WorldWideScience

Sample records for care systems obstacles

  1. Obstacle-avoiding navigation system

    Science.gov (United States)

    Borenstein, Johann; Koren, Yoram; Levine, Simon P.

    1991-01-01

    A system for guiding an autonomous or semi-autonomous vehicle through a field of operation having obstacles thereon to be avoided employs a memory for containing data which defines an array of grid cells which correspond to respective subfields in the field of operation of the vehicle. Each grid cell in the memory contains a value which is indicative of the likelihood, or probability, that an obstacle is present in the respectively associated subfield. The values in the grid cells are incremented individually in response to each scan of the subfields, and precomputation and use of a look-up table avoids complex trigonometric functions. A further array of grid cells is fixed with respect to the vehicle form a conceptual active window which overlies the incremented grid cells. Thus, when the cells in the active window overly grid cell having values which are indicative of the presence of obstacles, the value therein is used as a multiplier of the precomputed vectorial values. The resulting plurality of vectorial values are summed vectorially in one embodiment of the invention to produce a virtual composite repulsive vector which is then summed vectorially with a target-directed vector for producing a resultant vector for guiding the vehicle. In an alternative embodiment, a plurality of vectors surrounding the vehicle are computed, each having a value corresponding to obstacle density. In such an embodiment, target location information is used to select between alternative directions of travel having low associated obstacle densities.

  2. Obstacles to continuity of care in young mental health service users’ pathways - an explorative study

    Directory of Open Access Journals (Sweden)

    Marian Ådnanes

    2013-08-01

    Full Text Available Background: Users of mental health services often move between different primary and specialised health and care services, depending on their current condition, and this often leads to fragmentation of care. The aim of this study was to map care pathways in the case of young adult mental health service users and to identify key obstacles to continuity of care.Method: Quarterly semi-structured interviews were performed with nine young adults with mental health difficulties, following their pathways in and out of different services in the course of a year.Results: Key obstacles to continuity of care included the mental health system's lack of access to treatment, lack of integration between different specialist services, lack of progress in care and inadequate coordination tools such as ‘Individual Plan’ and case conferences that did not prevent fragmented care pathways.Conclusions: Continuity of care should be more explicitly linked to aspirations for development and progress in the users' care pathways, and how service providers can cooperate with users to actually develop and make progress. Coordination tools such as case conferences and ‘individual plans’ should be upgraded to this end and utilised to the utmost. This may be the most effective way to counteract the system obstacles.

  3. Obstacle penetrating dynamic radar imaging system

    Science.gov (United States)

    Romero, Carlos E.; Zumstein, James E.; Chang, John T.; Leach, Jr.. Richard R.

    2006-12-12

    An obstacle penetrating dynamic radar imaging system for the detection, tracking, and imaging of an individual, animal, or object comprising a multiplicity of low power ultra wideband radar units that produce a set of return radar signals from the individual, animal, or object, and a processing system for said set of return radar signals for detection, tracking, and imaging of the individual, animal, or object. The system provides a radar video system for detecting and tracking an individual, animal, or object by producing a set of return radar signals from the individual, animal, or object with a multiplicity of low power ultra wideband radar units, and processing said set of return radar signals for detecting and tracking of the individual, animal, or object.

  4. A stereo vision-based obstacle detection system in vehicles

    Science.gov (United States)

    Huh, Kunsoo; Park, Jaehak; Hwang, Junyeon; Hong, Daegun

    2008-02-01

    Obstacle detection is a crucial issue for driver assistance systems as well as for autonomous vehicle guidance function and it has to be performed with high reliability to avoid any potential collision with the front vehicle. The vision-based obstacle detection systems are regarded promising for this purpose because they require little infrastructure on a highway. However, the feasibility of these systems in passenger car requires accurate and robust sensing performance. In this paper, an obstacle detection system using stereo vision sensors is developed. This system utilizes feature matching, epipoplar constraint and feature aggregation in order to robustly detect the initial corresponding pairs. After the initial detection, the system executes the tracking algorithm for the obstacles. The proposed system can detect a front obstacle, a leading vehicle and a vehicle cutting into the lane. Then, the position parameters of the obstacles and leading vehicles can be obtained. The proposed obstacle detection system is implemented on a passenger car and its performance is verified experimentally.

  5. Optical Obstacle Avoidance System for Lunar and Mars Landing Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The systems developed at fibertek for Obstacle-Avoidance has so far all been operated at 1560nm. Such an operation is required due to the required eye-safety...

  6. Formation and obstacle avoidance control for multiagent systems

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    This paper considers the problems of formation and obstacle avoidance for multiagent systems.The objective is to design a term of agents that can reach a desired formation while avoiding collision with obstacles.To reduce the amount of information interaction between agents and target,we adopt the leader-follower formation strategy.By using the receding horizon control (RHC),an optimal problem is formulated in terms of cost minimization under constraints.Information on obstacles is incorporated online as se...

  7. The Obstacles against Nurse-Family Communication in Family-Centered Care in Neonatal Intensive Care Unit: a Qualitative Study

    Directory of Open Access Journals (Sweden)

    Zahra Hadian Shirazi

    2015-09-01

    Full Text Available Introduction: Communication is one of the key principles in Family-Centered Care (FCC. Studies have shown some drawbacks in communication between families and nurses. Therefore, the present study aimed to recognize the obstacles against nurse-family communication in FCC in Neonatal Intensive Care Unit (NICU. Methods: This qualitative study was conducted on 8 staff nurses in 2 NICUs affiliated to Shiraz University of Medical Sciences selected through purposive sampling. The data were collected using 8 deep semi-structured interviews and 3 observations. Then, they were analyzed through inductive content analysis. Results: Data analysis resulted in identification of 3 main categories and 7 subcategories. The first category was organizational factors with 2 subcategories of educational domain (inadequate education, lack of a system for nursing student selection, and poor professionalization and clinical domain (difficult working conditions, lack of an efficient system for ongoing education and evaluation, and authoritarian management. The second category was familial factors with socio-cultural, psychological, and economic subcategories. The last category was the factors related to nurses with socio-cultural and psycho-physical subcategories.Conclusion: Identification of the obstacles against nurse-family communication helps managers of healthcare systems to plan and eliminate the challenges of effective communication. Besides, elimination of these factors leads to appropriate strategies in NICUs for effective application of FCC.

  8. Obstacles to continuity of care in young mental health service users' pathways - an explorative study

    OpenAIRE

    Ådnanes, Marian; Steihaug, Sissel

    2013-01-01

    Background: Users of mental health services often move between different primary and specialised health and care services, depending on their current condition, and this often leads to fragmentation of care. The aim of this study was to map care pathways in the case of young adult mental health service users and to identify key obstacles to continuity of care.Method: Quarterly semi-structured interviews were performed with nine young adults with mental health difficulties, following their pat...

  9. Obstacles to health care: a nurse's experience in Sudan.

    Science.gov (United States)

    Klaassen, Whitney C

    2007-10-01

    Sudan is a country known for its long history of wars, poverty, and disease. These factors combine to cause a high incidence of morbidity and mortality and the inability of the population to seek and receive medical care.

  10. Target Tracking and Obstacle Avoidance for Multi-agent Systems

    Institute of Scientific and Technical Information of China (English)

    Jing Yan; Xin-Ping Guan; Fu-Xiao Tan

    2010-01-01

    This paper considers the problems of target tracking and obstacle avoidance for multi-agent systems.To solve the problem that multiple agents cannot effectively track the target while avoiding obstacle in dynamic environment,a novel control algorithm based on potential function and behavior rules is proposed.Meanwhile,the interactions among agents are also considered.According to the state whether an agent is within the area of its neighbors' influence,two kinds of potential functions are presented.Meanwhile,the distributed control input of each agent is determined by relative velocities as well as relative positions among agents,target and obstacle.The maximum linear speed of the agents is also discussed.Finally,simulation studies are given to demonstrate the performance of the proposed algorithm.

  11. Design of an obstacle avoidance system for automated guided vehicles

    OpenAIRE

    Lockwood, Stephen

    1992-01-01

    Most Industrial Automated Guided Vehicles CAGV s) follow fixed guide paths embedded in the floor or bonded to the floor surface. Whilst reliable in their basic operation, these AGV systems fail if unexpected obstacles are placed in the vehicle path. This can be a problem particularly in semi-automated factories where men and AGVs share the same environment. The perfonnance of line-guided AGVs may therefore be enhanced with a capability to avoid unexpected obstructions in the guide path. Th...

  12. RESIDENTIAL CARE IN THE CZECH REPUBLIC: PRESUMPTION OR OBSTACLE TO A SUCCESSFUL INTEGRATION OF YOUNG PEOPLE TO SOCIETY?

    Directory of Open Access Journals (Sweden)

    Štanclová Tereza

    2013-12-01

    Full Text Available Main purpose of this article is to find out how is situation of young people leaving residential care institutions and trying to integrate to a usual life after reaching adultery. Using personal interviews with the young people (present clients of residential care, former clients, employees of the caring institutions we try to answer questions how these young people are prepared for a normal life in a society and what are main barriers they have to overcome in order to start a new life without institutional help. Our findings confirm that present system of social services is not effective enough in an effort to help the young people with their integration. We conclude that transformation of the Czech residential care of children from pathological families is inevitable in order to overcome such obstacles as missing emotional help from their biological families and friends, low level of economic independency resulting from low qualification and problems to find a job and an accommodation.

  13. Whole-arm obstacle avoidance system conceptual design

    International Nuclear Information System (INIS)

    Whole-arm obstacle avoidance is needed for a variety of robotic applications in the Environmental Restoration and Waste Management (ER ampersand WM) Program. Typical industrial applications of robotics involve well-defined workspaces, allowing a predetermined knowledge of collision-free paths for manipulator motion. In the unstructured or poorly defined hazardous environments of the ER ampersand WM Program, the potential for significant problems resulting from collisions between manipulators and the environment in which they are utilized is great. The conceptual design for a sensing system that will provide protection against such collisions is described herein. The whole-arm obstacle avoidance system consists of a set of sensor ''bracelets,'' which cover the surface area of the manipulator links to the maximum extent practical, and a host processor. The host processor accepts commands from the robot control system, controls the operation of the sensors, manipulates data received from the bracelets, and makes the data available to the manipulator control system. The bracelets consist of a subset of the sensors, associated sensor interface electronics, and a bracelet interface. Redundant communications links between the host processor and the bracelets are provided, allowing single-point failure protection. The system allows reporting of 8-bit data from up to 1000 sensors at a minimum of 50 Hz. While the initial prototype implementation of the system utilizes capacitance proximity sensor, the system concept allows multiple types of sensors. These sensors are uniquely addressable, allowing remote calibration, thresholding at the bracelet, and correlation of a sensor measurement with the associated sensor and its location on the manipulator. Variable resolution allows high-speed, single-bit sensing as well as lower-speed higher-resolution sensing, which is necessary for sensor calibration and potentially useful in control

  14. ASPECTS OF OBSTACLES FOR APPLYING ACTIVITY BASED COSTING (ABC SYSTEM IN EGYPTIAN FIRMS

    Directory of Open Access Journals (Sweden)

    Petru STEFEA

    2013-10-01

    Full Text Available The following investigation aims to determine the aspects of obstacles for applying Activity Based Costing (ABC system in the Egyptian case and the significant differences among the effects of such obstacles . The Study used the survey method to describe and analyze the obstacles in some Egyptian firms. The population of the study is Egyptian manufacturing firms. This survey used the number of 392 questionnaires that were used throughout the total of 23 Egyptian manufacturing firms, during the first half of 2013. Finally, the study found some influencing obstacles for applying this system (ABC and there were significant differences among the aspects of obstacles for applying ABC system in the Egyptian manufacturing firms.

  15. Intelligent obstacle avoidance system for unmanned undersea vehicles in shallow water

    Science.gov (United States)

    Kim, Keehoon; Kostrzewski, Andrew A.; Erwin, Daniel A.

    2004-09-01

    An unmanned undersea vehicle (UUV) needs an obstacle avoidance capability to make autonomous path planning decisions for successful undersea search and survey, maritime reconnaissance, communication/navigation aids, and tracking and trailing in uncharted shallow water. Physical Optics Corporation (POC) has developed a novel autonomous UUV path optimization navigator system for real-time, robust, self-adjusting, intelligent autonomous obstacle avoidance/navigation of UUVs. The POC system is based on our proprietary fast genetic algorithm, which processes signals from on-board obstacle avoidance sonar sensors to continuously optimize the navigation path while avoiding both moving and stationary obstacles in shallow waters. The system performs autonomous obstacle avoidance, accommodating navigation parameter changes. Vehicle dynamics are also incorporated by hydrodynamic compensation.

  16. H∞ Formation Control and Obstacle Avoidance for Hybrid Multi-Agent Systems

    Directory of Open Access Journals (Sweden)

    Dong Xue

    2013-01-01

    Full Text Available A new concept of H∞ formation is proposed to handle a group of agents navigating in a free and an obstacle-laden environment while maintaining a desired formation and changing formations when required. With respect to the requirements of changing formation subject to internal or external events, a hybrid multiagent system (HMAS is formulated in this paper. Based on the fact that obstacles impose the negative effect on the formation of HMAS, the H∞ formation is introduced to reflect the above disturbed situation and quantify the attenuation level of obstacle avoidance via the H∞-norm of formation stability. An improved Newtonian potential function and a set of repulsive functions are employed to guarantee the HMAS formation-keeping and collision-avoiding from obstacles in a path planning problem, respectively. Simulation results in this paper show that the proposed formation algorithms can effectively allow the multiagent system to avoid penetration into obstacles while accomplishing prespecified global objective successfully.

  17. An Indoor Obstacle Detection System Using Depth Information and Region Growth

    Directory of Open Access Journals (Sweden)

    Hsieh-Chang Huang

    2015-10-01

    Full Text Available This study proposes an obstacle detection method that uses depth information to allow the visually impaired to avoid obstacles when they move in an unfamiliar environment. The system is composed of three parts: scene detection, obstacle detection and a vocal announcement. This study proposes a new method to remove the ground plane that overcomes the over-segmentation problem. This system addresses the over-segmentation problem by removing the edge and the initial seed position problem for the region growth method using the Connected Component Method (CCM. This system can detect static and dynamic obstacles. The system is simple, robust and efficient. The experimental results show that the proposed system is both robust and convenient.

  18. Development of an Obstacle Detection System for Human Supervisory Control of a UAV in Urban Environments

    OpenAIRE

    Culhane, Andrew Alan

    2007-01-01

    In order to operate UAVs under human supervisory control in more complex arenas such as urban environments, an obstacle detection system is a requirement to achieve safe navigation. The development of a system capable of meeting these requirements is presented. The first stage of development was sensor selection and initial testing. After this, the sensor was combined with a servomotor to allow it to rotate and provide obstacle detection coverage in front, below, and to both sides of the U...

  19. Real-Time Obstacle Avoidance for Telerobotic Systems Based on Equipotential Surface

    Directory of Open Access Journals (Sweden)

    Xin Li

    2012-09-01

    Full Text Available Redundant manipulators offer a dual advantage of flexibility and dexterity and can be used in many civilian and military areas. However, operating such systems by teleoperation is challenging because of the redundancy and unstructured task environment, which result in the human operator suffering a huge burden when telemanipulator is facing the complicated obstacles. The existing methods usually use some off‐line algorithms to solve the problem of obstacle avoidance. It is difficult for them to meet the requirements of real‐time teleoperation in some unknown environment. This paper presents an on‐line method for a telerobotic system to take advantage of redundancy to avoid obstacle, which is based on real‐time sensor information. With this method, the human operator can focus attention on the end‐effector operation regardless of the obstacle avoidance of other parts. The effectiveness and advantage of the method are well demonstrated by experiments.

  20. H∞ Formation Control and Obstacle Avoidance for Hybrid Multi-Agent Systems

    OpenAIRE

    Dong Xue; Jing Yao; Jun Wang

    2013-01-01

    A new concept of H∞ formation is proposed to handle a group of agents navigating in a free and an obstacle-laden environment while maintaining a desired formation and changing formations when required. With respect to the requirements of changing formation subject to internal or external events, a hybrid multiagent system (HMAS) is formulated in this paper. Based on the fact that obstacles impose the negative effect on the formation of HMAS, the H∞ formation is introduced to reflect the above...

  1. Obstacles to implementing evidence-based practice in Belgium: a context-specific qualitative evidence synthesis including findings from different health care disciplines.

    Science.gov (United States)

    Hannes, K; Goedhuys, J; Aertgeerts, B

    2012-01-01

    A number of barriers to the implementation of evidence-based practice have already been inventoried. However, little attention has been given to their context-specific nature. This qualitative evidence synthesis examines commonalities in the obstacles perceived by different groups of health care practitioners working in the Belgian health care system and sets out to discuss potential strategies to bridge some of these barriers. We actively searched for primary studies addressing our topic of interest in international and national databases (1990 to May 2008), consulted experts and screened references of retrieved studies. We opted for the meta-aggregative approach, developed by the Joanna Briggs Institute, to analyse our findings. The findings indicate that (1) evidence might have a limited role in decision-making processes; (2) aspects other than quality of care steer the evidence-based practice agenda; (3) some health care providers benefit less from evidence-based practice than others and (4) there is a lack of competences to put the evidence-based principles in practice. Belgian policy makers might consider health care system characteristics from and strategies developed or suggested by others to respond to country-specific obstacles. Examples include but are not limited to; (a) providing incentives for patient-centred care coordination and patient communication, (b) supporting practitioners interested in applying research-related activities, (c) considering direct access systems and interprofessional learning to respond to the demand for autonomous decision-making from satellite professional groups, (d) systematically involving allied health professionals in important governmental advisory boards, (e) considering pharmaceutical companies perceived as 'the enemy' an ally in filling in research gaps, (f) embedding the evaluation of evidence-based knowledge and skills in examinations (g) moving from (in)formative learning to transformative learning and (h

  2. Vision-based obstacle recognition system for automated lawn mower robot development

    Science.gov (United States)

    Mohd Zin, Zalhan; Ibrahim, Ratnawati

    2011-06-01

    Digital image processing techniques (DIP) have been widely used in various types of application recently. Classification and recognition of a specific object using vision system require some challenging tasks in the field of image processing and artificial intelligence. The ability and efficiency of vision system to capture and process the images is very important for any intelligent system such as autonomous robot. This paper gives attention to the development of a vision system that could contribute to the development of an automated vision based lawn mower robot. The works involve on the implementation of DIP techniques to detect and recognize three different types of obstacles that usually exist on a football field. The focus was given on the study on different types and sizes of obstacles, the development of vision based obstacle recognition system and the evaluation of the system's performance. Image processing techniques such as image filtering, segmentation, enhancement and edge detection have been applied in the system. The results have shown that the developed system is able to detect and recognize various types of obstacles on a football field with recognition rate of more 80%.

  3. Obstacles Faced by Deaf People in the Criminal Justice System

    Science.gov (United States)

    Vernon, M.; Miller, K.

    2005-01-01

    Deaf People, especially those who are not well educated, are at risk for serious injustices when they enter the criminal justice system. The present study describes these risks at all stages of the legal process, including arrest, trial, probation, prison, and parole. These dangers are greatest for those who are poorly educated, read at a…

  4. Vision System Prototype for UAV Positioning and Sparse Obstacle Detection

    OpenAIRE

    Jaroń, Piotr; Kucharczyk, Mateusz

    2012-01-01

    For the last few years computer vision due to its low exploitation cost and great capabilities has been experiencing rapid growth. One of the research fields that benefits from it the most is the aircrafts positioning and collision avoidance. Light cameras with low energy consumption are an ideal solution for UAVs (Unmanned Aerial Vehicles) navigation systems. With the new Swedish law – unique to Europe, that allows for civil usage of UAVs that fly on altitudes up to 120 meters, the need for ...

  5. Viscosity Solutions of Systems of PDEs with Interconnected Obstacles and Switching Problem

    Energy Technology Data Exchange (ETDEWEB)

    Hamadene, S., E-mail: hamadene@univ-lemans.fr; Morlais, M. A., E-mail: Marie_Amelie.Morlais@univ-lemans.fr [Universite du Maine, LMM (France)

    2013-04-15

    This paper deals with existence and uniqueness of a solution in viscosity sense, for a system of m variational partial differential inequalities with inter-connected obstacles. A particular case is the Hamilton-Jacobi-Bellmann system of the Markovian stochastic optimal m-states switching problem. The switching cost functions depend on (t,x). The main tool is the notion of systems of reflected backward stochastic differential equations with oblique reflection.

  6. 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...

  7. 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,

  8. Is distance to chemotherapy an obstacle to adjuvant care among the N.C. Medicaid—enrolled colon cancer patients?

    Science.gov (United States)

    Song, Eunyoung; Klepin, Heidi D.; Foley, Kristie L.

    2016-01-01

    Background Adjuvant chemotherapy for colon cancer has been linked to patient and provider characteristics but little is known about whether distance to chemotherapy providers constitutes an obstacle to chemotherapy. Methods A total of 1,184 Medicaid patients diagnosed with colon cancer in North Carolina in 1999–2002 comprised the sample. Data from the N.C. Central Cancer Registry, N.C. Medicaid Claims, American Hospital Directory and US Census were merged. Logistic regression models were used to estimate the association between chemotherapy receipt and the distance to nearest chemotherapy provider. Results Compared to the referent group of SEER-staged II (local) cancer patients living less than 2 miles from the nearest chemotherapy provider, the odds of receiving chemotherapy fell as the distance to the nearest provider increased. The odds ratio (OR) for those living ≥5 to <15 miles away was 0.13 [95% confidence intervals (CI), 0.04–0.39], and OR for those living ≥15 miles away was 0.06 (95% CI, 0.01–0.52). Patients diagnosed with regional, SEER-staged III (regional) cancer were less likely to receive chemotherapy if they lived in rural areas more than 20 miles away from the nearest provider (OR =0.08; 95% CI, 0.01–0.72). However, we found no evidence of association between chemotherapy receipt and distance to the nearest provider for regional cancer patients living in urban areas and those living in rural areas within 20 miles from the nearest chemotherapy provider. Conclusions Distance to provider may be an obstacle to chemotherapy for some groups of low-income colon cancer patients. Relieving travel burdens of rural patients living far from providers may help Medicaid increase guideline-consistent adjuvant care for regional cancer patients. PMID:27284464

  9. Real-Time Obstacle Detection System in Indoor Environment for the Visually Impaired Using Microsoft Kinect Sensor

    Directory of Open Access Journals (Sweden)

    Huy-Hieu Pham

    2016-01-01

    Full Text Available Any mobility aid for the visually impaired people should be able to accurately detect and warn about nearly obstacles. In this paper, we present a method for support system to detect obstacle in indoor environment based on Kinect sensor and 3D-image processing. Color-Depth data of the scene in front of the user is collected using the Kinect with the support of the standard framework for 3D sensing OpenNI and processed by PCL library to extract accurate 3D information of the obstacles. The experiments have been performed with the dataset in multiple indoor scenarios and in different lighting conditions. Results showed that our system is able to accurately detect the four types of obstacle: walls, doors, stairs, and a residual class that covers loose obstacles on the floor. Precisely, walls and loose obstacles on the floor are detected in practically all cases, whereas doors are detected in 90.69% out of 43 positive image samples. For the step detection, we have correctly detected the upstairs in 97.33% out of 75 positive images while the correct rate of downstairs detection is lower with 89.47% from 38 positive images. Our method further allows the computation of the distance between the user and the obstacles.

  10. Obstacle avoidance test using a sensor-based autonomous robotic system

    International Nuclear Information System (INIS)

    From a viewpoint of reducing personnel radiation exposure of plant staffs working in the high radiation area of nuclear facilities, it is often said to be necessary to develop remote robotic systems, which have great potential of performing various tasks in nuclear facilities. Hence, we developed an advanced remote robotic system, consisting of redundant manipulator and environment-sensing systems, which can be applied to complicated handling tasks under unstructured environment. In the robotic system, various types of sensors for environment-sensing are mounted on the redundant manipulator and sensor-based autonomous capabilities are incorporated. This report describes the results of autonomous obstacle avoidance test which was carried out as follows: manipulating valves at the rear-side of wall, through a narrow window of the wall, with the redundant manipulator mounted on an x-axis driving mechanism. From this test, it is confirmed that the developed robotic system can autonomously achieve handling tasks in limited space as avoiding obstacles, which is supposed to be difficult by a non-redundant manipulator. (author)

  11. Homoclinic orbits for the second-order Hamiltonian systems with obstacle item

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    This paper is concerned with the existence of homoclinic orbits for the second-order Hamiltonian system with obstacle item, ü(t)-A u(t) =▽F (t, u), where F (t, u) is T-periodic in t with ▽F (t, u) = L(t)u + ▽R(t,u). By using a generalized linking theorem for strongly indefinite functionals, we prove the existence of homoclinic orbits for both the super-quadratic case and the asymptotically linear one.

  12. DEVELOPMENT OF OBSTACLE AVOIDANCE TECHNIQUE IN WEB-BASED GEOGRAPHIC INFORMATION SYSTEM FOR TRAFFIC MANAGEMENT USING OPEN SOURCE SOFTWARE

    Directory of Open Access Journals (Sweden)

    Nik Mohd Ramli Nik Yusoff

    2014-01-01

    Full Text Available The shortest path routing is one of the well-known network analysis techniques implemented in road management systems. Pg Routing as an extension of Postgre SQL/Post GIS database is an open source library that implements the Dijkstra shortest path algorithm. However, the functionality to avoid obstacles in that analysis is still limited. Therefore, this study was conducted to enable obstacle avoidance function in the existing pgRouting algorithm using OpenStreetMap road network. By implementing this function, it enhances the Dijkstra algorithm ability in network analysis. In this study a dynamic restriction feature is added at the program level to represent the obstacles on the road. With this modification the algorithm is now able to generate an alternative route by avoiding the existence of obstacles on the roads. By using OpenLayers and PHP a web-based GIS platform was developed to ease the system’s usability.

  13. Awareness and Detection of Traffic and Obstacles Using Synthetic and Enhanced Vision Systems

    Science.gov (United States)

    Bailey, Randall E.

    2012-01-01

    Research literature are reviewed and summarized to evaluate the awareness and detection of traffic and obstacles when using Synthetic Vision Systems (SVS) and Enhanced Vision Systems (EVS). The study identifies the critical issues influencing the time required, accuracy, and pilot workload associated with recognizing and reacting to potential collisions or conflicts with other aircraft, vehicles and obstructions during approach, landing, and surface operations. This work considers the effect of head-down display and head-up display implementations of SVS and EVS as well as the influence of single and dual pilot operations. The influences and strategies of adding traffic information and cockpit alerting with SVS and EVS were also included. Based on this review, a knowledge gap assessment was made with recommendations for ground and flight testing to fill these gaps and hence, promote the safe and effective implementation of SVS/EVS technologies for the Next Generation Air Transportation System

  14. Overcoming the Obstacles in Promoting Hospice Palliative Care--Sharing Experiences of the Taiwan Changhua Christian Hospital.

    Science.gov (United States)

    Tsai, Pei-Yu

    2015-01-01

    Hospice palliative care for terminal patients is necessary, yet challenges are on the way worldwide. This study demonstrated that hospice palliative care has been quickly developed in Taiwan due to the support of the National Health Insurance system, the promotion by civil societies and religious groups, patient's legal right for DNR, easier access to pain killers through medical prescription, and well-planned hospice staff training programs. This paper introduces how hospice consultation is provided by a comprehensive hospice palliative team at Changhua Christian Hospital to establish trust and cooperation with the medical team, and to improve hospice-palliative care referral and utilization rates.

  15. Provision of Palliative Care in Low- and Middle-Income Countries: Overcoming Obstacles for Effective Treatment Delivery.

    Science.gov (United States)

    Hannon, Breffni; Zimmermann, Camilla; Knaul, Felicia M; Powell, Richard A; Mwangi-Powell, Faith N; Rodin, Gary

    2016-01-01

    Despite being declared a basic human right, access to adult and pediatric palliative care for millions of individuals in need in low- and middle-income countries (LMICs) continues to be limited or absent. The requirement to make palliative care available to patients with cancer is increasingly urgent because global cancer case prevalence is anticipated to double over the next two decades. Fifty percent of these cancers are expected to occur in LMICs, where mortality figures are disproportionately greater as a result of late detection of disease and insufficient access to appropriate treatment options. Notable initiatives in many LMICs have greatly improved access to palliative care. These can serve as development models for service scale-up in these regions, based on rigorous evaluation in the context of specific health systems. However, a multipronged public health approach is needed to fulfill the humane and ethical obligation to make palliative care universally available. This includes health policy that supports the integration of palliative care and investment in systems of health care delivery; changes in legislation and regulation that inappropriately restrict access to opioid medications for individuals with life-limiting illnesses; education and training of health professionals; development of a methodologically rigorous data and research base specific to LMICs that encompasses health systems and clinical care; and shifts in societal and health professional attitudes to palliative and end-of-life care. International partnerships are valuable to achieve these goals, particularly in education and research, but leadership and health systems stewardship within LMICs are critical factors that will drive and implement change. PMID:26578612

  16. Maryland Day Care Voucher System.

    Science.gov (United States)

    Hildebrand, Joan M.

    This manual was written to assist States and other governmental units wishing to replicate the Maryland Day Care Voucher Program, a system of providing child care subsidies to eligible families. Chapter I provides brief histories of day care in Maryland and that State's grant to demonstrate the viability of a day care voucher system. Chapter II…

  17. An Aerial-Ground Robotic System for Navigation and Obstacle Mapping in Large Outdoor Areas

    Directory of Open Access Journals (Sweden)

    David Zapata

    2013-01-01

    Full Text Available There are many outdoor robotic applications where a robot must reach a goal position or explore an area without previous knowledge of the environment around it. Additionally, other applications (like path planning require the use of known maps or previous information of the environment. This work presents a system composed by a terrestrial and an aerial robot that cooperate and share sensor information in order to address those requirements. The ground robot is able to navigate in an unknown large environment aided by visual feedback from a camera on board the aerial robot. At the same time, the obstacles are mapped in real-time by putting together the information from the camera and the positioning system of the ground robot. A set of experiments were carried out with the purpose of verifying the system applicability. The experiments were performed in a simulation environment and outdoor with a medium-sized ground robot and a mini quad-rotor. The proposed robotic system shows outstanding results in simultaneous navigation and mapping applications in large outdoor environments.

  18. An aerial–ground robotic system for navigation and obstacle mapping in large outdoor areas.

    Science.gov (United States)

    Garzón, Mario; Valente, João; Zapata, David; Barrientos, Antonio

    2013-01-21

    There are many outdoor robotic applications where a robot must reach a goal position or explore an area without previous knowledge of the environment around it. Additionally, other applications (like path planning) require the use of known maps or previous information of the environment. This work presents a system composed by a terrestrial and an aerial robot that cooperate and share sensor information in order to address those requirements. The ground robot is able to navigate in an unknown large environment aided by visual feedback from a camera on board the aerial robot. At the same time, the obstacles are mapped in real-time by putting together the information from the camera and the positioning system of the ground robot. A set of experiments were carried out with the purpose of verifying the system applicability. The experiments were performed in a simulation environment and outdoor with a medium-sized ground robot and a mini quad-rotor. The proposed robotic system shows outstanding results in simultaneous navigation and mapping applications in large outdoor environments.

  19. An Aerial–Ground Robotic System for Navigation and Obstacle Mapping in Large Outdoor Areas

    Science.gov (United States)

    Garzón, Mario; Valente, João; Zapata, David; Barrientos, Antonio

    2013-01-01

    There are many outdoor robotic applications where a robot must reach a goal position or explore an area without previous knowledge of the environment around it. Additionally, other applications (like path planning) require the use of known maps or previous information of the environment. This work presents a system composed by a terrestrial and an aerial robot that cooperate and share sensor information in order to address those requirements. The ground robot is able to navigate in an unknown large environment aided by visual feedback from a camera on board the aerial robot. At the same time, the obstacles are mapped in real-time by putting together the information from the camera and the positioning system of the ground robot. A set of experiments were carried out with the purpose of verifying the system applicability. The experiments were performed in a simulation environment and outdoor with a medium-sized ground robot and a mini quad-rotor. The proposed robotic system shows outstanding results in simultaneous navigation and mapping applications in large outdoor environments. PMID:23337332

  20. The Role of Rangelands in Diversified Farming Systems: Innovations, Obstacles, and Opportunities in the USA

    Directory of Open Access Journals (Sweden)

    Liz Carlisle

    2012-12-01

    Full Text Available Discussions of diversified farming systems (DFS rarely mention rangelands: the grasslands, shrublands, and savannas that make up roughly one-third of Earth's ice-free terrestrial area, including some 312 million ha of the United States. Although ranching has been criticized by environmentalists for decades, it is probably the most ecologically sustainable segment of the U.S. meat industry, and it exemplifies many of the defining characteristics of DFS: it relies on the functional diversity of natural ecological processes of plant and animal (reproduction at multiple scales, based on ecosystem services generated and regenerated on site rather than imported, often nonrenewable, inputs. Rangelands also provide other ecosystem services, including watershed, wildlife habitat, recreation, and tourism. Even where non-native or invasive plants have encroached on or replaced native species, rangelands retain unusually high levels of plant diversity compared with croplands or plantation forests. Innovations in management, marketing, incentives, and easement programs that augment ranch income, creative land tenure arrangements, and collaborations among ranchers all support diversification. Some obstacles include rapid landownership turnover, lack of accessible U.S. Department of Agriculture certified processing facilities, tenure uncertainty, fragmentation of rangelands, and low and variable income, especially relative to land costs. Taking advantage of rancher knowledge and stewardship, and aligning incentives with production of diverse goods and services, will support the sustainability of ranching and its associated public benefits. The creation of positive feedbacks between economic and ecological diversity should be the ultimate goal.

  1. Relay Placement for FSO Multihop DF Systems With Link Obstacles and Infeasible Regions

    KAUST Repository

    Zhu, Bingcheng

    2015-05-19

    Optimal relay placement is studied for free-space optical multihop communication with link obstacles and infeasible regions. An optimal relay placement scheme is proposed to achieve the lowest outage probability, enable the links to bypass obstacles of various geometric shapes, and place the relay nodes in specified available regions. When the number of relay nodes is large, the searching space can grow exponentially, and thus, a grouping optimization technique is proposed to reduce the searching time. We numerically demonstrate that the grouping optimization can provide suboptimal solutions close to the optimal solutions, but the average searching time linearly grows with the number of relay nodes. Two useful theorems are presented to reveal insights into the optimal relay locations. Simulation results show that our proposed optimization framework can effectively provide desirable solution to the problem of optimal relay nodes placement. © 2015 IEEE.

  2. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  3. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions. PMID:26016214

  4. RESIDENTIAL CARE IN THE CZECH REPUBLIC: PRESUMPTION OR OBSTACLE TO A SUCCESSFUL INTEGRATION OF YOUNG PEOPLE TO SOCIETY?

    OpenAIRE

    Štanclová Tereza; Kotrusová Miriam

    2013-01-01

    Main purpose of this article is to find out how is situation of young people leaving residential care institutions and trying to integrate to a usual life after reaching adultery. Using personal interviews with the young people (present clients of residential care, former clients, employees of the caring institutions) we try to answer questions how these young people are prepared for a normal life in a society and what are main barriers they have to overcome in order to start a new life witho...

  5. Unsatisfied basic needs of older patients in emergency care environments - obstacles to an active role in decision making.

    Science.gov (United States)

    Nydén, Kristoffer; Petersson, Martin; Nyström, Maria

    2003-03-01

    Little attention is paid in Emergency Care Units (ECUs) in Sweden to the special needs of older people. The aim of this study was thus to analyse older people's basic needs in the emergency care environment. The study was carried out with a life-world interpretative approach, and the theoretical framework for interpretation was Abraham Maslow's theory of motivation and personality. Seven informants aged between 65 and 88 years, with various experiences of being patients with urgent as well as non-urgent health-related problems, were interviewed about their experiences of ECU care. Their basic needs at the lower levels of Maslow's hierarchy were well-represented in the data. Higher needs, such as desire to know and understand, appeared to be totally neglected. Safety needs dominated the whole situation. Our conclusion is that standards of care must be developed in Sweden to make older patients feel safer and more secure in ECUs. Furthermore, the principles of nursing care for older patients need to be defined in order to encourage them to take an active part in their own health process.

  6. Trauma care system in Iran

    Institute of Scientific and Technical Information of China (English)

    Moussa Zargar; Sarah Ganji; Mahmoud Khodabandeh; Shahab Abdollahi Far; Morteza Abdollahi; Mohammad Reza Zarei; Seyed Mohammad Reza Kalantar Motamedi; Mojgan Karbakhsh; Seyed Mohammad Ghodsi; Vafa Rahimi-Movaghar; Farzad Panahi; Soheil Saadat; Ali Khaji; Seyed Mahdi Davachi

    2011-01-01

    Objective: The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to describe the current status of trauma system regarding the components and function. Methods: The current status of trauma system in all components of a trauma system was described through expert panels and semi-structured interviews with trauma specialists and policy makers.Results: Currently, various organizations are involved in prevention, management and rehabilitation of injuries,but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of public education through media, traffic regulation reinforcement,hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training standards of the front line medical team and continuing education and evaluation are yet to be addressed. Trauma registry has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance,financial resources), it is not yet established in our system of trauma care.Conclusions: It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system.

  7. 矿井机车防撞系统障碍物识别方法%Obstacle Recognition Method of Anti-collision System of Mine Locomotive

    Institute of Scientific and Technical Information of China (English)

    郭江涛

    2012-01-01

    分析了矿井机车防撞系统中车载摄像头获取的机车运行前方障碍物图像的特征,提出了近、中、远距离下的障碍物识别方法及实现流程.测试结果表明,该方法能够有效获取障碍物特征并快速识别出障碍物.%The paper analyzed characteristics of images of obstacle in front of running locomotive obtained by camera of anti-collision system of mine locomotive, and proposed recognition methods of obstacle away from the locomotive with short, middle and long distances and their realization flows. Thetesting result showed the method can obtain characteristics of obstacles validly and recognize the obstacles quickly.

  8. Trauma care system in Iran

    Directory of Open Access Journals (Sweden)

    Zargar Moussa

    2011-06-01

    Full Text Available 【Abstract】Objective: The high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to de- scribe the current status of trauma system regarding the components and function. Methods: The current status of trauma system in all components of a trauma system was described through ex- pert panels and semi-structured interviews with trauma spe- cialists and policy makers. Results: Currently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of pub- lic education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training stan- dards of the front line medical team and continuing educa- tion and evaluation are yet to be addressed. Trauma regis- try has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources, it is not yet established in our system of trauma care. Conclusions: It seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system. Key words: Emergency medical services; Trauma centers; Wounds and injuries

  9. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...... these to a discussion of future challenges in the form of an aging population, increased privatization and increased inequity...

  10. Irregular Time Dependent Obstacles

    CERN Document Server

    Lindqvist, Peter

    2010-01-01

    We study the obstacle problem for the Evolutionary p-Laplace Equation when the obstacle is discontinuous and without regularity in the time variable. Two quite different procedures yield the same solution.

  11. [Female migrants in the health care system. Health care utilisation, access barriers and health promotion strategies].

    Science.gov (United States)

    Wimmer-Puchinger, B; Wolf, H; Engleder, A

    2006-09-01

    Due to the evident interaction between social factors and health, migrants are exposed to specific risk factors and access barriers to health services. Some examples are the lower education level, the low social position and/or the insufficient language skills. This concept is further elaborated in the multi-factorial impacts of health literacy. Female migrants often experience additional discrimination because of their gender. Despite the lack of representative data, consistent studies show that female migrants do not regularly take advantage of health care prevention and present themselves with higher degrees of stress. The current "inadequate health care" manifests itself in a lack of care in the areas of prevention and health education and an abundance in the context of medication and diagnostic procedures. To meet these demands and to further reduce barriers, in particular language barriers, specific strategies for this target group involving both politics and the health care system have to be developed. Besides the employment of interpreters with a native cultural background and the distribution of information booklets, it is an important strategy to reduce structural obstacles such as cultural diversity. To contact these women in their living environment should help to increase their self-determined health promotion. Selected models of good practice in Austria with regard to the themes of FGM (female genital mutilation), violence, heart disease and breast cancer are presented to highlight the specific health situation and risk factors of female migrants as well as successful strategies to confront them. PMID:16927035

  12. [The most important obstacles of the development of Hungarian psychiatry].

    Science.gov (United States)

    Kalmár, Sándor

    2015-06-01

    A quarter of a century ago the change of the political system in Hungary precipitated a serious value-crisis and caused a lot of harmful effects in nurturing and the development of psychiatry. The author establishes that the attack against psychiatry is more intensive than previously but neither the education and health management nor the psychiatric leadership could cope with these difficulties. It can't be denied that the foundation of lifelong mental health begins in the early life years and about 75% of the first Mental Disorder manifests in adolescence and youth. We are not able to ensure the special rights of every child according to the Hungarian Constitution and the Declaration of the Rights of the Child by the United Nations. The large inequalities within the country, the lack of paramount mental education and nurturing, the lack of essential, consistent eternal values, the lack of required psychiatric care system are huge obstacles of the development of healthy individual and leads to self-destructive behaviour and several, serious physical and mental disorders. The purpose of the author is to call psychiatrists' attention to the main obstacles of the development of Hungarian Psychiatric Care System. The main obstacles of the present psychiatric care system: 1. Unclarified notions, confusion of ideas. 2. Somatic, neurologic, mental, cultural-social and spiritual ignorance. 3. Lack of organization in Mental Education and Psychiatric Care System. 4. Value-crisis in our society despite the fact that the "Council of Wise Men" created a "Scale of the Essential Consistent Eternal Values" for the Hungarian Education System in 2008. 5. Lack of mental health prevention both in education system and health care system. There is no teaching of hygiene lessons in the Hungarian schools. 6. Negligence and selfishness among the population. 7. Disinterest among competent authorities. 8. Leaving the most important possibilities out of consideration. The author establishes

  13. [The most important obstacles of the development of Hungarian psychiatry].

    Science.gov (United States)

    Kalmár, Sándor

    2015-06-01

    A quarter of a century ago the change of the political system in Hungary precipitated a serious value-crisis and caused a lot of harmful effects in nurturing and the development of psychiatry. The author establishes that the attack against psychiatry is more intensive than previously but neither the education and health management nor the psychiatric leadership could cope with these difficulties. It can't be denied that the foundation of lifelong mental health begins in the early life years and about 75% of the first Mental Disorder manifests in adolescence and youth. We are not able to ensure the special rights of every child according to the Hungarian Constitution and the Declaration of the Rights of the Child by the United Nations. The large inequalities within the country, the lack of paramount mental education and nurturing, the lack of essential, consistent eternal values, the lack of required psychiatric care system are huge obstacles of the development of healthy individual and leads to self-destructive behaviour and several, serious physical and mental disorders. The purpose of the author is to call psychiatrists' attention to the main obstacles of the development of Hungarian Psychiatric Care System. The main obstacles of the present psychiatric care system: 1. Unclarified notions, confusion of ideas. 2. Somatic, neurologic, mental, cultural-social and spiritual ignorance. 3. Lack of organization in Mental Education and Psychiatric Care System. 4. Value-crisis in our society despite the fact that the "Council of Wise Men" created a "Scale of the Essential Consistent Eternal Values" for the Hungarian Education System in 2008. 5. Lack of mental health prevention both in education system and health care system. There is no teaching of hygiene lessons in the Hungarian schools. 6. Negligence and selfishness among the population. 7. Disinterest among competent authorities. 8. Leaving the most important possibilities out of consideration. The author establishes

  14. The Spanish distribution system for oil products: an obstacle to competition?

    Energy Technology Data Exchange (ETDEWEB)

    Contin, I. [Universidad Publica de Navarra (Spain). Dpto. Gestion de Empresas; University of Njimegen (Netherlands). International Political Economy Centre; Correlje, A. [University of Rotterdam (Netherlands). Dept. of General Economy; Huerta, E. [Universidad Publica de Navarra (Spain). Dpto. Gestion de Empresas

    2001-01-01

    This paper examines why the formal liberalization of the Spanish market for automotive fuels did not introduce competition in the sector. Against the background of the transformation of the country's oil industry, it is shown how the Spanish distribution system emerged as the essential facility within the formally liberalized oil products market. 'Light-handed' regulation, in combination with the prevailing ownership structure turned the system into an impediment to newcomers' activities and to competition. This suggests that an evaluation of regulatory options for distribution systems in specific markets should take into due account crucial market characteristics like concentration and specific ownership/control relationships. (author)

  15. An Electronic System for Home Care Protocols

    OpenAIRE

    Saba, Virginia K.; Irwin, Ruth Galten

    2001-01-01

    This is demonstration of an Electronic Tracking System being implemented in several Home Health Agencies in the US. It uses the Home Health Care Classification (HHCC) System, a standardized terminology designed and developed to document patient care. The goal it to take the coded data to design the Electronic Tracking System as a method for predicting resource requirements, tracking care needs, and measuring the outcomes of the care.

  16. Robotic-Vehicle Perception Control For Detecting Obstacles

    Science.gov (United States)

    Grandjean, Pierrick C.; Matthies, Larry H.

    1995-01-01

    Obstacle-detection systems designed to make most of limited data-processing resources. Bump or step identified, from stereoscopic images of scene ahead, by obstacle-detection algorithm. If bump or step exceeds specified step height, marked as obstacle, and control actions taken to avoid obstacle.

  17. Trauma care systems in Spain.

    Science.gov (United States)

    Queipo de Llano, E; Mantero Ruiz, A; Sanchez Vicioso, P; Bosca Crespo, A; Carpintero Avellaneda, J L; de la Torre Prado, M V

    2003-09-01

    Trauma care systems in Spain are provided by the Nacional Health Service in a decentralized way by the seventeen autonomous communities whose process of decentralization was completed in January 2002. Its organisation is similar in all of them. Public sector companies of sanitary emergencies look after the health of citizens in relation to medical and trauma emergencies with a wide range of up to date resources both technical and human. In the following piece there is a description of the emergency response teams divided into ground and air that are responsible for the on site care of the patients in coordination with other public services. They also elaborate the prehospital clinical history that is going to be a valuable piece of information for the teams that receive the patient in the Emergency Hospital Unit (EHU). From 1980 to 1996 the mortality rate per 10.000 vehicles and the deaths per 1.000 accidents dropped significantly: in 1980 6.4 and 96.19% and in 1996, 2.8 and 64.06% respectively. In the intrahospital organisation there are two differentiated areas to receive trauma patients the casualty department and the EHU. In the EHU the severe and multiple injured patients are treated by the emergency hospital doctors; first in the triage or resuscitation areas and after when stabilised they are passed too the observation area or to the Intensive Care Unit (ICU) and from there the EHU or ICU doctors call the appropriate specialists. There is a close collaboration and coordination between the orthopaedic surgeon the EHU doctors and the other specialists surgeons in order to comply with treatment prioritization protocols. Once the patient has been transferred an entire process of assistance continuity is developed based on interdisciplinary teams formed in the hospital from the services areas involved in trauma assistance and usually coordinated by the ICU doctors. There is also mentioned the assistance registry of trauma patients, the ICU professional training

  18. Obstáculos da atenção farmacêutica no Brasil Obstacles of the pharmaceutical care in Brazil

    Directory of Open Access Journals (Sweden)

    Andrezza Beatriz Oliveira

    2005-12-01

    increasing the efficiency of medical treatment, as well as the detection of medicine-related problems. It consists in a practice that has being gradually applied in pharmacies of several regions of Brazil, and faces several difficulties for this, in part due to the lack of knowledge and preparation of our professionals, as well as certain rejection from the owners of the pharmacies. In this context, a research with participative characteristic was carried out, by means of interview with open questions to pharmacists and pharmacy owners and/or managers of Curitiba city, in which there were interaction of ideas, in order to establish an exchange of information about the subject. The results confirmed that the implantation of Pharmaceutical Care faces obstacles that include the link of the professional to the pharmacy and the rejection of the program by managers and owners of pharmacies, due to the high content of daily work and lack of time to dedicate to the service, besides the competition of sellers that seek commission on sales. It's observed the need of a way to stimulate the professional actuation, mainly among students and recently graduated professionals. This can represent the first step towards the success of Pharmaceutical Care and opening from the entrepreneurs, once the population starts to recognize the importance of the work provided by the pharmacist.

  19. Reforms of health care system in Romania

    NARCIS (Netherlands)

    Bara, AC; van den Heuvel, WJA; Maarse, JAM; Bara, Ana Claudia; Maarse, Johannes A.M.

    2002-01-01

    Aim. To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. Method. We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of th

  20. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals. PMID:27382731

  1. The teaching of French in the French educational system: Obstacle or way to promote the plurilingualism of pupils?

    Directory of Open Access Journals (Sweden)

    Michael Rigolot

    2011-01-01

    Full Text Available This paper proposes an in-depth on the legal and educational linguistic policy of  the state that affect the everyday practice school French students. The allied French academic culture to the  school culture are articulated to serve the construction of republican citizenship. This ideological construction, political and cultural affects students entering the use of  French particularities (phonetic, semiotic or symbolic... of its cultural, social status or family origin. From a historical and legislative perspective the authors address the orientation of the teaching of French in the educational system as an obstacle to the integration of groups of  students who do not fit the narrow linguistic-political patterns that the system imposes. And finally, from an applied perspective, explores the factors that can lead to the breakdown of  monolingual system, moreover, is articulated as a cultural system of segregation and exclusion of class.Este artículo propone una reflexión en profundidad sobre las consecuencias jurídicas y pedagógicas de la política lingüística del estado que afectan en la práctica cotidiana escolar al alumnado francés. La cultura académica francesa aliada con la cultura escolar se articulan al servicio de la construcción de la ciudadanía republicana. Esta construcción ideológica, política y cultural afecta a los estudiantes que incorporan al uso de la lengua francesa particularidades propias (fonéticas, semióticas, simbólicas ... de su entorno cultural, social o de su origen familiar. Desde una perspectiva histórica y legislativa los autores abordan la orientación de la enseñanza de la lengua francesa en el sistema educativo como un obstáculo para la integración de los grupos de alumnado que no se ajustan a los estrechos patrones linguístico-políticos que el sistema impone. Y por último, desde una perspectiva aplicada, exploran los factores que pueden desembocar en la ruptura del

  2. Optimal obstacle control problem

    Institute of Scientific and Technical Information of China (English)

    ZHU Li; LI Xiu-hua; GUO Xing-ming

    2008-01-01

    In the paper we discuss some properties of the state operators of the optimal obstacle control problem for elliptic variational inequality. Existence, uniqueness and regularity of the optimal control problem are established. In addition, the approximation of the optimal obstacle problem is also studied.

