WorldWideScience

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

    2010-04-01

    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 Thirty-seven clinic members who had withdrawn from their PCCNs were identified from the 2003-2005 Taiwan Primary Community Care Network Lists.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

    2007-06-01

    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. Care transition and network activation in Portugal

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    Santana, Silvina; M. Viana

    2012-01-01

    Purpose To report on the use of a user-centred model and methodology to assess the quality of care transition and network activation action, in light of an ongoing home supported discharge procedure for stroke patients in Portugal. Theory In Portugal, the health care system presents weaknesses resulting from a remarkable diversity of entry points, inadequate use of scarce and expensive resources and difficult information flow between institutions and professionals. The social care network is ...

  4. Team networking in palliative care

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    Odette Spruyt

    2011-01-01

    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. Evaluating the Effectiveness of Community-Based Dementia Care Networks: The Dementia Care Networks' Study

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    Lemieux-Charles, Louis; Chambers, Larry W.; Cockerill, Rhonda; Jaglal, Susan; Brazil, Kevin; Cohen, Carole; LeClair, Ken; Dalziel, Bill; Schulman, Barbara

    2005-01-01

    Purpose: The Dementia Care Networks' Study examined the effectiveness of four community-based, not-for-profit dementia networks. The study involved assessing the relationship between the types of administrative and service-delivery exchanges that occurred among the networked agencies and the network members' perception of the effectiveness of…

  6. The productivity of primary care research networks.

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    Griffiths, F; Wild, A; Harvey, J; Fenton, E

    2000-11-01

    Primary care research networks are being publicly funded in the United Kingdom to promote a culture of research and development in primary care. This paper discusses the organisational form of these networks and how their productivity can be evaluated, drawing on evidence from management science. An evaluation of a research network has to take account of the complexity of the organisation, the influence of its local context, and its stage of development. Output measures, such as number of research papers, and process measures, such as number of research meetings, may contribute to an evaluation. However, as networking relies on the development of informal, trust-based relationships, the quality of interactions within a network is of paramount importance for its success. Networks can audit and reflect on their success in promoting such relationships and a more formal qualitative evaluation by an independent observer can document their success to those responsible for funding. PMID:11141879

  7. Social networks in improvement of health care.

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    Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris

    2012-01-01

    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

  8. Communication security in open health care networks.

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    Blobel, B; Pharow, P; Engel, K; Spiegel, V; Krohn, R

    1999-01-01

    Fulfilling the shared care paradigm, health care networks providing open systems' interoperability in health care are needed. Such communicating and co-operating health information systems, dealing with sensitive personal medical information across organisational, regional, national or even international boundaries, require appropriate security solutions. Based on the generic security model, within the European MEDSEC project an open approach for secure EDI like HL7, EDIFACT, XDT or XML has been developed. The consideration includes both securing the message in an unsecure network and the transport of the unprotected information via secure channels (SSL, TLS etc.). Regarding EDI, an open and widely usable security solution has been specified and practically implemented for the examples of secure mailing and secure file transfer (FTP) via wrapping the sensitive information expressed by the corresponding protocols. The results are currently prepared for standardisation. PMID:10724890

  9. Social networking: applications for health care recruitment.

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    Russell, Judith

    2007-01-01

    In today's competitive landscape for health care talent, nursing executives and human resource professionals need to assess and evaluate new avenues for recruitment. The strategy of filling positions by means of print advertising is becoming outmoded quickly. As an industry, health care typically lags behind other industries when it relates to technology. This is especially true in implementing any interactive strategies to target hard-to-fill positions. Social networking sites have appeared on the Internet landscape quickly and continue to flourish. Nurse leaders need to capitalize on this phenomenon. PMID:18080628

  10. Structuring networks for maximum performance under managed care.

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    Miller, T R

    1996-12-01

    Healthcare providers interested in forming delivery networks to secure managed care contracts must decide how to structure their networks. Two basic structural models are available: the noncorporate model and the corporate model. The noncorporate model delivery network typically has a single governing body and management infrastructure to oversee only managed care contracting and related business. The corporate model delivery system has a unified governance management infrastructure that handles all of the network's business. While either structure can work, corporate model networks usually are better able to enforce provider behavior that is in the best interest of a network as a whole. PMID:10163003

  11. The impact of informal care-giving networks on adult children's care-giver burden

    OpenAIRE

    Tolkacheva, N.; Broese van Groenou, M. I.; Boer; Tilburg, van, P.J.A.

    2011-01-01

    Previous research on the care-giver burden experienced by adult children has typically focused on the adult child and parent dyad. This study uses information on multiple informal care-givers and examines how characteristics of the informal care-giving network affect the adult child's care-giver burden. In 2007, 602 Dutch care-givers who were assisting their older parents reported on parental and personal characteristics, care activities, experienced burden and characteristics of other inform...

  12. Collaborative Chronic Care Networks (C3Ns) to Transform Chronic Illness Care

    OpenAIRE

    Margolis, Peter A; Peterson, Laura E.; Seid, Michael

    2013-01-01

    Despite significant gains by pediatric collaborative improvement networks, the overall US system of chronic illness care does not work well. A new paradigm is needed: a Collaborative Chronic Care Network (C3N). A C3N is a network-based production system that harnesses the collective intelligence of patients, clinicians, and researchers and distributes the production of knowledge, information, and know-how over large groups of people, dramatically accelerating the discovery process. A C3N is a...

  13. Social Networks in Improvement of Health Care

    OpenAIRE

    Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris

    2012-01-01

    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...

  14. How can Health Care Social networks increase user innovation in Health Care?

    OpenAIRE

    Lochny, Jonas

    2015-01-01

    The health care industry has experienced a significant advancement in the usage of modern Information and Communication Technologies (ICT) that has allowed the different health care stakeholders an increasing access to health information and enables them to take health care decisions on their own behalf. In this thesis we evaluate this increasing usage of modern communication means and networking opportunities in health care online communities and which effects it can have on user innovation....

  15. Audit Trail Management System in Community Health Care Information Network.

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

    2015-01-01

    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.

  16. Nursing Home Care Quality: Insights from a Bayesian Network Approach

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    Goodson, Justin; Jang, Wooseung; Rantz, Marilyn

    2008-01-01

    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…

  17. Mixed care networks of community-dwelling older adults with physical health impairments in the Netherlands.

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    Broese van Groenou, Marjolein; Jacobs, Marianne; Zwart-Olde, Ilse; Deeg, Dorly J H

    2016-01-01

    As part of long-term care reforms, home-care organisations in the Netherlands are required to strengthen the linkage between formal and informal caregivers of home-dwelling older adults. Information on the variety in mixed care networks may help home-care organisations to develop network type-dependent strategies to connect with informal caregivers. This study first explores how structural (size, composition) and functional features (contact and task overlap between formal and informal caregivers) contribute to different types of mixed care networks. Second, it examines to what degree these network types are associated with the care recipients' characteristics. Through home-care organisations in Amsterdam, the Netherlands, we selected 74 frail home-dwelling clients who were receiving care in 2011-2012 from both informal and formal caregivers. The care networks of these older adults were identified by listing all persons providing help with five different types of tasks. This resulted in care networks comprising an average of 9.7 caregivers, of whom 67% were formal caregivers. On average, there was contact between caregivers within 34% of the formal-informal dyads, and both caregivers carried out at least one similar type of task in 29% of these dyads. A principal component analysis of size, composition, contact and task overlap showed two distinct network dimensions from which four network types were constructed: a small mixed care network, a small formal network, a large mixed network and a large formal network. Bivariate analyses showed that the care recipients' activities of daily living level, memory problems, social network, perceived control of care and level of mastery differed significantly between these four types. The results imply that different network types require different actions from formal home-care organisations, such as mobilising the social network in small formal networks, decreasing task differentiation in large formal networks and assigning

  18. Net one, net two: the primary care network income statement.

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    Halley, M D; Little, A W

    1999-10-01

    Although hospital-owned primary care practices have been unprofitable for most hospitals, some hospitals are achieving competitive advantage and sustainable practice operations. A key to the success of some has been a net income reporting tool that separates practice operating expenses from the costs of creating and operating a network of practices to help healthcare organization managers, physicians, and staff to identify opportunities to improve the network's financial performance. This "Net One, Net Two" reporting allows operations leadership to be held accountable for Net One expenses and strategic leadership to be held accountable for Net Two expenses. PMID:11066669

  19. Net one, net two: the primary care network income statement.

    Science.gov (United States)

    Halley, M D; Little, A W

    1999-10-01

    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.

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

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

    2015-07-01

    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.

  1. Complementary and alternative medicine for children's asthma: satisfaction, care provider responsiveness, and networks of care.

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    Freidin, Betina; Timmermans, Stefan

    2008-01-01

    We explain why some caretakers opt for alternative medicine for the treatment of children's asthma whereas others do not. In the past 15 years, asthma care has been standardized, with clinical practice guidelines centered on advanced pharmacological regimes. Clinicians argue that with proper biomedical treatment and environmental control, asthma should be a manageable chronic disease. Yet many patients forego available pharmacological treatments for alternative medicine or complement prescribed drugs with unconventional treatments. On the basis of open-ended, in-depth qualitative interviews with 50 mothers of children with asthma, we argue that the experience with biomedical treatments, social influence in mother's network of care, concerns about adverse and long-term effects, health care providers' responsiveness to such concerns, and familiarity with alternative treatments explain why some families rely on alternative medicine and others do not. PMID:18174534

  2. [Reform, responsibilities and networks: about mental health care].

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    Batista e Silva, Martinho Braga

    2009-01-01

    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 political, institutional and historical context such as mediation of social changes and conflicts. Among the analyzed materials are the medical records indicating the involvement of the social actors in the social support network. PMID:19142318

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

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    Aline do Amaral Zils

    2010-11-01

    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.

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

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    Kerry Byrne

    2012-07-01

    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.

  5. 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

    2015-07-01

    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

  6. Social networks of nursing staff and organizational performance. A study in long-term care facilities

    OpenAIRE

    Beek, A.P.A. van

    2013-01-01

    Over the years, there has been increasing attention for the role of social networks in explaining performance differences between organizations. Yet, research on social networks within healthcare organizations in general and long-term care facilities specifically has been rare, despite growing interest in explanations for differences in performance. In this thesis, we study informal social networks of nursing staff and organizational performance in different care settings for residents with d...

  7. [Health care networks in Germany: status quo and key success factors].

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    Wambach, Veit; Lindenthal, J

    2015-04-01

    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.

  8. Sensor Network Infrastructure for a Home Care Monitoring System

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    Filippo Palumbo

    2014-02-01

    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.

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

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    Barber Vicki S

    2008-06-01

    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. 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.

  11. Advanced course for doctors as Departmental IT Network Administrators in anesthesia and intensive care units.

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    Lanza, Vincenzo; Huang, Chun-Hsi

    2006-10-01

    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.

  12. 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

    2005-01-01

    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 (

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

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    Glonek Gary FV

    2007-10-01

    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.

  14. Care networking: a study of technical mediations in a home telecare service.

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    Correa, Gonzalo; Domènech, Miquel

    2013-07-01

    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. PMID:23880730

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

    Directory of Open Access Journals (Sweden)

    Miquel Domènech

    2013-07-01

    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.

    Science.gov (United States)

    Correa, Gonzalo; Domènech, Miquel

    2013-07-22

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

    OpenAIRE

    Miquel Domènech; Gonzalo Correa

    2013-01-01

    This article examines the processes of technical mediation within familial care networks based on a study of home telecare targeted at older people. upported by contributions from the actor—network theory as part of the social psychology of science and technology, these processes of technical mediation are analyzed using a qualitative approach. The data were gathered through six focus groups and four in-depth interviews; the participants in the study included users, relatives and formal care...

  18. [The network of mental health care from the family health strategy service].

    Science.gov (United States)

    Wetzel, Christine; de Pinho, Leandro Barbosa; Olschowsky, Agnes; Guedes, Ariane da Cruz; Camatta, Marcio Wagner; Schneider, Jacó Fernando

    2014-06-01

    The Family Health Strategy Service (FHSS) is an important ally in the mental health system, contributing to the completeness and effectiveness of care. This study aimed to discuss the mental health care network as compared to the daily routine of an FHSS. It is an evaluative study with a qualitative methodological approach. It was developed in an FHSS in Porto Alegre-RS, Brazil. Data was collected between July and December of 2010 through interviews with 16 workers and ten relatives. We identified important resources in primary health care, such as partnerships with academia. However, the constitution of this care is still based on specialty, following the logic of patient referral. Our intention for this study was to contribute to the operationalization of the mental health care network, consolidating the partnership with the FHSS and developing activities in the territorial space, raising awareness, demystifying health care service in the area, and countering the perception that it is uniquely specialized. PMID:25158457

  19. Social networks of nursing staff and organizational performance. A study in long-term care facilities

    NARCIS (Netherlands)

    Beek, A.P.A van

    2013-01-01

    Over the years, there has been increasing attention for the role of social networks in explaining performance differences between organizations. Yet, research on social networks within healthcare organizations in general and long-term care facilities specifically has been rare, despite growing inter

  20. European primary care surveillance networks: an overview of structure and operation.

    NARCIS (Netherlands)

    Deckers, J.G.M.; Paget, W.J.; Schellevis, F.G.; Fleming, D.M.

    2004-01-01

    In many European countries, primary care networks have a important role in public health surveillance. The networks are organised and function differently in EU member states. Their information is a potential source for a European health information and monitoring system as envisaged in the European

  1. Implementing a Trauma-Informed Approach in Pediatric Health Care Networks.

    Science.gov (United States)

    Marsac, Meghan L; Kassam-Adams, Nancy; Hildenbrand, Aimee K; Nicholls, Elizabeth; Winston, Flaura K; Leff, Stephen S; Fein, Joel

    2016-01-01

    Pediatric health care networks serve millions of children each year. Pediatric illness and injury are among the most common potentially emotionally traumatic experiences for children and their families. In addition, millions of children who present for medical care (including well visits) have been exposed to prior traumatic events, such as violence or natural disasters. Given the daily challenges of working in pediatric health care networks, medical professionals and support staff can experience trauma symptoms related to their work. The application of a trauma-informed approach to medical care has the potential to mitigate these negative consequences. Trauma-informed care minimizes the potential for medical care to become traumatic or trigger trauma reactions, addresses distress, provides emotional support for the entire family, encourages positive coping, and provides anticipatory guidance regarding the recovery process. When used in conjunction with family-centered practices, trauma-informed approaches enhance the quality of care for patients and their families and the well-being of medical professionals and support staff. Barriers to routine integration of trauma-informed approaches into pediatric medicine include a lack of available training and unclear best-practice guidelines. This article highlights the importance of implementing a trauma-informed approach and offers a framework for training pediatric health care networks in trauma-informed care practices. PMID:26571032

  2. VAMP - a vision based sensor network for health care hygiene

    OpenAIRE

    Curran, Padraig; Buckley, John; O'Flynn, Brendan; Li, Xuchun; Zhou, Jiang; Lacey, Gerard; Ó Mathúna, S. Cian

    2008-01-01

    Adequate hand-washing has been shown to be a critical activity in preventing the transmission of infections such as MRSA in health-care environments. Hand-washing guidelines published by various health-care related institutions recommend a technique incorporating six hand-washing poses that ensure all areas of the hands are thoroughly cleaned. In this paper, an embedded wireless vision system (VAMP) capable of accurately monitoring hand-washing quality is presented. The VAMP system hardware c...

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

    Directory of Open Access Journals (Sweden)

    Karen E. Hamilton

    2005-09-01

    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

  4. 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.

  5. Grassroots inter-professional networks: the case of organizing care for older cancer patients.

    Science.gov (United States)

    Bagayogo, Fatou Farima; Lepage, Annick; Denis, Jean-Louis; Lamothe, Lise; Lapointe, Liette; Vedel, Isabelle

    2016-09-19

    Purpose The purpose of this paper of inter-professional networks is to analyze the evolution of relationships between professional groups enacting new forms of collaboration to address clinical imperatives. Design/methodology/approach This paper uses a case study based on semi-structured interviews with physicians and nurses, document analysis and informal discussions. Findings This study documents how two inter-professional networks were developed through professional agency. The findings show that the means by which networks are developed influence the form of collaboration therein. One of the networks developed from day-to-day, immediately relevant, exchange, for patient care. The other one developed from more formal and infrequent research and training exchanges that were seen as less decisive in facilitating patient care. The latter resulted in a loosely knit network based on a small number of ad hoc referrals while the other resulted in a tightly knit network based on frequent referrals and advice seeking. Practical implications Developing inter-professional networks likely require a sustained phase of interpersonal contacts characterized by persuasion, knowledge sharing, skill demonstration and trust building from less powerful professional groups to obtain buy-in from more powerful professional groups. The nature of the collaboration in any resulting network depends largely on the nature of these initial contacts. Originality/value The literature on inter-professional healthcare networks focusses on mandated networks such as NHS managed care networks. There is a lack of research on inter-professional networks that emerged from the bottom up at the initiative of healthcare professionals in response to clinical imperatives. This study looks at some forms of collaboration that these "grass-root" initiatives engender and how they are consolidated. PMID:27681028

  6. Effect of social networks and well-being on acute care needs.

    Science.gov (United States)

    Sintonen, Sanna; Pehkonen, Aini

    2014-01-01

    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.

  7. Scotland's Knowledge Network: translating knowledge into action to improve quality of care.

    Science.gov (United States)

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

    2012-11-01

    The Knowledge Network (www.knowledge.scot.nhs.uk) 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.

  8. Family practices registration networks contributed to primary care research.

    NARCIS (Netherlands)

    Weel, C. van; Grauw, W.J.C. de

    2006-01-01

    BACKGROUND AND OBJECTIVE: Family physicians (FP) play a key role in the diagnosis and treatment of health problems in the community and for evidence-based guidance clinical research must be based on primary care data. This paper analyses the state-of-the-art approaches to collection of data and the

  9. Social networks and the communication of norms about prenatal care in rural Mexico.

    Science.gov (United States)

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

    2015-01-01

    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.

  10. SAT-Based Complete Don't-Care Computation for Network Optimization

    CERN Document Server

    Mishchenko, Alan

    2011-01-01

    This paper describes an improved approach to Boolean network optimization using internal don't-cares. The improvements concern the type of don't-cares computed, their scope, and the computation method. Instead of the traditionally used compatible observability don't-cares (CODCs), we introduce and justify the use of complete don't-cares (CDC). To ensure the robustness of the don't-care computation for very large industrial networks, a optional windowing scheme is implemented that computes substantial subsets of the CDCs in reasonable time. Finally, we give a SAT-based don't-care computation algorithm that is more efficient than BDD-based algorithms. Experimental results confirm that these improvements work well in practice. Complete don't-cares allow for a reduction in the number of literals compared to the CODCs. Windowing guarantees robustness, even for very large benchmarks on which previous methods could not be applied. SAT reduces the runtime and enhances robustness, making don't-cares affordable for a v...

  11. Care of burns in Scotland: 3-year data from the managed clinical network national registry

    OpenAIRE

    Gilhooly, Charlotte; Kinsella, John

    2014-01-01

    Introduction The Managed Clinical Network for Care of Burns in Scotland (COBIS) was launched in April 2007. Primary aims included establishing and maintaining a registry of complex burn injury in Scotland and setting mechanisms to regularly audit outcome of burn treatment against nationally agreed standards of care. On behalf of COBIS, we present 3-year incidence and mortality data of Scottish patients admitted with a complex burn injury in this abstract. Methods From January 2010 o...

  12. Transitional care in clinical networks for young people with juvenile idiopathic arthritis: current situation and challenges.

    Science.gov (United States)

    Cruikshank, Mary; Foster, Helen E; Stewart, Jane; Davidson, Joyce E; Rapley, Tim

    2016-04-01

    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

  13. Transitional care in clinical networks for young people with juvenile idiopathic arthritis: current situation and challenges.

    Science.gov (United States)

    Cruikshank, Mary; Foster, Helen E; Stewart, Jane; Davidson, Joyce E; Rapley, Tim

    2016-04-01

    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

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

    Directory of Open Access Journals (Sweden)

    Thaís Araújo Barbosa

    2016-02-01

    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.

  15. Current state of information technology use in a US primary care practice-based research network

    Directory of Open Access Journals (Sweden)

    James Andrews

    2004-02-01

    Conclusion While interest in enabling information technologies was high in KAN, adoption was variable, with use of several key technologies reported as low.The results suggest that research in this network that would be dependent on or enhanced by IT might be impeded and, generally, greater attention should be given to enhancing the IT infrastructure in primary care.

  16. 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

    2015-10-01

    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. 

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

    Directory of Open Access Journals (Sweden)

    Tjibbe Donker

    2010-03-01

    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.

  18. 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.

    2001-01-01

    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

  19. A Personal Health Network for Chemotherapy Care Coordination: Evaluation of Usability Among Patients.

    Science.gov (United States)

    Kim, Katherine K; Bell, Janice F; Bold, Richard; Davis, Andra; Ngo, Victoria; Reed, Sarah C; Joseph, Jill G

    2016-01-01

    Cancer is a top concern globally. Cancer care suffers from lack of coordination, silos of information, and high cost. Interest is emerging in person-centered technology to assist with coordination to address these challenges. This study evaluates the usability of the "personal health network" (PHN), a novel solution leveraging social networking and mobile technologies, among individuals undergoing chemotherapy and receiving care coordination. Early results from interviews of 12 participants in a randomized pragmatic trial suggest that they feel more connected to the healthcare team using the PHN, find value in access to the patient education library, and are better equipped to organize the many activities that occur during chemotherapy. Improvements are needed in navigation, connectivity, and integration with electronic health records. Findings contribute to improvements in the PHN and informs a roadmap for potentially greater impact in technology-enabled cancer care coordination. PMID:27332197

  20. The network social support experience of people involved in home care

    Directory of Open Access Journals (Sweden)

    Ingrid Meireles Gomes

    2014-06-01

    Full Text Available Objective: To build a theoretical model to configure the network social support experience of people involved in home care. Method: A quantitative approach research, utilizing the Grounded Theory method. The simultaneous data collection and analysis allowed the interpretation of the phenomenon meaning The network social support of people involved in home care. Results: The population passive posture in building their well-being was highlighted. The need of a shared responsibility between the involved parts, population and State is recognized. Conclusion: It is suggested for nurses to be stimulated to amplify home care to attend the demands of caregivers; and to elaborate new studies with different populations, to validate or complement the proposed theoretical model.

  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

    2011-07-01

    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. Computer network for improving quality and efficiency of children's primary health care

    Science.gov (United States)

    Deutsch, Larry

    1995-10-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Helmut Wenzel

    2015-11-01

    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.

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

    Science.gov (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

    2015-09-01

    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. Two Essential Roles: Health Care Network Nurse Leaders and Local Nurse Leaders.

    Science.gov (United States)

    Schneider, Maureen

    2016-01-01

    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.

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

    Science.gov (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.

    Science.gov (United States)

    Schneider, Maureen

    2016-01-01

    American health care organizations are experiencing increasing change driven by emerging partnerships, market demographics, population health initiatives, and merger and acquisition trends. The health care business environment necessitates alterations in how companies operate on a larger scale. New regional leadership roles are being created to provide leadership to systematize networks, build market share, and strengthen market needs. It is important and necessary to explore, review, and contrast the roles, skills, and behaviors of regional leader's roles and the solo organization leaders. It is also imperative to review the benefits of new affiliations for the community and hospital entity. PMID:27584890

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

    Science.gov (United States)

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

    2015-07-01

    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. The new Australian Primary Health Networks: how will they integrate public health and primary care?

    Science.gov (United States)

    Booth, Mark; Hill, Graham; Moore, Michael J; Dalla, Danielle; Moore, Michael G; Messenger, Anne

    2016-01-01

    On 1 July 2015, the Australian Government established 31 new Primary Health Networks (PHNs), following a review by its former Chief Medical Officer, John Horvath, of 61 Medicare Locals created under the previous Labor administration. The Horvath review recommended, among other things, that new, larger primary health organisations be established to reduce fragmentation of care by integrating and coordinating health services, supporting the role of general practice, and leveraging and administering health program funding. The two main objectives of the new PHNs, as stated on the Department of Health's website, are "increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time". Below are three viewpoints, commissioned for this primary health care themed issue of Public Health Research & Practice, from the Australian Government Department of Health, the Public Health Association of Australia and a Sydney-based PHN. We asked the authors to focus particularly on how the newly established networks might help to integrate public health within the primary health care landscape. Our authors have pointed out the huge overlap between public health and primary care and looked at evidence showing the great benefits for health systems of collaboration between the two. Challenges ahead include a possible government focus on delivery of 'frontline' medical services, which may come at the expense of population health, and the complexity of dealing with all primary health care stakeholders, including health professionals, Local Health Districts, nongovernment organisations, research institutions and local communities. PMID:26863166

  10. A Novel Intrusion Detection System for Wireless Body Area Network in Health Care Monitoring

    Directory of Open Access Journals (Sweden)

    T. V.P. Sundararajan

    2010-01-01

    Full Text Available Problem statement: Health monitoring, telemedicine, military, interactive entertainment and portable audio/video systems were most promising applications where WBANs can be used. However, designers of such systems face a number of challenging tasks, as they need to address often quite conflicting requirements for size, operating time, precision and reliability. Network security is very important in Wireless Body Area Network (WBAN since the vital human life might be jeopardized, unless managed properly. Approach: This article presented security architecture of a wireless body area network for ambulatory health status monitoring. A novel Intrusion Detection System (IDS inspired by the biological immune system that use Negative Selection Algorithm (NSA was proposed to enhance the performance of Wireless Body Area Networks (WBAN to operate despite the presence of compromised (misbehaving nodes. Results: The proposed IDS scheme had been implemented using network simulator Qualnet v5.2. The performances of IDS scheme had been analyzed using AODV, DSR and DSDV routing protocols for parameters such as average detection rate and false alarm rate. These negative selection detectors are capable of distinguishing well behaving nodes from compromised nodes with good degree of accuracy. The high false positives rate is also minimized. Conclusion/Recommendations: Wireless Body Area Networks are an enabling technology for mobile health care. The IDS can be implemented on today’s devices as it only requires minimal and low-cost hardware changes. The authors strongly believe that adding sufficient security mechanisms to WBAN will study as a trigger in the acceptance of this technology for health care purposes. Simulation results indicate the non-degradability of network performance when these IDS is incorporated in the routing algorithm for security enhancements.

