WorldWideScience

Sample records for care systems obstacles

  1. Primary mental health care: Indications and obstacles

    Directory of Open Access Journals (Sweden)

    Y.G. Pillay

    1992-09-01

    Full Text Available This paper considers indications and obstacles for the development of primary mental health care practice in both developed and under-developed countries. Both are considered as this represents the South African reality. While a significant body of literature has documented the need for primary mental health care, the obstacles (especially in terms of the commodification of health to its fruition are seldom addressed.

  2. 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.

  3. Obstacle Characterization in a Geocrowdsourced Accessibility System

    Science.gov (United States)

    Qin, H.; Aburizaiza, A. O.; Rice, R. M.; Paez, F.; Rice, M. T.

    2015-08-01

    Transitory obstacles - random, short-lived and unpredictable objects - are difficult to capture in any traditional mapping system, yet they have significant negative impacts on the accessibility of mobility- and visually-impaired individuals. These transitory obstacles include sidewalk obstructions, construction detours, and poor surface conditions. To identify these obstacles and assist the navigation of mobility- and visually- impaired individuals, crowdsourced mapping applications have been developed to harvest and analyze the volunteered obstacles reports from local students, faculty, staff, and residents. In this paper, we introduce a training program designed and implemented for recruiting and motivating contributors to participate in our geocrowdsourced accessibility system, and explore the quality of geocrowdsourced data with a comparative analysis methodology.

  4. 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.

  5. 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.

  6. Wearable Obstacle Detection System for visually impaired People

    OpenAIRE

    Cardin, S; Vexo, F.; Thalmann, D

    2005-01-01

    This paper presents an obstacle detection system for visually impaired people. User can be alerted of closed obstacles in range while traveling in their environment. The system we propose detects the nearest obstacle via a stereoscopic sonar system and sends back vibro-tactile feedback to inform the user about its localization. The system aims at increasing the mobility of visually impaired people by offering new sensing abilities.

  7. 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.

  8. 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...

  9. 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...

  10. 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...

  11. 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.

  12. A Hands-Free Obstacle Detection and Avoidance System

    Directory of Open Access Journals (Sweden)

    M. Abdul-Niby

    2015-06-01

    Full Text Available In this paper, we present a low cost hands-free detection and avoidance system designed to provide mobility assistance for visually impaired people. An ultrasonic sensor is attached to the jacket of the user and detects the obstacles in front. The information obtained is transferred to the user through audio messages and also by a vibration. The range of the detection is user-defined. A text-to-speech module is employed for the voice signal. The proposed obstacle avoidance device is cost effective, easy to use and easily upgraded.

  13. Obstacle detection and warning system for aircraft navigation at airports

    Science.gov (United States)

    Gallo, Laurent

    2000-06-01

    This paper speaks about work conducted in 1998 and 1999 by AEROSPATIALE MATRA in development of an obstacle detection system, which has been tested on a demonstrator aircraft in Toulouse. The purpose of this mock- up was to verify the feasibility of a passive technology, and to consider the limits of its use.

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

    OpenAIRE

    Zahra Hadian Shirazi; Farkhondeh Sharif; Mahnaz Rakhshan; Narjes Pishva; Faezeh Jahanpour

    2015-01-01

    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 collect...

  15. 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...

  16. 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.

  17. Community mental health care for the elderly--a look at the obstacles.

    OpenAIRE

    Waxman, H M

    1986-01-01

    Despite the recent attention given to mental disorders in the aged and their higher risk for organic mental disorders, older people rarely receive specialized mental health treatment. This paper reviews recent research on some of the major obstacles to the use of treatment by the elderly. These include claims of "ageism" by health care professionals, the negative attitudes and behaviors of older persons toward mental disorders and their treatment, and the failure of general practice physician...

  18. Clinical Alarms in Intensive Care Units: Perceived Obstacles of Alarm Management and Alarm Fatigue in Nurses

    OpenAIRE

    Cho, Ok Min; Kim, Hwasoon; Lee, Young Whee; Cho, Insook

    2016-01-01

    Objectives The purpose of this descriptive study was to investigate the current situation of clinical alarms in intensive care unit (ICU), nurses' recognition of and fatigue in relation to clinical alarms, and obstacles in alarm management. Methods Subjects were ICU nurses and devices from 48 critically ill patient cases. Data were collected through direct observation of alarm occurrence and questionnaires that were completed by the ICU nurses. The observation time unit was one hour block. On...

  19. 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

  20. An obstacle information display system with virtual radar

    International Nuclear Information System (INIS)

    During teleoperation, when the operator's attention is concentrated in controlling the end-effector motion, it is very difficult to recognize a possible link collision. Such collision may damage the environment or the link seriously, because usually the link has no sensors. In this paper, we propose a so-called 'virtual radar' which displays the collision information considering the whole manipulator at the end-effect level. The computer checks for unreachable areas due to the presence of obstacles and displays the appropriate information mapped in task-space coordinates using a 3D graphical image. This enhances the reliability of the system. However, in the case of a 6 D.O.F. manipulator, collision possibility space must be a 6 dimensional one and hence it is difficult to visualize and understand. To tackle this problem, a deformed sphere and patterns on its surface are employed. We have applied this method to a 6 D.O.F. manipulator and have verified the effectiveness of the proposed approach by experiments with a real telerobotic system. (author)

  1. 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.

