Sample records for care networks pccns

  1. Partnership disengagement from primary community care networks (PCCNs: A qualitative study for a national demonstration project

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    Lin Cheng-Chieh


    Full Text Available Abstract Background The Primary Community Care Network (PCCN Demonstration Project, launched by the Bureau of National Health Insurance (BNHI in 2003, is still in progress. Partnership structures in PCCNs represent both contractual clinic-to-clinic and clinic-to-hospital member relationships of organizational aspects. The partnership structures are the formal relationships between individuals and the total network. Their organizational design aims to ensure effective communication, coordination, and integration across the total network. Previous studies have focused largely on how contractual integration among the partnerships works and on its effects. Few studies, however, have tried to understand partnership disengagement in PCCNs. This study explores why some partnerships in PCCNs disengage. Methods This study used a qualitative methodology with semi-structured questions for in-depth interviews. The semi-structured questions were pre-designed to explore the factors driving partnership disengagement. Thirty-seven clinic members who had withdrawn from their PCCNs were identified from the 2003-2005 Taiwan Primary Community Care Network Lists. Results Organization/participant factors (extra working time spend and facility competency, network factors (partner collaboration, and community factors (health policy design incompatibility, patient-physician relationship, and effectiveness are reasons for clinic physicians to withdraw or change their partnerships within the PCCNs. Conclusions To strengthen partnership relationships, several suggestions are made, including to establish clinic and hospital member relationships, and to reduce administrative work. In addition, both educating the public about the concept of family doctors and ensuring well-organized national health policies could help health care providers improve the integration processes.

  2. Integration in primary community care networks (PCCNs: examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

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    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

  3. Sensor Networks for Medical Care


    Shnayder, Victor; Chen, Bor-rong; Lorincz, Konrad; Fulford-Jones, Thaddeus R. F.; Welsh, Matt


    Sensor networks have the potential to greatly impact many aspects of medical care. By outfitting patients with wireless, wearable vital sign sensors, collecting detailed real-time data on physiological status can be greatly simplified. However, there is a significant gap between existing sensor network systems and the needs of medical care. In particular, medical sensor networks must support multicast routing topologies, node mobility, a wide range of data rates and high degrees of reliabilit...

  4. Team networking in palliative care

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    Odette Spruyt


    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.

  5. Social networks in improvement of health care. (United States)

    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

  6. No exodus: physicians and managed care networks. (United States)

    O'Malley, Ann S; Reschovsky, James D


    After remaining stable since 1996-97, the percentage of U.S. physicians who do not contract with managed care plans rose from 9.2 percent in 2000-01 to 11.5 percent in 2004-05, according to a national study from the Center for Studying Health System Change (HSC). While physicians have not left managed care networks in large numbers, this small but statistically significant increase could signal a trend toward greater out-of-pocket costs for patients and a decline in patient access to physicians. The increase in physicians without managed care contracts was broad-based across specialties and other physician and practice characteristics. Compared with physicians who have one or more managed care contracts, physicians without managed care contracts are more likely to have practiced for more than 20 years, work part time, lack board certification, practice solo or in two-physician groups, and live in the western United States. The study also found substantial variation in the proportion of physicians without managed care contracts across communities, suggesting that local market conditions influence decisions to contract with managed care plans.

  7. Social networks of professionals in health care organizations: a review. (United States)

    Tasselli, Stefano


    In this article, we provide an overview of social network research in health care, with a focus on social interactions between professionals in organizations. We begin by introducing key concepts defining the social network approach, including network density, centrality, and brokerage. We then review past and current research on the antecedents of health care professionals' social networks-including demographic attributes, professional groups, and organizational arrangements-and their consequences-including satisfaction at work, leadership, behaviors, knowledge transfer, diffusion of innovation, and performance. Finally, we examine future directions for social network research in health care, focusing on micro-macro linkages and network dynamics.

  8. Social networks--the future for health care delivery. (United States)

    Griffiths, Frances; Cave, Jonathan; Boardman, Felicity; Ren, Justin; Pawlikowska, Teresa; Ball, Robin; Clarke, Aileen; Cohen, Alan


    With the rapid growth of online social networking for health, health care systems are experiencing an inescapable increase in complexity. This is not necessarily a drawback; self-organising, adaptive networks could become central to future health care delivery. This paper considers whether social networks composed of patients and their social circles can compete with, or complement, professional networks in assembling health-related information of value for improving health and health care. Using the framework of analysis of a two-sided network--patients and providers--with multiple platforms for interaction, we argue that the structure and dynamics of such a network has implications for future health care. Patients are using social networking to access and contribute health information. Among those living with chronic illness and disability and engaging with social networks, there is considerable expertise in assessing, combining and exploiting information. Social networking is providing a new landscape for patients to assemble health information, relatively free from the constraints of traditional health care. However, health information from social networks currently complements traditional sources rather than substituting for them. Networking among health care provider organisations is enabling greater exploitation of health information for health care planning. The platforms of interaction are also changing. Patient-doctor encounters are now more permeable to influence from social networks and professional networks. Diffuse and temporary platforms of interaction enable discourse between patients and professionals, and include platforms controlled by patients. We argue that social networking has the potential to change patterns of health inequalities and access to health care, alter the stability of health care provision and lead to a reformulation of the role of health professionals. Further research is needed to understand how network structure combined with


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    Camila Dubow


    Full Text Available The article proposes a critical reflection, based on national law, scholarly, scientific, on the current development of Networks of Health Care, as a strategy for strengthening the Single Health System (SUS. Are weighted inefficiency of traditional ways of organizing care and management, the challenge of Network Health Care for comprehensive care and management mechanisms used in this process. The work provides subsidies for the care practices and health management are reflected, pointing strategies that result in disruptions of paradigms through a refocusing of attention in existing models. For networks of health care can be consolidated, is fundamental to political sensitivity of health managers with a commitment to build a new model of care, through the struggle to consolidate the SUS and the realization of the principles of universality, comprehensiveness and equity.

  10. Children discharged from neonatal intensive care: implications for the social care networks

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    Maria Licele do Nascimento


    Full Text Available Objective: tounderstand the social care networks of children discharged from Neonatal Intensive Care Unit. Methods: qualitative study conducted in the home of six families of seven children. In data collection, authors used the triangulation of techniques with thematic content analysis. Results: family composition is nuclear, social networks are formed by the support of family, leisure and spiritual ties, by school and hospital institutions. The families reported the challenges of caring for a premature baby, and the main care demands were respiratory, motor and cognitive. The non-effective communication between professionals and family showed negative impact on hospitalization and home care. Conclusion:social care networks for children discharged from the Neonatal Intensive Care unit proved to be disjointed and health care for children and family proved to be fragmented.


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    Karoline Andrade


    Full Text Available This research aimed to investigate the coordination of the psychosocial care network (RAPS for mental health crisis care, in its workers’ view. It is a descriptive exploratory study with qualitative approach. The study was carried out from 62 portfolios made by the students of the Mental Health Crisis and Urgency Course, who answered the reflective question: "Considering your workplace as a point of RAPS / RUE, describe, reflect and write a text with the synthesis regarding the articulation with the other network points in the reality of your municipality". The data were analyzed according to Thematic Content Analysis method suggested by Bardin, which comprises three phases: Pre - analysis, Material Exploration and Treatment of the Information, inference and interpretation. As a result, three thematic categories were identified: Referral, the traditional way of referring to specialized care, which is associated to a more fragmented care process; Matrix support, the current proposal of collaborative care, a joint strategy that contributes to the complex care demanded by mental health services users; and new strategies for network care, exemplified by meetings or sessions that discuss new ways to enable the network care.

  12. Social networks and receiving informal care.

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    Boer, A. de; Klerk, M. de; Cardol, M.; Westert, G.


    In 2001, roughly half a million people (4% of the Dutch population) received informal care from family members living outside their home, and a quarter of a million (2% of the Dutch population) received this care from acquaintances, such as friend, neighbours and work colleagues. The potential suppl

  13. Care network for women in situation of violence: the challenges of care transversality

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    Angelina Lettiere


    Full Text Available A qualitative study aimed to understand how is configured the care for women in situation of violence, under the sight of professionals. Data was collected by interviews with seven key-informants, and it was analyzed by the method of interpretation of meanings. In the central theme category: auto eco-organizer system of institutions, two meaning nucleus were identified: Care axis and Institution Functionality. In the first, the care axis was classified as psychosocial care, health care and police care. At the institution functionality, attention to women was found while obtaining demands and referrals through triage. From the professional’s perspective, although advances were obtained on the past years, the “mismatch” still persists in the care network for women in situation of violence, which does not contemplates what is conceived by attention transversality. The study pointed aids to strengthen the network, aiming to guarantee women’s rights.

  14. Audit Trail Management System in Community Health Care Information Network. (United States)

    Nakamura, Naoki; Nakayama, Masaharu; Nakaya, Jun; Tominaga, Teiji; Suganuma, Takuo; Shiratori, Norio


    After the Great East Japan Earthquake we constructed a community health care information network system. Focusing on the authentication server and portal server capable of SAML&ID-WSF, we proposed an audit trail management system to look over audit events in a comprehensive manner. Through implementation and experimentation, we verified the effectiveness of our proposed audit trail management system.

  15. Nursing Home Care Quality: Insights from a Bayesian Network Approach (United States)

    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…

  16. Research priorities for administrative challenges of integrated networks of care. (United States)

    Pilgrim, Randy; Hilton, Joshua A; Carrier, Emily; Pines, Jesse M; Hufstetler, Greg; Thorby, Suzette; Milling, T J; Cesta, Beth; Hsia, Renee Y


    In 2006, the Institute of Medicine (IOM) advanced the concept of "coordinated, regionalized, and accountable emergency care systems" to address significant problems with the delivery of emergency medical care in the United States. Achieving this vision requires the thoughtful implementation of well-aligned, system-level structures and processes that enhance access to emergency care and improve patient outcomes at a sustainable cost. Currently, the delivery of emergency medical care is supported by numerous administrative systems, including economic; reimbursement; legal and regulatory structures; licensure, credentialing, and accreditation processes; medicolegal systems; and quality reporting mechanisms. In addition, many regionalized systems may not optimize patient outcomes because of current administrative barriers that make it difficult for providers to deliver the best care. However, certain administrative barriers may also threaten the sustainability of integration efforts or prevent them altogether. This article identifies significant administrative challenges to integrating networks of emergency care in four specific areas: reimbursement, medical-legal, quality reporting mechanisms, and regulatory aspects. The authors propose a research agenda for indentifying optimal approaches that support consistent access to quality emergency care with improved outcomes for patients, at a sustainable cost. Researching administrative challenges will involve careful examination of the numerous natural experiments in the recent past and will be crucial to understand the impact as we embark on a new era of health reform.

  17. How Primary Care Networks Can Help Integrate Academic and Service Initiatives in Primary Care (United States)

    Thomas, Paul; Graffy, Jonathan; Wallace, Paul; Kirby, Mike


    PURPOSE Theory of effective network operation in primary care is underdeveloped. This study aimed to identify how primary care networks can best integrate academic and service initiatives. METHODS We performed a comparative case study of 4 primary care research networks in North London, England, for the years 1998–2002. Indicators were selected to assess changes in (1) research capacity, (2) multidisciplinary collaboration, and (3) research productivity. We compared the profiles of network outcome with descriptions of their contexts and organizational types from a previous evaluation. RESULTS Together, the networks supported 133 viable projects and 30 others; 399 practitioners, managers, and academics participated in the research teams. How the networks organized themselves was influenced by the circumstances in which they were formed. Different ways of organizing were associated with different outcome profiles. Shared projects and learning spaces helped participants to develop trusted relationships. A top-down, hierarchical approach based on institutional alliances and academic expertise attracted more funding and appeared to be stable. The bottom-up, individualistic network with research practices was good at reflecting on practical primary care concerns. Whole-system methods brought together stakeholder contributions from all parts of the system. CONCLUSIONS Networks can help integrate academic research and service development initiatives by facilitating interorganizational interactions and in shared leadership of projects. Researchers and practitioners stand to gain considerably from an integrated approach in both the short and the long term. Success requires agreement about a set of pathways, learning spaces, and feedback mechanisms to harness the insights and efforts of stakeholders throughout the whole system. PMID:16735525

  18. Net one, net two: the primary care network income statement. (United States)

    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.

  19. Practice based research networks impacting periodontal care: PEARL Initiative. (United States)

    Curro, Frederick A; Thompson, Van P; Grill, Ashley; Vena, Don; Terracio, Louis; Naftolin, Frederick


    In 2005, the National Institute of Dental and Craniofacial Research /National Institutes of Health funded the largest initiative to date to affect change in the delivery of oral care. This commentary provides the background for the first study related to periodontics in a Practice Based Research Network (PBRN). It was conducted in the Practitioners Engaged in Applied Research & Learning (PEARL) Network. The PEARL Network is headquartered at New York University College of Dentistry. The basic tenet of the PBRN initiative is to engage clinicians to participate in clinical studies, where they will be more likely to accept the results and to incorporate the findings into their practices. This process may reduce the translational gap that exists between new findings and the time it takes for them to be incorporated into clinical practice. The cornerstone of the PBRN studies is to conduct comparative effectiveness research studies to disseminate findings to the profession and improve care. This is particularly important because the majority of dentists practice independently. Having practitioners generate clinical data allows them to contribute in the process of knowledge development and incorporate the results in their practice to assist in closing the translational gap. With the advent of electronic health systems on the horizon, dentistry may be brought into the mainstream health care paradigm and the PBRN concept can serve as the skeletal framework for advancing the profession provided there is consensus on the terminology used.

  20. The Care management Information system for the home Care Network (SI GESCAD): support for care coordination and continuity of care in the Brazilian Unified health system (SUS). (United States)

    Pires, Maria Raquel Gomes Maia; Gottems, Leila Bernarda Donato; Vasconcelos Filho, José Eurico; Silva, Kênia Lara; Gamarski, Ricardo


    The present article describes the development of the initial version of the Brazilian Care Management Information System for the Home Care Network (SI GESCAD). This system was created to enhance comprehensive care, care coordination and the continuity of care provided to the patients, family and caretakers of the Home Care (HC) program. We also present a reflection on the contributions, limitations and possibilities of the SI GESCAD within the scope of the Home Care Network of the Brazilian Unified Health System (RAS-AD). This was a study on technology production based on a multi-method protocol. It discussed software engineering and human-computer interaction (HCI) based on user-centered design, as well as evolutionary and interactive software process (prototyping and spiral). A functional prototype of the GESCAD was finalized, which allowed for the management of HC to take into consideration the patient's social context, family and caretakers. The system also proved to help in the management of activities of daily living (ADLs), clinical care and the monitoring of variables associated with type 2 HC. The SI GESCAD allowed for a more horizontal work process for HC teams at the RAS-AD/SUS level of care, with positive repercussions on care coordination and continuity of care.

  1. [Improving Health Care for Patients with Somatoform and Functional Disorders: A Collaborative Stepped Care Network (Sofu-Net)]. (United States)

    Shedden-Mora, Meike; Lau, Katharina; Kuby, Amina; Groß, Beatrice; Gladigau, Maria; Fabisch, Alexandra; Löwe, Bernd


    The management of somatoform disorders in primary care is often limited due to low diagnostic accuracy, delayed referral to psychotherapy and overuse of health care. To address these difficulties, this study aimed to establish a collaborative stepped health care network (Sofu-Net). Sofu-Net was established among 41 primary care physicians, 35 psychotherapists and 8 mental health clinics. Baseline assessment in primary care showed elevated psychopathology and deficits in health care among patients with somatoform symptoms. Network partners provided positive evaluations of Sofu-Net.

  2. [Hand injuries management of care and hand prevention networks]. (United States)

    Couturier, Christian


    Injuries of the hand are common and sometimes more serious than it appears on a non-specialist initial examination. They are a public health issue with some major impact on the continued activity of patients who have been victims of those injuries. The European Federation of Hand Emergency Services (FESUM) accredits SOS Hand centers, dedicated hand trauma organizations in which the specialized medical cares is optima, avoiding the loss of chance to inadequate primary orientation. If nevertheless a serious injury leaves a debilitating sequela Hand Prevention networks, organized by practitioners of SOS Hand centers, help patients establish a process of socio-professional rehabilitation as soon as possible. These networks organize primary, secondary and tertiary prevention of hand trauma and disabilities that can accompany them. Innovative organizations, they resemble a national association that supports the development of new structures. They are open to all professionals of health and their patients, members or not of the network.

  3. Sensitive hospitalizations to primary care and care in the health care network

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    Pollyanna Kássia de Oliveira Borges


    Full Text Available Objective: to check the profile of sensitive causes hospitalizations for primary care. Methods: this is an ecological, epidemiological study. Data was collected in the Hospital Information System at the Department of Health System Information, grouped according to the admissions list for Sensitive to Primary Causes of Health System. Results: there were 227,014 hospitalizations, 25.8% of them were sensitive to Primary care. The illnesses which caused sensitive admissions were pneumonia (n=19,832; 33.7%, heart failure (n=6,688, 11.3%, and gastroenteritis (n=6,287, 10.7%. Conclusion: sensitive hospitalizations for primary care have decreasing historical trend in the study area. Primary care services, with guidelines and principles, well conducted could minimize the risk of exacerbation of chronic conditions and also endorse lower rates of infection transmitted diseases.

  4. Users' satisfaction with Porto Alegre's Primary Care Network

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    Aline do Amaral Zils


    Full Text Available 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.

  5. Accelerating a Network Model of Care: Taking a Social Innovation to Scale

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    Kerry Byrne


    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.

  6. The performance of integrated health care networks in continuity of care: a qualitative multiple case study of COPD patients

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    Sina Waibel


    Full Text Available Background: Integrated health care networks (IHN are promoted in numerous countries as a response to fragmented care delivery by providing a coordinated continuum of services to a defined population. However, evidence on their effectiveness and outcome is scarce, particularly considering continuity across levels of care; that is the patient's experience of connected and coherent care received from professionals of the different care levels over time. The objective was to analyse the chronic obstructive pulmonary disease (COPD patients’ perceptions of continuity of clinical management and information across care levels and continuity of relation in IHN of the public health care system of Catalonia.Methods: A qualitative multiple case study was conducted, where the cases are COPD patients. A theoretical sample was selected in two stages: (1 study contexts: IHN and (2 study cases consisting of COPD patients. Data were collected by means of individual, semi-structured interviews to the patients, their general practitioners and pulmonologists and review of records. A thematic content analysis segmented by IHN and cases with a triangulation of sources and analysists was carried out.Results: COPD patients of all networks perceived that continuity of clinical management was existent due to clear distribution of roles for COPD care across levels, rapid access to care during exacerbations and referrals to secondary care when needed; nevertheless, patients of some networks highlighted too long waiting times to non-urgent secondary care. Physicians generally agreed with patients, however, also indicated unclear distribution of roles, some inadequate referrals and long waiting times to primary care in some networks. Concerning continuity of information, patients across networks considered that their clinical information was transferred across levels via computer and that physicians also used informal communication mechanisms (e-mail, telephone; whereas

  7. Effects of community-care networks on psychiatric emergency contacts, hospitalisation and involuntary admission

    NARCIS (Netherlands)

    A.I. Wierdsma (André); H.D. Poodt (Hilde); C.L. Mulder (Niels)


    textabstractBackground: Community-care networks are a partnership between the local police force, housing corporations, general social services, specialised home care and mental healthcare services. The networks were set up to improve the healthcare for patients with (chronic) psychiatric problems t

  8. [Health care networks in Germany: status quo and key success factors]. (United States)

    Wambach, Veit; Lindenthal, J


    One third of all practicing physicians are currently working in one of the 400 German health care networks. These physicians' networks bring together GPs and specialists and cooperate with different partners, for example, nursing homes, hospitals, and self-help groups. To increase the quality and the efficiency of care and patient satisfaction by improving the collaboration and communication between physicians and other health care providers.The example of the accountable care organization "Gesundheitsnetz Qualität und Effizienz" (QuE; Health Quality and Efficiency Network) in Nuremberg is used to show that it is possible to achieve an increase in efficiency while providing above-average quality of care and achieving high patient satisfaction. Additionally, the article deals with the status quo, the core objectives, and the key activities of previous generations of health care networks. Quality indicators, satisfaction surveys, and economic parameters are the basis for measuring and representing the above-average performance of physicians' networks. Regional health care networks offer an entire range of patient care, from outpatients and inpatients to the complementary sector, and thereby have excellent prospects for playing an even more important role in the German health care system. The key success factors are: the consideration of specific regional characteristics, their proximity to the patient, and consistent patient orientation.

  9. Study protocol: The Intensive Care Outcome Network ('ICON' study

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    Barber Vicki S


    Full Text Available Abstract Background Extended follow-up of survivors of ICU treatment has shown many patients suffer long-term physical and psychological consequences that affect their health-related quality of life. The current lack of rigorous longitudinal studies means that the true prevalence of these physical and psychological problems remains undetermined. Methods/Design The ICON (Intensive Care Outcome Network study is a multi-centre, longitudinal study of survivors of critical illness. Patients will be recruited prior to hospital discharge from 20–30 ICUs in the UK and will be assessed at 3, 6, and 12 months following ICU discharge for health-related quality of life as measured by the Short Form-36 (SF-36 and the EuroQoL (EQ-5D; anxiety and depression as measured by the Hospital Anxiety and Depression Scale (HADS; and post traumatic stress disorder (PTSD symptoms as measured by the PTSD Civilian Checklist (PCL-C. Postal questionnaires will be used. Discussion The ICON study will create a valuable UK database detailing the prevalence of physical and psychological morbidity experienced by patients as they recover from critical illness. Knowledge of the prevalence of physical and psychological morbidity in ICU survivors is important because research to generate models of causality, prognosis and treatment effects is dependent on accurate determination of prevalence. The results will also inform economic modelling of the long-term burden of critical illness. Trial Registration ISRCTN69112866

  10. Sensor Network Infrastructure for a Home Care Monitoring System

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    Filippo Palumbo


    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.

  11. Temporal trends of system of care for STEMI: insights from the Jakarta Cardiovascular Care Unit Network System.

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    Surya Dharma

    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.

  12. Advanced course for doctors as Departmental IT Network Administrators in anesthesia and intensive care units. (United States)

    Lanza, Vincenzo; Huang, Chun-Hsi


    The design and administration of a departmental computer network (Local Area Network) in anesthesiology and intensive care offer the opportunity to manage clinical information and control the work-flow. To improve the local network, after basic design, intelligence is necessary to maintain its efficiency. For this reason the role of a medical administrator of the network is fundamental because he is a qualified figure who recognizes the most important characteristics that a network must have, knows the users of the system, represents a valid consultant for the technician that has to build the network, and is able to face possible breakdowns. This paper illustrates the structure of a course to train a medical network administrator in anesthesiology and critical care.

  13. Nutritional deficiency in Dutch primary care : data from general practice research and registration networks

    NARCIS (Netherlands)

    van Wayenburg, CAM; van de Laar, FA; de Waal, MWM; Okkes, IM; van den Akker, M; van der Veen, WJ; Schellevis, FG; van Staveren, WA; van Binsbergen, JJ; van Weel, C


    Objective: To explore incidence and prevalence rates of nutritional deficiency in adults in general practice. Methods: Six Dutch general practice research and registration networks supplied incidence and prevalence rates of nutritional deficiency by the International Classification of Primary Care (

  14. Do social networks affect the use of residential aged care among older Australians?

    Directory of Open Access Journals (Sweden)

    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.

  15. Care Networking: A Study of Technical Mediations in a Home Telecare Service

    Directory of Open Access Journals (Sweden)

    Miquel Domènech


    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.

  16. Care networking: a study of technical mediations in a home telecare service. (United States)

    Correa, Gonzalo; Domènech, Miquel


    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.

  17. Do social networks affect the use of residential aged care among older Australians?


    Glonek Gary FV; Giles Lynne C; Luszcz Mary A; Andrews Gary R


    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. Mul...

  18. Social networks in health care teams: evidence from the United States. (United States)

    Poghosyan, Lusine; Lucero, Robert J; Knutson, Ashley R; W Friedberg, Mark; Poghosyan, Hermine


    Purpose The purpose of this paper is to synthesize existing evidence regarding health care team networks, including their formation and association with outcomes in various health care settings. Design/methodology/approach Network theory informed this review. A literature search was conducted in major databases for studies that used social network analysis methods to study health care teams in the USA between 2000 and 2014. Retrieved studies were reviewed against inclusion and exclusion criteria. Findings Overall, 25 studies were included in this review. Results demonstrated that health care team members form professional (e.g. consultation) and personal (e.g. friendship) networks. Network formation can be influenced by team member characteristics (i.e. demographics and professional affiliations) as well as by contextual factors (i.e. providers sharing patient populations and physical proximity to colleagues). These networks can affect team member practice such as adoption of a new medication. Network structures can also impact patient and organizational outcomes, including occurrence of adverse events and deficiencies in health care delivery. Practical implications Administrators and policy makers can use knowledge of health care networks to leverage relational structures in teams and tailor interventions that facilitate information exchange, promote collaboration, increase diffusion of evidence-based practices, and potentially improve individual and team performance as well as patient care and outcomes. Originality/value Most health services research studies have investigated health care team composition and functioning using traditional social science methodologies, which fail to capture relational structures within teams. Thus, this review is original in terms of focusing on dynamic relationships among team members.

  19. Ehlers-Danlos Syndrome Network C.A.R.E.S. (United States)

    ... view our diagnostic/information posters - click here EDS Network C.A.R.E.S. Foundation PO Box 66 Muskego, WI 53150 Phone: (262) 514-2851 Email: Website Designed at Homestead™ Build a Website for Your Business

  20. Solidarity Networks: What Are They? And Why Should We Care? (United States)

    Smith, Janel


    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.…

  1. Physician directed networks: the new generation of managed care. (United States)

    Bennett, T; O'Sullivan, D


    The external pressure to reduce cost while maintaining quality and services is moving the whole industry into a rapid mode of integration. Hospitals, vendors, MCOs, and now, physicians, are faced with the difficult decisions concerning how their operations will be integrated into the larger health care delivery system. These pressures have forced physicians to consolidate, build leverage, and create efficiencies to become more productive; thereby better positioning themselves to respond to the challenges and the opportunities that lie before them. This initial phase of consolidation has given many physicians the momentum to begin to wrestle back the control of health care and the courage to design the next generation of managed care: Physician Directed Managed Care. What will be the next phase? Perhaps, the next step will be fully-integrated specialty and multi-specialty groups leading to alternate delivery sites. "Everyone thinks of changing the world, but no one thinks of changing himself." - Leo Tolstoy

  2. A managed clinical network for cardiac services: set-up, operation and impact on patient care

    Directory of Open Access Journals (Sweden)

    Karen E. Hamilton


    Full Text Available Purpose: To investigate the set up and operation of a Managed Clinical Network for cardiac services and assess its impact on patient care. Methods: This single case study used process evaluation with observational before and after comparison of indicators of quality of care and costs. The study was conducted in Dumfries and Galloway, Scotland and used a three-level framework. Process evaluation of the network set-up and operation through a documentary review of minutes; guidelines and protocols; transcripts of fourteen semi-structured interviews with health service personnel including senior managers, general practitioners, nurses, cardiologists and members of the public. Outcome evaluation of the impact of the network through interrupted time series analysis of clinical data of 202 patients aged less than 76 years admitted to hospital with a confirmed myocardial infarction one-year pre and one-year post, the establishment of the network. The main outcome measures were differences between indicators of quality of care targeted by network protocols. Economic evaluation of the transaction costs of the set-up and operation of the network and the resource costs of the clinical care of the 202 myocardial infarction patients from the time of hospital admission to 6 months post discharge through interrupted time series analysis. The outcome measure was different in National Health Service resource use. Results: Despite early difficulties, the network was successful in bringing together clinicians, patients and managers to redesign services, exhibiting most features of good network management. The role of the energetic lead clinician was crucial, but the network took time to develop and ‘bed down’. Its primary “modus operand” was the development of a myocardial infarction pathway and associated protocols. Of sixteen clinical care indicators, two improved significantly following the launch of the network and nine showed improvements, which were

  3. Clinic Network Collaboration and Patient Tracing to Maximize Retention in HIV Care.

    Directory of Open Access Journals (Sweden)

    James H McMahon

    Full Text Available Understanding retention and loss to follow up in HIV care, in particular the number of people with unknown outcomes, is critical to maximise the benefits of antiretroviral therapy. Individual-level data are not available for these outcomes in Australia, which has an HIV epidemic predominantly focused amongst men who have sex with men.A network of the 6 main HIV clinical care sites was established in the state of Victoria, Australia. Individuals who had accessed care at these sites between February 2011 and June 2013 as assessed by HIV viral load testing but not accessed care between June 2013 and February 2014 were considered individuals with potentially unknown outcomes. For this group an intervention combining cross-referencing of clinical data between sites and phone tracing individuals with unknown outcomes was performed. 4966 people were in care in the network and before the intervention estimates of retention ranged from 85.9%-95.8% and the proportion with unknown outcomes ranged from 1.3-5.5%. After the intervention retention increased to 91.4-98.8% and unknown outcomes decreased to 0.1-2.4% (p<.01 for all sites for both outcomes. Most common reasons for disengagement from care were being too busy to attend or feeling well. For those with unknown outcomes prior to the intervention documented active psychiatric illness at last visit was associated with not re-entering care (p = 0.04.The network demonstrated low numbers of people with unknown outcomes and high levels of retention in care. Increased levels of retention in care and reductions in unknown outcomes identified after the intervention largely reflected confirmation of clinic transfers while a smaller number were successfully re-engaged in care. Factors associated with disengagement from care were identified. Systems to monitor patient retention, care transfer and minimize disengagement will maximise individual and population-level outcomes for populations with HIV.

  4. Do-it-yourself managed care. Case study I: Randall's Medical Network. Case study II: Hershey's Managed Care Plan. (United States)


    Employers, who pay for much of the healthcare in this country, are not waiting for government to restructure the healthcare system. In this cover story, PROFILES examines how two firms formed their own managed care networks to control healthcare cost and quality, and what hospitals did to become players. By understanding the employer' point of view, hospital marketers can better anticipate their needs and develop a marketing strategy to form closer relationships with employers, provide quality care at a lower cost, and increase their market share.

  5. Effect of social networks and well-being on acute care needs. (United States)

    Sintonen, Sanna; Pehkonen, Aini


    The effect of social surroundings has been noted as an important component of the well-being of elderly people. A strong social network and strong and steady relationships are necessary for coping when illness or functional limitations occur in later life. Vulnerability can affect well-being and functioning particularly when sudden life changes occur. The objective of this study was to analyse how the determinants of social well-being affect individual acute care needs when sudden life changes occur. Empirical evidence was collected using a cross-sectional mail survey in Finland in January 2011 among individuals aged 55-79 years. The age-stratified random sample covered 3000 individuals, and the eventual response rate was 56% (1680). Complete responses were received from 1282 respondents (42.7%). The study focuses on the compactness of social networks, social disability, the stability of social relationships and the fear of loneliness as well as how these factors influence acute care needs. The measurement was based on a latent factor structure, and the key concepts were measured using two ordinal items. The results of the structural model suggest that the need for care is directly affected by social disability and the fear of loneliness. In addition, social disability is a determinant of the fear of loneliness and therefore plays an important role if sudden life changes occur. The compactness of social networks decreases social disability and partly diminishes the fear of loneliness and therefore has an indirect effect on the need for care. The stability of social relationships was influenced by the social networks and disability, but was an insignificant predictor of care needs. To conclude, social networks and well-being can decrease care needs, and supportive actions should be targeted to avoid loneliness and social isolation so that the informal network could be applied as an aspect of care-giving when acute life changes occur.

  6. Scotland's Knowledge Network: translating knowledge into action to improve quality of care. (United States)

    Wales, A; Graham, S; Rooney, K; Crawford, A


    The Knowledge Network ( is Scotland's online knowledge service for health and social care. It is designed to support practitioners to apply knowledge in frontline delivery of care, helping to translate knowledge into better health-care outcomes through safe, effective, person-centred care. The Knowledge Network helps to combine the worlds of evidence-based practice and quality improvement by providing access to knowledge about the effectiveness of clinical interventions ('know-what') and knowledge about how to implement this knowledge to support individual patients in working health-care environments ('know-how'). An 'evidence and guidance' search enables clinicians to quickly access quality-assured evidence and best practice, while point of care and mobile solutions provide knowledge in actionable formats to embed in clinical workflow. This research-based knowledge is complemented by social networking services and improvement tools which support the capture and exchange of knowledge from experience, facilitating practice change and systems improvement. In these cases, the Knowledge Network supports key components of the knowledge-to-action cycle--acquiring, creating, sharing and disseminating knowledge to improve performance and innovate. It provides a vehicle for implementing the recommendations of the national Knowledge into Action review, which outlines a new national approach to embedding knowledge in frontline practice and systems improvement.

  7. Cooperation in Care: Integration of care in networks by steering, coordination and learning

    NARCIS (Netherlands)

    J.D.H. 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

  8. Behavioral health referrals and treatment initiation rates in integrated primary care: a Collaborative Care Research Network study. (United States)

    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.

  9. Learning to cross boundaries: the integration of a health network to deliver seamless care. (United States)

    van Wijngaarden, Jeroen D H; de Bont, Antoinette A; Huijsman, Robbert


    We analysed the development of an integrated network from a learning perspective to see how care givers from different organisations were able to cross the professional and organisational boundaries that existed between them to make sure patients receive the right care, at the right moment, in the right place. We show how through a process of collective learning social contacts between health professionals increased and improved. These professionals learned to speak each other's language, learned how other professionals and organisations work and learned to look at the care process from a network perspective instead of only from a professional or organisational perspective. Through this learning process, they also experienced the limitations of standardizing knowledge in criteria, protocols and rules, and the value of direct contact for sharing information and knowledge, to ensure continuity in care.

  10. Interoperable Medical Instrument Networking and Access System with Security Considerations for Critical Care

    Directory of Open Access Journals (Sweden)

    Deniz Gurkan


    Full Text Available The recent influx of electronic medical records in the health care field, coupled with the need of providing continuous care to patients in the critical care environment, has driven the need for interoperability of medical devices. Open standards are needed to support flexible processes and interoperability of medical devices, especially in intensive care units. In this paper, we present an interoperable networking and access architecture based on the CAN protocol. Predictability of the delay of medical data reports is a desirable attribute that can be realized using a tightly-coupled system architecture. Our simulations on network architecture demonstrate that a bounded delay for event reports offers predictability. In addition, we address security issues related to the storage of electronic medical records. We present a set of open source tools and tests to identify the security breaches, and appropriate measures that can be implemented to be compliant with the HIPAA rules.