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

    OpenAIRE

    Lopes, Tânia; Veiga-Branco, Augusta; Baptista, Gorete

    2014-01-01

    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...

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

    OpenAIRE

    Veiga-Branco, Augusta; Lopes, Tânia

    2012-01-01

    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...

  13. [ANMCO/SIC Consensus document: The heart failure network: organization of outpatient care].

    Science.gov (United States)

    Aspromonte, Nadia; Gulizia, Michele Massimo; Di Lenarda, Andrea; Mortara, Andrea; Battistoni, Ilaria; De Maria, Renata; Gabriele, Michele; Iacoviello, Massimo; Navazio, Alessandro; Pini, Daniela; Di Tano, Giuseppe; Marini, Marco; Ricci, Renato Pietro; Alunni, Gianfranco; Radini, Donatella; Metra, Marco; Romeo, Francesco

    2016-01-01

    Changing demographics and an increasing burden of multiple chronic comorbidities in western countries dictate refocusing of heart failure (HF) services from acute in-hospital care to better support the long inter-critical out-of-hospital phases of HF. The needs of the HF population are not adequately addressed by current HF outpatient services, as documented by differences in age, gender, comorbidities and recommended therapies between patients discharged for hospitalized HF and those followed up at HF clinics.The Working Group on Heart Failure of the Italian Association of Hospital Cardiologists (ANMCO) has drafted a consensus document for the organization of a national HF care network. The aims of this document are to describe tasks and requirements of the different health system points of contact for HF patients, and to define how diagnosis, management and care processes should be documented and shared among healthcare professionals. In this document, HF clinics are classified into three groups: 1) community HF clinics, devoted to the management of stable patients in strict liaison with primary care, regular re-evaluation of emerging clinical needs and prompt treatment of impending destabilizations, 2) hospital HF clinics, that target both new-onset and chronic HF patients for diagnostic assessment, treatment planning and early post-discharge follow-up. They act as main referral for medicine units and community clinics; 3) advanced HF clinics, directed at patients with severe disease or persistent clinical instability, candidates to advanced treatment options such as heart transplant or mechanical circulatory support. These different types of HF clinics are integrated in a dedicated network for the management of HF patients on a regional basis, according to geographic features. By sharing predefined protocols and communication systems, these HF networks integrate multiprofessional providers to ensure continuity of care. This consensus document is expected to

  14. [Palliative Care Network - 20 years of experiences from Ticino / Southern Switzerland].

    Science.gov (United States)

    Neuenschwander, Hans; Gamondi, Claudia

    2012-02-01

    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.

  15. Prenatal care in the primary health care network in FortalezaCE: an assessment of the structure, process and results

    Directory of Open Access Journals (Sweden)

    Rebeca Silveira Rocha

    2012-09-01

    Full Text Available Objective: To evaluate the prenatal care assistance in the primary health care network in Fortaleza-CE, considering the structure, process and results. Methods: A cross sectional descriptive study, of quantitative approach, performed between October 2009 and February 2011, in 30 Health Units randomly selected, keeping the ratio for each Regional Executive Secretary. For analysis of the structure, the information obtained was scored and classified as: excellent, satisfactory, precarious or insufficient. The form used was submitted to four experts for validation. In evaluating the process and results, data was available by the Municipal Health Secretary of Fortaleza for obtainance of the indicators recommended by the Ministry of Health. Results: There was, in general, a satisfactory structure. As for the process and result, we obtained: pregnant women who had, at least, six prenatal visits (7.6%; pregnant women who received tetanus immunization (22.8%; newborns with congenital syphilis (1.4%; newborns with neonatal tetanus (0%; maternal mortality rate (78.5% in 2008 and 51% in 2009 and total neonatal mortality rate (10.1% in 2008 and 11.2% in 2009. Conclusions: Despite good results with regard to the structure, the reflections on the process and outcome indicators were not positive, with low rates compared to those expected by the World Health Organization or the Ministry of Health, or in comparison with other regions.

  16. The Hospital Medicine Reengineering Network (HOMERuN): a learning organization focused on improving hospital care.

    Science.gov (United States)

    Auerbach, Andrew D; Patel, Mitesh S; Metlay, Joshua P; Schnipper, Jeffrey L; Williams, Mark V; Robinson, Edmondo J; Kripalani, Sunil; Lindenauer, Peter K

    2014-03-01

    Converting the health care delivery system into a learning organization is a key strategy for improving health outcomes. Although the collaborative learning organization approach has been successful in neonatal intensive care units and disease-specific collaboratives, there are few examples in general medicine and none in adult medicine that have leveraged the role of hospitalists nationally across multiple institutions to implement improvements. The authors describe the rationale for and early work of the Hospital Medicine Reengineering Network (HOMERuN), a collaborative of hospitals, hospitalists, and multidisciplinary care teams founded in 2011 that seeks to measure, benchmark, and improve the efficiency, quality, and outcomes of care in the hospital and afterwards. Robust and timely evaluation, with learning and refinement of approaches across institutions, should accelerate improvement efforts. The authors review HOMERuN's collaborative model, which focuses on a community-based participatory approach modified to include hospital-based staff as well as the larger community. HOMERuN's initial project is described, focusing on care transition measurement using perspectives from the patient, caregiver, and providers. Next steps and sustainability of the organization are discussed, including benchmarking, collaboration, and effective dissemination of best practices to stakeholders. PMID:24448050

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

    Directory of Open Access Journals (Sweden)

    Enserink Remko

    2012-10-01

    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.

  18. Blended Learning Networks Supported by Information and Communication Technology: An Intervention for Knowledge Transformation within Family Care of Older People

    Science.gov (United States)

    Hanson, Elizabeth; Magnusson, Lennart; Sennemark, Eva

    2011-01-01

    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…

  19. An Interactive Web Tool for Facilitating Shared Decision-Making in Dementia-Care Networks: A Field Study

    NARCIS (Netherlands)

    Span, M.; Smits, C.; Jukema, J.; Groen-van de Ven, L.M.; Janssen, R.; Vernooij-Dassen, M.; Eefsting, J.; Hettinga, M.

    2015-01-01

    BACKGROUND: An interactive web tool has been developed for facilitating shared decision-making in dementia-care networks. The DecideGuide provides a chat function for easier communication between network members, a deciding together function for step-by-step decision-making, and an individual opinio

  20. Networks for integrated care provision: an economic approach based on opportunism and trust.

    Science.gov (United States)

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

    2004-07-01

    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.

  1. The current situation and future scope of radiation emergency medical care network in Nagasaki

    International Nuclear Information System (INIS)

    Under the framework of the International Consortium for Medical Care of Hibakusha and Radiation Life Science (Nagasaki University 21st Century COE Program) and bearing in mind the unique history and responsibility of Nagasaki University, several projects on radiation emergency preparedness are in progress. The critical accident in Tokaimura, Japan in 1999 made us realize that nuclear emergencies happen anywhere radionuclides exist. In fact, nuclear accidents possibly take place in factories, research facilities, hospital and wherever radioactive materials are in transit. Therefore, it is necessary to establish an effective preparedness network system for potential radiation emergency that may occur in Nagasaki and nearby prefectures and to cooperate with other Japanese and worldwide networks. (author)

  2. Social networks, work and network-based resources for the management of long-term conditions: a framework and study protocol for developing self-care support

    Directory of Open Access Journals (Sweden)

    Kapadia Dharmi

    2011-05-01

    Full Text Available Abstract Background Increasing the effective targeting and promotion of self-care support for long-term conditions requires more of a focus on patient contexts and networks. The aim of this paper is to describe how within a programme of research and implementation, social networks are viewed as being centrally involved in the mobilisation and deployment of resources in the management of a chronic condition. This forms the basis of a novel approach to understanding, designing, and implementing new forms of self-management support. Methods Drawing on evidence syntheses about social networks and capital and the role of information in self-management, we build on four conceptual approaches to inform the design of our research on the implementation of self-care support for people with long-term conditions. Our approach takes into consideration the form and content of social networks, notions of chronic illness work, normalisation process theory (NPT, and the whole systems informing self-management engagement (WISE approach to self-care support. Discussion The translation and implementation of a self-care agenda in contemporary health and social context needs to acknowledge and incorporate the resources and networks operating in patients' domestic and social environments and everyday lives. The latter compliments the focus on healthcare settings for developing and delivering self-care support by viewing communities and networks, as well as people suffering from long-term conditions, as a key means of support for managing long-term conditions. By focusing on patient work and social-network provision, our aim is to open up a second frontier in implementation research, to translate knowledge into better chronic illness management, and to shift the emphasis towards support that takes place outside formal health services.

  3. Participation and coordination in Dutch health care policy-making. A network analysis of the system of intermediate organizations in Dutch health care.

    Science.gov (United States)

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

    2013-06-01

    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.

  4. [Dental care in cross-cultural networks-- case management--approaches in group prevention].

    Science.gov (United States)

    Robke, F J

    2000-01-01

    Oral epidemiology studies of previous years have shown an increasing difference in caries cases in respect of different social strata. Thus, frequency of caries cases is related to social status. High rates of caries prevalence are found especially among children from typical areas of welfare problems. Already, today every fifth child is born into a family of immigrants. In areas of typical social deprivation their share is about 40% and more. Since the previous educational campaigns for social fringe groups have hardly shown any positive effect on dental health, new strategies are necessary. In a community of Hanover with low socio-economic status and a generally high caries level, the treatment strategies of dental care for the young have centred on the case-management approaches of social welfare programmes since the early 90s. Beside the expanded basic preventive programme, which includes application of a fluoride varnish for children, social compensatory measures with intercultural networks are also being taken. This concept shows very clearly that the dental health of children living in areas of social disorganisation can be effectively improved by means of these strategies. For the future, dental care for these children requires more intercultural competence and more knowledge of social welfare work by adolescent dental care providers. PMID:11037670

  5. Teleradiology network to improve patient care in a peacekeeping military operation

    Science.gov (United States)

    Cleary, Kevin R.; Levine, Betty A.; Norton, Gary S.; Mun, Seong K.; Cramer, Timothy J.; de Treville, Robert E.

    1997-05-01

    The Imaging Science and Information Systems (ISIS) Center of the Department of Radiology at Georgetown University Medical Center recently collaborated with the US Army in developing an off-the-shelf teleradiology network for Operation Joint Endeavor, the peace-keeping mission in Bosnia-Herzegovina. The network is part of Operation Primetime III, a project to deploy advanced communications and medical equipment to provide state-of-the-art medical care to the 20,000 US troops stationed there. The network encompasses three major sites: the 212th Mobile Army Surgical Hospital (MASH) near Tuzla, Bosnia-Herzegovina; the 67th Combat Support Hospital (CSH) in Taszar, Hungary; and the Landstuhl Regional Medical Center (LRMC) in Landstuhl, Germany. Planning for the project began in January 1996, and all three sites were operational by April 1996. Since the system was deployed, computed radiography (CR) has been sued almost exclusively at the MASH and CSH for all general x-ray exams. From mid- May to September 1996, over 2700 CR images were acquired at the MASH and over 1600 at the CSH. Since there was not a radiologist a the MASH, the images were transferred to the CSH for primary diagnosis and archiving. In the same time period, over 550 patient folders were sent from the MASH to the CSH.

  6. Social care networks and older LGBT adults: challenges for the future.

    Science.gov (United States)

    Brennan-Ing, Mark; Seidel, Liz; Larson, Britta; Karpiak, Stephen E

    2014-01-01

    Research on service needs among older adults rarely addresses the special circumstances of lesbian, gay, bisexual, and transgender (LGBT) individuals, such as their reliance on friend-centered social networks or the experience of discrimination from service providers. Limited data suggests that older LGBT adults underutilize health and social services that are important in maintaining independence and quality of life. This study explored the social care networks of this population using a mixed-methods approach. Data were obtained from 210 LGBT older adults. The average age was 60 years, and 71% were men, 24% were women, and 5% were transgender or intersex. One-third was Black, and 62% were Caucasian. Quantitative assessments found high levels of morbidity and friend-centered support networks. Need for and use of services was frequently reported. Content analysis revealed unmet needs for basic supports, including housing, economic supports, and help with entitlements. Limited opportunities for socialization were strongly expressed, particularly among older lesbians. Implications for senior programs and policies are discussed. PMID:24313252

  7. The national improvement partnership network: state-based partnerships that improve primary care quality.

    Science.gov (United States)

    Shaw, Judith S; Norlin, Chuck; Gillespie, R J; Weissman, Mark; McGrath, Jane

    2013-01-01

    . 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.

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

    Directory of Open Access Journals (Sweden)

    Valente Thomas W

    2010-06-01

    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

  9. [Optimising care structures for severe hand trauma and replantation and chances of launching a national network].

    Science.gov (United States)

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

    2013-12-01

    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" (www.handverletzung.com) 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

  10. Using Social Network Analysis to Identify Key Child Care Center Staff for Obesity Prevention Interventions: A Pilot Study

    OpenAIRE

    Jennifer Marks; Barnett, Lisa M.; Chad Foulkes; Penelope Hawe; Steven Allender

    2013-01-01

    Introduction. Interest has grown in how systems thinking could be used in obesity prevention. Relationships between key actors, represented by social networks, are an important focus for considering intervention in systems. Method. Two long day care centers were selected in which previous obesity prevention programs had been implemented. Measures showed ways in which physical activity and dietary policy are conversations and actions transacted through social networks (interrelationships) with...

  11. As redes de atenção à saúde Health care networks

    Directory of Open Access Journals (Sweden)

    Eugênio Vilaça Mendes

    2010-08-01

    system of healthcare practice, with the implantation of health care networks. The conclusion is that there are evidences in the international literature on health care networks that these networks may improve the clinical quality, the sanitation results and the user's satisfaction and the reduction of healthcare systems costs.

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

    Science.gov (United States)

    Ferlie, Ewan; McGivern, Gerry; Fitzgerald, Louise

    2012-02-01

    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. Wills Eye Hospital and surgical network: successful pre-positioning strategies for payment reduction and managed care pressures.

    Science.gov (United States)

    Kessler, D M

    2001-01-01

    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.

  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.

    Science.gov (United States)

    Hindia, M N; Rahman, T A; Ojukwu, H; Hanafi, E B; Fattouh, A

    2016-01-01

    As the enterprise of the "Internet of Things" is rapidly gaining widespread acceptance, sensors are being deployed in an unrestrained manner around the world to make efficient use of this new technological evolution. A recent survey has shown that sensor deployments over the past decade have increased significantly and has predicted an upsurge in the future growth rate. In health-care services, for instance, sensors are used as a key technology to enable Internet of Things oriented health-care monitoring systems. In this paper, we have proposed a two-stage fundamental approach to facilitate the implementation of such a system. In the first stage, sensors promptly gather together the particle measurements of an android application. Then, in the second stage, the collected data are sent over a Femto-LTE network following a new scheduling technique. The proposed scheduling strategy is used to send the data according to the application's priority. The efficiency of the proposed technique is demonstrated by comparing it with that of well-known algorithms, namely, proportional fairness and exponential proportional fairness. PMID:27152423

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

    Science.gov (United States)

    Hindia, M N; Rahman, T A; Ojukwu, H; Hanafi, E B; Fattouh, A

    2016-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Mahbub Rashid

    2014-12-01

    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. The Role of Oral Language Revisited: A Comment on the NICHD Early Child Care Research Network (2005)

    Science.gov (United States)

    Bracken, Stacey Storch

    2005-01-01

    This article comments on the discussion of S. A. Storch and G. J. Whitehurst's literacy development model in the article by the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network (ECCRN). Specifically, this comment focuses on concerns raised by the NICHD ECCRN that Storch and Whitehurst's model does…

  19. Providing Hearing-Impaired Students with Learning Care after Classes through Smart Phones and the GPRS Network

    Science.gov (United States)

    Liu, Chen-Chung; Hong, Yi-Ching

    2007-01-01

    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…

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

    Directory of Open Access Journals (Sweden)

    Federica Paganelli

    2008-01-01

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

  1. 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

    2012-09-01

    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.

  2. Measuring horizontal integration among health care providers in the community: an examination of a collaborative process within a palliative care network.

    Science.gov (United States)

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

    2015-05-01

    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.

  3. A Secure Cloud-Assisted Wireless Body Area Network in Mobile Emergency Medical Care System.

    Science.gov (United States)

    Li, Chun-Ta; Lee, Cheng-Chi; Weng, Chi-Yao

    2016-05-01

    Recent advances in medical treatment and emergency applications, the need of integrating wireless body area network (WBAN) with cloud computing can be motivated by providing useful and real time information about patients' health state to the doctors and emergency staffs. WBAN is a set of body sensors carried by the patient to collect and transmit numerous health items to medical clouds via wireless and public communication channels. Therefore, a cloud-assisted WBAN facilitates response in case of emergency which can save patients' lives. Since the patient's data is sensitive and private, it is important to provide strong security and protection on the patient's medical data over public and insecure communication channels. In this paper, we address the challenge of participant authentication in mobile emergency medical care systems for patients supervision and propose a secure cloud-assisted architecture for accessing and monitoring health items collected by WBAN. For ensuring a high level of security and providing a mutual authentication property, chaotic maps based authentication and key agreement mechanisms are designed according to the concept of Diffie-Hellman key exchange, which depends on the CMBDLP and CMBDHP problems. Security and performance analyses show how the proposed system guaranteed the patient privacy and the system confidentiality of sensitive medical data while preserving the low computation property in medical treatment and remote medical monitoring. PMID:27000778

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

    Directory of Open Access Journals (Sweden)

    Venki Balasubramanian

    2010-01-01

    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.

  5. 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

    2012-11-01

    Full Text Available Malaz A Boustani,1–3 Amie Frame,1,2 Stephanie Munger,1,2 Patrick Healey,4 Jessie Westlund,5 Martin Farlow,6,7 Ann Hake,8 Mary Guerriero Austrom,6,9 Polly Shepard,10 Corby Bubp,10 Jose Azar,3 Arif Nazir,3 Nadia Adams,11 Noll L Campbell,1,2,12,13 Azita Chehresa,5 Paul Dexter2,31Indiana University Center for Aging Research, 2Regenstrief Institute, Inc, 3Department of Medicine, Indiana University School of Medicine (IUSM, 4St Vincent Health Network, 5Community Health Network, 6Indiana Alzheimer Disease Center, IUSM, 7Department of Neurology, IUSM, 8Eli Lilly and Company, 9Department of Psychiatry, IUSM, 10The Memory Clinic of Indianapolis, 11Indiana University Health, Indianapolis, IN, USA; 12Department of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, IN, USA; 13Department of Pharmacy, Wishard Health Services, Indianapolis, IN, USABackground: The US Institute of Medicine has recommended an integrated, locally sensitive collaboration among the various members of the community, health care systems, and research organizations to improve dementia care and dementia research.Methods: Using complex adaptive system theory and reflective adaptive process, we developed a professional network called the “Indianapolis Discovery Network for Dementia” (IDND. The IDND facilitates effective and sustainable interactions among a local and diverse group of dementia researchers, clinical providers, and community advocates interested in improving care for dementia patients in Indianapolis, Indiana.Results: The IDND was established in February 2006 and now includes more than 250 members from more than 30 local (central Indiana organizations representing 20 disciplines. The network uses two types of communication to connect its members. The first is a 2-hour face-to-face bimonthly meeting open to all members. The second is a web-based resource center (http://www.indydiscoverynetwork.org. To date, the network has: (1 accomplished the

  6. The role of social networks in the governance of health systems: the case of eye care systems in Ghana.

    Science.gov (United States)

    Blanchet, Karl; James, Philip

    2013-03-01

    Efforts have been increasingly invested to improve local health systems' capacities in developing countries. We describe the application of innovative methods based on a social network analysis approach. The findings presented refer to a study carried out between July 2008 and January 2010 in the Brong Ahafo region of Ghana. Social network analysis methods were applied in five different districts using the software package Ucinet to calculate the various properties of the social network of eye care providers. The study focused on the managerial decisions made by Ghanaian district hospital managers about the governance of the health system. The study showed that the health system in the Brong Ahafo region experienced significant changes specifically after a key shock, the departure of an international organization. Several other actors at different levels of the network disappeared, the positions of nurses and hospital managers changed, creating new relationships and power balances that resulted in a change in the general structure of the network. The system shifted from a centralized and dense hierarchical network towards an enclaved network composed of five sub-networks. The new structure was less able to respond to shocks, circulate information and knowledge across scales and implement multi-scale solutions than that which it replaced. Although the network became less resilient, it responded better to the management needs of the hospital managers who now had better access to information, even if this information was partial. The change of the network over time also showed the influence of the international organization on generating links and creating connections between actors from different levels. The findings of the study reveal the importance of creating international health connections between actors working in different spatial scales of the health system. PMID:22411882

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

    Science.gov (United States)

    2007-01-01

    GetWell:)Network, a Bethesda, MD-based interactive patient care provider, had the right tool. What it didn't have was the means to get the word out about that tool. So in September 2006, the provider tapped Waltham, MA-based healthcare public relations agency Schwartz Communications to design and execute a national media relations campaign about the PatientLife:)System, GetWell's interactive educational bedside tool. PMID:17361789

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

    Science.gov (United States)

    2007-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Pederzini Fabio

    2009-03-01

    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.

  10. 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.

  11. Validation of Single-Item Screening Measures for Provider Burnout in a Rural Health Care Network.

    Science.gov (United States)

    Waddimba, Anthony C; Scribani, Melissa; Nieves, Melinda A; Krupa, Nicole; May, John J; Jenkins, Paul

    2016-06-01

    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 < .0001; Kruskal-Wallis χ(2) = 149.9 and 56.5, p < .0001, respectively). In multivariable models, it predicted high EE (but neither low EE nor low/high DP). EE/DP single items were correlated with parent subscales (Spearman's ρ = .89 and .81, p < .0001; Kruskal-Wallis χ(2) = 230.98 and 197.84, p < .0001, respectively). In multivariable models, the EE item predicted high/low EE, whereas the DP item predicted only low DP. Therefore, the three single-item measures tested varied in effectiveness as screeners for EE/DP dimensions of burnout. PMID:25716107

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

    Science.gov (United States)

    Waddimba, Anthony C; Scribani, Melissa; Nieves, Melinda A; Krupa, Nicole; May, John J; Jenkins, Paul

    2016-06-01

    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 < .0001; Kruskal-Wallis χ(2) = 149.9 and 56.5, p < .0001, respectively). In multivariable models, it predicted high EE (but neither low EE nor low/high DP). EE/DP single items were correlated with parent subscales (Spearman's ρ = .89 and .81, p < .0001; Kruskal-Wallis χ(2) = 230.98 and 197.84, p < .0001, respectively). In multivariable models, the EE item predicted high/low EE, whereas the DP item predicted only low DP. Therefore, the three single-item measures tested varied in effectiveness as screeners for EE/DP dimensions of burnout.

  13. Children's Health in Brazil: orienting basic network to Primary Health Care.

    Science.gov (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

    2016-09-01

    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.

  14. Documentation for Students in Residential Care: Network of Relations of Human and Non-Human Actants

    Science.gov (United States)

    Severinsson, Susanne

    2016-01-01

    Swedish and international research points to serious problems for the education of students with social, emotional and behavioural difficulties (SEBD) in the care of social welfare, for example, in residential care. The aim of this article is to elucidate how documentation, care plans (CPs) and individual educational plans (IEPs) outline the…

  15. Assessing capacity and disease burden in a virtual network of New York City primary care providers following Hurricane Sandy.

    Science.gov (United States)

    Sebek, Kimberly; Jacobson, Laura; Wang, Jason; Newton-Dame, Remle; Singer, Jesse

    2014-08-01

    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

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

    DEFF Research Database (Denmark)

    Asboe, Mark; Fernandes, Joao; Grönvall, Erik

    2010-01-01

    This paper presents an ongoing project that focuses on improving the quality of life for senior citizens by developing IT support for independent living in their homes. We introduce a concept that explores and supports coordination within a social and care community targeting elderly people...

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

    OpenAIRE

    Mariko Hara

    2011-01-01

    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...

