Lin Blossom Yen-Ju
Full Text Available Abstract Background Taiwan's primary community care network (PCCN demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals within individual PCCNs. Methods The thorough questionnaire items, covering the network working infrastructures – governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003–2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at
Hreinsson, Julius; Woldearegay, Yonathan
Principles of business management are increasingly being used to analyze health care systems. Conceptualizing health care as business networks offers the possibility to apply the ARA model of Actors, Resources and Activities to understand the functioning of the system. We have used this model to study the phenomenon of networking in cross-border care using Uppsala University Hospital as a research case. The aim of the study was to understand actor’s perceptions of networking activities and ho...
Santana, Silvina; M. Viana
Purpose To report on the use of a user-centred model and methodology to assess the quality of care transition and network activation action, in light of an ongoing home supported discharge procedure for stroke patients in Portugal. Theory In Portugal, the health care system presents weaknesses resulting from a remarkable diversity of entry points, inadequate use of scarce and expensive resources and difficult information flow between institutions and professionals. The social care network is ...
"If you want to travel quickly, go alone. But if you want to travel far, you must go together". African proverb. The delivery of palliative care is often complex and always involves a group of people, the team, gathered around the patient and those who are close to them. Effective communication and functional responsive systems of care are essential if palliative care is to be delivered in a timely and competent way. Creating and fostering an effective team is one of the greatest challenges for providers of palliative care. Teams are organic and can be life giving or life sapping for their members. PMID:21811361
Full Text Available "If you want to travel quickly, go alone. But if you want to travel far, you must go together". African proverb. The delivery of palliative care is often complex and always involves a group of people, the team, gathered around the patient and those who are close to them. Effective communication and functional responsive systems of care are essential if palliative care is to be delivered in a timely and competent way. Creating and fostering an effective team is one of the greatest challenges for providers of palliative care. Teams are organic and can be life giving or life sapping for their members.
Griffiths, F; Wild, A; Harvey, J; Fenton, E
Primary care research networks are being publicly funded in the United Kingdom to promote a culture of research and development in primary care. This paper discusses the organisational form of these networks and how their productivity can be evaluated, drawing on evidence from management science. An evaluation of a research network has to take account of the complexity of the organisation, the influence of its local context, and its stage of development. Output measures, such as number of research papers, and process measures, such as number of research meetings, may contribute to an evaluation. However, as networking relies on the development of informal, trust-based relationships, the quality of interactions within a network is of paramount importance for its success. Networks can audit and reflect on their success in promoting such relationships and a more formal qualitative evaluation by an independent observer can document their success to those responsible for funding. PMID:11141879
"If you want to travel quickly, go alone. But if you want to travel far, you must go together". African proverb. The delivery of palliative care is often complex and always involves a group of people, the team, gathered around the patient and those who are close to them. Effective communication and functional responsive systems of care are essential if palliative care is to be delivered in a timely and competent way. Creating and fostering an effective team is one of the greatest challenges f...
Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris
Social network is a social structure made of individuals or organizations associated with one or more types of interdependence (friendship, common interests, work, knowledge, prestige, etc.) which are the "nodes" of the network. Networks can be organized to exchange information, knowledge or financial assistance under the various interest groups in universities, workplaces and associations of citizens. Today the most popular and widely used networks are based on application of the Internet as the main ICT. Depending on the method of connection, their field of activity and expertise of those who participate in certain networks, the network can be classified into the following groups: a) Social Networks with personal physical connectivity (the citizens' associations, transplant networks, etc.), b) Global social internet network (Facebook, Twitter, Skype), c) specific health internet social network (forums, Health Care Forums, Healthcare Industry Forum), d) The health community internet network of non professionals (DailyStrength, CaringBridge, CarePages, MyFamilyHealth), e) Scientific social internet network (BiomedExperts, ResearchGate, iMedExchange), f) Social internet network which supported professionals (HealthBoards, Spas and Hope Association of Disabled and diabetic Enurgi), g) Scientific medical internet network databases in the system of scientific and technical information (CC, Pubmed/Medline, Excerpta Medica/EMBASE, ISI Web Knowledge, EBSCO, Index Copernicus, Social Science Index, etc.). The information in the network are exchanged in real time and in a way that has until recently been impossible in real life of people in the community. Networks allow tens of thousands of specific groups of people performing a series of social, professional and educational activities in the place of living and housing, place of work or other locations where individuals are. Network provides access to information related to education, health, nutrition, drugs, procedures
Blobel, B; Pharow, P; Engel, K; Spiegel, V; Krohn, R
Fulfilling the shared care paradigm, health care networks providing open systems' interoperability in health care are needed. Such communicating and co-operating health information systems, dealing with sensitive personal medical information across organisational, regional, national or even international boundaries, require appropriate security solutions. Based on the generic security model, within the European MEDSEC project an open approach for secure EDI like HL7, EDIFACT, XDT or XML has been developed. The consideration includes both securing the message in an unsecure network and the transport of the unprotected information via secure channels (SSL, TLS etc.). Regarding EDI, an open and widely usable security solution has been specified and practically implemented for the examples of secure mailing and secure file transfer (FTP) via wrapping the sensitive information expressed by the corresponding protocols. The results are currently prepared for standardisation. PMID:10724890
In today's competitive landscape for health care talent, nursing executives and human resource professionals need to assess and evaluate new avenues for recruitment. The strategy of filling positions by means of print advertising is becoming outmoded quickly. As an industry, health care typically lags behind other industries when it relates to technology. This is especially true in implementing any interactive strategies to target hard-to-fill positions. Social networking sites have appeared on the Internet landscape quickly and continue to flourish. Nurse leaders need to capitalize on this phenomenon. PMID:18080628
Brennan, Patricia Flatley
High-tech home care includes the use of information technologies, such as computer networks, to provide direct care to patients in the home. This paper presents the justification and design of a project using a free, public access computer network to deliver home care nursing. The intervention attempts to reduce isolation and improve problem solving among home care patients and their informal caregivers. Three modules comprise the intervention: a decision module, a communications module, and ...
Miller, T R
Healthcare providers interested in forming delivery networks to secure managed care contracts must decide how to structure their networks. Two basic structural models are available: the noncorporate model and the corporate model. The noncorporate model delivery network typically has a single governing body and management infrastructure to oversee only managed care contracting and related business. The corporate model delivery system has a unified governance management infrastructure that handles all of the network's business. While either structure can work, corporate model networks usually are better able to enforce provider behavior that is in the best interest of a network as a whole. PMID:10163003
Tolkacheva, N.; Broese van Groenou, M. I.; Boer; Tilburg, van, P.J.A.
Previous research on the care-giver burden experienced by adult children has typically focused on the adult child and parent dyad. This study uses information on multiple informal care-givers and examines how characteristics of the informal care-giving network affect the adult child's care-giver burden. In 2007, 602 Dutch care-givers who were assisting their older parents reported on parental and personal characteristics, care activities, experienced burden and characteristics of other inform...
Margolis, Peter A; Peterson, Laura E.; Seid, Michael
Despite significant gains by pediatric collaborative improvement networks, the overall US system of chronic illness care does not work well. A new paradigm is needed: a Collaborative Chronic Care Network (C3N). A C3N is a network-based production system that harnesses the collective intelligence of patients, clinicians, and researchers and distributes the production of knowledge, information, and know-how over large groups of people, dramatically accelerating the discovery process. A C3N is a...
Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris
Social network is a social structure made of individuals or organizations associated with one or more types of interdependence (friendship, common interests, work, knowledge, prestige, etc.) which are the “nodes” of the network. Networks can be organized to exchange information, knowledge or financial assistance under the various interest groups in universities, workplaces and associations of citizens. Today the most popular and widely used networks are based on application of the Internet as...
The health care industry has experienced a significant advancement in the usage of modern Information and Communication Technologies (ICT) that has allowed the different health care stakeholders an increasing access to health information and enables them to take health care decisions on their own behalf. In this thesis we evaluate this increasing usage of modern communication means and networking opportunities in health care online communities and which effects it can have on user innovation....
Social networks are creating new ways for people with long-term conditions to seek support and offering new ways for health professionals to communicate with patients who have long-term conditions. There is evidence this may be helpful but nurses need to be skilled at operating in these new digital spaces to support patients effectively. This article discusses the growing use of social networks in long-term conditions, focusing on their use in diabetes care. PMID:23560343
Studt, Hans Henning
The development and state of the art is presented for inpatient psychotherapy in neurotic and psychosomatic patients. The question is then posed whether time-tested inpatient psychotherapy can survive the introduction of "diagnosis-related groups" (DRG) with its threat of flat-rate case billing. Thus, the development of an "in- and outpatient network" has been considered as a possible alternative, in which hospitals and private practices combine intervals of inpatient and outpatient psychotherapy. PMID:14733063
Goodson, Justin; Jang, Wooseung; Rantz, Marilyn
Purpose: The purpose of this research is twofold. The first purpose is to utilize a new methodology (Bayesian networks) for aggregating various quality indicators to measure the overall quality of care in nursing homes. The second is to provide new insight into the relationships that exist among various measures of quality and how such measures…
Broese van Groenou, Marjolein; Jacobs, Marianne; Zwart-Olde, Ilse; Deeg, Dorly J H
As part of long-term care reforms, home-care organisations in the Netherlands are required to strengthen the linkage between formal and informal caregivers of home-dwelling older adults. Information on the variety in mixed care networks may help home-care organisations to develop network type-dependent strategies to connect with informal caregivers. This study first explores how structural (size, composition) and functional features (contact and task overlap between formal and informal caregivers) contribute to different types of mixed care networks. Second, it examines to what degree these network types are associated with the care recipients' characteristics. Through home-care organisations in Amsterdam, the Netherlands, we selected 74 frail home-dwelling clients who were receiving care in 2011-2012 from both informal and formal caregivers. The care networks of these older adults were identified by listing all persons providing help with five different types of tasks. This resulted in care networks comprising an average of 9.7 caregivers, of whom 67% were formal caregivers. On average, there was contact between caregivers within 34% of the formal-informal dyads, and both caregivers carried out at least one similar type of task in 29% of these dyads. A principal component analysis of size, composition, contact and task overlap showed two distinct network dimensions from which four network types were constructed: a small mixed care network, a small formal network, a large mixed network and a large formal network. Bivariate analyses showed that the care recipients' activities of daily living level, memory problems, social network, perceived control of care and level of mastery differed significantly between these four types. The results imply that different network types require different actions from formal home-care organisations, such as mobilising the social network in small formal networks, decreasing task differentiation in large formal networks and assigning
Halley, M D; Little, A W
Although hospital-owned primary care practices have been unprofitable for most hospitals, some hospitals are achieving competitive advantage and sustainable practice operations. A key to the success of some has been a net income reporting tool that separates practice operating expenses from the costs of creating and operating a network of practices to help healthcare organization managers, physicians, and staff to identify opportunities to improve the network's financial performance. This "Net One, Net Two" reporting allows operations leadership to be held accountable for Net One expenses and strategic leadership to be held accountable for Net Two expenses. PMID:11066669
Veras, Renato Peixoto; Caldas, Célia Pereira; da Motta, Luciana Branco; de Lima, Kenio Costa; Siqueira, Ricardo Carreño; Rodrigues, Renata Teixeira da Silva Vendas; Santos, Luciana Maria Alves Martins; Guerra, Ana Carolina Lima Cavaletti
A detailed review was conducted of the literature on models evaluating the effectiveness of integrated and coordinated care networks for the older population. The search made use of the following bibliographic databases: Pubmed, The Cochrane Library, LILACS, Web of Science, Scopus and SciELO. Twelve articles on five different models were included for discussion. Analysis of the literature showed that the services provided were based on primary care, including services within the home. Service users relied on the integration of primary and hospital care, day centers and in-home and social services. Care plans and case management were key elements in care continuity. This approach was shown to be effective in the studies, reducing the need for hospital care, which resulted in savings for the system. There was reduced prevalence of functional loss and improved satisfaction and quality of life on the part of service users and their families. The analysis reinforced the need for change in the approach to health care for older adults and the integration and coordination of services is an efficient way of initiating this change. PMID:24897058
Freidin, Betina; Timmermans, Stefan
We explain why some caretakers opt for alternative medicine for the treatment of children's asthma whereas others do not. In the past 15 years, asthma care has been standardized, with clinical practice guidelines centered on advanced pharmacological regimes. Clinicians argue that with proper biomedical treatment and environmental control, asthma should be a manageable chronic disease. Yet many patients forego available pharmacological treatments for alternative medicine or complement prescribed drugs with unconventional treatments. On the basis of open-ended, in-depth qualitative interviews with 50 mothers of children with asthma, we argue that the experience with biomedical treatments, social influence in mother's network of care, concerns about adverse and long-term effects, health care providers' responsiveness to such concerns, and familiarity with alternative treatments explain why some families rely on alternative medicine and others do not. PMID:18174534
Full Text Available Government-funded systems of health and social care are facing enormous fiscal and human-resource challenges. The space for innovation in care is wide open and new disruptive patterns are emerging. These include self-management and personal budgets, participatory and integrated care, supported decision making and a renewed focus on prevention. Taking these disruptive patterns to scale can be accelerated by a technologically enabled shift to a network model of care to co-create the best outcomes for individuals, family caregivers, and health and social care organizations. The connections, relationships, and activities within an individual’s personal network lay the foundation for care that health and social care systems/policy must simultaneously support and draw on for positive outcomes. Practical tools, adequate information, and tangible resources are required to coordinate and sustain care. Tyze Personal Networks is a social venture that uses technology to engage and inform the individual, their personal networks, and their care providers to co-create the best outcomes. In this article, we demonstrate how Tyze contributes to a shift to a network model of care by strengthening our networks and enhancing partnerships between care providers, individuals, and family and friends.
Beek, A.P.A. van
Over the years, there has been increasing attention for the role of social networks in explaining performance differences between organizations. Yet, research on social networks within healthcare organizations in general and long-term care facilities specifically has been rare, despite growing interest in explanations for differences in performance. In this thesis, we study informal social networks of nursing staff and organizational performance in different care settings for residents with d...
Palumbo, Filippo; Ullberg, Jonas; Stimec, Ales; Furfari, Francesco; Karlsson, Lars; Coradeschi, Silvia
This paper presents the sensor network infrastructure for a home care system that allows long-term monitoring of physiological data and everyday activities. The aim of the proposed system is to allow the elderly to live longer in their home without compromising safety and ensuring the detection of health problems. The system offers the possibility of a virtual visit via a teleoperated robot. During the visit, physiological data and activities occurring during a period of time can be discussed. These data are collected from physiological sensors (e.g., temperature, blood pressure, glucose) and environmental sensors (e.g., motion, bed/chair occupancy, electrical usage). The system can also give alarms if sudden problems occur, like a fall, and warnings based on more long-term trends, such as the deterioration of health being detected. It has been implemented and tested in a test environment and has been deployed in six real homes for a year-long evaluation. The key contribution of the paper is the presentation of an implemented system for ambient assisted living (AAL) tested in a real environment, combining the acquisition of sensor data, a flexible and adaptable middleware compliant with the OSGistandard and a context recognition application. The system has been developed in a European project called GiraffPlus. PMID:24573309
Sumner, Jennifer; Liberman, Aaron; Rotarius, Timothy; Wan, Thomas T H; Eaglin, Ronald
Health care in the United States is a system that, organizationally speaking, is fragmented. Each hospital facility is independently operated and is responsible for the hiring of its own employees. Corrupt individuals can take advantage of this fragmentation and move from hospital to hospital, gaining employment while hiding previous employment history. However, the need to exchange pertinent information regarding employees will become necessary as hospitals seek to fill positions throughout their organizations. One way to promote this information exchange is to develop trusted information sharing networks among hospital units. This study examined the problems surrounding organizational information sharing and the cultural factors necessary to enhance the exchange of employee information. Surveys were disseminated to 2,603 hospital chief executive officers and chief information officers throughout the nation. A sample of 154 respondents provided data into their current hiring practices and on their willingness to engage in the sharing of employee information. Findings indicated that, although fear of defamation and privacy violations do hinder the exchange of information between hospitals during the hiring process, by increasing external trust, linking the sharing process with the organizational goals of the hospital, and developing a "sharing culture" among hospitals, the exchange of employee information could be enhanced. PMID:19910705
Full Text Available This paper presents the sensor network infrastructure for a home care system that allows long-term monitoring of physiological data and everyday activities. The aim of the proposed system is to allow the elderly to live longer in their home without compromising safety and ensuring the detection of health problems. The system offers the possibility of a virtual visit via a teleoperated robot. During the visit, physiological data and activities occurring during a period of time can be discussed. These data are collected from physiological sensors (e.g., temperature, blood pressure, glucose and environmental sensors (e.g., motion, bed/chair occupancy, electrical usage. The system can also give alarms if sudden problems occur, like a fall, and warnings based on more long-term trends, such as the deterioration of health being detected. It has been implemented and tested in a test environment and has been deployed in six real homes for a year-long evaluation. The key contribution of the paper is the presentation of an implemented system for ambient assisted living (AAL tested in a real environment, combining the acquisition of sensor data, a flexible and adaptable middleware compliant with the OSGistandard and a context recognition application. The system has been developed in a European project called GiraffPlus.
Latkin, Carl A.; Davey-Rothwell, Melissa A.; Knowlton, Amy R.; Alexander, Kamila A.; Williams, Chyvette T.; Boodram, Basmattee
This article reviews current issues and advancements in social network approaches to HIV prevention and care. Social network analysis can provide a method to understand health disparities in HIV rates and treatment access and outcomes. Social network analysis is a value tool to link social structural factors to individual behaviors. Social networks provide an avenue for low cost and sustainable HIV prevention interventions that can be adapted and translated into diverse populations. Social ne...
Full Text Available AIM: Guideline implementation programs are of paramount importance in optimizing acute ST-elevation myocardial infarction (STEMI care. Assessment of performance indicators from a local STEMI network will provide knowledge of how to improve the system of care. METHODS AND RESULTS: Between 2008-2011, 1505 STEMI patients were enrolled. We compared the performance indicators before (n = 869 and after implementation (n = 636 of a local STEMI network. In 2011 (after introduction of STEMI networking compared to 2008-2010, there were more inter-hospital referrals for STEMI patients (61% vs 56%, p12 hours after symptom onset were similar (53% vs 51%, NS. Moreover, the numbers of patients with door-to-balloon time ≤ 90 minutes were similar (49.1% vs 51.3%, NS, and in-hospital mortality rates were similar (8.3% vs 6.9%, NS in 2011 compared to 2008-2010. CONCLUSION: After a local network implementation for patients with STEMI, there were significantly more inter-hospital referral cases, primary PCI procedures, and patients with a door-to-needle time ≤ 30 minutes, compared to the period before implementation of this network. However, numbers of patients who presented very late, the targeted door-to-balloon time and in-hospital mortality rate were similar in both periods. To improve STEMI networking based on recent guidelines, existing pre-hospital and in-hospital protocols should be improved and managed more carefully, and should be accommodated whenever possible.
Full Text Available This article examines the processes of technical mediation within familial care networks based on a study of home telecare targeted at older people. Supported by contributions from the actor—network theory as part of the social psychology of science and technology, these processes of technical mediation are analyzed using a qualitative approach. The data were gathered through six focus groups and four in-depth interviews; the participants in the study included users, relatives and formal carers. Thematic analysis techniques encompassing the information were used, revealing the effects on the patterns of caring relationships. The results show the interplay between presence-absence made possible by the devices; the two-way direction of care between the older people and the artifacts; and the process of sustaining care using the technology. We conclude that care should be seen as a socio-technical network where technology plays an active role in sustaining family relationships.
Glonek Gary FV
Full Text Available Abstract Background Older people's social networks with family and friends can affect residential aged care use. It remains unclear if there are differences in the effects of specific (with children, other relatives, friends and confidants and total social networks upon use of low-level residential care and nursing homes. Methods Data were drawn from the Australian Longitudinal Study of Ageing. Six waves of data from 1477 people aged ≥ 70 collected over nine years of follow-up were used. Multinomial logistic regressions of the effects of specific and total social networks on residential care use were carried out. Propensity scores were used in the analyses to adjust for differences in participant's health, demographic and lifestyle characteristics with respect to social networks. Results Higher scores for confidant networks were protective against nursing home use (odds ratio [OR] upper versus lower tertile of confidant networks = 0.50; 95%CI 0.33–0.75. Similarly, a significant effect of upper versus lower total network tertile on nursing home use was observed (OR = 0.62; 95%CI 0.43–0.90. Evidence of an effect of children networks on nursing home use was equivocal. Nursing home use was not predicted by other relatives or friends social networks. Use of lower-level residential care was unrelated to social networks of any type. Social networks of any type did not have a significant effect upon low-level residential care use. Discussion Better confidant and total social networks predict nursing home use in a large cohort of older Australians. Policy needs to reflect the importance of these particular relationships in considering where older people want to live in the later years of life.
Miquel Domènech; Gonzalo Correa
This article examines the processes of technical mediation within familial care networks based on a study of home telecare targeted at older people. upported by contributions from the actor—network theory as part of the social psychology of science and technology, these processes of technical mediation are analyzed using a qualitative approach. The data were gathered through six focus groups and four in-depth interviews; the participants in the study included users, relatives and formal care...
Wetzel, Christine; de Pinho, Leandro Barbosa; Olschowsky, Agnes; Guedes, Ariane da Cruz; Camatta, Marcio Wagner; Schneider, Jacó Fernando
The Family Health Strategy Service (FHSS) is an important ally in the mental health system, contributing to the completeness and effectiveness of care. This study aimed to discuss the mental health care network as compared to the daily routine of an FHSS. It is an evaluative study with a qualitative methodological approach. It was developed in an FHSS in Porto Alegre-RS, Brazil. Data was collected between July and December of 2010 through interviews with 16 workers and ten relatives. We identified important resources in primary health care, such as partnerships with academia. However, the constitution of this care is still based on specialty, following the logic of patient referral. Our intention for this study was to contribute to the operationalization of the mental health care network, consolidating the partnership with the FHSS and developing activities in the territorial space, raising awareness, demystifying health care service in the area, and countering the perception that it is uniquely specialized. PMID:25158457
Beek, A.P.A van
Over the years, there has been increasing attention for the role of social networks in explaining performance differences between organizations. Yet, research on social networks within healthcare organizations in general and long-term care facilities specifically has been rare, despite growing inter
Deckers, J.G.M.; Paget, W.J.; Schellevis, F.G.; Fleming, D.M.
In many European countries, primary care networks have a important role in public health surveillance. The networks are organised and function differently in EU member states. Their information is a potential source for a European health information and monitoring system as envisaged in the European
Marsac, Meghan L; Kassam-Adams, Nancy; Hildenbrand, Aimee K; Nicholls, Elizabeth; Winston, Flaura K; Leff, Stephen S; Fein, Joel
Pediatric health care networks serve millions of children each year. Pediatric illness and injury are among the most common potentially emotionally traumatic experiences for children and their families. In addition, millions of children who present for medical care (including well visits) have been exposed to prior traumatic events, such as violence or natural disasters. Given the daily challenges of working in pediatric health care networks, medical professionals and support staff can experience trauma symptoms related to their work. The application of a trauma-informed approach to medical care has the potential to mitigate these negative consequences. Trauma-informed care minimizes the potential for medical care to become traumatic or trigger trauma reactions, addresses distress, provides emotional support for the entire family, encourages positive coping, and provides anticipatory guidance regarding the recovery process. When used in conjunction with family-centered practices, trauma-informed approaches enhance the quality of care for patients and their families and the well-being of medical professionals and support staff. Barriers to routine integration of trauma-informed approaches into pediatric medicine include a lack of available training and unclear best-practice guidelines. This article highlights the importance of implementing a trauma-informed approach and offers a framework for training pediatric health care networks in trauma-informed care practices. PMID:26571032
Purpose: The purpose of this paper is to investigate the theoretical foundations of the solidarity network concept and its perceived utility as an enabling force for social organizations to influence change. The theoretical framework presented is intended to stimulate dialogue, interest and investigation on the subject of solidarity networks.…
Latkin, Carl A; Davey-Rothwell, Melissa A; Knowlton, Amy R; Alexander, Kamila A; Williams, Chyvette T; Boodram, Basmattee
This article reviews the current issues and advancements in social network approaches to HIV prevention and care. Social network analysis can provide a method to understand health disparities in HIV rates, treatment access, and outcomes. Social network analysis is a valuable tool to link social structural factors to individual behaviors. Social networks provide an avenue for low-cost and sustainable HIV prevention interventions that can be adapted and translated into diverse populations. Social networks can be utilized as a viable approach to recruitment for HIV testing and counseling, HIV prevention interventions, optimizing HIV medical care, and medication adherence. Social network interventions may be face-to-face or through social media. Key issues in designing social network interventions are contamination due to social diffusion, network stability, density, and the choice and training of network members. There are also ethical issues involved in the development and implementation of social network interventions. Social network analyses can also be used to understand HIV transmission dynamics. PMID:23673888
Weel, C. van; Grauw, W.J.C. de
BACKGROUND AND OBJECTIVE: Family physicians (FP) play a key role in the diagnosis and treatment of health problems in the community and for evidence-based guidance clinical research must be based on primary care data. This paper analyses the state-of-the-art approaches to collection of data and the
Auxier, Andrea; Runyan, Christine; Mullin, Daniel; Mendenhall, Tai; Young, Jessica; Kessler, Rodger
Although the benefits of integrating behavioral health (BH) services into primary care are well established (World Health Organization and World Organization of Family Doctors, 2012; Chiles et al. in Clin Psychol-Sci Pr 6:204-220, 1999; Cummings 1997; O'Donohue et al. 2003; Olfson et al. in Health Aff 18:79-93, 1999; Katon et al. in Ann Intern Med 124:917-925, 2001; Simon et al. in Arch Gen Psychiatry 52:850-856, 1995; Anderson et al. in Diabetes Care 24:1069-1078, 2001; Ciechanowski et al. in Arch Intern Med 160:3278-3285, 2000; Egede et al. in Diabetes Care 25:464-470, 2002), research has focused primarily on describing the types of interventions behavioral health providers (BHPs) employ rather than on reasons for referral, treatment initiation rates, or the patient characteristics that may impact them. This study presents the results of a multisite card study organized by The Collaborative Care Research Network, a subnetwork of the American Academy of Family Physicians' National Research Network devoted to conducting practice-based research focused on the provision of BH and health behavior services within primary care practices. The goals of the study included: (1) identifying the characteristics of patients referred for BH services; (2) codifying reasons for referral and whether patients were treated for the referral; (3) exploring any differences between patients who initiated BH contact and those who did not; and (4) assessing the types and frequency of BH services provided to patients who attended at least one appointment. Of the 200 patients referred to a BHP, 81 % had an initial contact, 71 % of which occurred on the same day. Men and women were equally likely to engage with a BHP although the time between appointments varied by gender. Depression and anxiety were the primary reasons for referral. Practice-based research is a viable strategy for advancing the knowledge about integrated primary care. PMID:24073133
Jayter Silva Paula
Full Text Available PURPOSE: To describe the procedures used in developing Clinical and Regulatory Protocols for primary care teams to use in the management of the most common scenarios of impaired vision in Southern Brazil. METHODS: A retrospective review of 1.333 referral forms from all primary care practitioners was performed in Ribeirão Preto city, during a 30-day period. The major ophthalmic diagnostic categories were evaluated from those referrals forms. The Clinical and Regulatory Protocols development process was held afterwards and involved scientific cooperation between a university and the health care system, in the form of workshops attended by primary care practitioners and regulatory system team members composed of health care administrators, ophthalmologists, and professors of ophthalmology and social medicine. RESULTS: The management of impaired vision was chosen as the theme, since it accounted for 43.6% of the ophthalmology-related referrals from primary care providers of Ribeirão Preto. The Clinical and Regulatory Protocols developed involve distinctive diagnostic and therapeutic interventions that can be performed at the primary care level and in different health care settings. The most relevant clinical and regulatory interventions were expressed as algorithms in order to facilitate the use of the Clinical and Regulatory Protocols by health care practitioners. CONCLUSIONS: These Clinical and Regulatory Protocols could represent a useful tool for health systems with universal access, as well as for health care networks based on primary care and for regulatory system teams. Implementation of these Clinical and Regulatory Protocols can minimize the disparity between the needs of patients with impaired vision and the treatment modalities offered, resulting in a more cooperative health care network.
This paper describes an improved approach to Boolean network optimization using internal don't-cares. The improvements concern the type of don't-cares computed, their scope, and the computation method. Instead of the traditionally used compatible observability don't-cares (CODCs), we introduce and justify the use of complete don't-cares (CDC). To ensure the robustness of the don't-care computation for very large industrial networks, a optional windowing scheme is implemented that computes substantial subsets of the CDCs in reasonable time. Finally, we give a SAT-based don't-care computation algorithm that is more efficient than BDD-based algorithms. Experimental results confirm that these improvements work well in practice. Complete don't-cares allow for a reduction in the number of literals compared to the CODCs. Windowing guarantees robustness, even for very large benchmarks on which previous methods could not be applied. SAT reduces the runtime and enhances robustness, making don't-cares affordable for a v...
Gilhooly, Charlotte; Kinsella, John
Introduction The Managed Clinical Network for Care of Burns in Scotland (COBIS) was launched in April 2007. Primary aims included establishing and maintaining a registry of complex burn injury in Scotland and setting mechanisms to regularly audit outcome of burn treatment against nationally agreed standards of care. On behalf of COBIS, we present 3-year incidence and mortality data of Scottish patients admitted with a complex burn injury in this abstract. Methods From January 2010 o...
Bowerman, S; Bellman, M; Saltsman, P; Garvey, D; Pimstone, K; Skootsky, S; Wang, H J; Elashoff, R; Heber, D
Most primary care physicians do not treat obesity, citing lack of time, resources, insurance reimbursement, and knowledge of effective interventions as significant barriers. To address this need, a 10-minute intervention delivered by the primary care physician was coupled with individual dietary counseling sessions delivered by a registered dietitian via telephone with an automated calling system (House-Calls, Mobile, AL). Patients were seen for follow-up by their physician at weeks 4, 12, 24, 36 and 52. A total of 252 patients (202 women and 50 men) were referred by 18 primary care physicians to the program. The comorbid conditions reported for all patients at baseline included low back pain, 29% (n = 72); hypertension, 45% (n = 113); hypercholesterolemia, 41% (n = 104); type 2 diabetes, 10% (n = 26); and sleep apnea, 5% (n = 12). When offered a choice of meal plans based on foods or meal replacements, two-thirds of patients (n = 166) chose to use meal replacements (Ultra Slim-Fast; Slim-Fast Foods Co., West Palm Beach, FL) at least once daily. Baseline weights of subjects averaged 200 +/- 46 lb for women (n = 202) and 237 +/- 45 lb for men (n = 50). Patients completing 6 months in the program lost an average of 19.0 +/- 4.0 lb for women (n = 94) and 15.5 +/- 8.2 lb for men (n = 26). Physicians reported a high degree of satisfaction with the program, suggesting that a brief, effective physician-directed program with nutritionist support by telephone can be implemented in a busy primary care office. PMID:11707560
van Wijngaarden, Jeroen
textabstractIntegration of care delivery is a central theme in many Western countries. This is stimulated through various developments in health care and expectations of policy makers, managers, practitioners and researchers. First of all healthcare needs are changing and costs are rising because of an ageing population. Until 2010 major increases (25-60%) are expected in different forms of cancer, cardio-vascular disease (for example stroke), chronic heart failure, diabetes, dementia, asthma...
Lewis, Jenny M; Baeza, Juan I; Alexander, Damon
Partnerships represent a prescriptive form of network governance, based on the idea of cooperation. This article has four aims. The first is to describe why network governance and partnerships are important now, and what one particular example - Primary Care Partnerships - is addressing. The second is to analyse the network structure of two of these partnerships, and the third is to examine network dynamics. The fourth aim is to explore relationships and sustainability over the longer term. Two government-funded and steered partnerships, which were established to increase coordination between primary care services in Victoria, Australia, were examined. Annual interviews at three points in time between 2002 and 2005 were used to explore relationships between organizations within these two partnerships. The structure of two different communication networks, based on contacts for work and contacts for strategic information, were examined using social network analysis. Tracing network structures over time highlighted partnership dynamics. The network structures changed over the three years of the study, but an important constant was the continuing centrality of the independent staff employed to manage the partnerships. Over the longer term, it seems to be more important to fund independent partnership staff, rather than people who connect partnerships to the funding agency. If partnerships are seen as valuable in improving service coordination and health outcomes, then long term rather than just start-up funding support is required. PMID:18472201
Malakouti, Seyed Kazem; Nojomi, Marzieh; Ahmadkhaniha, Hamid Reza; Hosseini, Mohammad; Yekeh Fallah, Maryam; Mirzaei Khoshalani, Mosleh
Background: Suicide prevention is one of the priorities in policies of Iranian Ministry of Health and Medical Education (MHME). The suicide prevention program had two main parts of identifying and treatment of the depressed and suicide high risk individuals by Primary Health Care (PHC) network. The main aim of this study was to evaluate the results of integration of the program into PHC network in two cities with moderate to high rate of suicide with diverse socio-cultural backgrounds. Method...
Cruikshank, Mary; Foster, Helen E; Stewart, Jane; Davidson, Joyce E; Rapley, Tim
Clinical networks for paediatric and adolescent rheumatology are evolving, and their effect and role in the transition process between paediatric and adult services are unknown. We therefore explored the experiences of those involved to try and understand this further. Health professionals, young people with juvenile idiopathic arthritis and their families were recruited via five national health service paediatric and adolescent rheumatology specialist centres and networks across the UK. Seventy participants took part in focus groups and one-to-one interviews. Data was analysed using coding, memoing and mapping techniques to identify features of transitional services across the sector. Variation and inequities in transitional care exist. Although transition services in networks are evolving, development has lagged behind other areas with network establishment focusing more on access to paediatric rheumatology multidisciplinary teams. Challenges include workforce shortfalls, differences in service priorities, standards and healthcare infrastructures, and managing the legacy of historic encounters. Providing equitable high-quality clinically effective services for transition across the UK has a long way to go. There is a call from within the sector for more protected time, staff and resources to develop transition roles and services, as well as streamlining of local referral pathways between paediatric and adult healthcare services. In addition, there is a need to support professionals in developing their understanding of transitional care in clinical networks, particularly around service design, organisational change and the interpersonal skills required for collaborative working. Key messages • Transitional care in clinical networks requires collaborative working and an effective interface with paediatric and adult rheumatology.• Professional centrism and historic encounters may affect collaborative relationships within clinical networks.• Education
Davari, Soheil; Kilic, Kemal; Ertek, Gurdal
Preventive health care is unlike health care for acute ailments, as people are less alert to their unknown medical problems. In order to motivate public and to attain desired participation levels for preventive programs, the attractiveness of the health care facility is a major concern. Health economics literature indicates that attractiveness of a facility is significantly influenced by proximity of the clients to it. Hence attractiveness is generally modelled as a function of distance. However, abundant empirical evidence suggests that other qualitative factors such as perceived quality, attractions nearby, amenities, etc. also influence attractiveness. Therefore, a realistic measure should incorporate the vagueness in the concept of attractiveness to the model. The public policy makers should also maintain the equity among various neighborhoods, which should be considered as a second objective. Finally, even though the general tendency in the literature is to focus on health benefits, the cost effectiveness is still a factor that should be considered. In this paper, a fuzzy bi-objective model with budget constraints is developed. Later, by modelling the attractiveness by means of fuzzy triangular numbers and treating the budget constraint as a soft constraint, a modified (and more realistic) version of the model is introduced. Two solution methodologies, namely fuzzy goal programming and fuzzy chance constrained optimization are proposed as solutions. Both the original and the modified models are solved within the framework of a case study in Istanbul, Turkey. In the case study, the Microsoft Bing Map is utilized in order to determine more accurate distance measures among the nodes. PMID:25171939
Auerbach, Andrew D.; Patel, Mitesh S.; Metlay, Josh; Schnipper, Jeffrey; Williams, Mark V.; Robinson, Edmondo; Kripalani, Sunil; Lindenauer, Peter K.
Converting the health care delivery system into a learning organization is a key strategy for improving health outcomes. While the learning organization approach has been successful in neonatal intensive care units and disease specific collaboratives there are few examples in general medicine and fewer still have leveraged the role of hospitalists to implement improvements. This paper describes the rationale for and early work of the Hospital Medicine Reengineering Network (HOMERuN), a collaborative of hospitals, hospitalists, and care teams whose overarching purpose is to use data to guide collaborative efforts aimed at improving the care of hospitalized patients. We review HOMERuN’s collaborative model, which focuses on a community-based participatory approach modified to include hospital-based as well as the larger community, and HOMERuN’s initial project focusing on care transition improvement using perspectives from the patient and caregiver. PMID:24448050
Dembeyiotis, S; Konnis, G; Koutsouris, D
We have designed and developed a novel data communications network targeted at the provision of Emergency Medical Care in disaster situations over wide areas. The network nodes can transmit essential biosignals and in addition, support video and diagnostic quality sound (auscultation) broadcasting for teleconsultation purposes, by using a variety of wireless transports. The medical data acquisition stations are networked dynamically and on demand, with no requirement for an existing communications infrastructure at the disaster sites. The network design allows for limited transmitting station mobility and support for software-based Voice over IP during station roaming. Initial test results, following the hardware and software integration, indicate that the chosen network design meets specifications, and a full-scale field test, utilizing a large number of wireless stations operating under realistic conditions is to take place. PMID:17271008
Thaís Araújo Barbosa
Full Text Available Objective: to understand and identify the support network and social support from the perspective of families of children with chronic conditions. Methods: a qualitative study, with content analysis of 134 records, followed by ten semi-structured interviews. Results: the analysis has revealed that the primary caregiver, the mother, participates in a network of limited support, only with the help of her husband, children, grandparents and the child´s godparents. They also have a social network through a multidisciplinary team, which in some cases is not effective. Conclusion: families have a deficient and limited support network and the demand for care rely only on the support of the husband, grandparents, children, and godparents. Social networking refers to the philanthropic institutions, while the aid of public service, basic health unit is basic.