  11. Social networks and the communication of norms about prenatal care in rural Mexico. (United States)

    Lapinski, Maria Knight; Anderson, Jenn; Cruz, Shannon; Lapine, Peter


    Many normative beliefs are shared and learned through interpersonal communication, yet research on norms typically focuses on their effects rather than the communication that shapes them. This study focused on interpersonal communication during pregnancy to uncover (a) the nature of pregnancy-related communication and (b) normative information transmitted through such communication. Results from interviews with pregnant women living in rural Mexico revealed limited social networks; often, only a woman's mother or the baby's father were consulted about prenatal care decisions. However, women also indicated that communication with others during pregnancy provided important normative information regarding prenatal care. First, most referents believed that women should receive prenatal care (injunctive norm), which was conceptualized by participants as biomedical, nonmedical, or a blend of both. Second, family members often received prenatal care, whereas friends did not (descriptive norms). These findings highlight the key role of personal and social networks in shaping personal pregnancy-related beliefs and behaviors.

  12. Improving collaboration between primary care research networks using Access Grid technology

    Directory of Open Access Journals (Sweden)

    Zsolt Nagykaldi


    Full Text Available Access Grid (AG is an Internet2-driven, high performance audio_visual conferencing technology used worldwide by academic and government organisations to enhance communication, human interaction and group collaboration. AG technology is particularly promising for improving academic multi-centre research collaborations. This manuscript describes how the AG technology was utilised by the electronic Primary Care Research Network (ePCRN that is part of the National Institutes of Health (NIH Roadmap initiative to improve primary care research and collaboration among practice- based research networks (PBRNs in the USA. It discusses the design, installation and use of AG implementations, potential future applications, barriers to adoption, and suggested solutions.

  13. Analysis of the social network development of a virtual community for Australian intensive care professionals. (United States)

    Rolls, Kaye Denise; Hansen, Margaret; Jackson, Debra; Elliott, Doug


    Social media platforms can create virtual communities, enabling healthcare professionals to network with a broad range of colleagues and facilitate knowledge exchange. In 2003, an Australian state health department established an intensive care mailing list to address the professional isolation experienced by senior intensive care nurses. This article describes the social network created within this virtual community by examining how the membership profile evolved from 2003 to 2009. A retrospective descriptive design was used. The data source was a deidentified member database. Since 2003, 1340 healthcare professionals subscribed to the virtual community with 78% of these (n = 1042) still members at the end of 2009. The membership profile has evolved from a single-state nurse-specific network to an Australia-wide multidisciplinary and multiorganizational intensive care network. The uptake and retention of membership by intensive care clinicians indicated that they appeared to value involvement in this virtual community. For healthcare organizations, a virtual community may be a communications option for minimizing professional and organizational barriers and promoting knowledge flow. Further research is, however, required to demonstrate a link between these broader social networks, enabling the exchange of knowledge and improved patient outcomes.

  14. Transitional care in clinical networks for young people with juvenile idiopathic arthritis: current situation and challenges. (United States)

    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

  15. Support network and social support for children with special health care need

    Directory of Open Access Journals (Sweden)

    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.

  16. Outcomes of Specialized Foster Care in a Managed Child Welfare Services Network (United States)

    Cross, Theodore P.; Leavey, Joseph; Mosley, Peggy R.; White, Andrew W.; Andreas, Jasmina Burdzovic


    This study (N = 384) presents results from outcome measurement in a services network providing specialized foster care (SFC) to children in child protective service custody. A majority of participants improved on most outcomes. Global improvement was associated with increased length of stay up to two years, five months, and with younger age, fewer…

  17. Connecting primary care clinics and community pharmacies through a nationwide electronic prescribing network: A qualitative study

    Directory of Open Access Journals (Sweden)

    Marie-Pierre Gagnon


    Full Text Available Background The use of medication is at the heart of primary care, but is also the cause for major health concerns. It is therefore important to examine the prescription of medication process.Objective This study identifies the barriers and facilitators perceived by community pharmacists and primary care physicians concerning the adoption of a nationwide electronic prescribing (e-prescribing network in the province of Quebec, Canada.Methods We used purposive sampling to identify the most intensive users of the e-prescribing network. We conducted phone and in-person interviews. Interviews were transcribed, and we analysed their content with NVivo, using the clinical adoption framework (CAF for the codification of the data.Results We interviewed 33 pharmacists, 2 pharmacy technicians, 11 physicians and 3 clinic managers. Adoption of the e-prescribing network was fairly low. The respondents underlined adaptation of their work environment, openness to change and perception of benefits as facilitators to the adoption of the network. However, important barriers were perceived, including system quality issues and paper prescriptions being the only legal document in the prescribing process. Even if respondents recognised that the e-prescribing network can offer substantial benefits to the prescribing process, issues still persisted and raised barriers to the full use of such a network, especially in a context where different local information systems are connected within a nationwide e-prescribing network.Conclusion This study, based on the CAF, provides a better understanding of the factors related to the adoption of a nationwide e-prescribing network connecting primary care clinics and community pharmacies. 

  18. Patient referral patterns and the spread of hospital-acquired infections through national health care networks.

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    Tjibbe Donker


    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.

  19. Healthcare PANs: Personal Area Networks for trauma care and home care

    NARCIS (Netherlands)

    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

  20. Establishment of a Representative Practice-based Research Network (PBRN) for the Monitoring of Primary Care in Switzerland. (United States)

    Selby, Kevin; Cornuz, Jacques; Senn, Nicolas


    Data are urgently needed to better understand processes of care in Swiss primary care (PC). A total of 2027 PC physicians, stratified by canton, were invited to participate in the Swiss Primary care Active Monitoring network, of whom 200 accepted to join. There were no significant differences between participants and a random sample drawn from the same physician databases based on sex, year of obtaining medical school diploma, or location. The Swiss Primary care Active Monitoring network represents the first large-scale, nationally representative practice-based research network in Switzerland and will provide a unique opportunity to better understand the functioning of Swiss PC.

  1. Expanding a Care Network for People with Dementia and their Carers Through Musicking: Participant Observation with

    Directory of Open Access Journals (Sweden)

    Mariko Hara


    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.

  2. Regionalized care for time-critical conditions: lessons learned from existing networks. (United States)

    Carr, Brendan G; Matthew Edwards, J; Martinez, Ricardo


    The 2010 Academic Emergency Medicine (AEM) consensus conference "Beyond Regionalization" aimed to place the design of a 21st century emergency care delivery system at the center of emergency medicine's (EM's) health policy research agenda. To examine the lessons learned from existing regional systems, consensus conference organizers convened a panel discussion made up of experts from the fields of acute care surgery, interventional cardiology, acute ischemic stroke, cardiac arrest, critical care medicine, pediatric EM, and medical toxicology. The organizers asked that each member provide insight into the barriers that slowed network creation and the solutions that allowed them to overcome barriers. For ST-segment elevation myocardial infarction (STEMI) management, the American Heart Association's (AHA's) Mission: Lifeline aims to increase compliance with existing guidelines through improvements in the chain of survival, including emergency medical services (EMS) protocols. Increasing use of therapeutic hypothermia post-cardiac arrest through a network of hospitals in Virginia has led to dramatic improvements in outcome. A regionalized network of acute stroke management in Cincinnati was discussed, in addition to the effect of pediatric referral centers on pediatric capabilities of surrounding facilities. The growing importance of telemedicine to a variety of emergencies, including trauma and critical care, was presented. Finally, the importance of establishing a robust reimbursement mechanism was illustrated by the threatened closure of poison control centers nationwide. The panel discussion added valuable insight into the possibilities of maximizing patient outcomes through regionalized systems of emergency care. A primary challenge remaining is for EM to help to integrate the existing and developing disease-based systems of care into a more comprehensive emergency care system.

  3. Computer network for improving quality and efficiency of children's primary health care (United States)

    Deutsch, Larry


    Health care is at its best when both the practitioner and patient are well-informed. In many central urban and remote rural areas, however, health care is characterized by a lack of continuity and coordination among providers. In these areas, a local information infrastructure and a patient-centered system of primary care are missing. Decision-making and ability to follow through is hampered, with limited involvement of patients in planning care and insufficient aggregate data for cost analysis, outcome research, community health planning, and other purposes. A Children's Health Network has been designed to extend current information technology to these underserved areas. Our approach to improving quality of individual care and controlling costs emphasizes use of computerized clinical information networks for better decision making and continuity, and secondarily through data aggregation for financial, research, and public health functions. This is in distinction to information systems centered on billing and administrative needs and to cost-control efforts which rely on fiscal and managerial ('gatekeeper') mechanisms. A uniform data base among sites serving the same population will answer several clinical and public health needs.

  4. Proceedings from the Turner Resource Network symposium: the crossroads of health care research and health care delivery. (United States)

    Backeljauw, Philippe F; Bondy, Carolyn; Chernausek, Steven D; Cernich, Joseph T; Cole, David A; Fasciano, Laura P; Foodim, Joan; Hawley, Scott; Hong, David S; Knickmeyer, Rebecca C; Kruszka, Paul; Lin, Angela E; Lippe, Barbara M; Lorigan, Gary A; Maslen, Cheryl L; Mauras, Nelly; Page, David C; Pemberton, Victoria L; Prakash, Siddharth K; Quigley, Charmian A; Ranallo, Kelly C; Reiss, Allan L; Sandberg, David E; Scurlock, Cindy; Silberbach, Michael


    Turner syndrome, a congenital condition that affects ∼1/2,500 births, results from absence or structural alteration of the second sex chromosome. There has been substantial effort by numerous clinical and genetic research groups to delineate the clinical, pathophysiological, cytogenetic, and molecular features of this multisystem condition. Questions about the molecular-genetic and biological basis of many of the clinical features remain unanswered, and health care providers and families seek improved care for affected individuals. The inaugural "Turner Resource Network (TRN) Symposium" brought together individuals with Turner syndrome and their families, advocacy group leaders, clinicians, basic scientists, physician-scientists, trainees and other stakeholders with interest in the well-being of individuals and families living with the condition. The goal of this symposium was to establish a structure for a TRN that will be a patient-powered organization involving those living with Turner syndrome, their families, clinicians, and scientists. The TRN will identify basic and clinical questions that might be answered with registries, clinical trials, or through bench research to promote and advocate for best practices and improved care for individuals with Turner syndrome. The symposium concluded with the consensus that two rationales justify the creation of a TRN: inadequate attention has been paid to the health and psychosocial issues facing girls and women who live with Turner syndrome; investigations into the susceptibility to common disorders such as cardiovascular or autoimmune diseases caused by sex chromosome deficiencies will increase understanding of disease susceptibilities in the general population.

  5. Piloting an advanced methodology to analyse health care policy networks: The example of Belgrade, Serbia

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    Helmut Wenzel


    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.

  6. A Health Collaborative Network Focus on Self-care Processes in Personal Assistant Practice (United States)

    de La Fuente, Ma Victoria; Ros, Lorenzo

    Public health is oriented to the management of an adequate health atmosphere which acts directly on health, as well as health education work and the supervision of environmental health threats. The work presented in this paper aims to reduce inequality, and give disabled people the tools to be integrated more effectively, reducing social exclusion, removing obstacles and barriers, and facilitating mobility and the use of technology. The work is planned to design a special healthcare collaborative network as the best solution for addressing the needs of the disabled self-care and health care community through the creation and implementation of an interconnected, electronic information infrastructure and adoption of open data standards.

  7. Two Essential Roles: Health Care Network Nurse Leaders and Local Nurse Leaders. (United States)

    Schneider, Maureen


    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.

  8. [Prevention and Treatment of Eating Disorders: The Health Care Network Anorexia and Bulimia nervosa]. (United States)

    Weigel, Angelika; Gumz, Antje; Kästner, Denise; Romer, Georg; Wegscheider, Karl; Löwe, Bernd


    The "Health care network anorexia and bulimia nervosa", a subproject of psychenet - the Hamburg network for mental health - aims to decrease the incidence of eating disorders as well as the risk for chronic illness courses. One focal project, therefore, evaluates a school-based prevention manual in a randomized controlled trial. The other one examines the impact of a systemic public health intervention on early treatment initiation in anorexia nervosa. The present article provides an overview about study design and interventions in both focal projects as well as preliminary results.

  9. Nursing emotional competence profile: exploratory study in continued care national network


    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...

  10. Nurses in emotional competence: exploratory study on population of continued care national network


    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...

  11. [Sociability networks: approaches based on home-based therapeutic care services]. (United States)

    Argiles, Carmen Terezinha Leal; Kantorski, Luciane Prado; Willrich, Janaína Quinzen; Antonacci, Milena Hohmann; Coimbra, Valéria Cristina Christello


    Home-based therapeutic services emerge in the context of psychiatric reform in Brazil, as a step forward in the policy of de-institutionalization, as well as being essential services to overcome custody practices, typical of the asylum model. These services provide spaces for care, welcome and decent housing for people whose family and social ties have been affected by internment in psychiatric hospitals. The article seeks to evaluate the sociability network of users of home-based therapeutic services in Alegrete in the State of Rio Grande do Sul, based on a case report. This study is part of the research on 'Networks that Rehabilitate'--evaluating innovative experiments in the composition of psychosocial care networks. Data from semi-structured interviews with the six workers of the service were used. It was observed that the service provides unique and innovative experience to find solutions that bring people with long periods of psychiatric hospitalization back together with their family, the community and city life, thereby eliminating the segregation to which they were subjected. Coaching residents and workers in the creation of home-based therapeutic care services reveals the potential to reintegrate mentally handicapped patients into society.

  12. [Palliative Care Network - 20 years of experiences from Ticino / Southern Switzerland]. (United States)

    Neuenschwander, Hans; Gamondi, Claudia


    The PC program of the Italian speaking part of Switzerland (Ticino) has been developed bottom up since 1990. It was started with a palliative homecare service, called Hospice Ticino. Six years later PC consultant teams were introduced in the public hospitals. Finally in 2003 an acute palliative care unit was opened. Few resources are still lacking to ensure a comprehensive network, especially in the private clinics and in the elderly homes. Through the newly implemented National Strategy in PC 2010 - 12, the government of Canton Ticino has been charged with promoting a comprehensive, strategic and operative program in PC in order to guarantee access to high quality PC to every patient wherever he choses to be cared for. The article describes the history of Ticino's palliative care program, highlighting some of its controversial issues.

  13. A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research


    Marsolo, Keith; Margolis, Peter A; Forrest, Christopher B.; Colletti, Richard B.; Hutton, John J.


    Introduction: We collaborated with the ImproveCareNow Network to create a proof-of-concept architecture for a network-based Learning Health System. This collaboration involved transitioning an existing registry to one that is linked to the electronic health record (EHR), enabling a “data in once” strategy. We sought to automate a series of reports that support care improvement while also demonstrating the use of observational registry data for comparative effectiveness research. Description o...

  14. Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa

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    Mosa Moshabela


    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

  15. The KIzSS network, a sentinel surveillance system for infectious diseases in day care centers: study protocol

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    Enserink Remko


    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.

  16. Blended Learning Networks Supported by Information and Communication Technology: An Intervention for Knowledge Transformation within Family Care of Older People (United States)

    Hanson, Elizabeth; Magnusson, Lennart; Sennemark, Eva


    Purpose: This article describes an innovative practice called Blended Learning Networks (BLNs) whose aim is to enable older people, their families, and care providers to exchange knowledge, learn together, and support each other in local development work so that care is improved for older people. BLNs were established in 31 municipalities, headed…

  17. Networks for integrated care provision: an economic approach based on opportunism and trust. (United States)

    Meijboom, Bert; de Haan, Job; Verheyen, Piet


    In this paper, we provide the economic rationale for an important issue in the health care sector, namely the network formation, e.g., in The Netherlands. The presence of such cooperation structures is hard to explain using the basic concept of the economic organization (EO) theory, i.e., the dichotomy of hierarchy versus market. However, acknowledging the aspect of trust renders the clan concept to be a powerful tool in understanding the viability of intra- and inter-organizational cooperation in the health sector. The main reason for this is the manner in which the professionals involved perform, as well as the importance of the tacit knowledge of the actors employed in the various health institutions. First, we address the conversion from supply towards demand orientation and the resulting pressure on multi-professional cooperation between health care providers. Then, relevant EO concepts will be reviewed, while introducing theory on knowledge, learning, and trust. Moreover, we offer conclusions for the health care sector on a concept-by-concept basis. Finally, we propose the notion of interclan, a clan-inspired notion for inter-organizational cooperation, and analyse the observed network formation.

  18. Characteristics of diabetes care in an institutional network of health services Medellin. 2005-2008

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    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

  19. [Nurse leadership: intervening element in the relationships network of the community health care agent]. (United States)

    Lanzoni, Gabriela Marcellino de Melo; Meirelles, Betina Hörner Schlindwein


    This study aimed to understand the nurses' contributions in the network of relationships and interactions of community health workers (CHW) in a city located in the south of the country. The Grounded Theory was used and twenty individuals were interviewed, among health professionals and users of the health center, divided into three sample groups. The nurse is recognized as a key element in the network of relationships and interactions of the CHW with the community, being viewed as a leader. Although showing signs of an authoritarian leadership, the nurse promotes dialogue and acts as a facilitator of teamwork in health promotion. It was concluded that the nurses of the Family Health Strategy have a significant role in the health team, providing clinical support to organize the care, and management, to foster good relations, direct the activities and conduct the flow of information.

  20. Participation and coordination in Dutch health care policy-making. A network analysis of the system of intermediate organizations in Dutch health care. (United States)

    Lamping, Antonie J; Raab, Jörg; Kenis, Patrick


    This study explores the system of intermediate organizations in Dutch health care as the crucial system to understand health care policy-making in the Netherlands. We argue that the Dutch health care system can be understood as a system consisting of distinct but inter-related policy domains. In this study, we analyze four such policy domains: Finances, quality of care, manpower planning and pharmaceuticals. With the help of network analytic techniques, we describe how this highly differentiated system of >200 intermediate organizations is structured and coordinated and what (policy) consequences can be observed with regard to its particular structure and coordination mechanisms. We further analyze the extent to which this system of intermediate organizations enables participation of stakeholders in policy-making using network visualization tools. The results indicate that coordination between the different policy domains within the health care sector takes place not as one would expect through governmental agencies, but through representative organizations such as the representative organizations of the (general) hospitals, the health care consumers and the employers' association. We further conclude that the system allows as well as denies a large number of potential participants access to the policy-making process. As a consequence, the representation of interests is not necessarily balanced, which in turn affects health care policy. We find that the interests of the Dutch health care consumers are well accommodated with the national umbrella organization NPCF in the lead. However, this is no safeguard for the overall community values of good health care since, for example, the interests of the public health sector are likely to be marginalized.

  1. A survey of system architecture requirements for health care-based wireless sensor networks. (United States)

    Egbogah, Emeka E; Fapojuwo, Abraham O


    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.

  2. A Survey of System Architecture Requirements for Health Care-Based Wireless Sensor Networks

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    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.

  3. Social care networks and older LGBT adults: challenges for the future. (United States)

    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.

  4. A sensitivity analysis of the Children's Treatment Network trial: a randomized controlled trial of integrated services versus usual care for children with special health care needs

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    Ye C


    Full Text Available Chenglin Ye,1,2 Gina Browne,1,3 Joseph Beyene,1 Lehana Thabane1,2 1Department of Clinical Epidemiology and Biostatistics, McMaster University, 2Biostatistcs Unit, St Joseph's Healthcare Hamilton, 3School of Nursing, McMaster University, Hamilton, ON, Canada Background: The value of integrated care through comprehensive, coordinated, and family-centered services has been increasingly recognized for improving health outcomes of children with special health care needs (CSHCN. In a randomized controlled trial (RCT, the integrated care provided through the Children's Treatment Network (CTN was compared with usual care in improving the psychosocial health of target CSHCN. In this paper, we aimed to estimate the effect of CTN care by conducting multiple analyses to handle noncompliance in the trial. Methods: The trial recruited target children in Simcoe County and York Region, ON, Canada. Children were randomized to receive CTN or usual care and were followed for 2 years. The CTN group received integrated services through multiple providers to address their specific needs while the usual care group continued to receive care directed by their parents. The outcome was change in psychosocial quality of life at 2 years. We conducted intention-to-treat, as-treated, per-protocol, and instrumental variable analyses to analyze the outcome. Results: The trial randomized 445 children, with 229 in the intervention group and 216 in the control group. During follow-up, 52% of children in the intervention group did not receive complete CTN care for various reasons. At 2 years, we did not find a significant improvement in psychosocial quality of life among the children receiving CTN care compared with usual care (intention-to-treat mean difference 1.50, 95% confidence interval −1.49 to 4.50; P = 0.32. Other methods of analysis yielded similar results. Conclusion: Although the effect of CTN care was not significant, there was evidence showing benefits of integrated

  5. The national improvement partnership network: state-based partnerships that improve primary care quality. (United States)

    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.

  6. How do people with dementia utilise primary care physicians and specialists within dementia networks? Results of the Dementia Networks in Germany (DemNet-D) study. (United States)

    Wübbeler, Markus; Thyrian, Jochen René; Michalowsky, Bernhard; Erdmann, Pia; Hertel, Johannes; Holle, Bernhard; Gräske, Johannes; Schäfer-Walkmann, Susanne; Hoffmann, Wolfgang


    Outpatient dementia healthcare is predominantly fragmented, and dementia networks (DNs) represent an integrated care concept to overcome this problem. Little is known about the patients of these networks with regard to utilisation of physicians and associated factors. We interviewed 560 caregivers of people with dementia in 13 different DNs in Germany in 2013 and assessed socio-demographics, clinical data and physician utilisation. Networks were categorised in predominantly medical DNs and community-oriented DNs. Descriptive and multivariate statistical models were used to identify associated factors between DNs and users' data. Overall, the users of networks received high rates of physician care; 93% of the sample stated at least one contact with a primary care physician within the last 6 months, and 74% had been treated by a specialist (neurology/psychiatry physician). Only 5% of the sample had no contact with a physician in the 6 months preceding the interview. Females showed a lower odds for physician specialist consultations (OR = 0.641). Users of medical DNs receive greater specialist consultations overall (OR = 8.370). Compared to the German general population and people with dementia in other settings, users of DNs receive physician care more regularly, especially with regard to the consultations of neurologist/psychiatrists. Therefore, DNs seem to perform a supportive role within the integration of physician healthcare. More research is needed on the appropriate relationship between the needs of the people with dementia and utilisation behaviour.

  7. The impact of social networks on knowledge transfer in long-term care facilities: Protocol for a study

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    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

  8. [Optimising care structures for severe hand trauma and replantation and chances of launching a national network]. (United States)

    Haas, E M; Volkmer, E; Holzbach, T; Wallmichrath, J; Engelhardt, T O; Giunta, R E


    Severe hand traumata have a significant impact on our health system and on insurance companies, respectively. It is estimated that 33% of all occupational injuries and 9% of all invalidity pensions are due to severe hand trauma. Unfortunately, these high numbers are not only due to the severity of the trauma but to organisational deficiencies. Usually, the patient is treated at the general surgical emergency in the first place and only then forwarded to a microsurgeon. This redirection increases the time that is required for the patient to finally arrive at an expert for hand surgery. On the one hand, this problem can be explained by the population's lack of awareness for distinguished experts for hand and microsurgery, on the other hand, the emergency network, or emergency doctors in particular are not well informed about where to take a patient with a severe hand trauma - clearly a problem of communication between the hospitals and the ambulance. It is possible to tackle this problem, but put participating hand trauma centres have to work hand in hand as a network and thus exploit synergy effects. The French system "FESUM" is a good example for such a network and even comprises centres in Belgium and Switzerland. To improve the treatment of severe hand trauma, a similar alliance was initiated in Germany just recently. The pilot project "Hand Trauma Alliance" ( was started in April 2013 and currently comprises two hospitals within the region of upper Bavaria. The network provides hand trauma replantation service on a 24/7 basis and aims at shortening the way from the accident site to the fully qualified hand surgeon, to improve the therapy of severe hand injuries and to optimise acute patient care in general. In order to further increase the alliance's impact it is intended to extend the project's scope from regional to national coverage - nevertheless, such an endeavour can only be done in collaboration with the German Society for Hand

  9. European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS)

    DEFF Research Database (Denmark)

    Weiser, Prisca; Becker, Thomas; Losert, Carolin;


    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...... 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...... as to hold resonance for community dwelling people with mental health problems. DISCUSSION: A general strategy on health promotion for people with mental disorders must take into account behavioural, environmental and iatrogenic health risks. A European health promotion toolkit needs to consider...

  10. Improving performance of long-term care networks at their initial stage: an empirical study of factors affecting results. (United States)

    Angiola, Nunzio; Bianchi, Piervito


    Until now very little research has been carried out on the performance of health and human services networks in evolution. In particular, previous studies mainly referred to "centrally governed services networks" in the US context. According to Provan and Kenis (2008), these networks are "lead organization-governed", and are different from the "participant-governed" model or the "network administrative organization (NAO)" solution. We focused our attention on the Apulia region care services networks (Italy). In the last few years, the governance of these networks has passed from the "participant-governed" model to the NAO approach. We examined how the integration mechanisms work in this type of networks, and if there were challenges to tackle in order to improve their overall performance. These networks were examined at their initial stage, exactly when their governance model moved to a more integrated solution. We collected survey data from 17 health and human services networks out of 45 (38%). The research is carried out by means of statistical methods (OLS). The analysis is cross sectional. The implementation of "rational/technocratic" factors is important but not sufficient to enhance collaboration. The integration at the "professional level" should be kept in mind. In particular, the role of network (case) managers is paramount. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Wills Eye Hospital and surgical network: successful pre-positioning strategies for payment reduction and managed care pressures. (United States)

    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.

  12. A new mode of organizing in health care? Governmentality and managed networks in cancer services in England. (United States)

    Ferlie, Ewan; McGivern, Gerry; Fitzgerald, Louise


    We explore the argument that a new mode of health care organizing is emerging which moves beyond the established professional dominance versus New Public Management (NPM) debate. We review Foucault's work on 'governmentality', as applied to health care organizations. We specify two specific Foucauldian themes (the power/knowledge nexus in Evidence Based Medicine (EBM); and the technologies of the clinical managerial self) to analyse organizing in the English cancer services field. We introduce two qualitative case studies of Managed Cancer Networks. We suggest their governance can be fruitfully seen through a 'governmentality' lens. We consider implications for developing Foucauldian analysis of health care organizations.

  13. Protocol for a thematic synthesis to identify key themes and messages from a palliative care research network.

    LENUS (Irish Health Repository)

    Nicholson, Emma


    Research networks that facilitate collaborative research are increasing both regionally and globally and such collaborations contribute greatly to knowledge transfer particularly in health research. The Palliative Care Research Network is an Irish-based network that seeks to create opportunities and engender a collaborative environment to encourage innovative research that is relevant for policy and practice. The current review outlines a methodology to identify cross-cutting messages to identify how dissemination outputs can be optimized to ensure that key messages from this research reaches all knowledge users.

  14. Enabling Remote Health-Caring Utilizing IoT Concept over LTE-Femtocell Networks.

    Directory of Open Access Journals (Sweden)

    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.

  15. Enabling Remote Health-Caring Utilizing IoT Concept over LTE-Femtocell Networks. (United States)

    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.

  16. Alliance Against Cancer, the network of Italian cancer centers bridging research and care. (United States)

    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.

  17. Network of Spaces and Interaction-Related Behaviors in Adult Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Mahbub Rashid


    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.

  18. Sedation of mechanically ventilated adults in intensive care unit: a network meta-analysis (United States)

    Zhang, Zhongheng; Chen, Kun; Ni, Hongying; Zhang, Xiaoling; Fan, Haozhe


    Sedatives are commonly used for mechanically ventilated patients in intensive care units (ICU). However, a variety of sedatives are available and their efficacy and safety have been compared in numerous trials with inconsistent results. To resolve uncertainties regarding usefulness of these sedatives, we performed a systematic review and network meta-analysis. Randomized controlled trials comparing sedatives in mechanically ventilated ICU patients were included. Graph-theoretical methods were employed for network meta-analysis. A total of 51 citations comprising 52 RCTs were included in our analysis. Dexmedetomidine showed shorter MV duration than lorazepam (mean difference (MD): 68.7; 95% CI: 18.2–119.3 hours), midazolam (MD: 10.2; 95% CI: 7.7–12.7 hours) and propofol (MD: 3.4; 95% CI: 0.9–5.9 hours). Compared with dexmedetomidine, midazolam was associated with significantly increased risk of delirium (OR: 2.47; 95% CI: 1.17–5.19). Our study shows that dexmedetomidine has potential benefits in reducing duration of MV and lowering the risk of delirium. PMID:28322337

  19. Older adults’ networks and public care receipt : Do partners and adult children substitute for unskilled public care?

    NARCIS (Netherlands)

    Schenk, N.; Dykstra, Pearl; Maas, Ineke; van Gaalen, R.


    This study investigates how (a) the reliance on public care and (b) the type of public care received by older people in the Netherlands depends on the availability of partners and adult children. Older people aged 65 years and older were surveyed in the Netherlands Kinship Panel Study at two time-po

  20. The contribution of primary care based registration by sentinel networks to a European public health information system.

    NARCIS (Netherlands)

    Tomas Vega Alonso, A.; Schellevis, F.


    Primary care based registrations by Sentinel Networks have been operating for several decades in Europe. Participating general practitioners have provide health data for monitoring the health status and contribute to understand the epidemiological distribution of diseases and other conditons first a

  1. Providing Hearing-Impaired Students with Learning Care after Classes through Smart Phones and the GPRS Network (United States)

    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…

  2. Provider Network Development under the Department of Defense Coordinated Care Program: A Methodology for Primary Care Network Development and Its Implementation in the San Antonio Service Area (United States)


    Administration Academy of Health Sciences , U.S. Army (HSHA-MH) Fort Sam Houston, TX 78234-6100’ N1 11. SUPPLEMENTARY NOTES 12a. DISTRIBUTION/ AVAILABILITY...Dallas/Ft Worth areas. San Antonio’s largest employers include several health care related organizations: University of Texas Health Science Center... physicall Conducted by Primary Care Manager for for ages 2-6. ages over 24 months. (For well baby $15 copayment per care up to 24 months of age, see

  3. ERMHAN: A Context-Aware Service Platform to Support Continuous Care Networks for Home-Based Assistance. (United States)

    Paganelli, Federica; Spinicci, Emilio; Giuli, Dino


    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.

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

    Directory of Open Access Journals (Sweden)

    Federica Paganelli


    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.

  5. Improving care and wellness in bipolar disorder: origins, evolution and future directions of a collaborative knowledge exchange network

    Directory of Open Access Journals (Sweden)

    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.

  6. Secure and Efficient Two-Factor User Authentication Scheme with User Anonymity for Network Based E-Health Care Applications. (United States)

    Li, Xiong; Niu, Jianwei; Karuppiah, Marimuthu; Kumari, Saru; Wu, Fan


    Benefited from the development of network and communication technologies, E-health care systems and telemedicine have got the fast development. By using the E-health care systems, patient can enjoy the remote medical service provided by the medical server. Medical data are important privacy information for patient, so it is an important issue to ensure the secure of transmitted medical data through public network. Authentication scheme can thwart unauthorized users from accessing services via insecure network environments, so user authentication with privacy protection is an important mechanism for the security of E-health care systems. Recently, based on three factors (password, biometric and smart card), an user authentication scheme for E-health care systems was been proposed by Amin et al., and they claimed that their scheme can withstand most of common attacks. Unfortunate, we find that their scheme cannot achieve the untraceability feature of the patient. Besides, their scheme lacks a password check mechanism such that it is inefficient to find the unauthorized login by the mistake of input a wrong password. Due to the same reason, their scheme is vulnerable to Denial of Service (DoS) attack if the patient updates the password mistakenly by using a wrong password. In order improve the security level of authentication scheme for E-health care application, a robust user authentication scheme with privacy protection is proposed for E-health care systems. Then, security prove of our scheme are analysed. Security and performance analyses show that our scheme is more powerful and secure for E-health care systems when compared with other related schemes.

  7. [Strategies for integration of health care practices and sanitary surveillance in the context of the implementation of Rede Cegonha - a Brazilian mother and infant health care network]. (United States)

    Fernandes, Roberta Zanelli Sartori; Vilela, Maria Filomena de Gouveia


    Mother and infant mortality has been the scope of analysis throughout the history of public health in Brazil and various strategies to tackle the issue have been proposed to date. The Ministry of Health has been working on this and the Rede Cegonha strategy is the most recent policy in this context. Given the principle of comprehensive health care and the structure of the Unified Health System in care networks, it is necessary to ensure the integration of health care practices, among which are the sanitary surveillance actions (SSA). Considering that the integration of health care practices and SSA can contribute to reduce mother and infant mortality rates, this article is a result of qualitative research that analyzed the integration of these actions in four cities in the State of São Paulo/Brazil: Campinas, Indaiatuba, Jaguariúna and Santa Bárbara D'Oeste. The research was conducted through interviews with SSA and maternal health managers, and the data were evaluated using thematic analysis. The results converge with other studies, identifying the isolation of health care practices and SSA. The insertion of SSA in collectively-managed areas appears to be a potential strategy for health planning and implementation of actions in the context under scrutiny.

  8. Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study (United States)

    Rosener, Stephanie E.; Barr, Wendy B.; Frayne, Daniel J.; Barash, Joshua H.; Gross, Megan E.; Bennett, Ian M.


    PURPOSE Interconception care (ICC) is recommended to improve birth outcomes by targeting maternal risk factors, but little is known about its implementation. We evaluated the frequency and nature of ICC delivered to mothers at well-child visits and maternal receptivity to these practices. METHODS We surveyed a convenience sample of mothers accompanying their child to well-child visits at family medicine academic practices in the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques) Network. Health history, behaviors, and the frequency of the child’s physician addressing maternal depression, tobacco use, family planning, and folic acid supplementation were assessed, along with maternal receptivity to advice. RESULTS Three-quarters of the 658 respondents shared a medical home with their child. Overall, 17% of respondents reported a previous preterm birth, 19% reported a history of depression, 25% were smoking, 26% were not using contraception, and 58% were not taking folic acid. Regarding advice, 80% of mothers who smoked were counseled to quit, 59% reported depression screening, 71% discussed contraception, and 44% discussed folic acid. Screening for depression and family planning was more likely when the mother and child shared a medical home (P .05). CONCLUSIONS Family physicians provide key elements of ICC at well-child visits, and mothers are highly receptive to advice from their child’s physician even if they receive primary care elsewhere. Routine integration of ICC at these visits may provide an opportunity to reduce maternal risk factors for adverse subsequent birth outcomes. PMID:27401423

  9. Measuring horizontal integration among health care providers in the community: an examination of a collaborative process within a palliative care network. (United States)

    Bainbridge, Daryl; Brazil, Kevin; Krueger, Paul; Ploeg, Jenny; Taniguchi, Alan; Darnay, Julie


    In many countries formal or informal palliative care networks (PCNs) have evolved to better integrate community-based services for individuals with a life-limiting illness. We conducted a cross-sectional survey using a customized tool to determine the perceptions of the processes of palliative care delivery reflective of horizontal integration from the perspective of nurses, physicians and allied health professionals working in a PCN, as well as to assess the utility of this tool. The process elements examined were part of a conceptual framework for evaluating integration of a system of care and centred on interprofessional collaboration. We used the Index of Interdisciplinary Collaboration (IIC) as a basis of measurement. The 86 respondents (85% response rate) placed high value on working collaboratively and most reported being part of an interprofessional team. The survey tool showed utility in identifying strengths and gaps in integration across the network and in detecting variability in some factors according to respondent agency affiliation and profession. Specifically, support for interprofessional communication and evaluative activities were viewed as insufficient. Impediments to these aspects of horizontal integration may be reflective of workload constraints, differences in agency operations or an absence of key structural features.

