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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. Toward Ubiquitous Communication Platform for Emergency Medical Care

    Science.gov (United States)

    Ishibashi, Kenichi; Morishima, Naoto; Kanbara, Masayuki; Sunahara, Hideki; Imanishi, Masami

    Interaction between emergency medical technicians (EMTs) and doctors is essential in emergency medical care. Doctors require diverse information related to a patient to provide efficient aid. In 2005, we started the Ikoma119 project and have developed a ubiquitous communication platform for emergency medical care called Mobile ER. Our platform, which is based on wireless internet technology, has such desirable properties as low-cost, location-independent service, and ease of service introduction. We provide an overview of our platform and describe the services that we have developed. We also discuss the remaining issues to realize our platform's actual operation.

  6. 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...

  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. Cross-platform digital assessment forms for evaluating surgical skills

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts

    2015-01-01

    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...

  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. Assessing the assessment in emergency care training.

    Directory of Open Access Journals (Sweden)

    Mary E W Dankbaar

    Full Text Available Each year over 1.5 million health care professionals attend emergency care courses. Despite high stakes for patients and extensive resources involved, little evidence exists on the quality of assessment. The aim of this study was to evaluate the validity and reliability of commonly used formats in assessing emergency care skills.Residents were assessed at the end of a 2-week emergency course; a subgroup was videotaped. Psychometric analyses were conducted to assess the validity and inter-rater reliability of the assessment instrument, which included a checklist, a 9-item competency scale and a global performance scale.A group of 144 residents and 12 raters participated in the study; 22 residents were videotaped and re-assessed by 8 raters. The checklists showed limited validity and poor inter-rater reliability for the dimensions "correct" and "timely" (ICC = .30 and.39 resp.. The competency scale had good construct validity, consisting of a clinical and a communication subscale. The internal consistency of the (subscales was high (α = .93/.91/.86. The inter-rater reliability was moderate for the clinical competency subscale (.49 and the global performance scale (.50, but poor for the communication subscale (.27. A generalizability study showed that for a reliable assessment 5-13 raters are needed when using checklists, and four when using the clinical competency scale or the global performance scale.This study shows poor validity and reliability for assessing emergency skills with checklists but good validity and moderate reliability with clinical competency or global performance scales. Involving more raters can improve the reliability substantially. Recommendations are made to improve this high stakes skill assessment.

  11. Instruments to assess integrated care

    DEFF Research Database (Denmark)

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

    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 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...

  12. 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…

  13. 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...

  14. Cancer care coordination: building a platform for the development of care coordinator roles and ongoing evaluation.

    Science.gov (United States)

    Freijser, Louise; Naccarella, Lucio; McKenzie, Rosemary; Krishnasamy, Meinir

    2015-01-01

    Continuity of care is integral to the quality and safety of care provided to people with cancer and their carers. Further evidence is required to examine the contribution Nurse Cancer Care Coordinator (NCCC) roles make in improving the continuity. The aim of the present study was to clarify the assumptions underpinning the NCCC roles and provide a basis for ongoing evaluation. The project comprised a literature review and a qualitative study to develop program logic. The participants who were purposively sampled included policy makers, practitioners, patient advocates, and researchers. Both the literature and participant reports found that NCCC roles are diverse and responsive to contextual influences to coordinate care at the individual (patient), organisational, and systems levels. The application of the program logic for the development of NCCC roles was explored. The conceptualisation of NCCC roles was also examined in relation to Boundary Spanning and Relational Coordination theory. Further research is required to examine how NCCCs contribute to improving equity, safety, quality and coordination of care. The project has implications for research, policy and practice, and makes explicit existing assumptions to provide a platform for further development and evaluation of these roles. PMID:26509202

  15. Analysis and specification of an open platform for outpatient care in consideration of actual standard solutions

    Directory of Open Access Journals (Sweden)

    Rosales Saurer, Bruno

    2008-10-01

    Full Text Available The field of ambulatory nursing is rapidly growing due to rising health care costs and the demographic development. Today there are approximately 2 million persons in Germany who need outpatient care. Experts predict that there will be more than twice as much by 2050. Ambulatory care nurses must quickly and efficiently assess their patients’ condition and needs. Against this background, the VitaBIT project started in July 2007 with the objective of reorganizing ambulatory care in order to improve quality while at the same time increasing efficiency and saving costs. VitaBIT is promoted by the German federal ministry of economy and technology (BMWi. VitaBIT runs up to the end of 2009, partners of the project are CAS Software AG, PTV Planung Transport Verkehr AG, FZI Forschungszentrum Informatik, Sozial- und Diakoniestation Weinstadt e.V. und Wibu-Systems AG. VitaBIT aims to design an ICT platform for the safe application of mobile information services in ambulatory nursing. Communication and secure information exchange between all parties involved in the care process will also be guaranteed. The article explains the project’s current approach to develop a user-oriented solution by integrating already existing components and services.

  16. 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.

  17. 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)....

  18. Safety assessment of platform loadout procedures based on unascertained measures

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Safety assessment of offshore platforms is an urgent task. Such assessments are now focusing on the structure,maintenance, and retirement of a platform. Some methods employed have many shortcomings. For example, they cannot make the reliability adequately explicable. Therefore, a mathematical tool, the unascertained measure, was introduced. First, the basic knowledge of the unascertained sets was introduced briefly. Second, the unascertained measure was defined and credible identification was set up. The method has been introduced into the fields for safety assessment of a jacket loadout procedure.Engineering practices showed that it can complete the safety assessment systematically and scientifically without any assumption. The work should have significance in theory and practice for offshore engineering.

  19. 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.

  20. 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.

  1. 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

  2. Holistic wound assessment in primary care.

    Science.gov (United States)

    Cornforth, Amber

    2013-12-01

    Wound care is expensive and can cause immeasurable stress and inconvenience to patients and their significant others. It is therefore in the best interest of the patient, their significant others and the NHS as a whole that wounds are expertly assessed, managed and healed in the quickest timeframe possible. Nurses play a pivotal role in the process of accurate holistic wound assessment, evaluation and treatment. This article aims to help further develop and enhance both professional and clinical wound care assessment and evaluation skills. Pertinent wound care literature is critically reviewed and the crucial nature and important components of comprehensive wound assessment for facilitating the highest possible quality wound care to patients are presented alongside recommendations regarding how the enhanced knowledge and skills could be applied into everyday wound care practice.

  3. 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

  4. Agent-oriented context-aware platforms supporting communities of practice in health care

    NARCIS (Netherlands)

    Bonino da Silva Santos, L.O.; Guizzardi-Silva Souza, R.; Sinderen, van M.J.

    2005-01-01

    This paper presents and discusses the use of an agent-oriented context-aware platform to support communities of practice (CoPs) in the health care domain. Our work is based on a scenario where CoPs are applied in a hospital to enhance the knowledge sharing among the staff members who share interests

  5. PCATool: primary care assessment tool

    Directory of Open Access Journals (Sweden)

    Armando Henrique Norman

    2013-10-01

    Full Text Available A Revista Brasileira de Medicina de Família e Comunidade (RBMFC  encerra o ano de 2013 com uma edição em comemoração ao nascimento da Dra. Barbara Starfield em 18 de dezembro (18/12/1932 - 10/6/2011. A foto da capa, intitulada  “Desayuno en Buitrago de Lozoya” retrata a amizade entre Barbara Starfield, seu marido Neil “Tony” Holtzman e Juan Gérvas e Mercedes Pérez Fernández (autora da foto, na qual desfrutam e compartilham a vida à mesa. A mesa também faz referência a uma característica marcante de Starfield: a de nutriz (do latim nuctrix, que possui a capacidade de nutrir; que sustenta. Como  afirmou seu marido Tony: - “Ela fez isso por meio de sua pesquisa, sua paixão altruísta e sua orientação àqueles que se preocupam com as pessoas, a justiça e a verdade”1.O editorial especial para esta edição foi escrito pelo Dr. Juan Gérvas e reflete a importância de se avaliar a qualidade da atenção primária à saúde (APS a fim de que ela possa, continuamente,  se fortalecer. Em decorrência disso, todos os artigos desta edição versam sobre o Instrumento de Avaliação da Atenção Primária, em inglês Primary Care Assessment Tool (PCATool, sua validação, adaptação e aplicação para a APS2. Starfield e colaboradores desenvolveram, no The Johns Hopkins Populations Care Policy Center for the Underserved Populations, o PCATool, instrumento que permite mensurar a presença e a extensão dos atributos essenciais e derivados da APS3. Os quatro atributos essenciais da APS: a acesso de primeiro contato; b continuidade do cuidado; c abrangência  (comprehensiveness; e d coordenação dos cuidados são subcomponentes do acesso e, portanto, a qualidade dos serviços passa pela melhoria de estruturas e processos (efetividade que garantam o acesso tanto no nível individual – atendendo os indivíduos e suas necessidades em saúde – como no nível populacional, em que o acesso volta-se à dimensão ética da

  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. 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

  8. Secure eHealth-Care Service on Self-Organizing Software Platform

    Directory of Open Access Journals (Sweden)

    Im Y. Jung

    2014-01-01

    Full Text Available There are several applications connected to IT health devices on the self-organizing software platform (SoSp that allow patients or elderly users to be cared for remotely by their family doctors under normal circumstances or during emergencies. An evaluation of the SoSp applied through PAAR watch/self-organizing software platform router was conducted targeting a simple user interface for aging users, without the existence of extrasettings based on patient movement. On the other hand, like normal medical records, the access to, and transmission of, health information via PAAR watch/self-organizing software platform requires privacy protection. This paper proposes a security framework for health information management of the SoSp. The proposed framework was designed to ensure easy detection of identification information for typical users. In addition, it provides powerful protection of the user’s health information.

  9. 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

  10. IAServ: An Intelligent Home Care Web Services Platform in a Cloud for Aging-in-Place

    Directory of Open Access Journals (Sweden)

    Chang-Yu Chiang

    2013-11-01

    Full Text Available As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients’ needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet.

  11. IAServ: an intelligent home care web services platform in a cloud for aging-in-place.

    Science.gov (United States)

    Su, Chuan-Jun; Chiang, Chang-Yu

    2013-11-01

    As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients' needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform) to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet. PMID:24225647

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. 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 (pcare 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...... with a minimum of national legislation/finance (Meso-strategy of dissemination). Implications: IHC is an approach to clinical continuity for a majority of frail elder somatic patients....

  19. 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

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. 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

    C medical diagnostics context necessitates considering broader requirements, notably in terms of usability, flexibility, and integration capabilities. These characteristics call for multi-disciplinary design methodologies inspired from the field of systems engineering and constitute the motivations...... helping to address this challenge. Specifically, Lab-on-Chip (LoC) devices have a key role to play in the advent of Point-of-Care (PoC) medical applications, driving a shift of the medical diagnostics paradigm and the transition from a centralized, technical, high-throughput biological sample analysis...... 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...

  5. 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.

  6. 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

  7. 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

  8. 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

  9. 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...

  10. 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.

  11. Offshore Platform Hydrocarbon Risk Assessment – OPHRA: Feasibility

    DEFF Research Database (Denmark)

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

    and fire; • Detection, shut down and alarm; • Escape and evacuation; • Exposure and impact on people and equipment This method leads to a transparent framework for modelling, which helps to demonstrate the correctness and appropriateness of models and assumptions. The report lists the (type of) models...... 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....... Finally, further work is identified in order to develop an operational risk assessment tool....

  12. Cell Viability Assessment: Toward Content-Rich Platforms

    Science.gov (United States)

    Ramirez, Christina Nicole; Antczak, Christophe; Djaballah, Hakim

    2013-01-01

    Importance of the field Monitoring cell viability in vitro is critical in many areas of biomedical research, and the ultimate goal in drug discovery is the ability to predict the in vivo toxicology of drug candidates based on their toxicity profile in vitro. Over the last decade, the contribution of high-throughput screening (HTS) toward this goal has been tremendous, providing the ability to screen compounds in parallel against multiple cell types. However, the toxic effects of drug candidates uncovered during clinical trials are by far the main reason for their failure. Over the same period, our understanding of programmed cell death has evolved dramatically with the identification of critical control points in the cell death pathways. As a result, cell viability should no longer be characterized solely on the basis of discrete endpoint measurements such as membrane permeability. Areas covered in this review/What the reader will gain This review summarizes the traditional viability assays currently commercially available, focusing on methods amenable to high density format. Assays categorized into the following classes are discussed: dye exclusion assays, DNA condensation-based assays and assays monitoring a metabolic function. We describe each approach, and using case studies, we emphasize their limitations. Take home message Current low-content methods based on single parameter readouts are prone to error due to the heterogeneity of cell populations and the multi-faceted nature of cell death. High-content approaches based on continuous, multiplexed readouts are becoming increasingly important for monitoring multiple markers of cell death induction simultaneously, on a cell by cell basis. The use of such content-rich platforms is a necessity to predict the toxicology of drug candidates accurately. PMID:22823019

  13. 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.

  14. 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.

  15. 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)

  16. Evolvable Smartphone-Based Platforms for Point-Of-Care In-Vitro Diagnostics Applications

    DEFF Research Database (Denmark)

    Patou, François; Al Atraktchi, Fatima Al-Zahraa; Kjærgaard, Claus;

    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 ......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...

  17. Paper-based sample-to-answer molecular diagnostic platform for point-of-care diagnostics.

    Science.gov (United States)

    Choi, Jane Ru; Tang, Ruihua; Wang, ShuQi; Wan Abas, Wan Abu Bakar; Pingguan-Murphy, Belinda; Xu, Feng

    2015-12-15

    Nucleic acid testing (NAT), as a molecular diagnostic technique, including nucleic acid extraction, amplification and detection, plays a fundamental role in medical diagnosis for timely medical treatment. However, current NAT technologies require relatively high-end instrumentation, skilled personnel, and are time-consuming. These drawbacks mean conventional NAT becomes impractical in many resource-limited disease-endemic settings, leading to an urgent need to develop a fast and portable NAT diagnostic tool. Paper-based devices are typically robust, cost-effective and user-friendly, holding a great potential for NAT at the point of care. In view of the escalating demand for the low cost diagnostic devices, we highlight the beneficial use of paper as a platform for NAT, the current state of its development, and the existing challenges preventing its widespread use. We suggest a strategy involving integrating all three steps of NAT into one single paper-based sample-to-answer diagnostic device for rapid medical diagnostics in the near future.

  18. Accuracy assessment of the integration of GNSS and a MEMS IMU in a terrestrial platform.

    Science.gov (United States)

    Madeira, Sergio; Yan, Wenlin; Bastos, Luísa; Gonçalves, José A

    2014-11-04

    MEMS Inertial Measurement Units are available at low cost and can replace expensive units in mobile mapping platforms which need direct georeferencing. This is done through the integration with GNSS measurements in order to achieve a continuous positioning solution and to obtain orientation angles. This paper presents the results of the assessment of the accuracy of a system that integrates GNSS and a MEMS IMU in a terrestrial platform. We describe the methodology used and the tests realized where the accuracy of the positions and orientation parameters were assessed using an independent photogrammetric technique employing cameras that integrate the mobile mapping system developed by the authors. Results for the accuracy of attitude angles and coordinates show that accuracies better than a decimeter in positions, and under a degree in angles, can be achieved even considering that the terrestrial platform is operating in less than favorable environments.

  19. 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.

  20. 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

  1. 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

    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...

  2. 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.

  3. 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...

  4. Assessment, authorization and access to medicaid managed mental health care.

    Science.gov (United States)

    Masland, Mary C; Snowden, Lonnie R; Wallace, Neal T

    2007-11-01

    Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

  5. Household-based HIV counseling and testing as a platform for referral to HIV care and medical male circumcision in Uganda: a pilot evaluation.

    Directory of Open Access Journals (Sweden)

    Henry Tumwebaze

    Full Text Available BACKGROUND: Combination HIV prevention initiatives incorporate evidence-based, biomedical and behavioral interventions appropriate and acceptable to specific populations, aiming to significantly reduce population-level HIV incidence. Knowledge of HIV serostatus is key to linkages to HIV care and prevention. Household-based HIV counseling and testing (HBCT can achieve high HIV testing rates. We evaluated HBCT as a platform for delivery of combination HIV prevention services in sub-Saharan Africa. METHODS: We conducted HBCT in a semi-urban area in southwestern Uganda. All adults received standard HIV prevention messaging. Real-time electronic data collection included a brief risk assessment and prevention triage algorithm for referrals of HIV seropositive persons to HIV care and uncircumcised HIV seronegative men with multiple sex partners to male circumcision. Monthly follow-up visits for 3 months were conducted to promote uptake of HIV care and male circumcision. RESULTS: 855 households received HBCT; 1587 of 1941 (81.8% adults were present at the HBCT visit, 1557 (98.1% of those present were tested and received HIV results, of whom, 46.5% were men. A total of 152 (9.8% were HIV seropositive, for whom the median CD4 count was 456 cells/µL, and 50.7% were newly-identified as HIV seropositive. Three months after HBCT, 88.5% of HIV seropositive persons had attended an HIV care clinic; among those with CD4 counts <250 cells/µL, 71.4% initiated antiretroviral therapy. Among 123 HIV seronegative men with an HIV+ partner or multiple partners, 62.0% were circumcised by month 3. CONCLUSIONS: HBCT achieves high levels of knowledge of HIV serostatus and is an effective platform for identifying at-risk persons and achieving higher uptake of HIV prevention and care services through referrals and targeted follow-up than has been accomplished through other single focus strategies.