  2. 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.

  3. 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.

  4. 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...

  5. 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...

  6. 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

  7. 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%.

  8. Assisting the Visually Impaired: Obstacle Detection and Warning System by Acoustic Feedback

    OpenAIRE

    Andrés Cela; Javier Almazán; Bergasa, Luis M.; J. Javier Yebes; Alcantarilla, Pablo F.; Alberto Rodríguez

    2012-01-01

    The aim of this article is focused on the design of an obstacle detection system for assisting visually impaired people. A dense disparity map is computed from the images of a stereo camera carried by the user. By using the dense disparity map, potential obstacles can be detected in 3D in indoor and outdoor scenarios. A ground plane estimation algorithm based on RANSAC plus filtering techniques allows the robust detection of the ground in every frame. A polar grid representation is proposed t...

  9. 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…

  10. 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...

  11. A salient information processing system for bionic eye with application to obstacle avoidance.

    Science.gov (United States)

    Stacey, Ashley; Li, Yi; Barnes, Nick

    2011-01-01

    In this paper we present a visual processing system for bionic eye with a focus on obstacle avoidance. Bionic eye aims at restoring the sense of vision to people living with blindness and low vision. However, current hardware implant technology limits the image resolution of the electrical stimulation device to be very low (e.g., 100 electrode arrays, which is approx. 12 × 9 pixels). Therefore, we need a visual processing unit that extracts salient information in an unknown environment for assisting patients in daily tasks such as obstacle avoidance. We implemented a fully portable system that includes a camera for capturing videos, a laptop for processing information using a state-of-the-art saliency detection algorithm, and a head-mounted display to visualize results. The experimental environment consists of a number of objects, such as shoes, boxes, and foot stands, on a textured ground plane. Our results show that the system efficiently processes the images, effectively identifies the obstacles, and eventually provides useful information for obstacle avoidance. PMID:22255490

  12. 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 ...

  13. 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.

  14. 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,

  15. 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.

  16. 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)

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. MOVING OBSTACLE DETECTION AND REMOTE VIDEO MONITORING SYSTEM USING CORTEX-A8

    Directory of Open Access Journals (Sweden)

    V.PADMAJA, KAVITHA MAMINDLA

    2013-11-01

    Full Text Available In this paper the Detection of Moving obstacle and remote video monitoring and extracting the key frames from the captured video system based on high performance SAMSUNG S5PV210 CORTEX-A8 processor core is build and expanding peripheral devices using embedded Linux as the operating system. Today monitoring systems are either webcam based or simple motion detection based. Here we have interfaced both webcam and PIR sensor to the embedded system so that the user can get an immediate alert message and can take necessary steps. This system is based on the kernel of Cortex board with the GSM module being triggered by a Pyroelectric Infrared Sensor (PIR, which senses changes in the external temperature, especially in this case when an invader enters in to remote location and send SMS to the user. At the same time, by using a smart device or a PC, the user can link to the video streaming server constructed on the embedded board via the internet and browse the webpage to monitor the surveillance area, here the UVC driver and V4L programming is used to interface USB camera to the board to capture video information and then board will do two parallel works first one is transmits the processed captured video information using wireless network, which will be collected and monitored at client side using wireless network connection through the wireless device, second one is extracts the key frames from captured video using OpenCV and served on a server, the both provides an advantage to surveillance monitoring system.

  2. 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.

  3. Systems architecture for integrated care

    OpenAIRE

    2012-01-01

    Introduction Telehealth and telecare projects do not always pay enough attention to the wider information systems architecture required to deliver integrated care. They often focus on technologies to support specific diseases or social care problems which can result in information silos that impede integrated care of the patient. While these technologies can deliver discrete benefits, they could potentially generate unintended disbenefits in terms of creating data silos which may cause patien...

  4. [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

  5. 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...

  6. Obstacles to the prevention of overweight and obesity in the context of child health care in Sweden

    OpenAIRE

    Isma, Gabriella; Bramhagen, Ann-Cathrine; Ahlström, Gerd; Ostman, Margareta; Dykes, Anna-Karin

    2013-01-01

    Background: Overweight and obesity in younger children could better be brought in focus through a deeper understanding of how Child Health Care nurses (CHC-nurses) perceive their work with the problems of overweight at the CHC Centers. The aim of this study was to elucidate the CHC-nurses conceptions of their preventive work with childhood overweight and obesity in Child Health Care. Method: A qualitative study, based on open-ended interviews, involving 18 CHC-nurses strategically selected fr...

  7. 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.

  8. 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...

  9. 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.

  10. Reforms of health care system in Romania

    OpenAIRE

    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 the health care system. Results. The reforms of the health care system in Romania have been realized in a rather difficult context of scarcity of financial and human resources. The Gross Domestic Pro...

  11. Dementia Care: Intersecting Informal Family Care and Formal Care Systems

    OpenAIRE

    Prabhjot Singh; Rafat Hussain; Adeel Khan; Lyn Irwin; Roslyn Foskey

    2014-01-01

    Dementia is one of the major causes of disability and dependence amongst older people and previous research has highlighted how the well-being of people with dementia is inherently connected to the quality of their relationships with their informal carers. In turn, these carers can experience significant levels of emotional stress and physical burden from the demands of caring for a family member with dementia, yet their uptake of formal services tends to be lower than in other conditions rel...