  10. A Secure Cloud-Assisted Wireless Body Area Network in Mobile Emergency Medical Care System. (United States)

    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.

  11. Reliability Measure Model for Assistive Care Loop Framework Using Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Venki Balasubramanian


    Full Text Available Body area wireless sensor networks (BAWSNs are time-critical systems that rely on the collective data of a group of sensor nodes. Reliable data received at the sink is based on the collective data provided by all the source sensor nodes and not on individual data. Unlike conventional reliability, the definition of retransmission is inapplicable in a BAWSN and would only lead to an elapsed data arrival that is not acceptable for time-critical application. Time-driven applications require high data reliability to maintain detection and responses. Hence, the transmission reliability for the BAWSN should be based on the critical time. In this paper, we develop a theoretical model to measure a BAWSN's transmission reliability, based on the critical time. The proposed model is evaluated through simulation and then compared with the experimental results conducted in our existing Active Care Loop Framework (ACLF. We further show the effect of the sink buffer in transmission reliability after a detailed study of various other co-existing parameters.

  12. Validation of Single-Item Screening Measures for Provider Burnout in a Rural Health Care Network. (United States)

    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.

  13. Direct Care Workers in the National Drug Abuse Treatment Clinical Trials Network: Characteristics, Opinions, and Beliefs (United States)

    McCarty, Dennis; Fuller, Bret E.; Arfken, Cynthia; Miller, Michael; Nunes, Edward V.; Edmundson, Eldon; Copersino, Marc; Floyd, Anthony; Forman, Robert; Laws, Reesa; Magruder, Kathy M.; Oyama, Mark; Sindelar, Jody; Wendt, William W.


    Objective Individuals with direct care responsibilities in 348 drug abuse treatment units were surveyed to obtain a description of the workforce and to assess support for evidence-based therapies. Methods Surveys were distributed to 112 programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN). Descriptive analyses characterized the workforce. Analyses of covariance tested the effects of job category (counselors, medical staff, manager-supervisors, and support staff) on opinions about evidence-based practices and controlled for the effects of education, modality (outpatient or residential), race, and gender. Results Women made up two-thirds of the CTN workforce. One-third of the workforce had a master’s or doctoral degree. Responses from 1,757 counselors, 908 support staff, 522 managers-supervisors, and 511 medical staff (71% of eligible participants) suggested that the variables that most consistently influenced responses were job category (19 of 22 items) and education (20 of 22 items). Managers-supervisors were the most supportive of evidence-based therapies, and support staff were the least supportive. Generally, individuals with graduate degrees had more positive opinions about evidence-based therapies. Support for using medications and contingency management was modest across job categories. Conclusions The relatively traditional beliefs of support staff could inhibit the introduction of evidence-based practices. Programs initiating changes in therapeutic approaches may benefit from including all employees in change efforts. PMID:17287373

  14. Connecting research discovery with care delivery in dementia: the development of the Indianapolis Discovery Network for Dementia

    Directory of Open Access Journals (Sweden)

    Boustani MA


    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 ( To date, the network has: (1 accomplished the

  15. The hearing voices network: initial lessons and future directions for mental health professionals and Systems of Care. (United States)

    Styron, Thomas; Utter, Lauren; Davidson, Larry


    For more than two decades, the Hearing Voices Network (HVN) has provided alternative approaches to supporting voice hearers, and an emerging body of research is now confirming their value. HVN approaches present unique opportunities and challenges for mental health professionals and systems of care that work with individuals who hear voices. An overview of the HVN is presented, including its history, principles and approaches. HVN approaches are compared and contrasted with traditional mental health treatments. HVN's potential contribution to the transformation of mental health care is discussed. Directions for future research are presented.

  16. The role of social networks in the governance of health systems: the case of eye care systems in Ghana. (United States)

    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.

  17. Patient satisfaction point-of-care technology makes media waves. Public relations campaign heightens presence for GetWell:)Network. (United States)


    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.

  18. Mode of effective connectivity within a putative neural network differentiates moral cognitions related to care and justice ethics.

    Directory of Open Access Journals (Sweden)

    Ricardo Cáceda

    Full Text Available BACKGROUND: Moral sensitivity refers to the interpretive awareness of moral conflict and can be justice or care oriented. Justice ethics is associated primarily with human rights and the application of moral rules, whereas care ethics is related to human needs and a situational approach involving social emotions. Among the core brain regions involved in moral issue processing are: medial prefrontal cortex, anterior (ACC and posterior (PCC cingulate cortex, posterior superior temporal sulcus (pSTS, insula and amygdala. This study sought to inform the long standing debate of whether care and justice moral ethics represent one or two different forms of cognition. METHODOLOGY/PRINCIPAL FINDINGS: Model-free and model-based connectivity analysis were used to identify functional neural networks underlying care and justice ethics for a moral sensitivity task. In addition to modest differences in patterns of associated neural activity, distinct modes of functional and effective connectivity were observed for moral sensitivity for care and justice issues that were modulated by individual variation in moral ability. CONCLUSIONS/SIGNIFICANCE: These results support a neurobiological differentiation between care and justice ethics and suggest that human moral behavior reflects the outcome of integrating opposing rule-based, self-other perspectives, and emotional responses.

  19. Comparison of neonatal intensive care: Trento area versus Vermont Oxford Network

    Directory of Open Access Journals (Sweden)

    Pederzini Fabio


    Full Text Available Abstract Background S. Chiara hospital is the only neonatal intensive care unit (NICU in the Province of Trento (Italy. It serves a population of about 460000 people with about 5000 infants per year, admitting the totality of the inborn and outborn VLBWI of the province. The aim of this work is to compare mortality, morbidity and neonatal treatment of the very low birth weight infants (VLBWI of Trento area with those recorded in the Vermont Oxford Network (VON during 2004. Methods In this retrospective analysis, the rates of complications and related treatments reported in VLBWI admitted in the S. Chiara NICU during the period 2000–2005 were compared with those recorded in the VON in 2004. The analysis included both the total populations and different weight groups. Results The frequency of inborn infants was significantly higher in Trento than in VON: 91% vs 84% (MH 8.56; p-value 0.003. The administration of prenatal steroids (82% vs 74%; MH 7.47 and p-value 0.006 and caesarean section were significantly more frequent in the Trento area than in VON. In Trento significantly more VLBWI with BW ≤ 1000 grams were given surfactant prophylaxis compared with VON and significantly fewer VLBWI in every Trento weight group developed RDS (MH 18.55; p-value 0.00001. Overall rates of complications (CLD, PDA, NEC, IVH were significantly lower than in the Vermont Oxford Network. In CLD and PDA the differences were marked also in infants weighting less than 1000 grams. Overall rates of PNX, PVL, severe grade of ROP and mortality were similar in the two populations. In Trento, significantly more infants were discharged on human milk than in VON, in both the overall population and in BW sub-groups. Conclusion On the basis of this analysis, a less aggressive therapeutic strategy based on perinatal prevention in global management, such as that employed in Trento area, may be associated with an improvement in clinical outcomes in very low birth weight infants.

  20. Implementation of an agency to improve chronic kidney disease care in Ontario: lessons learned by the Ontario Renal Network. (United States)

    Woodward, Graham L; Iverson, Alex; Harvey, Rebecca; Blake, Peter G


    In 2009, Ontario's Ministry of Health and Long-Term Care initiated the transfer of oversight and coordination of chronic kidney disease (CKD) care to the Ontario Renal Network (ORN) under the auspices of Cancer Care Ontario (CCO). The aim was to replicate the quality improvement and change management practices used for cancer control within CKD. Much of the ORN's first three years were dedicated to building the infrastructure necessary to bridge the gap between provincial policy and clinical practice. This article explores the accomplishments, challenges and lessons learned over that period. The results, which are applicable to the management of chronic diseases in Ontario, Canada, and internationally, confirm that sustainable change takes time and requires strong leadership, transparency, accountability and communication, supported by a solid foundation of data and evidence.

  1. Children's Health in Brazil: orienting basic network to Primary Health Care. (United States)

    Damasceno, Simone Soares; Nóbrega, Vanessa Medeiros da; Coutinho, Simone Elizabeth Duarte; Reichert, Altamira Pereira da Silva; Toso, Beatriz Rosana Gonçalves de Oliveira; Collet, Neusa


    This is an integrative literature review that analyzed the scientific knowledge produced on the orientation of Brazilian basic care services to primary health care focusing on child health. Searches were carried out in SciELO, Lilacs and Medline databases using descriptors "primary health care", "family health program", "child health" and "evaluation of health services". Studies published in Portuguese, English and Spanish between 2000 and 2013 were selected. A total of 32 studies were chosen and characterized in relation to the features of primary health care, region of the country, type of study and authors' practice area. A thematic review of studies was conducted and resulted in two categories: child care in the context of Brazilian primary health care and primary health care features: limitations to child care. It can be understood that Brazilian primary health care services are heterogeneous regarding the presence and scope of essential child care characteristics. There is a lack of structural and process changes in the services to substantially plan child care actions in basic care.

  2. Assessing capacity and disease burden in a virtual network of New York City primary care providers following Hurricane Sandy. (United States)

    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 Information Project (PCIP) at the New York City Department of Health and Mental Hygiene has partnered with local clinicians to establish an electronic data system, and this network provides infrastructure to support primary care surveillance activities in New York City. After Hurricane Sandy, PCIP generated several sets of data to contribute to the city's efforts to assess the impact of the storm, including daily connectivity data to establish practice operations, data to examine patterns of primary care utilization in severely affected and less affected areas, and data on the frequency of respiratory infection diagnosis in the primary care setting. Daily patient visit data from three heavily affected neighborhoods showed the health department where primary care capacity was most affected in the weeks following Sandy. Overall transmission data showed that practices in less affected areas were quicker to return to normal reporting patterns, while those in more affected areas did not resume normal data transmissions for a few months. Rates of bronchitis increased after Sandy compared to the two prior years; while this was most likely attributable to a more severe flu season, it demonstrates the capacity of primary care networks to pick up on these types of post-emergency trends. Hurricane Sandy was the first disaster situation where PCIP was asked to assess public health impact, generating information that could contribute to aid and recovery efforts. This experience allowed us to

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

    DEFF Research Database (Denmark)

    Asboe, Mark; Fernandes, Joao; Grönvall, Erik


    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...

  4. Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis



    Background A variety of psychological interventions to treat depressive disorders have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mode for depressed patients in this setting. Methods Randomized trials comparing a psychological treatment with usual care, placebo, another psychological treatment, pharmacothera...

  5. Questions and Answers about School-Age Children in Self-Care: A Sloan Work and Family Research Network Fact Sheet (United States)

    Sloan Work and Family Research Network, 2009


    The Sloan Work and Family Research Network has prepared Fact Sheets that provide statistical answers to some important questions about work-family and work-life issues. This Fact Sheet includes statistics about Children in Self-Care, and answers the following questions about school-age children in self-care: (1) How many school-age children are in…

  6. Effects of Natural Disaster Trends: A Case Study for Expanding the Pre-Positioning Network of CARE International

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    Serhan Duran


    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.

  7. Effects of natural disaster trends: a case study for expanding the pre-positioning network of CARE International. (United States)

    Bozkurt, Melda; Duran, Serhan


    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.

  8. NET-Works: Linking families, communities and primary care to prevent obesity in preschool-age children. (United States)

    Sherwood, Nancy E; French, Simone A; Veblen-Mortenson, Sara; Crain, A Lauren; Berge, Jerica; Kunin-Batson, Alicia; Mitchell, Nathan; Senso, Meghan


    Obesity prevention in children offers a unique window of opportunity to establish healthful eating and physical activity behaviors to maintain a healthful body weight and avoid the adverse proximal and distal long-term health consequences of obesity. Given that obesity is the result of a complex interaction between biological, behavioral, family-based, and community environmental factors, intervention at multiple levels and across multiple settings is critical for both short- and long-term effectiveness. The Minnesota NET-Works (Now Everybody Together for Amazing and Healthful Kids) study is one of four obesity prevention and/or treatment trials that are part of the Childhood Obesity Prevention and Treatment (COPTR) Consortium. The goal of the NET-Works study is to evaluate an intervention that integrates home, community, primary care and neighborhood strategies to promote healthful eating, activity patterns, and body weight among low income, racially/ethnically diverse preschool-age children. Critical to the success of this intervention is the creation of linkages among the settings to support parents in making home environment and parenting behavior changes to foster healthful child growth. Five hundred racially/ethnically diverse, two-four year old children and their parent or primary caregiver will be randomized to the multi-component intervention or to a usual care comparison group for a three-year period. This paper describes the study design, measurement and intervention protocols, and statistical analysis plan for the NET-Works trial.

  9. Mobile Health Care over 3G Networks: the MobiHealth Pilot System and Service

    NARCIS (Netherlands)

    Wac, Katarzyna; Bults, Richard; Konstantas, Dimitri; Halteren, van Aart; Jones, Val; Widya, Ing; Herzog, Rainer


    Health care is one of the most prominent areas for the application of wireless technologies. New services and applications are today under research and development targeting different areas of health care, from high risk and chronic patients’ remote monitoring to mobility tools for the medical perso

  10. EurOOHnet-the European research network for out-of-hours primary health care

    NARCIS (Netherlands)

    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

  11. Documentation of body mass index and control of associated risk factors in a large primary care network

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    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.

  12. A network of Pediatric Environmental Health Specialty Units (PEHSUs: Filling a critical gap in the health care system

    Directory of Open Access Journals (Sweden)

    Christine M. Zachek


    Full Text Available A network of pediatric environmental health specialty units (PEHSUs in the United States was formed in 1998 out of a recognized need for clinical expertise in children’s environmental health. Documented trends in a rise of pediatric diseases caused or exacerbated by environmental conditions, coupled with the failure of medical schools and residency programs to cover these issues in a significant way, leaves health care providers, parents, communities, and governments at a loss for this specialized knowledge. The PEHSUs fill this gap by providing: 1 medical education, 2 general outreach and communications, and 3 consultative services to communities and health care professionals. This paper presents examples of key situations where PEHSU involvement was instrumental in improved patient outcomes or advancing clinical expertise in children’s environmental health. Challenges and opportunities for future directions for the program are also discussed.

  13. Integrating a Suicide Prevention Program into the Primary Health Care Network: A Field Trial Study in Iran

    Directory of Open Access Journals (Sweden)

    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.

  14. Structure of the Social Support Network of Patients with Severe and Persistent Psychiatric Disorders in Follow-Ups to Primary Health Care. (United States)

    de Souza, Jacqueline; de Almeida, Letícia Yamawaka; Moll, Marciana Fernandes; Silva, Lucas Duarte; Ventura, Carla Aparecida Arena


    The objective of this study is to analyze the characteristics of social support networks of patients with psychiatric disorders at follow-up to primary care. This is a cross-sectional qualitative research study. Forty-five interviews were held with patients and their supporters. The results showed small and dense networks, with a strong emphasis on the bonds with formal supporters and a scant network of informal supporters. It is recommended to develop strategies to improve social support networks and use this as an outcome indicator related to social integration of these patients and to the quality of services involved with outpatient healthcare.

  15. An interactive web tool for facilitating shared decision-making in dementia-care networks: a field study

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    Marijke eSpan


    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.

  16. First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database.

    Directory of Open Access Journals (Sweden)

    Robert L Grant


    Full Text Available BACKGROUND: Dementia is one of the most disabling and burdensome diseases. Incontinence in people with dementia is distressing, adds to carer burden, and influences decisions to relocate people to care homes. Successful and safe management of incontinence in people with dementia presents additional challenges. The aim of this study was to investigate the rates of first diagnosis in primary care of urinary and faecal incontinence among people aged 60-89 with dementia, and the use of medication or indwelling catheters for urinary incontinence. METHODS AND FINDINGS: We extracted data on 54,816 people aged 60-89 with dementia and an age-gender stratified sample of 205,795 people without dementia from 2001 to 2010 from The Health Improvement Network (THIN, a United Kingdom primary care database. THIN includes data on patients and primary care consultations but does not identify care home residents. Rate ratios were adjusted for age, sex, and co-morbidity using multilevel Poisson regression. The rates of first diagnosis per 1,000 person-years at risk (95% confidence interval for urinary incontinence in the dementia cohort, among men and women, respectively, were 42.3 (40.9-43.8 and 33.5 (32.6-34.5. In the non-dementia cohort, the rates were 19.8 (19.4-20.3 and 18.6 (18.2-18.9. The rates of first diagnosis for faecal incontinence in the dementia cohort were 11.1 (10.4-11.9 and 10.1 (9.6-10.6. In the non-dementia cohort, the rates were 3.1 (2.9-3.3 and 3.6 (3.5-3.8. The adjusted rate ratio for first diagnosis of urinary incontinence was 3.2 (2.7-3.7 in men and 2.7 (2.3-3.2 in women, and for faecal incontinence was 6.0 (5.1-7.0 in men and 4.5 (3.8-5.2 in women. The adjusted rate ratio for pharmacological treatment of urinary incontinence was 2.2 (1.4-3.7 for both genders, and for indwelling urinary catheters was 1.6 (1.3-1.9 in men and 2.3 (1.9-2.8 in women. CONCLUSIONS: Compared with those without a dementia diagnosis, those with a dementia diagnosis

  17. [Beyond care, the collaboration of freelance nurses in a healthcare network]. (United States)

    Lacour, Frédérique; Estrate, Margot


    With home palliative care, patients and their family testify to the work of freelance nurses and the relationships which are created during the home visit.This special proximity sees the nurse become the custodian of the patient's words and wishes.

  18. Disseminating educational innovations in health care practice : Training versus social networks

    NARCIS (Netherlands)

    Jippes, Erik; Achterkamp, Marjolein C.; Brand, Paul L. P.; Kiewiet, Derk Jan; Pols, Jan; van Engelen, Jo M. L.


    Improvements and innovation in health service organization and delivery have become more and more important due to the gap between knowledge and practice, rising costs, medical errors, and the organization of health care systems. Since training and education is widely used to convey and distribute i

  19. Poor perinatal care practices in urban slums: Possible role of social mobilization networks

    Directory of Open Access Journals (Sweden)

    Khan Zulfia


    Full Text Available Background: Making perinatal care accessible to women in marginalized periurban areas poses a public health problem. Many women do not utilize institutional care in spite of physical accessibility. Home-based care by traditional birth attendants (TBA is hazardous. Inappropriate early neonatal feeding practices are common. Many barriers to perinatal care can be overcome by social mobilization and capacity building at the community level. Objectives: To determine the existing perinatal practices in an urban slum and to identify barriers to utilization of health services by mothers. Study Design: This is a cross-sectional descriptive study. Setting and Participants: The high-risk periurban areas of Nabi Nagar, Aligarh has a population of 40,000 living in 5,480 households. Mothers delivering babies in September 2007 were identified from records of social mobilization workers (Community Mobilization Coordinators or CMCs already working in an NGO in the area. A total of 92 mothers were interviewed at home. Current perinatal practices and reasons for utilizing or not utilizing health services were the topics of inquiry. Statistical Analysis: Data was tabulated and analyzed using SPSS 12. Results: Analyses revealed that 80.4% of mothers had received antenatal care. However, this did not translate into safe delivery practices as more than 60% of the women had home deliveries conducted by traditional untrained or trained birth attendants. Reasons for preferring home deliveries were mostly tradition (41.9% or related to economics (30.7%. A total of 56% of the deliveries were conducted in the squatting position and in 25% of the cases, the umbilical cord was cut using the edge of a broken cup. Although breast-feeding was universal, inappropriate early neonatal feeding practices were common. Prelacteal feeds were given to nearly 50% of the babies and feeding was delayed beyond 24 hours in 8% of the cases. Several mothers had breastfeeding problems

  20. The Fourth Annual Meeting of the International Network for Pediatric Hemophilia: Current Challenges and Recommendations in the Clinical Care of Children with Hemophilia


    Ljung, Rolf; van den Berg, Marijke; Valentino, Leonard A.; Manco-Johnson, Michael


    The International Network for Pediatric Hemophilia (INPH) comprises a group of physicians committed to the unique care of and challenges facing pediatric hemophilia patients. By collaborating on an international level, extensive experience can be shared on current practice, new trends can be discussed and scientifically valid studies can be developed and performed. The three overall objectives of the group (scientific progress, education and networking) are achieved at each annual meeting sta...

  1. Health care applications based on mobile phone centric smart sensor network. (United States)

    Quero, J M; Tarrida, C L; Santana, J J; Ermolov, V; Jantunen, I; Laine, H; Eichholz, J


    This paper presents the MIMOSA architecture and development platform to create Ambient Intelligence applications. MIMOSA achieves this objective by developing a personal mobile-device centric architecture and open technology platform where microsystem technology is the key enabling technology for their realization due to its low-cost, low power consumption, and small size. This paper focuses the demonstration activities carried out in the field of health care. MIMOSA project is a European level initiative involving 15 enterprises and research institutions and universities.

  2. Network-based modeling and intelligent data mining of social media for improving care. (United States)

    Akay, Altug; Dragomir, Andrei; Erlandsson, Bjorn-Erik


    Intelligently extracting knowledge from social media has recently attracted great interest from the Biomedical and Health Informatics community to simultaneously improve healthcare outcomes and reduce costs using consumer-generated opinion. We propose a two-step analysis framework that focuses on positive and negative sentiment, as well as the side effects of treatment, in users' forum posts, and identifies user communities (modules) and influential users for the purpose of ascertaining user opinion of cancer treatment. We used a self-organizing map to analyze word frequency data derived from users' forum posts. We then introduced a novel network-based approach for modeling users' forum interactions and employed a network partitioning method based on optimizing a stability quality measure. This allowed us to determine consumer opinion and identify influential users within the retrieved modules using information derived from both word-frequency data and network-based properties. Our approach can expand research into intelligently mining social media data for consumer opinion of various treatments to provide rapid, up-to-date information for the pharmaceutical industry, hospitals, and medical staff, on the effectiveness (or ineffectiveness) of future treatments.

  3. Conference report: Undergraduate family medicine and primary care training in Sub-Saharan Africa: Reflections of the PRIMAFAMED network

    Directory of Open Access Journals (Sweden)

    Innocent Besigye


    Full Text Available Internationally, there is a move towards strengthening primary healthcare systems and encouraging community-based and socially responsible education. The development of doctors with an interest in primary healthcare and family medicine in the African region should begin during undergraduate training. Over the last few years, attention has been given to the development of postgraduate training in family medicine in the African region, but little attention has been given to undergraduate training. This article reports on the 8th PRIMAFAMED (Primary Care and Family Medicine Education network meeting held in Nairobi from 21 to 24 May 2016. At this meeting the delegates spent time presenting and discussing the current state of undergraduate training at 18 universities in the region and shared lessons on how to successfully implement undergraduate training. This article reports on the rationale for, information presented, process followed and conclusions reached at the conference.

  4. Audit of primary care electrocardiograms sent as emergency to a telehealth service - the Telehealth Network of Minas Gerais, Brazil. (United States)

    Marcolino, Milena S; Carvalho, Bárbara C; Lucena, Aline M; França, Ana Luiza N; Pessoa, Cristiane G; Neves, Daniel S; Alkmim, Maria Beatriz M


    The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service in Brazil that has performed electrocardiogram (ECG) analysis since 2005. From February to March 2014, 28% of ECGs were classified as "emergency" by the primary care tele-health sites. This quasi-experimental study aimed to investigate the reasons behind the high number of emergency ECGs being sent in, the implementation of corrective actions, and an assessment of the impact of these actions. In the 1st phase, primary care units that sent >70% of ECGs as emergency from February to March 2014 were selected. The 2nd phase consisted of the intervention. In the 3rd phase, the proportion of ECGs sent as an emergency during the 1st and 2nd months post intervention were assessed. Of the 63 cities selected during the 1st phase, 50% of the practitioners did not know the proper definition of emergency. After the intervention, 67% of the cities had a significant reduction in the proportion of ECGs sent as an emergency during the 1st month, and 17% had a significant reduction during the 2nd month.

  5. Social support network, mental health and quality of life: a cross-sectional study in primary care

    Directory of Open Access Journals (Sweden)

    Flávia Batista Portugal

    Full Text Available The objective of this study was to identify the association between emotional distress and social support networks with quality of life in primary care patients. This was a cross-sectional study involving 1,466 patients in the cities of São Paulo and Rio de Janeiro, Brazil, in 2009/2010. The General Health Questionnaire, the Hospital Anxiety and Depression Scale and the brief version of the World Health Organization Quality of Life Instrument were used. The Social Support Network Index classified patients with the highest and lowest index as socially integrated or isolated. A bivariate analysis and four multiple linear regressions were conducted for each quality of life outcome. The means scores for the physical, psychological, social relations, and environment domains were, respectively, 64.7; 64.2; 68.5 and 49.1. In the multivariate analysis, the psychological domain was negatively associated with isolation, whereas the social relations and environment domains were positively associated with integration. Integration and isolation proved to be important factors for those in emotional distress as they minimize or maximize negative effects on quality of life.

  6. Networking and training in palliative care - Challenging values and changing practice

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    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.

  7. Mobile RFID of Wireless Mesh Network for Intelligent Safety Care System

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    Chwen-Fu Horng


    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.

  8. Social media: opportunities for quality improvement and lessons for providers-a networked model for patient-centered care through digital engagement. (United States)

    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.

  9. Behavior analysis for elderly care using a network of low-resolution visual sensors (United States)

    Eldib, Mohamed; Deboeverie, Francis; Philips, Wilfried; Aghajan, Hamid


    Recent advancements in visual sensor technologies have made behavior analysis practical for in-home monitoring systems. The current in-home monitoring systems face several challenges: (1) visual sensor calibration is a difficult task and not practical in real-life because of the need for recalibration when the visual sensors are moved accidentally by a caregiver or the senior citizen, (2) privacy concerns, and (3) the high hardware installation cost. We propose to use a network of cheap low-resolution visual sensors (30×30 pixels) for long-term behavior analysis. The behavior analysis starts by visual feature selection based on foreground/background detection to track the motion level in each visual sensor. Then a hidden Markov model (HMM) is used to estimate the user's locations without calibration. Finally, an activity discovery approach is proposed using spatial and temporal contexts. We performed experiments on 10 months of real-life data. We show that the HMM approach outperforms the k-nearest neighbor classifier against ground truth for 30 days. Our framework is able to discover 13 activities of daily livings (ADL parameters). More specifically, we analyze mobility patterns and some of the key ADL parameters to detect increasing or decreasing health conditions.

  10. Structuring an integrated care system: interpreted through the enacted diversity of the actors involved – the case of a French healthcare network

    Directory of Open Access Journals (Sweden)

    Corinne Grenier


    Full Text Available Research question: We are looking at the process of structuring an integrated care system as an innovative process that swings back and forth between the diversity of the actors involved, local aspirations and national and regional regulations. We believe that innovation is enriched by the variety of the actors involved, but may also be blocked or disrupted by that diversity. Our research aims to add to other research, which, when questioning these integrated systems, analyses how the actors involved deal with diversity without really questioning it. Case study: The empirical basis of the paper is provided by case study analysis. The studied integrated care system is a French healthcare network that brings together healthcare professionals and various organisations in order to improve the way in which interventions are coordinated and formalised, in order to promote better detection and diagnosis procedures and the implementation of a care protocol. We consider this case as instrumental in developing theoretical proposals for structuring an integrated care system in light of the diversity of the actors involved. Results and discussion: We are proposing a model for structuring an integrated care system in light of the enacted diversity of the actors involved. This model is based on three factors: the diversity enacted by the leaders, three stances for considering the contribution made by diversity in the structuring process and the specific leading role played by those in charge of the structuring process.  Through this process, they determined how the actors involved in the project were differentiated, and on what basis those actors were involved. By mobilizing enacted diversity, the leaders are seeking to channel the emergence of a network in light of their own representation of that network. This model adds to published research on the structuring of integrated care systems.

  11. Structuring an integrated care system: interpreted through the enacted diversity of the actors involved – the case of a French healthcare network

    Directory of Open Access Journals (Sweden)

    Corinne Grenier


    Full Text Available Research question: We are looking at the process of structuring an integrated care system as an innovative process that swings back and forth between the diversity of the actors involved, local aspirations and national and regional regulations. We believe that innovation is enriched by the variety of the actors involved, but may also be blocked or disrupted by that diversity. Our research aims to add to other research, which, when questioning these integrated systems, analyses how the actors involved deal with diversity without really questioning it.Case study: The empirical basis of the paper is provided by case study analysis. The studied integrated care system is a French healthcare network that brings together healthcare professionals and various organisations in order to improve the way in which interventions are coordinated and formalised, in order to promote better detection and diagnosis procedures and the implementation of a care protocol. We consider this case as instrumental in developing theoretical proposals for structuring an integrated care system in light of the diversity of the actors involved.Results and discussion: We are proposing a model for structuring an integrated care system in light of the enacted diversity of the actors involved. This model is based on three factors: the diversity enacted by the leaders, three stances for considering the contribution made by diversity in the structuring process and the specific leading role played by those in charge of the structuring process.  Through this process, they determined how the actors involved in the project were differentiated, and on what basis those actors were involved. By mobilizing enacted diversity, the leaders are seeking to channel the emergence of a network in light of their own representation of that network. This model adds to published research on the structuring of integrated care systems.

  12. Collaboration and entanglement: An actor-network theory analysis of team-based intraprofessional care for patients with advanced heart failure. (United States)

    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.

  13. Convergence Revolution Comes to Wearables: Multiple Advances are Taking Biosensor Networks to the Next Level in Health Care. (United States)

    Mertz, Leslie


    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.

  14. New directions for patient-centred care in scleroderma: the Scleroderma Patient-centred Intervention Network (SPIN) (United States)

    Thombs, Brett D.; Jewett, Lisa R.; Assassi, Shervin; Baron, Murray; Bartlett, Susan J.; Costa Maia, Angela; El-Baalbaki, Ghassan; Furst, Daniel E.; Gottesman, Karen; Haythornthwaite, Jennifer A.; Hudson, Marie; Ann Impens, PhD; Korner, Annett; Leite, Catarina; Mayes, Maureen D.; Malcarne, Vanessa L.; Motivala, Sarosh J.; Mouthon, Luc; Nielson, Warren R.; Plante, Diane; Poiraudeau, Serge; Poole, Janet L.; Pope, Janet; Sauve, Maureen; Steele, Russell J.; Suarez-Almazor, Maria E.; Taillefer, Suzanne; van den Ende, Cornelia H.; Erin Arthurs, BSc; Bassel, Marielle; Delisle, Vanessa; Milette, Katherine; Leavens, Allison; Razykov, Ilya; Khanna, Dinesh


    Systemic sclerosis (SSc), or scleroderma, is a chronic multisystem autoimmune disorder characterised by thickening and fibrosis of the skin and by the involvement of internal organs such as the lungs, kidneys, gastrointestinal tract, and heart. Because there is no cure, feasibly-implemented and easily accessible evidence-based interventions to improve health-related quality of life (HRQoL) are needed. Due to a lack of evidence, however, specific recommendations have not been made regarding non-pharmacological interventions (e.g. behavioural/psychological, educational, physical/occupational therapy) to improve HRQoL in SSc. The Scleroderma Patient-centred Intervention Network (SPIN) was recently organised to address this gap. SPIN is comprised of patient representatives, clinicians, and researchers from Canada, the USA, and Europe. The goal of SPIN, as described in this article, is to develop, test, and disseminate a set of accessible interventions designed to complement standard care in order to improve HRQoL outcomes in SSc. PMID:22244687

  15. Optimization and implementation of scaling-free CORDIC-based direct digital frequency synthesizer for body care area network systems. (United States)

    Juang, Ying-Shen; Ko, Lu-Ting; Chen, Jwu-E; Sung, Tze-Yun; Hsin, Hsi-Chin


    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.

  16. Optimization and Implementation of Scaling-Free CORDIC-Based Direct Digital Frequency Synthesizer for Body Care Area Network Systems

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    Ying-Shen Juang


    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.

  17. One Family's Journey: Medical Home and the Network of Supports It Offers Children and Youth with Special Health Care Needs, Part Two--Care Coordination (United States)

    Kondrad, Monica; Zehr, Bonnie; Hanna, Christine; Rote, Vicki; Jain, Sweety


    The Medical Home series follows fictional parents Amita and Samir and their premature daughter, Anjali. In Part Two, Amita and Samir bring Anjali home from the hospital, contact the care coordinator who will be responsible for Anjali's care, and go to their first appointment with the pediatrician. Emphasis is placed on the manner in which the…

  18. [Care networks, mobile palliative and supportive teams. What benefits are there for patients, natural caregivers and general practitioners in patient homes?]. (United States)

    Hubault, Philippe; Chataigner, Bernard; Diquero, Vincent; Cesbron, Jean-Yves; Pommateau, Romuald; Cotinat, Jean-Paul; Guitard, Véronique; Mathien, Laurence; Thetas, Elisabeth


    Civil society at large and all caregivers, whether at home or within institutions, are involved in palliative care However, procedures may vary considerably, excluding a single approach. So as to best adapt their responses, the authors recorded everyone's expectations. Such a participatory methodology is, sine 1990, behind the establishment of local networks providing assistance, support and training to physicians non-specialized in palliative care (general practitioners, specialists, students or residents facing specific aspects of this medical management, as well as other health and social workers).