  3. DIFFERENTIAL SOIL IMPEDANCE OBSTACLE DETECTION

    Energy Technology Data Exchange (ETDEWEB)

    Maximillian J. Kieba

    2002-08-30

    This project develops a new and unique obstacle detection sensor for horizontal directional drilling (HDD) equipment. The development of this new technology will greatly improve the reliability and safety of natural gas HDD construction practices. This sensor utilizes a differential soil impedance measurement technique that will be sensitive to the presence of plastic and ceramic, as well as metallic obstacles. The use of HDD equipment has risen significantly in the gas industry because HDD provides a much more cost-effective and less disruptive method for gas pipe installation than older, trenching methods. However, there have been isolated strikes of underground utilities by HDD equipment, which may have been avoided if methods were available to detect other underground obstacles when using HDD systems. GTI advisors from the gas industry have ranked the value of solving the obstacle detection problem as the most important research and development project for GTI to pursue using Federal Energy Regulatory Commission (FERC) funds available through its industry partner, GRI. GTI proposes to develop a prototype down-hole sensor system that is simple and compact. The sensor utilizes an impedance measurement technique that is sensitive to the presence of metallic or nonmetallic objects in the proximity of the HDD head. The system will use a thin film sensor conformal with the drill head. The impedance of the soil will be measured with a low frequency signal injected through the drill head itself. A pair of bridge type impedance sensors, mounted orthogonal to one another, is capacitively coupled to the soil. Inclusions in the soil will cause changes to the sensor balance distinguishable from homogeneous soil. The sensor will provide range and direction data for obstacles near the HDD head. The goal is to provide a simple, robust system that provides the information required to avoid obstacles. This must be done within the size and ruggedness constraints of the HDD

  4. Care credits in the British pension system

    OpenAIRE

    Vlachantoni, Athina

    2009-01-01

    The paper is a brief outline of the first stage of a comparative research project in the role and adequacy of care credits in the British and German pension systems. The provision of care credits has been an essential part of pension reforms around Europe, which significantly changes the prospects of carers to accumulate adequate pension contributions through their life course. But although the policy significance of care credits is due to rise in line with an increasing demand...

  5. Research on BIM Application Obstacles and Evaluation System of Owner%业主方BIM应用障碍及评价体系研究

    Institute of Scientific and Technical Information of China (English)

    杨冬梅; 董娜

    2016-01-01

    BIM技术的应用,业主方是最大的获益者,但是BIM技术的推广普及仍存在很多阻碍。首先基于现阶段国内业主方BIM技术应用情况,分析BIM技术的自主型应用障碍,然后以应用障碍为影响因子,提出BIM应用评价体系,以期对业主方BIM应用有一定的借鉴作用。%Owner are the biggest beneficiaries in the application of BIM technology. However,there are still many obstacles in the application and popularization of BIM. First,analyzes the BIM application obstacles of owner according to the present domestic situation. Then,puts forward the evaluation system that make application obstacles as influence factors,in order to provide reference for the BIM application of owner.

  6. Laser-Based Obstacle Detection at Railway Level Crossings

    OpenAIRE

    Vítor Amaral; Francisco Marques; André Lourenço; José Barata; Pedro Santana

    2016-01-01

    This paper presents a system for obstacle detection in railway level crossings from 3D point clouds acquired with tilting 2D laser scanners. Although large obstacles in railway level crossings are detectable with current solutions, the detection of small obstacles remains an open problem. By relying on a tilting laser scanner, the proposed system is able to acquire highly dense and accurate point clouds, enabling the detection of small obstacles, like rocks laying near the rail. During an off...

  7. Financial management in leading health care systems.

    Science.gov (United States)

    Smith, D G; Wheeler, J R; Rivenson, H L; Reiter, K L

    2000-01-01

    To understand better the financial management practices and strategies of modern health care organizations, we conducted interviews with chief financial officers (CFOs) of several leading health care systems. In this introduction, we present an overview of the project and summary responses on corporate financial structures and strategic challenges facing CFOs. PMID:10845383

  8. Breaching in light obstacles

    Directory of Open Access Journals (Sweden)

    Marius Moldovan

    2015-09-01

    Full Text Available Breaching in light obstacles consists in making openings in the non-structural elements of a building with the view to enabling quick access in emergency cases. The light barriers under scrutiny throughout the current paper stand for walls of brick or concrete masonry units, reinforced concrete walls with thicknesses up to 12.5 cm and metal doors. To create breaches, two different kinds of special explosive devices were used, according to the obstacle: cutting and pushing charges. The subject is looked into from two complementary perspectives, that is, the first approach regards the technical solutions of breaching in light obstacles, whereas the latter is concerned with the protection of the emergency team and people to be rescued. The paper under consideration addresses the overall findings of the experimental research regarding breaching in light obstacles based on the above-mentioned perspectives.

  9. The Italian health-care system.

    Science.gov (United States)

    France, George; Taroni, Francesco; Donatini, Andrea

    2005-09-01

    Italy's national health service is statutorily required to guarantee the uniform provision of comprehensive care throughout the country. However, this is complicated by the fact that, constitutionally, responsibility for health care is shared between the central government and the 20 regions. There are large and growing differences in regional health service organisation and provision. Public health-care expenditure has absorbed a relatively low share of gross domestic product, although in the last 25 years it has consistently exceeded central government forecasts. Changes in payment systems, particularly for hospital care, have helped to encourage organisational appropriateness and may have contributed to containing expenditure. Tax sources used to finance the Servizio Sanitario Nazionale (SSN) have become somewhat more regressive. The limited evidence on vertical equity suggests that the SSN ensures equal access to primary care but lower income groups face barriers to specialist care. The health status of Italians has improved and compares favourably with that in other countries, although regional disparities persist.

  10. Capital structure strategy in health care systems.

    Science.gov (United States)

    Wheeler, J R; Smith, D G; Rivenson, H L; Reiter, K L

    2000-01-01

    The capital structures (the relative use of debt and equity to support assets) of leading health care systems are viewed as a strategic component of their financial plans. While not-for-profit hospitals as a group have maintained nearly constant levels of debt over the past decade, investor-owned hospitals and a group of leading health care systems have reduced their relative use of debt. Chief financial officers indicated that in addition to reducing debt because of less favorable reimbursement incentives, there was a focus on maintaining high bond ratings. Debt levels have not been reduced as sharply in these health care systems as they have in investor-owned hospitals, in part due to the use of debt to support investments in financial markets. Because these health care systems do not have easy access to equity, high bond ratings and solid investment earnings are central to their capital structure policies of preserving access to debt markets.

  11. Health Care Information System (HCIS) Data File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data was derived from the Health Care Information System (HCIS), which contains Medicare Part A (Inpatient, Skilled Nursing Facility, Home Health Agency (Part A...

  12. Compétences en santé déficientes: obstacle à une prise en charge optimale [Low health literacy: barrier to optimal care].

    OpenAIRE

    Zenklusen S.; Bischoff T.; Panese F.; Bodenmann P.

    2012-01-01

    Les carences en compétences en santé touchent principalement certaines populations à risques en limitant l'accès aux soins, l'interaction avec les soignants et l'autoprise en charge. L'utilisation systématique d'instruments de dépistage n'est pas recommandée et les interventions préconisées en pratique consistent plutôt à diminuer les obstacles entravant la communication patient-soignant. Il s'agit d'intégrer non seulement les compétences de la population en matière de santé mais aussi les co...

  13. 小型环境检测轮式机器人的避障控制系统研究%Research on Obstacle Avoidance Control System for Small Scale Environment Detection Wheeled Robot

    Institute of Scientific and Technical Information of China (English)

    谭苗苗; 于路路; 王静

    2016-01-01

    In the complex space environment, the robot should have the function of intelligent obstacle avoidance, which can realize the automatic identification and avoid obstacles, and environment detection with safe and reliability. The hardware and software of the obstacle avoidance control system are constructed by using the ultrasonic sensor as the obstacle perception device and the single chip microcomputer as the control core. Aiming at different sizes of obstacles, two kinds of obstacle avoidance modes are realized by hardware layout and algorithm programming. Finally the automatic obstacle avoidance for small wheeled robot is realized.%环境检测的轮式机器人应具备智能避障功能,在复杂的空间环境中实现自动识别和躲避障碍物,安全可靠地完成环境检测任务。采用超声波传感器为障碍感知器件,以单片机为控制核心搭建了避障控制系统的软硬件。针对障碍物尺寸的不同,通过硬件布置和算法编程实现了两种避障模式。最终实现了小型轮式机器人的自动避障运行。

  14. The chinese health care system

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter Raahave; Yu, Yi

    2011-01-01

    We describe the structure and present situation of the Chinese healthcare system and discuss its primary problems and challenges. We discuss problems with inefficient burden sharing, adverse provider incentives and huge inequities, and seek explanations in the structural features of the Chinese h...... healthcare system. The current situation will be further challenged in the future by an aging population, an increasing need for privatization and growing expectations about quality of healthcare....

  15. Permanency and the Foster Care System.

    Science.gov (United States)

    Lockwood, Katie K; Friedman, Susan; Christian, Cindy W

    2015-10-01

    Each year over 20,000 youth age out of the child welfare system without reaching a permanent placement in a family. Certain children, such as those spending extended time in foster care, with a diagnosed disability, or adolescents, are at the highest risk for aging out. As young adults, this population is at and increased risk of incarceration; food, housing, and income insecurity; unemployment; educational deficits; receipt of public assistance; and mental health disorders. We reviewed the literature on foster care legislation, permanency, outcomes, and interventions. The outcomes of children who age out of the child welfare system are poor. Interventions to increase permanency include training programs for youth and foster parents, age extension for foster care and insurance coverage, an adoption tax credit, and specialized services and programs that support youth preparing for their transition to adulthood. Future ideas include expanding mentoring, educational support, mental health services, and post-permanency services to foster stability in foster care placements and encourage permanency planning. Children in the child welfare system are at a high risk for physical, mental, and emotional health problems that can lead to placement instability and create barriers to achieving permanency. Failure to reach the permanency of a family leads to poor outcomes, which have negative effects on the individual and society. Supporting youth in foster care throughout transitions may mediate the negative outcomes that have historically followed placement in out-of-home care. PMID:26403649

  16. Comprehensive care in systemic sclerosis

    NARCIS (Netherlands)

    Schouffoer, Anne-Marie Adriana

    2014-01-01

    Patients with Systemic Sclerosis have to cope with an uncertain disease course, varying impact on physical functioning and limited treatment options. There is increasing acknowledgement of the psychological burden that this entails, however, from a medical point of view, the impact of a disease is o

  17. 基于ARM的智能避障小车设计%Design of an Obstacle Avoidance System for Intelligent Carriage Based on ARM

    Institute of Scientific and Technical Information of China (English)

    黄鹏勇

    2014-01-01

    避障是智能小车应具备的基本功能之一,以s3c44b0x芯片为核心,采集前方障碍信息并对智能小车进行控制,选用红外避障传感器检测智能小车前方的障碍物,设计了智能小车的自动避障系统,并阐述其工作原理。本系统设计简单、成本低、实时性好,在室内环境中取得了预期的实验结果,能使智能小车无碰撞到达目的地。%The obstacle avoidance is one of the main functions that an independently intelligent carriage should provide. The intelligent carriage uses ARM chip s3c44b0x as the key component to collect the front environmental information and control the intelligent carriage, chooses infrared obstacle avoidance sensors to detect the barriers in front of the intelligent carriage and the barriers. The system features simple design, lower cost and better real time. At the same time, this system has obtained anticipated experimental results in the indoor environment. That is for the intelligent carriage to arrive the destination without any collision.

  18. Obstacle mean-field game problem

    KAUST Repository

    Gomes, Diogo A.

    2015-01-01

    In this paper, we introduce and study a first-order mean-field game obstacle problem. We examine the case of local dependence on the measure under assumptions that include both the logarithmic case and power-like nonlinearities. Since the obstacle operator is not differentiable, the equations for first-order mean field game problems have to be discussed carefully. Hence, we begin by considering a penalized problem. We prove this problem admits a unique solution satisfying uniform bounds. These bounds serve to pass to the limit in the penalized problem and to characterize the limiting equations. Finally, we prove uniqueness of solutions. © European Mathematical Society 2015.

  19. Apparatus for obstacle traversion

    Science.gov (United States)

    Borenstein, Johann

    2004-08-10

    An apparatus for traversing obstacles having an elongated, round, flexible body that includes a plurality of drive track assemblies. The plurality of drive track assemblies cooperate to provide forward propulsion wherever a propulsion member is in contact with any feature of the environment, regardless of how many or which ones of the plurality of drive track assemblies make contact with such environmental feature.

  20. Obstacles to Laser Safety

    Energy Technology Data Exchange (ETDEWEB)

    Barat, K

    2005-04-25

    The growth of laser development & technology has been remarkable. Unfortunately, a number of traps or obstacles to laser safety have also developed with that growth. The goal of this article is to highlight those traps, in the hope that an aware laser user will avoid them. These traps have been the cause or contributing factor of many a preventable laser accident.

  1. Evaluation of Ambulatory Care Information Systems

    OpenAIRE

    Simborg, Donald W.; Whiting-O'Keefe, Quinn E.

    1980-01-01

    The central purpose of an ambulatory care information system is to communicate information to the practitioner to facilitate clinical decision making. The clinical decision can be considered the dependent output variable in a process having the information system, the patient, clinician characteristics, and the environment as the independent input variables. Evaluation approaches using patient outcomes are problematic because of the indirect relationship between the information system and pat...

  2. Application of database systems in diabetes care.

    Science.gov (United States)

    Kopelman, P G; Sanderson, A J

    1996-01-01

    The St Vincent Declaration includes a commitment to continuous quality improvement in diabetes care. This necessitates the collection of appropriate information to ensure that diabetes services are efficient, effective and equitable. The quantity of information, and the need for rapid access, means that this must be computer-based. The choice of architecture and the design of a database for diabetes care must take into account available equipment and operational requirements. Hardware topology may be determined by the operating system and/or netware software. An effective database system will include: user-friendliness, rapid but secure access to data, a facility for multiple selections for analysis and audit, the ability to be used as part of the patient consultation process, the ability to interface or integrate with other applications, and cost efficiency. An example of a clinical information database for diabetes care, Diamond, is described. PMID:9244825

  3. Child Poverty and the Health Care System.

    Science.gov (United States)

    Racine, Andrew D

    2016-04-01

    The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty. PMID:27044708

  4. Care of the elderly persons in the system of social protection in the Republic of Srpska

    Directory of Open Access Journals (Sweden)

    Lepir Ljubo

    2010-01-01

    Full Text Available The number of the elderly in the overall population is increasing, which poses a need to seek an adequate model of organizing social care of the elderly. Most of them get social safety through the social welfare system. A functional and sustainable social welfare system requires application of efficient management and technique models based on the theoretical premises of contemporary management. The role and the importance of old people's protection in a social welfare system is becoming a topic of great importance both for theoreticians and the practitioners in the social sector area. This research analyzes the management functions and the roles of managers in running social protection of the elderly in the example of the social welfare system in the Republic of Srpska. A decentralized system, such as the one existing in the Republic of Srpska, brings along a number of organizational problems which points out to a need to apply the theoretical bases of managerial processes. The results obtained via empirical analyses indicate a number of deficiencies and obstacles in the implementation of social protection of the elderly in the social welfare system of the Republic of Srpska which are result of the insufficient and inconsistent application of the basic managerial elements. The obstacles emerging from this analysis indicate that there are chances and opportunities to improve the system and enhance the development of new forms of protection by applying managerial theories. .

  5. A Robust Obstacle Avoidance for Service Robot Using Bayesian Approach

    Directory of Open Access Journals (Sweden)

    Widodo Budiharto

    2011-03-01

    Full Text Available The objective of this paper is to propose a robust obstacle avoidance method for service robot in indoor environment. The method for obstacles avoidance uses information about static obstacles on the landmark using edge detection. Speed and direction of people that walks as moving obstacle obtained by single camera using tracking and recognition system and distance measurement using 3 ultrasonic sensors. A new geometrical model and maneuvering method for moving obstacle avoidance introduced and combined with Bayesian approach for state estimation. The obstacle avoidance problem is formulated using decision theory, prior and posterior distribution and loss function to determine an optimal response based on inaccurate sensor data. Algorithms for moving obstacles avoidance method proposed and experiment results implemented to service robot also presented. Various experiments show that our proposed method very fast, robust and successfully implemented to service robot called Srikandi II that equipped with 4 DOF arm robot developed in our laboratory.

  6. Introducing variable-step topography (VST) coordinates within dynamically constrained nonhydrostatic modeling system (NMS). Part 2: VST performance on orthodox obstacle flows

    Science.gov (United States)

    Tripoli, Gregory J.; Smith, Eric A.

    2014-06-01

    In this second part of a two-part sequence of papers, the performance metrics and quantitative advantages of a new VST surface coordinate system, implemented within a dynamically constrained, nonhydrostatic, cloud mesoscale atmospheric model, are evaluated in conjunction with seven orthodox obstacle flow problems. [The first part presented a full formulation of the VST model, prefaced by a description of the framework of the newly re-tooled nonhydrostatic modeling system (NMS) operating within integral constraints based on the conservation of the foremost quantities of mass, energy and circulation.] The intent behind VST is to create a vertical surface coordinate system boundary underpinning a nonhydrostatic atmosphere capable of reliable simulations of flows over both smooth and steep terrain without sacrificing dynamical integrity over either type of surface. Model simulation results are analyzed for six classical fluid dynamics problems involving flows relative to obstacles with known analytical or laboratory-simulated solutions, as well as for a seventh noteworthy mountain wave breaking problem that has well-studied numerical solutions. For cases when topography becomes excessively severe or poorly resolved numerically, atmospheric models using transform (terrain-following) coordinates produce noteworthy errors rendering a stable integration only if the topography is smoothed. For cases when topography is slowly varying (smooth or subtle), models using discrete-step coordinates also produce noteworthy errors relative to known solutions. Alternatively, the VST model demonstrates that both limitations of the two conventional approaches, for the entire range of slope severities, can be overcome. This means that VST is ideally suited for a scalable, nonhydrostatic atmospheric model, safeguarded with physically realistic dynamical constraints.

  7. Statistics of dislocation pinning at localized obstacles

    Science.gov (United States)

    Dutta, A.; Bhattacharya, M.; Barat, P.

    2014-10-01

    Pinning of dislocations at nanosized obstacles like precipitates, voids, and bubbles is a crucial mechanism in the context of phenomena like hardening and creep. The interaction between such an obstacle and a dislocation is often studied at fundamental level by means of analytical tools, atomistic simulations, and finite element methods. Nevertheless, the information extracted from such studies cannot be utilized to its maximum extent on account of insufficient information about the underlying statistics of this process comprising a large number of dislocations and obstacles in a system. Here, we propose a new statistical approach, where the statistics of pinning of dislocations by idealized spherical obstacles is explored by taking into account the generalized size-distribution of the obstacles along with the dislocation density within a three-dimensional framework. Starting with a minimal set of material parameters, the framework employs the method of geometrical statistics with a few simple assumptions compatible with the real physical scenario. The application of this approach, in combination with the knowledge of fundamental dislocation-obstacle interactions, has successfully been demonstrated for dislocation pinning at nanovoids in neutron irradiated type 316-stainless steel in regard to the non-conservative motion of dislocations. An interesting phenomenon of transition from rare pinning to multiple pinning regimes with increasing irradiation temperature is revealed.

  8. Consumer-Centered, Collaborative, and Comprehensive Care: The Core Essentials of Recovery-Oriented System of Care.

    Science.gov (United States)

    DiClemente, Carlo C; Norwood, Amber E Q; Gregory, W Henry; Travaglini, Letitia; Graydon, Meagan M; Corno, Catherine M

    2016-01-01

    Recovery from substance abuse and mental health disorders represents a journey through which individuals move beyond treatment of provider-identified problems toward a path of achieving wellness and productive lives. Overcoming obstacles and barriers encountered along the recovery process, individuals reveal their own strengths and resilience necessary to cope, survive, and thrive in the face of adversity. Recovery-oriented system of care (ROSC) is a framework designed to address the multidimensional nature of recovery by creating a system for coordinating multiple systems, services, and supports that are person centered and build on the strengths and resiliencies of individuals, families, and communities. As is common knowledge among substance abuse and mental health providers, consumers often present with high rates of comorbidity, which complicates care. In addition, behavioral health consumers engage in risky health behaviors (e.g., smoking) at a disproportionate rate, which places them at increased risk for developing noncommunicable diseases. ROSCs are ideal for addressing the complicated and varied needs of consumers as they progress toward wellness. The challenges of creating an ROSC framework that is effective, efficient, and acceptable to consumers is formidable. It requires change on the part of agencies, organizations, providers, and consumers. The importance of comprehensive, integrated screening is highlighted as a critical component of ROSC. Key suggestions for initiating ROSC are offered. PMID:27272993

  9. Toward a 21st-century health care system: Recommendations for health care reform

    NARCIS (Netherlands)

    K. Arrow (Kenneth); A. Auerbach (Alan); J. Bertko (John); L.P. Casalino (Lawrence Peter); F.J. Crosson (Francis); A. Enthoven (Alain); E. Falcone; R.C. Feldman; V.R. Fuchs (Victor); A.M. Garber (Alan); M.R. Gold (Marthe Rachel); D.A. Goldman; G.K. Hadfield (Gillian); M.A. Hall (Mark Ann); R.I. Horwitz (Ralph); M. Hooven; P.D. Jacobson (Peter); T.S. Jost (Timothy Stoltzfus); L.J. Kotlikoff; J. Levin (Jonathan); S. Levine (Sharon); R. Levy; K. Linscott; H.S. Luft; R. Mashal; D. McFadden (Daniel); D. Mechanic (David); D. Meltzer (David); J.P. Newhouse (Joseph); R.G. Noll (Roger); J.B. Pietzsch (Jan Benjamin); P. Pizzo (Philip); R.D. Reischauer (Robert); S. Rosenbaum (Sara); W. Sage (William); L.D. Schaeffer (Leonard Daniel); E. Sheen; B.N. Silber (Bernie Michael); J. Skinner (Jonathan Robert); S.M. Shortell (Stephen); S.O. Thier (Samuel); S. Tunis (Sean); L. Wulsin Jr.; P. Yock (Paul); G.B. Nun; S. Bryan (Stirling); O. Luxenburg (Osnat); W.P.M.M. van de Ven (Wynand); J. Cooper (Jim)

    2009-01-01

    textabstractThe coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a

  10. Hospital System Readmissions: A Care Cycle Approach

    Directory of Open Access Journals (Sweden)

    Cody Mullen

    2012-01-01

    Full Text Available Hospital readmission rates can be used as an indicator of the quality of health care services and can highlight high-priority research areas to ensure better health. A readmission is defined as when a patient is discharged from an acute care hospital and is admitted back to an acute care hospital in a set amount of days, with 30 days being the current national standard. On average, 19.6% of Medicare patients are readmitted to the hospital within 30 days of discharge and 56.1% within a year (Jencks, Williams, & Coleman, 2009. The hypothesis of this study was that the discharge location, or where a patient went immediately after discharge, would not have a significant effect on readmissions. A data set with all admission records was obtained from a major health provider. These data contain all hospital patients’ demographic and diagnosis information. General, women’s, and children’s hospitals were looked at from a system perspective to study the discharge location of patients as well as the effects of patient demographics on discharge location. By using a z-significance test in Microsoft Excel and SAS 9.2, it was discovered that patients discharged to home have a significantly lower likelihood of readmission. Generally, patients who are discharged to an extended care or intermediate care facility or patients with home health carerelated services had a significantly higher likelihood of being readmitted. The findings may indicate a possible need for an institution-to-institution intervention as well as institution-to-patient intervention. Future work will develop potential interventions in partnership with hospital staff.

  11. Bellco Formula Domus Home Care System.

    Science.gov (United States)

    Trewin, Elizabeth

    2004-01-01

    There are certain characteristics in a dialysis machine that would be desirable for use in home and limited care environments. These features relate to safety, ease of use, consideration of physical space, and reliability. The Bellco Formula Domus Home Care System was designed to meet all these requirements. Bellco's philosophy of patient treatment centers on global biocompatibility. This is evident in the design of the Formula Domus Home Care System. It has the smallest hydraulic fluid pathway of any dialysis machine on the market. Formula is capable of preparing ultrapure dialysate. The ultrafiltration measurement mechanism, the patented Coriolis flow meter, measures the mass of the dialysate, not the volume. For this reason it is the only dialysis machine that detects actual backfiltration, not just the theoretical possibility of it based on transmembrane pressure. The Coriolis flow meter also ensures that dialysate flow is a true single pass. The operator interface is a single window operating control. It is possible to select up to 14 different languages. There is an online help key to assist patients with troubleshooting. Programmable start-up and shutdown times save time for the patient. Formula is the only dialysis machine to offer a backup battery feature. Formula is capable of communicating with any software available. The focus on global biocompatibility ensures the best quality dialysis treatments for a population of patients who will likely remain on dialysis for a longer period of time than conventional dialysis patients. PMID:15043621

  12. Reciprocally-Rotating Velocity Obstacles

    KAUST Repository

    Giese, Andrew

    2014-05-01

    © 2014 IEEE. Modern multi-agent systems frequently use highlevel planners to extract basic paths for agents, and then rely on local collision avoidance to ensure that the agents reach their destinations without colliding with one another or dynamic obstacles. One state-of-the-art local collision avoidance technique is Optimal Reciprocal Collision Avoidance (ORCA). Despite being fast and efficient for circular-shaped agents, ORCA may deadlock when polygonal shapes are used. To address this shortcoming, we introduce Reciprocally-Rotating Velocity Obstacles (RRVO). RRVO generalizes ORCA by introducing a notion of rotation for polygonally-shaped agents. This generalization permits more realistic motion than ORCA and does not suffer from as much deadlock. In this paper, we present the theory of RRVO and show empirically that it does not suffer from the deadlock issue ORCA has, permits agents to reach goals faster, and has a comparable collision rate at the cost of performance overhead quadratic in the (typically small) user-defined parameter δ.

  13. Seamless health care for chronic diseases in a dual health care system: managed care and the role of family physicians.

    Science.gov (United States)

    Lee, A

    1998-01-01

    Neither private nor state run health care systems are perfect. Although there is increasing evidence that Health Maintenance Organizations (HMOs) provide comparable care at lower cost, HMOs tend to select healthy patients. The dual health care system in Hong Kong spends about 3.9 per cent of GDP, with health indices among the best in the world. Hong Kong still faces the problem of escalating health care expenditure. One should take advantage of the dual health care system to evolve a new paradigm for a primary-led seamless health care service. The Diabetes Centre of a university teaching hospital together with the University of Community and Family Medicine has started a structured shared care programme in diabetes mellitus, involving general practitioners in both the private and public sectors integrating the primary and secondary care, and the private and public sectors. This programme starts to develop an infrastructure for providing quality care at an affordable cost for a large pool of patients with chronic disease. Unlike other "managed care schemes", this one is not run by profit-oriented companies, but by health professionals with an interest in providing best possible care at an affordable cost. The "disease management" approach needs a care delivery system without traditional boundaries; and a continuous improvement process which develops and refines the knowledge base, guidelines and delivery system. PMID:10351265

  14. The Taiwanese health care system under efficiency scrutiny

    OpenAIRE

    Schreyögg, Jonas

    2004-01-01

    This thesis describes the status quo of the Taiwanese health care system in the year 2000, 5 years after the reforms, analyses the economic efficiency of single components of the new health care system and searches for possible solutions to solve uncovered problems. For a better understanding of the Taiwanese health care system, the economic, political and demographic environment is described first of all. Although the Taiwanese economy developed rapidly, the health care system was still look...

  15. Communicating to promote justice in the modern health care system.

    Science.gov (United States)

    Kreps, G L

    1996-01-01

    The systemic prejudices and biases that often limit the effectiveness of health care delivery are examined. How the inherent imbalance in control between consumers and providers of health care, based on the micropolitics of sharing relevant health information, perpetuates a system of marginalization and alienation within health care delivery systems is discussed. Communication barriers that often confront many stigmatized groups of health care consumers, such as the poor, people with AIDS, minorities, the ill elderly, and women, are identified. Such prejudicial treatment is framed within a cultural ideologies model, leading to identification of communication strategies for promoting justice in the modern health care system and enhancing the quality of health care delivery.

  16. Evolving Systems of Care with Total Clinical Outcomes Management

    Science.gov (United States)

    Lyons, John S.; Epstein, Richard A.; Jordan, Neil

    2010-01-01

    The current article proposes that further specification of the system of care concept is required. Based on the assertions that the system of care concept (a) refers to an ideal as opposed to an observable phenomenon, and (b) is engaged in offering transformational experiences, the authors propose that the system of care definition must be…

  17. Corruption in health-care systems and its effect on cancer care in Africa.

    Science.gov (United States)

    Mostert, Saskia; Njuguna, Festus; Olbara, Gilbert; Sindano, Solomon; Sitaresmi, Mei Neni; Supriyadi, Eddy; Kaspers, Gertjan

    2015-08-01

    At the government, hospital, and health-care provider level, corruption plays a major role in health-care systems in Africa. The returns on health investments of international financial institutions, health organisations, and donors might be very low when mismanagement and dysfunctional structures of health-care systems are not addressed. More funding might even aggravate corruption. We discuss corruption and its effects on cancer care within the African health-care system in a sociocultural context. The contribution of high-income countries in stimulating corruption is also described. Corrupt African governments cannot be expected to take the initiative to eradicate corruption. Therefore, international financial institutions, health organisations, and financial donors should use their power to demand policy reforms of health-care systems in Africa troubled by the issue of corruption. These modifications will ameliorate the access and quality of cancer care for patients across the continent, and ultimately improve the outcome of health care to all patients.

  18. [Health care systems and impossibility theorems].

    Science.gov (United States)

    Penchas, Shmuel

    2004-02-01

    Health care systems, amongst the most complicated systems that serve mankind, have been in turmoil for many years. They are characterized by widespread dissatisfaction, repeated reforms and a general perception of failure. Is it possible that this abominable situation derives from underlying causes, which are inherent to the most basic elements of these systems? Those elements compromise the use of words and definitions in the formulation of their principles and their way of action, in their logical structure as well as in the social order in which they exist. An in-depth investigation of these elements raises findings that may negate the basic feasibility of the success of such complex systems, as currently known in the western world. One of the main elements of the democratic regime is its system of decision/choice making, i.e. the majority vote. But, already in the nineteenth century, it was discovered that a majority was an intransitive ordering and did not produce a consistent definition of a preference. The Marquis of Condorcet in his famous 1785 "Essai sur l'application de l'analyse a la probabilite des decisions rendues a la plurite des voix", clearly demonstrated that majority decisions might lead to intransitivity and an indeterminancy in social choices. On the basis of his discoveries, it was later shown that legislative rules may lead to the choice of a proposal that is actually opposed by the majority, or to a deadlock and therefore, to socially undesirable implications. Subsequent to these theories of Condorcet, which became known as "The Paradox of Condorcet", many papers were published in the 19th and 20th centuries regarding the issue of problems dealing with individual preferences leading to social order--a complex procedure of, amongst others, aggregation in a defined axiomatic framework. During the twentieth century it became astoundingly manifest that certain issues, although correctly attacked logically, could not be resolved. Two such famous

  19. Midwives and obstetric nurses in the Brazilian Unified Health System and Primary Health Care: for a systemic and progressive incorporation

    Directory of Open Access Journals (Sweden)

    Armando Henrique Norman

    2015-03-01

    Full Text Available The objective of this paper is to present a proposal for a gradual and systemic incorporation of midwives and obstetric nurses into the Brazilian Unified Health System (SUS and Primary Health Care (PHC. The proposal was born from contact with the British experience, based on midwives, which is briefly described. In Brazil, these professionals would progressively take over the prenatal, delivery and postpartum care for pregnant women of usual risk in a region, in partnership with the PHC teams. This creates a specific niche for practicing, monitoring and evaluating the pregnancy care, based on the specific life cycle continued care with the user closely linked to the PHC team. There are technical and institutional conditions favorable to the development of this type of proposal, but there is a need to overcome the political obstacles. Its realization is a powerful strategy to reduce the high rates of obstetric violence, especially the significant cesarean rates in Brazil, contributing to humanization of childbirth in the SUS.

  20. Obstacle Avoidance Through Visual Teleoperation

    Directory of Open Access Journals (Sweden)

    Muhammad Usman Keerio

    2009-01-01

    Full Text Available This paper presents a novel controlling approach forHumanoid Robot to work safely in critical situations like badlight environment using Visual Teleoperation. In this regardmodeling environments for Humanoid Teleoperation Systemis developed. Here virtual reality modeling environmentincludes development of virtual Humanoid BHR-2, andvirtual objects like table etc. The main goal of this work is toenhance our visual teleoperation system for BHR-2 in orderto avoid any collision during real time operation. SoftwareMaya is used for modeling and simulations. Maya plug-insin VC++ provides efficient modeling rule, real timeinteraction, and time saving rendering approach in a virtualenvironment. In this paper the validity of proposed scheme isshown by conducting experiments using offline step overtrajectory to avoid obstacle in bad light environment.

  1. The health professions and the performance of future health systems in low-income countries: support or obstacle?

    Science.gov (United States)

    Dussault, Gilles

    2008-05-01

    This paper discusses the present and future role of the health professions in health services delivery systems in low-income countries. Unlike richer countries, most low-income countries do not have a tradition of labour market regulation and the capacity of the professions themselves to regulate the provision of health services by their members tends to be weak. The paper looks at the impact of professional monopolies on the performance of health services delivery systems, e.g. equity of access, effectiveness of services, efficiency in the use of scarce resources, responsiveness to users' needs, including protection against the financial impact of utilising health services. It identifies issues which policy-makers face in relation to opening the health labour market while guaranteeing the safety and security of services provided by professionals. The suggestion is made that a "social contract", granting privileges of practice in exchange of a commitment to actively maintain and enhance the quality of their services, may be a viable course of action. This would require that the actors in the policy process collaborate in strengthening the capacity of regulatory agencies to perform their role. PMID:18336977

  2. Ambivalent implications of health care information systems: a study in the Brazilian public health care system

    Directory of Open Access Journals (Sweden)

    João Porto de Albuquerque

    2011-01-01

    Full Text Available This article evaluates social implications of the "SIGA" Health Care Information System (HIS in a public health care organization in the city of São Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.

  3. Measuring the strength of primary care systems in Europe.

    NARCIS (Netherlands)

    Kringos, D.S.; Boerma, W.G.W.

    2009-01-01

    Background: The investment in primary care (PC) reforms to improve the overall performance of health care systems has been substantial in Europe. There is however a lack of up to date comparable information to evaluate the development and strength of PC systems. This EU-funded Primary Health Care A

  4. Guidelines for Psychological Practice in Health Care Delivery Systems

    Science.gov (United States)

    American Psychologist, 2013

    2013-01-01

    Psychologists practice in an increasingly diverse range of health care delivery systems. The following guidelines are intended to assist psychologists, other health care providers, administrators in health care delivery systems, and the public to conceptualize the roles and responsibilities of psychologists in these diverse contexts. These…

  5. "Differences" are the Biggest Obstacle

    Institute of Scientific and Technical Information of China (English)

    常胜越

    2008-01-01

    China has the greatest numbers of both teachers and students worldwide ,who teach and learn English. Therefore ,to analyze the obstacles of learning English for Chinese is necessary. This article gives the idea of differences between Chinese and English mainly in languages and cultures fields. Through these we can see deafly that "differences" are the biggest obstacle in language learning.

  6. Obstacle detection during day and night conditions using stereo vision

    NARCIS (Netherlands)

    Dubbelman, G.; Mark, W. van der; Heuvel, J.C. van den; Groen, F.C.A.

    2007-01-01

    We have developed a stereo vision based obstacle detection (OD) system that can be used to detect obstacles in off-road terrain during both day and night conditions. In order to acquire enough depth estimates for reliable OD during low visibility conditions, we propose a stereo disparity (depth) est

  7. Research of Brain-Controlled Wheelchair Obstacle Avoidance System Based on Ultrasonic Sensor%基于超声波传感器的脑控轮椅避障系统的研究

    Institute of Scientific and Technical Information of China (English)

    刘甜; 李远清; 王洪涛; 胡友盼

    2012-01-01

    A method of obstacle avoidance is proposed aimed at the phenomenon of collision accident likely caused by the non-stationary nature of the electroencephalogram (EEG) signals while the users steer the brain-controlled wheelchair. Multi-channel ultrasonic sensors obstacle avoidance system and a feedback interface used for obstacle avoidance alert are also designed. The prompt messages displayed on the feedback interface will assist the users to make effective obstacle avoidance decisions. If the wheelchair can't avoid obstacle successfully when the users apply their EEG signals to steer the wheelchair autonomously, the system will send messages to stop the wheelchair immediately to avoid collision with obstacles, which ensures the personal safety of the wheelchair users. The experimental results of brain - controlled wheelchair show that when the safety area critical value and the emergency stop distance critical value of the front and back are respectively set as 500 millimeters, 400 millimeters and 200 millimeters, the obstacle avoidance system with good stability and strong real -time property can meet the needs of brain -controlled wheelchair users' safety navigation.%针对脑控轮椅行驶时因用户脑电信号的不稳定性可能引起碰撞事故发生的现象,提出了一种避障方法,并设计了多路超声波传感器避障系统及避障提示反馈界面;反馈界面上实时显示的提示信息将辅助用户做出有效的避障决策;当用户采用脑电自主控制轮椅运行时,若无法成功避障,则该避障系统立即启动紧急停车功能以避免与障碍物发生碰撞,保证了脑控轮椅用户的人身安全;实验结果表明:当把安全区域临界值、前后及左右紧急停车距离临界值分别设置为500mm、400mm和200mm时,该超声波传感器避障系统稳定性好、实时性强,能够满足脑控轮椅的用户安全导航的需要.

  8. Toward a 21st-century health care system: Recommendations for health care reform

    OpenAIRE

    Arrow, Kenneth; Auerbach, Alan; Bertko, John; Casalino, Lawrence Peter; Crosson, Francis; Enthoven, Alain; Falcone, E.; Feldman, R.C.; Fuchs, Victor; Garber, Alan; Gold, Marthe Rachel; Goldman, D A; Hadfield, Gillian; Hall, Mark Ann; Horwitz, Ralph

    2009-01-01

    textabstractThe coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspective...

  9. Organizational Fragmentation and Care Quality in the U.S. Health Care System

    OpenAIRE

    Randall D. Cebul; James B. Rebitzer; Taylor, Lowell J.; Mark Votruba

    2008-01-01

    Many goods and services can be readily provided through a series of unconnected transactions, but in health care close coordination over time and within care episodes improves both health outcomes and efficiency. Close coordination is problematic in the US health care system because the financing and delivery of care is distributed across a variety of distinct and often competing entities, each with its own objectives, obligations and capabilities. These fragmented organizational structures l...

  10. Health-Care Waste Management System

    Directory of Open Access Journals (Sweden)

    T. Subramani

    2014-06-01

    Full Text Available The main purpose of this paper is to give A view of the hospital waste management and environmental problem in india. The objective of this study is to analyze the health care waste management system, including practices and compliances. Most countries of the world, especially the developing countries, are facing the grim situation arising out of environmental pollution due to pathological waste arising from increasing populations and the consequent rapid growth in the number of hospital units. In india, there are about 6 lakhs hospital beds, over 23,000 primary health centers, more than 15,000 small and private hospitals. In india, the biomedical waste (management and handling rules 1998 make it mandatory for hospitals, clinics, and other medical and veterinary institutes to dispose of bio medical wastes strictly according to the rules.

  11. 基于“蝇眼”网络模糊控制的装甲车避障系统研究%Armored Vehicle Obstacle Avoidance System Research Based on“Fly's Sye”Network Fuzzy Control

    Institute of Scientific and Technical Information of China (English)

    杨英杰; 张科

    2014-01-01

    Armored car body weight,body length there such as congenital disadvantage,in the process of vehicle walking vision less than 180degrees,the body and the distance between the obstacles only by the human eye estimating,appear visual blind area,in turn and reverse often appear collision.This paper puts forward a based on the“fly's eye”network fuzzy control technology of armored vehicle obstacle avoid-ance system research,the armored car around the obstacles 360degree detection,real-time display bearing and distance,vehicle body of da-ta transmission using high stability of CAN bus technology,to realize the sensor information fusion based on neural network with fuzzy con-trol obstacle avoidance technology on armored vehicles to walk for intelligent obstacle avoidance control.In different environment of system test the obstacle avoidance method can make the obstacles bearing and distance measurement accuracy assurance in 95% and 98% above, have very strong practicability.%装甲车车身重,存在车体长宽等先天劣势,在车辆行走的过程中视野不到180度,车身与障碍物之间的距离只能通过人眼进行估测,驾驶员出现视觉盲区,在转弯与倒车时经常出现碰撞;提出一种基于“蝇眼”网络模糊控制技术的装甲车避障系统研究,对装甲车周围的障碍物进行360°的探测,实时显示方位与距离,车辆本体中的数据传输使用稳定性较高的 CAN 总线技术实现,对传感器的信息融合后使用基于神经网络模糊控制的避障技术对装甲车行走进行智能避障控制;在不同环境下的系统测试中本文的避障方法能够将障碍物的方位与距离测量准确率保证在95%与98%以上,具有很强的实用性。

  12. Training a system-literate care coordination workforce.

    Science.gov (United States)

    Naccarella, Lucio; Osborne, Richard H; Brooks, Peter M

    2016-04-01

    People with chronic complex conditions continue to experience increasing health system fragmentation and poor coordination. To reverse these trends, one solution has been an investment in effective models of care coordination that use a care coordinator workforce. Care coordinators are not a homogenous workforce - but an applied professional role, providing direct and indirect care, and is often undertaken by nurses, allied health professionals, social workers or general practitioners. In Australia, there is no training curriculum nor courses, nor nationally recognised professional quality standards for the care coordinator workforce. With the growing complexity and fragmentation of the health care system, health system literacy - shared understanding of the roles and contributions of the different workforce professions, organisations and systems, among patients and indeed the health workforce is required. Efforts to improve health system literacy among the health workforce are increasing at a policy, practice and research level. However, insufficient evidence exists about what are the health system literacy needs of care coordinators, and what is required for them to be most effective. Key areas to build a health system literate care coordination workforce are presented. Care coordination is more than an optional extra, but one of the only ways we are going to be able to provide equitable health services for people with chronic complex conditions. People with low health literacy require more support with the coordination of their care, therefore we need to build a high performing care coordinator workforce that upholds professional quality standards, and is health literacy responsive.

  13. Dynamic Obstacle Avoidance for an Omnidirectional Mobile Robot

    Directory of Open Access Journals (Sweden)

    Robert L. Williams

    2010-01-01

    Full Text Available We have established a novel method of obstacle-avoidance motion planning for mobile robots in dynamic environments, wherein the obstacles are moving with general velocities and accelerations, and their motion profiles are not preknown. A hybrid system is presented in which a global deliberate approach is applied to determine the motion in the desired path line (DPL, and a local reactive approach is used for moving obstacle avoidance. A machine vision system is required to sense obstacle motion. Through theoretical analysis, simulation, and experimental validation applied to the Ohio University RoboCup robot, we show the method is effective to avoid collisions with moving obstacles in a dynamic environment.

  14. Optimal obstacle placement with disambiguations

    OpenAIRE

    Ceyhan, Elvan; Aksakalli, Vural

    2012-01-01

    arXiv:1201.5076v3 [stat.AP] 14 Jan 2013 The Annals of Applied Statistics 2012, Vol. 6, No. 4, 1730–1774 DOI: 10.1214/12-AOAS556 c Institute of Mathematical Statistics, 2012 OPTIMAL OBSTACLE PLACEMENT WITH DISAMBIGUATIONS By Vural Aksakalli and Elvan Ceyhan Istanbul S¸ehir University and Ko¸c University We introduce the optimal obstacle placement with disambigua-tions problem wherein the goal is to place true obstacles in an en-vironment cluttered with false obst...

  15. Smart Sensor Based Obstacle Detection for High-Speed Unmanned Surface Vehicle

    DEFF Research Database (Denmark)

    Hermann, Dan; Galeazzi, Roberto; Andersen, Jens Christian;

    2015-01-01

    This paper describes an obstacle detection system for a high-speed and agile unmanned surface vehicle (USV), running at speeds up to 30 m/s. The aim is a real-time and high performance obstacle detection system using both radar and vision technologies to detect obstacles within a range of 175 m. ...

  16. [Home care for the chronically ill: a self-care health system].

    Science.gov (United States)

    Silva, Leticia Robles

    2004-01-01

    This article focuses on home care for chronically ill adults and seniors. According to our thesis, home care should be understood as a self-care system, and its aim is to guarantee the individual's social and bodily survival. Home care consists of three areas, related to illness, the home, and to life history. Caregiving, usually under women's responsibility, is present throughout the history of the illness and the health-seeking process. The article analyzes these issues in light of the ageing process, the epidemiological changes occurring worldwide, and the urgency to incorporate this analysis into the heath care research agenda. PMID:15073644

  17. Obstacle detection of mobile robot based on data fusion

    Institute of Scientific and Technical Information of China (English)

    YUAN Xin; SU Li; SUN Li-ning

    2009-01-01

    To study the problem of obstacle detection based on multi-sensors data fusion, the multi-target track-ing theory and techniques are introduced into obstacle detection systems, and the exact position of obstacle can be determined. Data fusion problems are discussed directly based on achievable data from some sensors without considering the specific structure of each individual sensor. With respect to normal linear systems and nonlinear systems, the corresponding algorithms are proposed. The validity of the method is confirmed by simulation re-suits.

  18. Preventive health care and payment systems

    OpenAIRE

    Martínez Giralt, Xavier; Barros, Pedro Pita

    2003-01-01

    Prevention has been a main issue of recent policy orientations in health care. This renews the interest on how different organizational designs and the definition of payment schemes to providers may affect the incentives to provide preventive health care. We focus on the externality resulting from referral decisions from primary to acute care providers. This makes our analysis complementary to most works in the literature allowing to address in a more direct way the issue of preventive health...

  19. Obstacles, strenghts and weaknesses

    OpenAIRE

    Akinyemi, Okoro Monday

    2010-01-01

    In drawing a conclusion for this study, care must be taken in generalizing findings since the population of students and teachers investigated were limited to certain levels in the different schools and countries. This study recognized some complexity of the factors underlying the status of school gardening instruction and activities in Germany, Nigeria and the U.S. as inadequate time for decision-making in the process of gardening, motivation of teachers and students. This was seen as the ma...

  20. Obstacle problems in mathematical physics

    CERN Document Server

    Rodrigues, J-F

    1987-01-01

    The aim of this research monograph is to present a general account of the applicability of elliptic variational inequalities to the important class of free boundary problems of obstacle type from a unifying point of view of classical Mathematical Physics.The first part of the volume introduces some obstacle type problems which can be reduced to variational inequalities. Part II presents some of the main aspects of the theory of elliptic variational inequalities, from the abstract hilbertian framework to the smoothness of the variational solution, discussing in general the properties of the free boundary and including some results on the obstacle Plateau problem. The last part examines the application to free boundary problems, namely the lubrication-cavitation problem, the elastoplastic problem, the Signorini (or the boundary obstacle) problem, the dam problem, the continuous casting problem, the electrochemical machining problem and the problem of the flow with wake in a channel past a profile.

  1. The Manchester Triage System in paediatric emergency care

    NARCIS (Netherlands)

    M. van Veen (Mirjam)

    2010-01-01

    textabstractIn the first part of the thesis performance of the Manchester Triage System in paediatric emergency care was evaluated. In chapter 1 we reviewed the literature to evaluate realibility and validity of triage systems in paediatric emergency care. The Manchester Triage System was used to tr

  2. 2nd International Conference on Health Care Systems Engineering

    CERN Document Server

    Sahin, Evren; Li, Jingshan; Guinet, Alain; Vandaele, Nico

    2016-01-01

    In this volume, scientists and practitioners write about new methods and technologies for improving the operation of health care organizations. Statistical analyses play an important role in these methods with the implications of simulation and modeling applied to the future of health care. Papers are based on work presented at the Second International Conference on Health Care Systems Engineering (HCSE2015) in Lyon, France. The conference was a rare opportunity for scientists and practitioners to share work directly with each other. Each resulting paper received a double blind review. Paper topics include: hospital drug logistics, emergency care, simulation in patient care, and models for home care services. Discusses statistical analysis and operations management for health care delivery systems based on real case studies Papers in this volume received a double blind review Brings together the work of scientists, practitioners, and clinicians to unite research and practice in the future of these systems Top...

  3. A decision technology system for health care electronic commerce.

    Science.gov (United States)

    Forgionne, G A; Gangopadhyay, A; Klein, J A; Eckhardt, R

    1999-08-01

    Mounting costs have escalated the pressure on health care providers and payers to improve decision making and control expenses. Transactions to form the needed decision data will routinely flow, often electronically, between the affected parties. Conventional health care information systems facilitate flow, process transactions, and generate useful decision information. Typically, such support is offered through a series of stand-alone systems that lose much useful decision knowledge and wisdom during health care electronic commerce (e-commerce). Integrating the stand-alone functions can enhance the quality and efficiency of the segmented support, create synergistic effects, and augment decision-making performance and value for both providers and payers. This article presents an information system that can provide complete and integrated support for e-commerce-based health care decision making. The article describes health care e-commerce, presents the system, examines the system's potential use and benefits, and draws implications for health care management and practice. PMID:10539421

  4. A decision technology system for health care electronic commerce.

    Science.gov (United States)

    Forgionne, G A; Gangopadhyay, A; Klein, J A; Eckhardt, R

    1999-08-01

    Mounting costs have escalated the pressure on health care providers and payers to improve decision making and control expenses. Transactions to form the needed decision data will routinely flow, often electronically, between the affected parties. Conventional health care information systems facilitate flow, process transactions, and generate useful decision information. Typically, such support is offered through a series of stand-alone systems that lose much useful decision knowledge and wisdom during health care electronic commerce (e-commerce). Integrating the stand-alone functions can enhance the quality and efficiency of the segmented support, create synergistic effects, and augment decision-making performance and value for both providers and payers. This article presents an information system that can provide complete and integrated support for e-commerce-based health care decision making. The article describes health care e-commerce, presents the system, examines the system's potential use and benefits, and draws implications for health care management and practice.

  5. Obstacle Avoidance for Unmanned Undersea Vehicle in Unknown Unstructured Environment

    Directory of Open Access Journals (Sweden)

    Zheping Yan

    2013-01-01

    Full Text Available To avoid obstacle in the unknown environment for unmanned undersea vehicle (UUV, an obstacle avoiding system based on improved vector field histogram (VFH is designed. Forward looking sonar is used to detect the environment, and the divisional sonar modal is applied to deal with the measure uncertainty. To adapt to the VFH, rolling occupancy grids are used for the map building, and high accuracy details of local environment are obtained. The threshold is adaptively adjusted by the statistic of obstacles to solve the problem that VFH is sensitive to threshold. To improve the environment adaptability, the hybrid-behaviors strategy is proposed, which selects the optimal avoidance command according to the motion status and environment character. The simulation shows that UUV could avoid the obstacles fast and escape from the U shape obstacles.

  6. Mean curvature flow with obstacles

    CERN Document Server

    Almeida, Luís; Novaga, Matteo

    2011-01-01

    We consider the evolution of fronts by mean curvature in the presence of obstacles. We construct a weak solution to the flow by means of a variational method, corresponding to an implicit time-discretization scheme. Assuming the regularity of the obstacles, in the two-dimensional case we show existence and uniqueness of a regular solution before the onset of singularities. Finally, we discuss an application of this result to the positive mean curvature flow.

  7. Slow maturation of planning in obstacle avoidance in humans.

    Science.gov (United States)

    Corporaal, Sharissa H A; Swinnen, Stephan P; Duysens, Jacques; Bruijn, Sjoerd M

    2016-01-01

    Complex gait (e.g., obstacle avoidance) requires a higher cognitive load than simple steady-state gait, which is a more automated movement. The higher levels of the central nervous system, responsible for adjusting motor plans to complex gait, develop throughout childhood into adulthood. Therefore, we hypothesize that gait strategies in complex gait are likely to mature until adulthood as well. However, little is known about the maturation of complex gait from childhood into adolescence and adulthood. To address this issue, we investigated obstacle avoidance in forty-four 8- to 18-yr-old participants who walked at preferred speed along a 6-m walkway on which a planar obstacle (150% of step length, 1 m wide) was projected. Participants avoided the obstacle by stepping over this projection, while lower body kinematics were recorded. Results showed that step length and speed adjustments during successful obstacle avoidance were similar across all ages, even though younger children modified step width to a greater extent. Additionally, the younger children used larger maximal toe elevations and take-off distances than older children. Moreover, during unsuccessful trials, younger children deployed exaggerated take-off distances, which resulted in obstacle contact upon the consecutive heel strike. These results indicate that obstacle avoidance is not fully matured in younger children, and that the inability to plan precise foot placements is an important factor contributing to failures in obstacle avoidance.