  18. Questions and Answers about School-Age Children in Self-Care: A Sloan Work and Family Research Network Fact Sheet

    Science.gov (United States)

    Sloan Work and Family Research Network, 2009

    2009-01-01

    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…

  19. A public-private trauma center network in Florida harnesses data to improve care quality for an aging population.

    Science.gov (United States)

    DuVernay, Christina

    2013-12-01

    As the US population ages, trauma systems face new challenges in addition to the long-standing problem of access. Patients ages sixty-five and older are more likely than younger patients to fall and suffer serious injury or death as a result. This older patient population, when compared with younger cohorts, suffers higher mortality rates, has more comorbidities-diabetes, cancer, and heart conditions being the more serious among them-and takes more medications, which can complicate treatment. The University of South Florida (USF) Medical School and the HCA hospital system have partnered to create a network of five trauma centers in underserved areas of the state to increase access to trauma care for all Floridians while maintaining a special focus on geriatric trauma care. Collecting and analyzing data for improving care quality and undertaking research is a central aim of the partnership. Based on their research findings, trauma surgeons in the USF/HCA Trauma Network have identified best practices and codified them in standard operating procedures. PMID:24301397

  20. NET-Works: Linking families, communities and primary care to prevent obesity in preschool-age children.

    Science.gov (United States)

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

    2013-11-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Serhan Duran

    2012-08-01

    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.

  2. 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

    2004-01-01

    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

  3. 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.

    2014-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Grant Richard W

    2009-12-01

    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.

  5. 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

    2015-01-01

    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.

  6. Patient-powered research networks aim to improve patient care and health research.

    Science.gov (United States)

    Fleurence, Rachael L; Beal, Anne C; Sheridan, Susan E; Johnson, Lorraine B; Selby, Joe V

    2014-07-01

    The era of big data, loosely defined as the development and analysis of large or complex data sets, brings new opportunities to empower patients and their families to generate, collect, and use their health information for both clinical and research purposes. In 2013 the Patient-Centered Outcomes Research Institute launched a large national research network, PCORnet, that includes both clinical and patient-powered research networks. This article describes these networks, their potential uses, and the challenges they face. The networks are engaging patients, family members, and caregivers in four key ways: contributing data securely, with privacy protected; including diverse and representative groups of patients in research; prioritizing research questions, participating in research, and disseminating results; and participating in the leadership and governance of patient-powered research networks. If technical, regulatory, and organizational challenges can be overcome, PCORnet will allow research to be conducted more efficiently and cost-effectively and results to be disseminated quickly back to patients, clinicians, and delivery systems to improve patient health. PMID:25006148

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

    Directory of Open Access Journals (Sweden)

    Marijke eSpan

    2015-07-01

    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.

  8. Value networks in the life science industry. Case: Wound care product segment

    OpenAIRE

    Kiuru, Tony

    2015-01-01

    Chronic wounds have been steadily increasing in the developed countries, caused by the combination of aging population and obesity. In the EU-27 area there are around 4 million patients yearly requiring hospital care for wounds. The total costs of treatment for a wound are around €6650-€10000 per patient. The medical supplies and equipment market, where wound care products belong to, is estimated to grow 5.8% between 2013 and 2018. These growth and value creation opportunities have been notic...

  9. 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

    2013-08-01

    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

  10. Health monitoring in sentinel practice networks: the contribution of primary care.

    NARCIS (Netherlands)

    Fleming, D.M.; Schellevis, F.G.; Paget, W.J.

    2003-01-01

    BACKGROUND: The health monitoring programme of the European Commission has proposed a set of health indicators whereby the health status of member states can be measured. As part of that programme we considered how primary care might contribute relevant data. METHODS: Using a questionnaire distribut

  11. Impacts of social networking sites on patient care in the emergency department.

    Science.gov (United States)

    Bennett, Anne; Pourmand, Ali; Shokoohi, Hamid; Shesser, Robert; Sanchez, Jesus; Joyce, Joseph

    2014-01-01

    The use of Facebook is ubiquitous among both patients and physicians. Often Facebook intrudes into medical practice, thereby highlighting its potential to be either a positive or negative factor in a patient's medical care. Despite being a "hot topic" in the medical literature, very few real world examples exist of physicians actually using information obtained from Facebook to reach a diagnosis or otherwise affect patient care. We present a case involving a 13-year-old girl who posted photographs and captions on Facebook demonstrating suicidal ideation. The patient's parents were alerted to the girl's statements in her Facebook profile and brought her to the emergency department. The girl's statements and photographs, as reported by her parents, were used by an emergency physician to make a diagnosis of suicidal risk and to disposition of the patient to an inpatient psychiatric ward. We discuss the potential diagnostic utility of information posted on Facebook and briefly discuss the ethical questions surrounding this situation. PMID:24160899

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

    OpenAIRE

    M N Hindia; T. A. Rahman; H. Ojukwu; Hanafi, E. B.; Fattouh, A.

    2016-01-01

    As the enterprise of the "Internet of Things" is rapidly gaining widespread acceptance, sensors are being deployed in an unrestrained manner around the world to make efficient use of this new technological evolution. A recent survey has shown that sensor deployments over the past decade have increased significantly and has predicted an upsurge in the future growth rate. In health-care services, for instance, sensors are used as a key technology to enable Internet of Things oriented health-car...

  13. Deep Convolutional Neural Networks for Microscopy-Based Point of Care Diagnostics

    OpenAIRE

    Quinn, John A.; Nakasi, Rose; Mugagga, Pius K. B.; Byanyima, Patrick; Lubega, William; Andama, Alfred

    2016-01-01

    Point of care diagnostics using microscopy and computer vision methods have been applied to a number of practical problems, and are particularly relevant to low-income, high disease burden areas. However, this is subject to the limitations in sensitivity and specificity of the computer vision methods used. In general, deep learning has recently revolutionised the field of computer vision, in some cases surpassing human performance for other object recognition tasks. In this paper, we evaluate...

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

    Directory of Open Access Journals (Sweden)

    Mhoira EF Leng

    2011-01-01

    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.

  15. The historical development of the Dutch Sentinel General Practice Network from a paper based into a digital primary care monitoring system.

    NARCIS (Netherlands)

    Schweikardt, C.; Verheij, R.A.; Donker, G.A.; Coppieters, Y.

    2016-01-01

    Aim: The Dutch Sentinel General Practice Network (SGPN) was founded in 1970 for disease surveillance in primary care, based on paper questionnaires. Advances in information technology offered new prospects of data collection from electronic health records (EHRs). This study investigates the resultin

  16. 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;

    2009-01-01

    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...... 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...... across different settings in Europe. HELPS will develop and implement a "physical health promotion toolkit". The toolkit will provide information to empower residents and staff to identify the most relevant risk factors in their specific context and to select the most appropriate action out of a range...

  17. Delivery of rural and remote health care via a broadband Internet Protocol network - views of potential users.

    Science.gov (United States)

    Jennett, P; Yeo, M; Scott, R; Hebert, M; Teo, W

    2005-01-01

    We asked the views of potential users of a proposed Canadian broadband Internet Protocol (IP) network for health, the Alberta SuperNet. The three user groups were drawn from the public, provider and private sectors. In all, 35 health-sector participants were selected (17 government, nine health-care organizations, five providers/practitioners and four private sector). The questionnaire was Web-based, semistructured and self-administered. It consisted of four major areas: value, readiness, effect on usual care and limitations. A total of 28 (80%) individuals responded to the questionnaire: 21 (81%) were from the public sector (three provincial, nine regional and nine organizational), three (60%) were from the provider sector and four (100%) were from the private sector. Overall, the items related to health services and health human resources were considered to be the most valuable to rural communities. Respondents identified the expansion of telehealth services as the most important, except those from the private sector, who ranked this a close second. The health system's move to the use of electronic health records was ranked second in importance by all respondents. The private-sector respondents viewed all user groups to be generally less ready (mean score 2.5 on a seven-point scale from 1 = not ready to 7 = ready), while the public-sector respondents were the most optimistic (mean score 4.0). Specific socioeconomic impact data were limited. The top-ranked disadvantage of the 10 suggested was that 'Changes in health-service delivery practices and/or processes will be required'. PMID:16356317

  18. Improving network performance in the health care system: a network-based analysis of the Hungarian health care services = A hálózati teljesítmény javítása az egészségügyi rendszerben: a magyar egészségügyi szolgáltatások hálózati megközelítésű elemzése

    OpenAIRE

    Kiss, Norbert

    2016-01-01

    The dissertation aims to contribute to better understanding of what role networks play in the organisation of health services, and how networks can contribute to better performance in the health care sector. Literature about performance measurement and management of public services as well as network research in public administration and public management was reviewed, and served as a solid theoretical base for the empirical research. Examples from the health care sector were provided through...

  19. Geographical accessibility and spatial coverage modeling of the primary health care network in the Western Province of Rwanda

    Directory of Open Access Journals (Sweden)

    Huerta Munoz Ulises

    2012-09-01

    Full Text Available Abstract Background Primary health care is essential in improving and maintaining the health of populations. It has the potential to accelerate achievement of the Millennium Development Goals and fulfill the “Health for All” doctrine of the Alma-Ata Declaration. Understanding the performance of the health system from a geographic perspective is important for improved health planning and evidence-based policy development. The aims of this study were to measure geographical accessibility, model spatial coverage of the existing primary health facility network, estimate the number of primary health facilities working under capacity and the population underserved in the Western Province of Rwanda. Methods This study uses health facility, population and ancillary data for the Western Province of Rwanda. Three different travel scenarios utilized by the population to attend the nearest primary health facility were defined with a maximum travelling time of 60 minutes: Scenario 1 – walking; Scenario 2 – walking and cycling; and Scenario 3 – walking and public transportation. Considering these scenarios, a raster surface of travel time between primary health facilities and population was developed. To model spatial coverage and estimate the number of primary health facilities working under capacity, the catchment area of each facility was calculated by taking into account population coverage capacity, the population distribution, the terrain topography and the travelling modes through the different land categories. Results Scenario 2 (walking and cycling has the highest degree of geographical accessibility followed by Scenario 3 (walking and public transportation. The lowest level of accessibility can be observed in Scenario 1 (walking. The total population covered differs depending on the type of travel scenario. The existing primary health facility network covers only 26.6% of the population in Scenario 1. In Scenario 2, the use of a bicycle

  20. Networking

    OpenAIRE

    Rauno Lindholm, Daniel; Boisen Devantier, Lykke; Nyborg, Karoline Lykke; Høgsbro, Andreas; de Fries, Louise Skovlund

    2016-01-01

    The purpose of this project was to examine what influencing factor that has had an impact on the presumed increasement of the use of networking among academics on the labour market and how it is expressed. On the basis of the influence from globalization on the labour market it can be concluded that the globalization has transformed the labour market into a market based on the organization of networks. In this new organization there is a greater emphasis on employees having social...

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

    Science.gov (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

    2014-01-01

    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

  2. Convergence Revolution Comes to Wearables: Multiple Advances are Taking Biosensor Networks to the Next Level in Health Care.

    Science.gov (United States)

    Mertz, Leslie

    2016-01-01

    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.

  3. Convergence Revolution Comes to Wearables: Multiple Advances are Taking Biosensor Networks to the Next Level in Health Care.

    Science.gov (United States)

    Mertz, Leslie

    2016-01-01

    In the field of wearable biomedical sensors, the convergence revolution is more than a fanciful, utopian view of the way innovation should be done. Medical-grade wearable sensors rely on it. Their development requires technical know-how, computing expertise, clinical input, and collaboration-a true meeting of the minds to permit the conversion of wearables from neat gadgets into practical and proficient tools that will propel health care to new heights. Beyond the increasing miniaturization of hardware and the shift to wireless communication technology, flexible electronics and more powerful computing capabilities, including application specific integrated circuits (ASICs) and microelectromechanical systems (MEMS), have enabled new work on body sensor networks (BSNs) that monitor, analyze, and make sense of body signals for the prevention, diagnosis, and treatment of health disorders. Developments in processing, such as sensor-connected nodes combined with evolving algorithms and decreasing power requirements, have also contributed. In addition, new approaches to subjective measures (pain and emotion) have opened possibilities. PMID:26799721

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

    Directory of Open Access Journals (Sweden)

    Ying-Shen Juang

    2012-01-01

    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.

  5. 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

    2011-02-01

    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.

  6. 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

    2011-02-01

    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.

  7. Collaboration and entanglement: An actor-network theory analysis of team-based intraprofessional care for patients with advanced heart failure.

    Science.gov (United States)

    McDougall, A; Goldszmidt, M; Kinsella, E A; Smith, S; Lingard, L

    2016-09-01

    Despite calls for more interprofessional and intraprofessional team-based approaches in healthcare, we lack sufficient understanding of how this happens in the context of patient care teams. This multi-perspective, team-based interview study examined how medical teams negotiated collaborative tensions. From 2011 to 2013, 50 patients across five sites in three Canadian provinces were interviewed about their care experiences and were asked to identify members of their health care teams. Patient-identified team members were subsequently interviewed to form 50 "Team Sampling Units" (TSUs), consisting of 209 interviews with patients, caregivers and healthcare providers. Results are gathered from a focused analysis of 13 TSUs where intraprofessional collaborative tensions involved treating fluid overload, or edema, a common HF symptom. Drawing on actor-network theory (ANT), the analysis focused on intraprofessional collaboration between specialty care teams in cardiology and nephrology. The study found that despite a shared narrative of common purpose between cardiology teams and nephrology teams, fluid management tools and techniques formed sites of collaborative tension. In particular, care activities involved asynchronous clinical interpretations, geographically distributed specialist care, fragmented forms of communication, and uncertainty due to clinical complexity. Teams 'disentangled' fluid in order to focus on its physiological function and mobilisation. Teams also used distinct 'framings' of fluid management that created perceived collaborative tensions. This study advances collaborative entanglement as a conceptual framework for understanding, teaching, and potentially ameliorating some of the tensions that manifest during intraprofessional care for patients with complex, chronic disease. PMID:27490299

  8. 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

    Science.gov (United States)

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

    2007-01-01

    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…

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

    Science.gov (United States)

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

    2009-06-20

    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).

  10. Caring for patients with chronic kidney disease: a joint opinion of the ambulatory care and the nephrology practice and research networks of the American College of Clinical Pharmacy.

    Science.gov (United States)

    Zillich, Alan J; Saseen, Joseph J; Dehart, Renee M; Dumo, Peter; Grabe, Darren W; Gilmartin, Cheryl; Hachey, David M; Hudson, Joanna Q; Pruchnicki, Maria C; Joy, Melanie S

    2005-01-01

    An increasing number of patients are developing chronic kidney disease (CKD). Appropriate care for patients with CKD must occur in the earliest stages, preferably before CKD progresses to more severe stages. Therefore, recognition and treatment of CKD and its associated complications must occur in primary care settings. Patients with CKD often have comorbid conditions such as diabetes mellitus, hypertension, and dyslipidemia, creating specific considerations when treating these diseases. Also, these patients have CKD-related conditions, including anemia and renal osteodystrophy, that are not traditionally evaluated and monitored by the primary care practitioner. Collectively, many opportunities exist for pharmacists who practice in the primary care setting to improve the care of patients with CKD. PMID:15767229

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

    Directory of Open Access Journals (Sweden)

    Rawiwan Hansudewechakul

    2012-10-01

    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

  12. Data Extraction and Management in Networks of Observational Health Care Databases for Scientific Research: A Comparison of EU-ADR, OMOP, Mini-Sentinel and MATRICE Strategies

    OpenAIRE

    Gini, Rosa; Schuemie, Martijn; Brown, Jeffrey; Ryan, Patrick; Vacchi, Edoardo; Coppola, Massimo; Cazzola, Walter; Coloma, Preciosa; Berni, Roberto; Diallo, Gayo; Oliveira, José Luis; Avillach, Paul; Trifirò, Gianluca; Rijnbeek, Peter; Bellentani, Mariadonata

    2016-01-01

    Introduction: We see increased use of existing observational data in order to achieve fast and transparent production of empirical evidence in health care research. Multiple databases are often used to increase power, to assess rare exposures or outcomes, or to study diverse populations. For privacy and sociological reasons, original data on individual subjects can’t be shared, requiring a distributed network approach where data processing is performed prior to data sharing. Case Descriptions...

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

    Directory of Open Access Journals (Sweden)

    Martinho Braga Batista e Silva

    2009-02-01

    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

  14. Brief encounters: what do primary care professionals contribute to peoples’ self-care support network for long-term conditions? A mixed methods study

    OpenAIRE

    Rogers, Anne; Vassilev, Ivaylo; Brooks, Helen; Kennedy, Anne; Blickem, Christian

    2016-01-01

    Background Primary care professionals are presumed to play a central role in delivering long-term condition management. However the value of their contribution relative to other sources of support in the life worlds of patients has been less acknowledged. Here we explore the value of primary care professionals in people’s personal communities of support for long-term condition management. Methods A mixed methods survey with nested qualitative study designed to identify relationships and socia...

  15. Implementing Role-Changing Versus Time-Changing Innovations in Health Care: Differences in Helpfulness of Staff Improvement Teams, Management, and Network for Learning.

    Science.gov (United States)

    Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H

    2015-12-01

    Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. PMID:26116611

  16. 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

    Science.gov (United States)

    Wodchis, Walter P; Upshur, Ross; Cott, Cheryl; McKinstry, Brian; Mercer, Stewart; Palen, Ted E; Ramsay, Tim; Thavorn, Kednapa

    2016-01-01

    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

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

    Science.gov (United States)

    Carrier, Sébastien

    2013-09-01

    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.

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

    Science.gov (United States)

    Carrier, Sébastien

    2013-09-01

    The objective of this article is to understand coordination as it unfolds in case management practices in the context of integrated care networks devoted to frail elderly individuals. More specifically, we describe practical coordination processes. We conducted a qualitative exploratory study using an embedded case study design. Our study covers three health and social service centers in Québec. We noted that coordination produces convention in case management practices through a process of bringing together different types of compromise in home care situations where multidimensionality appears to be more or less important. We constructed four different types of compromise-producing convention with regard to coordination in case management practices: compromise at the interface, scheduling compromise, compromise of opportunity, and compromising change. PMID:23880440

  19. [Prospective qualification requirements in nursing care. Results and conclusions of the BMBF research network FreQueNz].

    Science.gov (United States)

    Schüler, G; Klaes, L; Rommel, A; Schröder, H; Köhler, T

    2013-08-01

    Demographic change, advances in medicine, and innovative health care services are leading to changes in the professional qualification requirements for nursing and care staff. Detecting future trends in relation to these requirements was the focus of a Delphi study developed as part of the BMBF FreQueNz initiative. After qualitative expert interviews, data collection was organized in three consecutive steps, with 243 interviews realized in the second wave. It was found that home care will further diversify in the fields of supporting and counseling services as well as in palliative care, resulting in the necessary expansion of specific qualifications (e.g., intensive care). Moreover, there will be an increased need for interprofessional, intersectoral, and intercultural coordination and communication skills. As a consequence of the delegation of medical tasks, new duties for nonmedical professions in inpatient and outpatient care will also arise. For instance, qualifications need to be tailored to the new demands of assessment, diagnostics, therapy, and patient education and they should take into account evidence-based knowledge as well as clinical practice guidelines. Consequently, the system of care professionals will further diversify through advanced training programs and the continued academization of nursing. PMID:23884530

  20. Enhancing social networks: a qualitative study of health and social care practice in UK mental health services.

    Science.gov (United States)

    Webber, Martin; Reidy, Hannah; Ansari, David; Stevens, Martin; Morris, David

    2015-03-01

    People with severe mental health problems such as psychosis have access to less social capital, defined as resources within social networks, than members of the general population. However, a lack of theoretically and empirically informed models hampers the development of social interventions which seek to enhance an individual's social networks. This paper reports the findings of a qualitative study, which used ethnographic field methods in six sites in England to investigate how workers helped people recovering from psychosis to enhance their social networks. This study drew upon practice wisdom and lived experience to provide data for intervention modelling. Data were collected from 73 practitioners and 51 people who used their services in two phases. Data were selected and coded using a grounded theory approach to depict the key themes that appeared to underpin the generation of social capital within networks. Findings are presented in four over-arching themes - worker skills, attitudes and roles; connecting people processes; role of the agency; and barriers to network development. The sub-themes which were identified included worker attitudes; person-centred approach; equality of worker-individual relationship; goal setting; creating new networks and relationships; engagement through activities; practical support; existing relationships; the individual taking responsibility; identifying and overcoming barriers; and moving on. Themes were consistent with recovery models used within mental health services and will provide the basis for the development of an intervention model to enhance individuals' access to social capital within networks. PMID:25441461

  1. Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip

    Energy Technology Data Exchange (ETDEWEB)

    Caniato, M., E-mail: marcocaniato@gmail.com [Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), University of Brescia, Brescia (Italy); Tudor, T. [Centre for Sustainable Waste Management, School of Science and Technology, University of Northampton, Northampton (United Kingdom); Vaccari, M. [Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), University of Brescia, Brescia (Italy)

    2015-01-15

    Highlights: • We systematically review scientific literature about health-care waste management. • We identify and discuss gaps, trends, efforts, and key-factors. • We suggest areas for improvement and best practices reported in literature. • We include recommendations for policy makers, practitioners and researchers. • We promote a holistic and harmonized approach to health-care waste management. - Abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology

  2. Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip

    International Nuclear Information System (INIS)

    Highlights: • We systematically review scientific literature about health-care waste management. • We identify and discuss gaps, trends, efforts, and key-factors. • We suggest areas for improvement and best practices reported in literature. • We include recommendations for policy makers, practitioners and researchers. • We promote a holistic and harmonized approach to health-care waste management. - Abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology

  3. 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.

    Science.gov (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…

  4. Supportive Care.

    Science.gov (United States)

    Olsen, Pia Riis; Lorenzo, Rosalía

    2016-01-01

    This chapter takes its point of departure in psychosocial aspects of supportive care in adolescent and young adult cancer care. The purpose is to describe some of the challenges that these young people face following a cancer diagnosis and guide healthcare professionals in how to provide care that improves the quality of life. In most hospitals and healthcare systems, adolescents and young adults are cared for and treated in settings for children or adults. Accordingly, healthcare professionals may lack attention to and knowledge about what characterize young peoples' life situation, their special needs and how to meet them. The topics we include in the chapter are the following: the youth friendly environment, social support and social network, parents, information during a psychosocial crisis event, the use of HEADSS, peer support, fertility, body image and self-esteem, after treatment and future challenges and palliative and end of life care. PMID:27595353

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

    Directory of Open Access Journals (Sweden)

    May Phyo Maung

    2014-03-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Liechty Edward A

    2010-12-01

    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

  7. Data Extraction and Management in Networks of Observational Health Care Databases for Scientific Research: A Comparison of EU-ADR, OMOP, Mini-Sentinel and MATRICE Strategies

    Science.gov (United States)

    Gini, Rosa; Schuemie, Martijn; Brown, Jeffrey; Ryan, Patrick; Vacchi, Edoardo; Coppola, Massimo; Cazzola, Walter; Coloma, Preciosa; Berni, Roberto; Diallo, Gayo; Oliveira, José Luis; Avillach, Paul; Trifirò, Gianluca; Rijnbeek, Peter; Bellentani, Mariadonata; van Der Lei, Johan; Klazinga, Niek; Sturkenboom, Miriam

    2016-01-01

    Introduction: We see increased use of existing observational data in order to achieve fast and transparent production of empirical evidence in health care research. Multiple databases are often used to increase power, to assess rare exposures or outcomes, or to study diverse populations. For privacy and sociological reasons, original data on individual subjects can’t be shared, requiring a distributed network approach where data processing is performed prior to data sharing. Case Descriptions and Variation Among Sites: We created a conceptual framework distinguishing three steps in local data processing: (1) data reorganization into a data structure common across the network; (2) derivation of study variables not present in original data; and (3) application of study design to transform longitudinal data into aggregated data sets for statistical analysis. We applied this framework to four case studies to identify similarities and differences in the United States and Europe: Exploring and Understanding Adverse Drug Reactions by Integrative Mining of Clinical Records and Biomedical Knowledge (EU-ADR), Observational Medical Outcomes Partnership (OMOP), the Food and Drug Administration’s (FDA’s) Mini-Sentinel, and the Italian network—the Integration of Content Management Information on the Territory of Patients with Complex Diseases or with Chronic Conditions (MATRICE). Findings: National networks (OMOP, Mini-Sentinel, MATRICE) all adopted shared procedures for local data reorganization. The multinational EU-ADR network needed locally defined procedures to reorganize its heterogeneous data into a common structure. Derivation of new data elements was centrally defined in all networks but the procedure was not shared in EU-ADR. Application of study design was a common and shared procedure in all the case studies. Computer procedures were embodied in different programming languages, including SAS, R, SQL, Java, and C++. Conclusion: Using our conceptual framework

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

    Science.gov (United States)

    Zakerolhosseini, Ali; Sokouti, Massoud; Pezeshkian, Massoud

    2013-01-01

    Quick responds to heart attack patients before arriving to hospital is a very important factor. In this paper, a combined model of Body Sensor Network and Personal Digital Access using QTRU cipher algorithm in Wifi networks is presented to efficiently overcome these life threatening attacks. The algorithm for optimizing the routing paths between sensor nodes and an algorithm for reducing the power consumption are also applied for achieving the best performance by this model. This system is consumes low power and has encrypting and decrypting processes. It also has an efficient routing path in a fast manner. PMID:24252988

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

    OpenAIRE

    Boustani MA; Frame A; Munger S; Healey P; Westlund J; Farlow M; Hake A; Austrom MG; Shepard P; Bubp C; Azar J; Nazir A; Adams N; Campbell NL; Chehresa A

    2012-01-01

    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 ...