  6. 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.

  7. A Geospatial Web Platform for Natural Hazard Exposure Assessment in the Insurance Sector

    Science.gov (United States)

    Iris, Julien; Chemitte, Jérôme; Napoli, Aldo

    The work of natural hazard exposure assessment involves various geographic data sets (referential, hazard, assets) and various disciplines intended for insurance professionals (catastrophe modeling, prevention engineering). The emergence of Geospatial Web technology induces the emergence of new sets of online services. Mission Risques Naturels (MRN) is a French actor in the mutualization and diffusion of information on natural hazards knowledge and prevention for the general interest of insurance professionals. The MRN Web-GIS platform has been built to address these requirements. This chapter starts by presenting the role of MRN in the network of natural hazard assessment. It then presents Geospatial Web tools for natural hazard exposure assessment as well as the system architecture of the MRN Web-GIS platform, including all its services.

  8. 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...

  9. 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.

  10. A virtual reality platform for assessment and rehabilitation of neglect using a kinect.

    Science.gov (United States)

    Cipresso, Pietro; Serino, Silvia; Pedroli, Elisa; Gaggioli, Andrea; Riva, Giuseppe

    2014-01-01

    Unilateral Spatial Neglect (USN) is normally assessed with paper-and-pencil tests. Virtual reality can be an effective neuropsychological tool for a more ecological and functional assessment and rehabilitation of neglect. We developed a 3D Virtual Reality platform - NeuroVirtual 3D - for the assessment and rehabilitation of cognitive deficits, in particular for USN. Within the virtual environments it is possible to interact with virtual objects and execute specific exercises using a Microsoft Kinect. Through the analysis of different grasping tasks it is possible to evaluate in an ecological way the patients' ability to find and handle objects in both sides of the virtual space.

  11. 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. ...

  12. 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...

  13. 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...

  14. Point of care information services: a platform for self-directed continuing medical education for front line decision makers.

    Science.gov (United States)

    Moja, Lorenzo; Kwag, Koren Hyogene

    2015-02-01

    The structure and aim of continuing medical education (CME) is shifting from the passive transmission of knowledge to a competency-based model focused on professional development. Self-directed learning is emerging as the foremost educational method for advancing competency-based CME. In a field marked by the constant expansion of knowledge, self-directed learning allows physicians to tailor their learning strategy to meet the information needs of practice. Point of care information services are innovative tools that provide health professionals with digested evidence at the front line to guide decision making. By mobilising self-directing learning to meet the information needs of clinicians at the bedside, point of care information services represent a promising platform for competency-based CME. Several points, however, must be considered to enhance the accessibility and development of these tools to improve competency-based CME and the quality of care.

  15. 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...

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

    Science.gov (United States)

    Kar, S S; Subitha, L; Iswarya, S

    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 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.

  17. 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.

  18. Compassionate Care: Can it be Defined and Measured? The Development of the Compassionate Care Assessment Tool

    Directory of Open Access Journals (Sweden)

    Lori Burnell

    2013-01-01

    Full Text Available Background: Compassion has not been universally defined or understood, nonetheless is recognized as a component of nursing excellence. If compassionate care is routine in health care delivery models, nursing behaviors and actions that exemplify compassion ought to be easily identifiable to patients. However, a standardized scale measuring compassionate care attributes has been notably absent.Objective: To address this gap and ascertain the importance of compassionate care to patients, a Compassionate Care Assessment Tool (CCAT© was formulated. This new tool, derived from a pilot study of two published surveys, combined the constructs of compassion and caring to generate 28 elements of compassionate care.Methodology: The CCAT© was administered to 250 hospitalized patients. Patients were asked to rate (a the importance of these items to compassionate care and (b the extent to which nurses made this type of care apparent to them.Results: Four categorical segments illustrated compassion from the patients’ perspective: the ability to establish meaningful connections, meet expectations, exhibit caring attributes, and function as a capable practitioner.Conclusions: The provision of compassionate care requires a holistic approach. Patients value nurses forming personal connections, serving as their advocates, and responding to their individual needs.

  19. 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)

  20. 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.

  1. 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

  2. Nutritional care of medical inpatients: a health technology assessment

    Science.gov (United States)

    Lassen, Karin O; Olsen, Jens; Grinderslev, Edvin; Kruse, Filip; Bjerrum, Merete

    2006-01-01

    Background The inspiration for the present assessment of the nutritional care of medical patients is puzzlement about the divide that exists between the theoretical knowledge about the importance of the diet for ill persons, and the common failure to incorporate nutritional aspects in the treatment and care of the patients. The purpose is to clarify existing problems in the nutritional care of Danish medical inpatients, to elucidate how the nutritional care for these inpatients can be improved, and to analyse the costs of this improvement. Methods Qualitative and quantitative methods are deployed to outline how nutritional care of medical inpatients is performed at three Danish hospitals. The practices observed are compared with official recommendations for nutritional care of inpatients. Factors extraneous and counterproductive to optimal nutritional care are identified from the perspectives of patients and professional staff. A review of the literature illustrates the potential for optimal nutritional care. A health economic analysis is performed to elucidate the savings potential of improved nutritional care. Results The prospects for improvements in nutritional care are ameliorated if hospital management clearly identifies nutritional care as a priority area, and enjoys access to management tools for quality assurance. The prospects are also improved if a committed professional at the ward has the necessary time resources to perform nutritional care in practice, and if the care staff can requisition patient meals rich in nutrients 24 hours a day. At the kitchen production level prospects benefit from a facilitator contact between care and kitchen staff, and if the kitchen staff controls the whole food path from the kitchen to the patient. At the patient level, prospects are improved if patients receive information about the choice of food and drink, and have a better nutrition dialogue with the care staff. Better nutritional care of medical patients in Denmark

  3. Nutritional care of medical inpatients: a health technology assessment

    Directory of Open Access Journals (Sweden)

    Kruse Filip

    2006-02-01

    Full Text Available Abstract Background The inspiration for the present assessment of the nutritional care of medical patients is puzzlement about the divide that exists between the theoretical knowledge about the importance of the diet for ill persons, and the common failure to incorporate nutritional aspects in the treatment and care of the patients. The purpose is to clarify existing problems in the nutritional care of Danish medical inpatients, to elucidate how the nutritional care for these inpatients can be improved, and to analyse the costs of this improvement. Methods Qualitative and quantitative methods are deployed to outline how nutritional care of medical inpatients is performed at three Danish hospitals. The practices observed are compared with official recommendations for nutritional care of inpatients. Factors extraneous and counterproductive to optimal nutritional care are identified from the perspectives of patients and professional staff. A review of the literature illustrates the potential for optimal nutritional care. A health economic analysis is performed to elucidate the savings potential of improved nutritional care. Results The prospects for improvements in nutritional care are ameliorated if hospital management clearly identifies nutritional care as a priority area, and enjoys access to management tools for quality assurance. The prospects are also improved if a committed professional at the ward has the necessary time resources to perform nutritional care in practice, and if the care staff can requisition patient meals rich in nutrients 24 hours a day. At the kitchen production level prospects benefit from a facilitator contact between care and kitchen staff, and if the kitchen staff controls the whole food path from the kitchen to the patient. At the patient level, prospects are improved if patients receive information about the choice of food and drink, and have a better nutrition dialogue with the care staff. Better nutritional care of

  4. 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

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

    DEFF Research Database (Denmark)

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

    2002-01-01

    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......-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 symptomatology of participating patients and examines differences in symptomatology between patients in three palliative care functions: inpatient, outpatient, and palliative home care. RESULTS: Of 267 eligible patients who were referred to a department of palliative medicine, initial self...

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. [Assessing and evaluating physical activity during counseling in health care].

    Science.gov (United States)

    Hagströmer, Maria; Wisén, Anita; Hassmén, Peter

    2015-01-01

    To make individualized counseling possible, valid and reliable measures of physical activity are necessary. In health care, quality must be continuously secured and developed. Follow-up of life-style habits such as physical activity does not differ from monitoring of other treatment in the health care setting.  After counseling and appropriate period of time, evaluation should be done to assess if there has been any change in the physical activity level. For assessment and evaluation of physical activity in routine clinical practice the National Board for Health and Social Welfare indicator questions regarding physical activity are recommended. For a more detailed assessment and evaluation of physical activity and sedentary behavior comprehensive validated instruments/diaries should be used. For precise and objective assessment and evaluation of both physical activity and sedentary behavior, movement sensors are recommended.

  17. 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

  18. Microchip Screening Platform for Single Cell Assessment of NK Cell Cytotoxicity

    Science.gov (United States)

    Guldevall, Karolin; Brandt, Ludwig; Forslund, Elin; Olofsson, Karl; Frisk, Thomas W.; Olofsson, Per E.; Gustafsson, Karin; Manneberg, Otto; Vanherberghen, Bruno; Brismar, Hjalmar; Kärre, Klas; Uhlin, Michael; Önfelt, Björn

    2016-01-01

    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-h 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. PMID:27092139

  19. 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.

  20. [DEVELOPMENTAL CARE IN THE NEONATAL INTENSIVE CARE UNIT ACCORDING TO NEWBORN INDIVIDUALIZED DEVELOPMENTAL CARE AND ASSESSMENT PROGRAM (NIDCAP)].

    Science.gov (United States)

    Silberstein, Dalia; Litmanovitz, Ita

    2016-01-01

    During hospitalization in the neonatal intensive care unit (NICU), the brain of the preterm infant undergoes a particularly vulnerable and sensitive period of development. Brain development might be negatively influenced by direct injury as well as by complications of prematurity. Over the past few years, stress has come to be increasingly recognized as a potential risk factor. The NICU environment contains numerous stress factors due to maternal deprivation and over-stimulation, such as light, sound and pain, which conflict with the brain's developmental requirements. Developmental care is a caregiving approach that addresses the early developmental needs of the preterm infant as an integral component of quality neonatal care. NIDCAP (Newborn Individualized Developmental Care and Assessment Program) is a comprehensive program that aims to reduce environmental stress, to support the infant's neuro-behavioral maturation and organization, and to promote early parent-infant relationships. The implementation of developmental care based on NIDCAP principles is a gradual, in-depth systems change process, which affects all aspects of care in the NICU. This review describes the theoretical basis of the NIDCAP approach, summarizes the scientific evidence and addresses some of the implications of the transition from a traditional to a developmental care NICU.

  1. 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.

  2. 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...

  3. Evaluation of a Web-Based E-Learning Platform for Brief Motivational Interviewing by Nurses in Cardiovascular Care: A Pilot Study

    Science.gov (United States)

    Cossette, Sylvie; Heppell, Sonia; Boyer, Louise; Mailhot, Tanya; Simard, Marie-Josée; Tanguay, Jean-Francois

    2016-01-01

    Background Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-face brief MI training on a large scale is complicated, Web-based e-learning is promising because of the flexibility it offers. Objective The primary objective of this pilot study was to examine the feasibility and acceptability of a Web-based e-learning platform for brief MI (MOTIV@CŒUR), which was evaluated by nurses in cardiovascular care. The secondary objective was to assess the preliminary effect of the training on nurses’ perceived brief MI skills and self-reported clinical use of brief MI. Methods We conducted a single-group, pre-post pilot study involving nurses working in a coronary care unit to evaluate MOTIV@CŒUR, which is a Web-based e-learning platform for brief MI, consisting of two sessions lasting 30 and 20 minutes. MOTIV@CŒUR covers 4 real-life clinical situations through role-modeling videos showing nurse-client interactions. A brief introduction to MI is followed by role playing, during which a nurse practitioner evaluates clients’ motivation to change and intervenes according to the principles of brief MI. The clinical situations target smoking, medication adherence, physical activity, and diet. Nurses were asked to complete both Web-based training sessions asynchronously within 20 days, which allowed assessment of the feasibility of the intervention. Data regarding acceptability and preliminary effects (perceived skills in brief MI, and self-reported clinical use of conviction and confidence interventions) were self-assessed through Web-based questionnaires 30 days (±5 days) after the first session. Results We enrolled 27 women and 4 men (mean age 37, SD 9 years) in March 2016. Of the 31 participants, 24 (77%, 95% CI 63%

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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

  10. Comprehensive Geriatric Assessment and Transitional Care in Acutely Hospitalized Patients The Transitional Care Bridge Randomized Clinical Trial

    NARCIS (Netherlands)

    Buurman, Bianca M.; Parlevliet, Juliette L.; Allore, Heather G.; Blok, Willem; van Deelen, Bob A. J.; van Charante, Eric P. Moll; de Haan, Rob J.; de Rooij, Sophia E.

    2016-01-01

    IMPORTANCE Older adults acutely hospitalized are at risk of disability. Trials on comprehensive geriatric assessment (CGA) and transitional care present inconsistent results. OBJECTIVE To test whether an intervention of systematic CGA, followed by the transitional care bridge program, improved activ

  11. 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.

  12. 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

  13. Assessing the role of GPs in Nordic health care systems.

    Science.gov (United States)

    Quaye, Randolph K

    2016-05-01

    Purpose This paper examines the changing role of general practitioners (GPs) in Nordic countries of Sweden, Norway and Denmark. It aims to explore the "gate keeping" role of GPs in the face of current changes in the health care delivery systems in these countries. Design/methodology/approach Data were collected from existing literature, interviews with GPs, hospital specialists and representatives of Danish regions and Norwegian Medical Association. Findings The paper contends that in all these changes, the position of the GPs in the medical division of labor has been strengthened, and patients now have increased and broadened access to choice. Research limitations/implications Health care cost and high cancer mortality rates have forced Nordic countries of Sweden, Norway and Denmark to rethink their health care systems. Several attempts have been made to reduce health care cost through market reform and by strenghtening the position of GPs. The evidence suggests that in Norway and Denmark, right incentives are in place to achieve this goal. Sweden is not far behind. The paper has limitations of a small sample size and an exclusive focus on GPs. Practical implications Anecdotal evidence suggests that physicians are becoming extremely unhappy. Understanding the changing status of primary care physicians will yield valuable information for assessing the effectiveness of Nordic health care delivery systems. Social implications This study has wider implications of how GPs see their role as potential gatekeepers in the Nordic health care systems. The role of GPs is changing as a result of recent health care reforms. Originality/value This paper contends that in Norway and Denmark, right incentives are in place to strengthen the position of GPs.

  14. 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...

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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.)

  20. [Vitalink: a digital platform to share patient health records in primary care. Report of the pilot projects for sharing medication schemes].

    Science.gov (United States)

    Zwaenepoel, L; Hulshagen, L

    2014-03-01

    Vitalink is a digital platform to share health patient data among health care professionals in primary care. The Flemish community started the development of this platform in collaboration with representatives of professional associations primary care. Sharing medication charts online was the first Vitalink project. In December 2012 four pilot regions in Flanders (Turnhout, Limburg, Aalst and Halle) tested medication chart sharing through Vitalink. Due to difficulties with software development effective sharing started only in April 2013. The test phase was ended in October 2013. Each pilot region made an evaluation report. Conclusions were similar: the realization business cases were limited. Integration in end user software was insufficiently performant. Moreover, interpretation of downloaded medication charts was found out to differ among participating software applications. Because of these problems exchange of patient records among primary care actors was limited. Therefore research questions could not be conclusively answered. Nevertheless the Vitalink pilot project can be considered successful in some ways. Collaboration and communication among health care professionals and their associations was ameliorated. The awareness of digital data sharing in primary care is growing. Pilot projects created buy in among patients, physicians, pharmacists and nurses. Uniform lay-out guidelines were established in deliberation with all participating actors. Since November 2013 Vitalink is in production. Medication charts, summarized electronic health records and vaccination data can be uploaded to the platform and health care professionals that are registered can consult them. End user software must still be developed to make broad use of the platform feasible. Meanwhile further deliberation with software vendors and professional associations can be organized in order to achieve the implementation and integration of user friendly Vitalink modules.

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. [Risk factors for the spine: nursing assessment and care].