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

    Science.gov (United States)

    Chung, Joyce; Aguila, Fatima; Harris, Odette

    2015-01-01

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

  9. [A theoretical analysis of coordination in the field of health care: application to coordinated care systems].

    Science.gov (United States)

    Sebai, Jihane

    2016-01-01

    Various organizational, functional or structural issues have led to a review of the foundations of the former health care system based on a traditional market segmentation between general practice and hospital medicine, and between health and social sectors and marked by competition between private and public sectors. The current reconfiguration of the health care system has resulted in “new” levers explained by the development of a new organizational reconfiguration of the primary health care model. Coordinated care structures (SSC) have been developed in this context by making coordination the cornerstone of relations between professionals to ensure global, continuous and quality health care. This article highlights the contributions of various theoretical approaches to the understanding of the concept of coordination in the analysis of the current specificity of health care.

  10. [A theoretical analysis of coordination in the field of health care: application to coordinated care systems].

    Science.gov (United States)

    Sebai, Jihane

    2016-01-01

    Various organizational, functional or structural issues have led to a review of the foundations of the former health care system based on a traditional market segmentation between general practice and hospital medicine, and between health and social sectors and marked by competition between private and public sectors. The current reconfiguration of the health care system has resulted in “new” levers explained by the development of a new organizational reconfiguration of the primary health care model. Coordinated care structures (SSC) have been developed in this context by making coordination the cornerstone of relations between professionals to ensure global, continuous and quality health care. This article highlights the contributions of various theoretical approaches to the understanding of the concept of coordination in the analysis of the current specificity of health care. PMID:27392057

  11. Research on UAV Intelligent Obstacle Avoidance Technology During Inspection of Transmission Line

    Science.gov (United States)

    Wei, Chuanhu; Zhang, Fei; Yin, Chaoyuan; Liu, Yue; Liu, Liang; Li, Zongyu; Wang, Wanguo

    Autonomous obstacle avoidance of unmanned aerial vehicle (hereinafter referred to as UAV) in electric power line inspection process has important significance for operation safety and economy for UAV intelligent inspection system of transmission line as main content of UAV intelligent inspection system on transmission line. In the paper, principles of UAV inspection obstacle avoidance technology of transmission line are introduced. UAV inspection obstacle avoidance technology based on particle swarm global optimization algorithm is proposed after common obstacle avoidance technologies are studied. Stimulation comparison is implemented with traditional UAV inspection obstacle avoidance technology which adopts artificial potential field method. Results show that UAV inspection strategy of particle swarm optimization algorithm, adopted in the paper, is prominently better than UAV inspection strategy of artificial potential field method in the aspects of obstacle avoidance effect and the ability of returning to preset inspection track after passing through the obstacle. An effective method is provided for UAV inspection obstacle avoidance of transmission line.

  12. The next pandemic: anticipating an overwhelmed health care system.

    OpenAIRE

    Duley, Mary Grace Keating

    2005-01-01

    INTRODUCTION: In September 2005, an overview of current health care system planning efforts was presented to the audience at the Yale University Ethics Symposium on Avian and Pandemic Influenza. The speaker, also the author of this article, provided the audience with a summary of what was being undertaken with the use of federal preparedness funds to improve the overall infrastructure of the health care system. All of Connecticut's 31 acute care hospitals, the Veteran's Administration Hospita...

  13. Princeton HealthCare System name reflects comprehensive services. New brand identity focuses on 'Redefining Care'.

    Science.gov (United States)

    Botvin, Judith D

    2004-01-01

    The Medical Center at Princeton, Princeton, N.J., introduced its new name last June, both to its community and its internal stakeholders. It is now known as Princeton HealthCare System, a name chosen to reflect its growth and diversity. It's being branded as a unique institution that combines the sensitive, caring serice of a community hospital with the sophisticated care of a teaching hospital. PMID:15162577

  14. Costing nursing care: using the clinical care classification system to value nursing intervention in an acute-care setting.

    Science.gov (United States)

    Moss, Jacqueline; Saba, Virginia

    2011-08-01

    The purpose of this study was to combine an established methodology for coding nursing interventions and action types using the Clinical Care Classification System with a reliable formula (relative value units) to cost nursing services. Using a flat per-diem rate to cost nursing care greatly understates the actual costs and fails to address the high levels of variability within and across units. We observed nurses performing commonly executed nursing interventions and recorded these into an electronic database with corresponding Clinical Care Classification System codes. The duration of these observations was used to calculate intervention costs using relative value unit calculation formulas. The costs of the five most commonly executed interventions were nursing care coordination/manage-refer ($2.43), nursing status report/assess-monitor ($4.22), medication treatment/perform-direct ($6.33), physical examination/assess-monitor ($3.20), and universal precautions/perform-direct ($1.96). Future studies across a variety of nursing specialties and units are needed to validate the relative value unit for Clinical Care Classification System action types developed for use with the Clinical Care Classification System nursing interventions as a method to cost nursing care.

  15. Novel approaches to helicopter obstacle warning

    Science.gov (United States)

    Seidel, Christian; Samuelis, Christian; Wegner, Matthias; Münsterer, Thomas; Rumpf, Thomas; Schwartz, Ingo

    2006-05-01

    EADS Germany is the world market leader in commercial Helicopter Laser Radar (HELLAS) Obstacle Warning Systems. The HELLAS-Warning System has been introduced into the market in 2000, is in service at German Border Control (Bundespolizei) and Royal Thai Airforce and is successfully evaluated by the Foreign Comparative Test Program (FCT) of the USSOCOM. Currently the successor system HELLAS-Awareness is in development. It will have extended sensor performance, enhanced realtime data processing capabilities and advanced HMI features. We will give an outline of the new sensor unit concerning detection technology and helicopter integration aspects. The system provides a widespread field of view with additional dynamic line of sight steering and a large detection range in combination with a high frame rate of 3Hz. The workflow of the data processing will be presented with focus on novel filter techniques and obstacle classification methods. As commonly known the former are indispensable due to unavoidable statistical measuring errors and solarisation. The amount of information in the filtered raw data is further reduced by ground segmentation. The remaining raised objects are extracted and classified in several stages into different obstacle classes. We will show the prioritization function which orders the obstacles concerning to their threat potential to the helicopter taking into account the actual flight dynamics. The priority of an object determines the display and provision of warnings to the pilot. Possible HMI representation includes video or FLIR overlay on multifunction displays, audio warnings and visualization of information on helmet mounted displays and digital maps. Different concepts will be presented.

  16. Pain management improves care and revenue: an interview with ProCare Systems.

    Science.gov (United States)

    Davis, F N; Walsh, C

    2000-01-01

    As provider and managed care organizations continue to look for better ways to control costs and improve patient outcomes, disease management programs are getting an increasing share of their attention. One often-over-looked area with significant potential to improve outcomes, reduce costs, and enhance revenues is pain management. It has been estimated that at least 40 percent of senior citizens suffer from chronic pain, and as the population ages, the number of chronic pain sufferers will only increase. Pain management companies have been forming to meet the current and future demand for comprehensive pain management programs. One such company is ProCare Systems, a single-specialty physician practice management company based in Grand Rapids, Michigan. HFM spoke with Fred N. Davis, MD, president and cofounder of ProCare Systems, and Cyndy Walsh, ProCare System's CEO, about pain management programs and the patient care and financial impact they can effect.

  17. Foster Care and College: The Educational Aspirations and Expectations of Youth in the Foster Care System

    Science.gov (United States)

    Kirk, Chris M.; Lewis, Rhonda K.; Nilsen, Corinne; Colvin, Deltha Q.

    2013-01-01

    Despite an overall increase in college attendance, low-income youth and particularly those in the foster care system are less likely to attend college (Wolanin, 2005). Although youth in foster care report high educational aspirations, as little as 4% obtain a 4-year college degree (Nixon & Jones, 2007). The purpose of this study is to explore…

  18. Hospital Systems, Convenient Care Strategies, and Healthcare Reform.

    Science.gov (United States)

    Kaissi, Amer; Shay, Patrick; Roscoe, Christina

    2016-01-01

    Retail clinics (RCs) and urgent care centers (UCCs) are convenient care models that emerged on the healthcare scene in the past 10 to 15 years. Characterized as disruptive innovations, these models of healthcare delivery seem to follow a slightly different path from each other. Hospital systems, the very organizations that were originally threatened by convenient care models, are developing them and partnering with existing models. We posit that legislative changes such as the Affordable Care Act created challenges for hospital systems that accelerated their adoption of these models. In this study, we analyze 117 hospital systems in six states and report on their convenient care strategies. Our data suggest that UCCs are more prevalent than RCs among hospital systems, and that large and unexplained state-by-state variations exist in the adoption of these strategies. We also postulate about the future role of hospital systems in leading these innovations. PMID:27111934

  19. Quality measurement and system change of cancer care delivery.

    Science.gov (United States)

    Haggstrom, David A; Doebbeling, Bradley N

    2011-12-01

    Cancer care quality measurement and system change may serve as a case example for larger possibilities in the health care system related to other diseases. Cancer care quality gaps and variation exist across both technical and patient-centered cancer quality measures, especially among vulnerable populations. There is a need to develop measures that address the following dimensions of quality and its context: disparities, overuse, patient-centeredness, and uncertainty. Developments that may promote system change in cancer care delivery include changes in the information market, organizational accountability, and consumer empowerment. Information market changes include public cancer care quality reporting, enabled by health information exchange, and incentivized by pay-for-performance. Moving organizational accountability, reimbursement, and quality measurement from individual episodes of care to multiple providers providing coordinated cancer care may address quality gaps associated with the fragmentation of care delivery. Consumer empowerment through new technologies, such as personal health records, may lead to the collection of patient-centered quality measures and promote patient self-management. Across all of these developments, leadership and ongoing research to guide informed system changes will be necessary to transform the cancer care delivery system.

  20. Sources of project financing in health care systems.

    Science.gov (United States)

    Smith, D G; Wheeler, J R; Rivenson, H L; Reiter, K L

    2000-01-01

    Through discussions with chief financial officers of leading health care systems, insights are offered on preferences for project financing and development efforts. Data from these same systems provide at least anecdotal evidence in support of pecking-order theory.

  1. Obstacles, levers and impacts of organic farming development in Camargue

    OpenAIRE

    Delmotte, Sylvestre; Lacombe, C.; Couderc, Vincent; Mailly, F; Mouret, J.C.; Lopez-Ridaura, S; Barbier, J.M.

    2013-01-01

    We are presenting an analysis of the obstacles and levers for the development of organic cropping systems in Camargue, documented with a multicriteria analysis of scenarios of organic farming (OF) development. This communication is built using results from on-farm agronomic monitoring, stakeholders and farmers’ interviews and the use of models for integrated assessment of scenarios. At the farm level, the obstacles are related to identification of profitable cropping systems and rotations tha...

  2. Hardware-in-the-loop Simulation System of UUV Obstacle Avoidance Based on Binocular Vision%基于双目视觉的UUV避障半实物仿真系统

    Institute of Scientific and Technical Information of China (English)

    严浙平; 姜玲; 王晓娟; 赵玉飞

    2012-01-01

    The sea trials for the obstacle avoidance research of an unmanned underwater vehicle (UUV) are expensive and high-risk. To facilitate the research of automatic obstacle avoidance of an UUV in laboratory, a hardware-in-the-loop simulation system of UUV obstacle avoidance has been developed based on binocular vision, where the multi-degree of freedom test platform is used to simulate the motion of the UUV, and the double-stereo vision system is used to simulate forward looking sonar. In this paper, the structure and data stream of the system are discussed. The key technologies for vision subsystem and the software scheme for UUV model subsystem are also described. Joint simulation tests were conducted by adopting rule-based obstacle avoidance approach. Experimental results show that the system has the advantages of simple structure and convenient application, and it can be used in demonstration, validation, and evaluation of obstacle avoidance path plan.%由于无人水下航行器(UUV)避障研究的实物海洋试验成本高且风险较大,故针对在试验室进行UUV自主避障规划的需求,利用双目视觉展开了UUV避障半实物仿真试验系统的设计研究,包括多自由度运动台架模拟UUV的运动,双目摄像机代替前视声纳作为避障传感器.阐述了实物双目视觉子系统的关键技术和UUV模型子系统的软件实现方法,以及系统的体系结构、数据交换方法,并进行了基于规则的避障仿真联调试验,结果表明,该系统结构简单,试验实施便利,可作为演示、验证和评估避障路径规划正确性和有效性的实用手段.

  3. Do Danes enjoy a high performing chronic care system?

    DEFF Research Database (Denmark)

    Hernández-Quevedo, Christina; Olejaz, Maria; Juul, Annegrete;

    2012-01-01

    The trends in population health in Denmark are similar to those in most Western European countries. Major health issues include, among others, the high prevalence of chronic illnesses and lifestyle related risk factors such as obesity, tobacco, physical inactivity and alcohol. This has pressed th...... in a recent report, the fragmented structure of the Danish health system poses challenges in providing effectively coordinated care to patients with chronic diseases....... the health system towards a model of provision of care based on the management of chronic care conditions. While the Chronic Care Model was introduced in 2005, the Danish health system does not fulfil the ten key preconditions that would characterise a high-performing chronic care system. As revealed...

  4. Catastrophic disasters and the design of disaster medical care systems.

    Science.gov (United States)

    Mahoney, L E; Reutershan, T P

    1987-09-01

    The National Disaster Medical System (NDMS) is aimed at medical care needs resulting from catastrophic earthquakes, which may cause thousands of deaths and injuries. Other geophysical events may cause great mortality, but leave few injured survivors. Weather incidents, technological disasters, and common mass casualty incidents cause much less mortality and morbidity. Catastrophic disasters overwhelm the local medical care system. Supplemental care is provided by disaster relief forces; this care should be adapted to prevalent types of injuries. Most care should be provided at the disaster scene through supplemental medical facilities, while some can be provided by evacuating patients to distant hospitals. Medical response teams capable of stabilizing, sorting, and holding victims should staff supplemental medical facilities. The NDMS program includes hospital facilities, evacuation assets, and medical response teams. The structure and capabilities of these elements are determined by the medical care needs of the catastrophic disaster situation. PMID:3631673

  5. New systems of care for substance use disorders: treatment, finance, and technology under health care reform.

    Science.gov (United States)

    Pating, David R; Miller, Michael M; Goplerud, Eric; Martin, Judith; Ziedonis, Douglas M

    2012-06-01

    This article outlined ways in which persons with addiction are currently underserved by our current health care system. However, with the coming broad scale reforms to our health care system, the access to and availability of high-quality care for substance use disorders will increase. Addiction treatments will continue to be offered through traditional substance abuse care systems, but these will be more integrated with primary care, and less separated as treatment facilities leverage opportunities to blend services, financing mechanisms, and health information systems under federally driven incentive programs. To further these reforms, vigilance will be needed by consumers, clinicians, and policy makers to assure that the unmet treatment needs of individuals with addiction are addressed. Embedded in this article are essential recommendations to facilitate the improvement of care for substance use disorders under health care reform. Ultimately, as addiction care acquires more of the “look and feel” of mainstream medicine, it is important to be mindful of preexisting trends in health care delivery overall that are reflected in recent health reform legislation. Within the world of addiction care, clinicians must move beyond their self-imposed “stigmatization” and sequestration of specialty addiction treatment. The problem for addiction care, as it becomes more “mainstream,” is to not comfortably feel that general slogans like “Treatment Works,” as promoted by Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment during its annual Recovery Month celebrations, will meet the expectations of stakeholders outside the specialty addiction treatment community. Rather, the problem is to show exactly how addiction treatment works, and to what extent it works-there have to be metrics showing changes in symptom level or functional outcome, changes in health care utilization, improvements in workplace attendance and

  6. How Obstacles Perturb Population Fronts and Alter Their Genetic Structure.

    Directory of Open Access Journals (Sweden)

    Wolfram Möbius

    2015-12-01

    Full Text Available As populations spread into new territory, environmental heterogeneities can shape the population front and genetic composition. We focus here on the effects of an important building block of heterogeneous environments, isolated obstacles. With a combination of experiments, theory, and simulation, we show how isolated obstacles both create long-lived distortions of the front shape and amplify the effect of genetic drift. A system of bacteriophage T7 spreading on a spatially heterogeneous Escherichia coli lawn serves as an experimental model system to study population expansions. Using an inkjet printer, we create well-defined replicates of the lawn and quantitatively study the population expansion of phage T7. The transient perturbations of the population front found in the experiments are well described by a model in which the front moves with constant speed. Independent of the precise details of the expansion, we show that obstacles create a kink in the front that persists over large distances and is insensitive to the details of the obstacle's shape. The small deviations between experimental findings and the predictions of the constant speed model can be understood with a more general reaction-diffusion model, which reduces to the constant speed model when the obstacle size is large compared to the front width. Using this framework, we demonstrate that frontier genotypes just grazing the side of an isolated obstacle increase in abundance, a phenomenon we call 'geometry-enhanced genetic drift', complementary to the founder effect associated with spatial bottlenecks. Bacterial range expansions around nutrient-poor barriers and stochastic simulations confirm this prediction. The effect of the obstacle on the genealogy of individuals at the front is characterized by simulations and rationalized using the constant speed model. Lastly, we consider the effect of two obstacles on front shape and genetic composition of the population illuminating the

  7. How Obstacles Perturb Population Fronts and Alter Their Genetic Structure.

    Science.gov (United States)

    Möbius, Wolfram; Murray, Andrew W; Nelson, David R

    2015-12-01

    As populations spread into new territory, environmental heterogeneities can shape the population front and genetic composition. We focus here on the effects of an important building block of heterogeneous environments, isolated obstacles. With a combination of experiments, theory, and simulation, we show how isolated obstacles both create long-lived distortions of the front shape and amplify the effect of genetic drift. A system of bacteriophage T7 spreading on a spatially heterogeneous Escherichia coli lawn serves as an experimental model system to study population expansions. Using an inkjet printer, we create well-defined replicates of the lawn and quantitatively study the population expansion of phage T7. The transient perturbations of the population front found in the experiments are well described by a model in which the front moves with constant speed. Independent of the precise details of the expansion, we show that obstacles create a kink in the front that persists over large distances and is insensitive to the details of the obstacle's shape. The small deviations between experimental findings and the predictions of the constant speed model can be understood with a more general reaction-diffusion model, which reduces to the constant speed model when the obstacle size is large compared to the front width. Using this framework, we demonstrate that frontier genotypes just grazing the side of an isolated obstacle increase in abundance, a phenomenon we call 'geometry-enhanced genetic drift', complementary to the founder effect associated with spatial bottlenecks. Bacterial range expansions around nutrient-poor barriers and stochastic simulations confirm this prediction. The effect of the obstacle on the genealogy of individuals at the front is characterized by simulations and rationalized using the constant speed model. Lastly, we consider the effect of two obstacles on front shape and genetic composition of the population illuminating the effects expected from

  8. Teaching Evidence-Based Practice to Undergraduate Nursing Students: Overcoming Obstacles

    Science.gov (United States)

    Martin, Sharon D.

    2007-01-01

    Evidence-based practice is highly valued in health care literature at this time. But research suggests that U.S. RNs face many obstacles when implementing evidence-based practice including a lack of value for research in practice (Pravikoff et al, 2005). Additional obstacles may exist for traditional U.S. BSN nursing students who may not value the…

  9. Characterizing emergency departments to improve understanding of emergency care systems

    OpenAIRE

    Steptoe, Anne P; Corel, Blanka; Sullivan, Ashley F; Camargo, Carlos A.

    2011-01-01

    International emergency medicine aims to understand different systems of emergency care across the globe. To date, however, international emergency medicine lacks common descriptors that can encompass the wide variety of emergency care systems in different countries. The frequent use of general, system-wide indicators (e.g. the status of emergency medicine as a medical specialty or the presence of emergency medicine training programs) does not account for the diverse methods that contribute t...

  10. Obstacle negotiation control for a mobile robot suspended on overhead ground wires by optoelectronic sensors

    Science.gov (United States)

    Zheng, Li; Yi, Ruan

    2009-11-01

    Power line inspection and maintenance already benefit from developments in mobile robotics. This paper presents mobile robots capable of crossing obstacles on overhead ground wires. A teleoperated robot realizes inspection and maintenance tasks on power transmission line equipment. The inspection robot is driven by 11 motor with two arms, two wheels and two claws. The inspection robot is designed to realize the function of observation, grasp, walk, rolling, turn, rise, and decline. This paper is oriented toward 100% reliable obstacle detection and identification, and sensor fusion to increase the autonomy level. An embedded computer based on PC/104 bus is chosen as the core of control system. Visible light camera and thermal infrared Camera are both installed in a programmable pan-and-tilt camera (PPTC) unit. High-quality visual feedback rapidly becomes crucial for human-in-the-loop control and effective teleoperation. The communication system between the robot and the ground station is based on Mesh wireless networks by 700 MHz bands. An expert system programmed with Visual C++ is developed to implement the automatic control. Optoelectronic laser sensors and laser range scanner were installed in robot for obstacle-navigation control to grasp the overhead ground wires. A novel prototype with careful considerations on mobility was designed to inspect the 500KV power transmission lines. Results of experiments demonstrate that the robot can be applied to execute the navigation and inspection tasks.

  11. 脑卒中吞咽障碍患者对人性化护理需求的研究%Stroke patients with swallow obstacle to the study of humanized care needs

    Institute of Scientific and Technical Information of China (English)

    胡玮琳; 李保兰; 陈海; 冯丽华; 卢琦

    2013-01-01

    Objective:To investigate in stroke patients with swallow obstacle to the characteristics of the needs of the humanized nursing and analyze its influencing factors, and provide a theoretical basis for improve the humanized nursing measures. Methods The questionnaire was designed by, through the pre - experiments verify the reliability and validity of the questionnaire. Formal investigation using cluster sampling, 90 effective questionnaires were recovered, will investigate data entry SPSS13.0 to internal consistency check descriptive analysis, correlation analysis and exploratory factor analysis. Results Pre - survey two score each item there was no statistically significant difference (P > 0.05). Questionnaire total Cronbach's alpha coefficient is 0.85 the factors Cronbach 's alpha coefficients is greater than 0.76, the relevance of the project and its subordinate factors is stronger, principal component analysis after extraction of five male factor, the cumulated variance contribution rate reached 63.47% . Conclusion Initially formed including the five dimensions of 18 items "swallowing disorder in patients with cerebral apoplexy humanized care needs questionnaire the questionnaire has good representativeness.%目的:调查住院脑卒中吞咽障碍患者对人性化护理需求的特点并分析其影响因素,为改进人性化护理措施提供理论依据.方法:采用自行设计的调查表,通过预实验检验调查表的信度、效度.正式调查采用整群抽样,共收回90份有效问卷,将调查数据录入SPSS13.0进行内部一致性检验、相关性分析和探索性因子分析以及描述性分析结果预调查两次评分各条目差异无统计学意义(P>0.05).调查表总Cronbach's α系数为0.85各因素Cronbach's α系数均大于0.76,各项目与其所属因素的相关性较强,主成分分析后共提取5个公因子,其累积方差贡献率达到63.47%.结论:初步形成了包括5个维度18个条目的“脑卒中吞咽障

  12. Strategic management of health care information systems: nurse managers' perceptions.

    Science.gov (United States)

    Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha

    2009-01-01

    The aim of this study is to describe nurse managers' perceptions of the strategic management of information systems in health care. Lack of strategic thinking is a typical feature in health care and this may also concern information systems. The data for this study was collected by eight focus group interviews including altogether 48 nurse managers from primary and specialised health care. Five main categories described the strategic management of information systems in health care; IT as an emphasis of strategy; lack of strategic management of information systems; the importance of management; problems in privacy protection; and costs of IT. Although IT was emphasised in the strategies of many health care organisations, a typical feature was a lack of strategic management of information systems. This was seen both as an underutilisation of IT opportunities in health care organisations and as increased workload from nurse managers' perspective. Furthermore, the nurse managers reported that implementation of IT strengthened their managerial roles but also required stronger management. In conclusion, strategic management of information systems needs to be strengthened in health care and nurse managers should be more involved in this process.

  13. Five Obstacles to Grading Reform

    Science.gov (United States)

    Guskey, Thomas R.

    2011-01-01

    Educators seeking to reform grading must combat five long-held traditions that stand as formidable obstacles to change: (1) Grades should provide the basis for differentiating students; (2) grade distributions should resemble a bell-shaped curve; (3) grades should be based on students' standing among classmates; (4) poor grades prompt students to…

  14. Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

    Science.gov (United States)

    Monroe, C Douglas; Chin, Karen Y

    2013-05-01

    The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

  15. Medicaid Managed Care in an Integrated Health Care Delivery System: Lessons from Geisinger's Early Experience.

    Science.gov (United States)

    Maeng, Daniel D; Snyder, Susan R; Baumgart, Charles; Minnich, Amy L; Tomcavage, Janet F; Graf, Thomas R

    2016-08-01

    Many states in the United States, including Pennsylvania, have opted to rely on private managed care organizations to provide health insurance coverage for their Medicaid population in recent years. Geisinger Health System has been one such organization since 2013. Based on its existing care management model involving data-driven population management, advanced patient-centered medical homes, and targeted case management, Geisinger's Medicaid management efforts have been redesigned specifically to accommodate those with complex health care issues and social service needs to facilitate early intervention, effective and efficient care support, and ultimately, a positive impact on health care outcomes. An analysis of Geisinger's claims data suggests that during the first 19 months since beginning Medicaid member enrollment, Geisinger's Medicaid members, particularly those eligible for the supplemental security income benefits, have incurred lower inpatient, outpatient, and professional costs of care compared to expected levels. However, the total cost savings were partially offset by the higher prescription drug costs. These early data suggest that an integrated Medicaid care management effort may achieve significant cost of care savings. (Population Health Management 2016;19:257-263). PMID:26565693

  16. Design and Realization of Dynamic Obstacle on URWPSSim2D

    Directory of Open Access Journals (Sweden)

    Xiao Chen

    2013-07-01

    Full Text Available Simulation system is charged with the strategy validation and dual team meets, and as the 2-dimensional simulation platform for underwater robotic fish game, URWPGSim2D is the assigned platform for Chinese underwater robot contest and Robot cup underwater program. By now on URWPGSim2D, there is only static obstacles,thus short of changeableness. In order to improve the changeableness and innovation of robotic fish contest, to extend the space for the programming of contest strategy, and to increase the interest, this paper study the design of dynamic obstacles on URWPGSim2D, and design and implement two kinds of dynamic obstacles, which are the evadible dynamic obstacle and the forcing dribbling obstacle.  

  17. Uncovering the systemic issues that reside in home care

    OpenAIRE

    Giannasi, Wynona

    2012-01-01

    This video clip comprises the Keynote Address: “Uncovering the systemic issues that reside in home care” held at the 21st Annual John K. Friesen Conference, "Innovations in Home Care: A Public Policy Perspective," MAY 16-17, 2012, Vancouver, BC. Presented by Wynona Giannasi, Partner, Howegroup – Public Sector Consultants, Vancouver BC. It is well known that jurisdictions with more comprehensive and integrated home care delivery systems are able to extend independent living for older p...

  18. A clinician-driven home care delivery system.

    Science.gov (United States)

    August, D A; Faubion, W C; Ryan, M L; Haggerty, R H; Wesley, J R

    1993-12-01

    The financial, entrepreneurial, administrative, and legal forces acting within the home care arena make it difficult for clinicians to develop and operate home care initiatives within an academic setting. HomeMed is a clinician-initiated and -directed home care delivery system wholly owned by the University of Michigan. The advantages of a clinician-directed system include: Assurance that clinical and patient-based factors are the primary determinants of strategic and procedural decisions; Responsiveness of the system to clinician needs; Maintenance of an important role for the referring physician in home care; Economical clinical research by facilitation of protocol therapy in ambulatory and home settings; Reduction of lengths of hospital stays through clinician initiatives; Incorporation of outcome analysis and other research programs into the mission of the system; Clinician commitment to success of the system; and Clinician input on revenue use. Potential disadvantages of a clinician-based system include: Entrepreneurial, financial, and legal naivete; Disconnection from institutional administrative and data management resources; and Inadequate clinician interest and commitment. The University of Michigan HomeMed experience demonstrates a model of clinician-initiated and -directed home care delivery that has been innovative, profitable, and clinically excellent, has engendered broad physician, nurse, pharmacist, and social worker enthusiasm, and has supported individual investigator clinical protocols as well as broad outcomes research initiatives. It is concluded that a clinician-initiated and -directed home care program is feasible and effective, and in some settings may be optimal. PMID:8242586

  19. Embedding effective depression care: using theory for primary care organisational and systems change

    Directory of Open Access Journals (Sweden)

    Gunn Jane M

    2010-08-01

    , which proposes that agreement is reached about how care is organised; and reflexive monitoring, which proposes that depression work requires agreement about how depression work will be monitored at the patient and practice level. We describe how these constructs can be used to guide the design and implementation of effective depression care in a way that can take account of contextual differences. Conclusions Ideas about what is required for an effective model and system of depression care in primary care need to be accompanied by theoretically informed frameworks that consider how these can be implemented. The conceptual framework we have presented can be used to guide organisational and system change to develop common language around each construct between policy makers, service users, professionals, and researchers. This shared understanding across groups is fundamental to the effective implementation of change in primary care for depression.

  20. Enhancing Health-Care Services with Mixed Reality Systems

    Science.gov (United States)

    Stantchev, Vladimir

    This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

  1. Global and local obstacle avoidance technique for an autonomous vehicle

    Science.gov (United States)

    Gray, Keith W.; Saunders, Kevin S.

    1999-07-01

    The Center for Self-Organizing and Intelligent Systems (CSOIS) is engaged in developing autonomous ground vehicles. A significant problem for such vehicles is obstacle detection and avoidance. After studying various methods of detection, a scanning laser system was chosen that can detect objects at a distance of up to thirty feet while traveling between five and ten miles per hour. Once an object is detected, the vehicle must avoid it. The project employs a mission-level path planner that predetermines the path of a vehicle. One avoidance scheme is to inform the path planner of the obstacle and then let it re-plan the path. This is the global approach to the problem, which allows the use of existing software for maneuvering the vehicle. However, replanning is time consuming and lacks knowledge of the entire obstacle. An alternative approach is to use local avoidance, whereby a vehicle determines how to get by an obstacle without help from the path planner. This approach offers faster response without requiring the computing resource of the path planner. The disadvantage is that during local avoidance the vehicle ignores the global map of known obstacles and does not know to turn control back to the path planner if mission efficiency is adversely affected. This paper will describe a method for combining the current global path planner with a local obstacle avoidance technique to efficiently complete required tasks in a partially unknown environment.

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

    Science.gov (United States)

    Othieno, Joan

    2007-08-01

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

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

    Science.gov (United States)

    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.

  4. 40 CFR 792.43 - Test system care facilities.

    Science.gov (United States)

    2010-07-01

    ... CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.43 Test system care facilities. (a) A testing facility shall have a sufficient number of animal rooms or other test system areas, as... different tests. (b) A testing facility shall have a number of animal rooms or other test system...

  5. Obstacle crossing in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A.H.; van Keeken, H.G.; Schoppen, Tanneke; Otten, Egbert; Halbertsma, J.P.; Hof, A.L.; Postema, K.

    2007-01-01

    Objective: To study limitations in function and adjustment strategies in lower limb amputees during obstacle crossing. Design: Observational cohort study. Subjects: Transfemoral and transtibial amputees and able-bodied control subjects. Methods: In a motion analysis laboratory unimpeded and obstacle

  6. Fuzzy and Robust Control System of Intelligent RLED Arm Manipulators for Dynamic Obstacles%智能RLED动态目标中机器手的模糊鲁棒控制系统

    Institute of Scientific and Technical Information of China (English)

    魏武; Jean; Bosco; Mbede; 等

    2001-01-01

    This paper presents a fuzzy and robust close loop control system for nonlinear electromechanical systems of an electric motor actuating an arm robot. This control system is applied to the three basic navigation problems of intelligent robot systems in unstructured environments: autonomous planning, fast nonstop navigation without collision with obstacles, and dealing with structured and/or unstructured uncertainties. The stability of close loop control system is guaranteed by Lyapunov theory.%给出了一种电机驱动机器手中非线性机电模型的模糊鲁棒闭环控制系统,此控制系统可处理非结构环境下的三个主要的智能机器人导航问题:自动化规划、快速连续导航中的避障、处理结构和(或)非结构不确定性.

  7. Detection of Obstacles in Monocular Image Sequences

    Science.gov (United States)

    Kasturi, Rangachar; Camps, Octavia

    1997-01-01

    The ability to detect and locate runways/taxiways and obstacles in images captured using on-board sensors is an essential first step in the automation of low-altitude flight, landing, takeoff, and taxiing phase of aircraft navigation. Automation of these functions under different weather and lighting situations, can be facilitated by using sensors of different modalities. An aircraft-based Synthetic Vision System (SVS), with sensors of different modalities mounted on-board, complements the current ground-based systems in functions such as detection and prevention of potential runway collisions, airport surface navigation, and landing and takeoff in all weather conditions. In this report, we address the problem of detection of objects in monocular image sequences obtained from two types of sensors, a Passive Millimeter Wave (PMMW) sensor and a video camera mounted on-board a landing aircraft. Since the sensors differ in their spatial resolution, and the quality of the images obtained using these sensors is not the same, different approaches are used for detecting obstacles depending on the sensor type. These approaches are described separately in two parts of this report. The goal of the first part of the report is to develop a method for detecting runways/taxiways and objects on the runway in a sequence of images obtained from a moving PMMW sensor. Since the sensor resolution is low and the image quality is very poor, we propose a model-based approach for detecting runways/taxiways. We use the approximate runway model and the position information of the camera provided by the Global Positioning System (GPS) to define regions of interest in the image plane to search for the image features corresponding to the runway markers. Once the runway region is identified, we use histogram-based thresholding to detect obstacles on the runway and regions outside the runway. This algorithm is tested using image sequences simulated from a single real PMMW image.

  8. [President Obama's health care reform: lessons to and from the Israeli health care system].

    Science.gov (United States)

    Balicer, Ran D; Shadmi, Efrat

    2011-08-01

    In March 2010 the United States enacted the most significant health care reform in several decades. The Patient Protection and Affordable Care Act, amongst other provisions, addresses two of the main current shortcomings of the U.S. health system: the large portion of the population that are uninsured and the high percentage of hsealth expenditures (mostly private] which amounts to about 16% of the GDP. Changes to the current structure and financing of the U.S. health system will have implications for other health systems, for science (e.g., through enhanced federal funding for comparative effectiveness research), and for technological advance (e.g., through accelerated development and use of electronic health records). There are several lessons from the reform, and the factors leading to its implementation, for the Israeli health system. Firstly, the basic principles of the Israeli health system are a source of pride, and undermining its main values can have deleterious effects. Overreliance on private, out-of-pocket, spending and lack of support for public practice of medicine (in community and hospital settings) will weaken the public sector, strengthen the private sector, and could result in a tiered lower quality and less accessible public system with greater widening of gaps in health and health care utilization. This paper reviews the main provisions of the U.S. health care reform and the potential implications for the IsraeLi health system. PMID:21939111

  9. Echoic Sensory Substitution Information in a Single Obstacle Circumvention Task.

    Science.gov (United States)

    Kolarik, Andrew J; Scarfe, Amy C; Moore, Brian C J; Pardhan, Shahina

    2016-01-01

    Accurate motor control is required when walking around obstacles in order to avoid collisions. When vision is unavailable, sensory substitution can be used to improve locomotion through the environment. Tactile sensory substitution devices (SSDs) are electronic travel aids, some of which indicate the distance of an obstacle using the rate of vibration of a transducer on the skin. We investigated how accurately such an SSD guided navigation in an obstacle circumvention task. Using an SSD, 12 blindfolded participants navigated around a single flat 0.6 x 2 m obstacle. A 3-dimensional Vicon motion capture system was used to quantify various kinematic indices of human movement. Navigation performance under full vision was used as a baseline for comparison. The obstacle position was varied from trial to trial relative to the participant, being placed at two distances 25 cm to the left, right or directly ahead. Under SSD guidance, participants navigated without collision in 93% of trials. No collisions occurred under visual guidance. Buffer space (clearance between the obstacle and shoulder) was larger by a factor of 2.1 with SSD guidance than with visual guidance, movement times were longer by a factor of 9.4, and numbers of velocity corrections were larger by a factor of 5 (all pSSD and visual guidance conditions. The results are consistent with the idea that SSD information can be used to generate a protective envelope during locomotion in order to avoid collisions when navigating around obstacles, and to pass on the side of the obstacle affording the most space in the majority of trials. PMID:27494318

  10. Research on Vision Measurement and Obstacle Avoidance Control System of Picking Robot Based on Embedded System%嵌入式采摘机器人视觉测量与避障控制系统研究

    Institute of Scientific and Technical Information of China (English)

    孙承庭; 胡平

    2016-01-01

    采摘机器人拥有自主收集信息并进行有效判断的能力,可以独立完成对果实的采摘作业,对满足水果种植需求、减小水果种植的劳动力投入及降低生产成本有着很重要的实际应用价值。为此,以嵌入式 ARM 智控系统为基础平台,设计了采摘机器人视觉测量与避障控制系统。该系统集机器视觉、视觉传感感知、伺服电机驱动和ARM智控模块于一体,建立了采摘机器人采摘运动学的数学模型,并通过 BP 网络神经型迭代学习算法测量果实的距离和球心坐标,对成熟果实进行精准识别和定位采摘。试验结果表明:采摘机器人能准确地进行自主采摘,成功率比较高,躲避障碍物的能力很强,更适合在复杂未知的果园中进行收获作业。%Harvesting robot has the ability to collect information and carry out effective judgment .It can be used to com-plete the picking of fruit .It is very important to have a very important practical application value for fruit growing de-mand, reducing the labor input and reducing production cost .This paper takes the embedded intelligence control system as the basic platform to design and research the picking robot vision measurement and obstacle avoidance control system , the system in machine vision , sensory perception , servo motor drive and arm intellectual control module in one , estab-lished picking picking robot kinematics mathematical model , and through BP neural network type iterative learning algo-rithm for measuring fruit distance and center coordinates , to mature fruits were accurate identification and localization of picking .The experimental results show that the picking robot can carry out self picking accurately , the success rate is relatively high , and the ability of avoiding obstacles is also very strong , and it is more suitable for harvesting operations in complex unknown orchard .

  11. Laser-Based Obstacle Detection at Railway Level Crossings

    Directory of Open Access Journals (Sweden)

    Vítor Amaral

    2016-01-01

    Full Text Available This paper presents a system for obstacle detection in railway level crossings from 3D point clouds acquired with tilting 2D laser scanners. Although large obstacles in railway level crossings are detectable with current solutions, the detection of small obstacles remains an open problem. By relying on a tilting laser scanner, the proposed system is able to acquire highly dense and accurate point clouds, enabling the detection of small obstacles, like rocks laying near the rail. During an offline training phase, the system learns a background model of the level crossing from a set of point clouds. Then, online, obstacles are detected as occupied space contrasting with the background model. To reduce the need for manual on-site calibration, the system automatically estimates the pose of the level crossing and railway with respect to the laser scanner. Experimental results show the ability of the system to successfully perform on a set of 41 point clouds acquired in an operational one-lane level crossing.

  12. 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.

  13. Systems and processes that ensure high quality care.

    Science.gov (United States)

    Bassett, Sally; Westmore, Kathryn

    2012-10-01

    This is the second in a series of articles examining the components of good corporate governance. It considers how the structures and processes for quality governance can affect an organisation's ability to be assured about the quality of care. Complex information systems and procedures can lead to poor quality care, but sound structures and processes alone are insufficient to ensure good governance, and behavioural factors play a significant part in making sure that staff are enabled to provide good quality care. The next article in this series looks at how the information reporting of an organisation can affect its governance. PMID:23252087

  14. LPN-BSN: education for a reformed health care system.

    Science.gov (United States)

    Redmond, G M

    1997-03-01

    Nursing practice has experienced a paradigm shift in health care delivery from hospitals to community-based models of health care. Nursing education must respond to accommodate the shift through curriculum reform. This article discusses a LPN-BSN program to promote educational mobility for LPNs while educating them for a reformed health care system. The needs assessment and curriculum implementation are discussed. Student comments and experiences are included throughout. Student academic support and recruiting which addresses the special needs of the LPN-BSN student are also described. The evaluation of the project thus far indicates student success. PMID:9067870

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

    Science.gov (United States)

    Quaye, Randolph K

    2016-05-01

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

  16. Care and Conversing in Dialogical Systems

    DEFF Research Database (Denmark)

    Steffensen, Sune Vork

    2012-01-01

    -present human beings engaged in interactivity that bring forth situated behavioural coordination (or a communicative, structural coupling). Dialogical systems, however, have emergent properties irreducible to individual actions or microsocial norms. Among the emergent properties one find a tendency to establish...

  17. Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems.

    Science.gov (United States)

    2014-05-01

    Understanding a care coordination framework, its functions, and its effects on children and families is critical for patients and families themselves, as well as for pediatricians, pediatric medical subspecialists/surgical specialists, and anyone providing services to children and families. Care coordination is an essential element of a transformed American health care delivery system that emphasizes optimal quality and cost outcomes, addresses family-centered care, and calls for partnership across various settings and communities. High-quality, cost-effective health care requires that the delivery system include elements for the provision of services supporting the coordination of care across settings and professionals. This requirement of supporting coordination of care is generally true for health systems providing care for all children and youth but especially for those with special health care needs. At the foundation of an efficient and effective system of care delivery is the patient-/family-centered medical home. From its inception, the medical home has had care coordination as a core element. In general, optimal outcomes for children and youth, especially those with special health care needs, require interfacing among multiple care systems and individuals, including the following: medical, social, and behavioral professionals; the educational system; payers; medical equipment providers; home care agencies; advocacy groups; needed supportive therapies/services; and families. Coordination of care across settings permits an integration of services that is centered on the comprehensive needs of the patient and family, leading to decreased health care costs, reduction in fragmented care, and improvement in the patient/family experience of care.

  18. Patients with type II diabetes mellitus display reduced toe-obstacle clearance with altered gait patterns during obstacle-crossing.

    Science.gov (United States)

    Liu, Ming-Wei; Hsu, Wei-Chun; Lu, Tung-Wu; Chen, Hao-Ling; Liu, Hwa-Chang

    2010-01-01

    Patients with type II diabetes mellitus (DM) have been reported to be at high risk of falls that may be further increased by the effects of challenging activities such as obstacle-crossing. The purpose of this study was to compare the end-point trajectory and joint kinematic and kinetic patterns of the lower extremities between healthy subjects and individuals with DM during obstacle-crossing with the leading limb. Fourteen patients with type II DM, with no to minimal peripheral neuropathy (PN), and 14 healthy controls walked and crossed obstacles of three different heights (10%, 20% and 30% of leg length) while kinematic and kinetic data were measured using a motion analysis system and two forceplates. Compared to normal, the DM group had similar walking speeds and horizontal footobstacle distances but significantly reduced leading toe-obstacle clearances, suggesting an increased risk of tripping over the obstacle. When the swing toe was above the obstacle, the DM group showed greater pelvic anterior tilt, stance ankle dorsiflexion, and smaller swing hip abduction, with reduced hip abductor moments but greater knee flexor and ankle plantarflexor and adductor moments. It is suggested that patients with type II DM, with no or minimal PN, should also be targeted for prevention of falls. Possible therapeutic interventions to decrease falls for those with DM may include strengthening of the knee flexors and ankle plantarflexor muscles, together with proprioception and balance training. PMID:19875290

  19. Policy challenges in US health care system reform.

    Science.gov (United States)

    Hussain, Aftab; Rivers, Patrick A

    2010-01-01

    Once again, efforts are being made to overhaul the US health care system. Democrats and Republicans have conflicting views on how to repair this ailing system. However, this is not a new phenomenon. Reformers have long struggled to form a universal health care system only to find themselves in conflict with groups whose financial stake is threatened as well as numerous labor associations who are concerned about a loss of power. This struggle is also caused by differences in ideologies. This article surveys social movements for national health insurance (NHI) that occurred in the United States and will examine features that prevented NHI policy formation. PMID:22329329

  20. [Information system for supporting the Nursing Care Systematization].

    Science.gov (United States)

    Malucelli, Andreia; Otemaier, Kelly Rafaela; Bonnet, Marcel; Cubas, Marcia Regina; Garcia, Telma Ribeiro

    2010-01-01

    It is an unquestionable fact, the importance, relevance and necessity of implementing the Nursing Care Systematization in the different environments of professional practice. Considering it as a principle, emerged the motivation for the development of an information system to support the Nursing Care Systematization, based on Nursing Process steps and Human Needs, using the diagnoses language, nursing interventions and outcomes for professional practice documentation. This paper describes the methodological steps and results of the information system development - requirements elicitation, modeling, object-relational mapping, implementation and system validation.

  1. Evidence Based Order Sets as a Nursing Care Planning System

    OpenAIRE

    LaCrosse, Lisa M.; Heermann, Judith; Azevedo, Karen; Sorrentino, Catherine; Straub, Dawn; O'Dowd, Gloria

    2002-01-01

    The process for developing the nursing care planning (NCP) function for integration into a clinical information system (CIS) will be described. This NCP system uses evidence based order sets or interventions that are specific to a problem with associated patient focused goals or outcomes. The problem, order set, goal framework will eventually be used by all disciplines in the patient focused record.

  2. 40 CFR 160.43 - Test system care facilities.

    Science.gov (United States)

    2010-07-01

    ... GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.43 Test system care facilities. (a) A testing... testing facility shall have a number of animal rooms or other test system areas separate from those... sanitary storage of waste before removal from the testing facility. Disposal facilities shall be...

  3. Comparative effectiveness of the SNaP™ Wound Care System.

    Science.gov (United States)

    Hutton, David W; Sheehan, Peter

    2011-04-01

    Diabetic lower extremity wounds cause substantial burden to healthcare systems, costing tens of thousands of dollars per episode. Negative pressure wound therapy (NPWT) devices have been shown to be cost-effective at treating these wounds, but the traditional devices use bulky electrical pumps that require a durable medical equipment rental-based procurement process. The Spiracur SNaP™ Wound Care System is an ultraportable NPWT system that does not use an electric pump and is fully disposable. It has superior healing compared to standard of care with modern dressings and comparable healing to traditional NPWT devices while giving patients greater mobility and giving clinicians a simpler procurement process. We used a mathematical model to analyse the costs of the SNaP™ system and compare them to standard of care and electrically powered NPWT devices. When compared to standard of care, the SNaP™ system saves over $9000 per wound treated and more than doubles the number of patients healed. The SNaP system has similar healing time to powered NPWT devices, but saves $2300 in Medicare payments or $2800 for private payers per wound treated. Our analysis shows that the SNaP™ system could save substantial treatment costs in addition to allowing patients greater freedom and mobility. PMID:21385320

  4. Four proposals for market-based health care system reform.

    Science.gov (United States)

    Sumner, W

    1994-08-01

    A perfectly free, competitive medical market would not meet many social goals, such as universal access to health care. Micromanagement of interactions between patients and providers does not guarantee quality care and frequently undermines that relationship, to the frustration of all involved. Furthermore, while some North American health care plans are less expensive than others, none have reduced the medical inflation rate to equal the general inflation rate. Markets have always fixed uneven inflation rates in other domains. The suggested reforms could make elective interactions between patients and providers work more like a free market than did any preceding system. The health and life insurance plan creates cost-sensitive consumers, informed by a corporation with significant research incentives and abilities. The FFEB proposal encourages context-sensitive pricing, established by negotiation processes that weigh labor and benefit. Publication of providers' expected outcomes further enriches the information available to consumers and may reduce defensive medicine incentives. A medical career ladder would ease entry and exit from medical professions. These and complementary reforms do not specifically cap spending yet could have a deflationary impact on elective health care prices, while providing incentives to maintain quality. They accomplish these ends by giving more responsibility, information, incentives, and choice to citizens. We could provide most health care in a marketlike environment. We can incorporate these reforms in any convenient order and allow them to compete with alternative schemes. Our next challenge is to design, implement, and evaluate marketlike health care systems.

  5. Interdisciplinary Shared Governance in Ambulatory Care: One Health System's Journey.

    Science.gov (United States)

    Powers, Sharon; Bacon, Cynthia Thornton

    2016-01-01

    The implementation of shared governance structures in acute care has illustrated the positive relationship between shared decision making and nurse empowerment and positive nurse and patient outcomes. Little is known, however, about interdisciplinary shared governance, and even less is known about shared governance in ambulatory care. This article details one health system's experience with the implementation of an interdisciplinary shared governance structure in ambulatory care over a 4-year period. The authors report lessons learned, positive health system outcomes that resulted including improved communication, better preparedness for accreditation visits, improved assessment of fall risk, and a streamlined documentation system. Also discussed are mechanisms to enhance sustainability of the structure and discussion of future opportunities and challenges. PMID:27259130

  6. Convergence creates opportunities across health care system.

    Science.gov (United States)

    Fox, Brent I; Felkey, Bill G

    2014-04-01

    Industrial design students at Auburn do a creativity exercise where they are asked to combine a common household appliance with an animal. Have you seen a snake light? In health technology, we have a similar opportunity. In the connection between jewelry and vital sign monitoring technology or household security and health status monitoring, we are witnessing active convergence that will benefit patients, providers, and health systems.

  7. Patient Experienced Continuity of Care in the Psychiatric Healthcare System

    DEFF Research Database (Denmark)

    Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne;

    2014-01-01

    , developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups......Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse...... migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry...

  8. Exposure management systems in emergencies as comprehensive medical care

    International Nuclear Information System (INIS)

    The emergency management of nuclear hazards relies on a comprehensive medical care system that includes accident prevention administration, environmental monitoring, a health physics organization, and a medical institution. In this paper, the care organization involved in the criticality accident at Tokai-mura is described, and the problems that need to be examined are pointed out. In that incident, even the expert was initially utterly confused and was unable to take appropriate measures. The author concluded that the members of the care organization were all untrained for dealing with nuclear hazards and radiation accidents. The education and training of personnel at the job site are important, and they are even more so for the leaders. Revisions of the regional disaster prevention plans and care manual are needed. (K.H.)

  9. Public hospitals: the legal obstacles of entering into joint ventures.

    Science.gov (United States)

    Miller, J N

    1986-03-01

    Public hospitals, as public entities, are limited in many of their activities by state constitutions and statutes. One area where activity can be particularly limited is the joint venture. Constitutional and statutory limitations can influence several aspects of the joint venture: scope of activities, geographic boundaries, authority to enter into joint ventures, gift of public funds prohibition, and stock ownership. Therefore, public hospitals must be aware of possible legal obstacles and carefully consider their options.