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

    Science.gov (United States)

    Zakerolhosseini, Ali; Sokouti, Massoud; Pezeshkian, Massoud

    2013-01-01

    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.

  11. Epidemiology of Gram Negative Antimicrobial Resistance in a Multi-State Network of Long Term Care Facilities

    Science.gov (United States)

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

    2009-01-01

    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

  12. 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

    2016-01-01

    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.

  13. Diabetes network.

    Science.gov (United States)

    2016-07-01

    Diabetes UK has launched a network of information and support for commissioning and improvement in diabetes care. The network is free to join and offers monthly updates on good practice from around the UK, a forum for sharing ideas and learning, and access to Diabetes UK resources. PMID:27369708

  14. 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

    2011-12-01

    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

  15. 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

    2008-04-01

    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

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

    OpenAIRE

    Serhan Duran; Melda Bozkurt

    2012-01-01

    The increasing number of natural disasters in the last decade necessitates the increase in capacity and agility while delivering humanitarian relief. A common logistics strategy used by humanitarian organizations to respond this need is the establishment of pre-positioning warehouse networks. In the pre-positioning strategy, critical relief inventories are located near the regions at which they will be needed in advance of the onset of the disaster. Therefore, pre-positioning reduces the resp...

  17. Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network

    Directory of Open Access Journals (Sweden)

    Woodhams Victoria

    2012-06-01

    Full Text Available Abstract Background Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare. Method We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN. We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops. Results We identified three types of intervention: pre-hospital; within the emergency department (ED; and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR – Patients at risk of readmission and ACG – Adjusted Clinical Groups sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission. Conclusions Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don’t change.

  18. 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

    2012-08-01

    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.

  19. Changes in the use of manual vacuum aspiration for postabortion care within the public healthcare service network in Honduras.

    Science.gov (United States)

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

    2014-07-01

    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.

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

    Science.gov (United States)

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

    2016-01-01

    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

  1. 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

    2011-11-01

    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

  2. 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, Anton; Tjäderborn, M.; Schjerning, Ole;

    2016-01-01

    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......) prescribed average daily dose (ADD) of pregabalin for all patients was 150.0 (162.5) mg/day; this was highest in patients with epilepsy (191.9 mg/day), followed by neuropathic pain (158.0 mg/day) and GAD (150.0 mg/day). Only 1.0% (136/13,480) of patients were prescribed an ADD of pregabalin over the maximum...... 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...

  3. Mandated Local Health Networks across the province of Québec: a better collaboration with primary care working in the communities?

    Science.gov (United States)

    Breton, Mylaine; Maillet, Lara; Haggerty, Jeannie; Vedel, Isabelle

    2014-01-01

    Background In 2004, the Québec government implemented an important reform of the healthcare system. The reform was based on the creation of new organisations called Health Services and Social Centres (HSSC), which were formed by merging several healthcare organisations. Upon their creation, each HSSC received the legal mandate to establish and lead a Local Health Network (LHN) with different partners within their territory. This mandate promotes a 'population-based approach' based to the responsibility for the population of a local territory. Objective The aim of this paper is to illustrate and discuss how primary healthcare organisations (PHC) are involved in mandated LHNs in Québec. For illustration, we describe four examples that facilitate a better understanding of these integrated relationships. Results The development of the LHNs and the different collaboration relationships are described through four examples: (1) improving PHC services within the LHN - an example of new PHC models; (2) improving access to specialists and diagnostic tests for family physicians working in the community - an example of centralised access to specialists services; (3) improving chronic-disease-related services for the population of the LHN - an example of a Diabetes Centre; and (4) improving access to family physicians for the population of the LHN - an example of the centralised waiting list for unattached patients. Conclusion From these examples, we can see that the implementation of large-scale reform involves incorporating actors at all levels in the system, and facilitates collaboration between healthcare organisations, family physicians and the community. These examples suggest that the reform provided room for multiple innovations. The planning and organisation of health services became more focused on the population of a local territory. The LHN allows a territorial vision of these planning and organisational processes to develop. LHN also seems a valuable lever when

  4. Practice network-based care management for patients with type 2 diabetes and multiple comorbidities (GEDIMAplus): study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Bozorgmehr, K.; Szecsenyi, J.; Ose, D.; Besier, W.; Mayer, M.; Krisam, J.; Jacke, C.O.; Salize, H.J.; Brandner, R.; Schmitt, S.; Kiel, M.; Kamradt, M.; Freund, T.

    2014-01-01

    BACKGROUND: Care management interventions in the German health-care system have been evaluated with promising results, but further research is necessary to explore their full potential in the context of multi-morbidity. Our aim in this trial is to assess the efficacy of a primary care practice netwo

  5. 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

    2012-06-01

    Full Text Available Abstract Background While strong and consistent evidence supports the role of lifestyle modification in the prevention and management of type 2 diabetes (T2DM, the best strategies for program implementation to support lifestyle modification within primary care remain to be determined. The objective of the study is to evaluate the implementation of an evidence-based self- management program for patients with T2DM within a newly established primary care network (PCN environment. Method Using a non-randomized design, participants (total N = 110 per group will be consecutively allocated in bi-monthly blocks to either a 6-month self-management program lead by an Exercise Specialist or to usual care. Our primary outcome is self-reported physical activity and pedometer steps. Discussion The present study will assess whether a diabetes self-management program lead by an Exercise Specialist provided within a newly emerging model of primary care and linked to available community-based resources, can lead to positive changes in self-management behaviours for adults with T2DM. Ultimately, our work will serve as a platform upon which an emerging model of primary care can incorporate effective and efficient chronic disease management practices that are sustainable through partnerships with local community partners. Clinical Trials Registration ClinicalTrials.gov identifier: NCT00991380

  6. 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

    2011-07-01

    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

  7. One Family's Journey: Medical Home and the Network of Supports It Offers Children and Youth with Special Health Care Needs. Part One

    Science.gov (United States)

    MacDonald, Sarah; Gatto, Molly; Walker, Deb; Turchi, Renee

    2007-01-01

    This is the first article in a year long series that presents the experiences of a fictitious couple, Amita and Samir, as they learn to adapt to the reality of having a premature baby with special needs. Doris, the fictitious nurse who took care of baby Anjali in the neonatal intensive care unit (NICU), has had ten years of experience working in…

  8. 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

    2011-07-01

    Full Text Available Abstract Background Whiplash injury affects 83% of persons in a traffic collision and leads to whiplash-associated disorders (WAD. A major challenge facing health care decision makers is identifying cost-effective interventions due to lack of economic evidence. Our objective is to compare the cost-effectiveness of: 1 physician-based education and activation, 2 a rehabilitation program developed by Aviva Canada (a group of property and casualty insurance providers, and 3 the legislated standard of care in the Canadian province of Ontario: the Pre-approved Framework Guideline for Whiplash developed by the Financial Services Commission of Ontario. Methods/Design The economic evaluation will use participant-level data from the University Health Network Whiplash Intervention Trial and will be conducted from the societal perspective over the trial's one-year follow-up. Resource use (costs will include all health care goods and services, and benefits provided during the trial's 1-year follow-up. The primary health effect will be the quality-adjusted life year. We will identify the most cost-effective intervention using the incremental cost-effectiveness ratio and incremental net-benefit. Confidence ellipses and cost-effectiveness acceptability curves will represent uncertainty around these statistics, respectively. A budget impact analysis will assess the total annual impact of replacing the current legislated standard of care with each of the other interventions. An expected value of perfect information will determine the maximum research expenditure Canadian society should be willing to pay for, and inform priority setting in, research of WAD management. Discussion Results will provide health care decision makers with much needed economic evidence on common interventions for acute whiplash management. Trial Registration http://ClinicalTrials.gov identifier NCT00546806 [Trial registry date: October 18, 2007; Date first patient was randomized: February

  9. Child Care Aware

    Science.gov (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 Copyright 2015 CCAoA. All Rights Reserved. Careers Privacy Policy Site Terms Newsroom Contact Us Pin It on ...

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

    Science.gov (United States)

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

    2016-07-01

    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. PMID:27400465

  11. Prenatal Care

    Science.gov (United States)

    ... am thinking about getting pregnant. How can I take care of myself? You should start taking care of ... What should I do — or not do — to take care of myself and my unborn baby? Follow these ...

  12. Critical Care

    Science.gov (United States)

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

  13. Palliative Care

    Science.gov (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 ...

  14. Self Care

    Science.gov (United States)

    ... Care Connections Experiences Research Learning Evaluation Print Email Self Care If you are living with a chronic ... help you cope can make a real difference. Self-care techniques are things you can do for ...

  15. Ensuring Patient Safety by using Colored Petri Net Simulation in the Design of Heterogeneous, Multi-Vendor, Integrated, Life-Critical Wireless (802.x) Patient Care Device Networks.

    Science.gov (United States)

    Sloane, Elliot; Gehlot, Vijay

    2005-01-01

    Hospitals and manufacturers are designing and deploying the IEEE 802.x wireless technologies in medical devices to promote patient mobility and flexible facility use. There is little information, however, on the reliability or ultimate safety of connecting multiple wireless life-critical medical devices from multiple vendors using commercial 802.11a, 802.11b, 802.11g or pre-802.11n devices. It is believed that 802.11-type devices can introduce unintended life-threatening risks unless delivery of critical patient alarms to central monitoring systems and/or clinical personnel is assured by proper use of 802.11e Quality of Service (QoS) methods. Petri net tools can be used to simulate all possible states and transitions between devices and/or systems in a wireless device network, and can identify failure modes in advance. Colored Petri Net (CPN) tools are ideal, in fact, as they allow tracking and controlling each message in a network based on pre-selected criteria. This paper describes a research project using CPN to simulate and validate alarm integrity in a small multi-modality wireless patient monitoring system. A 20-monitor wireless patient monitoring network is created in two versions: one with non-prioritized 802.x CSM protocols and the second with simulated Quality of Service (QoS) capabilities similar to 802.11e (i.e., the second network allows message priority management.) In the standard 802.x network, dangerous heart arrhythmia and pulse oximetry alarms could not be reliably and rapidly communicated, but the second network's QoS priority management reduced that risk significantly. PMID:17282136

  16. Improving the quality of health care : using international collaboration to inform guideline programmes by founding the Guidelines International Network (G-I-N)

    NARCIS (Netherlands)

    Ollenschlager, G; Marshall, C; Qureshi, S; Rosenbrand, K; Burgers, J; Makela, M; Slutsky, J

    2004-01-01

    Clinical practice guidelines are regarded as powerful tools to achieve effective health care. Although many countries have built up experience in the development, appraisal, and implementation of guidelines, until recently there has been no established forum for collaboration at an international lev

  17. Variation in recorded child maltreatment concerns in UK primary care records: a cohort study using The Health Improvement Network (THIN database.

    Directory of Open Access Journals (Sweden)

    Jenny Woodman

    Full Text Available OBJECTIVES: To determine variation over time and between practices in recording of concerns related to abuse and neglect (maltreatment in children's primary care records. DESIGN: Retrospective cohort study using a United Kingdom representative primary care database. SETTING: 448 General Practices. PARTICIPANTS: In total 1,548, 972 children (<18 y registered between 1995 and 2010. MAIN OUTCOME MEASURES: Change in annual incidence of one or more maltreatment-related codes per child year of registration. Variation between general practices measured as the proportion of registered children with one or more maltreatment-related codes during 3 years (2008-2010. RESULTS: From 1995-2010, annual incidence rates of any coded maltreatment-related concerns rose by 10.8% each year (95% confidence interval 10.5, 11.2; adjusted for sex, age and deprivation. In 2010 the rate was 9.5 per 1000 child years (95%CI: 9.3, 9.8, equivalent to a prevalence of 0.8% of all registered children in 2010. Across all practices, the median prevalence of children with any maltreatment-related codes in three years (2008 to 2010 was 0.9% (range 0%-13.4%; 11 practices (2.5% had zero children with relevant codes in the same period. Once we accounted for sex, age, and deprivation, the prevalence for each practice was within two standard errors of the grand mean. CONCLUSIONS: General Practitioners (GPs are far from disengaged from safeguarding children; they are consistently and increasingly recording maltreatment concerns. As these results are likely to underestimate the burden of maltreatment known to primary care, there is much scope for increasing recording in primary care records with implications for resources to respond to concerns about maltreatment. Interventions and policies should build on this evidence that the average GP in the UK is engaged in child safeguarding activity.

  18. [Managed care. Its impact on health care in the USA, especially on anesthesia and intensive care].

    Science.gov (United States)

    Bauer, M; Bach, A

    1998-06-01

    Managed care, i.e., the integration of health insurance and delivery of care under the direction of one organization, is gaining importance in the USA health market. The initial effects consisted of a decrease in insurance premiums, a very attractive feature for employers. Managed care promises to contain expenditures for health care. Given the shrinking public resources in Germany, managed care seems attractive for the German health system, too. In this review the development of managed care, the principal elements, forms of organisation and practical tools are outlined. The regulation of the delivery of care by means of controlling and financial incentives threatens the autonomy of physicians: the physician must act as a "double agent", caring for the interest for the individual patient and being restricted by the contract with the managed care organisation. Cost containment by managed care was achieved by reducing the fees for physicians and hospitals (and partly by restricting care for patients). Only a fraction of this cost reduction was handed over to the enrollee or employer, and most of the money was returned with profit to the shareholders of the managed care organisations. The preeminent role of primary care physicians as gatekeepers of the health network led to a reduced demand for specialist services in general and for university hospitals and anesthesiologists in particular. The paradigm of managed care, i.e., to guide the patient and the care giver through the health care system in order to achieve cost-effective and high quality care, seems very attractive. The stress on cost minimization by any means in the daily practice of managed care makes it doubtful if managed care should be an option for the German health system, in particular because there are a number of restrictions on it in German law. PMID:9676303

  19. Bridging gaps to promote networked care between teams and groups in health delivery systems: a systematic review of non-health literature

    OpenAIRE

    Braithwaite, Jeffrey

    2015-01-01

    Objectives To assess non-health literature, identify key strategies in promoting more networked teams and groups, apply external ideas to healthcare, and build a model based on these strategies. Design A systematic review of the literature outside of healthcare. Method Searches guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) of ABI/INFORM Global, CINAHL, IBSS, MEDLINE and Psychinfo databases following a mind-mapping exercise generating key terms centred o...

  20. Rede de significações: perspectiva para análise da inserção de bebês na creche The insertion of babies into a day care center analysed through a network of meanings

    Directory of Open Access Journals (Sweden)

    Katia de Souza Amorim

    2000-03-01

    's first period in a day care thus implies the emergence and creation of new meanings which are attributed to, assumed by, confronted to and negotiated in the interactions established by all participants. A model was developed to analyse this process based on a research project on the insertion of 26 infants (5 to 18 months old into a day care. Video recordings, observational reports, as well as interviews with mothers, caregivers and technicians were made during the babies' first year at an university day care centre. The model focus on three main personages: mother, child and caregiver and on their mutual relationships which create three interconnected fields. The mother-child field is inserted in a larger network, the family scenery. The other two, caregiver-child and mother-caregiver fields are located in the day-care scenery. Both scenarios are impregnated by a wider social-historical matrix created in complex cultural, economic and political systems. The various elements are interconnected in a semiotic network of meanings, which continuously transforms and structures human development, allowing varied paths of behavior for each individual.

  1. Low-cost computing and network communication for a point-of-care device to perform a 3-part leukocyte differential

    Science.gov (United States)

    Powless, Amy J.; Feekin, Lauren E.; Hutcheson, Joshua A.; Alapat, Daisy V.; Muldoon, Timothy J.

    2016-03-01

    Point-of-care approaches for 3-part leukocyte differentials (granulocyte, monocyte, and lymphocyte), traditionally performed using a hematology analyzer within a panel of tests called a complete blood count (CBC), are essential not only to reduce cost but to provide faster results in low resource areas. Recent developments in lab-on-a-chip devices have shown promise in reducing the size and reagents used, relating to a decrease in overall cost. Furthermore, smartphone diagnostic approaches have shown much promise in the area of point-of-care diagnostics, but the relatively high per-unit cost may limit their utility in some settings. We present here a method to reduce computing cost of a simple epi-fluorescence imaging system using a Raspberry Pi (single-board computer, USB color camera in conjunction with a leukocyte-selective vital dye (acridine orange) in order to determine a leukocyte count and differential from a low volume (<20 microliters) of whole blood obtained via fingerstick. Additionally, the system utilizes a "cloud-based" approach to send image data from the Raspberry Pi to a main server and return results back to the user, exporting the bulk of the computational requirements. Six images were acquired per minute with up to 200 cells per field of view. Preliminary results showed that the differential count varied significantly in monocytes with a 1 minute time difference indicating the importance of time-gating to produce an accurate/consist differential.

  2. Low-cost computing and network communication for a point-of-care device to perform a 3-part leukocyte differential

    Science.gov (United States)

    Powless, Amy J.; Feekin, Lauren E.; Hutcheson, Joshua A.; Alapat, Daisy V.; Muldoon, Timothy J.

    2016-03-01

    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, 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.

  3. Tracheostomy care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000076.htm Tracheostomy care To use the sharing features on this ... through your nose and mouth. Caring for Your Tracheostomy Once the hole in your neck is not ...

  4. Daily Care

    Science.gov (United States)

    ... to Know Online Tools Enhancing Daily Life Daily Plan Activities Communication Food & Eating Music & Art Personal Care Incontinence Bathing ... Tweet Email | Print Create a Daily Routine Daily Plan Activities Communication Food/Eating Get Tips on Personal Care Bathing ...

  5. Continuing Care

    Science.gov (United States)

    ... Care Obesity at Midlife May Speed Alzheimer’s Onset Hello from my mom Easing the Behavior Problems of ... Managers Continuing Care FOR MORE ARTICLES CLICK HERE Hello from my mom Common Estate Planning Errors Alzheimer’s ...

  6. Pin care

    Science.gov (United States)

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

  7. 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

    2008-08-01

    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.

  8. Collaboration and Networking.

    Science.gov (United States)

    Husson, O; Manten-Horst, E; van der Graaf, W T A

    2016-01-01

    Awareness of the need for collaboration across pediatric and adult cancer to care for adolescents and young adults (AYAs) arose from the recognition of the unique characteristics of AYAs with cancer. Neither pediatric nor adult oncology hospital departments are able to provide age-appropriate care single handedly. The best way to bridge the gap in care of AYA cancer patients is to centralize aspects of their care within dedicated AYA care programs, including the following essential components: provision of developmentally appropriate and multidisciplinary (supportive) care, availability of AYA inpatient and outpatient facilities and healthcare professional AYA expertise as collaboration between adult and pediatric departments. Barriers are related to the slowly emerging evidence of benefit, cultural differences (collaboration between pediatric and adult oncology professionals), administrative and logistic challenges (small number of AYAs makes it difficult to create an AYA program in every hospital) and financial aspects (dependency on philanthropic funds). The sustainable development of an AYA program requires acceptance as a standard of care at the clinical and patient community and at government level. To improve the quality, equity and quantity of research and innovation in AYA cancer care across the world, it is necessary to join forces and collaborate in international networks to study issues such as the features of quality care, collaboration between pediatric and adult clinical teams, trial groups and professional societies, and AYA-specific groups such as Critical Mass, Canteen or European Network for Teenagers and Young Adults with Cancer. PMID:27595356

  9. An Overview of the Sensor Networks

    Science.gov (United States)

    Ikegami, Tetsushi

    Recently, the sensor network technology attracts a great deal of attention achieving a safe and comfortable ubiquitous society. The sensor networks are already used in environment and disaster monitoring, medical care, logistics and transportation. This paper aimed to understand the outline of the sensor network technology centering on the wireless sensor network technology.

  10. Strengthen Humanistic Care to College Students in Network Age%网络时代应加强对大学生的人文关怀

    Institute of Scientific and Technical Information of China (English)

    姚瑞

    2011-01-01

    网络时代的人文关怀缺失,对大学生心理健康、道德品质和人际交往等方面的负面影响日益严重。高校思想教育工作者需要重视这一问题。本文分析了大学生人文关怀缺失的表现及出现的原因,提出了一些解决的建议。%For scarcity of humanistic care, it has caused increasingly serious negative affect to college students' spirit health, moral character and interpersonal interaction etc. to which the educators of ideology in colleges and universities shall pay attention. And in this article, symptoms and causes of scarcity of humanistic case to college students are analyzed, and suggestions for resolution of the matter are brought forward also.

  11. Comparing Care

    NARCIS (Netherlands)

    Evert Pommer; Isolde Woittiez; John Stevens

    2007-01-01

    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

  12. Beyond Space For Spatial Networks

    CERN Document Server

    Expert, Paul; Blondel, Vincent D; Lambiotte, Renaud

    2010-01-01

    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...

  13. Accountable care organizations: back to the future?

    Science.gov (United States)

    Burns, Lawton R; Pauly, Mark V

    2012-01-01

    Accountable Care Organizations (ACOs) are networks of providers that assume risk for the quality and total cost of the care they deliver. Public policymakers and private insurers hope that ACOs will achieve the elusive "triple aim" of improving quality of care, improving population health, and reducing costs. The model is still evolving, but the premise is that ACOs will accomplish these aims by coordinating care, managing chronic disease, and aligning financial incentives for hospitals and physicians. If this sounds familiar, it may be because the integrated care networks of the 1990s tried some of the same things, and mostly failed in their attempts. This Issue Brief summarizes the similarities and differences between the new ACOs and the integrated delivery networks of the 1990s, and presents the authors' analysis of the likely success of these new organizations in affecting the costs and quality of health care. PMID:23610793

  14. Learning Networks, Networked Learning

    NARCIS (Netherlands)

    Sloep, Peter; Berlanga, Adriana

    2010-01-01

    Sloep, P. B., & Berlanga, A. J. (2011). Learning Networks, Networked Learning [Redes de Aprendizaje, Aprendizaje en Red]. Comunicar, XIX(37), 55-63. Retrieved from http://dx.doi.org/10.3916/C37-2011-02-05

  15. Learning Networks, Networked Learning

    NARCIS (Netherlands)

    Sloep, Peter

    2011-01-01

    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.

  16. The Building Infrastructure and Home Care

    OpenAIRE

    Lundberg, Stefan

    2007-01-01

    Puropse - To discus the importance of the facilities management in Home Care service. Design/methodology/approach - A case study of a project where new assistive technolgy was used to improve the security for elderly in Home Care service. Findings - The infrastructure of a multi-story building is of vital importance for the delivery chain of Home Care. The care provider is depending on the functionality of the communication network in the home to sustain the care during the time of "care abse...

  17. Professional social networking.

    Science.gov (United States)

    Rowley, Robert D

    2014-12-01

    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.

  18. Situation of the supplementary diet of children between 6 and 24 months attended in the Primary Care Network of Macaé, RJ, Brazil.

    Science.gov (United States)

    Marinho, Leticia Maia Forte; Capelli, Jane de Carlos Santana; Rocha, Camilla Medeiros Macedo da; Bouskela, Alice; do Carmo, Cleber Nascimento; de Freitas, Silvia Eliza Almeida Pereira; Anastácio, Alexandra da Silva; de Almeida, Maria Fernanda Larcher; Pontes, Juliana da Silva

    2016-03-01

    This study aimed to analyze the supplementary nutritional situation of children aged 6-24 months attended by the Primary Care unit of Macaé/RJ. It was conducted as a cross-sectional study, and data was obtained from the SISVAN Web website, including and analyzing all of the records (n=218) of children between 6-24 months in the year 2013. In infants between 6-12 months, the consumption of 72.3% of vegetables, 75.3% of fruits, and 63.4% of meats was detected, considered indicators of healthy supplementary nutrition. In contrast, 23.8% were already consuming sugar-based food sources (honey, molasses, simple sugar, and unrefined cane sugar), 34.7% industrialized juice, and 17.8% soft drinks. The consumption of industrialized juice was significantly greater in boys (p-value soft drinks. Between 18-24 months, it was recorded that 89.9% of children consumed vegetables, 83.1% fruits, and 96.7% meat. The consumption of sugar-based foods was 33.9%, 69.5% for industrialized juices, and 55.5% for soft drinks. We conclude that the indicators of healthy complementary nutrition come close to the target set by the Ministry of Health (80%). PMID:26960109

  19. Advance care directives

    Science.gov (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 - ...

  20. Study of Early Child Care and Youth Development (SECCYD)

    Science.gov (United States)

    ... NICHD Science Advances Supported Networks, Programs & Initiatives NICHD Study of Early Child Care and Youth Development (SECCYD) ... Sunsetted/For Reference Only The NICHD started the Study of Early Child Care and Youth Development (SECCYD), ...

  1. Network Potentials

    OpenAIRE

    Chakrabarti, Subhadip; Gilles, Robert Paul

    2005-01-01

    A network payoff function assigns a utility to all participants in a (social) network. In this paper we discuss properties of such network payoff functions that guarantee the existence of certain types of pairwise stable networks and the convergence of certain network formation processes. In particular we investigate network payoff functions that admit an exact network potential or an ordinal network potential. We relate these network potentials to exact and ordinal potentials of a non-cooper...