    Science.gov (United States)

    Bringuente, M E; de Castro, I S; de Jesus, J C; Luciano, L dos S

    1997-01-01

    The present work aimed at studying risk factor that affect people with back pain, identifying them and implementing an intervention proposal of a health education program based on self-care teaching, existential humanist philosophical projects and stress equalization approach line, skeletal-muscle reintegration activities, basic techniques on stress equalization and massage. It has been developed for a population of 42 (forty-two) clients. Two instruments which integrate nursing consultation protocol have been used in data collection. The results showed the existence of associated risk factors which are changeable according to health education programs. The assessment process has contributed for therapeutic measures focus, using non-conventional care methods for this approach providing an improvement to these clients life quality.

  8. 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

  9. 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.

  10. 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

  11. Postural Stability Assessment of University Marching Musicians Using Force Platform Measures.

    Science.gov (United States)

    Magnotti, Trevor D; McElhiney, Danielle; Russell, Jeffrey A

    2016-09-01

    Lower extremity injury is prevalent in marching musicians, and poor postural stability is a possible risk factor for this. The external load of an instrument may predispose these performers to injury by decreasing postural stability. The purpose of this study was to determine the relationship between instrument load and static and dynamic postural stability in this population. Fourteen university marching musicians were recruited and completed a balance assessment protocol on a force platform with and without their instrument. Mean center of pressure (CoP) displacement was then calculated for each exercise in the anterior/posterior and medial/lateral planes. Mean anterior/posterior CoP displacement significantly increased in the instrument condition for the static surface, eyes closed, 2 feet condition (p≤0.005; d=0.89). No significant differences were found in the medial/lateral plane between non-instrument and instrument conditions. Significant differences were not found between test stance conditions independent of group. Comparisons between the non-instrument-loaded and instrument-loaded conditions revealed possible significance of instrument load on postural stability in the anterior/posterior plane. Mean differences indicated that an unstable surface created a greater destabilizing effect on postural stability than instrument load. PMID:27575294

  12. A screening-based platform for the assessment of cellular respiration in Caenorhabditis elegans.

    Science.gov (United States)

    Koopman, Mandy; Michels, Helen; Dancy, Beverley M; Kamble, Rashmi; Mouchiroud, Laurent; Auwerx, Johan; Nollen, Ellen A A; Houtkooper, Riekelt H

    2016-10-01

    Mitochondrial dysfunction is at the core of many diseases ranging from inherited metabolic diseases to common conditions that are associated with aging. Although associations between aging and mitochondrial function have been identified using mammalian models, much of the mechanistic insight has emerged from Caenorhabditis elegans. Mitochondrial respiration is recognized as an indicator of mitochondrial health. The Seahorse XF96 respirometer represents the state-of-the-art platform for assessing respiration in cells, and we adapted the technique for applications involving C. elegans. Here we provide a detailed protocol to optimize and measure respiration in C. elegans with the XF96 respirometer, including the interpretation of parameters and results. The protocol takes ∼2 d to complete, excluding the time spent culturing C. elegans, and it includes (i) the preparation of C. elegans samples, (ii) selection and loading of compounds to be injected, (iii) preparation and execution of a run with the XF96 respirometer and (iv) postexperimental data analysis, including normalization. In addition, we compare our XF96 application with other existing techniques, including the eight-well Seahorse XFp. The main benefits of the XF96 include the limited number of worms required and the high throughput capacity due to the 96-well format.

  13. 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.

  14. A screening-based platform for the assessment of cellular respiration in Caenorhabditis elegans.

    Science.gov (United States)

    Koopman, Mandy; Michels, Helen; Dancy, Beverley M; Kamble, Rashmi; Mouchiroud, Laurent; Auwerx, Johan; Nollen, Ellen A A; Houtkooper, Riekelt H

    2016-10-01

    Mitochondrial dysfunction is at the core of many diseases ranging from inherited metabolic diseases to common conditions that are associated with aging. Although associations between aging and mitochondrial function have been identified using mammalian models, much of the mechanistic insight has emerged from Caenorhabditis elegans. Mitochondrial respiration is recognized as an indicator of mitochondrial health. The Seahorse XF96 respirometer represents the state-of-the-art platform for assessing respiration in cells, and we adapted the technique for applications involving C. elegans. Here we provide a detailed protocol to optimize and measure respiration in C. elegans with the XF96 respirometer, including the interpretation of parameters and results. The protocol takes ∼2 d to complete, excluding the time spent culturing C. elegans, and it includes (i) the preparation of C. elegans samples, (ii) selection and loading of compounds to be injected, (iii) preparation and execution of a run with the XF96 respirometer and (iv) postexperimental data analysis, including normalization. In addition, we compare our XF96 application with other existing techniques, including the eight-well Seahorse XFp. The main benefits of the XF96 include the limited number of worms required and the high throughput capacity due to the 96-well format. PMID:27583642

  15. 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.

  16. ASSESSING SATISFACTION WITH THE NURSING CARE OF OLDER PATIENTS

    Directory of Open Access Journals (Sweden)

    Pediaditaki O.

    2009-10-01

    Full Text Available Assessing patients’ views indicates to patients that we are concerned about continuous assessment and improvingservices in general. It also indicates that we are a conscientious professional within a genuine humanistic line of work. Thepaper discusses the many theoretical and methodological problems that have arisen from attempts to measure andquantify patient satisfaction. Numerical data are thought to be ‘sterile’ without any insight into personal meanings. On theother hand purely qualitative methods have not been widely used. This discussion paper ends with the formulation of twosimple questions which can help us to explore and negotiate patients’ needs and satisfaction. Two non-offensivestraightforward questions are proposed as examples which could be used on a regular basis by nurses caring for olderpatients.

  17. 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...

  18. 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。

  19. 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.

  20. 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

  1. 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.

  2. 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...

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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)…

  8. 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

  9. 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…

  10. 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.

  11. 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...

  12. From the design to real e-textile platforms for Rehabilitation and chronic obstructive pulmonary diseases care.

    Science.gov (United States)

    Paradiso, Rita; Caldani, Laura; De Toma, Gianluca

    2015-08-01

    In this paper is described the work done to move from the concept of a monitoring system based on a sensing textile platform to the working prototype, in the frame of two different European projects: INTERACTION and WELCOME.

  13. Assessment of women's perspectives and experiences of childbirth and postnatal care using Q-methodology.

    Science.gov (United States)

    Shabila, N P; Ahmed, H M; Yasin, M Y

    2015-09-01

    To complement standard measures of maternity care outcomes, an assessment of women's satisfaction with care is needed. The aim of this study was to elicit the perspectives and experiences of Iraqi women about childbirth and postnatal care services. The study participants were a sample of 37 women of different educational and socioeconomic status who had given birth during the previous 6 months. Q-methodology was used for data collection and analysis. Three distinct viewpoints and experiences of childbirth and postnatal care services were identified: a general perception of poor childbirth and postnatal care with lack of appropriate interpersonal care and support; a high satisfaction and positive experience with childbirth and postnatal care services among the confident and well-supported women; and poor satisfaction with the childbirth and postnatal care services in terms of meeting traditional cultural practices. Needs assessment around providers' skills and attitudes and the wider sociocultural environment of childbirth and postnatal care is necessary in Iraq.

  14. 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).

  15. Whole-body isometric force/torque measurements for functional assessment in neuro-rehabilitation: platform design, development and verification

    Directory of Open Access Journals (Sweden)

    Cavallo Giuseppe

    2009-10-01

    Full Text Available Abstract Background One of the main scientific and technological challenges of rehabilitation bioengineering is the development of innovative methodologies, based on the use of appropriate technological devices, for an objective assessment of patients undergoing a rehabilitation treatment. Such tools should be as fast and cheap to use as clinical scales, which are currently the daily instruments most widely used in the routine clinical practice. Methods A human-centered approach was used in the design and development of a mechanical structure equipped with eight force/torque sensors that record quantitative data during the initiation of a predefined set of Activities of Daily Living (ADL tasks, in isometric conditions. Results Preliminary results validated the appropriateness, acceptability and functionality of the proposed platform, that has become now a tool used for clinical research in three clinical centres. Conclusion This paper presented the design and development of an innovative platform for whole-body force and torque measurements on human subjects. The platform has been designed to perform accurate quantitative measurements in isometric conditions with the specific aim to address the needs for functional assessment tests of patients undergoing a rehabilitation treatment as a consequence of a stroke. The versatility of the system also enlightens several other interesting possible areas of application for therapy in neurorehabilitation, for research in basic neuroscience, and more.

  16. 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

  17. 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...

  18. 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...

  19. Assessment of health care by children and adolescents depends on when they respond to the questionnaire

    DEFF Research Database (Denmark)

    Jensen, Hanne Irene; Ammentorp, Jette; Kofoed, Poul-Erik

    2010-01-01

    The aim of this study was to examine the assessments and priorities by children and adolescents of health care in a paediatric outpatient clinic, to examine the influence of the time factor on the assessments and priorities by children and adolescents of health care, and to determine...

  20. The assessment and management of skin tears in care homes.

    Science.gov (United States)

    Stephen-Haynes, Jackie; Callaghan, Rosie; Bethell, Elaine; Greenwood, Michelle

    This article discusses a project conducted in Worcestershire nursing homes to review current practices in the management of skin tears and the subsequent development and implementation of guidelines resulting in a standardised client care package. An initial audit in five care homes was followed by an in-depth audit in 52 homes over a 12-week period. This led to the development of resources and the 'STAR box' to assist with implementation of timely and appropriate care delivery.

  1. 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]。

  2. 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…

  3. 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…

  4. 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…

  5. 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.…

  6. 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...

  7. A Tool for Assessing a Community’s Capacity for Substance Abuse Care

    Science.gov (United States)

    Lyerla, Rob; Stroup, Donna F.; Azofeifa, Alejandro; High, Patrick M.

    2016-01-01

    Evidence-based programs for prevention and intervention in substance abuse are increasing. Community needs assessments and health rankings provide descriptions of local behavioral health needs but do not provide public health practitioners and policy makers with guidelines on the number of programs, health care practitioners, or interventions needed in the local substance abuse care system. This article presents a new framework for measuring and assessing the substance abuse care system in a community. The assessment can inform resource allocation across the continuum of care to more equitably and efficiently distribute interventions and care. We conducted 2 literature reviews and synthesized our findings to create a community assessment methodology and needs calculator, CAST (calculating for an adequate system tool). We reviewed 212 articles to produce an inventory of community and social correlates of behavioral health, components of a substance abuse care system, and numerical values for guidelines for estimating community needs. CAST produces community-specific assessments of the capacity of the components of a community substance abuse care system. CAST generates recommendations by the application of social and community determinants of health as risk coefficients to each estimate of component need. CAST can assist public health practitioners in evaluation and improvement of the capacity of community-based, substance abuse care systems. By using recommendations for component needs across the continuum of care, community leaders can use CAST to prioritize resource allocation more effectively and efficiently. PMID:27657505

  8. Generation and functional assessment of 3D multicellular spheroids in droplet based microfluidics platform.

    Science.gov (United States)

    Sabhachandani, P; Motwani, V; Cohen, N; Sarkar, S; Torchilin, V; Konry, T

    2016-02-01

    Here we describe a robust, microfluidic technique to generate and analyze 3D tumor spheroids, which resembles tumor microenvironment and can be used as a more effective preclinical drug testing and screening model. Monodisperse cell-laden alginate droplets were generated in polydimethylsiloxane (PDMS) microfluidic devices that combine T-junction droplet generation and external gelation for spheroid formation. The proposed approach has the capability to incorporate multiple cell types. For the purposes of our study, we generated spheroids with breast cancer cell lines (MCF-7 drug sensitive and resistant) and co-culture spheroids of MCF-7 together with a fibroblast cell line (HS-5). The device has the capability to house 1000 spheroids on chip for drug screening and other functional analysis. Cellular viability of spheroids in the array part of the device was maintained for two weeks by continuous perfusion of complete media into the device. The functional performance of our 3D tumor models and a dose dependent response of standard chemotherapeutic drug, doxorubicin (Dox) and standard drug combination Dox and paclitaxel (PCT) was analyzed on our chip-based platform. Altogether, our work provides a simple and novel, in vitro platform to generate, image and analyze uniform, 3D monodisperse alginate hydrogel tumors for various omic studies and therapeutic efficiency screening, an important translational step before in vivo studies. PMID:26686985

  9. 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.

  10. 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

  11. 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.

  12. Twin Cities care system assessment: process, findings, and recommendations.

    Science.gov (United States)

    Othieno, Joan

    2007-08-01

    The Twin Cities Care system lacks services that are most needed in the later stages of HIV disease. Services in highest demand included housing, transportation, and translation; available translations services are generally limited to Somali, Oromo, and Amharic, the languages most widely spoken by the three largest African immigrant and refugee groups in the Twin Cities. The care system is not well-integrated, and most of the work of moving clients within the system is done by case managers and care advocates. The main technical competencies identified by providers as lacking are understanding mental health from the perspective of African-born people living with HIV/AIDS (PLWH) and addressing sexual issues, especially with women. African providers with foreign certifications not recognized in the United States are not able to use their professional skills. African clients are not well-informed about HIV, and African women are more likely than men to seek and stay in care.

  13. 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.

  14. 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.

  15. 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.

  16. The Development and Validation of a Rapid Assessment Tool of Primary Care in China

    Directory of Open Access Journals (Sweden)

    Jie Mei

    2016-01-01

    Full Text Available Introduction. With Chinese health care reform increasingly emphasizing the importance of primary care, the need for a tool to evaluate primary care performance and service delivery is clear. This study presents a methodology for a rapid assessment of primary care organizations and service delivery in China. Methods. The study translated and adapted the Primary Care Assessment Tool-Adult Edition (PCAT-AE into a Chinese version to measure core dimensions of primary care, namely, first contact, continuity, comprehensiveness, and coordination. A cross-sectional survey was conducted to assess the validity and reliability of the Chinese Rapid Primary Care Assessment Tool (CR-PCAT. Eight community health centers in Guangdong province have been selected to participate in the survey. Results. A total of 1465 effective samples were included for data analysis. Eight items were eliminated following principal component analysis and reliability testing. The principal component analysis extracted five multiple-item scales (first contact utilization, first contact accessibility, ongoing care, comprehensiveness, and coordination. The tests of scaling assumptions were basically met. Conclusion. The standard psychometric evaluation indicates that the scales have achieved relatively good reliability and validity. The CR-PCAT provides a rapid and reliable measure of four core dimensions of primary care, which could be applied in various scenarios.

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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...

  3. Assessing process of care under capitated and fee-for-service Medicare

    OpenAIRE

    Bates, Elizabeth W.; Connors, Kathleen A.

    1987-01-01

    In 1986 more than 770,000 Medicare beneficiaries were enrolled in risk-based health plans that had very little experience in providing medical care to elderly patients. This article addresses one major facet of the National Medicare Competition Evaluation of capitated versus fee-for-service delivery of Medicare benefits, sponsored by the Health Care Financing Administration: the assessment of the quality of the process of care delivered to Medicare enrollees. The rationale, design, and analys...

  4. Assessment of a prototype for the Systemization of Nursing Care on a mobile device 1

    OpenAIRE

    Rezende, Laura Cristhiane Mendonça; dos Santos, Sérgio Ribeiro; Medeiros, Ana Lúcia

    2016-01-01

    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 exper...

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

    OpenAIRE

    Laura Cristhiane Mendonça Rezende; Sérgio Ribeiro dos Santos; Ana Lúcia Medeiros

    2016-01-01

    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...

  6. 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.

  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. Adsorption kinetics of pesticide in soil assessed by optofluidics-based biosensing platform.

    Science.gov (United States)

    Long, Feng; Zhu, Anna; Shi, Hanchang; Sheng, Jianwu; Zhao, Zhen

    2015-02-01

    The adsorption of pesticides in soil is a key process that affects transport, degradation, mobility, and bioaccumulation of these substances. To obtain extensive knowledge regarding the adsorption processes of pesticides in the environment, the new green assay technologies for the rapid, sensitive, field-deployable, and accurate quantification of pesticides are required. In the present study, an evanescent wave-based optofluidics biosensing platform (EWOB) was developed by combining advanced photonics and microfluidics technology for the rapid sensitive immunodetection and adsorption kinetics assay of pesticides. The robustness, reusability, and accuracy of the EWOB allow an enhanced prediction of pesticide adsorption kinetics in soil. Using atrazine (ATZ) as the target model, we found that the adsorption kinetics in soil followed a pseudo-second-order kinetic model. EWOB was compared with liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method and yielded a good correlation coefficient (r(2)=0.9968). The underestimated results of LC-MS/MS resulted in a higher adsorption constant of ATZ in soil derived from LC-MS/MS than that of a biosensor. The proposed EWOB system provides a simple, green, and powerful tool to investigate the transport mechanism and fate of pesticide residues.