  10. An intelligent partner system for improving chronic illness care

    Directory of Open Access Journals (Sweden)

    Tibor Deutsch

    2003-02-01

    Full Text Available Chronic care consists of a sequence of actions to treat a specific clinical disorder over time as a function of the ways in which illness progresses and patients respond to management actions. Outcomes depend on physicians' skills to select the actions best suited for their patients and competent self-management. This paper presents the architecture of an intelligent partner system (IPS, which helps to provide doctors with relevant data and skills and empowers chronically ill patients with the information and confidence to manage their health wisely. The services of this intelligent system are presented as 'therapies' for the information-processing 'pathologies' associated with traditional chronic illness care.

  11. 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

  12. 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.

  13. 用于避障研究的微型仿生机器鱼3维仿真系统%3D simulation system of micro robotic fish for obstacle avoidance research

    Institute of Scientific and Technical Information of China (English)

    叶秀芬; 关红玲; 张哲会; 杨博文

    2011-01-01

    基于VC++6.0开发环境和OpenGL(open graphics library)国际图形标准,在Windows系统下开发了微型仿生机器鱼3维仿真系统.该系统可以降低用实体机器鱼进行机器鱼避障能力研究的成本和减少在研究过程中对实体机器鱼造成的损害.采用多边形建模的方法构建了虚拟微型仿生机器鱼模型,模拟了鱼类尾鳍的摆动.提出了一种模拟红外传感器探测障碍物的虚拟射线方法.并采用实时模糊决策算法设计了基于多传感器信息的复合模糊控制器,决策微型仿生机器鱼的避障行为.仿真实验表明,复合模糊控制器实时性好、效率高;无论是单个任意形状的障碍物还是多个连续障碍物,复合模糊控制器都能有效地引导仿生机器鱼避开障碍物,到达目标点.微型仿生机器鱼3维仿真系统为研究仿生机器鱼的自主避障能力提供了可靠、逼真、便利的平台.%A 3D simulation system of micro robotic fish was developed in windows operation system with VC++ 6.0developing environment and OpenGL international graphic standard, in order to reduce the cost of obstacle avoidance research using real robotic fish and reduce the damage to the real robotic fish. A virtual robotic fish was built using polygon modeling method and the swing of fish tail was simulated. A virtual ray method which simulated infrared sensor detecting obstacles was proposed. Based on the information of multiple sensors, a composite fuzzy controller using real time fuzzy control algorithm was designed to decide the avoidance behavior of micro robotic fish. The simulation results demonstrate the composite fuzzy controller is of real-time and has high efficienly. Micro robotic fish was efficiently conducted by the composite fuzzy controller to avoid both single arbitrary shape obstacle and multiple continuous obstacles and achieved the targeting result. A reliable, realistic and convenient platform was provided for researching the

  14. Comparing the Canadian and US systems of health care in an era of health care reform.

    Science.gov (United States)

    LaPierre, Tracey A

    2012-01-01

    The purpose of this article is to provide an informed comparison of health care in the United States and Canada along multiple dimensions. Specifically this article looks at coverage, access, cost, health outcomes, satisfaction, and underlying ideology. Canada fares better than the United States with regard to coverage, cost, and health outcomes. While overall access is better in Canada, patients are sometimes required to endure longer wait times than in the United States. Reports of satisfaction levels vary across studies, but most evidence points toward comparable levels of satisfaction in Canada and the United States. Strong ideological differences underlie the Canadian and American systems, making the acceptance and implementation of certain reforms difficult. The potential impact of the US Patient Protection and Affordable Care Act (PPACA), as well as recent Canadian health care reforms on coverage, access, cost, and health outcomes are also discussed. PMID:22894018

  15. Systemic racism and U.S. health care.

    Science.gov (United States)

    Feagin, Joe; Bennefield, Zinobia

    2014-02-01

    This article draws upon a major social science theoretical approach-systemic racism theory-to assess decades of empirical research on racial dimensions of U.S. health care and public health institutions. From the 1600s, the oppression of Americans of color has been systemic and rationalized using a white racial framing-with its constituent racist stereotypes, ideologies, images, narratives, and emotions. We review historical literature on racially exploitative medical and public health practices that helped generate and sustain this racial framing and related structural discrimination targeting Americans of color. We examine contemporary research on racial differentials in medical practices, white clinicians' racial framing, and views of patients and physicians of color to demonstrate the continuing reality of systemic racism throughout health care and public health institutions. We conclude from research that institutionalized white socioeconomic resources, discrimination, and racialized framing from centuries of slavery, segregation, and contemporary white oppression severely limit and restrict access of many Americans of color to adequate socioeconomic resources-and to adequate health care and health outcomes. Dealing justly with continuing racial "disparities" in health and health care requires a conceptual paradigm that realistically assesses U.S. society's white-racist roots and contemporary racist realities. We conclude briefly with examples of successful public policies that have brought structural changes in racial and class differentials in health care and public health in the U.S. and other countries.

  16. Systemic racism and U.S. health care.

    Science.gov (United States)

    Feagin, Joe; Bennefield, Zinobia

    2014-02-01

    This article draws upon a major social science theoretical approach-systemic racism theory-to assess decades of empirical research on racial dimensions of U.S. health care and public health institutions. From the 1600s, the oppression of Americans of color has been systemic and rationalized using a white racial framing-with its constituent racist stereotypes, ideologies, images, narratives, and emotions. We review historical literature on racially exploitative medical and public health practices that helped generate and sustain this racial framing and related structural discrimination targeting Americans of color. We examine contemporary research on racial differentials in medical practices, white clinicians' racial framing, and views of patients and physicians of color to demonstrate the continuing reality of systemic racism throughout health care and public health institutions. We conclude from research that institutionalized white socioeconomic resources, discrimination, and racialized framing from centuries of slavery, segregation, and contemporary white oppression severely limit and restrict access of many Americans of color to adequate socioeconomic resources-and to adequate health care and health outcomes. Dealing justly with continuing racial "disparities" in health and health care requires a conceptual paradigm that realistically assesses U.S. society's white-racist roots and contemporary racist realities. We conclude briefly with examples of successful public policies that have brought structural changes in racial and class differentials in health care and public health in the U.S. and other countries. PMID:24507906

  17. Obstacles to Rural Residents’ Consumption in China and the Countermeasures

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    On the basis of relevant statistical data, this paper analyzes the obstacles to rural residents’ consumption in China as follows: the consumption structure is restricted critically; the consumption environment cannot meet the need of social development; the traditional consumption concept has not yet been changed; the social security system is not sound; the support of rural finance is short. Pointed countermeasures for eliminating the obstacles to rural residents’ consumption are put forward as follows: first, adopt effective measures to elevate the level of farmers’ income; second, strengthen the credit support of rural finance; third, quicken the pace of modernized development in rural areas; fourth, construct perfect rural social security system.

  18. [Major obstacles in the development of child and adolescent psychiatry in Hungary].

    Science.gov (United States)

    Kalmar, Sandor

    2016-06-01

    The author ascertains that healthy personality development faces increasingly serious obstacles and consequently the number of children in need of mental healthcare is on the rise. Child and adolescent psychiatry has drawn increasing appreciation, however, it is only formal and deficient in Hungary today and cannot assure optimal mental care according to the principles of evidence-based medicine. The author emphasizes that 75% of the first manifestation of the psychiatric disorders occurs during adolescence and young adulthood. In spite of legal regulation, several deficiencies hinder the development of children into healthy adults. The author analyses the most important obstacles in the development of child and adolescent Psychiatry. The author emphasizes the role of keypersons, describes the situation of and problems faced by Hungarian child psychiatric care. The author lists in detail the most important contradictions, deficiencies and obstacles and outlines suggestions for resolving the present crisis. The author emphasizes (1) the responsibility of institutions, and people dealing with society and children, and the disinterest of competent authorities. (2) The somatic, mental, cultural and spiritual ignorance/illiteracy among parents, teachers, healthcare workers, and the general population partly related to crises among the pedagogues. (3) The lack of holistic approach to treatment of children suffering from mental disorder. (4) The importance and the lack of knowledge concerning central nervous system function in child psychiatry. (5) Application of evidence-based medicine in child and adolescent psychiatry based on understanding the relationship between central nervous system alterations and mental functions. (6) Respecting keypersons' competence limits. (7) Immediate development of inpatient and outpatient child and adolescent psychiatry in the whole country. (8) Reform of child psychiatry board exam. (9) Development of currently missing textbooks and

  19. Architecture of a prehospital emergency patient care report system (PEPRS).

    Science.gov (United States)

    Majeed, Raphael W; Stöhr, Mark R; Röhrig, Rainer

    2013-01-01

    In recent years, prehospital emergency care adapted to the technology shift towards tablet computers and mobile computing. In particular, electronic patient care report (e-PCR) systems gained considerable attention and adoption in prehospital emergency medicine [1]. On the other hand, hospital information systems are already widely adopted. Yet, there is no universal solution for integrating prehospital emergency reports into electronic medical records of hospital information systems. Previous projects either relied on proprietary viewing workstations or examined and transferred only data for specific diseases (e.g. stroke patients[2]). Using requirements engineering and a three step software engineering approach, this project presents a generic architecture for integrating prehospital emergency care reports into hospital information systems. Aim of this project is to describe a generic architecture which can be used to implement data transfer and integration of pre hospital emergency care reports to hospital information systems. In summary, the prototype was able to integrate data in a standardized manner. The devised methods can be used design generic software for prehospital to hospital data integration. PMID:23920925

  20. Three-dimensional velocity obstacle method for UAV deconflicting maneuvers

    NARCIS (Netherlands)

    Jenie, Y.I.; Van Kampen, E.J.; De Visser, C.C.; Ellerbroek, J.; Hoekstra, J.M.

    2015-01-01

    Autonomous systems are required in order to enable UAVs to conduct self-separation and collision avoidance, especially for flights within the civil airspace system. A method called the Velocity Obstacle Method can provide the necessary situational awareness for UAVs in a dynamic environment, and can

  1. Algorithms for High-Performance Networking in the Presence of Obstacles

    OpenAIRE

    Lozev, Kamen

    2012-01-01

    This work develops novel algorithms for high-performance networking in the presence of obstacles based on a method for communicating via ultrasonic rays reflected at the obstacles. The rays are curves determined by the variable speed of sound and initial conditions and we develop ultrasonic ray models based on a system of differential equations. We present new parallel algorithms and software for shape and trajectory reconstruction of moving obstacles and show how the reconstructed reflection...

  2. The Danish health care system from a British perspective.

    Science.gov (United States)

    Hurst, Jeremy

    2002-02-01

    The organisation and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of strengths, weakness, opportunities and threats) by a panel of five members with a background in health economics. The evaluation was based on reading an extensive amount of selected documents and literature on the Danish health care system, and a one-week visit to health care authorities, providers and key persons. The present paper includes the main findings by one of the panel members. The dominance of tax financing helps to achieve control over the level of health care expenditure, as well as securing equity in financing the services. The reliance on local government for financing and running health care has both advantages and disadvantages, and the split between county and municipal responsibility leads to problems of co-ordination. The remuneration of general practitioners by a mix of capitation payment and fee for services has the advantage of capping expenditure whilst leaving the GPs with an incentive to compete for patients by providing them with good services. The GP service is remarkably economical. The hospital sector displays much strength, but there seem to be problems with respect to: (i) perceived lack of resources and waiting lists; (ii) impersonal care, lack of continuity of care and failures in communication between patients and staff; (iii) management problems and sometimes demotivated staff. The relationship between patients and providers is facilitated by free access to GPs and absence of any charges for hospital treatment. The biggest threat is continuation of avoidable illness caused by poor health habits in the population. The biggest opportunity is to strengthen public health measures to tackle these poor health habits. PMID:11755995

  3. The Danish health care system from a British perspective.

    Science.gov (United States)

    Hurst, Jeremy

    2002-02-01

    The organisation and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of strengths, weakness, opportunities and threats) by a panel of five members with a background in health economics. The evaluation was based on reading an extensive amount of selected documents and literature on the Danish health care system, and a one-week visit to health care authorities, providers and key persons. The present paper includes the main findings by one of the panel members. The dominance of tax financing helps to achieve control over the level of health care expenditure, as well as securing equity in financing the services. The reliance on local government for financing and running health care has both advantages and disadvantages, and the split between county and municipal responsibility leads to problems of co-ordination. The remuneration of general practitioners by a mix of capitation payment and fee for services has the advantage of capping expenditure whilst leaving the GPs with an incentive to compete for patients by providing them with good services. The GP service is remarkably economical. The hospital sector displays much strength, but there seem to be problems with respect to: (i) perceived lack of resources and waiting lists; (ii) impersonal care, lack of continuity of care and failures in communication between patients and staff; (iii) management problems and sometimes demotivated staff. The relationship between patients and providers is facilitated by free access to GPs and absence of any charges for hospital treatment. The biggest threat is continuation of avoidable illness caused by poor health habits in the population. The biggest opportunity is to strengthen public health measures to tackle these poor health habits.

  4. Darwinian drift: Effects of Wake Vortices and Multiple Obstacles

    Science.gov (United States)

    Melkoumian, Sergei; Protas, Bartosz

    2015-11-01

    When a body passes through an unbounded fluid, it induces a net displacement of fluid particles. The difference between the initial and final positions of a fluid particle is defined as the Darwinian drift and plays an important role in the characterization of the stirring occurring in multiphase flows and in the context of biogenic mixing. Traditional studies of drift have mainly focused on single obstacles moving in a potential flow. In the present investigation we consider the effect of wake vorticity, represented by a pair of Föppl point vortices, and the combined effect of multiple obstacles. The drift in various configurations is determined using methods of complex analysis and careful numerical computations. It is demonstrated that, while the total drift increases with the size of the wake for large vortex strengths, it is actually decreased for small circulation values. We also discuss how the interaction of two obstacles affects the drift in comparison to the case of two isolated obstacles. In particular, we identify the lower and upper bound on the drift due to two identical cylinders. In certain cases our results are supported by asymptotic analysis. A physical explanation of the observed affects is offered in terms of the trajectories of individual particles.

  5. 基于dsPIC30f4012的越障小车控制系统设计%Design of Obstacle-Navigation Car and Controlling System Based on dsPIC30f4012

    Institute of Scientific and Technical Information of China (English)

    黄金虎; 卢刚; 王俊

    2012-01-01

    According to the performance requirements of obstacle-navigation car, the characteristics of the motion control system were analyzed, and the distributed motor control system based on CAN bus was used. The car's main controller and controller unit of the drive wheel were designed. The digital signal controller dsPIC30f4012 with higher cost performance was selected as the master and slave controller processor. The communication between the main controller and each joint movement was achieved through the CAN bus. Tests proved that the system design was reasonable with good response and control accuracy, and the operation requirements of the obstacle-navigation car were met.%根据越障小车的性能要求,分析其运动控制系统的特点,采用基于CAN总线的分布式电机控制系统,设计了监控云台的主控制器和驱动轮的单元控制器.选用了性价比较高的数字信号控制器dsPIC30f4012在作为主、从控制器的处理器,通过CAN总线实现了主控制器和各个运动关节的驱动控制器之间的通讯.试验证明该系统设计合理,具有良好的响应速度和控制精度,可以满足越障小车运行要求.

  6. Rationing and competition in the Dutch health-care system.

    Science.gov (United States)

    Schut, Frederik T; Van de Ven, Wynand P M M

    2005-09-01

    In this paper we examine the goals and effects of health-care policy in the Netherlands over the period 1980--2000. During this period Dutch health-care policy is marked by a peculiar combination of increasingly stringent cost-containment policies alongside a persistent pursuit of market-oriented reforms. The main goal of cost containment was to keep labour costs down under the restriction of universal equal access to health care. Supply and price control policies were quite successful in achieving cost containment, but in due course prolonged quantity rationing began to jeopardise universal physical access to health services. The main goal of market-oriented health-care reforms is to increase the system's efficiency and its responsiveness to patient's needs, while maintaining equal access. The feasibility of the reforms crucially hinges on the realisation of adequate methods of risk adjustment, product classification and quality measurement, an appropriate consumer information system and an effective competition policy. Realising these preconditions requires a lengthy and cautious implementation process. Although considerable progress has been made in setting the appropriate stage for regulated competition in Dutch health care, the role of the market is still limited. PMID:16161190

  7. Regionalized trauma care: a methodological proposal from the system dynamics

    Directory of Open Access Journals (Sweden)

    Piedad Roldán J

    2009-08-01

    Full Text Available Studies relating to trauma are mainly multicausal, but when we observe the impact of interventions on their causes, there is no clarity about the best way for prevention and control. Objective: To approach the problem of trauma from an integral point of view that facilitates understanding the phenomenon from its complex interrelationships. Methodology: using the system dynamics raised by Forrester to propose a dynamic model capable of predicting situations related to prevention and care, to raise public policies towards reducing the incidence and mortality. The process included six steps of the dynamics of systems to deliver a model for the analysis of existing and potential scenarios in their care, based on simulations of the behavior of the trauma, including the incidence and prevention of variables in interaction with prehospital care and hospitable. Results: the proposal was ideal in the care of trauma described in the dynamic scenario put “appropriate care of the patient described in the appropriate institution, is guaranteed to reduce the mortality for trauma”.

  8. Medical Information Management System (MIMS) CareWindows.

    Science.gov (United States)

    Stiphout, R. M.; Schiffman, R. M.; Christner, M. F.; Ward, R.; Purves, T. M.

    1991-01-01

    The demonstration of MIMS/CareWindows will include: (1) a review of the application environment and development history, (2) a demonstration of a very large, comprehensive clinical information system with a cost effective graphic user server and communications interface. PMID:1807755

  9. Primary Health Care in Canada: Systems in Motion

    OpenAIRE

    Hutchison, Brian; Levesque, Jean-Frederic; Strumpf, Erin; Coyle, Natalie

    2011-01-01

    Context: During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged.

  10. Indonesia health care system and Asean economic community

    Directory of Open Access Journals (Sweden)

    Joko Gunawan

    2015-07-01

    However, AEC, by looking at this challenges, is expected to improve health care system and service in Indonesia, and close the gap by collaborating among ten ASEAN member countries through 4 modes of AEC consisting of cross border supply, consumption abroad, commercial presence, and movement of natural persons. [Int J Res Med Sci 2015; 3(7.000: 1571-1577

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

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

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

  12. Can casemix-systems be applied in Danish primary care?

    DEFF Research Database (Denmark)

    Halling, Anders; Kristensen, Troels

    Background: New technology in terms of IT systems, better data infrastructure and improved registrations of health data provide new opportunities for health care systems to improve the care experience of individual patients, improve public health and reduce healthcare costs. Application of "Big...... Data", which covers the collection, storage, analysis, processing and interpretation of large amounts of data can via a casemix system provide new and insightful information about the morbidity burden of populations in terms of co-morbidity in addition to index conditions/multi-morbidity and related...... resource consumption. . Aim: The objective of this study was to conduct a preliminary analysis of the usefulness of the ACG casemix system in Denmark. This includes presenting the results for a region of Denmark and assessment of the usefulness and quality of the results. Methods and Data: This cross...

  13. Obstacle Avoidance in Groping Locomotion of a Humanoid Robot

    Directory of Open Access Journals (Sweden)

    Masahiro Ohka

    2008-11-01

    Full Text Available This paper describes the development of an autonomous obstacle-avoidance method that operates in conjunction with groping locomotion on the humanoid robot Bonten-Maru II. Present studies on groping locomotion consist of basic research in which humanoid robot recognizes its surroundings by touching and groping with its arm on the flat surface of a wall. The robot responds to the surroundings by performing corrections to its orientation and locomotion direction. During groping locomotion, however, the existence of obstacles within the correction area creates the possibility of collisions. The objective of this paper is to develop an autonomous method to avoid obstacles in the correction area by applying suitable algorithms to the humanoid robot's control system. In order to recognize its surroundings, six-axis force sensors were attached to both robotic arms as end effectors for force control. The proposed algorithm refers to the rotation angle of the humanoid robot's leg joints due to trajectory generation. The algorithm relates to the groping locomotion via the measured groping angle and motions of arms. Using Bonten-Maru II, groping experiments were conducted on a wall's surface to obtain wall orientation data. By employing these data, the humanoid robot performed the proposed method autonomously to avoid an obstacle present in the correction area. Results indicate that the humanoid robot can recognize the existence of an obstacle and avoid it by generating suitable trajectories in its legs.

  14. Interaction of turbulent deflagrations with representative flow obstacles

    Energy Technology Data Exchange (ETDEWEB)

    Durst, B.; Ardey, N.; Mayinger, F. [Lehrstul a fuer Thermodynamik, Technische Universitat Munchen (Germany)

    1997-03-01

    In the case of a gradual release of hydrogen in the course of an assumed, severe accident in a light water reactor, the combustion will normally start out as a slow deflagration. Acceleration of an initially slow flame due to interactions of chemical kinetics and turbulent heat and mass transfer can result in very high flame speeds. Therefore, in order to assess hydrogen mitigation techniques, detailed knowledge about flame acceleration and interaction of flames with obstacles is required. The reported investigations are aimed at the investigation of the mechanisms responsible for turbulent flame acceleration and improving present correlations for estimates and models for numerical simulations of hydrogen combustion processes. A medium-scale square cross-section setup is employed, using flow obstacles with shapes representative for reactor containments. The global flame speed is deduced from measurements using thermocouples, pressure transducers and photodiodes. Measurements using a two-component LDA-system are being carried through in order to correlate global flame spread and local turbulence parameters. Results indicate that low blockage-ratio obstacles only marginally influence the flame, as disturbances which are induced remain local to the vicinity of the obstacle and die out very quickly downstream thereof. Flow visualizations by means of a Schlieren setup indicate very complex flow structures in the vicinity of obstacles. The results are being used to validate turbulent reaction models. A model based on probability density functions (pdf) of assumed shape has been developed and initial calculations are presented. (author)

  15. A SUSTAINABLE HEALTH CARE SYSTEM REQUIRES MANAGEMENT TRANSFORMATION

    Directory of Open Access Journals (Sweden)

    Kanellopoulos Dimitros

    2011-12-01

    Full Text Available In order to be the health care system sustainable , management transformations must be based on very precise diagnostic analysis that includes complete and current information. It is necessary to implement an information system that collects information in real time, that watches the parameters that significantly influence the sustainability of the system. Such an information system should point out a radiography(a scan of the system at some time under following aspects:: 1. An overview of system; 2 An overview of the economic situation; 3 A technical presentation ;4. A legal overview; 5. A social overview ; 6. A management overview .Based on these Xrays of the health system, it outlines a series of conclusions and recommendations together with a SWOT analysis that highlights the potential internal (strengths and weaknesses and external potential (opportunities and threats. Based on this analysis and recommendations, the management is going to redesign the system in order to be adapted to the changing environmental requirements. Management transformation is recommended to be by following steps. :1. The development of a new management system that would make a positive change in the health care system 2. Implementation of the new management system 3. Assessment of the changes

  16. Obstacles and foliage discrimination using lidar

    Science.gov (United States)

    Morris, Daniel D.

    2016-05-01

    A central challenge to autonomous off-road navigation is discriminating between obstacles that are safe to drive over and those that pose a hazard to navigation and so must be circumnavigated. Foliage, which can often be safely driven over, presents two important perception problems. First, foliage can appear as a large impenetrable obstacle, and so must be discriminated from other objects. Second, real obstacles are much harder to detect when adjacent to or occluded by foliage and many detection methods fail to detect them due to additional clutter and partial occlusions from foliage. This paper addresses both the discrimination of foliage, and the detection of obstacles in and near foliage using Lidar. Our approach uses neighboring pixels in a depth image to construct features at each pixel that provide local surface properites. A generative model for obstacles is used to accumulate probabilistic evidence for obstacles and foliage in the vicinity of a moving platform. Detection of obstacles is then based on evidence within overlapping cells of a map without the need to segment segment obstacles and foliage. High accuracy obstacle and foliage discrimination is obtained and compared with the use of a point scatter measure.

  17. Health care financing and the sustainability of health systems.

    Science.gov (United States)

    Liaropoulos, Lycourgos; Goranitis, Ilias

    2015-01-01

    The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to "traditional" issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability. PMID:26369417

  18. Requirements Engineering for a Pervasive Health Care System

    DEFF Research Database (Denmark)

    Jørgensen, Jens Bæk; Bossen, Claus

    2003-01-01

    support are represented via a combination of prose, formal models, and animation. The representation enables various stakeholders to make interactive investigations of requirements for the system in the context of the envisioned work processes. We describe lessons learned from collaboration between users......We describe requirements engineering for a new pervasive health care system for hospitals in Denmark. The chosen requirements engineering approach composes iterative prototyping and explicit environment description in terms of workflow modelling. New work processes and their proposed computer...... and system developers in engineering the requirements for the new system...

  19. Health Care Professionals Devise Ways to Get Around Using Electronic Health Record Systems

    Science.gov (United States)

    ... Task Force Improving Primary Care Practice Health IT Integration Health Care/System Redesign Clinical-Community Linkages Care Coordination Capacity Building Behavioral and Mental Health Self-Management Support Resources Clinical Community Relationships ...

  20. Reform Drivers and Reform Obstacles in Natural Resource Management

    DEFF Research Database (Denmark)

    Gezelius, Stig S.; Raakjær, Jesper; Hegland, Troels Jacob

    2010-01-01

    ABSTRACT: The ability to transform historical learning into institutional reform is a key to success in the management of common pool natural resources. Based on a model of institutional inertia and a comparative analysis of Northeast Atlantic fisheries management from 1945 to the present......, the paper aims to identify drivers and obstacles to learning-based institutional reform. We argue that the ineffectiveness of implementation systems has been a key driver of reform requirements, but that the need for agreement amongst a large number of interdependent decision makers has been an obstacle...

  1. OBSTACLE-AVOIDANCE NAVIGATION OF MULTIPLE MOBILE ROBOTS

    Institute of Scientific and Technical Information of China (English)

    罗青; 李智军; 吕恬生

    2002-01-01

    In the context of robot soccer, the robots have to select actions to achieve individual and team goals in the dynamic environment. It is important for a robot to acquire navigation behaviors for avoiding other robots and obstacles in the real-time environment. This paper suggested an efficient approach to collision-avoidance in multirobot system. This approach is based on velocity information of moving objects and the distance between robot and obstacle in three specified directions. The main contribution of this paper is that it provides a method for robots with decreased-computational cost and makes the robot navigate without collision with each other in a complicated environment.

  2. Constructing target product profiles (TPPs) to help vaccines overcome post-approval obstacles.

    Science.gov (United States)

    Lee, Bruce Y; Burke, Donald S

    2010-04-01

    As history has demonstrated, post-approval obstacles can impede a vaccine's use and potentially lead to its withdrawal. Addressing these potential obstacles when changes in a vaccine's technology can still be easily made may improve a vaccine's chances of success. Augmented vaccine target product profiles (TPPs) can help vaccine scientists better understand and anticipate these obstacles and galvanize conversations among various vaccine stakeholders (e.g., scientists, marketers, business development managers, policy makers, public health officials, health care workers, third party payors, etc.) earlier in a vaccine's development. PMID:19782109

  3. Time based management in health care system: The chosen aspects

    Directory of Open Access Journals (Sweden)

    Joanna Kobza

    2014-08-01

    Full Text Available Time-based management (TBM is the key element of the whole management process. For many years in health care systems of highly developed countries modern and effective methods of time-based management have been implemented in both primary health care and hospitals (emergency departments and operating rooms. Over the past two decades a systematic review of Polish literature (since 1990 and peer reviewed articles published in international journals based on PubMed/Medline (2001–2011 have been carried out. The collected results indicate that the demographic and health changes in the populations are one of the main challenges facing general practitioners in the nearest future. Time-based management needs new and effective tools and skills, i.e., identification of priorities, well designed planning, delegation of the tasks, proper coordination, and creation of primary care teams that include additional members and human resources management. Proper reimbursement of health services, development of IT in health care system, better collection, storage, processing, analysis and exchange of information and research findings will also be needed. The use of innovative technologies, like telemedicine consultations, provides the possibility of reducing waiting time for diagnosis and treatment and in some cases could be applied in terms of secondary care. To improve the efficiency of operating rooms it is necessary to introduce different solutions, such as operating room coordinator involvement, application of automation to guide decision-making or use of robotic tools to assist surgical procedures. Overcrowded emergency departments have a major detrimental effect on the quality of hospital functions, therefore, efforts should be made to reduce them. Time-based management training among physicians and health care management in Poland, as well as the implementation of practice-based solutions still applied in highly developed countries seem to be necessary

  4. Open architecture for health care systems: the European RICHE experience.

    Science.gov (United States)

    Frandji, B

    1997-01-01

    Groupe RICHE is bringing to the market of health IT the Open Systems approach allowing a new generation of health information systems to arise with benefit for patients, health care professionals, hospital managers, agencies and citizens. Groupe RICHE is a forum for exchanging information, expertise around open systems in health care. It is open to any organisation interested by open systems in health care and wanting to participate and influence the work done by its user, marketing and technical committees. The Technical Committee is in charge of the maintenance of the architecture and impact the results of industrial experiences on new releases. Any Groupe RICHE member is entitled to participate to this process. This unique approach in Europe allows health care professionals to benefit from applications supporting their business processes, including providing a cooperative working environment, a shared electronic record, in an integrated system where the information is entered only once, customised according to the user needs and available to the administrative applications. This allows Hospital managers to satisfy their health care professionals, to smoothly migrate from their existing environment (protecting their investment), to choose products in a competitive environment, being able to mix and match system components and services from different suppliers, being free to change suppliers without having to replace their existing system (minimising risk), in line with national and regional strategies. For suppliers, this means being able to commercialise products well fitted to their field of competence in a large market, reducing investments and increasing returns. The RICHE approach also allows agencies to define a strategy, allowing to create a supporting infrastructure, organising the market leaving enough freedom to health care organisations and suppliers. Such an approach is based on the definition of an open standard architecture. The RICHE esprit project

  5. Open architecture for health care systems: the European RICHE experience.

    Science.gov (United States)

    Frandji, B

    1997-01-01

    Groupe RICHE is bringing to the market of health IT the Open Systems approach allowing a new generation of health information systems to arise with benefit for patients, health care professionals, hospital managers, agencies and citizens. Groupe RICHE is a forum for exchanging information, expertise around open systems in health care. It is open to any organisation interested by open systems in health care and wanting to participate and influence the work done by its user, marketing and technical committees. The Technical Committee is in charge of the maintenance of the architecture and impact the results of industrial experiences on new releases. Any Groupe RICHE member is entitled to participate to this process. This unique approach in Europe allows health care professionals to benefit from applications supporting their business processes, including providing a cooperative working environment, a shared electronic record, in an integrated system where the information is entered only once, customised according to the user needs and available to the administrative applications. This allows Hospital managers to satisfy their health care professionals, to smoothly migrate from their existing environment (protecting their investment), to choose products in a competitive environment, being able to mix and match system components and services from different suppliers, being free to change suppliers without having to replace their existing system (minimising risk), in line with national and regional strategies. For suppliers, this means being able to commercialise products well fitted to their field of competence in a large market, reducing investments and increasing returns. The RICHE approach also allows agencies to define a strategy, allowing to create a supporting infrastructure, organising the market leaving enough freedom to health care organisations and suppliers. Such an approach is based on the definition of an open standard architecture. The RICHE esprit project

  6. Factors influencing obstacle crossing performance in patients with Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Ying-Yi Liao

    Full Text Available BACKGROUND: Tripping over obstacles is the major cause of falls in community-dwelling patients with Parkinson's disease (PD. Understanding the factors associated with the obstacle crossing behavior may help to develop possible training programs for crossing performance. This study aimed to identify the relationships and important factors determining obstacle crossing performance in patients with PD. METHODS: Forty-two idiopathic patients with PD (Hoehn and Yahr stages I to III participated in this study. Obstacle crossing performance was recorded by the Liberty system, a three-dimensional motion capture device. Maximal isometric strength of the lower extremity was measured by a handheld dynamometer. Dynamic balance and sensory integration ability were assessed using the Balance Master system. Movement velocity (MV, maximal excursion (ME, and directional control (DC were obtained during the limits of stability test to quantify dynamic balance. The sum of sensory organization test (SOT scores was used to quantify sensory organization ability. RESULTS: Both crossing stride length and stride velocity correlated significantly with lower extremity muscle strength, dynamic balance control (forward and sideward, and sum of SOT scores. From the regression model, forward DC and ankle dorsiflexor strength were identified as two major determinants for crossing performance (R(2 = .37 to.41 for the crossing stride length, R(2 = .43 to.44 for the crossing stride velocity. CONCLUSIONS: Lower extremity muscle strength, dynamic balance control and sensory integration ability significantly influence obstacle crossing performance. We suggest an emphasis on muscle strengthening exercises (especially ankle dorsiflexors, balance training (especially forward DC, and sensory integration training to improve obstacle crossing performance in patients with PD.

  7. Applying principles of health system strengthening to eye care

    Directory of Open Access Journals (Sweden)

    Karl Blanchet

    2012-01-01

    Full Text Available Understanding Health systems have now become the priority focus of researchers and policy makers, who have progressively moved away from a project-centred perspectives. The new tendency is to facilitate a convergence between health system developers and disease-specific programme managers in terms of both thinking and action, and to reconcile both approaches: one focusing on integrated health systems and improving the health status of the population and the other aiming at improving access to health care. Eye care interventions particularly in developing countries have generally been vertically implemented (e.g. trachoma, cataract surgeries often with parallel organizational structures or specialised disease specific services. With the emergence of health system strengthening in health strategies and in the service delivery of interventions there is a need to clarify and examine inputs in terms governance, financing and management. This present paper aims to clarify key concepts in health system strengthening and describe the various components of the framework as applied in eye care interventions.

  8. The French Health Care System: What Can We Learn?

    Directory of Open Access Journals (Sweden)

    El Taguri A

    2008-01-01

    Full Text Available All public systems look for the best organizational structure to funnel part of their national income into healthcare services. Appropriate policies may differ widely across country settings. Most healthcare systems fall under one of two broad categories, either Bismark or Beveridge systems. There is no simple ideal model for the organization of health services, but most healthcare systems that follow the Beveridge healthcare model are poor performers. The Libyan Health system is a low responsive, inefficient and underperforming system that lacks goals and/or SMART. (Specific, Measurable, Achievable, Realistic, Time specific objectives. A look at different organization models in the world would reinforce efforts to reorganize and improve the performance of the Libyan National Healthcare services.The French Health Care System (FHCS ranked first according to the WHO and the European Health Consumer Powerhouse. The FHCS was described to have a technically efficient, generous healthcare system that provides the best overall health care. This makes the FHCS a practical model of organization having many of the essential aspects of a modern national health service. In this review, we describe the main features of the FHCS, current challenges and future trends with particular attention paid to aspects that could be of importance to the Libyan Healthcare System.

  9. A framework to support team-based models of primary care within the Australian health care system.

    Science.gov (United States)

    Naccarella, Lucio; Greenstock, Louise N; Brooks, Peter M

    2013-09-01

    Health systems with strong primary care orientations are known to be associated with improved equity, better access for patients to appropriate services at lower costs, and improved population health. Team-based models of primary care have emerged in response to health system challenges due to complex patient profiles, patient expectations and health system demands. Successful team-based models of primary care require a combination of interprofessional education and learning; organisational and management policies and systems; and practice support systems. To ensure evidence is put into practice, we propose a framework comprising five domains (theory, implementation, infrastructure, sustainability and evaluation) to assist policymakers, educators, researchers, managers and health professionals in supporting team-based models of primary care within the Australian health care system. PMID:25370088

  10. A framework to support team-based models of primary care within the Australian health care system.

    Science.gov (United States)

    Naccarella, Lucio; Greenstock, Louise N; Brooks, Peter M

    2013-09-01

    Health systems with strong primary care orientations are known to be associated with improved equity, better access for patients to appropriate services at lower costs, and improved population health. Team-based models of primary care have emerged in response to health system challenges due to complex patient profiles, patient expectations and health system demands. Successful team-based models of primary care require a combination of interprofessional education and learning; organisational and management policies and systems; and practice support systems. To ensure evidence is put into practice, we propose a framework comprising five domains (theory, implementation, infrastructure, sustainability and evaluation) to assist policymakers, educators, researchers, managers and health professionals in supporting team-based models of primary care within the Australian health care system.

  11. 河北省农民工市民化的外在体制障碍研究%External System Obstacle of Urbanization of Rural Migrant Workers in Hebei Province

    Institute of Scientific and Technical Information of China (English)

    刘妮雅

    2013-01-01

    In the process of urbanization, realizing comprehensive citizenization of peasant workers is the key to improve the quality of urbanization. Taking migrant workers in Hebei province as the research object, this paper analyzes the current situation of citizenizaiton of peasant workers according to the field survey data of Shijiazhuang, Handan, Tangshan, and Qinhuangdao, and draw a conclusion that the main causes of restricting citizenization of present workers are that the social security is not complete, cost of living is high, the household registration system limitation and they can't really into city life. On the basis, it makes the further study of the influence of the citizenization of migrant workers and their system of external factors, this paper argues that the household registration system, the social security system and salary system are the main system obstacle of urbanization of rural migrant workers, and puts forward the measures to break system obstacle and promote the urbanization of rural migrant workers.%在加快城镇化的进程中,实现农民工全面市民化是提高城镇化质量的关键。本文以河北省农民工为研究对象,基于石家庄、邯郸、唐山、秦皇岛四地的实地调研数据,分析了农民工市民化的现状,得出社会保障不全、生活成本高、户籍制度限制和无法真正融入城市生活是制约农民工市民化的主要障碍。在此基础上深入研究了影响农民工市民化的外在体制因素及其影响,本文认为户籍制度、社会保障制度和工资制度是制约农民工市民化的主要体制障碍,并提出破除体制障碍、促进农民工市民化的对策建议。

  12. Robot vision: obstacle-avoidance techniques for unmanned aerial vehicles

    NARCIS (Netherlands)

    Carloni, Raffaella; Lippiello, Vincenzo; D'auria, Massimo; Fumagalli, Matteo; Mersha, Abeje Y.; Stramigioli, Stefano; Sicilano, Bruno

    2013-01-01

    In this article, a vision-based technique for obstacle avoidance and target identification is combined with haptic feedback to develop a new teleoperated navigation system for underactuated aerial vehicles in unknown environments. A three-dimensional (3-D) map of the surrounding environment is built

  13. Provider barriers to telemental health: obstacles overcome, obstacles remaining.

    Science.gov (United States)

    Brooks, Elizabeth; Turvey, Carolyn; Augusterfer, Eugene F

    2013-06-01

    Many providers are hesitant to use telemental health technologies. When providers are queried, various barriers are presented, such as the clinician's skepticism about the effectiveness of telemental health (TMH), viewing telehealth technologies as inconvenient, or reporting difficulties with medical reimbursement. Provider support for TMH is critical to its diffusion because clinicians often serve as the initial gatekeepers to telehealth implementation and program success. In this article, we address provider concerns in three broad domains: (1) personal barriers, (2) clinical workflow and technology barriers, and (3) licensure, credentialing, and reimbursement barriers. We found evidence that, although many barriers have been discussed in the literature for years, advancements in TMH have rapidly reduced obstacles for its use. Improvements include extensive opportunities for training, a growing evidence base supporting positive TMH outcomes, and transformations in technologies that improve provider convenience and transmission quality. Recommendations for further change are discussed within each domain. In particular, it is important to grow and disseminate data underscoring the promise and effectiveness of TMH, integrate videoconferencing capabilities into electronic medical record platforms, expand TMH reimbursement, and modify licensure standards.

  14. [The revised system of hospitalization for medical care and protection].

    Science.gov (United States)

    Fukuo, Yasuhisa

    2014-01-01

    The Act to Partially Amend the Act on Mental Health and Welfare for the Mentally Disabled was passed on June 13, 2013. Major amendments regarding hospitalization for medical care and protection include the points listed below. The guardianship system will be abolished. Consent by a guardian will no longer be required in the case of hospitalization for medical care and protection. In the case of hospitalization for medical care and protection, the administrators of the psychiatric hospital are required to obtain the consent of one of the following persons: spouse, person with parental authority, person responsible for support, legal custodian, or curator. If no qualified person is available, consent must be obtained from the mayor, etc. of the municipality. The following three obligations are imposed on psychiatric hospital administrators. (1) Assignment of a person, such as a psychiatric social worker, to provide guidance and counseling to patients hospitalized for medical care and protection regarding their postdischarge living environment. (2) Collaboration with community support entities that consult with and provide information as necessary to the person hospitalized, their spouse, a person with parental authority, a person responsible for support, or their legal custodian or curator. (3) Organizational improvements to promote hospital discharge. With regard to requests for discharge, the revised law stipulates that, in addition to the person hospitalized with a mental disorder, others who may file a request for discharge with the psychiatric review board include: the person's spouse, a person with parental authority, a person responsible for support, or their legal custodian or curator. If none of the above persons are available, or if none of them are able to express their wishes, the mayor, etc. of the municipality having jurisdiction over the place of residence of the person hospitalized may request a discharge. In order to promote transition to life in the

  15. Is U.S. health care an appropriate system? A strategic perspective from systems science

    Directory of Open Access Journals (Sweden)

    Janecka Ivo P

    2009-01-01

    Full Text Available Abstract Context Systems science provides organizational principles supported by biologic findings that can be applied to any organization; any incongruence indicates an incomplete or an already failing system. U.S. health care is commonly referred to as a system that consumes an ever- increasing percentage of the gross domestic product and delivers seemingly diminishing value. Objective To perform a comparative study of U.S. health care with the principles of systems science and, if feasible, propose solutions. Design General systems theory provides the theoretical foundation for this observational research. Main Outcome Measures A degree of compliance of U.S. health care with systems principles and its space-time functional location within the dynamic systems model. Results of comparative analysis U.S. health care is an incomplete system further threatened by the fact that it functions in the zone of chaos within the dynamic systems model. Conclusion Complying with systems science principles and the congruence of pertinent cycles, U.S. health care would likely dramatically improve its value creation for all of society as well as its resiliency and long-term sustainability. Immediate corrective steps could be taken: Prioritize and incentivize health over care; restore fiscal soundness by combining health and life insurance for the benefit of the insured and the payer; rebalance horizontal/providers and vertical/government hierarchies.

  16. Ep for efficient stochastic control with obstacles

    NARCIS (Netherlands)

    Mensink, T.; Verbeek, J.; Kappen, H.J.

    2010-01-01

    Abstract. We address the problem of continuous stochastic optimal control in the presence of hard obstacles. Due to the non-smooth character of the obstacles, the traditional approach using dynamic programming in combination with function approximation tends to fail. We consider a recently introduce

  17. Stability control during the performance of a simultaneous obstacle avoidance and auditory Stroop task.

    Science.gov (United States)

    Worden, Timothy A; Vallis, Lori Ann

    2016-02-01

    Navigation through complex environments requires a greater degree of control and attentional resources from the central nervous system to ensure postural stability and efficient goal completion as compared to quiet standing or unobstructed walking. Furthermore, when a cognitive task is also performed in a dual-task scenario, additional resources may be required. The purpose of the current study was to examine the effects of performing a concurrent cognitive (auditory Stroop task) and complex locomotor task (with a stationary or dynamic obstacle) on frontal plane stability control quantified using a margin of stability (MOS) measure. Fourteen healthy young adults performed 40 dual-task trials (randomized in a balanced design for auditory Stroop congruency and obstacle movement). Results indicated that frontal plane MOS was greatest for the obstacle crossing step and was greater for the dynamic obstacle as compared to the stationary obstacle. Conversely, frontal plane MOS was the smallest for the pre-crossing step, indicating that this point in the obstacle stepping strategy may be the least stable. No effect of cognitive task difficulty was observed for any of the experimental conditions, providing support for a 'posture-first' strategy. These findings suggest that an increase in stability is prioritized for the obstacle crossing step, potentially at the expense of reduced stability in the step immediately preceding the obstacle. These results have implications for better understanding how the CNS controls stability at different events during the obstacle crossing strategy in a complex environment. PMID:26487180

  18. Organisational culture matters for system integration in health care.

    Science.gov (United States)

    Munir, Samina K; Kay, Stephen

    2003-01-01

    This paper illustrates the importance of organisational culture for Clinical Information Systems (CIS) integration. The study is based on data collected in intensive care units in the UK and Denmark. Data were collected using qualitative methods, i.e., observations, interviews and shadowing of health care providers, together with a questionnaire at each site. The data are analysed to extract salient variables for CIS integration, and it is shown that these variables can be separated into two categories that describe the 'Actual Usefulness' of the system and the 'Organisational Culture'. This model is then extended to show that CIS integration directly affects the work processes of the organisation, forming an iterative process of change as a CIS is introduced and integrated. PMID:14728220

  19. Obstacle detection in range-image sequence for outdoor navigation

    Science.gov (United States)

    Garduno, M.; Vachon, Bertrand

    1994-08-01

    We deal with the conception of a perception system that's goal is to assist a mobile robot teleoperator by providing pertinent information about eventual obstacles appearing in the robot work space. This range image based perception system is to be embedded on a vehicle able to move at speeds up to 40 km/h in an outdoor environment. A method taking speed constraints into account is proposed. In the first step of this method, a segmentation algorithm is applied to the first range image scanned by the motionless robot to determine areas of interest. From these areas, distinctive attributes are computed and recorded as symbolic representations of each obstacle region. In the second and following steps, obstacles are localized in images scanned during robot motion. The difference between actual object position in the range image and its predicted value is used by an extended Kalman filter to correct the estimated robot configuration. A dynamic image segmentation using emergency and security criteria is carried out and new obstacles can now be detected from the range image and expressed in the robot coordinates system.

  20. Community health workers in primary care practice: redesigning health care delivery systems to extend and improve diabetes care in underserved populations.

    Science.gov (United States)

    Collinsworth, Ashley; Vulimiri, Madhulika; Snead, Christine; Walton, James

    2014-11-01

    New, comprehensive, approaches for chronic disease management are needed to ensure that patients, particularly those more likely to experience health disparities, have access to the clinical care, self-management resources, and support necessary for the prevention and control of diabetes. Community health workers (CHWs) have worked in community settings to reduce health care disparities and are currently being deployed in some clinical settings as a means of improving access to and quality of care. Guided by the chronic care model, Baylor Health Care System embedded CHWs within clinical teams in community clinics with the goal of reducing observed disparities in diabetes care and outcomes. This study examines findings from interviews with patients, CHWs, and primary care providers (PCPs) to understand how health care delivery systems can be redesigned to effectively incorporate CHWs and how embedding CHWs in primary care teams can produce informed, activated patients and prepared, proactive practice teams who can work together to achieve improved patient outcomes. Respondents indicated that the PCPs continued to provide clinical exams and manage patient care, but the roles of diabetes education, nutritional counseling, and patient activation were shifted to the CHWs. CHWs also provided patients with social support and connection to community resources. Integration of CHWs into clinical care teams improved patient knowledge and activation levels, the ability of PCPs to identify and proactively address specific patient needs, and patient outcomes.

  1. Provider's Constraints and Difficulties in Primary Health Care System

    OpenAIRE

    Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Anu

    2014-01-01

    Background: The contractualization of human resource in recent years has resulted into various human resource management issues. Objective: To explore the administrative and management issues of contractual model of human resource under primary health care system in Delhi. Materials and Methods: Comparative study was conducted on randomly selected sample of 333, comprised of Medical Officers, ANMs, Pharmacist and Laboratory Assistants and Technicians, both regular and contractual cadre. The d...

  2. A Systems Approach to Improving Rural Care in Ethiopia

    OpenAIRE

    Bradley, Elizabeth H.; Byam, Patrick; Alpern, Rachelle; Thompson, Jennifer W.; Zerihun, Abraham; Abeb, Yigeremu; Leslie A Curry

    2012-01-01

    Background Multiple interventions have been launched to improve the quality, access, and utilization of primary health care in rural, low-income settings; however, the success of these interventions varies substantially, even within single studies where the measured impact of interventions differs across sites, centers, and regions. Accordingly, we sought to examine the variation in impact of a health systems strengthening intervention and understand factors that might explain the variation i...

  3. The meaning of integrated care: a systems approach

    OpenAIRE

    Edgren, Lars

    2008-01-01

    Introduction In all well developed societies, such as those that we live in, there tend to be strong borders or barriers between different organisations and different professions. People with different kinds of knowledge are kept well apart. So how can we—should we—manage health and social services that are located in different organisations? If we are to improve the capability of a health care organisation to function as an integrated part of a locally driven health and social service system...

  4. A system for intelligent home care ECG upload and priorisation.

    Science.gov (United States)

    D'Angelo, Lorenzo T; Tarita, Eugeniu; Zywietz, Tosja K; Lueth, Tim C

    2010-01-01

    In this contribution, a system for internet based, automated home care ECG upload and priorisation is presented for the first time. It unifies the advantages of existing telemonitoring ECG systems adding functionalities such as automated priorisation and usability for home care. Chronic cardiac diseases are a big group in the geriatric field. Most of them can be easily diagnosed with help of an electrocardiogram. A frequent or long-term ECG analysis allows early diagnosis of e.g. a cardiac infarction. Nevertheless, patients often aren't willing to visit a doctor for prophylactic purposes. Possible solutions of this problem are home care devices, which are used to investigate patients at home without the presence of a doctor on site. As the diffusion of such systems leads to a huge amount of data which has to be managed and evaluated, the presented approach focuses on an easy to use software for ECG upload from home, a web based management application and an algorithm for ECG preanalysis and priorisation.

  5. 40 CFR 792.90 - Animal and other test system care.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Animal and other test system care. 792... Animal and other test system care. (a) There shall be standard operating procedures for the housing, feeding, handling, and care of animals and other test systems. (b) All newly received test systems...

  6. Remodeling of legacy systems in health care using UML.

    Science.gov (United States)

    Garde, Sebastian; Knaup, Petra; Herold, Ralf

    2002-01-01

    Research projects in the field of Medical Informatics often involve the development of application systems. Usually they are developed over a longer period of time, so that at a certain point of time a systematically planned reimplementation is necessary. The first step of reimplementation should be a systematic and comprehensive remodeling. When using UML for this task a systematic approach for remodeling activities is missing. Therefore, we developed a method for remodeling of legacy systems (Qumquad) and applied it to DOSPO, a documentation and therapy planning system for pediatric oncology. Qumquad helps to systematically carry out three steps: the modeling of the current actual state of the application system, the systematic identification of weak points and the development of a target concept for reimplementation considering the identified weak points. Results show that this approach is valuable and feasible and could be applied to various application systems in health care.

  7. A systems approach to improving rural care in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Elizabeth H Bradley

    Full Text Available BACKGROUND: Multiple interventions have been launched to improve the quality, access, and utilization of primary health care in rural, low-income settings; however, the success of these interventions varies substantially, even within single studies where the measured impact of interventions differs across sites, centers, and regions. Accordingly, we sought to examine the variation in impact of a health systems strengthening intervention and understand factors that might explain the variation in impact across primary health care units. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a mixed methods positive deviance study of 20 Primary Health Care Units (PHCUs in rural Ethiopia. Using longitudinal data from the Ethiopia Millennium Rural Initiative (EMRI, we identified PHCUs with consistently higher performance (n = 2, most improved performance (n = 3, or consistently lower performance (n = 2 in the provision of antenatal care, HIV testing in antenatal care, and skilled birth attendance rates. Using data from site visits and in-depth interviews (n = 51, we applied the constant comparative method of qualitative data analysis to identify key themes that distinguished PHCUs with different performance trajectories. Key themes that distinguished PHCUs were 1 managerial problem solving capacity, 2 relationship with the woreda (district health office, and 3 community engagement. In higher performing PHCUs and those with the greatest improvement after the EMRI intervention, health center and health post staff were more able to solve day-to-day problems, staff had better relationships with the woreda health official, and PHCU communities' leadership, particularly religious leadership, were strongly engaged with the health improvement effort. Distance from the nearest city, quality of roads and transportation, and cultural norms did not differ substantially among PHCUs. CONCLUSIONS/SIGNIFICANCE: Effective health strengthening efforts may require intensive

  8. National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care

    OpenAIRE

    Darko Gvozdanovi_; Miroslav Kon_ar; Vinko Kojund_i_; Hrvoje Jezid_i_

    2007-01-01

    In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on...