  12. [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

  13. 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.

  14. [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

  15. 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)

  16. 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

  17. Degree, instability and bifurcation of reaction-diffusion systems with obstacles near certain hyperbolas

    Czech Academy of Sciences Publication Activity Database

    Eisner, J.; Väth, Martin

    2016-01-01

    Roč. 135, April (2016), s. 158-193. ISSN 0362-546X Institutional support: RVO:67985840 Keywords : reaction-diffusion system * turing instability * global bifurcation Subject RIV: BA - General Mathematics Impact factor: 1.327, year: 2014 http://www. science direct.com/ science /article/pii/S0362546X16000146

  18. 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

  19. [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

  20. Quality systems in Dutch health care institutions.

    OpenAIRE

    Casparie, Anton; Sluijs, Emmy; Wagner, Cordula; de Bakker, Dinny

    1997-01-01

    The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived from the European Quality Award-was sent to 1594 health care institutions; the response was 74%. The results showed that in 13% of the institutions a coherent quality system had been implemented. These ...

  1. Health care system in bangladesh

    Directory of Open Access Journals (Sweden)

    Dibyajyoti Saha

    2015-10-01

    Full Text Available Pharmacists are healthcare professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use. The role of pharmacist has shifted from the classical “lick, stick and pour” dispensary role, to being an integrated member of the health care team directly involved in patient care. But, in our country pharmacists are mainly engaged with manufacturing of drugs, which is secondary responsibility of pharmacist.

  2. Health care system in bangladesh

    OpenAIRE

    Dibyajyoti Saha,

    2015-01-01

    Pharmacists are healthcare professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use. The role of pharmacist has shifted from the classical “lick, stick and pour” dispensary role, to being an integrated member of the health care team directly involved in patient care. But, in our country pharmacists are mainly engaged with manufacturing of drugs, which is secondary responsibility of pharmacist.

  3. 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.

  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. 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

  6. Critical care nursing: Embedded complex systems.

    Science.gov (United States)

    Trinier, Ruth; Liske, Lori; Nenadovic, Vera

    2016-01-01

    Variability in parameters such as heart rate, respiratory rate and blood pressure defines healthy physiology and the ability of the person to adequately respond to stressors. Critically ill patients have lost this variability and require highly specialized nursing care to support life and monitor changes in condition. The critical care environment is a dynamic system through which information flows. The critical care unit is typically designed as a tree structure with generally one attending physician and multiple nurses and allied health care professionals. Information flow through the system allows for identification of deteriorating patient status and timely interventionfor rescue from further deleterious effects. Nurses provide the majority of direct patient care in the critical care setting in 2:1, 1:1 or 1:2 nurse-to-patient ratios. The bedside nurse-critically ill patient relationship represents the primary, real-time feedback loop of information exchange, monitoring and treatment. Variables that enhance information flow through this loop and support timely nursing intervention can improve patient outcomes, while barriers can lead to errors and adverse events. Examining patient information flow in the critical care environment from a dynamic systems perspective provides insights into how nurses deliver effective patient care and prevent adverse events. PMID:27047997

  7. 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...

  8. 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...

  9. Trauma care systems in India - An overview

    Directory of Open Access Journals (Sweden)

    Joshipura M

    2004-01-01

    Full Text Available Trauma-care systems in India are at a nascent stage of development. Industrialized cities, rural towns and villages coexist, with variety of health care facilities and almost complete lack of organized trauma care. There is gross disparity between trauma services available in various parts of the country. Rural India has inefficient services for trauma care, due to the varied topography, financial constraints and lack of appropriate health infrastructure. There is no national lead agency to coordinate various components of a trauma system. No mechanism for accreditation of trauma centres and professionals exists. Education in trauma life-support skills has only recently become available. A nationwide survey encompassing various facilities has demonstrated significant deficiencies in current trauma systems. Although injury is a major public-health problem, the government, medical fraternity and the society are yet to recognize it as a growing challenge.

  10. Challenges for the German Health Care System.

    Science.gov (United States)

    Dietrich, C F; Riemer-Hommel, P

    2012-06-01

    The German Health Care System (GHCS) faces many challenges among which an aging population and economic problems are just a few. The GHCS traditionally emphasised equity, universal coverage, ready access, free choice, high numbers of providers and technological equipment; however, real competition among health-care providers and insurance companies is lacking. Mainly in response to demographic changes and economic challenges, health-care reforms have focused on cost containment and to a lesser degree also quality issues. In contrast, generational accounting, priorisation and rationing issues have thus far been completely neglected. The paper discusses three important areas of health care in Germany, namely the funding process, hospital management and ambulatory care, with a focus on cost control mechanisms and quality improving measures as the variables of interest. Health Information Technology (HIT) has been identified as an important quality improvement tool. Health Indicators have been introduced as possible instruments for the priorisation debate. PMID:22660990

  11. A telemedicine health care delivery system

    Science.gov (United States)

    Sanders, Jay H.

    1991-01-01

    The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described.

  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. 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

  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...