  9. 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

  10. 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

  11. 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;…

  12. Nursing-care dependency : Development of an assessment scale for demented and mentally handicapped patients

    NARCIS (Netherlands)

    Dijkstra, Ate; Buist, Girbe; Dassen, T

    1996-01-01

    This article describing the first phase in the development of an assessment scale of nursing-care dependency (NCD) for Dutch demented and mentally handicapped patients focuses on the background to the study and the content validation of the nursing-care dependency scale. The scale aims to characteri

  13. The Assessment of Athletic Training Students' Knowledge and Behavior to Provide Culturally Competent Care

    Science.gov (United States)

    Nynas, Suzette Marie

    2015-01-01

    Context: Culturally competent knowledge and skills are critical for all healthcare professionals to possess in order to provide the most appropriate health care for their patients and clients. Objective: To investigate athletic training students' knowledge of culture and cultural differences, to assess the practice of culturally competent care,…

  14. 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 ...

  15. Assessing the quality of health care: a consumerist approach.

    Science.gov (United States)

    Soliman, A A

    1992-01-01

    Recent investigations show that nontechnical interventions influence patients' ratings of the quality of health care, and that these aspects of the medical encounter are as important to the patient as the technical aspects; perhaps more important. This paper adopts a consumerist approach and measures patients' perceptions of health care quality using a scale adapted from the consumer behavior literature (SERVQUAL). The study measures health care quality as well as five of its individual dimensions. The findings indicate that, for the whole sample, patients' ratings of overall quality as well as the ratings of four of the five dimensions of care are negative. Further analysis indicates that many individual aspects (scale items) are rated negatively by each of two age groups (25-65 and over 65 years old), but the gap between perceptions of the younger group and their expectations is greater than that of the senior group. The two dimensions of "assurance" and "empathy" are found to be the most discriminating dimensions between the two groups. Other analyses indicate that age, annual household income, and work status significantly relate to overall quality rating. Marketing and strategic planning implications of the results are discussed. PMID:10124785

  16. 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...

  17. 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...

  18. 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.

  19. 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...

  20. 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.

  1. 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

  2. Social construction of the managerialism of needs assessment by health and social care professionals.

    Science.gov (United States)

    Chevannes, Mel

    2002-05-01

    Managerialism in community care has not only radically changed organisational structures delivering care, but the assessment of health and social care needs, the justifications for the assessments, and the experience of those who require publicly funded services. The present paper describes the social construction of the managerialism of needs assessment by health and social care professionals, and illustrates this through the identification of older people as a particular kind of client. The argument draws on 'third way', modernity and postmodernity thinking to show needs assessment as a socially constructed area of welfare. The empirical work in this study is based on the views of 38 health and social care professionals obtained by semi-structured in-depth interviews and a postal questionnaire. The views of these professionals show that the social construction of needs assessment takes place in managing the matching of eligibility criteria against types of services. The key to this process is the application of the concept of management that places health and social care professionals in roles where they are acting for state, voluntary or private agencies, and not in all contexts working together with older people. The study shows that professionals identify older people into two groups or 'classes', i.e. those having health needs as distinct from those with social care. The techniques used amount to an exercise of power by professionals over older people. Change is necessary to break down the dominance by professionals in the needs assessment process. A broader concept of the 'third way' vision by Giddens (1998) is also required to achieve greater relevance to how health and social care is organised, and how relations between professionals and older people are integrated into the idea and practice of participatory care. Therefore, the emancipatory side of modernity remains a largely unfinished project.

  3. 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...

  4. 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...

  5. 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.

  6. 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 ...

  7. 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

  8. 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

    2014-11-26

    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.

  9. StudTest – A Platform Supporting Complex and Interactive Knowledge Assessment

    Directory of Open Access Journals (Sweden)

    Vlado Glavinić

    2008-12-01

    Full Text Available This paper describes the model and prototype implementation of a knowledge assessment framework based on problem management components. In order to support student testing with complex problem types and enable usage of rich graphical user interfaces for solution entry, we have developed an e-examination model in which the core concept is a component that can generate complex questions and evaluate students' solutions with additional explanation generation, which we named prlet. The respective system implementation is described, which can operate under heavy loads.

  10. 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.

  11. 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

  12. 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

  13. Care Transitions: Using Narratives to Assess Continuity of Care Provided to Older Patients after Hospital Discharge

    Science.gov (United States)

    Wong, Carolyn; Hogan, David B.

    2016-01-01

    Background A common scenario that may pose challenges to primary care providers is when an older patient has been discharged from hospital. The aim of this pilot project is to examine the experiences of patients’ admission to hospital through to discharge back home, using analysis of patient narratives to inform the strengths and weaknesses of the process. Methods For this qualitative study, we interviewed eight subjects from the Sheldon M. Chumir Central Teaching Clinic (CTC). Interviews were analyzed for recurring themes and phenomena. Two physicians and two resident learners employed at the CTC were recruited as a focus group to review the narrative transcripts. Results Narratives generally demonstrated moderate satisfaction among interviewees with respect to their hospitalization and follow-up care in the community. However, the residual effects of their hospitalization surprised five patients, and five were uncertain about their post-discharge management plan. Conclusion Both secondary and primary care providers can improve on communicating the likely course of recovery and follow-up plans to patients at the time of hospital discharge. Our findings add to the growing body of research advocating for the implementation of quality improvement measures to standardize the discharge process. PMID:27729948

  14. Implications for platform re-assessment based on in-service damage resulting from accidental loadings

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, J.V.; Stacey, A. [Health and Safety Executive, London (United Kingdom); Frieze, P.A.; Nichols, N.W.

    1996-12-01

    Current offshore design codes enable the capacity of structural components to be determined, but the equations apply only to the undamaged state. The ability to assess the performance of such components containing damage has only recently been developed and is important in the re-assessment of structures. In particular knowledge of the performance of members which are dented or bowed as a result of accidental damage is important in establishing the capacity of structures in-service, when for example using pushover analyses. Much research has been taken on the capacity of dented and bowed members. This paper reviews this data and establishes a database using screening criteria. This data is then compared with theoretical predictions from recently developed draft ISO equations. These show that dents and bows can significantly reduce the performance of members. A survey of offshore damage resulting in repairs has shown that 30% of this damage is the result of accidental events such as ship impact and dropped objects. Most damage found to members was in the form of dents, bows and cracks, with member severance in a few cases. The implications of this information for reassessment and offshore inspections are considered.

  15. 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

  16. 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

  17. 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

  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. 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.

  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. 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.

  2. 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

  3. 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.

  4. Infertile men's needs and assessment of fertility care

    DEFF Research Database (Denmark)

    Sylvest, Randi; Fürbringer, Jeanette Krogh; Schmidt, Lone;

    2016-01-01

    of the men participated in a follow-up interview after their first ICSI treatment. The data collection took place during November 2014 to May 2015. Data were analysed using qualitative content analysis. RESULTS: Two themes were found: 'The maze' and 'Desire for care'. It felt like an eternity for the men...... from the referral until treatment started. The men did not understand the process, and it was like being in a maze. The men saw fatherhood as something to strive for. They felt that they could not do what a man is supposed to do, and they felt pushed aside and that treatment focused on the women....... The men appreciated the staff's kindness and professionalism but desired the staff to address emotional subjects too. CONCLUSION: The process from referral to treatment felt like a maze for these men. They needed the staff to give them the opportunity to speak of the psychosocial consequences of severe...

  5. 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...

  6. Linked Patient-Reported Outcomes Data From Patients With Multiple Sclerosis Recruited on an Open Internet Platform to Health Care Claims Databases Identifies a Representative Population for Real-Life Data Analysis in Multiple Sclerosis

    Science.gov (United States)

    Ghodge, Bhaskar; Bonzani, Ian C; Korn, Jonathan R; Medin, Jennie; Saraykar, Tanmay; Sengupta, Souvik; Saini, Deepanshu; Olson, Melvin

    2016-01-01

    Background An enormous amount of information relevant to public health is being generated directly by online communities. Objective To explore the feasibility of creating a dataset that links patient-reported outcomes data, from a Web-based survey of US patients with multiple sclerosis (MS) recruited on open Internet platforms, to health care utilization information from health care claims databases. The dataset was generated by linkage analysis to a broader MS population in the United States using both pharmacy and medical claims data sources. Methods US Facebook users with an interest in MS were alerted to a patient-reported survey by targeted advertisements. Eligibility criteria were diagnosis of MS by a specialist (primary progressive, relapsing-remitting, or secondary progressive), ≥12-month history of disease, age 18-65 years, and commercial health insurance. Participants completed a questionnaire including data on demographic and disease characteristics, current and earlier therapies, relapses, disability, health-related quality of life, and employment status and productivity. A unique anonymous profile was generated for each survey respondent. Each anonymous profile was linked to a number of medical and pharmacy claims datasets in the United States. Linkage rates were assessed and survey respondents’ representativeness was evaluated based on differences in the distribution of characteristics between the linked survey population and the general MS population in the claims databases. Results The advertisement was placed on 1,063,973 Facebook users’ pages generating 68,674 clicks, 3719 survey attempts, and 651 successfully completed surveys, of which 440 could be linked to any of the claims databases for 2014 or 2015 (67.6% linkage rate). Overall, no significant differences were found between patients who were linked and not linked for educational status, ethnicity, current or prior disease-modifying therapy (DMT) treatment, or presence of a relapse in

  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. 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.

  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. 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...

  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

    2014-11-11

    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.

  12. 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

    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

  13. 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...

  14. 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...

  15. [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

  16. [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

  17. 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.

  18. 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...

  19. Psychometric performance of an assessment scale for strain in nursing care: The M-NCAS

    OpenAIRE

    Kleinman Leah; Frank Lori; Ciesla Gabrielle; Rupnow Marcia; Brodaty Henry

    2004-01-01

    Abstract Background Multiple instruments exist to measure dementia behaviors, but the nursing staff perspective on those behaviors and their level of burden has not been well measured. The goal of this study was to examine the psychometric performance of the Modified Nursing Care Assessment Scale (M-NCAS), a 28-item nurse rating of burden associated with care for institutionalized individuals with dementia. Nurses rate items in terms of extent to which the behavior or characteristic is presen...

  20. 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 ...

  1. 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

  2. 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.

  3. 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.

  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. 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.

  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. 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

  8. 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...

  9. 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...

  10. The Development of a Critical Care Resident Research Curriculum: A Needs Assessment

    Directory of Open Access Journals (Sweden)

    Sangeeta Jain

    2016-01-01

    Full Text Available Background. Conducting research is expected from many clinicians’ professional profile, yet many do not have advanced research degrees. Research training during residency is variable amongst institutions and research education needs of trainees are not well understood. Objective. To understand needs of critical care trainees regarding research education. Methods. Canadian critical care trainees, new critical care faculty, program directors, and research coordinators were surveyed regarding research training, research expectations, and support within their programs. Results. Critical care trainees and junior faculty members highlighted many gaps in research knowledge and skills. In contrast, critical care program directors felt that trainees were prepared to undertake research careers. Major differences in opinion amongst program directors and other respondent groups exist regarding preparation for designing a study, navigating research ethics board applications, and managing a research budget. Conclusion. We demonstrated that Canadian critical care trainees and junior faculty reported gaps in knowledge in all areas of research. There was disagreement amongst trainees, junior faculty, research coordinators, and program directors regarding learning needs. Results from this needs assessment will be used to help redesign the education program of the Canadian Critical Care Trials Group to complement local research training offered for critical care trainees.

  11. The Development of a Critical Care Resident Research Curriculum: A Needs Assessment.

    Science.gov (United States)

    Jain, Sangeeta; Menon, Kusum; Piquette, Dominique; Gottesman, Ronald; Hutchison, James; Gilfoyle, Elaine; Group, Canadian Critical Care Trials

    2016-01-01

    Background. Conducting research is expected from many clinicians' professional profile, yet many do not have advanced research degrees. Research training during residency is variable amongst institutions and research education needs of trainees are not well understood. Objective. To understand needs of critical care trainees regarding research education. Methods. Canadian critical care trainees, new critical care faculty, program directors, and research coordinators were surveyed regarding research training, research expectations, and support within their programs. Results. Critical care trainees and junior faculty members highlighted many gaps in research knowledge and skills. In contrast, critical care program directors felt that trainees were prepared to undertake research careers. Major differences in opinion amongst program directors and other respondent groups exist regarding preparation for designing a study, navigating research ethics board applications, and managing a research budget. Conclusion. We demonstrated that Canadian critical care trainees and junior faculty reported gaps in knowledge in all areas of research. There was disagreement amongst trainees, junior faculty, research coordinators, and program directors regarding learning needs. Results from this needs assessment will be used to help redesign the education program of the Canadian Critical Care Trials Group to complement local research training offered for critical care trainees. PMID:27610029

  12. Transitioning to routine breast cancer risk assessment and management in primary care: what can we learn from cardiovascular disease?

    Science.gov (United States)

    Phillips, Kelly-Anne; Steel, Emma J; Collins, Ian; Emery, Jon; Pirotta, Marie; Mann, G Bruce; Butow, Phyllis; Hopper, John L; Trainer, Alison; Moreton, Jane; Antoniou, Antonis C; Cuzick, Jack; Keogh, Louise

    2016-01-01

    To capitalise on advances in breast cancer prevention, all women would need to have their breast cancer risk formally assessed. With ~85% of Australians attending primary care clinics at least once a year, primary care is an opportune location for formal breast cancer risk assessment and management. This study assessed the current practice and needs of primary care clinicians regarding assessment and management of breast cancer risk. Two facilitated focus group discussions were held with 17 primary care clinicians (12 GPs and 5 practice nurses (PNs)) as part of a larger needs assessment. Primary care clinicians viewed assessment and management of cardiovascular risk as an intrinsic, expected part of their role, often triggered by practice software prompts and facilitated by use of an online tool. Conversely, assessment of breast cancer risk was not routine and was generally patient- (not clinician-) initiated, and risk management (apart from routine screening) was considered outside the primary care domain. Clinicians suggested that routine assessment and management of breast cancer risk might be achieved if it were widely endorsed as within the remit of primary care and supported by an online risk-assessment and decision aid tool that was integrated into primary care software. This study identified several key issues that would need to be addressed to facilitate the transition to routine assessment and management of breast cancer risk in primary care, based largely on the model used for cardiovascular disease.

  13. 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

  14. 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...

  15. 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

  16. Opportunities for Prevention: Assessing Where Low-Income Patients Seek Care for Preventable Coronary Artery Disease.

    Science.gov (United States)

    Klaiman, Tamar A; Valdmanis, Vivian G; Bernet, Patrick; Moises, James

    2015-10-01

    The Affordable Care Act has many aspects that are aimed at improving health care for all Americans, including mandated insurance coverage for individuals, as well as required community health needs assessments (CHNAs), and reporting of investments in community benefit by nonprofit hospitals in order to maintain tax exemptions. Although millions of Americans have gained access to health insurance, many--often the most vulnerable--remain uninsured, and will continue to depend on hospital community benefits for care. Understanding where patients go for care can assist hospitals and communities to develop their CHNA and implementation plans in order to focus resources where the need for prevention is greatest. This study evaluated patient care-seeking behavior among patients with coronary artery disease (CAD) in Florida in 2008--analyzed in 2013--to assess whether low-income patients accessed specific safety net hospitals for treatment or received care from hospitals that were geographically closer to their residence. This study found evidence that low-income patients went to hospitals that treated more low-income patients, regardless of where they lived. The findings demonstrate that hospitals-especially public safety net hospitals with a tradition of treating low-income patients suffering from CAD-should focus prevention activities where low-income patients reside. PMID:25856375

  17. 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.

  18. 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.

  19. 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...

  20. 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...

  1. Self-care assessment as an indicator for clinical supervision in nursing

    Directory of Open Access Journals (Sweden)

    Sílvia Marlene Monteiro Teixeira

    2016-01-01

    Full Text Available Objective : to evaluate the needs of clinical supervision for nurses to assess the degree of dependence on self- care and planning of nursing interventions. Methods : analytical study, cross-cutting nature, collecting data from a sample of 110 patients. Results : it was shown the differences in the identification of the degree of dependence between registers and experts, as well as the selection of operations for each self-care and failures to the original assessment of the filling level (no evaluation self-care/no identification of the degree of dependence. Conclusion : there were gaps in the nursing process; they have proposed strategies such as clinical supervision sessions, training, case studies, protocols and guidance documents, to be included in a clinical supervision in nursing model.