  2. Multidisciplinary care in haemoglobinopathies

    Directory of Open Access Journals (Sweden)

    Adriana Ceci

    2014-12-01

    Full Text Available While most complications are related to haemoglobinopathies and their treatment, it is also possible to observe substantial differences in comorbidities’ onset and seriousness which depend also to the different HPs genotypes. These differences should be carefully considered when health authorities set up and manage adequate care systems and treatments plans. We describe services organisation in Italy including the availability of multispecialty care and tools, in the HPs units participating to the HTA-THAL Multiregional Registry, with the aim to derive the impact of the services and multispecialty care availability on the management of the disease and on the patients wellbeing. The high dispersion and heterogeneity of services demonstrated, exposes the Italian system to a high risk of: a inappropriate use of economical and medical resources, b limited access to multidisciplinary care of some patients with apparent inequality among different centres, and c low patients satisfaction with the services provided. The identification of a ‘standard for HPs services’ is necessary not only at national but also at interventional level in order to implement collaborative research and the identification and networking of reference’ centres worldwide. Following the big efforts provided in the last years here there is a new challenging mission for the TIF.

  3. Managed care under siege.

    Science.gov (United States)

    Epstein, R A

    1999-10-01

    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.

  4. Primary care research in Denmark

    DEFF Research Database (Denmark)

    Vedsted, Peter; Kallestrup, Per

    2016-01-01

    the inter-professional nature of the discipline, the book also features a section on cross-nation organisations and primary care networks supporting research. National perspectives are offered from researchers in 20 countries that form part of the World Organization of Family Doctors, providing case...... histories from research-rich to resource-poor nations that illustrate the range of research development and capacity building. This book argues the importance of primary care research, especially to policy makers, decision makers and funders in informing best practice, training primary health care providers...

  5. Network Competition with Local Network

    OpenAIRE

    Oystein Fjeldstad; Moen, Espen R; Christian Riis

    2007-01-01

    Local network externalities are present when the network externalities associated with entering a certain network depends not only on the total number of agents in the network, but on the identity of the agents in the network. We explore the consequences of local network externalities within a framework where two networks compete on the Hotelling circle. We first show that local network externalities, in contrast to global network externalities, do not sharpen competition. Then we show that t...

  6. Integrated regional network construction for ST-segment elevation myocardial infarction care%区域协同ST段抬高型心肌梗死救治网络建设探讨

    Institute of Scientific and Technical Information of China (English)

    王斌; 王焱; 叶涛; 肖国胜; 常贺; 温红梅; 陈媛; 林吉怡; 杨鹭琳

    2014-01-01

    (STEMI) care in China and evaluate the implementation effect of this network.Methods Based on real-time electrocardiogram transmission technology,we established an integrated regional network for STEMI care (IRN-STEMI) with Xiamen Heart Center as the core center,120Emergency Systems,PCI-capable hospitals and other community health units as core elements of this network.Reperfusion treatment data of Xiamen Heart Center including the number of patients receiving primary percutaneous coronary intervention (PCI),the mean first medical contact to balloon (FMC-to-B)time,the mean door to balloon (D-to-B) time,the mean length of hospital stay,the mean medical cost and in-hospital mortality were compared before (n =165) and at 1 year after the built-up of IRN-STEMI (n =343).Results Compared to pre-IRN-STEMI era,primary PCI ratio (84.5% (290/343) vs.75.5%(185/245)) were significantly increased post establishment of IRN-STEMI within the network(P =0.06).STEMI patients admitted in Xiamen Heart Center was significantly increased from 165 to 256,the annual mean FMC-to-B time ((110.3 ± 34.0) min vs.(137.9 ± 58.5) min,P < 0.01) and D-to-B ((76.5 ±33.0) min vs.(107.3 ± 38.0) min,P < 0.01),as well as the mean medical cost were significantly decreased ((51 398±22 100)RMB vs.(56 970 ± 24 593)RMB,P < 0.05),while the mean length of hospital stay ((9.0 ± 4.3) d vs.(9.7 ± 4.8) d,P > 0.05) and in-hospital mortality (3.1% (8/256) vs.3.0% (5/165),P > 0.05) remained unchanged before and after the setting of IRN-STEMI in Xiamen Heart Center.Conclusion Establishment of an integrated regional network system for STEMI patients in China is feasible.With collaboration of qualified heart center,EMS and PCI-capable and non-PCI capable local hospitals,establishment of IRN-STEMI effectively increased the ratio of primary PCI for STEMI patients,it also significantly shortened the FMC-to-B and D-to-B time,decreased mean medical cost,thus,the regional IRN-STEMI network might be an

  7. Palliative Care in Lung Cancer.

    Science.gov (United States)

    Shinde, Arvind M; Dashti, Azadeh

    2016-01-01

    Lung cancer is the most common cancer worldwide and is the leading cause of cancer death for both men and women in the USA. Symptom burden in patients with advanced lung cancer is very high and has a negative impact on their quality of life (QOL). Palliative care with its focus on the management of symptoms and addressing physical, psychosocial, spiritual, and existential suffering, as well as medically appropriate goal setting and open communication with patients and families, significantly adds to the quality of care received by advanced lung cancer patients. The Provisional Clinical Opinion (PCO) of American Society of Clinical Oncology (ASCO) as well as the National Cancer Care Network's (NCCN) clinical practice guidelines recommends early integration of palliative care into routine cancer care. In this chapter, we will provide an overview of palliative care in lung cancer and will examine the evidence and recommendations with regard to a comprehensive and interdisciplinary approach to symptom management, as well as discussions of goals of care, advance care planning, and care preferences. PMID:27535397

  8. Taiwan Automated Telescope Network

    Directory of Open Access Journals (Sweden)

    Dean-Yi Chou

    2010-01-01

    can be operated either interactively or fully automatically. In the interactive mode, it can be controlled through the Internet. In the fully automatic mode, the telescope operates with preset parameters without any human care, including taking dark frames and flat frames. The network can also be used for studies that require continuous observations for selected objects.

  9. 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...

  10. NETWORK OF CARE OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS

    Directory of Open Access Journals (Sweden)

    Eliane Tatsch Neves

    2015-01-01

    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.

  11. Telemedicine—Health Care Business Process Reengineering

    OpenAIRE

    KaiKai, John

    1995-01-01

    This paper provides a framework for implementing Telemedicine using Business Process Reengineering (BPR) methodology and tools. The practice of medicine using electronic communication is Telemedicine. Telemedicine enhances the national health care initiatives such as global research, development, and deployment of sophisticated communication, management and imaging network systems. Telemedicine will become an integral part of patient care activities.

  12. Emergent Subjectivity in Caring Institutions for Teenagers

    Science.gov (United States)

    Severinsson, Susanne; Nord, Catharina

    2015-01-01

    We investigate how different mealtime situations help shape teenager and staff subjectivities in two Swedish residential care homes and a special school for girls and boys, 12-15 years old, with social, emotional and behavioural difficulties. Three mealtime networks are analysed using concepts from actor-network theory, treating architectural…

  13. Hospice Care

    Science.gov (United States)

    ... your care. Other team members may include a music therapist, physical therapist, speech therapist or occupational therapist. ... to the Terms and Conditions and Privacy Policy Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium ...

  14. Multidisciplinary Care.

    Science.gov (United States)

    Daly, Megan E; Riess, Jonathan W

    2016-01-01

    Optimal multidisciplinary care of the lung cancer patient at all stages should encompass integration of the key relevant medical specialties, including not only medical, surgical, and radiation oncology, but also pulmonology, interventional and diagnostic radiology, pathology, palliative care, and supportive services such as physical therapy, case management, smoking cessation, and nutrition. Multidisciplinary management starts at staging and tissue diagnosis with pathologic and molecular phenotyping, extends through selection of a treatment modality or modalities, management of treatment and cancer-related symptoms, and to survivorship and end-of-life care. Well-integrated multidisciplinary care may reduce treatment delays, improve cancer-specific outcomes, and enhance quality of life. We address key topics and areas of ongoing investigation in multidisciplinary decision making at each stage of the lung cancer treatment course for early-stage, locally advanced, and metastatic lung cancer patients. PMID:27535399

  15. Caring Encounters

    Science.gov (United States)

    Gunn, Alyson

    2012-01-01

    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.

  16. Declarative Networking

    CERN Document Server

    Loo, Boon Thau

    2012-01-01

    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

  17. 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

    2010-11-01

    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

  18. Integrating Palliative Care into Primary Care.

    Science.gov (United States)

    Gorman, Rosemary D

    2016-09-01

    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.

  19. Wound Care in Primary Health Care

    OpenAIRE

    Nail Ersoz; Ismail Hakki Ozerhan; Fatih Zor

    2008-01-01

    Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000): 71-74

  20. Wound Care in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nail Ersoz

    2008-02-01

    Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull. 2008; 7(1: 71-74

  1. Wound Care in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nail Ersoz

    2008-02-01

    Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000: 71-74

  2. Collaborative Decision Support Systems for Primary Health care Managers

    Directory of Open Access Journals (Sweden)

    Gunjan Pahuja

    2012-03-01

    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.

  3. Multi databases in Health Care Networks

    Directory of Open Access Journals (Sweden)

    Nadir Kamal Salih

    2011-11-01

    Full Text Available E-Health is a relatively recent term for healthcare practice supported by electronic processes and communication, dating back to at least 1999. E-Health is greatly impacting on information distribution and availability within the health services, hospitals and to the public. E-health was introduced as the death of telemedicine, because - in the context of a broad availability of medical information systems that can interconnect and communicate - telemedicine will no longer exist as a specific field. The same could also be said for any other traditional field in medical informatics, including information systems and electronic patient records. E-health presents itself as a common name for all such technological fields. In this paper we focuses in multi database by determined some sites and distributed it in Homogenous way. This will be followed by an illustrative example as related works. Finally, the paper concludes with general remarks and a statement of further work.

  4. Multi databases in Health Care Networks

    CERN Document Server

    Salih, Nadir K; Sun, Mingrui

    2011-01-01

    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.

  5. Virtual health care center in Georgia.

    Science.gov (United States)

    Schrader, Thomas; Kldiashvili, Ekaterina

    2008-01-01

    Application of telemedicine systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for creation of national networks does not seem to be widely appreciated. The article describes the "Virtual Health Care Knowledge Center in Georgia" project. Its aim was the set up of an online integrated web-based platform to provide remote medical consultations and eLearning cycles. The project "Virtual Health Care Knowledge Center in Georgia" was the NATO Networking Infrastructure Grant dedicated for development of telemedicine in non-NATO countries. The project implemented a pilot to organize the creation of national eHealth network in Georgia and to promote the use of innovative telemedicine and eLearning services in the Georgian healthcare system. In June 2007 it was continued under the NATO Networking Infrastructure Grant "ePathology--Virtual Pathology Center in Georgia as the Continuation of Virtual Health Care Center". PMID:18673518

  6. Clustering Coefficients in Multiplex Networks

    CERN Document Server

    Cozzo, Emanuele; De Domenico, Manlio; Solé, Albert; Arenas, Alex; Gómez, Sergio; Porter, Mason A; Moreno, Yamir

    2013-01-01

    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.

  7. [Promoting citizenship through nursing care].

    Science.gov (United States)

    Backes, Dirce Stein; Backes, Marli Stein; Erdmann, Alacoque Lorenzini

    2009-01-01

    This study is the result of the project: networks care and social entrepreneurship: the autonomy and social commitment of nurses. The purpose of this qualitative study is to comprehend the meaning of nursing care as a social enterprising practice. The Grounded Theory was used as a methodological reference and the interview, conducted with 35 participants as technique of data collection. Data codification led to the central theme: Viewing Nursing Care as a Social Enterprising Practice. This theme is complemented by the category, characterized the cause condition: the social integration through the creation a political identity that expresses your involvement. The results showed that is necessary to learn and have a deep dialogic knowledge. In order to consolidate popular participation as a citizenship ideal, a critical professional attitude, base don the combination of care with liberty, participation end autonomy. PMID:19597667

  8. [Promoting citizenship through nursing care].

    Science.gov (United States)

    Backes, Dirce Stein; Backes, Marli Stein; Erdmann, Alacoque Lorenzini

    2009-01-01

    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.

    Science.gov (United States)

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve. PMID:26022525

  10. Wound Care.

    Science.gov (United States)

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    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.

  11. Redesigning ambulatory care business processes supporting clinical care delivery.

    Science.gov (United States)

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

    1997-04-01

    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. PMID:10181605

  12. Economists’ Statement on Network Neutrality Policy

    OpenAIRE

    Kahn, Alfred E.; Bruce M. Owen; Mayo, John; Vernon, John; Lawrence J. White; Waverman, Leonard; Cave, Martin; Patrick A. Messerlin; Joskow, Paul L.; Cramton, Peter; Litan, Robert E.; Robert S. Pindyck; Hahn, Robert W.; Savage, Scott J; Wallsten, Scott

    2007-01-01

    Network neutrality is a policy proposal that would regulate how network providers manage and price the use of their networks. Congress has introduced several bills on network neutrality. Proposed legislation generally would mandate that Internet service providers exercise no control over the content that flows over their lines and would bar providers from charging more for preferentially faster access to the Internet. These proposals must be considered carefully in light of the underlying eco...

  13. Regionalization of neonatal intensive care in Korea

    Directory of Open Access Journals (Sweden)

    Yun Sil Chang

    2011-12-01

    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. Home Care

    Science.gov (United States)

    ... care is especially useful for persons who need nursing, therapy, or aide services. You may need help if you are dealing with one or more of the following: You have trouble getting around (for example, after a hospital stay or an accident) You have wounds that need to be cleaned, ...

  15. Just caring.

    Science.gov (United States)

    Hussey, Trevor

    2012-01-01

    Social justice is concerned with fair distribution of the benefits and burdens of living together in society. Regarding nursing care, social justice is concerned with who should receive its benefits, how much they should receive, and who should take up the burden of providing and paying for it. A specific thesis is offered: 'Health care, including nursing care, should be distributed on the basis of need, free at the point of use, the cost being born by the community involved.' This thesis is shown to be incompatible with consequentialist (utilitarian) and libertarian approaches to social justice, but reasons are given for rejecting these theories. It is shown that it may be compatible with Rawl's liberal theory of justice and definitely compatible with a version of the teleological (Aristotelian) theory. The thesis is then defended against criticisms concerned with desert and responsibility: that the provident ought not to pay for the improvident, and that those who are responsible for their health do not deserve free care. There are answered by an epistemological argument concerning what we need to know before we can decide what people deserve, and an argument about social cohesion. The conclusion is that the thesis can be offered as a moral principle for a fair society. PMID:22176544

  16. The network researchers' network

    DEFF Research Database (Denmark)

    Henneberg, Stephan C.; Jiang, Zhizhong; Naudé, Peter;

    2009-01-01

    The Industrial Marketing and Purchasing (IMP) Group is a network of academic researchers working in the area of business-to-business marketing. The group meets every year to discuss and exchange ideas, with a conference having been held every year since 1984 (there was no meeting in 1987). In thi......The Industrial Marketing and Purchasing (IMP) Group is a network of academic researchers working in the area of business-to-business marketing. The group meets every year to discuss and exchange ideas, with a conference having been held every year since 1984 (there was no meeting in 1987......). In this paper, based upon the papers presented at the 22 conferences held to date, we undertake a Social Network Analysis in order to examine the degree of co-publishing that has taken place between this group of researchers. We identify the different components in this database, and examine the large main...

  17. CareCoor: Augmenting the Coordination of Cooperative Home Care Work

    DEFF Research Database (Denmark)

    Bossen, Claus; Christensen, Lars Rune; Grönvall, Erik;

    2013-01-01

    workers, while the second test lasted for six weeks and involved five elderly people, their next of kin and relevant home care workers. Results In the paper we make three major points, namely, (1) home care work is highly cooperative in nature and involves substantial coordinative efforts on the part......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...

  18. Three-level network system of pre-hospital emergency care in Kunshan City, Jiangsu Province%昆山市院外急救三级网络体系建设的探索

    Institute of Scientific and Technical Information of China (English)

    陈丽卿; 沈寅; 吴福荣

    2012-01-01

    院外急救是急救医学服务体系(EMSS)的首要环节,社会保障系统的重要组成部分.我国院外急救起步较晚,各城市院外急救发展也不平衡,与发达国家相比,还存在明显的差异.如何发展我国的院外急救事业,实现急救社会化、结构网络化、抢救现代化、知识普及化,努力为人民提供及时、优质、高效的院外急救服务,值得大家共同去研究探讨.%The experience of the Emergency Center of Kunshan City, Jiangsu Province was summed up and discussed. The pre-hospital emergency care model of this city is a mixed type of pre-hospital type and command-based type, the construction of the substations directly under this center relies on the Municipal Bureau of Fire Protection, and the construction of the 6 Internet-based substations relies on the town hospitals so that the substations cover all communities. A 120-119 linkage mechanism, the first one in China, was established in this city. A 120 green channel for the retirees was established in cooperation with the City Bureau of Retired Veteran Cadres, and a 120 green channel for the acute cardiac infarction patients was established in cooperation with the City TCM Hospital. A real-time video network transmission system is being piloted in this city to connect the emergency rescue rooms in different community health centers with the Municipal Emergency Command Center and Medical Experts Teleconsultation Center so as to guide the emergency practice of the community medical staff. The personal appointment of an ambulance from this City Emergency Center includes a medical doctor, a nurse, a driver, and a stretcher-bearer. In addition, first aid skills are popularized among the citizens.

  19. Identifying PHM market and network opportunities.

    Science.gov (United States)

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

    2015-11-01

    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.

  20. 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

    2011-12-01

    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.

  1. Maternal care

    OpenAIRE

    2001-01-01

    In June 2000 a distinguished group of obstetricians, midwives, general practitioners, and medical statisticians came together to discuss maternal care. Chaired by Professor James Drife from Leeds, discussion ranged over many topics, including: the changing role of the obstetrician, general practitioners, and the increasing status and responsibility of midwives. Other subjects include the induction of labour, obstetric analgesia and anaesthesia, and debates about the place and kind of delivery...

  2. Green networking

    CERN Document Server

    Krief, Francine

    2012-01-01

    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

  3. Network Information Management Subsystem

    Science.gov (United States)

    Chatburn, C. C.

    1985-01-01

    The Deep Space Network is implementing a distributed data base management system in which the data are shared among several applications and the host machines are not totally dedicated to a particular application. Since the data and resources are to be shared, the equipment must be operated carefully so that the resources are shared equitably. The current status of the project is discussed and policies, roles, and guidelines are recommended for the organizations involved in the project.

  4. Advances in network complexity

    CERN Document Server

    Dehmer, Matthias; Emmert-Streib, Frank

    2013-01-01

    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.

  5. Telecommunication networks

    CERN Document Server

    Iannone, Eugenio

    2011-01-01

    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

  6. An Integrated Care Initiative to Improve Patient Outcome in Schizophrenia

    OpenAIRE

    Norbert eMayer-Amberg; Rainer eWoltmann; Stefanie eWalther

    2016-01-01

    The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various healthcare service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The current work is a quality monitoring report of a novel care setting, called Integrated Care Initiative Schizophrenia. It has implemented a networked care con...

  7. [Inflammatory Bowel Disease Competence Network].

    Science.gov (United States)

    Schreiber, Stefan; Hartmann, Heinz; Kruis, Wolfgang; Kucharzik, Torsten; Mudter, Jonas; Siegmund, Britta; Stallmach, Andreas; Witte, Christine; Fitzke, Klaus; Bokemeyer, Bernd

    2016-04-01

    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.

  8. [Inflammatory Bowel Disease Competence Network].

    Science.gov (United States)

    Schreiber, Stefan; Hartmann, Heinz; Kruis, Wolfgang; Kucharzik, Torsten; Mudter, Jonas; Siegmund, Britta; Stallmach, Andreas; Witte, Christine; Fitzke, Klaus; Bokemeyer, Bernd

    2016-04-01

    The Inflammatory Bowel Disease Competence Network is a network of more than 500 physicians and scientists from university clinics, hospitals and gastroenterology practices. The focus extends from the two major forms of inflammatory bowel diseases, Crohn's disease and ulcerative colitis, into other chronic inflammatory conditions affecting the intestine, including coeliac disease and microscopic colitis. The network translates basic science discoveries (in particular in the molecular epidemiology research) into innovative diagnostics and therapy. Through its strong networking structures it supports a continuous process to improve quality and standardisation in patient care that is implemented in close interaction with European networks addressing this disease group.Optimisation of patient care based on scientifically proven evidence is a main focus of the network. Therefore, it supports and coordinates translational research and infrastructure projects that investigate aetiology, improvement of diagnostic methods, and development of new or improved use of established therapies. Members participate in various training projects, thus ensuring the rapid transfer of research results into clinical practice.The competence network cooperates with the main patient organisations to engage patients in all levels of activities. The network and the patient organisations have interest in promoting public awareness about the disease entities, because their importance and burden is underestimated in non-specialised medical fields and among the general public. PMID:26968556

  9. Interconnected networks

    CERN Document Server

    2016-01-01

    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.

  10. Structure of triadic relations in multiplex networks

    Science.gov (United States)

    Cozzo, Emanuele; Kivelä, Mikko; De Domenico, Manlio; Solé-Ribalta, Albert; Arenas, Alex; Gómez, Sergio; Porter, Mason A.; Moreno, Yamir

    2015-07-01

    Recent advances in the study of networked systems have highlighted that our interconnected world is composed of networks that are coupled to each other through different ‘layers’ that each represent one of many possible subsystems or types of interactions. Nevertheless, it is traditional to aggregate multilayer networks into a single weighted network in order to take advantage of existing tools. This is admittedly convenient, but it is also extremely problematic, as important information can be lost as a result. It is therefore important to develop multilayer generalizations of network concepts. In this paper, we analyze triadic relations and generalize the idea of transitivity to multiplex networks. By focusing on triadic relations, which yield the simplest type of transitivity, we generalize the concept and computation of clustering coefficients to multiplex networks. We show how the layered structure of such networks introduces a new degree of freedom that has a fundamental effect on transitivity. We compute multiplex clustering coefficients for several real multiplex networks and illustrate why one must take great care when generalizing standard network concepts to multiplex networks. We also derive analytical expressions for our clustering coefficients for ensemble averages of networks in a family of random multiplex networks. Our analysis illustrates that social networks have a strong tendency to promote redundancy by closing triads at every layer and that they thereby have a different type of multiplex transitivity from transportation networks, which do not exhibit such a tendency. These insights are invisible if one only studies aggregated networks.

  11. Caring for Multiples

    Science.gov (United States)

    ... labor & premature birth The newborn intensive care unit (NICU) Birth defects & other health conditions Loss & grief Tools & ... Home > Complications & Loss > The newborn intensive care unit (NICU) > Caring for multiples Caring for multiples E-mail ...

  12. Home Care Services

    Science.gov (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. Network maintenance

    CERN Multimedia

    GS Department

    2009-01-01

    A site-wide network maintenance operation has been scheduled for Saturday 28 February. Most of the network devices of the general purpose network will be upgraded to a newer software version, in order to improve our network monitoring capabilities. This will result in a series of short (2-5 minutes) random interruptions everywhere on the CERN sites throughout the day. This upgrade will not affect the Computer Centre itself, Building 613, the Technical Network and the LHC experiments, dedicated networks at the pits. For further details of this intervention, please contact Netops by phone 74927 or e-mail mailto:Netops@cern.ch. IT/CS Group

  14. Network maintenance

    CERN Multimedia

    IT Department

    2009-01-01

    A site wide network maintenance has been scheduled for Saturday 28 February. Most of the network devices of the General Purpose network will be upgraded to a newer software version, in order to improve our network monitoring capabilities. This will result in a series of short (2-5 minutes) random interruptions everywhere on the CERN sites along this day. This upgrade will not affect: the Computer centre itself, building 613, the Technical Network and the LHC experiments dedicated networks at the pits. Should you need more details on this intervention, please contact Netops by phone 74927 or email mailto:Netops@cern.ch. IT/CS Group

  15. Who cares!

    Institute of Scientific and Technical Information of China (English)

    老晃

    2013-01-01

    1有人再三怂恿,希望我能吐槽《富春山居图》,务求鞭辟入里,揭露丑恶真相。我舍不得,舍不得浪费纸。好吧,小吐一下。传说,在《富春山居图》开拍之前有心人提醒导演孙健君,剧本有硬伤,得改,例举一三三四……话没说完,孙勃然大怒,"Who cares!"这位目空一切的君王,他什么都不care,所以他花钱砸的那堆玩意儿,根本也不是电影。这就是真相。值得一说的,是此刻红得发紫,摸都摸不得的《小时代》。

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

    Science.gov (United States)

    Perez, Beatrix F.; Romo, Harriett D.

    2011-01-01

    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. Network Ambivalence

    Directory of Open Access Journals (Sweden)

    Patrick Jagoda

    2015-08-01

    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. 