  15. Barriers of Referral System to Health Care Provision in Rural Societies in Iran

    Directory of Open Access Journals (Sweden)

    Manijeh Eskandari

    2013-08-01

    Full Text Available Introduction: Health care delivery systems in rural areas face numerous challenges in meeting the community's needs. This study aimed to describe barriers of health care process in rural societies in Iran. Methods: In this qualitative study, 26 participants (21 rural health care providers and five rural patients were selected through purposive sampling. The data was collected via semi-structured individual interviews and small focus group discussions. Data was analyzed with qualitative content analysis.Results: One category, “ineffective referral system”, and five subcategories, i.e. being far from the ideal referral system, lack of adequate governmental referral system, lack of connection between different levels of the referral system, self-referential and bypassing the referral system, and insufficient knowledge about the referral system, were found. Conclusion: Considering the obstacles to the referral system, improvements in its structure are necessary to promote the quality of health care in rural areas. Such changes require coordination between the three levels of the referral system, strengthening the public sector of the system, increasing public awareness about the referral system, and prevention of self-referential.

  16. [Informatics in the Croatian health care system].

    Science.gov (United States)

    Kern, Josipa; Strnad, Marija

    2005-01-01

    Informatization process of the Croatian health care system started relatively early. Computer processing of data of persons not covered by health insurance started in 1968 in Zagreb. Remetinec Health Center served as a model of computer data processing (CDP) in primary health care and Sveti Duh General Hospital in inpatient CDP, whereas hospital administration and health service were first introduced to Zagreb University Hospital Center and Sestre Milosrdnice University Hospital. At Varazdin Medical Center CDP for health care services started in 1970. Several registries of chronic diseases have been established: cancer, psychosis, alcoholism, and hospital registries as well as pilot registries of lung tuberculosis patients and diabetics. Health statistics reports on healthcare services, work accidents and sick-leaves as well as on hospital mortality started to be produced by CDP in 1977. Besides alphanumeric data, the modern information technology (IT) can give digital images and signals. Communication in health care system demands a standardized format of all information, especially for telemedicine. In 2000, Technical Committee for Standardization in Medical Informatics was founded in Croatia, in order to monitor the activities of the International Standardization Organization (ISO) and Comite Européen de Normalisation (CEN), and to implement their international standards in the Croatian standardization procedure. The HL7 Croatia has also been founded to monitor developments in the communication standard HL7. So far, the Republic of Croatia has a number of acts regulating informatization in general and consequently the informatization of the health care system (Act on Personal Data Confidentiality, Act on Digital Signature, Act of Standardization) enacted. The ethical aspect of data security and data protection has been covered by the Code of Ethics for medical informaticians. It has been established by the International Medical Informatics Association (IMIA

  17. 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...

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. Opportunities Outweigh Obstacles

    OpenAIRE

    Rozum, Betty; Thoms, Becky L.; Bates, Scott C.; Barandiaran, Danielle M

    2015-01-01

    Student research is an untapped commodity. A survey of 238 Institutional Repositories in 2013 indicated that only 38% collect student research other than theses and dissertations. We think student research is a potential goldmine. Do other librarians agree? What about stake holders outside of the library? And, what are the obstacles preventing more robust collection of student research?

  3. 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.

  4. La gestión de úlceras por presión en residencias de mayores: Obstáculos y facilitadores The management of pressure ulcers in nursing home care: Obstacles and facilitators

    Directory of Open Access Journals (Sweden)

    Manuel Rodríguez Palma

    2010-09-01

    Full Text Available Introducción y objetivos: las úlceras por presión (UPP son un problema que repercute negativamente en la calidad de vida del anciano, contribuyendo a la morbilidad y mortalidad de la población institucionalizada. La heterogénea realidad de la asistencia y la variabilidad epidemiológica de estas lesiones dificultan su abordaje en las instituciones socio-sanitarias. Intentaremos conocer la gestión de las UPP en las residencias de mayores y los obstáculos que impiden su adecuado manejo, planteando estrategias para optimizar los cuidados. Método: revisión bibliográfica en bases de datos nacionales e internacionales. Resultados: la adopción e implementación de las mejores directrices de prevención y tratamiento de UPP ofrece una elevada variabilidad. Se detectan obstáculos a nivel de dirección e instituciones, costes económicos y materiales, formación, actitudes y motivaciones del personal, implantación y cuidados. Conclusiones: el uso de programas adaptados a los centros, el compromiso mantenido de la institución, planes globales y multidimensionales, formación interdisciplinar y evaluación continua serían algunas de las recomendaciones para la mejora de los cuidados de prevención y tratamiento de ancianos con UPP.Introduction and aims: the PU is a problem that adversely affects the quality of life among the elderly, contributing to morbidity and mortality in the institutionalized population. The heterogeneous reality of care and epidemiological variability of these injuries make it difficult to approach in socio-sanitary institutions. Knowing the management of pressure ulcers in nursing homes and obstacles to its proper management, raising strategies to optimize care. Method: literature review on the basis of national and international data. Results: the adoption and implementation of best practice guidelines for prevention and treatment of PU offers a high variability. Obstacles are detected at the managerial and

  5. 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

  6. Highly Oscillating Thin Obstacles

    CERN Document Server

    Lee, Ki-ahm; Yoo, Minha

    2012-01-01

    The focus of this paper is on a thin obstacle problem where the obstacle is defined on the intersection between a hyper-plane $\\Gamma$ in $\\mathbb{R}^n$ and a periodic perforation $\\mathcal{T}_\\varepsilon$ of $\\mathbb{R}^n$, depending on a small parameter $\\varepsilon>0$. As $\\varepsilon\\to 0$, it is crucial to estimate the frequency of intersections and to determine this number locally. This is done using strong tools from uniform distribution. By employing classical estimates for the discrepancy of sequences of type $\\{k\\alpha\\}_{k=1}^\\infty$, $\\alpha\\in\\R$, we are able to extract rather precise information about the set $\\Gamma\\cap\\mathcal{T}_\\varepsilon$. As $\\varepsilon\\to0$, we determine the limit $u$ of the solution $u_\\varepsilon$ to the obstacle problem in the perforated domain, in terms of a limit equation it solves. We obtain the typical "strange term" behaviour for the limit problem, but with a different constant taking into account the contribution of all different intersections, that we call the...