Conclusion While interest in enabling information technologies was high in KAN, adoption was variable, with use of several key technologies reported as low.The results suggest that research in this network that would be dependent on or enhanced by IT might be impeded and, generally, greater attention should be given to enhancing the IT infrastructure in primary care.
Jones, V.M.; Bults, R.G.A.; Konstantas, D.; Vierhout, P.A.M.
The first hour following the trauma is of crucial importance in trauma care. The sooner treatment begins, the better the ultimate outcome for the patient. Generally the initial treatment is handled by paramedical personnel arriving at the site of the accident with an ambulance. There is evidence to
Full Text Available Rates of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA, are increasingly used as quality indicators for hospital hygiene. Alternatively, these rates may vary between hospitals, because hospitals differ in admission and referral of potentially colonized patients. We assessed if different referral patterns between hospitals in health care networks can influence rates of hospital-acquired infections like MRSA. We used the Dutch medical registration of 2004 to measure the connectedness between hospitals. This allowed us to reconstruct the network of hospitals in the Netherlands. We used mathematical models to assess the effect of different patient referral patterns on the potential spread of hospital-acquired infections between hospitals, and between categories of hospitals (University medical centers, top clinical hospitals and general hospitals. University hospitals have a higher number of shared patients than teaching or general hospitals, and are therefore more likely to be among the first to receive colonized patients. Moreover, as the network is directional towards university hospitals, they have a higher prevalence, even when infection control measures are equally effective in all hospitals. Patient referral patterns have a profound effect on the spread of health care-associated infections like hospital-acquired MRSA. The MRSA prevalence therefore differs between hospitals with the position of each hospital within the health care network. Any comparison of MRSA rates between hospitals, as a benchmark for hospital hygiene, should therefore take the position of a hospital within the network into account.
Kim, Katherine K; Bell, Janice F; Bold, Richard; Davis, Andra; Ngo, Victoria; Reed, Sarah C; Joseph, Jill G
Cancer is a top concern globally. Cancer care suffers from lack of coordination, silos of information, and high cost. Interest is emerging in person-centered technology to assist with coordination to address these challenges. This study evaluates the usability of the "personal health network" (PHN), a novel solution leveraging social networking and mobile technologies, among individuals undergoing chemotherapy and receiving care coordination. Early results from interviews of 12 participants in a randomized pragmatic trial suggest that they feel more connected to the healthcare team using the PHN, find value in access to the patient education library, and are better equipped to organize the many activities that occur during chemotherapy. Improvements are needed in navigation, connectivity, and integration with electronic health records. Findings contribute to improvements in the PHN and informs a roadmap for potentially greater impact in technology-enabled cancer care coordination. PMID:27332197
Ingrid Meireles Gomes
Full Text Available Objective: To build a theoretical model to configure the network social support experience of people involved in home care. Method: A quantitative approach research, utilizing the Grounded Theory method. The simultaneous data collection and analysis allowed the interpretation of the phenomenon meaning The network social support of people involved in home care. Results: The population passive posture in building their well-being was highlighted. The need of a shared responsibility between the involved parts, population and State is recognized. Conclusion: It is suggested for nurses to be stimulated to amplify home care to attend the demands of caregivers; and to elaborate new studies with different populations, to validate or complement the proposed theoretical model.
Full Text Available Normal 0 0 2 false false false EN-US JA X-NONE MicrosoftInternetExplorer4 Music use in dementia care often takes place within a music therapy context, where music therapy sessions aim to reduce agitated behaviour, access emotions or enhance inter-personal communication. Such sessions usually take place within care homes and their effect has been evaluated by a number of studies. However, there is little research on music use that takes place outside of care homes (e.g. in community centres for people with dementia who are cared for at home by their family. This paper discusses this type of music use, focusing on the meaning of weekly local music making activities in relation to every day dementia care. I use empirical data from a study of a community based music activity called "Singing for the Brain" (SFTB run by the Alzheimer's Society in the UK. The data was collected through extensive participant observation research and interviews with organisers, carers and care receivers. The preliminary findings from the data analysis are discussed: how SFTB can be seen as a ecological practice; its various “spin-off’ effects in the everyday care of the members with dementia; how SFTB, together with other local music groups, constitute the music and care world in the town; and how this develops into fluid support networks to support local people with dementia and their carers.
Full Text Available Aim: Political decisions usually emerge from the competing interests of politicians, voters, and special interest groups. We investigated the applicability of an advanced methodological concept to determine whether certain institutional positions in a cooperating network have influence on the decision-making procedures. To that end, we made use of the institutional network of relevant health care and health governance institutions, concentrated in Belgrade, Serbia. Methods: We used a Principal Component Analysis (PCA based on a combination of measures for centrality in order to evaluate the positions of 25 players in Belgrade‟s institutional network. Their directed links were determined by a simulated position approach employing the authors‟ long-term involvement. Software packages used consisted of Visone 2.9, UCINET 6, and KeyPlayer 1.44. Results: In our analysis, the network density score in Belgrade was 71%. The PCA revealed two dimensions: control and attractiveness. The Ministry of Health exerted the highest level of control but displayed a low attractiveness in terms of receiving links from important players. The National Health Insurance Fund had less control capacity but a high attractiveness. The National Institute of Public Health‟s position was characterized by a low control capacity and high attractiveness, whereas the National Drug Agency, the National Health Council, and Non-Governmental Organisations were no prominent players. Conclusions: The advanced methodologies used here to analyse the health care policy network in Belgrade provided consistent results indicating that the intended decentralization of the health care network in Belgrade may be incomplete, still with low participation of civil society representatives. With the present study we set the stage for a broad-range survey based data collection applying the methodology piloted in Belgrade.
American health care organizations are experiencing increasing change driven by emerging partnerships, market demographics, population health initiatives, and merger and acquisition trends. The health care business environment necessitates alterations in how companies operate on a larger scale. New regional leadership roles are being created to provide leadership to systematize networks, build market share, and strengthen market needs. It is important and necessary to explore, review, and contrast the roles, skills, and behaviors of regional leader's roles and the solo organization leaders. It is also imperative to review the benefits of new affiliations for the community and hospital entity. PMID:27584890
Booth, Mark; Hill, Graham; Moore, Michael J; Dalla, Danielle; Moore, Michael G; Messenger, Anne
On 1 July 2015, the Australian Government established 31 new Primary Health Networks (PHNs), following a review by its former Chief Medical Officer, John Horvath, of 61 Medicare Locals created under the previous Labor administration. The Horvath review recommended, among other things, that new, larger primary health organisations be established to reduce fragmentation of care by integrating and coordinating health services, supporting the role of general practice, and leveraging and administering health program funding. The two main objectives of the new PHNs, as stated on the Department of Health's website, are "increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time". Below are three viewpoints, commissioned for this primary health care themed issue of Public Health Research & Practice, from the Australian Government Department of Health, the Public Health Association of Australia and a Sydney-based PHN. We asked the authors to focus particularly on how the newly established networks might help to integrate public health within the primary health care landscape. Our authors have pointed out the huge overlap between public health and primary care and looked at evidence showing the great benefits for health systems of collaboration between the two. Challenges ahead include a possible government focus on delivery of 'frontline' medical services, which may come at the expense of population health, and the complexity of dealing with all primary health care stakeholders, including health professionals, Local Health Districts, nongovernment organisations, research institutions and local communities. PMID:26863166
T. V.P. Sundararajan
Full Text Available Problem statement: Health monitoring, telemedicine, military, interactive entertainment and portable audio/video systems were most promising applications where WBANs can be used. However, designers of such systems face a number of challenging tasks, as they need to address often quite conflicting requirements for size, operating time, precision and reliability. Network security is very important in Wireless Body Area Network (WBAN since the vital human life might be jeopardized, unless managed properly. Approach: This article presented security architecture of a wireless body area network for ambulatory health status monitoring. A novel Intrusion Detection System (IDS inspired by the biological immune system that use Negative Selection Algorithm (NSA was proposed to enhance the performance of Wireless Body Area Networks (WBAN to operate despite the presence of compromised (misbehaving nodes. Results: The proposed IDS scheme had been implemented using network simulator Qualnet v5.2. The performances of IDS scheme had been analyzed using AODV, DSR and DSDV routing protocols for parameters such as average detection rate and false alarm rate. These negative selection detectors are capable of distinguishing well behaving nodes from compromised nodes with good degree of accuracy. The high false positives rate is also minimized. Conclusion/Recommendations: Wireless Body Area Networks are an enabling technology for mobile health care. The IDS can be implemented on todays devices as it only requires minimal and low-cost hardware changes. The authors strongly believe that adding sufficient security mechanisms to WBAN will study as a trigger in the acceptance of this technology for health care purposes. Simulation results indicate the non-degradability of network performance when these IDS is incorporated in the routing algorithm for security enhancements.
Background: As health providers move towards higher levels of information technology (IT) integration, they become increasingly dependent on the availability of the electronic health record (EHR). Current solutions of individually managed storage by each healthcare provider focus on efforts to ensure data security, availability and redundancy. Such models, however, scale poorly to a future of a planet-wide public health-care network (PWPHN). Our aim was to review the research literature on di...
Javaid, N.; Khan, N. A.; Shakir, M.; Khan, M.A.; Bouk, S. H.; Khan, Z. A.
Advances in wireless communication, system on chip and low power sensor nodes allowed realization of Wireless Body Area Network (WBAN). WBAN comprised of tiny sensors, which collect information of patient's vital signs and provide a real time feedback. In addition, WBAN also supports many applications including Ubiquitous HealthCare (UHC), entertainment, gaming, military, etc. UHC is required by elderly people to facilitate them with instant monitoring anywhere they move around. In this paper...
Lopes, Tânia; Veiga-Branco, Augusta; Baptista, Gorete
The relevance of this study - the first empirical research (to our knowledge) in Continued Care National Network (RCNN) context - emerge to understand the role of emotions in workplace behaviour (Côté, 2005; Austin, Dore & Donovan, 2008; Liu et al. 2008; Barsade, Ramarajan, Burack, 2008), but here, with terminally ill people and great physical and psychological weakness. Recent scientific literature is exposing a significatly negative correlations between Emotional Intelligence...
Veiga-Branco, Augusta; Lopes, Tânia
The relevance of this study—the first empirical research (to our knowledge) in Continued Care National Network (RCNN) context—emerge to understand the role of emotions in workplace behaviour (Coˆte´, 2005; Austin, Dore & Donovan, 2008; Liu et al. 2008; Barsade, Ramarajan, Burack, 2008), but here, with terminally ill people and great physical and psychological weakness. Recent scientific literature is exposing a significatly negative correlations between Emotional Intellig...
Tjibbe Donker; Jacco Wallinga; Hajo Grundmann
Rates of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly used as quality indicators for hospital hygiene. Alternatively, these rates may vary between hospitals, because hospitals differ in admission and referral of potentially colonized patients. We assessed if different referral patterns between hospitals in health care networks can influence rates of hospital-acquired infections like MRSA. We used the Dutch medical registration of 2...
Donker, Tjibbe; Wallinga, Jacco; Grundmann, Hajo
Rates of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly used as quality indicators for hospital hygiene. Alternatively, these rates may vary between hospitals, because hospitals differ in admission and referral of potentially colonized patients. We assessed if different referral patterns between hospitals in health care networks can influence rates of hospital-acquired infections like MRSA. We used the Dutch medical registration of 2...
Aspromonte, Nadia; Gulizia, Michele Massimo; Di Lenarda, Andrea; Mortara, Andrea; Battistoni, Ilaria; De Maria, Renata; Gabriele, Michele; Iacoviello, Massimo; Navazio, Alessandro; Pini, Daniela; Di Tano, Giuseppe; Marini, Marco; Ricci, Renato Pietro; Alunni, Gianfranco; Radini, Donatella; Metra, Marco; Romeo, Francesco
Changing demographics and an increasing burden of multiple chronic comorbidities in western countries dictate refocusing of heart failure (HF) services from acute in-hospital care to better support the long inter-critical out-of-hospital phases of HF. The needs of the HF population are not adequately addressed by current HF outpatient services, as documented by differences in age, gender, comorbidities and recommended therapies between patients discharged for hospitalized HF and those followed up at HF clinics.The Working Group on Heart Failure of the Italian Association of Hospital Cardiologists (ANMCO) has drafted a consensus document for the organization of a national HF care network. The aims of this document are to describe tasks and requirements of the different health system points of contact for HF patients, and to define how diagnosis, management and care processes should be documented and shared among healthcare professionals. In this document, HF clinics are classified into three groups: 1) community HF clinics, devoted to the management of stable patients in strict liaison with primary care, regular re-evaluation of emerging clinical needs and prompt treatment of impending destabilizations, 2) hospital HF clinics, that target both new-onset and chronic HF patients for diagnostic assessment, treatment planning and early post-discharge follow-up. They act as main referral for medicine units and community clinics; 3) advanced HF clinics, directed at patients with severe disease or persistent clinical instability, candidates to advanced treatment options such as heart transplant or mechanical circulatory support. These different types of HF clinics are integrated in a dedicated network for the management of HF patients on a regional basis, according to geographic features. By sharing predefined protocols and communication systems, these HF networks integrate multiprofessional providers to ensure continuity of care. This consensus document is expected to
Rebeca Silveira Rocha
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.
Full Text Available Background: Community care workers (CCWs in rural South Africa provide medical, personal, household, educational, and social care services to their clients. However, little understanding exists on how provision of services is approached within a household, taking into account available social support networks. Objective: The aim of this study was to generate an understanding of the processes that underpin the provision of care by CCWs in rural households and their engagement with clients, primary caregivers (PCGs, and other members of the social support network. Design: We analysed in-depth interviews conducted in a triad of participants involved in a home-based care (HBC encounter – 32 clients, 32 PCGs, and 17 CCWs. For each triad, a purposefully selected CCW was linked with a purposefully selected client and the corresponding PCG using maximum variation sampling. Three coders used an inductive content analysis method to describe participants’ references to the nuances of processes followed by CCWs in servicing HBC clients. Written informed consent was obtained from all participants. Findings: The results suggest that, by intuition and prior knowledge, CCWs treated each household uniquely, depending on the clients’ care needs, cooperation, availability of a social network, and the reliability and resilience of the social support system for the client. Four distinct processes took place in rural households: needs assessment for care, rationing of care, appraisal of care, and reinforcement of a social support system. However, there was no particular order or sequence established for these processes, and caregivers followed no prescribed or shared standards. Conclusions: CCWs bring a basket of services to a household, but engage in a constant, dynamic, and cyclical process of weighing needs against services provided. The service package is uniquely crafted and tailored for each household, depending on the absorptive capacity of the social
Auerbach, Andrew D; Patel, Mitesh S; Metlay, Joshua P; Schnipper, Jeffrey L; Williams, Mark V; Robinson, Edmondo J; Kripalani, Sunil; Lindenauer, Peter K
Converting the health care delivery system into a learning organization is a key strategy for improving health outcomes. Although the collaborative learning organization approach has been successful in neonatal intensive care units and disease-specific collaboratives, there are few examples in general medicine and none in adult medicine that have leveraged the role of hospitalists nationally across multiple institutions to implement improvements. The authors describe the rationale for and early work of the Hospital Medicine Reengineering Network (HOMERuN), a collaborative of hospitals, hospitalists, and multidisciplinary care teams founded in 2011 that seeks to measure, benchmark, and improve the efficiency, quality, and outcomes of care in the hospital and afterwards. Robust and timely evaluation, with learning and refinement of approaches across institutions, should accelerate improvement efforts. The authors review HOMERuN's collaborative model, which focuses on a community-based participatory approach modified to include hospital-based staff as well as the larger community. HOMERuN's initial project is described, focusing on care transition measurement using perspectives from the patient, caregiver, and providers. Next steps and sustainability of the organization are discussed, including benchmarking, collaboration, and effective dissemination of best practices to stakeholders. PMID:24448050
Full Text Available Abstract Background Day care-associated infectious diseases are widely recognized as a public health problem but rarely studied. Insights into their dynamics and their association with the day care setting are important for effective decision making in management of infectious disease control. This paper describes the purpose, design and potential of our national multi-center, day care-based sentinel surveillance network for infectious diseases (the KIzSS network. The aim of the KIzSS network is to acquire a long-term insight into the syndromic and microbiological aspects of day care-related infectious diseases and associated disease burden and to model these aspects with day care setting characteristics. Methods/design The KIzSS network applies a prospective cohort design, following day care centers rather than individual children or staff members over time. Data on infectious disease symptoms and related morbidity (children and staff, medical consumption, absenteeism and circulating enteric pathogens (children are collected on a daily, weekly or monthly basis. Every two years, a survey is performed to assess the characteristics of participating day care centers. Discussion The KIzSS network offers a unique potential to study infectious disease dynamics in the day care setting over a sustained period of time. The created (biodatabases will help us to assess day care-related disease burden of infectious diseases among attending children and staff and their relation with the day care setting. This will support the much needed development of evidence-based and pragmatic guidelines for infectious disease control in day care centers.
Jiang, Lixiang; Giachetti, Ronald E
The total time a patient spends in an outpatient facility, called the patient cycle time, is a major contributor to overall patient satisfaction. A frequently recommended strategy to reduce the total time is to perform some activities in parallel thereby shortening patient cycle time. To analyze patient cycle time this paper extends and improves upon existing multi-class open queueing network model (MOQN) so that the patient flow in an urgent care center can be modeled. Results of the model are analyzed using data from an urgent care center contemplating greater parallelization of patient care activities. The results indicate that parallelization can reduce the cycle time for those patient classes which require more than one diagnostic and/ or treatment intervention. However, for many patient classes there would be little if any improvement, indicating the importance of tools to analyze business process reengineering rules. The paper makes contributions by implementing an approximation for fork/join queues in the network and by improving the approximation for multiple server queues in both low traffic and high traffic conditions. We demonstrate the accuracy of the MOQN results through comparisons to simulation results. PMID:18826003
Span, M.; Smits, C.; Jukema, J.; Groen-van de Ven, L.M.; Janssen, R.; Vernooij-Dassen, M.; Eefsting, J.; Hettinga, M.
BACKGROUND: An interactive web tool has been developed for facilitating shared decision-making in dementia-care networks. The DecideGuide provides a chat function for easier communication between network members, a deciding together function for step-by-step decision-making, and an individual opinio
Sandra M. Agudelo
Full Text Available Because of its severity, frequency and increasing social and economic impact, Diabetes Mellitus (DM is considered the third priority health problem in the world. Although to date there is no curative treatment, it does have effective measures to reduce its occurrence and limit its complications. Objective: to describe the control program of diabetes in a statewide network of health services in regard to clinical variables, the epidemiology of population served and the control actions, in order to identify strategies for improvement. Methodology: operational research based on secondary data. We reviewed the general conditions of operation of the program based on records of patient care. We studied a random sample of medical records of patients served by the control program of diabetes care units in the network.The results were validated in a meeting with officials of the institution. Results: we detected flaws and points of improvement in the performance of the control program that resulted in specific recommendations for the institutional network. Other failures are due to rules that hinder health system monitoring and control of the DM at the first level. Conclusion:the review of medical records reveals important problems about registration, monitoring and control of diabetics. Other regulatory and contractual provisions of the colombian health system were identified as restrictions that prevent the program to control hyperglycemia and early detection of renal damage. These restrictions could be affecting the programs of control of diabetes in other institutions of the country that are subject to the same rules
Maria A. Osborne, PharmD
Full Text Available Objective: To identify and describe Pennsylvania pharmacists who currently provide or are interested in providing community-basedpatient care services and are interested in joining a statewide practice network. Design: Cross-sectional survey. Setting: February toJune 2009 in Pennsylvania. Participants: 1700 pharmacists. Intervention: Mailed and electronic survey. Main outcome measures:Number and geographic location of pharmacists providing or interested in providing community-based patient care in Pennsylvania.Description of patient care documentation methods; physical space; services provided; perceived barriers to providing patient care;training needs; and interest in joining a statewide practice network. Results: The final analysis included data from 1700 pharmacists.Approximately one-third of pharmacists (n=554 were providing patient care services to community-based patients. Most wereroutinely documenting (67.5% and many had a semi-private or private space to provide care. MTM and immunizations were themost common services provided. Respondents reported the most significant barrier to providing MTM, diabetes education, andsmoking cessation education was time constraints, whereas training was a barrier for immunization provision. Most pharmacistswere not being compensated for patient care services. Of the 869 pharmacists interested in joining a statewide network, thoseproviding care were more interested in joining than those who were not (70.8% vs. 43.8%, p < 0.001. Conclusion: Pennsylvaniapharmacists are interested in providing community-based patient care services and joining a statewide practice network focused onproviding community-based patient care services. This research serves as a foundation for building a pharmacist practice network inPennsylvania.
Under the framework of the International Consortium for Medical Care of Hibakusha and Radiation Life Science (Nagasaki University 21st Century COE Program) and bearing in mind the unique history and responsibility of Nagasaki University, several projects on radiation emergency preparedness are in progress. The critical accident in Tokaimura, Japan in 1999 made us realize that nuclear emergencies happen anywhere radionuclides exist. In fact, nuclear accidents possibly take place in factories, research facilities, hospital and wherever radioactive materials are in transit. Therefore, it is necessary to establish an effective preparedness network system for potential radiation emergency that may occur in Nagasaki and nearby prefectures and to cooperate with other Japanese and worldwide networks. (author)
Delamater Paul L
Full Text Available Abstract Background Inequalities in geographic access to health care result from the configuration of facilities, population distribution, and the transportation infrastructure. In recent accessibility studies, the traditional distance measure (Euclidean has been replaced with more plausible measures such as travel distance or time. Both network and raster-based methods are often utilized for estimating travel time in a Geographic Information System. Therefore, exploring the differences in the underlying data models and associated methods and their impact on geographic accessibility estimates is warranted. Methods We examine the assumptions present in population-based travel time models. Conceptual and practical differences between raster and network data models are reviewed, along with methodological implications for service area estimates. Our case study investigates Limited Access Areas defined by Michigan’s Certificate of Need (CON Program. Geographic accessibility is calculated by identifying the number of people residing more than 30 minutes from an acute care hospital. Both network and raster-based methods are implemented and their results are compared. We also examine sensitivity to changes in travel speed settings and population assignment. Results In both methods, the areas identified as having limited accessibility were similar in their location, configuration, and shape. However, the number of people identified as having limited accessibility varied substantially between methods. Over all permutations, the raster-based method identified more area and people with limited accessibility. The raster-based method was more sensitive to travel speed settings, while the network-based method was more sensitive to the specific population assignment method employed in Michigan. Conclusions Differences between the underlying data models help to explain the variation in results between raster and network-based methods. Considering that the
Full Text Available Abstract Background Increasing the effective targeting and promotion of self-care support for long-term conditions requires more of a focus on patient contexts and networks. The aim of this paper is to describe how within a programme of research and implementation, social networks are viewed as being centrally involved in the mobilisation and deployment of resources in the management of a chronic condition. This forms the basis of a novel approach to understanding, designing, and implementing new forms of self-management support. Methods Drawing on evidence syntheses about social networks and capital and the role of information in self-management, we build on four conceptual approaches to inform the design of our research on the implementation of self-care support for people with long-term conditions. Our approach takes into consideration the form and content of social networks, notions of chronic illness work, normalisation process theory (NPT, and the whole systems informing self-management engagement (WISE approach to self-care support. Discussion The translation and implementation of a self-care agenda in contemporary health and social context needs to acknowledge and incorporate the resources and networks operating in patients' domestic and social environments and everyday lives. The latter compliments the focus on healthcare settings for developing and delivering self-care support by viewing communities and networks, as well as people suffering from long-term conditions, as a key means of support for managing long-term conditions. By focusing on patient work and social-network provision, our aim is to open up a second frontier in implementation research, to translate knowledge into better chronic illness management, and to shift the emphasis towards support that takes place outside formal health services.
Kapadia Dharmi; Reeves David; Blickem Christian; Bower Peter; Protheroe Joanne; Kennedy Anne; Chew-Graham Carolyn; Kirk Susan; Sanders Caroline; Vassilev Ivaylo; Rogers Anne; Brooks Helen; Fullwood Catherine; Richardson Gerry
Abstract Background Increasing the effective targeting and promotion of self-care support for long-term conditions requires more of a focus on patient contexts and networks. The aim of this paper is to describe how within a programme of research and implementation, social networks are viewed as being centrally involved in the mobilisation and deployment of resources in the management of a chronic condition. This forms the basis of a novel approach to understanding, designing, and implementing...
Morishima, Atsutomo; Kijima, Yasuaki
In hospitals, information technology(IT)has been a natural part of care for some time. However, IT has not yet been widely introduced into home care. While performing home care, healthcare providers must carry numerous patients' medical records, and are unable to share the information included in those records with other providers. Thus, we introduced the system of sharing patient information using iPads. This system enables access to patient information regardless of time and place. In addition, we can share information such as X-ray images and computed tomography(CT)scans between different clinics. Thus, we are able to give clearer instructions to patients and other providers in a smoother way. This system could be used to construct a network for home care. In the future, we could aim to share patient information within a much wider network, including families and other kinds of organizations, for optimal care. This system will aid in the development of IT use in home care. PMID:23268884
Abraham O. Fapojuwo
Full Text Available Wireless Sensor Networks (WSNs have emerged as a viable technology for a vast number of applications, including health care applications. To best support these health care applications, WSN technology can be adopted for the design of practical Health Care WSNs (HCWSNs that support the key system architecture requirements of reliable communication, node mobility support, multicast technology, energy efficiency, and the timely delivery of data. Work in the literature mostly focuses on the physical design of the HCWSNs (e.g., wearable sensors, in vivo embedded sensors, et cetera. However, work towards enhancing the communication layers (i.e., routing, medium access control, et cetera to improve HCWSN performance is largely lacking. In this paper, the information gleaned from an extensive literature survey is shared in an effort to fortify the knowledge base for the communication aspect of HCWSNs. We highlight the major currently existing prototype HCWSNs and also provide the details of their routing protocol characteristics. We also explore the current state of the art in medium access control (MAC protocols for WSNs, for the purpose of seeking an energy efficient solution that is robust to mobility and delivers data in a timely fashion. Furthermore, we review a number of reliable transport layer protocols, including a network coding based protocol from the literature, that are potentially suitable for delivering end-to-end reliability of data transmitted in HCWSNs. We identify the advantages and disadvantages of the reviewed MAC, routing, and transport layer protocols as they pertain to the design and implementation of a HCWSN. The findings from this literature survey will serve as a useful foundation for designing a reliable HCWSN and also contribute to the development and evaluation of protocols for improving the performance of future HCWSNs. Open issues that required further investigations are highlighted.
Robke, F J
Oral epidemiology studies of previous years have shown an increasing difference in caries cases in respect of different social strata. Thus, frequency of caries cases is related to social status. High rates of caries prevalence are found especially among children from typical areas of welfare problems. Already, today every fifth child is born into a family of immigrants. In areas of typical social deprivation their share is about 40% and more. Since the previous educational campaigns for social fringe groups have hardly shown any positive effect on dental health, new strategies are necessary. In a community of Hanover with low socio-economic status and a generally high caries level, the treatment strategies of dental care for the young have centred on the case-management approaches of social welfare programmes since the early 90s. Beside the expanded basic preventive programme, which includes application of a fluoride varnish for children, social compensatory measures with intercultural networks are also being taken. This concept shows very clearly that the dental health of children living in areas of social disorganisation can be effectively improved by means of these strategies. For the future, dental care for these children requires more intercultural competence and more knowledge of social welfare work by adolescent dental care providers. PMID:11037670
Cleary, Kevin R.; Levine, Betty A.; Norton, Gary S.; Mun, Seong K.; Cramer, Timothy J.; de Treville, Robert E.
The Imaging Science and Information Systems (ISIS) Center of the Department of Radiology at Georgetown University Medical Center recently collaborated with the US Army in developing an off-the-shelf teleradiology network for Operation Joint Endeavor, the peace-keeping mission in Bosnia-Herzegovina. The network is part of Operation Primetime III, a project to deploy advanced communications and medical equipment to provide state-of-the-art medical care to the 20,000 US troops stationed there. The network encompasses three major sites: the 212th Mobile Army Surgical Hospital (MASH) near Tuzla, Bosnia-Herzegovina; the 67th Combat Support Hospital (CSH) in Taszar, Hungary; and the Landstuhl Regional Medical Center (LRMC) in Landstuhl, Germany. Planning for the project began in January 1996, and all three sites were operational by April 1996. Since the system was deployed, computed radiography (CR) has been sued almost exclusively at the MASH and CSH for all general x-ray exams. From mid- May to September 1996, over 2700 CR images were acquired at the MASH and over 1600 at the CSH. Since there was not a radiologist a the MASH, the images were transferred to the CSH for primary diagnosis and archiving. In the same time period, over 550 patient folders were sent from the MASH to the CSH.
Brennan-Ing, Mark; Seidel, Liz; Larson, Britta; Karpiak, Stephen E
Research on service needs among older adults rarely addresses the special circumstances of lesbian, gay, bisexual, and transgender (LGBT) individuals, such as their reliance on friend-centered social networks or the experience of discrimination from service providers. Limited data suggests that older LGBT adults underutilize health and social services that are important in maintaining independence and quality of life. This study explored the social care networks of this population using a mixed-methods approach. Data were obtained from 210 LGBT older adults. The average age was 60 years, and 71% were men, 24% were women, and 5% were transgender or intersex. One-third was Black, and 62% were Caucasian. Quantitative assessments found high levels of morbidity and friend-centered support networks. Need for and use of services was frequently reported. Content analysis revealed unmet needs for basic supports, including housing, economic supports, and help with entitlements. Limited opportunities for socialization were strongly expressed, particularly among older lesbians. Implications for senior programs and policies are discussed. PMID:24313252
Shaw, Judith S; Norlin, Chuck; Gillespie, R J; Weissman, Mark; McGrath, Jane
. Since 2008, IPs have offered credit toward Part 4 of Maintenance of Certification for participants in some of their projects. To date, IPs have focused on achieving improvements in care delivery through individual projects. Rigorous measurement and evaluation of their efforts and impact will be essential to understanding, spreading, and sustaining state/regional child health care QI programs. We describe the origins, evolution to date, and hopes for the future of these partnerships and the National Improvement Partnership Network (NIPN), which was established to support existing and nurture new IPs. PMID:24268091
Valente Thomas W
Full Text Available Abstract Background Social networks are theorized as significant influences in the innovation adoption and behavior change processes. Our understanding of how social networks operate within healthcare settings is limited. As a result, our ability to design optimal interventions that employ social networks as a method of fostering planned behavior change is also limited. Through this proposed project, we expect to contribute new knowledge about factors influencing uptake of knowledge translation interventions. Objectives Our specific aims include: To collect social network data among staff in two long-term care (LTC facilities; to characterize social networks in these units; and to describe how social networks influence uptake and use of feedback reports. Methods and design In this prospective study, we will collect data on social networks in nursing units in two LTC facilities, and use social network analysis techniques to characterize and describe the networks. These data will be combined with data from a funded project to explore the impact of social networks on uptake and use of feedback reports. In this parent study, feedback reports using standardized resident assessment data are distributed on a monthly basis. Surveys are administered to assess report uptake. In the proposed project, we will collect data on social networks, analyzing the data using graphical and quantitative techniques. We will combine the social network data with survey data to assess the influence of social networks on uptake of feedback reports. Discussion This study will contribute to understanding mechanisms for knowledge sharing among staff on units to permit more efficient and effective intervention design. A growing number of studies in the social network literature suggest that social networks can be studied not only as influences on knowledge translation, but also as possible mechanisms for fostering knowledge translation. This study will contribute to building
Jennifer Marks; Barnett, Lisa M.; Chad Foulkes; Penelope Hawe; Steven Allender
Introduction. Interest has grown in how systems thinking could be used in obesity prevention. Relationships between key actors, represented by social networks, are an important focus for considering intervention in systems. Method. Two long day care centers were selected in which previous obesity prevention programs had been implemented. Measures showed ways in which physical activity and dietary policy are conversations and actions transacted through social networks (interrelationships) with...
Eugênio Vilaça Mendes
system of healthcare practice, with the implantation of health care networks. The conclusion is that there are evidences in the international literature on health care networks that these networks may improve the clinical quality, the sanitation results and the user's satisfaction and the reduction of healthcare systems costs.
Kessler, D M
Through strategic clinical diversification, political activism, and bold expansion, Wills Eye Hospital, a teaching specialty surgical hospital, survives ravages of sudden onslaughts of managed care payment reductions while maintaining autonomy. Slack inpatient resources were re-utilized to create unique programs attractive to regional managed care organizations. Advocacy and lobbying for short-term favorable treatment from Medicare bought the Hospital valuable time and positioning. Building out a regional network of ambulatory surgical centers assures the growth and access to market required for Wills to maintain its autonomy in a managed care contracting environment. PMID:11372488
Hindia, M. N.; Rahman, T. A.; Ojukwu, H.; Hanafi, E. B.; Fattouh, A.
As the enterprise of the “Internet of Things” is rapidly gaining widespread acceptance, sensors are being deployed in an unrestrained manner around the world to make efficient use of this new technological evolution. A recent survey has shown that sensor deployments over the past decade have increased significantly and has predicted an upsurge in the future growth rate. In health-care services, for instance, sensors are used as a key technology to enable Internet of Things oriented health-care monitoring systems. In this paper, we have proposed a two-stage fundamental approach to facilitate the implementation of such a system. In the first stage, sensors promptly gather together the particle measurements of an android application. Then, in the second stage, the collected data are sent over a Femto-LTE network following a new scheduling technique. The proposed scheduling strategy is used to send the data according to the application’s priority. The efficiency of the proposed technique is demonstrated by comparing it with that of well-known algorithms, namely, proportional fairness and exponential proportional fairness. PMID:27152423
Kannan, Venkateshan; Swartz, Fredrik; Kiani, Narsis A; Silberberg, Gilad; Tsipras, Giorgos; Gomez-Cabrero, David; Alexanderson, Kristina; Tegnèr, Jesper
Health care data holds great promise to be used in clinical decision support systems. However, frequent near-synonymous diagnoses recorded separately, as well as the sheer magnitude and complexity of the disease data makes it challenging to extract non-trivial conclusions beyond confirmatory associations from such a web of interactions. Here we present a systematic methodology to derive statistically valid conditional development of diseases. To this end we utilize a cohort of 5,512,469 individuals followed over 13 years at inpatient care, including data on disability pension and cause of death. By introducing a causal information fraction measure and taking advantage of the composite structure in the ICD codes, we extract an effective directed lower dimensional network representation (100 nodes and 130 edges) of our cohort. Unpacking composite nodes into bipartite graphs retrieves, for example, that individuals with behavioral disorders are more likely to be followed by prescription drug poisoning episodes, whereas women with leiomyoma were more likely to subsequently experience endometriosis. The conditional disease development represent putative causal relations, indicating possible novel clinical relationships and pathophysiological associations that have not been explored yet. PMID:27211115
M N Hindia
Full Text Available As the enterprise of the "Internet of Things" is rapidly gaining widespread acceptance, sensors are being deployed in an unrestrained manner around the world to make efficient use of this new technological evolution. A recent survey has shown that sensor deployments over the past decade have increased significantly and has predicted an upsurge in the future growth rate. In health-care services, for instance, sensors are used as a key technology to enable Internet of Things oriented health-care monitoring systems. In this paper, we have proposed a two-stage fundamental approach to facilitate the implementation of such a system. In the first stage, sensors promptly gather together the particle measurements of an android application. Then, in the second stage, the collected data are sent over a Femto-LTE network following a new scheduling technique. The proposed scheduling strategy is used to send the data according to the application's priority. The efficiency of the proposed technique is demonstrated by comparing it with that of well-known algorithms, namely, proportional fairness and exponential proportional fairness.
Hindia, M N; Rahman, T A; Ojukwu, H; Hanafi, E B; Fattouh, A
As the enterprise of the "Internet of Things" is rapidly gaining widespread acceptance, sensors are being deployed in an unrestrained manner around the world to make efficient use of this new technological evolution. A recent survey has shown that sensor deployments over the past decade have increased significantly and has predicted an upsurge in the future growth rate. In health-care services, for instance, sensors are used as a key technology to enable Internet of Things oriented health-care monitoring systems. In this paper, we have proposed a two-stage fundamental approach to facilitate the implementation of such a system. In the first stage, sensors promptly gather together the particle measurements of an android application. Then, in the second stage, the collected data are sent over a Femto-LTE network following a new scheduling technique. The proposed scheduling strategy is used to send the data according to the application's priority. The efficiency of the proposed technique is demonstrated by comparing it with that of well-known algorithms, namely, proportional fairness and exponential proportional fairness. PMID:27152423
Full Text Available Using three spatial network measures of “space syntax”, this correlational study describes four interaction-related behaviors among three groups of users in relation to visibility and accessibility of spaces in four adult intensive care units (ICUs of different size, geometry, and specialty. Systematic field observations of interaction-related behaviors show significant differences in spatial distribution of interaction-related behaviors in the ICUs. Despite differences in unit characteristics and interaction-related behaviors, the study finds that when nurses and physicians “interact while sitting” they prefer spaces that help maintain a high level of environmental awareness; that when nurses “walk” and “interact while walking” they avoid spaces with better global access and visibility; and that everyone in ICUs “walk” more in spaces with higher control over neighboring spaces. It is argued that such consistent behavioral patterns occur due to the structural similarities of spatial networks over and above the more general functional similarities of ICUs.