  19. Successful clinical outcomes following decentralization of tertiary paediatric HIV care to a community-based paediatric antiretroviral treatment network, Chiangrai, Thailand, 2002 to 2008

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    Rawiwan Hansudewechakul


    Full Text Available Introduction: Most paediatric antiretroviral treatments (ARTs in Thailand are limited to tertiary care hospitals. To decentralize paediatric HIV treatment and care, Chiangrai Prachanukroh Hospital (CRH strengthened a provincial paediatric HIV care network by training community hospital (CH care teams to receive referrals of children for community follow-up. In this study, we assessed factors associated with death and clinical outcomes of HIV-infected children who received care at CRH and CHs after implementation of a community-based paediatric HIV care network. Methods: Clinical records were abstracted for all children who initiated ART at CRH. Paired Wilcoxon signed rank tests were used to assess CD4% and virological change among all children. Cox proportional hazard models were used to assess factors associated with death. Treatment outcomes (CD4%, viral load (VL and weight-for-age Z-score (WAZ were compared between CRH and CH children who met the criteria for analysis. Results: Between February 2002 and April 2008, 423 HIV-infected children initiated ART and 410 included in the cohort analysis. Median follow-up for the cohort was 28 months (interquartile range (IQR=12 to 42; 169 (41% children were referred for follow-up at CH. As of 31 March 2008, 42 (10% children had died. Baseline WAZ (<−2 (p=0.001 and baseline CD4% (<5% (p=0.015 were independently associated with death. At 48 months, 86% of ART-naïve children in follow-up had VL<400 copies/ml. For sub-group analysis, 133 children at CRH and 154 at CHs were included for comparison. Median baseline WAZ was lower in CH children than in CRH children (p=0.001; in both groups, WAZ, CD4% and VL improved after ART with no difference in rate of WAZ and CD4% gain (p=0.421 and 0.207, respectively. Conclusions: Children at CHs had more severe immunological suppression and low WAZ at baseline. Community- and tertiary care-based paediatric ART follow-ups result in equally beneficial outcomes with the

  20. Redes de atenção à saúde: contextualizando o debate Health care networks: contextualizing the debate

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    Rosana Kuschnir


    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

  1. Using social network methods to reach out-of-care or ART-nonadherent HIV+ injection drug users in Russia: addressing a gap in the treatment cascade

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    Yuri Amirkhanian


    Full Text Available Introduction: HIV treatment to reduce downstream HIV incidence and to decrease disease mortality and morbidity at a population level both require that hidden, out-of-care people living with HIV (PLH in the community be reached and engaged to enter care. This research evaluated the feasibility of reaching out-of-care or non-adherent PLH through members of their social networks in St Petersburg, Russia. Materials and Methods: To recruit a social network sample of HIV-positive injection drug users, 16 HIV+ seeds were enrolled into the study through PLH-oriented websites and online forums using recruitment ads or approached in needle exchange sites. Interested persons called the study phone number and completed a brief eligibility interview. Seed inclusion criteria were HIV+ status, being 18 years or older, having ever injected drugs, and having not visited an HIV doctor in the past 6 months. Seeds provided blood specimens tested for HIV to confirm their self-reported status. Eligible seeds were enrolled, completed brief network elicitation interview, and were asked to invite their own HIV+ friends into the study. Incentives were provided as compensation for participants’ time and additional smaller incentives were provided for inviting each HIV+ network member to also participate. The seed's PLH friends established the first ring of participants who, in turn were asked to invite their own PLH friends (second ring. All study participants completed assessment of psychosocial wellbeing and sexual and injection-related HIV risk behaviour. Blood samples were collected from all participants to confirm their HIV+ status. Results: Through this chain referral process, the initial 16 seeds led to the enrolment of a total of 66 PLH from the community (mean=4 per initial seed, most of whom – like the seed – were not presently in HIV care or were ART non-adherent. Conclusions: Implementation of treatment cascade goals requires complementing conventional

  2. Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis


    Guo, Lei; Wang, Weiwei; Zhao, Nana; Guo, Libo; Chi, Chunjie; Hou, Wei; Wu, Anqi; Tong, Hongshuang; Wang, Yue; Wang, Changsong; Li, Enyou


    Background It has been shown that the application of a lung-protective mechanical ventilation strategy can improve the prognosis of patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). However, the optimal mechanical ventilation strategy for intensive care unit (ICU) patients without ALI or ARDS is uncertain. Therefore, we performed a network meta-analysis to identify the optimal mechanical ventilation strategy for these patients. Methods We searched the Cochra...

  3. Echocardiography practice, training and accreditation in the intensive care: document for the World Interactive Network Focused on Critical Ultrasound (WINFOCUS

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    Catena Emanuele


    Full Text Available Abstract Echocardiography is increasingly used in the management of the critically ill patient as a non-invasive diagnostic and monitoring tool. Whilst in few countries specialized national training schemes for intensive care unit (ICU echocardiography have been developed, specific guidelines for ICU physicians wishing to incorporate echocardiography into their clinical practice are lacking. Further, existing echocardiography accreditation does not reflect the requirements of the ICU practitioner. The WINFOCUS (World Interactive Network Focused On Critical UltraSound ECHO-ICU Group drew up a document aimed at providing guidance to individual physicians, trainers and the relevant societies of the requirements for the development of skills in echocardiography in the ICU setting. The document is based on recommendations published by the Royal College of Radiologists, British Society of Echocardiography, European Association of Echocardiography and American Society of Echocardiography, together with international input from established practitioners of ICU echocardiography. The recommendations contained in this document are concerned with theoretical basis of ultrasonography, the practical aspects of building an ICU-based echocardiography service as well as the key components of standard adult TTE and TEE studies to be performed on the ICU. Specific issues regarding echocardiography in different ICU clinical scenarios are then described. Obtaining competence in ICU echocardiography may be achieved in different ways – either through completion of an appropriate fellowship/training scheme, or, where not available, via a staged approach designed to train the practitioner to a level at which they can achieve accreditation. Here, peri-resuscitation focused echocardiography represents the entry level – obtainable through established courses followed by mentored practice. Next, a competence-based modular training programme is proposed: theoretical

  4. Reforma, responsabilidades e redes: sobre o cuidado em saúde mental Reform, responsibilities and networks: about mental health care

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    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

  5. Development of a telecare system based on ZigBee mesh network for monitoring blood pressure of patients with hemodialysis in health care centers. (United States)

    Du, Yi-Chun; Lee, You-Yun; Lu, Yun-Yuan; Lin, Chia-Hung; Wu, Ming-Jei; Chen, Chung-Lin; Chen, Tainsong


    In Taiwan, the number of the patients needing dialysis increases rapidly in recent years. Because there is risk in every hemodialysis session, monitoring physiological status, such as blood pressure measurement every 30 min to 1 h is needed during about 4 h hemodialysis process. Therefore, an assisted measurement on blood pressure is needful in dialysis care centers. Telecare system (TCS) is regarded as one of important technique in the medical care. In this study, we utilized ZigBee wireless technique to establish a mesh network for monitoring blood pressure automatically and data storage in medical record system for display and further analysis. Moreover, while the blood pressure exceeds the normal range, the system could send a warning signal to remind, or inform the relatives and clinicians in health care center through the personal handy-phone system (PHS) immediately. The proposed system provides an assisted device for monitoring patients' blood pressure during hemodialysis process and saving medical manpower.

  6. 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 (United States)

    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

  7. The level of participation during the development of a mobile care data application for home-based healthcare in a developing context: An actor-network theory perspective

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    Retha de la Harpe


    Full Text Available The context of this study is home-based healthcare in a South African resource-restricted community. The research case involved the design and development of a mobile care data application, created to assist community caregivers in their professional activities. The development principles of a suitable application for feature phones (limited functionality in this context are not fully established, however. For the mobile care data application, a participatory design approach was employed. It was observed, conversely, that the level of participation of all stakeholders differed significantly. It was especially observed that the designer and end-users were less involved in the actual development of the prototype. These differences may have an influence on the end product/result. Actor-network theory may provide the mechanism to describe how the human and non-human actors formed relations as they participate in these processes. Considering the alignment of such networks, the coordination, devices and passages during the four translation moments provide valuable insights in the design and development of technology products. This paper will consider these elements in more depth. With a social embeddedness perspective the level of participation was high during the design of the proposed ICT solution with the active participation of the care givers from the developing context. The socio-economic factors of the developing context influenced the development of the mobile application with the complexities of the socio-technical context evident in the difficult translations between the participants

  8. [Coordination in case management practices in the context of integrated home care networks devoted to the frail elderly, a qualitative exploratory analysis]. (United States)

    Carrier, Sébastien


    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.

  9. Enhancing social networks: a qualitative study of health and social care practice in UK mental health services. (United States)

    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.

  10. 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. (United States)

    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…

  11. Development of e-Education and e-Health Care System Based on Heterogeneous Wireless Network Control System

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    May Phyo Maung


    Full Text Available The purpose of this research is to propose a system in which both the medical students and the patients can communicate with physician and get the instruction in a heterogeneous wireless network system without any difficulty. As the physician uses with mobile phone can easily communicate and the instructions of the different situation will also be provided to the medical students and his patients. In this way none of them will have the difficulty to understand the instructions of their physician. All the machines or laptops will be connected on wireless LAN and if the medical students have any difficulty to see on laptops monitor then he can directly ask the questions for their studies on this screen. The patients can also be cured by following the instructions from the physician on the network. In this research, the radio resource management for this integrated heterogeneous wireless network control system will be proposed. At the mobile terminal, network selection algorithm will be developed to make the decision of connection so that the QoS requirements are satisfied while the connection cost is minimized. An optimization problem will be formulated and solved for an optimal decision for intelligent network control system. In addition, the applications of this integrated heterogeneous wireless networks control system in e-Education and e-Health will be explored.

  12. Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the global network's EmONC trial

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    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

  13. Supporting cancer patients through the continuum of care: a view from the age of social networks and computer-mediated communication. (United States)

    Bender, J L; O'Grady, L; Jadad, A R


    Almost since its inception, the Internet has been used by ordinary people to connect with peers and to exchange health-related information and support. With the rapid development of software applications deliberately designed to facilitate social interaction, a new era is dawning in which patients and their loved ones can collaboratively build knowledge related to coping with illness, while meeting their mutual supportive care needs in a timely way, regardless of location. In this article, we provide background information on the use of "one-to-one" (for example, e-mail), "one-to-many" (for example, e-mail lists), and "many-to-many" (for example, message boards and chat rooms, and more recently, applications associated with Web 2.0) computer-mediated communication to nurture health-related social networks and online supportive care. We also discuss research that has investigated the use of social networks by patients, highlight opportunities for health professionals in this area, and describe new advances that are fuelling this new era of collaboration in the management of cancer.

  14. Support networks for Chinese older immigrants accessing English health and social care services: the concept of Bridge People. (United States)

    Liu, Xiayang; Cook, Glenda; Cattan, Mima


    As Chinese immigrants in the United Kingdom age, they experience an increasing need to access health and care services. It has, however, been reported that older Chinese immigrants have difficulties in accessing these services. This study explored the experiences of this population in using health and care services and the strategies that they adopted to address their difficulties. A grounded theory method with a two-staged research design was used. Stage 1 explored the participants' experiences of ageing and use of health and social care services through focus group interviews. Stage 2 investigated the strategies individuals used to support access to and use of services through individual interviews. Forty-four older Chinese people and 15 supporters participated in interviews during August 2011 and May 2013. These older Chinese immigrants were challenged in knowing about and in accessing services. Their difficulties were attributed to language barriers, lack of information and instrumental support, and emotional and cultural issues regarding use of health and care services. Their supporters facilitated access to services and acted as a bridge between the service and the user; therefore, they were given the title 'Bridge People'. Bridge People have different backgrounds: family and friends, public sector workers and staff from community-based Chinese organisations. The defining attributes of these supporters were: bilinguality, bicultural, multifunctionality and accessibility. There is no charge for this support; and the relationship between the Bridge Person and recipient involves trust and influence over decisions regarding use of health and care services. Bridge People should be recognised and identified by health, social care and housing services to promote engagement and use of services by older immigrant Chinese people.

  15. Home and Clinical Cardiovascular Care Center (H4C: a Framework for Integrating Body Sensor Networks and QTRU Cryptography System

    Directory of Open Access Journals (Sweden)

    Ali Zakerolhosseini


    Full Text Available 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

  16. Home and Clinical Cardiovascular Care Center (H4C): a Framework for Integrating Body Sensor Networks and QTRU Cryptography System. (United States)

    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.

  17. Epidemiology of Gram Negative Antimicrobial Resistance in a Multi-State Network of Long Term Care Facilities (United States)

    Lautenbach, Ebbing; Marsicano, Roseann; Tolomeo, Pam; Heard, Michael; Serrano, Steve; Stieritz, Donald D.


    We identified 1,805 gram-negative organisms in urine cultures from residents of 63 long-term care facilities (LTCFs) over 10 months. Fluoroquinolone resistance was 51% among E. coli, while 26% and 6% of Klebsiella were resistant to ceftazidime and imipenem, respectively. Resistance varied significantly by type of LTCF, LTCF size, and geographic region. PMID:19566445

  18. Transmission of methicillin-resistant Staphylococcus aureus in long-term care facilities and their related healthcare networks


    Harrison, Ewan M.; Ludden, Catherine; Brodrick, Hayley J.; Blane, Beth; Brennan, Gráinne; Morris, Dearbháile; Coll, Francesc; Reuter, Sandra; Brown, Nicholas M.; Holmes, Mark A.; O’Connell, Brian; Parkhill, Julian; Török, M.E.; Cormican, Martin; Sharon J Peacock


    Abstract Background Long-term care facilities (LTCF) are potential reservoirs for methicillin-resistant Staphylococcus aureus (MRSA), control of which may reduce MRSA transmission and infection elsewhere in the healthcare system. Whole-genome sequencing (WGS) has been used successfully to understand MRSA epidemiology and transmission in hospitals and has the potential to identify transmission between these and LTCF. ...

  19. Making the pieces fit. After assembling their care networks, systems' next big challenge is to build a unifying information infrastructure. (United States)

    Morrissey, J


    Five years into a manic pace of consolidation, hospital-based health delivery systems across the country are feeling the pressure to establish computer networks to unite all sites and services. In the campaign to lift healthcare out of an era of paper and pencil, organizations have spent freely on healthcare software applications. But computer pros say that's not enough.

  20. Application of modern network technology in nursing care of chronic wound%现代网络技术在慢性伤口护理中的应用

    Institute of Scientific and Technical Information of China (English)

    赵彩均; 丁福


    从伤口护理模式的变迁、对“网络”的理解、对我国伤口护理的启示3个方面,就现代网络技术在慢性伤口护理中的应用进行分析,提出要善于跟踪现代技术发展,完善伤口护理的网络平台。%It analyzed the application of modern network technology in the chronic wound care from three as-pects including change of wound care mode,understanding of “network”,enlightenment of wound care in our country.And it put forward we should be good at tracking the development of modern technology and perfect network platform of wound care.

  1. An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan

    Directory of Open Access Journals (Sweden)

    Chang Ching


    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

  2. Tecendo a rede assistencial em saúde mental com a ferramenta matricial Building the mental health care network with the matrix support tool

    Directory of Open Access Journals (Sweden)

    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

  3. Re: Pregabalin prescriptions in the United Kingdom - a drug utilisation study of The Health Improvement Network (THIN) primary care database by Asomaning et al

    DEFF Research Database (Denmark)

    Pottegård, A; Tjäderborn, M; Schjerning, O


    Aim In Europe, pregabalin is approved for treatment of neuropathic pain, general anxiety disorder (GAD) and as adjunctive therapy for epilepsy. The purpose of this study was to assess utilisation of pregabalin in the UK, including patients with a recorded history of substance abuse, from a large...... 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...... 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...

  4. Medication documentation in a primary care network serving North Carolina medicaid patients: results of a cross-sectional chart review

    Directory of Open Access Journals (Sweden)

    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.

  5. Changes in the use of manual vacuum aspiration for postabortion care within the public healthcare service network in Honduras. (United States)

    Chinchilla, Ana Ligia; Flores, Ivo Flores; Morales, Alma Fabiola; de Gil, Marina Padilla


    Honduras is one of the 17 priority countries included in the International Federation of Gynecology and Obstetrics (FIGO) Initiative for the Prevention of Unsafe Abortion and its Consequences. The priority category enables the country to request emergency funding to acquire services or commodities that could contribute toward achieving the objectives laid out in its plan of action. These objectives include improving postabortion care by increasing the use of manual vacuum aspiration (MVA) as an outpatient procedure with minimal human and material resources. Since the Ministry of Health lacked funding, use of the emergency fund was approved for the purchase and distribution of MVA kits nationwide to ensure continuity and the hope of increasing MVA use. Eleven hospitals participating in this initiative provided data for analysis of the outcome. These data show no increase in MVA use; however, as discussed in the article, further investigation provided valuable information on the reasons behind these results.

  6. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions

    DEFF Research Database (Denmark)

    Hutton, Brian; Salanti, Georgia; Caldwell, Deborah M;


    The PRISMA statement is a reporting guideline designed to improve the completeness of reporting of systematic reviews and meta-analyses. Authors have used this guideline worldwide to prepare their reviews for publication. In the past, these reports typically compared 2 treatment alternatives...... to improve the reporting of systematic reviews incorporating network meta-analyses. A group of experts participated in a systematic review, Delphi survey, and face-to-face discussion and consensus meeting to establish new checklist items for this extension statement. Current PRISMA items were also clarified....... With the evolution of systematic reviews that compare multiple treatments, some of them only indirectly, authors face novel challenges for conducting and reporting their reviews. This extension of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement was developed specifically...

  7. Family Practitioners’ Advice about Taking Time Off Work for Lower Respiratory Tract Infections: A Prospective Study in Twelve European Primary Care Networks (United States)

    Godycki-Cwirko, Maciek; Nocun, Marek; Butler, Christopher C.; Little, Paul; Verheij, Theo; Hood, Kerenza; Fleten, Nils; Kowalczyk, Anna; Melbye, Hasse


    Background Acute cough and lower respiratory tract infections (LRTIs) are one of the most important causes of lost working hours. Aim to explore variation and predictors in family practitioners (FPs) advice to patients with LRTIs about taking time off work in different European countries. Methods Prospective observational study in primary care networks in 12 countries, with multilevel mixed-effects binomial logistic regression. Results 324 FPs recruited 1616 employed adults who presented to primary care with LRTIs. The proportion of patients advised to take time off work varied from 7.6% in the Netherlands to 89.2% in Slovakia, and of these, 88.2% overall were advised to stay off work for seven days or less. None of Finnish or Dutch patients were advised to take more than 7 days off, in contrast to 35.5% of Polish and 27.0% of Slovak patients. The strongest predictors of FPs’ advice about time off work were: patient symptoms interfering with normal activities (OR 4.43; P<0.001), fever (2.49; P<0.001), patients feeling generally unwell (2.21; P<0.001), antibiotic prescribing (1.51; P = 0.025) and auscultation abnormality (1.50; P = 0.029). Advice to take time off was not associated with patient reported recovery. Conclusions There is large variation in FPs’ advice given to patients with LRTIs in Europe about taking time off work, which is not explained by differences in patients’ reported illness duration, but might be explained by differences in regulations around certification and sick pay. Evidence based guidance for advising patients about taking time off work for this common condition is needed. PMID:27760225

  8. Evaluation of the implementation of an integrated primary care network for prevention and management of cardiometabolic risk in Montréal

    Directory of Open Access Journals (Sweden)

    Provost Sylvie


    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

  9. 人工神经网络在重症监护室的应用%Applications of artificial neural network in intensive care unit

    Institute of Scientific and Technical Information of China (English)

    周伟炜; 宋以信


    随着医学和电子信息技术的迅速发展,人工神经网络(ANN)越来越多地被应用在重症监护室(IcU)中.ANN可以把大量的临床资料转化为信息,辅助医护人员进行诊断和治疗.在ICU中,ANN的作用有很多,主要是用来进行结果预测.应用ANN对于合理利用我国有限的医疗卫生资源以及改善患者预后具有重要的意义.%With the development of medical sciences and intelligent software, the amount of data acquired electronically from patients in intensive care unit (ICU) has grown exponentially, therefore they were susceptible to analysis by artificial neural network (ANN). ANN has been used in ICU in a variety of fashions, but most extensively for outcome prediction. ANN can function as intelligent assistant to clinicians, constantly monitoring electronic data streams for important trends. The integration of ANN into the ICU can be expected to make significant use of health resources and improve outcome of the patients.

  10. Child Care Aware (United States)

    ... a stream of our activity across multiple social networks by visiting the Child Care Aware® of America Social Dashboard. Visit Our Social Dashboard Follow and Engage ... Care Aware of America Home Newsroom Contact Us Log In Register Back About ...

  11. Are Pediatric Emergency Care Applied Research Network Rules (PECARN Sufficient for Computed Cranial Tomography Decision in Pediatric Patients with Mild Head Trauma?

    Directory of Open Access Journals (Sweden)

    Hasan Mansur Durgun


    Full Text Available Objective: In this study we aimed to investigate the ap­plicability of Pediatric Emergency Care Applied Research Network (PECARN rules for decision to perform computed cranial tomography (CCT in pediatric patients with minor head trauma (MHT. Methods: 317 pediatric patients who underwent CCT for mild head trauma were evaluated retrospectively. The pa­tients were classified in two groups according to PECARN rules: below 2 years old, above 2 years old and then, these patient groups were classified into two subgroups accord­ing to the compatibility with PECARN rules. The patients re­quiring CCT according to PECARN rules were classified as PECARN compatible (PECARN +, the patients who under­went CCT without the need of CCT according to PECARN were classified as PECARN incompatible (PECARN -. Results: Approximately 20% patients in PECARN (+ group had abnormalities leading to prolonged hospitalization and only 3.8% patients of PECARN (- group had abnormali­ties. However, none of PECARN (- group patients required follow-up longer than 48 hours in the hospital. The most common symptoms necessitate CCT in PECARN (+ group were scalp swelling, scalp hematoma and vomiting. In PE­CARN (- group the most common signs were cuts in the scalp and dermal abrasions. The incidence of fracture in CCT was significantly higher in PECARN (+ group. Conclusion: Because CCT poses serious radiation expo­sure, neurological examination and clinical follow-up should be preferred in the evaluation of children with MHT. In con­clusion, PECARN rules were sufficient for CCT decision in pediatric patients with MHT. J Clin Exp Invest 2016; 7 (1: 35-40

  12. Improving the quality of palliative and terminal care in the hospital by a network of palliative care nurse champions: The study protocol of the PalTeC-H project

    NARCIS (Netherlands)

    F.E. Witkamp (Frederika); L. van Zuylen (Lia); P.J. van der Maas (Paul); H.V. Dijk (Helma Van); C.C.D. van der Rijt (Carin); A. van der Heide (Agnes)


    textabstractBackground: The quality of care of patients dying in the hospital is often judged as insufficient. This article describes the protocol of a study to assess the quality of care of the dying patient and the contribution of an intervention targeted on staff nurses of inpatient wards of a la

  13. Healthy eating and active living for diabetes in primary care networks (HEALD-PCN: rationale, design, and evaluation of a pragmatic controlled trial for adults with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    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 identifier: NCT00991380

  14. 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

    Directory of Open Access Journals (Sweden)

    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

  15. Critical Care (United States)

    Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications ... a team of specially-trained health care providers. Critical care usually takes place in an intensive care ...

  16. Tracheostomy care (United States)

    Respiratory failure - tracheostomy care; Ventilator - tracheostomy care; Respiratory insufficiency - tracheostomy care ... Before you leave the hospital, health care providers will teach you how ... and suction the tube Keep the air you breathe moist Clean ...

  17. The Construction of Home-based Care System for the Elderly under the Network Governance%网络化治理视角下的居家养老模式之构建

    Institute of Scientific and Technical Information of China (English)



    As aging of population is becoming an inevitable trend in China,possible solutions to caring for the elderly are seri-ously needed. In light of this situation, the construction of home-based care system under the model of network governance pro-vides a realistic choice. Theoretically supported by the network governance,through the analysis of the perspectives of design-ing,operation,and supervision,the paper arrives at the conclusion that by constructing contract relationships and enhancing gov-ernment guidance,enhancing digital connections and information communication,a new path of home-based care services under network governance can be established with effective measures of indisputable responsibilities and performance assessment.%  面对我国人口老龄化日益严峻的形势,网络化治理模式下的社会化居家养老服务体系建设为解决我国养老问题提供了一种现实选择。本文以网络化治理理论为指导,针对居家养老治理网络的设计、运行及监管这三个核心问题,提出了通过构建合同关系、强化政府引导,实施数字化连接、加强信息沟通,明确各方责任、强化绩效评估等措施来构筑一条网络化治理居家养老的新路径。

  18. An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan


    Chang Ching; Chang Hsin


    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 enh...

  19. 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

    Directory of Open Access Journals (Sweden)

    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 identifier NCT00546806 [Trial registry date: October 18, 2007; Date first patient was randomized: February

  20. [From the Competence Network on Depression and Suicidality to the German Depression Foundation. National and international prevention of suicidal behaviour and optimizing health care through using of E‑Mental-Health]. (United States)

    Hegerl, Ulrich; Rummel-Kluge, Christine; Heinz, Ines


    Depression is a very common, severe, socio-economically highly relevant disorder and the main cause for approximately 10,000 suicides in Germany annually. There is capital room for improvement and optimization of the care for depressed patients, as effective and evidence-based treatment options are available. However, they are only used optimally by a minority of the people affected due to huge diagnostic and therapeutic deficits. The "Compentence Network on Depression and Suicidality" provided several evidence-based concepts to improve care for patients affected by depression and to prevent suicidal behaviour. Especially the four-level intervention approach of the Alliances Against Depression has been successfully adapted and implemented by more than 100 regions within Europe and globally as well. The infrastructure of the Competence Network could be efficiently sustained throughout the establishment of the German Depression Foundation and the European Alliance against Depression. Since 2014, all research activities have been extended nationally and internationally by the establishment of a Depression Research Centre with a special focus on various E‑Mental-Health-projects.

  1. Hospice Care (United States)

    Hospice care is end-of-life care. A team of health care professionals and volunteers provides it. ... can remain as alert and comfortable as possible. Hospice programs also provide services to support a patient's ...

  2. Palliative Care (United States)

    Palliative care is treatment of the discomfort, symptoms, and stress of serious illness. It provides relief from distressing symptoms ... of the medical treatments you're receiving. Hospice care, care at the end of life, always includes ...

  3. Discordance between presumed standard of care and actual clinical practice: the example of rubber dam use during root canal treatment in the National Dental Practice-Based Research Network (United States)

    Gilbert, Gregg H; Riley, Joseph L; Eleazer, Paul D; Benjamin, Paul L; Funkhouser, Ellen


    Objectives Use of a rubber dam during root canal treatment is considered the standard of care because it enhances patient safety and optimises the odds of successful treatment. Nonetheless, not all dentists use a rubber dam, creating disconnect between presumed standard of care and what is actually done in clinical practice. Little is known about dentists’ attitudes towards use of the rubber dam in their practices. The objectives were to: (1) quantify these attitudes and (2) test the hypothesis that specific attitudes are significantly associated with rubber dam use. Setting National Dental Practice-Based Research Network ( Participants 1490 network dentists. Outcome measures Dentists completed a questionnaire about their attitudes towards rubber dam use during root canal treatment. Three attitude scales comprised 33 items that used a 5-point ordinal scale to measure beliefs about effectiveness, inconvenience, ease of placement, comparison to other isolation techniques and patient factors. Factor analysis, cluster analysis and multivariable logistic regression analysed the relationship between attitudes and rubber dam use. Results All items had responses at each point on the 5-point scale, with an overall pattern of substantial variation across dentists. Five attitudinal factors (rubber dam effectiveness; inconvenient/time-consuming; ease of placement; effectiveness compared to Isolite; patient factors) and 4 clusters of practitioners were identified. Each factor and cluster was independently and strongly associated with rubber dam use. Conclusions General dentists have substantial variation in attitudes about rubber dam use. Beliefs that rubber dam use is not effective, inconvenient, time-consuming, not easy to place or affected by patient factors, were independently and significantly associated with lower rubber dam use. These attitudes explain why there is substantial discordance between presumed standard of care and actual practice

  4. Americans' Experiences with ACA Marketplace Coverage: Affordability and Provider Network Satisfaction: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016. (United States)

    Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beutel, Sophie


    For people with low and moderate incomes, the Affordable Care Act's tax credits have made premium costs roughly comparable to those paid by people with job-based health insurance. For those with higher incomes, the tax credits phase out, meaning that adults in marketplace plans on average have higher premium costs than those in employer plans. The law's cost-sharing reductions are reducing deductibles. Lower-income adults in marketplace plans were less likely than higher-income adults to report having deductibles of $1,000 or more. Majorities of new marketplace enrollees and those who have changed plans since they initially obtained marketplace coverage are satisfied with the doctors participating in their plans. Overall, the majority of marketplace enrollees expressed confidence in their ability to afford care if they were to become seriously ill. This issue brief explores these and other findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.

  5. [Home care in Sapporo]. (United States)

    Yazaki, Kazuo


    We established a clinic specialized in home care in Sapporo in July 2001. In these 2 years we have provided medical home care service to 160 patients, and 97 are still receiving regular service. At first we accepted any patients living within 16 km from the clinic. However, bad traffic conditions in winter made it difficult to visit patients living in districts far away from the clinic. Therefore, we planned a network of home care physicians in Sapporo. Now 12 home care physicians hold monthly meetings. In Sapporo, meetings of home care related workers are organized in each ward, as suggested by the Sapporo Medical Association. There is a relatively good supply of home care related services and resources, including availability of an important number of visiting nurses. Patients being taken care of at home who present an acute exacerbation of symptoms are relatively easily accepted by acute hospitals. But those who have difficulties in continuing home care due to a sudden change in family conditions are not easily accepted by nursing hospitals. Recently, the number of group homes and lodging houses for elderly persons has markedly increased in Sapporo. It might have some problems in medical support in the near future.

  6. Demographic and Indication-Specific Characteristics Have Limited Association With Social Network Engagement: Evidence From 24,954 Members of Four Health Care Support Groups (United States)


    Background Digital health social networks (DHSNs) are widespread, and the consensus is that they contribute to wellness by offering social support and knowledge sharing. The success of a DHSN is based on the number of participants and their consistent creation of externalities through the generation of new content. To promote network growth, it would be helpful to identify characteristics of superusers or actors who create value by generating positive network externalities. Objective The aim of the study was to investigate the feasibility of developing predictive models that identify potential superusers in real time. This study examined associations between posting behavior, 4 demographic variables, and 20 indication-specific variables. Methods Data were extracted from the custom structured query language (SQL) databases of 4 digital health behavior change interventions with DHSNs. Of these, 2 were designed to assist in the treatment of addictions (problem drinking and smoking cessation), and 2 for mental health (depressive disorder, panic disorder). To analyze posting behavior, 10 models were developed, and negative binomial regressions were conducted to examine associations between number of posts, and demographic and indication-specific variables. Results The DHSNs varied in number of days active (3658-5210), number of registrants (5049-52,396), number of actors (1085-8452), and number of posts (16,231-521,997). In the sample, all 10 models had low R2 values (.013-.086) with limited statistically significant demographic and indication-specific variables. Conclusions Very few variables were associated with social network engagement. Although some variables were statistically significant, they did not appear to be practically significant. Based on the large number of study participants, variation in DHSN theme, and extensive time-period, we did not find strong evidence that demographic characteristics or indication severity sufficiently explain the variability in

  7. Palliative Care (United States)

    ... you are a partner with the palliative care team as you all work toward the same goal — providing the best quality of life for your child for as ... Care for Children With Terminal Illness Managing Home Health Care Taking Care of You: Support ...

  8. Hospice care (United States)

    ... family a break (called respite care). Doctor services. Nursing care. Home health aide and homemaker services. Counseling. Medical ... may be given in other locations, including: A nursing home A ... in charge of care is called the primary care giver. This may ...

  9. Risk stratification and stroke prevention therapy care gaps in Canadian atrial fibrillation patients (from the Co-ordinated National Network to Engage Physicians in the Care and Treatment of Patients With Atrial Fibrillation chart audit). (United States)

    Patel, Ashish D; Tan, Mary K; Angaran, Paul; Bell, Alan D; Berall, Murray; Bucci, Claudia; Demchuk, Andrew M; Essebag, Vidal; Goldin, Lianne; Green, Martin S; Gregoire, Jean C; Gross, Peter L; Heilbron, Brett; Lin, Peter J; Ramanathan, Krishnan; Skanes, Allan; Wheeler, Bruce H; Goodman, Shaun G


    The objectives of this national chart audit (January to June 2013) of 6,346 patients with atrial fibrillation (AF; ≥18 years without a significant heart valve disorder) from 647 primary care physicians were to (1) describe the frequency of stroke and bleed risk assessments in patients with nonvalvular AF by primary care physicians, including the accuracy of these assessments relative to established predictive indexes; (2) outline contemporary methods of anticoagulation used; and (3) report the time in the therapeutic range among patients prescribed warfarin. An annual stroke risk assessment was not undertaken in 15% and estimated without a formal risk tool in 33%; agreement with CHADS2 score estimation was seen in 87% of patients. Major bleeding risk assessment was not undertaken in 25% and estimated without a formal risk tool in 47%; agreement with HAS-BLED score estimation was observed in 64% with physician overestimation in 26% of patients. Antithrombotic therapy included warfarin (58%), dabigatran (22%), rivaroxaban (14%), and apixaban (risk for stroke. There is apparent overestimation of bleeding risk in many patients. Warfarin was the dominant stroke prevention treatment; however, the suggested TTR target was achieved in only 55% of these patients.

  10. Pin care (United States)

    ... gov/pubmed/24302374 . Nagy K. Discharge instructions for wound cares. The American Association of the Surgery of Trauma. . Accessed May 13, 2016.

  11. Palliative Care (United States)

    ... possessions to others, write a letter or a poem or compose a song, or decide what they ... One Year Off Treatment Transitioning to Adult Care Long-Term Follow-Up Care Coping With Cancer Overview ...

  12. [Matricial support in workers' health: creating networks in primary care in the Unified Health System (SUS), the case of Amparo in the state of São Paulo]. (United States)

    Santos, Ana Paula Lopes dos; Lacaz, Francisco Antonio de Castro


    The Reference Center in Workers' Health of Amparo in the State of São Paulo promotes actions directed to workers' health in primary care. In order to understand the process, we conducted research in Matricial Support in Workers' Health, its trajectory, difficulties and potential, using a qualitative case study approach. The main matricial support activities are thematic meetings, informative bulletins and systematic support. The exchange of knowledge and experience leads to a closer bond between the professionals. Horizontal technical support brings about a reorganization of work in health, mutual responsibility for cases and a new outlook on illness by integrating assistance and surveillance actions. An excess workload, rotation of health professionals, undernotification of Work-Related Accidents and Diseases and regional organization are the challenges to be tackled. Matricial Support in Workers' Health is strategic for the insertion of such actions in primary care and represents a step forward in the reorientation of the assistential medical model, with the introduction of the work-health relationship in family health.