  7. 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.

  8. Redundant Robot Can Avoid Obstacles

    Science.gov (United States)

    Homayoun, Seraji; Colbaugh, Richard; Glass, Kristin

    1991-01-01

    Simple and direct control scheme enables redundant robot to avoid obstacles in workspace. In proposed scheme, called "configuration control", degrees of freedom used to configure robot to satisfy set of inequality constraints representing avoidance of obstacles, while simultaneously making end effector follow desired trajectory. Provides capability to avoid obstacles in dynamically varying environment where apriori planning of tasks not feasible.

  9. Developing a web 2.0 diabetes care support system with evaluation from care provider perspectives.

    Science.gov (United States)

    Lin, Yung-Hsiu; Chen, Rong-Rong; Guo, Sophie Huey-Ming; Chang, Hui-Yu; Chang, Her-Kun

    2012-08-01

    Diabetes is a life-long illness condition that many diabetic patients end up with related complications resulted largely from lacking of proper supports. The success of diabetes care relies mainly on patient's daily self-care activities and care providers' continuous support. However, the self-care activities are socially bounded with patient's everyday schedules that can easily be forgotten or neglected and the care support from providers has yet been fully implemented. This study develops a Web 2.0 diabetes care support system for patients to integrate required self-care activities with different context in order to enhance patient's care knowledge and behavior adherence. The system also supports care managers in a health service center to conduct patient management through collecting patient's daily physiological information, sharing care information, and maintaining patient-provider relationships. After the development, we evaluate the acceptance of the system through a group of nursing staffs. PMID:21369781

  10. 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.

  11. 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

  12. Systems modelling for improving health care

    OpenAIRE

    Pitt, Martin; Monks, Thomas; Allen, Michael

    2016-01-01

    The growing complexity of health care coupled with the ever-increasing pressures to ensure efficient and effective use of limited resources have encouraged policy makers to turn to system modelling solutions. Such techniques have been available for decades, but despite ample research which demonstrates potential, their application in health services to date is limited. This presentation surveys the breadth of approaches available to support delivery and design across many areas and levels of ...

  13. Visual navigation for the blind: path and obstacle detection

    OpenAIRE

    José, João; Rodrigues, J. M. F.; du Buf, J. M. H.

    2012-01-01

    We present a real-time vision system to assist blind and visually impaired persons. This system complements the white cane, and it can be used both indoor and outdoor. It detects borders of paths and corridors, obstacles within the borders, and it provides guidance for centering and obstacle avoidance. Typical obstacles are backpacks, trash cans, trees, light poles, holes, branches, stones and other objects at a distance of 2 to 5 meters from the camera position. Walkable paths ar...

  14. 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

  15. 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

  16. 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...

  17. [Justice in health care systems from an economic perspective].

    Science.gov (United States)

    Schreyögg, J

    2004-01-01

    Due to rising health care expenditures international comparisons of health care systems are recently gaining more importance. These benchmarks can provide interesting information for improving health care systems. Many of these comparisons implicitly assume that countries have a universal understanding of justice. But this assumption is rather questionable. With regard to the existing cultural differences in the understanding of justice the transferability of elements of health care systems is not always assured. A transfer usually requires a thorough examination of the judicial systems in each country. This article analyses the influence of different judicial systems applying to health care. In this context theories of justice by Rawls, Nozick and Confucius representing the possible understanding of justice in different cultures are described and analysed with regards to their influence on health care systems. The example of financing health care shows that the three theories of justice have very different consequences for designing health care systems especially concerning the role of governments. PMID:14767785

  18. 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. PMID:26248847

  19. 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.

  20. [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

  1. [Differences and similarities of Primary Care in the German and Spanish Health Care Systems].

    Science.gov (United States)

    Salvador Comino, María Rosa; Krane, Sibylla; Schelling, Jörg; Regife García, Víctor

    2016-02-01

    An efficient primary care is of particular importance for any countries' health care system. Many differences exist on how distinctive countries try to obtain the goal of an efficient, cost-effective primary care for its population. In this article we conducted a selective literature review, which includes both scientific and socio-political publications. The findings are complemented with the experience of a Spanish physician from Seville in her last year of training in family medicine, who completed a four months long rotation in the German health care system. We highlighted different features by comparing both countries, including their health care expenditure, the relation between primary and secondary care, the organization in the academic field and the training of future primary care physicians. It is clear that primary care in both countries plays a central role, have to deal with shortcomings, and in some points one system can learn from the other. PMID:26363955

  2. Antimicrobial stewardship programs in health care systems.

    Science.gov (United States)