  2. Self-care assessment as an indicator for clinical supervision in nursing

    Directory of Open Access Journals (Sweden)

    Sílvia Marlene Monteiro Teixeira

    2016-06-01

    Full Text Available Objective: to evaluate the needs of clinical supervision for nurses to assess the degree of dependence on self-care and planning of nursing interventions. Methods: analytical study, cross-cutting nature, collecting data from a sample of 110 patients. Results: it was shown the differences in the identification of the degree of dependence between registers and experts, as well as the selection of operations for each self-care and failures to the original assessment of the filling level (no evaluation self-care/no identification of the degree of dependence. Conclusion: there were gaps in the nursing process; they have proposed strategies such as clinical supervision sessions, training, case studies, protocols and guidance documents, to be included in a clinical supervision in nursing model.

  3. Personality assessment in today's health care environment: therapeutic alliance and patient satisfaction.

    Science.gov (United States)

    Quirk, Michael P; Erdberg, Philip; Crosier, Marlan; Steinfeld, Bradley

    2007-10-01

    This article addresses the role of personality assessment-specifically the Rorschach (Exner, 2002)-]in the context of the health care industry's increased focus on patient satisfaction. When providing psychotherapy, a challenge to providing patient-centered care turns on understanding and acting on the key aspects of the patient's personality that are crucial to forming an effective alliance. This article includes a description and examples of how personality assessment can enhance therapists' understanding of the ideational, affective, and self-control aspects of complicated patients' problem-solving styles. This enhanced understanding in turn can lead to improved therapeutic alliance between therapists and patients and to increased patient satisfaction with their care. How to provide feedback to the therapist also is addressed.

  4. The impact of behavioral and mental health risk assessments on goal setting in primary care.

    Science.gov (United States)

    Krist, Alex H; Glasgow, Russell E; Heurtin-Roberts, Suzanne; Sabo, Roy T; Roby, Dylan H; Gorin, Sherri N Sheinfeld; Balasubramanian, Bijal A; Estabrooks, Paul A; Ory, Marcia G; Glenn, Beth A; Phillips, Siobhan M; Kessler, Rodger; Johnson, Sallie Beth; Rohweder, Catherine L; Fernandez, Maria E

    2016-06-01

    Patient-centered health risk assessments (HRAs) that screen for unhealthy behaviors, prioritize concerns, and provide feedback may improve counseling, goal setting, and health. To evaluate the effectiveness of routinely administering a patient-centered HRA, My Own Health Report, for diet, exercise, smoking, alcohol, drug use, stress, depression, anxiety, and sleep, 18 primary care practices were randomized to ask patients to complete My Own Health Report (MOHR) before an office visit (intervention) or continue usual care (control). Intervention practice patients were more likely than control practice patients to be asked about each of eight risks (range of differences 5.3-15.8 %, p set goals for six risks (range of differences 3.8-16.6 %, p controls, intervention patients felt clinicians cared more for them and showed more interest in their concerns. Patient-centered health risk assessments improve screening and goal setting.Trial RegistrationClinicaltrials.gov identifier: NCT01825746.

  5. 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

  6. 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...

  7. QUOTE-HIV: an instrument for assessing quality of HIV care from the patients' perspective.

    NARCIS (Netherlands)

    Hekkink, C.F.; Sixma, H.J.; Wigersma, L.; Yzermans, C.J.; Meer, J.T.M. van der; Bindels, P.J.E.; Brinkman, K.; Danner, S.A.

    2003-01-01

    BACKGROUND: An HIV-specific version of the QUOTE questionnaire was developed to measure the quality of care of patients infected with HIV from the patients' perspective. The consistency and validity of the questionnaire was assessed. METHODS: Focus group discussions were held to select aspects for i

  8. 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…

  9. 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…

  10. Caregiving Hassles Scale: Assessing the Daily Hassles of Caring for a Family Member with Dementia.

    Science.gov (United States)

    Kinney, Jennifer M.; Stephens, Mary Ann Parris

    1989-01-01

    Primary caregivers to Alzheimer disease patients (N=60) twice completed Caregiving Hassles Scale and reported on their well-being. Scale provided reliable and psychometrically sound instrument for assessing hassles associated with assistance in basic and instrumental activities of daily living, care-recipient cognitive status and behavior, and…

  11. The Sensitivity of the Geriatric Oral Health Assessment Index to Dental Care.

    Science.gov (United States)

    Dolan, Teresa A.

    1997-01-01

    A 24-month study of 96 patients in a community-based oral health promotion project found the Geriatric Oral Health Assessment Index (GOHAI), a self-report measure of oral health, to be sensitive to provision of dental care. Some further development of measures is needed. Potential applications of this and similar self-report measures in dental…

  12. 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

  13. 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…

  14. 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…

  15. 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)…

  16. 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…

  17. 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…

  18. Usage patterns of personal care products: Important factors for exposure assessment

    NARCIS (Netherlands)

    Biesterbos, J.W.H.; Dudzina, T.; Delmaar, C.J.; Bakker, Mireille; Russel, F.G.M.; Goetz, N. von; Scheepers, P.T.J.; Roeleveld, N.

    2013-01-01

    Complete information regarding the use of personal care products (PCPs) by consumers is limited, but such information is crucial for realistic consumer exposure assessment. To fill this gap, a database was created with person-oriented information regarding usage patterns and circumstances of use for

  19. 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.

  20. 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.

  1. 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…

  2. Inpatient care of the elderly in Brazil and India: assessing social inequalities.

    Science.gov (United States)

    Channon, Andrew Amos; Andrade, Monica Viegas; Noronha, Kenya; Leone, Tiziana; Dilip, T R

    2012-12-01

    The rapidly growing older adult populations in Brazil and India present major challenges for health systems in these countries, especially with regard to the equitable provision of inpatient care. The objective of this study was to contrast inequalities in both the receipt of inpatient care and the length of time that care was received among adults aged over 60 in two large countries with different modes of health service delivery. Using the Brazilian National Household Survey from 2003 and the Indian National Sample Survey Organisation survey from 2004 inequalities by wealth (measured by income in Brazil and consumption in India) were assessed using concentration curves and indices. Inequalities were also examined through the use of zero-truncated negative binomial models, studying differences in receipt of care and length of stay by region, health insurance, education and reported health status. Results indicated that there was no evidence of inequality in Brazil for both receipt and length of stay by income per capita. However, in India there was a pro-rich bias in the receipt of care, although once care was received there was no difference by consumption per capita for the length of stay. In both countries the higher educated and those with health insurance were more likely to receive care, while the higher educated had longer stays in hospital in Brazil. The health system reforms that have been undertaken in Brazil could be credited as a driver for reducing healthcare inequalities amongst the elderly, while the significant differences by wealth in India shows that reform is still needed to ensure the poor have access to inpatient care. Health reforms that move towards a more public funding model of service delivery in India may reduce inequality in elderly inpatient care in the country.

  3. 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.

  4. 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...

  5. 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

  6. Assessment of a prototype for the Systemization of Nursing Care on a mobile device 1

    Science.gov (United States)

    Rezende, Laura Cristhiane Mendonça; dos Santos, Sérgio Ribeiro; Medeiros, Ana Lúcia

    2016-01-01

    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. PMID:27384467

  7. 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

  8. 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.

  9. 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.

  10. 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 (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.

  11. Age-friendly primary health care: an assessment of current service provision for older adults in Hong Kong.

    Science.gov (United States)

    Woo, Jean; Mak, Benise; Yeung, Fannie

    2013-01-01

    There has been no study evaluating whether primary care services are sufficiently oriented towards the older population in Hong Kong, particularly those with increasing frailty. Since primary care is a key first interface in promotion and maintenance of health in older people, an assessment of the age-friendliness of service provisions is of critical importance in optimizing the health of aging populations. The age-friendliness of primary care services for older people was assessed using focus groups of elderly people and also of service providers who care for them. Discussion content was based on the WHO guidelines for age-friendly primary care in the following areas: Information, education and training, community-based health care management systems, and the physical environment. Desirable improvements were identified in all domains. The findings underscore the need for wider dissemination of health care needs of older people in the primary care setting.

  12. 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

  13. 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

  14. 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

    2016-01-06

    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.

  15. 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.

  16. Assessment of Financial Burden as a Standard of Care in Pediatric Oncology.

    Science.gov (United States)

    Pelletier, Wendy; Bona, Kira

    2015-12-01

    Family financial hardship has emerged as a burden of pediatric cancer treatment with negative implications for family well-being. As part of an extensive project to create evidence-based standards for the psychosocial care of children with cancer, we performed a literature review of pediatric cancer-associated financial hardship utilizing six databases, and identified 24 publications for incorporation into this review. Financial hardship during childhood cancer was found to affect a significant proportion of the population and to negatively impact family well-being. Existing literature supports a strong recommendation for assessment of financial hardship as a component of comprehensive psychosocial care in pediatric oncology.

  17. Assessing Medication Adherence as a Standard of Care in Pediatric Oncology.

    Science.gov (United States)

    Pai, Ahna L H; McGrady, Meghan E

    2015-12-01

    Poor adherence to pediatric cancer treatment protocols may prevent children and adolescents from realizing the potential benefits of therapy. This paper presents the evidence for a standard of care for supporting medication adherence. Databases were reviewed for articles examining adherence and including children and/or adolescents with cancer. Fourteen articles (i.e., qualitative, quantitative, review, and randomized clinical trials) were evaluated for rigor. There is moderate-quality evidence to support a strong recommendation for adherence to be assessed routinely and monitored throughout the treatment. Integrating the proposed clinical procedures into standard clinical care may improve outcomes for children and adolescents with cancer.

  18. 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.

  19. 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

  20. 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...

  1. 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...

  2. 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.

  3. 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

  4. 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 .

  5. Platform Constellations

    DEFF Research Database (Denmark)

    Staykova, Kalina Stefanova; Damsgaard, Jan

    2016-01-01

    This research paper presents an initial attempt to introduce and explain the emergence of new phenomenon, which we refer to as platform constellations. Functioning as highly modular systems, the platform constellations are collections of highly connected platforms which co-exist in parallel and a......’ acquisition and users’ engagement rates as well as unlock new sources of value creation and diversify revenue streams....

  6. Content Validity for a Child Care Self-assessment Tool: Creating Healthy Eating Environments Scale (CHEERS).

    Science.gov (United States)

    Lafave, Lynne; Tyminski, Sheila; Riege, Theresa; Hoy, Diane; Dexter, Bria

    2016-06-01

    The purpose of this project was to develop and content validate both a formative and summative self-assessment scale designed to measure the nutrition and physical activity environment in community-based child care programs. The study followed a mixed-method modified Ebel procedure. An expert group with qualifications in nutrition, physical activity, and child care were recruited for content validation. The survey was subjected to expert review through digital communication followed by a face-to-face validation meeting. To establish consensus for content validity beyond the standard error of proportion (P physical activity environment, and healthy body image environment. Content validation is an integral step in scale development that is often overlooked or poorly carried out. Initial content validity of this scale has been established and will be of value to researchers and practitioners interested in conducting healthy eating interventions in child care. PMID:26771216

  7. 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.

  8. Development of a questionnaire to assess interprofessional collaboration between two different care levels

    Directory of Open Access Journals (Sweden)

    Roberto Nuño Solinís

    2013-04-01

    Full Text Available Introduction. This paper reports the development and validation of a questionnaire to assess collaboration between clinical professionals from two different care levels (primary and specialised care, according to the clinicians' own perceptions. This questionnaire has been elaborated to be used as part of the monitoring and evaluation process of the integrated care pilots in the public Basque Health Service. Methods. The process was carried out in four phases: development of the first version of the questionnaire, validation of the content, pre-testing, and evaluation of its construct validity and homogeneity in a sample of doctors and nurses. This last phase involved confirmatory factor analysis, as well as the calculation of Cronbach's α and various correlation coefficients. Results. The process demonstrated that the theoretical content of the questionnaire was appropriate, and also that its items were clear, relevant and intelligible. The fit indices for the confirmatory factor analysis were: c2 of 45.51 (p = 0.089, RMSEA of 0.043, RMR of 0.046, GFI of 0.92 and CFI of 0.99. Discussion. The statistics indicate a good fit between the data and a conceptual two-factor structure, in which both personal relationships between professionals and characteristics of the organisational environment are understood to underlie interprofessional collaboration. Conclusion. The end-product is a new instrument with good validity to assess the degree of interprofessional collaboration between clinicians working at two different levels of care.

  9. Development of a questionnaire to assess interprofessional collaboration between two different care levels

    Directory of Open Access Journals (Sweden)

    Roberto Nuño Solinís

    2013-04-01

    Full Text Available Introduction. This paper reports the development and validation of a questionnaire to assess collaboration between clinical professionals from two different care levels (primary and specialised care, according to the clinicians' own perceptions. This questionnaire has been elaborated to be used as part of the monitoring and evaluation process of the integrated care pilots in the public Basque Health Service.Methods. The process was carried out in four phases: development of the first version of the questionnaire, validation of the content, pre-testing, and evaluation of its construct validity and homogeneity in a sample of doctors and nurses. This last phase involved confirmatory factor analysis, as well as the calculation of Cronbach's α and various correlation coefficients.Results. The process demonstrated that the theoretical content of the questionnaire was appropriate, and also that its items were clear, relevant and intelligible. The fit indices for the confirmatory factor analysis were: c2 of 45.51 (p = 0.089, RMSEA of 0.043, RMR of 0.046, GFI of 0.92 and CFI of 0.99.Discussion. The statistics indicate a good fit between the data and a conceptual two-factor structure, in which both personal relationships between professionals and characteristics of the organisational environment are understood to underlie interprofessional collaboration.Conclusion. The end-product is a new instrument with good validity to assess the degree of interprofessional collaboration between clinicians working at two different levels of care.

  10. 平台理论视角下的互联网与“分级诊疗”%Internet and “tiered health care system” in China:A platform theory perspective

    Institute of Scientific and Technical Information of China (English)

    杜创

    2016-01-01

    本文运用产业经济学中的平台理论对当前我国推进分级诊疗的难点、互联网促进分级诊疗的可能性及其可行模式进行了分析,得出结论:分级诊疗的主要障碍为事业单位体制下医生对医院的依附关系、医院分级管理制度与医院平台正外部性三者的相互作用,使三甲医院“强者愈强”、基层“弱者愈弱”;互联网医疗平台促进医生走出体制自由执业,有助于破除传统医院平台的正外部性,实现分级诊疗;互联网医疗平台采取双层结构,“大平台套小平台”,是推动分级诊疗的可行模式。%We explore the difficulty of the possibility of the way to a “tiered health care system” in China. This means that high-end hospitals treat “serious” diseases and community ones and/or individual clinics focus on“non-serious” diseases. The exploration is done using a new theoretical framework in industrial economics, the plat-forms theory. The research achieved three main results which are as follows:Firstly, it shows that three main obsta-cles to build a“tiered health care system” comprise the employment relationship between doctors and hospitals, hier-archical hospital system, and positive hospital platform externalities, whose interaction enhance the high-end hospitals to be stronger and community ones to become weaker. Secondly, internet medical platforms will help doctors to leave the high-end public hospitals, build individual clinics, and thus achieve a“tiered health care system”. Finally, the“two-tier structure”, adopted by some internet medical platforms, is a possible way to build the “tiered health care system”, and means a large platform including many small professional platforms on one hand and patients on the other hand.

  11. The development and evaluation of a holistic needs assessment within children's palliative care.

    Science.gov (United States)

    Hartley, Georgina; Berger, Zoe; Maynard, Linda

    2016-05-01

    Caring for a child with a life-limiting condition brings a number of challenges and many families require additional support. The need for services to move away from a 'one size fits all' approach to a personalised care planning approach is well recognised, as is the value of establishing a robust way of assessing family members' differing needs. A number of assessment tools that consider individuals' holistic needs already exist. These are predominantly for the adult cancer population and exclude consideration of the child in its system. There was therefore a need to develop a tool that would appropriately meet the needs of children and parents who access services provided by a children's hospice. The tool was evaluated qualitatively. Feedback was positive; the experience of professionals was one of concordance with their ethical stance, improved communication, improved documentation and the wish to embed the tool into daily practice.

  12. 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.

  13. Validation of a new instrument for self-assessment of nurses' core competencies in palliative care.

    Science.gov (United States)

    Slåtten, Kari; Hatlevik, Ove; Fagerström, Lisbeth

    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 colleges in Norway answered the questionnaire. The initial analysis, with structural equation modelling, was run in Mplus 7. A modified confirmatory factor analysis revealed the following five domains: knowledge in symptom management, systematic use of the Edmonton symptom assessment system, teamwork skills, interpersonal skills, and life closure skills. The actual instrument needs to be tested in a practice setting with a larger sample to confirm its usefulness. The instrument has the potential to be used to refine clinical competence in palliative care and be used for the training and evaluation of palliative care nurses.