  13. Low-cost computing and network communication for a point-of-care device to perform a 3-part leukocyte differential (United States)

    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, count and differential from a low volume (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.

  14. The Strengthening of Primary Health Care Network Building to Promote the Cooperation of Healthy Development%加强基层卫生网络建设促进合作医疗健康发展

    Institute of Scientific and Technical Information of China (English)



    由中共中央、国务院下发的加强农村卫生工作的决定,明确指出了新型合作医疗制度是由政府组织、引导、支持,农民自愿参加,个人、集体和政府多方筹资,以大病统筹为主的农民医疗互助共济制度,而计算机网络建设的好坏将直接决定这一制度的成败。这一系统应以国家农村合作医疗制度为依据,同时又要结合2005年5月最新的卫生部《新型农村合作医疗信息管理系统规范》,并结合本地新型农村合作医疗特点,开发出一套适合当地实际情况的计算机网络。%The CPC Central Committee and State Council issued the decision to strengthen rural health work,clear that the new cooperative medical care system is organized by the government, guidance,support,farmers voluntary, individual,collective and multi-government funding,mainly to serious co-ordination farmers medical Huzhugongji system,and computer networks will directly determine the quality of the construction of the system's success or failure.This system should be country-based rural cooperative medical care system,but also with the latest in May 2005,the Ministry of Health,"the new rural cooperative medical information management system standards",and with local characteristics of the new rural cooperative medical care,to develop a suitable local conditions of the computer network.

  15. Comparing Care

    NARCIS (Netherlands)

    Evert Pommer; Isolde Woittiez; John Stevens


    Home care is one of the most important means of compensating for disabilities and ensuring continuity in people's daily functioning. Home care services in the Netherlands have recently been transferred from a national social security provision for long-term care to a local social service. In most ot

  16. Dimensão ética do cuidado em saúde mental na rede pública de serviços Ethical dimension of mental health care within the public health network

    Directory of Open Access Journals (Sweden)

    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.

  17. Acupuncture in Primary Care



    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...

  18. Preconception Care and Prenatal Care (United States)

    ... at risk for complications? How does stress affect pregnancy? NICHD Research Information Clinical Trials Resources and Publications Preconception Care and Prenatal Care: Condition Information Skip sharing on social media links Share this: Page Content What is preconception ...

  19. Beyond Space For Spatial Networks

    CERN Document Server

    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...

  20. Virtual care

    DEFF Research Database (Denmark)

    Kamp, Annette; Aaløkke Ballegaard, Stinne

    of retrenchment, promising better quality, empowerment of citizens and work that is smarter and more qualified. Through ethnographic field studies we study the introduction of virtual home care in Danish elderly care, focusing on the implications for relational work and care relations. Virtual home care entails...... and professionals, and they instigate change in organization and professional identities. Studies, which more specifically deal with telecare, stress how virtualization alters the character of the observations care workers are able to make, and how the validity of the patients’ own measurements and observations...... point out how issues of trust and surveillance, which are always negotiated in care relations, are in fact accentuated in this kind of virtual care work. Moreover, we stress that the contemporary institutional context, organization and time schedules have a vast impact on the practices developed....

  1. Comparison of substance use, subjective well-being and interpersonal relationships among young people in foster care and private households: a cross sectional analysis of the School Health Research Network survey in Wales (United States)

    Evans, Rhiannon E; Fletcher, Adam; Hewitt, Gillian; Murphy, Simon; Young, Honor; Moore, Graham F


    Objective To investigate the association of living in foster care (FC) with substance use and subjective well-being in a sample of secondary school students (11–16 years) in Wales in 2015/16, and to examine whether these associations are attenuated by the perceived quality of interpersonal relationships. Design Cross-sectional, population-based health behaviour and lifestyle questionnaire. Setting and participants Wales, UK; young people who took part in the 2015/16 School Health Research Network (SHRN) questionnaire (n=32 479). Primary outcome Health behaviours among young people in FC were compared with those from private households. Results The prevalence of all adverse outcomes was higher among young people in FC. Those in FC were significantly more likely to report mephedrone use (OR=9.24, 95% CI 5.60 to 15.34), multiple substance misuse behaviours (OR=3.72, 95% CI 2.30 to 6.00), poorer relationships with peers (RR=1.88, 95% CI 1.23 to 2.88) and teachers (RR=1.83, 95% CI 1.31 to 2.56), having experienced bullying (OR=1.80, 95% CI 1.38 to 2.35), dating violence (OR=1.66, 95% CI 1.13 to 2.43) and poor well-being (RR=1.72, 95% CI 1.20 to 2.46). The association between FC and substance use remained significant, though was attenuated after accounting for relationship variables. The association between FC and subjective well-being became non-significant after adjustment for relationship variables. Conclusions Young people living in FC experience significantly worse outcomes than young people not in care, likely due to a range of care and precare factors, which impact adversely on subsequent social relationships. The analyses are consistent with the hypothesis that the associations of FC with substance use and life satisfaction are partially explained by poorer quality social relationships. Large scale, longitudinal studies are required to investigate the relationship between being in care and health, educational and social outcomes. Mental health interventions

  2. Who Cares for Care Leavers? (United States)

    Askew, Julie; Rodgers, Paul; West, Andrew


    This chapter describes a programme of learning and development at the University of Sheffield, United Kingdom, to support looked-after children and care leavers (youth previously provided care outside or beyond family) throughout the student lifecycle. In this context, looked-after children are those cared for by a town/city authority where…

  3. Acupuncture in primary care. (United States)

    Mao, Jun J; Kapur, Rahul


    Acupuncture, an ancient traditional Chinese medical therapy, is used widely around the world. When practiced by a certified provider, it is safe and patients often find it calming and relaxing. Animal and human studies have found a physiologic basis for acupuncture needling in that it affects the complex central and peripheral neurohormonal network. Although it is unclear whether acupuncture is beneficial over sham/placebo acupuncture, acupuncture care yields clinically relevant short- and long-term benefits for low back pain, knee osteoarthritis, chronic neck pain, and headache. The integration of acupuncture into a primary care setting also appears to be cost-effective. The practice of acupuncture in primary care requires rigorous training, financial discipline, and good communication skills. When done correctly, acupuncture is beneficial for both patients and providers.

  4. 机构养老之品质内涵研究--以台湾兆如多层级养老机构为实例%Study on Quality Connotation for Institutional Elderly Population Care ---Example of Taiwan Zhaoru Multiple Long -term Care Network

    Institute of Scientific and Technical Information of China (English)

    张团; 穆光宗; 傅旻


    With the ageing tendency of population in China and the quality demands of the aged , the quality pursuit has been a key issue of its development of the institution for the aged ..Based on Taiwan Zhao-ru multiple long-term care network study , we propose quality connotation principle with three key elements to improve the quality in institutional elderly population care including demand , requirement and pursuit .Their relationship would be:the quality connotation of the institutional care for the aged is the demand for the aged , the requirement for the government and the pursuit for the institutions ...Taiwan empirical study and its good practices may provide solid reference to mainland quality journey .%面对中国特色的人口老龄化,以及老人对机构养老的品质需求,机构养老的品质追求成为其发展的核心话题。本研究通过亲身参访台湾养老机构,以台湾恒安集团旗下的台北市兆如老人安养中心为例,提出机构品质养老“需求-要求-追求”三要素理论,即机构养老的品质内涵,对老人来说是需求,对政府来说是要求,对机构来说是追求。结合台湾机构养老经验,以汲取众家之长,为构建中国特色的机构养老品质之路提供借鉴与指导。

  5. Advance care directives (United States)

    ... advance directive; Do-not-resuscitate - advance directive; Durable power of attorney - advance care directive; POA - advance care directive; Health care agent - advance care directive; Health care proxy - ...

  6. Learning Networks, Networked Learning

    NARCIS (Netherlands)

    Sloep, Peter


    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.

  7. Learning Networks, Networked Learning

    NARCIS (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

  8. Professional social networking. (United States)

    Rowley, Robert D


    We review the current state of social communication between healthcare professionals, the role of consumer social networking, and some emerging technologies to address the gaps. In particular, the review covers (1) the current state of loose social networking for continuing medical education (CME) and other broadcast information dissemination; (2) social networking for business promotion; (3) social networking for peer collaboration, including simple communication as well as more robust data-centered collaboration around patient care; and (4) engaging patients on social platforms, including integrating consumer-originated data into the mix of healthcare data. We will see how, as the nature of healthcare delivery moves from the institution-centric way of tradition to a more social and networked ambulatory pattern that we see emerging today, the nature of health IT has also moved from enterprise-centric systems to more socially networked, cloud-based options.

  9. Characteristics and outcome of infants with candiduria in neonatal intensive care - a Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC study

    Directory of Open Access Journals (Sweden)

    Langley Joanne M


    Full Text Available Abstract Background There is limited information in the literature on the presentation and prognosis of candidal urinary tract infection (UTI in infants in the neonatal intensive care unit (NICU. Methods This was a prospective cohort study performed in 13 Canadian NICUs. Infants with candidal UTI without extra-renal candidal infection at presentation were enrolled. Results Thirty infants fit the study criteria. Median birth weight and gestational age were 2595 grams (range 575-4255 and 35 weeks (range 24-41 with 10 infants being Conclusion Candidal UTI in the NICU population occurs both in term infants with congenital abnormalities and in preterm infants, and is associated with renal parenchymal disease and extra-renal dissemination. A wide variation in clinical approach was documented in this multicenter study. The overall mortality rate in these infants was significant (30%. In one third of the deaths, Candida infection was deemed to be a contributing factor, suggesting the need for antifungal therapy with repeat evaluation for dissemination in infants who are slow to respond to therapy.

  10. Identifying changes in the support networks of end-of-life carers using social network analysis. (United States)

    Leonard, Rosemary; Horsfall, Debbie; Noonan, Kerrie


    End-of-life caring is often associated with reduced social networks for both the dying person and for the carer. However, those adopting a community participation and development approach, see the potential for the expansion and strengthening of networks. This paper uses Knox, Savage and Harvey's definitions of three generations social network analysis to analyse the caring networks of people with a terminal illness who are being cared for at home and identifies changes in these caring networks that occurred over the period of caring. Participatory network mapping of initial and current networks was used in nine focus groups. The analysis used key concepts from social network analysis (size, density, transitivity, betweenness and local clustering) together with qualitative analyses of the group's reflections on the maps. The results showed an increase in the size of the networks and that ties between the original members of the network strengthened. The qualitative data revealed the importance between core and peripheral network members and the diverse contributions of the network members. The research supports the value of third generation social network analysis and the potential for end-of-life caring to build social capital.

  11. Strengthening care of injured children globally. (United States)

    Mock, Charles; Abantanga, Francis; Goosen, Jacques; Joshipura, Manjul; Juillard, Catherine


    Part of the solution to the growing problem of child injury is to strengthen the care that injured children receive. This paper will point out the potential health gains to be made by doing this and will then review recent advances in the care of injured children in individual institutions and countries. It will discuss how these individual efforts have been aided by increased international attention to trauma care. Although there are no major, well-funded global programmes to improve trauma care, recent guidance documents developed by WHO and a broad network of collaborators have stimulated increased global attention to improving planning and resources for trauma care. This has in turn led to increased attention to strengthening trauma care capabilities in countries, including needs assessments and implementation of WHO recommendations in national policy. Most of these global efforts, however, have not yet specifically addressed children. Given the special needs of the injured child and the high burden of injury-related death and disability among children, clearly greater emphasis on childhood trauma care is needed. Trauma care needs assessments being conducted in a growing number of countries need to focus more on capabilities for care of injured children. Trauma care policy development needs to better encompass childhood trauma care. More broadly, the growing network of individuals and groups collaborating to strengthen trauma care globally needs to engage a broader range of stakeholders who will focus on and champion the improvement of care for injured children.

  12. Managed care under siege. (United States)

    Epstein, R A


    Managed Care Organizations (MCOs) are frequently criticized for their marketing mistakes. Often that criticism is leveled against an implicit benchmark of an ideal competitive market or an ideal system of government provision. But any accurate assessment in the choice of health care organizations always requires a comparative measure of error rates. These are high in the provision of health care, given the inherent uncertainties in both the cost and effectiveness of treatment. But the continuous and rapid evolution of private health care mechanisms is, in the absence of regulation, more likely to secure access and contain costs than any system of government regulation. State regulation is subject to the risk of capture and to the sluggish and acquisitive behavior of state run monopolies. The proposed fixes for the MCOs (rights to specialists, access to physicians outside the network, guaranteed emergency room access) are likely, when imposed from without, to cost more than they are worth. The long-term risk is that markets will fail under regulation, paving the way for greater losses from massive government control of the health care delivery system.

  13. 现代网络院前急救模式对重型颅脑损伤预后影响%Influence of modern network pre-hospital emergency care mode on the prognosis of severe brain trauma

    Institute of Scientific and Technical Information of China (English)

    张守祥; 王诚; 戴利强; 吴涛; 刘胜


    目的 探讨现代网络院前急救模式对重型颅脑损伤患者预后的影响.方法 将院前重型颅脑外伤患者分成两组;现代网络院前急救模式(A组,162例)由经过专业培训的急救队伍组成,能够进行基础、高级生命支持,配备先进急救设备和现代交通工具等,利用现代网络连接快捷的特点,在深圳市急救中心调度下开展院前现场急救工作;传统模式组(B组,124例)患者自行到达医院,无医务人员现场抢救及陪同.统计调度时间、到达时间、现场时间、返回时间、总时间,同时对受伤类型、颅内损伤程度、格拉斯哥预后分级( GOS)进行统计学分析.结果 A组和B组的受伤类型、颅内损伤程度差异无显著性(P>0.05).A组预后伤残程度评级:良好72.22%,中残19.14%,重残1.85%,植物状态0.62%,死亡6.17%;B组预后伤残程度评级:良好47.58%,中残24.19%,重残12.10%,植物状态2.23%,死亡14.51%;A组预后优于B组,差异有显著性(P<0.05).结论 现代网络院前急救模式能提升重型颅脑损伤急救速度,降低死亡率和改善预后.%Objective To explore the influence of modern network pre-hospital emergency care mode on the prognosis of the patients with severe brain trauma.Methods Divided the patients with severe brain trauma into 2 groups:modern network pre-hospital emergency care mode group( A group,162 cases ),which had a professional rescue team that equipped with advanced first-aid equipment and had modern transportation and modem fast network,carried pre-hospital emergency rescue work out under the management of the Shenzhen City Emergency Center; Patients in traditional mode group ( B group,124 cases ) went to hospital with no health care and no companionship of medical worker.Then recorded the scheduling time,running time,rescue time,returning time,and total time; statistically analyzed the traumatic type,traumatic degree,and Glasgow Outcome Scale( GOS ) in both

  14. Action research and Care Work

    DEFF Research Database (Denmark)

    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...... with social innovation....

  15. 机械通气患者口腔护理液效果评价的网状Meta分析%Network meta-analysis on the effect of oral care for patients with mechanical ventilation

    Institute of Scientific and Technical Information of China (English)

    赵娜; 赵倩; 李娟; 谢莹; 崔文香


    Objective To evaluate the clinical effect of different oral care solution.Methods Literature data were collected by computer retrieval covering China National Knowledge Infrastructure (CNKI),China Biology Medicine (CBI) and Wanfang database,and Note Express and Addis software were used to evaluate the randomized controlled trials of literature.Results 19 separate randomized controlled trials were included in the research hterature;Network Meta analysis results showed that in the prevention of ventilator-associated pneumonia,the electrolyzed oxidizing water,compound chlothexidine,hydrogen peroxide,sodium bicarbonate,distilled water and 0.9% saline had statistically significant difference (OR=0.25,95%CI=0.02-0.72),and the effect of sodium bicarbonate was better than the other oral care solutions;in the prevention of oral odor,the oral care solution had no significant difference (OR=0.86,95%CI=0.34-1.74),and sodium bicarbonate of the total ranked the best preventive effect;in the prevention of oral infection,the oral care solution had no significant difference (OR=0.62,95%CI=0.09-1.60).Conclusions Based on the meta analysis results,with 0.9% saline for common interventions,sodium bicarbonate oral nursing liquid is superior to other oral nursing liquid in the prevention of ventilator-associated pneumonia,oral smell and infection.%目的 评价不同口腔护理液的临床应用效果.方法 计算机系统检索中国知网、生物医学文献数据库、万方等中文数据库收集文献资料,通过Note Express进行筛选及去重,利用ADDIS软件对符合纳入标准的随机对照试验研究文献进行系统评价.结果 共纳入19篇独立的随机对照试验研究文献;网状Meta分析结果显示:在预防呼吸机相关性肺炎方面,氧化电位水、复方氯己定、过氧化氢、碳酸氢钠、蒸馏水和0.9%氯化钠之间差异有统计学意义[95%CI=0.25 (0.02 ~ 0.72)],且碳酸氢钠的效果优于其他口腔护理液;

  16. Operating systems and network protocols for wireless sensor networks. (United States)

    Dutta, Prabal; Dunkels, Adam


    Sensor network protocols exist to satisfy the communication needs of diverse applications, including data collection, event detection, target tracking and control. Network protocols to enable these services are constrained by the extreme resource scarcity of sensor nodes-including energy, computing, communications and storage-which must be carefully managed and multiplexed by the operating system. These challenges have led to new protocols and operating systems that are efficient in their energy consumption, careful in their computational needs and miserly in their memory footprints, all while discovering neighbours, forming networks, delivering data and correcting failures.

  17. CARES Foundation (United States)

    ... today and CARES will receive 5% of your purchase! THEIR HISTORY: In 2001, Lauren’s Hope introduced the ... Go to the staff directory Find Us on Facebook Recent Tweets In case you missed it! http:// ...

  18. Dysarthria - care (United States)

    Speech and language disorder - dysarthria care; Slurred speech - dysarthria; Articulation disorder - dysarthria ... Dysarthria is a condition that occurs when there are problems with the muscles that help you talk. ...

  19. Residential Care (United States)

    ... Last name: Email: * Zip: * *required We will not sell or share your name. Residential Care Tweet Bookmark ... for the future. Use Alzheimer's Navigator ™ - our free online tool - to guide you as you map out ...

  20. Caring Encounters (United States)

    Gunn, Alyson


    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.


    Directory of Open Access Journals (Sweden)

    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.

  2. CareCoor: Augmenting the coordination of cooperative home care work

    DEFF Research Database (Denmark)

    Bossen, Claus; Christensen, Lars Rune; Gronvall, 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...... of CareCoor. Methods We employed ethnographic fieldwork methods and conducted participatory design workshops to throw light on the nature of cooperative home care work, and to elicit implications for the design of an IT system that would support the work of relatives and home care workers around elderly...... during test and evaluation. Conclusion Home care work is increasingly important due to the ageing populations of Europe, the USA and large parts of Asia. Home care work between relatives and home care workers is inherently a cooperative effort, and can be facilitated and augmented by new information...

  3. Integrating Palliative Care into Primary Care. (United States)

    Gorman, Rosemary D


    Improved quality of life, care consistent with patient goals of care, and decreased health care spending are benefits of palliative care. Palliative care is appropriate for anyone with a serious illness. Advances in technology and pharmaceuticals have resulted in increasing numbers of seriously ill individuals, many with a high symptom burden. The numbers of individuals who could benefit from palliative care far outweighs the number of palliative care specialists. To integrate palliative care into primary care it is essential that resources are available to improve generalist palliative care skills, identify appropriate patients and refer complex patients to specialist palliative care providers.

  4. Collaborative Decision Support Systems for Primary Health care Managers

    Directory of Open Access Journals (Sweden)

    Gunjan Pahuja


    Full Text Available In this paper, a collaborative DSS Model for health care systems and results obtained are described. The proposed framework [1] 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.

  5. Users' satisfaction with Porto Alegre's Primary Care Network Satisfação dos usuários da rede de Atenção Primária de Porto Alegre

    Directory of Open Access Journals (Sweden)

    Erno Harzheim


    Full Text Available

    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

  6. Effect of continuing care based on network platform on patients with multiple myeloma%基于网络平台的延续护理在多发性骨髓瘤患者中的应用效果

    Institute of Scientific and Technical Information of China (English)



    Objective To explore the effect of network platform continuing care on patients with multiple myeloma.Methods A total of 80 patients with multiple myeloma in our hospital between January 2013 and January 2015 were included and randomly divided into observation group ( n=40) and control group ( n=40) . All the patients received bortezomib. The routine nursing of follow-up at home once a week was performed in control group, additionally, the network platform continuing care was adopted in observation group. The effect of health education, the score of self-rating anxiety scale (SAS) and self-rating depression scale (SDS), incidence of adverse events and recurrence rate, and patients′ satisfaction were evaluated. Results The effect of health education in observation group was better than that in control group. The scores of SAS and SDS in observation group were lower than those in control group. The differences between two groups were statistically significant ( P<0.01) . The incidence of adverse events and recurrence rate in observation group were 2. 50% and 0.00%, respectively, which were lower than those in control group. The differences between two groups were statistically significant ( P<0.05) . The patients′satisfaction in observation group and control group was 97.50% and 72.50%, respectively. The difference between two groups was statistically significant (P<0.05).Conclusions The network platform continuing care can improve the effect of health education, reduce the incidence of adverse events and recurrence rate, increase patients′satisfaction.%目的探讨网络平台延续护理在多发性骨髓瘤患者中的应用效果。方法选取2013年1月—2015年1月于天津医科大学总医院接受治疗的80例多发性骨髓瘤患者为研究对象,按照随机数字表将患者分为观察组和对照组各40例。两组患者均采用硼替佐米进行治疗,对照组采用常规每周到患者家中随访1次;观察组在对照组基础上

  7. Declarative Networking

    CERN Document Server

    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

  8. [Promoting citizenship through nursing care]. (United States)

    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.

  9. Wound Care. (United States)

    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.

  10. Multi databases in Health Care Networks

    CERN Document Server

    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.

  11. Redesigning ambulatory care business processes supporting clinical care delivery. (United States)

    Patterson, C; Sinkewich, M; Short, J; Callas, E


    The first step in redesigning the health care delivery process for ambulatory care begins with the patient and the business processes that support the patient. Patient-related business processes include patient access, service documentation, billing, follow-up, collection, and payment. Access is the portal to the clinical delivery and care management process. Service documentation, charge capture, and payment and collection are supporting processes to care delivery. Realigned provider networks now demand realigned patient business services to provide their members/customers/patients with improved service delivery at less cost. Purchaser mandates for cost containment, health maintenance, and enhanced quality of care have created an environment where every aspect of the delivery system, especially ambulatory care, is being judged. Business processes supporting the outpatient are therefore being reexamined for better efficiency and customer satisfaction. Many health care systems have made major investments in their ambulatory care environment, but have pursued traditional supporting business practices--such as multiple access points, lack of integrated patient appointment scheduling and registration, and multiple patient bills. These are areas that are appropriate for redesign efforts--all with the customer's needs and convenience in mind. Similarly, setting unrealistic expectations, underestimating the effort required, and ignoring the human elements of a patient-focused business service redesign effort can sabotage the very sound reasons for executing such an endeavor. Pitfalls can be avoided if a structured methodology, coupled with a change management process, are employed. Deloitte & Touche Consulting Group has been involved in several major efforts, all with ambulatory care settings to assist with the redesign of their business practices to consider the patient as the driver, instead of the institution providing the care.

  12. Clustering Coefficients in Multiplex Networks

    CERN Document Server

    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.

  13. Regionalization of neonatal intensive care in Korea

    Directory of Open Access Journals (Sweden)

    Yun Sil Chang


    Full Text Available In the current era of low-birth rate in Korea, it is important to improve our neonatal intensive care and to establish an integrative system including a regional care network adequate for both high-risk pregnancies and highrisk newborn infants. Therefore, official discussion for nation-wide augmentation, proper leveling, networking, and regionalization of neonatal and perinatal care is urgently needed. In this report, I describe the status of neonatal intensive care in Korea, as well as nationwide flow of transfer of high-risk newborn infants and pregnant women, and present a short review of the regionalization of neonatal and perinatal care in the Unites States and Japan. It is necessary not only to increase the number of neonatal intensive care unit (NICU beds, medical resources and manpower, but also to create a strong network system with appropriate leveling of NICUs and regionalization. A systematic approach toward perinatal care, that includes both high-risk pregnancies and newborns with continuous support from the government, is also needed, which can be spearheaded through the establishment of an integrative advisory board to propel systematic care forward.

  14. Hospice Care (United States)

    ... Hospice is a combination of services designed to address not only the physical needs of patients, but also the psychosocial needs of patients, their loved ones. Hospice combines pain control, symptom ... plan to address each patient’s individual needs. The hospice care team ...

  15. Respite Care (United States)

    ... provided in a home, an adult day-care program or over a weekend in a nursing home or an assisted living facility. For more information on the NFCSP visit the Administration on Aging website at ...

  16. Prenatal Care. (United States)

    Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Office for Maternal and Child Health Services.

    This booklet is the first in a series of publications designed to provide parents with useful information about childrearing. Contents are organized into three parts. Part I focuses on the pregnancy, prenatal care, development of the baby, pregnant lifestyles, nutrition, common discomforts, and problems of pregnancy. Part II provides information…

  17. Developing network-based services in the NHS. (United States)

    Conner, M


    Networks, based upon informal relationships, have ensured that care was delivered to patients for many years. This informal organisation of care, based upon personal relationships, ensures that where the bureaucratic organisation fails the patient, health professionals' work together to network the resources the patient needs. Networks are not new. Formalising networks and recognising their potential to deliver seamless care is new. The NHS must ensure that networks are developed, allowing them freedom from bureaucracy to reach their potential. The Northern and Yorkshire Learning Alliance (NYLA) was established as part of the Northern and Yorkshire health community's efforts to radically improve care. The NYLA operates as a network with a small team of change experts working to develop change management and service improvement capacity across 10,000 square miles. As a network based organisation the team has learned many lessons, which may inform the development of clinical networks in England.

  18. Formative evaluation of practice changes for managing depression within a Shared Care model in primary care. (United States)

    Beaulac, Julie; Edwards, Jeanette; Steele, Angus


    Aim To investigate the implementation and initial impact of the Physician Integrated Network (PIN) mental health indicators, which are specific to screening and managing follow-up for depression, in three primary care practices with Shared Mental Health Care in Manitoba.

  19. Network Science (United States)

    Barabási, Albert-László


    Preface; Personal introduction; 1. Introduction; 2. Graph theory; 3. Random networks; 4. The scale-free property; 5. The Barabási-Albert model; 6. Evolving networks; 7. Degree correlation; 8. Network robustness; 9. Communities; 10. Spreading phenomena; Index.

  20. FastStats: Hospice Care (United States)

    ... Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography Pap Tests Disability ... Care National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare and Medicaid ...

  1. 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

    Directory of Open Access Journals (Sweden)

    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.

  2. Identifying PHM market and network opportunities. (United States)

    Grube, Mark E; Krishnaswamy, Anand; Poziemski, John; York, Robert W


    Two key processes for healthcare organizations seeking to assume a financially sustainable role in population health management (PHM), after laying the groundwork for the effort, are to identify potential PHM market opportunities and determine the scope of the PHM network. Key variables organizations should consider with respect to market opportunities include the patient population, the overall insurance/employer market, and available types of insurance products. Regarding the network's scope, organizations should consider both traditional strategic criteria for a viable network and at least five additional criteria: network essentiality and PHM care continuum, network adequacy, service distribution right-sizing, network growth strategy, and organizational agility.

  3. Health care social media: engagement and health care in the digital era. (United States)

    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.

  4. Managing care in an integrated delivery system via an Intranet. (United States)

    Halamka, J D; Hughes, M; Mack, J; Hurwitz, M; Davis, F; Wood, D; Borten, K; Saal, A K


    The CareGroup Provider Service Network is a managed care contracting organization which provides central administrative services for over 1800 physicians and 200,000 managed care lives. Services include utilization management, disease management and credentialing for the entire network. The management model of the Provider Service Network empowers local physician groups with information and education. To meet the managed care information needs of the network, we implemented an intranet-based executive information system, PSNWeb, which retrieves data from a managed care data warehouse. The project required the integration of diverse technologies and development of a complex security/confidentiality infrastructure to deliver information to 8 major clinician groups, each with different information needs.

  5. Defense Health Care: Availability and Quality Measurement of Women’s Health Care Services in U.S. Military Hospitals (United States)


    identify a military treatment facility and if one is not available then they refer to a facility contracted with the MHS network . 22Military service ...DEFENSE HEALTH CARE Availability and Quality Measurement of Women’s Health Care Services in U.S. Military Hospitals...committees June 2016 DEFENSE HEALTH CARE Availability and Quality Measurement of Women’s Health Care Services in U.S. Military Hospitals What GAO Found

  6. Green networking

    CERN Document Server

    Krief, Francine


    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

  7. Advances in network complexity

    CERN Document Server

    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.

  8. Community Care and the Care Transition in the Netherlands

    Directory of Open Access Journals (Sweden)

    Ymke Kelders


    for our research group in particular. The AUAS Community Care Research Group covers a variety of research topics that are clustered into three “streams”: informal care, social inclusion and network strengthening. Within these streams, we focus on care by society and link this to professional caregiving. We will also explain why our research interests are specifically relevant in the context of the transition of the healthcare system, as this transition explicitly accentuates the importance of a “caring society” and thus a change in role for the care professional. We will also reflect on how we can best translate our research results into the curriculum of education programmes for students who will soon work as professionals in the social and/or care domains.

  9. Telecommunication networks

    CERN Document Server

    Iannone, Eugenio


    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

  10. Careful science?

    DEFF Research Database (Denmark)

    Jespersen, Astrid P; Bønnelycke, Julie; Eriksen, Hanne Hellerup


    Concern about obesity has prompted numerous public health campaigns that urge people to be more physically active. The campaigns often include normative statements and attempt to impose restrictions on individuals' lives without considering the complexities of daily life. We suggest that broadening...... 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...

  11. Medical Care during Pregnancy (United States)

    ... 1- to 2-Year-Old Medical Care During Pregnancy KidsHealth > For Parents > Medical Care During Pregnancy A ... both moms and their babies. Prenatal Care Before Pregnancy Prenatal care should start before you get pregnant. ...

  12. Home Care Services (United States)

    Home care is care that allows a person with special needs stay in their home. It might be for people who are getting ... chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help with ...

  13. What is palliative care? (United States)

    Comfort care; End of life - palliative care; Hospice - palliative care ... The goal of palliative care is to help people with serious illnesses feel better. It prevents or treats symptoms and side effects of disease and ...

  14. [Inflammatory Bowel Disease Competence Network]. (United States)

    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.

  15. Structuring successful collaboration: a longitudinal social network analysis of a translational research network


    Long, Janet C; Hibbert, Peter; Braithwaite, Jeffrey


    Background In 2012 and 2013, we conducted a social network survey of a new translational research network (TRN) designed to deliver better care to cancer patients. Results of these two surveys showed that silos of researchers and clinicians existed before the TRN was established but that the network had mediated collaborative relationships. This paper reports on a third social network survey of the TRN and focusses on the structure of the collaborative arrangements among members. Methods Memb...

  16. "Couch Surfing" of Latino Foster Care Alumni: Reliance on Peers as Social Capital (United States)

    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…

  17. Neural networks of human nature and nurture

    Directory of Open Access Journals (Sweden)

    Daniel S. Levine


    Full Text Available Neural network methods have facilitated the unifi - cation of several unfortunate splits in psychology, including nature versus nurture. We review the contributions of this methodology and then discuss tentative network theories of caring behavior, of uncaring behavior, and of how the frontal lobes are involved in the choices between them. The implications of our theory are optimistic about the prospects of society to encourage the human potential for caring.

  18. The shape of digital engagement: health care and social media. (United States)

    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.

  19. Interconnected networks

    CERN Document Server


    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.

  20. Palliative wound care: principles of care. (United States)

    Dale, Barbara; Emmons, Kevin R


    Home care nursing occurs in a complex care environment. Nurses working in this setting care for a wide array of individuals who often are sicker and more complex than ever before. The high prevalence of wounds among these individuals requires that home care nurses have a certain level of knowledge to provide excellent care. Many times, individuals with wounds do not have the capacity to heal or are burdened with numerous symptoms affecting quality of life. In these cases, the home care nurse must understand concepts of palliative wound care to alleviate symptoms with the goal of improving quality of life.

  1. Network maintenance

    CERN Multimedia

    GS Department


    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 IT/CS Group

  2. Network maintenance

    CERN Multimedia

    IT Department


    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 IT/CS Group

  3. 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.

    Directory of Open Access Journals (Sweden)

    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


    Yuen, J. H.


    This program was developed as part of a research study on the topology design and performance analysis for the Space Station Information System (SSIS) network. It uses an efficient algorithm to generate candidate network designs (consisting of subsets of the set of all network components) in increasing order of their total costs, and checks each design to see if it forms an acceptable network. This technique gives the true cost-optimal network, and is particularly useful when the network has many constraints and not too many components. It is intended that this new design technique consider all important performance measures explicitly and take into account the constraints due to various technical feasibilities. In the current program, technical constraints are taken care of by the user properly forming the starting set of candidate components (e.g. nonfeasible links are not included). As subsets are generated, they are tested to see if they form an acceptable network by checking that all requirements are satisfied. Thus the first acceptable subset encountered gives the cost-optimal topology satisfying all given constraints. The user must sort the set of "feasible" link elements in increasing order of their costs. The program prompts the user for the following information for each link: 1) cost, 2) connectivity (number of stations connected by the link), and 3) the stations connected by that link. Unless instructed to stop, the program generates all possible acceptable networks in increasing order of their total costs. The program is written only to generate topologies that are simply connected. Tests on reliability, delay, and other performance measures are discussed in the documentation, but have not been incorporated into the program. This program is written in PASCAL for interactive execution and has been implemented on an IBM PC series computer operating under PC DOS. The disk contains source code only. This program was developed in 1985.

  5. Network Ambivalence

    Directory of Open Access Journals (Sweden)

    Patrick Jagoda


    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. 

  6. Network Coded Software Defined Networking

    DEFF Research Database (Denmark)

    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...... buffering, scheduling, and processing over the network. On the other hand, NC has shown great potential for increasing robustness and performance when deployed on intermediate nodes in the network. This new paradigm changes the dynamics of network protocols, requiring new designs that exploit its potential....... This paper advocates for the use of SDN to bring about future Internet and 5G network services by incorporating network coding (NC) functionalities. The inherent flexibility of both SDN and NC provides a fertile ground to envision more efficient, robust, and secure networking designs, that may also...

  7. Provider Services Network Project. Draft Final Report. (United States)

    Urban and Rural Systems Associates, San Francisco, CA.