    MacDougall, Conan; Polk, Ron E

    2005-10-01

    Antimicrobial stewardship programs in hospitals seek to optimize antimicrobial prescribing in order to improve individual patient care as well as reduce hospital costs and slow the spread of antimicrobial resistance. With antimicrobial resistance on the rise worldwide and few new agents in development, antimicrobial stewardship programs are more important than ever in ensuring the continued efficacy of available antimicrobials. The design of antimicrobial management programs should be based on the best current understanding of the relationship between antimicrobial use and resistance. Such programs should be administered by multidisciplinary teams composed of infectious diseases physicians, clinical pharmacists, clinical microbiologists, and infection control practitioners and should be actively supported by hospital administrators. Strategies for changing antimicrobial prescribing behavior include education of prescribers regarding proper antimicrobial usage, creation of an antimicrobial formulary with restricted prescribing of targeted agents, and review of antimicrobial prescribing with feedback to prescribers. Clinical computer systems can aid in the implementation of each of these strategies, especially as expert systems able to provide patient-specific data and suggestions at the point of care. Antibiotic rotation strategies control the prescribing process by scheduled changes of antimicrobial classes used for empirical therapy. When instituting an antimicrobial stewardship program, a hospital should tailor its choice of strategies to its needs and available resources. PMID:16223951

  3. 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.

  4. 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.

  5. 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…

  6. 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

  7. Health Care System Responses to Children Exposed to Domestic Violence.

    Science.gov (United States)

    Culross, Patti L.

    1999-01-01

    Summarizes health care approaches to identifying and treating child and adult victims of domestic violence. Describes innovative programs that tie children's well-being to that of their mothers and proposes strategies for improving current health care system responses. (SLD)

  8. A variational approach to bifurcation points of a reaction-diffusion system with obstacles and neumann boundary conditions

    Czech Academy of Sciences Publication Activity Database

    Eisner, Jan; Kučera, Milan; Väth, Martin

    2016-01-01

    Roč. 61, č. 1 (2016), s. 1-25. ISSN 0862-7940 R&D Projects: GA ČR GA13-12580S Institutional support: RVO:67985904 ; RVO:67985840 Keywords : reaction-diffusion system * unlateral condition * variational inequality Subject RIV: EG - Zoology; BA - General Mathematics (MU-W) Impact factor: 0.400, year: 2014

  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. 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...

  11. An enhanced MMW and SMMW/THz imaging system performance prediction and analysis tool for concealed weapon detection and pilotage obstacle avoidance

    Science.gov (United States)

    Murrill, Steven R.; Jacobs, Eddie L.; Franck, Charmaine C.; Petkie, Douglas T.; De Lucia, Frank C.

    2015-10-01

    The U.S. Army Research Laboratory (ARL) has continued to develop and enhance a millimeter-wave (MMW) and submillimeter- wave (SMMW)/terahertz (THz)-band imaging system performance prediction and analysis tool for both the detection and identification of concealed weaponry, and for pilotage obstacle avoidance. The details of the MATLAB-based model which accounts for the effects of all critical sensor and display components, for the effects of atmospheric attenuation, concealment material attenuation, and active illumination, were reported on at the 2005 SPIE Europe Security and Defence Symposium (Brugge). An advanced version of the base model that accounts for both the dramatic impact that target and background orientation can have on target observability as related to specular and Lambertian reflections captured by an active-illumination-based imaging system, and for the impact of target and background thermal emission, was reported on at the 2007 SPIE Defense and Security Symposium (Orlando). Further development of this tool that includes a MODTRAN-based atmospheric attenuation calculator and advanced system architecture configuration inputs that allow for straightforward performance analysis of active or passive systems based on scanning (single- or line-array detector element(s)) or staring (focal-plane-array detector elements) imaging architectures was reported on at the 2011 SPIE Europe Security and Defence Symposium (Prague). This paper provides a comprehensive review of a newly enhanced MMW and SMMW/THz imaging system analysis and design tool that now includes an improved noise sub-model for more accurate and reliable performance predictions, the capability to account for postcapture image contrast enhancement, and the capability to account for concealment material backscatter with active-illumination- based systems. Present plans for additional expansion of the model's predictive capabilities are also outlined.

  12. 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.

  13. [Costs of maternal-infant care in an institutionalized health care system].

    Science.gov (United States)

    Villarreal Ríos, E; Salinas Martínez, A M; Guzmán Padilla, J E; Garza Elizondo, M E; Tovar Castillo, N H; García Cornejo, M L

    1998-01-01

    Partial and total maternal and child health care costs were estimated. The study was developed in a Primary Care Health Clinic (PCHC) and a General Hospital (GH) of a social security health care system. Maternal and child health care services, type of activity and frequency utilization during 1995, were defined; cost examination was done separately for the PCHC and the GH. Estimation of fixed cost included departmentalization, determination of inputs, costs, basic services disbursements, and weighing. These data were related to depreciation, labor period and productivity. Estimation of variable costs required the participation of field experts; costs corresponded to those registered in billing records. The fixed cost plus the variable cost determined the unit cost, which multiplied by the of frequency of utilization generated the prenatal care, labor and delivery care, and postnatal care cost. The sum of these three equaled the maternal and child health care cost. The prenatal care cost was $1,205.33, the labor and delivery care cost was $3,313.98, and the postnatal care was $559.91. The total cost of the maternal and child health care corresponded to $5,079.22. Cost information is valuable for the health care personnel for health care planning activities. PMID:9528219