  14. Lysimeter Platform

    Science.gov (United States)

    Klammler, Gernot; Murer, Erwin; Plieschnegger, Markus

    2014-05-01

    The existing European Lysimeter Platform (www.lysimeter.at/HP_EuLP) provides an overview of lysimeter types used in Europe and show details on equipment, research results and future perspectives of lysimeter facilities. However, this platform is not user-editable and has not been updated since 2008. Thus, the Lysimeter Research Group (www.lysimeter.at) intends to serve a new database based website called Lysimeter Platform, where existing information of the former European Lysimeter Platform will be transferred to the new Lysimeter Platform and, furthermore, registered users are able to create and edit sites where lysimeters, soil water samplers and soil hydrologic measuring profiles are operated. The Lysimeter Research Group is a scientific association and, therefore, the membership is free of charge. The new Lysimeter Platform contains general information of lysimeter sites worldwide (e.g., what is measured at which site) in a standardized form to get a quick but informative overview of the sites and can be linked to more detailed, already existing information provided by the site operators. Due to the standardized information in the database the Lysimeter Platform serves also as search-engine for soil water measurements and helps to find sites of interest and corresponding contact information worldwide. The Session "Estimation of soil-atmosphere and vadose zone water fluxes by use of precision lysimeter measurements" at the EGU General Assembly 2014 would be an excellent chance to present the idea and the concept of this new Lysimeter Platform to international site operators and scientists.

  15. 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, ...

  16. 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...

  17. 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...

  18. 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

  19. 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...

  20. 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.

  1. Development of an Inventory for Health-Care Office Staff to Self-Assess Their Patient-Centered Cultural Sensitivity

    Directory of Open Access Journals (Sweden)

    Carolyn M. Tucker

    2016-02-01

    Full Text Available Background: Patient-centered culturally sensitive health care (PC-CSHC is a best practice approach for improving health-care delivery to culturally diverse populations and reducing health disparities. Despite patients’ report that cultural sensitivity by health-care office staff is an important aspect of PC-CSHC, the majority of available research on PC-CSHC focuses exclusively on health-care providers. This may be due in part to the paucity of instruments available to assess the cultural sensitivity of health-care office staff. The objective of the present study is to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF. This instrument is designed to enable health-care office staff to self-assess their level of agreement that they display behaviors and attitudes that culturally diverse patients have identified as office staff cultural sensitivity indicators. Methods: A sample of 510 health-care office staff were recruited at 67 health-care sites across the United States. These health-care office staff anonymously completed the T-CSHCOSI-SAF and a demographic data questionnaire. Results and Level of Evidence: Confirmatory factor analyses of the T-CSHCOSI-SAF revealed that this inventory has 2 factors with high internal consistency reliability (Cronbach’s αs= .916 and .912. Conclusion and Implications: The T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity. Such self-assessment data can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff and to help draw the attention of these staff to displaying patient-centered cultural sensitivity.

  2. 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

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

    DEFF Research Database (Denmark)

    Munk, Lone; Mortensen, Niels Henrik

    2009-01-01

    This article studies the performance and challenges of using nine implemented product platforms in LEGO Company. Most of these do produce results, but do not meet their goals due to challenges in their usage in the daily product. The main challenges are that the platforms are not being used...... 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...

  4. Using a multi-method, user centred, prospective hazard analysis to assess care quality and patient safety in a care pathway

    Directory of Open Access Journals (Sweden)

    Escoto Kamisha

    2007-06-01

    Full Text Available Abstract Background Care pathways can be complex, often involving multiple care providers and as such are recognised as containing multiple opportunities for error. Prospective hazard analysis methods may be useful for evaluating care provided across primary and secondary care pathway boundaries. These methods take into account the views of users (staff and patients when determining where potential hazards may lie. The aim of this study is to evaluate the feasibility of prospective hazard analysis methods when assessing quality and safety in care pathways that lie across primary and secondary care boundaries. Methods Development of a process map of the care pathway for patients entering into a Chronic Obstructive Pulmonary Disease (COPD supported discharge programme. Triangulation of information from: care process mapping, semi-structured interviews with COPD patients, semi-structured interviews with COPD staff, two round modified Delphi study and review of prioritised quality and safety challenges by health care staff. Results Interview themes emerged under the headings of quality of care and patient safety. Quality and safety concerns were mostly raised in relation to communication, for example, communication with other hospital teams. The three highest ranked safety concerns from the modified Delphi review were: difficulties in accessing hospital records, information transfer to primary care and failure to communicate medication changes to primary care. Conclusion This study has demonstrated the feasibility of using mixed methods to review the quality and safety of care in a care pathway. By using multiple research methods it was possible to get a clear picture of service quality variations and also to demonstrate which points in the care pathway had real potential for patient safety incidents or system failures to occur. By using these methods to analyse one condition specific care pathway it was possible to uncover a number of hospital

  5. 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...

  6. 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...

  7. 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.

  8. 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

  9. Psychometric performance of an assessment scale for strain in nursing care: The M-NCAS

    Directory of Open Access Journals (Sweden)

    Kleinman Leah

    2004-11-01

    Full Text Available Abstract Background Multiple instruments exist to measure dementia behaviors, but the nursing staff perspective on those behaviors and their level of burden has not been well measured. The goal of this study was to examine the psychometric performance of the Modified Nursing Care Assessment Scale (M-NCAS, a 28-item nurse rating of burden associated with care for institutionalized individuals with dementia. Nurses rate items in terms of extent to which the behavior or characteristic is present ("attitude" domain, and extent to which it is a burden ("strain" domain. Methods Data from 282 patients enrolled in a 12-week, double-blind, randomized clinical trial comparing risperidone treatment to placebo was used to evaluate M-NCAS item performance, internal consistency reliability, and construct validity. Empirical subscales were identified via exploratory factor analysis (EFA. Results Four poorly-performing items were deleted from further analyses. EFA identified 3 "attitude" subscales and 5 "strain" subscales. Cronbach's alphas were 0.65 and above. Correlation with the Cohen-Mansfield Agitation Inventory and the BEHAVE-AD, clinical ratings of dementia behaviors, were low to moderate. Conclusion The M-NCAS provides a valid and reliable means of obtaining care burden ratings from formal caregivers in long-term care, and provides a method for evaluating dementia interventions from the perspective of nursing staff.

  10. E-health readiness assessment: promoting "hope" in the health-care institutions of Pakistan.

    Science.gov (United States)

    Khoja, Shariq; Scott, Richard; Gilani, Salman

    2008-01-01

    e-Health readiness refers to the preparedness of health-care institutions to implement programmes that involve use of Information and Communication Technology (ICT) in provision and management of health services. Level of readiness depends on a number of factors that lead to success or failure of e-health programmes, and thus increase or decrease hope of achieving the desired results. This report presents results from in-depth interviews conducted during a larger study and presents views of managers and health-care providers from various institutions in Pakistan about the usefulness of e-health readiness assessment tools. Participants emphasized the need for implementing e-health programmes in the country, while appreciating the need for readiness assessment tools, and the way these tools could avoid failures related to implementation of e-health programmes. Participants also linked e-health readiness with the process of change management, essential for sustainable implementation of e-health programmes in the health-care institutions of developing countries.

  11. [Informal caregivers of elderly people in South Tyrol. A qualitative assessment of home care situation].

    Science.gov (United States)

    Ausserhofer, Dietmar; Mantovan, Franco; Innerhofer, Esther; Götsch, Ingrid; Ploner, Elfriede; Them, Christa

    2009-11-01

    Within the framework of a pilot project in the sanitary district of Bruneck (sanitary establishment of South Tyrol), the concept of care management is being investigated both practically and scientifically for informal caregivers of elderly people in need of care since 2009 the results of the qualitative assessment of the homecare situation. The assessment before the intervention will form the basis for further design and implementation of individual stress-reducing and supportive offers for the informal caregivers. Using a semi structured interview guideline twelve problem-centered interviews with informal caregivers were conducted and analysed according to Mayring's content analysis technique (2007). Informal caregivers are exposed to burdens in social, physical and mental areas. Own resources, family ties and support reduce stress and burdens caused by the homecare situation. The need of individual and continuous support of families and implications for further measures of care management can be deduced from the results. There is a need of support in the areas coping strategies, empowerment and direct stress reduction with regard to the homecare situation through education, training, counselling and the interconnection of social and health services.

  12. 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

  13. 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

  14. Point-of-care echocardiography in simulation-based education and assessment

    Directory of Open Access Journals (Sweden)

    Amini R

    2016-05-01

    Full Text Available Richard Amini, Lori A Stolz, Parisa P Javedani, Kevin Gaskin, Nicola Baker, Vivienne Ng, Srikar Adhikari Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ, USA Background: Emergency medicine milestones released by the Accreditation Council for Graduate Medical Education require residents to demonstrate competency in bedside ultrasound (US. The acquisition of these skills necessitates a combination of exposure to clinical pathology, hands-on US training, and feedback. Objectives: We describe a novel simulation-based educational and assessment tool designed to evaluate emergency medicine residents’ competency in point-of-care echocardiography for evaluation of a hypotensive patient with chest pain using bedside US. Methods: This was a cross-sectional study conducted at an academic medical center. A simulation-based module was developed to teach and assess the use of point-of-care echocardiography in the evaluation of the hypotensive patient. The focus of this module was sonographic imaging of cardiac pathology, and this focus was incorporated in all components of the session: asynchronous learning, didactic lecture, case-based learning, and hands-on stations. Results: A total of 52 residents with varying US experience participated in this study. Questions focused on knowledge assessment demonstrated improvement across the postgraduate year (PGY of training. Objective standardized clinical examination evaluation demonstrated improvement between PGY I and PGY III; however, it was noted that there was a small dip in hands-on scanning skills during the PGY II. Clinical diagnosis and management skills also demonstrated incremental improvement across the PGY of training. Conclusion: The 1-day, simulation-based US workshop was an effective educational and assessment tool at our institution. Keywords: point-of care ultrasound, simulation education

  15. 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.

  16. Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

    Science.gov (United States)

    Arunasalam, Mark; Paulson, Albert; Wallace, William

    2003-01-01

    Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

  17. Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

    Science.gov (United States)

    Arunasalam, Mark; Paulson, Albert; Wallace, William

    2003-01-01

    Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers. PMID:15271631

  18. 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...

  19. Platform contents

    OpenAIRE

    Renault, Régis

    2014-01-01

    A monopoly platform hosts advertisers who compete on a market for horizontally differentiated products. These products may be either mass market products that appeal broadly to the entire consumer population or niche products that are tailored to the tastes of some particular group. Consumers search sequentially through ads incurring a surfing cost of moving to the next ad. They may click on an ad at some cost, which provides all relevant information and the opportunity to buy. The platform c...

  20. 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

  1. 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

  2. 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…

  3. 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.

  4. 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

  5. Needs assessment for training in interprofessional skills in Swiss primary care: a Delphi study.

    Science.gov (United States)

    Junod Perron, Noelle; Cerutti, Bernard; Picchiottino, Patricia; Empeyta, Sebastien; Cinter, Francoise; van Gessel, Elisabeth

    2014-05-01

    Despite the importance of appropriate interprofessional collaboration in health care, it is still insufficiently taught in health professions education. The aim of the study was to conduct a needs assessment among health professionals on the themes and skills to be taught during interprofessional education programs in the context of Swiss primary care. A three round Delphi electronic survey was carried out in order to identify priority themes and skills to be included in such a program. Participants comprised 12 categories of health professionals. Seventy-two participated in the first, 41 in the second and 43 in the third round. Patient communication, case management of chronic conditions, therapeutic patient education, health promotion and prevention, ethics and medication were the most important themes identified. The most important skill was regarded as "to define and then share tasks and responsibilities between professionals". Sub-analysis revealed that both priority themes and skills chosen differed between health professional categories.

  6. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting.Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers.Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined.Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  7. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting. Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers. Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined. Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. 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...

  11. Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention.

    Science.gov (United States)

    Pfefferbaum, Betty; North, Carol S

    2016-01-01

    Several decades of research have informed our knowledge of children's reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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 ...

  19. 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

  20. 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

  1. 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.

  2. 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

  3. Assessing risk: professional perspectives on work involving mental health and child care services.

    Science.gov (United States)

    Barbour, Rosaline S; Stanley, Nicky; Penhale, Bridget; Holden, Sue

    2002-11-01

    The assessment of risk is central to work with families where parental mental health needs and child care concerns coexist. This article reports on the findings of three interprofessional focus groups which examined professionals' experiences of working with such families. Specialisation and differing thresholds and codes were identified as factors which contributed to difficulties for practitioners and families and scepticism was expressed concerning the feasibility of a key worker system for this group. The issue of psychiatric diagnosis evoked ambivalent responses and was both valued as offering direction for planning interventions and seen as a means of labelling and excluding individuals from services. The focus group participants were aware that assessing risk placed families under considerable pressure, but practitioners themselves also appeared to experience an emphasis on risk as restrictive.

  4. Assessment of fitness for work in health care workers: biomechanical risk factors.

    Science.gov (United States)

    Violante, E S; Mattioli, S; Camagni, Angela; Bottoli, Elena; Farioli, A; Bonfiglioli, Roberta

    2012-01-01

    In current practice the assessment of fitness for work in health care workers exposed to biomechanical risk factors is often based on conventional approaches rather than on evidence-based guidelines. However, an accurate evaluation of worker's psychophysical resources compared to job demand and potential occupational risk factors is essential in order to properly assess fitness for work. The latest published guidelines on the management of patients suffering from back pain reported that the evidence-based approach can minimize the period of inactivity by encouraging return to work (and to other non-dangerous physical activities) in a relatively short period of time. As for carpal tunnel syndrome, there is no scientific evidence supporting a restriction of physical activities requiring forceful movements of the hand/wrist. PMID:22838297

  5. 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.

  6. 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 ...

  7. 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

  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. 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...

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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

  18. Assessment of the Ionospheric and Tropospheric Effects in Location Errors of Data Collection Platforms in Equatorial Region during High and Low Solar Activity Periods

    Directory of Open Access Journals (Sweden)

    Áurea Aparecida da Silva

    2012-01-01

    Full Text Available The geographical locations of data collection platforms (DCP in the Brazilian Environmental Data Collection System are obtained by processing Doppler shift measurements between satellites and DCP. When the signals travel from a DCP to a satellite crossing the terrestrial atmosphere, they are affected by the atmosphere layers, which generate a delay in the signal propagation, and cause errors in its final location coordinates computation. The signal propagation delay due to the atmospheric effects consists, essentially, of the ionospheric and tropospheric effects. This work provides an assessment of ionospheric effects using IRI and IONEX models and tropospheric delay compensation using climatic data provided by National Climatic Data Center. Two selected DCPs were used in this study in conjunction with SCD-2 satellite during high and low solar activity periods. Results show that the ionospheric effects on transmission delays are significant (about hundreds of meters in equatorial region and should be considered to reduce DCP location errors, mainly in high solar activity periods, while in those due to tropospheric effects the zenith errors are about threemeters. Therefore it is shown that the platform location errors can be reduced when the ionospheric and tropospheric effects are properly considered.

  19. 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.

  20. Assessment of alkoxylphenacyl-based polycarbonates as a potential platform for controlled delivery of a model anti-glaucoma drug.

    Science.gov (United States)

    Manickavasagam, Dharani; Wehrung, Daniel; Chamsaz, Elaheh A; Sanders, Matthew; Bouhenni, Rachida; Crish, Samuel D; Joy, Abraham; Oyewumi, Moses O

    2016-10-01

    Treatment strategies for glaucoma will benefit from injectable and/or implantable delivery systems that can achieve sustained delivery of neuroprotective agents (to the posterior segment) and/or intraocular pressure lowering drugs (to the anterior segment). In this regard, we have evaluated the suitability of a new polymer (alkoxylphenacyl-based polycarbonates copolymer with polycaprolactone; AP-PCL 20% w/w) as a platform for ocular drug delivery. Brimonidine tartrate (BRT) was applied as a model anti-glaucoma drug. The polymer was applied to develop injectable (nanoparticles) and implantable (microfilms) delivery systems. Nanoparticles fabricated from AP-PCL were stable and have an average size less than 200nm. The AP-PCL microfilms prepared by compression molding showed a gradual hydrolytic in-vitro degradation monitored by water uptake, weight loss, microscopy, DSC and FT-IR measurements. AP-PCL microfilms achieve sustained delivery of BRT for up to 90days. Biocompatibility of AP-PCL-based delivery systems was demonstrated from studies in human trabecular meshwork cell line as well as after intravitreal injections in rats. The overall trend demonstrated that AP-PCL delivery systems may be considered as suitable candidates for prolonged drug delivery in chronic ocular disorders such as glaucoma. PMID:27320697

  1. 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

  2. Role-playing simulation as an educational tool for health care personnel: developing an embedded assessment framework.