  18. Fermionic networks

    Science.gov (United States)

    Javarone, Marco Alberto

    2016-08-01

    We study the structure of fermionic networks, i.e. a model of networks based on the behavior of fermionic gases, and we analyze dynamical processes over them. In this model, particle dynamics have been mapped to the domain of networks, hence a parameter representing the temperature controls the evolution of the system. In doing so, it is possible to generate adaptive networks, i.e. networks whose structure varies over time. As shown in previous works, networks generated by quantum statistics can undergo critical phenomena as phase transitions and, moreover, they can be considered as thermodynamic systems. In this study, we analyze fermionic networks and opinion dynamics processes over them, framing this network model as a computational model useful to represent complex and adaptive systems. Results highlight that a strong relation holds between the gas temperature and the structure of the achieved networks. Notably, both the degree distribution and the assortativity vary as the temperature varies, hence we can state that fermionic networks behave as adaptive networks. On the other hand, it is worth to highlight that we did not finding relation between outcomes of opinion dynamics processes and the gas temperature. Therefore, although the latter plays a fundamental role in gas dynamics, on the network domain, its importance is related only to structural properties of fermionic networks.

  19. Action Planning for Daily Mouth Care in Long-Term Care: The Brushing Up on Mouth Care Project

    Directory of Open Access Journals (Sweden)

    Mary E. McNally

    2012-01-01

    Full Text Available Research focusing on the introduction of daily mouth care programs for dependent older adults in long-term care has met with limited success. There is a need for greater awareness about the importance of oral health, more education for those providing oral care, and organizational structures that provide policy and administrative support for daily mouth care. The purpose of this paper is to describe the establishment of an oral care action plan for long-term care using an interdisciplinary collaborative approach. Methods. Elements of a program planning cycle that includes assessment, planning, implementation, and evaluation guided this work and are described in this paper. Findings associated with assessment and planning are detailed. Assessment involved exploration of internal and external factors influencing oral care in long-term care and included document review, focus groups and one-on-one interviews with end-users. The planning phase brought care providers, stakeholders, and researchers together to design a set of actions to integrate oral care into the organizational policy and practice of the research settings. Findings. The establishment of a meaningful and productive collaboration was beneficial for developing realistic goals, understanding context and institutional culture, creating actions suitable and applicable for end-users, and laying a foundation for broader networking with relevant stakeholders and health policy makers.

  20. Network Coded Software Defined Networking

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  1. Regional cross national networks for education and training in health

    DEFF Research Database (Denmark)

    Nøhr, Christian; Bygholm, Ann; Hejlesen, Ole;

    The paper argues that the education activities in health informatics should be established in net-works covering regions with comparable health care systems involving one or more comparable countries.......The paper argues that the education activities in health informatics should be established in net-works covering regions with comparable health care systems involving one or more comparable countries....

  2. Palliative wound care: principles of care.

    Science.gov (United States)

    Dale, Barbara; Emmons, Kevin R

    2014-01-01

    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.

  3. Organizational Networks

    DEFF Research Database (Denmark)

    Grande, Bård; Sørensen, Ole Henning

    1998-01-01

    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. Network workshop

    DEFF Research Database (Denmark)

    Bruun, Jesper; Evans, Robert Harry

    2014-01-01

    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...

  5. 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

    2007-09-01

    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

  6. Careful science?

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... the focus to reflect everyday practices would foster better targeted public health campaigns. This article is based on our participation in FINE, a multidisciplinary Danish research project. The core methodology of FINE was a randomised controlled trial in which 61 moderately overweight men were put...... 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...

  7. Changes in Adult Child Caregiver Networks

    Science.gov (United States)

    Szinovacz, Maximiliane E.; Davey, Adam

    2007-01-01

    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…

  8. Social networking for well-being

    NARCIS (Netherlands)

    Steen, M.G.D.; Aarts, O.A.J.; Broekman, C.C.M.T.; Prins, S.C.L.

    2011-01-01

    In this paper, we present some of the work that is being done in the WeCare project (in the AAL programme). The project’s goal is to introduce social networking services in the lives of older people, in order to improve their well-being. Participation in social networks, both online and ‘in real lif

  9. How physician networks are selling themselves.

    Science.gov (United States)

    Volz, D

    1999-01-01

    A growing number of physicians are creating discount networks due to the anger they feel about their loss of professional autonomy and financial compensation to managed care. They are seeking a niche among patients who lack adequate health insurance coverage or are dissatisfied with their plans. To win patients, the physician networks are marketing services that are deeply discounted. PMID:10351396

  10. Medicaid and Financing of Health Care for Children in Foster Care: Findings from a National Survey. Health Services for Children in Foster Care. Number 1

    Science.gov (United States)

    Inkelas, Moira; Halfon, Neal

    2002-01-01

    In recent years, state Medicaid programs have implemented significant change and innovation in delivering health and behavioral health services. Prepaid capitated financing and the provider networks created by Medicaid managed care expansions have altered systems of medical and mental/behavioral health. Most children in foster care receive…

  11. The Health Improvement Network (THIN)

    Science.gov (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.

  12. Networked Identities

    DEFF Research Database (Denmark)

    Ryberg, Thomas; Larsen, Malene Charlotte

    2008-01-01

    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......In this article we take up a critique of the concept of Communities of Practice (CoP) voiced by several authors, who suggest that networks may provide a better metaphor to understand social forms of organisation and learning. Through a discussion of the notion of networked learning and the critique...

  13. Technical Network

    CERN Multimedia

    2007-01-01

    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

  14. The Time Efficient Security for Broadcast Networks

    OpenAIRE

    Kamaksi Prasad V2; Ayachit, N. H.; Santosh L Deshpande1

    2008-01-01

    The audit ability and security of the broadcast network and security needs to be enhanced. This article is proposing the security solutions for such networks that are cost effective. The solution also takes care of the reduction of effective bandwidth-delay product. The improvement in terms of a cost effective comparator improves the efficiency and security of such networks. The threats like Eavesdropping, Interception and modification of transmitted data, Spoofing, Denial of service (DoS), F...

  15. Hopfield neural network based on ant system

    Institute of Scientific and Technical Information of China (English)

    洪炳镕; 金飞虎; 郭琦

    2004-01-01

    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.

  16. Perioperative Care of Prisoners: Providing Safe Care.

    Science.gov (United States)

    Smith, Francis Duval

    2016-03-01

    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.

  17. Network science

    CERN Document Server

    Barabasi, Albert-Laszlo

    2016-01-01

    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...

  18. Network regularizability

    CERN Document Server

    Franceschet, Massimo

    2016-01-01

    A network is regularizable if it is possible to assign weights to its edges so that all nodes have the same degree. We define a hierarchy of four network classes in terms of their regularization properties. For the classes of the hierarchy, we investigate structural conditions on both the network and the corresponding adjacency matrix that are necessary and sufficient for the inclusion of a network in the class. Moreover, we provide an algorithmic solution for the problem of positioning a network in the hierarchy. We argue that the regularization solution is useful to build an egalitarian, friction-free network in which all actors of the network has the same centrality (and power).

  19. Creating a Regional Healthcare Network: People First.

    Science.gov (United States)

    Michel-Verkerke, Margreet B

    2016-01-01

    Care organizations in the Dutch region Apeldoorn want to collaborate more in order to improve the care provision to elderly and psychiatric patients living independently. In order to support the collaboration they intend to create a regional digital healthcare network. The research was focused on the relevance of a regional healthcare network for care providers. Eleven semi-structured interviews based on the USE IT-model, were conducted with care providers and staff members. Results show that care providers need to tune their activities for this target group and create an agreement on integrated care. The relevance of a digital communication and collaboration platform is high. The regional healthcare network should support the collaboration between care providers by: 1. Offering a communication platform to replace the time consuming communication by telephone; 2. Making patient information available for patient and care provider at patients' homes; 3. Giving insight in who is giving what care to whom; and 4. Giving access to knowledge about the target group: elderly and psychiatric patients living independently. PMID:27577356

  20. Electronic Health Information Exchange, Competition, and Network Effects

    OpenAIRE

    Sunita Desai

    2014-01-01

    As in most industries, in health care, information is a competitive asset, and we expect that health care providers may have incentive to protect their information from competitors. This study aims to understand how this incentive to protect information may be a barrier to the development of a health information network. Health information networks are designed to facilitate electronic information sharing across health care providers. The electronic exchange of health information is widely co...

  1. Disseminating evidence-based care into practice.

    Science.gov (United States)

    Coleman, Eric A; Rosenbek, Susan A; Roman, Sarah P

    2013-08-01

    The Centers for Medicare and Medicaid Services (CMS) has launched the Partnership for Patients initiative, promising a 20% reduction in readmissions nationally across all payers by December 31, 2013. To address this ambitious goal, CMS has awarded grants to Hospital Engagement Networks, Pioneer Accountable Care Organizations, and the Community-based Care Transitions Program, as well as instituted new penalties for excessive readmission that began in October 2012. National efforts aimed at realizing this goal are predicated, in part, on our effectiveness in disseminating evidence-based care models into practice to improve outcomes and reduce costs. The Care Transitions Intervention (CTI) has been developed, tested, and disseminated to over 750 health care organizations in 40 states nationwide. Four factors promote wide-scale CTI dissemination. The first factor focuses on model fidelity whereby adopters are given insight into which elements of the intervention can be adapted and customized. The second factor concerns the selection of Transitions Coaches and reinforcement of their role through training and participation in a national peer learning network. The third factor relates to model execution with attention to integrating the intervention into existing workflows and fostering relationships with community stakeholders. The fourth factor involves cultivating the support to sustain or expand the intervention through continually making the business case in a changing health care landscape. The lessons learned through the dissemination and implementation of the CTI may be generalizable to the spread of a variety of evidence-based care models.

  2. Medical imaging and alternative health care organizations

    International Nuclear Information System (INIS)

    Imaging is not easy to measure in economic terms for France to day. The impact of innovation process is no more clear and especially the substitutions expected between different techniques. Nevertheless, these new techniques could provoque big changes in medical practices and health care organizations. They should probably increase the proportion of ambulatory patients in total examinations and encourage the development of extra-hospital health care. But, in France, alternative health care organizations (day hospital, home care, etc...) are under developed because of many non technical factors (behavioural managerial and institutional). Perhaps major potential change shall come from imaging networks. But can imaging development contribute to moderate health expanses growth rate. Economic evaluations of each new technique are difficult and ambiguous but necessary to maximize health care system efficiency

  3. Older patients' experiences during care transition

    Directory of Open Access Journals (Sweden)

    Rustad EC

    2016-05-01

    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

  4. Computer Networks As Social Networks

    Science.gov (United States)

    Wellman, Barry

    2001-09-01

    Computer networks are inherently social networks, linking people, organizations, and knowledge. They are social institutions that should not be studied in isolation but as integrated into everyday lives. The proliferation of computer networks has facilitated a deemphasis on group solidarities at work and in the community and afforded a turn to networked societies that are loosely bounded and sparsely knit. The Internet increases people's social capital, increasing contact with friends and relatives who live nearby and far away. New tools must be developed to help people navigate and find knowledge in complex, fragmented, networked societies.

  5. Health care operations management

    OpenAIRE

    Carter, M W; Hans, E.W.; Kolisch, R.

    2012-01-01

    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully selected papers dealing with optimization and decision analysis problems in the field of health care operations management.

  6. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies

    2009-10-01

    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.

  7. Network Coded Software Defined Networking

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  8. A survey of TCP over ad hoc networks

    NARCIS (Netherlands)

    Al Hanbali, Ahmad; Altman, Eitan; Nain, Philippe

    2005-01-01

    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

  9. 42 CFR 405.2110 - Designation of ESRD networks.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Designation of ESRD networks. 405.2110 Section 405... End-Stage Renal Disease (ESRD) Services § 405.2110 Designation of ESRD networks. CMS designated ESRD networks in which the approved ESRD facilities collectively provide the necessary care for ESRD...

  10. 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

    2012-04-01

    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

  11. Networking Japan

    DEFF Research Database (Denmark)

    Hansen, Annette Skovsted

    Human Resource Development was the first and remains an important pillar in Japanese foreign aid. I will argue that Japan has access to a global network of alumni who will co-define Japanese foreign aid in the future, because Japan has encouraged alumni societies and networking since 1965. A total...... 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...... (WNF). Through the alumni network, Japan continues to infuse ideas to participants and alumni, who interpret and disseminate these ideas through alumni society networks and activities, but their discussions nationally and regionally also get reported back to Japan and affect future policies...

  12. Adoption & Foster Care

    Science.gov (United States)

    ... Children > Family Life > Family Dynamics > Adoption & Foster Care Adoption & Foster Care Article Body ​Each year, many children join families through adoption and foster care. These families may face unique ...

  13. About Critical Care Nursing

    Science.gov (United States)

    ... requiring intense and vigilant nursing care. Number of Critical Care Nurses in the United States According to "The Registered ... nurses who work in a hospital setting. Where Critical Care Nurses Work According to "The Registered Nurse Population" study, ...

  14. Channel Networks

    Science.gov (United States)

    Rinaldo, Andrea; Rodriguez-Iturbe, Ignacio; Rigon, Riccardo

    This review proceeds from Luna Leopold's and Ronald Shreve's lasting accomplishments dealing with the study of random-walk and topologically random channel networks. According to the random perspective, which has had a profound influence on the interpretation of natural landforms, nature's resiliency in producing recurrent networks and landforms was interpreted to be the consequence of chance. In fact, central to models of topologically random networks is the assumption of equal likelihood of any tree-like configuration. However, a general framework of analysis exists that argues that all possible network configurations draining a fixed area are not necessarily equally likely. Rather, a probability P(s) is assigned to a particular spanning tree configuration, say s, which can be generally assumed to obey a Boltzmann distribution: P(s) % e^-H(s)/T, where T is a parameter and H(s) is a global property of the network configuration s related to energetic characters, i.e. its Hamiltonian. One extreme case is the random topology model where all trees are equally likely, i.e. the limit case for T6 4 . The other extreme case is T 6 0, and this corresponds to network configurations that tend to minimize their total energy dissipation to improve their likelihood. Networks obtained in this manner are termed optimal channel networks (OCNs). Observational evidence suggests that the characters of real river networks are reproduced extremely well by OCNs. Scaling properties of energy and entropy of OCNs suggest that large network development is likely to effectively occur at zero temperature (i.e. minimizing its Hamiltonian). We suggest a corollary of dynamic accessibility of a network configuration and speculate towards a thermodynamics of critical self-organization. We thus conclude that both chance and necessity are equally important ingredients for the dynamic origin of channel networks---and perhaps of the geometry of nature.

  15. Network medicine

    DEFF Research Database (Denmark)

    Pawson, Tony; Linding, Rune

    2008-01-01

    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....

  16. Wireless Networks

    OpenAIRE

    Samaka, Mohammed; Khan, Khaled M.D.

    2007-01-01

    Wireless communication is the fastest-growing field in the telecommunication industry. Wireless networks have grown significantly as an important segment of the communications industry. They have become popular networks with the potential to provide high-speed, high-quality information exchange between two or more portable devices without any wire or conductors. Wireless networks can simply be characterized as the technology that provides seamless access to information, anywhere, anyplace, an...

  17. Oncology and palliative care

    OpenAIRE

    Bausewein, Claudia; Hartenstein, R.

    2000-01-01

    Oncology developed as a discipline over the last decades. Treatment is concentrated on cure or palliation of the illness with the help of chemotherapy, radiotherapy or surgery. Palliative care has its origin in the hospice movement that started around 1960 in the UK. Centre of care is the patient and his family. Focus of care has moved from quantity to quality of life. Symptom control, communication, rehabilitation and care for the dying are main areas of palliative care. Palliative care and ...

  18. Critical care during epidemics

    OpenAIRE

    Rubinson, Lewis; O'Toole, Tara

    2005-01-01

    We recommend several actions that could improve hospitals' abilities to deliver critical care during epidemics involving large numbers of victims. In the absence of careful pre-event planning, demand for critical care services may quickly exceed available intensive care unit (ICU) staff, beds and equipment, leaving the bulk of the infected populace without benefit of potentially lifesaving critical care. The toll of death may be inversely proportional to the ability to augment critical care c...

  19. Network security

    CERN Document Server

    Perez, André

    2014-01-01

    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

  20. Network Security

    CERN Document Server

    Huang, Scott; Du, Ding-Zhu

    2010-01-01

    This book provides a reference tool for the increasing number of the scientists whose research is related to sensor network security. The book is organized into several sections, each including some chapters exploring a specific topic. Network security is attracting great attention and there are many research topics waiting to be studied. In this book, the topics covered include network design and modeling, network management, data management, security and applications. The aim, intent, and motivation of this book is to provide a reference tool for the increasing number of scientists whose res

  1. Technical Network

    CERN Multimedia

    2007-01-01

    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

  2. The future of managed care organization.

    Science.gov (United States)

    Robinson, J C

    1999-01-01

    This paper analyzes the transformation of the central organization in the managed care system: the multiproduct, multimarket health plan. It examines vertical disintegration, the shift from ownership to contractual linkages between plans and provider organizations, and horizontal integration--the consolidation of erstwhile indemnity carriers, Blue Cross plans, health maintenance organizations (HMOs), and specialty networks. Health care consumers differ widely in their preferences and willingness to pay for particular products and network characteristics, while providers differ widely in their willingness to adopt particular organization and financing structures. This heterogeneity creates an enduring role for health plans that are diversified into multiple networks, benefit products, distribution channels, and geographic regions. Diversification now is driving health plans toward being national, full-service corporations and away from being local, single-product organizations linked to particular providers and selling to particular consumer niches. PMID:10091427

  3. Risk management and data: managed care company perspective.

    Science.gov (United States)

    Kanwit, S W

    1998-11-01

    As both public and private health plans move increasingly to managed care, a vigorous debate is occurring about how to ensure health care quality for the American public, while at the same time managing the cost of that care. Health plans generate large volumes of data related to their networks and providers, plan sponsors, member care, and medical protocols. This data can help assure quality, and at the same time help managed care organizations deal with one of the most critical tasks facing them--risk management. This paper may be helpful in providing an outline of two key areas--managed care liability for quality of patient care, and privacy and confidentiality concerns from a managed care organization perspective--followed by suggestions to avoid or minimize liability. PMID:10028510

  4. Millennial transformation for primary care.

    Science.gov (United States)

    Cowan, Michael

    2010-06-01

    We do not need a crystal ball to see the future. Our web-based future has already arrived in all other aspects of our lives--even our mobile phones. The tools for progress--Personal Health Records, Social Networks, and Online medical information--are widely available. The demand is at hand--Millennials are flexing consumer muscles as they enter the healthcare market. Real "Health Care Reform" requires fundamental changes in practice--which in turn requires effective use of information technologies and adaption to changing consumer expectations. The VHA and the MHS are uniquely capable of leveraging political, academic and technological forces to help move American health care through this millennial transformation. Federal health systems are positioned to demonstrate the value of innovation as America seeks healthcare reform. PMID:20572466

  5. Integrating palliative care into comprehensive cancer care.

    Science.gov (United States)

    Abrahm, Janet L

    2012-10-01

    While there are operational, financial, and workforce barriers to integrating oncology with palliative care, part of the problem lies in ourselves, not in our systems. First, there is oncologists' "learned helplessness" from years of practice without effective medications to manage symptoms or training in how to handle the tough communication challenges every oncologist faces. Unless they and the fellows they train have had the opportunity to work with a palliative care team, they are unlikely to be fully aware of what palliative care has to offer to their patients at the time of diagnosis, during active therapy, or after developing advanced disease, or may believe that, "I already do that." The second barrier to better integration is the compassion fatigue many oncologists develop from caring for so many years for patients who, despite the oncologists' best efforts, suffer and die. The cumulative grief oncologists experience may go unnamed and unacknowledged, contributing to this compassion fatigue and burnout, both of which inhibit the integration of oncology and palliative care. Solutions include training fellows and practicing oncologists in palliative care skills (eg, in symptom management, psychological disorders, communication), preventing and treating compassion fatigue, and enhancing collaboration with palliative care specialists in caring for patients with refractory distress at any stage of disease. As more oncologists develop these skills, process their grief, and recognize the breadth of additional expertise offered by their palliative care colleagues, palliative care will become integrated into comprehensive cancer care. PMID:23054873

  6. Caring for Active Duty Military Personnel in the Civilian Sector

    OpenAIRE

    Marylou Noble; Howard Waitzkin

    2009-01-01

    Due to the wars in Iraq and Afghanistan, the unmet medical and psychological needs of military personnel are creating major challenges. Increasingly, active duty military personnel are seeking physical and mental health services from civilian professionals. The Civilian Medical Resources Network attempts to address these unmet needs. Participants in the Network include primary care and mental health practitioners in all regions of the country. Network professionals provide independent assessm...

  7. Network chemistry, network toxicology, network informatics, and network behavioristics: A scientific outline

    OpenAIRE

    WenJun Zhang

    2016-01-01

    In present study, I proposed some new sciences: network chemistry, network toxicology, network informatics, and network behavioristics. The aims, scope and scientific foundation of these sciences are outlined.

  8. Overlay networks toward information networking

    CERN Document Server

    Tarkoma, Sasu

    2010-01-01

    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. Diophantine networks

    Science.gov (United States)

    Bedogne', C.; Masucci, A. P.; Rodgers, G. J.

    2008-03-01

    We introduce a new class of deterministic networks by associating networks with Diophantine equations, thus relating network topology to algebraic properties. The network is formed by representing integers as vertices and by drawing cliques between M vertices every time that M distinct integers satisfy the equation. We analyse the network generated by the Pythagorean equation x2 +y2 =z2 showing that its degree distribution is well approximated by a power law with exponential cut-off. We also show that the properties of this network differ considerably from the features of scale-free networks generated through preferential attachment. Remarkably we also recover a power law for the clustering coefficient. We then study the network associated with the equation x2 +y2 = z showing that the degree distribution is consistent with a power law for several decades of values of k and that, after having reached a minimum, the distribution begins rising again. The power-law exponent, in this case, is given by γ ∼ 4.5 We then analyse clustering and ageing and compare our results to the ones obtained in the Pythagorean case.

  10. Organizational Networks

    DEFF Research Database (Denmark)

    Sørensen, Ole Henning; Grande, Bård

    1996-01-01

    The paper focuses on the concept of organizational networks. Four different uses of the concept are identified and critically discussed.......The paper focuses on the concept of organizational networks. Four different uses of the concept are identified and critically discussed....

  11. Probabilistic Networks

    DEFF Research Database (Denmark)

    Jensen, Finn Verner; Lauritzen, Steffen Lilholt

    2001-01-01

    This article describes the basic ideas and algorithms behind specification and inference in probabilistic networks based on directed acyclic graphs, undirected graphs, and chain graphs.......This article describes the basic ideas and algorithms behind specification and inference in probabilistic networks based on directed acyclic graphs, undirected graphs, and chain graphs....

  12. Network Affordances

    DEFF Research Database (Denmark)

    Samson, Audrey; Soon, Winnie

    2015-01-01

    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......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...

  13. Natural networks

    CERN Document Server

    Hartonen, Tuomo

    2011-01-01

    Scale-free and non-computable characteristics of natural networks are found to result from the least-time dispersal of energy. To consider a network as a thermodynamic system is motivated since ultimately everything that exists can be expressed in terms of energy. According to the variational principle, the network will grow and restructure when flows of energy diminish energy differences between nodes as well as relative to nodes in surrounding systems. The natural process will yield scale-free characteristics because the nodes that contribute to the least-time consumption of free energy preferably attach to each other. Network evolution is a path-dependent and non-deterministic process when there are two or more paths to consume a common source of energy. Although evolutionary courses of these non-Hamiltonian systems cannot be predicted, many mathematical functions, models and measures that characterize networks can be recognized as appropriate approximations of the thermodynamic equation of motion that has...

  14. Genetic Algorithm for Hierarchical Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Sajid Hussain

    2007-09-01

    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.

  15. Fuzzy neural network theory and application

    CERN Document Server

    Liu, Puyin

    2004-01-01

    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

  16. Developing Evidence to Inform Decisions about Effectiveness (DeCIDE) Network

    Science.gov (United States)

    The Developing Evidence to Inform Decisions about Effectiveness Network is a network of research centers that the Agency for Healthcare Research and Quality created to conduct practical studies about health care items and services.

  17. Child care and other support programs.

    Science.gov (United States)

    Floyd, Latosha; Phillips, Deborah A

    2013-01-01

    The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a sprawling network with nearly 23,000 workers that directly serves or subsidizes care for 200,000 children every day. Child-care options available to civilians typically pale in comparison, and the military's system, embedded in a broader web of family support services, is widely considered to be a model for the nation. The military's child-care success rests on four pillars, write Major Latosha Floyd and Deborah A. Phillips. The first is certification by the military itself, including unannounced inspections to check on safety, sanitation, and general compliance with DoD rules. The second is accreditation by nationally recognized agencies, such as the National Association for the Education of Young Children. The third is a hiring policy that sets educational and other requirements for child-care workers, and the fourth is a pay scale that not only sets wages high enough to discourage the rapid turnover common in civilian child care but also rewards workers for completing additional training. Floyd and Phillips sound a few cautionary notes. For one, demand for military child care continues to outstrip the supply In particular, as National Guard and Reserve members have been activated during the wars in Iraq and Afghanistan, the DoD has sometimes struggled to provide child care for their children. And force reductions and budget cuts are likely to force the military to make difficult choices as it seeks to streamline its child-care services in the years ahead. PMID:25518693

  18. Tiresias: Online Anomaly Detection for Hierarchical Operational Network Data

    OpenAIRE

    Hong, Chi-Yao; Caesar, Matthew; Duffield, Nick; Wang, Jia

    2012-01-01

    Operational network data, management data such as customer care call logs and equipment system logs, is a very important source of information for network operators to detect problems in their networks. Unfortunately, there is lack of efficient tools to automatically track and detect anomalous events on operational data, causing ISP operators to rely on manual inspection of this data. While anomaly detection has been widely studied in the context of network data, operational data presents sev...