De Paoli, Paolo; Ciliberto, Gennaro; Ferrarini, Manlio; Pelicci, PierGiuseppe; Dellabona, Paolo; De Lorenzo, Francesco; Mantovani, Alberto; Musto, Pellegrino; Opocher, Giuseppe; Picci, Piero; Ricciardi, Walter; De Maria, Ruggero
Alliance Against Cancer (ACC) was established in Rome in 2002 as a consortium of six Italian comprehensive cancer centers (Founders). The aims of ACC were to promote a network among Italian oncologic institutions in order to develop specific, advanced projects in clinical and translational research. During the following years, many additional full and associate members joined ACC, that presently includes the National Institute of Health, 17 research-oriented hospitals, scientific and patient organizations. Furthermore, in the last three years ACC underwent a reorganization process that redesigned the structure, governance and major activities. The present goal of ACC is to achieve high standards of care across Italy, to implement and harmonize principles of modern personalized and precision medicine, by developing cost effective processes and to provide tailored information to cancer patients. We herein summarize some of the major initiatives that ACC is currently developing to reach its goal, including tumor genetic screening programs, establishment of clinical trial programs for cancer patients treated in Italian cancer centers, facilitate their access to innovative drugs under development, improve quality through an European accreditation process (European Organization of Cancer Institutes), and develop international partnerships. In conclusion, ACC is a growing organization, trying to respond to the need of networking in Italy and may contribute significantly to improve the way we face cancer in Europe. PMID:26578263
English, MC; Tuti, T; Paton, C.; Malla, L; Clinical Information Network
In many low income countries health information systems are poorly equipped to provide detailed information on hospital care and outcomes. Information is thus rarely used to support practice improvement. We describe efforts to tackle this challenge and to foster learning concerning collection and use of information. This could improve hospital services in Kenya. We are developing a Clinical Information Network, a collaboration spanning 14 hospitals, policy makers and researchers with the g...
Bracken, Stacey Storch
This article comments on the discussion of S. A. Storch and G. J. Whitehurst's literacy development model in the article by the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network (ECCRN). Specifically, this comment focuses on concerns raised by the NICHD ECCRN that Storch and Whitehurst's model does…
Liu, Chen-Chung; Hong, Yi-Ching
Although computers and network technology have been widely utilised to assist students learn, few technical supports have been developed to help hearing-impaired students learn in Taiwan. A significant challenge for teachers is to provide after-class learning care and assistance to hearing-impaired students that sustain their motivation to…
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.
Michalak Erin E
Full Text Available Abstract The Collaborative RESearch team to study psychosocial factors in bipolar disorder (CREST.BD is a multidisciplinary, cross-sectoral network dedicated to both fundamental research and knowledge exchange on bipolar disorder (BD. The core mission of the network is to advance the science and understanding of psychological and social issues associated with BD, improve the care and wellness of people living with BD, and strengthen services and supports for these individuals. CREST.BD bridges traditional and newer research approaches, particularly embracing community-based participatory research (CBPR methods. Membership of CREST is broad, including academic researchers, people with BD, their family members and supports, and a variety of health care providers. Here, we describe the origins, evolution, approach to planning and evaluation and future vision for our network within the landscape of CBPR and integrated knowledge translation (KT, and explore the keys and challenges to success we have encountered working within this framework.
Li, Chun-Ta; Lee, Cheng-Chi; Weng, Chi-Yao
Recent advances in medical treatment and emergency applications, the need of integrating wireless body area network (WBAN) with cloud computing can be motivated by providing useful and real time information about patients' health state to the doctors and emergency staffs. WBAN is a set of body sensors carried by the patient to collect and transmit numerous health items to medical clouds via wireless and public communication channels. Therefore, a cloud-assisted WBAN facilitates response in case of emergency which can save patients' lives. Since the patient's data is sensitive and private, it is important to provide strong security and protection on the patient's medical data over public and insecure communication channels. In this paper, we address the challenge of participant authentication in mobile emergency medical care systems for patients supervision and propose a secure cloud-assisted architecture for accessing and monitoring health items collected by WBAN. For ensuring a high level of security and providing a mutual authentication property, chaotic maps based authentication and key agreement mechanisms are designed according to the concept of Diffie-Hellman key exchange, which depends on the CMBDLP and CMBDHP problems. Security and performance analyses show how the proposed system guaranteed the patient privacy and the system confidentiality of sensitive medical data while preserving the low computation property in medical treatment and remote medical monitoring. PMID:27000778
Waddimba, Anthony C; Scribani, Melissa; Nieves, Melinda A; Krupa, Nicole; May, John J; Jenkins, Paul
We validated three single-item measures for emotional exhaustion (EE) and depersonalization (DP) among rural physician/nonphysician practitioners. We linked cross-sectional survey data (on provider demographics, satisfaction, resilience, and burnout) with administrative information from an integrated health care network (1 academic medical center, 6 community hospitals, 31 clinics, and 19 school-based health centers) in an eight-county underserved area of upstate New York. In total, 308 physicians and advanced-practice clinicians completed a self-administered, multi-instrument questionnaire (65.1% response rate). Significant proportions of respondents reported high EE (36.1%) and DP (9.9%). In multivariable linear mixed models, scores on EE/DP subscales of the Maslach Burnout Inventory were regressed on each single-item measure. The Physician Work-Life Study's single-item measure (classifying 32.8% of respondents as burning out/completely burned out) was correlated with EE and DP (Spearman's ρ = .72 and .41, p burnout. PMID:25716107
Full Text Available Malaz A Boustani,1–3 Amie Frame,1,2 Stephanie Munger,1,2 Patrick Healey,4 Jessie Westlund,5 Martin Farlow,6,7 Ann Hake,8 Mary Guerriero Austrom,6,9 Polly Shepard,10 Corby Bubp,10 Jose Azar,3 Arif Nazir,3 Nadia Adams,11 Noll L Campbell,1,2,12,13 Azita Chehresa,5 Paul Dexter2,31Indiana University Center for Aging Research, 2Regenstrief Institute, Inc, 3Department of Medicine, Indiana University School of Medicine (IUSM, 4St Vincent Health Network, 5Community Health Network, 6Indiana Alzheimer Disease Center, IUSM, 7Department of Neurology, IUSM, 8Eli Lilly and Company, 9Department of Psychiatry, IUSM, 10The Memory Clinic of Indianapolis, 11Indiana University Health, Indianapolis, IN, USA; 12Department of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, IN, USA; 13Department of Pharmacy, Wishard Health Services, Indianapolis, IN, USABackground: The US Institute of Medicine has recommended an integrated, locally sensitive collaboration among the various members of the community, health care systems, and research organizations to improve dementia care and dementia research.Methods: Using complex adaptive system theory and reflective adaptive process, we developed a professional network called the “Indianapolis Discovery Network for Dementia” (IDND. The IDND facilitates effective and sustainable interactions among a local and diverse group of dementia researchers, clinical providers, and community advocates interested in improving care for dementia patients in Indianapolis, Indiana.Results: The IDND was established in February 2006 and now includes more than 250 members from more than 30 local (central Indiana organizations representing 20 disciplines. The network uses two types of communication to connect its members. The first is a 2-hour face-to-face bimonthly meeting open to all members. The second is a web-based resource center (http://www.indydiscoverynetwork.org. To date, the network has: (1 accomplished the
Blanchet, Karl; James, Philip
Efforts have been increasingly invested to improve local health systems' capacities in developing countries. We describe the application of innovative methods based on a social network analysis approach. The findings presented refer to a study carried out between July 2008 and January 2010 in the Brong Ahafo region of Ghana. Social network analysis methods were applied in five different districts using the software package Ucinet to calculate the various properties of the social network of eye care providers. The study focused on the managerial decisions made by Ghanaian district hospital managers about the governance of the health system. The study showed that the health system in the Brong Ahafo region experienced significant changes specifically after a key shock, the departure of an international organization. Several other actors at different levels of the network disappeared, the positions of nurses and hospital managers changed, creating new relationships and power balances that resulted in a change in the general structure of the network. The system shifted from a centralized and dense hierarchical network towards an enclaved network composed of five sub-networks. The new structure was less able to respond to shocks, circulate information and knowledge across scales and implement multi-scale solutions than that which it replaced. Although the network became less resilient, it responded better to the management needs of the hospital managers who now had better access to information, even if this information was partial. The change of the network over time also showed the influence of the international organization on generating links and creating connections between actors from different levels. The findings of the study reveal the importance of creating international health connections between actors working in different spatial scales of the health system. PMID:22411882
GetWell:)Network, a Bethesda, MD-based interactive patient care provider, had the right tool. What it didn't have was the means to get the word out about that tool. So in September 2006, the provider tapped Waltham, MA-based healthcare public relations agency Schwartz Communications to design and execute a national media relations campaign about the PatientLife:)System, GetWell's interactive educational bedside tool. PMID:17361789
Sebek, Kimberly; Jacobson, Laura; Wang, Jason; Newton-Dame, Remle; Singer, Jesse
Urban contexts introduce unique challenges that must be addressed to ensure that areas of high population density can function when disasters occur. The ability to generate useful data to guide decision-making is critical in this context. Widespread adoption of electronic health record (EHR) systems in recent years has created electronic data sources and networks that may play an important role in public health surveillance efforts, including in post-disaster situations. The Primary Care Info...
Swedish and international research points to serious problems for the education of students with social, emotional and behavioural difficulties (SEBD) in the care of social welfare, for example, in residential care. The aim of this article is to elucidate how documentation, care plans (CPs) and individual educational plans (IEPs) outline the…
Lee, Ren-Guey; Lai, Chien-Chih; Chiang, Shao-Shan; Liu, Hsin-Sheng; Chen, Chun-Chang; Hsieh, Guan-Yu
According to home healthcare requirement of chronic patients, this paper proposes a mobile-care system integrated with a variety of vital-sign monitoring, where all the front-end vital-sign measuring devices are portable and have the ability of short-range wireless communication. In order to make the system more suitable for home applications, the technology of wireless sensor network is introduced to transmit the captured vital signs to the residential gateway by means of multi-hop relay. Then the residential gateway uploads data to the care server via Internet to carry out patient's condition monitoring and the management of pathological data. Furthermore, the system is added in the alarm mechanism, which the portable care device is able to immediately perceive the critical condition of the patient and to send a warning message to medical and nursing personnels in order to achieve the goal of prompt rescue. PMID:17945927
Müller, H L; Blanke, J-G; Bonse, B; Bosse, H; Erkel, J; Gitmans, R; Kolb, R; Krull, F; Langlitz, J; Liebner, T; Löning, L; Mokross, C; Niekrens, C; Schüler, D; Wessel, V; Wosnitza, A P
The cure rates in pediatric oncology have been substantially improved due to standardized treatment strategies and centralization of therapy. Close clinical and hematological monitoring is mandatory for patients between periods of chemotherapy for early detection and treatment of therapy-related complications such as infections. This results in frequent and time-consuming outpatient examinations for the patient and family at the oncological center in order to evaluate clinical condition and hematological findings. In widespread regions such as the Weser-Ems area in northwest Lower Saxony, Germany, the long distances between patients' home and the oncological center lead to higher risks and impairment of quality of life (QoL) for the patients and their families. Accordingly, in 2001 pediatric hospitals and practices, patient care services and patients' support groups in Weser-Ems founded a network (Verbund PädOnko Weser-Ems). The "Verbund PädOnko" aims at coordinated, high-quality regional outpatient patient treatment in order to reduce risks of long-distance transports to reach the oncological center. Since 2005 a newly established mobile care team realized 1 443 home visits covering a total of 150 300 km. Since 2007 the network has been funded by health insurance organisations. Internal and external benchmarking was performed showing that the rate of short term inpatient treatments were reduced. Treatment quality was assured and the QoL of the patients and their families was improved through the work of the network. The "Verbund PädOnko Weser-Ems" network represents a promising prototype model for the regional coordination of outpatient treatment and care of patients with rare diseases in wide spread areas. PMID:21058228
Music use in dementia care often takes place within a music therapy context, where music therapy sessions aim to reduce agitated behaviour, access emotions or enhance inter-personal communication. Such sessions usually take place within care homes and their effect has been evaluated by a number of studies. However, there is little research on music use that takes place outside of care homes (e.g. in community centres) for people with dementia who are cared for at home by their family. This...
As the US population ages, trauma systems face new challenges in addition to the long-standing problem of access. Patients ages sixty-five and older are more likely than younger patients to fall and suffer serious injury or death as a result. This older patient population, when compared with younger cohorts, suffers higher mortality rates, has more comorbidities-diabetes, cancer, and heart conditions being the more serious among them-and takes more medications, which can complicate treatment. The University of South Florida (USF) Medical School and the HCA hospital system have partnered to create a network of five trauma centers in underserved areas of the state to increase access to trauma care for all Floridians while maintaining a special focus on geriatric trauma care. Collecting and analyzing data for improving care quality and undertaking research is a central aim of the partnership. Based on their research findings, trauma surgeons in the USF/HCA Trauma Network have identified best practices and codified them in standard operating procedures. PMID:24301397
Full Text Available The increasing number of natural disasters in the last decade necessitates the increase in capacity and agility while delivering humanitarian relief. A common logistics strategy used by humanitarian organizations to respond this need is the establishment of pre-positioning warehouse networks. In the pre-positioning strategy, critical relief inventories are located near the regions at which they will be needed in advance of the onset of the disaster. Therefore, pre-positioning reduces the response time by totally or partially eliminating the procurement phase and increasing the availability of relief items just after the disaster strikes. Once the pre-positioning warehouse locations are decided and warehouses on those locations become operational, they will be in use for a long time. Therefore, the chosen locations should be robust enough to enable extensions, and to cope with changing trends in disaster types, locations and magnitudes. In this study, we analyze the effects of natural disaster trends on the expansion plan of pre-positioning warehouse network implemented by CARE International. We utilize a facility location model to identify the additional warehouse location(s for relief items to be stored as an extension of the current warehouse network operated by CARE International, considering changing natural disaster trends observed over the past three decades.
Huibers, L.; Philips, H.; Giesen, P.; Remmen, R.; Christensen, M.B.; Bondevik, G.T.
Abstract Background and rationale: European countries face similar challenges in the provision of health care. Demographic factors like ageing, population growth, changing patient behaviour, and lack of work force lead to increasing demands, costs, and overcrowding of out-of-hours (OOH) care (i.e. p
Grant Richard W
Full Text Available Abstract Background Body mass index (BMI will be a reportable health measure in the United States (US through implementation of Healthcare Effectiveness Data and Information Set (HEDIS guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network. Methods We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m2, overweight (OW, 25-29.9, and obese (OB, ≥ 30. We measured documentation (yes/no and control (above/below of the following three risk factors: blood pressure (BP ≤130/≤85 mmHg, low-density lipoprotein (LDL ≤130 mg/dL (3.367 mmol/L, and fasting glucose Results BMI was documented in 48,376 patients (61%, range 34-94%, distributed as 30% OB, 34% OW, and 36% NW. Documentation of all three risk factors was higher in obesity (OB = 58%, OW = 54%, NW = 41%, p for trend Conclusions In a large primary care network BMI documentation has been incomplete and for patients with BMI measured, risk factor control has been poorer in obese patients compared with NW, even in those with obesity and CVD or diabetes. Better knowledge of BMI could provide an opportunity for improved quality in obesity care.
Seyed Kazem Malakouti
Full Text Available Objective. To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. Methodology. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. Results. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ2=14.8, P<0.001. We also found a reduction in the rate of suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Conclusion. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas.
Asboe, Mark; Fernandes, Joao; Grönvall, Erik
This paper presents an ongoing project that focuses on improving the quality of life for senior citizens by developing IT support for independent living in their homes. We introduce a concept that explores and supports coordination within a social and care community targeting elderly people. The...... paper reports on early project findings such as how elderly perceive a touch screen based interface and why a touch screen based interface might be favorable for this category of users in respect to a standard PC. Furthermore, This paper contributes to the societal debate on how IT may support ageing in...
Jorstedt, Jakob; Engqvist, Emma
Consumers are increasingly adopting new ways of purchasing and consuming hair care products, utilizing multiple channels (showrooming) in a hair care market where E-commerce actors are increasingly offering premium products at low price points. While previous research has extensively portrayed consumers as the central actor and villain of showrooming, this paper has instead focused its purpose and empirical investigation on the act ions and relationships between consumers, hairdressers, L’Oré...
T.V.P.Sundararajan; Shanmugam, A
Problem statement: Health monitoring, telemedicine, military, interactive entertainment and portable audio/video systems were most promising applications where WBANs can be used. However, designers of such systems face a number of challenging tasks, as they need to address often quite conflicting requirements for size, operating time, precision and reliability. Network security is very important in Wireless Body Area Network (WBAN) since the vital human life might be jeopardized, unless manag...
Fleurence, Rachael L; Beal, Anne C; Sheridan, Susan E; Johnson, Lorraine B; Selby, Joe V
The era of big data, loosely defined as the development and analysis of large or complex data sets, brings new opportunities to empower patients and their families to generate, collect, and use their health information for both clinical and research purposes. In 2013 the Patient-Centered Outcomes Research Institute launched a large national research network, PCORnet, that includes both clinical and patient-powered research networks. This article describes these networks, their potential uses, and the challenges they face. The networks are engaging patients, family members, and caregivers in four key ways: contributing data securely, with privacy protected; including diverse and representative groups of patients in research; prioritizing research questions, participating in research, and disseminating results; and participating in the leadership and governance of patient-powered research networks. If technical, regulatory, and organizational challenges can be overcome, PCORnet will allow research to be conducted more efficiently and cost-effectively and results to be disseminated quickly back to patients, clinicians, and delivery systems to improve patient health. PMID:25006148
Full Text Available BackgroundAn interactive web tool has been developed for facilitating shared decision-making in dementia-care networks. The DecideGuide provides a chat function for easier communication between network members, a deciding together function for step-by-step decision-making, and an individual opinion function for eight dementia-related life domains. The aim of this study was to gain insight in the user friendliness of the DecideGuide, user acceptance and satisfaction, and participants’ opinion of the DecideGuide for making decisions.Materials and methodsA 5-month field study included four dementia-care networks (19 participants in total. The data derived from structured interviews, observations, and information that participants logged in the DecideGuide. Structured interviews took place at the start, middle, and end of the field study with people with dementia, informal caregivers, and case managers. Results1. The user friendliness of the chat and individual opinion functions was adequate for case managers and most informal caregivers. Older participants, with or without dementia, had some difficulties using a tablet and the DecideGuide. The deciding together function does not yet provide adequate instructions for all. The user interface needs simplification. 2. User acceptance and satisfaction: everybody liked the chat’s easy communication, handling difficult issues for discussion, and the option of individual opinions. 3. The DecideGuide helped participants structure their thoughts. They felt more involved and shared more information about daily issues than before. ConclusionParticipants found the DecideGuide valuable in decision-making. The chat function seems powerful in helping members engage with one another constructively. Such engagement is a prerequisite for making shared decisions. Regardless of participants’ use of the tool, they saw the DecideGuide's added value.
Fleming, D.M.; Schellevis, F.G.; Paget, W.J.
BACKGROUND: The health monitoring programme of the European Commission has proposed a set of health indicators whereby the health status of member states can be measured. As part of that programme we considered how primary care might contribute relevant data. METHODS: Using a questionnaire distribut
Bennett, Anne; Pourmand, Ali; Shokoohi, Hamid; Shesser, Robert; Sanchez, Jesus; Joyce, Joseph
The use of Facebook is ubiquitous among both patients and physicians. Often Facebook intrudes into medical practice, thereby highlighting its potential to be either a positive or negative factor in a patient's medical care. Despite being a "hot topic" in the medical literature, very few real world examples exist of physicians actually using information obtained from Facebook to reach a diagnosis or otherwise affect patient care. We present a case involving a 13-year-old girl who posted photographs and captions on Facebook demonstrating suicidal ideation. The patient's parents were alerted to the girl's statements in her Facebook profile and brought her to the emergency department. The girl's statements and photographs, as reported by her parents, were used by an emergency physician to make a diagnosis of suicidal risk and to disposition of the patient to an inpatient psychiatric ward. We discuss the potential diagnostic utility of information posted on Facebook and briefly discuss the ethical questions surrounding this situation. PMID:24160899
Full Text Available Abstract Background People with mental disorders have a higher prevalence of physical illnesses and reduced life expectancy as compared with the general population. However, there is a lack of knowledge across Europe concerning interventions that aim at reducing somatic morbidity and excess mortality by promoting behaviour-based and/or environment-based interventions. Methods and design HELPS is an interdisciplinary European network that aims at (i gathering relevant knowledge on physical illness in people with mental illness, (ii identifying health promotion initiatives in European countries that meet country-specific needs, and (iii at identifying best practice across Europe. Criteria for best practice will include evidence on the efficacy of physical health interventions and of their effectiveness in routine care, cost implications and feasibility for adaptation and implementation of interventions across different settings in Europe. HELPS will develop and implement a "physical health promotion toolkit". The toolkit will provide information to empower residents and staff to identify the most relevant risk factors in their specific context and to select the most appropriate action out of a range of defined health promoting interventions. The key methods are (a stakeholder analysis, (b international literature reviews, (c Delphi rounds with experts from participating centres, and (d focus groups with staff and residents of mental health care facilities. Meanwhile a multi-disciplinary network consisting of 15 European countries has been established and took up the work. As one main result of the project they expect that a widespread use of the HELPS toolkit could have a significant positive effect on the physical health status of residents of mental health and social care facilities, as well as to hold resonance for community dwelling people with mental health problems. Discussion A general strategy on health promotion for people with mental
M N Hindia; T. A. Rahman; H. Ojukwu; Hanafi, E. B.; Fattouh, A.
As the enterprise of the "Internet of Things" is rapidly gaining widespread acceptance, sensors are being deployed in an unrestrained manner around the world to make efficient use of this new technological evolution. A recent survey has shown that sensor deployments over the past decade have increased significantly and has predicted an upsurge in the future growth rate. In health-care services, for instance, sensors are used as a key technology to enable Internet of Things oriented health-car...
Quinn, John A.; Nakasi, Rose; Mugagga, Pius K. B.; Byanyima, Patrick; Lubega, William; Andama, Alfred
Point of care diagnostics using microscopy and computer vision methods have been applied to a number of practical problems, and are particularly relevant to low-income, high disease burden areas. However, this is subject to the limitations in sensitivity and specificity of the computer vision methods used. In general, deep learning has recently revolutionised the field of computer vision, in some cases surpassing human performance for other object recognition tasks. In this paper, we evaluate...
HINDIA, M. N.; T.A.Rahman; Ojukwu, H.; Hanafi, E. B.; Fattouh, A.
As the enterprise of the “Internet of Things” is rapidly gaining widespread acceptance, sensors are being deployed in an unrestrained manner around the world to make efficient use of this new technological evolution. A recent survey has shown that sensor deployments over the past decade have increased significantly and has predicted an upsurge in the future growth rate. In health-care services, for instance, sensors are used as a key technology to enable Internet of Things oriented health-car...
Price, Richard; MacLennan, Graeme; Glen, John
Objectives To determine the effect on mortality of selective digestive decontamination, selective oropharyngeal decontamination, and topical oropharyngeal chlorhexidine in adult patients in general intensive care units and to compare these interventions with each other in a network meta-analysis. Design Systematic review, conventional meta-analysis, and network meta-analysis. Medline, Embase, and CENTRAL were searched to December 2012. Previous meta-analyses, conference abstracts, and key jou...
Lo, Benny P L; Ip, Henry; Yang, Guang-Zhong
Despite the myriad assistive technologies that have been developed over the years, high installation costs and limited functionalities have prevented their widespread adoption. To overcome these barriers, the concept of body sensor networks (BSNs) was introduced, which proposes the development of miniaturized wireless sensing systems to continuously capture physiological signals and context information. Many novel sensing platforms have since been introduced, enabling pervasive monitoring of blood pressure, Galvanic skin response, electrocardiogram (EKG), gait, photoplethysmogram (PPG), and other vital signs. PMID:26799719
Sofaer, Shoshanna; Bazzoli, Gloria J; Alexander, Jeffrey A; Conrad, Douglas A; Hasnain-Wynia, Romana; Shortell, Stephen M; Margolin, Frances; Pittman, Mary; Casey, Elizabeth; Ladenheim, Kala; Mauery, D Richard; Zukoski, Ann P
Evaluations of multisite community-based projects are notoriously difficult to conceptualize and conduct. Projects may share an overarching vision but operate in varying contexts and pursue different initiatives. One tool that can assist evaluators facing these challenges is to develop a "theory of action" (TOA) that identifies critical assumptions regarding how a program expects to achieve its goals. Community Care Network (CCN) evaluators used the TOA to refine research questions, define key variables, relate questions to each other, and identify when we might realistically expect to observe answers. In this article, the authors present their national-level CCN TOA. They also worked with sites to help them "surface" their local TOA; the article analyzes the results to determine the content, clarity, extent of evidence base, and strategic orientation of theories articulated by different sites. PMID:14687428
Mhoira EF Leng
Full Text Available What make a good doctor is a question posed by the public and profession and is key when designing training programmes. The goal of training is to change practice not simply acquire knowledge yet too often curriculums and assessment focuses on knowledge and skills. Professional practice is underpinned by beliefs and values and therefore training may need to challenge deeply held values in order to result in a change in practice. Palliative care offers an opportunity to challenge values at a deeply personal level as it brings experiences of pain and suffering alongside clinical knowledge and skills. Palliative care is holistic and so real scenarios where physical, psychological, social and spiritual issues are evident can be presented in an interactive, learner centered environment. Training in ethics alongside clinical skills will assist the development of judgment which should also be assessed. Communication skills enable the clinician to hear and understand the needs and wishes of those facing life limiting illness. Training should include aspects of modeling and mentorship to demonstrate and integrate the learning with the realities of clinical practice and include those who lead and influence policy and advocacy.
Schweikardt, C.; Verheij, R.A.; Donker, G.A.; Coppieters, Y.
Aim: The Dutch Sentinel General Practice Network (SGPN) was founded in 1970 for disease surveillance in primary care, based on paper questionnaires. Advances in information technology offered new prospects of data collection from electronic health records (EHRs). This study investigates the resultin
Full Text Available This paper presents the Wi-Fi phone with RFID (Radio frequency identification of student entered the school, via Wireless Access Points (APs of school will transmit MAC address with RFID of Wi-Fi phone to Internet Data Center (IDC for server and then the message exchanged by using GSM (or 3G has been transmitted message (or mail to the mobile user of parents (or client user. The wireless access points support broadcasting multiple SSIDs, each of which can have a different set of security and network setting. The RADIUS server is used to authenticate the Wireless Access Point (AP and mobile nodes. In safety case system, we used the several authentication and encryption options for the WLAN. We will discuss the use of Wi-Fi protected Access (WPA, RFID, IP Security (IPSec, and Secure Socket Layer (SSL, and there are high Quality of service (QoS and performance.
Bornkessel, Alexandra; Furberg, Robert; Lefebvre, R Craig
Social media brings a new dimension to health care for patients, providers, and their support networks. Increasing evidence demonstrates that patients who are more actively involved in their healthcare experience have better health outcomes and incur lower costs. In the field of cardiology, social media are proposed as innovative tools for the education and update of clinicians, physicians, nurses, and medical students. This article reviews the use of social media by healthcare providers and patients and proposes a model of "networked care" that integrates the use of digital social networks and platforms by both patients and providers and offers recommendations for providers to optimize their use and understanding of social media for quality improvement. PMID:24947833
Improving network performance in the health care system: a network-based analysis of the Hungarian health care services = A hálózati teljesítmény javítása az egészségügyi rendszerben: a magyar egészségügyi szolgáltatások hálózati megközelítésű elemzése
The dissertation aims to contribute to better understanding of what role networks play in the organisation of health services, and how networks can contribute to better performance in the health care sector. Literature about performance measurement and management of public services as well as network research in public administration and public management was reviewed, and served as a solid theoretical base for the empirical research. Examples from the health care sector were provided through...
Huerta Munoz Ulises
Full Text Available Abstract Background Primary health care is essential in improving and maintaining the health of populations. It has the potential to accelerate achievement of the Millennium Development Goals and fulfill the “Health for All” doctrine of the Alma-Ata Declaration. Understanding the performance of the health system from a geographic perspective is important for improved health planning and evidence-based policy development. The aims of this study were to measure geographical accessibility, model spatial coverage of the existing primary health facility network, estimate the number of primary health facilities working under capacity and the population underserved in the Western Province of Rwanda. Methods This study uses health facility, population and ancillary data for the Western Province of Rwanda. Three different travel scenarios utilized by the population to attend the nearest primary health facility were defined with a maximum travelling time of 60 minutes: Scenario 1 – walking; Scenario 2 – walking and cycling; and Scenario 3 – walking and public transportation. Considering these scenarios, a raster surface of travel time between primary health facilities and population was developed. To model spatial coverage and estimate the number of primary health facilities working under capacity, the catchment area of each facility was calculated by taking into account population coverage capacity, the population distribution, the terrain topography and the travelling modes through the different land categories. Results Scenario 2 (walking and cycling has the highest degree of geographical accessibility followed by Scenario 3 (walking and public transportation. The lowest level of accessibility can be observed in Scenario 1 (walking. The total population covered differs depending on the type of travel scenario. The existing primary health facility network covers only 26.6% of the population in Scenario 1. In Scenario 2, the use of a bicycle
McDougall, A; Goldszmidt, M; Kinsella, E A; Smith, S; Lingard, L
Despite calls for more interprofessional and intraprofessional team-based approaches in healthcare, we lack sufficient understanding of how this happens in the context of patient care teams. This multi-perspective, team-based interview study examined how medical teams negotiated collaborative tensions. From 2011 to 2013, 50 patients across five sites in three Canadian provinces were interviewed about their care experiences and were asked to identify members of their health care teams. Patient-identified team members were subsequently interviewed to form 50 "Team Sampling Units" (TSUs), consisting of 209 interviews with patients, caregivers and healthcare providers. Results are gathered from a focused analysis of 13 TSUs where intraprofessional collaborative tensions involved treating fluid overload, or edema, a common HF symptom. Drawing on actor-network theory (ANT), the analysis focused on intraprofessional collaboration between specialty care teams in cardiology and nephrology. The study found that despite a shared narrative of common purpose between cardiology teams and nephrology teams, fluid management tools and techniques formed sites of collaborative tension. In particular, care activities involved asynchronous clinical interpretations, geographically distributed specialist care, fragmented forms of communication, and uncertainty due to clinical complexity. Teams 'disentangled' fluid in order to focus on its physiological function and mobilisation. Teams also used distinct 'framings' of fluid management that created perceived collaborative tensions. This study advances collaborative entanglement as a conceptual framework for understanding, teaching, and potentially ameliorating some of the tensions that manifest during intraprofessional care for patients with complex, chronic disease. PMID:27490299
In the field of wearable biomedical sensors, the convergence revolution is more than a fanciful, utopian view of the way innovation should be done. Medical-grade wearable sensors rely on it. Their development requires technical know-how, computing expertise, clinical input, and collaboration-a true meeting of the minds to permit the conversion of wearables from neat gadgets into practical and proficient tools that will propel health care to new heights. Beyond the increasing miniaturization of hardware and the shift to wireless communication technology, flexible electronics and more powerful computing capabilities, including application specific integrated circuits (ASICs) and microelectromechanical systems (MEMS), have enabled new work on body sensor networks (BSNs) that monitor, analyze, and make sense of body signals for the prevention, diagnosis, and treatment of health disorders. Developments in processing, such as sensor-connected nodes combined with evolving algorithms and decreasing power requirements, have also contributed. In addition, new approaches to subjective measures (pain and emotion) have opened possibilities. PMID:26799721
Full Text Available Coordinate rotation digital computer (CORDIC is an efficient algorithm for computations of trigonometric functions. Scaling-free-CORDIC is one of the famous CORDIC implementations with advantages of speed and area. In this paper, a novel direct digital frequency synthesizer (DDFS based on scaling-free CORDIC is presented. The proposed multiplier-less architecture with small ROM and pipeline data path has advantages of high data rate, high precision, high performance, and less hardware cost. The design procedure with performance and hardware analysis for optimization has also been given. It is verified by Matlab simulations and then implemented with field programmable gate array (FPGA by Verilog. The spurious-free dynamic range (SFDR is over 86.85 dBc, and the signal-to-noise ratio (SNR is more than 81.12 dB. The scaling-free CORDIC-based architecture is suitable for VLSI implementations for the DDFS applications in terms of hardware cost, power consumption, SNR, and SFDR. The proposed DDFS is very suitable for medical instruments and body care area network systems.
Zillich, Alan J; Saseen, Joseph J; Dehart, Renee M; Dumo, Peter; Grabe, Darren W; Gilmartin, Cheryl; Hachey, David M; Hudson, Joanna Q; Pruchnicki, Maria C; Joy, Melanie S
An increasing number of patients are developing chronic kidney disease (CKD). Appropriate care for patients with CKD must occur in the earliest stages, preferably before CKD progresses to more severe stages. Therefore, recognition and treatment of CKD and its associated complications must occur in primary care settings. Patients with CKD often have comorbid conditions such as diabetes mellitus, hypertension, and dyslipidemia, creating specific considerations when treating these diseases. Also, these patients have CKD-related conditions, including anemia and renal osteodystrophy, that are not traditionally evaluated and monitored by the primary care practitioner. Collectively, many opportunities exist for pharmacists who practice in the primary care setting to improve the care of patients with CKD. PMID:15767229
Rauno Lindholm, Daniel; Boisen Devantier, Lykke; Nyborg, Karoline Lykke; Høgsbro, Andreas; de Fries, Louise Skovlund
The purpose of this project was to examine what influencing factor that has had an impact on the presumed increasement of the use of networking among academics on the labour market and how it is expressed. On the basis of the influence from globalization on the labour market it can be concluded that the globalization has transformed the labour market into a market based on the organization of networks. In this new organization there is a greater emphasis on employees having social...
Full Text Available A proposta de organização de redes de atenção à saúde tem sido incluída no grande campo do "cuidado integrado", denominação genérica que agrupa intervenções que variam muito em objetivos e escopo, tendo em comum a busca por mecanismos e instrumentos de integração do cuidado. Entre as experiências consideradas centrais, estão os sistemas integrados americanos e as redes regionalizadas dos sistemas nacionais de saúde, especialmente após a adoção de novos mecanismos de cooperação. No entanto, ainda que possam ser observadas semelhanças nas estratégias e arranjos organizacionais, é fundamental contextualizar o debate. Não considerar a natureza distinta dos sistemas de saúde tende a obscurecer diferenças centrais do âmbito da política, que condicionam as possibilidades de aplicação em um dado sistema de instrumentos desenvolvidos em outro contexto. Este artigo tem por objetivo buscar referências na literatura e na experiência internacional que possam contribuir para o debate da constituição de redes no SUS. Busca contextualizar a discussão da organização de serviços de saúde "em redes" em dois casos, o sistema nacional de saúde britânico e o sistema privado americano, focalizando especificamente no recorte da organização de serviços.The proposal of organization in health services networks has been included in the broad field of integrated health care, a general denomination which includes a wide range of interventions varying in objectives and scope, which have in common the pursuit of integration strategies and tools. Among the main experiences in the field are the American integrated delivery systems and the traditional regionalized networks of the national health systems, especially after the introduction of new cooperation strategies. However, while strategies and organizational arrangements might be similar, context is central to debate. Not considering differences concerning health systems nature
Gini, Rosa; Schuemie, Martijn; Brown, Jeffrey; Ryan, Patrick; Vacchi, Edoardo; Coppola, Massimo; Cazzola, Walter; Coloma, Preciosa; Berni, Roberto; Diallo, Gayo; Oliveira, José Luis; Avillach, Paul; Trifirò, Gianluca; Rijnbeek, Peter; Bellentani, Mariadonata
Introduction: We see increased use of existing observational data in order to achieve fast and transparent production of empirical evidence in health care research. Multiple databases are often used to increase power, to assess rare exposures or outcomes, or to study diverse populations. For privacy and sociological reasons, original data on individual subjects can’t be shared, requiring a distributed network approach where data processing is performed prior to data sharing. Case Descriptions...
Osborn, D. P.; Horsfall, L.; Hassiotis, A.; Petersen, I.; Walters, K; Nazareth, I
Objectives To assess whether people with learning disability in the UK have poorer access to cancer screening. Design Four cohort studies comparing people with and without learning disability, within the recommended age ranges for cancer screening in the UK. We used Poisson regression to determine relative incidence rates of cancer screening. Setting The Health Improvement Network, a UK primary care database with over 450 General practices. Participants Individuals with a...
Martinho Braga Batista e Silva
Full Text Available Tendo em vista o processo paulatino de responsabilização de atores e instâncias sociais pelo cuidado no contexto da Reforma Psiquiátrica brasileira, percebe-se que familiares e vizinhos de pacientes psiquiátricos têm sido instigados a " participar" da política pública, principalmente no lugar de " suporte social" , embora oficialmente considerados " parceiros" . Essa reconfiguração da relação entre Estado e sociedade civil é consagrada pela diretriz governamental de tomada de responsabilidade dos serviços pelo território, uma mudança da lógica de demanda e oferta de atendimento no sentido de estimular serviços extra-hospitalares - como os Centros de Atenção Psicossocial, campo desse estudo - a se encarregarem pela população adscrita a uma área geográfica. O objetivo desse texto é investigar as tecnologias psicossociais produzidas nesse contexto político, institucional e histórico específico, tais como a mediação de trocas sociais e a arbitragem de conflitos. Um dos materiais analisados são os registros em prontuário, que podem constituir os atores e instâncias sociais citados como envolvidos no campo da saúde mental, enredando-os na malha administrativa construída como rede de suporte social.In the context of the Brazilian Psychiatric Reform family members and neighbors of psychiatric patients have been urged to " participate" in the public policies, mainly as " social support" although officially considered " partners" . This reconfiguration of the relationship between State and civil society is reflected in the directive that the services have to take over the responsibility for territories, a change in the logic of supply and demand aimed at stimulating extra-hospital services such as Psychosocial Care Centers, the object of this study, to provide care to the population of a certain geographical area. The purpose of this article is to investigate the psychosocial technologies produced in this specific
Rogers, Anne; Vassilev, Ivaylo; Brooks, Helen; Kennedy, Anne; Blickem, Christian
Background Primary care professionals are presumed to play a central role in delivering long-term condition management. However the value of their contribution relative to other sources of support in the life worlds of patients has been less acknowledged. Here we explore the value of primary care professionals in people’s personal communities of support for long-term condition management. Methods A mixed methods survey with nested qualitative study designed to identify relationships and socia...
Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H
Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. PMID:26116611
Supporting Goal-Oriented Primary Health Care for Seniors with Complex Care Needs Using Mobile Technology: Evaluation and Implementation of the Health System Performance Research Network, Bridgepoint Electronic Patient Reported Outcome Tool
Wodchis, Walter P; Upshur, Ross; Cott, Cheryl; McKinstry, Brian; Mercer, Stewart; Palen, Ted E; Ramsay, Tim; Thavorn, Kednapa
health care systems. We have partnered with family health teams and quality improvement organizations in Ontario to ensure that our research is practical and that findings are shared widely. We will work with our established international network to develop an implementation framework to support continued adaptation and adoption across Canada and internationally. PMID:27341765
The objective of this article is to understand coordination as it unfolds in case management practices in the context of integrated care networks devoted to frail elderly individuals. More specifically, we describe practical coordination processes. We conducted a qualitative exploratory study using an embedded case study design. Our study covers three health and social service centers in Québec. We noted that coordination produces convention in case management practices through a process of bringing together different types of compromise in home care situations where multidimensionality appears to be more or less important. We constructed four different types of compromise-producing convention with regard to coordination in case management practices: compromise at the interface, scheduling compromise, compromise of opportunity, and compromising change. PMID:23880440
Schüler, G; Klaes, L; Rommel, A; Schröder, H; Köhler, T
Demographic change, advances in medicine, and innovative health care services are leading to changes in the professional qualification requirements for nursing and care staff. Detecting future trends in relation to these requirements was the focus of a Delphi study developed as part of the BMBF FreQueNz initiative. After qualitative expert interviews, data collection was organized in three consecutive steps, with 243 interviews realized in the second wave. It was found that home care will further diversify in the fields of supporting and counseling services as well as in palliative care, resulting in the necessary expansion of specific qualifications (e.g., intensive care). Moreover, there will be an increased need for interprofessional, intersectoral, and intercultural coordination and communication skills. As a consequence of the delegation of medical tasks, new duties for nonmedical professions in inpatient and outpatient care will also arise. For instance, qualifications need to be tailored to the new demands of assessment, diagnostics, therapy, and patient education and they should take into account evidence-based knowledge as well as clinical practice guidelines. Consequently, the system of care professionals will further diversify through advanced training programs and the continued academization of nursing. PMID:23884530
Olsen, Pia Riis; Lorenzo, Rosalía
This chapter takes its point of departure in psychosocial aspects of supportive care in adolescent and young adult cancer care. The purpose is to describe some of the challenges that these young people face following a cancer diagnosis and guide healthcare professionals in how to provide care that improves the quality of life. In most hospitals and healthcare systems, adolescents and young adults are cared for and treated in settings for children or adults. Accordingly, healthcare professionals may lack attention to and knowledge about what characterize young peoples' life situation, their special needs and how to meet them. The topics we include in the chapter are the following: the youth friendly environment, social support and social network, parents, information during a psychosocial crisis event, the use of HEADSS, peer support, fertility, body image and self-esteem, after treatment and future challenges and palliative and end of life care. PMID:27595353
Hill, Nikki L; Penrod, Janice; Milone-Nuzzo, Paula
Translational research is a leading trend in science with the aim of bridging the research-practice gap to significantly speed the implementation of effective interventions in clinical practice. Integrating the values and preferences of older adults and their families into this process is critical to the success of translational research. Engaging communities in meaningful research is an important part of advancing translational science in which older adults are partners in developing solutions to the health needs of individuals within communities. The current article describes one approach to developing an infrastructure (i.e., community-based nursing research network) to support patient-centered care within translational research. Nurses are uniquely poised and prepared to assume leadership roles in community-based research networks to support a true collaboration among stakeholders that prizes the voices of older adults and integrates them into practice efforts. PMID:25275784
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Highlights: • We systematically review scientific literature about health-care waste management. • We identify and discuss gaps, trends, efforts, and key-factors. • We suggest areas for improvement and best practices reported in literature. • We include recommendations for policy makers, practitioners and researchers. • We promote a holistic and harmonized approach to health-care waste management. - Abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology
Webber, Martin; Reidy, Hannah; Ansari, David; Stevens, Martin; Morris, David
People with severe mental health problems such as psychosis have access to less social capital, defined as resources within social networks, than members of the general population. However, a lack of theoretically and empirically informed models hampers the development of social interventions which seek to enhance an individual's social networks. This paper reports the findings of a qualitative study, which used ethnographic field methods in six sites in England to investigate how workers helped people recovering from psychosis to enhance their social networks. This study drew upon practice wisdom and lived experience to provide data for intervention modelling. Data were collected from 73 practitioners and 51 people who used their services in two phases. Data were selected and coded using a grounded theory approach to depict the key themes that appeared to underpin the generation of social capital within networks. Findings are presented in four over-arching themes - worker skills, attitudes and roles; connecting people processes; role of the agency; and barriers to network development. The sub-themes which were identified included worker attitudes; person-centred approach; equality of worker-individual relationship; goal setting; creating new networks and relationships; engagement through activities; practical support; existing relationships; the individual taking responsibility; identifying and overcoming barriers; and moving on. Themes were consistent with recovery models used within mental health services and will provide the basis for the development of an intervention model to enhance individuals' access to social capital within networks. PMID:25441461
Creating High-Quality Health Care Workplaces. A Background Paper for Canadian Policy Research Networks' National Roundtable (Ottawa, Ontario, Canada, October 29, 2001). CPRN Work Network Discussion Paper.
Koehoorn, Mieke; Lowe, Graham S.; Rondeau, Kent V.; Schellenberg, Grant; Wagar, Terry H.
Insights from a variety of research streams were synthesized to identify the key ingredients of a high-quality work environment in Canada's health care sector and ways of achieving high-quality workplaces in the sector. The following sets of interacting factors were considered: (1) the work environment and the human resource practices that shape…
Liechty Edward A
Full Text Available Abstract Background Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes. Methods/Design We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and improvement of quality of care in health facilities on perinatal mortality in low and middle-income countries where the majority of births take place in homes or first level care facilities. This trial will take place in 106 clusters (300-500 deliveries per year each across 7 sites of the Global Network for Women's and Children's Health Research in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. The trial intervention has three key elements, community mobilization, home-based life saving skills for communities and birth attendants, and training of providers at obstetric facilities to improve quality of care. The primary outcome of the trial is perinatal mortality. Secondary outcomes include rates of stillbirth, 7-day neonatal mortality, maternal death or severe morbidity (including obstetric fistula, eclampsia and obstetrical sepsis and 28-day neonatal mortality. Discussion In this trial, we are evaluating a combination of interventions including community mobilization and facility training in an attempt to improve pregnancy outcomes. If successful, the results of this trial will provide important information for policy makers and clinicians as they attempt to improve delivery services for pregnant
Gini, Rosa; Schuemie, Martijn; Brown, Jeffrey; Ryan, Patrick; Vacchi, Edoardo; Coppola, Massimo; Cazzola, Walter; Coloma, Preciosa; Berni, Roberto; Diallo, Gayo; Oliveira, José Luis; Avillach, Paul; Trifirò, Gianluca; Rijnbeek, Peter; Bellentani, Mariadonata; van Der Lei, Johan; Klazinga, Niek; Sturkenboom, Miriam
Introduction: We see increased use of existing observational data in order to achieve fast and transparent production of empirical evidence in health care research. Multiple databases are often used to increase power, to assess rare exposures or outcomes, or to study diverse populations. For privacy and sociological reasons, original data on individual subjects can’t be shared, requiring a distributed network approach where data processing is performed prior to data sharing. Case Descriptions and Variation Among Sites: We created a conceptual framework distinguishing three steps in local data processing: (1) data reorganization into a data structure common across the network; (2) derivation of study variables not present in original data; and (3) application of study design to transform longitudinal data into aggregated data sets for statistical analysis. We applied this framework to four case studies to identify similarities and differences in the United States and Europe: Exploring and Understanding Adverse Drug Reactions by Integrative Mining of Clinical Records and Biomedical Knowledge (EU-ADR), Observational Medical Outcomes Partnership (OMOP), the Food and Drug Administration’s (FDA’s) Mini-Sentinel, and the Italian network—the Integration of Content Management Information on the Territory of Patients with Complex Diseases or with Chronic Conditions (MATRICE). Findings: National networks (OMOP, Mini-Sentinel, MATRICE) all adopted shared procedures for local data reorganization. The multinational EU-ADR network needed locally defined procedures to reorganize its heterogeneous data into a common structure. Derivation of new data elements was centrally defined in all networks but the procedure was not shared in EU-ADR. Application of study design was a common and shared procedure in all the case studies. Computer procedures were embodied in different programming languages, including SAS, R, SQL, Java, and C++. Conclusion: Using our conceptual framework
Zakerolhosseini, Ali; Sokouti, Massoud; Pezeshkian, Massoud
Quick responds to heart attack patients before arriving to hospital is a very important factor. In this paper, a combined model of Body Sensor Network and Personal Digital Access using QTRU cipher algorithm in Wifi networks is presented to efficiently overcome these life threatening attacks. The algorithm for optimizing the routing paths between sensor nodes and an algorithm for reducing the power consumption are also applied for achieving the best performance by this model. This system is consumes low power and has encrypting and decrypting processes. It also has an efficient routing path in a fast manner. PMID:24252988
Boustani MA; Frame A; Munger S; Healey P; Westlund J; Farlow M; Hake A; Austrom MG; Shepard P; Bubp C; Azar J; Nazir A; Adams N; Campbell NL; Chehresa A
Malaz A Boustani,1–3 Amie Frame,1,2 Stephanie Munger,1,2 Patrick Healey,4 Jessie Westlund,5 Martin Farlow,6,7 Ann Hake,8 Mary Guerriero Austrom,6,9 Polly Shepard,10 Corby Bubp,10 Jose Azar,3 Arif Nazir,3 Nadia Adams,11 Noll L Campbell,1,2,12,13 Azita Chehresa,5 Paul Dexter2,31Indiana University Center for Aging Research, 2Regenstrief Institute, Inc, 3Department of Medicine, Indiana University School of Medicine (IUSM), 4St Vincent Health Network, 5Community Health Network, 6Indiana ...
Full Text Available Abstract Background Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters. Methods This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54 to analyze and evaluate the data. Results The findings are as follows: (1 Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2 After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3 Network security contributes a positive moderating effect on service quality and patient satisfaction. Conclusion It revealed that the impact of electronic workflow (online appointment system service on service quality was greater than electronic facilities (electronic medical record systems in technology-based service encounters. Convenience and
Fernando Sérgio Pereira de Sousa
Full Text Available Objetivou-se analisar o matriciamento como ferramenta articuladora da rede de atenção em saúde mental. Trata-se de uma pesquisa de natureza qualitativa, realizada no Nordeste brasileiro, no período de março a abril de 2010. Utilizaram-se para a coleta das informações a entrevista semiestruturada e a observação sistemática. Como participantes da pesquisa, incluíram-se 47 profissionais de saúde da Estratégia Saúde da Família e dos Centros de Atenção Psicossocial, distribuídos em dois grupos. Os dados foram organizados e analisados pelos pressupostos da análise de conteúdo articulando o teórico com o empírico. Em cumprimento ao exigido, o estudo foi submetido à análise do Comitê de Ética em Pesquisa adequando-se às normas da pesquisa envolvendo seres humanos. Segundo os resultados evidenciaram, o apoio matricial é uma estratégia potente, pois possibilita a construção de um sistema articulado em rede no SUS, não limitado às fronteiras de um dado serviço. Interconectado por uma equipe de referência, que mobiliza diversos atores para lidar com o andamento do caso, o apoio matricial sinaliza os caminhos que viabilizam a conexão de redes de cuidados em saúde mental.This study aimed to analyze the matrix support as an organizer tool of mental health care network. This is a qualitative survey, conducted in Brazilian Northeast, from March to April 2010. Systematic observations and semi-structured interviews were conducted with 47 health professionals from the Family Health Strategy and Psychosocial Care Centers. The collected information was organized and analyzed by content analysis. Pursuant to the requirements, the study was submitted to the Research Ethics Committee for adapting to the standards of research involving human beings. The results showed the matrix support as a powerful strategy since it enables the construction of a linkage in SUS network services, not limited to the borders of a specific service. Also
Seyed Kazem Malakouti; Marzieh Nojomi; Marjan Poshtmashadi; Mitra Hakim Shooshtari; Fariba Mansouri Moghadam; Afarin Rahimi-Movaghar; Susan Afghah; Jafar Bolhari; Shahrzad Bazargan-Hejazi
Objective. To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. Methodology. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Wester...
Serhan Duran; Melda Bozkurt
The increasing number of natural disasters in the last decade necessitates the increase in capacity and agility while delivering humanitarian relief. A common logistics strategy used by humanitarian organizations to respond this need is the establishment of pre-positioning warehouse networks. In the pre-positioning strategy, critical relief inventories are located near the regions at which they will be needed in advance of the onset of the disaster. Therefore, pre-positioning reduces the resp...
Marginean Roxana; Lucas Ramona; Lech Katarzyna; Larsen Jens; Lai Taavi; Hjorth Peter; Henderson John; Halis Ulaş; Germanavicius Arunas; Genova Aneta; Friedrich Fabian; Freidl Marion; Dragomirecka Eva; Dernovsek Mojca; Burton Alexandra
Abstract Background People with mental disorders have a higher prevalence of physical illnesses and reduced life expectancy as compared with the general population. However, there is a lack of knowledge across Europe concerning interventions that aim at reducing somatic morbidity and excess mortality by promoting behaviour-based and/or environment-based interventions. Methods and design HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical il...
Weiser, P.; Becker, T; Losert, C.; Altpekin, K.; Berti, L.; Burti, L.; Burton, A
Background People with mental disorders have a higher prevalence of physical illnesses and reduced life expectancy as compared with the general population. However, there is a lack of knowledge across Europe concerning interventions that aim at reducing somatic morbidity and excess mortality by promoting behaviour-based and/or environment-based interventions. Methods and design HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical ...
Pottegård, A; Tjäderborn, M; Schjerning, O;
general practice database. Methods This observational drug utilisation study (DUS) analysed pregabalin prescription data from the UK Health Improvement Network primary care database between September 2004 and July 2009. Patient demographics, diagnoses (by READ codes) and pregabalin dosing data were...... collected. Diagnosis codes were used as proxy for approved indication for pregabalin. Result A cohort of 18,951 patients was prescribed pregabalin; dosing information was available for 13,480 (71.1%). Median age of patients was 58 years, and majority were female (60.1%). Median (interquartile range...... approved dose of 600 mg/day. Of these, 18.4% (25/136) of patients had a history of substance abuse compared with 14.0% (1884/13,480) in the full population. Conclusion Data from this DUS indicated that the majority of pregabalin prescribing in the UK was consistent with product labelling. The proportion of...
Full Text Available Abstract Background Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare. Method We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN. We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops. Results We identified three types of intervention: pre-hospital; within the emergency department (ED; and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR – Patients at risk of readmission and ACG – Adjusted Clinical Groups sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission. Conclusions Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don’t change.
Olson Matthew D
Full Text Available Abstract Background Medical records that do not accurately reflect the patient’s current medication list are an open invitation to errors and may compromise patient safety. Methods This cross-sectional study compares primary care provider (PCP medication lists and pharmacy claims for 100 patients seen in 8 primary care practices and examines the association of congruence with demographic, clinical, and practice characteristics. Medication list congruence was measured as agreement of pharmacy claims with the entire PCP chart, including current medication list, visit notes, and correspondence sections. Results Congruence between pharmacy claims and the PCP chart was 65%. Congruence was associated with large chronic disease burden, frequent PCP visits, group practice, and patient age ≥45 years. Conclusion Agreement of medication lists between the PCP chart and pharmacy records is low. Medication documentation was more accurate among patients who have more chronic conditions, those who have frequent PCP visits, those whose practice has multiple providers, and those at least 45 years of age. Improved congruence among patients with multiple chronic conditions and in group practices may reflect more frequent visits and reviews by providers.
Full Text Available Abstract Background The goal of this project is to evaluate the implementation of an integrated and interdisciplinary program for prevention and management of cardiometabolic risk (PCMR. The intervention is based on the Chronic Care Model. The study will evaluate the implementation of the PCMR in 6 of the 12 health and social services centres (CSSS in Montréal, and the effects of the PCMR on patients and the practice of their primary care physicians up to 40 months following implementation, as well as the sustainability of the program. Objectives are: 1-to evaluate the effects of the PCMR and their persistence on patients registered in the program and the practice of their primary care physicians, by implementation site and degree of exposure to the program; 2-to assess the degree of implementation of PCMR in each CSSS territory and identify related contextual factors; 3-to establish the relationships between the effects observed, the degree of PCMR implementation and the related contextual factors; 4-to assess the impact of the PCMR on strengthening local services networks. Methods/Design The evaluation will use a mixed design that includes two complementary research strategies. The first strategy is similar to a quasi-experimental "before-after" design, based on a quantitative approach; it will look at the program's effects and their variations among the six territories. The effects analysis will use data from a clinical database and from questionnaires completed by participating patients and physicians. Over 3000 patients will be recruited. The second strategy corresponds to a multiple case study approach, where each of the six CSSS constitutes a case. With this strategy, qualitative methods will set out the context of implementation using data from semi-structured interviews with program managers. The quantitative data will be analyzed using linear or multilevel models complemented with an interpretive approach to qualitative data analysis
A new class of patient-driven health care services is emerging to supplement and extend traditional health care delivery models and empower patient self-care. Patient-driven health care can be characterized as having an increased level of information flow, transparency, customization, collaboration and patient choice and responsibility-taking, as well as quantitative, predictive and preventive aspects. The potential exists to both improve traditional health care systems and expand the concept...
Bossen, Claus; Christensen, Lars Rune; Grönvall, Erik;
Objectives The present study aims to augment the network of home care around elderly. We investigate the nature of cooperative work between relatives and home care workers around elderly persons; present the CareCoor system developed to support that work; and report experiences from two pilot tests...... persons. The design implications led to the development of a prototype, called CareCoor, which is accessible via a tablet PC and on the Internet. CareCoor was subsequently evaluated in two pilot tests. The first lasted a week and included three elderly, their next of kin and the affiliated home care...... workers, while the second test lasted for six weeks and involved five elderly people, their next of kin and relevant home care workers. Results In the paper we make three major points, namely, (1) home care work is highly cooperative in nature and involves substantial coordinative efforts on the part...
Breton, Mylaine; Maillet, Lara; Haggerty, Jeannie; Vedel, Isabelle
Background In 2004, the Québec government implemented an important reform of the healthcare system. The reform was based on the creation of new organisations called Health Services and Social Centres (HSSC), which were formed by merging several healthcare organisations. Upon their creation, each HSSC received the legal mandate to establish and lead a Local Health Network (LHN) with different partners within their territory. This mandate promotes a 'population-based approach' based to the responsibility for the population of a local territory. Objective The aim of this paper is to illustrate and discuss how primary healthcare organisations (PHC) are involved in mandated LHNs in Québec. For illustration, we describe four examples that facilitate a better understanding of these integrated relationships. Results The development of the LHNs and the different collaboration relationships are described through four examples: (1) improving PHC services within the LHN - an example of new PHC models; (2) improving access to specialists and diagnostic tests for family physicians working in the community - an example of centralised access to specialists services; (3) improving chronic-disease-related services for the population of the LHN - an example of a Diabetes Centre; and (4) improving access to family physicians for the population of the LHN - an example of the centralised waiting list for unattached patients. Conclusion From these examples, we can see that the implementation of large-scale reform involves incorporating actors at all levels in the system, and facilitates collaboration between healthcare organisations, family physicians and the community. These examples suggest that the reform provided room for multiple innovations. The planning and organisation of health services became more focused on the population of a local territory. The LHN allows a territorial vision of these planning and organisational processes to develop. LHN also seems a valuable lever when
Séror, Ann C
Background The Internet and emergent telecommunications infrastructures are transforming the future of health care management. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources. Objective To identify the effects of ideological differences on health care market infrastructures includ...
Bozorgmehr, K.; Szecsenyi, J.; Ose, D.; Besier, W.; Mayer, M.; Krisam, J.; Jacke, C.O.; Salize, H.J.; Brandner, R.; Schmitt, S.; Kiel, M.; Kamradt, M.; Freund, T.
BACKGROUND: Care management interventions in the German health-care system have been evaluated with promising results, but further research is necessary to explore their full potential in the context of multi-morbidity. Our aim in this trial is to assess the efficacy of a primary care practice netwo
David P J Osborn
Full Text Available To assess whether people with learning disability in the UK have poorer access to cancer screening.Four cohort studies comparing people with and without learning disability, within the recommended age ranges for cancer screening in the UK. We used Poisson regression to determine relative incidence rates of cancer screening.The Health Improvement Network, a UK primary care database with over 450 General practices.Individuals with a recorded diagnosis of learning disability including general diagnostic terms, specific syndromes, chromosomal abnormalities and autism in their General Practitioner computerised notes. For each type of cancer screening, a comparison cohort of up to six people without learning disability was selected for each person with a learning disability, using stratified sampling on age within GP practice.Incidence rate ratios for receiving 1 a cervical smear test, 2 a mammogram, 3 a faecal occult blood test and 4 a prostate specific antigen test.Relative rates of screening for all four cancers were significantly lower for people with learning disability. The adjusted incidence rate ratios (95% confidence intervals were Cervical smears: Number eligible with learning disability = 6,254; IRR = 0.54 (0.52-0.56. Mammograms: Number eligible with learning disability = 2,956; IRR = 0.76 (0.72-0.81; Prostate Specific Antigen: Number eligible = 3,520; IRR = 0.87 (0.80-0.96 and Faecal Occult Blood Number eligible = 6,566; 0.86 (0.78-0.94. Differences in screening rates were less pronounced in more socially deprived areas. Disparities in cervical screening rates narrowed over time, but were 45% lower in 2008/9, those for breast cancer screening appeared to widen and were 35% lower in 2009.Despite recent incentives, people with learning disability in the UK are significantly less likely to receive screening tests for cancer that those without learning disability. Other methods for reducing inequalities in access to cancer screening should be
Johnson Steven T
Full Text Available Abstract Background While strong and consistent evidence supports the role of lifestyle modification in the prevention and management of type 2 diabetes (T2DM, the best strategies for program implementation to support lifestyle modification within primary care remain to be determined. The objective of the study is to evaluate the implementation of an evidence-based self- management program for patients with T2DM within a newly established primary care network (PCN environment. Method Using a non-randomized design, participants (total N = 110 per group will be consecutively allocated in bi-monthly blocks to either a 6-month self-management program lead by an Exercise Specialist or to usual care. Our primary outcome is self-reported physical activity and pedometer steps. Discussion The present study will assess whether a diabetes self-management program lead by an Exercise Specialist provided within a newly emerging model of primary care and linked to available community-based resources, can lead to positive changes in self-management behaviours for adults with T2DM. Ultimately, our work will serve as a platform upon which an emerging model of primary care can incorporate effective and efficient chronic disease management practices that are sustainable through partnerships with local community partners. Clinical Trials Registration ClinicalTrials.gov identifier: NCT00991380
Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries
Veen Robert ER
Full Text Available Abstract Background Implementing a primary care clinical research study in several countries can make it possible to recruit sufficient patients in a short period of time that allows important clinical questions to be answered. Large multi-country studies in primary care are unusual and are typically associated with challenges requiring innovative solutions. We conducted a multi-country study and through this paper, we share reflections on the challenges we faced and some of the solutions we developed with a special focus on the study set up, structure and development of Primary Care Networks (PCNs. Method GRACE-01 was a multi-European country, investigator-driven prospective observational study implemented by 14 Primary Care Networks (PCNs within 13 European Countries. General Practitioners (GPs recruited consecutive patients with an acute cough. GPs completed a case report form (CRF and the patient completed a daily symptom diary. After study completion, the coordinating team discussed the phases of the study and identified challenges and solutions that they considered might be interesting and helpful to researchers setting up a comparable study. Results The main challenges fell within three domains as follows: i selecting, setting up and maintaining PCNs; ii designing local context-appropriate data collection tools and efficient data management systems; and iii gaining commitment and trust from all involved and maintaining enthusiasm. The main solutions for each domain were: i appointing key individuals (National Network Facilitator and Coordinator with clearly defined tasks, involving PCNs early in the development of study materials and procedures. ii rigorous back translations of all study materials and the use of information systems to closely monitor each PCNs progress; iii providing strong central leadership with high level commitment to the value of the study, frequent multi-method communication, establishing a coherent ethos
Dedecker, Peter; Hoebeke, Jeroen; Moerman, Ingrid; Demeester, Piet
The internet is evolving towards a large "network of networks", integrating a large number of different networking technologies and offering users broadband connectivity at any time and place. As such users can enjoy more interactive, multi-media driven content (Web 2.0). however, many scenarios (personal networks, collaborative working, health care networks, emergency networks...) require secure communication between a limited number of possible distributed and mobile devices and for a varie...
MacDonald, Sarah; Gatto, Molly; Walker, Deb; Turchi, Renee
This is the first article in a year long series that presents the experiences of a fictitious couple, Amita and Samir, as they learn to adapt to the reality of having a premature baby with special needs. Doris, the fictitious nurse who took care of baby Anjali in the neonatal intensive care unit (NICU), has had ten years of experience working in…
Protocol for an economic evaluation alongside the University Health Network Whiplash Intervention Trial: cost-effectiveness of education and activation, a rehabilitation program, and the legislated standard of care for acute whiplash injury in Ontario
van der Velde Gabrielle
Full Text Available Abstract Background Whiplash injury affects 83% of persons in a traffic collision and leads to whiplash-associated disorders (WAD. A major challenge facing health care decision makers is identifying cost-effective interventions due to lack of economic evidence. Our objective is to compare the cost-effectiveness of: 1 physician-based education and activation, 2 a rehabilitation program developed by Aviva Canada (a group of property and casualty insurance providers, and 3 the legislated standard of care in the Canadian province of Ontario: the Pre-approved Framework Guideline for Whiplash developed by the Financial Services Commission of Ontario. Methods/Design The economic evaluation will use participant-level data from the University Health Network Whiplash Intervention Trial and will be conducted from the societal perspective over the trial's one-year follow-up. Resource use (costs will include all health care goods and services, and benefits provided during the trial's 1-year follow-up. The primary health effect will be the quality-adjusted life year. We will identify the most cost-effective intervention using the incremental cost-effectiveness ratio and incremental net-benefit. Confidence ellipses and cost-effectiveness acceptability curves will represent uncertainty around these statistics, respectively. A budget impact analysis will assess the total annual impact of replacing the current legislated standard of care with each of the other interventions. An expected value of perfect information will determine the maximum research expenditure Canadian society should be willing to pay for, and inform priority setting in, research of WAD management. Discussion Results will provide health care decision makers with much needed economic evidence on common interventions for acute whiplash management. Trial Registration http://ClinicalTrials.gov identifier NCT00546806 [Trial registry date: October 18, 2007; Date first patient was randomized: February
As people live longer, healthier lives and the new health care law extends benefits to millions more Americans, the need for nurses, technicians, and others to staff the nation's hospitals and medical facilities presents an enormous opportunity for workers displaced by the faltering economy. This article features Virtual Career Network that helps…
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Sloane, Elliot; Gehlot, Vijay
Hospitals and manufacturers are designing and deploying the IEEE 802.x wireless technologies in medical devices to promote patient mobility and flexible facility use. There is little information, however, on the reliability or ultimate safety of connecting multiple wireless life-critical medical devices from multiple vendors using commercial 802.11a, 802.11b, 802.11g or pre-802.11n devices. It is believed that 802.11-type devices can introduce unintended life-threatening risks unless delivery of critical patient alarms to central monitoring systems and/or clinical personnel is assured by proper use of 802.11e Quality of Service (QoS) methods. Petri net tools can be used to simulate all possible states and transitions between devices and/or systems in a wireless device network, and can identify failure modes in advance. Colored Petri Net (CPN) tools are ideal, in fact, as they allow tracking and controlling each message in a network based on pre-selected criteria. This paper describes a research project using CPN to simulate and validate alarm integrity in a small multi-modality wireless patient monitoring system. A 20-monitor wireless patient monitoring network is created in two versions: one with non-prioritized 802.x CSM protocols and the second with simulated Quality of Service (QoS) capabilities similar to 802.11e (i.e., the second network allows message priority management.) In the standard 802.x network, dangerous heart arrhythmia and pulse oximetry alarms could not be reliably and rapidly communicated, but the second network's QoS priority management reduced that risk significantly. PMID:17282136
Bauer, M; Bach, A
Managed care, i.e., the integration of health insurance and delivery of care under the direction of one organization, is gaining importance in the USA health market. The initial effects consisted of a decrease in insurance premiums, a very attractive feature for employers. Managed care promises to contain expenditures for health care. Given the shrinking public resources in Germany, managed care seems attractive for the German health system, too. In this review the development of managed care, the principal elements, forms of organisation and practical tools are outlined. The regulation of the delivery of care by means of controlling and financial incentives threatens the autonomy of physicians: the physician must act as a "double agent", caring for the interest for the individual patient and being restricted by the contract with the managed care organisation. Cost containment by managed care was achieved by reducing the fees for physicians and hospitals (and partly by restricting care for patients). Only a fraction of this cost reduction was handed over to the enrollee or employer, and most of the money was returned with profit to the shareholders of the managed care organisations. The preeminent role of primary care physicians as gatekeepers of the health network led to a reduced demand for specialist services in general and for university hospitals and anesthesiologists in particular. The paradigm of managed care, i.e., to guide the patient and the care giver through the health care system in order to achieve cost-effective and high quality care, seems very attractive. The stress on cost minimization by any means in the daily practice of managed care makes it doubtful if managed care should be an option for the German health system, in particular because there are a number of restrictions on it in German law. PMID:9676303
Seyed Mohammad Alavi
Full Text Available Hepatitis C virus (HCV infection is a major public health in Iran as well as throughout the world. Health care workers (HCW are occupationally at the risk of HCV infection. The aim of this article is to review the information about the epidemiology, nosocomial epidemiology, natural history, immunopathogenesis, and occupational risks associated with managing HCV in the health care workplace. Information obtained from previous investigation on HCV infection has yielded a better knowledge about HCV. Because data demonstrating the efficacy of any intervention are not yet available, no definitive post exposure anti viral therapy can be recommended for HCWs who are occupationally exposed to HCV. Based on existing data, the preemptive therapy and watchful waiting strategies outlined in this review article represent reasonable interim approaches to this complex problem.
Full Text Available OBJECTIVES: To determine variation over time and between practices in recording of concerns related to abuse and neglect (maltreatment in children's primary care records. DESIGN: Retrospective cohort study using a United Kingdom representative primary care database. SETTING: 448 General Practices. PARTICIPANTS: In total 1,548, 972 children (<18 y registered between 1995 and 2010. MAIN OUTCOME MEASURES: Change in annual incidence of one or more maltreatment-related codes per child year of registration. Variation between general practices measured as the proportion of registered children with one or more maltreatment-related codes during 3 years (2008-2010. RESULTS: From 1995-2010, annual incidence rates of any coded maltreatment-related concerns rose by 10.8% each year (95% confidence interval 10.5, 11.2; adjusted for sex, age and deprivation. In 2010 the rate was 9.5 per 1000 child years (95%CI: 9.3, 9.8, equivalent to a prevalence of 0.8% of all registered children in 2010. Across all practices, the median prevalence of children with any maltreatment-related codes in three years (2008 to 2010 was 0.9% (range 0%-13.4%; 11 practices (2.5% had zero children with relevant codes in the same period. Once we accounted for sex, age, and deprivation, the prevalence for each practice was within two standard errors of the grand mean. CONCLUSIONS: General Practitioners (GPs are far from disengaged from safeguarding children; they are consistently and increasingly recording maltreatment concerns. As these results are likely to underestimate the burden of maltreatment known to primary care, there is much scope for increasing recording in primary care records with implications for resources to respond to concerns about maltreatment. Interventions and policies should build on this evidence that the average GP in the UK is engaged in child safeguarding activity.
Objectives To assess non-health literature, identify key strategies in promoting more networked teams and groups, apply external ideas to healthcare, and build a model based on these strategies. Design A systematic review of the literature outside of healthcare. Method Searches guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) of ABI/INFORM Global, CINAHL, IBSS, MEDLINE and Psychinfo databases following a mind-mapping exercise generating key terms centred o...
Sloep, Peter; Berlanga, Adriana
Learning Networks are on-line social networks through which users share knowledge with each other and jointly develop new knowledge. This way, Learning Networks may enrich the experience of formal, school-based learning and form a viable setting for professional development. Although networked learning enjoys an increasing interest, many questions remain on how exactly learning in such networked contexts can contribute to successful education and training. Put differently, how should networke...
Katia de Souza Amorim
's first period in a day care thus implies the emergence and creation of new meanings which are attributed to, assumed by, confronted to and negotiated in the interactions established by all participants. A model was developed to analyse this process based on a research project on the insertion of 26 infants (5 to 18 months old into a day care. Video recordings, observational reports, as well as interviews with mothers, caregivers and technicians were made during the babies' first year at an university day care centre. The model focus on three main personages: mother, child and caregiver and on their mutual relationships which create three interconnected fields. The mother-child field is inserted in a larger network, the family scenery. The other two, caregiver-child and mother-caregiver fields are located in the day-care scenery. Both scenarios are impregnated by a wider social-historical matrix created in complex cultural, economic and political systems. The various elements are interconnected in a semiotic network of meanings, which continuously transforms and structures human development, allowing varied paths of behavior for each individual.
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Powless, Amy J.; Feekin, Lauren E.; Hutcheson, Joshua A.; Alapat, Daisy V.; Muldoon, Timothy J.
Point-of-care approaches for 3-part leukocyte differentials (granulocyte, monocyte, and lymphocyte), traditionally performed using a hematology analyzer within a panel of tests called a complete blood count (CBC), are essential not only to reduce cost but to provide faster results in low resource areas. Recent developments in lab-on-a-chip devices have shown promise in reducing the size and reagents used, relating to a decrease in overall cost. Furthermore, smartphone diagnostic approaches have shown much promise in the area of point-of-care diagnostics, but the relatively high per-unit cost may limit their utility in some settings. We present here a method to reduce computing cost of a simple epi-fluorescence imaging system using a Raspberry Pi (single-board computer, USB color camera in conjunction with a leukocyte-selective vital dye (acridine orange) in order to determine a leukocyte count and differential from a low volume (<20 microliters) of whole blood obtained via fingerstick. Additionally, the system utilizes a "cloud-based" approach to send image data from the Raspberry Pi to a main server and return results back to the user, exporting the bulk of the computational requirements. Six images were acquired per minute with up to 200 cells per field of view. Preliminary results showed that the differential count varied significantly in monocytes with a 1 minute time difference indicating the importance of time-gating to produce an accurate/consist differential.
Liliane Brandão Carvalho
which were psychologists working in the state public health network. Data was obtained by means of non-directive interviews which were taped and transcribed. Categories were obtained from the discourses based on a hermeneutical approach by means of which an interpretive network was constructed. ANALISYS OF RESULTS: The interpretative network indicated that psychologists recognize their insertion in the field of public health as distinct from the professional field in which they obtained their training and, consequently, as a challenge. The predominant conceptions of care were circumscribed to the technical dimension, although other dimensions, closer to ethical concerns and to those related to respect for the "other" were also identified. CONCLUSIONS: In the daily routine of assistance within the public health network, care is perceived as a technical attitude. It involves control and nullification of alterity, being more closely aligned to the traditional models of biomedicine and clinical psychology. However, other practices were observed that overcome this attitude. These emerging practices assume a new configuration, oriented towards affection, dialogue between professionals and those seeking assistance and an ethical commitment forged within a political and socio-cultural perspective.
Mao, Jun J; Kapur, Rahul
Acupuncture is an ancient traditional Chinese medical therapy that is used widely around the world. When practiced by a certified provider, it is safe and often perceived as calming and relaxing for patients. Animal and human studies have found a physiological basis for acupuncture needling in that it affects the complex central and peripheral neuro-hormonal network. Although it is unclear whether acupuncture is beneficial over sham/placebo acupuncture, acupuncture care yields clinically rele...
网络时代的人文关怀缺失，对大学生心理健康、道德品质和人际交往等方面的负面影响日益严重。高校思想教育工作者需要重视这一问题。本文分析了大学生人文关怀缺失的表现及出现的原因，提出了一些解决的建议。%For scarcity of humanistic care, it has caused increasingly serious negative affect to college students＇ spirit health, moral character and interpersonal interaction etc. to which the educators of ideology in colleges and universities shall pay attention. And in this article, symptoms and causes of scarcity of humanistic case to college students are analyzed, and suggestions for resolution of the matter are brought forward also.
Husson, O; Manten-Horst, E; van der Graaf, W T A
Awareness of the need for collaboration across pediatric and adult cancer to care for adolescents and young adults (AYAs) arose from the recognition of the unique characteristics of AYAs with cancer. Neither pediatric nor adult oncology hospital departments are able to provide age-appropriate care single handedly. The best way to bridge the gap in care of AYA cancer patients is to centralize aspects of their care within dedicated AYA care programs, including the following essential components: provision of developmentally appropriate and multidisciplinary (supportive) care, availability of AYA inpatient and outpatient facilities and healthcare professional AYA expertise as collaboration between adult and pediatric departments. Barriers are related to the slowly emerging evidence of benefit, cultural differences (collaboration between pediatric and adult oncology professionals), administrative and logistic challenges (small number of AYAs makes it difficult to create an AYA program in every hospital) and financial aspects (dependency on philanthropic funds). The sustainable development of an AYA program requires acceptance as a standard of care at the clinical and patient community and at government level. To improve the quality, equity and quantity of research and innovation in AYA cancer care across the world, it is necessary to join forces and collaborate in international networks to study issues such as the features of quality care, collaboration between pediatric and adult clinical teams, trial groups and professional societies, and AYA-specific groups such as Critical Mass, Canteen or European Network for Teenagers and Young Adults with Cancer. PMID:27595356
Recently, the sensor network technology attracts a great deal of attention achieving a safe and comfortable ubiquitous society. The sensor networks are already used in environment and disaster monitoring, medical care, logistics and transportation. This paper aimed to understand the outline of the sensor network technology centering on the wireless sensor network technology.
