care is one of the most important sectors in the development of each country and disparities in their distribution will reduce the level of development. The aim of this study was to examine the access to healthcare and degree of development in health care resources in the west of Iran in 2011. Method: This was a cross-sectional and retrospective study. The study setting was 51 cities of five western provinces of Iran, including Kermanshah, Kurdistan, Ilam, Lorestan and Hamadan. For assessing these towns in terms of the degree of development in healthcare resources by the numerical taxonomy technique, 23 indicators of health resources were selected and obtained from the statistics yearbook. The data was analyzed by EXCEL software. Results:Our study showed that the highest and lowest access to health care based on numerical taxonomy belonged to cities of Kermanshah (0.61 and Salas Babajani (1.07. Also, most towns of Ilam, Lorestan and Kurdistan provinces are underdeveloped and developing, while the most towns of Kermanshah and Hamadan provinces were placed in the developed region. Conclusion: This study showed that there was a large gap between the cities of one province and also among the provinces in terms of the access to and degree of development in health care resources. Therefore, it is suggested that a higher priority in terms of health resource allocation should be placed on the developing and underdeveloped areas in order to reduce these disparities.

  6. Analyzing the "CareGap": assessing gaps in adherence to clinical guidelines in adult soft tissue sarcoma.

    Science.gov (United States)

    Waks, Zeev; Goldbraich, Esther; Farkash, Ariel; Torresani, Michele; Bertulli, Rossella; Restifo, Nicola; Locatelli, Paolo; Casali, Paolo; Carmeli, Boaz

    2013-01-01

    Clinical decision support systems (CDSSs) are gaining popularity as tools that assist physicians in optimizing medical care. These systems typically comply with evidence-based medicine and are designed with input from domain experts. Nonetheless, deviations from CDSS recommendations are abundant across a broad spectrum of disorders, raising the question as to why this phenomenon exists. Here, we analyze this gap in adherence to a clinical guidelines-based CDSS by examining the physician treatment decisions for 1329 adult soft tissue sarcoma patients in northern Italy using patient-specific parameters. Dubbing this analysis "CareGap", we find that deviations correlate strongly with certain disease features such as local versus metastatic clinical presentation. We also notice that deviations from the guideline-based CDSS suggestions occur more frequently for patients with shorter survival time. Such observations can direct physicians' attention to distinct patient cohorts that are prone to higher deviation levels from clinical practice guidelines. This illustrates the value of CareGap analysis in assessing quality of care for subsets of patients within a larger pathology. PMID:23542965

  7. Subjective Assessment of Diabetes Self-Care Correlates with Perceived Glycemic Control but not with Actual Glycemic Control

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    Jung Hun Ohn

    2015-02-01

    Full Text Available BackgroundWe investigated whether patients' perceived glycemic control and self-reported diabetes self-care correlated with their actual glycemic control.MethodsA survey was administered among patients with diabetes mellitus at an outpatient clinic with structured self-report questionnaires regarding perceived glycemic control and diabetes self-management. Actual glycemic control was defined as a change in glycated hemoglobin (A1C or fasting plasma glucose (FPG since the last clinic visit.ResultsPatients who perceived their glycemic control as "improved" actually showed a mild but significant decrease in the mean A1C (-0.1%, P=0.02, and those who perceived glycemic control as "aggravated" had a significant increase in the mean FPG (10.5 mg/dL or 0.59 mmol/L, P=0.04 compared to the "stationary" group. However, one-half of patients falsely predicted their actual glycemic control status. Subjective assessment of diabetes self-care efforts, such as adherence to a diet regimen or physical activity, correlated positively with perceived glycemic control but showed no association with actual glycemic control.ConclusionPatients should be encouraged to assess and monitor diabetes self-care more objectively to motivate behavioral modifications and improve their actual glycemic control.

  8. Nurse Work Engagement Impacts Job Outcome and Nurse-Assessed Quality of Care: Model Testing with Nurse Practice Environment and Nurse Work Characteristics as Predictors

    OpenAIRE

    Peter Mathieu Van Bogaert; Danny eVan heusden; Olaf eTimmermans; Erik eFranck

    2014-01-01

    Key words: burnout,job satisfaction, nurse retention, nurse practice environment,quality of care, acute health care,structural equation modelling. Aim:To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption.Background: Un...