  14. Health disparities and health care financing: restructuring the American health care system.

    Science.gov (United States)

    Diggs, Schnequa N

    2012-01-01

    For more than seven decades there has been a systematic disregard for the health needs of certain groups of individuals. Discrepancies in treatment and privilege based on race/ethnicity, gender, sexual orientation, class, and socio-economic status have been significant players in any portrait of American health care and have helped frame considerations of those who deserve and those undeserving of quality health care. Continuous incidences of inequitable health care practices strongly suggest a need for drastic changes in our current health care system. Although growing interest in social inequalities in health preside, health policy makers struggle to find appropriate intervention strategies to alleviate health disparities. The purpose of this article is to depict a clearer portrait of the American health care system within the context of health disparities and recognize intervention strategies to reduce/eliminate health care disparities. This article concludes with suggestions on how to refinance the American health care system based on equality principles. PMID:22894023

  15. 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

  16. 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.

  17. "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.

  18. CHINs in the context of an evolving health care system.

    OpenAIRE

    Duncan, K. A.

    1996-01-01

    Community Health Information Network (CHIN) developments have slowed, due to the chaotic change in the health care system and stakeholders' attendant short-sighted focus. CHINs are a long-term investment that is necessary for the health care system's evolution to maturity. Several arenas of essential CHIN activity are given that would be characteristic of a mature, goal-directed health care system Lack of enterprise-wide computer-based patient record systems is a major barrier. Even in the sh...

  19. Obstacle dropping detection device for nuclear power plant

    International Nuclear Information System (INIS)

    The present invention provides a device for monitoring dropping of obstacles to a reactor well, cavity or spent fuel pool during periodical inspection to detect/display the position when obstacles are dropped. Namely, an optical detection means has a light emitting portion and a light receiving portion, and detects dropping of obstacles by the interruption of the light when obstacles pass through between them. The optical detection means are disposed each by one system to at least two intersecting directions while having an opening face of the pool defined as a retrieving area. An acoustic monitoring means has at least a set of three microphones and detect a time difference of the sounds of the obstacles arriving on water which is detected by each of the microphones to detect the position of the obstacles arriving on the water. The acoustic monitoring means is disposed while having the water surface of the pool as an area for retrieving. The obstacle dropping detection device always monitor the dropping of obstacles, and can determine the position when they are dropped. Accordingly, information can be provided, which is quite effective for the recovery of obstacles which is performed separately. (I.S.)

  20. 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

  1. 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...

  2. 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.

  3. Clogging and Jamming Transitions in Granular Matter Flowing Through Obstacles

    Science.gov (United States)

    Reichhardt, Cynthia Olson; Reichhardt, Charles

    2015-03-01

    We consider a two-dimensional system of bidisperse disks driven through a landscape of fixed obstacles. In the limit of a single obstacle, the disks cease moving when the disk density is increased to the jamming density. The threshold density value decreases as the number of obstacles increases, but we also observe a change in the nature of the frozen state. At low obstacle density we find a homogeneous jammed state, but for higher obstacle density we instead find a heterogeneous clogged state containing void areas and possessing a memory of the driving direction. The transition to the clogged state is strongly stochastic and we observe large fluctuations in clogging time both for clogging in the original driving direction and for transverse clogging when the drive is suddenly rotated by 90 degrees. We find evidence for a diverging clogging transition time at a critical disk density well below the jamming density in a clean system.

  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. PMID:10539421

  5. Fostering the coexistence of caring philosophy and economics in today's health care system.

    Science.gov (United States)

    Cara, Chantal M; Nyberg, Jan J; Brousseau, Sylvain

    2011-01-01

    For the past decade, several health care systems are undergoing continuous administrative restructuring, whose main objective is cost reduction. These changes often result in the patients' needs not being met because nurses are continuously affected by widespread budget cuts and staff downsizing. Have we reached a point, where we are setting aside our prime directive of patient well-being for the sake of finances? If so, are we at risk of forsaking our professional identity as nurses? The authors believe that caring management and economical constraints can coexist while promoting quality patient care. The purpose of this article is to show how nurse managers and administrators can facilitate caring practices while maintaining their financial responsibilities within the health care organization. This article suggests several strategies for assisting nurse managers in promoting caring in the health care environment. PMID:21157259

  6. 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...

  7. Primary care training and the evolving healthcare system.

    Science.gov (United States)

    Peccoralo, Lauren A; Callahan, Kathryn; Stark, Rachel; DeCherrie, Linda V

    2012-01-01

    With growing numbers of patient-centered medical homes and accountable care organizations, and the potential implementation of the Patient Protection and Affordable Care Act, the provision of primary care in the United States is expanding and changing. Therefore, there is an urgent need to create more primary-care physicians and to train physicians to practice in this environment. In this article, we review the impact that the changing US healthcare system has on trainees, strategies to recruit and retain medical students and residents into primary-care internal medicine, and the preparation of trainees to work in the changing healthcare system. Recruitment methods for medical students include early preclinical exposure to patients in the primary-care setting, enhanced longitudinal patient experiences in clinical clerkships, and primary-care tracks. Recruitment methods for residents include enhanced ambulatory-care training and primary-care programs. Financial-incentive programs such as loan forgiveness may encourage trainees to enter primary care. Retaining residents in primary-care careers may be encouraged via focused postgraduate fellowships or continuing medical education to prepare primary-care physicians as both teachers and practitioners in the changing environment. Finally, to prepare primary-care trainees to effectively and efficiently practice within the changing system, educators should consider shifting ambulatory training to community-based practices, encouraging resident participation in team-based care, providing interprofessional educational experiences, and involving trainees in quality-improvement initiatives. Medical educators in primary care must think innovatively and collaboratively to effectively recruit and train the future generation of primary-care physicians. PMID:22786734