Expert, Paul; Blondel, Vincent D; Lambiotte, Renaud
Many complex systems are organized in the form of a network embedded in space. Important examples include the physical Internet infrastucture, road networks, flight connections, brain functional networks and social networks. The effect of space on network topology has recently come under the spotlight because of the emergence of pervasive technologies based on geo-localization, which constantly fill databases with people's movements and thus reveal their trajectories and spatial behaviour. Extracting patterns and regularities from the resulting massive amount of human mobility data requires the development of appropriate tools for uncovering information in spatially-embedded networks. In contrast with most works that tend to apply standard network metrics to any type of network, we argue in this paper for a careful treatment of the constraints imposed by space on network topology. In particular, we focus on the problem of community detection and propose a modularity function adapted to spatial networks. We sh...
Full Text Available With the rapid development and integration of the Internet, wireless communication network and the Internet of Things, the Internet faces many challenges as a bearer network: a large volume of information exchange, multi-level QoS and smoothly switching multiple access protocols.The Internet should be able to provide a variety of network capacities in a more dynamic and on-demand way, not just limited network resource provision through virtualization. The elastic network is expected to adapt to network changes by enabling network protocols selection and combination dynamically. Cloud computing illustrates a new Internet-based model of IT resources (hardware, software, data provision, delivery and consumption as a service. Therefore, networking as a service can provide guaranteed quality of service and good quality of experience to users who do not care about any network configuration and network management.In this paper, we propose a novel idea of networking as a service by combining the service provision model of cloud computing with the openness of the network protocol. The related conception and stakeholders of networking as a service is depicted. Cloud-based network architecture is design to present the provision, delivery and consumption of networking as a service and discuss the key features of cloud-based network. Finally, a prototype of cloud-based network is implemented by extending OpenFlow architecture.
... NICHD Science Advances Supported Networks, Programs & Initiatives NICHD Study of Early Child Care and Youth Development (SECCYD) ... Sunsetted/For Reference Only The NICHD started the Study of Early Child Care and Youth Development (SECCYD), ...
Marinho, Leticia Maia Forte; Capelli, Jane de Carlos Santana; Rocha, Camilla Medeiros Macedo da; Bouskela, Alice; do Carmo, Cleber Nascimento; de Freitas, Silvia Eliza Almeida Pereira; Anastácio, Alexandra da Silva; de Almeida, Maria Fernanda Larcher; Pontes, Juliana da Silva
This study aimed to analyze the supplementary nutritional situation of children aged 6-24 months attended by the Primary Care unit of Macaé/RJ. It was conducted as a cross-sectional study, and data was obtained from the SISVAN Web website, including and analyzing all of the records (n=218) of children between 6-24 months in the year 2013. In infants between 6-12 months, the consumption of 72.3% of vegetables, 75.3% of fruits, and 63.4% of meats was detected, considered indicators of healthy supplementary nutrition. In contrast, 23.8% were already consuming sugar-based food sources (honey, molasses, simple sugar, and unrefined cane sugar), 34.7% industrialized juice, and 17.8% soft drinks. The consumption of industrialized juice was significantly greater in boys (p-value soft drinks. Between 18-24 months, it was recorded that 89.9% of children consumed vegetables, 83.1% fruits, and 96.7% meat. The consumption of sugar-based foods was 33.9%, 69.5% for industrialized juices, and 55.5% for soft drinks. We conclude that the indicators of healthy complementary nutrition come close to the target set by the Ministry of Health (80%). PMID:26960109
Sloep, P. B. (2011). Learning Networks, Networked Learning. Presentation at Annual Assembly of the European Society for the Systemic Innovation of Education - ESSIE. May, 27, 2011, Leuven, Belgium: Open University in the Netherlands.
Sloep, Peter; Berlanga, Adriana
Sloep, P. B., & Berlanga, A. J. (2011). Learning Networks, Networked Learning [Redes de Aprendizaje, Aprendizaje en Red]. Comunicar, XIX(37), 55-63. Retrieved from http://dx.doi.org/10.3916/C37-2011-02-05
Full Text Available While most complications are related to haemoglobinopathies and their treatment, it is also possible to observe substantial differences in comorbidities’ onset and seriousness which depend also to the different HPs genotypes. These differences should be carefully considered when health authorities set up and manage adequate care systems and treatments plans. We describe services organisation in Italy including the availability of multispecialty care and tools, in the HPs units participating to the HTA-THAL Multiregional Registry, with the aim to derive the impact of the services and multispecialty care availability on the management of the disease and on the patients wellbeing. The high dispersion and heterogeneity of services demonstrated, exposes the Italian system to a high risk of: a inappropriate use of economical and medical resources, b limited access to multidisciplinary care of some patients with apparent inequality among different centres, and c low patients satisfaction with the services provided. The identification of a ‘standard for HPs services’ is necessary not only at national but also at interventional level in order to implement collaborative research and the identification and networking of reference’ centres worldwide. Following the big efforts provided in the last years here there is a new challenging mission for the TIF.
Chakrabarti, Subhadip; Gilles, Robert Paul
A network payoff function assigns a utility to all participants in a (social) network. In this paper we discuss properties of such network payoff functions that guarantee the existence of certain types of pairwise stable networks and the convergence of certain network formation processes. In particular we investigate network payoff functions that admit an exact network potential or an ordinal network potential. We relate these network potentials to exact and ordinal potentials of a non-cooper...
Shinde, Arvind M; Dashti, Azadeh
Lung cancer is the most common cancer worldwide and is the leading cause of cancer death for both men and women in the USA. Symptom burden in patients with advanced lung cancer is very high and has a negative impact on their quality of life (QOL). Palliative care with its focus on the management of symptoms and addressing physical, psychosocial, spiritual, and existential suffering, as well as medically appropriate goal setting and open communication with patients and families, significantly adds to the quality of care received by advanced lung cancer patients. The Provisional Clinical Opinion (PCO) of American Society of Clinical Oncology (ASCO) as well as the National Cancer Care Network's (NCCN) clinical practice guidelines recommends early integration of palliative care into routine cancer care. In this chapter, we will provide an overview of palliative care in lung cancer and will examine the evidence and recommendations with regard to a comprehensive and interdisciplinary approach to symptom management, as well as discussions of goals of care, advance care planning, and care preferences. PMID:27535397
Jespersen, Astrid P; Bønnelycke, Julie; Eriksen, Hanne Hellerup
into different exercise groups. In this article we analyse the scientific work of the trial as representing entangled processes of bodywork, where data are extracted and objectified bodies are manipulated and care practices address the emotional, social and mundane aspects of the participants' everyday...... lives. Care practices are an inherent part of producing scientific facts but they are removed from the recognised results of scientific practice and thus from common public health recommendations. However, knowledge about the strategic use of care practices in lifestyle interventions is important for...
Andersen, John; Bilfeldt, Anette
The paper is a about planning and empowerment in care work at public nursing homes and the role of action research. It is based on ongoing work in the “Center for Demokratisk Samfundsudvikling og Aktionsforskning” at Roskilde University and the transnational research network KATARSIS, which works...
Vedsted, Peter; Kallestrup, Per
inter-professional nature of the discipline, the book also features a section on cross-nation organisations and primary care networks supporting research. National perspectives are offered from researchers in 20 countries that form part of the World Organization of Family Doctors, providing case...
王斌; 王焱; 叶涛; 肖国胜; 常贺; 温红梅; 陈媛; 林吉怡; 杨鹭琳
(STEMI) care in China and evaluate the implementation effect of this network.Methods Based on real-time electrocardiogram transmission technology,we established an integrated regional network for STEMI care (IRN-STEMI) with Xiamen Heart Center as the core center,120Emergency Systems,PCI-capable hospitals and other community health units as core elements of this network.Reperfusion treatment data of Xiamen Heart Center including the number of patients receiving primary percutaneous coronary intervention (PCI),the mean first medical contact to balloon (FMC-to-B)time,the mean door to balloon (D-to-B) time,the mean length of hospital stay,the mean medical cost and in-hospital mortality were compared before (n =165) and at 1 year after the built-up of IRN-STEMI (n =343).Results Compared to pre-IRN-STEMI era,primary PCI ratio (84.5％ (290/343) vs.75.5％(185/245)) were significantly increased post establishment of IRN-STEMI within the network(P =0.06).STEMI patients admitted in Xiamen Heart Center was significantly increased from 165 to 256,the annual mean FMC-to-B time ((110.3 ± 34.0) min vs.(137.9 ± 58.5) min,P ＜ 0.01) and D-to-B ((76.5 ±33.0) min vs.(107.3 ± 38.0) min,P ＜ 0.01),as well as the mean medical cost were significantly decreased ((51 398±22 100)RMB vs.(56 970 ± 24 593)RMB,P ＜ 0.05),while the mean length of hospital stay ((9.0 ± 4.3) d vs.(9.7 ± 4.8) d,P ＞ 0.05) and in-hospital mortality (3.1％ (8/256) vs.3.0％ (5/165),P ＞ 0.05) remained unchanged before and after the setting of IRN-STEMI in Xiamen Heart Center.Conclusion Establishment of an integrated regional network system for STEMI patients in China is feasible.With collaboration of qualified heart center,EMS and PCI-capable and non-PCI capable local hospitals,establishment of IRN-STEMI effectively increased the ratio of primary PCI for STEMI patients,it also significantly shortened the FMC-to-B and D-to-B time,decreased mean medical cost,thus,the regional IRN-STEMI network might be an
Oystein Fjeldstad; Moen, Espen R; Christian Riis
Local network externalities are present when the network externalities associated with entering a certain network depends not only on the total number of agents in the network, but on the identity of the agents in the network. We explore the consequences of local network externalities within a framework where two networks compete on the Hotelling circle. We first show that local network externalities, in contrast to global network externalities, do not sharpen competition. Then we show that t...
... Providing emotional support Comprehensive care includes attention to emotional health as well as physical health. Mental health professionals provide support and education, as well as diagnose and treat the depression, ...
... Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals Q&A ... assess the complex needs of the patient and family, facilitate communication with the care team and within the family, ...
Daly, Megan E; Riess, Jonathan W
Optimal multidisciplinary care of the lung cancer patient at all stages should encompass integration of the key relevant medical specialties, including not only medical, surgical, and radiation oncology, but also pulmonology, interventional and diagnostic radiology, pathology, palliative care, and supportive services such as physical therapy, case management, smoking cessation, and nutrition. Multidisciplinary management starts at staging and tissue diagnosis with pathologic and molecular phenotyping, extends through selection of a treatment modality or modalities, management of treatment and cancer-related symptoms, and to survivorship and end-of-life care. Well-integrated multidisciplinary care may reduce treatment delays, improve cancer-specific outcomes, and enhance quality of life. We address key topics and areas of ongoing investigation in multidisciplinary decision making at each stage of the lung cancer treatment course for early-stage, locally advanced, and metastatic lung cancer patients. PMID:27535399
This paper provides a framework for implementing Telemedicine using Business Process Reengineering (BPR) methodology and tools. The practice of medicine using electronic communication is Telemedicine. Telemedicine enhances the national health care initiatives such as global research, development, and deployment of sophisticated communication, management and imaging network systems. Telemedicine will become an integral part of patient care activities.
Children with autism may seem to not care about things or have the same range of emotions as those of us who see them and care for them. But they do have empathy and they can be taught how to communicate it, says the author, a teacher of children with autism. We simply need to listen to them, watch them, and be with them in their moment.
Eliane Tatsch Neves
Full Text Available Estudio cualitativo que objetivó describir la red de cuidados de niños con necesidades especiales en salud en los diferentes niveles de atención después del alta hospitalaria. Los datos fueron producidos con la aplicación de la dinámica de creatividad y sensibilidad, el mapa hablante y del método creativo sensible, con cinco familias de estos niños entre 2009 y 2011. Los discursos de la familia señalaron que la red de cuidados se compone de las dimensiones institucional y familiar. La primera se mostró amplia y diversa, aunque dispersa, compuesto por profesionales de salud y educación. Y en la segunda, la asistencia es exclusivamente familiar, con miembros, todas mujeres, como madres y abuelas. Se recomienda la ampliación y consolidación de la red de cuidado con abordaje multidisciplinar, facilitando el acceso a la atención de salud y la calidad de vida estos niños y sus familiares cuidadores.
can be operated either interactively or fully automatically. In the interactive mode, it can be controlled through the Internet. In the fully automatic mode, the telescope operates with preset parameters without any human care, including taking dark frames and flat frames. The network can also be used for studies that require continuous observations for selected objects.
Severinsson, Susanne; Nord, Catharina
We investigate how different mealtime situations help shape teenager and staff subjectivities in two Swedish residential care homes and a special school for girls and boys, 12-15 years old, with social, emotional and behavioural difficulties. Three mealtime networks are analysed using concepts from actor-network theory, treating architectural…
Braithwaite Jeffrey; Westbrook Johanna I; Creswick Nerida
Abstract Background Emergency departments (EDs) are high pressure health care settings involving complex interactions between staff members in providing and organising patient care. Without good communication and cooperation amongst members of the ED team, quality of care is at risk. This study examined the problem-solving, medication advice-seeking and socialising networks of staff working in an Australian hospital ED. Methods A social network survey (Response Rate = 94%) was administered to...
Nail Ersoz; Ismail Hakki Ozerhan; Fatih Zor
Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000): 71-74
Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull. 2008; 7(1: 71-74
Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000: 71-74
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Users' satisfaction is an important end-point to evaluate health services. This study has to do with an assessment of the level of user's satisfaction with relation to the last visit held in the primary health care network of Porto Alegre — RS, whose objective is to compare satisfaction of the users that assess the quality of the care process received as being of high APS score with that of the users who evaluate it as low APS score. A cross-sectional study based on the population, using the Primary Care Assessment Tool - PCATool, which enables the classification of the health services at the level of guidance to APS by means of the general score of primary care, defining it as high or low, in accordance with the users' experience. The satisfaction of the user was measured by a questionnaire consisting of twelve questions relative to the last visit, being measured by a 5-item Likert scale: "very good", "good", "regular", "bad" and "very bad". For the analysis, the results were grouped into two classifications, i.e. "satisfied", when referred as "veg good" or "good", and "dissatisfied" when referred to any of the other items. A significant difference was noticed in the 12 variables reflecting satisfaction in several aspects of the visit, showing higher satisfaction in users that classified the service as being of high score. The .general evaluation of the service presented 95.6% and 73.5% of "satisfied" in the services with high and low APS score, respectively (p<0.001. Users of services with high level of guidance to primary care obtain higher satisfaction in their visits. This higher satisfaction can benefit the decision-making process of the patient in face of the medical recommendations made.
A satisfação dos usuários é um importante desfecho para avaliar serviços de saúde. Este estudo trata-se de uma avaliação do grau de satisfação dos usuários em relação à última consulta realizada na rede de atenção primária A
Full Text Available In this paper, a collaborative DSS Model for health care systems and results obtained are described. The proposed framework  embeds expert knowledge within DSS to provide intelligent decision support, and implements the intelligent DSS using collaboration technologies. The problem space contains several Hub and Spoke networks. Information about such networks is dynamically captured and represented in a Meta-data table. This master table enables collaboration between any two networks in the problem space, through load transfer, between them. In order to show the collaboration the sample database of 15 health care centers is taken assuming that there are 5 health care centers in one network.
Backes, Dirce Stein; Backes, Marli Stein; Erdmann, Alacoque Lorenzini
This study is the result of the project: networks care and social entrepreneurship: the autonomy and social commitment of nurses. The purpose of this qualitative study is to comprehend the meaning of nursing care as a social enterprising practice. The Grounded Theory was used as a methodological reference and the interview, conducted with 35 participants as technique of data collection. Data codification led to the central theme: Viewing Nursing Care as a Social Enterprising Practice. This theme is complemented by the category, characterized the cause condition: the social integration through the creation a political identity that expresses your involvement. The results showed that is necessary to learn and have a deep dialogic knowledge. In order to consolidate popular participation as a citizenship ideal, a critical professional attitude, base don the combination of care with liberty, participation end autonomy. PMID:19597667
Balsa, Ingrid M; Culp, William T N
Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve. PMID:26022525
Schrader, Thomas; Kldiashvili, Ekaterina
Application of telemedicine systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for creation of national networks does not seem to be widely appreciated. The article describes the "Virtual Health Care Knowledge Center in Georgia" project. Its aim was the set up of an online integrated web-based platform to provide remote medical consultations and eLearning cycles. The project "Virtual Health Care Knowledge Center in Georgia" was the NATO Networking Infrastructure Grant dedicated for development of telemedicine in non-NATO countries. The project implemented a pilot to organize the creation of national eHealth network in Georgia and to promote the use of innovative telemedicine and eLearning services in the Georgian healthcare system. In June 2007 it was continued under the NATO Networking Infrastructure Grant "ePathology--Virtual Pathology Center in Georgia as the Continuation of Virtual Health Care Center". PMID:18673518
Nadir Kamal Salih
Full Text Available E-Health is a relatively recent term for healthcare practice supported by electronic processes and communication, dating back to at least 1999. E-Health is greatly impacting on information distribution and availability within the health services, hospitals and to the public. E-health was introduced as the death of telemedicine, because - in the context of a broad availability of medical information systems that can interconnect and communicate - telemedicine will no longer exist as a specific field. The same could also be said for any other traditional field in medical informatics, including information systems and electronic patient records. E-health presents itself as a common name for all such technological fields. In this paper we focuses in multi database by determined some sites and distributed it in Homogenous way. This will be followed by an illustrative example as related works. Finally, the paper concludes with general remarks and a statement of further work.
Salih, Nadir K; Sun, Mingrui
E-Health is a relatively recent term for healthcare practice supported by electronic processes and communication, dating back to at least 1999. E-Health is greatly impacting on information distribution and availability within the health services, hospitals and to the public. E-health was introduced as the death of telemedicine, because - in the context of a broad availability of medical information systems that can interconnect and communicate - telemedicine will no longer exist as a specific field. The same could also be said for any other traditional field in medical informatics, including information systems and electronic patient records. E-health presents itself as a common name for all such technological fields. In this paper we focuses in multi database by determined some sites and distributed it in Homogenous way. This will be followed by an illustrative example as related works. Finally, the paper concludes with general remarks and a statement of further work.
Loo, Boon Thau
Declarative Networking is a programming methodology that enables developers to concisely specify network protocols and services, which are directly compiled to a dataflow framework that executes the specifications. Declarative networking proposes the use of a declarative query language for specifying and implementing network protocols, and employs a dataflow framework at runtime for communication and maintenance of network state. The primary goal of declarative networking is to greatly simplify the process of specifying, implementing, deploying and evolving a network design. In addition, decla
... care is especially useful for persons who need nursing, therapy, or aide services. You may need help if you are dealing with one or more of the following: You have trouble getting around (for example, after a hospital stay or an accident) You have wounds that need to be cleaned, ...
Roč. 9, č. 2 (2015), s. 216-222. ISSN 1749-6535 R&D Projects: GA ČR(CZ) GPP401/12/P544 Institutional support: RVO:67985955 Keywords : ethics of care * enactivism * autonomy * social institutions * autism * exclusion Subject RIV: AA - Philosophy ; Religion http://dx.doi.org/10.1080/17496535.2015.1022356
Petersen, Morten Krogh
practices. If that is the case, the great challenge is to “come up with ingenious solutions to the problem of how to become interesting enough for practices to care about” (ibid: 72). Through ethnographic fieldwork encounters with Radicand Design Collaboratory, a collaborative product development...
Cozzo, Emanuele; De Domenico, Manlio; Solé, Albert; Arenas, Alex; Gómez, Sergio; Porter, Mason A; Moreno, Yamir
Recent advances in the study of complex networked systems has highlighted that our interconnected world is made of networks that are coupled together through different layers that each stand for one type of interaction or system. Despite this situation, it is traditional to aggregate multiplex data into a single weighted network in order take advantage of existing tools. This is admittedly convenient, but it is also extremely problematic. In this paper, we generalize the concept of clustering coefficients for multiplex networks. We show how the layered structure of multiplex networks introduces a new degree of freedom that has a fundamental effect on transitivity. We compute our new multiplex clustering coefficients for several real multiplex networks and illustrate why generalizing monoplex concepts to multiplex networks must be done with great care.
This paper provides a survey of recent experimental work in eco- nomics focussing on social and economic networks.The experiments consider networks of coordination and cooperation,buyer-seller net- works,and network formation.
Email correspondents play an important role in many people's social networks. Finding email correspondents in social networks accurately, though may seem to be straightforward at a first glance, is challenging. To the best of our knowledge, this problem has not been carefully and thoroughly addressed in research. Most of the existing online social networking sites recommend possible matches by comparing the information of email accounts and social network profiles. However, as shown empirical...
Kahn, Alfred E.; Bruce M. Owen; Mayo, John; Vernon, John; Lawrence J. White; Waverman, Leonard; Cave, Martin; Patrick A. Messerlin; Joskow, Paul L.; Cramton, Peter; Litan, Robert E.; Robert S. Pindyck; Hahn, Robert W.; Savage, Scott J; Wallsten, Scott
Network neutrality is a policy proposal that would regulate how network providers manage and price the use of their networks. Congress has introduced several bills on network neutrality. Proposed legislation generally would mandate that Internet service providers exercise no control over the content that flows over their lines and would bar providers from charging more for preferentially faster access to the Internet. These proposals must be considered carefully in light of the underlying eco...
陈丽卿; 沈寅; 吴福荣
院外急救是急救医学服务体系(EMSS)的首要环节,社会保障系统的重要组成部分.我国院外急救起步较晚,各城市院外急救发展也不平衡,与发达国家相比,还存在明显的差异.如何发展我国的院外急救事业,实现急救社会化、结构网络化、抢救现代化、知识普及化,努力为人民提供及时、优质、高效的院外急救服务,值得大家共同去研究探讨.%The experience of the Emergency Center of Kunshan City, Jiangsu Province was summed up and discussed. The pre-hospital emergency care model of this city is a mixed type of pre-hospital type and command-based type, the construction of the substations directly under this center relies on the Municipal Bureau of Fire Protection, and the construction of the 6 Internet-based substations relies on the town hospitals so that the substations cover all communities. A 120-119 linkage mechanism, the first one in China, was established in this city. A 120 green channel for the retirees was established in cooperation with the City Bureau of Retired Veteran Cadres, and a 120 green channel for the acute cardiac infarction patients was established in cooperation with the City TCM Hospital. A real-time video network transmission system is being piloted in this city to connect the emergency rescue rooms in different community health centers with the Municipal Emergency Command Center and Medical Experts Teleconsultation Center so as to guide the emergency practice of the community medical staff. The personal appointment of an ambulance from this City Emergency Center includes a medical doctor, a nurse, a driver, and a stretcher-bearer. In addition, first aid skills are popularized among the citizens.
Complex systems are very often organized under the form of networks where nodes and edges are embedded in space. Transportation and mobility networks, Internet, mobile phone networks, power grids, social and contact networks, neural networks, are all examples where space is relevant and where topology alone does not contain all the information. Characterizing and understanding the structure and the evolution of spatial networks is thus crucial for many different fields ranging from urbanism t...
The rapid increase in computer, mobile applications and wireless networks has globally changed the features of network security. A series of Internet attack and fraudulent acts on companies and individual network have shown us that open computer networks have no immunity from intrusions. The traditional way of protecting computer networks, such as firewalls and software encryption are insufficient and ineffective. The wireless ad-hoc network is susceptible to physical attack or harm due to...
In June 2000 a distinguished group of obstetricians, midwives, general practitioners, and medical statisticians came together to discuss maternal care. Chaired by Professor James Drife from Leeds, discussion ranged over many topics, including: the changing role of the obstetrician, general practitioners, and the increasing status and responsibility of midwives. Other subjects include the induction of labour, obstetric analgesia and anaesthesia, and debates about the place and kind of delivery...
Henneberg, Stephan C.; Jiang, Zhizhong; Naudé, Peter;
The Industrial Marketing and Purchasing (IMP) Group is a network of academic researchers working in the area of business-to-business marketing. The group meets every year to discuss and exchange ideas, with a conference having been held every year since 1984 (there was no meeting in 1987). In thi......The Industrial Marketing and Purchasing (IMP) Group is a network of academic researchers working in the area of business-to-business marketing. The group meets every year to discuss and exchange ideas, with a conference having been held every year since 1984 (there was no meeting in 1987......). In this paper, based upon the papers presented at the 22 conferences held to date, we undertake a Social Network Analysis in order to examine the degree of co-publishing that has taken place between this group of researchers. We identify the different components in this database, and examine the large main...
La red de atención a la salud mental correspondiente al hospital universitario Príncipe de Asturias en Madrid (España The network of mental health care in the hospital universitário Principe de Asturias in Madrid (Spain
Alberto Fernández Liria
Full Text Available Se describe la estructura y funcionamiento de una red pública de atención a la salud mental que cubre una población de 450.000 habitantes de la zona metropolitana este de Madrid. Se trata de una red que funciona como parte de un sistema público, universal y gratuito en el momento del pago, aunque tiene varios financiadores y parte de los proveedores son instituciones de titularidad privada que se financian mediante un concierto con la administración pública. Integra 26 dispositivos en los que trabajan 229 profesionales asignados a equipos interprofesionales. Además de las funciones asistenciales, la red desarrolla labores de docencia e investigación.We describe the structure and functioning of a public mental health care network that covers a population of 450.000 inhabitants in the metropolitan east area of Madrid. It is a network that operates as part of a public, universal and without payment at the time of being attended National Health Service, although it is granted from several different public founders and some of the providers are private institutions employed by the public system. It includes 229 mental health professionals work in 26 integrated inter-professional teams. In addition to the functions of care, the network develops teaching and research work.
Aase, Lee; Timimi, Farris K
Health care as an industry continues in reluctant participation with consumers through social networks. Factors behind health care's laggard position range from providers' concerns about patient privacy and lack of personal psychic bandwidth to organizational anxiety about employee time management and liability for online behavior. Despite these concerns, our patients are spending increasing amounts of their time online, often looking for information regarding their diagnosis, treatment, care providers, and hospitals, with much of that time spent in social networks. Our real opportunity for meaningful engagement in the future may depend on our capacity to meet our patients where they are, online, utilizing the tools that they use, that is, social media. PMID:23787711
Norbert eMayer-Amberg; Rainer eWoltmann; Stefanie eWalther
The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various healthcare service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The current work is a quality monitoring report of a novel care setting, called Integrated Care Initiative Schizophrenia. It has implemented a networked care con...
... labor & premature birth The newborn intensive care unit (NICU) Birth defects & other health conditions Loss & grief Tools & ... Home > Complications & Loss > The newborn intensive care unit (NICU) > Caring for multiples Caring for multiples E-mail ...
Dehmer, Matthias; Emmert-Streib, Frank
A well-balanced overview of mathematical approaches to describe complex systems, ranging from chemical reactions to gene regulation networks, from ecological systems to examples from social sciences. Matthias Dehmer and Abbe Mowshowitz, a well-known pioneer in the field, co-edit this volume and are careful to include not only classical but also non-classical approaches so as to ensure topicality. Overall, a valuable addition to the literature and a must-have for anyone dealing with complex systems.
This book focuses on green networking, which is an important topic for the scientific community composed of engineers, academics, researchers and industrialists working in the networking field. Reducing the environmental impact of the communications infrastructure has become essential with the ever increasing cost of energy and the need for reducing global CO2 emissions to protect our environment.Recent advances and future directions in green networking are presented in this book, including energy efficient networks (wired networks, wireless networks, mobile networks), adaptive networ
Many argue that telecommunications network infrastructure is the most impressive and important technology ever developed. Analyzing the telecom market's constantly evolving trends, research directions, infrastructure, and vital needs, Telecommunication Networks responds with revolutionized engineering strategies to optimize network construction. Omnipresent in society, telecom networks integrate a wide range of technologies. These include quantum field theory for the study of optical amplifiers, software architectures for network control, abstract algebra required to design error correction co
Schreiber, Stefan; Hartmann, Heinz; Kruis, Wolfgang; Kucharzik, Torsten; Mudter, Jonas; Siegmund, Britta; Stallmach, Andreas; Witte, Christine; Fitzke, Klaus; Bokemeyer, Bernd
The Inflammatory Bowel Disease Competence Network is a network of more than 500 physicians and scientists from university clinics, hospitals and gastroenterology practices. The focus extends from the two major forms of inflammatory bowel diseases, Crohn's disease and ulcerative colitis, into other chronic inflammatory conditions affecting the intestine, including coeliac disease and microscopic colitis. The network translates basic science discoveries (in particular in the molecular epidemiology research) into innovative diagnostics and therapy. Through its strong networking structures it supports a continuous process to improve quality and standardisation in patient care that is implemented in close interaction with European networks addressing this disease group.Optimisation of patient care based on scientifically proven evidence is a main focus of the network. Therefore, it supports and coordinates translational research and infrastructure projects that investigate aetiology, improvement of diagnostic methods, and development of new or improved use of established therapies. Members participate in various training projects, thus ensuring the rapid transfer of research results into clinical practice.The competence network cooperates with the main patient organisations to engage patients in all levels of activities. The network and the patient organisations have interest in promoting public awareness about the disease entities, because their importance and burden is underestimated in non-specialised medical fields and among the general public. PMID:26968556
Mary E. McNally
Full Text Available Research focusing on the introduction of daily mouth care programs for dependent older adults in long-term care has met with limited success. There is a need for greater awareness about the importance of oral health, more education for those providing oral care, and organizational structures that provide policy and administrative support for daily mouth care. The purpose of this paper is to describe the establishment of an oral care action plan for long-term care using an interdisciplinary collaborative approach. Methods. Elements of a program planning cycle that includes assessment, planning, implementation, and evaluation guided this work and are described in this paper. Findings associated with assessment and planning are detailed. Assessment involved exploration of internal and external factors influencing oral care in long-term care and included document review, focus groups and one-on-one interviews with end-users. The planning phase brought care providers, stakeholders, and researchers together to design a set of actions to integrate oral care into the organizational policy and practice of the research settings. Findings. The establishment of a meaningful and productive collaboration was beneficial for developing realistic goals, understanding context and institutional culture, creating actions suitable and applicable for end-users, and laying a foundation for broader networking with relevant stakeholders and health policy makers.
Perez, Beatrix F.; Romo, Harriett D.
Youth exiting foster care often experience difficulties transitioning into adulthood. This paper focuses on Latino foster care youth in a major southwestern U.S. city and addresses the importance of peer networks as a crucial form of social capital as youth leave foster care. Case studies illustrate experiences of foster care alumni ranging in age…
Timimi, Farris K
Health care lags behind other industries in engaging with customers via social networking. In part, this reflects concerns regarding health information privacy concerns, organizational fears regarding employee time mismanagement, and the real challenge that health care providers face with multiple and competing demands on time. Despite these fears and concerns, our patients are spending more and more of their time online seeking health care information, more often in social networks. Our greatest capacity for health care change management at present may well center on our strategic capacity to meet our patients where they spend the majority of their time online. PMID:23748265
Else Cathrine Rustad,1–4 Bodil Furnes,1 Berit Seiger Cronfalk,2,5,6 Elin Dysvik1 1Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway; 2Faculty of Health and Caring Sciences, Stord Haugesund University College, Stord, Norway; 3Research Network on Integrated Health Care in Western Norway, Helse Fonna Local Health Authority, Haugesund, Norway; 4Department of Clinical Medicine, Helse Fonna Local Health Authority, Haugesund, Norway; 5Pal...
Rustad EC; Furnes B; Cronfalk BS; Dysvik E
Else Cathrine Rustad,1–4 Bodil Furnes,1 Berit Seiger Cronfalk,2,5,6 Elin Dysvik1 1Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway; 2Faculty of Health and Caring Sciences, Stord Haugesund University College, Stord, Norway; 3Research Network on Integrated Health Care in Western Norway, Helse Fonna Local Health Authority, Haugesund, Norway; 4Department of Clinical Medicine, Helse Fonna Local Health Authority, Haugesund, Norway; 5Palliat...
Kldiashvili Ekaterina; Schrader Thomas
Abstract Application of telemedicine systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for creation of national networks does not seem to be widely appreciated. The article describes the "Virtual Health Care Knowledge Center in Georgia" project. Its aim was the set up of an online integrated web-based platform to provide remote medical consultations and eLearning cycles. The project "Virtual Health Care Knowledge Center in...
Hitz Lindenmüller, Irène; Lambrecht, J Thomas
Adequate dental and oral hygiene may become a challenge for all users and especially for elderly people and young children because of their limited motor skills. The same holds true for patients undergoing/recovering from chemo-/radiotherapy with accompanying sensitive mucosal conditions. Poor dental hygiene can result in tooth decay, gingivitis, periodontitis, tooth loss, bad breath (halitosis), fungal infection and gum diseases. The use of a toothbrush is the most important measure for oral hygiene. Toothbrushes with soft bristles operated carefully by hand or via an electric device help to remove plaque and to avoid mucosal trauma. A handlebar with a grip cover can be helpful for manually disabled patients or for those with reduced motor skills. In case of oral hygiene at the bedside or of patients during/after chemo-/radiotherapy a gauze pad can be helpful for gently cleaning the teeth, gums and tongue. The use of fluoride toothpaste is imperative for the daily oral hygiene. Detergents such as sodium lauryl sulphate improve the cleaning action but may also dehydrate and irritate the mucous membrane. The use of products containing detergents and flavouring agents (peppermint, menthol, cinnamon) should therefore be avoided by bedridden patients or those with dry mouth and sensitive mucosa. Aids for suitable interdental cleaning, such as dental floss, interdental brushes or dental sticks, are often complicated to operate. Their correct use should be instructed by healthcare professionals. To support dental care, additional fluoridation with a fluoride gel or rinse can be useful. Products further containing antiseptics such as chlorhexidine or triclosan reduce the quantity of bacteria in the mouth. For patients undergoing or having undergone radio-/chemotherapy, a mouthwash that concomitantly moisturizes the oral mucosa is advisable. PMID:21325845
This volume provides an introduction to and overview of the emerging field of interconnected networks which include multi layer or multiplex networks, as well as networks of networks. Such networks present structural and dynamical features quite different from those observed in isolated networks. The presence of links between different networks or layers of a network typically alters the way such interconnected networks behave – understanding the role of interconnecting links is therefore a crucial step towards a more accurate description of real-world systems. While examples of such dissimilar properties are becoming more abundant – for example regarding diffusion, robustness and competition – the root of such differences remains to be elucidated. Each chapter in this topical collection is self-contained and can be read on its own, thus making it also suitable as reference for experienced researchers wishing to focus on a particular topic.
The concept of temporal networks is an extension of complex networks as a modeling framework to include information on when interactions between nodes happen. Many studies of the last decade examine how the static network structure affect dynamic systems on the network. In this traditional approach the temporal aspects are pre-encoded in the dynamic system model. Temporal-network methods, on the other hand, lift the temporal information from the level of system dynamics to the mathematical representation of the contact network itself. This framework becomes particularly useful for cases where there is a lot of structure and heterogeneity both in the timings of interaction events and the network topology. The advantage compared to common static network approaches is the ability to design more accurate models in order to explain and predict large-scale dynamic phenomena (such as, e.g., epidemic outbreaks and other spreading phenomena). On the other hand, temporal network methods are mathematically and concept...
Time, Cost, Information Seeking Skills and Format of Resources Present Barriers to Information Seeking by Primary Care Practitioners in a Research Environment. A review of: Andrews James E., Kevin A. Pearce, Carol Ireson, and Margaret M. Love. “Information‐Seeking Behaviors of Practitioners in a Primary Care Practice‐Based Research Network (PBRN.” Journal of the Medical Library Association 93.2 (Apr. 2005: 206‐12.
Martha Ingrid Preddie
Full Text Available Objective – To determine the information seeking behaviors of primary care practitioners in order to inform future efforts towards the design of information services that would support quality inprimary care.Design – A cross‐sectional survey.Setting – A primary care practice based research network (PBRN of caregivers who serve a broad population while simultaneously studying and disseminating innovations aimed at improvements in quality, efficiency and/or safety of primaryhealth care in the United States.Subjects – All primary care practitioners in the PBRN including family practitioners, general practitioners, nurse practitioners and physician assistants.Methods – A questionnaire comprising twenty‐six questions was distributed to 116 practitioners. Practitioners attached to academic centres (who were also members of the PBRN were excluded in order “to achieve a sample of practices more representative of the primary care practising population” (208. Descriptive data were collected and analyzed. SPSS v11.5 was used for statistical analyses.Main results – There was a response rate of 51% (59 of 116. Fifty‐eight percent of the respondents stated that they sought information (excluding drug dosing or drug interactions information to support patient care several times a week. Sixty‐eight per cent sought this information while the patient waited. Almost half of therespondents had access to a small medical library (48% or a hospital library (46%, while 21% used a university medical library.Approximately 14% had no immediate access to a medical library. Almost 60% of practitioners stated that they had an e‐mail account. Thirty‐four percent agreed that the use of e‐mail to communicate with patients enhanced medical practice, while 24% disagreed. There was frequent prescribing of Internet‐based consumer health information to patients by only 16% of the practitioners, while Internet support groups were frequently recommended
Bruun, Jesper; Evans, Robert Harry
This paper describes the background for, realisation of and author reflections on a network workshop held at ESERA2013. As a new research area in science education, networks offer a unique opportunity to visualise and find patterns and relationships in complicated social or academic network data...... and analysed networks using the commonly used and freely available software Gephi (gephi.org). Reflecting upon why science education researchers might be hesitant to adopt network methodology we identify a key problem for networks in science education research: The cost in resources of learning how to include...