  19. Models of Comprehensive Care

    Science.gov (United States)

    The second plenary of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study: Cultural Considerations When Caring for African Americans reviews the various models for integration of hospice and palliative care into traditional cancer care that have been shown to improve outcomes.

  20. Online social networking: a primer for radiology.

    Science.gov (United States)

    Prasanna, Prasanth M; Seagull, F Jacob; Nagy, Paul

    2011-10-01

    Online social networking is an immature, but rapidly evolving industry of web-based technologies that allow individuals to develop online relationships. News stories populate the headlines about various websites which can facilitate patient and doctor interaction. There remain questions about protecting patient confidentiality and defining etiquette in order to preserve the doctor/patient relationship and protect physicians. How much social networking-based communication or other forms of E-communication is effective? What are the potential benefits and pitfalls of this form of communication? Physicians are exploring how social networking might provide a forum for interacting with their patients, and advance collaborative patient care. Several organizations and institutions have set forth policies to address these questions and more. Though still in its infancy, this form of media has the power to revolutionize the way physicians interact with their patients and fellow health care workers. In the end, physicians must ask what value is added by engaging patients or other health care providers in a social networking format. Social networks may flourish in health care as a means of distributing information to patients or serve mainly as support groups among patients. Physicians must tread a narrow path to bring value to interactions in these networks while limiting their exposure to unwanted liability. PMID:21360214

  1. Accelerating networks

    International Nuclear Information System (INIS)

    Evolving out-of-equilibrium networks have been under intense scrutiny recently. In many real-world settings the number of links added per new node is not constant but depends on the time at which the node is introduced in the system. This simple idea gives rise to the concept of accelerating networks, for which we review an existing definition and-after finding it somewhat constrictive-offer a new definition. The new definition provided here views network acceleration as a time dependent property of a given system as opposed to being a property of the specific algorithm applied to grow the network. The definition also covers both unweighted and weighted networks. As time-stamped network data becomes increasingly available, the proposed measures may be easily applied to such empirical datasets. As a simple case study we apply the concepts to study the evolution of three different instances of Wikipedia, namely, those in English, German, and Japanese, and find that the networks undergo different acceleration regimes in their evolution

  2. Using Digital Crumbs from an Electronic Health Record to Identify, Study and Improve Health Care Teams

    Science.gov (United States)

    Gray, James E; Feldman, Henry; Reti, Shane; Markson, Larry; Lu, Xiaoning; Davis, Roger B.; Safran, Charles A

    2011-01-01

    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

  3. Pediatric Palliative Care

    OpenAIRE

    Johnston, Donna L.; Hentz, Tracy A.; Friedman, Debra L.

    2005-01-01

    Pediatric palliative care provides benefit to children living with life-threatening or terminal conditions. Palliative care should be available to all seriously ill children. Palliative care includes the treatment of symptoms such as pain, nausea, dyspnea, constipation, anorexia, and sialorrhea. This care can occur in a variety of settings, from home to hospice to hospital, and must include bereavement care and follow up after the death of a child. There are many challenges in pediatric palli...

  4. Network Warrior

    CERN Document Server

    Donahue, Gary

    2011-01-01

    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

  5. Social networks

    CERN Document Server

    Etaner-Uyar, A Sima

    2014-01-01

    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

  6. Personalized elderly care scheme: providing personalized services based on context and behavior analysis

    OpenAIRE

    Tsiourti, Christiana; Τσιουρτή, Χριστιάνα

    2011-01-01

    Elders who live alone generally have rich care networks—support networks of people who provide the elder with care. Such networks provide assistance ranging from day-to-day activities to social support and often include people of varying ages and skills, which have significantly different roles in the elder‘s care and may or may not be professional caregivers (family members, friends, neighbors, medical staff, etc.). Clearly, the support network‘s major objective is to keep the elder physi...

  7. Care for the Health Care Provider.

    Science.gov (United States)

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

    Pretravel care for the health care provider begins with an inventory, including the destination, length of stay, logistical arrangements, type of lodging, food and water supply, team members, personal medical needs, and the needs of the community to be treated. This inventory should be created and processed well in advance of the planned medical excursion. The key thing to remember in one's planning is to be a health care provider during one's global health care travel and not to become a patient oneself. This article will help demonstrate the medical requirements and recommendations for such planning. PMID:26900113

  8. Clustering and inertia: structural integration of home care in Swedish elderly care

    Directory of Open Access Journals (Sweden)

    Nils Olof Hedman

    2007-09-01

    Full Text Available Purpose: To study the design and distribution of different organizational solutions regarding the responsibility for and provision of home care for elderly in Swedish municipalities. Method: Directors of the social welfare services in all Swedish municipalities received a questionnaire about old-age care organization, especially home care services and related activities. Rate of response was 73% (211/289. Results: Three different organizational models of home care were identified. The models represented different degrees of integration of home care, i.e. health and social aspects of home care were to varying degrees integrated in the same organization. The county councils (i.e. large sub-national political-administrative units tended to contain clusters of municipalities (smaller sub-national units with the same organizational characteristics. Thus, municipalities' home care organization followed a county council pattern. In spite of a general tendency for Swedish municipalities to reorganize their activities, only 1% of them had changed their home care services organization in relation to the county council since the reform. Conclusion: The decentralist intention of the reform—to give actors at the sub-national levels freedom to integrate home care according to varying local circumstances—has resulted in a sub-national inter-organizational network structure at the county council, rather than municipal, level, which is highly inert and difficult to change.

  9. Kidney stones - self-care

    Science.gov (United States)

    Renal calculi - self-care; Nephrolithiasis - self-care; Stones - kidney - self-care ... You visited your health care provider or the hospital because you have a kidney stone. You will need to take self-care steps. Which steps ...

  10. Network Power Fault Detection

    OpenAIRE

    Siviero, Claudio

    2013-01-01

    Network power fault detection. At least one first network device is instructed to temporarily disconnect from a power supply path of a network, and at least one characteristic of the power supply path of the network is measured at a second network device connected to the network while the at least one first network device is temporarily disconnected from the network

  11. 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...... 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......, as a Danida fellow. Today, the older sister works in Nepal and the younger in Seattle, where they still make use of their personal networks including connections to their fellow alumni of technical assistance courses. Inspired by work on social remittances in combination with network theory , I argue...

  12. computer networks

    Directory of Open Access Journals (Sweden)

    N. U. Ahmed

    2002-01-01

    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.

  13. Sentinel Network

    Science.gov (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.

  14. Industrial Networks

    DEFF Research Database (Denmark)

    Karlsson, Christer

    2015-01-01

    Companies organize in a way that involves many activities that are external to the traditional organizational boundaries. This presents challenges to operations management and managing operations involves many issues and actions dealing with external networks. Taking a network perspective changes...... the focus of operations management from managing the own organization to continuously developing and managing a network of external and internal resources forming a production system. This perspective may be called managing an “extraprise” rather than an “enterprise.” It should be noted that “an industrial...... network” should not be seen as an organizational form but as a perspective that can be used to enrich one's understanding of organizations. The industrial network perspective has three basic building blocks: actors, resources, and activities. The three building blocks and their relations constitute...

  15. Meeting Abstracts - Academy of Managed Care Pharmacy Nexus 2016.

    Science.gov (United States)

    2016-10-01

    The Academy of Managed Care Pharmacy (AMCP) Abstracts program provides a forum through which authors can share their insights and outcomes of advanced managed care practice through publication in AMCP's Journal of Managed Care & Specialty Pharmacy (JMCP). Poster presentations are Tuesday, October 4, at 4:00 pm. The posters will also be displayed on Wednesday, October 5. The reviewed abstracts are published in the JMCP Meeting Abstracts supplement. The AMCP Nexus 2016 Meeting in National Harbor, Maryland, is expected to attract more than 2,000 managed care pharmacists and other health care professionals who manage and evaluate drug therapies, develop and manage networks, and work with medical managers and information specialists to improve the care of all individuals enrolled in managed care programs. PMID:27611065

  16. Affective Networks

    Directory of Open Access Journals (Sweden)

    Jodi Dean

    2010-02-01

    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.

  17. Chemical networks*

    OpenAIRE

    Thi Wing-Fai

    2015-01-01

    This chapter discusses the fundamental ideas of how chemical networks are build, their strengths and limitations. The chemical reactions that occur in disks combine the cold phase reactions used to model cold molecular clouds with the hot chemistry applied to planetary atmosphere models. With a general understanding of the different types of reactions that can occur, one can proceed in building a network of chemical reactions and use it to explain the abundance of species seen in disks. One o...

  18. [ANOREXIA AND BULIMIA: IMPACT ON NETWORK SOCIETY].

    Science.gov (United States)

    Alex Sánchez, María Dolores

    2015-01-01

    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. Complex Networks

    CERN Document Server

    Evsukoff, Alexandre; González, Marta

    2013-01-01

    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...

  20. Sentient networks

    Energy Technology Data Exchange (ETDEWEB)

    Chapline, G.

    1998-03-01

    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.

  1. Network virtualization and programmability

    OpenAIRE

    Colle, Didier; Jooris, Bart; Gurzi, Pasquale; Pickavet, Mario; Demeester, Piet

    2010-01-01

    We present network virtualization (building virtual or logical networks over a physical infrastructure) and network programmability (allowing the network operator to at least control the network but more fundamentally to define its behavior) concepts.

  2. Ten years of integrated care in Switzerland

    Directory of Open Access Journals (Sweden)

    Peter Berchtold

    2011-03-01

    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.

  3. Research in cardiovascular care

    DEFF Research Database (Denmark)

    Jaarsma, Tiny; Deaton, Christi; Fitzsimmons, Donna;

    2014-01-01

    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....

  4. European Higher Health Care Education Curriculum

    DEFF Research Database (Denmark)

    Koskinen, Liisa; Kelly, Hélène; Bergknut, Eva;

    2012-01-01

    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...

  5. care about还是care for?

    Institute of Scientific and Technical Information of China (English)

    曾克辉

    2015-01-01

    1问care about和care for可以相互替换使用吗?答:有时可以。但在不同情况下,它们在较确切的含义上还是有区别的。1在表示"喜欢,关心,担心"时,意思一样,常可以互换使用。如:I care about/for your integrity and honesty.我喜欢你的正直和诚实。She doesn’t care about/for politics.她不关心政治。You needn't care about/for his safety.你不必为他的安全担心。2在表示"介意,计较,在乎"等意思时,

  6. Management continuity in local health networks

    Directory of Open Access Journals (Sweden)

    Mylaine Breton

    2012-04-01

    Full Text Available Introduction: Patients increasingly receive care from multiple providers in a variety of settings. They expect management continuity that crosses boundaries and bridges gaps in the healthcare system. To our knowledge, little research has been done to assess coordination across organizational and professional boundaries from the patients' perspective. Our objective was to assess whether greater local health network integration is associated with management continuity as perceived by patients. Method: We used the data from a research project on the development and validation of a generic and comprehensive continuity measurement instrument that can be applied to a variety of patient conditions and settings. We used the results of a cross-sectional survey conducted in 2009 with 256 patients in two local health networks in Quebec, Canada. We compared four aspects of management continuity between two contrasting network types (highly integrated vs. poorly integrated. Results: The scores obtained in the highly integrated network are better than those of the poorly integrated network on all dimensions of management continuity (coordinator role, role clarity and coordination between clinics, and information gaps between providers except for experience of care plan. Conclusion: Some aspects of care coordination among professionals and organizations are noticed by patients and may be valid indicators to assess care coordination.

  7. Tufts academic health information network: concept and scenario.

    Science.gov (United States)

    Stearns, N S

    1986-04-01

    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.

  8. Network Cosmology

    CERN Document Server

    Krioukov, Dmitri; Sinkovits, Robert S; Rideout, David; Meyer, David; Boguna, Marian

    2012-01-01

    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...

  9. Elder care - resources

    Science.gov (United States)

    Resources - elder care ... The following organizations are good resources for information on aging and elder care: Administration on Aging -- www.aoa.gov Eldercare Locator -- www.eldercare.gov National Institute on ...

  10. Day Care Centers

    Data.gov (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...

  11. Palliative Care in Cancer

    Science.gov (United States)

    ... care that is given to a person when cancer therapies are no longer controlling the disease. It focuses on caring, not curing. When a person has a terminal diagnosis (usually defined as having a life expectancy ...

  12. US EPA CARE Grants

    Data.gov (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...

  13. Critical Care Team

    Science.gov (United States)

    ... of these areas: Surgery Internal medicine Pediatrics Anesthesiology Critical care nurse: A highly skilled nurse who provides all aspects ... and can often uphold the patient's wishes. The critical care nurse becomes an important part of decision-making with ...

  14. Wound Care: Preventing Infection

    Science.gov (United States)

    ... happening, the better you’ll be prepared to take care of yourself once you leave the hospital. You ... skin. If you catch a problem early and take care, you will often be able to continue to ...

  15. Caring for the Caregiver

    Science.gov (United States)

    ... But during this time, it’s important that caregivers take care of themselves too. PDF Kindle ePub This booklet ... cancer This booklet is not about how to take care of a patient. Instead, it mainly provides ways ...

  16. Children's hospice care.

    Science.gov (United States)

    Armstrong-Dailey, A

    1990-01-01

    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.

  17. National Health Care Survey

    Science.gov (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.

  18. What is palliative care?

    Science.gov (United States)

    ... Living Wills: A Guide to Advance Directives, the Health Care Power of Attorney, and Other Key Documents . Cambridge, MA: Harvard Health Publications. 2013. Oxenham D. Palliative care and pain. ...

  19. Preeclampsia - self-care

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000606.htm Preeclampsia - self-care To use the sharing features on this ... have frequent checkups and tests. Bed Rest and Self-care at Home When you are at home, ...

  20. Diabetes - eye care

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000078.htm Diabetes - eye care To use the sharing features on this ... enable JavaScript. Diabetic retinopathy - care Diabetes and your eyes Diabetes can harm your eyes. It can damage ...

  1. Surgical Critical Care Initiative

    Data.gov (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....

  2. Managed care demands flexibility, creativity.

    Science.gov (United States)

    1996-05-01

    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.

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

    CERN Document Server

    Mills, David L

    2010-01-01

    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. Parental Care and Investment

    OpenAIRE

    González-Voyer, Alejandro; Kolm, N.

    2010-01-01

    Parental care is common throughout the animal kingdom and among caring species there is a bewildering variation in how parents care for offspring, as well as in the amount of resources parents invest in care. For instance, there is considerable variation in the relative parental investment by the sexes – in some species females invest more, in others males invest more, and in some investment is more or less equally shared. Different hypotheses have been proposed to explain patterns of parenta...

  5. CARE07 Coordinated Accelerator Research in Europe

    CERN Multimedia

    2007-01-01

    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...

  6. CARE07 Coordinated Accelerator Research in Europe

    CERN Multimedia

    2007-01-01

    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 ...

  7. 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

    2013-02-01

    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

  8. Network interruptions

    CERN Multimedia

    2005-01-01

    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.

  9. Network dismantling

    CERN Document Server

    Braunstein, Alfredo; Semerjian, Guilhem; Zdeborová, Lenka

    2016-01-01

    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.

  10. Gradient networks

    Science.gov (United States)

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

    2008-04-01

    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).

  11. Innovation networks

    CERN Document Server

    Ahrweiler, Petra

    2013-01-01

    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...

  12. Value of care - National

    Data.gov (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...

  13. Enlarged prostate - after care

    Science.gov (United States)

    ... self-care; Benign prostatic hypertrophy - self-care; Benign prostatic hyperplasia - self-care ... Kaplan SA. Benign prostatic hyperplasia and prostatis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap ...

  14. 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...

  15. Power Networks

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Present States and Characteristics Since implementing reform and open policy,power industry in China has implemented the policy of separating govemment functions from enterprises, taking provincial power sectors as independent entities,integrating power networks, unified power dispatching and raising fund from various sources”, which has brought about rapid growth of power industry. With 12 years of continuous annual growth over 10,000 MW since 1988, the national total installed capacity reached 319.320.9 MW with an annual generation of 1368.482 TWh in 2000. To cope with the rapid growth of power source. all power networks in China have expanded correspondingly.

  16. Intergenerational care in the Danish welfare society

    DEFF Research Database (Denmark)

    Singla, Rashmi

    2015-01-01

    I denne artikel undersøger vi generationsforholdet mellem yngre voksne og deres forældre i det danske velfærdssamfund. Vores fokus er på omsorgspraksis og på slægtledsforpligtelser (filial responsibility). Artiklen omfatter dybdeanalyser af omsorgspraksis og intergenerationelle normer (filial nor...... individuel livsorientering ikke udelukker intergenerationel solidaritet i den danske velfærdsstat. Keywords: intergenerational care, individualisation, communality/ interconnectedness, social network analysis, ideals, everyday practices, social psychology....

  17. 7th Workshop on Complex Networks

    CERN Document Server

    Gonçalves, Bruno; Menezes, Ronaldo; Sinatra, Roberta

    2016-01-01

    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...

  18. Speak Up: Help Prevent Errors in Your Care: Ambulatory Care

    Science.gov (United States)

    ... role in making health care safe. That includes doctors, nurses and other health care professionals. Health care organizations ... embarrassed if you don't understand what your doctor, nurse or other health care professional tells you. • Don’ ...

  19. Effects of an Integrated Care System on quality of care and satisfaction for children with special health care needs.

    Science.gov (United States)

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

    2012-04-01

    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. PMID:21509433

  20. Effects of an Integrated Care System on quality of care and satisfaction for children with special health care needs.

    Science.gov (United States)

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

    2012-04-01

    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.

  1. Finnish care integrated?

    Directory of Open Access Journals (Sweden)

    Jouni Niskanen

    2002-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Isabella Teixeira Bastos

    2014-12-01

    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.

  3. At what cost care?

    Science.gov (United States)

    Pitman, J; Warelow, P J

    2000-03-01

    This paper looks at the concept of care in nursing and considers the ever-changing focus relative to the meaning of the term care and how this care is delivered by nursing staff. In the process of looking at these issues it examines the theoretical and practical issues and how these factors have changed considerably over the last twenty-five years. This examination touches upon some of the intermingled and not mutually exclusive issues which surround care and caring such as technology, stress and burnout, bureaucracy, fiscal policy, the humanness of the nurse and the ever changing nature of care delivery. Many readers will be able to relate to the issues discussed and understand how some of these factors tend to get in the way of one another and affect good patient care and outcomes. PMID:11141767

  4. Does Care Matter?

    DEFF Research Database (Denmark)

    Loft, Lisbeth Trille Gylling; Hogan, Dennis P.

    2014-01-01

    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-parental...... 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...... child care prior to employment is independently and positively associated with the timing of maternal employment entry. This finding applies both to first-time mothers (n = 3,800) and to mothers of multiple children (n = 6,600). Although data currently available for investigating child care capital...

  5. Neuroeconomics and Integrated Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

    Background: Fragmented specialized care for the frail elderly as claimed by WHO needs horizontal integration across settings. The home of the patient seems to be a promising place to integrate hospital care, primary care and social services for high-risk discharges where the quality...... of rehabilitation makes a difference. Objective: The study aims to reveal how integrated home care may be organised to improve quality of care as compared to usual hospital care. Method: A qualitative case study of the use of a neuroeconomic model in relation to multidisciplianry collaboration on a RCT...... of integrated home care for stroke patients. Results: (1) The classical understanding of CNS is that of a dual system of ANS and Cortex. The new neuroeconomic understanding is that of a reciprocal balance of Limbic System (LS) and Neocortex (NC). This applies directly in favour of integrated homecare compared...

  6. String Network

    OpenAIRE

    Sen, Ashoke

    1997-01-01

    Type IIB string theory admits a BPS configuration in which three strings (of different type) meet at a point. Using this three string configuration we construct a string network and study its properties. In particular we prove supersymmetry of this configuration. We also consider string lattices, which can be used to construct BPS states in toroidally compactified string theory.

  7. Telecommunication Networks

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

  8. Acute care nurses' spiritual care practices.

    Science.gov (United States)

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

    2013-06-01

    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.

  9. A Novel Network for Mentoring Family Physicians on Mental Health Issues Using E-Mail

    Science.gov (United States)

    Hunter, Jon J.; Rockman, Patricia; Gingrich, Nadine; Silveira, Jose; Salach, Lena

    2008-01-01

    Objective: Family practitioners are significant providers of mental health care and routinely report difficulty acquiring timely support in this area. The Collaborative Mental Health Care Network assembled groups of family practitioners and provided them with mental health practitioner mentors. This article addresses communication in the Network,…

  10. Network-Aware HEFT Scheduling for Grid

    Directory of Open Access Journals (Sweden)

    Muhammad Murtaza Yousaf

    2014-01-01

    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.

  11. Towards an Information Theory of Complex Networks

    CERN Document Server

    Dehmer, Matthias; Mehler, Alexander

    2011-01-01

    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

  12. The Time Efficient Security for Broadcast Networks

    Directory of Open Access Journals (Sweden)

    Kamaksi Prasad V2

    2008-04-01

    Full Text Available The audit ability and security of the broadcast network and security needs to be enhanced. This article is proposing the security solutions for such networks that are cost effective. The solution also takes care of the reduction of effective bandwidth-delay product. The improvement in terms of a cost effective comparator improves the efficiency and security of such networks. The threats like Eavesdropping, Interception and modification of transmitted data, Spoofing, Denial of service (DoS, Free–loading, and Accidental threats are some of the threats addressed in this article.

  13. Careful telemedicine planning limits costly liability exposure.

    Science.gov (United States)

    Edelstein, S A

    1999-12-01

    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.

  14. Timely and Effective Care - State

    Data.gov (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,...

  15. Genital herpes - self-care

    Science.gov (United States)

    Herpes - genital -self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care ... yourself healthy can also minimize the risk of future outbreaks. Things you can do include: Get plenty ...

  16. Broken toe - self-care

    Science.gov (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 ...

  17. Reconciliation of work and care among lone mothers of adults with intellectual disabilities: the role and limits of care capital.

    Science.gov (United States)

    Chou, Yueh-Ching; Kröger, Teppo

    2014-07-01

    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.

  18. Fuzzy logic and neural networks basic concepts & application

    CERN Document Server

    Alavala, Chennakesava R

    2008-01-01

    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

  19. Blending Formal and Informal Learning Networks for Online Learning

    Science.gov (United States)

    Czerkawski, Betül C.

    2016-01-01

    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 impact of the Quality and Outcomes Framework (QOF on the recording of smoking targets in primary care medical records: cross-sectional analyses from The Health Improvement Network (THIN database

    Directory of Open Access Journals (Sweden)

    Taggar Jaspal S

    2012-07-01

    Full Text Available Abstract Background Smoking is a UK public health threat but GPs can be effective in helping patients to quit; consequently, the Quality and Outcomes Framework (QOF incentivises the recording of smoking status and delivery of cessation advice in patients’ medical records. This study investigates the association between smoking-related QOF targets and such recording, and the factors which influence these clinical activities. Methods For 2000 to 2008, using medical records in The Health Improvement Network (THIN database, the annual proportions of i patients who had a record of smoking status made in the previous 27 months and ii current smokers recorded as receiving cessation advice in the previous 15 months were calculated. Then, for all patients at selected points before and after the QOF’s implementation, data on gender, age, Townsend score, and smoking-related morbidity were extracted. Multivariate logistic regression was used to investigate individual-level characteristics associated with the recording of smoking status and cessation advice. Results Rapid increases in recording smoking status and advice occurred around the QOF’s introduction in April 2004. Subsequently, compliance to targets has been sustained, although rates of increase have slowed. By 2008 64.5% of patients aged 15+ had smoking status documented in the previous 27 months and 50.5% of current smokers had cessation advice recorded in the last 15 months. Adjusted odds ratios show that, both before and after the introduction of the QOF, those with chronic medical conditions, greater social deprivation and women were more likely to have a recent recording of smoking status or cessation advice. Since the QOF’s introduction, the strongest characteristic associated with recording activities was the presence of co-morbidity. An example of this was patients with COPD, who in 2008, were 15.38 (95% CI 13.70-17.27 times and 11.72 (95% CI 10.41-13.21 times more likely to

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

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Parsaei

    2016-01-01

    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.

  2. Ecological network analysis: network construction

    NARCIS (Netherlands)

    Fath, B.D.; Scharler, U.M.; Ulanowicz, R.E.; Hannon, B.

    2007-01-01

    Ecological network analysis (ENA) is a systems-oriented methodology to analyze within system interactions used to identify holistic properties that are otherwise not evident from the direct observations. Like any analysis technique, the accuracy of the results is as good as the data available, but t

  3. Network Security Scanner

    OpenAIRE

    G. MURALI; M.Pranavi; Y.Navateja; K. Bhargavi

    2011-01-01

    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...

  4. Linear network theory

    CERN Document Server

    Sander, K F

    1964-01-01

    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

  5. Network biology concepts in complex disease comorbidities

    DEFF Research Database (Denmark)

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

    2016-01-01

    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 bein...