    This draft report on the development and testing of a child care Provider Services Network (PSN) model in Santa Clara County, California, includes a handbook (Manual to Optimize a PSN) designed to provide the State Department of Education and regional or local child care coordinating agencies with information needed to develop PSN optimization…

  8. The network researchers' network

    DEFF Research Database (Denmark)

    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...... components in some detail. The egonets of three of the original 'founding fathers' are examined in detail, and we draw comparisons as to how their publishing strategies vary. Finally, the paper draws some more general conclusions as to the insights that SNA can bring to those working within business-to-business...... marketing....

  9. Network workshop

    DEFF Research Database (Denmark)

    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....... These include student relations and interactions and epistemic and linguistic networks of words, concepts and actions. Network methodology has already found use in science education research. However, while networks hold the potential for new insights, they have not yet found wide use in the science education...... research community. With this workshop, participants were offered a way into network science based on authentic educational research data. The workshop was constructed as an inquiry lesson with emphasis on user autonomy. Learning activities had participants choose to work with one of two cases of networks...

  10. Network workshop

    DEFF Research Database (Denmark)

    Bruun, Jesper; Evans, Robert Harry


    research community. With this workshop, participants were offered a way into network science based on authentic educational research data. The workshop was constructed as an inquiry lesson with emphasis on user autonomy. Learning activities had participants choose to work with one of two cases of networks......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....... These include student relations and interactions and epistemic and linguistic networks of words, concepts and actions. Network methodology has already found use in science education research. However, while networks hold the potential for new insights, they have not yet found wide use in the science education...

  11. Changes in Adult Child Caregiver Networks (United States)

    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…

  12. Network science. (United States)

    Barabási, Albert-László


    Professor Barabási's talk described how the tools of network science can help understand the Web's structure, development and weaknesses. The Web is an information network, in which the nodes are documents (at the time of writing over one trillion of them), connected by links. Other well-known network structures include the Internet, a physical network where the nodes are routers and the links are physical connections, and organizations, where the nodes are people and the links represent communications.

  13. Perioperative Care of Prisoners: Providing Safe Care. (United States)

    Smith, Francis Duval


    Correctional nurses are trained to care for prisoners in a controlled security environment; however, when a convict is transferred to a noncorrectional health care facility, the nurses there are often unfamiliar with custody requirements or how to safely care for these patients. The care of prisoners outside of prison has not been adequately investigated, and a gap exists between research and nursing education and practice. Nurses rarely have to consider how providing care for a prisoner in custody affects their practice, the potential dissonance between routine nursing care and the requirements to maintain security, or that care of prisoners in unsecured clinical areas places the nurse and other personnel at risk for physical assault or prisoner escape. Educating perioperative nurses in the care of prisoners in a public hospital environment is important for the provision of safe care and prevention of physical and emotional repercussions to personnel.

  14. Body sensor networks for ubiquitous healthcare

    Institute of Scientific and Technical Information of China (English)


    Body sensor networks provide a platform for ubiquitous healthcare, driving the diagnosis in hospital static environment to the daily life dynamic context. We realized the importance of sensing of activities, which is not only a dimension of human health but also important context information for diagnosis based on the physiologic data. This paper presents our ubiquitous healthcare system, uCare. It consists of uCare devices and a server system. Currently, the uCare system is designed for cardiovascular dise...

  15. Networked Identities

    DEFF Research Database (Denmark)

    Ryberg, Thomas; Larsen, Malene Charlotte


    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...

  16. The Health Improvement Network (THIN) (United States)

    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.

  17. Hopfield neural network based on ant system

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Older patients' experiences during care transition

    Directory of Open Access Journals (Sweden)

    Rustad EC


    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

  19. Acne - self-care (United States)

    Acne vulgaris - self-care; Cystic acne - self-care; Pimples - self-care; Zits - self-care ... If daily skin care does not clear up blemishes, try over-the-counter acne medicines that you apply to your skin. These products ...

  20. Understanding palliative care. (United States)

    Martin, Caren McHenry


    While most pharmacists and other health care practitioners are familiar with the programs and philosophy of hospice, they may lack a clear understanding of palliative care. Because myths and misconceptions about palliative care abound, a review of the definitions and components of palliative care can enhance the practice of all practitioners who care for patients with chronic diseases.

  1. Building a global health education network for clinical care and research. The benefits and challenges of distance learning tools. Lessons learned from the Hopkins Center for Clinical Global Health Education. (United States)

    Bollinger, Robert C; McKenzie-White, Jane; Gupta, Amita


    Expanding the capacity for clinical care and health research is a global priority and a global challenge. The Johns Hopkins Center for Clinical Global Health Education (CCGHE) was established in 2005 to provide access to high-quality training to health care providers in resource-limited settings. The CCGHE made a strategic decision to develop, use, and evaluate distance learning platforms to achieve its mission. In the initial years of this new program, several lessons have been learned that may be helpful to other programs considering the use of distance learning programs to expand global health clinical and research capacity.

  2. Technical Network

    CERN Multimedia


    In order to optimise the management of the Technical Network (TN), to facilitate understanding of the purpose of devices connected to the TN and to improve security incident handling, the Technical Network Administrators and the CNIC WG have asked IT/CS to verify the "description" and "tag" fields of devices connected to the TN. Therefore, persons responsible for systems connected to the TN will receive e-mails from IT/CS asking them to add the corresponding information in the network database at "network-cern-ch". Thank you very much for your cooperation. The Technical Network Administrators & the CNIC WG

  3. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies


    Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  4. The future of intensive care medicine. (United States)

    Blanch, L; Annane, D; Antonelli, M; Chiche, J D; Cuñat, J; Girard, T D; Jiménez, E J; Quintel, M; Ugarte, S; Mancebo, J


    Intensive care medical training, whether as a primary specialty or as secondary add-on training, should include key competences to ensure a uniform standard of care, and the number of intensive care physicians needs to increase to keep pace with the growing and anticipated need. The organisation of intensive care in multiple specialty or central units is heterogeneous and evolving, but appropriate early treatment and access to a trained intensivist should be assured at all times, and intensivists should play a pivotal role in ensuring communication and high-quality care across hospital departments. Structures now exist to support clinical research in intensive care medicine, which should become part of routine patient management. However, more translational research is urgently needed to identify areas that show clinical promise and to apply research principles to the real-life clinical setting. Likewise, electronic networks can be used to share expertise and support research. Individuals, physicians and policy makers need to allow for individual choices and priorities in the management of critically ill patients while remaining within the limits of economic reality. Professional scientific societies play a pivotal role in supporting the establishment of a defined minimum level of intensive health care and in ensuring standardised levels of training and patient care by promoting interaction between physicians and policy makers. The perception of intensive care medicine among the general public could be improved by concerted efforts to increase awareness of the services provided and of the successes achieved.

  5. Network science

    CERN Document Server

    Barabasi, Albert-Laszlo


    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...

  6. A survey of TCP over ad hoc networks

    NARCIS (Netherlands)

    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

  7. Emergency care toolkits. (United States)

    Black, Steven


    Emergency care services are the focus of a series of toolkits developed by the NHS National electronic Library for Health to provide resources for emergency care leads and others involved in modernising emergency care, writes Steven Black.

  8. Your cancer care team (United States)

    ... gov/ency/patientinstructions/000929.htm Your cancer care team To use the sharing features on this page, ... help your body heal. Working with Your Care Team Each member of your care team plays an ...

  9. Office of Child Care (United States)

    ... for Children & Families Office of Child Care By Office Administration for Native Americans (ANA) Administration on Children, ... Care Partnerships. Review the profiles. > What is the Office of Child Care (OCC)? The Office of Child ...

  10. Developing the Care in Pharmaceutical Care. (United States)

    Fjortoft, Nancy F.; Zgarrick, David P.

    The purpose of this study was to assess the level of caring ability of a sample of pharmacy students and assess the relationship between selected predictor variables and pharmacy students' caring ability. Caring was viewed as the ability to assume responsibility for the protection and welfare of another without being perfunctory or begrudging.…

  11. 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

    Directory of Open Access Journals (Sweden)

    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

  12. Network Coded Software Defined Networking

    DEFF Research Database (Denmark)

    Hansen, Jonas; Roetter, Daniel Enrique Lucani; Krigslund, Jeppe


    Software defined networking has garnered large attention due to its potential to virtualize services in the Internet, introducing flexibility in the buffering, scheduling, processing, and routing of data in network routers. SDN breaks the deadlock that has kept Internet network protocols stagnant...... for decades, while applications and physical links have evolved. This article advocates for the use of SDN to bring about 5G network services by incorporating network coding (NC) functionalities. The latter constitutes a major leap forward compared to the state-of-the- art store and forward Internet paradigm....... The inherent flexibility of both SDN and NC provides fertile ground to envision more efficient, robust, and secure networking designs, which may also incorporate content caching and storage, all of which are key challenges of the upcoming 5G networks. This article not only proposes the fundamentals...

  13. Entry Into a Care Trajectory

    Directory of Open Access Journals (Sweden)

    Normand Carpentier


    Full Text Available A broad range of services are developing in response to the needs of an aging population. Although most interventions are carried out in the patient’s living environment—at the heart of society—few studies on service utilization refer to social theory. This paper suggests that studies on older people with chronic health conditions would benefit from a stronger theoretical foundation. Drawing on 15 in-depth interviews, it highlights the relevance of individualization processes and the network society, 2 central theoretical concerns in sociology. The research provides a unique perspective on the entry into the care trajectory and expands our comprehension of the emergence of a social organization that can respond to the needs of elderly patients. Data of this nature may be useful in service planning and the development of a care-centered approach.

  14. Millennial transformation for primary care. (United States)

    Cowan, Michael


    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.

  15. Multilayer Networks

    CERN Document Server

    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...

  16. Cosmological networks

    CERN Document Server

    Boguna, Marian; Krioukov, Dmitri


    Networks often represent systems that do not have a long history of studies 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 FLRW 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. New links in these networks not only connect new nodes to existing ones, but also appear at a certain rate between existing nodes, as they do in many complex networks.

  17. Managed consumerism in health care. (United States)

    Robinson, James C


    The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.

  18. 5th International Workshop on Complex Networks and their Applications

    CERN Document Server

    Gaito, Sabrina; Quattrociocchi, Walter; Sala, Alessandra


    This book highlights cutting-edge research in the field of network science, offering scientists, researchers and graduate students a unique opportunity to catch up on the latest advances in theory and a multitude of applications. It presents the peer-reviewed proceedings of the fifth International Workshop on Complex Networks & their Applications (COMPLEX NETWORKS 2016), which took place in Milan during the last week of November 2016. The carefully selected papers are divided into 11 sections reflecting the diversity and richness of research areas in the field. More specifically, the following topics are covered: Network models; Network measures; Community structure; Network dynamics; Diffusion, epidemics and spreading processes; Resilience and control; Network visualization; Social and political networks; Networks in finance and economics; Biological and ecological networks; and Network analysis.

  19. Putting the 'care' back into aged care. (United States)

    Beadnell, Cathy


    Aged care is well and truly back on the political agenda in Australia. While the mainstream media has recently exposed a number of horrific cases of alleged abuse in aged care facilities it has done little to highlight the failings of social policy over time or to foster debate on how to improve the care of older Australians. What are the barriers to providing safe and quality aged care to a growing number of our citizens and how do we overcome them? If you relied on the recent media coverage for your impression of aged care you could be forgiven for thinking it is all bad news. But there are facilities providing high quality care and stories of nurses working wonders in the face of adversity. Cathy Beadnell considers some of the broader cultural and workforce issues in aged care.

  20. Network Kriging


    Chua, David B.; Kolaczyk, Eric D.; Crovella, Mark


    Network service providers and customers are often concerned with aggregate performance measures that span multiple network paths. Unfortunately, forming such network-wide measures can be difficult, due to the issues of scale involved. In particular, the number of paths grows too rapidly with the number of endpoints to make exhaustive measurement practical. As a result, it is of interest to explore the feasibility of methods that dramatically reduce the number of paths measured in such situati...

  1. Network medicine

    DEFF Research Database (Denmark)

    Pawson, Tony; Linding, Rune


    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....

  2. Network security

    CERN Document Server

    Perez, André


    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

  3. Organizational Networks

    DEFF Research Database (Denmark)

    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 ...... the organizational forms discussed in the paper. It is asserted that the underlying organizational phenomena are not changing but that the manifestations and representations are shifting due to technological developments.......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...

  4. Technical Network

    CERN Multimedia


    In order to optimize the management of the Technical Network (TN), to ease the understanding and purpose of devices connected to the TN, and to improve security incident handling, the Technical Network Administrators and the CNIC WG have asked IT/CS to verify the "description" and "tag" fields of devices connected to the TN. Therefore, persons responsible for systems connected to the TN will receive email notifications from IT/CS asking them to add the corresponding information in the network database. Thank you very much for your cooperation. The Technical Network Administrators & the CNIC WG

  5. Evaluating the effectiveness of a clinical practice change intervention in increasing clinician provision of preventive care in a network of community-based mental health services: a study protocol of a non-randomized, multiple baseline trial



    Background People with a mental illness experience substantial disparities in health, including increased rates of morbidity and mortality caused by potentially preventable chronic diseases. One contributing factor to such disparity is a higher prevalence of modifiable health risk behaviors, such as smoking, inadequate fruit and vegetable intake, harmful alcohol consumption, and inadequate physical activity. Evidence supports the effectiveness of preventive care in reducing such risks, and gu...

  6. Spiritual Care Education of Health Care Professionals

    Directory of Open Access Journals (Sweden)

    Donia Baldacchino


    Full Text Available Nurses and health care professionals should have an active role in meeting the spiritual needs of patients in collaboration with the family and the chaplain. Literature criticizes the impaired holistic care because the spiritual dimension is often overlooked by health care professionals. This could be due to feelings of incompetence due to lack of education on spiritual care; lack of inter-professional education (IPE; work overload; lack of time; different cultures; lack of attention to personal spirituality; ethical issues and unwillingness to deliver spiritual care. Literature defines spiritual care as recognizing, respecting, and meeting patients’ spiritual needs; facilitating participation in religious rituals; communicating through listening and talking with clients; being with the patient by caring, supporting, and showing empathy; promoting a sense of well-being by helping them to find meaning and purpose in their illness and overall life; and referring them to other professionals, including the chaplain/pastor. This paper outlines the systematic mode of intra-professional theoretical education on spiritual care and its integration into their clinical practice; supported by role modeling. Examples will be given from the author’s creative and innovative ways of teaching spiritual care to undergraduate and post-graduate students. The essence of spiritual care is being in doing whereby personal spirituality and therapeutic use of self contribute towards effective holistic care. While taking into consideration the factors that may inhibit and enhance the delivery of spiritual care, recommendations are proposed to the education, clinical, and management sectors for further research and personal spirituality to ameliorate patient holistic care.

  7. Pediatric intensive care. (United States)

    Macintire, D K


    To provide optimal care, a veterinarian in a pediatric intensive care situation for a puppy or kitten should be familiar with normal and abnormal vital signs, nursing care and monitoring considerations, and probable diseases. This article is a brief discussion of the pediatric intensive care commonly required to treat puppies or kittens in emergency situations and for canine parvovirus type 2 enteritis.

  8. Overlay networks toward information networking

    CERN Document Server

    Tarkoma, Sasu


    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

  9. Palliative care situation in Palestinian Authority. (United States)

    Shawawra, Mousa; Khleif, Amal Dweib


    available for cancer patients or their families, absence of organizations strategic planning for palliative care, No presence of educational resources for palliative care, No presence of communication or consultation to the clergy man, Absence of bereavement support group, no active follow up for the patient and the family, no standards for palliative care service or training programs in palliative care, no home care service for palliative care, absence of community awareness for palliative care And Absence of national standard for palliative care. The recommendations that we can conclude, depending on the needs assessment that we did, and according to the recommendations that come up through the workshop that was organized by Al-Sadeel Society and was attended by key personnel from the Palestinian MOH who summarized the conclusion, are as follows: 1. The need for better quality care for the cancer patient.2. The need for training of health professionals in palliative care.3. The importance of networking and cooperation between the national NGO's and the MOH.4. The need for public awareness regarding the early detection for cancer especially breast cancer.5. The need for national policy and standards for palliative care and opioids legislations.6. The importance of base line data and research. 7. The need for interdisciplinary team work in the issue of cancer. 8. To involve palliative care education within the curriculum of schools of health professions.

  10. About Skin-to-Skin Care (Kangaroo Care) (United States)

    ... Size Email Print Share About Skin-to-Skin Care Page Content Article Body You may be able ... care, also called kangaroo care. What is Kangaroo Care? Kangaroo care was developed in South America as ...

  11. Genetic Algorithm for Hierarchical Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Sajid Hussain


    Full Text Available Large scale wireless sensor networks (WSNs can be used for various pervasive and ubiquitous applications such as security, health-care, industry automation, agriculture, environment and habitat monitoring. As hierarchical clusters can reduce the energy consumption requirements for WSNs, we investigate intelligent techniques for cluster formation and management. A genetic algorithm (GA is used to create energy efficient clusters for data dissemination in wireless sensor networks. The simulation results show that the proposed intelligent hierarchical clustering technique can extend the network lifetime for different network deployment environments.

  12. Fuzzy neural network theory and application

    CERN Document Server

    Liu, Puyin


    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

  13. Network Flows (United States)


    Researchers have suggested other solution strategies, using ideas from nonlinear progamming for solving this general separable convex cost flow problems. Some...plane methods and branch and bound procedures of integer programming, primal-dual methods of linear and nonlinear programming, and polyhedral methods...Combinatorial Optimization: Networks and Matroids), Bazaraa and Jarvis [1978] (Linear Programming and Network Flows), Minieka [1978] (Optimization Algorithms for

  14. Bibliometric Networks

    CERN Document Server

    Havemann, Frank


    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.

  15. Networking Japan

    DEFF Research Database (Denmark)

    Hansen, Annette Skovsted

    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 Friends...

  16. Using Digital Crumbs from an Electronic Health Record to Identify, Study and Improve Health Care Teams (United States)

    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

  17. Managed care and the infectious diseases specialist. (United States)

    Tice, A D; Slama, T G; Berman, S; Braun, P; Burke, J P; Cherney, A; Gross, P A; Harris, P; Reid-Hatton, M; Hoffman, R; Joseph, P; Lawton, S; Massanari, R M; Miller, Z I; Osheroff, W J; Poretz, D; Shalowitz, M; Simmons, B; Turner, J P; Wade, B; Nolet, B R


    There is growing demand to contain health care costs and to reassess the value of medical services. The traditional hospital, academic, and research roles of the infectious disease (ID) specialist are threatened, yet there is an increasing need for expertise because of growing antimicrobial resistance and emerging pathogens. Opportunities exist to develop and expand services for the care of patients infected with human immunodeficiency virus and in infection control, epidemiology, outcomes research, outpatient intravenous therapy, and resource management. It is important for ID physicians to appreciate the principles involved in managed care and the areas in which ID services can be valuable. To be effective, physicians need to know about tools such as practice guidelines, physician profiling, outcomes monitoring, computerized information management, risk sharing, networking, and marketing, as well as related legal issues. With a positive attitude toward learning, application, and leadership, ID physicians can redefine their role and expand their services through managed care.

  18. Value added telecommunication services for health care. (United States)

    Danelli-Mylonas, Vassiliki


    The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.

  19. A Developed Network Layer Handover Based Wireless Networks

    Directory of Open Access Journals (Sweden)

    Ali Safa Sadiq


    Full Text Available This paper proposes an Advanced Mobility Handover (AMH scheme based on Wireless Local Area Networks (WLANs by developing a network layer handover procedure which triggers messages to be sent to the next access point. The proposed AMH scheme performs the network handover process, which is represented by binding update procedure in advance during the time mobile node is still connected to the current AP in the link layer. Furthermore, a unique home IPv6 address is developed to maintain an IP communication with other corresponding nodes without a care-of-address during mobile node$'$s roaming process. This can contribute significantly to reducing network layer handover delays and signaling costs by eliminate the process of obtaining a new care-of-address and processing the handover of network layer in advance while the mobile node is still communicating with the current access point. Eventually, the conducted OMNET++ simulated scenario shows that the proposed AMH scheme performs the best in terms of reducing the handover delay as compared to the state of the art.

  20. Telecommunication Networks

    DEFF Research Database (Denmark)

    Olsen, Rasmus Løvenstein; Balachandran, Kartheepan; Hald, Sara Ligaard


    illustrates how protocols can be reconfigured to fulfil reliability requirements, as an important part of providing reliable data access to the critical applications running over the network. Thereafter, we take a look at the security of the network, by looking at a framework that describes the digital......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...

  1. Network Affordances

    DEFF Research Database (Denmark)

    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...

  2. The Affordable Care Act and integrated care. (United States)

    Kuramoto, Ford


    The Patient Protection and Affordable Care Act (ACA) of 2010 offers a comprehensive, integrated health insurance reform program for those who are eligible to enroll. A core feature of the ACA is the integration of primary health, behavioral health, and related services in a new national program for the first time. This article traces the history of past federal services integration efforts and identify varying approaches for implementing them to improve care, especially for underserved populations. The business case for integrated care, reducing escalating health care costs and overcoming barriers to implementation, is also discussed.

  3. Kidney stones - self-care (United States)

    ... self-care; Nephrolithiasis and self-care; Stones and kidney - self-care; Calcium stones and self-care; Oxalate ... provider or the hospital because you have a kidney stone. You will need to take self-care ...

  4. Genital herpes - self-care (United States)

    Herpes - genital -self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care ... genital herpes can be treated. Follow your health care provider's instructions for treatment and follow-up.

  5. Defense Health Care: DOD Is Meeting Most Mental Health Care Access Standards, but It Needs a Standard for Follow-up Appointments (United States)


    adequacy of contractors’ provider networks and customer - satisfaction outcomes. Overseas, TRICARE is divided into three areas: Eurasia- Africa, Latin...reservists. Page 19 GAO-16-416 Defense Health Care supplementing that MTF’s delivery of care with telehealth services instead of using...inpatient mental health bed days through purchased care. To deliver mental health care, the military services use a range of strategies including

  6. Dementia Care Knowledge Sharing within a First Nations Community. (United States)

    Forbes, Dorothy; Blake, Catherine; Thiessen, Emily; Finkelstein, Sara; Gibson, Maggie; Morgan, Debra G; Markle-Reid, Maureen; Culum, Ivan


    This article discusses the First Nations sample of a larger study on dementia care decisions and knowledge sharing.The purpose is to enhance understanding of the process of knowledge sharing among health care practitioners(HCPs), care partners, and persons with dementia (PWDs) within a rural First Nations community. A constructivist grounded theory methodology was used. Nineteen interviews were conducted at three points in time with two dementia care networks that included two PWDs, three care partners, and two HCPs. A sharing dementia care knowledge model was conceived, with the PWDs and their care partners at the centre. Knowledge sharing in the model was represented by three broad themes: (1) developing trusting relationships, (2) accessing and adapting the information, and (3) applying the information. Culturally sensitive approaches were essential to developing trusting relationships. Once developed, knowledge sharing through accessing, adapting, and applying the information was possible.

  7. Influence of choice of null network on small-world parameters of structural correlation networks. (United States)

    Hosseini, S M Hadi; Kesler, Shelli R


    In recent years, coordinated variations in brain morphology (e.g., volume, thickness) have been employed as a measure of structural association between brain regions to infer large-scale structural correlation networks. Recent evidence suggests that brain networks constructed in this manner are inherently more clustered than random networks of the same size and degree. Thus, null networks constructed by randomizing topology are not a good choice for benchmarking small-world parameters of these networks. In the present report, we investigated the influence of choice of null networks on small-world parameters of gray matter correlation networks in healthy individuals and survivors of acute lymphoblastic leukemia. Three types of null networks were studied: 1) networks constructed by topology randomization (TOP), 2) networks matched to the distributional properties of the observed covariance matrix (HQS), and 3) networks generated from correlation of randomized input data (COR). The results revealed that the choice of null network not only influences the estimated small-world parameters, it also influences the results of between-group differences in small-world parameters. In addition, at higher network densities, the choice of null network influences the direction of group differences in network measures. Our data suggest that the choice of null network is quite crucial for interpretation of group differences in small-world parameters of structural correlation networks. We argue that none of the available null models is perfect for estimation of small-world parameters for correlation networks and the relative strengths and weaknesses of the selected model should be carefully considered with respect to obtained network measures.

  8. Teamwork in health care. (United States)

    Landman, Natalie; Aannestad, Liv K; Smoldt, Robert K; Cortese, Denis A


    It is becoming increasingly clear that maintaining and improving the health of the population, and doing so in a financially sustainable manner, requires the coordination of acute medical care with long-term care, and social support services, that is, team-based care. Despite a growing body of evidence on the benefits of team-based care, the health care ecosystem remains "resistant" to a broader implementation of such care models. This resistance is a function of both system-wide and organizational barriers, which result primarily from fragmentation in reimbursement for health care services, regulatory restrictions, and the siloed nature of health professional education. To promote the broader adoption of team-based care models, the health care system must transition to pay for value reimbursement, as well as break down the educational silos and move toward team-based and value-based education of health professionals.

  9. Telemedicine and competitive change in health care. (United States)

    LaMay, C L


    Telemedicine--the delivery of health care services to the underserved through communications technologies--has the potential to bring medical care to remote areas where health care is either inadequate or nonexistent. Telemedicine can be something as simple as a phone call, a network transmission of a radiograph or other diagnostic image, or, much more advanced, realtime video surgical consultations from anywhere on the globe. Telemedicine programs operate throughout Europe, Japan, and Australia. International programs, for profit and nonprofit, serve Asia, Africa, and the Middle East. The United States is also a major telemedicine developer, principally through government agencies such as the Department of Defense and the Office of Rural Health Policy, and, to a lesser extent, the private sector. But telemedicine in the United States has yet to prove itself economically viable, and it faces a number of political and regulatory barriers. Even more significantly, telemedicine's potential to increase overall health care spending by increasing access to health care has deterred private industry from investing heavily in it. In the short term, telemedicine's most important contribution to health care may be raising fundamental questions about United States health care policy.

  10. Network Warrior

    CERN Document Server

    Donahue, Gary


    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

  11. Social networks

    CERN Document Server

    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

  12. Innovation network. (United States)

    Acemoglu, Daron; Akcigit, Ufuk; Kerr, William R


    Technological progress builds upon itself, with the expansion of invention in one domain propelling future work in linked fields. Our analysis uses 1.8 million US patents and their citation properties to map the innovation network and its strength. Past innovation network structures are calculated using citation patterns across technology classes during 1975-1994. The interaction of this preexisting network structure with patent growth in upstream technology fields has strong predictive power on future innovation after 1995. This pattern is consistent with the idea that when there is more past upstream innovation for a particular technology class to build on, then that technology class innovates more.

  13. Ten years of integrated care in Switzerland

    Directory of Open Access Journals (Sweden)

    Peter Berchtold


    Full Text Available In Switzerland, a growing part of primary care is provided by networks of physicians and health maintenance organizations (HMOs acting on the principles of gatekeeping. To date, an average of one out of eight insured person in Switzerland, and one out of three in the regions in north-eastern Switzerland, opted for the provision of care by general practitioners in one of the 86 physician networks or HMOs. About 50% of all general practitioners and more than 400 other specialists have joined a physician networks. Seventy-three of the 86 networks (84% have contracts with the healthcare insurance companies in which they agree to assume budgetary co-responsibility, i.e. to adhere to set cost targets for particular groups of patients. Within and outside the physician networks, at regional and/or cantonal levels, several initiatives targeting chronic diseases have been developed, such as clinical pathways for heart failure and breast cancer patients or chronic disease management programs for patients with diabetes. The relevance of these developments towards more integration of healthcare as well as their implications for the future are discussed.

  14. Rede de infarto com supradesnivelamento de ST: sistematização em 205 casos diminui eventos clínicos na rede pública ST-Elevation myocardial infarction network: systematization in 205 cases reduced clinical events in the public health care system

    Directory of Open Access Journals (Sweden)

    Ana Christina Vellozo Caluza


    % due to difficulties inherent in large metropoles. OBJECTIVE:To describe in-hospital mortality in ST-segment elevation acute myocardial infarction (STEMI of patients admitted via ambulance or peripheral hospitals, which are part of a structured training network (STEMI Network. METHODS: Health care teams of four emergency services (Ermelino Matarazzo, Campo Limpo, Tatuapé and Saboya of the periphery of the city of São Paulo and advanced ambulances of the Emergency Mobile Health Care Service (abbreviation in Portuguese, SAMU were trained to use tenecteplase or to refer for primary angioplasty. A central office for electrocardiogram reading was used. After thrombolysis, the patient was sent to a tertiary reference hospital to undergo cardiac catheterization immediately (in case of failed thrombolysis or in 6 to 24 hours, if the patient was stable. Quantitative and qualitative variables were assessed by use of uni- and multivariate analysis. RESULTS: From January 2010 to June 2011, 205 consecutive patients used the STEMI Network, and the findings were as follows: 87 anterior wall infarctions; 11 left bundle-branch blocks; 14 complete atrioventricular blocks; and 14 resuscitations after initial cardiorespiratory arrest. In-hospital mortality was 6.8% (14 patients, most of which due to cardiogenic shock, one hemorrhagic cerebrovascular accident, and one bleeding. CONCLUSION: The organization in the public health care system of a network for the treatment of STEMI, involving diagnosis, reperfusion, immediate transfer, and tertiary reference hospital, resulted in immediate improvement of STEMI outcomes.

  15. Research in cardiovascular care

    DEFF Research Database (Denmark)

    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....

  16. The role of accountable care organizations in delivering value. (United States)

    O'Halloran, Kevin; Depalma, Andres; Joseph, Vilma; Cobelli, Neil; Sharan, Alok


    The goal of Accountable Care Organizations is to improve patient outcomes while maximizing the value of the services provided. This will be achieved through the use of performance and quality measures that facilitate efficient, cost-effective, evidence-based care. By creating a network connecting primary care physicians, specialists, rehabilitation facilities and hospitals, patient care should be maximized while at the same time delivering appropriate value for those services provided. The Medicare Shared Savings Program will financially reward ACOs that meet performance standards while at the same time lowering costs. The orthopaedic surgeon can only benefit by understanding how to participate in and negotiate the complexities of these organizations.

  17. European Higher Health Care Education Curriculum

    DEFF Research Database (Denmark)

    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...


    Alex Sánchez, María Dolores


    The Information and Communication Technologies (ICT) have an increasing influence on the way we relate and in shaping personal identity. The phenomenon of online social networking emerges strongly and contributes to the development of new spaces breaking with the official discourse that marks the scientific evidence on health. This paper analyzes the impact of ICT in relation to the identity of the digital natives and eating disorders (ED). Particular attention to how the network society determines the response of young people in situations of social tension is dedicated. To do this, provides a perspective on the concept of interaction from the analysis of the discourse on anorexia and bulimia in the network, and how to care nurses should consider these factors to improve efficiency and quality in clinical care and patient care.

  19. Personal Care in Learning Health Care Systems. (United States)

    Miller, Franklin G; Kim, Scott Y H


    The idea of a "learning health care system"--one that systematically integrates clinical research with medical care--has received considerable attention recently. Some commentators argue that under certain conditions pragmatic comparative effectiveness randomized trials can be conducted ethically within the context of a learning health care system without the informed consent of patients for research participation. In this article, we challenge this perspective and contend that conducting randomized trials of individual treatment options without consent is neither necessary nor desirable to promote and sustain learning health care systems. Our argument draws on the normative conception of personal care developed by Charles Fried in a landmark 1974 book on the ethics of randomized controlled trials.

  20. Sentinel Network (United States)

    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.

  1. computer networks

    Directory of Open Access Journals (Sweden)

    N. U. Ahmed


    Full Text Available In this paper, we construct a new dynamic model for the Token Bucket (TB algorithm used in computer networks and use systems approach for its analysis. This model is then augmented by adding a dynamic model for a multiplexor at an access node where the TB exercises a policing function. In the model, traffic policing, multiplexing and network utilization are formally defined. Based on the model, we study such issues as (quality of service QoS, traffic sizing and network dimensioning. Also we propose an algorithm using feedback control to improve QoS and network utilization. Applying MPEG video traces as the input traffic to the model, we verify the usefulness and effectiveness of our model.

  2. Affective Networks

    Directory of Open Access Journals (Sweden)

    Jodi Dean


    Full Text Available This article sets out the idea of affective networks as a constitutive feature of communicative capitalism. It explores the circulation of intensities in contemporary information and communication networks, arguing that this circulation should be theorized in terms of the psychoanalytic notion of the drive. The article includes critical engagements with theorists such as Guy Debord, Jacques Lacan, Tiziana Terranova, and Slavoj Zizek.

  3. Afloat Networks (United States)


    COP, ISR Data Management and full array of Warfare Network Storage Common Computing Environment (ISNS): 20 TB storage per enclave (up from 20 MB...Hardrive) CANES: 9.5 TB for apps alone Applications - Over 800 Connected or hosted (up from 3) CANES – Consolidated Afloat Networks and Enterprise...classified/unclassified) Immediate File Delivery (IFD) CWSP/CBSP JSIPS/JCA JWICS SIPRNET NIPRNET VTC POTS MSG TRAFFIC EHF MDR JWICS

  4. Sentient networks

    Energy Technology Data Exchange (ETDEWEB)

    Chapline, G.


    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.

  5. Complex Networks

    CERN Document Server

    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...

  6. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions:checklist and explanations%系统综述与网状Meta分析的PRISMA扩展声明

    Institute of Scientific and Technical Information of China (English)

    李志霞; 杨俊; 叶欣; 周凌波; 杨智荣; 孙凤; 詹思延(审校)


    The PRISMA statement is a reporting guideline designed to improve the completeness of reporting of systematic reviews and meta-analyses. Authors have used this guideline worldwide to prepare their reviews for publication. In the past, these reports typically compared 2 treatment alternatives. With the evolution of systematic reviews that compare multiple treatments, some of them only indirectly, authors face novel challenges for conducting and reporting their reviews. This extension of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement was developed specifically to improve the reporting of systematic reviews incorporating network meta-analyses. A group of experts participated in a systematic review, Delphi survey, and face-to-face discussion and consensus meeting to establish new checklist items for this extension statement. Current PRISMA items were also clarified. A modified, 32-item PRISMA extension checklist was developed to address what the group considered to be immediately relevant to the reporting of network meta-analyses. This document presents the extension and provides examples of good reporting, as well as elaborations regarding the rationale for new checklist items and the modification of previously existing items from the PRISMA statement. It also highlights educational information related to key considerations in the practice of network meta-analysis. The target audience includes authors and readers of network meta-analyses, as well as journal editors and peer reviewers.%PRISMA声明旨在提高系统综述和META分析报告的完整性,该声明已经广泛用于指导系统综述和META分析的报告和发表。原始的PRISMA声明是针对两种干预措施比较的传统的系统综述与META分析而制定的,然而,随着多种干预措施比较的系统综述的发展,实施和报告这一类系统综述面临较大挑战。此时,针对网状META分析的PRISMA扩展声明应运而生,旨

  7. FastStats: Home Health Care (United States)

    ... Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography Pap Tests Disability ... Care National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare and Medicaid ...