  9. Describing and analysing primary health care system support for chronic illness care in Indigenous communities in Australia's Northern Territory – use of the Chronic Care Model

    OpenAIRE

    Stewart Allison; Dowden Michelle; Robinson Gary; Cunningham Joan; Bailie Ross; Si Damin; Connors Christine; Weeramanthri Tarun

    2008-01-01

    Abstract Background Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from chronic illness such as diabetes, renal disease and cardiovascular disease. Improving the understanding of how Indigenous primary care systems are organised to deliver chronic illness care will inform efforts to improve the quality of care for Indigenous people. Methods This cross-sectional study was conducted in 12 Indigenous communities in Australia's Northern Territ...

  10. Selecting, adapting, and sustaining programs in health care systems

    Directory of Open Access Journals (Sweden)

    Zullig LL

    2015-04-01

    Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies 

  11. The meaning of integrated care: a systems approach

    Directory of Open Access Journals (Sweden)

    Lars Edgren

    2008-10-01

    Full Text Available Introduction: Organizations can be regarded as systems. The traditional model of systems views them as machines. This seems to be insufficient when it comes to understanding and organizing complex tasks. To better understand integrated care we should approach organizations as constantly changing living organisms, where many agents are interconnected in so-called Complex Adaptive Systems (CAS. Theory and discussion: The term “complex” emphasizes that the necessary competence to perform a task is not owned by any one part, but comes as a result of co-operation within the system. “Adaptive” means that system change occurs through successive adaptations. A CAS consists of several subsystems called agents, which act in dependence of one another. Examples would be the ant-hill, the human immune defence, the financial market and the surgical operating theatre team. Studying a CAS, the focus is on the interaction and communication between agents. Although these thoughts are not new, the CAS-approach has not yet been widely applied to the management of integrated care. This helps the management to understand why the traditional top down way of managing, following the machine model thinking, may meet with problems in interdependent organizations with complex tasks. Conclusion: When we perceive health and social services as CASs we should gain more insight into the processes that go on within and between organizations and how top management, for example within a hospital, in fact executes its steering function.

  12. OBSTACLE DETECTION BY ALV USING TWO 2D LASER RANGE FINDERS

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    This paper describes an effective method of obstacle detection by ALV (Autonomous Land Vehi- cle) equipped with two 2D laser range finders (LRF) installed at different locations of the ALV to obtain eom- prehensive information on the environment. The data processing includes two main steps: ( 1 ) data-processing of the current sample; (2) fusion of the former range data and the current one. The rough description of the ALV's environnent via the four sub-steps ( Data Filter, Obstacle Extraction, Obstacle Merging, Distinguish- ing Obstacle from Road-Edge) was not reliable enough for our control system. To overcome the shortcoming of the 2D LRF and the motion noise of the ALV, a Kalman filter was used to estimate the position of the obsta- cles; then the data of the two LRFs were collated to obtain the height and width of the obstacles. Experiment results attested the feasibility of the detection system.

  13. Autonomous Navigation and Obstacle Avoidance of a Micro-bus

    Directory of Open Access Journals (Sweden)

    Carlos Fernández

    2013-04-01

    Full Text Available At present, the topic of automated vehicles is one of the most promising research areas in the field of Intelligent Transportation Systems (ITS. The use of automated vehicles for public transportation also contributes to reductions in congestion levels and to improvements in traffic flow. Moreover, electrical public autonomous vehicles are environmentally friendly, provide better air quality and contribute to energy conservation. The driverless public transportation systems, which are at present operating in some airports and train stations, are restricted to dedicated roads and exhibit serious trouble dynamically avoiding obstacles in the trajectory. In this paper, an electric autonomous mini-bus is presented. All datasets used in this article were collected during the experiments carried out in the demonstration event of the 2012 IEEE Intelligent Vehicles Symposium that took place in Alcalá de Henares (Spain. The demonstration consisted of a route 725 metres long containing a list of latitude-longitude points (waypoints. The mini-bus was capable of driving autonomously from one waypoint to another using a GPS sensor. Furthermore, the vehicle is provided with a multi-beam Laser Imaging Detection and Ranging (LIDAR sensor for surrounding reconstruction and obstacle detection. When an obstacle is detected in the planned path, the planned route is modified in order to avoid the obstacle and continue its way to the end of the mission. On the demonstration day, a total of 196 attendees had the opportunity to get a ride on the vehicles. A total of 28 laps were successfully completed in full autonomous mode in a private circuit located in the National Institute for Aerospace Research (INTA, Spain. In other words, the system completed 20.3 km of driverless navigation and obstacle avoidance.

  14. [Information system at Department of Cardiac Surgery Intensive Care Unit].

    Science.gov (United States)

    Dokozić, Josipa

    2014-03-01

    This paper analyzes the aspects of using computer technology in nursing practice. Transfer and managing of data, information and knowledge in nursing is enabled by using modern technology and suitable applications. Cardio applications at the Intensive Care Unit of Department of Cardiac Surgery in Osijek enables nurses/technicians to gain insight into patient personal data, medical history, microbiological findings, interventions that have been made as well as those scheduled in the field of health care, all this by using a few simple connections. Nurses/technicians are those who enter patient data into his/her Electronic Health Record. There are multiple contributions of cardiac system. In comparison with previous paper-based managing of nursing documentation, this program has considerably facilitated and improved nursing practice.

  15. Impact of national health care systems on patient evaluations of general practice in Europe.

    NARCIS (Netherlands)

    Wensing, M.J.P.; Baker, R.; Szecsenyi, J.; Grol, R.P.T.M.

    2004-01-01

    OBJECTIVE: To examine associations between patient evaluations of general practice and characteristics of national health care systems. METHODS: International comparative study in 17 countries, using international patient survey data (n= 25052) and data-bases for health care system characteristics.

  16. Obstacles a l'inclusion scolaire des enfants d'age prescolaire ayant des besoins speciaux. [Obstacles to Inclusion of Preschool-Age Special Needs Children.

    Science.gov (United States)

    Tetreault, Sylvie; Beaupre, Pauline; Giroux, Martine; Gagne, Marie-eve; Guerard, Lucie

    2001-01-01

    Identifies obstacles faced by young children with special needs when trying to integrate into school. Proposes new strategies to prepare and support personnel involved during transition and inclusion in the school setting. Details group discussion of parents, care center educators, teachers, and administrators that resulted in a transition plan.…

  17. Ideas of Forbidding Forced Confessions and System Obstacles%试析刑讯逼供控制的观念与体制障碍

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    The difficulty of torture control comes from two aspects. First,people have a relatively recognition on torture owing to ideology,as a result,improving and carrying out the legal system about torture control become dif-ficult. Second,the judicial system and the structure of criminal procedure are not conducive to the enforcement of such legal system. To control the torture,we should change our recognition and attitude on torture;create the con-ditions for improving and successfully carrying out such legal system. at the same time,to ensure successfully carry-ing out such legal system,we should improve system and structure conditions for law enforcement.%我国刑讯逼供控制的困难主要来自两个方面:首先,由于观念原因,人们实际对刑讯逼供抱有一种相对认可的态度,这不仅使控制刑讯逼供的法律制度难以完善,而且使现行相关法律制度难以实施;其次,我国现行司法体制和刑诉程序结构也不利于这些法律制度的实施。因此要有效控制刑讯逼供,一要改变对刑讯逼供的观念和态度,为相关刑事诉讼立法的完善和顺利实施创造条件;二是要改善法律实施的体制和结构环境,确保这些立法得到严格执行。

  18. Controlled drug delivery systems towards new frontiers in patient care

    CERN Document Server

    Rossi, Filippo; Masi, Maurizio

    2016-01-01

    This book offers a state-of-the-art overview of controlled drug delivery systems, covering the most important innovative applications. The principles of controlled drug release and the mechanisms involved in controlled release are clearly explained. The various existing polymeric drug delivery systems are reviewed, and new frontiers in material design are examined in detail, covering a wide range of polymer modification techniques. The concluding chapter is a case study focusing on use of a drug-eluting stent. The book is designed to provide the reader with a complete understanding of the mechanisms and design of controlled drug delivery systems, and to this end includes numerous step-by-step tutorials. It illustrates how chemical engineers can advance medical care by designing polymeric delivery systems that achieve either temporal or spatial control of drug delivery and thus ensure more effective therapy that eliminates the potential for both under-and overdosing.

  19. 我国用水户协会发展的制度障碍与完善建议%The Development Obstacles and Relevant Suggestion on Water User Association System in China

    Institute of Scientific and Technical Information of China (English)

    邵龙; 张忠潮

    2013-01-01

    The obstacles of relevant law and system of Water User Association(WUA) in China were analyzed. Except for technology and fund, the defect of the relevant system is also an inevitable reason. On the basis of this, several suggestions were put forward, namely determining legal person status, deepening property reform of small agriculture water conservancy facilities, weakening administration of WUA.%分析了我国农民用水户协会相关法律制度方面存在的障碍,除了技术或资金,制度的缺陷也是制约其发展的重要原因.在此基础上提出相关建议,即明确农民用水协会的法人地位、深化小型农业水利设施的产权制度改革、弱化农民用水协会的行政色彩等.

  20. An innovative national health care waste management system in Kyrgyzstan.

    Science.gov (United States)

    Toktobaev, Nurjan; Emmanuel, Jorge; Djumalieva, Gulmira; Kravtsov, Alexei; Schüth, Tobias

    2015-02-01

    A novel low-cost health care waste management system was implemented in all rural hospitals in Kyrgyzstan. The components of the Kyrgyz model include mechanical needle removers, segregation using autoclavable containers, safe transport and storage, autoclave treatment, documentation, recycling of sterilized plastic and metal parts, cement pits for anatomical waste, composting of garden wastes, training, equipment maintenance, and management by safety and quality committees. The gravity-displacement autoclaves were fitted with filters to remove pathogens from the air exhaust. Operating parameters for the autoclaves were determined by thermal and biological tests. A hospital survey showed an average 33% annual cost savings compared to previous costs for waste management. All general hospitals with >25 beds except in the capital Bishkek use the new system, corresponding to 67.3% of all hospital beds. The investment amounted to US$0.61 per capita covered. Acceptance of the new system by the staff, cost savings, revenues from recycled materials, documented improvements in occupational safety, capacity building, and institutionalization enhance the sustainability of the Kyrgyz health care waste management system. PMID:25649402

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

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

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

  2. Diffusion induced flow on a wedge-shaped obstacle

    Science.gov (United States)

    Zagumennyi, Ia V.; Dimitrieva, N. F.

    2016-08-01

    In this paper the problem of evolution of diffusion induced flow on a wedge-shaped obstacle is analyzed numerically. The governing set of fundamental equations is solved using original solvers from the open source OpenFOAM package on supercomputer facilities. Due to breaking of naturally existing diffusion flux of a stratifying agent by the impermeable surface of the wedge a complex multi-level vortex system of compensatory fluid motions is formed around the obstacle. Sharp edges of the obstacle generate extended high-gradient horizontal interfaces which are clearly observed in laboratory experiments by high-resolution Schlieren visualization. Formation of an intensive pressure depression zone in front of the leading vertex of the wedge is responsible for generation of propulsive force resulting in a self-displacement of the obstacle along the neutral buoyancy horizon in a stably stratified environment. The size of the pressure deficiency area near the sharp vertex of a concave wedge is about twice that for a convex one. This demonstrates a more intensive propulsion mechanism in case of the concave wedge and, accordingly, a higher velocity of its self-movement in a continuously stratified medium.

  3. 论中国辩诉交易制度的构建%On Obstacles to the Implementation of Plea Bargaining with the System Construction

    Institute of Scientific and Technical Information of China (English)

    谭佳

    2012-01-01

    It is only natural that plea bargaining system originated from the United States and then got widely spread. On the one hand, the plea bargaining system gets the defendant actively involved in litigation, making it possible for the defendant to strive for their own rigbts and interests. On the other hand, the existence of plea bargaining system balances the state power and the contradiction between individual rights and provides a rational dialogue platform for both parties. Finally, the modern social harmony and human rights protection does not simply rely on punishment itself, it 'also helps to meet most people's litigation rights, thus making it possible to solve social contradictions and maintain social order. But in China constructing plea bargaining system can not be achieved in one day. We should have an in - depth understanding of China's national conditions and the systems concerned.%辩诉交易制度最早起源于美国,而后得到广泛传播是有其内在合理性的:一方面,辩诉交易制度给予了被告人充分参与诉讼的机会,使被告人可以为自己的权益而奋斗;另一方面,辩诉交易制度的存在平衡了国家权力与个人权利之间的矛盾,为双方权利的行驶提供了一个理性对话的平台;最后,现代社会的和谐与人权的保障并不简单依靠刑罚其本身,辩诉交易通过满足多数人的诉讼权益,从而迅速解决社会矛盾、稳定社会秩序。但是在中国构建辩诉交易制度绝非一朝一夕之事,要在深入了解我国国情以及与辩诉交易有关的制度环境的基础上,借鉴与改造,使其成为我国刑事司法制度的重要组成部分。

  4. United States and Canadian approaches to justice in health care: a comparative analysis of health care systems and values.

    Science.gov (United States)

    Jecker, N S; Meslin, E M

    1994-06-01

    The purpose of this study is to compare and contrast the basic ethical values underpinning national health care policies in the United States and Canada. We use the framework of ethical theory to name and elaborate ethical values and to facilitate moral reflection about health care reform. Section one describes historical and contemporary social contract theories and clarifies the ethical values associated with them. Sections two and three show that health care debates and health care systems in both countries reflect the values of this tradition; however, each nation interprets the tradition differently. In the U.S., standards of justice for health care are conceived as a voluntary agreement reached by self-interested parties. Canadians, by contrast, interpret the same justice tradition as placing greater emphasis on concern for others and for the community. The final section draws out the implications of these differences for future U.S. and Canadian health care reforms.

  5. Describing and analysing primary health care system support for chronic illness care in Indigenous communities in Australia's Northern Territory – use of the Chronic Care Model

    Directory of Open Access Journals (Sweden)

    Stewart Allison

    2008-05-01

    Full Text Available Abstract Background Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from chronic illness such as diabetes, renal disease and cardiovascular disease. Improving the understanding of how Indigenous primary care systems are organised to deliver chronic illness care will inform efforts to improve the quality of care for Indigenous people. Methods This cross-sectional study was conducted in 12 Indigenous communities in Australia's Northern Territory. Using the Chronic Care Model as a framework, we carried out a mail-out survey to collect information on material, financial and human resources relating to chronic illness care in participating health centres. Follow up face-to-face interviews with health centre staff were conducted to identify successes and difficulties in the systems in relation to providing chronic illness care to community members. Results Participating health centres had distinct areas of strength and weakness in each component of systems: 1 organisational influence – strengthened by inclusion of chronic illness goals in business plans, appointment of designated chronic disease coordinators and introduction of external clinical audits, but weakened by lack of training in disease prevention and health promotion and limited access to Medicare funding; 2 community linkages – facilitated by working together with community organisations (e.g. local stores and running community-based programs (e.g. "health week", but detracted by a shortage of staff especially of Aboriginal health workers working in the community; 3 self management – promoted through patient education and goal setting with clients, but impeded by limited focus on family and community-based activities due to understaffing; 4 decision support – facilitated by distribution of clinical guidelines and their integration with daily care, but limited by inadequate access to and support from specialists; 5 delivery system

  6. Central nervous system infections in the intensive care unit

    Directory of Open Access Journals (Sweden)

    B. Vengamma

    2014-04-01

    Full Text Available Neurological infections constitute an uncommon, but important aetiological cause requiring admission to an intensive care unit (ICU. In addition, health-care associated neurological infections may develop in critically ill patients admitted to an ICU for other indications. Central nervous system infections can develop as complications in ICU patients including post-operative neurosurgical patients. While bacterial infections are the most common cause, mycobacterial and fungal infections are also frequently encountered. Delay in institution of specific treatment is considered to be the single most important poor prognostic factor. Empirical antibiotic therapy must be initiated while awaiting specific culture and sensitivity results. Choice of empirical antimicrobial therapy should take into consideration the most likely pathogens involved, locally prevalent drug-resistance patterns, underlying predisposing, co-morbid conditions, and other factors, such as age, immune status. Further, the antibiotic should adequately penetrate the blood-brain and blood- cerebrospinal fluid barriers. The presence of a focal collection of pus warrants immediate surgical drainage. Following strict aseptic precautions during surgery, hand-hygiene and care of catheters, devices constitute important preventive measures. A high index of clinical suspicion and aggressive efforts at identification of aetiological cause and early institution of specific treatment in patients with neurological infections can be life saving.

  7. MULITIGRID METHODS FOR OBSTACLE PROBLEMS

    Institute of Scientific and Technical Information of China (English)

    Carsten Gr(a)ser; Ralf Kornhuber

    2009-01-01

    In this review,we intend to clarify the underlying ideas and the relations between various multigrid methods ranging from subset decomposition,to projected subspace decomposition and truncated multigrid.In addition,we present a novel globally convergent inexact active set method which is closely related to truncated multigrid.The numerical properties of algorithms are carefully assessed by means of a degenerate problem and a problem with a complicated coincidence set.

  8. Scattering of electromagnetic waves by obstacles

    CERN Document Server

    Kristensson, Gerhard

    2016-01-01

    The main purpose of Scattering of Electromagnetic Waves by Obstacles is to give a theoretical treatment of the scattering phenomena, and to illustrate numerical computations of some canonical scattering problems for different geometries and materials.

  9. Optical Flow based Robot Obstacle Avoidance

    Directory of Open Access Journals (Sweden)

    Kahlouche Souhila

    2008-11-01

    Full Text Available In this paper we try to develop an algorithm for visual obstacle avoidance of autonomous mobile robot. The input of the algorithm is an image sequence grabbed by an embedded camera on the B21r robot in motion. Then, the optical flow information is extracted from the image sequence in order to be used in the navigation algorithm. The optical flow provides very important information about the robot environment, like: the obstacles disposition, the robot heading, the time to collision and the depth. The strategy consists in balancing the amount of left and right side flow to avoid obstacles, this technique allows robot navigation without any collision with obstacles. The robustness of the algorithm will be showed by some examples.

  10. In place of fear: aligning health care planning with system objectives to achieve financial sustainability.

    Science.gov (United States)

    Birch, Stephen; Murphy, Gail Tomblin; MacKenzie, Adrian; Cumming, Jackie

    2015-04-01

    The financial sustainability of publicly funded health care systems is a challenge to policymakers in many countries as health care absorbs an ever increasing share of both national wealth and government spending. New technology, aging populations and increasing public expectations of the health care system are often cited as reasons why health care systems need ever increasing funding as well as reasons why universal and comprehensive public systems are unsustainable. However, increases in health care spending are not usually linked to corresponding increases in need for care within populations. Attempts to promote financial sustainability of systems such as limiting the range of services is covered or the groups of population covered may compromise their political sustainability as some groups are left to seek private cover for some or all services. In this paper, an alternative view of financial sustainability is presented which identifies the failure of planning and management of health care to reflect needs for care in populations and to integrate planning and management functions for health care expenditure, health care services and the health care workforce. We present a Health Care Sustainability Framework based on disaggregating the health care expenditure into separate planning components. Unlike other approaches to planning health care expenditure, this framework explicitly incorporates population health needs as a determinant of health care requirements, and provides a diagnostic tool for understanding the sources of expenditure increase.

  11. Functional systemic approach to the resuscitation and intensive care

    Directory of Open Access Journals (Sweden)

    Sadchikov D.V.

    2014-09-01

    Full Text Available Functional systemic approach to the resuscitation and intensive care may be considered as a direct correlation between analysis and synthesis, induction and deduction, and, in general, between the formal and dialectical categories. The realization of this system should be started with the interaction and formation of the final beneficial result. Therefore the experience assessment on the basis of functional systematic approach will enable us to formulate more precisely the subject and methods of resuscitation from the philosophical point of view taking into consideration the interaction of the human life integrity with death phenomenon as fixed in ontogenesis and will allow to methodically justify the distinguishing of functional systems and standard processes both in sanogenesis and thanatogenesis.

  12. New systems of care can leverage the health care workforce: how many doctors do we really need?

    Science.gov (United States)

    Garson, Arthur

    2013-12-01

    Improving access to appropriate health care, currently inadequate for many Americans, is more complex than merely increasing the projected number of physicians and nurses. Any attainable increase in their numbers will not solve the problem. To bring supply and demand closer, new systems of care are required, leveraging every member of the health care workforce, permitting professionals to provide their unique contributions.To increase supply: Redefine the roles of physicians and nurse practitioners (NPs), assess how much primary care must be delivered by a physician, and provide support from other team members to let the physician deal with complex patients. NPs can deliver much primary care and some specialty care. Care must be delivered in integrated systems permitting new payment models (e.g., salary with bonus) and team-based care as well as maximum use of electronic health records. Teams must make better use of nonprofessionals, such as Grand-Aides, using telephone protocols and portable telemedicine with home visits and online direct reporting of every encounter. The goals are to improve health and reduce unnecessary clinic and emergency department visits, admissions, and readmissions.To decrease demand: Physician payment must foster quality and appropriate patient volume (if accompanied by high patient satisfaction). Patients must be part of the team, work to remain healthy, and reduce inappropriate demand.The nation may not need as many physicians and nurses if the systems can be changed to promote integration, leveraging every member of the workforce to perform at his or her maximum competency.

  13. The VA Maryland Health Care System's telemental health program.

    Science.gov (United States)

    Koch, Edward F

    2012-05-01

    The VA Maryland Health Care System introduced videoconferencing technology to provide psychiatry, evidenced-based psychotherapy, case management, and patient education at rural clinics where it was difficult to recruit providers. Telemental health services enable rural clinics to offer additional services, such as case management and patient education. Services have been expanded to urban outpatient clinics where a limited number of mental health clinic hours are available. This technology expands the availability of mental health providers and services, allowing patients to receive services from providers located at distant medical centers.

  14. Development of the trauma emergency care system based on the three links theory

    Institute of Scientific and Technical Information of China (English)

    JIANG Guan-yu; SHEN Wei-feng; GAN Jian-xin

    2005-01-01

    The three links theory applied in trauma emergency care system refers to an integrated system with the three important components of trauma emergency care system, viz. prehospital trauma services, hospital trauma services and critical care services. The development of the trauma emergency care system should be guided by the three links theory so as to set up a practical and highly efficient system: a prompt operating and monitoring transportation system, a smooth and real-time information system, a rational and sustainable system of regulations and contingency plans, and a system for cultivating all-round trauma physicians.

  15. Teaching medical ethics to meet the realities of a changing health care system.

    Science.gov (United States)

    Millstone, Michael

    2014-06-01

    The changing context of medical practice--bureaucratic, political, or economic--demands that doctors have the knowledge and skills to face these new realities. Such changes impose obstacles on doctors delivering ethical care to vulnerable patient populations. Modern medical ethics education requires a focus upon the knowledge and skills necessary to close the gap between the theory and practice of ethical care. Physicians and doctors-in-training must learn to be morally sensitive to ethical dilemmas on the wards, learn how to make professionally grounded decisions with their patients and other medical providers, and develop the leadership, dedication, and courage to fulfill ethical values in the face of disincentives and bureaucratic challenges. A new core focus of medical ethics education must turn to learning how to put ethics into practice by teaching physicians to realistically negotiate the new institutional maze of 21st-century medicine.

  16. Obstacles Detection Algorithm in Forest based on Multi-sensor Data Fusion

    Directory of Open Access Journals (Sweden)

    Xiaokang Ding

    2013-12-01

    Full Text Available In this paper an obstacle detection system was set up and a novel algorithm was proposed to detect obstacles in forest, aiming to improve the efficiency of automated operations and reduce the risk to cause the accident of forestry harvester in the complicated environment of forest areas. First a 2D laser scanner and an infrared thermal imager were used to collect the information of obstacles in forest areas. Second the features of each obstacle including temperature, color, aspect ratio, and rectangularity, were extracted from the laser points, visible images and infrared images. Then, we use the sample feature data to train a support vector machine (SVM for object identification. The experiments were conducted on the various obstacles and the experimental results showed that the proposed algorithm was effective and provided a computation basis for automated operations of harvester

  17. The Australian experiment: how primary health care organizations supported the evolution of a primary health care system.

    Science.gov (United States)

    Nicholson, Caroline; Jackson, Claire L; Marley, John E; Wells, Robert

    2012-03-01

    Primary health care in Australia has undergone 2 decades of change. Starting with a vision for a national health strategy with general practice at its core, Australia established local meso-level primary health care organizations--Divisions of General Practice--moving from focus on individual practitioners to a professional collective local voice. The article identifies how these meso-level organizations have helped the Australian primary health care system evolve by supporting the roll-out of initiatives including national practice accreditation, a focus on quality improvement, expansion of multidisciplinary teams into general practice, regional integration, information technology adoption, and improved access to care. Nevertheless, there are still challenges to ensuring equitable access and the supply and distribution of a primary care workforce, addressing the increasing rates of chronic disease and obesity, and overcoming the fragmentation of funding and accountability in the Australian system. PMID:22403246

  18. Study on Korean Radiological Emergency System-Care System- and National Nuclear Emergency Preparedness System Development

    International Nuclear Information System (INIS)

    Care system; Radiological Emergency Supporting System. Environmental radiology level is the main aspect that should be concerned deal with the utilization of nuclear energy. The usage of informational technology in nuclear area gives significant contribution to anticipate and to protect human and environment. Since 1960, South Korea has developed environment monitoring system as the effort to protect the human and environment in the radiological emergency condition. Indonesia has possessed several nuclear installations and planned to build and operate nuclear power plants (PLTN) in the future. Therefore, Indonesia has to prepare the integrated system, technically enables to overcome the radiological emergency. Learning from the practice in South Korea, the system on the radiological emergency should be prepared and applied in Indonesia. However, the government regulation draft on National Radiological Emergency System, under construction, only touches the management aspect, not the technical matters. Consequently, when the regulation is implemented, it will need an additional regulation on technical aspect including the consideration on the system (TSS), the organization of operator and the preparation of human resources development of involved institution. For that purpose, BAPETEN should have a typical independence system in regulatory frame work. (author)

  19. Analysis of American Health Care System with respect to current affairs: Is Universal Health Care a Potential Reality?

    OpenAIRE

    Šotolová, Petra

    2009-01-01

    The main task of the Thesis is to analyze an American health care system, its management and behavior including its pros and cons. To describe and study the system will help to understand its eventual future progress and to answer a basic question "Is Universal Health Care a Potential Reality in U.S.A.?". With a respect to current affairs, as was the comprehensive health care reform signing, it will be possible to think and forecast relevant course of events that might improve consciousness a...

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Depth Image Processing for Obstacle Avoidance of an Autonomous VTOL UAV

    OpenAIRE

    Andert, Franz; Strickert, Gordon; Thielecke, Frank

    2006-01-01

    We describe a new approach for stereo-based obstacle avoidance. This method analyzes the images of a stereo camera in realtime and searches for a safe target point that can be reached without collision. The obstacle avoidance system is used by our unmanned helicopter ARTIS (Autonomous Rotorcraft Testbed for Intelligent Systems) and its simulation environment. It is optimized for this UAV, but not limited to aircraft systems.

  2. Dimensions of health care system quality in Finland

    OpenAIRE

    Jenni Pääkkönen; Timo Seppälä

    2012-01-01

    This paper evaluates the determinants of quality - cost relationship in primary health care. We first summarize information from various indicators of care by principal component analysis (PCA), effectively producing quality of care indicators: accessibility, coverage and allocative efficiency. We then regress the costs of care against these indicators to evaluate their relationship. Our results suggest that PCA may be used to produce quality of care indicators. Furthermore, the relationship ...

  3. Performance Issues of Health Care System using SQL server

    Directory of Open Access Journals (Sweden)

    Narendra Kohli

    2010-05-01

    Full Text Available In this paper, a smart card based on line health care system and its performance issues using SQL server are proposed. To provide a good quality of treatment in the hospital, it is required to integrate all the hospitals of country via internet. A Smart Card with 10 digits unique registration no. with his some personal information is issued to patient. After getting registration in any hospital of the hospital network, patient has to go for checkup with smart card only. All the patient information i.e. personal, doctor prescriptions, test reports etc. will be stored in the database of the local server of the hospital and time to time uploaded to the centralized server. On the basis of unique registration no., all the patient information can be retrieved from the database of the centralized server. Smart card based online health care system application has been designed as front end .Net and back end in SQL server. The block size or page size being used during the database creation is playing very important role in performance tuning. It is very important to decide the proper block size before database design. You cannot change the block size once you have created the database. Recreating the database again is a very costly affair.

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

    Science.gov (United States)

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

    2009-04-01

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

  5. Sensor Network Infrastructure for a Home Care Monitoring System

    Directory of Open Access Journals (Sweden)

    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.

  6. Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

    Science.gov (United States)

    Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

    2012-04-01

    This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

  7. Smart Sensor Based Obstacle Detection for High-Speed Unmanned Surface Vehicle

    OpenAIRE

    Hermann, Dan; Galeazzi, Roberto; Andersen, Jens Christian; Blanke, Mogens

    2015-01-01

    This paper describes an obstacle detection system for a high-speed and agile unmanned surface vehicle (USV), running at speeds up to 30 m/s. The aim is a real-time and high performance obstacle detection system using both radar and vision technologies to detect obstacles within a range of 175 m. A computer vision horizon detector enables a highly accurate attitude estimation despite large and sudden vehicle accelerations. This further facilitates the reduction of sea clutter by utilising a at...

  8. Wrestling with typology: penetrating the "black box" of managed care by focusing on health care system characteristics.

    Science.gov (United States)

    Brach, C; Sanches, L; Young, D; Rodgers, J; Harvey, H; McLemore, T; Fraser, I

    2000-01-01

    The health care system has undergone a fundamental transformation undermining the usefulness of the typology of the health maintenance organization, the independent practice association, the preferred provider organization, and so forth. The authors present a new approach to studying the health care system. In matrix form, they have identified a set of organizational and delivery characteristics with the potential to influence outcomes of interest, such as access to services, quality, health status and functioning, and cost. The matrix groups the characteristics by domain--financial features, structure, care delivery and management policies, and products--and by key roles in the health care system--sponsor, plan, provider intermediary organization, and direct services provider. The matrix is a tool for researchers, administrators, clinicians, data collectors, regulators, and other policy makers. It suggests a new set of players to be studied, emphasizes the relationships among the players, and provides a checklist of independent, control, and interactive variables to be included in analyses.

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

    Science.gov (United States)

    Child Trends, 2010

    2010-01-01

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

  10. [Application and obstacles of ANAMMOX process].

    Science.gov (United States)

    Jin Rencun; Zhang, Zhengzhe; Ji, Yuxin; Chen, Hui; Guo, Qiong; Zhou, Yuhuang; Wu, Conghui; Jin, Rencun

    2014-12-01

    Anaerobic ammonium oxidation (ANAMMOX), as its essential advantages of high efficiency and low cost, is a promising novel biological nitrogen elimination process with attractive application prospects. Over the past two decades, many processes based on the ANAMMOX reaction have been continuously studied and applied to practical engineering, with the perspective of reaching 100 full-scale installations in operation worldwide by 2014. Our review summarizes various forms of ANAMMOX processes, including partial nitritation-ANAMMOX, completely autotrophic nitrogen removal over nitrite, oxygen limited autotrophic nitrification and denitrification, denitrifying ammonium oxidation, aerobic deammonification, simultaneous partial nitrification, ANAMMOX and denitrification, single-stage nitrogen removal using ANAMMOX and partial nitritation. We also compare the operating conditions for one-stage and two-stage processes and summarize the obstacles and countermeasures in engineering application of ANAMMOX systems, such as moving bed biofilm reactor, sequencing batch reactor and granular sludge reactor. Finally, we discuss the future research and application direction, which should focus on the optimization of operating conditions and applicability of the process to the actual wastewater, especially on automated control and the impact of special wastewater composition on process performance. PMID:26016370

  11. The Team Approach to Home-Based Primary Care: Restructuring Care to Meet Patient, Program, and System Needs

    Science.gov (United States)

    Reckrey, Jennifer M.; Soriano, Theresa A.; Hernandez, Cameron R.; DeCherrie, Linda V.; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2016-01-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address patient, program, and system needs, we restructured a portion of our large, physician-led academic home-based primary care practice into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. Our Team Approach is an innovative way to improve interdisciplinary, team-based care though practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound. PMID:25645568

  12. Simulation and Analysis of a Combined Mobility Model with Obstacles

    OpenAIRE

    Pecchia, Emiliano; Erman, David; Popescu, Adrian

    2009-01-01

    The use of simulations have become increasingly frequent in the study and the performance evaluation of network systems. The simulation environment deeply influences the behavior of results, so a model that simulates a realistic movement of the nodes is necessary for the study of wireless networks. Simple mobility models do not provide realistic scenarios. Often movements are completely random, uncorrelated and in open space, without the chance of considering the effects of obstacles or rules...

  13. Task-role-based Access Control Model in Smart Health-care System

    OpenAIRE

    Wang Peng; Jiang Lingyun

    2015-01-01

    As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for...

  14. Economic crisis and counter-reform of universal health care systems: Spanish case

    OpenAIRE

    Paulo Antônio de Carvalho Fortes; Regina Ribeiro Parizi Carvalho; Marília Cristina Prado Louvison

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, ...

  15. Holistic System of Care: a ten-year perspective.

    Science.gov (United States)

    Nebelkopf, Ethan; Wright, Serena

    2011-01-01

    The Holistic System of Care for Native Americans in an Urban Environment is a community-focused intervention that provides behavioral health care, promotes health, and prevents disease. This approach is based on a community strategic planning process that honored Native American culture and relationships. Substance abuse, mental illness, homelessness, poverty, crime, physical illness, and violence are symptoms of historical trauma, family dysfunction, and spiritual imbalance. The holistic model links treatment, prevention, and recovery. The link between prevention and treatment is early intervention. Peer support is the link between treatment and recovery. Recovering individuals serve as role models linking recovery to prevention. Culture and spirituality build a strong and resilient foundation for recovery. This article documents the effectiveness of the holistic model over a ten-year period that it has been implemented at the Family & Child Guidance Clinic of the Native American Health Center in the San Francisco Bay Area. The holistic model has produced statistically significant reductions in substance abuse among adult Native American women, men, reentry, and homeless populations; reductions in substance abuse among Native American adolescents; reductions in HIV/AIDS high-risk behavior among Native American men, women, and adolescents; and decreases in acting out behavior among Native American severely emotionally disturbed children.

  16. Managed care contracting issues in integrated delivery systems.

    Science.gov (United States)

    Stewart, E E

    1996-01-01

    This article is a checklist for use by health care providers in reviewing proposed managed care contracting agreements. This checklist is not an exhaustive list, but is intended to be used as a framework for review.

  17. Proposition of Generic Validation Criteria using stereo-vision for On-Road Obstacle Detection

    OpenAIRE

    Perrollaz, Mathias; Labayrade, Raphaël; Gruyer, Dominique; Lambert, Alain; Aubert, Didier

    2014-01-01

    Real-time obstacle detection is an essential function for the future of Advanced Driver Assistance Systems (ADAS), but its applications to the driving safety require a very high reliability: the detection rate must be high, while the false detection rate must remain extremely low. Such features seem antinomic for obstacle detection systems, especially when using a single sensor. Multi-sensor fusion is often considered as a mean to reduce this limitation. In this paper, we propose to use stere...

  18. Usage Analysis of a Shared Care Planning System

    OpenAIRE

    Warren, Jim; Gu, Yulong; Humphrey, Gayl

    2012-01-01

    We examined the content of electronically mediated communications in a trial of shared care planning (SCP) for long-term condition management. Software supports SCP by sharing patient records and care plans among members of the multidisciplinary care team (with patient access). Our analysis focuses on a three-month period with 73 enrolled patients, 149 provider-assigned tasks, 64 clinical notes and 48 care plans with 162 plan elements. Results show that content of notes entries is often relat...

  19. [Military medical and health care system in the Song Dynasty].

    Science.gov (United States)

    DU, J

    2016-05-01

    The military medical and health care system in the Song Dynasty manifested as two aspects, namely disease prevention and medical treatment. Disease prevention included ensuring food and drink safety, avoiding dangerous stations and enjoying regular vacations, etc. Medical treatment included sending medical officials to patrol, stationing military physicians to follow up, applying emergency programs, establishing military medical and pharmacy centers, dispensing required medicines, and accommodating and nursing sick and injured personnel, etc. Meanwhile, the imperial court also supervised the implementation of military medical mechanism, in order to check the soldiers' foods, check and restrict the military physicians' responsibilities, etc., which did play a positive role in protecting soldier's health, guaranteeing the military combat effectiveness, and maintaining national security. PMID:27485867

  20. Population aging and its impacts: strategies of the health-care system in Taipei.

    Science.gov (United States)

    Lin, Ming-Hsien; Chou, Ming-Yueh; Liang, Chih-Kuang; Peng, Li-Ning; Chen, Liang-Kung

    2010-11-01

    Taiwan is one of the fastest aging countries in the world. As such, the government has developed various strategies to promote an age-friendly health-care system. Health services are supported by National Health Insurance (NHI), which insures over 97% of citizens and over 99% of health-care institutes. The current health-care system has difficulties in caring for older patients with multiple comorbidities, complex care needs, functional impairments, and post-acute care needs. Taipei, an international metropolis with a well-preserved tradition of filial piety in Chinese societies, has developed various strategies to overcome the aforementioned barriers to an age-friendly health-care system. These include an emphasis on general medical care and a holistic approach in all specialties, development of a geriatrics specialty training program, development of post-acute services, and strengthening of linkages between health and social care services. Despite achievements thus far, challenges still include creating a more extensive integration between medical specialties, promotion of an interdisciplinary care model across specialties and health-care settings, and integration of health and social care services. The experiences of Taipei in developing an age-friendly health-care service system may be a culturally appropriate model for other Chinese and Asian communities.

  1. The possible price of auditory cueing: influence on obstacle avoidance in Parkinson's disease.

    NARCIS (Netherlands)

    Nanhoe-Mahabier, S.W.; Delval, A.; Snijders, A.H.; Weerdesteijn, V.G.; Overeem, S.; Bloem, B.R.

    2012-01-01

    BACKGROUND: Under carefully controlled conditions, rhythmic auditory cueing can improve gait in patients with Parkinson's disease (PD). In complex environments, attention paid to cueing might adversely affect gait, for example when a simultaneous task-such as avoiding obstacles-has to be executed. W

  2. Obstacle Course Training Can Improve Mobility and Prevent Falls in People with Intellectual Disabilities

    Science.gov (United States)

    Van Hanegem, E.; Enkelaar, L.; Smulders, E.; Weerdesteyn, V.

    2014-01-01

    Background: Persons with intellectual disabilities (ID) constitute a special-needs population at high risk of falling. This is the first study to evaluate whether obstacle course training can improve mobility and prevent falls in this population. Methods: The intervention was implemented as part of an institution-wide health care improvement plan…

  3. Adaptive Tracking and Obstacle Avoidance Control for Mobile Robots With Unknown Sliding

    Directory of Open Access Journals (Sweden)

    Mingyue Cui

    2012-11-01

    Full Text Available An adaptive control approach is proposed for trajectory tracking and obstacle avoidance for mobile robots with consideration given to unknown sliding. A kinematic model of mobile robots is established in this paper, in which both longitudinal and lateral sliding are considered and processed as three time‐varying parameters. A sliding model observer is introduced to estimate the sliding parameters online. A stable tracking control law for this nonholonomic system is proposed to compensate the unknown sliding effect. From Lyapunov‐stability analysis, it is proved, regardless of unknown sliding, that tracking errors of the controlled closed‐loop system are asymptotically stable, the tracking errors converge to zero outside the obstacle detection region and obstacle avoidance is guaranteed inside the obstacle detection region. The efficiency and robustness of the proposed control system are verified by simulation results.

  4. The System-of-Care Model: Implementation in Twenty-Seven Communities.

    Science.gov (United States)

    Vinson, Nina B.; Brannan, Ana Maria; Baughman, Lela N.; Wilce, Maureen; Gawron, Timothy

    2001-01-01

    A 4-year study of 27 system-of-care sites designed to provides mental health services to children and adolescents, found that despite many changes in each local service system, no site was able to fully implement all 16 key attributes comprising an ideal system-of-care model (including sites with previous system-building experience). (Contains…

  5. Promoting patient-centred fundamental care in acute healthcare systems.

    Science.gov (United States)

    Feo, Rebecca; Kitson, Alison

    2016-05-01

    Meeting patients' fundamental care needs is essential for optimal safety and recovery and positive experiences within any healthcare setting. There is growing international evidence, however, that these fundamentals are often poorly executed in acute care settings, resulting in patient safety threats, poorer and costly care outcomes, and dehumanising experiences for patients and families. Whilst care standards and policy initiatives are attempting to address these issues, their impact has been limited. This discussion paper explores, through a series of propositions, why fundamental care can be overlooked in sophisticated, high technology acute care settings. We argue that the central problem lies in the invisibility and subsequent devaluing of fundamental care. Such care is perceived to involve simple tasks that require little skill to execute and have minimal impact on patient outcomes. The propositions explore the potential origins of this prevailing perception, focusing upon the impact of the biomedical model, the consequences of managerial approaches that drive healthcare cultures, and the devaluing of fundamental care by nurses themselves. These multiple sources of invisibility and devaluing surrounding fundamental care have rendered the concept underdeveloped and misunderstood both conceptually and theoretically. Likewise, there remains minimal role clarification around who should be responsible for and deliver such care, and a dearth of empirical evidence and evidence-based metrics. In explicating these propositions, we argue that key to transforming the delivery of acute healthcare is a substantial shift in the conceptualisation of fundamental care. The propositions present a cogent argument that counters the prevailing perception that fundamental care is basic and does not require systematic investigation. We conclude by calling for the explicit valuing and embedding of fundamental care in healthcare education, research, practice and policy. Without this

  6. Pluralist social constraints on the development of a health care system: the case of Israel.

    Science.gov (United States)

    Palley, H A; Yishai, Y; Ever-Hadani, P

    1983-01-01

    The effectiveness of Israel's health care system is hindered by pluralism, in terms both of its many separate health service institutions and of the particularism of those institutions. Although the health care system provides modern health care to a widely insured population, it does so inefficiently and at unnecessary expense. The lack of vertical and horizontal integration of the health care system has led to problems of fragmentation, duplication, and lack of coordination of services. Because of its limited resources, Israel must work to surmount this pluralism and achieve integrated planning if it is to succeed in providing the efficient and cost-effective care its population needs.

  7. Key elements of successful care process of patients with heart symptoms in an emergency care - could an ERP system help?

    Science.gov (United States)

    Kontio, Elina; Korvenranta, Heikki; Lundgren-Laine, Heljä; Salanterä, Sanna

    2009-01-01

    The aim of the study was to identify key elements of successful care process of patients with heart symptoms from the nursing management viewpoint in an emergency care. Through these descriptions, we aimed at identifying possibilities for using enterprise resource planning (ERP) systems to support decision making in emergency care. Hospitals are increasingly moving to process-based workings and at the same time new information system in healthcare are developed and therefore it is essential to understand the strengths and weaknesses of current processes better. A qualitative descriptive design using critical incident technique was employed. Critical Incidents were collected with an open-ended questionnaire. The sample (n=50), 13 head nurses and 37 registered nurses, was purposeful selected from three acute hospitals in southern Finland. The process of patients with heart symptoms in emergency care was described. We identified three competence categories where special focus should be placed to achieve successful process of patients with heart symptoms: process-oriented competencies, personal/management competencies and logistics oriented competencies. Improvement of decision making requires that the care processes are defined and modeled. The research showed that there are several happenings in emergency care where an ERP system could help and support decision making. These happenings can be categorized in two groups: 1) administrative related happenings and 2) patient processes related happenings. PMID:19592808

  8. Computation of blast wave-obstacle interactions

    Science.gov (United States)

    Champney, J. M.; Chaussee, D. S.; Kutler, P.

    1982-01-01

    Numerical simulations of the interaction of a planar blast wave with various obstacles are presented. These obstacles are either ground structures or vehicles flying in the atmosphere. For a structure on the ground, the blast wave encounter is side-on, while for the flying vehicles the encounter is either head-on or oblique. Second-order accurate, finite-difference, and shock-capturing procedures are employed to solve the two-dimensional, axisymmetric, and three-dimensional unsteady Euler equations. Results are presented for the flow field consisting of blast wave striking obstacles that are at rest, moving subsonically and moving supersonically. Comparison of the numerical results with experimental data for a configuration at rest substantiates the validity of this approach and its potential as a flow analysis tool.

  9. An obstacle problem for Tug-of-War games

    OpenAIRE

    Manfredi, Juan J.; Rossi, Julio D.; Somersille, Stephanie J.

    2013-01-01

    We consider the obstacle problem for the infinity Laplace equation. Given a Lipschitz boundary function and a Lipschitz obstacle we prove the existence and uniqueness of a super infinity-harmonic function constrained to lie above the obstacle which is infinity harmonic where it lies strictly above the obstacle. Moreover, we show that this function is the limit of value functions of a game we call obstacle tug-of-war.

  10. The establishment of a primary spine care practitioner and its benefits to health care reform in the United States

    Directory of Open Access Journals (Sweden)

    Donald Murphy R

    2011-07-01

    Full Text Available Abstract It is widely recognized that the dramatic increase in health care costs in the United States has not led to a corresponding improvement in the health care experience of patients or the clinical outcomes of medical care. In no area of medicine is this more true than in the area of spine related disorders (SRDs. Costs of medical care for SRDs have skyrocketed in recent years. Despite this, there is no evidence of improvement in the quality of this care. In fact, disability related to SRDs is on the rise. We argue that one of the key solutions to this is for the health care system to have a group of practitioners who are trained to function as primary care practitioners for the spine. We explain the reasons we think a primary spine care practitioner would be beneficial to patients, the health care system and society, some of the obstacles that will need to be overcome in establishing a primary spine care specialty and the ways in which these obstacles can be overcome.

  11. Primary Care Clinicians’ Perspectives on Reducing Low-Value Care in an Integrated Delivery System

    Science.gov (United States)

    Buist, Diana SM; Chang, Eva; Handley, Matt; Pardee, Roy; Gundersen, Gabrielle; Cheadle, Allen; Reid, Robert J

    2016-01-01

    Context: Perceptions about low-value care (eg, medical tests and procedures that may be unnecessary and/or harmful) among clinicians with capitated salaries are unknown. Objective: Explore clinicians’ perceived use of and responsibility for reducing low-value care by focusing on barriers to use, awareness of the Choosing Wisely campaign, and response to reports of peer-comparison resource use and practice patterns. Methods: Electronic, cross-sectional survey, distributed in 2013, to 304 salaried primary care physicians and physician assistants at Group Health Cooperative. Main Outcome Measures: Attitudes, awareness, and barriers of low-value care strategies and initiatives. Results: A total of 189 clinicians responded (62% response rate). More than 90% believe cost is important to various stakeholders and believe it is fair to ask clinicians to be cost-conscious. Most found peer-comparison resource-use reports useful for understanding practice patterns and prompting peer discussions. Two-thirds of clinicians were aware of the Choosing Wisely campaign; among them, 97% considered it a legitimate information source. Although 88% reported being comfortable discussing low-value care with patients, 80% reported they would order tests or procedures when a patient insisted. As key barriers in reducing low-value care, clinicians identified time constraints (45%), overcoming patient preferences/values (44%), community standards (43%), fear of patients’ dissatisfaction (41%), patients’ knowledge about the harms of low-value care (38%), and availability of tools to support shared decision making (37%). Conclusions: Salaried clinicians are aware of rising health care costs and want to be stewards of limited health care resources. Evidence-based initiatives such as the Choosing Wisely campaign may help motivate clinicians to be conscientious stewards of limited health care resources. PMID:26562308

  12. Implementation of Obstacle-Avoidance Control for an Autonomous Omni-Directional Mobile Robot Based on Extension Theory

    Directory of Open Access Journals (Sweden)

    Yi-Chung Lai

    2012-10-01

    Full Text Available The paper demonstrates a following robot with omni-directional wheels, which is able to take action to avoid obstacles. The robot design is based on both fuzzy and extension theory. Fuzzy theory was applied to tune the PMW signal of the motor revolution, and correct path deviation issues encountered when the robot is moving. Extension theory was used to build a robot obstacle-avoidance model. Various mobile models were developed to handle different types of obstacles. The ultrasonic distance sensors mounted on the robot were used to estimate the distance to obstacles. If an obstacle is encountered, the correlation function is evaluated and the robot avoids the obstacle autonomously using the most appropriate mode. The effectiveness of the proposed approach was verified through several tracking experiments, which demonstrates the feasibility of a fuzzy path tracker as well as the extensible collision avoidance system.

  13. Implementation of obstacle-avoidance control for an autonomous omni-directional mobile robot based on extension theory.

    Science.gov (United States)

    Pai, Neng-Sheng; Hsieh, Hung-Hui; Lai, Yi-Chung

    2012-10-16

    The paper demonstrates a following robot with omni-directional wheels, which is able to take action to avoid obstacles. The robot design is based on both fuzzy and extension theory. Fuzzy theory was applied to tune the PMW signal of the motor revolution, and correct path deviation issues encountered when the robot is moving. Extension theory was used to build a robot obstacle-avoidance model. Various mobile models were developed to handle different types of obstacles. The ultrasonic distance sensors mounted on the robot were used to estimate the distance to obstacles. If an obstacle is encountered, the correlation function is evaluated and the robot avoids the obstacle autonomously using the most appropriate mode. The effectiveness of the proposed approach was verified through several tracking experiments, which demonstrates the feasibility of a fuzzy path tracker as well as the extensible collision avoidance system.

  14. General Investigations on Obstacle Courses in Romania

    Directory of Open Access Journals (Sweden)

    Flavia Luminiţa Bochiş

    2011-05-01

    Full Text Available Show jumping is an equestrian sport event, where each horse-rider couple must run in average about 12-20 obstacles, named a set course, within a specified time. Faults or penalties are collected if the couple brings down the highest element of an obstacle, if the horse refuses to jump or when the allocated time exceeds the allowed seconds. The idea of the jumping events is never to standardize the courses and types of competitions; the variety provides a precious element of interest for competitors and spectators.

  15. A Novel Artificial Immune Algorithm for Spatial Clustering with Obstacle Constraint and Its Applications

    Directory of Open Access Journals (Sweden)

    Liping Sun

    2014-01-01

    Full Text Available An important component of a spatial clustering algorithm is the distance measure between sample points in object space. In this paper, the traditional Euclidean distance measure is replaced with innovative obstacle distance measure for spatial clustering under obstacle constraints. Firstly, we present a path searching algorithm to approximate the obstacle distance between two points for dealing with obstacles and facilitators. Taking obstacle distance as similarity metric, we subsequently propose the artificial immune clustering with obstacle entity (AICOE algorithm for clustering spatial point data in the presence of obstacles and facilitators. Finally, the paper presents a comparative analysis of AICOE algorithm and the classical clustering algorithms. Our clustering model based on artificial immune system is also applied to the case of public facility location problem in order to establish the practical applicability of our approach. By using the clone selection principle and updating the cluster centers based on the elite antibodies, the AICOE algorithm is able to achieve the global optimum and better clustering effect.