    Science.gov (United States)

    Libin, Alexander; Lauderdale, Manon; Millo, Yuri; Shamloo, Christine; Spencer, Rachel; Green, Brad; Donnellan, Joyce; Wellesley, Christine; Groah, Suzanne

    2010-04-01

    Simulation- and video game-based role-playing techniques have been proven effective in changing behavior and enhancing positive decision making in a variety of professional settings, including education, the military, and health care. Although the need for developing assessment frameworks for learning outcomes has been clearly defined, there is a significant gap between the variety of existing multimedia-based instruction and technology-mediated learning systems and the number of reliable assessment algorithms. This study, based on a mixed methodology research design, aims to develop an embedded assessment algorithm, a Knowledge Assessment Module (NOTE), to capture both user interaction with the educational tool and knowledge gained from the training. The study is regarded as the first step in developing an assessment framework for a multimedia educational tool for health care professionals, Anatomy of Care (AOC), that utilizes Virtual Experience Immersive Learning Simulation (VEILS) technology. Ninety health care personnel of various backgrounds took part in online AOC training, choosing from five possible scenarios presenting difficult situations of everyday care. The results suggest that although the simulation-based training tool demonstrated partial effectiveness in improving learners' decision-making capacity, a differential learner-oriented approach might be more effective and capable of synchronizing educational efforts with identifiable relevant individual factors such as sociobehavioral profile and professional background.

  3. 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.

  4. 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.

  5. 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...

  6. 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.

  7. 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

  8. 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

  9. 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

  10. 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.

  11. 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...

  12. 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 ...

  13. 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...

  14. 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...

  15. 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

  16. 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.    

  17. Assessment of biomedical waste management practices in a tertiary care teaching hospital in Ludhiana

    Directory of Open Access Journals (Sweden)

    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.

  18. Can Health Technology Assessment (HTA provide a solution to tackle the increasing health-care expenditure in India?

    Directory of Open Access Journals (Sweden)

    Amit Dang

    2016-01-01

    Full Text Available 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.

  19. 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

  20. Demands and Job Resources in the Child Care Workforce: Swiss Lead Teacher and Assistant Teacher Assessments

    Science.gov (United States)

    Bloechliger, Olivia R.; Bauer, Georg F.

    2016-01-01

    Center-based child care has been struggling with poor health and high turnover rates of child care staff and their adverse impact on care quality for decades. Yet little is known about personal and structural antecedents of job resources and job demands that are valid predictors of health and turnover in the child care workforce. Research…

  1. Clinical mentorship of nurse initiated antiretroviral therapy in Khayelitsha, South Africa: a quality of care assessment.

    Directory of Open Access Journals (Sweden)

    Ann Green

    Full Text Available INTRODUCTION: To combat the AIDS epidemic and increase HIV treatment access, the South African government implemented a nurse-based, doctor-supported model of care that decentralizes administration of antiretroviral treatment (ART for HIV positive patients through nurse initiated and managed ART. Médecins Sans Frontières (MSF implemented a mentorship programme to ensure successful task-shifting, subsequently assessing the quality of clinical care provided by nurses. METHODS: A before-after cross-sectional study was conducted on nurses completing the mentorship programme in Khayelitsha, South Africa, from February 2011-September 2012. Routine clinical data from 229 patient folders and 21 self-assessment questionnaires was collected to determine the number of patients initiated on ART by nurses; quality of ART management before-after mentorship; patient characteristics for doctor and nurse ART initiations; and nurse self-assessments after mentorship. RESULTS: Twenty one nurses were authorized by one nurse mentor with one part-time medical officer's support, resulting in nurses initiating 77% of ART eligible patients. Improvements in ART management were found for drawing required bloods (91% vs 99%, p = 0.03, assessing adherence (50% vs 78%, p<0.001 and WHO staging (63% vs 91%, p<0.001. Nurse ART initiation indicators were successfully completed at 95-100% for 11 of 16 indicators: clinical presentation; patient weight; baseline blood work (CD4, creatinine, haemoglobin; STI screening; WHO stage, correlating medical history; medications prescribed appropriately; ART start date; and documented return date. Doctors initiated more patients with TB/HIV co-infection and WHO Stage 3 and 4 disease than nurses. Nurse confidence improved for managing HIV-infected children and pregnant women, blood result interpretation and long-term side effects. CONCLUSIONS: Implementation of a clinical mentorship programme in Khayelitsha led to nurse initiation of a

  2. Availability of antidotes and key emergency drugs in tertiary care hospitals of Punjab and assessment of the knowledge of health care professionals in the management of poisoning cases.

    Science.gov (United States)

    Arslan, Naheed; Khiljee, Sonia; Bakhsh, Allah; Ashraf, Muhammad; Maqsood, Iram

    2016-03-01

    This study was conducted to evaluate the availability of antidotes/key emergency drugs in tertiary care hospitals of the Punjab province, and to assess the knowledge of health care professionals in the stocking and administration of antidotes in the proper management of poisoning cases. Seventeen (n=17) tertiary care hospitals of Punjab Pakistan were selected. Two performas (A and B) were designed for 26 antidotes/key emergency drugs and given to the hospital pharmacists and physicians respectively. It was observed that Activated Charcoal, being the universal antidote was found only in 6 hospitals (41%). Digoxin Immune Fab, Edentate Calcium disodium and Glucagon were not available in emergency department of any hospital and even not included in the formulary of any hospital. About 80% pharmacists were aware of the method of preparation of Activated Charcoal and 85% physicians were familiar with its route of administration. Data showed that tertiary care hospitals of Punjab do not stock antidotes according to national drug policy. Moreover the study strongly suggests the development of health care centers and professional by organizing antidote awareness programs, continuous education and record keeping of poisonous cases and availability of emergency drugs around the clock. PMID:27087082

  3. 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

  4. Assessment of Patients that Request Prescription by Primary Care Physicians' Views

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    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

  5. 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...

  6. 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

  7. Assessment of knowledge attitude and practice towards hepatitis B among health care workers in a tertiary care hospital

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    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

  8. 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

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

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    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.

  10. Development and evaluation of a sensor-based system for remote monitoring and treatment of chronic diseases - the continuous care & coaching platform

    NARCIS (Netherlands)

    Akker, op den Harm; Tabak, Monique; Marin-Perianu, Mihai; Huis in 't Veld, Rianne; Jones, Valerie M.; Hofs, Dennis; Tönis, Thijs M.; Schooten, van Boris W.; Vollenbroek-Hutten, Miriam M.R.; Hermens, Hermie J.

    2012-01-01

    The steep increase in the number of people with chronic diseases in the Western world is a long recognised problem which forces us to look for less labour intensive and more cost effective methods to deliver health-care. Wider use of telemedicine services seems to be a solution that can contribute s

  11. Physical activity assessed in routine care predicts mortality after a COPD hospitalisation

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    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.

  12. Personal care product preservatives: risk assessment and mixture toxicities with an industrial wastewater.

    Science.gov (United States)

    Carbajo, Jose B; Perdigón-Melón, Jose A; Petre, Alice L; Rosal, Roberto; Letón, Pedro; García-Calvo, Eloy

    2015-04-01

    The aquatic toxicity of eight preservatives frequently used in personal care products (PCPs) (iodopropynyl butylcarbamate, bronopol, diazolidinyl urea, benzalkonium chloride, zinc pyrithione, propylparaben, triclosan and a mixture of methylchloroisothiazolinone and methylisothiazolinone) was assessed by means of two different approaches: a battery of bioassays composed of single species tests of bacteria (Vibrio fischeri and Pseudomonas putida) and protozoa (Tetrahymena thermophila), and a whole biological community resazurin-based assay using activated sludge. The tested preservatives showed considerable toxicity in the studied bioassays, but with a marked difference in potency. In fact, all biocides except propylparaben and diazolidinyl urea had EC50 values lower than 1 mg L(-1) in at least one assay. Risk quotients for zinc pyrithione, benzalkonium chloride, iodopropynyl butylcarbamate and triclosan as well as the mixture of the studied preservatives exceeded 1, indicating a potential risk for the process performance and efficiency of municipal sewage treatment plants (STPs). These four single biocides explained more than 95% of the preservative mixture risk in all bioassays. Each individual preservative was also tested in combination with an industrial wastewater (IWW) from a cosmetics manufacturing facility. The toxicity assessment was performed on binary mixtures (preservative + IWW) and carried out using the median-effect principle, which is a special case of the concept of Concentration Addition (CA). Almost 70% of all experiments resulted in EC50 values within a factor of 2 of the values predicted by the median-effect principle (CI values between 0.5 and 2). The rest of the mixtures whose toxicity was mispredicted by CA were assessed with the alternative concept of Independent Action (IA), which showed higher predictive power for the biological community assay. Therefore, the concept used to accurately predict the toxicity of mixtures of a preservative

  13. 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

  14. Assessment of Registration Information on Methodological Design of Acupuncture RCTs: A Review of 453 Registration Records Retrieved from WHO International Clinical Trials Registry Platform.

    Science.gov (United States)

    Gu, Jing; Wang, Qi; Wang, Xiaogang; Li, Hailong; Gu, Mei; Ming, Haixia; Dong, Xiaoli; Yang, Kehu; Wu, Hongyan

    2014-01-01

    Background. This review provides the first methodological information assessment of protocol of acupuncture RCTs registered in WHO International Clinical Trials Registry Platform (ICTRP). Methods. All records of acupuncture RCTs registered in the ICTRP have been collected. The methodological design assessment involved whether the randomization methods, allocation concealment, and blinding were adequate or not based on the information of registration records (protocols of acupuncture RCTs). Results. A total of 453 records, found in 11 registries, were examined. Methodological details were insufficient in registration records; there were 76.4%, 89.0%, and 21.4% records that did not provide information on randomization methods, allocation concealment, and blinding respectively. The proportions of adequate randomization methods, allocation concealment, and blinding were only 107 (23.6%), 48 (10.6%), and 210 (46.4%), respectively. The methodological design improved year by year, especially after 2007. Additionally, methodology of RCTs with ethics approval was clearly superior to those without ethics approval and different among registries. Conclusions. The overall methodological design based on registration records of acupuncture RCTs is not very well but improved year by year. The insufficient information on randomization methods, allocation concealment, and blinding maybe due to the relevant description is not taken seriously in acupuncture RCTs' registration.

  15. 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.

  16. Assessment of work stress and alcohol use in mental health care workers

    Directory of Open Access Journals (Sweden)

    Athanasiadis T.

    2011-10-01

    Full Text Available Aim: The documentation and assessment of general work stressors and alcohol use on mental health care workers as well as the relationship between them. Material and method: The sample consisted of 300 mental health care workers who worked in Private and Public Psychiatric Clinics and Psychiatric Hospitals of the country (Hellas. The collection of empirical material was done by using a questionnaire that included a scale of 34 questions for detecting occupational stress factors, the self-esteem scale of the Spielberger and questions about alcohol use. The statistical analysis of data was done with the statistical program SPSS version 15.0 using Student t - test, the ANOVA analysis of variance test and x2 test. Results: Higher frequency occupational stress factors appeared in Nurses rather than Doctors as well as in employees in Private Psychiatric Clinics rather than employees in the Public sector. The fact that Nurses have higher frequency in stressors rather than Doctors is reflected in measurements of anxiety, as a state as well as a personality trait. Also the employees of Private Psychiatric Clinics exhibit greater indicator of anxiety as a personality trait than the employees of the Public sector. Regarding alcohol use (concept of efficiency and normal consumption quantity it was found to be positively associated with the age of the employees. Also the concept of the effectiveness of alcohol in tackling work stress is associated with some occupational stress factors (dangerous conditions of work, rolling working hours. Conclusions: Factors such as specialty and the type of workplace (Public, Private sector affect the stress experienced by the mental health professional. The view of alcohol as a means of relieving working stress is associated with certain stressors of work and the worker's age.

  17. 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...

  18. 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 ...

  19. 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

  20. 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 ...

  1. 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...

  2. 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.

  3. Non-invasive measurement of hemoglobin: assessment of two different point-of-care technologies.

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    Etienne Gayat

    Full Text Available BACKGROUND: Measurement of blood hemoglobin (Hb concentration is a routine procedure. Using a non-invasive point-of-care device reduces pain and discomfort for the patient and allows time saving in patient care. The aims of the present study were to assess the concordance of Hb levels obtained non-invasively with the Pronto-7 monitor (version 2.1.9, Masimo Corporation, Irvine, USA or with the NBM-200MP monitor (Orsense, Nes Ziona, Israel and the values obtained from the usual colorimetric method using blood samples and to determine the source of discordance. METHODS AND FINDINGS: We conducted two consecutive prospective open trials enrolling patients presenting in the emergency department of a university hospital. The first was designed to assess Pronto-7™ and the second NBM-200MP™. In each study, the main outcome measure was the agreement between both methods. Independent factors associated with the bias were determined using multiple linear regression. Three hundred patients were prospectively enrolled in each study. For Pronto-7™, the absolute mean difference was 0.56 g.L(-1 (95% confidence interval [CI] 0.41 to 0.69 with an upper agreement limit at 2.94 g.L(-1 (95% CI [2.70;3.19], a lower agreement limit at -1.84 g.L(-1 (95% CI [-2.08;-1.58] and an intra-class correlation coefficient at 0.80 (95% CI [0.74;0.84]. The corresponding values for the NBM-200MP™ were 0.21 [0.02;0.39], 3.42 [3.10;3.74], -3.01 [-3.32;-2.69] and 0.69 [0.62;0.75]. Multivariate analysis showed that age and laboratory values of hemoglobin were independently associated with the bias when using Pronto-7™, while perfusion index and laboratory value of hemoglobin were independently associated with the bias when using NBM-200MP™. CONCLUSION: Despite a relatively limited bias in both cases, the large limits of agreement found in both cases render the clinical usefulness of such devices debatable. For both devices, the bias is independently and inversely associated

  4. Development and first assessment of a questionnaire for health care utilization and costs for cardiac patients

    Directory of Open Access Journals (Sweden)

    Hahmann Harry

    2008-09-01

    Full Text Available Abstract Background The valid and reliable measurement of health service utilization, productivity losses and consequently total disease-related costs is a prerequisite for health services research and for health economic analysis. Although administrative data sources are usually considered to be the most accurate, their use is limited as some components of utilization are not systematically captured and, especially in decentralized health care systems, no single source exists for comprehensive utilization and cost data. The aim of this study was to develop and test a questionnaire for the measurement of disease-related costs for patients after an acute cardiac event (ACE. Methods To design the questionnaire, the literature was searched for contributions to the assessment of utilization of health care resources by patient-administered questionnaires. Based on these findings, we developed a retrospective questionnaire appropriate for the measurement of disease-related costs over a period of 3 months in ACE patients. Items were generated by reviewing existing guidelines and by interviewing medical specialists and patients. In this study, the questionnaire was tested on 106 patients, aging 35–65 who were admitted for rehabilitation after ACE. It was compared with prospectively measured data; selected items were compared with administrative data from sickness funds. Results The questionnaire was accepted well (response rate = 88%, and respondents completed the questionnaire in an average time of 27 minutes. Concordance between retrospective and prospective data showed an intraclass correlation (ICC ranging between 0.57 (cost of medical intake and 0.9 (hospital days with the other main items (physician visits, days off work, medication clustering around 0.7. Comparison between self-reported and administrative data for days off work and hospitalized days were possible for n = 48. Respective ICCs ranged between 0.92 and 0.94, although differences in

  5. Does Subtype Matter? Assessing the Effects of Maltreatment on Functioning in Preadolescent Youth in Out-of-Home Care

    Science.gov (United States)

    Petrenko, Christie L. M.; Friend, Angela; Garrido, Edward F.; Taussig, Heather N.; Culhane, Sara E.

    2012-01-01

    Objectives: Attempts to understand the effects of maltreatment subtypes on childhood functioning are complicated by the fact that children often experience multiple subtypes. This study assessed the effects of maltreatment subtypes on the cognitive, academic, and mental health functioning of preadolescent youth in out-of-home care using both…

  6. 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…

  7. Validation and Evaluation of Two Observational Pain Assessment Tools in a Trauma and Neurosurgical Intensive Care Unit

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    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.

  8. 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)…

  9. Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care

    NARCIS (Netherlands)

    Wagemakers, H.P.; Luijsterburg, P.A.; Boks, S.S.; Heintjes, E.M.; Berger, M.Y.; Verhaar, J.A.; Koes, B.W.; Bierma-Zeinstra, S.M.