  8. 无线传感网络在居家养老中的实践研究%Practice research on wireless sensor network in home-based care

    Institute of Scientific and Technical Information of China (English)

    吴泳; 徐秀兰


    随着老龄化社会的来临,养老作为一个社会化问题日益突显出来。政府提出“互联网+”的新战略,提倡人们利用信息技术为传统行业注入活力。文章以cc2530芯片为核心,设计在居家环境下老人的身体健康指标、摔倒、煤气等多种参数进行检测,当参数出现异常情况下显示告警提示的一种无线传感网络系统。无线传感网络中的终端节点是感知节点,是系统能够实现的基础。无线传感网络具有部署方便,无需布线,低成本、低功耗、扩展简单等多方面的优点,应用前景广阔。%With the coming of an aging society, the supporting problem has been a social problem. The government puts forward the new strategy of Internet+which advocates people to use information technology to invigorate the traditional industry. Taking cc2530 chip as the core, a wireless sensor network system has been developed which is designed to detect multiple parameters of the housebound elderly such as health indicators, falling-down and gas. When the parameters are abnormal, the system can give an alarm. The terminal nodes are perception nodes which are the foundation of the system. Wireless sensor network has many advantages such as easy deployment, no wiring, low cost, low power consumption and simple extension and has a broad application prospect.

  9. Managed care demands flexibility, creativity. (United States)


    The definition of hospice care is changing as home care providers come under managed care regulations. Hospice care for AIDS patients is demanding, requiring extra time from home care providers. The managed care cost-cutting measures require creativitity and patience. The Visiting Nurses and Hospice of San Francisco (VNH) has held seminars to help providers adapt to managed care.

  10. Surgical Critical Care Initiative (United States)

    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....

  11. US EPA CARE Grants (United States)

    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...

  12. Day Care Centers (United States)

    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...

  13. Children's hospice care. (United States)

    Armstrong-Dailey, A


    Facing the inevitable death of a child is a difficult reality for many parents and health care providers as well. Children's Hospice International offers a variety of information and education services to support the provision of children's hospice care.

  14. Does Care Matter?

    DEFF Research Database (Denmark)

    Loft, Lisbeth Trille Gylling; Hogan, Dennis P.


    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......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...

  15. National Health Care Survey (United States)

    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.

  16. CARE07 Coordinated Accelerator Research in Europe

    CERN Multimedia


    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 ...

  17. CARE07 Coordinated Accelerator Research in Europe

    CERN Multimedia


    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...

  18. Value of care - National (United States)

    U.S. Department of Health & Human Services — Value of care displays – national data. This data set includes national-level data for the value of care displays associated with a 30-day episode of care for...

  19. Critical Care Team (United States)

    ... Patients and Families > About Critical Care > Team Tweet Team Page Content ​The critical care team is a group of specially trained caregivers who ... help very ill patients get better. The care team often teach the patient and family strategies that ...

  20. Child Care Services Handbook. (United States)

    Duval County School Board, Jacksonville, FL.

    A companion document to the curriculum guide for a secondary level child care services curriculum, this handbook contains a variety of administrative and program resources for the teacher: The vocational curriculum outline for child care services; a calendar of suggested public relations activities; procedures for building child care services…

  1. Hospice Care in America (United States)

    ... Patient receives hospice care consisting predominantly of licensed nursing care on a continuous basis at home. Continuous home ... Gozalo PL, Mor V. The Growth of Hospice Care in U.S. Nursing Homes . JAGS. 2010 58:1481-88. © 2015 NHPCO ...

  2. Tufts academic health information network: concept and scenario. (United States)

    Stearns, N S


    Tufts University School of Medicine's new health sciences education building, the Arthur M. Sackler Center for Health Communications, will house a modern medical library and computer center, classrooms, auditoria, and media facilities. The building will also serve as the center for an information and communication network linking the medical school and adjacent New England Medical Center, Tufts' primary teaching hospital, with Tufts Associated Teaching Hospitals throughout New England. Ultimately, the Tufts network will join other gateway networks, information resource facilities, health care institutions, and medical schools throughout the world. The center and the network are intended to facilitate and improve the education of health professionals, the delivery of health care to patients, the conduct of research, and the implementation of administrative management approaches that should provide more efficient utilization of resources and save dollars. A model and scenario show how health care delivery and health care education are integrated through better use of information transfer technologies by health information specialists, practitioners, and educators.

  3. Computer network time synchronization the network time protocol on earth and in space

    CERN Document Server

    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

  4. Evidence on the Efficacy of Integrated Care

    DEFF Research Database (Denmark)

    Larsen, Torben


    : low-tech patient benefits affordable to middle income countries; Threat: low levels of trust across professions and settings   A meso-strategy for EU recommends: (1) Make a synthesis of existing and ongoing research as a health technology assessment (HTA) of IHC for multidisciplinary teamwork across...... the hospital and primary care interface (2) Focus on dissemination by the formation of country specific multidisciplinary networks on IHC, see .  ...

  5. A New Vision for Integrated Breast Care (United States)


    open at our center. Tools that capitalized on an active advocacy network, the Internet and collaborations with civic organizations were instituted as...aboutindex.html Education/ Psycological Consultation Evaluation Questions 1, 08/28/01 Carol Franc Buck Breast Care Center: Education Evaluation Prior...Overall, rate the educational materials you received .............................. 1 2 3 4 5 6 D. Lubeck 08/28/01 128 Education/ Psycological Consultation

  6. Secondary Health Care: best practices in the health services network La atención secundaria en salud: mejores prácticas en la red de servicios A atenção secundária em saúde: melhores práticas na rede de serviços

    Directory of Open Access Journals (Sweden)

    Alacoque Lorenzini Erdmann


    Full Text Available OBJECTIVE: to understand the organization of health practices, based on the interactions at the secondary care level, and to analyze how the actions and services at this level of care contribute to the development of best practice in health. METHOD: a qualitative approach, based in Grounded Theory. Data was obtained from individual interviews, with managers, health care professionals and health service users making up the sample group representing the secondary level of healthcare. The theoretical model was formulated based on four categories, analyzed based in the elements of the network modeling of health care theoretical framework. RESULTS: The organization of health practices at a secondary level is in the process of consolidation and is contributing to the development of best practices in the locale studied. CONCLUSION: The broadening of access to consultations and specialized procedures, and the articulation of the network's points, are aspects of this level of care which are considered essential for care which is effective and integral. This study contributes to the analysis of health practices from the perspective of network modeling, based on the interactions between secondary care and the health system's other health facilities, which are shown as going through a process of consolidation in the locale studied.OBJETIVO: Comprender la organización de las prácticas de salud, desde las interacciones en el nivel de la atención secundaria y analizar cómo las acciones y servicios en este nivel han contribuido al desarrollo de mejores prácticas en salud. MÉTODO: Enfoque cualitativo, apoyado en la Teoría Fundamentada en los Datos. Se realizaron entrevistas con gestores, profesionales de salud y usuarios, que conforman el grupo muestral de la atención secundaria. RESULTADOS: Se formuló el modelo desde cuatro categorías, analizadas con base en los elementos del modelado de red de atención a la salud. La organización de las pr

  7. Network Cosmology

    CERN Document Server

    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...

  8. Effects of an Integrated Care System on quality of care and satisfaction for children with special health care needs. (United States)

    Knapp, Caprice; Madden, Vanessa; Sloyer, Phyllis; Shenkman, Elizabeth


    To assess the effects of an Integrated Care System (ICS) on parent-reported quality of care and satisfaction for Children with Special Health Care Needs (CSHCN). In 2006 Florida reformed its Medicaid program in Broward and Duval counties. Children's Medical Services Network (CMSN) chose to participate in the reform and developed an ICS for CSHCN. The ICS ushered in several changes such as more prior approval requirements and closing of the provider network. Telephone surveys were conducted with CMSN parents whose children reside in the reform counties and parents whose children reside outside of the reform counties in 2006 and 2007 (n = 1,727). Results from multivariate quasi-experimental models show that one component of parent-report quality of care, customer service, increased. Following implementation of the ICS, customer service increased by 0.22 points. After implementation of the ICS, parent-reported quality and satisfaction were generally unaffected. Although significant increases were not seen in the majority of the quality and satisfaction domains, it is nonetheless encouraging that parents did not report negative experiences with the ICS. It is important to present these interim findings so that progress can be monitored and decision-makers can begin to consider if the program should be expanded statewide.

  9. Finnish care integrated?

    Directory of Open Access Journals (Sweden)

    Jouni Niskanen


    Full Text Available The public Finnish social and health care system has been challenged by the economic crisis, administrative reforms and increased demands. Better integration as a solution includes many examples, which have been taken to use. The most important are the rewritten national and municipals strategies and quality recommendations, where the different sectors and the levels of care are seen as one entity. Many reorganisations have taken place, both nationally and locally, and welfare clusters have been established. The best examples of integrated care are the forms of teamwork, care management, emphasis on non-institutional care and the information technology.

  10. Identity of care in a Psychosocial Care Center for Children and Adolescents who uses drugs

    Directory of Open Access Journals (Sweden)

    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.

  11. Neuroeconomics and Integrated Care

    DEFF Research Database (Denmark)

    Larsen, Torben


    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......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...

  12. The Epital Care Model

    DEFF Research Database (Denmark)

    Phanareth, Klaus; Vingtoft, Søren; Christensen, Anders Skovbo


    and organizations that provide health care. Technology may be a way to enable the creation of a coherent, cocreative, person-centered method to provide health care for individuals with one or more long-term conditions (LTCs). It remains to be determined how a new care model can be introduced that supports...... the intentions of the World Health Organization (WHO) to have integrated people-centered care. OBJECTIVE: To design, pilot, and test feasibility of a model of health care for people with LTCs based on a cocreative, iterative, and stepwise process in a way that recognizes the need for person-centered care...... and face-to-face support for COPD management. In step five the initial model was extended with elements that support continuity of care. Beginning in the autumn of 2013, 1102 frail elderly individuals were included and offered two additional services: an outgoing acute medical team and a local subacute bed...

  13. Network dismantling

    CERN Document Server

    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.

  14. Innovation networks

    CERN Document Server

    Ahrweiler, Petra


    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...

  15. Nepal Networking

    DEFF Research Database (Denmark)

    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...... that their personal networks engage not only their families, but also their home communities and by extension Nepal. The two women constitute weak links between their country and other countries and as such they function as bridges or channels for transmission of practices, ideas, knowledge, and artefacts. However...... 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...

  16. Gradient networks (United States)

    Toroczkai, Zoltán; Kozma, Balázs; Bassler, Kevin E.; Hengartner, N. W.; Korniss, G.


    Gradient networks are defined (Toroczkai and Bassler 2004 Nature 428 716) as directed graphs formed by local gradients of a scalar field distributed on the nodes of a substrate network G. We present the derivation for some of the general properties of gradient graphs and give an exact expression for the in-degree distribution R(l) of the gradient network when the substrate is a binomial (Erd{\\;\\kern -0.10em \\raise -0.35ex \\{{^{^{\\prime\\prime}}}}\\kern -0.57em \\o} s-Rényi) random graph, G_{N,p} , and the scalars are independent identically distributed (i.i.d.) random variables. We show that in the limit N \\to \\infty, p \\to 0, z = pN = \\mbox{const} \\gg 1, R(l)\\propto l^{-1} for l Bassler (2004 Nature 428 716).

  17. Network interruptions

    CERN Multimedia


    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.

  18. Acute care nurses' spiritual care practices. (United States)

    Gallison, Barry S; Xu, Yan; Jurgens, Corrine Y; Boyle, Suzanne M


    The purpose of this study was to identify barriers in providing spiritual care to hospitalized patients. A convenience sample (N = 271) was recruited at an academic medical center in New York City for an exploratory, descriptive questionnaire. The Spiritual Care Practice (SCP) questionnaire assesses spiritual care practices and perceived barriers to spiritual care. The SCP determines the percentage that provides spiritual support and perceived barriers inhibiting spiritual care. The participation rate was 44.3% (N = 120). Most (61%) scored less than the ideal mean on the SCP. Although 96% (N = 114) believe addressing patients spiritual needs are within their role, nearly half (48%) report rarely participating in spiritual practices. The greatest perceived barriers were belief that patient's spirituality is private, insufficient time, difficulty distinguishing proselytizing from spiritual care, and difficulty meeting needs when spiritual beliefs were different from their own. Although nurses identify themselves as spiritual, results indicate spirituality assessments are inadequate. Addressing barriers will provide nurses opportunities to address spirituality. Education is warranted to improve nurses' awareness of the diversity of our society to better meet the spiritual needs of patients. Understanding these needs provide the nurse with opportunities to address spirituality and connect desires with actions to strengthen communication and the nurse-patient relationship.

  19. 7th Workshop on Complex Networks

    CERN Document Server

    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...

  20. Prehospital care and new models of regionalization. (United States)

    Cone, David C; Brooke Lerner, E; Band, Roger A; Renjilian, Chris; Bobrow, Bentley J; Crawford Mechem, C; Carter, Alix J E; Kupas, Douglas F; Spaite, Daniel W


    This article summarizes the discussions of the emergency medical services (EMS) breakout session at the June 2010 Academic Emergency Medicine consensus conference "Beyond Regionalization: Integrated Networks of Emergency Care." The group focused on prehospital issues such as the identification of patients by EMS personnel, protocol-driven destination selection, bypassing closer nondesignated centers to transport patients directly to more distant designated specialty centers, and the modes of transport to be used as they relate to the regionalization of emergency care. It is our hope that the proposed research agenda will be advanced in a way that begins to rigorously approach the unanswered research questions and that these answers, in turn, will lead to an evidence-based, cohesive, comprehensive, and more uniform set of guidelines that govern the delivery and practice of prehospital emergency care.

  1. Careful telemedicine planning limits costly liability exposure. (United States)

    Edelstein, S A


    Recent Federal and state legislation and new payment opportunities from Medicare, Medicaid, and private payers may make it possible to offer telemedicine as a viable, cost-effective alternative to traditional care delivery in communities where access to health care is limited. Originally, nonexistent payment and expensive technology held back telemedicine but, these barriers are giving way to specific applications that can yield dramatic cost savings for group practices in the delivery of medical care while adding features and benefits not typically available in traditional delivery settings. Before joining a telemedicine network, group practices need to negotiate a variety of legal issues related to the corporate practice of medicine, patient confidentiality and privacy, malpractice, informed consent, licensure and credentialing, intellectual property, Medicare and Medicaid payment, fraud and abuse, medical device regulation, and antitrust.

  2. Managing Networks

    DEFF Research Database (Denmark)

    Jørgensen, Heidi; Vintergaard, Christian

    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...... of networkbehaviour, knowing how to manage this relation becomes essential, especiallyduring the development of new strategies.......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...

  3. Industrial Networks

    DEFF Research Database (Denmark)

    Karlsson, Christer


    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...

  4. Understanding communication networks in the emergency department

    Directory of Open Access Journals (Sweden)

    Braithwaite Jeffrey


    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.

  5. Timely and Effective Care - National (United States)

    U.S. Department of Health & Human Services — Timely and Effective Care measures - national data. This data set includes national-level data for measures of heart attack care, heart failure care, pneumonia care,...

  6. Timely and Effective Care - Hospital (United States)

    U.S. Department of Health & Human Services — Timely and Effective Care measures - provider data. This data set includes provider-level data for measures of heart attack care, heart failure care, pneumonia care,...

  7. Broken toe - self-care (United States)

    Fractured toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care; Fracture phalanx - toe ... often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that ...

  8. Timely and Effective Care - State (United States)

    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,...

  9. Reconciliation of work and care among lone mothers of adults with intellectual disabilities: the role and limits of care capital. (United States)

    Chou, Yueh-Ching; Kröger, Teppo


    In this study, the concept of social capital is applied to an exploration of Guanxi (social networking to create good relationships) among working lone mothers of adults with intellectual disabilities (ID) in Taiwan. Using in-depth interviews, this study explores the role of social capital, here referred to as 'care capital', in making it possible for working lone mothers to combine their roles as family carers and workers. Eleven divorced or widowed mothers combining their paid work with long-term care responsibilities were recruited from a survey or through NGOs and were interviewed at their home between October 2008 and July 2010. An interpretative phenomenological approach was adopted for data analysis. The findings revealed that the mothers' care capital was extremely limited and was lost, gained and lost again during their life-cycles of long-term care-giving. Guanxi, especially in relation to their employers, proved to be the sole source of care capital for these mothers, making reconciliation between work and care responsibilities possible. In the absence of formal or informal support, religion and the mother-child relationship seemed also to become a kind of care capital for these lone mothers, helping them to get by with their life-long care responsibilities. For formal social and healthcare services, not just in Taiwan but in every country, it is important to develop support for lone mothers of adults with ID who have long-term care responsibilities and low levels of care capital and thus face care poverty.

  10. Carefully Creating"Network Political"——Analysis of Innovative New Ideas of Political Work%精心打造"网络政工"——革新思政工作新思路分析

    Institute of Scientific and Technical Information of China (English)



    Ideological and political work to educate people as a guide main content of the work of man, their work more dif-ficult, trying to optimize the teaching objectives, it is necessary to effectively combine characteristics of the times, innovative teaching ideas. Internet age, more rapid speed of information dissemination, communication channels more widely, so you want to effectively carry out ideological and political work, we need to effectively combine the characteristics of the Internet, ideological and political work of innovative ideas. This paper from the characteristics of the Internet era, combining the new requirements to carry out ideological and political work, Lands and as an entry point to the network, explore new ideas to car-ry out ideological and political work.%思想政治工作作为一项以教育人、引导人为主要内容的工作,其工作难度较大,想优化教学目标,就必须有效结合时代特点,革新教学思路.互联网时代,信息传播速度更为迅猛,传播渠道更为广泛,因此想要有效开展思政工作,就需要有效结合互联网特点,革新思政工作思路.本文拟从互联网时代特点入手,结合思政工作开展新要求,以网络政工为切入点,探索思政工作开展的新思路.

  11. Who are the key players in a new translational research network?


    Long, Janet C; Cunningham, Frances C.; Carswell, Peter; Braithwaite, Jeffrey


    Background Professional networks are used increasingly in health care to bring together members from different sites and professions to work collaboratively. Key players within these networks are known to affect network function through their central or brokerage position and are therefore of interest to those who seek to optimise network efficiency. However, their identity may not be apparent. This study using social network analysis to ask: (1) Who are the key players of a new translational...

  12. Network Physiology: Mapping Interactions Between Networks of Physiologic Networks (United States)

    Ivanov, Plamen Ch.; Bartsch, Ronny P.

    The human organism is an integrated network of interconnected and interacting organ systems, each representing a separate regulatory network. The behavior of one physiological system (network) may affect the dynamics of all other systems in the network of physiologic networks. Due to these interactions, failure of one system can trigger a cascade of failures throughout the entire network. We introduce a systematic method to identify a network of interactions between diverse physiologic organ systems, to quantify the hierarchical structure and dynamics of this network, and to track its evolution under different physiologic states. We find a robust relation between network structure and physiologic states: every state is characterized by specific network topology, node connectivity and links strength. Further, we find that transitions from one physiologic state to another trigger a markedly fast reorganization in the network of physiologic interactions on time scales of just a few minutes, indicating high network flexibility in response to perturbations. This reorganization in network topology occurs simultaneously and globally in the entire network as well as at the level of individual physiological systems, while preserving a hierarchical order in the strength of network links. Our findings highlight the need of an integrated network approach to understand physiologic function, since the framework we develop provides new information which can not be obtained by studying individual systems. The proposed system-wide integrative approach may facilitate the development of a new field, Network Physiology.

  13. Towards an Information Theory of Complex Networks

    CERN Document Server

    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

  14. Network-Aware HEFT Scheduling for Grid

    Directory of Open Access Journals (Sweden)

    Muhammad Murtaza Yousaf


    Full Text Available We present a network-aware HEFT. The original HEFT does not take care of parallel network flows while designing its schedule for a computational environment where computing nodes are physically at distant locations. In the proposed mechanism, such data transfers are stretched to their realistic completion time. A HEFT schedule with stretched data transfers exhibits the realistic makespan of the schedule. It is shown how misleading a schedule can be if the impact of parallel data transfers that share a bottleneck is ignored. A network-aware HEFT can be used to yield a benefit for Grid applications.

  15. The concept of care

    Directory of Open Access Journals (Sweden)

    Georgia Kiparisi


    Full Text Available Introduction: From the literature review it derives that the concept of care is multidimensional. Every individual forms a specific attitude towards care depending on the particular social framework he/she has been raised in as well as his/her religious beliefs and cultural background. The theoretical framework of the research is based on both selected terms of meaning of “care” as well as on selected principles of intercultural Nursing care as they have been described by Leininger (1997. According to Leininger, Nursing care as a phenomenon is met in all civilizations while there are particular cultural care standards. The aim of this research is semantic determination of care and therefore, how the Greeks perceive the meaning of Care.Methodology: To answer the above research questions, we chose the approach of phenomenological research method. The collection of data has been accomplished with the method of interviews with open questions. Then, the analysis of the interview data followed in accordance to the technique of content analysis with the Mayring method (summary.Result: From the content analysis the following categories derived:1. Care means love2. Care means understanding3. Care means prevention4. Care means touchConclusions: The semantic approach of care as it is perceived from the individuals, accentuates in fact the thesis that the philosophy of nursing science is based on ideals and universal values, whose respect from the professional ensures high quality in provided care and promotes the nursing work for the benefit of the individual and the society, too.

  16. The Patient Care Connect Program: Transforming Health Care Through Lay Navigation. (United States)

    Rocque, Gabrielle B; Partridge, Edward E; Pisu, Maria; Martin, Michelle Y; Demark-Wahnefried, Wendy; Acemgil, Aras; Kenzik, Kelly; Kvale, Elizabeth A; Meneses, Karen; Li, Xuelin; Li, Yufeng; Halilova, Karina I; Jackson, Bradford E; Chambless, Carol; Lisovicz, Nedra; Fouad, Mona; Taylor, Richard A


    The Patient Care Connect Program (PCCP) is a lay patient navigation program, implemented by the University of Alabama at Birmingham Health System Cancer Community Network. The PCCP's goal is to provide better health and health care, as well as to lower overall expenditures. The program focuses on enhancing the health of patients, with emphasis on patient empowerment and promoting proactive participation in health care. Navigator training emphasizes palliative care principles and includes development of skills to facilitate advance care planning conversations. Lay navigators are integrated into the health care team, with the support of a nurse supervisor, physician medical director, and administrative champion. The intervention focuses on patients with high needs to reach those with the greatest potential for benefit from supportive services. Navigator activities are guided by frequent distress assessments, which help to identify patient concerns across multiple domains, triage patients to appropriate resources, and ultimately overcome barriers to health care. In this article, we describe the PCCP's development, infrastructure, selection and training of lay navigators, and program operations.

  17. Fuzzy logic and neural networks basic concepts & application

    CERN Document Server

    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

  18. Educating primary care providers about HIV disease: multidisciplinary interactive mechanisms.


    Macher, A; Goosby, E; Barker, L; Volberding, P; Goldschmidt, R.; Balano, K B; Williams, A; Hoenig, L; Gould, B; Daniels, E.


    As HIV-related prophylactic and therapeutic research findings continue to evolve, the Health Resources and Services Administration (HRSA) of the Public Health Service has created multidisciplinary mechanisms to disseminate new treatment options and educate primary care providers at rural and urban sites throughout our nation's health care system. HRSA has implemented (a) the International State-of-the-Art HIV Clinical Conference Call Series, (b) the national network of AIDS Education and Trai...

  19. Blending Formal and Informal Learning Networks for Online Learning (United States)

    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…

  20. The APA and the rise of pediatric generalist network research. (United States)

    Wasserman, Richard; Serwint, Janet R; Kuppermann, Nathan; Srivastava, Rajendu; Dreyer, Benard


    The Academic Pediatric Association (APA, formerly the Ambulatory Pediatric Association) first encouraged multi-institutional collaborative research among its members over 30 years ago. Individual APA members subsequently went on to figure prominently in establishing formal research networks. These enduring collaborations have been established to conduct investigations in a variety of generalist contexts. At present, 4 generalist networks--Pediatric Research in Office Settings (PROS), the Pediatric Emergency Care Applied Research Network (PECARN), the COntinuity Research NETwork (CORNET), and Pediatric Research in Inpatient Settings (PRIS)--have a track record of extensive achievement in generating new knowledge aimed at improving the health and health care of children. This review details the history, accomplishments, and future directions of these networks and summarizes the common themes, strengths, challenges, and opportunities inherent in pediatric generalist network research.

  1. Airborne Network Optimization with Dynamic Network Update (United States)



  2. Advance Care Planning. (United States)

    Stallworthy, Elizabeth J


    Advance care planning should be available to all patients with chronic kidney disease, including end-stage kidney disease on renal replacement therapy. Advance care planning is a process of patient-centred discussion, ideally involving family/significant others, to assist the patient to understand how their illness might affect them, identify their goals and establish how medical treatment might help them to achieve these. An Advance Care Plan is only one useful outcome from the Advance Care Planning process, the education of patient and family around prognosis and treatment options is likely to be beneficial whether or not a plan is written or the individual loses decision making capacity at the end of life. Facilitating Advance Care Planning discussions requires an understanding of their purpose and communication skills which need to be taught. Advance Care Planning needs to be supported by effective systems to enable the discussions and any resulting Plans to be used to aid subsequent decision making.

  3. Danish Palliative Care Database

    DEFF Research Database (Denmark)

    Grønvold, Mogens; Adsersen, Mathilde; Hansen, Maiken Bang


    Aims: The aim of the Danish Palliative Care Database (DPD) is to monitor, evaluate, and improve the clinical quality of specialized palliative care (SPC) (ie, the activity of hospital-based palliative care teams/departments and hospices) in Denmark. Study population: The study population is all......, and the patient-reported European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care questionnaire, assessing health-related quality of life. The data support the estimation of currently five quality of care indicators, ie, the proportions of 1) referred......-Core-15-Palliative Care at admission to SPC, and 5) patients who were discussed at a multidisciplinary conference. Descriptive data: In 2014, all 43 SPC units in Denmark reported their data to DPD, and all 9,434 cancer patients (100%) referred to SPC were registered in DPD. In total, 41,104 unique cancer...

  4. Exact Modeling of the Performance of Random Linear Network Coding in Finite-buffer Networks

    CERN Document Server

    Torabkhani, Nima; Beirami, Ahmad; Fekri, Faramarz


    In this paper, we present an exact model for the analysis of the performance of Random Linear Network Coding (RLNC) in wired erasure networks with finite buffers. In such networks, packets are delayed due to either random link erasures or blocking by full buffers. We assert that because of RLNC, the content of buffers have dependencies which cannot be captured directly using the classical queueing theoretical models. We model the performance of the network using Markov chains by a careful derivation of the buffer occupancy states and their transition rules. We verify by simulations that the proposed framework results in an accurate measure of the network throughput offered by RLNC. Further, we introduce a class of acyclic networks for which the number of state variables is significantly reduced.

  5. A Generalized Loss Network Model with Overflow for Capacity Planning of a Perinatal Network

    CERN Document Server

    Asaduzzaman, Md


    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.

  6. A Novel Method for Enhancing Network Monitoring in Remote Medical Applications Using Software Defined Networks

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Parsaei


    Full Text Available The most important way for providing health in a large population, particularly developing countries, is developing efficient health care services such that everyone can use the services equally and justly. Telemedicine is a new area which uses modern communication technology for exchanging medical information. This communication might be between a patient and a doctor or two medical centers for consultation. Implementation of a Telemedicine system requires creating the necessary infrastructures, among which network monitoring is one of the most important ones. From hundreds to thousands of computers, hubs to switched networks, and Ethernet to either ATM or 10Gbps Ethernet, administrators need more sophisticated network traffic monitoring and analysis tools in order to deal with development. These tools are needed, not only to fix network problems on time, but also to prevent network failure, to detect inside and outside threats, and make good decisions for network planning. In this paper, a comprehensive survey on Telemedicine and network monitoring is performed. Afterward, network monitoring techniques and methods in current networks are discussed. Finally, an efficient architecture based on Software Defined Networks (SDNs in remote surgical applications is presented which significantly improves monitoring of the communication networks. The results showed the effectiveness of the proposed method.

  7. Improving Care for Children With Complex Needs (United States)


    Medically Complex Children; Care Coordination; Case Manager; Care Manager; Collaborative Care; Disease Management; Patient Care Team or Organization; Managed Care; Children With Chronic Conditions; Children With Special Health Care Needs; Shared Care Plan; Patient Care Plan; Health Care and Resource Utilization; Adherence to Care; Functional Status and Productivity; Health Related Quality of Life; Satisfaction With Care; Care Coordinator; Family Experience of Care; Quality Health Care

  8. Integrated and interprofessional care

    Directory of Open Access Journals (Sweden)

    Hugh Barr


    Full Text Available No wonder two movements described in such similar terms are so often confused. One strives to knit services together, the other to cultivate collaborative practice amongst their workers.  Dedicated though both of them are to the improvement of health and social care, integrated care falters without engaging the workforce actively as partners in change whilst interprofessional care falters without organisational support. Neither stands alone. Each depends on the other.

  9. Music in child care


    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...

  10. The meaning of care dependency as shared by care givers and care recipients : a concept analysis

    NARCIS (Netherlands)

    Boggatz, Thomas; Dijkstra, Ate; Lohrmann, Christa; Dassen, Theo


    Aim. This paper is a report of a concept analysis to identify a meaning of care dependency that can be shared by both care givers and care recipients. Background. Care dependency can be perceived from the care recipient's and the care giver's perspective. To allow for comparisons, both sides should

  11. The Influence of Setting on Care Coordination for Childhood Asthma. (United States)

    Kelly, R Patrick; Stoll, Shelley C; Bryant-Stephens, Tyra; Janevic, Mary R; Lara, Marielena; Ohadike, Yvonne U; Persky, Victoria; Ramos-Valencia, Gilberto; Uyeda, Kimberly; Malveaux, Floyd J


    Asthma affects 7.1 million children in the United States, disproportionately burdening African American and Latino children. Barriers to asthma control include insufficient patient education and fragmented care. Care coordination represents a compelling approach to improve quality of care and address disparities in asthma. The sites of The Merck Childhood Asthma Network Care Coordination Programs implemented different models of care coordination to suit specific settings-school district, clinic or health care system, and community-and organizational structures. A variety of qualitative data sources were analyzed to determine the role setting played in the manifestation of care coordination at each site. There were inherent strengths and challenges of implementing care coordination in each of the settings, and each site used unique strategies to deliver their programs. The relationship between the lead implementing unit and entities that provided (1) access to the priority population and (2) clinical services to program participants played a critical role in the structure of the programs. The level of support and infrastructure provided by these entities to the lead implementing unit influenced how participants were identified and how asthma care coordinators were integrated into the clinical care team.

  12. Communities as co-producers in integrated care

    Directory of Open Access Journals (Sweden)

    Henk Nies


    Full Text Available Integrated care has become too much a professionals' concept, in research and theory development, as well as in practice, especially in high-income countries. The current debate on integrated care is dominated by norms and values of professionals, while most of the care is provided by non-professionals. The paradigms of integrated care for people with complex needs need to be reconsidered. It is argued that non-professional care and care by local communities need to be incorporated as a resource and a co-producer of care. It seems fair to assume that the community as such can take a more prominent role in organising and delivering health and long-term care. This implies redefining professional and non-professional responsibilities and boundaries. The boundary between public and private space is losing its significance, as is the distinction between formal and non-formal care. It also requires renegotiating and transforming organisational boundaries. This has consequences for legislation, funding and professional qualifications, as well as for management and governance. It challenges current professional identities as well as identities of service users, their informal carers and citizens. It may also require new types of funding, including non-monetary currencies, time-sharing and social impact bonds. The challenge is that big, that it needs to be addressed at its smallest scale: the citizen in his social network and local community, being co-producer of really integrated care

  13. Network biology concepts in complex disease comorbidities

    DEFF Research Database (Denmark)

    Hu, Jessica Xin; Thomas, Cecilia Engel; Brunak, Søren


    The co-occurrence of diseases can inform the underlying network biology of shared and multifunctional genes and pathways. In addition, comorbidities help to elucidate the effects of external exposures, such as diet, lifestyle and patient care. With worldwide health transaction data now often being...

  14. Penis care (uncircumcised) (United States)

    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 ...

  15. Crossing the caring chasm

    DEFF Research Database (Denmark)

    Kitson, Alison; Sørensen, Erik Elgaard


    upon prevention and screening, the trend will continue to be around providing care and support for individuals, families and communities for chronic and life-style induced diseases. The emphasis will therefore be on the need for evidence-based care as much as evidence-based medicine (or cure......). By definition, patients with chronic conditions cannot be cured; this means their fundamental care needs are at the centre of their course of care and hence, nursing (Henderson 1966). This article is protected by copyright. All rights reserved....

  16. Nursing Care after Death



    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...

  17. Ad hoc mobile wireless networks principles, protocols and applications

    CERN Document Server

    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

  18. Why Telestroke networks? Rationale, implementation and results of the Stroke Eastern Saxony Network. (United States)

    Bodechtel, Ulf; Puetz, Volker


    Stroke is the third leading cause of death and the leading cause of acquired long-term disability in Europe and North America. Intravenous (IV) thrombolysis with alteplase and organized inpatient (stroke unit) care have been shown to improve stroke patients' functional outcomes. However, stroke unit care is not area-wide available and thrombolysis rates are low, partly due to limited stroke thrombolysis expertise in smaller community hospitals. Telemedical stroke networks (Telestroke network) with remote video assessment of patients and brain computed tomography (CT) scans by stroke neurologists have been shown to increase IV thrombolysis rates and functional outcomes of patients in smaller community hospitals. Our article summarizes the rationale, clinical, and currently published scientific results of Telestroke networks with special respect to the telemedical Stroke Eastern Saxony Network (SOS-NET), which has been established by the Dresden University Stroke Center (DUSC) in July 2007. From July 2007 to December 2012, 3416 teleconsultations have been performed within the SOS-NET.