  16. A novel artificial immune algorithm for spatial clustering with obstacle constraint and its applications.

    Science.gov (United States)

    Sun, Liping; Luo, Yonglong; Ding, Xintao; Zhang, Ji

    2014-01-01

    An important component of a spatial clustering algorithm is the distance measure between sample points in object space. In this paper, the traditional Euclidean distance measure is replaced with innovative obstacle distance measure for spatial clustering under obstacle constraints. Firstly, we present a path searching algorithm to approximate the obstacle distance between two points for dealing with obstacles and facilitators. Taking obstacle distance as similarity metric, we subsequently propose the artificial immune clustering with obstacle entity (AICOE) algorithm for clustering spatial point data in the presence of obstacles and facilitators. Finally, the paper presents a comparative analysis of AICOE algorithm and the classical clustering algorithms. Our clustering model based on artificial immune system is also applied to the case of public facility location problem in order to establish the practical applicability of our approach. By using the clone selection principle and updating the cluster centers based on the elite antibodies, the AICOE algorithm is able to achieve the global optimum and better clustering effect.

  17. Components of equity-oriented health care system: perspective of Iranian nurses.

    Science.gov (United States)

    Rooddehghan, Zahra; Nasrabadi, Alireza Nikbakht; Parsa Yekta, Zohreh

    2015-01-01

    Equity in health is one of key objectives in health care systems world wide. This study aimed to explain the perspective of Iranian nurses about equity in the health care system. A qualitative exploratory design with thematic analysis approach was used to collect and analyze data. Using a purposeful sampling helped the researchers to recruit 16 eligible participants. Data were collected via in-depth semi-structured interviews. Five main categories were extracted through data analysis process including (1) inequity against the nurse, (2) the recommended patient, (3) no claim for equity-oriented care in health system, (4) physicians' dominancy system; and (5) the need to define criteria to measure equity-oriented care. All health care systems around the world struggle to establish equity-oriented care. In perspective of Iranian nurses, the reform of structures in the health system is possible through providing the context of equitable care for caregivers and care recipients. Health system should commit the flow of equity at all of its levels. It should utilize policies to claim equity and consider the interests of all beneficiaries. Furthermore, certain criteria should be defined for equity-oriented care in the health care system, and also provides the possibility to measure and monitor it.

  18. Making Our Health and Care Systems Fit for an Ageing Population: Considerations for Canada

    Science.gov (United States)

    Andrew, Melissa K.; Rockwood, Kenneth

    2014-01-01

    A report from the United Kingdom on making health and care systems fit for an ageing population proposes a range of interventions to make care better for older adults, especially those who are frail. Here, we discuss the proposed shift for the acute care hospital to other models of care. The key for these models of care requires a fundamental shift to care that addresses the full range of an individual’s needs, rather than being based around single diseases. How this might apply in the Canadian context is considered. We emphasize strategies to keep people out of hospital but still receive needed care, make acute hospital care less hazardous, and improve the interface between acute and long-term care. PMID:25452826

  19. The Arizona Health Care Cost Containment System: A Prepayment Model for a National Health Service?

    OpenAIRE

    Orient, Jane M.

    1986-01-01

    The Arizona Health Care Cost Containment System (AHCCCS), the Arizona Medicaid alternative, is an experiment in contracting “prepaid” indigent health care to the lowest bidding group. The consequences have been substantial cost overruns and serious unanswered questions about the quality and avilability of care.

  20. Medical tourism and its impact on the US health care system.

    Science.gov (United States)

    Forgione, Dana A; Smith, Pamela C

    2007-01-01

    The health care industry within the United States continues to face unprecedented increases in costs, along with the task of providing care to an estimated 46 million uninsured or underinsured patients. These patients, along with both insurers and employers, are seeking to reduce the costs of treatment through international outsourcing of medical and surgical care. Knows as medical tourism, this trend is on the rise, and the US health care system has not fully internalized the effects this will have on its economic structure and policies. The demand for low-cost health care services is driving patients to seek treatment on a globally competitive basis, while balancing important quality of care issues. In this article, we outline some of the issues facing legislators, health care policy makers, providers, and health service researchers regarding the impact of medical tourism on the US health care system. PMID:18972983

  1. National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care

    Directory of Open Access Journals (Sweden)

    Darko Gvozdanovi_

    2007-09-01

    Full Text Available In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1 to provide efficient healthcare-related data management in support of decision-making processes; (2 to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution.

  2. National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care.

    Science.gov (United States)

    Gvozdanović, Darko; Koncar, Miroslav; Kojundzić, Vinko; Jezidzić, Hrvoje

    2007-01-01

    In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1) to provide efficient healthcare-related data management in support of decision-making processes; (2) to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS) on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories) into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution. PMID:18005567

  3. ASPECTS OF OBSTACLES FOR APPLYING TARGET COSTING: A SURVEY OF MANUFACTURING FIRMS IN EGYPT

    Directory of Open Access Journals (Sweden)

    Petru STEFEA

    2014-04-01

    Full Text Available The present investigation aims to determine the aspects of obstacles for applying Target Costing(TC system in Egyptian case and the significant differences among effects of these obstacles . The study used the survey method to describe and analyze the obstacles in some Egyptian firms. The population of the study is Egyptian manufacturing firms. Accordingly, the number of received questionnaires was 388 (21 Egyptian manufacturing firms in 2013. Finally, the study found that there is a significant divergence among obstacles for applying Target Costing (TC system in Egyptian manufacturing firms (Internal and external.The external dimensions are the most influence of internal dimensions, where the weakness of the competition is the highest effect in the external dimensions case but resistance top management is the highest effect in external dimensions case.

  4. Fusion of 3D laser scanner and depth images for obstacle recognition in mobile applications

    Science.gov (United States)

    Budzan, Sebastian; Kasprzyk, Jerzy

    2016-02-01

    The problem of obstacle detection and recognition or, generally, scene mapping is one of the most investigated problems in computer vision, especially in mobile applications. In this paper a fused optical system using depth information with color images gathered from the Microsoft Kinect sensor and 3D laser range scanner data is proposed for obstacle detection and ground estimation in real-time mobile systems. The algorithm consists of feature extraction in the laser range images, processing of the depth information from the Kinect sensor, fusion of the sensor information, and classification of the data into two separate categories: road and obstacle. Exemplary results are presented and it is shown that fusion of information gathered from different sources increases the effectiveness of the obstacle detection in different scenarios, and it can be used successfully for road surface mapping.

  5. Japan Health Care System SEISHIRO Kudo. Japan Health Care System%日本的医疗制度①

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      本文从各种公共医疗保险,社会保险和国民健康保险的区别,医疗给付、全民保险制度的维持,诊疗报酬制度,医疗相关法律及专业等方面详细介绍了日本的医疗制度和日本引为自豪的医疗保险制度。以前日本实施的是自愿参保的国民医疗保险制度,但从1961年新的国民健康保险制度实施以来,所有的自愿参保都变成强制参保,奠定了为所有国民提供平等医疗服务的基础。%This paper gives a detailed introduction to the Japanese health care system and medical insurance system, from the section of how public medical insurance works, the differences between social insurance and national health insurance, how medical expenses are paid, how national health insurance is maintained, how medical payment system works, and the health legislation and education system, which the Japanese are particularly proud of. Japan used to implement a voluntary national health insurance system. However, since the new national health insurance system was implemented in 1961, all of the voluntary insurance has become compulsory, which laid the groundwork to pro-vide equal medical services to all citizens.

  6. Technology acceptance for an Intelligent Comprehensive Interactive Care (ICIC) system for care of the elderly: a survey-questionnaire study.

    Science.gov (United States)

    Wong, Alice M K; Chang, Wei-Han; Ke, Pei-Chih; Huang, Chun-Kai; Tsai, Tsai-Hsuan; Chang, Hsien-Tsung; Shieh, Wann-Yun; Chan, Hsiao-Lung; Chen, Chih-Kuang; Pei, Yu-Cheng

    2012-01-01

    The key components of caring for the elderly are diet, living, transportation, education, and safety issues, and telemedical systems can offer great assistance. Through the integration of personal to community information technology platforms, we have developed a new Intelligent Comprehensive Interactive Care (ICIC) system to provide comprehensive services for elderly care. The ICIC system consists of six items, including medical care (physiological measuring system, Medication Reminder, and Dr. Ubiquitous), diet, living, transportation, education (Intelligent Watch), entertainment (Sharetouch), and safety (Fall Detection). In this study, we specifically evaluated the users' intention of using the Medication Reminder, Dr. Ubiquitous, Sharetouch, and Intelligent Watch using a modified technological acceptance model (TAM). A total of 121 elderly subjects (48 males and 73 females) were recruited. The modified TAM questionnaires were collected after they had used these products. For most of the ICIC units, the elderly subjects revealed great willingness and/or satisfaction in using this system. The elderly users of the Intelligent Watch showed the greatest willingness and satisfaction, while the elderly users of Dr. Ubiquitous revealed fair willingness in the dimension of perceived ease of use. The old-old age group revealed greater satisfaction in the dimension of result demonstrability for the users of the Medication Reminder as compared to the young-old and oldest-old age groups. The women revealed greater satisfaction in the dimension of perceived ease of use for the users of Dr. Ubiquitous as compared to the men. There were no statistically significant differences in terms of gender, age, and education level in the other dimensions. The modified TAM showed its effectiveness in evaluating the acceptance and characteristics of technologic products for the elderly user. The ICIC system offers a user-friendly solution in telemedical care and improves the quality of

  7. On Robust Methodologies for Managing Public Health Care Systems

    Directory of Open Access Journals (Sweden)

    Shastri L. Nimmagadda

    2014-01-01

    Full Text Available Authors focus on ontology-based multidimensional data warehousing and mining methodologies, addressing various issues on organizing, reporting and documenting diabetic cases and their associated ailments, including causalities. Map and other diagnostic data views, depicting similarity and comparison of attributes, extracted from warehouses, are used for understanding the ailments, based on gender, age, geography, food-habits and other hereditary event attributes. In addition to rigor on data mining and visualization, an added focus is on values of interpretation of data views, from processed full-bodied diagnosis, subsequent prescription and appropriate medications. The proposed methodology, is a robust back-end application, for web-based patient-doctor consultations and e-Health care management systems through which, billions of dollars spent on medical services, can be saved, in addition to improving quality of life and average life span of a person. Government health departments and agencies, private and government medical practitioners including social welfare organizations are typical users of these systems.

  8. Finding economies of scale and coordination of care along the continuum to achieve true system integration.

    Science.gov (United States)

    Davies, Maura

    2014-01-01

    Is it time to reduce hospitals and replace them with digitally enabled distributed specialty service delivery channels that focus on ambulatory care, urgent care, and patient reactivation? Is delivery system integration immaterial if care is standardized and supported by integrated information systems? Maybe Lean methodology needs to be applied across the entire delivery systems, not just within its component functions and processes. Comments are offered on each of these perspectives.

  9. Finding economies of scale and coordination of care along the continuum to achieve true system integration.

    Science.gov (United States)

    Davies, Maura

    2014-01-01

    Is it time to reduce hospitals and replace them with digitally enabled distributed specialty service delivery channels that focus on ambulatory care, urgent care, and patient reactivation? Is delivery system integration immaterial if care is standardized and supported by integrated information systems? Maybe Lean methodology needs to be applied across the entire delivery systems, not just within its component functions and processes. Comments are offered on each of these perspectives. PMID:25671876

  10. Quantitative Risk Analysis of Obstacle Limitation Standards

    Science.gov (United States)

    Sandaradura, Amila Silva

    Obstacle limitation surfaces (OLS) are the main safeguard against objects that can pose a hazard to aircraft operations at and around the airports. The standard dimensions of the most of these surfaces were estimated using the pilot's experience at the time when they were included in to the standard documents. As a result, some of these standards may have been overestimated while others may not provide an adequate level of safety. With airports moving to the Safety Management System (SMS) approach to design and operations safety, proper evaluation of the level of safety provided by OLS at specific sites becomes great importance to airport operators. There is no published evidence, however, for the estimation of the safety level provided by the existing OLS standards. Moreover, the rationale used by the ICAO to establish existing OLS standards is not readily available in the standard documents. Therefore this study attempts to collect actual flight path data using information provided by air traffic control radars and construct a methodology to assess the probability of aircraft deviating from their intended/protected path. The extension of the developed methodology can be used to estimate the OLS dimensions that provide an acceptable safety level for the aircraft operations. This will be helpful to estimate safe and efficient standard dimensions of the OLS and assess the risk level of objects to the aircraft operations around airports. In order to assess the existing standards and show the applications of the methodology, three case studies were conducted using aircraft data collected from Ottawa (CYOW), Calgary (CYYC) and Edmonton (CYEG) International Airports.

  11. Identification and analysis of obstacles in bioterrorism preparedness and response

    Science.gov (United States)

    Sincavage, Suzanne Michele

    The focus of this study was to identify and analyze the obstacles to bioterrorism preparedness and response facing emergency management agencies and public authorities. In order to establish the limits of this discussion, the obstacles will examine a combined conceptual framework of public health, environmental security and social response. The interdisciplinary characteristics of this framework are ideal for addressing the issue of bioterrorism because of its simultaneous impact, which encompasses the complex interrelationships that pertain to public health and national security and social response. Based on a review of literature, the obstacles presented range from the absence of an effective surveillance system for biological terrorism related diseases to the inadequate training of first responders in bioterrorism preparedness and the difficult challenges of a mass casualty situation and the intense pressures associated with the crisis response. Furthermore, the impending reality of bioterrorism will further illustrate a close examination of the characteristics and management of three major biowarfare agents---anthrax, plague and smallpox. Finally, to provide a realistic understanding of the impact of bioterrorism, three case studies of actual events and two hypothetical scenarios will be discussed. Specifically, the discussion will provide the following three unconventional terrorist attacks: the recent anthrax attacks of 2001, the Aum Shinrikyo's attack of the Tokyo subway in 1995, and the Rajneeshees' use of salmonella poisoning in 1994. The inclusion of the hypothetical scenarios of two massive outbreaks of smallpox and anthrax will be presented to illuminate the seriousness and magnitude of the threat of bioterrorism and the probable consequences of failing to overcome the obstacles presented in this study. The importance of this research cannot be overemphasized, the threat is undeniably serious, and the potential for biological agents to cause devastating

  12. Health care systems in Sweden and China: Legal and formal organisational aspects

    Directory of Open Access Journals (Sweden)

    Hjelm Katarina

    2010-06-01

    Full Text Available Abstract Background Sharing knowledge and experience internationally can provide valuable information, and comparative research can make an important contribution to knowledge about health care and cost-effective use of resources. Descriptions of the organisation of health care in different countries can be found, but no studies have specifically compared the legal and formal organisational systems in Sweden and China. Aim To describe and compare health care in Sweden and China with regard to legislation, organisation, and finance. Methods Literature reviews were carried out in Sweden and China to identify literature published from 1985 to 2008 using the same keywords. References in recent studies were scrutinized, national legislation and regulations and government reports were searched, and textbooks were searched manually. Results The health care systems in Sweden and China show dissimilarities in legislation, organisation, and finance. In Sweden there is one national law concerning health care while in China the law includes the "Hygienic Common Law" and the "Fundamental Health Law" which is under development. There is a tendency towards market-orientated solutions in both countries. Sweden has a well-developed primary health care system while the primary health care system in China is still under development and relies predominantly on hospital-based care concentrated in cities. Conclusion Despite dissimilarities in health care systems, Sweden and China have similar basic assumptions, i.e. to combine managerial-organisational efficiency with the humanitarian-egalitarian goals of health care, and both strive to provide better care for all.

  13. International comparison of health care systems using resource profiles.

    OpenAIRE

    2000-01-01

    The most frequently used bases for comparing international health care resources are health care expenditures, measured either as a fraction of gross domestic product (GDP) or per capita. There are several possible reasons for this, including the widespread availability of historic expenditure figures; the attractiveness of collapsing resource data into a common unit of measurement; and the present focus among OECD member countries and other governments on containing health care costs. Despit...

  14. Health System Quality Improvement: Impact of Prompt Nutrition Care on Patient Outcomes and Health Care Costs.

    Science.gov (United States)

    Meehan, Anita; Loose, Claire; Bell, Jvawnna; Partridge, Jamie; Nelson, Jeffrey; Goates, Scott

    2016-01-01

    Among hospitalized patients, malnutrition is prevalent yet often overlooked and undertreated. We implemented a quality improvement program that positioned early nutritional care into the nursing workflow. Nurses screened for malnutrition risk at patient admission and then immediately ordered oral nutritional supplements for those at risk. Supplements were given as regular medications, guided and monitored by medication administration records. Post-quality improvement program, pressure ulcer incidence, length of stay, 30-day readmissions, and costs of care were reduced. PMID:26910129

  15. 40 CFR 160.90 - Animal and other test system care.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Animal and other test system care. 160... PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.90 Animal and other test... care of animals and other test systems. (b) All newly received test systems from outside sources...

  16. The Obstacles in Cross-cultural Communication

    Institute of Scientific and Technical Information of China (English)

    WANG Jian-hua

    2009-01-01

    In Cross-cultural communication,the ability of the languages and the ability of the cultures ale the crucial factors in the communicating activities.People with the sanle cultural background communicate with each other easily and smoothly,and understand each other better,and there are fewer or no obstacles in their communication at all.The different cultural backgrounds and traditions,the different social customs and everyday living habits,and the different values all will affect the communication quality and will surely result in obstacles in cross-cultural communication.The obstacles which frequently occur in the cross-cultural communication are:ethnocentrism,stereotyping,prejudice,and the different cultural backgrounds.In order to do away with the obstacles and to make the communication smoothly and successfully,the communicating parties both should observe the cooperative principles and politeness principles.And what's more,they must discard their own prejudices,and respect others,together to fulfill the cross-cultural communicating activities.

  17. Simple Obstacle Avoidance Algorithm for Rehabilitation Robots

    NARCIS (Netherlands)

    Stuyt, F.H.A.; Römer, G.R.B.; Stuyt, H.J.A.

    2007-01-01

    The efficiency of a rehabilitation robot is improved by offering record-and-replay to operate the robot. While automatically moving to a stored target (replay) collisions of the robot with obstacles in its work space must be avoided. A simple, though effective, generic and deterministic algorithm fo

  18. Visualizing news: obstacles, challenges, and solutions

    NARCIS (Netherlands)

    Smit, Gerard; Haan, Yael de; Buijs, Laura; Bakker, Piet

    2013-01-01

    Depicting news graphically is considered an apt way to deal with challenges of modern journalism: to disclose big data, and present news attractively, visually, and fast to grasp. This study delves into reported obstacles and challenges for the production of news visualizations. It focuses on the qu

  19. Teachers’ conceptions of, and obstacles to, sex education in portuguese primary schools

    OpenAIRE

    Anastácio, Zélia; Carvalho, Graça Simões; Clément, Pierre

    2005-01-01

    Teachers’ conceptions result from the interaction between their scientific knowledge, their systems of values, and their social and professional practice. Obstacles to teaching sex education may have several origins: epistemological, didactical, psychological and social. The aim of this research is to identify teachers’ conceptions and obstacles, that prevent them from teaching sex education. We intend to apply several research instruments: questionnaires, debates, focus groups, individual in...

  20. Breast cancer in limited-resource countries: health care systems and public policy.

    Science.gov (United States)

    Anderson, Benjamin O; Yip, Cheng-Har; Ramsey, Scott D; Bengoa, Rafael; Braun, Susan; Fitch, Margaret; Groot, Martijn; Sancho-Garnier, Helene; Tsu, Vivien D

    2006-01-01

    As the largest cancer killer of women around the globe, breast cancer adversely impacts countries at all levels of economic development. Despite major advances in the early detection, diagnosis, and treatment of breast cancer, health care ministries face multitiered challenges to create and support health care programs that can improve breast cancer outcomes. In addition to the financial and organizational problems inherent in any health care system, breast health programs are hindered by a lack of recognition of cancer as a public health priority, trained health care personnel shortages and migration, public and health care provider educational deficits, and social barriers that impede patient entry into early detection and cancer treatment programs. No perfect health care system exists, even in the wealthiest countries. Based on inevitable economic and practical constraints, all health care systems are compelled to make trade-offs among four factors: access to care, scope of service, quality of care, and cost containment. Given these trade-offs, guidelines can define stratified approaches by which economically realistic incremental improvements can be sequentially implemented within the context of resource constraints to improve breast health care. Disease-specific "vertical" programs warrant "horizontal" integration with existing health care systems in limited-resource countries. The Breast Health Global Initiative (BHGI) Health Care Systems and Public Policy Panel defined a stratified framework outlining recommended breast health care interventions for each of four incremental levels of resources (basic, limited, enhanced, and maximal). Reallocation of existing resources and integration of a breast health care program with existing programs and infrastructure can potentially improve outcomes in a cost-sensitive manner. This adaptable framework can be used as a tool by policymakers for program planning and research design to make best use of available resources

  1. Principles of justice as a basis for conceptualizing a health care system.

    Science.gov (United States)

    Bryant, J H

    1977-01-01

    This paper opens with a concern for the causes of the maldistribution of health care throughout most of the world. It then explores briefly the question of entitlement to health care, focusing on the appropriateness of expressing that entitlement in terms of social justice. Some principles of justice as related to health care are formulated, drawing on the thinking of John Rawls and his Theory of Justice, and the ideas of distributive justice that have been set forth by Nicholas Rescher. These principles are then used as a basis for planning a theoretical health care system in the setting of a less-developed country. This theoretical health care system is intended to reflect a just distribution of health care under conditions of varying limitations of resources, including those in which resources are not adequate to provide care for all of the people. Some of the technical, social, and political implications of such a system are discussed.

  2. Fast obstacle detection based on multi-sensor information fusion

    Science.gov (United States)

    Lu, Linli; Ying, Jie

    2014-11-01

    Obstacle detection is one of the key problems in areas such as driving assistance and mobile robot navigation, which cannot meet the actual demand by using a single sensor. A method is proposed to realize the real-time access to the information of the obstacle in front of the robot and calculating the real size of the obstacle area according to the mechanism of the triangle similarity in process of imaging by fusing datum from a camera and an ultrasonic sensor, which supports the local path planning decision. In the part of image analyzing, the obstacle detection region is limited according to complementary principle. We chose ultrasonic detection range as the region for obstacle detection when the obstacle is relatively near the robot, and the travelling road area in front of the robot is the region for a relatively-long-distance detection. The obstacle detection algorithm is adapted from a powerful background subtraction algorithm ViBe: Visual Background Extractor. We extracted an obstacle free region in front of the robot in the initial frame, this region provided a reference sample set of gray scale value for obstacle detection. Experiments of detecting different obstacles at different distances respectively, give the accuracy of the obstacle detection and the error percentage between the calculated size and the actual size of the detected obstacle. Experimental results show that the detection scheme can effectively detect obstacles in front of the robot and provide size of the obstacle with relatively high dimensional accuracy.

  3. Iraqi primary care system in Kurdistan region: providers’ perspectives on problems and opportunities for improvement

    Directory of Open Access Journals (Sweden)

    Shabila Nazar P

    2012-09-01

    Full Text Available Abstract Background As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers’ perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. Methods A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Results Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene, health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system, shortage in resources (shortage and low quality of medical supplies and shortage in financing, poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. Conclusions This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq’s Kurdistan region from the perspective of primary care providers. From their experience

  4. Toward a Learning Health-care System - Knowledge Delivery at the Point of Care Empowered by Big Data and NLP.

    Science.gov (United States)

    Kaggal, Vinod C; Elayavilli, Ravikumar Komandur; Mehrabi, Saeed; Pankratz, Joshua J; Sohn, Sunghwan; Wang, Yanshan; Li, Dingcheng; Rastegar, Majid Mojarad; Murphy, Sean P; Ross, Jason L; Chaudhry, Rajeev; Buntrock, James D; Liu, Hongfang

    2016-01-01

    The concept of optimizing health care by understanding and generating knowledge from previous evidence, ie, the Learning Health-care System (LHS), has gained momentum and now has national prominence. Meanwhile, the rapid adoption of electronic health records (EHRs) enables the data collection required to form the basis for facilitating LHS. A prerequisite for using EHR data within the LHS is an infrastructure that enables access to EHR data longitudinally for health-care analytics and real time for knowledge delivery. Additionally, significant clinical information is embedded in the free text, making natural language processing (NLP) an essential component in implementing an LHS. Herein, we share our institutional implementation of a big data-empowered clinical NLP infrastructure, which not only enables health-care analytics but also has real-time NLP processing capability. The infrastructure has been utilized for multiple institutional projects including the MayoExpertAdvisor, an individualized care recommendation solution for clinical care. We compared the advantages of big data over two other environments. Big data infrastructure significantly outperformed other infrastructure in terms of computing speed, demonstrating its value in making the LHS a possibility in the near future. PMID:27385912

  5. Toward a Learning Health-care System - Knowledge Delivery at the Point of Care Empowered by Big Data and NLP.

    Science.gov (United States)

    Kaggal, Vinod C; Elayavilli, Ravikumar Komandur; Mehrabi, Saeed; Pankratz, Joshua J; Sohn, Sunghwan; Wang, Yanshan; Li, Dingcheng; Rastegar, Majid Mojarad; Murphy, Sean P; Ross, Jason L; Chaudhry, Rajeev; Buntrock, James D; Liu, Hongfang

    2016-01-01

    The concept of optimizing health care by understanding and generating knowledge from previous evidence, ie, the Learning Health-care System (LHS), has gained momentum and now has national prominence. Meanwhile, the rapid adoption of electronic health records (EHRs) enables the data collection required to form the basis for facilitating LHS. A prerequisite for using EHR data within the LHS is an infrastructure that enables access to EHR data longitudinally for health-care analytics and real time for knowledge delivery. Additionally, significant clinical information is embedded in the free text, making natural language processing (NLP) an essential component in implementing an LHS. Herein, we share our institutional implementation of a big data-empowered clinical NLP infrastructure, which not only enables health-care analytics but also has real-time NLP processing capability. The infrastructure has been utilized for multiple institutional projects including the MayoExpertAdvisor, an individualized care recommendation solution for clinical care. We compared the advantages of big data over two other environments. Big data infrastructure significantly outperformed other infrastructure in terms of computing speed, demonstrating its value in making the LHS a possibility in the near future.

  6. Integrated care: implementation issues for ‘countries in transition’

    OpenAIRE

    Boulton, George

    2012-01-01

    Purpose Exploration of some major obstacles to integrated care in ‘countries in transition’ in central/eastern Europe. Context ‘Integration’ is virtually a universal policy aim of European ‘transition’ countries. Seduced by the prospect of increased value from scarce resources, governments strive to transform traditional compartmentalised ‘curative’ health systems, into more integrated systems focused on population health improvement and effective chronic disease management. Theory is commend...

  7. Measurement of post dryout heat transfer coefficient in a double heated annulus with flow obstacles

    International Nuclear Information System (INIS)

    An experimental study on post dryout heat transfer regime in annuli with flow obstacles was conducted in the High-pressure Water Test (HWAT) loop at the Royal Institute of Technology in Stockholm, Sweden. The experimental investigations were performed in a wide range of the operational conditions: mass flux (500-750) kg/(m2s), inlet subcooling (10-40) K and system pressure (5-7) MPa. The wall superheat was measured at 88 different axial and azimuthal positions (40 on the inner tube and 48 on the outer tube). The results show an enhancement of heat transfer downstream of flow obstacles. The biggest influence has been observed in case of pin spacers and grid obstacle. This result is consistent with blockage area of various obstacles, which was the highest in case of pin spacers. (author)

  8. Mesoscopic model for filament orientation in growing actin networks: the role of obstacle geometry

    CERN Document Server

    Weichsel, Julian; 10.1088/1367-2630/15/3/035006

    2013-01-01

    Propulsion by growing actin networks is a universal mechanism used in many different biological systems. Although the core molecular machinery for actin network growth is well preserved in most cases, the geometry of the propelled obstacle can vary considerably. In recent years, filament orientation distribution has emerged as an important observable characterizing the structure and dynamical state of the growing network. Here we derive several continuum equations for the orientation distribution of filaments growing behind stiff obstacles of various shapes and validate the predicted steady state orientation patterns by stochastic computer simulations based on discrete filaments. We use an ordinary differential equation approach to demonstrate that for flat obstacles of finite size, two fundamentally different orientation patterns peaked at either +35/-35 or +70/0/-70 degrees exhibit mutually exclusive stability, in agreement with earlier results for flat obstacles of very large lateral extension. We calculat...

  9. Implementation of a program for type 2 diabetes based on the Chronic Care Model in a hospital-centered health care system: 'the Belgian experience'

    OpenAIRE

    Van Royen Paul; Vermeire Etienne; Wens Johan; Nobels Frank; Snauwaert Boris; Feyen Luc; Bastiaens Hilde; Sunaert Patricia; De Maeseneer Jan; De Sutter An; Willems Sara

    2009-01-01

    Abstract Background Most research publications on Chronic Care Model (CCM) implementation originate from organizations or countries with a well-structured primary health care system. Information about efforts made in countries with a less well-organized primary health care system is scarce. In 2003, the Belgian National Institute for Health and Disability Insurance commissioned a pilot study to explore how care for type 2 diabetes patients could be organized in a more efficient way in the Bel...

  10. Explaining public satisfaction with health care systems: findings from a nationwide survey in China

    OpenAIRE

    Munro, Neil; Duckett, Jane

    2016-01-01

    Objective: To identify factors and covariates associated with health care system satisfaction in China. Context: Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health care utilization, media use and perceptions of services may affect health care system satisfaction, but the relationships between these factors are poorly understood. New data from China offers the opportunity to test theories about the source...

  11. Exploring information systems outsourcing in U.S. hospital-based health care delivery systems.

    Science.gov (United States)

    Diana, Mark L

    2009-12-01

    The purpose of this study is to explore the factors associated with outsourcing of information systems (IS) in hospital-based health care delivery systems, and to determine if there is a difference in IS outsourcing activity based on the strategic value of the outsourced functions. IS sourcing behavior is conceptualized as a case of vertical integration. A synthesis of strategic management theory (SMT) and transaction cost economics (TCE) serves as the theoretical framework. The sample consists of 1,365 hospital-based health care delivery systems that own 3,452 hospitals operating in 2004. The findings indicate that neither TCE nor SMT predicted outsourcing better than the other did. The findings also suggest that health care delivery system managers may not be considering significant factors when making sourcing decisions, including the relative strategic value of the functions they are outsourcing. It is consistent with previous literature to suggest that the high cost of IS may be the main factor driving the outsourcing decision.

  12. Who cares for former child soldiers? Mental health systems of care in Sierra Leone

    NARCIS (Netherlands)

    S. Song; H. van den Brink; J. de Jong

    2013-01-01

    While numerous studies on former child soldiers (FCS) have shown mental health needs, adequate services are a challenge. This study aimed to identify priorities, barriers and facilitators of mental health care for Sierra Leonean FCS. Thematic analysis was done on 24 qualitative interviews with parti

  13. Investigation of obstacles against effective crisis management in earthquake

    Institute of Scientific and Technical Information of China (English)

    Mahmood Nekoei-Moghadam; Mohammadreza Amiresmaili; Zeynab Aradoei

    2016-01-01

    Floods, hurricanes, landslides, hurricanes, tornadoes, earthquakes are events that a large group of people on earth are affected. In December 2003, the residents of Bam, Iran experienced an earthquake that measured 6.6 on the Richter scale and destroyed more than 90% of the city. The purpose of this study was to investigate obstacles against effective crisis management with considering service received by individuals in the Bam earthquake. In this study, domestic journals, foreign dissertations in Persian bases such as Google scholar, Magiran, IranMedex, SID and in English bases such as PubMed, Web of Science, Google scholar were used. The results of this study showed that there were many problems in various aspects of planning including: lack of coherent programs, lack of attention to the needs of health care, poor coordination between agencies and organiza-tions and lack of appropriate training of volunteers and people.

  14. Investigation of obstacles against effective crisis management in earthquake

    Directory of Open Access Journals (Sweden)

    Mahmood Nekoei-Moghadam

    2016-03-01

    Full Text Available Floods, hurricanes, landslides, hurricanes, tornadoes, earthquakes are events that a large group of people on earth are affected. In December 2003, the residents of Bam, Iran experienced an earthquake that measured 6.6 on the Richter scale and destroyed more than 90% of the city. The purpose of this study was to investigate obstacles against effective crisis management with considering service received by individuals in the Bam earthquake. In this study, domestic journals, foreign dissertations in Persian bases such as Google scholar, Magiran, IranMedex, SID and in English bases such as PubMed, Web of Science, Google scholar were used. The results of this study showed that there were many problems in various aspects of planning including: lack of coherent programs, lack of attention to the needs of health care, poor coordination between agencies and organizations and lack of appropriate training of volunteers and people.

  15. 中学教师远程研修障碍指标体系及影响因素研究%Study of the Index System and the Effect Factors of Middle School Teacher’s Distance Training Obstacle

    Institute of Scientific and Technical Information of China (English)

    乔爱玲; 田润

    2014-01-01

    With the development of information technology, network-based teachers’ training has become more important for teachers professional development. However, inlfuenced by a lot of factors, there are still more problems on teachers’ distance training, such as study obstacle of distance training. It’s urgent to ifnd out the factors and the primary and secondary relations of distance training obstacle. This research has concluded the effect factors and subordinate index of restricting middle school teacher’s distance study obstacle by literature and survey research. It also investigates a part of middle school teachers to show the primary and secondary relations of the effect factors of middle school teacher’s distance study obstacle. We hope our result can provide reference to solve the study obstacle of teacher’s distance training.%利用网络开展网络研修,已经成为当前教师专业发展的重要途径。然而,受一些因素影响,基于网络的教师远程研修还存在着很多的问题,比如远程研修过程中的学习障碍。如何找到这些远程学习障碍因素以及主次要关系,是解决当前教师研修的急需问题。该研究通过文献研究和调查研究,总结出制约中学教师远程学习障碍的影响因素以及下级指标,并对部分中学教师进行了调查,总结出影响中学教师远程学习障碍因素的主次要关系,希望该研究结果能对解决教师远程学习障碍提供参考和借鉴。

  16. 77 FR 4908 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-02-01

    ... INFORMATION: I. Background In FR Doc. 2011-19719 of August 18, 2011 (76 FR 51476), the final rule entitled... Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates; Corrections AGENCY: Centers...

  17. Round table: the silent revolution towards sustainable health care systems in Europe. (workshop)

    NARCIS (Netherlands)

    Groenewegen, P.P.

    2013-01-01

    Under the subsidiarity principles of the EU Member States have always had great autonomy in organising their health care systems, contributing to the patchwork of different health care systems across the EU. However, due to the continuing economic and political crisis, an unprecedented - and relativ

  18. Methane-air explosion characteristics with different obstacle configurations

    Institute of Scientific and Technical Information of China (English)

    Wen Xiaoping; Yu Minggao; Ji Wentao; Yue Meng; Chen Junjie

    2015-01-01

    To investigate the flame and overpressure characteristics of methane–air explosion with different obsta-cle configurations, an experimental study has been conducted, taking account of the number of obstacles, obstacle distance from ignition source, and stream-wise and cross-wise obstacle positions. The results show that the flame speed and peak overpressure increase with the increasing number of obstacles, while the time to reach the peak is not fully determined by it. And the configuration having the farthest obstacle produces a higher overpressure and takes a longer time to reach the peak, but a slower flame propagation speed is obtained. Similar explosion characteristics are also observed in the configurations with two obstacles fixed at different stream-wise positions. Furthermore, the experimental results demonstrate that the peak overpressures and flame speeds in configurations with central or staggered obstacles are relatively higher, which should to be avoided in practical processes to minimize the risk associated with methane–air explosion.

  19. Patient Safety in Critical Care Unit: Development of a Nursing Quality Indicator System.

    Science.gov (United States)

    Lima, Camila S P; Barbosa, Sayonara F F

    2015-01-01

    This is a methodological study and technological production that aims to describe the development of a computerized system of nursing care quality indicators for the Intensive Care Unit. The study population consisted of a systems analyst and fifteen critical care nurses. For the development of the system we adopted some of the best practices of the Unified Process methodology using the Unified Modeling Language and the programming language Java Enterprise Edition 7. The system consists of an access menu with the following functions: Home (presents general information), New Record (records the indicator), Record (record search), Census (add information and indicators of the patient), Report (generates report of the indicators) and Annex (accesses the Braden Scale). This information system allows for measurement of the quality of nursing care and to evaluate patient safety in intensive care unit by monitoring quality indicators in nursing. PMID:26262049

  20. Obstacle and predator avoidance by a flock

    OpenAIRE

    Mecholsky, Nicholas A.; Ott, Edward; Antonsen Jr., Thomas M.

    2009-01-01

    The modeling and investigation of the dynamics and configurations of animal groups is a subject of growing attention. In this paper, we present a continuum model of flocking and use it to investigate the reaction of a flock to an obstacle or an attacking predator. We show that the flock response is in the form of density disturbances that resemble Mach cones whose configuration is determined by the anisotropic propagation of waves through the flock. We analytically and numerically test relati...

  1. Negotiating access into firms: obstacles and strategies

    OpenAIRE

    Laryea, Sam; Hughes, Will

    2011-01-01

    Researchers often experience difficulties with the negotiation of access into firms for the purpose of data collection. The question we explore is: What are the main obstacles associated with access negotiation into firms; and what strategies do researchers employ to increase their chances of success? Our research work on the tendering process of contractors took place between 2006 and 2008. We successfully negotiated access into four firms (two each in Ghana and the UK) to observe live ex...

  2. The Major Obstacles in Improving English Reading Speed

    Institute of Scientific and Technical Information of China (English)

    任政谦

    2012-01-01

    This thesis analyzes the major obstacles in improving English reading speed,such as being lack of vocabulary and grammatical knowledge,bad reading habits,being lack of reading interest and the obstacle of cultural background knowledge,etc.Through discussing those major obstacles,this thesis puts forward some suggestions and teaching strategies.Those suggestions and teaching strategies will help college students to overcome the major obstacles and improve English reading speed.

  3. Intelligent Surveillance Robot with Obstacle Avoidance Capabilities Using Neural Network.

    Science.gov (United States)

    Budiharto, Widodo

    2015-01-01

    For specific purpose, vision-based surveillance robot that can be run autonomously and able to acquire images from its dynamic environment is very important, for example, in rescuing disaster victims in Indonesia. In this paper, we propose architecture for intelligent surveillance robot that is able to avoid obstacles using 3 ultrasonic distance sensors based on backpropagation neural network and a camera for face recognition. 2.4 GHz transmitter for transmitting video is used by the operator/user to direct the robot to the desired area. Results show the effectiveness of our method and we evaluate the performance of the system. PMID:26089863

  4. Intelligent Surveillance Robot with Obstacle Avoidance Capabilities Using Neural Network.

    Science.gov (United States)

    Budiharto, Widodo

    2015-01-01

    For specific purpose, vision-based surveillance robot that can be run autonomously and able to acquire images from its dynamic environment is very important, for example, in rescuing disaster victims in Indonesia. In this paper, we propose architecture for intelligent surveillance robot that is able to avoid obstacles using 3 ultrasonic distance sensors based on backpropagation neural network and a camera for face recognition. 2.4 GHz transmitter for transmitting video is used by the operator/user to direct the robot to the desired area. Results show the effectiveness of our method and we evaluate the performance of the system.

  5. Application of A* Algorithm for Real-time Path Re-planning of an Unmanned Surface Vehicle Avoiding Underwater Obstacles

    Institute of Scientific and Technical Information of China (English)

    Thanapong Phanthong; Toshihiro Maki; Tamaki Ura; Takashi Sakamaki; Pattara Aiyarak

    2014-01-01

    This paper describes path re-planning techniques and underwater obstacle avoidance for unmanned surface vehicle (USV) based on multi-beam forward looking sonar (FLS). Near-optimal paths in static and dynamic environments with underwater obstacles are computed using a numerical solution procedure based on an A*algorithm. The USV is modeled with a circular shape in 2 degrees of freedom (surge and yaw). In this paper, two-dimensional (2-D) underwater obstacle avoidance and the robust real-time path re-planning technique for actual USV using multi-beam FLS are developed. Our real-time path re-planning algorithm has been tested to regenerate the optimal path for several updated frames in the field of view of the sonar with a proper update frequency of the FLS. The performance of the proposed method was verified through simulations, and sea experiments. For simulations, the USV model can avoid both a single stationary obstacle, multiple stationary obstacles and moving obstacles with the near-optimal trajectory that are performed both in the vehicle and the world reference frame. For sea experiments, the proposed method for an underwater obstacle avoidance system is implemented with a USV test platform. The actual USV is automatically controlled and succeeded in its real-time avoidance against the stationary undersea obstacle in the field of view of the FLS together with the Global Positioning System (GPS) of the USV.

  6. Economic crisis and counter-reform of universal health care systems: Spanish case

    Science.gov (United States)

    Fortes, Paulo Antônio de Carvalho; Carvalho, Regina Ribeiro Parizi; Louvison, Marília Cristina Prado

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities. PMID:26083942

  7. The Danish patient safety experience: the Act on Patient Safety in the Danish health care system

    OpenAIRE

    Mette Lundgaard; Louise Raboel; Elisabeth Broegger Jensen; Jacob Anhoej; Beth Lilja Pedersen; Danish Society for Patient Safety

    2005-01-01

    This paper describes the process that lead to the passing of the Act for Patient Safety in the Danish health care system, the contents of the act and how the act is used in the Danish health care system.

    The act obligates frontline health care personnel to report adverse events, hospital owners to act on the reports and the National Board of Health to communicate the learning nationally.

    The act protects health care providers from sanctions as a re...

  8. Economic crisis and counter-reform of universal health care systems: Spanish case

    Directory of Open Access Journals (Sweden)

    Paulo Antônio de Carvalho Fortes

    2015-01-01

    Full Text Available The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities.

  9. Economic crisis and counter-reform of universal health care systems: Spanish case.

    Science.gov (United States)

    Fortes, Paulo Antônio de Carvalho; Carvalho, Regina Ribeiro Parizi; Louvison, Marília Cristina Prado

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities. PMID:26083942

  10. The Effects of Organization Design and Patient Perceptions of Care on Switching Behavior and Reliance on a Health Care System Across Time.

    Science.gov (United States)

    Labonte, Alan J; Benzer, Justin K; Burgess, James F; Cramer, Irene E; Meterko, Mark; Pogoda, Terri K; Charns, Martin P

    2016-04-01

    Sustaining ongoing relationships with patients is a strategic, clinically relevant goal of health care systems. This study develops and tests a conceptual model that aims to account for the influence of organization design, perceptions of quality of patient care, and other patient-level factors on the extent to which patients sustain reliance on a health care system. We use a longitudinal survey design and structural equation modeling to predict increases or decreases in patient reliance on the Department of Veterans Affairs health care system across a 4-year period for Veterans with Parkinson's Disease. Our findings show that specialized and integrated clinical practices have a positive association with the quality of patient care. Health care systems may be able to foster long-term relations with patients and improve service quality by allocating resources to form integrated, specialized, disease-specific centers of care designed for patients with chronic illnesses. PMID:26311255

  11. The Obstacles in Learning English of English Majors

    Institute of Scientific and Technical Information of China (English)

    陈树琴

    2015-01-01

    In recent years,more and more foreign language researchers have taken the obstacle factors into consideration. Among the obstacle factors influencing language learning,anxiety ranks high.This paper focuses on the obstacle factors analysis and the way to reduce the negative effects they cause.

  12. The Obstacles in Learning English of English Majors

    Institute of Scientific and Technical Information of China (English)

    陈树琴

    2015-01-01

    In recent years,more and more foreign language researchers have taken the obstacle factors into consideration.Among the obstacle factors influencing language learning,anxiety ranks high.This paper focuses on the obstacle factors analysis and the way to reduce the negative effects they cause.

  13. Monte Carlo simulations of protein micropatterning in biomembranes: effects of immobile sticky obstacles

    Science.gov (United States)

    Arnold, Andreas M.; Sevcsik, Eva; Schütz, Gerhard J.

    2016-09-01

    Single molecule trajectories of lipids and proteins can yield valuable information about the nanoscopic organization of the plasma membrane itself. The interpretation of such trajectories, however, is complicated, as the mobility of molecules can be affected by the presence of immobile obstacles, and the transient binding of the tracers to these obstacles. We have previously developed a micropatterning approach that allows for immobilizing a plasma membrane protein and probing the diffusional behavior of a putative interaction partner in living cells. Here, we provide guidelines on how this micropatterning approach can be extended to quantify interaction parameters between plasma membrane constituents in their natural environment. We simulated a patterned membrane system and evaluated the effect of different surface densities of patterned immobile obstacles on the relative mobility as well as the surface density of diffusing tracers. In the case of inert obstacles, the size of the obstacle can be assessed from its surface density at the percolation threshold, which in turn can be extracted from the diffusion behavior of the tracer. For sticky obstacles, 2D dissociation constants can be determined from the tracer diffusion or surface density.

  14. Orphan Care in Russia

    Directory of Open Access Journals (Sweden)

    Schmidt, Victoria

    2009-07-01

    Full Text Available Current public opinion about the residential care system in contemporary Russia is extremely negative. A majority of Russians, both citizens and professionals, consider that family placement is the best arrangement for orphaned children. The year 2007 was announced as the Year of the Child in Russia. The majority of officials interpreted it as the year of de-institutionalization of the residential care system for children in Russia. De-institutionalization is mostly identified as reform focused on family placement instead of placement in institutions. Vladimir Fridlyanov, the executive director of the Ministry of Science and Education, announced in May, 2007 that the government is going to transfer 120,000 children from institutions into families every year from 2007 until 2010 and reduce the number of residential care institutions by one-third (Nesterova 2007. But the likelihood of family placement is small, with the exception of the adoption of infants without serious pathologies, and the attempts of precipitant de-institutionalization (when children’s homes are closed and children are distributed among families have failed (children were returned into children homes. According to the opinion of the Ministry, the key obstacle to effective de-institutionalization is the lack of professionals in adoption and foster care (Vazhdaeva 2006.

  15. Awareness of bispectral index monitoring system among the critical care nursing personnel in a tertiary care hospital of India

    Directory of Open Access Journals (Sweden)

    Shikha Thakur

    2011-01-01

    Full Text Available Background: Bispectral index monitoring system (BIS is one of the several systems used to measure the effects of anaesthetic and sedative drugs on the brain and to track changes in the patient′s level of sedation and hypnosis. BIS monitoring provides information clinically relevant to the adjustment of dosages of sedating medication. It can help the nursing personnel in preventing under- and over sedation among intensive care unit (ICU patients. Objective: The present study was conducted to assess the knowledge of nursing personnel working in the ICU regarding BIS. Methods: Fifty-four subjects participated in the study. A structured questionnaire was developed to assess the knowledge of the nursing personnel regarding BIS. Focus group discussions were held among the nursing personnel to know their views regarding BIS. Results: Mean age (years of the subjects was 30.7΁7.19 (21-47 years, with a female preponderance. Although the use of BIS in ICU is not common, majority (94.44% were aware of BIS and its purpose. 79.62% of the subjects knew about its implication in patient care. The mean knowledge score of the subjects was 11.87΁2.43 (maximum score being 15. Conclusion: There exists an awareness among the critical care nursing staff in our institution regarding BIS and its clinical implications. Its use in the critical care setting may benefit the patients in terms of providing optimal sedation.

  16. Transnational capital and confessional politics: the paradox of the health care system in Lebanon.

    Science.gov (United States)

    Sen, Kasturi; Mehio-Sibai, Abla

    2004-01-01

    For the past two decades there has been a debate over the implementation of structural adjustment policies in the health sector of developing countries, much of it focusing on the political and economic relevance of the reform process for public health provision. However, very few studies have been able to assess the relevance of the private sector, which has had a central role in the restructuring of health services worldwide. Lebanon provides just such a case, with a predominantly private provider and the role of the state relegated to financing, with few controls over supply. This situation has ensured the systematic destruction of what remained of public provision in the 1970s. The country is now faced with one of the most expensive health services in the world, and one in which much of the population continues to live under conditions of considerable economic deprivation. The unique situation of Lebanon is maintained by its politics of confessionalism, with sociopolitical relations dominated by primordial ties of family, tribe, and kin, which does not seem to be an obstacle to the process of globalization. The authors suggest that this context reinforces the gross inequalities in access to health care; they explore the complex relationship between state, finance capital, and confessional politics in the context of health sector reform, in particular the financing of health care. PMID:15346684

  17. Leadership Perspectives on Operationalizing the Learning Health Care System in an Integrated Delivery System

    Science.gov (United States)

    Psek, Wayne; Davis, F. Daniel; Gerrity, Gloria; Stametz, Rebecca; Bailey-Davis, Lisa; Henninger, Debra; Sellers, Dorothy; Darer, Jonathan

    2016-01-01

    Introduction: Healthcare leaders need operational strategies that support organizational learning for continued improvement and value generation. The learning health system (LHS) model may provide leaders with such strategies; however, little is known about leaders’ perspectives on the value and application of system-wide operationalization of the LHS model. The objective of this project was to solicit and analyze senior health system leaders’ perspectives on the LHS and learning activities in an integrated delivery system. Methods: A series of interviews were conducted with 41 system leaders from a broad range of clinical and administrative areas across an integrated delivery system. Leaders’ responses were categorized into themes. Findings: Ten major themes emerged from our conversations with leaders. While leaders generally expressed support for the concept of the LHS and enhanced system-wide learning, their concerns and suggestions for operationalization where strongly aligned with their functional area and strategic goals. Discussion: Our findings suggests that leaders tend to adopt a very pragmatic approach to learning. Leaders expressed a dichotomy between the operational imperative to execute operational objectives efficiently and the need for rigorous evaluation. Alignment of learning activities with system-wide strategic and operational priorities is important to gain leadership support and resources. Practical approaches to addressing opportunities and challenges identified in the themes are discussed. Conclusion: Continuous learning is an ongoing, multi-disciplinary function of a health care delivery system. Findings from this and other research may be used to inform and prioritize system-wide learning objectives and strategies which support reliable, high value care delivery. PMID:27683668

  18. Europe's strong primary care systems are linked to better population health but also to higher health spending.

    NARCIS (Netherlands)

    Kringos, D.S.; Boerma, W.; Zee, J. van der; Groenewegen, P.

    2013-01-01

    Strong primary care systems are often viewed as the bedrock of health care systems that provide high-quality care, but the evidence supporting this view is somewhat limited. We analyzed comparative primary care data collected in 2009-10 as part of a European Union-funded project, the Primary Health

  19. Developing Governance Structures in Health Care System Consolidation: A Framework for Nurse Leaders.

    Science.gov (United States)

    Swartz, Colleen H; Bentley, Sarah

    2016-01-01

    Given the acceleration and increasing complexity of integrative care models across health systems, the question how governance and management structure(s) should be operationalized and evolved to achieve peak system performance is paramount. In a recent evaluation of partnerships with the University of Kentucky HealthCare (UK HealthCare), the conceptualization of the integration management model was explored. It was recognized that nursing leadership, governance structure, and relationships are vital for successful movement and migration of appropriate care models. In this case, the evolving governance models and the forecasted impact on models of care delivery were carefully considered. This included the potential impact on nursing practice. As the model was developed, a conceptual framework was utilized to examine potential variant relationship arrangements and to provide organization to key constructs. Utilization of a blueprint to optimize decision making and provide a replicable approach was essential to management of the integration philosophy.