  9. Assessing the Need for a New Household Panel Study: Health Insurance and Health Care

    Science.gov (United States)

    Levy, Helen

    2016-01-01

    This paper considers the availability of data for addressing questions related to health insurance and health care and the potential contribution of a new household panel study. The paper begins by outlining some of the major questions related to policy and concludes that survey data on health insurance, access to care, health spending, and overall economic well-being will likely be needed to answer them. The paper considers the strengths and weaknesses of existing sources of survey data for answering these questions. The paper concludes that either a new national panel study, an expansion in the age range of subjects in existing panel studies, or a set of smaller changes to existing panel and cross-sectional surveys, would significantly enhance our understanding of the dynamics of health insurance, access to health care, and economic well-being.

  10. Medical savings accounts: assessing their impact on efficiency, equity and financial protection in health care.

    Science.gov (United States)

    Wouters, Olivier J; Cylus, Jonathan; Yang, Wei; Thomson, Sarah; McKee, Martin

    2016-07-01

    Medical savings accounts (MSAs) allow enrolees to withdraw money from earmarked funds to pay for health care. The accounts are usually accompanied by out-of-pocket payments and a high-deductible insurance plan. This article reviews the association of MSAs with efficiency, equity, and financial protection. We draw on evidence from four countries where MSAs play a significant role in the financing of health care: China, Singapore, South Africa, and the United States of America. The available evidence suggests that MSA schemes have generally been inefficient and inequitable and have not provided adequate financial protection. The impact of these schemes on long-term health-care costs is unclear. Policymakers and others proposing the expansion of MSAs should make explicit what they seek to achieve given the shortcomings of the accounts. PMID:26883211

  11. Assessment of level of comfort in providing multicultural nursing care by baccalaureate nursing students.

    Science.gov (United States)

    Kulwicki, A; Boloink, B J

    1996-01-01

    The purpose of this study was to measure the level of comfort in providing transcultural nursing care to clients of diverse cultural backgrounds by graduating baccalaureate students. The sample consisted of 71 senior baccalaureate students. The Cultural Self-Efficacy Scale developed by Bernal and Froman was modified and used to measure the confidence level of the graduating nurses in providing transcultural care to five major minority groups in Michigan. The Cultural Self Efficacy Scale is a 26-item Likert type scale which is grouped into two categories: knowledge of cultural concepts for specific ethnic groups (African Americans, Latino-Hispanics, Middle Easterners/Arabics, Asian/Pacific Islanders, and Native American), and confidence in transcultural nursing skills. The items are rated on a scale of 1-5. Results of the study indicate a total mean cultural self-efficacy rating of 2.6. This suggests that the graduating students had little self confidence in their ability to give culturally congruent care. This was evident across the five ethnic groups. Test item analysis for specific ethnic groups suggest that students felt the least degree of confidence in their knowledge of class structure and migration patterns. They felt the greatest degree of confidence in their knowledge of family organization and economic style of living. Test item analysis for the skills suggest that students had the highest degree of confidence in their ability to use interpreters that were provided by either the family or the hospital. They had the least amount of confidence in their ability to instruct clients in child care and evaluating the effectiveness of discharge teaching. Results suggest that the sample of graduating baccalaureate students studied do not feel confident about caring for Michigan's five major ethnic groups. The data obtained in this study support previous research that nursing students are not provided with the experiences needed to give transcultural care to

  12. Assessment of the Status of Prehospital Care in 13 Low- and Middle-Income Countries

    Science.gov (United States)

    Nielsen, Katie; Mock, Charles; Joshipura, Manjul; Rubiano, Andres M.; Zakariah, Ahmed; Rivara, Frederick