A site-wide network maintenance operation has been scheduled for Saturday 28 February. Most of the network devices of the general purpose network will be upgraded to a newer software version, in order to improve our network monitoring capabilities. This will result in a series of short (2-5 minutes) random interruptions everywhere on the CERN sites throughout the day. This upgrade will not affect the Computer Centre itself, Building 613, the Technical Network and the LHC experiments, dedicated networks at the pits. For further details of this intervention, please contact Netops by phone 74927 or e-mail mailto:Netops@cern.ch. IT/CS Group
A site wide network maintenance has been scheduled for Saturday 28 February. Most of the network devices of the General Purpose network will be upgraded to a newer software version, in order to improve our network monitoring capabilities. This will result in a series of short (2-5 minutes) random interruptions everywhere on the CERN sites along this day. This upgrade will not affect: the Computer centre itself, building 613, the Technical Network and the LHC experiments dedicated networks at the pits. Should you need more details on this intervention, please contact Netops by phone 74927 or email mailto:Netops@cern.ch. IT/CS Group
Full Text Available The language of networks now describes everything from the Internet to the economy to terrorist organizations. In distinction to a common view of networks as a universal, originary, or necessary form that promises to explain everything from neural structures to online traffic, this essay emphasizes the contingency of the network imaginary. Network form, in its role as our current cultural dominant, makes scarcely imaginable the possibility of an alternative or an outside uninflected by networks. If so many things and relationships are figured as networks, however, then what is not a network? If a network points towards particular logics and qualities of relation in our historical present, what others might we envision in the future? In many ways, these questions are unanswerable from within the contemporary moment. Instead of seeking an avant-garde approach (to move beyond networks or opting out of networks (in some cases, to recover elements of pre-networked existence, this essay proposes a third orientation: one of ambivalence that operates as a mode of extreme presence. I propose the concept of "network aesthetics," which can be tracked across artistic media and cultural forms, as a model, style, and pedagogy for approaching interconnection in the twenty-first century. The following essay is excerpted from Network Ambivalence (Forthcoming from University of Chicago Press.
Javarone, Marco Alberto
We study the structure of fermionic networks, i.e. a model of networks based on the behavior of fermionic gases, and we analyze dynamical processes over them. In this model, particle dynamics have been mapped to the domain of networks, hence a parameter representing the temperature controls the evolution of the system. In doing so, it is possible to generate adaptive networks, i.e. networks whose structure varies over time. As shown in previous works, networks generated by quantum statistics can undergo critical phenomena as phase transitions and, moreover, they can be considered as thermodynamic systems. In this study, we analyze fermionic networks and opinion dynamics processes over them, framing this network model as a computational model useful to represent complex and adaptive systems. Results highlight that a strong relation holds between the gas temperature and the structure of the achieved networks. Notably, both the degree distribution and the assortativity vary as the temperature varies, hence we can state that fermionic networks behave as adaptive networks. On the other hand, it is worth to highlight that we did not finding relation between outcomes of opinion dynamics processes and the gas temperature. Therefore, although the latter plays a fundamental role in gas dynamics, on the network domain, its importance is related only to structural properties of fermionic networks.
Grande, Bård; Sørensen, Ole Henning
The paper focuses on the concept of organizational networks. Four different uses of the concept of organizational network are identified and critically discussed. Special focus is placed on how information and communication technologies as communication mediators and cognitive pictures influence...
A growing number of physicians are creating discount networks due to the anger they feel about their loss of professional autonomy and financial compensation to managed care. They are seeking a niche among patients who lack adequate health insurance coverage or are dissatisfied with their plans. To win patients, the physician networks are marketing services that are deeply discounted. PMID:10351396
Steen, M.G.D.; Aarts, O.A.J.; Broekman, C.C.M.T.; Prins, S.C.L.
In this paper, we present some of the work that is being done in the WeCare project (in the AAL programme). The project’s goal is to introduce social networking services in the lives of older people, in order to improve their well-being. Participation in social networks, both online and ‘in real lif
Szinovacz, Maximiliane E.; Davey, Adam
Purpose: Caregiving research has typically relied on cross-sectional data that focus on the primary caregiver. This approach neglects the dynamic and systemic character of caregiver networks. Our analyses addressed changes in adult child care networks over a 2-year period. Design and Methods: The study relied on pooled data from Waves 1 through 5…
Imaging is not easy to measure in economic terms for France to day. The impact of innovation process is no more clear and especially the substitutions expected between different techniques. Nevertheless, these new techniques could provoque big changes in medical practices and health care organizations. They should probably increase the proportion of ambulatory patients in total examinations and encourage the development of extra-hospital health care. But, in France, alternative health care organizations (day hospital, home care, etc...) are under developed because of many non technical factors (behavioural managerial and institutional). Perhaps major potential change shall come from imaging networks. But can imaging development contribute to moderate health expanses growth rate. Economic evaluations of each new technique are difficult and ambiguous but necessary to maximize health care system efficiency
Carter, M W; Hans, E.W.; Kolisch, R.
Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully selected papers dealing with optimization and decision analysis problems in the field of health care operations management.
Full Text Available Else Cathrine Rustad,1–4 Bodil Furnes,1 Berit Seiger Cronfalk,2,5,6 Elin Dysvik1 1Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway; 2Faculty of Health and Caring Sciences, Stord Haugesund University College, Stord, Norway; 3Research Network on Integrated Health Care in Western Norway, Helse Fonna Local Health Authority, Haugesund, Norway; 4Department of Clinical Medicine, Helse Fonna Local Health Authority, Haugesund, Norway; 5Palliative Research Center, Ersta Sköndal University College, Stockholm, Sweden; 6Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Background: A fragmented health care system leads to an increased demand for continuity of care across health care levels. Research indicates age-related differences during care transition, with the oldest patients having experiences and needs that differ from those of other patients. To meet the older patients’ needs and preferences during care transition, professionals must understand their experiences.Objective: The purpose of the study was to explore how patients ≥80 years of age experienced the care transition from hospital to municipal health care services.Methods: The study has a descriptive, explorative design, using semistructured interviews. Fourteen patients aged ≥80 participated in the study. Qualitative content analysis was used to describe the individuals’ experiences during care transition.Results: Two complementary themes emerged during the analysis: “Participation depends on being invited to plan the care transition” and “Managing continuity of care represents a complex and challenging process”.Discussion: Lack of participation, insufficient information, and vague responsibilities among staff during care transition seemed to limit the continuity of care. The patients are the vulnerable part of the care transition process, although they possess important
The Health Improvement Network is a collaboration between Cegedim Strategic Data EPIC, an expert in the provision of UK primary care patient data that is used for medical research, and In Practice Systems (InPS), who continue to develop and supply the widely-used Vision general practice computer system.
Ahmed, Faheem; Mays, Nicholas; Ahmed, Naeem; Bisognano, Maureen; Gottlieb, Gary
Following the global economic recession, health care systems have experienced intense political pressure to contain costs without compromising quality. One response is to focus on improving the continuity and coordination of care, which is seen as beneficial for both patients and providers. However, cultural and structural barriers have proved difficult to overcome in the quest to provide integrated care for entire populations. By holding groups of providers responsible for the health outcomes of a designated population, in the United States, Accountable Care Organizations are regarded as having the potential to foster collaboration across the continuum of care. They could have a similar role in England's National Health Service. However, it is important to consider the difference in context before implementing a similar model, adapted to suit the system's strengths. Working together, general practice federations and the Academic Health Science Networks could form the basis of accountable care in England. PMID:26079144
Cho, Hyunghoon; Berger, Bonnie; Peng, Jian
Reverse-engineering of biological networks is a central problem in systems biology. The use of intervention data, such as gene knockouts or knockdowns, is typically used for teasing apart causal relationships among genes. Under time or resource constraints, one needs to carefully choose which intervention experiments to carry out. Previous approaches for selecting most informative interventions have largely been focused on discrete Bayesian networks. However, continuous Bayesian networks are ...
Kamaksi Prasad V2; Ayachit, N. H.; Santosh L Deshpande1
The audit ability and security of the broadcast network and security needs to be enhanced. This article is proposing the security solutions for such networks that are cost effective. The solution also takes care of the reduction of effective bandwidth-delay product. The improvement in terms of a cost effective comparator improves the efficiency and security of such networks. The threats like Eavesdropping, Interception and modification of transmitted data, Spoofing, Denial of service (DoS), F...
As in most industries, in health care, information is a competitive asset, and we expect that health care providers may have incentive to protect their information from competitors. This study aims to understand how this incentive to protect information may be a barrier to the development of a health information network. Health information networks are designed to facilitate electronic information sharing across health care providers. The electronic exchange of health information is widely co...
洪炳镕; 金飞虎; 郭琦
Hopfield neural network is a single layer feedforward neural network. Hopfield network requires some control parameters to be carefully selected, else the network is apt to converge to local minimum. An ant system is a nature inspired meta heuristic algorithm. It has been applied to several combinatorial optimization problems such as Traveling Salesman Problem, Scheduling Problems, etc. This paper will show an ant system may be used in tuning the network control parameters by a group of cooperated ants. The major advantage of this network is to adjust the network parameters automatically, avoiding a blind search for the set of control parameters.This network was tested on two TSP problems, 5 cities and 10 cities. The results have shown an obvious improvement.
Networks often represent systems that do not have a long history of study in traditional fields of physics; albeit, there are some notable exceptions, such as energy landscapes and quantum gravity. Here, we consider networks that naturally arise in cosmology. Nodes in these networks are stationary observers uniformly distributed in an expanding open Friedmann–Lemaître–Robertson–Walker universe with any scale factor and two observers are connected if one can causally influence the other. We show that these networks are growing Lorentz-invariant graphs with power-law distributions of node degrees. These networks encode maximum information about the observable universe available to a given observer. (paper)
... Children > Family Life > Family Dynamics > Adoption & Foster Care Adoption & Foster Care Article Body Each year, many children join families through adoption and foster care. These families may face unique ...
... ill, recovering from surgery, or disabled. Home care services include Personal care, such as help with bathing, ... your home. Some types of care and community services are free or donated. Many other types you ...
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... requiring intense and vigilant nursing care. Number of Critical Care Nurses in the United States According to "The Registered ... nurses who work in a hospital setting. Where Critical Care Nurses Work According to "The Registered Nurse Population" study, ...
BPH - self-care; Benign prostatic hypertrophy - self-care; Benign prostatic hyperplasia - self-care ... exercises ( Kegel exercises ) that strengthen the pelvic floor muscles. Doing these exercise may help with leaking or ...
A network is regularizable if it is possible to assign weights to its edges so that all nodes have the same degree. We define a hierarchy of four network classes in terms of their regularization properties. For the classes of the hierarchy, we investigate structural conditions on both the network and the corresponding adjacency matrix that are necessary and sufficient for the inclusion of a network in the class. Moreover, we provide an algorithmic solution for the problem of positioning a network in the hierarchy. We argue that the regularization solution is useful to build an egalitarian, friction-free network in which all actors of the network has the same centrality (and power).
Networks are everywhere, from the Internet, to social networks, and the genetic networks that determine our biological existence. Illustrated throughout in full colour, this pioneering textbook, spanning a wide range of topics from physics to computer science, engineering, economics and the social sciences, introduces network science to an interdisciplinary audience. From the origins of the six degrees of separation to explaining why networks are robust to random failures, the author explores how viruses like Ebola and H1N1 spread, and why it is that our friends have more friends than we do. Using numerous real-world examples, this innovatively designed text includes clear delineation between undergraduate and graduate level material. The mathematical formulas and derivations are included within Advanced Topics sections, enabling use at a range of levels. Extensive online resources, including films and software for network analysis, make this a multifaceted companion for anyone with an interest in network sci...
Havlin, S.; Kenett, D. Y.; Bashan, A.; Gao, J.; Stanley, H. E.
Our dependence on networks - be they infrastructure, economic, social or others - leaves us prone to crises caused by the vulnerabilities of these networks. There is a great need to develop new methods to protect infrastructure networks and prevent cascade of failures (especially in cases of coupled networks). Terrorist attacks on transportation networks have traumatized modern societies. With a single blast, it has become possible to paralyze airline traffic, electric power supply, ground transportation or Internet communication. How, and at which cost can one restructure the network such that it will become more robust against malicious attacks? The gradual increase in attacks on the networks society depends on - Internet, mobile phone, transportation, air travel, banking, etc. - emphasize the need to develop new strategies to protect and defend these crucial networks of communication and infrastructure networks. One example is the threat of liquid explosives a few years ago, which completely shut down air travel for days, and has created extreme changes in regulations. Such threats and dangers warrant the need for new tools and strategies to defend critical infrastructure. In this paper we review recent advances in the theoretical understanding of the vulnerabilities of interdependent networks with and without spatial embedding, attack strategies and their affect on such networks of networks as well as recently developed strategies to optimize and repair failures caused by such attacks.
Bausewein, Claudia; Hartenstein, R.
Oncology developed as a discipline over the last decades. Treatment is concentrated on cure or palliation of the illness with the help of chemotherapy, radiotherapy or surgery. Palliative care has its origin in the hospice movement that started around 1960 in the UK. Centre of care is the patient and his family. Focus of care has moved from quantity to quality of life. Symptom control, communication, rehabilitation and care for the dying are main areas of palliative care. Palliative care and ...
Rubinson, Lewis; O'Toole, Tara
We recommend several actions that could improve hospitals' abilities to deliver critical care during epidemics involving large numbers of victims. In the absence of careful pre-event planning, demand for critical care services may quickly exceed available intensive care unit (ICU) staff, beds and equipment, leaving the bulk of the infected populace without benefit of potentially lifesaving critical care. The toll of death may be inversely proportional to the ability to augment critical care c...
The social network of children with special healthcare needs in the (invisibility of nursing care La red social de niños con necesidades especiales de salud en la (in visibilidad del cuidar de enfermería A rede social de crianças com necessidades especiais de saúde na (invisibilidade do cuidado de enfermagem
Juliana Rezende Montenegro Medeiros de Moraes
Full Text Available This study aimed to identify the (invisibility of nursing care and discuss ways of (disarticulating this care with family care in the social network of children with special healthcare needs. A qualitative research was performed with health professionals at a pediatric hospital, four units of the Family Medical Program (FMP, and children’s relatives living in Niterói (RJ. The field work was put in practice after IRB approval (HESFA/EEAN, consisting of five semi-structured interviews and two group dynamics. Critical Discourse Analysis indicated that nursing care is visible in the child’s social network through the nurse’s educational and care activities and home visits by the nurisng aide of the FMP. Due to errors in the national health system’s referral and counter-referral, mothers articulate the network and not the health service; thus, the reorganization of the system in the State would foster social networks that are less wearing for their families.El objetivo fue identificar la (in visibilidad del cuidado de enfermería y discutir los modos de (des articulación de ese cuidado con el cuidado familiar en red social de niños con necesidades especiales de salud. Investigación cualitativa con profesionales de salud de un hospital pediátrico, de cuatro unidades del Programa Médico de Familia (PMF, y familiares residentes en Niterói (RJ. Trabajo de campo fue ejecutado después de aprobación por el Comité de Ética (HESFA/EEAN, consistiendo de cinco entrevistas seme-estructuradas y dos dinámicas grupales. Análisis Critica del Discurso apuntó que cuidado de enfermería es visible en red social del niño por actividades cuidadoras y educativas de enfermera y por visita domiciliar del auxiliar de enfermería del PSF. Debido a fallos en la referencia y contra referencia del sistema de salud, la madre, articula red y no servicio de salud; por tanto la reorganización del sistema en el Estado promovería redes sociales menos
Moody, Karen; Siegel, Linda; Scharbach, Kathryn; Cunningham, Leslie; Cantor, Rabbi Mollie
Progress in pediatric palliative care has gained momentum, but there remain significant barriers to the appropriate provision of palliative care to ill and dying children, including the lack of properly trained health care professionals, resources to finance such care, and scientific research, as well as a continued cultural denial of death in children. This article reviews the epidemiology of pediatric palliative care, special communication concerns, decision making, ethical and legal considerations, symptom assessment and management, psychosocial issues, provision of care across settings, end-of-life care, and bereavement. Educational and supportive resources for health care practitioners and families, respectively, are included. PMID:21628042
... Rulemaking (NPRM), 75 FR 48236, August 9, 2010. The self-construction option will only be available, however... care networks; and (3) reduce the burden on the USF by maximizing the cost-effectiveness of the health... March 1, 2013 Part II Federal Communications Commission 47 CFR Part 54 Rural Health Care...
Al Hanbali, Ahmad; Altman, Eitan; Nain, Philippe
The Transmission Control Protocol (TCP) was designed to provide reliable end-to-end delivery of data over unreliable networks. In practice, most TCP deployments have been carefully designed in the context of wired networks. Ignoring the properties of wireless ad hoc networks can lead to TCP implemen
... 42 Public Health 2 2010-10-01 2010-10-01 false Designation of ESRD networks. 405.2110 Section 405... End-Stage Renal Disease (ESRD) Services § 405.2110 Designation of ESRD networks. CMS designated ESRD networks in which the approved ESRD facilities collectively provide the necessary care for ESRD...
We do not need a crystal ball to see the future. Our web-based future has already arrived in all other aspects of our lives--even our mobile phones. The tools for progress--Personal Health Records, Social Networks, and Online medical information--are widely available. The demand is at hand--Millennials are flexing consumer muscles as they enter the healthcare market. Real "Health Care Reform" requires fundamental changes in practice--which in turn requires effective use of information technologies and adaption to changing consumer expectations. The VHA and the MHS are uniquely capable of leveraging political, academic and technological forces to help move American health care through this millennial transformation. Federal health systems are positioned to demonstrate the value of innovation as America seeks healthcare reform. PMID:20572466
Abrahm, Janet L
While there are operational, financial, and workforce barriers to integrating oncology with palliative care, part of the problem lies in ourselves, not in our systems. First, there is oncologists' "learned helplessness" from years of practice without effective medications to manage symptoms or training in how to handle the tough communication challenges every oncologist faces. Unless they and the fellows they train have had the opportunity to work with a palliative care team, they are unlikely to be fully aware of what palliative care has to offer to their patients at the time of diagnosis, during active therapy, or after developing advanced disease, or may believe that, "I already do that." The second barrier to better integration is the compassion fatigue many oncologists develop from caring for so many years for patients who, despite the oncologists' best efforts, suffer and die. The cumulative grief oncologists experience may go unnamed and unacknowledged, contributing to this compassion fatigue and burnout, both of which inhibit the integration of oncology and palliative care. Solutions include training fellows and practicing oncologists in palliative care skills (eg, in symptom management, psychological disorders, communication), preventing and treating compassion fatigue, and enhancing collaboration with palliative care specialists in caring for patients with refractory distress at any stage of disease. As more oncologists develop these skills, process their grief, and recognize the breadth of additional expertise offered by their palliative care colleagues, palliative care will become integrated into comprehensive cancer care. PMID:23054873
In the Netherlands, children with cerebral palsy are the largest diagnostic group treated in paediatric rehabilitation, requiring specialized health-, education- and social services of multiple professionals from diverse organizations. To provide ‘integrated care’ in these settings, effective care coordination is essential, though in practice this is challenged by inadequate communication across the child’s care network. In order to improve communication across the integrated care setting of ...
Duncan, K. A.
Community Health Information Network (CHIN) developments have slowed, due to the chaotic change in the health care system and stakeholders' attendant short-sighted focus. CHINs are a long-term investment that is necessary for the health care system's evolution to maturity. Several arenas of essential CHIN activity are given that would be characteristic of a mature, goal-directed health care system Lack of enterprise-wide computer-based patient record systems is a major barrier. Even in the sh...
Kivelä, Mikko; Barthelemy, Marc; Gleeson, James P; Moreno, Yamir; Porter, Mason A
Most real and engineered systems include multiple subsystems and layers of connectivity, and it is important to take such features into account to try to obtain a complete understanding of these systems. It is thus necessary to generalize "traditional" network theory by developing (and validating) a framework and associated tools to study multilayer systems in a comprehensive fashion. The origins of such efforts occurred several decades ago, but now the study of multilayer networks has become one of the major directions in network science. In this paper, we discuss the history of multilayer networks (and related concepts) and then review the exploding body of work on such networks. To unify the disparate terminology in the large body of recent work, we discuss a general framework for multilayer networks, construct a dictionary of terminology to relate the numerous existing concepts to each other, and provide a thorough discussion that compares, contrasts, and translates between related notions such as multila...
Ryberg, Thomas; Larsen, Malene Charlotte
In this article we take up a critique of the concept of Communities of Practice (CoP) voiced by several authors, who suggest that networks may provide a better metaphor to understand social forms of organisation and learning. Through a discussion of the notion of networked learning and the critique...... of CoPs we shall argue that the metaphor or theory of networked learning is itself confronted with some central tensions and challenges that need to be addressed. We then explore these theoretical and analytic challenges to the network metaphor, through an analysis of a Danish social networking site. We...... argue that understanding meaning-making and ‘networked identities’ may be relevant analytic entry points in navigating the challenges....
Olsen, Rasmus Løvenstein; Balachandran, Kartheepan; Hald, Sara Ligaard;
In this chapter, we look into the role of telecommunication networks and their capability of supporting critical infrastructure systems and applications. The focus is on smart grids as the key driving example, bearing in mind that other such systems do exist, e.g., water management, traffic control......, etc. First, the role of basic communication is examined with a focus on critical infrastructures. We look at heterogenic networks and standards for smart grids, to give some insight into what has been done to ensure inter-operability in this direction. We then go to the physical network, and look...... at the deployment of the physical layout of the communication network and the related costs. This is an important aspect as one option to use existing networks is to deploy dedicated networks. Following this, we look at some generic models that describe reliability for accessing dynamic information. This part...
Aidan G O’Keeffe,1 Irwin Nazareth,2 Irene Petersen2 1Department of Statistical Science, 2Department of Primary Care and Population Health, University College London, London, UK Background: Statins are widely prescribed for the primary prevention of cardiovascular disease. Guidelines exist for statin prescriptions, but there is little recent analysis concerning prescription trends over time and how these vary with respect to demographic variables.Methods and results: Using The Health...
O’Keeffe AG; Nazareth I; Petersen I.
Aidan G O’Keeffe,1 Irwin Nazareth,2 Irene Petersen2 1Department of Statistical Science, 2Department of Primary Care and Population Health, University College London, London, UK Background: Statins are widely prescribed for the primary prevention of cardiovascular disease. Guidelines exist for statin prescriptions, but there is little recent analysis concerning prescription trends over time and how these vary with respect to demographic variables.Methods and results: Using The Health Imp...
Marylou Noble; Howard Waitzkin
Due to the wars in Iraq and Afghanistan, the unmet medical and psychological needs of military personnel are creating major challenges. Increasingly, active duty military personnel are seeking physical and mental health services from civilian professionals. The Civilian Medical Resources Network attempts to address these unmet needs. Participants in the Network include primary care and mental health practitioners in all regions of the country. Network professionals provide independent assessm...
For much of the twentieth century, urban networks was a term used by sociologists and others to describe social networks, their importance for bonding within communities and bridging between communities, and their relationship to the geographical mobility implied by late-nineteenth- and early-twentieth-century urbanization, mid-twentieth-century suburbanization, and late-twentieth-century globalization. This relationship is often assumed to be one in which social networks are threatened by ge...
Rinaldo, Andrea; Rodriguez-Iturbe, Ignacio; Rigon, Riccardo
This review proceeds from Luna Leopold's and Ronald Shreve's lasting accomplishments dealing with the study of random-walk and topologically random channel networks. According to the random perspective, which has had a profound influence on the interpretation of natural landforms, nature's resiliency in producing recurrent networks and landforms was interpreted to be the consequence of chance. In fact, central to models of topologically random networks is the assumption of equal likelihood of any tree-like configuration. However, a general framework of analysis exists that argues that all possible network configurations draining a fixed area are not necessarily equally likely. Rather, a probability P(s) is assigned to a particular spanning tree configuration, say s, which can be generally assumed to obey a Boltzmann distribution: P(s) % e^-H(s)/T, where T is a parameter and H(s) is a global property of the network configuration s related to energetic characters, i.e. its Hamiltonian. One extreme case is the random topology model where all trees are equally likely, i.e. the limit case for T6 4 . The other extreme case is T 6 0, and this corresponds to network configurations that tend to minimize their total energy dissipation to improve their likelihood. Networks obtained in this manner are termed optimal channel networks (OCNs). Observational evidence suggests that the characters of real river networks are reproduced extremely well by OCNs. Scaling properties of energy and entropy of OCNs suggest that large network development is likely to effectively occur at zero temperature (i.e. minimizing its Hamiltonian). We suggest a corollary of dynamic accessibility of a network configuration and speculate towards a thermodynamics of critical self-organization. We thus conclude that both chance and necessity are equally important ingredients for the dynamic origin of channel networks---and perhaps of the geometry of nature.
Samaka, Mohammed; Khan, Khaled M.D.
Wireless communication is the fastest-growing field in the telecommunication industry. Wireless networks have grown significantly as an important segment of the communications industry. They have become popular networks with the potential to provide high-speed, high-quality information exchange between two or more portable devices without any wire or conductors. Wireless networks can simply be characterized as the technology that provides seamless access to information, anywhere, anyplace, an...
Huang, Scott; Du, Ding-Zhu
This book provides a reference tool for the increasing number of the scientists whose research is related to sensor network security. The book is organized into several sections, each including some chapters exploring a specific topic. Network security is attracting great attention and there are many research topics waiting to be studied. In this book, the topics covered include network design and modeling, network management, data management, security and applications. The aim, intent, and motivation of this book is to provide a reference tool for the increasing number of scientists whose res
This book introduces the security mechanisms deployed in Ethernet, Wireless-Fidelity (Wi-Fi), Internet Protocol (IP) and MultiProtocol Label Switching (MPLS) networks. These mechanisms are grouped throughout the book according to the following four functions: data protection, access control, network isolation, and data monitoring. Data protection is supplied by data confidentiality and integrity control services. Access control is provided by a third-party authentication service. Network isolation is supplied by the Virtual Private Network (VPN) service. Data monitoring consists of applying
Floyd, Latosha; Phillips, Deborah A
The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a sprawling network with nearly 23,000 workers that directly serves or subsidizes care for 200,000 children every day. Child-care options available to civilians typically pale in comparison, and the military's system, embedded in a broader web of family support services, is widely considered to be a model for the nation. The military's child-care success rests on four pillars, write Major Latosha Floyd and Deborah A. Phillips. The first is certification by the military itself, including unannounced inspections to check on safety, sanitation, and general compliance with DoD rules. The second is accreditation by nationally recognized agencies, such as the National Association for the Education of Young Children. The third is a hiring policy that sets educational and other requirements for child-care workers, and the fourth is a pay scale that not only sets wages high enough to discourage the rapid turnover common in civilian child care but also rewards workers for completing additional training. Floyd and Phillips sound a few cautionary notes. For one, demand for military child care continues to outstrip the supply In particular, as National Guard and Reserve members have been activated during the wars in Iraq and Afghanistan, the DoD has sometimes struggled to provide child care for their children. And force reductions and budget cuts are likely to force the military to make difficult choices as it seeks to streamline its child-care services in the years ahead. PMID:25518693
Johnston, Donna L.; Hentz, Tracy A.; Friedman, Debra L.
Pediatric palliative care provides benefit to children living with life-threatening or terminal conditions. Palliative care should be available to all seriously ill children. Palliative care includes the treatment of symptoms such as pain, nausea, dyspnea, constipation, anorexia, and sialorrhea. This care can occur in a variety of settings, from home to hospice to hospital, and must include bereavement care and follow up after the death of a child. There are many challenges in pediatric palli...
Krigslund, Jeppe; Hansen, Jonas; Roetter, Daniel Enrique Lucani;
Software Defined Networking (SDN) and Network Coding (NC) are two key concepts in networking that have garnered a large attention in recent years. On the one hand, SDN's potential to virtualize services in the Internet allows a large flexibility not only for routing data, but also to manage buffe......). Our results on single–hop, multi–hop, and multi–path scenarios show that gains of 3x to 11x are attainable over standard TCP and multi–path TCP....
Gray, James E; Feldman, Henry; Reti, Shane; Markson, Larry; Lu, Xiaoning; Davis, Roger B; Safran, Charles A
We have developed a novel approach, the Digital Crumb Investigator, for using data collected as a byproduct of Electonic Health Record (EHR) use to help define care teams and care processes. We are developing tools and methods to utilize these routinely collected data to visualize and quantify care networks across acute care and ambulatory settings We have chosen a clinical care domain where clinicians use EHRs in their offices, on the maternity wards and in the neonatal intensive care units as a test paradigm for this technology. The tools and methods we deliver should readily translate to other health care settings that collect behind-the-scenes electronic metadata such as audit trails. We believe that by applying the methods of social networking to define clinical relationships around a patient's care we will enable new areas of research into the usage of EHRs to promote patient safety and other improvements in care. PMID:22195103
In present study, I proposed some new sciences: network chemistry, network toxicology, network informatics, and network behavioristics. The aims, scope and scientific foundation of these sciences are outlined.
With their ability to solve problems in massive information distribution and processing, while keeping scaling costs low, overlay systems represent a rapidly growing area of R&D with important implications for the evolution of Internet architecture. Inspired by the author's articles on content based routing, Overlay Networks: Toward Information Networking provides a complete introduction to overlay networks. Examining what they are and what kind of structures they require, the text covers the key structures, protocols, and algorithms used in overlay networks. It reviews the current state of th
Havemann, Frank; Scharnhorst, Andrea
This text is based on a translation of a chapter in a handbook about network analysis (published in German) where we tried to make beginners familiar with some basic notions and recent developments of network analysis applied to bibliometric issues (Havemann and Scharnhorst 2010). We have added some recent references.
Bedogne', C.; Masucci, A. P.; Rodgers, G. J.
We introduce a new class of deterministic networks by associating networks with Diophantine equations, thus relating network topology to algebraic properties. The network is formed by representing integers as vertices and by drawing cliques between M vertices every time that M distinct integers satisfy the equation. We analyse the network generated by the Pythagorean equation x2 +y2 =z2 showing that its degree distribution is well approximated by a power law with exponential cut-off. We also show that the properties of this network differ considerably from the features of scale-free networks generated through preferential attachment. Remarkably we also recover a power law for the clustering coefficient. We then study the network associated with the equation x2 +y2 = z showing that the degree distribution is consistent with a power law for several decades of values of k and that, after having reached a minimum, the distribution begins rising again. The power-law exponent, in this case, is given by γ ∼ 4.5 We then analyse clustering and ageing and compare our results to the ones obtained in the Pythagorean case.
Jensen, Finn Verner; Lauritzen, Steffen Lilholt
This article describes the basic ideas and algorithms behind specification and inference in probabilistic networks based on directed acyclic graphs, undirected graphs, and chain graphs.......This article describes the basic ideas and algorithms behind specification and inference in probabilistic networks based on directed acyclic graphs, undirected graphs, and chain graphs....
Sørensen, Ole Henning; Grande, Bård
The paper focuses on the concept of organizational networks. Four different uses of the concept are identified and critically discussed.......The paper focuses on the concept of organizational networks. Four different uses of the concept are identified and critically discussed....
Holme, Petter; Saramäki, Jari
A great variety of systems in nature, society and technology-from the web of sexual contacts to the Internet, from the nervous system to power grids-can be modeled as graphs of vertices coupled by edges. The network structure, describing how the graph is wired, helps us understand, predict and optimize the behavior of dynamical systems. In many cases, however, the edges are not continuously active. As an example, in networks of communication via e-mail, text messages, or phone calls, edges represent sequences of instantaneous or practically instantaneous contacts. In some cases, edges are active for non-negligible periods of time: e.g., the proximity patterns of inpatients at hospitals can be represented by a graph where an edge between two individuals is on throughout the time they are at the same ward. Like network topology, the temporal structure of edge activations can affect dynamics of systems interacting through the network, from disease contagion on the network of patients to information diffusion over an e-mail network. In this review, we present the emergent field of temporal networks, and discuss methods for analyzing topological and temporal structure and models for elucidating their relation to the behavior of dynamical systems. In the light of traditional network theory, one can see this framework as moving the information of when things happen from the dynamical system on the network, to the network itself. Since fundamental properties, such as the transitivity of edges, do not necessarily hold in temporal networks, many of these methods need to be quite different from those for static networks. The study of temporal networks is very interdisciplinary in nature. Reflecting this, even the object of study has many names-temporal graphs, evolving graphs, time-varying graphs, time-aggregated graphs, time-stamped graphs, dynamic networks, dynamic graphs, dynamical graphs, and so on. This review covers different fields where temporal graphs are considered
This book systematically synthesizes research achievements in the field of fuzzy neural networks in recent years. It also provides a comprehensive presentation of the developments in fuzzy neural networks, with regard to theory as well as their application to system modeling and image restoration. Special emphasis is placed on the fundamental concepts and architecture analysis of fuzzy neural networks. The book is unique in treating all kinds of fuzzy neural networks and their learning algorithms and universal approximations, and employing simulation examples which are carefully designed to he
The Developing Evidence to Inform Decisions about Effectiveness Network is a network of research centers that the Agency for Healthcare Research and Quality created to conduct practical studies about health care items and services.
Samson, Audrey; Soon, Winnie
This paper examines the notion of network affordance within the context of network art. Building on Gibson's theory (Gibson, 1979) we understand affordance as the perceived and actual parameters of a thing. We expand on Gaver's affordance of predictability (Gaver, 1996) to include ecological...... and computational parameters of unpredictability. We illustrate the notion of unpredictability by considering four specific works that were included in a network art exhibiton, SPEED SHOW [2.0] Hong Kong. The paper discusses how the artworks are contingent upon the parameteric relations (Parisi, 2013......), of the network. We introduce network affordance as a dynamic framework that could articulate the experienced tension arising from the (visible) symbolic representation of computational processes and its hidden occurrences. We base our proposal on the experience of both organising the SPEED SHOW and participating...
Scale-free and non-computable characteristics of natural networks are found to result from the least-time dispersal of energy. To consider a network as a thermodynamic system is motivated since ultimately everything that exists can be expressed in terms of energy. According to the variational principle, the network will grow and restructure when flows of energy diminish energy differences between nodes as well as relative to nodes in surrounding systems. The natural process will yield scale-free characteristics because the nodes that contribute to the least-time consumption of free energy preferably attach to each other. Network evolution is a path-dependent and non-deterministic process when there are two or more paths to consume a common source of energy. Although evolutionary courses of these non-Hamiltonian systems cannot be predicted, many mathematical functions, models and measures that characterize networks can be recognized as appropriate approximations of the thermodynamic equation of motion that has...
Bartlett, J G
Approximately one-half of all patients with HIV infection who are under care have Medicaid as the third party payor. Unlike Medicare, Medicaid is a state-specific program that has huge variations in reimbursement strategies. Multiple studies have shown that care for persons with AIDS is about $20,000/year, but reimbursement through various state Medicaid programs varies about $100/m/m to $2800/m/m despite the fact that expectations for care are identical. Hopkins has a major commitment to persons with HIV infection with a program that now includes 30 faculty members and a support staff of 170. With the introduction of mandatory managed care for Medicaid recipients in July, 1997, we were confronted with the issue of substantial downsizing with abandonment of over half of our patients, or learning the transition to managed care. This has been a steep learning curve involving negotiations with the state Medicaid office, reorganization of our clinic, careful scrutiny of our database regarding resource utilization and cost, education of providers, and longitudinal collection of new information and integration of the rapid changes in the field. In the process of this transition, we learned that there are precious few resources to provide guidance and that there is a perceived need for assistance by HIV providers throughout the country. Consequently, we have now established the "HIV Managed Care Network" with substantial funding from diverse sources to support education, data collection, and public policy review. It is premature to evaluate performance since most of these activities have just begun, but we expect that this Network will serve as a demonstration model for methods to deal with chronic diseases under managed care. PMID:10881336
Tsiourti, Christiana; Τσιουρτή, Χριστιάνα
Elders who live alone generally have rich care networks—support networks of people who provide the elder with care. Such networks provide assistance ranging from day-to-day activities to social support and often include people of varying ages and skills, which have significantly different roles in the elder‘s care and may or may not be professional caregivers (family members, friends, neighbors, medical staff, etc.). Clearly, the support network‘s major objective is to keep the elder physi...
Hong, Chi-Yao; Caesar, Matthew; Duffield, Nick; Wang, Jia
Operational network data, management data such as customer care call logs and equipment system logs, is a very important source of information for network operators to detect problems in their networks. Unfortunately, there is lack of efficient tools to automatically track and detect anomalous events on operational data, causing ISP operators to rely on manual inspection of this data. While anomaly detection has been widely studied in the context of network data, operational data presents sev...
Prasanna, Prasanth M; Seagull, F Jacob; Nagy, Paul
Online social networking is an immature, but rapidly evolving industry of web-based technologies that allow individuals to develop online relationships. News stories populate the headlines about various websites which can facilitate patient and doctor interaction. There remain questions about protecting patient confidentiality and defining etiquette in order to preserve the doctor/patient relationship and protect physicians. How much social networking-based communication or other forms of E-communication is effective? What are the potential benefits and pitfalls of this form of communication? Physicians are exploring how social networking might provide a forum for interacting with their patients, and advance collaborative patient care. Several organizations and institutions have set forth policies to address these questions and more. Though still in its infancy, this form of media has the power to revolutionize the way physicians interact with their patients and fellow health care workers. In the end, physicians must ask what value is added by engaging patients or other health care providers in a social networking format. Social networks may flourish in health care as a means of distributing information to patients or serve mainly as support groups among patients. Physicians must tread a narrow path to bring value to interactions in these networks while limiting their exposure to unwanted liability. PMID:21360214
Baggot, Deirdre; Edeburn, Andy
Health care is on the brink of an industrywide shift to a bundled payment model in which payment covers episodes of care extending from prehospitalization into post-acute care. Hospitals and health systems should begin development of a post-acute care network strategy in preparation for bundled payments. The strategic effort will require four broad phases: Defining the value proposition. Developing the post-acute care network. Building the bundle. Executing smartly from the start with new delivery models that reduce clinical variation and real-time performance monitoring. PMID:26595978
The study of networks in the form of mathematical graph theory is one of the fundamental pillars of discrete mathematics. However, recent years have witnessed a substantial new movement in network research. The focus of the research is shifting away from the analysis of small graphs and the properties of individual vertices or edges to consideration of statistical properties of large scale networks. This new approach has been driven largely by the availability of technological networks like the Internet , World Wide Web network , etc. that allow us to gather and analyze data on a scale far larger than previously possible. At the same time, technological networks have evolved as a socio-technological system, as the concepts of social systems that are based on self-organization theory have become unified in technological networks . In today’s society, we have a simple and universal access to great amounts of information and services. These information services are based upon the infrastructure of the Internet and the World Wide Web. The Internet is the system composed of ‘computers’ connected by cables or some other form of physical connections. Over this physical network, it is possible to exchange e-mails, transfer files, etc. On the other hand, the World Wide Web (commonly shortened to the Web) is a system of interlinked hypertext documents accessed via the Internet where nodes represent web pages and links represent hyperlinks between the pages. Peer-to-peer (P2P) networks  also have recently become a popular medium through which huge amounts of data can be shared. P2P file sharing systems, where files are searched and downloaded among peers without the help of central servers, have emerged as a major component of Internet traffic. An important advantage in P2P networks is that all clients provide resources, including bandwidth, storage space, and computing power. In this chapter, we discuss these technological networks in detail. The review
A great variety of systems in nature, society and technology can be modeled as graphs of vertices coupled by edges. The network structure, describing how the graph is wired, helps us understand, predict and optimize the behavior of dynamic systems. In many cases, however, the edges are not continuously active. As an example, in networks of communication via email, text messages, or phone calls, edges represent sequences of instantaneous or practically instantaneous contacts. In some cases, edges are active for non-negligible periods of time: e.g., the proximity patterns of inpatients at hospitals can be represented by a graph where an edge between two individuals is on throughout the time they are at the same ward. Like network topology, the temporal structure of edge activations can affect dynamics of systems interacting through the network, from disease contagion on the network of patients to information diffusion over an e-mail network. In this review, we present the emergent field of temporal networks, an...