    2010-01-01

    Wagemakers HP, Luijsterburg PA, Boks SS, Heintjes EM, Berger MY, Verhaar JA, Koes BK, Bierma-Zeinstra SM. Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care. Arch Phys Med Rehabil 2010;91:1452-9. Objective: To a

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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

  16. Qualification of an automated device to objectively assess the effect of hair care products on hair shine.

    Science.gov (United States)

    Hagens, Ralf; Wiersbinski, Tim; Becker, Michael E; Weisshaar, Jürgen; Schreiner, Volker; Wenck, Horst

    2011-01-01

    The authors developed and qualified an automated routine screening tool to quantify hair shine. This tool is able to separately record individual properties of hair shine such as specular reflection and multiple reflection, as well as additional features such as sparkle, parallelism of hair fibers, and hair color, which strongly affect the subjective ranking by individual readers. A side-by-side comparison of different hair care and styling products with regard to hair shine using the automated screening tool in parallel with standard panel assessment showed that the automated system provides an almost identical ranking and the same statistical significances as the panel assessment. Provided stringent stratification of hair fibers for color and parallelism, the automated tool competes favorably with panel assessments of hair shine. In this case, data generated with the opsira Shine-Box are clearly superior over data generated by panel assessment in terms of reliability and repeatability, workload and time consumption, and sensitivity and specificity to detect differences after shampoo, conditioner, and leave-in treatment. The automated tool is therefore well suited to replace standard panel assessments in claim support, at least as a screening tool. A further advantage of the automated system over panel assessments is the fact that absolute numeric values are generated for a given hair care product, whereas panel assessments can only give rankings of a series of hair care products included in the same study. Thus, the absolute numeric data generated with the automated system allow comparison of hair care products between studies or at different time points after treatment.

  17. PHP47 - Early assessment of highly innovative medical technology: clinical and economical gains of point-of-care applications for measuring potassium concentrations

    NARCIS (Netherlands)

    Wetering, G.; Hummel, J.M.; Montfoort, A.; IJzerman, M.J.

    2009-01-01

    OBJECTIVES: Innovative point-of-care diagnostics are likely to be having a strong impact on health care. The aim of this study is to conduct an early assessment of point-of-care chips. These chips can detect many particles and, consequently, many product-market combinations can be developed. This st

  18. Assessment of the need for care 15 years after onset of a Dutch cohort of patients with schizophrenia, and an international comparison

    NARCIS (Netherlands)

    Wiersma, D; Giel, R; deJong, A; Nienhuis, FJ; Slooff, CJ

    1996-01-01

    Assessment of needs for care is crucial in the evaluation of ongoing changes from institutional care to various forms of day- and outpatient treatment, Do patients really do better in the community and are they adequately cared for? The 15-year follow-up of a Dutch incidence cohort of patients with

  19. Assessing the Validity of a Continuum-of-care Survey: A Rasch Measurement Approach.

    Science.gov (United States)

    Peabody, Michael; Bradley, Kelly D; Custer, Melba

    2016-01-01

    Satisfied patients are more likely to be compliant, have better outcomes, and are more likely to return to the same provider or institution for future care. The Satisfaction with a Continuum of Care survey (SCC) was designed to improve patient care using measures of patient satisfaction and facilitate a cultural shift from a "silos-of-care" to a "continuum-of-care" mentality by fostering inter-departmental communication as patients moved between environments of care at a Midwestern rehabilitation hospital. This study provides a Rasch measurement framework for investigating issues related to survey reliability and validity. The results indicate that although certain aspects of the survey seem to function in a psychometrically sound manner, the questions are too easy to endorse and provide little information to help improve patient care. Suggestions for future revisions to this survey instrument are provided. PMID:26784375

  20. 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.

  1. 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

  2. Applications of life cycle assessment and cost analysis in health care waste management.

    Science.gov (United States)

    Soares, Sebastião Roberto; Finotti, Alexandra Rodrigues; da Silva, Vamilson Prudêncio; Alvarenga, Rodrigo A F

    2013-01-01

    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.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. Quality of Care for Patients with Type 2 Diabetes Mellitus in Dubai: A HEDIS-Like Assessment.

    Science.gov (United States)

    Szabo, Shelagh M; Osenenko, Katherine M; Qatami, Lara; Korenblat Donato, Bonnie M; Korol, Ellen E; Al Madani, Abdulrazzaq A; Al Awadi, Fatheya F; Al-Ansari, Jaber; Maclean, Ross; Levy, Adrian R

    2015-01-01

    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.

  8. 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.

  9. 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

  10. 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

  11. 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

  12. 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.

  13. 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

  14. User satisfaction is influenced by the interval between a health care service and the assessment of the service

    DEFF Research Database (Denmark)

    Jensen, Hanne Irene; Ammentorp, Jette; Kofoed, Poul-Erik

    2010-01-01

    In order to improve the quality of patient care, questionnaires are often used to identify user's experiences and evaluations, but only a few studies have examined whether measuring user satisfaction at different time points influences the assessment of health care. Several studies have shown...... times. In a follow-up study, parents from a paediatric outpatient clinic in Denmark were quasi-randomised to 1 of 3 groups: group 1 completed an electronic questionnaire on a touch screen computer in the outpatient clinic and a paper questionnaire 3-6 weeks after the visit; group 2 completed a paper...

  15. 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...

  16. 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...

  17. 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...

  18. Assessing the viability of situationally driven segmentation opportunities in the health care market.

    Science.gov (United States)

    Gehrt, K C; Pinto, M B

    1993-01-01

    The impact of situational factors has typically been investigated in the context of goods marketing. Very few studies have investigated the influence of situational factors on services marketing. This study demonstrates the importance of situational influence on services marketing by delineating a consumer-based, situationally characterized competitive market structure for health care services. The competitive structure of the health care market is delineated in terms of the similarity/substitutability of the three-factor, situational characterizations of ten health care alternatives. The general marketing implications of the market-structure delineation procedure and the health care-specific implications of the findings are discussed.

  19. Application of Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS) to psychiatric practice in Japan: a preliminary assessment of validity and sensitivity to change.

    Science.gov (United States)

    Kimura, Taku; Yagi, Fukashi; Yoshizumi, Akira

    2013-08-01

    We applied an American medical necessity scale, Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS), to psychiatric practice in Japan. This is an exploratory analysis of empirical data of 272 patients. We examined the relationships between levels of care of LOCUS and clinical variables, contribution of care levels on admission decision, and changes in care levels over time. Inpatients showed significantly higher levels of care than outpatients. Levels of care showed significant strong inverse correlations to Global Assessment Scale (GAS) scores, and significant moderate correlations to admission types, care environment, and diagnostic subgroups in almost all groups. Levels of care contributed as much to the admission decision as GAS scores. Levels of care significantly decreased from the time of admission to discharge. Our preliminary evidence indicates that LOCUS is valid and sensitive to change, and applicable for clinical use in Japan.

  20. Assessing response to treatment of bone metastases from breast cancer: what should be the standard of care?

    Science.gov (United States)

    Woolf, D K; Padhani, A R; Makris, A

    2015-06-01

    Bone is the most common site for breast cancer metastases, occurring in up to 70% of those with metastatic disease. In order to effectively manage these patients, it is essential to have consistent, reproducible and validated methods of assessing response to therapy. We present current clinical practice of imaging response assessment of bone metastases. We also review the biology of bone metastases and measures of response assessment including clinical assessment, tumour markers and imaging techniques; bone scans (BSs), computed tomography (CT), positron emission tomography, magnetic resonance imaging (MRI) and whole-body diffusion-weighted MRI (WB DW-MRI). The current standard of care of BSs and CT has significant limitations and are not routinely recommended for the purpose of response assessment in the bones. WB DW-MRI has the potential to address this unmet need and should be evaluated in clinical trials.

  1. [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

    2016-07-07

    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.

  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. 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

  4. 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.

  5. 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.

  6. 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

  7. Essentials for emergency care: Lessons from an inventory assessment of an emergency centre in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Kofi Marfo Osei

    2014-12-01

    Conclusion: Beyond pointing out specific material resource deficiencies at the Surgical Medical Emergency (SME centre, our inventory assessment indicated a need to develop better implementation strategies for infection control policies, to collaborate with other departments on coordination of patient care, and to set a research agenda to develop emergency and acute care protocols that are both effective and sustainable in our setting. Equipment and supplies are essential elements of emergency preparedness that must be both available and ‘ready-to-hand’. Consequently, key factors in determining readiness to provide quality emergency care include supply-chain, healthcare financing, functionality of systems, and a coordinated institutional vision. Lessons learnt may be useful for others facing similar challenges to emergency medicine development.

  8. 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…

  9. 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,…

  10. 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%…

  11. 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

  12. 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...

  13. 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 ...

  14. 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

  15. Evaluating capacity to live independently and safely in the community: Performance Assessment of Self-care Skills.

    Science.gov (United States)

    Chisholm, Denise; Toto, Pamela; Raina, Ketki; Holm, Margo; Rogers, Joan

    2014-02-01

    To determine clients' capacity for community living, occupational therapists must use measures that capture the person-task-environment transaction and compare clients' task performance to a performance standard. The Performance Assessment of Self-care Skills, a performance-based, criterion-referenced, observational tool, fulfills this purpose. In this practice analysis, using data from this tool from multiple clinical studies (N = 941), the authors describe tasks that clients from various diagnostic populations could and could not perform independently and safely. For clinicians, the Performance Assessment of Self-care Skills can be used to identify which daily tasks are compromised and the point of task breakdown, as well as to provide guidance about potential interventions.

  16. Robustness assessment of jacket platforms for progressive collapse under extreme environmental loading%极端环境下导管架平台连续倒塌鲁棒性评估

    Institute of Scientific and Technical Information of China (English)

    朱本瑞; 陈国明; 林红; 刘红兵; 胡春友

    2015-01-01

    The ultimate limit state and residual strength reserve ratio of jacket platforms were analyzed based on alternate path ( AP) and Pushover methods, and the influence of component types on platforms' anti-collapse capacity was investigated. The certainty indexes of WDSR , WRIF and WSRF were used to assess the robustness of jacket platforms as well as the importance of components. Considering the impact of environmental loading on the ultimate bearing capacity of jacket platforms, random plat-form reliability assessment method under random loading was established based on multi strips analysis ( MSA) and load se-quence incremental analysis (LSIA). Combining MSA and LSIA, a novel safety assessment figure (SAF) was proposed to e-valuate the safety of jacket platforms under full scale environmental loading. Further, probabilistic robustness of the platform was assessed utilizing probabilistic redundancy index. The results show that the resistance of the platform is not sensitive to the failure of horizontal bracings, which can be regarded as the redundant components because their deterministic robustness index is more significant. Diagonal bracings play an important role in ensuring the robustness of platform structures. The failure of this kind of components will affect the capacity of the platform. Therefore, it should be ensured that the strength and toughness are sufficient in the design of jacket platforms. The SAF introduced in this paper can improve the calculation precision of proba-bilistic robustness evaluation.%基于Pushover和AP法分析平台结构极限状态及剩余强度储备比,探讨不同类别承载模式的构件对平台结构抗倒塌能力的影响规律;采用WDSR、WRIF和WSRF确定性指标,评估平台结构鲁棒性和构件重要度.考虑平台抗力受环境载荷变化的影响,基于MSA和LSIA建立随机平台在随机载荷下的可靠度评估方法,提出导管架平台"安全评定图"概念,对服役平台全尺度载荷下的

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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 ...

  2. The Ethics of Rationing of Critical Care Services: Should Technology Assessment Play a Role?

    Directory of Open Access Journals (Sweden)

    Eric L. Bloomfield

    2009-01-01

    Full Text Available The costs of health care continue to increase rapidly and steeply in the United States. One area of great expense is that of intensive care units (ICUs. The causes of inflation have not been addressed effectively. ICU resources could become stretched such that they may no longer be available. This paper discusses some of the ethics and concerns behind decision making when providing ICU services in the United States. In particular, the use of electronic records with decision making tools, risk-analysis methods, and documentation of patient wishes for extraordinary care may help with better utilization of resources in the future.

  3. 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.

  4. Implementation of a brief anxiety assessment and evaluation in a Department of Veterans Affairs geriatric primary care clinic

    Directory of Open Access Journals (Sweden)

    Christine E. Gould, PhD

    2016-04-01

    Full Text Available Anxiety disorders are common and debilitating in older individuals, yet anxiety is often not formally assessed in primary care. We conducted a quality improvement project to examine the feasibility of implementing a brief anxiety assessment, the Geriatric Anxiety Inventory (GAI, in a Department of Veterans Affairs geriatric primary care clinic. We compared the GAI with a depression assessment, the 15-item Geriatric Depression Scale (GDS-15. Fifty older Veterans (mean age = 78.5 +/– 7.4 yr completed the GAI and GDS-15. Mean completion time and feedback to patients was brief (6.20 min; n = 10. Good internal consistency (alpha = 0.82 was found for GAI scores. Patients with psychiatric diagnoses obtained significantly higher GAI scores (mean = 4.73 +/– 1.15 compared with patients without psychiatric diagnoses (mean = 1.15 +/– 1.86, t(11.46 = –3.10, p = 0.01. Findings suggest that the GAI is acceptable to patients but may not be suitable for differentiating anxiety symptoms or disorders from depression. Interdisciplinary team members continued to implement the GAI after project completion to screen for and track anxiety symptoms in our geriatric primary care patients. Detecting anxiety with the GAI had the benefit of allowing providers to initiate conversations about available treatments and track symptoms as part of noting treatment progress.

  5. 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.

  6. 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...

  7. 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

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

    NARCIS (Netherlands)

    D.A.W.M. van der Windt (Daniëlle); B.W. Koes (Bart); M. van Aarst; M.A. Heemskerk; L.M. Bouter (Lex)

    2000-01-01

    textabstractBACKGROUND: 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 invol

  9. 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.

  10. 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

  11. 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...

  12. Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation.

    Science.gov (United States)

    Hadjistavropoulos, Thomas; Williams, Jaime; Kaasalainen, Sharon; Hunter, Paulette V; Savoie, Maryse L; Wickson-Griffiths, Abigail

    2016-01-01

    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. PMID:27445619

  13. Community oriented primary care in Tshwane District, South Africa: Assessing the first phase of implementation

    Science.gov (United States)

    Marcus, Tessa; Memon, Shehla; Bam, Nomonde; Hugo, Jannie

    2013-01-01

    Abstract Background Re-engineering primary health care is a cornerstone of the health sector reform initiated nationally in South Africa in 2009. Using the concept of ward based NGO-run health posts, Tshwane District, Gauteng, began implementing community oriented primary care (COPC) through ward based outreach teams (WBOT) in seven wards during 2011. Objectives This study sought to gain insight into how primary health care providers understood and perceived the first phase of implementing COPC in the Tshwane district. Method Qualitative research was performed through focus group interviews with staff of the seven health posts during September 2011 and October 2011. It explored primary health care providers’ understanding, perception and experience of COPC. Results Participants raised organisational, workplace and community relationship issues in the discussions. Organisationally, these related to the process of initiating and setting up COPC and the relationship between governmental and nongovernmental organisations. Issues that arose around the workplace related to the job situation and employment status and remuneration of health post staff. Community related issues centred on the role and relationship between service providers and their communities. Conclusion COPC touched a responsive nerve in the health care system, both nationally and locally. It was seen as an effective way to respond to South Africa's crisis of health care. Initiating the reform was inevitably a complex process. In this initial phase of implementing COPC the political commitment of governmental and nongovernmental organisations was evident. What still had to be worked through was how the collaboration would materialise in practice on the ground.

  14. 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

  15. 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

  16. 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

  17. 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.

  18. Competency assessment and development among health-care leaders: results of a cross-sectional survey.

    Science.gov (United States)

    Yarbrough Landry, Amy; Stowe, Michael; Haefner, James

    2012-05-01

    In light of the challenges involved in leading a health care organization, it is important that the executives and managers charged with doing so are competent in a variety of areas. However, leading at all organizational levels does not necessarily require the same levels and types of competencies. The purpose of this research is to determine how well competency training works in health care organizations, and to obtain a better understanding of the competencies needed for leaders at different points of their careers and at various organizational levels. Ten health care management competency domains thought to positively influence job performance for health care executives are presented. The study seeks to answer four hypotheses related to self-perceptions of competencies and training opportunities at various hierarchical levels. A survey method was used to sample a subset of the healthcare executive population in the USA, based on three variables of interest, competency training opportunities, self-reported level of competency and hierarchical level. A series of Kruskal-Wallis and Mann-Whitney U tests were conducted to identify perceived differences in both competency level and training opportunities among respondents of various hierarchical levels. The most significant result of our research is that competency training is effective in health care organizations. The implications and need for additional research are discussed.

  19. 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.

  20. 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.