    2012-01-01

    Objectives Injury and other medical emergencies are becoming increasingly common in low- and middle-income countries (LMICs). Many to most of the deaths from these conditions occur outside of hospitals, necessitating the development of prehospital care. Prehospital capabilities are inadequately developed to meet the growing needs for emergency care in most LMICs. In order to better plan for development of prehospital care globally, this study sought to better understand the current status of prehospital care in a wide range of LMICs. Methods A survey was conducted of emergency medical services (EMS) leaders and other key informants in 13 LMICs in Africa, Asia, and Latin America. Questions addressed methods of transport to hospital, training and certification of EMS providers, organization and funding of EMS systems, public access to prehospital care, and barriers to EMS development. Results Prehospital care capabilities varied significantly, but in general, were less developed in low-income countries and in rural areas, where utilization of formal emergency medical services was often very low. Commercial drivers, volunteers, and other bystanders provided a large proportion of prehospital transport and occasionally also provide first aid in many locations. Although taxes and mandatory motor vehicle insurance provided supplemental funds to EMS in 85% of the countries, the most frequently cited barriers to further development of prehospital care was inadequate funding (36% of barriers cited). The next most commonly sited barriers were lack of leadership within the system (18%) and lack of legislation setting standards (18%). Conclusions Expansion of prehospital care to currently under- or un-served areas, especially in low-income countries and in rural areas, could make use of the already existing networks of first responders, such as commercial drivers and lay persons. Efforts to increase their effectiveness, such as more widespread first aid training, and better

  13. Assessment of new public management in health care: the French case.

    Science.gov (United States)

    Simonet, Daniel

    2014-01-01

    The French health care system embraced New Public Management (NPM) selectively, and crafted their own version of NPM using Diagnostic-Related-Group accounting to re-centralize the health care system. Other organizational changes include the adoption of quasi-markets, public private partnerships, and pay-for-performance schemes for General Practitioners. There is little evidence that these improved the performance of the system. Misrepresentation has remained high. With the 2009 Hospital, Patients, Health and Territories Act physician participation in hospital governance receded. Decision-making powers and health units were re-concentrated to instill greater national coherence into the health system. PMID:25283813

  14. An assessment of diabetes care in Palestinian refugee camps in Syria

    OpenAIRE

    Alabed, Samer; Guul, Aisha; Crighton, Claire; Alahdab, Fares; Fares, Munes; Morad, Mohammad; Sonbol, Mohamad B; Madmani, Mohammed E; Sasa, Anas; Unwin, Nigel

    2014-01-01

    Background: Palestinian refugees have been a displaced group of people since 1948, many of whom are living in refugee camps in the Middle East. They are entitled to free health care from the United Nations Relief and Work Agency (UNRWA). They show a higher prevalence of diabetes than the population in their host countries in the Middle East. This study examined the realities of care for diabetic patients in UNRWA health clinics in Damascus, Syria. The aim was three-fold: To investigate the le...

  15. Dental auscultation for nursing personnel as a model of oral health care education: development, baseline, and 6-month follow-up assessments.

    Science.gov (United States)

    Wårdh, Inger; Berggren, Ulf; Hallberg, Lillemor R M; Andersson, Lars; Sörensen, Stefan

    2002-01-01

    Oral health care has been shown to have low priority in nursing and has been only partly successful. To create more positive effects than those achieved through traditional oral health care education, this project tested an educational model for nursing staff personnel. In addition to traditional oral health care education, some of the nursing staff members passed an additional dental auscultation period and served as oral care aides. The aides were responsible for the oral health care of the residents at their nursing facilities (intervention group). The intervention nursing facilities were compared with facilities where nursing personnel only received a traditional oral health care education program. Assessments were made at baseline and at a 6-month follow-up. At follow-up it was shown that the nursing staff in the intervention group gave higher priority to the oral health care work than the nursing staff in the control group. PMID:11905448

  16. [Assessment of pharmaceutical care for pregnant women treated in the public health system in Praia Grande, São Paulo State, Brazil].