Evolving out-of-equilibrium networks have been under intense scrutiny recently. In many real-world settings the number of links added per new node is not constant but depends on the time at which the node is introduced in the system. This simple idea gives rise to the concept of accelerating networks, for which we review an existing definition and-after finding it somewhat constrictive-offer a new definition. The new definition provided here views network acceleration as a time dependent property of a given system as opposed to being a property of the specific algorithm applied to grow the network. The definition also covers both unweighted and weighted networks. As time-stamped network data becomes increasingly available, the proposed measures may be easily applied to such empirical datasets. As a simple case study we apply the concepts to study the evolution of three different instances of Wikipedia, namely, those in English, German, and Japanese, and find that the networks undergo different acceleration regimes in their evolution
Welton, John M; Harper, Ellen M
The value of nursing care as well as the contribution of individual nurses to clinical outcomes has been difficult to measure and evaluate. Existing health care financial models hide the contribution of nurses; therefore, the link between the cost and quality o nursing care is unknown. New data and methods are needed to articulate the added value of nurses to patient care. The final results and recommendations of an expert workgroup tasked with defining and measuring nursing care value, including a data model to allow extraction of key information from electronic health records to measure nursing care value, are described. A set of new analytic metrics are proposed. PMID:27055306
Jaarsma, Tiny; Deaton, Christi; Fitzsimmons, Donna;
To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined...... of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given....
1问care about和care for可以相互替换使用吗？答：有时可以。但在不同情况下,它们在较确切的含义上还是有区别的。1在表示＂喜欢,关心,担心＂时,意思一样,常可以互换使用。如：I care about/for your integrity and honesty.我喜欢你的正直和诚实。She doesn’t care about/for politics.她不关心政治。You needn＇t care about/for his safety.你不必为他的安全担心。2在表示＂介意,计较,在乎＂等意思时,
Pick up where certification exams leave off. With this practical, in-depth guide to the entire network infrastructure, you'll learn how to deal with real Cisco networks, rather than the hypothetical situations presented on exams like the CCNA. Network Warrior takes you step by step through the world of routers, switches, firewalls, and other technologies based on the author's extensive field experience. You'll find new content for MPLS, IPv6, VoIP, and wireless in this completely revised second edition, along with examples of Cisco Nexus 5000 and 7000 switches throughout. Topics include: An
Etaner-Uyar, A Sima
The present volume provides a comprehensive resource for practitioners and researchers alike-both those new to the field as well as those who already have some experience. The work covers Social Network Analysis theory and methods with a focus on current applications and case studies applied in various domains such as mobile networks, security, machine learning and health. With the increasing popularity of Web 2.0, social media has become a widely used communication platform. Parallel to this development, Social Network Analysis gained in importance as a research field, while opening up many
Koskinen, Liisa; Kelly, Hélène; Bergknut, Eva;
This article concerns the European Curriculum in Cultural Care Project (2005-2009), which aimed at developing a curriculum framework for the enhancement of cultural competence in European health care education. The project was initiated and supported by the Consortium of Institutes in Higher...... Education in Health and Rehabilitation, whose goal is to nurture educational development and networking among member institutions. The framework is the result of a collaborative endeavor by nine nurse educators from five different European countries. The production of the framework will be described...
Pawson, Tony; Linding, Rune
To more effectively target complex diseases like cancer, diabetes and schizophrenia, we may need to rethink our strategies for drug development and the selection of molecular targets for pharmacological treatments. Here, we discuss the potential use of protein signaling networks as the targets...... for new therapeutic intervention. We argue that by targeting the architecture of aberrant signaling networks associated with cancer and other diseases new therapeutic strategies can be implemented. Transforming medicine into a network driven endeavour will require quantitative measurements of cell...... signaling processes; we will describe how this may be performed and combined with new algorithms to predict the trajectories taken by a cellular system either in time or through disease states. We term this approach, network medicine....
Hansen, Annette Skovsted
Human Resource Development was the first and remains an important pillar in Japanese foreign aid. I will argue that Japan has access to a global network of alumni who will co-define Japanese foreign aid in the future, because Japan has encouraged alumni societies and networking since 1965. A total...... of more than a million people in more than 100 countries have attended courses in Japan funded fully or partly by Japanese ODA since the inception of the technical assistance programs in 1954 through the Colombo Plan and since 1959 through the Association of Overseas Technical Scholarships (AOTS from...... 2009 HIDA). Many of these alumni have and will in the future exchange ideas and keep contact not only to Japan, but also to fellow alumni around the globe and, thereby, practice south-south exchanges, which are made possible and traceable by their established alumni network and the World Network of...
Hansen, Annette Skovsted
Technical Assistance courses have many functions apart from disseminating knowledge and information, one such function is to engender networks. During the course period, participants meet and establish contact and some of these contacts remain connections between alumni for many years after the...... courses are finished. The alumni networks depend on the uses they are put to by the individual alumni and the support they get from alumni and host countries. The United Nations initiated technical assistance courses in the late 1940s in order to train nationals from developing countries as a means to......, Denmark, as a Danida fellow. Today, the older sister works in Nepal and the younger in Seattle, where they still make use of their personal networks including connections to their fellow alumni of technical assistance courses. Inspired by work on social remittances in combination with network theory , I...
Companies organize in a way that involves many activities that are external to the traditional organizational boundaries. This presents challenges to operations management and managing operations involves many issues and actions dealing with external networks. Taking a network perspective changes...... the focus of operations management from managing the own organization to continuously developing and managing a network of external and internal resources forming a production system. This perspective may be called managing an “extraprise” rather than an “enterprise.” It should be noted that “an industrial...... network” should not be seen as an organizational form but as a perspective that can be used to enrich one's understanding of organizations. The industrial network perspective has three basic building blocks: actors, resources, and activities. The three building blocks and their relations constitute...
The Sentinel Network is an integrated, electronic, national medical product safety initiative that compiles information about the safe and effective use of medical products accessible to patients and healthcare practitioners.
Jørgensen, Heidi; Vintergaard, Christian
Logically it seems that companies pursuing different business strategies wouldalso manage their relationships with other firms accordingly. Nevertheless, due tothe lack of research in the field of network strategies, this link still remainsinadequately examined. Based on the well-known framework...... of organisationalbehaviour developed by Miles and Snow (1978), this paper argues that thepatterns of network behaviour practiced by firms greatly depend on the businesstypology of the company. That is, a company's business typology will to a certaindegree dictate the network identity of the company. In this paper evidence...... isprovided, that the relation between a company's strategy, structure and processesin fact have a considerable influence on its pattern of network behaviour. Threecase studies from the Danish biotech industry exemplify and illustrate how acompany's strategy is directly correlated with how it manages its...
Network power fault detection. At least one first network device is instructed to temporarily disconnect from a power supply path of a network, and at least one characteristic of the power supply path of the network is measured at a second network device connected to the network while the at least one first network device is temporarily disconnected from the network
This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.
... happening, the better you’ll be prepared to take care of yourself once you leave the hospital. You ... skin. If you catch a problem early and take care, you will often be able to continue to ...
... But during this time, it’s important that caregivers take care of themselves too. PDF Kindle ePub This booklet ... cancer This booklet is not about how to take care of a patient. Instead, it mainly provides ways ...
Department of Homeland Security — This database contains locations of day care centers for 50 states and Washington D.C. and Puerto Rico. The dataset only includes center based day care locations...
U.S. Environmental Protection Agency — This is a provisional dataset that contains point locations for the subset of Community Action for a Renewed Environment (CARE) grants given out by the US EPA. CARE...
... care that is given to a person when cancer therapies are no longer controlling the disease. It focuses on caring, not curing. When a person has a terminal diagnosis (usually defined as having a life expectancy ...
... of these areas: Surgery Internal medicine Pediatrics Anesthesiology Critical care nurse: A highly skilled nurse who provides all aspects ... and can often uphold the patient's wishes. The critical care nurse becomes an important part of decision-making with ...
Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....
... page: //medlineplus.gov/ency/patientinstructions/000606.htm Preeclampsia - self-care To use the sharing features on this ... have frequent checkups and tests. Bed Rest and Self-care at Home When you are at home, ...
... AVMA Meeting Dates Meetings & CE Calendar Symposiums & Summits Pet Health Awareness Events About AVMA Who We Are ... 12 Educators You are here: Home | Public Resources | Pet Care Print Share This! Your Veterinarian Pet Care ...
Loft, Lisbeth Trille Gylling; Hogan, Dennis P.
The aim of this study is to introduce the concept of care capital and provide an example of its application in the context of child care and maternal employment using the currently most suitable American data. We define care capital as the nexus of available, accessible, and experienced resources...... for care. The American setting is an ideal context to investigate the linkages between child care capital and maternal employment as the patterns of child care use tend to be more diverse compared to other national context. In the presented application of care capital, we examine mothers’ entry to paid...... employment during the first 36 weeks following a birth, and its association with experienced non-parental child care use before labor force entry. Using data from the Early Childhood Longitudinal Survey – Birth Cohort (N = 10,400 mothers), results from discrete-time hazard models show that use of non...
We introduce a generalization of tree-based generators called delegation networks. These make it possible to generate objects such as strings, trees, graphs, and pictures in a modular way by combining tree-based generators of several types. Our main result states that, if all underlying tree generators generate regular tree languages (or finite tree languages), then the tree-generating power of delegation networks is the same as that of context-free tree grammars working in IO mode.
This chapter discusses the fundamental ideas of how chemical networks are build, their strengths and limitations. The chemical reactions that occur in disks combine the cold phase reactions used to model cold molecular clouds with the hot chemistry applied to planetary atmosphere models. With a general understanding of the different types of reactions that can occur, one can proceed in building a network of chemical reactions and use it to explain the abundance of species seen in disks. One o...
González-Voyer, Alejandro; Kolm, N.
Parental care is common throughout the animal kingdom and among caring species there is a bewildering variation in how parents care for offspring, as well as in the amount of resources parents invest in care. For instance, there is considerable variation in the relative parental investment by the sexes – in some species females invest more, in others males invest more, and in some investment is more or less equally shared. Different hypotheses have been proposed to explain patterns of parenta...
Bulger, R J
As prefigured in the Greek tragedy Antigone, one of the primary conflicts in contemporary health care is that between humane concern for the individual and concern for society at large and administrative rules. The computerization of the health care system and development of large data bases will create new forms of this conflict that will challenge the self-definition of health care and health care professionals. PMID:2394563
The engineering problems of constructing autonomous networks of sensors and data processors that can provide alerts for dangerous situations provide a new context for debating the question whether man-made systems can emulate the cognitive capabilities of the mammalian brain. In this paper we consider the question whether a distributed network of sensors and data processors can form ``perceptions`` based on sensory data. Because sensory data can have exponentially many explanations, the use of a central data processor to analyze the outputs from a large ensemble of sensors will in general introduce unacceptable latencies for responding to dangerous situations. A better idea is to use a distributed ``Helmholtz machine`` architecture in which the sensors are connected to a network of simple processors, and the collective state of the network as a whole provides an explanation for the sensory data. In general communication within such a network will require time division multiplexing, which opens the door to the possibility that with certain refinements to the Helmholtz machine architecture it may be possible to build sensor networks that exhibit a form of artificial consciousness.
Evsukoff, Alexandre; González, Marta
In the last decade we have seen the emergence of a new inter-disciplinary field focusing on the understanding of networks which are dynamic, large, open, and have a structure sometimes called random-biased. The field of Complex Networks is helping us better understand many complex phenomena such as the spread of deseases, protein interactions, social relationships, to name but a few. Studies in Complex Networks are gaining attention due to some major scientific breakthroughs proposed by network scientists helping us understand and model interactions contained in large datasets. In fact, if we could point to one event leading to the widespread use of complex network analysis is the availability of online databases. Theories of Random Graphs from Erdös and Rényi from the late 1950s led us to believe that most networks had random characteristics. The work on large online datasets told us otherwise. Starting with the work of Barabási and Albert as well as Watts and Strogatz in the late 1990s, we now know th...
Colle, Didier; Jooris, Bart; Gurzi, Pasquale; Pickavet, Mario; Demeester, Piet
We present network virtualization (building virtual or logical networks over a physical infrastructure) and network programmability (allowing the network operator to at least control the network but more fundamentally to define its behavior) concepts.
Alzheimer ’s Caregiving Tips Caring forYourself Taking care of yourself is one of the most important things you ... are some ways you can take care of yourself: • Ask for help when you need it. • Join ...
Weissman, David E; Blust, Linda
Palliative care education includes the domains of pain and nonpain symptom management, communications skills, ethics and law, psychosocial care, and health systems. Defining key attitudes, knowledge, and skill objectives, and matching these to appropriate learning formats, is essential in educational planning. Abundant educational resource material is available to support classroom and experiential palliative care training. PMID:15639043
U.S. Department of Health & Human Services — Value of care displays â national data. This data set includes national-level data for the value of care displays associated with a 30-day episode of care for...
Annual Meeting, at CERN, 29-31 October 2007 The CARE project started on 1st January 2004 and will end on 31st December 2008. At the end of each year, the progress and status of its activities are reported in a general meeting. This year, the meeting takes place at CERN. The CARE objective is to generate structured and integrated European cooperation in the field of accelerator research and related R&D. The programme includes the most advanced scientific and technological developments, relevant to accelerator research for particle physics. It is articulated around three Networking Activities and four Joint Activities. The Networking Activities ELAN, BENE and HHH aim to better coordinate R&D efforts at the European level and to strengthen Europe’s ability to produce intense and high-energy particle beams (electrons and positrons, muons and neutrinos, protons and ions, respectively). The Joint Activities, SRF, PHIN, HIPPI and NED, aim at technical developments on s...
Annual Meeting, at CERN, 29-31 October 2007 The CARE project started on 1st January 2004 and will end on 31st December 2008. At the end of each year, the progress and status of its activities are reported in a general meeting. This year, the meeting is taking place at CERN. The CARE objective is to generate structured and integrated European cooperation in the field of accelerator research and related R&D. The programme includes the most advanced scientific and technological developments, relevant to accelerator research for particle physics. It is articulated around three Networking Activities and four Joint Activities. The Networking Activities ELAN, BENE and HHH aim to better coordinate R&D efforts at the European level and to strengthen Europe’s ability to produce intense and high-energy particle beams (electrons and positrons, muons and neutrinos, protons and ions, respectively). The Joint Activities, SRF, PHIN, HIPPI and NED, aim at technical developments ...
Una red para promover sistemas de salud basados en la atención primaria de salud en la Región de las Américas A network to promote health systems based on primary health care in the Region of the Americas
María Magdalena Herrera Vázquez
ón identificados pueden favorecer la cooperación internacional en el desarrollo de sistemas de salud basados en la APS, una vez que la OPS formule estrategias de implementación claras y tome el liderazgo para movilizar recursos financieros y generar vínculos de acción informal e interpersonal.OBJECTIVES: To identify the relational components of an international network of organizations that provide technical and financial assistance to promote the development of health systems based on primary health care in the countries of the Region of the Americas; to analyze the linkages that would allow the collaborating partners of the Pan American Health Organization (PAHO to work together on health issues; and to determine the basic theoretical elements that can help to develop action strategies that support advocacy efforts by a network. METHODS: This was a qualitative and quantitative cross-sectional study based on identifying key informants and on analyzing social networks. Ethnographic and relational information from 46 international organizations was collected through a self-administered semistructured questionnaire. From 46 international health cooperation organizations, 29 decisionmakers from 29 organizations participated (63.0% response rate. The structure and the strength of the network was evaluated in terms of density, closeness, clustering, and centralization. The statistical analysis was done using computer programs that included UCINET, Pajek, and Microsoft Access. RESULTS: We found a structurally centralized theoretical network, whose nodes were clustered into four central subgroups linked by a shared vision. The leadership, influence, and political interests reflected the formal and technical-cooperation linkages, the formal support for health systems based on primary health care, and the flow of resources being more often technical ones than financial ones. CONCLUSIONS: The interorganizational relational components and the social-action ties that were identified could
Physicists use large detectors to measure particles created in high-energy collisions at particle accelerators. These detectors typically produce signals indicating either where ionization occurs along the path of the particle, or where energy is deposited by the particle. The data produced by these signals is fed into pattern recognition programs to try to identify what particles were produced, and to measure the energy and direction of these particles. Ideally, there are many techniques used in this pattern recognition software. One technique, neural networks, is particularly suitable for identifying what type of particle caused by a set of energy deposits. Neural networks can derive meaning from complicated or imprecise data, extract patterns, and detect trends that are too complex to be noticed by either humans or other computer related processes. To assist in the advancement of this technology, Physicists use a tool kit to experiment with several neural network techniques. The goal of this research is interface a neural network tool kit into Java Analysis Studio (JAS3), an application that allows data to be analyzed from any experiment. As the final result, a physicist will have the ability to train, test, and implement a neural network with the desired output while using JAS3 to analyze the results or output. Before an implementation of a neural network can take place, a firm understanding of what a neural network is and how it works is beneficial. A neural network is an artificial representation of the human brain that tries to simulate the learning process . It is also important to think of the word artificial in that definition as computer programs that use calculations during the learning process. In short, a neural network learns by representative examples. Perhaps the easiest way to describe the way neural networks learn is to explain how the human brain functions. The human brain contains billions of neural cells that are responsible for processing
A prospective survey of activity in neonatal nurseries associated with 17 specialist maternity units delivering some 38,700 babies in the Northern region was undertaken during 1991. Data were collected concerning the numbers of babies requiring various forms of neonatal care, using a nursing dependency scale validated by work study. Facilities for prolonged high dependency care are partially decentralised in the Northern region, with a network of five units operating on a flexible and collabo...
... role in making health care safe. That includes doctors, nurses and other health care professionals. Health care organizations ... embarrassed if you don't understand what your doctor, nurse or other health care professional tells you. • Don’ ...
The Nurses Christian Fellowship International Quadrennial Conference was held November 5-10, 2012, in Santiago, Chile. The theme, "Partners in Care: Unity in diversity through Christ" brought together nurses from all over the world for Bible teaching, education, networking, and fellowship. Plenary and session abstracts are available as supplemental digital content through the HTML and PDF versions of this article at journalofchristiannursing.com. PMID:23607156
I denne artikel undersøger vi generationsforholdet mellem yngre voksne og deres forældre i det danske velfærdssamfund. Vores fokus er på omsorgspraksis og på slægtledsforpligtelser (filial responsibility). Artiklen omfatter dybdeanalyser af omsorgspraksis og intergenerationelle normer (filial nor...... individuel livsorientering ikke udelukker intergenerationel solidaritet i den danske velfærdsstat. Keywords: intergenerational care, individualisation, communality/ interconnectedness, social network analysis, ideals, everyday practices, social psychology....
Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda;
ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care were...... to North, patients from other regions had significantly lower odds of virological response; the difference was most pronounced for East and Argentina (adjusted OR 0.16[95%CI 0.11-0.23, p care utilization...
Garralda, Eduardo; Hasselaar, Jeroen; Carrasco, José Miguel; Van Beek, Karen; Siouta, Naouma; Csikos, Agnes; Menten, Johan; Centeno, Carlos
Background Integrated palliative care (IPC) involves bringing together administrative, organisational, clinical and service aspects in order to achieve continuity of care between all actors involved in the care network of patients receiving palliative care (PC) services. The purpose of this study is to identify literature on IPC in the Spanish context, either in cancer or other advanced chronic diseases. Methods Systematic review of the literature about IPC published in Spain between 1995 and...
Lorant, Vincent; Grard, Adeline; Van Audenhove, Chantal; Helmer, Eva; Vanderhaegen, Joke; Nicaise, Pablo
Background Belgium is currently implementing a nation-wide reform of mental health care delivery based on service networks. These networks are supposed to strengthen the community-based supply of care, reduce the resort to hospitals, and improve the continuity of care. They are also intended to supply comprehensive care to all adult mental health users. It is unclear, however, if one single model of network can target the needs of the whole adult population with mental health problems. Method...
Wireless sensor networks (WSNs) were made possible around the late 1990s by industry scale availability of small and energy efficient microcontrollers and radio interfaces. Application areas for WSNs range from agriculture to health care and emergency response scenarios. Depending on the scenario a sensor network can span from some rooms to an area of several square miles in size and so the number of sensor nodes can vary from a fistful of nodes to hundreds or thousands. Sensor nodes are comp...
Mills, David L
Carefully coordinated, reliable, and accurate time synchronization is vital to a wide spectrum of fields-from air and ground traffic control, to buying and selling goods and services, to TV network programming. Ill-gotten time could even lead to the unimaginable and cause DNS caches to expire, leaving the entire Internet to implode on the root servers.Written by the original developer of the Network Time Protocol (NTP), Computer Network Time Synchronization: The Network Time Protocol on Earth and in Space, Second Edition addresses the technological infrastructure of time dissemination, distrib
Background: Fragmented specialized care for the frail elderly as claimed by WHO needs horizontal integration across settings. The home of the patient seems to be a promising place to integrate hospital care, primary care and social services for high-risk discharges where the quality...... of rehabilitation makes a difference. Objective: The study aims to reveal how integrated home care may be organised to improve quality of care as compared to usual hospital care. Method: A qualitative case study of the use of a neuroeconomic model in relation to multidisciplianry collaboration on a RCT...... of integrated home care for stroke patients. Results: (1) The classical understanding of CNS is that of a dual system of ANS and Cortex. The new neuroeconomic understanding is that of a reciprocal balance of Limbic System (LS) and Neocortex (NC). This applies directly in favour of integrated homecare compared...
Krioukov, Dmitri; Sinkovits, Robert S; Rideout, David; Meyer, David; Boguna, Marian
Causal sets are an approach to quantum gravity in which the causal structure of spacetime plays a fundamental role. The causal set is a quantum network which underlies the fabric of spacetime. The nodes in this network are tiny quanta of spacetime, with two such quanta connected if they are causally related. Here we show that the structure of these networks in de Sitter spacetime, such as our accelerating universe, is remarkably similar to the structure of complex networks -- the brain or the Internet, for example. Specifically, we show that the node degree distribution of causal sets in de Sitter spacetime is described by a power law with exponent 2, similar to many complex networks. Quantifying the differences between the causal set structure in de Sitter spacetime and in the real universe, we find that since the universe today is relatively young, its power-law exponent is not 2 but 3/4, yet exponent 2 is currently emerging. Finally, we show that as a consequence of a simple geometric duality, the growth d...
Isabella Teixeira Bastos
Full Text Available Objective To associate the territory of identity with the production of care within a PCC focusing on children and adolescents with drug abuse and their institutional identity. Method We used the “ process tracing methodology” in four research categories: focus groups, characterization of professionals, observing the everyday and interviewing two members of emblematic cases of the service. Results territory of identity of the institution, which operates the production of care is crossed by the difficulty of dealing with the complexity brought by the users and the performance of the PCC network. This paper is also permeated by different conceptions of care and small problematization of these issues in collective spaces of service. Conclusion The discussion in focus groups and other devices can be powerful resources to reframe the meaning of care and identity of collective service.
Mohammadzadeh, Zeinab; Davoodi, Somayeh; Ghazisaeidi, Marjan
Online social network technologies have become important to health and apply in most health care areas. Particularly in cancer care, because it is a disease which involves many social aspects, online social networks can be very useful. Use of online social networks provides a suitable platform for cancer patients and families to present and share information about their medical conditions, address their educational needs, support decision making, and help to coping with their disease and improve their own outcomes. Like any other new technologies, online social networks, along with many benefits, have some negative effects such as violation of privacy and publication of incorrect information. However, if these effects are managed properly, they can empower patients to manage cancer through changing behavioral patterns and enhancing the quality of cancer patients lives This paper explains some application of online social networks in the cancer patient care process. It also covers advantages and disadvantages of related technologies. PMID:27039815
U.S. Department of Health & Human Services — Timely and Effective Care measures - state data. This data set includes state-level data for measures of heart attack care, heart failure care, pneumonia care,...
... care; Anterior tibial pain - self-care; Medial tibial stress syndrome - self-care; MTSS - self-care; Exercise-induced ... these medicines have side effects and can cause ulcers and bleeding. Talk to your doctor about how ...
The use of social network methodological framework in nursing care to breastfeeding women La utilización del marco metodológico de red social en asistencia de enfermería a mujeres que amamantan A utilização do referencial metodológico de rede social na assistência de enfermagem a mulheres que amamentam
Maria Helena do Nascimento Souza
Full Text Available This study aimed to discuss the contribution of the social network methodological framework in nursing care delivered to women who breastfeed their children up to six months of age. This qualitative study aimed to elaborate the social network map of 20 women through tape-recorded interview. Social network analysis evidenced a "strong" bond between these women and members from their primary network, especially friends, neighbors, mothers or with the child's father, who were reported as the people most involved in the breastfeeding period. The contribution of this framework to nursing practice is discussed, especially in care and research processes. We believe that nurses' appropriation of this framework can be an important support for efficacious actions, as well as to favor a broader perspective on the social context people experience.Este estudio tuvo como objetivo discutir la contribución del marco metodológico de red social en la asistencia de enfermería, a partir de su aplicación en mujeres que amamantan sus hijos hasta seis meses de edad. Se trata de estudio de abordaje cualitativa, donde se buscó elaborar el mapa de red social de 20 mujeres, mediante entrevista grabada. El análisis de las redes sociales evidenció la presencia de vínculo "fuerte" de esas mujeres con miembros de la red primaria, especialmente con amigas, vecinas, su madre y con el padre del niño, revelando ser esas las personas que más participan con ellas durante el amamantar. Se discute la contribución de ese marco de referencia para las prácticas de enfermería, particularmente para el proceso de asistir e investigar, acreditando que la apropiación de ese marco de referencia por enfermeros puede constituirse en un importante subsidio para la eficacia de sus acciones, así como favorecer una perspectiva más amplia acerca del contexto social experimentado por las personas.Este estudo teve como objetivo discutir a contribuição do referencial metodológico de
Full Text Available This article presents an approach to transnational family solidarity in terms of the “circulation of care”. This approach is based on a multidimensional vision of care-giving that goes beyond the personal care given to a dependent person. It takes the whole family network as its unit of analysis, and uses it to show the multiplicity of actors and the roles they play in the maintenance of transnational family solidarity in the long term. The article provides an analysis model of the institutional contexts that partially constitute the resources necessary for the circulation of care, recognising that other factors, such as the history of intra-family relationships, influence the dynamics at play.
On Sunday 12 June 2005, a site-wide security software upgrade will be performed on all CERN network equipment. This maintenance operation will cause at least 2 short network interruptions of 2 minutes on each equipment item. There are hundreds of such items across the CERN site (Meyrin, Prévessin and all SPS and LHC pits), and it will thus take the whole day to treat them all. All network users and services will be affected. Central batch computing services will be interrupted during this period, expected to last from 8 a.m. until late evening. Job submission will still be possible but no jobs will actually be run. It is hoped to complete the computer centre upgrades in the morning so that stable access can be restored to lxplus, afs and nice services as soon as possible; this cannot be guaranteed, however. The opportunity will be used to interrupt and perform upgrades on the CERN Document Servers.
Marzo, José L.; Stidsen, Thomas Riis; Ruepp, Sarah Renée;
– are vital to modern services such as mobile telephony, online banking and VoIP. This book examines communication networking from a mathematical viewpoint. The contributing authors took part in the European COST action 293 – a four-year program of multidisciplinary research on this subject. In this book...... they offer introductory overviews and state-of-the-art assessments of current and future research in the fields of broadband, optical, wireless and ad hoc networks. Particular topics of interest are design, optimization, robustness and energy consumption. The book will be of interest to graduate students......, researchers and practitioners in the areas of networking, theoretical computer science, operations research, distributed computing and mathematics....
This paper advances a framework for modeling the component interactions between cognitive and social aspects of scientific creativity and technological innovation. Specifically, it aims to characterize Innovation Networks; those networks that involve the interplay of people, ideas and organizations to create new, technologically feasible, commercially-realizable products, processes and organizational structures. The tri-partite framework captures networks of ideas (Concept Level), people (Individual Level) and social structures (Social-Organizational Level) and the interactions between these levels. At the concept level, new ideas are the nodes that are created and linked, kept open for further investigation or closed if solved by actors at the individual or organizational levels. At the individual level, the nodes are actors linked by shared worldviews (based on shared professional, educational, experiential backgrounds) who are the builders of the concept level. At the social-organizational level, the nodes...
Braunstein, Alfredo; Semerjian, Guilhem; Zdeborová, Lenka
We study the problem of network dismantling, that is of finding a minimal set of vertices whose removal leaves the network broken in connected components of sub-extensive size. For a large class of random graphs this problem is tightly connected to the decycling problem (the removal of vertices leaving the graph acyclic). Exploiting this connection and recent works on epidemic spreading we present precise predictions for the minimal size of a dismantling set in a large random graph with a prescribed (light-tailed) degree distribution. Building on the statistical mechanics perspective we propose a three-stage Min-Sum algorithm for efficiently dismantling networks, including heavy-tailed ones for which the dismantling and decycling problems are not equivalent. We also provide insight into the dismantling problem concluding that it is an intrinsically collective problem and optimal dismantling sets cannot be viewed as a collection of individually well performing nodes.
In this paper we consider the question whether a distributed network of sensors and data processors can form "perceptions" based on the sensory data. Because sensory data can have exponentially many explanations, the use of a central data processor to analyze the outputs from a large ensemble of sensors will in general introduce unacceptable latencies for responding to dangerous situations. A better idea is to use a distributed "Helmholtz machine" architecture in which the collective state of the network as a whole provides an explanation for the sensory data.
Gonçalves, Bruno; Menezes, Ronaldo; Sinatra, Roberta
The last decades have seen the emergence of Complex Networks as the language with which a wide range of complex phenomena in fields as diverse as Physics, Computer Science, and Medicine (to name just a few) can be properly described and understood. This book provides a view of the state of the art in this dynamic field and covers topics ranging from network controllability, social structure, online behavior, recommendation systems, and network structure. This book includes the peer-reviewed list of works presented at the 7th Workshop on Complex Networks CompleNet 2016 which was hosted by the Université de Bourgogne, France, from March 23-25, 2016. The 28 carefully reviewed and selected contributions in this book address many topics related to complex networks and have been organized in seven major groups: (1) Theory of Complex Networks, (2) Multilayer networks, (3) Controllability of networks, (4) Algorithms for networks, (5) Community detection, (6) Dynamics and spreading phenomena on networks, (7) Applicat...
Full Text Available Abstract Background Emergency departments (EDs are high pressure health care settings involving complex interactions between staff members in providing and organising patient care. Without good communication and cooperation amongst members of the ED team, quality of care is at risk. This study examined the problem-solving, medication advice-seeking and socialising networks of staff working in an Australian hospital ED. Methods A social network survey (Response Rate = 94% was administered to all ED staff (n = 109 including doctors, nurses, allied health professionals, administrative staff and ward assistants. Analysis of the network characteristics was carried out by applying measures of density (the extent participants are concentrated, connectedness (how related they are, isolates (how segregated, degree centrality (who has most connections measured in two ways, in-degree, the number of ties directed to an individual and out-degree, the number of ties directed from an individual, betweenness centrality (who is important or powerful, degree of separation (how many ties lie between people and reciprocity (how bi-directional are interactions. Results In all three networks, individuals were more closely connected to colleagues from within their respective professional groups. The problem-solving network was the most densely connected network, followed by the medication advice network, and the loosely connected socialising network. ED staff relied on each other for help to solve work-related problems, but some senior doctors, some junior doctors and a senior nurse were important sources of medication advice for their ED colleagues. Conclusions Network analyses provide useful ways to assess social structures in clinical settings by allowing us to understand how ED staff relate within their social and professional structures. This can provide insights of potential benefit to ED staff, their leaders, policymakers and researchers.
The objective of this contribution is to characterize the functional and institutional features of the German health-care system. This takes place after a short introduction and examination of the ongoing debate on health care in Germany. External funding describes the form of revenue generation. Regarding external funding of the German health care system, one of the favored alternatives in the current debate is the possibility of introducing per capita payments. After a short introduction to the capitation option, focus is on the so-called health fund that is currently debated on and being made ready for implementation in Germany, actually a mixed system of capitation and contributions based on income. On the other hand, internal funding is the method of how different health-care services are purchased or reimbursed. This becomes a rather hot topic in light of new trends for integrated and networked care to patients and different types of budgeting. Another dominating question in the German health-care system is the liberalization of the contractual law, with its "joint and uniform" regulations that have to be loosened for competition gains. After a discussion of the consequences of diagnosis-related groups (DRGs) in Germany, the article is concluded by a note on the political rationality of the current health-care reform for increased competition within the Statutory Health Insurance and its players as exemplified by the health fund. To sum up, it has to be said that the complexity and specific features of how the German system is financed seem to require ongoing reform considerations even after realization of the currently debated health-care reform law which, unfortunately, is dominated by political rationalities rather than objective thoughts. PMID:17497087
Hull, Sally; Mathur, Rohini; Lloyd-Owen, Simon; Round, Thomas; Robson, John
Background: Structured care for people with chronic obstructive pulmonary disease (COPD) can improve outcomes. Delivering care in a deprived ethnically diverse area can prove challenging. Aims: Evaluation of a system change to enhance COPD care delivery in a primary care setting between 2010 and 2013 using observational data. Methods: All 36 practices in one inner London primary care trust were grouped geographically into eight networks of 4–5 practices, each supported by a network manager, c...
Type IIB string theory admits a BPS configuration in which three strings (of different type) meet at a point. Using this three string configuration we construct a string network and study its properties. In particular we prove supersymmetry of this configuration. We also consider string lattices, which can be used to construct BPS states in toroidally compactified string theory.
Dehmer, Matthias; Mehler, Alexander
For over a decade, complex networks have steadily grown as an important tool across a broad array of academic disciplines, with applications ranging from physics to social media. A tightly organized collection of carefully-selected papers on the subject, Towards an Information Theory of Complex Networks: Statistical Methods and Applications presents theoretical and practical results about information-theoretic and statistical models of complex networks in the natural sciences and humanities. The book's major goal is to advocate and promote a combination of graph-theoretic, information-theoreti
Kamaksi Prasad V2
Full Text Available The audit ability and security of the broadcast network and security needs to be enhanced. This article is proposing the security solutions for such networks that are cost effective. The solution also takes care of the reduction of effective bandwidth-delay product. The improvement in terms of a cost effective comparator improves the efficiency and security of such networks. The threats like Eavesdropping, Interception and modification of transmitted data, Spoofing, Denial of service (DoS, FreeÃ¢â‚¬â€œloading, and Accidental threats are some of the threats addressed in this article.
Taggar Jaspal S
Full Text Available Abstract Background Smoking is a UK public health threat but GPs can be effective in helping patients to quit; consequently, the Quality and Outcomes Framework (QOF incentivises the recording of smoking status and delivery of cessation advice in patients’ medical records. This study investigates the association between smoking-related QOF targets and such recording, and the factors which influence these clinical activities. Methods For 2000 to 2008, using medical records in The Health Improvement Network (THIN database, the annual proportions of i patients who had a record of smoking status made in the previous 27 months and ii current smokers recorded as receiving cessation advice in the previous 15 months were calculated. Then, for all patients at selected points before and after the QOF’s implementation, data on gender, age, Townsend score, and smoking-related morbidity were extracted. Multivariate logistic regression was used to investigate individual-level characteristics associated with the recording of smoking status and cessation advice. Results Rapid increases in recording smoking status and advice occurred around the QOF’s introduction in April 2004. Subsequently, compliance to targets has been sustained, although rates of increase have slowed. By 2008 64.5% of patients aged 15+ had smoking status documented in the previous 27 months and 50.5% of current smokers had cessation advice recorded in the last 15 months. Adjusted odds ratios show that, both before and after the introduction of the QOF, those with chronic medical conditions, greater social deprivation and women were more likely to have a recent recording of smoking status or cessation advice. Since the QOF’s introduction, the strongest characteristic associated with recording activities was the presence of co-morbidity. An example of this was patients with COPD, who in 2008, were 15.38 (95% CI 13.70-17.27 times and 11.72 (95% CI 10.41-13.21 times more likely to
Donham, Carolyn S.; Maple, Brenda T.; Letsch, Suzanne W.
This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avai...
Donham, Carolyn S.; Maple, Brenda T.; Cowan, Cathy A.
This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avai...
Donham, Carolyn S.; Maple, Brenda T.; Sensenig, Arthur L.
This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avai...
Donham, Carolyn S.; Maple, Brenda T.; Sivarajan, Lekha
This regular feature of the journal includes a discussion of each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avail...
Donham, Carolyn S.; Sensenig, Arthur L.; Heffler, Stephen K.
This regular feature of the journal includes a discussion of each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avail...
Maple, Brenda T.; Cowan, Cathy A.; Donham, Carolyn S.; Letsch, Suzanne W.