  20. Developing Governance Structures in Health Care System Consolidation: A Framework for Nurse Leaders.

    Science.gov (United States)

    Swartz, Colleen H; Bentley, Sarah

    2016-01-01

    Given the acceleration and increasing complexity of integrative care models across health systems, the question how governance and management structure(s) should be operationalized and evolved to achieve peak system performance is paramount. In a recent evaluation of partnerships with the University of Kentucky HealthCare (UK HealthCare), the conceptualization of the integration management model was explored. It was recognized that nursing leadership, governance structure, and relationships are vital for successful movement and migration of appropriate care models. In this case, the evolving governance models and the forecasted impact on models of care delivery were carefully considered. This included the potential impact on nursing practice. As the model was developed, a conceptual framework was utilized to examine potential variant relationship arrangements and to provide organization to key constructs. Utilization of a blueprint to optimize decision making and provide a replicable approach was essential to management of the integration philosophy. PMID:27584887

  1. Confidence and confusion: the health care system in the United States.

    Science.gov (United States)

    Fronstin, P

    2000-01-01

    Results from the latest "Health Confidence Survey" show that Americans generally appear to be happy with their health care system experiences. Satisfaction with the care received over the past two years and with current health insurance plans remains high and virtually unchanged since the 1998 survey. Close to nine out of 10 respondents were satisfied with their health plan in 1999 as well as the quality of care received. Confidence in many aspects of the health care system is high--94 percent of Americans report being confident that their pharmacist will fill their prescription correctly, 90 percent are confident they will be able to see a health care specialist, as needed, and 89 percent have confidence in the quality of care that hospitals deliver. Confidence is not as high, however, for belief in the confidentiality of medical records or that a fair review will be be received if health insurance coverage is denied. While Americans are highly confident in most aspects of the health care system today, they continue to be less so for the next 10 years and even less so once they become Medicare eligible. Confidence in the future of health care may be low because Americans appear to be uncertain about managed care and what constitutes a managed care plan. While 71 percent of those enrolled in a managed care plan label it as a PPO or HMO, only 21 percent reported that they are currently enrolled ina managed care plan. The fact that so many Americans do not know that their health plan is a managed care plan lends support to our contention that these plans, benefits managers, employers, policymakers and the media have failed to educate enrollees and the general public about the features and potential advantages of such plans. PMID:10666781

  2. HEALTH CARE DATA WAREHOUSE SYSTEM ARCHITECTURE FOR INFLUENZA (FLU DISEASES

    Directory of Open Access Journals (Sweden)

    Rajib Dutta

    2013-02-01

    Full Text Available Data Warehouse is the most reliable technology used by the company for planning, forecasting and management. Critical business management data was contained in several unrelated and disconnected databases, both internally managed and from external sources. Client was unable to view the data from an integrated viewpoint. The data warehousing is one of the best technique to integrate data. This paper presents the Influenza (Flu diseases specific data warehouse architecture for health care. This could be used by the database administrator or executive manager, doctors, nurses, other staff members of the health care. Health care data warehouse is mostly important to integrate different data format from different data source. All information about patient including their medical test reports are store in the database, the executive manager needs to access those data and make a report. By seeing the report, the doctor takes action.

  3. The suitability of care pathways for integrating processes and information systems in healthcare

    OpenAIRE

    Crocker, TF; Johnson, OA; King, SF

    2009-01-01

    Purpose: This paper examines the suitability of current care pathway modelling techniques for supporting business improvement and the development of information systems. This is in the light of current UK government policies advocating the use of care pathways as part of the £12.4 billion programme for IT and as a key strategy to reducing waiting times. Approach: We conducted a qualitative analysis of the variety in purpose, syntax and semantics in a selection of existing care pathways. Findi...

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

    OpenAIRE

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

    2016-01-01

    Abstract Objectives: assess a prototype for use on mobile devices that permits registering data for the Systemization of Nursing Care at a Neonatal Intensive Care Unit. Method: an exploratory and descriptive study was undertaken, characterized as an applied methodological research, developed at a teaching hospital. Results: the mobile technology the nurses at the Neonatal Intensive Care Unit use was positive, although some reported they faced difficulties to manage it, while others with exper...

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

    OpenAIRE

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

    2016-01-01

    Abstract Objectives: assess a prototype for use on mobile devices that permits registering data for the Systemization of Nursing Care at a Neonatal Intensive Care Unit. Method: an exploratory and descriptive study was undertaken, characterized as an applied methodological research, developed at a teaching hospital. Results: the mobile technology the nurses at the Neonatal Intensive Care Unit use was positive, although some reported they faced difficulties to manage it, while others with...

  6. Characteristics of physical activity programs in the Brazilian primary health care system

    OpenAIRE

    Grace Angélica de Oliveira Gomes; Eduardo Kokubun; Grégore Iven Mieke; Luiz Roberto Ramos; Michael Pratt; Diana C. Parra; Eduardo Simões; Florindo, Alex A; Mario Bracco; Danielle Cruz; Deborah Malta; Felipe Lobelo; Hallal, Pedro C.

    2014-01-01

    The aim of this study was to describe the characteristics of programs that promote physical activity in the public primary care system by region of Brazil, subject to the presence or absence of multidisciplinary primary care teams (NASF). We conducted a cross sectional and population-based telephone survey of the health unit coordinators from 1,251 health care units. Coordinators were asked about the presence and characteristics of physical activity programs. Four out of ten health units repo...

  7. Effects of different broiler production systems on health care costs in the Netherlands.

    Science.gov (United States)

    Gocsik, É; Kortes, H E; Lansink, A G J M Oude; Saatkamp, H W

    2014-06-01

    This study analyzed the effects of different broiler production systems on health care costs in the Netherlands. In addition to the conventional production system, the analysis also included 5 alternative animal welfare systems representative of the Netherlands. The study was limited to the most prevalent and economically relevant endemic diseases in the broiler farms. Health care costs consisted of losses and expenditures. The study investigated whether higher animal welfare standards increased health care costs, in both absolute and relative terms, and also examined which cost components (losses or expenditures) were affected and, if so, to what extent. The results show that health care costs represent only a small proportion of total production costs in each production system. Losses account for the major part of health care costs, which makes it difficult to detect the actual effect of diseases on total health care costs. We conclude that, although differences in health care costs exist across production systems, health care costs only make a minor contribution to the total production costs relative to other costs, such as feed costs and purchase of 1-d-old chicks.

  8. Image-guided neurosurgery. Global concept of a surgical tele-assistance using obstacle detection robotics

    International Nuclear Information System (INIS)

    Surgical tele-assistance significantly increases accuracy of surgical gestures, especially in the case of brain tumor neurosurgery. The robotic device is tele-operated through a microscope and the surgeon's gestures are guided by real-time overlaying of the X-ray imagery in the microscope. During the device's progression inside the brain, the focus is ensured by the microscope auto-focus feature. The surgeon can thus constantly check his position on the field workstation. Obstacles to avoid or dangerous areas can be previewed in the operation field. This system is routinely used for 5 years in the neurosurgery division of the Val de Grace hospital. More than 400 brain surgery operations have been done using it. An adaptation is used for rachis surgery. Other military hospitals begin to be equipped with similar systems. It will be possible to link them for data transfer. When it will be operational, such a network it will show what could be, in the future, a medical/surgical remote-assistance system designed to take care of wounded/critical conditions people, including assistance to surgical gestures. (authors)

  9. A web-based care-requiring client and Home Helper mutual support system.

    Science.gov (United States)

    Ogawa, Hidekuni; Yonezawa, Yoshiharu; Maki, Hiromichi; Hahn, Allen W; Caldwell, W Morton

    2005-01-01

    For the improved efficiency of home care of the elderly, a web-based system has been developed to enable faster communications between care-requiring clients, their Home Helper and the care manager. Changes to care items, such as cooking, bathing, washing, cleaning and shopping are usually requested by the elderly client over the telephone. However, the care central office often requires 24 hours to process and respond to such spoken requests. The system we have developed consists of Internet client computers with liquid crystal input tablets, wireless Internet Java enabled mobile phones and a central office server that yields almost instant communication. The care clients enter requests on the liquid crystal tablet at their home and then their computer sends these requests to the server at the Home Helper central office. The server automatically creates a new file of the requested items, and then immediately transfers them to the care manager and Home Helper's mobile phone. With this non-vocal and paperless system, the care-requiring clients, who can easily operate the liquid crystal tablet, can very quickly communicate their needed care change requests to their Home Helper.

  10. Transforming to a computerized system for nursing care: organizational success within Magnet idealism.

    Science.gov (United States)

    Lindgren, Carolyn L; Elie, Leslie G; Vidal, Elizabeth C; Vasserman, Alex

    2010-01-01

    In reaching the goal for standardized, quality care, a not-for-profit healthcare system consisting of seven institutional entities is transforming nursing practice guidelines, patient care workflow, and patient documents into electronic, online, real-time modalities for use across departments and all healthcare delivery entities of the system. Organizational structure and a strategic plan were developed for the 2-year Clinical Transformation Project. The Siemens Patient Care Document System was adopted and adapted to the hospitals' documentation and information needs. Two fast-track sessions of more than 100 nurses and representatives from other health disciplines were held to standardize assessments, histories, care protocols, and interdisciplinary plans of care for the top 10 diagnostic regulatory groups. Education needs of the users were addressed. After the first year, a productive, functional system is evidenced. For example, the bar-coded Medication Administration Check System is in full use on the clinical units of one of the hospitals, and the other institutional entities are at substantial stages of implementation of Patient Care Documentation System. The project requires significant allocation of personnel and financial resources for a highly functional informatics system that will transform clinical care. The project exemplifies four of the Magnet ideals and serves as a model for others who may be deciding about launching a similar endeavor. PMID:20182156

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

    OpenAIRE

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

    2015-01-01

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

  12. PATIENT DATA MANAGEMENT SYSTEM IN INTENSIVE CARE UNIT (ICU) USING LABVIEW

    OpenAIRE

    Amritjot Kaur*, Shimi S. L

    2016-01-01

    This paper proposes a new system that takes the benefits of data flow technology. Its objective is to collect the data from monitoring system in the intensive care unit (ICU) and store that data for further analysis. Then it will be available for medical personnel to analyze data and take the suitable medication for patients. In fact, the monitoring system in intensive care unit provides a large amount of data quickly and continuously. Most units operate with a very limited storage capacity w...

  13. Measuring quality of diabetes care by linking health care system administrative databases with laboratory data

    Directory of Open Access Journals (Sweden)

    Klomp Helena

    2010-08-01

    Full Text Available Abstract Background Chronic complications of diabetes can be reduced through optimal glycemic and lipid control as evaluated through measurement of glycosylated hemoglobin (A1C and low-density lipoprotein cholesterol (LDL-C. We aimed to produce measures of quality of diabetes care in Saskatchewan and to identify sub-groups at particular risk of developing complications. Findings Prevalent adult cases of diabetes in 2005/06 were identified from administrative databases and linked with A1C and LDL-C tests measured in centralized laboratories. A1C results were performed in 33,927 of 50,713 (66.9% diabetes cases identified in Saskatchewan, and LDL-C results were performed in 12,031 of 24,207 (49.7% cases identified within the province's two largest health regions. The target A1C of Conclusions Linkage of laboratory with administrative data is an effective method of assessing quality of diabetes care on a population basis and to identify sub-groups requiring particular attention. We found that less than 50% of Saskatchewan people with diabetes achieved optimal glycemic and lipid control. Disparities were most evident among First Nations people and young women. The indicators described can be used to provide standardized information that would support quality improvement initiatives.

  14. A unified emergency care system for the early management of emergencies in medicine.

    Science.gov (United States)

    Morgan-Jones, D; Hodgetts, T J

    1999-06-01

    Emergency medicine is increasingly compartmentalised. The Unified Emergency Care System (UECS) requires the user to consider every option for emergency care for each patient, in a logical manner that transcends these artificial compartments and recognises the relative priority of concomitant medical, surgical, environmental and toxicological problems. The system is presented as a series of icons, allowing considerations to be made at a glance. Drop shadows refer the user to detailed management protocols for specific conditions. The system follows the logical sequence of quick history, quick look, primary survey with resuscitation and secondary survey. Established management principles of airway-breathing-circulation-disability (ABCD) are incorporated. The complexity of the management algorithms increases from first aider through medic, paramedic, and primary care physician to emergency physician. The stepwise care facilitates seamless immediate medical care between providers, teamwork, and the development of a structured series of training programmes. PMID:10420340

  15. APPLICATION OF DSM IN OBSTACLE CLEARANCE SURVEYING OF AERODROME

    Directory of Open Access Journals (Sweden)

    X. Qiao

    2016-06-01

    Full Text Available Compared to the wide use of digital elevation model (DEM, digital surface model (DSM receives less attention because that it is composed by not only terrain surface, but also vegetations and man-made objects which are usually regarded as useless information. Nevertheless, these objects are useful for the identification of obstacles around an aerodrome. The primary objective of the study was to determine the applicability of DSM in obstacle clearance surveying of aerodrome. According to the requirements of obstacle clearance surveying at QT airport, aerial and satellite imagery were used to generate DSM, by means of photogrammetry, which was spatially analyzed with the hypothetical 3D obstacle limitation surfaces (OLS to identify the potential obstacles. Field surveying was then carried out to retrieve the accurate horizontal position and height of the obstacles. The results proved that the application of DSM could make considerable improvement in the efficiency of obstacle clearance surveying of aerodrome.

  16. Sedimentation control in the reservoirs by using an obstacle

    Indian Academy of Sciences (India)

    Morteza Marosi; Mehdi Ghomeshi; Hamed Sarkardeh

    2015-06-01

    In the present experimental research, effect of different heights of obstacle on turbidity current, to control the sedimentation in a reservoir, was investigated. Experiments were carried out with horizontal and steep bed slopes and different flow conditions. To see the effect of obstacle on concentration of overflow turbidity current, some experiments were carried out without an obstacle. Results showed that concentration of the currents without obstacle reduced exponentially by distance from the entrance gate. More reduction of density and dilution of the currents were observed in the presence of an obstacle, especially with increasing the heights. Increasing height of obstacle also improved their trap efficiency. Moreover, it was concluded that effect of the presence of an obstacle was less intense in a steep bed slope of the reservoir than in a horizontal one.

  17. A person-focused model of care for the twenty-first century: a system-of-systems perspective.

    Science.gov (United States)

    Greene, Robert A; Dasso, Edwin; Ho, Sam; Genaidy, Ash M

    2014-06-01

    The US health care system is challenged to provide high-quality care and is burdened with unsustainable expenditures, making it difficult for health care participants (patients, payers, providers, caregivers) to create value. This communication presents the theoretical foundation for a person-focused model of care that addresses a number of these challenges. The model integrates aspects of prior models of chronic care with new empiric findings and complex adaptive system (CAS) theory. The model emphasizes the relationship among all health care stakeholders. The health care delivery process is examined in terms of the role of each stakeholder and the value each adds to and receives from the process. The authors present pilot results illustrating the implications of CAS theory in regard to multi-morbidity, disease management programs, multi-morbid households, and person- and household-focused care. The model incorporates the physical, mental, and social dimensions of health, and operationalizes an individual patient's health as a CAS, identifying CASs for each of the other stakeholders as well. Health care can then be conceptualized as a system-of-systems with a person's health as its output. Deploying the model need not require major infrastructure investments or changes. It can be implemented by repurposing, aligning, and better integrating currently available interventions. The authors believe that the model creates not only survival value (health) but also purposeful value. The model offers a unifying focus for all participants in the health care delivery process, thereby constructing a health care system that is structurally person-focused and meaningful for all participants. PMID:24720637

  18. Integrated care requires integrated supervision

    OpenAIRE

    Ketelaars, Corry

    2011-01-01

    Introduction: Given recent developments in integrated care, it is becoming increasingly important for the Dutch Health Care Inspectorate to direct its supervision in a way that may help speed up the implementation of integrated care.Description of care practice: Since the implementation of integrated care for chronic patients is facing obstacles, alternative methods are required to ensure that the implementation process does not run into any delays. By applying a risk-based approach to integr...

  19. Within-population variation in mating system and parental care patterns in the Sander ling (

    NARCIS (Netherlands)

    Reneerkens, J.; van Veelen, P.; van der Velde, M.; Luttikhuizen, P.; Piersma, T.

    2014-01-01

    Sandpipers and allies (Scolopacidae) show an astounding diversity in mating and parental care strategies. Comparative studies have tried to interpret this variation in terms of phylogenetic constraints and ecological shaping factors. In such analyses, mating and parental care systems are necessarily

  20. Organizational restructuring in European health systems: the role of primary care.

    NARCIS (Netherlands)

    Rico, A.; Saltman, R.B.; Boerma, W.G.W.

    2003-01-01

    The main goal of this paper is to review the strategies developed across European health care systems during the 1990s to improve coordination among health care providers. A second goal is to provide some analytical insights in two fields. On the one hand, we attempt to clarify the relationships bet

  1. The quest for integrated systems of care for frail older persons.

    Science.gov (United States)

    Kodner, Dennis L

    2002-08-01

    The challenge of an increasing elderly population, particularly with respect to frail older persons in need of long-term care, has coupled with ever-present budget constraints to make the financing, organization and delivery of elder care a major priority in North America, Europe and elsewhere in the developed world. Despite obvious cross-national differences in health and social care arrangements for the frail elderly, evidence of poorly coordinated services, disjointed care, less than optimum outcomes, system inefficiency, inadequate accountability, and uncontrolled costs can be found in all countries. There is a growing belief that more comprehensive approaches are needed to effectively address these problems. One such strategy, so-called integrated systems of care, shows great promise. The author critically examines the concept of integrated systems of care for the frail elderly, including the theoretical benefits and drawbacks of the model. At the policy and practice levels, descriptions are presented of, and evidence and lessons are summarized from a representative sample of such projects in the US (Social HMO and PACE), Canada (SIPA), Italy (Rovereto) and Australia (Coordinated Care Trials). The introduction of prototypes such as these raises a number of significant issues for policymakers, payers, providers, consumers and researchers. These are briefly examined in concluding remarks on the important potential of integrated systems of care for vulnerable older people.

  2. Interorganizational health care systems implementations: an exploratory study of early electronic commerce initiatives.

    Science.gov (United States)

    Payton, F C; Ginzberg, M J

    2001-01-01

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

  3. Scoring system for the selection of high-risk patients in the intensive care unit

    NARCIS (Netherlands)

    Iapichino, G; Mistraletti, G; Corbella, D; Bassi, G; Borotto, E; Miranda, DR; Morabito, A

    2006-01-01

    Objective. Patients admitted to the intensive care unit greatly differ in severity and intensity of care. We devised a system for selecting high-risk patients that reduces bias by excluding low-risk patients and patients with an early death irrespective of the treatment. Design: A posteriori analysi

  4. Scientific Productivity in Transition Countries: Trends and Obstacles

    Directory of Open Access Journals (Sweden)

    Iva Radocaj Novak

    2013-04-01

    Full Text Available Scientific productivity is one of the engines of development in the 21st century. The most common way of its measurement is through publication in peer-review articles. Current research indicates that there is a strong connection between country’s development and its share in the world publication of scientific articles. Transition countries are still catching-up with the most developed countries in terms of scientific productivity, which is especially evident in Western Balkan countries. As one of the rare attempts to assess obstacles to scientific productivity in transition countries, this study investigates different factors and their effects to the scientific productivity. The obstacles are the results of the historical reasons, inadequate systems for advancement in the scientific community, and problems with the development and/or implementation of strategies for scientific development of the particular country. In addition, without efficient measurement of scientific productivity, it is hard to analyse its behaviour. Papers written by authors from transition countries are often published in local journals that are covered insufficiently by the Web of Science. Therefore, up-to-date systems for tracking scientific publications in transition countries are of the highest importance.

  5. StereoBox: A Robust and Efficient Solution for Automotive Short-Range Obstacle Detection

    Directory of Open Access Journals (Sweden)

    Alberto Broggi

    2007-07-01

    Full Text Available This paper presents a robust method for close-range obstacle detection with arbitrarily aligned stereo cameras. System calibration is performed by means of a dense grid to remove perspective and lens distortion after a direct mapping between image pixels and world points. Obstacle detection is based on the differences between left and right images after transformation phase and with a polar histogram, it is possible to detect vertical structures and to reject noise and small objects. Found objects' world coordinates are transmitted via CAN bus; the driver can also be warned through an audio interface. The proposed algorithm can be useful in different automotive applications, requiring real-time segmentation without any assumption on background. Experimental results proved the system to be robust in several envitonmental conditions. In particular, the system has been tested to investigate presence of obstacles in blind spot areas around heavy goods vehicles (HGVs and has been mounted on three different prototypes at different heights.

  6. StereoBox: A Robust and Efficient Solution for Automotive Short-Range Obstacle Detection

    Directory of Open Access Journals (Sweden)

    Broggi Alberto

    2007-01-01

    Full Text Available This paper presents a robust method for close-range obstacle detection with arbitrarily aligned stereo cameras. System calibration is performed by means of a dense grid to remove perspective and lens distortion after a direct mapping between image pixels and world points. Obstacle detection is based on the differences between left and right images after transformation phase and with a polar histogram, it is possible to detect vertical structures and to reject noise and small objects. Found objects' world coordinates are transmitted via CAN bus; the driver can also be warned through an audio interface. The proposed algorithm can be useful in different automotive applications, requiring real-time segmentation without any assumption on background. Experimental results proved the system to be robust in several envitonmental conditions. In particular, the system has been tested to investigate presence of obstacles in blind spot areas around heavy goods vehicles (HGVs and has been mounted on three different prototypes at different heights.

  7. Fuzzy Inference Based Obstacle Avoidance Control of Electric Powered Wheelchair Considering Driving Risk

    Science.gov (United States)

    Kiso, Atsushi; Murakami, Hiroki; Seki, Hirokazu

    This paper describes a novel obstacle avoidance control scheme of electric powered wheelchairs for realizing the safe driving in various environments. The “electric powered wheelchair” which generates the driving force by electric motors is expected to be widely used as a mobility support system for elderly people and disabled people; however, the driving performance must be further improved because the number of driving accidents caused by elderly operator's narrow sight and joystick operation errors is increasing. This paper proposes a novel obstacle avoidance control scheme based on fuzzy algorithm to prevent driving accidents. The proposed control system determines the driving direction by fuzzy algorithm based on the information of the joystick operation and distance to obstacles measured by ultrasonic sensors. Fuzzy rules to determine the driving direction are designed surely to avoid passers-by and walls considering the human's intent and driving environments. Some driving experiments on the practical situations show the effectiveness of the proposed control system.

  8. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra;

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....

  9. Recovering an obstacle using integral equations

    KAUST Repository

    Rundell, William

    2009-05-01

    We consider the inverse problem of recovering the shape, location and surface properties of an object where the surrounding medium is both conductive and homogeneous and we measure Cauchy data on an accessible part of the exterior boundary. It is assumed that the physical situation is modelled by harmonic functions and the boundary condition on the obstacle is one of Dirichlet type. The purpose of this paper is to answer some of the questions raised in a recent paper that introduced a nonlinear integral equation approach for the solution of this type of problem.

  10. Interventions geared towards strengthening the health system of Namibia through the integration of palliative care.

    Science.gov (United States)

    Freeman, Rachel; Luyirika, Emmanuel Bk; Namisango, Eve; Kiyange, Fatia

    2016-01-01

    The high burden of non-communicable diseases and communicable diseases in Africa characterised by late presentation and diagnosis makes the need for palliative care a priority from the point of diagnosis to death and through bereavement. Palliative care is an intervention that requires a multidisciplinary team to address the multifaceted needs of the patient and family. Thus, its development takes a broad approach that involves engaging all key stakeholders ranging from policy makers, care providers, educators, the public, patients, and families. The main focus of stakeholder engagement should address some core interventions geared towards improving knowledge and awareness, strengthening skills and attitudes about palliative care. These interventions include educating health and allied healthcare professionals on the palliative care-related problems of patients and best practices for care, explaining palliative care as a clinical and holistic discipline and demonstrating its effectiveness, the need to include palliative care into national policies, strategic plans, training curriculums of healthcare professionals and the engagement of patients, families, and communities. Interventions from a five-year programme that was aimed at strengthening the health system of Namibia through the integration of palliative care for people living with HIV and AIDS and cancer in Namibia are shared. This article illustrates how a country can implement the World Health Organisation's public health strategy for developing palliative care services, which recommends four pillars: government policy, education, drug availability, and implementation. PMID:27563348

  11. Interventions geared towards strengthening the health system of Namibia through the integration of palliative care

    Science.gov (United States)

    Freeman, Rachel; Luyirika, Emmanuel BK; Namisango, Eve; Kiyange, Fatia

    2016-01-01

    The high burden of non-communicable diseases and communicable diseases in Africa characterised by late presentation and diagnosis makes the need for palliative care a priority from the point of diagnosis to death and through bereavement. Palliative care is an intervention that requires a multidisciplinary team to address the multifaceted needs of the patient and family. Thus, its development takes a broad approach that involves engaging all key stakeholders ranging from policy makers, care providers, educators, the public, patients, and families. The main focus of stakeholder engagement should address some core interventions geared towards improving knowledge and awareness, strengthening skills and attitudes about palliative care. These interventions include educating health and allied healthcare professionals on the palliative care-related problems of patients and best practices for care, explaining palliative care as a clinical and holistic discipline and demonstrating its effectiveness, the need to include palliative care into national policies, strategic plans, training curriculums of healthcare professionals and the engagement of patients, families, and communities. Interventions from a five-year programme that was aimed at strengthening the health system of Namibia through the integration of palliative care for people living with HIV and AIDS and cancer in Namibia are shared. This article illustrates how a country can implement the World Health Organisation’s public health strategy for developing palliative care services, which recommends four pillars: government policy, education, drug availability, and implementation.

  12. Creating a continuum. The goal is to provide an integrated system of care.

    Science.gov (United States)

    Evashwick, C J

    1989-06-01

    The idea of a continuum of care is hardly new. In its purest form, it is simply the essence of good patient care. Today, the complex U.S. healthcare organization has emerged as a highly sophisticated but fragmented collection of service providers. We now must put energy and resources into rebuilding the comprehensiveness and continuity that represent high-quality care. The rationale for a continuum of care is that it is appropriate for patients' needs, demanded by today's consumers, an organized way of maximizing use of healthcare resources, and cost-effective for providers, patients, and payers. A continuum of care comprises services and integrating mechanisms. The services can be broken into seven basic categories: extended care, acute hospital care, ambulatory care, home care, outreach, wellness, and housing. The four basic integrating mechanisms are interentity planning and management, care coordination, case-based financing, and integrated information systems. Shaping a continuum mandates translating broad principles into pragmatic application suitable for the organization and community. The organization should define goals and objectives, identify a target population, assess services, evaluate integrating mechanisms, communicate, and prepare a business plan. PMID:10293328

  13. Comprehensive care of pain: Developing systems and tools to improve patient care and resident education.

    Science.gov (United States)

    Rickert, Julie; Devlin, Kwanza; Krohn, Kimberly

    2016-05-01

    Chronic non-cancer pain is a common condition associated with tremendous risk for morbidity and mortality. In many settings, the management of chronic non-cancer pain by primary care providers, although customary, can be difficult due to inadequate training and conflicts between patient expectations and best practices. Resident physicians, faculty, and staff of this family medicine residency program developed a comprehensive chronic pain management program to address these issues while improving patient outcomes. The program was aligned with evidence-based chronic non-cancer pain management strategies yet tailored to the needs of the providers and patients and the strengths of the clinic. In the end, the societal demand for improved chronic non-cancer pain management resulted in a massive curricular and clinical practice overhaul for this residency program. PMID:27497454

  14. Big things come in bundled packages: implications of bundled payment systems in health care reimbursement reform.

    Science.gov (United States)

    Delisle, Dennis R

    2013-01-01

    With passage of the Affordable Care Act, the ever-evolving landscape of health care braces for another shift in the reimbursement paradigm. As health care costs continue to rise, providers are pressed to deliver efficient, high-quality care at flat to minimally increasing rates. Inherent systemwide inefficiencies between payers and providers at various clinical settings pose a daunting task for enhancing collaboration and care coordination. A change from Medicare's fee-for-service reimbursement model to bundled payments offers one avenue for resolution. Pilots using such payment models have realized varying degrees of success, leading to the development and upcoming implementation of a bundled payment initiative led by the Center for Medicare and Medicaid Innovation. Delivery integration is critical to ensure high-quality care at affordable costs across the system. Providers and payers able to adapt to the newly proposed models of payment will benefit from achieving cost reductions and improved patient outcomes and realize a competitive advantage.

  15. Stroke burden and stroke care system in Asia

    OpenAIRE

    Suwanwela, Nijasri C.; Niphon Poungvarin; the Asian Stroke Advisory Panel

    2016-01-01

    Background: Stroke is a major cause of death and disability. Asia is the largest and mostly populated continent of the world. The Asian Stroke Advisory Panel (ASAP) consists of stroke neurologists from 12 different countries in 13 Asian regions. It has been established for 17 years, and holds regular meetings for reviewing the stroke activities in Asia. It also helps in conducting several multinational research projects. This study is one of the ASAP projects and aims to explore stroke care s...

  16. "Fighting the system": Families caring for ventilator-dependent children and adults with complex health care needs at home

    Directory of Open Access Journals (Sweden)

    Nielsen Erik W

    2011-07-01

    Full Text Available Abstract Background An increasing number of individuals with complex health care needs now receive life-long and life-prolonging ventilatory support at home. Family members often take on the role of primary caregivers. The aim of this study was to explore the experiences of families giving advanced care to family members dependent on home mechanical ventilation. Methods Using qualitative research methods, a Grounded Theory influenced approach was used to explore the families' experiences. A total of 15 family members with 11 ventilator-dependent individuals (three children and eight adults were recruited for 10 in-depth interviews. Results The core category, "fighting the system," became the central theme as family members were asked to describe their experiences. In addition, we identified three subcategories, "lack of competence and continuity", "being indispensable" and "worth fighting for". This study revealed no major differences in the families' experiences that were dependent on whether the ventilator-dependent individual was a child or an adult. Conclusions These findings show that there is a large gap between family members' expectations and what the community health care services are able to provide, even when almost unlimited resources are available. A number of measures are needed to reduce the burden on these family members and to make hospital care at home possible. In the future, the gap between what the health care can potentially provide and what they can provide in real life will rapidly increase. New proposals to limit the extremely costly provision of home mechanical ventilation in Norway will trigger new ethical dilemmas that should be studied further.

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

    OpenAIRE

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

    2015-01-01

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

  18. How to Pay for Health Care.

    Science.gov (United States)

    Porter, Michael E; Kaplan, Robert S

    2016-01-01

    The United States stands at a crossroads in how to pay for health care. Fee for service, the dominant payment model in the U.S. and many other countries, is now widely recognized as perhaps the single biggest obstacle to improving health care delivery. A battle is currently raging, outside of the public eye, between the advocates of two radically different payment approaches: capitation and bundled payments. The stakes are high, and the outcome will define the shape of the health care system for many years to come, for better or for worse. In this article, the authors argue that although capitation may deliver modest savings in the short run, it brings significant risks and will fail to fundamentally change the trajectory of a broken system. The bundled payment model, in contrast, triggers competition between providers to create value where it matters--at the individual patient level--and puts health care on the right path. The authors provide robust proof-of-concept examples of bundled payment initiatives in the U.S. and abroad, address the challenges of transitioning to bundled payments, and respond to critics' concerns about obstacles to implementation. PMID:27526565

  19. The Danish patient safety experience: the Act on Patient Safety in the Danish Health care system

    DEFF Research Database (Denmark)

    Lundgaard, Mette; Rabøl, Louise; Jensen, Elisabeth Agnete Brøgger;

    2005-01-01

    This paper describes the process that lead to the passing of the Act for Patient Safety in the Danisk health care sytem, the contents of the act and how the act is used in the Danish health care system. The act obligates frontline health care personnel to report adverse events, hospital owners...... to act on the reports and the National Board of Health to commuicate the learning nationally. The act protects health care providers from sanctions as a result of reporting. In January 2004, the Act on Patient Safety in the Danish health care system was put into force. In the first twelve months 5740...... adverse events were reported. the reports were analyzed locally (hospital and region), anonymized ad then sent to the National Board af Health. The Act on Patient Safety has driven the work with patient safety forward but there is room for improvement. Continuous and improved feedback from all parts...

  20. The Influence of Organizational Systems on Information Exchange in Long-Term Care Facilities: An Institutional Ethnography.

    Science.gov (United States)

    Caspar, Sienna; Ratner, Pamela A; Phinney, Alison; MacKinnon, Karen

    2016-06-01

    Person-centered care is heavily dependent on effective information exchange among health care team members. We explored the organizational systems that influence resident care attendants' (RCAs) access to care information in long-term care (LTC) settings. We conducted an institutional ethnography in three LTC facilities. Investigative methods included naturalistic observations, in-depth interviews, and textual analysis. Practical access to texts containing individualized care-related information (e.g., care plans) was dependent on job classification. Regulated health care professionals accessed these texts daily. RCAs lacked practical access to these texts and primarily received and shared information orally. Microsystems of care, based on information exchange formats, emerged. Organizational systems mandated written exchange of information and did not formally support an oral exchange. Thus, oral information exchanges were largely dependent on the quality of workplace relationships. Formal systems are needed to support structured oral information exchange within and between the microsystems of care found in LTC. PMID:26758177

  1. Regularity of solutions of obstacle problems

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    LetΩbe a bounded domain ofRnand letDbe aclosedsubset ofΩ.ForΨ∈W1,2(Ω)suchthatΨ0onΩ[1-2],we setKΨ={w∈W01,2(Ω)|wΨonDinthesense ofW1,2(Ω)}.Ifaij(x)=aji(x)(i,j=1,2,…,n)∈L∞(Ω)andλ|ξ|2 aij(x)ξiξj,x∈Ω,ξ∈Rn,(1.1)The obstacle problems are to find a functionu∈KΨwhich mini mizesj(v)=∫ΩaijivjvdxoverKΨ.Main resultsFor the obstacle problems,the following results arewell known,whose proof can be foundin[3]and[4].Lemma 1.1(i)There exists a uniqueΓΨ∈KΨsuchthat∫ΩaijiΓΨjΓΨdx=wi∈nfK∫ΨΩaijiwjwdx.(ii)There exists a unique...

  2. Obstacles and possibilities in police research

    Directory of Open Access Journals (Sweden)

    Ragnhild Sollund

    2005-09-01

    Full Text Available Drawing on a Norwegian research project investigating the possible existence of police racism, this article explores challenges related to conducting research in such sensitive sites as the police with reference to methodological and institutional obstacles. The project featured participant observation, in-depth interviews with ethnic minority men, and in-depth interviews with police officers and lays the basis for a discussion of the diverging perspectives on police racism held by the police and by members of ethnic minorities. The degree to which research on the police can reveal the  ‘truth’ of policing and thereby contribute to changing police practice is problematised and questions are asked about the extent to which research can contribute to facilitating change within the police that might be of benefit to the relationship between the police and ethnic minorities. A key question raised is whether the existence of a specific police culture, featuring loyalty, a hierarchical organisational structure and the use of discretion may prevent such research methods from revealing ‘true’ data, as well as organisational change. A discussion of problem-oriented policing illustrates some  of the obstacles to implementing changes. The article concludes that the police in Oslo do not demonstrate evidence of institutional racism though there is evidence of derogatory language use and stereotyping where ethnic minorities are stereotyped in homologous ways to other marginalised groups who come into contact with the police such as drug users.

  3. Histoplasma capsulatum surmounts obstacles to intracellular pathogenesis.

    Science.gov (United States)

    Garfoot, Andrew L; Rappleye, Chad A

    2016-02-01

    The fungal pathogen Histoplasma capsulatum causes respiratory and disseminated disease, even in immunocompetent hosts. In contrast to opportunistic pathogens, which are readily controlled by phagocytic cells, H. capsulatum yeasts are able to infect macrophages, survive antimicrobial defenses, and proliferate as an intracellular pathogen. In this review, we discuss some of the molecular mechanisms that enable H. capsulatum yeasts to overcome obstacles to intracellular pathogenesis. H. capsulatum yeasts gain refuge from extracellular obstacles such as antimicrobial lung surfactant proteins by engaging the β-integrin family of phagocytic receptors to promote entry into macrophages. In addition, H. capsulatum yeasts conceal immunostimulatory β-glucans to avoid triggering signaling receptors such as the β-glucan receptor Dectin-1. H. capsulatum yeasts counteract phagocyte-produced reactive oxygen species by expression of oxidative stress defense enzymes including an extracellular superoxide dismutase and an extracellular catalase. Within the phagosome, H. capsulatum yeasts block phagosome acidification, acquire essential metals such as iron and zinc, and utilize de novo biosynthesis pathways to overcome nutritional limitations. These mechanisms explain how H. capsulatum yeasts avoid and negate macrophage defense strategies and establish a hospitable intracellular niche, making H. capsulatum a successful intracellular pathogen of macrophages. PMID:26235362

  4. Path planning for first responders in the presence of moving obstacles

    Directory of Open Access Journals (Sweden)

    Zhiyong Wang

    2015-06-01

    Full Text Available Navigation services have gained much importance for all kinds of human activities ranging from tourist navigation to support of rescue teams in disaster management. However, despite the considerable amount of route guidance research that has been performed, many issues that are related to navigation for first responders still need to be addressed.During disasters, emergencies can result in different types of moving obstacles (e.g., fires, plumes, floods, which make some parts of the road network temporarily unavailable. After such incidents occur, responders have to go to different destinations to perform their tasks in the environment affected by the disaster. Therefore they need a path planner that is capable of dealing with such moving obstacles, as well as generating and coordinating their routes quickly and efficiently.During the past decades, more and more hazard simulations, which can modify the models with incorporation of dynamic data from the field, have been developed. These hazard simulations use methods such as data assimilation, stochastic estimation, and adaptive measurement techniques, and are able to generate more reliable results of hazards. This would allow the hazard simulation models to provide valuable information regarding the state of road networks affected by hazards, which supports path planning for first responders among the moving obstacles.The objective of this research is to develop an integrated navigation system for first responders in the presence of moving obstacles. Such system should be able to navigate one or more responders to one or multiple destinations avoiding the moving obstacles, using the predicted information of the moving obstacles generated from by hazard simulations. In this dissertation, the objective we have is expressed as the following research question:How do we safely and efficiently navigate one or more first responders to one or more destinations avoiding moving obstacles?To address the

  5. Role of Static and Dynamic Obstacles in the Protein Search for Targets on DNA.

    Science.gov (United States)

    Shvets, Alexey; Kochugaeva, Maria; Kolomeisky, Anatoly B

    2016-07-01

    Protein search for specific sequences on DNA marks the beginning of major biological processes. Experiments indicate that proteins find and recognize their targets quickly and efficiently. Because of the large number of experimental and theoretical investigations, there is a reasonable understanding of the protein search processes in purified in vitro systems. However, the situation is much more complex in live cells where multiple biochemical and biophysical processes can interfere with the protein search dynamics. In this study, we develop a theoretical method that explores the effect of crowding on DNA chains during the protein search. More specifically, the role of static and dynamic obstacles is investigated. The method employs a discrete-state stochastic framework that accounts for most relevant physical and chemical processes in the system. Our approach also provides an analytical description for all dynamic properties. It is found that the presence of the obstacles can significantly modify the protein search dynamics. This effect depends on the size of the obstacles, on the spatial positions of the target and the obstacles, on the nature of the search regime, and on the dynamic nature of the obstacles. It is argued that the crowding on DNA can accelerate or slow down the protein search dynamics depending on these factors. A comparison with existing experimental and theoretical results is presented. Theoretical results are discussed using simple physical-chemical arguments, and they are also tested with extensive Monte Carlo computer simulations. PMID:26618222

  6. Intelligence-Based Multi-Resolution 3D Visual Modeling, Registration And Obstacle Avoidance Capabilities For Unmanned Vehicles Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The use of truly autonomous vehicles (UV) has been hampered by a lack of sophisticated and resource efficient obstacle avoidance systems. Current approaches have...

  7. The Nuka System of Care: improving health through ownership and relationships

    Directory of Open Access Journals (Sweden)

    Katherine Gottlieb

    2013-08-01

    Full Text Available Southcentral Foundation’s Nuka System of Care, based in Anchorage, Alaska, is a result of a customer-driven overhaul of what was previously a bureaucratic system centrally controlled by the Indian Health Service. Alaska Native people are in control as the “customer-owners” of this health care system. The vision and mission focus on physical, mental, emotional, and spiritual wellness and working together as a Native Community. Coupled with operational principles based on relationships, core concepts and key points, this framework has fostered an environment for creativity, innovation and continuous quality improvement. Alaska Native people have received national and international recognition for their work and have set high standards for performance excellence, community engagement, and overall impact on population health. In this article, the health care transformation led by Alaska Native people is described and the benefits and results of customer ownership and the relationship-based Nuka System of Care are discussed.

  8. Obstacle Avoidance And Navigational Sensing For An Autonomous Underwater Vehicle

    Science.gov (United States)

    Chande, A. M.; Noon, K. M.

    1987-02-01

    This paper addresses the critical issues of sense acquisition and sense analysis, using multiple Obstacle Avoidance (OA) sensors, for Autonomous Underwater Vehicles (AUVs). Currently, an AUV research and development testbed is being engineered at Martin Marietta Baltimore Aerospace, and the pertinent research on OA sensing that may be applied to such a testbed is presented. The complexities of relevant and conventional navigation systems for undersea vehicles are also discussed. Using a multitude of sensors and the Zonal-Spot Environmental Analysis (ZSEA) sensing technique, the spatial scenarios are characterized cogently by amalgamating the sensor information to form a description of the external world, which in turn are preserved in a world model database. The ZSEA sensing strategy performs sensor-level processes to recognize obstacles with certain levels of surety, based on apriori semantic data, and thereby provides safer and more efficient path planning capabilities to the AUV. Furthermore, the ZSEA sensing strategy ameliorates sensory deprivation and paves the way for the incremental enhancement of the control process at the higher levels without having to modify the lower servocontrol levels.

  9. Trust-based learning and behaviors for convoy obstacle avoidance

    Science.gov (United States)

    Mikulski, Dariusz G.; Karlsen, Robert E.

    2015-05-01

    In many multi-agent systems, robots within the same team are regarded as being fully trustworthy for cooperative tasks. However, the assumption of trustworthiness is not always justified, which may not only increase the risk of mission failure, but also endanger the lives of friendly forces. In prior work, we addressed this issue by using RoboTrust to dynamically adjust to observed behaviors or recommendations in order to mitigate the risks of illegitimate behaviors. However, in the simulations in prior work, all members of the convoy had knowledge of the convoy goal. In this paper, only the lead vehicle has knowledge of the convoy goals and the follow vehicles must infer trustworthiness strictly from lead vehicle performance. In addition, RoboTrust could only respond to observed performance and did not dynamically learn agent behavior. In this paper, we incorporate an adaptive agent-specific bias into the RoboTrust algorithm that modifies its trust dynamics. This bias is learned incrementally from agent interactions, allowing good agents to benefit from faster trust growth and slower trust decay and bad agents to be penalized with slower trust growth and faster trust decay. We then integrate this new trust model into a trust-based controller for decentralized autonomous convoy operations. We evaluate its performance in an obstacle avoidance mission, where the convoy attempts to learn the best speed and following distances combinations for an acceptable obstacle avoidance probability.

  10. The impact of prospective pricing on the information system in the health care industry.

    Science.gov (United States)

    Matta, K F

    1988-02-01

    The move from a retrospective payment system (value added) to a prospective payment system (diagnostic related) has not only influenced the health care business but also changed their information systems' requirements. The change in requirements can be attributed both to an increase in data processing tasks and also to an increase in the need for information to more effectively manage the organization. A survey was administered to capture the response of health care institutions, in the area of information systems, to the prospective payment system. The survey results indicate that the majority of health care institutions have responded by increasing their information resources, both in terms of hardware and software, and have moved to integrate the medical and financial data. In addition, the role of the information system has changed from a cost accounting system to one intended to provide a competitive edge in a highly competitive marketing environment. PMID:3397683

  11. [Prediction on the medical care system for the aged people in the new century].

    Science.gov (United States)

    Igata, A

    2000-12-01

    Japan has become the country with the longest life expectancy in the world in about 25 years. Among many factors for this success, the medical care system, including the health insurance for everyone, played the important role, which has been evaluated as the best in the world. However, since the national economy in Japan has become recently suppressed it has become one of the big political problems to keep this system as same as before. In addition, the medical expenses for the elderly and aged people is now as high as 40% of all. In this meaning, we should create the better system by ourselves, based on ethical criteria, harmonized with the progress of medicine. In April of 2000, the new long term care system was introduced aiming the self independence of aged people. Now, the medical and long term care system has become unified into one toward the ideal society in the future. In this paper, the ideal medical care system, especially for the aged people was discussed. Needless to say, the medical care system should have widely view to the future. The progress of medicine, high technology and health promotion will play very important parts to create the ideal society in future. If any geriatric diseases including senile dementia will be settled in near future, the medical care system for the aged will change completely. In addition, the nationwide campaign of health promotion will induce excellent results. Thus the society in the future will become much brighter and happier. In this meaning, health promotion, medical care, and welfare systems should be unified into one system. The expenses for these systems should be regarded as the investments expecting the huge profit in health and happiness in the future. PMID:11464454

  12. HealthStyles: a new psychographic segmentation system for health care marketers.

    Science.gov (United States)

    Endresen, K W; Wintz, J C

    1988-01-01

    HealthStyles is a new psychographic segmentation system specifically designed for the health care industry. This segmentation system goes beyond traditional geographic and demographic analysis and examines health-related consumer attitudes and behaviors. Four statistically distinct "styles" of consumer health care preferences have been identified. The profiles of the four groups have substantial marketing implications in terms of design and promotion of products and services. Each segment of consumers also has differing expectations of physician behavior. PMID:10288444

  13. THE SEEN AND UNSEEN FACE OF ETHICAL CODES WITHIN THE HEALTH CARE SYSTEM

    OpenAIRE

    Daniela Tatiana Agheorghiesei (Corodeanu)

    2012-01-01

    Our article makes a short review of several opinions and studies that exist within the specialized literature concerned with the role and the application of the code of ethics and professional conduct from the health care system. The theoretical process implied a necessary terminological clarification. Although we can see there are numerous professional codes that govern the activity of the health care system, both at national and supranational level, there are studies that highlight that the...

  14. The Evolving Role of the Radiologist within the Health Care System

    OpenAIRE

    Knechtges, Paul Martin; Carlos, Ruth C.

    2007-01-01

    The traditional view of the radiologist as a physician who adds value to the health care system solely by generating and interpreting diagnostic images is outdated. The radiologists’ roles have expanded to encompass economic gatekeeping, political advocacy, public health delivery, patient safety, quality of care improvement, and information technology. It is through these roles that radiologists will continue to find new ways to add value to the healthcare system.

  15. LOCATION AND PLANNING OF HEALTH CARE DELIVERY SYSTEM AT THE DISTICT LEVEL

    OpenAIRE

    Rajguru. S. A

    2015-01-01

    There is a wide variety of health systems around the world, with as many histories and organizational structures as there are nations. In some countries, health system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, charities, religious, or other coordinate bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has been described as often e...

  16. Developing a Total Quality Management Model for Health Care Systems

    Directory of Open Access Journals (Sweden)

    AM Mosadegh Rad

    2005-10-01

    Full Text Available Background: Total quality management (TQM is a managerial practice to improve the effectiveness, efficiency, flexibility, and competitiveness of a business as a whole. However, in practice, these TQM benefits are not easy to achieve. Despite its theoretical promise and the enthusiastic response to TQM, recent evidence suggests that attempts to implement it are often unsuccessful. Many of these TQM programmes have been cancelled, or are in the process of being cancelled, as a result of the negative impact on profits. Therefore, there is a pressing need for a clinical approach to establishing TQM. Method: The aim of this article is therefore: “To identify the strengths and weakness of TQM, the logical steps towards TQM, and to develop a model so that health care organizations aiming at using TQM to achieve excellence can follow through easily”. Based on the research questions proposed in this study, the research strategies of a literature review, a questionnaire survey, semi-structured interviews, and a participatory action research were adopted in this study. For determining the success and barriers of TQM in health care organizations, a questionnaire survey has done in 90 health acre organizations in Isfahan Province, which implement TQM. The results of this survey were used for introducing a new model of TQM. This model will be developed via a semi-structured interview with at minimum 10 health care and quality managers. Then, through a participatory action research, this model will be implemented in 3 sites. At this time, the questionnaire survey has done and the model is introduced. Therefore, developing the model and its implementation will be done later. Results: In this survey, the mean score of TQM success was 3.48±0.68 (medium from 5 credits. Implementation of TQM was very low, low, medium, high and very high successful respectively in 3.6, 10.9, 21.8, 56.4 and 7.3 percent of health care organizations. TQM had the most effect on

  17. A SWOT analysis of the organization and financing of the Danish health care system.

    Science.gov (United States)

    Christiansen, Terkel

    2002-02-01

    The organization and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of Strengths, Weaknesses, Opportunities and Threats) by a panel of five members with a background in health economics. The present paper describes the methods and materials used for the evaluation: selection of panel members, structure of the evaluation task according to the health care triangle model, selection of background material consisting of documents and literature on the Danish health care system, and a 1-week study visit.

  18. Initial Implementation Indicators From a Statewide Rollout of SafeCare Within a Child Welfare System

    OpenAIRE

    Whitaker, Daniel J; Ryan, Kerry A.; Wild, Robert C.; Self-Brown, Shannon; John R. Lutzker; Shanley, Jenelle R.; Edwards, Anna M.; McFry, Erin A.; Moseley, Colby N.; Hodges, Amanda E.

    2011-01-01

    There is a strong movement toward implementation of evidence-based practices (EBP) in child welfare systems. The SafeCare parenting model is one of few parent-training models that addresses child neglect, the most common form of maltreatment. Here, the authors describe initial findings from a statewide effort to implement the EBP, SafeCare®, into a state child welfare system. A total of 50 agencies participated in training, with 295 individuals entering training to implement SafeCare. Analyse...

  19. A Family Guide to Systems of Care for Children with Mental Health Needs = Guia para la familia de "Systems of Care" para la salud mental de sus hijos.

    Science.gov (United States)

    Dougherty, Janice; Harris, Pam; Hawes, Janet; Shepler, Rick; Tolin, Canice; Truman, Connie

    This bilingual (English-Spanish) guide is intended to assist parents and caregivers in seeking help for children with mental health problems. As part of the system of care, parents and caregivers need to work together to help the child in need. Caregivers and counselors can help families define their strengths, determine the things they want to…

  20. Oral health care systems in developing and developed countries

    DEFF Research Database (Denmark)

    Kandelman, Daniel; Arpin, Sophie; Baez, Ramon J;

    2012-01-01

    ; these institutions or clinics may be equipped with the latest technical facilities. In developing countries, health services are mostly directed to provide emergency care only or interventions towards certain age group population. The most common diseases are dental caries and periodontal disease and frequently...... developed countries where the periodontal profile is also less than satisfactory. Despite the fact that in several developed countries there are advanced programmes oriented to periodontal disease treatments, the concern is related to the lack of preventive oriented treatments. According to data available...