  6. Regional Knowledge Networks of Corporations, Universities and Public Institutions (Japanese)

    OpenAIRE

    Sakata, Ichiro; Kajikawa, Yuya; Takeda, Yoshiyuki; Shibata, Naoki; Hashimoto, Masahiro; MATSUSHIMA Katsumori

    2006-01-01

    The diversity of industry-university-government networks formed within regional clusters may dictate the degree of vigor of cutting-edge industries within a zone. After gaining a multidimensional grasp of the structural characteristics of the networks, we discuss their relationship with the location of concentrations of cutting-edge industries and with their growth. Specifically, we introduced certain network analysis methods and conducted quantitative analysis of health care-related industri...

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

    CERN Document Server

    Sarkar, Subir Kumar; Puttamadappa, C

    2007-01-01

    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

  8. A survey on the wireless sensor network technology

    International Nuclear Information System (INIS)

    Wireless sensor technology is required in the safety inspection for safety-critical unit of nuclear power plant. This report describes wireless sensor technology related with the project named 'Development of a remote care system of NPP components based on the network and safety database'. This report includes contents of methodology and status of sensor network construction, status of zigbee sensor network, problem of security and sensor battery. Energy harvesting technology will be mentioned on the next report

  9. Network Survivability

    DEFF Research Database (Denmark)

    Marzo, José L.; Stidsen, Thomas Riis; Ruepp, Sarah Renée;

    2010-01-01

    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 – are......, researchers and practitioners in the areas of networking, theoretical computer science, operations research, distributed computing and mathematics.......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...... – 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...

  10. Network Gravity

    CERN Document Server

    Lombard, John

    2016-01-01

    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...

  11. Neural Networks

    Directory of Open Access Journals (Sweden)

    Schwindling Jerome

    2010-04-01

    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.

  12. 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...

  13. [Economics of health care in Mali].

    Science.gov (United States)

    Coulibaly, S O; Keita, M

    1996-01-01

    From the results obtained regarding the financing of health care in Mali, we emphasize two important points. First, there is a lack of criteria for the distribution of finding in the health care sector, resulting in a waste of resources. Secondly, there is an absence of adequate pharmaceutical policies. The field studies led in 1987 provided the following observations. The rate of occupation of the beds is very low. Also, the numerous new investments are not yet put into service because of the lack of necessary equipment of qualified personnel. In addition, this does not consider the excessive investments occurring in certain localities where neither the rate of frequentation nor the economic conditions will ever allow the use of the capacity created. Among the possible solutions for the crisis of health care funding in Mali, the following should be priority: first, to fight against the complete lack of organization of the activities at the health care centers; secondly, to fight against the waste and misappropriation of money resulting from the behavior of the medical and paramedical personnel: and thirdly, to clarify the management of the resources coming from the charges for each service. The pharmaceutical policies adopted and implemented in recent years Largely contributed to, first, the creation of competition between essential generic medications and nongeneric medications that can be replaced, and then, the destruction of the public network of drug distribution. These conditions considerably limited the distribution of essential medications; yet, this is the only manner of reducing the pharmaceutical expenses and accordingly, allowing more funding for other medical services. As the distribution network is disorganized, the only alternative for the population to obtain the medications at the lowest price was to create centers of purchasing and distribution and to multiply the number of retailers of essential medications. Extensive work has been conducted in

  14. Socialist Networks

    OpenAIRE

    Agarez, Ricardo; Bechini, Thibault; Dalachanis, Angelos; El-Wakil, Leila; Gzowska, Alicja; James-Chakraborty, Kathleen; Kögel, Eduard; Kulić, Vladimir; Lagae, Johan; Schwenkel, Christina; Stanek, Łukasz; Zandi-Sayek, Sibel

    2014-01-01

    This issue of ABE focuses on the internationalization of building culture after WWII and the contributions of architects, planners, and engineers from socialist countries to these processes. Complementing the studies of colonial and postcolonial links, international organizations such as the UN, and economic globalization as conduits of the world-wide spread of architecture, this issue discusses the intersection of these networks with flows of labor power, materials, technologies, discourses ...

  15. [Primary care in France].

    Science.gov (United States)

    Sánchez-Sagrado, T

    2016-01-01

    The poor planning of health care professionals in Spain has led to an exodus of doctors leaving the country. France is one of the chosen countries for Spanish doctors to develop their professional career. The French health care system belongs to the Bismarck model. In this model, health care system is financed jointly by workers and employers through payroll deduction. The right to health care is linked to the job, and provision of services is done by sickness-funds controlled by the Government. Primary care in France is quite different from Spanish primary care. General practitioners are independent workers who have the right to set up a practice anywhere in France. This lack of regulation has generated a great problem of "medical desertification" with problems of health care access and inequalities in health. French doctors do not want to work in rural areas or outside cities because "they are not value for money". Medical salary is linked to professional activity. The role of doctors is to give punctual care. Team work team does not exist, and coordination between primary and secondary care is lacking. Access to diagnostic tests, hospitals and specialists is unlimited. Duplicity of services, adverse events and inefficiencies are the norm. Patients can freely choose their doctor, and they have a co-payment for visits and hospital care settings. Two years training is required to become a general practitioner. After that, continuing medical education is compulsory, but it is not regulated. Although the French medical Health System was named by the WHO in 2000 as the best health care system in the world, is it not that good. While primary care in Spain has room for improvement, there is a long way for France to be like Spain. PMID:26304179

  16. Patient-centered Care.

    Science.gov (United States)

    Reynolds, April

    2009-01-01

    Patient-centered care focuses on the patient and the individual's particular health care needs. The goal of patient-centered health care is to empower patients to become active participants in their care. This requires that physicians, radiologic technologists and other health care providers develop good communication skills and address patient needs effectively. Patient-centered care also requires that the health care provider become a patient advocate and strive to provide care that not only is effective but also safe. For radiologic technologists, patient-centered care encompasses principles such as the as low as reasonably achievable (ALARA) concept and contrast media safety. Patient-centered care is associated with a higher rate of patient satisfaction, adherence to suggested lifestyle changes and prescribed treatment, better outcomes and more cost-effective care. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store. According to one theory, most patients judge the quality of their healthcare much like they rate an airplane flight. They assume that the airplane is technically viable and is being piloted by competent people. Criteria for judging a particular airline are personal and include aspects like comfort, friendly service and on-time schedules. Similarly, patients judge the standard of their healthcare on nontechnical aspects, such as a healthcare practitioner's communication and "soft skills." Most are unable to evaluate a practitioner's level of technical skill or training, so the qualities they can assess become of the utmost importance in satisfying patients and providing patient-centered care.(1). PMID:19901351

  17. Music in child care

    OpenAIRE

    Maria Polikandrioti; Ioannis Koutelekos

    2007-01-01

    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...

  18. Italian health care reform

    OpenAIRE

    Livio Garattini

    1992-01-01

    It is remarkable how health care systems, created over decades and influenced by very different cultures exhibit similar problems. Most health care systems are compartmentalised with managers at margins responding to perverse incentives and seeking to shift patients and costs onto rival organisations. Decision makers behave selfishly, considering the welfare of their own organisations rather than those of the health care system as a whole, and in the absence if evidence about the cost-effecti...

  19. Health care delivery systems.

    OpenAIRE

    Stevens, F; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective, meaningful, and socially accepted. From a sociological point of view, the analysis of health care delivery systems implies recognition of their distinct history over time, their specific values an...

  20. Health Care Indicators

    OpenAIRE

    Donham, Carolyn S.; Maple, Brenda T.; Letsch, Suzanne W.

    1993-01-01

    This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avai...

  1. Health Care Indicators

    OpenAIRE

    Donham, Carolyn S.; Maple, Brenda T.; Cowan, Cathy A.

    1992-01-01

    This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avai...

  2. Health Care Indicators

    OpenAIRE

    Donham, Carolyn S.; Maple, Brenda T.; Sensenig, Arthur L.

    1994-01-01

    This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avai...

  3. Health Care Indicators

    OpenAIRE

    Donham, Carolyn S.; Maple, Brenda T.; Sivarajan, Lekha

    1993-01-01

    This regular feature of the journal includes a discussion of each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avail...

  4. Health Care Indicators

    OpenAIRE

    Donham, Carolyn S.; Sensenig, Arthur L.; Heffler, Stephen K.

    1995-01-01

    This regular feature of the journal includes a discussion of each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avail...

  5. Health Care Indicators

    OpenAIRE

    Maple, Brenda T.; Cowan, Cathy A.; Donham, Carolyn S.; Letsch, Suzanne W.

    1991-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of...

  6. Health Care Indicators

    OpenAIRE

    Donham, Carolyn S.; Sensenig, Arthur L.; Heffler, Stephen K.

    1995-01-01

    This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the avai...

  7. Health Care Indicators

    OpenAIRE

    Cowan, Cathy A.; Donham, Carolyn S.; Letsch, Suzanne W.; Maple, Brenda T.; Lazenby, Helen C.

    1992-01-01

    This regular feature of the journal includes a section on each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of...

  8. Pediatric palliative care

    OpenAIRE

    Trapanotto Manuela; Spizzichino Marco; Benini Franca; Ferrante Anna

    2008-01-01

    Abstract The WHO defines pediatric palliative care as the active total care of the child's body, mind and spirit, which also involves giving support to the family. Its purpose is to improve the quality of life of young patients and their families, and in the vast majority of cases the home is the best place to provide such care, but for cultural, affective, educational and organizational reasons, pediatric patients rarely benefit from such an approach. In daily practice, it is clear that pedi...

  9. Integrated and interprofessional care

    Directory of Open Access Journals (Sweden)

    Hugh Barr

    2012-07-01

    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.

  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

    2007-01-01

    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. Communities as co-producers in integrated care

    Directory of Open Access Journals (Sweden)

    Henk Nies

    2014-06-01

    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

  12. The Influence of Setting on Care Coordination for Childhood Asthma.

    Science.gov (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

    2015-11-01

    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.

  13. Democracy, caring and competence

    DEFF Research Database (Denmark)

    Broström, Stig; Johannesson, Eva Marianne; Purola, Anna-Maija;

    2015-01-01

    The aim of the study is to explore how Nordic Early Childhood Education and Care policies frame values education in preschools with a special focus on the values of democracy, caring and competence. The study is part of a larger Nordic project, Valueseducation in Nordic preschools: Basis of...... the study. Keywords related with democratic, caring and competence values were selected. The findings reveal different dimensions and meanings of the three value fields, such as democracy as being and/or becoming; care as fulfilment of basic needs and an ethical relationship; and competence values as...

  14. Caring for the caregiver.

    Science.gov (United States)

    2008-01-01

    Caring for the Caregiver is information for persons helping to care for people with cancer. The emphasis is on what caregivers can do to help themselves at this stressful time. Topics included are: Who Is a Caregiver, Your Feelings, Asking For Help, Caring for Yourself, Going With Your Loved One to Medical Visits, Talking With Others, Remember, Other Resources for Caregivers. The information is written on a basic level and it is very suitable for health professionals to share with persons helping to care for family members or friends who have cancer. The National Cancer Institute posted this information on its website last June 29. PMID:19062356

  15. Progressive Care of Obese Patients.

    Science.gov (United States)

    Dambaugh, Lori A; Ecklund, Margaret M

    2016-08-01

    Obese patients have complex needs that complicate their care during hospitalization. These patients often have comorbid conditions, including hypertension, heart failure, obstructive sleep apnea, pressure ulcers, and difficulty with mobility. Obese patients may be well served in the progressive care setting because they may require more intensive nursing care than can be delivered in a general care unit. Progressive care nurses have core competencies that enable them to safely and effectively care for obese patients. A plan of care with interdisciplinary collaboration illustrates the integrative care for obese progressive care patients. (Critical Care Nurse 2016; 36[4]:58-63). PMID:27481802

  16. Why Network? Theoretical Perspectives on Networking

    Science.gov (United States)

    Muijs, Daniel; West, Mel; Ainscow, Mel

    2010-01-01

    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…

  17. The Seniors Health Research Transfer Network Knowledge Network Model: system-wide implementation for health and healthcare of seniors.

    Science.gov (United States)

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

    2010-01-01

    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.

  18. 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

    2008-01-01

    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.

  19. Mental Health, School Problems, and Social Networks: Modeling Urban Adolescent Substance Use

    Science.gov (United States)

    Mason, Michael J.

    2010-01-01

    This study tested a mediation model of the relationship with school problems, social network quality, and substance use with a primary care sample of 301 urban adolescents. It was theorized that social network quality (level of risk or protection in network) would mediate the effects of school problems, accounting for internalizing problems and…

  20. An innovative telemedicine knowledge translation program to improve quality of care in intensive care units: protocol for a cluster randomized pragmatic trial

    OpenAIRE

    Pinto Ruxandra; Hales Brigette; Dainty Katie; Scales Damon C; Fowler Robert A; Adhikari Neill KJ; Zwarenstein Merrick

    2009-01-01

    Abstract Background There are challenges to timely adoption of, and ongoing adherence to, evidence-based practices known to improve patient care in the intensive care unit (ICU). Quality improvement initiatives using a collaborative network approach may increase the use of such practices. Our objective is to evaluate the effectiveness of a novel knowledge translation program for increasing the proportion of patients who appropriately receive the following six evidence-based care practices: ve...

  1. The Caregiver as Gatekeeper for Accessing Health Care for Children in Foster Care: A Qualitative Study of Kinship and Unrelated Caregivers

    OpenAIRE

    Schneiderman, Janet U.; Smith, Caitlin; Palinkas, Lawrence A

    2012-01-01

    The objective of this qualitative study was to examine issues that unrelated and kinship foster caregivers in Los Angeles, CA, have in seeking help and accessing and using health care for children in foster care. There were four themes identified for all caregivers: (1) “Doing Our Best” (caregivers advocated persistently and creatively for health care); (2) “Support from Others Helped” (caregivers relied on caseworkers, organizations, and their social network); (3) “Child has Complicated, Ser...

  2. Social Media and Health Care Professionals: Benefits, Risks, and Best Practices

    OpenAIRE

    Ventola, C. Lee

    2014-01-01

    Health care professionals can use a variety of social media tools to improve or enhance networking, education, and other activities. However, these tools also present some potential risks, such as unreliable information and violations of patients’ privacy rights.

  3. Substance use among adolescents in special education and residential youth care : Prevalence, onset and risk factors

    NARCIS (Netherlands)

    Kepper, A.S.

    2013-01-01

    Adolescents attending special education for learning disabilities (SEL), special education for behavioural problems (SEB) and adolescents living in a residential youth care (RYC) institution present a complex risk profile including severe behavioural and emotional problems, deviant peer networks, an

  4. Social media and health care professionals: benefits, risks, and best practices.

    Science.gov (United States)

    Ventola, C Lee

    2014-07-01

    Health care professionals can use a variety of social media tools to improve or enhance networking, education, and other activities. However, these tools also present some potential risks, such as unreliable information and violations of patients' privacy rights. PMID:25083128

  5. Translational networks in healthcare? Evidence on the design and initiation of organizational networks for knowledge mobilization.

    Science.gov (United States)

    Fitzgerald, Louise; Harvey, Gill

    2015-08-01

    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.

  6. Improving network management with Software Defined Networking

    International Nuclear Information System (INIS)

    Software-defined networking (SDN) is developed as an alternative to closed networks in centers for data processing by providing a means to separate the control layer data layer switches, and routers. SDN introduces new possibilities for network management and configuration methods. In this article, we identify problems with the current state-of-the-art network configuration and management mechanisms and introduce mechanisms to improve various aspects of network management

  7. Effect of Primary Health Care Orientation on Chronic Care Management

    OpenAIRE

    Schmittdiel, Julie A.; Shortell, Stephen M.; Rundall, Thomas G; Bodenheimer, Thomas; SELBY, Joe V.

    2006-01-01

    PURPOSE It has been suggested that the best way to improve chronic illness care is through a redesign of primary care emphasizing comprehensive, coordinated care as espoused by the Chronic Care Model (CCM). This study examined the relationship between primary care orientation and the implementation of the CCM in physician organizations.

  8. Do We Value Caring?

    Science.gov (United States)

    Weissbourd, Richard; Anderson, Trisha Ross

    2016-01-01

    When asked about their child-rearing priorities, parents in the United States are likely to say it's more important to raise children who are caring than to raise high achievers. Schools, too, typically trumpet values such as caring, honesty, and fairness. These values are posted on walls, reiterated in assemblies, and included in mission…

  9. Costs of Emergency Care

    Science.gov (United States)

    ... to care for patients, not fewer, and medical liability reform would help reduce overall costs by reducing ... NewsMediaResources/StatisticsData/Just%202%20booklet.pdf [ii] Report: Accounting for the cost of US health care: A ...

  10. Nail care for newborns

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001914.htm Nail care for newborns To use the sharing features on ... finger or toe instead of the nail. Baby's nails grow quickly, so you may have to cut the fingernails at least once a week. You may only need ... SG, Bedwell C, Cork MJ. Neonatal skin care and toxicology. In: Eichenfield LF, Frieden IJ, Mathes ...

  11. Alliance in Youth Care

    NARCIS (Netherlands)

    Rothman, Linda; Rijsingen, Rinie van; Pijnenburg, Huub

    2015-01-01

    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

  12. Primary Care's Dim Prognosis

    Science.gov (United States)

    Alper, Philip R.

    2010-01-01

    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…

  13. Robots that care

    NARCIS (Netherlands)

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

    2010-01-01

    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

  14. Health Care Waste Management

    OpenAIRE

    World Bank

    2003-01-01

    Health care waste management (HCWM) is a process to help ensure proper hospital hygiene and safety of health care workers and communities. It includes planning and procurement, construction, staff training and behavior, proper use of tools, machines and pharmaceuticals, proper disposal methods inside and outside the hospital, and evaluation. Its many dimensions require a broader focus than ...

  15. Health care marketing management.

    Science.gov (United States)

    Cooper, P D

    1979-01-01

    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.

  16. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

  17. Finding Health Care Services

    Science.gov (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.

  18. Surgical wound care

    Science.gov (United States)

    ... F for more than 4 hours Alternate Names Surgical incision care; Open wound care Images Proper hand washing References Lynn PB. Cleaning a wound and applying a dry, sterile dressing. In: Lynn PB. Taylor’s Handbook of Nursing Skills . Philadelphia, PA: Lippincott Williams and Wilkins, Wolters ...

  19. The Inquiry of Care

    Science.gov (United States)

    Nelsen, Peter

    2013-01-01

    While discussions of the moral dimensions of the caring relation and their implications for teaching and learning are well developed within the literature, there has not been much analysis of the place of inquiry within our understanding of caring and the education inspired by it. Previous discussions offer important insight into what…

  20. Educating to Care

    Science.gov (United States)

    Mortari, Luigina

    2004-01-01

    The root of the ecological crisis lies in an ethic of nature consumption. In order to reconstruct our cultural framework, it is necessary to cultivate another ethical approach, an ethic of care. It is the responsibility of school to encourage students to learn how to care for not only the human world, but also for the natural world. This paper is…

  1. Prevention IS Care

    Centers for Disease Control (CDC) Podcasts

    2009-03-26

    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.

  2. Caring about the young

    NARCIS (Netherlands)

    John Stevens; Evert Pommer; Hetty van Kempen; Elke Zeijl; Isolde Woittiez; Klarita Sadiraj; Rob Gilsing; Saskia Keuzenkamp

    2009-01-01

    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

  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. Child Care Centres.

    Science.gov (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…

  5. Child Care at CERN

    CERN Document Server

    CERN, Child Care Initiative

    2008-01-01

    This is a document summarizing a survey of child care needs of CERN staff and users which was performed in February 2008 by the CERN Child Care Initiative. The document presents the analysis of this data. Conclusions on the minimal facilities size are derived and possible funding source at the European Union are discussed.

  6. Improved wound care product

    DEFF Research Database (Denmark)

    2012-01-01

    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....

  7. ENLIGHT Network

    CERN Multimedia

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

    2011-01-01

    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.

  8. Network Security with Cryptography

    OpenAIRE

    Prof. Mukund R. Joshi; Renuka Avinash Karkade

    2015-01-01

    Network Security & Cryptography is a concept to protect network and data transmission over wireless network. Data Security is the main aspect of secure data transmission over unreliable network. Network security involves the authorization of access to data in a network, which is controlled by the network administrator. Users choose or are assigned an ID and password or other authenticating information that allows them access to information and programs within their authority. Netw...

  9. Local Social Networks

    OpenAIRE

    Sapuppo, Antonio; Sørensen, Lene Tolstrup

    2011-01-01

    Online social networks have become essential for many users in their daily communication. Through a combination of the online social networks with opportunistic networks, a new concept arises: Local Social Networks. The target of local social networks is to promote social networking benefits in physical environment in order to leverage personal affinities in the users' surroundings. The purpose of this paper is to present and discuss the concept of local social networks as a new social commun...

  10. Benchmarking HIV health care

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda;

    2012-01-01

    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...

  11. Shared care and boundaries:

    DEFF Research Database (Denmark)

    Winthereik, Brit Ross

    2008-01-01

    of responsibilities entailed in shared care projects. Rather than seeking to connect all actors in an unbounded space, shared care might instead suggest a space for patients and professionals to experiment with new roles and responsibilities. Practical implications – When designing coordination tools for health care......Purpose – The paper seeks to examine how an online maternity record involving pregnant women worked as a means to create shared maternity care. Design/methodology/approach – Ethnographic techniques have been used. The paper adopts a theoretical/methodological framework based on science...... and technology studies. Findings – The paper shows how a version of “the responsible patient” emerges from the project which is different from the version envisioned by the project organisation. The emerging one is concerned with the boundary between primary and secondary sector care, and not with the boundary...

  12. Empowering and caring professionals

    DEFF Research Database (Denmark)

    Hansen, Agnete Meldgaard

    care services. The reform programs are put in place to counter the demographic challenges faced by the Nordic (and many other) welfare states, known under the pessimistic expression ‘the burden of ageing’. Based on ethnographic case studies in two Danish municipalities, the paper illustrates how care......A wave of policies to reform municipal elderly care services is sweeping across Denmark. Under headings such as ‘help for self-help’, ‘everyday rehabilitation’, and ‘re-ablement’, municipalities are working to make their elderly citizens more self-reliant, active and less dependent on municipal...... workers negotiate professional identities and understandings of meaningful care work, in the new regime of rehabilitative elderly care – how they manage the ambiguities of a simultaneously empowering and interventionist practice. The paper’s analytical framework draws on an understanding of empowerment...

  13. Orphan Care in China

    Directory of Open Access Journals (Sweden)

    Meng, Liu

    2009-07-01

    Full Text Available Orphan care in China was once provided by the central government as a means of social control. The centralized welfare delivery guaranteed some of the poorest orphans to be protected by the government. Since the economic reform, the central government started to relinquish its control over social welfare delivery, new forms of orphan care were introduced into China, sharing the responsibilities and burdens for caring the orphans. Yet, many issues and problems exist in social delivery due to a lack of finances, professionals, and policy support. In this chapter, we will discuss the background of social welfare changes in China, as pertains to orphan care, focusing on the different types of orphans as a result of social issues, service delivery, barriers and solutions. It is claimed that during the reform, the burden of orphan care in China may not be reduced in the coming future, and we offer suggestions to cope with that.

  14. "Patient care in radiology"

    DEFF Research Database (Denmark)

    Bro Brask, Kirsten; Birkelund, Regner

    2014-01-01

    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...

  15. 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...

  16. 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

    2012-06-01

    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

  17. Occupational therapists’ conceptions on mental health care line

    Directory of Open Access Journals (Sweden)

    Michelle Helena Pereira de Paiva

    2012-12-01

    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.

  18. Performance of an integrated network model

    Science.gov (United States)

    Lehmann, François; Dunn, David; Beaulieu, Marie-Dominique; Brophy, James

    2016-01-01

    Objective To evaluate the changes in accessibility, patients’ care experiences, and quality-of-care indicators following a clinic’s transformation into a fully integrated network clinic. Design Mixed-methods study. Setting Verdun, Que. Participants Data on all patient visits were used, in addition to 2 distinct patient cohorts: 134 patients with chronic illness (ie, diabetes, arteriosclerotic heart disease, or both); and 450 women between the ages of 20 and 70 years. Main outcome measures Accessibility was measured by the number of walk-in visits, scheduled visits, and new patient enrolments. With the first cohort, patients’ care experiences were measured using validated serial questionnaires; and quality-of-care indicators were measured using biologic data. With the second cohort, quality of preventive care was measured using the number of Papanicolaou tests performed as a surrogate marker. Results Despite a negligible increase in the number of physicians, there was an increase in accessibility after the clinic’s transition to an integrated network model. During the first 4 years of operation, the number of scheduled visits more than doubled, nonscheduled visits (walk-in visits) increased by 29%, and enrolment of vulnerable patients (those with chronic illnesses) at the clinic remained high. Patient satisfaction with doctors was rated very highly at all points of time that were evaluated. While the number of Pap tests done did not increase with time, the proportion of patients meeting hemoglobin A1c and low-density lipoprotein guideline target levels increased, as did the number of patients tested for microalbuminuria. Conclusion Transformation to an integrated network model of care led to increased efficiency and enhanced accessibility with no negative effects on the doctor-patient relationship. Improvements in biologic data also suggested better quality of care. PMID:27521410

  19. Managed care and economic dynamics.

    Science.gov (United States)

    Riggs, J E

    1996-09-01

    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.

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

    CERN Document Server

    Spagnolo, Paolo; Distante, Cosimo

    2014-01-01

    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