    Science.gov (United States)

    Vieira, Marlene Rosimar da Silva; Lorandi, Paulo Angelo; Bousquat, Aylene

    2008-06-01

    The use of medication in primary health care has increased steadily in recent decades, thus highlighting the relevance of assessing the pharmaceutical care provided to patients in the primary care setting. This article aimed to evaluate the pharmaceutical care provided by the public system in Greater Metropolitan Santos, São Paulo State, Brazil, focusing specifically on women during gestation. Methods included secondary data analysis, document analysis, interviews with key players, and visits to health services and to the pharmaceutical supply center. Deficiencies were identified in most stages of pharmaceutical care: selection, planning, purchase, storage, distribution, and dispensing. The results suggest that in order to improve primary health care, with better access, equality, and comprehensiveness, the evaluation of pharmaceutical care should be incorporated as a routine procedure. PMID:18545767

  17. From concept to content: assessing the implementation fidelity of a chronic care model for frail, older people who live at home.

    NARCIS (Netherlands)

    Muntinga, M.E.; Leeuwen, K.M. van; Schellevis, F.G.; Nijpels, G.; Jansen, A.P.D.

    2015-01-01

    Background: Implementation fidelity, the degree to which a care program is implemented as intended, can influence program impact. Since results of trials that aim to implement comprehensive care programs for frail, older people have been conflicting, assessing implementation fidelity alongside these

  18. Is the beck anxiety inventory a good tool to assess the severity of anxiety? A primary care study in The Netherlands study of depression and anxiety (NESDA)

    NARCIS (Netherlands)

    Muntingh, Anna D. T.; van der Feltz-Cornelis, Christina M.; van Marwijk, Harm W. J.; Spinhoven, Philip; Penninx, Brenda W. J. H.; van Balkom, Anton J. L. M.

    2011-01-01

    Background: Appropriate management of anxiety disorders in primary care requires clinical assessment and monitoring of the severity of the anxiety. This study focuses on the Beck Anxiety Inventory (BAI) as a severity indicator for anxiety in primary care patients with different anxiety disorders (so

  19. Dose assessment of medical staff taking care of patients treated with 131I due to the intake of 131I

    International Nuclear Information System (INIS)

    Aim: Legislation requires that patient receiving 131I in activities greater than 550MBq have to be hospitalized in special closed department. Medical staff taking care of these patients can be exposed to external irradiation and internal contamination with 131I. The aim of this study was to assess the annual effective dose of medical staff taking care of patients treated with 131I due to the occupational intake of 131I. Material - Medical Staff: 6 nurses took care of 6 patients (placed into two rooms) treated with 131I in activities between 550 and 1100 MBq. 131I was normally delivered to patients once per week. After patients received 131I nurses were in contact with patients in average 4 hours per day, 4 days per week. Methods: Direct Method - whole body counting (WBC) of staff was performed daily after they finished their work and indirect method - determination of air 131I concentration in patient's rooms (AC) were used to assess the intake of 131I by staff. Measurements were done in winter period.Results and Dose Assessment: Results of measurements of medical staff and determination of 131I air concentration are presented. Average daily 131I intake of staff assessed from WBC results was 315 Bq; average daily 131I air concentration for first four days was 35 Bq/m3. Assessment of annual effective dose due to the internal contamination (realistic approach): - Direct method: 315 Bq/day x 208 days/year x 7,6 Sv/Bq x 10-9 = 0,498 mSv/year. - Indirect method: 35 Bq/m3 x 1,5 m3/hour x 832 hours/year x 7,6 Sv/Bq x 10-9 = 0,332 mSv/year. Conclusion: Medical staff taking care of patients treated with 131I received effective dose less than 0,5 mSv/year due to the intake of 131I. In the some time period they received 1,65 to 2,24 mSv due to the exposure to the external radiation coming from patients treated with 131I

  20. Investigating mental health risk assessment in primary care and the potential role of a structured decision support tool, GRiST

    OpenAIRE

    Vail, Laura; Adams, Ann; Gilbert, Eleanor; Nettleingham, Alice; Buckingham, Christopher D.

    2012-01-01

    Aim To explore current risk assessment processes in general practice and Improving Access to Psychological Therapies (IAPT) services, and to consider whether the Galatean Risk and Safety Tool (GRiST) can help support improved patient care.