This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of...
Donham, Carolyn S.; Sensenig, Arthur L.; Heffler, Stephen K.
Cowan, Cathy A.; Donham, Carolyn S.; Letsch, Suzanne W.; Maple, Brenda T.; Lazenby, Helen C.
This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of...
It is remarkable how health care systems, created over decades and influenced by very different cultures exhibit similar problems. Most health care systems are compartmentalised with managers at margins responding to perverse incentives and seeking to shift patients and costs onto rival organisations. Decision makers behave selfishly, considering the welfare of their own organisations rather than those of the health care system as a whole, and in the absence if evidence about the cost-effecti...
Stevens, F; Zee, J. van der
A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective, meaningful, and socially accepted. From a sociological point of view, the analysis of health care delivery systems implies recognition of their distinct history over time, their specific values an...
Aujard, Ségolène; de Brisoult, Béatrice; Broussard, Daniel; Petitclerc-Roche, Solenne; Lefort, Hugues
In France, nurses practising in the prison environment work in a health care unit, for somatic care, or in a regional medical-psychological unit for large facilities and psychological care. These units belong to the regional hospitals. Located at the heart of the prison, they cater for prisoner-patients. On the frontline, the nurse has specific autonomy and responsibility in this unique context. PMID:26975674
OBJECTIVE: To define the special health care needs of Canadian lesbians. DESIGN: A questionnaire containing 61 yes-or-no and multiple-choice questions sought information on six areas: demographics; health care use; habits, diet, and exercise; preventive care; mental health; and physical health. SETTING: The organizational meeting of a lesbian softball league in Toronto. PARTICIPANTS: Of 360 women eligible for the meeting, 205 attended and 195 completed the survey. Questionnaires used for anal...
Del Ferraro, Catherine; Ferrell, Betty; Van Zyl, Carin; Freeman, Bonnie; Klein, Linda
Over a decade ago, the Institute of Medicine (IOM) presented Ensuring Quality Cancer Care in the United States, with recommendations for change (IOM, 1999). However, barriers to integrating palliative care (PC) to achieve high-quality care in cancer still remain. As novel therapeutic agents evolve, patients are living longer, and advanced cancer is now considered a chronic illness. In addition to complex symptom concerns, patients and family caregivers are burdened with psychological, social,...
Trapanotto Manuela; Spizzichino Marco; Benini Franca; Ferrante Anna
Abstract The WHO defines pediatric palliative care as the active total care of the child's body, mind and spirit, which also involves giving support to the family. Its purpose is to improve the quality of life of young patients and their families, and in the vast majority of cases the home is the best place to provide such care, but for cultural, affective, educational and organizational reasons, pediatric patients rarely benefit from such an approach. In daily practice, it is clear that pedi...
Maria Polikandrioti; Ioannis Koutelekos
Music has been used therapeutically for many centuries, and numerous studies have researched the curative and preventative powers of music in several diseases. Music, as a therapy was shown to have positive effects in child care, such as in premature infants, children in emergency care, children receiving surgery, children in oncology departments and handicapped children. The aim of this review was to study the therapeutic effects of music in child care at hospital. The method οf this study i...
Patient-centered care focuses on the patient and the individual's particular health care needs. The goal of patient-centered health care is to empower patients to become active participants in their care. This requires that physicians, radiologic technologists and other health care providers develop good communication skills and address patient needs effectively. Patient-centered care also requires that the health care provider become a patient advocate and strive to provide care that not only is effective but also safe. For radiologic technologists, patient-centered care encompasses principles such as the as low as reasonably achievable (ALARA) concept and contrast media safety. Patient-centered care is associated with a higher rate of patient satisfaction, adherence to suggested lifestyle changes and prescribed treatment, better outcomes and more cost-effective care. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store. According to one theory, most patients judge the quality of their healthcare much like they rate an airplane flight. They assume that the airplane is technically viable and is being piloted by competent people. Criteria for judging a particular airline are personal and include aspects like comfort, friendly service and on-time schedules. Similarly, patients judge the standard of their healthcare on nontechnical aspects, such as a healthcare practitioner's communication and "soft skills." Most are unable to evaluate a practitioner's level of technical skill or training, so the qualities they can assess become of the utmost importance in satisfying patients and providing patient-centered care.(1). PMID:19901351
The poor planning of health care professionals in Spain has led to an exodus of doctors leaving the country. France is one of the chosen countries for Spanish doctors to develop their professional career. The French health care system belongs to the Bismarck model. In this model, health care system is financed jointly by workers and employers through payroll deduction. The right to health care is linked to the job, and provision of services is done by sickness-funds controlled by the Government. Primary care in France is quite different from Spanish primary care. General practitioners are independent workers who have the right to set up a practice anywhere in France. This lack of regulation has generated a great problem of "medical desertification" with problems of health care access and inequalities in health. French doctors do not want to work in rural areas or outside cities because "they are not value for money". Medical salary is linked to professional activity. The role of doctors is to give punctual care. Team work team does not exist, and coordination between primary and secondary care is lacking. Access to diagnostic tests, hospitals and specialists is unlimited. Duplicity of services, adverse events and inefficiencies are the norm. Patients can freely choose their doctor, and they have a co-payment for visits and hospital care settings. Two years training is required to become a general practitioner. After that, continuing medical education is compulsory, but it is not regulated. Although the French medical Health System was named by the WHO in 2000 as the best health care system in the world, is it not that good. While primary care in Spain has room for improvement, there is a long way for France to be like Spain. PMID:26304179
Coulibaly, S O; Keita, M
From the results obtained regarding the financing of health care in Mali, we emphasize two important points. First, there is a lack of criteria for the distribution of finding in the health care sector, resulting in a waste of resources. Secondly, there is an absence of adequate pharmaceutical policies. The field studies led in 1987 provided the following observations. The rate of occupation of the beds is very low. Also, the numerous new investments are not yet put into service because of the lack of necessary equipment of qualified personnel. In addition, this does not consider the excessive investments occurring in certain localities where neither the rate of frequentation nor the economic conditions will ever allow the use of the capacity created. Among the possible solutions for the crisis of health care funding in Mali, the following should be priority: first, to fight against the complete lack of organization of the activities at the health care centers; secondly, to fight against the waste and misappropriation of money resulting from the behavior of the medical and paramedical personnel: and thirdly, to clarify the management of the resources coming from the charges for each service. The pharmaceutical policies adopted and implemented in recent years Largely contributed to, first, the creation of competition between essential generic medications and nongeneric medications that can be replaced, and then, the destruction of the public network of drug distribution. These conditions considerably limited the distribution of essential medications; yet, this is the only manner of reducing the pharmaceutical expenses and accordingly, allowing more funding for other medical services. As the distribution network is disorganized, the only alternative for the population to obtain the medications at the lowest price was to create centers of purchasing and distribution and to multiply the number of retailers of essential medications. Extensive work has been conducted in
We are advancing the research of patient service cloud in the global medical collaboration network system based on 3D electronic referral letters. In this paper it proposes one configuration method of private cloud that aims at the home care patient's health care and independence support based on voice navigation system (VONAVS). We evaluate 3D image compression rate, try image compositing Cloud's configuration by the multi sensor network, and search for the configuration method of the remote image diagnosis. The proposed configuration method expands the possibility to the global medical collaboration network system for new large areas such as a telemedicine, an emergency care, and home medical care. (author)
Giangreco, Antonio; Sebastiano, Antnio; Carugati, Andrea
-driven modernization process of an Italian nursing home. Based on qualitative research methods, our aim is to identify what are the elements of a designing approach of an IT-tool meant to enhance a process of modernization in a health care organization. Our results show that a patient-centered, user-friendly, bottomup...... designed and results-driven tool is more likely to be beneficial for the patients and the users and therefore, for the organization at large. This study contributes to the extant literature on health care management providing the alternative view that, if the tool is designed around and for the individuals...... (patients and users), then it will produce positive results for the organization. In other words, who dares to care, will perform....
Uncircumcised penis - bathing; Cleaning an uncircumcised penis ... An uncircumcised penis has its foreskin intact. An infant boy with an uncircumcised penis does not need special care. Normal bathing ...
Broström, Stig; Johannesson, Eva Marianne; Purola, Anna-Maija;
The aim of the study is to explore how Nordic Early Childhood Education and Care policies frame values education in preschools with a special focus on the values of democracy, caring and competence. The study is part of a larger Nordic project, Valueseducation in Nordic preschools: Basis of...... the study. Keywords related with democratic, caring and competence values were selected. The findings reveal different dimensions and meanings of the three value fields, such as democracy as being and/or becoming; care as fulfilment of basic needs and an ethical relationship; and competence values as...
Nurses care, help and support patients before they are born, when they are alive and after they die. The starting points of this study were how nurses provide physical care for the dead patients and psychological care for the bereaved families. The purpose of this study was to describe the role of a nurse when patients die. The aims of this study were that the results of the study could help the nurses’ clinical work and could be used as part of teaching material in post-mortem care or nu...
Caring for the Caregiver is information for persons helping to care for people with cancer. The emphasis is on what caregivers can do to help themselves at this stressful time. Topics included are: Who Is a Caregiver, Your Feelings, Asking For Help, Caring for Yourself, Going With Your Loved One to Medical Visits, Talking With Others, Remember, Other Resources for Caregivers. The information is written on a basic level and it is very suitable for health professionals to share with persons helping to care for family members or friends who have cancer. The National Cancer Institute posted this information on its website last June 29. PMID:19062356
Alavala, Chennakesava R
About the Book: The primary purpose of this book is to provide the student with a comprehensive knowledge of basic concepts of fuzzy logic and neural networks. The hybridization of fuzzy logic and neural networks is also included. No previous knowledge of fuzzy logic and neural networks is required. Fuzzy logic and neural networks have been discussed in detail through illustrative examples, methods and generic applications. Extensive and carefully selected references is an invaluable resource for further study of fuzzy logic and neural networks. Each chapter is followed by a question bank
Zhou, Jie; Chen, Guanrong
Network topology and nodal dynamics are two fundamental stones of adaptive networks. Detailed and accurate knowledge of these two ingredients is crucial for understanding the evolution and mechanism of adaptive networks. In this paper, by adopting the framework of the adaptive SIS model proposed by Gross et al. [Phys. Rev. Lett. 96, 208701 (2006)] and carefully utilizing the information of degree correlation of the network, we propose a link-based formalism for describing the system dynamics with high accuracy and subtle details. Several specific degree correlation measures are introduced to reveal the coevolution of network topology and system dynamics.
Cross-sectional study that used the Social Network Index and the genogram to assess the social network of 110 family caregivers of dependent patients attended by a Home Care Service in São Paulo, Brazil. Data were analyzed using the test U of Mann-Whitney, Kruskal-Wallis and Spearman correlation. Results were considered statistically significant when p
Czerkawski, Betül C.
With the emergence of social software and the advance of web-based technologies, online learning networks provide invaluable opportunities for learning, whether formal or informal. Unlike top-down, instructor-centered, and carefully planned formal learning settings, informal learning networks offer more bottom-up, student-centered participatory…
Dambaugh, Lori A; Ecklund, Margaret M
Obese patients have complex needs that complicate their care during hospitalization. These patients often have comorbid conditions, including hypertension, heart failure, obstructive sleep apnea, pressure ulcers, and difficulty with mobility. Obese patients may be well served in the progressive care setting because they may require more intensive nursing care than can be delivered in a general care unit. Progressive care nurses have core competencies that enable them to safely and effectively care for obese patients. A plan of care with interdisciplinary collaboration illustrates the integrative care for obese progressive care patients. (Critical Care Nurse 2016; 36:58-63). PMID:27481802
Riggio, Roberto; Bradai, Abbas; Rasheed, Tinku; Schulz-Zander, Julius; Kuklinski, Slawomir; Ahmed, Toufik
Network Function Virtualization (NFV) is emerging as one of the most innovative concepts in the networking landscape. By migrating network functions from dedicated mid-dleboxes to general purpose computing platforms, NFV can effectively reduce the cost to deploy and to operate large networks. However, in order to achieve its full potential, NFV needs to encompass also the radio access network allowing Mobile Virtual Network Operators to deploy custom resource allocation solutions within their...
We develop a generalized loss network framework for capacity planning of a perinatal network in the UK. Decomposing the network by hospitals, each unit is analyzed with a GI/G/c/0 overflow loss network model. A two-moment approximation is performed to obtain the steady state solution of the GI/G/c/0 loss systems, and expressions for rejection probability and overflow probability have been derived. Using the model framework, the number of required cots can be estimated based on the rejection probability at each level of care of the neonatal units in a network. The generalization ensures that the model can be applied to any perinatal network for renewal arrival and discharge processes.
Fath, B.D.; Scharler, U.M.; Ulanowicz, R.E.; Hannon, B.
Ecological network analysis (ENA) is a systems-oriented methodology to analyze within system interactions used to identify holistic properties that are otherwise not evident from the direct observations. Like any analysis technique, the accuracy of the results is as good as the data available, but t
Prabhjot Singh; Rafat Hussain; Adeel Khan; Lyn Irwin; Roslyn Foskey
Dementia is one of the major causes of disability and dependence amongst older people and previous research has highlighted how the well-being of people with dementia is inherently connected to the quality of their relationships with their informal carers. In turn, these carers can experience significant levels of emotional stress and physical burden from the demands of caring for a family member with dementia, yet their uptake of formal services tends to be lower than in other conditions rel...
Douglass, Anne; Klerman, Lorraine
Research Findings: This study investigated how the Strengthening Families through Early Care and Education initiative in Illinois (SFI) influenced change in 4 child care programs. Findings indicate that SFI influenced quality improvements through 4 primary pathways: (a) Learning Networks, (b) the quality of training, (c) the engagement of program…
Sarkar, Subir Kumar; Puttamadappa, C
Ad hoc mobile wireless networks have seen increased adaptation in a variety of disciplines because they can be deployed with simple infrastructures and virtually no central administration. In particular, the development of ad hoc wireless and sensor networks provides tremendous opportunities in areas including disaster recovery, defense, health care, and industrial environments. Ad Hoc Mobile Wireless Networks: Principles, Protocols and Applications explains the concepts, mechanisms, design, and performance of these systems. It presents in-depth explanations of the latest wireless technologies
Pan, Wei; Aharony, Nadav; Pentland, Alex
We have carefully instrumented a large portion of the population living in a university graduate dormitory by giving participants Android smart phones running our sensing software. In this paper, we propose the novel problem of predicting mobile application (known as "apps") installation using social networks and explain its challenge. Modern smart phones, like the ones used in our study, are able to collect different social networks using built-in sensors. (e.g. Bluetooth proximity network, ...
Wireless sensor technology is required in the safety inspection for safety-critical unit of nuclear power plant. This report describes wireless sensor technology related with the project named 'Development of a remote care system of NPP components based on the network and safety database'. This report includes contents of methodology and status of sensor network construction, status of zigbee sensor network, problem of security and sensor battery. Energy harvesting technology will be mentioned on the next report
Carlsson, Patrik; Fiedler, Markus; Tutschku, Kurt; Chevul, Stefan; Nilsson, Arne A.
The Simple Network Management Protocol, SNMP, is the most widespread standard for Internet management. As SNMP stacks are available on most equipment, this protocol has to be considered when it comes to performance management, traffic engineering and network control. However, especially when using the predominant version 1, SNMPv1, special care has to be taken to avoid erroneous results when calculating bit rates. In this work, we evalute six off-the-shelf network components. We demonstrate t...
Nascimento, Andrea; Sofia C., Rute; Condeixa, Tiago; Sargento, Susana
Mobility management is a key aspect to consider in future Internet architectures, as these architectures include a highly nomadic end-user which often relies on services provided by multi-access networks. In contrast, today’s mobility management solutions were designed having in mind simpler scenarios and requirements from the network and where roaming could often be taken care of with previously established agreements. With a more dynamic behavior in the network, and also with a more p...
NITYA; PUSHPAM; MANINDER KAUR
In this paper we propose a system architecture for smart healthcare based on an advanced Wireless Sensor Network(WSN). It specifically targets assisted-living residents and others who may benefit from continuous, remote health monitoring .It presents best practices in wireless sensor network design for health care applications. Based on the most important aspects like power efficiency and security which guide the development of a wireless sensor network based applications.
Pries, Jan Rastin
Future broadband wireless networks should be able to support not only best effort traffic but also real-time traffic with strict Quality of Service (QoS) constraints. In addition, their available resources are scare and limit the number of users. To facilitate QoS guarantees and increase the maximum number of concurrent users, wireless networks require careful planning and optimization. In this monograph, we studied three aspects of performance optimization in wireless networks: resource opti...
Sakata, Ichiro; Kajikawa, Yuya; Takeda, Yoshiyuki; Shibata, Naoki; Hashimoto, Masahiro; MATSUSHIMA Katsumori
The diversity of industry-university-government networks formed within regional clusters may dictate the degree of vigor of cutting-edge industries within a zone. After gaining a multidimensional grasp of the structural characteristics of the networks, we discuss their relationship with the location of concentrations of cutting-edge industries and with their growth. Specifically, we introduced certain network analysis methods and conducted quantitative analysis of health care-related industri...
The purpose of this final year project is to research on new network security products and implementation techniques in order to enhance the current network security structure of Savonia University of Applied Sciences. This is very important because, it will avoid the university from suffering any major network attack associated with the present network security architecture. At the time this final project was approved, the university network security architecture was optimized...
Sander, K F
Linear Network Theory covers the significant algebraic aspect of network theory, with minimal reference to practical circuits. The book begins the presentation of network analysis with the exposition of networks containing resistances only, and follows it up with a discussion of networks involving inductance and capacity by way of the differential equations. Classification and description of certain networks, equivalent networks, filter circuits, and network functions are also covered. Electrical engineers, technicians, electronics engineers, electricians, and students learning the intricacies
G. MURALI; M.Pranavi; Y.Navateja; K. Bhargavi
Network Security Scanner (NSS) is a tool that allows auditing and monitoring remote network computers for possible vulnerabilities, checks your network for all potential methods that a hacker might use to attack it. Network Security Scanner is a complete networking utilities package that includes a wide range of tools for network security auditing, vulnerability Auditing, scanning, monitoring and more. Network Security Scanner (NSS) is an easy to use, intuitive network security scanner that c...
Huang, Hong; Al-Azzawi, Hussein; Brani, Hajar
This paper presents a tutorial for network anomaly detection, focusing on non-signature-based approaches. Network traffic anomalies are unusual and significant changes in the traffic of a network. Networks play an important role in today's social and economic infrastructures. The security of the network becomes crucial, and network traffic anomaly detection constitutes an important part of network security. In this paper, we present three major approaches to non-signature-based network detect...
Schmittdiel, Julie A.; Shortell, Stephen M.; Rundall, Thomas G; Bodenheimer, Thomas; SELBY, Joe V.
PURPOSE It has been suggested that the best way to improve chronic illness care is through a redesign of primary care emphasizing comprehensive, coordinated care as espoused by the Chronic Care Model (CCM). This study examined the relationship between primary care orientation and the implementation of the CCM in physician organizations.
We introduce the construction of a new framework for probing discrete emergent geometry and boundary-boundary observables based on a fundamentally a-dimensional underlying network structure. Using a gravitationally motivated action with Forman weighted combinatorial curvatures and simplicial volumes relying on a decomposition of an abstract simplicial complex into realized embeddings of proper skeletons, we demonstrate properties such as a minimal volume-scale cutoff, the necessity of a positive-definite cosmological constant as a regulator for non-degenerate geometries, and naturally emergent simplicial structures from Metropolis network evolution simulations with no restrictions on attachment rules or regular building blocks. We see emergent properties which echo results from both the spinfoam formalism and causal dynamical triangulations in quantum gravity, and provide analytical and numerical results to support the analogy. We conclude with a summary of open questions and intent for future work in develop...
This chapter discusses the fundamental ideas of how chemical networks are build, their strengths and limitations. The chemical reactions that occur in disks combine the cold phase reactions used to model cold molecular clouds with the hot chemistry applied to planetary atmosphere models. With a general understanding of the different types of reactions that can occur, one can proceed in building a network of chemical reactions and use it to explain the abundance of species seen in disks. One on-going research subject is finding new paths to synthesize species either in the gas-phase or on grain surfaces. Specific formation routes for water or carbon monoxide are discussed in more details. 13th Lecture of the Summer School "Protoplanetary Disks: Theory and Modelling Meet Observations"
Schneiderman, Janet U.; Smith, Caitlin; Palinkas, Lawrence A
The objective of this qualitative study was to examine issues that unrelated and kinship foster caregivers in Los Angeles, CA, have in seeking help and accessing and using health care for children in foster care. There were four themes identified for all caregivers: (1) “Doing Our Best” (caregivers advocated persistently and creatively for health care); (2) “Support from Others Helped” (caregivers relied on caseworkers, organizations, and their social network); (3) “Child has Complicated, Ser...
Pinto Ruxandra; Hales Brigette; Dainty Katie; Scales Damon C; Fowler Robert A; Adhikari Neill KJ; Zwarenstein Merrick
Abstract Background There are challenges to timely adoption of, and ongoing adherence to, evidence-based practices known to improve patient care in the intensive care unit (ICU). Quality improvement initiatives using a collaborative network approach may increase the use of such practices. Our objective is to evaluate the effectiveness of a novel knowledge translation program for increasing the proportion of patients who appropriately receive the following six evidence-based care practices: ve...
The root of the ecological crisis lies in an ethic of nature consumption. In order to reconstruct our cultural framework, it is necessary to cultivate another ethical approach, an ethic of care. It is the responsibility of school to encourage students to learn how to care for not only the human world, but also for the natural world. This paper is…
Rothman, Linda; Rijsingen, Rinie van; Pijnenburg, Huub
This article introduces the concept of alliance in youth care. The concept of (therapeutic) alliance originates in adult psychotherapy and related research. Alliance refers to the working relationship between youth care workers and their clients. Within this concept, personal (emotional) and task re
... F for more than 4 hours Alternate Names Surgical incision care; Open wound care Images Proper hand washing References Lynn PB. Cleaning a wound and applying a dry, sterile dressing. In: Lynn PB. Taylor’s Handbook of Nursing Skills . Philadelphia, PA: Lippincott Williams and Wilkins, Wolters ...
This podcast provides an overview of the Prevention IS Care campaign, which provides HIV prevention tools for medical care providers to use on a daily basis with patients who are living with HIV. Created: 3/26/2009 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). Date Released: 3/26/2009.
While discussions of the moral dimensions of the caring relation and their implications for teaching and learning are well developed within the literature, there has not been much analysis of the place of inquiry within our understanding of caring and the education inspired by it. Previous discussions offer important insight into what…
... this page: //medlineplus.gov/ency/article/001914.htm Nail care for newborns To use the sharing features on ... finger or toe instead of the nail. Baby's nails grow quickly, so you may have to cut the fingernails at least once a week. You may only need ... SG, Bedwell C, Cork MJ. Neonatal skin care and toxicology. In: Eichenfield LF, Frieden IJ, Mathes ...
Hawthorne, Henry C; Masterson, David J
Principles of Lean management are being adopted more widely in health care as a way of improving quality and safety while controlling costs. The authors, who are chief executive officers of rural North Carolina hospitals, explain how their organizations are using Lean principles to improve quality and safety of health care delivery. PMID:23802475
Stevens, F.; Zee, J. van der
A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,
Del Ferraro, Catherine; Ferrell, Betty; Van Zyl, Carin; Freeman, Bonnie; Klein, Linda
Over a decade ago, the Institute of Medicine (IOM) presented Ensuring Quality Cancer Care in the United States, with recommendations for change (IOM, 1999). However, barriers to integrating palliative care (PC) to achieve high-quality care in cancer still remain. As novel therapeutic agents evolve, patients are living longer, and advanced cancer is now considered a chronic illness. In addition to complex symptom concerns, patients and family caregivers are burdened with psychological, social, and spiritual distress. Furthermore, data show that PC continues to be underutilized and inaccessible, and current innovative models of integrating PC into standard cancer care lack uniformity. The aim of this article is to address the existing barriers in implementing PC into our cancer care delivery system and discuss how the oncology advanced practice nurse plays an essential role in providing high-quality cancer care. We also review the IOM recommendations; highlight the work done by the National Consensus Project in promoting quality PC; and discuss a National Cancer Institute-funded program project currently conducted at a National Comprehensive Cancer Center, "Palliative Care for Quality of Life and Symptoms Concerns in Lung Cancer," which serves as a model to promote high-quality care for patients and their families. PMID:26114013
Australian Dept. of Labour and National Service, Melbourne. Women's Bureau.
Based on a survey of legislation relating to full-day care for preschool children of working mothers and a study of records, this report: (1) covers the number of registered child care centers in Australia and the number of children being served, (2) sets the conditions applying to registration of centers, (3) indicates the extent and levels of…
CERN, Child Care Initiative
This is a document summarizing a survey of child care needs of CERN staff and users which was performed in February 2008 by the CERN Child Care Initiative. The document presents the analysis of this data. Conclusions on the minimal facilities size are derived and possible funding source at the European Union are discussed.
Health care waste management (HCWM) is a process to help ensure proper hospital hygiene and safety of health care workers and communities. It includes planning and procurement, construction, staff training and behavior, proper use of tools, machines and pharmaceuticals, proper disposal methods inside and outside the hospital, and evaluation. Its many dimensions require a broader focus than ...
John Stevens; Evert Pommer; Hetty van Kempen; Elke Zeijl; Isolde Woittiez; Klarita Sadiraj; Rob Gilsing; Saskia Keuzenkamp
Original title: De jeugd een zorg. Youth care services are going through major changes. This has created a need for a better insight into the demand that is likely to be placed on these services in the future at both national and regional level. This report suggests that the use of ambulant care w
The present invention pertains to use of sodium diacetate (NaHAc 2) as an antimicrobial agent against bacteria growing in biofilms. The aspects of the invention include a wound care product comprising sodium diacetate, a kit comprising a wound care product,and a methodof treating an infected wound....
... to care for patients, not fewer, and medical liability reform would help reduce overall costs by reducing ... NewsMediaResources/StatisticsData/Just%202%20booklet.pdf [ii] Report: Accounting for the cost of US health care: A ...
Weissbourd, Richard; Anderson, Trisha Ross
When asked about their child-rearing priorities, parents in the United States are likely to say it's more important to raise children who are caring than to raise high achievers. Schools, too, typically trumpet values such as caring, honesty, and fairness. These values are posted on walls, reiterated in assemblies, and included in mission…
Christensen, Henrik Bærbak; Hansen, K.M.
propose a software ecosystem approach for telemedicine applications, providing a framework, Net4Care, encapsulating national/global design decisions with respect to standardization while allowing for local innovation. This paper presents an analysis of existing systems, of requirements for a software...... ecosystem for telemedicine, and a summary of initial design decisions for the Net4Care framework....
A presentation of a case and a theoretical discussion concerning what characterizes the sozialisation and formation taking place in educations related to care work inside the Danish welfare system presently. The article presents an analysis of the relation between curriculum,didactics and...... clash between competing rationalities, that cause dilemmas in care....
Agarez, Ricardo; Bechini, Thibault; Dalachanis, Angelos; El-Wakil, Leila; Gzowska, Alicja; James-Chakraborty, Kathleen; Kögel, Eduard; Kulić, Vladimir; Lagae, Johan; Schwenkel, Christina; Stanek, Łukasz; Zandi-Sayek, Sibel
This issue of ABE focuses on the internationalization of building culture after WWII and the contributions of architects, planners, and engineers from socialist countries to these processes. Complementing the studies of colonial and postcolonial links, international organizations such as the UN, and economic globalization as conduits of the world-wide spread of architecture, this issue discusses the intersection of these networks with flows of labor power, materials, technologies, discourses ...
In this paper we consider the question whether a distributed network of sensors and data processors can form "perceptions" based on the sensory data. Because sensory data can have exponentially many explanations, the use of a central data processor to analyze the outputs from a large ensemble of sensors will in general introduce unacceptable latencies for responding to dangerous situations. A better idea is to use a distributed "Helmholtz machine" architecture in which the collective state of...
Vajda, Igor; Grim, Jiří
Oxford : Eolss Publishers-UNESCO, 2008 - (Parra-Luna, F.), s. 224-248 ISBN 978-1-84826-654-4. - (Encyclopedia of Life Support Systems. Volume III) R&D Projects: GA ČR GA102/07/1594 Institutional research plan: CEZ:AV0Z10750506 Keywords : neural networks * probabilistic approach Subject RIV: BD - Theory of Information http://library.utia.cas.cz/separaty/2008/SI/vajda-systems science and cybernetics .pdf
Franke, Jörg; Öztürk, Tahir
Conflict parties are frequently involved into more than one conflict at a given time. In this paper the interrelated structure of conflictive relations is modeled as a conflict network where opponents are embedded in a local structure of bilateral conflicts. Conflict parties invest in specific conflict technology to attack their respective rivals and defend their own resources. We show that there exists a unique equilibrium for this conflict game and examine the relation between aggregated eq...
Marcelo Rodrigues Gonçalves
Full Text Available Objective: To investigate the association between primary health care (PHC quality and diabetes mellitus (DM management in adult patients living within the catchment area of PHC services in Porto Alegre, Brazil. Methods: Cross-sectional, population-based study of adults reporting known diabetes. Quality of PHC was assessed through the Primary Care Assesment Tool (PCATool-Brazil. Statistical analyses were performed with Poisson regression with robust variance. Results: Of the 3,014 adults interviewed, 205 (6.8% reported having diabetes; of these, 64.4% were women and 68.3% were white. Regarding PHC score of the health service attended, people with diabetes that were classified with a high PHC score, presented longer duration of disease (10.9 vs 8.4 anos, p=0.03 and greater frequency of diabetes-related complications (75.3% vs 58.8%, p=0.02. Regarding the proportion of respondents with good glycemic control, no significant difference between groups was found (31.7% vs 38%, p=0.3. In the multivariate analysis, services with a high PHC score presented a better profile of care for the prevention of the main comorbidities – greater blood pressure assessment (PR=1.07; CI95% 1.01-1.14, lipid profile request (PR=1.23; CI95% 1.09-1.39, counseling for physical activity (PR=1.50; CI95% 1.21-1.86, foot examination (PR=2.08; CI95% 1.54-2,81, and counseling for foot care (PR=1.37; CI95% 1.18-1.59. Conclusion: High PHC score services showed better performance in the management of diabetes and care for more complicated patients, but they did not differ significantly from lower PHC score services in terms of patients’ glycemic control.
Sergio Saponara; Tony Bacchillone
This paper discusses aims, architecture, and security issues of Smart Grid, taking care of the lesson learned at University of Pisa in research projects on smart energy and grid. A key element of Smart Grid is the energy home area network (HAN), for which an implementation is proposed, dealing with its security aspects and showing some solutions for realizing a wireless network based on ZigBee. Possible hardware-software architectures and implementations using COTS (Commercial Off The Shelf) ...
Rhu, Minsoo; Gimelshein, Natalia; Clemons, Jason; Zulfiqar, Arslan; Keckler, Stephen W.
The most widely used machine learning frameworks require users to carefully tune their memory usage so that the deep neural network (DNN) fits into the DRAM capacity of a GPU. This restriction hampers a researcher's flexibility to study different machine learning algorithms, forcing them to either use a less desirable network architecture or parallelize the processing across multiple GPUs. We propose a runtime memory manager that virtualizes the memory usage of DNNs such that both GPU and CPU...
Full Text Available Orphan care in China was once provided by the central government as a means of social control. The centralized welfare delivery guaranteed some of the poorest orphans to be protected by the government. Since the economic reform, the central government started to relinquish its control over social welfare delivery, new forms of orphan care were introduced into China, sharing the responsibilities and burdens for caring the orphans. Yet, many issues and problems exist in social delivery due to a lack of finances, professionals, and policy support. In this chapter, we will discuss the background of social welfare changes in China, as pertains to orphan care, focusing on the different types of orphans as a result of social issues, service delivery, barriers and solutions. It is claimed that during the reform, the burden of orphan care in China may not be reduced in the coming future, and we offer suggestions to cope with that.
Bro Brask, Kirsten; Birkelund, Regner
The aim of this study was to research how the staff experience care expressed during the brief encounter with the patients in a diagnostic imaging department. This was a qualitative study with a phenomenological and hermeneutical frame of reference. The data were collected using field observations...... and semistructured interviews and analyzed according to the guidelines for meaning condensation by Giorgi. The imaging staff found that care is expressed in an administrative, an instrumental, and a compassionate sense. The imaging staff perceived care in a way that clearly differs from the traditional perception...... of care understood as the close relations between people. In their self-understanding, the staff found that care not only comprised the relational aspect but also that it was already delivered during the preparatory phases before the actual meeting with the patient and up until the image...
respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser...... and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine...... of secondary data from the Danish healthcare system and Kaiser Permanente, California were used to compare population characteristics, professional staff, delivery structure, utilisation, quality measures and direct costs. A cross-sectional survey among primary care clinicians in Denmark and in Kaiser...
Jensen, Anne Winther
The paper discusses the shaping of students´ identity within a vocational education programme for elderly care in Denmark. The focus is on the correlation between identity construction within the theoretical periods and students´ experiences in the traineeships. In the school setting the future...... care helper is being constructed within the overall term ‘professional’, but students may meet differing ways of being care helper in the traineeships, and the paper points to an ongoing struggle about the definition of ‘being care helper’. The analysis of the identity issues mobilises the concepts...... ‘positioning’ and ‘storyline’, c.f. Bronwyn Davies, and the empirical material consists of interviews and observations in the theoretical periods and in the traineeships. The paper suggests that a shift from identity to subjectivity may help students to deal with the diversity of ‘care helpers’ and thereby...
Hansen, Agnete Meldgaard
A wave of policies to reform municipal elderly care services is sweeping across Denmark. Under headings such as ‘help for self-help’, ‘everyday rehabilitation’, and ‘re-ablement’, municipalities are working to make their elderly citizens more self-reliant, active and less dependent on municipal...... care services. The reform programs are put in place to counter the demographic challenges faced by the Nordic (and many other) welfare states, known under the pessimistic expression ‘the burden of ageing’. Based on ethnographic case studies in two Danish municipalities, the paper illustrates how care...... workers negotiate professional identities and understandings of meaningful care work, in the new regime of rehabilitative elderly care – how they manage the ambiguities of a simultaneously empowering and interventionist practice. The paper’s analytical framework draws on an understanding of empowerment as...
Ventola, C Lee
Health care professionals can use a variety of social media tools to improve or enhance networking, education, and other activities. However, these tools also present some potential risks, such as unreliable information and violations of patients' privacy rights. PMID:25083128
Ventola, C. Lee
Health care professionals can use a variety of social media tools to improve or enhance networking, education, and other activities. However, these tools also present some potential risks, such as unreliable information and violations of patients’ privacy rights.
Mason, Michael J.
This study tested a mediation model of the relationship with school problems, social network quality, and substance use with a primary care sample of 301 urban adolescents. It was theorized that social network quality (level of risk or protection in network) would mediate the effects of school problems, accounting for internalizing problems and…
Annual Meeting at CERN, 23-25 November 2005 CARE started on 1st January 2004 and will last for five years. At the end of each year it holds a general meeting to report on the progress and status of its activities. This year, the CARE annual meeting is taking place at CERN The objective of the CARE project is to generate structured and integrated European cooperation in the field of accelerator research and related R&D. The program includes the most advanced scientific and technological developments, relevant to accelerator research for Particle Physics. It is articulated around three Networking Activities and four Joint Activities. The Networking Activities ELAN, BENE and HHH aim to better coordinate R&D efforts at the European level and to strengthen Europe's ability to evaluate and develop methods of producing intense and high energy beams of electrons, protons, muons and neutrinos. These activities are embedded in world-wide efforts towards future e+e- linear colliders, superior neutrino beam fa...
Open innovation in networks has been a popular topic for long, this paper rethinks the concepts of innovation network and network organization, and clarifies the differences between them based on the network perspective. Network perspective means that: network is the context of firms; market...... and hierarchy can be analyzed from a network approach. Within a network perspective, there are different levels of network, and a firm may not always has the power to “manage” innovation networks due to different levels of power. Based on the strength of a firm’s power, its role may varies from manager...
Kong-qing YANG; Lei YANG; Bai-hua GONG; Zhong-cai LIN; Hong-sheng HE; Liang HUANG
Complex networks describe a wide range of sys-tems in nature and society. Since most real systems exist in certain physical space and the distance between the nodes has influence on the connections, it is helpful to study geographi-cal complex networks and to investigate how the geographical constrains on the connections affect the network properties. In this paper, we briefly review our recent progress on geo-graphical complex networks with respect of statistics, mod-elling, robustness, and synchronizability. It has been shown that the geographical constrains tend to make the network less robust and less synchronizable. Synchronization on random networks and clustered networks is also studied.
Victoria Tait; Megan Higgs; Linda Magann; Joanne Dixon; Jan Maree Davis; Ritin Fernandez
The quality of palliative care given to terminally ill patients and their family members can be directly impacted by the attitudes that nurses hold towards palliative care. This study aimed to investigate the attitudes of nonpalliative care nurses towards death and dying in the context of palliative care. Nurses working within the medical aged care, cardiology and respiratory wards at two metropolitan teaching hospitals in Sydney completed the Frommelt Attitudes Towards Care of the Dying (FAT...
Thulasiraj D Ravilla
Full Text Available The effectiveness of eye care service delivery is often dependant on how the different stakeholders are aligned. These stakeholders range from the ministries of health who have the capacity to grant government subsidies for eye care, down to the primary healthcare workers who can be enrolled to screen for basic eye diseases. Advocacy is a tool that can help service providers draw the attention of key stakeholders to a particular area of concern. By enlisting the support, endorsement and participation of a wider circle of players, advocacy can help to improve the penetration and effectiveness of the services provided. There are several factors in the external environmental that influence the eye care services - such as the availability of trained manpower, supply of eye care consumables, government rules and regulations. There are several instances where successful advocacy has helped to create an enabling environment for eye care service delivery. Providing eye care services in developing countries requires the support - either for direct patient care or for support services such as producing trained manpower or for research and dissemination. Such support, in the form of financial or other resources, can be garnered through advocacy.