  19. A Novel Approach to Fair Routing in Wireless Mesh Networks

    Directory of Open Access Journals (Sweden)

    Määttä Juho


    Full Text Available Multiradio wireless mesh network (WMN is a feasible choice for several applications, as routers with multiple network interface cards have become cheaper. Routing in any network has a great impact on the overall network performance, thus a routing protocol or algorithm for WMN should be carefully designed taking into account the specific characteristics of the network. In addition, in wireless networks, serious unfairness can occur between users if the issue is not addressed in the network protocols or algorithms. In this paper, we are proposing a novel centralized routing algorithm, called Subscriber Aware Fair Routing in WMN (SAFARI, for multiradio WMN that assures fairness, leads to a feasible scheduling, and does not collapse the aggregate network throughput with a strict fairness criterion. We show that our protocol is feasible and practical, and exhaustive simulations show that the performance is improved compared to traditional routing algorithms.

  20. Linear network theory

    CERN Document Server

    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

  1. Network Security Scanner



    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...

  2. UK Parkinson's Excellence Network: empowering service improvement across the UK. (United States)

    Burn, David


    Parkinson's UK, together with leading Parkinson's professionals, has set up the UK Parkinson's Excellence Network to bring together the passion and expertise of leading clinicians with the strategic leadership and resources of Parkinson's UK underpinned by the voice of people affected by Parkinson's. Launched in London in February 2015, the Excellence Network aims to drive sustainable improvements in health and social care services. It will provide a more strategic approach to clinical development so that Parkinson's services across health and social care can be transformed to provide the best quality care across the UK.

  3. Network Gravity

    CERN Document Server

    Lombard, John


    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...

  4. Neural Networks

    Directory of Open Access Journals (Sweden)

    Schwindling Jerome


    Full Text Available This course presents an overview of the concepts of the neural networks and their aplication in the framework of High energy physics analyses. After a brief introduction on the concept of neural networks, the concept is explained in the frame of neuro-biology, introducing the concept of multi-layer perceptron, learning and their use as data classifer. The concept is then presented in a second part using in more details the mathematical approach focussing on typical use cases faced in particle physics. Finally, the last part presents the best way to use such statistical tools in view of event classifers, putting the emphasis on the setup of the multi-layer perceptron. The full article (15 p. corresponding to this lecture is written in french and is provided in the proceedings of the book SOS 2008.

  5. Network Survivability

    DEFF Research Database (Denmark)

    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......Algorithmic discrete mathematics plays a key role in the development of information and communication technologies, and methods that arise in computer science, mathematics and operations research – in particular in algorithms, computational complexity, distributed computing and optimization...... 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...

  6. Network Architecture, Security Issues, and Hardware Implementation of a Home Area Network for Smart Grid


    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) ...

  7. Designing a Care Pathway Model – A Case Study of the Outpatient Total Hip Arthroplasty Care Pathway

    Directory of Open Access Journals (Sweden)

    Robin I. Oosterholt


    Full Text Available Introduction: Although the clinical attributes of total hip arthroplasty (THA care pathways have been thoroughly researched, a detailed understanding of the equally important organisational attributes is still lacking. The aim of this article is to contribute with a model of the outpatient THA care pathway that depicts how the care team should be organised to enable patient discharge on the day of surgery. Theory: The outpatient THA care pathway enables patients to be discharged on the day of surgery, short- ening the length of stay and intensifying the provision and organisation of care. We utilise visual care modelling to construct a visual design of the organisation of the care pathway. Methods: An embedded case study was conducted of the outpatient THA care pathway at a teaching hospital in the Netherlands. The data were collected using a visual care modelling toolkit in 16 semi- structured interviews. Problems and inefficiencies in the care pathway were identified and addressed in the iterative design process. Results: The results are two visual models of the most critical phases of the outpatient THA care pathway: diagnosis & preparation (1 and mobilisation & discharge (4. The results show the care team composition, critical value exchanges, and sequence that enable patient discharge on the day of surgery. Conclusion: The design addressed existing problems and is an optimisation of the case hospital’s pathway. The network of actors consists of the patient (1, radiologist (1, anaesthetist (1, nurse specialist (1, pharmacist (1, orthopaedic surgeon (1,4, physiotherapist (1,4, nurse (4, doctor (4 and patient applica- tion (1,4. The critical value exchanges include patient preparation (mental and practical, patient education, aligned care team, efficient sequence of value exchanges, early patient mobilisation, flexible availability of the physiotherapist, functional discharge criteria, joint decision making and availability of the care team.

  8. NASA Network (United States)

    Carter, David; Wetzel, Scott


    The NASA Network includes nine NASA operated and partner operated stations covering North America, the west coast of South America, the Pacific, and Western Australia . A new station is presently being setup in South Africa and discussions are underway to add another station in Argentina. NASA SLR operations are supported by Honeywell Technical Solutions, Inc (HTSI), formally AlliedSignal Technical Services, The University of Texas, the University of Hawaii and Universidad Nacional de San Agustin.

  9. How to build your network. (United States)

    Uzzi, Brian; Dunlap, Shannon


    Many sensational ideas have faded away into obscurity because they failed to reach the right people. A strong personal network, however, can launch a burgeoning plan into the limelight by delivering private information, access to diverse skill sets, and power. Most executives know that they need to learn about the best ideas and that, in turn, their best ideas must be heard by the rest of the world. But strong personal networks don't just happen around a watercooler or at reunions with old college friends. As Brian Uzzi and Shannon Dunlap explain, networks have to be carefully constructed through relatively high-stakes activities that bring you into contact with a diverse group of people. Most personal networks are highly clustered--that is, your friends are likely to be friends with one another as well. And, if you made those friends by introducing yourself to them, the chances are high that their experiences and perspectives echo your own. Because ideas generated within this type of network circulate among the same people with shared views, though, a potential winner can wither away and die if no one in the group has what it takes to bring that idea to fruition. But what if someone within that cluster knows someone else who belongs to a whole different group? That connection, formed by an information broker, can expose your idea to a new world, filled with fresh opportunities for success. Diversity makes the difference. Uzzi and Dunlap show you how to assess what kind of network you currently have, helping you to identify your super-connectors and demonstrating how you act as an information broker for others. They then explain how to diversify your contacts through shared activities and how to manage your new, more potent, network.

  10. A Management Project to Determine the Potential Cost Avoidance Due to the Application of Managed Care Mechanisms on CHAMPUS Inpatient Mental Health Care in Colorado Springs, Colorado (United States)


    within a network of contracted services ( Langman -Dorwart and Peebles, 1988). This review process often includes monitoring of treatment protocols and...demonstrated reduced z in average lengths of stay ( Langman -Dorwart et al, 1988). In fact, according to George-Perry (1988), carefully managed care...28). Tension typifiez relationship between psychiatric providers, managed care. Modern Healthcare, 86-87. Mental Health 90 Langman -Dorwart, Nancy M.S

  11. Hierarchical Network Design

    DEFF Research Database (Denmark)

    Thomadsen, Tommy


    Communication networks are immensely important today, since both companies and individuals use numerous services that rely on them. This thesis considers the design of hierarchical (communication) networks. Hierarchical networks consist of layers of networks and are well-suited for coping...... the clusters. The design of hierarchical networks involves clustering of nodes, hub selection, and network design, i.e. selection of links and routing of ows. Hierarchical networks have been in use for decades, but integrated design of these networks has only been considered for very special types of networks....... The thesis investigates models for hierarchical network design and methods used to design such networks. In addition, ring network design is considered, since ring networks commonly appear in the design of hierarchical networks. The thesis introduces hierarchical networks, including a classification scheme...

  12. The Seniors Health Research Transfer Network Knowledge Network Model: system-wide implementation for health and healthcare of seniors. (United States)

    Chambers, Larry W; Luesby, Deirdre; Brookman, Catherine; Harris, Megan; Lusk, Elizabeth


    The Ontario Seniors Health Research Transfer Network (SHRTN) aims to improve the health of older adults through increasing the knowledge capacity of 850 community care agencies and 620 long-term care homes. The SHRTN includes caregivers, researchers, policy makers, administrators, educators, and organizations. The SHRTN comprises communities of practice, a library service, a network of 7 research institutes, and local implementation teams. The SHRTN combines face-to-face meetings with information technology to promote change at the client care level in organizational and provincial policies and in the promotion of health services research.

  13. Health care marketing management. (United States)

    Cooper, P D


    Health Care Marketing Management is the process of understanding the needs and the wats of a target market. Its purpose is to provide a viewpoint from which to integrate the analysis, planning, implementation (or organization) and control of the health care delivery system.

  14. Lean health care. (United States)

    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.

  15. Prevention IS Care

    Centers for Disease Control (CDC) Podcasts


    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.

  16. Wound Healing and Care (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Wound Healing and Care KidsHealth > For Teens > Wound Healing and Care Print A A A What's in ... mouth, or sunken eyes. There's good news about wound healing when you're a teen: Age is on ...

  17. Robots that care

    NARCIS (Netherlands)

    Looije, R.; Arendsen, J.; Saldien, J.; Vanderborght, B.; Broekens, J.; Neerincx, M.


    Many countries face pressure on their health care systems. To alleviate this pressure, 'self care' and 'self monitoring' are often stimulated with the use of new assistive technologies. Social robotics is a research area where robotic technology is optimized for various social functions. One of thes

  18. Primary Care's Dim Prognosis (United States)

    Alper, Philip R.


    Given the chorus of approval for primary care emanating from every party to the health reform debate, one might suppose that the future for primary physicians is bright. Yet this is far from certain. And when one looks to history and recognizes that primary care medicine has failed virtually every conceivable market test in recent years, its…

  19. Child Care Centres. (United States)

    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…

  20. Finding Health Care Services (United States)

    If you have been diagnosed with cancer, finding a doctor and treatment facility for your cancer care is an important step to getting the best treatment possible. Learn tips for choosing a doctor and treatment facility to manage your cancer care.

  1. Alliance in Youth Care

    NARCIS (Netherlands)

    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

  2. Improved wound care product

    DEFF Research Database (Denmark)


    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....

  3. Care, Europeanization and Gender

    DEFF Research Database (Denmark)

    Dyrberg, Torben Bech

    This book adresses the recent underexamined developments concerning care in Europe, including the negotiations about care at the top EU level to that of individual workers. Through a comparative and interdisciplinary approach, this collection examines and further develops current theoretical and ...

  4. Caring about the young

    NARCIS (Netherlands)

    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

  5. Evaluation of MAC protocols with wake-up radio for implantable body sensor networks

    NARCIS (Netherlands)

    Karuppiah Ramachandran, Vignesh raja; Zwaag, van der Berend Jan; Meratnia, Nirvana; Havinga, Paul J.M.


    The use of wireless communication in implantable medical devices is growing rapidly due to an increasing demand for sophisticated health-care. Recently, a new type of sensor network called Implantable Body Sensor Network (IBSN) has emerged. IBSN is a network of implantable medical sensors and device

  6. Benchmarking HIV health care

    DEFF Research Database (Denmark)

    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...... assessed: Compliance with current guidelines on initiation of 1) combination antiretroviral therapy (cART), 2) chemoprophylaxis, 3) frequency of laboratory monitoring, and 4) virological response to cART (proportion of patients with HIV-RNA 90% of time on cART). RESULTS: 7097 Euro...... 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 HIV health care utilization...

  7. Becoming Care Helper

    DEFF Research Database (Denmark)

    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...

  8. "Patient care in radiology"

    DEFF Research Database (Denmark)

    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...

  9. Occupational therapists’ conceptions on mental health care line

    Directory of Open Access Journals (Sweden)

    Michelle Helena Pereira de Paiva


    Full Text Available The care line recommended by the Brazilian Health System - SUS must be attained by every professionalof the area, milieu and subject. This study aimed to know the occupational therapists’ conceptions about the lineof care in mental health. The data of this study were obtained from a questionnaire sent via virtual network ofcontacts and snowball technique. Data were subjected to qualitative and quantitative analysis. Most participantswere professionals from the southeast region of the country with over five years of training. They exercise theprofessional activity mainly in Psychiatric Hospitals, Psychosocial Assistance Centers – CAPS II and MentalHealth Clinics. There was no registry of professional performance in Residential Therapeutic Services – SRTand Outpatient Clinics - UBS. Regarding care line, six participants did not respond and five were unaware of theterm, followed by the psychosocial rehabilitation principles and therapeutic project; only one answer identified care line as a practice based on care management with reception principles and articulation of social networksand services. Results showed that the professionals’ practices are little guided in care line logic; however, thereis the need systematization of the assistance according this logic in order to apply the Psychiatric Reform,searching the quality of life improvement and reestablishment of the citizenship of people with psychologicaldistress insofar as, in addition to optimizing the care network, which promotes comprehensive humane careand social contractualism.

  10. Why Network? Theoretical Perspectives on Networking (United States)

    Muijs, Daniel; West, Mel; Ainscow, Mel


    In recent years, networking and collaboration have become increasingly popular in education. However, there is at present a lack of attention to the theoretical basis of networking, which could illuminate when and when not to network and under what conditions networks are likely to be successful. In this paper, we will attempt to sketch the…

  11. Open innovation in networks

    DEFF Research Database (Denmark)

    Hu, Yimei

    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...

  12. Chronic disease management: a review of current performance across quality of care domains and opportunities for improving osteoarthritis care. (United States)

    Brand, Caroline A; Ackerman, Ilana N; Bohensky, Megan A; Bennell, Kim L


    Osteoarthritis is the most prevalent chronic joint disease worldwide. The incidence and prevalence are increasing as the population ages and lifestyle risk factors such as obesity increase. There are several evidence-based clinical practice guidelines available to guide clinician decision making, but there is evidence that care provided is suboptimal across all domains of quality: effectiveness, safety, timeliness and appropriateness, patient-centered care, and efficiency. System, clinician, and patient barriers to optimizing care need to be addressed. Innovative models designed to meet patient needs and those that harness social networks must be developed, especially to support those with mild to moderate disease.

  13. Challenges for Managed Care from 340B Contract Pharmacies. (United States)

    Fein, Adam J


    The federal 340B Drug Pricing Program has expanded rapidly, with important yet still unmeasured impact on both managed care practice and policies. Notably, providers increasingly rely on external, contract pharmacies to extend 340B pricing to a broad set of patients. In 2014, 1 in 4 U.S. retail, mail, and specialty pharmacy locations acted as contract pharmacies for 340B-covered entities. This commentary discusses crucial ways in which 340B growth is affecting managed care pharmacy through formulary rebates, profits from managed care paid prescriptions, disruption of retail pharmacy networks, and reduced generic dispensing rates. Managed care should become more engaged in the discussion on how the 340B program should evolve and offer policy proposals to mitigate the challenges being encountered. There is also an urgent need for objective, transparent research on the 340B program's costs, benefits, and implications for managed care pharmacy and practice.

  14. Geographical networks: geographical effects on network properties

    Institute of Scientific and Technical Information of China (English)

    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.

  15. Translational networks in healthcare? Evidence on the design and initiation of organizational networks for knowledge mobilization. (United States)

    Fitzgerald, Louise; Harvey, Gill


    International attention has focussed on the variations between research evidence and practice in healthcare. This prompted the creation of formalized translational networks consisting of academic-service partnerships. The English Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are one example of a translational network. Using longitudinal, archival case study data from one CLAHRC over a 3-year period (2008-11), this article explores the relationship between organizational form and the function(s) of a translational network. The article focuses on the research gaps on the effective structures and appropriate governance to support a translational network. Data analysis suggested that the policy of setting up translational networks is insufficient of itself to produce positive translational activity. The data indicate that to leverage the benefits of the whole network, attention must be paid to devising a structure which integrates research production and use and facilitates lateral cross-disciplinary and cross-organizational communication. Equally, appropriate governance arrangements are necessary, particularly in large, multi-stakeholder networks, where shared governance may be questionable. Inappropriate network structure and governance inhibits the potential of the translational network. Finally, the case provides insights into the movement of knowledge within and between network organizations. The data demonstrate that knowledge mobilization extends beyond knowledge translation; knowledge mobilization includes the negotiated utilization of knowledge - a balanced power form of collaboration. Whilst much translational effort is externally focused on the health system, our findings highlight the essential need for the internal negotiation and mobilization of knowledge within academia.

  16. Managed care and economic dynamics. (United States)

    Riggs, J E


    Over the past several decades, health care delivery in the United States evolved in an environment lacking marketplace constraints. The unforeseen result was the current health care crisis--uncontrolled costs, shrinking access, and redundant technological capabilities. Managed care is a strategy to impose fiscal constraints on health care delivery. A diagrammatic analysis of the economic dynamics between consumers and producers in an open marketplace is compared with that of patients, providers, and payers under the health care scheme that produced the health care crisis and under managed care. Patient demands, expectations, and needs for health care are not subject to fiscal constraint under managed care since the dislinkage between consumer and payer still exits. Managed care does not impose true open marketplace fiscal constraints on health care delivery. Furthermore, any solution to the US health care crisis that used true marketplace fiscal constraints would necessitate fundamental changes in societal values concerning individual rights to health care.

  17. Network Management Framework for Wireless Sensor Networks (United States)

    Kim, Jaewoo; Jeon, Hahnearl; Lee, Jaiyong

    Network Management is the process of managing, monitoring, and controlling the network. Conventional network management was based on wired network which is heavy and unsuitable for resource constrained WSNs. WSNs can have large scale network and it is impossible to manage each node individually. Also, polling mechanism of Simple Network Management Protocol (SNMP) impose heavy management traffic overhead. Since management messages consume resources of WSNs, it can affect the performance of the network. Therefore, it is necessary for WSNs to perform energy efficient network management. In this paper, we will propose network management framework. We will introduce cluster-based network management architecture, and classify the Management Information Base (MIB) according to their characteristics. Then, we will define management messages and message exchange operation for each kind of MIB. The analysis result of the management overhead indicates that the proposed framework can reduce management traffic compared to polling mechanism.

  18. Actividades Instrumentales de la Vida Diaria en Personas Mayores atendidas en la red de Atención Primaria de Salud en la comuna de Chillán Viejo-Chile Instrumental activities of daily living of older people cared for at the Primary Health Care network in the commune of Chillan Viejo-Chile

    Directory of Open Access Journals (Sweden)

    Roxana Alejandra Lara Jaque


    Full Text Available Justificación. Estadísticas nacionales e internacionales demuestran que los equipos de salud tendrán que responder a la necesidad de cuidado de las personas mayores, reconociendo la trascendencia de la capacidad funcional como variable de evaluación de su estado de salud. Objetivo. Determinar características de las personas mayores que pueden influir en su capacidad funcional según las Actividades Instrumentales de la Vida Diaria. Diseño. Estudio cuantitativo, descriptivo-correlacional de corte transversal. Resultados. De 136 individuos estudiados (61% mujeres y una edad promedio de 73,28 ± 6,77 años, se observó que las Actividades Instrumentales de la Vida Diaria dependen significativamente de: nivel de alfabetización (p=0,002, nivel de instrucción (p=0,024, participación comunitaria (p=0,007, estado nutricional (p=0,028 y depresión (p=0,018. Conclusión. Factores sociales, físicos y mentales se relacionan con la funcionalidad de las personas mayores. Es primordial la generación de políticas públicas de protección a este grupo de la población, con un enfoque multidisciplinario y sistémico.Justification. National and International statistics show that health teams will have to respond to the needs of caring for older people, considering the implication of the functional capacity as a variable of evaluation of their health condition. Objective. To determine those characteristics in older people that may influence their functional capacity, according to the Instrumental Activities of Daily Living. Design. Quantitative, descriptive-correlational cross sectional study. Results. Out of 136 individuals studied (61% female and an average age of 73,28 ± 6,77 years old, it was observed that the Instrumental Activities of Daily Living depend significantly on: literacy level (p=0,002, instruction level (p=0,024, community participation (p=0,007, nutritional status (p=0,028 and depression (p=0,018. Conclusion. Social, physical and

  19. CARE05 coordinated accelerator research in Europe

    CERN Multimedia


    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...

  20. Palliative Care: Video Tells a Mother's Story of Caring Support (United States)

    ... care, and when is it provided? Palliative care combines pain and symptom management with spiritual support, counseling, ... fully understand your needs. Read More "Palliative Care" Articles Increasing the quality of life for patients and ...

  1. Exemplar pediatric collaborative improvement networks: achieving results. (United States)

    Billett, Amy L; Colletti, Richard B; Mandel, Keith E; Miller, Marlene; Muething, Stephen E; Sharek, Paul J; Lannon, Carole M


    A number of pediatric collaborative improvement networks have demonstrated improved care and outcomes for children. Regionally, Cincinnati Children's Hospital Medical Center Physician Hospital Organization has sustained key asthma processes, substantially increased the percentage of their asthma population receiving "perfect care," and implemented an innovative pay-for-performance program with a large commercial payor based on asthma performance measures. The California Perinatal Quality Care Collaborative uses its outcomes database to improve care for infants in California NICUs. It has achieved reductions in central line-associated blood stream infections (CLABSI), increased breast-milk feeding rates at hospital discharge, and is now working to improve delivery room management. Solutions for Patient Safety (SPS) has achieved significant improvements in adverse drug events and surgical site infections across all 8 Ohio children's hospitals, with 7700 fewer children harmed and >$11.8 million in avoided costs. SPS is now expanding nationally, aiming to eliminate all events of serious harm at children's hospitals. National collaborative networks include ImproveCareNow, which aims to improve care and outcomes for children with inflammatory bowel disease. Reliable adherence to Model Care Guidelines has produced improved remission rates without using new medications and a significant increase in the proportion of Crohn disease patients not taking prednisone. Data-driven collaboratives of the Children's Hospital Association Quality Transformation Network initially focused on CLABSI in PICUs. By September 2011, they had prevented an estimated 2964 CLABSI, saving 355 lives and $103,722,423. Subsequent improvement efforts include CLABSI reductions in additional settings and populations.

  2. Mesh network simulation


    Pei Ping; YURY N. PETRENKO


    A Mesh network simulation framework which provides a powerful and concise modeling chain for a network structure will be introduce in this report. Mesh networks has a special topologic structure. The paper investigates a message transfer in wireless mesh network simulation and how does it works in cellular network simulation. Finally the experimental result gave us the information that mesh networks have different principle in transmission way with cellular networks in transmission, and multi...

  3. ENLIGHT Network

    CERN Multimedia

    Ballantine, A; Dixon-Altaber, H; Dosanjh, M; Kuchina, L


    State-of-the-art techniques borrowed from particle accelerators and detectors are a key element in hadrontherapy and several European projects are actively fostering the collaboration amongst the various disciplines and countries. ENLIGHT was established in 2002 to coordinate these European efforts in hadron therapy. The ENLIGHT network is formed by the European hadrontherapy Community, with more than 300 participants from twenty European countries. A major achievement of ENLIGHT has been the blending of traditionally separate communities so that clinicians, physicists, biologists and engineers with experience and interest in particle therapy are working together.

  4. Human behavior understanding in networked sensing theory and applications of networks of sensors

    CERN Document Server

    Spagnolo, Paolo; Distante, Cosimo


    This unique text/reference provides a broad overview of both the technical challenges in sensor network development, and the real-world applications of distributed sensing. Important aspects of distributed computing in large-scale networked sensor systems are analyzed in the context of human behavior understanding, including such topics as systems design tools and techniques, in-network signals, and information processing. Additionally, the book examines a varied range of application scenarios, covering surveillance, indexing and retrieval, patient care, industrial safety, social and ambient

  5. Primary care for refugees. (United States)

    Eckstein, Barbara


    Over the past decade, at least 600,000 refugees from more than 60 different countries have been resettled in the United States. The personal history of a refugee is often marked by physical and emotional trauma. Although refugees come from many different countries and cultures, their shared pattern of experiences allows for some generalizations to be made about their health care needs and challenges. Before being accepted for resettlement in the United States, all refugees must pass an overseas medical screening examination, the purpose of which is to identify conditions that could result in ineligibility for admission to the United States. Primary care physicians have the opportunity to care for members of this unique population once they resettle. Refugees present to primary care physicians with a variety of health problems, including musculoskeletal and pain issues, mental and social health problems, infectious diseases, and longstanding undiagnosed chronic illnesses. Important infectious diseases to consider in the symptomatic patient include tuberculosis, parasites, and malaria. Health maintenance and immunizations should also be addressed. Language barriers, cross-cultural medicine issues, and low levels of health literacy provide additional challenges to caring for this population. The purpose of this article is to provide primary care physicians with a guide to some of the common issues that arise when caring for refugee patients.

  6. Advocacy for eye care

    Directory of Open Access Journals (Sweden)

    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.

  7. Technical elements, demonstration projects, and fiscal models in Medicaid managed care for people with developmental disabilities. (United States)

    Kastner, T A; Walsh, K K; Criscione, T


    We presented a general model of the structure and functioning of managed care and described elements (provider networks, fiscal elements, risk estimation, case-mix, management information systems, practice parameters, and quality improvement) critical to service delivery for people with developmental disabilities. A number of technical elements of managed care systems were delineated and reviewed in relation to the inclusion of people with developmental disabilities. Several managed care demonstration projects were described and, finally, a multi-year hypothetical budget model, including long-term care, was presented as a framework for considering how managed care affects specific service structures. Implications for people with developmental disabilities were discussed.

  8. Accountable care organizations and kidney disease care: health reform innovation or more same-old, same-old? (United States)

    Pauly, Mark V


    The conceptual model for an accountable care organization imagines that care will be rendered to a defined population by an entity that receives bundled payment for that care, coordinates the individual services involved in that care, provides measures of outcomes and quality, and divides the bundled payment among those who supply services. How does this concept differ from earlier efforts, and what, if anything, does it mean for the care of patients with end-stage renal disease? The concept is similar to the largely abandoned integrated delivery networks of the 1990s. The support from Medicare may make a difference, but Medicare's need to constrain spending growth will pose a challenge. Kidney disease care is already much more coordinated than health care for the rest of the population. There are some potential gains from greater coordination, especially with care for comorbid conditions associated with hospitalization. However, economic analysis suggests that the absence of large populations of patients in given geographic sites and the relatively smaller gain from incremental improvements in coordination might mean that the accountable care organization model are not ideal for the dialysis market.

  9. Primary Care Clinics and Accountable Care Organizations

    Directory of Open Access Journals (Sweden)

    Judith Ortiz PhD


    Full Text Available Background: The Accountable Care Organization (ACO is one of the new models of health care delivery in the United States. To date, little is known about the characteristics of health care organizations that have joined ACOs. We report on the findings of a survey of primary care clinics, the objective of which was to investigate the opinions of clinic management about participation in ACOs and the characteristics of clinic organizational structure that may contribute to joining ACOs or be willing to do so. Methods: A 27-item survey questionnaire was developed and distributed by mail in 3 annual waves to all Rural Health Clinics (RHCs in 9 states. Two dependent variables—participation in ACOs and willingness to join ACOs—were created and analyzed using a generalized estimating equation approach. Results: A total of 257 RHCs responded to the survey. A small percentage (5.2% of the respondent clinics reported that they were participating in ACOs. Rural Health Clinics in isolated areas were 78% less likely to be in ACOs (odds ratio = 0.22, P = .059. Nonprofit RHCs indicated a higher willingness to join an ACO than for-profit RHCs (B = 1.271, P = .054. There is a positive relationship between RHC size and willingness to join an ACO (B = 0.402, P = .010. Conclusion: At this early stage of ACO development, many RHC personnel are unfamiliar with the ACO model. Rural providers’ limited technological and human resources, and the lack of ACO development in rural areas, may delay or prevent their participation in ACOs.

  10. Hair care and dyeing. (United States)

    Draelos, Zoe Diana


    Alopecia can be effectively camouflaged or worsened through the use of hair care techniques and dyeing. Proper hair care, involving hair styling and the use of mild shampoos and body-building conditioners, can amplify thinning scalp hair; however, chemical processing, including hair dyeing, permanent waving, and hair straightening, can encourage further hair loss through breakage. Many patients suffering from alopecia attempt to improve their hair through extensive manipulation, which only increases problems. Frequent haircuts to minimize split ends, accompanied by gentle handling of the fragile fibers, is best. This chapter offers the dermatologist insight into hair care recommendations for the alopecia patient.


    Institute of Scientific and Technical Information of China (English)


    IN April, the Beijing Education Commission, Beijing Women’s Federation and the China Institute of Family Education jointly decided the theme of China’s family education for 1997: Learn to care and teach good behavior. This theme reminds us of the requirement of young generations in many other countries: Learn to survive, learn to care. It reveals that learning to care about others is not only a problem faced by Chinese children, most of whom grow up as an only child, but is a common problem in children’s education

  12. Health care utilization

    DEFF Research Database (Denmark)

    Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

    An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...... are important, but that economics cannot alone explain the differences in health care utilization....

  13. Glossary of Managed Care Definitions (United States)

    ... care provided to a patient by a health care provider. The medical record includes notes from physician visits, hospitalization records, test results, and consultations by specialists. Each health care provider who treats a patient usually creates and maintains ...

  14. Your cancer survivorship care plan (United States)

    ... ency/patientinstructions/000822.htm Your cancer survivorship care plan To use the sharing features on this page, ... get one. What Is a Cancer Survivorship Care Plan? A cancer survivorship care plan is a document ...

  15. Increasing the marketability and recognition of provider network joint ventures. (United States)

    Sjobeck, S J


    Physicians have been developing provider network joint ventures to market their services jointly to managed care plans, employers, and other purchasers. Over the past few years, external market factors have produced a growing impact on these joint ventures. These external market factors include the Federal government's revised antitrust guidelines, National Committee for Quality Assurance activities, and state and Federal consumer protection laws. Simply responding to these forces may not increase a provider network's marketability unless the network can demonstrate its value in the terms and measurements accepted by the consumer, managed care plans, and provider networks. By doing so, a provider network can not only increase its marketability, but also increase its recognition in the market, improve its competitive advantage, and enhance its return on investment.

  16. How to integrate social care services into primary health care? An experience from Iran (United States)

    Montazeri, Ali; Riazi-Isfahani, Sahand; Damari, Behzad


    Background: Social issues have prominent effects on the peoples' physical and mental health and on the health risk factors. In Iran, many organizations provide social care services to their target population. This study aimed to explore the roles and functions of Primary Health Care (PHC) system in providing social care services in Iran. Methods: This was a qualitative study, for which data were collected via three sources: A review of the literature, in-depth interviews and focus group discussions with experts and stakeholders. The main objective was to find a way to integrate social care into the Iranian PHC system. A conventional content analysis was performed to explore the data. Results: Overall, 20 experts were interviewed and the acquired data were classified into four major categories including priorities, implementation, requirements and stewardship. The main challenges were the existing controversies in the definition of social care, social service unit disintegration, multiple stewards for social care services, weaknesses of rules and regulations and low financing of the public budget. Social care services can be divided into two categories: Basic and advanced. Urban and rural health centers, as the first level of PHC, could potentially provide basic social care services for their defined population and catchment areas such as detecting social harms in high risk individuals and families and providing counseling for people in need. They can also refer the individuals to receive advanced services. Conclusion: Iran has a successful history of establishing the PHC System especially in rural areas. This network has an invaluable capacity to provide social health services. Establishing these services needs some prerequisites such as a reform PHC structure, macro support and technical intersectoral collaboration. They should also be piloted and evaluated before they could be implemented in the whole country. PMID:27683649

  17. Interorganizational health care systems implementations: an exploratory study of early electronic commerce initiatives. (United States)

    Payton, F C; Ginzberg, M J


    Changing business practices, customers needs, and market dynamics have driven many organizations to implement interorganizational systems (IOSs). IOSs have been successfully implemented in the banking, cotton, airline, and consumer-goods industries, and recently attention has turned to the health care industry. This article describes an exploratory study of health care IOS implementations based on the voluntary community health information network (CHIN) model.

  18. Patient centredness in integrated care: results of a qualitative study based on a systems theoretical framework

    Directory of Open Access Journals (Sweden)

    Daniel Lüdecke


    Full Text Available Introduction: Health care providers seek to improve patient-centred care. Due to fragmentation of services, this can only be achieved by establishing integrated care partnerships. The challenge is both to control costs while enhancing the quality of care and to coordinate this process in a setting with many organisations involved. The problem is to establish control mechanisms, which ensure sufficiently consideration of patient centredness. Theory and methods: Seventeen qualitative interviews have been conducted in hospitals of metropolitan areas in northern Germany. The documentary method, embedded into a systems theoretical framework, was used to describe and analyse the data and to provide an insight into the specific perception of organisational behaviour in integrated care. Results: The findings suggest that integrated care partnerships rely on networks based on professional autonomy in the context of reliability. The relationships of network partners are heavily based on informality. This correlates with a systems theoretical conception of organisations, which are assumed autonomous in their decision-making. Conclusion and discussion: Networks based on formal contracts may restrict professional autonomy and competition. Contractual bindings that suppress the competitive environment have negative consequences for patient-centred care. Drawbacks remain due to missing self-regulation of the network. To conclude, less regimentation of integrated care partnerships is recommended.

  19. Patient centredness in integrated care: results of a qualitative study based on a systems theoretical framework

    Directory of Open Access Journals (Sweden)

    Daniel Lüdecke


    Full Text Available Introduction: Health care providers seek to improve patient-centred care. Due to fragmentation of services, this can only be achieved by establishing integrated care partnerships. The challenge is both to control costs while enhancing the quality of care and to coordinate this process in a setting with many organisations involved. The problem is to establish control mechanisms, which ensure sufficiently consideration of patient centredness.Theory and methods: Seventeen qualitative interviews have been conducted in hospitals of metropolitan areas in northern Germany. The documentary method, embedded into a systems theoretical framework, was used to describe and analyse the data and to provide an insight into the specific perception of organisational behaviour in integrated care.Results: The findings suggest that integrated care partnerships rely on networks based on professional autonomy in the context of reliability. The relationships of network partners are heavily based on informality. This correlates with a systems theoretical conception of organisations, which are assumed autonomous in their decision-making.Conclusion and discussion: Networks based on formal contracts may restrict professional autonomy and competition. Contractual bindings that suppress the competitive environment have negative consequences for patient-centred care. Drawbacks remain due to missing self-regulation of the network. To conclude, less regimentation of integrated care partnerships is recommended.

  20. TELECOM 1 multiservices network (United States)

    Lombard, D.; Ramat, P.; Rancy, F.

    The main objectives of the TELECOM 1 French domestic satellite project are to set up a business communication network which is to carry a wide range of digital services including data, voice, and pictures between a number of small earth stations located on the subscribers' premises. The parallel development of terrestrial specialized services networks has enabled the fitting of the TELECOM 1 network with high interworking capabilities with these networks. It has also allowed TELECOM 1 to be designed as the basis of the Future Integrated Services Digital Network. The TELECOM 1 network consists of the terrestrial network, the satellite network, and the maintenance network. Various elements which include the terrestrial network; the satellite network, and its modulation, TDMA frame and terminals; the System Management Center; the signalling system; and the demand assignment operation which are involved in the operation of the multiservices network are presented. The TELECOM 1 network evolution until 1990 through the rapid development of the ISDN is discussed.