  1. Midwives and obstetric nurses in the Brazilian Unified Health System and Primary Health Care: for a systemic and progressive incorporation

    OpenAIRE

    Armando Henrique Norman; Charles Dalcanale Tesser

    2015-01-01

    The objective of this paper is to present a proposal for a gradual and systemic incorporation of midwives and obstetric nurses into the Brazilian Unified Health System (SUS) and Primary Health Care (PHC). The proposal was born from contact with the British experience, based on midwives, which is briefly described. In Brazil, these professionals would progressively take over the prenatal, delivery and postpartum care for pregnant women of usual risk in a region, in partnership with the PHC tea...

  2. The consumer choice model: a humane reconstruction of the U.S. health care system.

    Science.gov (United States)

    Coulter, C H

    2000-01-01

    "Consumer choice," "defined contribution health programs," "voucher systems," and "health marts" are variations on a theme: employees buying their own health care. This new approach to health care purchasing, which is designed to minimize the role of employers, is being proposed by an array of economists and by both Republican and Democratic legislators as the best way to address the nation's health care ills. Although enabling national legislation is unlikely to pass soon, the debate will nevertheless change the face of health care in America. The prospect is reminiscent of the debate over "Clinton Care" in 1993--although legislation was never passed, managed care rapidly came to dominate the U.S. health care system. As this reform takes hold, beneficiaries will make their own health plan selections but will have more responsibility and may bear more cost. Providers will have to adapt to new, customer-driven requirements for performance, accountability, and communications but will also find opportunities in a marketplace that they will have a major role in shaping. Physicians, health plans, and insurers should understand how these proposals will transform their role in health care. PMID:10847942

  3. Intensive Care Nurses’ Belief Systems Regarding the Health Economics: A Focused Ethnography

    Science.gov (United States)

    Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

    2016-01-01

    Background: Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses’ beliefs and their effect on nurse’s: practices and behavior patterns regarding the health economics. Methods: In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Findings: Eight beliefs were found that gave meaning to ICU nurse’s practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2. Monitoring and auditing improve consumption; 3. There is a fear of possible shortage in the future; 4. Supply and replacement of equipment is difficult; 5. Higher prices lead to more accurate consumption; 6. The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8. Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. Conclusions: ICU nurses’ belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the

  4. Impact of the ABCDE triage in primary care emergency department on the number of patient visits to different parts of the health care system in Espoo City

    Directory of Open Access Journals (Sweden)

    Kantonen Jarmo

    2012-01-01

    Full Text Available Abstract Background Many Finnish emergency departments (ED serve both primary and secondary health care patients and are therefore referred to as combined emergency departments. Primary care doctors are responsible for the initial assessment and treatment. They, thereby, also regulate referral and access to secondary care. Primary health care EDs are easy for the public to access, leading to non-acute patient visits to the emergency department. This has caused increased queues and unnecessary difficulties in providing immediate treatment for urgent patients. The primary aim of this study was to assess whether the flow of patients was changed by implementing the ABCDE-triage system in the EDs of Espoo City, Finland. Methods The numbers of monthly visits to doctors were recorded before and after intervention in Espoo primary care EDs. To study if the implementation of the triage system redirects patients to other health services, the numbers of monthly visits to doctors were also scored in the private health care, the public sector health services of Espoo primary care during office hours and local secondary health care ED (Jorvi hospital. A face-to-face triage system was applied in the primary care EDs as an attempt to provide immediate treatment for the most acute patients. It is based on the letters A (patient sent directly to secondary care, B (to be examined within 10 min, C (to be examined within 1 h, D (to be examined within 2 h and E (no need for immediate treatment for assessing the urgency of patients' treatment needs. The first step was an initial patient assessment by a health care professional (triage nurse. The introduction of this triage system was combined with information to the public on the "correct" use of emergency services. Results After implementation of the ABCDE-triage system the number of patient visits to a primary care doctor decreased by up to 24% (962 visits/month as compared to the three previous years in the EDs

  5. Warning systems in a computerized nursing process for Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Daniela Couto Carvalho Barra

    2014-02-01

    Full Text Available A hybrid study combining technological production and methodological research aiming to establish associations between the data and information that are part of a Computerized Nursing Process according to the ICNP® Version 1.0, indicators of patient safety and quality of care. Based on the guidelines of the Agency for Healthcare Research and Quality and the American Association of Critical Care Nurses for the expansion of warning systems, five warning systems were developed: potential for iatrogenic pneumothorax, potential for care-related infections, potential for suture dehiscence in patients after abdominal or pelvic surgery, potential for loss of vascular access, and potential for endotracheal extubation. The warning systems are a continuous computerized resource of essential situations that promote patient safety and enable the construction of a way to stimulate clinical reasoning and support clinical decision making of nurses in intensive care.

  6. Hearing health care provision in the national systems of Australia, Denmark, Finland, Germany and Switzerland

    DEFF Research Database (Denmark)

    Egbert, Maria; Groeber, Simone; Damsø Johansen, Jette;

    2012-01-01

    the similarities and differences in these five countries’ health care systems in order to find features which may contribute to (non-)use of hearing instruments. After a general overview of the commonalities, we compare legal provisions, medical indication for prescription of a hearing aid, accessing health care......The five western countries represented in this volume share highly developed medical and technological provisions for hearing health, yet they differ in the compliance rates for hearing aid usage. A contributing factor may lie in the diversity of the national health care systems. We examine...... and diagnosing hearing impairment, selection and fitting of hearing aid, costs of hearing aids, and help to learn how to live with hearing loss and using a hearing aid. Finally, we reflect on how aspects of the health care systems may contribute to hearing aid use....

  7. Adhesive and nonadhesive systems for health-care packaging.

    Science.gov (United States)

    Pilchik, R

    2000-04-01

    This review of the important attributes of adhesive systems also assesses the potential benefits of nonadhesive systems, such as peelable films, which are gaining favour as cost-saving alternatives. PMID:10947334

  8. Effects of different broiler production systems on health care costs in the Netherlands

    NARCIS (Netherlands)

    Gocsik, E.; Kortes, H.E.; Oude Lansink, A.G.J.M.; Saatkamp, H.W.

    2014-01-01

    This study analyzed the effects of different broiler production systems on health care costs in the Netherlands. In addition to the conventional production system, the analysis also included 5 alternative animal welfare systems representative of the Netherlands. The study was limited to the most pre

  9. Developing a cost-effective home care management support system for small nursing homes in Taiwan.

    Science.gov (United States)

    Tu, Ming-Hsiang; Chang, Polun

    2009-01-01

    Home care is important in Taiwan but most of the institutes are small and cannot afford computerization. We develop a support system based on InterRAI case management system using Excel VBA which is the most "free" application in institutes. The prototype system shows promising. PMID:19592932

  10. Decision Criteria for Distributed Versus Non-Distributed Information Systems in the Health Care Environment

    OpenAIRE

    McGinnis, John W.

    1980-01-01

    The very same technological advances that support distributed systems have also dramatically increased the efficiency and capabilities of centralized systems making it more complex for health care managers to select the “right” system architecture to meet their particular needs.

  11. Medical care of asylum seekers: a descriptive study of the appropriateness of nurse practitioners' care compared to traditional physician-based care in a gatekeeping system

    Directory of Open Access Journals (Sweden)

    Pécoud Alain

    2007-10-01

    Full Text Available Abstract Background Medical care for asylum seekers is a complex and critical issue worldwide. It is influenced by social, political, and economic pressures, as well as premigration conditions, the process of migration, and postmigration conditions in the host country. Increasing needs and healthcare costs have led public health authorities to put nurse practitioners in charge of the management of a gatekeeping system for asylum seekers. The quality of this system has never been evaluated. We assessed the competencies of nurses and physicians in identifying the medical needs of asylum seekers and providing them with appropriate treatment that reflects good clinical practice. Methods This cross-sectional descriptive study evaluated the appropriateness of care provided to asylum seekers by trained nurse practitioners in nursing healthcare centers and by physicians in private practices, an academic medical outpatient clinic, and the emergency unit of the university hospital in Lausanne, Switzerland. From 1687 asylum seeking patients who had consulted each setting between June and December 2003, 450 were randomly selected to participate. A panel of experts reviewed their medical records and assessed the appropriateness of medical care received according to three parameters: 1 use of appropriate procedures to identify medical needs (medical history, clinical examination, complementary investigations, and referral, 2 provision of access to treatment meeting medical needs, and 3 absence of unnecessary medical procedures. Results In the nurse practitioner group, the procedures used to identify medical needs were less often appropriate (79% of reports vs. 92.4% of reports; p Conclusion Although the nursing gatekeeping system provides appropriate treatment to asylum seekers, it might be improved with further training in recording medical history and performing targeted clinical examination.

  12. Improving quality in systems of care: solving complicated challenges with simulation-based continuing professional development.

    Science.gov (United States)

    Dow, Alan W; Salas, Eduardo; Mazmanian, Paul E

    2012-01-01

    The delivery of quality health care depends on the successful interactions of practitioners, teams, and systems of care comprising culture. Designing educational programs to improve these interactions is a major goal of continuing professional development, and one approach for educational planners to effect desired changes is simulation-based education. Because simulation-based education affords an opportunity for educators to train health care professionals in environments that resemble clinical practice, this instructional method allows planners to integrate overarching priorities for improvement in health care practice with the training goals of individuals. Educational planners should consider how to structure scenarios to meet training objectives based on the complicated interactions within the health care system. To optimize the benefit of simulation-based experiences, evidence and insights from industrial and organizational psychology, as well as from human factors studies, provide guidance to the planning process, and interdisciplinary studies of complex health care systems can help produce educational programs that improve the quality of health care delivery. PMID:23280525

  13. Reducing Ex-offender Health Disparities through the Affordable Care Act: Fostering Improved Health Care Access and Linkages to Integrated Care

    Directory of Open Access Journals (Sweden)

    Lacreisha Ejike-King

    2014-04-01

    Full Text Available Despite steadily declining incarceration rates overall, racial and ethnic minorities, namely African Americans, Latinos, and American Indians and Alaska Natives, continue to be disproportionately represented in the justice system. Ex-offenders commonly reenter communities with pressing health conditions but encounter obstacles to accessing care and remaining in care. The lack of health insurance coverage and medical treatment emerge as the some of the most reported reentry health needs and may contribute to observed health disparities. Linking ex-offenders to care and services upon release increases the likelihood that they will remain in care and practice successful disease management. The Affordable Care Act (ACA offers opportunities to address health disparities experienced by the reentry population that places them at risk for negative health outcomes and recidivism. Coordinated efforts to link ex-offenders with these newly available opportunities may result in a trajectory for positive health and overall well-being as they reintegrate into society.

  14. Obstacle classification and 3D measurement in unstructured environments based on ToF cameras.

    Science.gov (United States)

    Yu, Hongshan; Zhu, Jiang; Wang, Yaonan; Jia, Wenyan; Sun, Mingui; Tang, Yandong

    2014-01-01

    Inspired by the human 3D visual perception system, we present an obstacle detection and classification method based on the use of Time-of-Flight (ToF) cameras for robotic navigation in unstructured environments. The ToF camera provides 3D sensing by capturing an image along with per-pixel 3D space information. Based on this valuable feature and human knowledge of navigation, the proposed method first removes irrelevant regions which do not affect robot's movement from the scene. In the second step, regions of interest are detected and clustered as possible obstacles using both 3D information and intensity image obtained by the ToF camera. Consequently, a multiple relevance vector machine (RVM) classifier is designed to classify obstacles into four possible classes based on the terrain traversability and geometrical features of the obstacles. Finally, experimental results in various unstructured environments are presented to verify the robustness and performance of the proposed approach. We have found that, compared with the existing obstacle recognition methods, the new approach is more accurate and efficient. PMID:24945679

  15. Construction of Fisheye Lens Inverse Perspective Mapping Model and Its Applications of Obstacle Detection

    Directory of Open Access Journals (Sweden)

    Chin-Teng Lin

    2010-01-01

    Full Text Available In this paper, we develop a vision based obstacle detection system by utilizing our proposed fisheye lens inverse perspective mapping (FLIPM method. The new mapping equations are derived to transform the images captured by the fisheye lens camera into the undistorted remapped ones under practical circumstances. In the obstacle detection, we make use of the features of vertical edges on objects from remapped images to indicate the relative positions of obstacles. The static information of remapped images in the current frame is referred to determining the features of source images in the searching stage from either the profile or temporal IPM difference image. The profile image can be acquired by several processes such as sharpening, edge detection, morphological operation, and modified thinning algorithms on the remapped image. The temporal IPM difference image can be obtained by a spatial shift on the remapped image in the previous frame. Moreover, the polar histogram and its post-processing procedures will be used to indicate the position and length of feature vectors and to remove noises as well. Our obstacle detection can give drivers the warning signals within a limited distance from nearby vehicles while the detected obstacles are even with the quasi-vertical edges.

  16. Obstacle classification and 3D measurement in unstructured environments based on ToF cameras.

    Science.gov (United States)

    Yu, Hongshan; Zhu, Jiang; Wang, Yaonan; Jia, Wenyan; Sun, Mingui; Tang, Yandong

    2014-06-18

    Inspired by the human 3D visual perception system, we present an obstacle detection and classification method based on the use of Time-of-Flight (ToF) cameras for robotic navigation in unstructured environments. The ToF camera provides 3D sensing by capturing an image along with per-pixel 3D space information. Based on this valuable feature and human knowledge of navigation, the proposed method first removes irrelevant regions which do not affect robot's movement from the scene. In the second step, regions of interest are detected and clustered as possible obstacles using both 3D information and intensity image obtained by the ToF camera. Consequently, a multiple relevance vector machine (RVM) classifier is designed to classify obstacles into four possible classes based on the terrain traversability and geometrical features of the obstacles. Finally, experimental results in various unstructured environments are presented to verify the robustness and performance of the proposed approach. We have found that, compared with the existing obstacle recognition methods, the new approach is more accurate and efficient.

  17. Obstacle Classification and 3D Measurement in Unstructured Environments Based on ToF Cameras

    Directory of Open Access Journals (Sweden)

    Hongshan Yu

    2014-06-01

    Full Text Available Inspired by the human 3D visual perception system, we present an obstacle detection and classification method based on the use of Time-of-Flight (ToF cameras for robotic navigation in unstructured environments. The ToF camera provides 3D sensing by capturing an image along with per-pixel 3D space information. Based on this valuable feature and human knowledge of navigation, the proposed method first removes irrelevant regions which do not affect robot’s movement from the scene. In the second step, regions of interest are detected and clustered as possible obstacles using both 3D information and intensity image obtained by the ToF camera. Consequently, a multiple relevance vector machine (RVM classifier is designed to classify obstacles into four possible classes based on the terrain traversability and geometrical features of the obstacles. Finally, experimental results in various unstructured environments are presented to verify the robustness and performance of the proposed approach. We have found that, compared with the existing obstacle recognition methods, the new approach is more accurate and efficient.

  18. A hybrid model of obstacle-aided snake robot locomotion

    OpenAIRE

    Liljeback, Pål; Pettersen, Kristin Ytterstad; Stavdahl, Øyvind; Gravdahl, Jan Tommy

    2010-01-01

    A snake can traverse cluttered and irregular environments by using irregularities around its body as push-points to aid the propulsion. This characteristic feature of biological snake locomotion, denoted obstacle-aided locomotion, is investigated for snake robot locomotion purposes in this paper. The paper presents a hybrid model of the dynamics of a planar snake robot interacting with obstacles in its environment. Obstacle contact forces are calculated by formulating and solving a linear com...

  19. Directed cell migration in the presence of obstacles

    Directory of Open Access Journals (Sweden)

    Grima Ramon

    2007-01-01

    Full Text Available Abstract Background Chemotactic movement is a common feature of many cells and microscopic organisms. In vivo, chemotactic cells have to follow a chemotactic gradient and simultaneously avoid the numerous obstacles present in their migratory path towards the chemotactic source. It is not clear how cells detect and avoid obstacles, in particular whether they need a specialized biological mechanism to do so. Results We propose that cells can sense the presence of obstacles and avoid them because obstacles interfere with the chemical field. We build a model to test this hypothesis and find that this naturally enables efficient at-a-distance sensing to be achieved with no need for a specific and active obstacle-sensing mechanism. We find that (i the efficiency of obstacle avoidance depends strongly on whether the chemotactic chemical reacts or remains unabsorbed at the obstacle surface. In particular, it is found that chemotactic cells generally avoid absorbing barriers much more easily than non-absorbing ones. (ii The typically low noise in a cell's motion hinders the ability to avoid obstacles. We also derive an expression estimating the typical distance traveled by chemotactic cells in a 3D random distribution of obstacles before capture; this is a measure of the distance over which chemotaxis is viable as a means of directing cells from one point to another in vivo. Conclusion Chemotactic cells, in many cases, can avoid obstacles by simply following the spatially perturbed chemical gradients around obstacles. It is thus unlikely that they have developed specialized mechanisms to cope with environments having low to moderate concentrations of obstacles.

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

    Directory of Open Access Journals (Sweden)

    Simon de Lusignan

    2014-02-01

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

  1. Quality of management in the health care system.

    Science.gov (United States)

    Borgenhammar, E

    1990-01-01

    Quality of management is a necessary, yet not sufficient, prerequisite in quality of care. There are two main approaches to improved quality. One is the individualist approach, where the role of the manager is emphasized. The other is the contextual approach. Focus is on managerial prerequisites such as organizational structure, culture, participation in decision making, and use of management time. Individualist as well as contextualist approaches are presented. Each decade during the 20th century has had its own "pet theory" regarding what problems the manager should allocate time on. A study of 41 Nordic public health researchers illustrates that cost-benefit analysis is the best known of ten theories. Management ethics, with the manager as ideologist, is seen as particularly demanding on managerial creativity.

  2. Arkansas: a leading laboratory for health care payment and delivery system reform.

    Science.gov (United States)

    Bachrach, Deborah; du Pont, Lammot; Lipson, Mindy

    2014-08-01

    As states' Medicaid programs continue to evolve from traditional fee-for-service to value-based health care delivery, there is growing recognition that systemwide multipayer approaches provide the market power needed to address the triple aim of improved patient care, improved health of populations, and reduced costs. Federal initiatives, such as the State Innovation Model grant program, make significant funds available for states seeking to transform their health care systems. In crafting their reform strategies, states can learn from early innovators. This issue brief focuses on one such state: Arkansas. Insights and lessons from the Arkansas Health Care Payment Improvement Initiative (AHCPII) suggest that progress is best gained through an inclusive, deliberative process facilitated by committed leadership, a shared agreement on root problems and opportunities for improvement, and a strategy grounded in the state's particular health care landscape. PMID:25204031

  3. Arkansas: a leading laboratory for health care payment and delivery system reform.

    Science.gov (United States)

    Bachrach, Deborah; du Pont, Lammot; Lipson, Mindy

    2014-08-01

    As states' Medicaid programs continue to evolve from traditional fee-for-service to value-based health care delivery, there is growing recognition that systemwide multipayer approaches provide the market power needed to address the triple aim of improved patient care, improved health of populations, and reduced costs. Federal initiatives, such as the State Innovation Model grant program, make significant funds available for states seeking to transform their health care systems. In crafting their reform strategies, states can learn from early innovators. This issue brief focuses on one such state: Arkansas. Insights and lessons from the Arkansas Health Care Payment Improvement Initiative (AHCPII) suggest that progress is best gained through an inclusive, deliberative process facilitated by committed leadership, a shared agreement on root problems and opportunities for improvement, and a strategy grounded in the state's particular health care landscape.

  4. Regularity for solutions to anisotropic obstacle problems

    Institute of Scientific and Technical Information of China (English)

    GAO HongYa

    2014-01-01

    For Ω a bounded subset of R n,n 2,ψ any function in Ω with values in R∪{±∞}andθ∈W1,(q i)(Ω),let K(q i)ψ,θ(Ω)={v∈W1,(q i)(Ω):vψ,a.e.and v-θ∈W1,(q i)0(Ω}.This paper deals with solutions to K(q i)ψ,θ-obstacle problems for the A-harmonic equation-divA(x,u(x),u(x))=-divf(x)as well as the integral functional I(u;Ω)=Ωf(x,u(x),u(x))dx.Local regularity and local boundedness results are obtained under some coercive and controllable growth conditions on the operator A and some growth conditions on the integrand f.

  5. Obstacle avoidance using a line laser

    Science.gov (United States)

    Ricotti, Marcello; Barili, Antonio; Ceresa, Marco

    1994-02-01

    A line laser has been used to help navigation and obstacle detection for the indoor mobile robot PARIDE (Pavia autonomous robot for industrial environment). PARIDE is an A.M.R. based on a TRC platform that is being implemented using a subsumption architecture simulated through software on a 68030 board. The line is projected on the robot path and continually monitored using a CCD camera to detect line interruption or deviation. Laser, CCD camera, and frame grabber have been chosen in order to be commercially available and within the power requirements and physical dimensions of the mobile platform. The robot has to act in a human environment thus the laser must be safe (class 3A), visible (685 nm) and powerful to allow good quality images acquisition. Images are filtered, during acquisition, in order to simplify the low-level image processing.

  6. Obstacle detection by stereo vision of fast correlation matching

    International Nuclear Information System (INIS)

    Mobile robot navigation needs acquiring positions of obstacles in real time. A common method for performing this sensing is through stereo vision. In this paper, indoor images are acquired by binocular vision, which contains various shapes of obstacles. From these stereo image data, in order to obtain distances to obstacles, we must deal with the correspondence problem, or get the region in the other image corresponding to the projection of the same surface region. We present an improved correlation matching method enhancing the speed of arbitrary obstacle detection. The results are faster, simple matching, robustness to noise, and improvement of precision. Experimental results under actual surroundings are presented to reveal the performance. (author)

  7. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management

    Directory of Open Access Journals (Sweden)

    Muhammad Saiful Ridhwan

    2014-02-01

    Full Text Available The importance of managing medical information has become very critical in the healthcare delivery system. Medical information nowadays are optimized towards serving different areas such as; diagnosing of diseases, planning and administration, treatment and monitoring of patient outcomes, services and costs. This article provides a review into various Health and Social Care systems which encompasses the Knowledge Management value. For analysis, more than 30 systems that are related to Health and Social Care were gathered via Internet research, only 20 of these systems were finally selected based on recent system development and popularity of the system.Keywords: Health Care, Knowledge, Knowledge Management, Social Care, systemdoi:10.12695/ajtm.2013.6.2.4 How to cite this article:Ridhwan, M.S., and Oyefolahan, I.O. (2013. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management. The Asian Journal of Technology Management 6 (2: 92-101. Print ISSN: 1978-6956; Online ISSN: 2089-791X. doi:10.12695/ajtm.2013.6.2.4

  8. Emotion-Aware Assistive System for Humanistic Care Based on the Orange Computing Concept

    Directory of Open Access Journals (Sweden)

    Jhing-Fa Wang

    2012-01-01

    Full Text Available Mental care has become crucial with the rapid growth of economy and technology. However, recent movements, such as green technologies, place more emphasis on environmental issues than on mental care. Therefore, this study presents an emerging technology called orange computing for mental care applications. Orange computing refers to health, happiness, and physiopsychological care computing, which focuses on designing algorithms and systems for enhancing body and mind balance. The representative color of orange computing originates from a harmonic fusion of passion, love, happiness, and warmth. A case study on a human-machine interactive and assistive system for emotion care was conducted in this study to demonstrate the concept of orange computing. The system can detect emotional states of users by analyzing their facial expressions, emotional speech, and laughter in a ubiquitous environment. In addition, the system can provide corresponding feedback to users according to the results. Experimental results show that the system can achieve an accurate audiovisual recognition rate of 81.8% on average, thereby demonstrating the feasibility of the system. Compared with traditional questionnaire-based approaches, the proposed system can offer real-time analysis of emotional status more efficiently.

  9. Toward a Learning Health-care System – Knowledge Delivery at the Point of Care Empowered by Big Data and NLP

    OpenAIRE

    Kaggal, Vinod C; Elayavilli, Ravikumar Komandur; Mehrabi, Saeed; Pankratz, Joshua J.; Sohn, Sunghwan; Wang, Yanshan; Li, Dingcheng; Rastegar, Majid Mojarad; Murphy, Sean P.; Ross, Jason L.; Chaudhry, Rajeev; Buntrock, James D.; Liu, Hongfang

    2016-01-01

    The concept of optimizing health care by understanding and generating knowledge from previous evidence, ie, the Learning Health-care System (LHS), has gained momentum and now has national prominence. Meanwhile, the rapid adoption of electronic health records (EHRs) enables the data collection required to form the basis for facilitating LHS. A prerequisite for using EHR data within the LHS is an infrastructure that enables access to EHR data longitudinally for health-care analytics and real ti...

  10. Health system challenges in organizing quality diabetes care for urban poor in South India

    OpenAIRE

    Upendra Bhojani; Narayanan Devedasan; Arima Mishra; Stefaan De Henauw; Patrick Kolsteren; Bart Criel

    2014-01-01

    Background: Weak health systems in low-and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. Methods: We used the health system d...

  11. Measuring the Mental Health-Care System Responsiveness: Results of an Outpatient Survey in Tehran

    OpenAIRE

    Forouzan, Setareh; Padyab, Mojgan; Rafiey, Hassan; Ghazinour, Mehdi; Dejman, Masoumeh; San Sebastian, Miguel

    2016-01-01

    As explained by the World Health Organization (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health-care system of Tehran. Utilizing...

  12. Measuring the mental health care system responsiveness: results of an outpatient survey in Tehran

    OpenAIRE

    Setareh eForouzan; Mojgan ePadyab; Hassan eRafiey; Mehdi eGhazinour; Masoumeh eDejman; Miguel eSan Sebastian

    2016-01-01

    AbstractAs explained by the World Health Organisation (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health care system of Tehran. U...

  13. Managing flexible care with a context aware system for ageing-in-place

    Directory of Open Access Journals (Sweden)

    Saskia Robben

    2015-08-01

    Full Text Available This paper describes the Care4Balance (C4B system for better facilitating communication and task coordination between formal and informal caregivers, and older adults as care receivers. Field-tests with older adults (n=3 and user studies (n=9 were conducted to evaluate the system and the perceived usefulness of the system. A review of related work and the study findings show that (1 the perceived benefit for the older target group was very low. The main motivation for using the system was triggered by the perceived benefit for their closest informal caregivers; (2 Informal caregivers do not regularly seek help for themselves, and (3 Introducing a C4B-like system is more than solving hardware and usability issues. The study suggests that more flexibility in the organizational structure of formal care (in The Netherlands and beyond is needed.

  14. Expenditures in the health care system in Brazil: the participation of states and the Federal District in financing the health care system from 2002 to 2013

    Directory of Open Access Journals (Sweden)

    Renata Maria de Deus Costa

    2015-04-01

    Full Text Available OBJECTIVE: To analyze the public expenditures of states on health care and the participation of states and the Federal District in financing the Unified Health System, better known by the acronym SUS. To develop the research, two targets were used: “to rescue expenses per government source (federal, state and municipal during the period from 2002 to 2013” and “to rescue resource transfers from the federal SUS to the states and also to municipalities”. METHODS: This research is bibliographic, documentary and descriptive and used a quantitative approach. Data were extracted from the Information System Public Health Budget, and additional data were collected from the public managers of states, municipalities and the Federal District during the period from 2002 to 2013. Federal data from the Undersecretary of Planning and Budget (originally extracted from the Integrated System of Financial Administration of the Federal Government and available on the Budget Public Health System webpage were also collected. RESULTS: The data revealed that during the same researched period, the Federal District has maintained the health care system budget, whereas states and municipalities have increased their budgets for the same spending. CONCLUSIONS: By analyzing the results, there is clearly a disparity regarding the investment expended by the entities of the Federation. Although municipalities and states have gradually increased their application of resources to health care, the federal state has maintained the same budget. These results reveal a bit of concern about public health funding.

  15. UAV formation control design with obstacle avoidance in dynamic three-dimensional environment.

    Science.gov (United States)

    Chang, Kai; Xia, Yuanqing; Huang, Kaoli

    2016-01-01

    This paper considers the artificial potential field method combined with rotational vectors for a general problem of multi-unmanned aerial vehicle (UAV) systems tracking a moving target in dynamic three-dimensional environment. An attractive potential field is generated between the leader and the target. It drives the leader to track the target based on the relative position of them. The other UAVs in the formation are controlled to follow the leader by the attractive control force. The repulsive force affects among the UAVs to avoid collisions and distribute the UAVs evenly on the spherical surface whose center is the leader-UAV. Specific orders or positions of the UAVs are not required. The trajectories of avoidance obstacle can be obtained through two kinds of potential field with rotation vectors. Every UAV can choose the optimal trajectory to avoid the obstacle and reconfigure the formation after passing the obstacle. Simulations study on UAV are presented to demonstrate the effectiveness of proposed method.

  16. Binocular Visual Navigation and Obstacle Avoidance of Mobile Robots Based on Speeded-Up Robust Features

    Institute of Scientific and Technical Information of China (English)

    WANG Meng-di; HAN Bao-ling; LUO Qing-sheng

    2013-01-01

    This article presents a good robust and real-time system scheme of the mobile robot obstacle detection and navigation, which principle of work is based on the feature descriptor SURF. In this scheme, firstly, the image information of the mobile robot path was captured by the binocular camera; then the feature points were extracted and corresponding matched using SURF to the binocular images as the undetected obstacles;finally fixed the position of the objective by the parallax between the matching points combining with the binocular vision calibration model. Theoretical derivation and experimental results show that this scheme is more accurate for the detection and navigation of the interest points. It has fast matching speed and high accuracy and low error. So, it has certain practical effect and popularizing value for the mobile robot real-time obstacle avoidance and navigation.

  17. Transient waves generated by a moving bottom obstacle: a new near-field solution

    DEFF Research Database (Denmark)

    Madsen, Per A.; Hansen, Asger Bendix

    2012-01-01

    We consider the classical problem of a single-layer homogeneous fluid at rest and a low, slowly varying, long and positive bottom obstacle, which is abruptly started from rest to move with a constant speed $V$. As a result a system of transient waves will develop, and we assume that locally...... analytically integrate and eliminate the backward-going family and achieve a versatile unidirectional single-family formulation, which covers subcritical, transcritical and supercritical conditions with relatively high accuracy. The formulation accounts for the temporal and spatial evolution of the bound waves...... in the vicinity of the obstacle as well as the development of the transient free waves generated at the onset of the motion. At some distance from the obstacle, dispersion starts to play a role and undular bores develop, but up to this point the new formulation agrees very well with numerical simulations based...

  18. Non-linear water waves generated by impulsive motion of submerged obstacle

    Directory of Open Access Journals (Sweden)

    N. I. Makarenko

    2013-12-01

    Full Text Available Fully nonlinear problem on unsteady water waves generated by impulsively moving obstacle is studied analytically. Our method involves the reduction of Euler equations to the integral-differential system for the wave elevation together with normal and tangential fluid velocities at the free surface. Exact model equations are derived in explicit form in the case when the isolated obstacle is presented by totally submerged elliptic cylinder. Small-time asymptotic solution is constructed for the cylinder which starts with constant acceleration from rest. It is demonstrated that the leading-order solution terms describe several wave regimes such as the formation of non-stationary splash jets by vertical rising or vertical submersion of the obstacle, as well as the generation of diverging waves is observed.

  19. Applying principles of health system strengthening to eye care

    OpenAIRE

    Karl Blanchet; Daksha Patel

    2012-01-01

    Understanding Health systems have now become the priority focus of researchers and policy makers, who have progressively moved away from a project-centred perspectives. The new tendency is to facilitate a convergence between health system developers and disease-specific programme managers in terms of both thinking and action, and to reconcile both approaches: one focusing on integrated health systems and improving the health status of the population and the other aiming at improving access to...

  20. Future of health care dominates meeting as CMA urges governments to fix “system in crisis”

    OpenAIRE

    Sullivan, Patrick

    1996-01-01

    Despite some media predictions that the CMA would endorse a parallel private health care system for Canadians during its August annual meeting, General Council in fact defeated motions favouring a move to privatized health care delivery. Sixteen resolutions on the future of health and health care were passed at the meeting, and most dealt with ways to improve the existing system.

  1. Leg stiffness and joint stiffness while running to and jumping over an obstacle

    OpenAIRE

    Mauroy, Geoffrey; Schepens, Bénédicte; Willems, Patrick

    2014-01-01

    During running, muscles of the lower limb act like a linear spring bouncing on the ground. When approaching an obstacle, the overall stiffness of this leg-spring system (kleg) is modified during the two steps preceding the jump to enhance the movement of the center of mass of the body while leaping the obstacle. The aim of the present study is to understand how kleg is modified during the running steps preceding the jump. Since kleg depends on the joint torsional stiffness and on the leg geom...

  2. A numerical study of a vertical solar air collector with obstacle

    Science.gov (United States)

    Moumeni, A.; Bouchekima, B.; Lati, M.

    2016-07-01

    Because of the lack of heat exchange obtained by a solar air between the fluid and the absorber, the introduction of obstacles arranged in rows overlapping in the ducts of these systems improves heat transfer. In this work, a numerical study using the finite volume methods is made to model the dynamic and thermal behavior of air flow in a vertical solar collector with baffles destined for integration in building. We search essentially to compare between three air collectors models with different inclined obstacles angle. The first kind with 90° shows a good performance energetic and turbulent.

  3. Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply

    Directory of Open Access Journals (Sweden)

    Henrickson Michael

    2011-08-01

    Full Text Available Abstract The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery system is primarily organized for the diagnosis and treatment of acute conditions. For pediatric patients with chronic health conditions, the typical acute problem-oriented visit actually serves as a barrier to care. The biomedical model of patient education prevails, characterized by unilateral transfer of medical information. However, the evidence basis for improvement in disease outcomes supports the use of the chronic care model, initially proposed by Dr. Edward Wagner. Six inter-related elements distinguish the success of the chronic care model, which include self-management support and care coordination by a prepared, proactive team. United States health care lacks a coherent policy direction for the management of high cost chronic conditions, including rheumatic diseases. A fundamental restructure of United States health care delivery must urgently occur which places the patient at the center of care. For the pediatric rheumatology workforce, reimbursement policies and the actions of health plans and insurers are consistent barriers to chronic disease improvement. United States reimbursement policy and overall fragmentation of health care services pose specific challenges for widespread implementation of the chronic care model. Team-based multidisciplinary care, care coordination and self-management are integral to improve outcomes. Pediatric rheumatology demand in the United States far exceeds available workforce supply. This article reviews the career

  4. A proposed systems approach to the evaluation of integrated palliative care

    Directory of Open Access Journals (Sweden)

    Krueger Paul

    2010-05-01

    Full Text Available Abstract Background There is increasing global interest in regional palliative care networks (PCN to integrate care, creating systems that are more cost-effective and responsive in multi-agency settings. Networks are particularly relevant where different professional skill sets are required to serve the broad spectrum of end-of-life needs. We propose a comprehensive framework for evaluating PCNs, focusing on the nature and extent of inter-professional collaboration, community readiness, and client-centred care. Methods In the absence of an overarching structure for examining PCNs, a framework was developed based on previous models of health system evaluation, explicit theory, and the research literature relevant to PCN functioning. This research evidence was used to substantiate the choice of model factors. Results The proposed framework takes a systems approach with system structure, process of care, and patient outcomes levels of consideration. Each factor represented makes an independent contribution to the description and assessment of the network. Conclusions Realizing palliative patients' needs for complex packages of treatment and social support, in a seamless, cost-effective manner, are major drivers of the impetus for network-integrated care. The framework proposed is a first step to guide evaluation to inform the development of appropriate strategies to further promote collaboration within the PCN and, ultimately, optimal palliative care that meets patients' needs and expectations.

  5. Investigating the health care delivery system in Japan and reviewing the local public hospital reform

    Directory of Open Access Journals (Sweden)

    Zhang X

    2016-03-01

    Full Text Available Xing Zhang, Tatsuo Oyama National Graduate Institute for Policy Studies, Tokyo, Japan Abstract: Japan's health care system is considered one of the best health care systems in the world. Hospitals are one of the most important health care resources in Japan. As such, we investigate Japanese hospitals from various viewpoints, including their roles, ownership, regional distribution, and characteristics with respect to the number of beds, staff, doctors, and financial performance. Applying a multivariate analysis and regression model techniques, we show the functional differences between urban populated prefectures and remote ones; the equality gap among all prefectures with respect to the distribution of the number of beds, staff, and doctors; and managerial differences between private and public hospitals. We also review and evaluate the local public hospital reform executed in 2007 from various financial aspects related to the expenditure and revenue structure by comparing public and private hospitals. We show that the 2007 reform contributed to improving the financial situation of local public hospitals. Strategic differences between public and private hospitals with respect to their management and strategy to improve their financial situation are also quantitatively analyzed in detail. Finally, the remaining problems and the future strategy to further improve the Japanese health care system are described. Keywords: health care system, health care resource, public hospital, multivariate regression model, financial performance

  6. [Learning from failure - implications for respiratory and intensive care medicine: a conceptual review].

    Science.gov (United States)

    Kabitz, H-J

    2013-08-01

    The clinical, social and economical impact of failure in medicine [i. e., adverse health care events (AHCE)] is overwhelming. Respiratory and intensive care medicine are strongly relevant to AHCE, particularly in cases associated with respiratory failure, mechanical ventilation and pharmacotherapy. In spite of the obvious necessity to learn from AHCE, its realisation in health-care organisations is still rare. This conceptual review therefore aims to (i) clarify the most relevant terminology, (ii) identify obstacles related to this health-care topic, and (iii) present possible strategies for solving the problems, thereby enabling respiratory and intensive care medicine to systematically and effectively learn from failure. A review of the literature (effective as of June 2013) derived from the electronic databases Medline via PubMed, EMBASE, ERIC and Google Scholar identified the following relevant obstacles (ii): a so-called blame culture associated with concealing failure, missing system analyses (vs. individual breakdown), and (economically) misdirected incentives. Possible strategies to overcome these obstacles (iii) include acknowledging the importance of leadership, a safe environment, open reporting, an effective feedback culture, and detection (e. g., trigger-tools), analysis and discussion (e. g., double loop learning) of failure. The underlying reasons for the occurrence of AHCE are based on structural, organisational and human shortcomings, and affect all categories of caregivers. Approaches to solving the problem should therefore focus primarily on the entire system, rather than on the individual alone. PMID:23846430

  7. Multi-agent systems: effective approach for cancer care information management.

    Science.gov (United States)

    Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

    2013-01-01

    Physicians, in order to study the causes of cancer, detect cancer earlier, prevent or determine the effectiveness of treatment, and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive, and timely cancer data. The cancer care environment has become more complex because of the need for coordination and communication among health care professionals with different skills in a variety of roles and the existence of large amounts of data with various formats. The goals of health care systems in such a complex environment are correct health data management, providing appropriate information needs of users to enhance the integrity and quality of health care, timely access to accurate information and reducing medical errors. These roles in new systems with use of agents efficiently perform well. Because of the potential capability of agent systems to solve complex and dynamic health problems, health care system, in order to gain full advantage of E- health, steps must be taken to make use of this technology. Multi-agent systems have effective roles in health service quality improvement especially in telemedicine, emergency situations and management of chronic diseases such as cancer. In the design and implementation of agent based systems, planning items such as information confidentiality and privacy, architecture, communication standards, ethical and legal aspects, identification opportunities and barriers should be considered. It should be noted that usage of agent systems only with a technical view is associated with many problems such as lack of user acceptance. The aim of this commentary is to survey applications, opportunities and barriers of this new artificial intelligence tool for cancer care information as an approach to improve cancer care management.

  8. Multi-agent systems: effective approach for cancer care information management.

    Science.gov (United States)

    Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

    2013-01-01

    Physicians, in order to study the causes of cancer, detect cancer earlier, prevent or determine the effectiveness of treatment, and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive, and timely cancer data. The cancer care environment has become more complex because of the need for coordination and communication among health care professionals with different skills in a variety of roles and the existence of large amounts of data with various formats. The goals of health care systems in such a complex environment are correct health data management, providing appropriate information needs of users to enhance the integrity and quality of health care, timely access to accurate information and reducing medical errors. These roles in new systems with use of agents efficiently perform well. Because of the potential capability of agent systems to solve complex and dynamic health problems, health care system, in order to gain full advantage of E- health, steps must be taken to make use of this technology. Multi-agent systems have effective roles in health service quality improvement especially in telemedicine, emergency situations and management of chronic diseases such as cancer. In the design and implementation of agent based systems, planning items such as information confidentiality and privacy, architecture, communication standards, ethical and legal aspects, identification opportunities and barriers should be considered. It should be noted that usage of agent systems only with a technical view is associated with many problems such as lack of user acceptance. The aim of this commentary is to survey applications, opportunities and barriers of this new artificial intelligence tool for cancer care information as an approach to improve cancer care management. PMID:24460364

  9. Implementing the evidence for language-appropriate health care systems: The Welsh context.

    Science.gov (United States)

    Roberts, Gwerfyl W; Burton, Christopher R

    2013-01-01

    Like Canada, Wales, UK is a bilingual nation: the Welsh language is an important part of its national identity and legislative framework. This has implications for the delivery of public sector services, particularly in the context of health and social care, where responding to the language needs of service users is fundamental to quality health care provision. Nevertheless, despite the strengthening policy commitment for a whole-system approach towards enhancing Welsh language services, there is a paucity of evidence to guide best practice in organizational planning in health care settings. This commentary outlines the context and significance of bilingual health care provision in Wales and the implications for building and embedding the evidence base. It calls for further work to translate our knowledge and understanding of language-appropriate practice to provide more effective and sensitive health care services; and to close the implementation gap between evidence and practice. Given the relevance of this challenge for health care providers in Canada who plan and deliver services for French-language minorities, this approach has resonance across our research communities. Thus, in our common pursuit to establish integrated knowledge translation research for language-appropriate health care systems, this commentary offers a focus for reflection, discussion and collaborative action. PMID:24300330

  10. [Primary care pediatrics in the public health system of the twenty-first century. SESPAS report 2012].

    Science.gov (United States)

    Domínguez Aurrecoechea, Begoña; Valdivia Jiménez, Carlos

    2012-03-01

    Today in our country, the primary care pediatrician is the first contact between children and adolescents with the health system, being also a highly resolving specialist that addresses over 90% of the health needs of this population, monitors growth and development and participates in all activities of prevention, health promotion and health education within primary care teams with nurses and family doctors. Witnessing rapid and profound demographic, social, cultural, scientific and technological changes as well as the demands and expectations of health care for citizens, which should enhance the value and response capacity of primary care. These changes also affect infant morbidity and health care priorities in child and adolescent, posing new challenges for primary care practice and reinforce the role of the pediatrician in primary care. Primary care is not only the gateway to the health system. Primary care teams have to take responsibility for the care of people assigned to coordinate the necessary resources and advising citizens on their health problems and his itinerary care by the health system. It identifies the need to foster teamwork within the health department involved nursing staff to take care activities in this age group. It aims to foster a model based on cooperation and complementarity. A recent systematic review recommended maintaining the figure of the pediatrician in primary care teams and strengthen their specific role as first point of contact with the child's health care system, found significant benefits for children. PMID:22196036

  11. Evaluation of Sustainable Land Management and Diagnosis of Obstacle at County Scale in Sichuan Basin: Taking Lezhi County as Example

    Institute of Scientific and Technical Information of China (English)

    CHEN Guangjian; LIU Qing

    2006-01-01

    This paper established sustainable land resources evaluating indicators fit for hilly area in Sichuan Basin, Southwest of China, and evaluated the case of sustainable land management of Lezhi County from 1990 to 2001. The result showed that the land resource sustainable utilization ability in Lezhi County is belong to Second level(better sustainable). Secondly, this paper diagnosed some years obstacles of sustainable land management of Lezhi County from base period to goal period and compared the obstacles factors in the indicators system. There were 16 indexes orderly become major affect factor to land sustainable utilization of Lezhi county in indicator system, of which there are 8 obstacles indexes exist both in 1990 and 2001. The value of obstacles degree of five indicators exceeded 5 in 1990, but in 2001, only two indicators' values were more than 5.

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

    Directory of Open Access Journals (Sweden)

    Henrard Jean-Claude

    2009-04-01

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

  13. A Mobile Care Coordination System for the Management of Complex Chronic Disease.

    Science.gov (United States)

    Haynes, Sarah; Kim, Katherine K

    2016-01-01

    There is global concern about healthcare cost, quality, and access as the prevalence of complex and chronic diseases, such as heart disease, continues to grow. Care for patients with complex chronic disease involves diverse practitioners and multiple transitions between medical centers, physician practices, clinics, community resources, and patient homes. There are few systems that provide the flexibility to manage these varied and complex interactions. Participatory and user-centered design methodology was applied to the first stage of building a mobile platform for care coordination for complex, chronic heart disease. Key informant interviews with patients, caregivers, clinicians, and care coordinators were conducted. Thematic analysis led to identification of priority user functions including shared care plan, medication management, symptom management, nutrition, physical activity, appointments, personal monitoring devices, and integration of data and workflow. Meaningful stakeholder engagement contributes to a person-centered system that enhances health and efficiency.

  14. Primary Care Behavioral Health Provider Training: Systematic Development and Implementation in a Large Medical System.

    Science.gov (United States)

    Dobmeyer, Anne C; Hunter, Christopher L; Corso, Meghan L; Nielsen, Matthew K; Corso, Kent A; Polizzi, Nicholas C; Earles, Jay E

    2016-09-01

    The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense's experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed.

  15. Public policy and medical tourism: ethical implications for the Egyptian health care system.

    Science.gov (United States)

    Haley, Bob

    2011-01-01

    Egypt's medical tourism industry has been experiencing tremendous growth. However, Egypt continues to lack the necessary investment in its public health system to effectively care for its population. Current policy and the emergence of medical tourism have led to unequal health care access, resulting in high a prevalence of infectious diseases and lack of resources for its most vulnerable populations. As a new Egyptian government emerges, it is important for policymakers to understand the critical issues and ethical concerns of existing health policy. This understanding may be used to propose new policy that more effectively allocates to care for Egypt's population. PMID:22619867

  16. Quality of care in single-payer and multipayer health systems.

    Science.gov (United States)

    Feldman, Roger

    2009-08-01

    In this article, I argue that unregulated markets will not find the right level of health care quality but that at the same time it is not clear that single-payer systems will do any better. My perspective combines the economic theory of public goods and the institutional payment arrangements found in many single-payer systems. If, as I believe, health care quality is a public good, it will be underprovided in a multipayer system. Single-payer systems often allocate a fixed budget to health care professionals or administrators and give them considerable discretion in determining quality as well as quantity of service. With care being free or almost free at the point of use, patients will demand more services than administrators want to provide. The result is rationing by waiting -- which should be present in all such systems and is present in most of them. I develop several implications of the theory and an agenda for future research on quality of care in single-payer and multipayer health systems. PMID:19633227

  17. Record of hospitalizations for ambulatory care sensitive conditions: validation of the hospital information system

    Directory of Open Access Journals (Sweden)

    Tania Cristina Morais Santa Barbara Rehem

    2013-09-01

    Full Text Available OBJECTIVE: to estimate the sensitivity, specificity and positive and negative predictive values of the Unified Health System's Hospital Information System for the appropriate recording of hospitalizations for ambulatory care-sensitive conditions. METHOD: the hospital information system records for conditions which are sensitive to ambulatory care, and for those which are not, were considered for analysis, taking the medical records as the gold standard. Through simple random sampling, a sample of 816 medical records was defined and selected by means of a list of random numbers using the Statistical Package for Social Sciences. RESULT: the sensitivity was 81.89%, specificity was 95.19%, the positive predictive value was 77.61% and the negative predictive value was 96.27%. In the study setting, the Hospital Information System (SIH was more specific than sensitive, with nearly 20% of care sensitive conditions not detected. CONCLUSION: there are no validation studies in Brazil of the Hospital Information System records for the hospitalizations which are sensitive to primary health care. These results are relevant when one considers that this system is one of the bases for assessment of the effectiveness of primary health care.

  18. Measuring the Mental Health-Care System Responsiveness: Results of an Outpatient Survey in Tehran.

    Science.gov (United States)

    Forouzan, Setareh; Padyab, Mojgan; Rafiey, Hassan; Ghazinour, Mehdi; Dejman, Masoumeh; San Sebastian, Miguel

    2015-01-01

    As explained by the World Health Organization (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health-care system of Tehran. Utilizing the same method used by the WHO for its responsiveness survey, responsiveness for outpatient mental health care was evaluated using a validated Farsi questionnaire. A sample of 500 public mental health service users in Tehran participated and subsequently completed the questionnaire. On average, 47% of participants reported experiencing poor responsiveness. Among responsiveness domains, confidentiality and dignity were the best performing factors while autonomy, access to care, and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Attention and access to care were responsiveness dimensions that performed poorly but were considered to be highly important by study participants. In summary, the study suggests that measuring responsiveness could provide guidance for further development of mental health-care systems to become more patient orientated and provide patients with more respect. PMID:26858944

  19. A web-based laboratory information system to improve quality of care of tuberculosis patients in Peru: functional requirements, implementation and usage statistics

    Directory of Open Access Journals (Sweden)

    Yale Gloria

    2007-10-01

    Full Text Available Abstract Background Multi-drug resistant tuberculosis patients in resource-poor settings experience large delays in starting appropriate treatment and may not be monitored appropriately due to an overburdened laboratory system, delays in communication of results, and missing or error-prone laboratory data. The objective of this paper is to describe an electronic laboratory information system implemented to alleviate these problems and its expanding use by the Peruvian public sector, as well as examine the broader issues of implementing such systems in resource-poor settings. Methods A web-based laboratory information system "e-Chasqui" has been designed and implemented in Peru to improve the timeliness and quality of laboratory data. It was deployed in the national TB laboratory, two regional laboratories and twelve pilot health centres. Using needs assessment and workflow analysis tools, e-Chasqui was designed to provide for improved patient care, increased quality control, and more efficient laboratory monitoring and reporting. Results Since its full implementation in March 2006, 29,944 smear microscopy, 31,797 culture and 7,675 drug susceptibility test results have been entered. Over 99% of these results have been viewed online by the health centres. High user satisfaction and heavy use have led to the expansion of e-Chasqui to additional institutions. In total, e-Chasqui will serve a network of institutions providing medical care for over 3.1 million people. The cost to maintain this system is approximately US$0.53 per sample or 1% of the National Peruvian TB program's 2006 budget. Conclusion Electronic laboratory information systems have a large potential to improve patient care and public health monitoring in resource-poor settings. Some of the challenges faced in these settings, such as lack of trained personnel, limited transportation, and large coverage areas, are obstacles that a well-designed system can overcome. e-Chasqui has the

  20. Obstacles and proposed solutions to effective antiretroviral therapy in resource-limited settings.

    Science.gov (United States)

    Bartlett, John A; Hornberger, John; Shewade, Ashwini; Bhor, Menaka; Rajagopalan, Rukmini

    2009-01-01

    More than 3 million people were receiving antiretroviral therapy (ART) at the end of 2007, but this number represents only 31% of people clinically eligible for ART in resource-limited settings. The primary objective of this study is to summarize the key obstacles that impede the goal of universal access prevention, care, and treatment. We performed a systematic literature search to review studies that reported barriers to diagnosis and access to treatment of HIV/AIDS in resource-limited countries. Persons living with HIV/ AIDS commonly face economic, sociocultural, and behavioral obstacles to access treatment and care for HIV. A variety of programs to overcome these barriers have been implemented, including efforts to destigmatize HIV/AIDS, enhance treatment literacy, provide income-generation skills, decentralize HIV services, promote gender equality, and adopt a multisectoral approach to optimize limited resources. An understanding of these obstacles and suggested methods to overcome them must be addressed by global policy makers before universal ART access can be achieved. PMID:19721103