  8. [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

  9. Directional Preconditioner for High Frequency Obstacle Scattering

    OpenAIRE

    Ying, Lexing

    2014-01-01

    The boundary integral method is an efficient approach for solving time-harmonic obstacle scattering problems by a bounded scatterer. This paper presents the directional preconditioner for the iterative solution of linear systems of the boundary integral method. This new preconditioner builds a data-sparse approximation of the integral operator, transforms it into a sparse linear system, and computes an approximate inverse with efficient sparse and hierarchical linear algebra algorithms. This ...

  10. 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...

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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...

  16. 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.

  17. 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.

  18. Setting goals and targets for performance standards within the Swedish health care system.

    Science.gov (United States)

    Axelsson, L; Svensson, P G

    1994-01-01

    The development of any health care system towards setting goals and targets and intended outcomes--with national guidelines, a legislative framework, limited resources, consumer influence and competitive forces--makes great demands on the control mechanisms required. The Swedish health care system has no tradition of goal formulation of this type. Hence, the purpose of this article is to clarify the goal-setting process of performance standards, and to examine whether goal setting is a relevant method within the organization of a Swedish county council. Goal setting can be seen partly as a control method and partly as an administrative process. The approach used is a combination of qualitative and quantitative methods. Data have been collected from interviews, observations, notes taken in the field and available performance statistics. The analysis shows that working towards a goal is made easier through a common and simple concept. It 'stands and falls' with the management of the work and its manager. Good communications and information are important prerequisites if goal formulation, through dialogue, is to succeed. This process takes time and can be described as an iterative process, in which a common behaviour pattern develops a 'we-feeling' which spreads among the staff. It is important that the goal is relevant and directly related to the basic objects of the work. It is also crucial that the goal is realistic and reflects a priority. Goal formulation relating to performance standards can be a contributing factor to staff's experience of job satisfaction through increased engagement and motivation, and to the satisfaction of patients/relatives with the care given. It is difficult to formulate performance standards; there are many problems and obstacles. If goal formulation as a control method within the health care system in Sweden is to work, clearer manifestations of political will are necessary and also better measuring methods in order to guage

  19. 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…

  20. 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.

  1. 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

  2. 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.

  3. Nonholonomic feedback control among moving obstacles

    Science.gov (United States)

    Armstrong, Stephen Gregory

    A feedback controller is developed for navigating a nonholonomic vehicle in an area with multiple stationary and possibly moving obstacles. Among other applications the developed algorithms can be used for automatic parking of a passenger car in a parking lot with complex configuration or a ground robot in cluttered environment. Several approaches are explored which combine nonholonomic systems control based on sliding modes and potential field methods.

  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. Large-System Transformation in Health Care: A Realist Review

    OpenAIRE

    Best, Allan; Greenhalgh, Trisha; Lewis, Stephen; Saul, Jessie E.; Carroll, Simon; Bitz, Jennifer

    2012-01-01

    Context: An evidence base that addresses issues of complexity and context is urgently needed for large-system transformation (LST) and health care reform. Fundamental conceptual and methodological challenges also must be addressed. The Saskatchewan Ministry of Health in Canada requested a six-month synthesis project to guide four major policy development and strategy initiatives focused on patient- and family-centered care, primary health care renewal, quality improvement, and surgical wait l...

  6. 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...

  7. 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...

  8. Effects of Quality Improvement System for Child Care Centers

    Science.gov (United States)

    Ma, Xin; Shen, Jianping; Kavanaugh, Amy; Lu, Xuejin; Brandi, Karen; Goodman, Jeff; Till, Lance; Watson, Grace

    2011-01-01

    Using multiple years of data collected from about 100 child care centers in Palm Beach County, Florida, the authors studied whether the Quality Improvement System (QIS) made a significant impact on quality of child care centers. Based on a pre- and postresearch design spanning a period of 13 months, QIS appeared to be effective in improving…

  9. Physician leadership: a health-care system's investment in the future of quality care.

    Science.gov (United States)

    Orlando, Rocco; Haytaian, Marcia

    2012-08-01

    The current state of health care and its reform will require physician leaders to take on greater management responsibilities, which will require a set of organizational and leadership competencies that traditional medical education does not provide. Physician leaders can form a bridge between the clinical and administrative sides of a health-care organization, serving to further the organization's strategy for growth and success. Recognizing that the health-care industry is rapidly changing and physician leaders will play a key role in that transformation, Hartford HealthCare has established a Physician Leadership Development Institute that provides advanced leadership skills and management education to select physicians practicing within the health-care system. PMID:23248866

  10. 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…

  11. Antimicrobial Stewardship Programs in Health Care Systems

    OpenAIRE

    MacDougall, Conan; Polk, Ron E.

    2005-01-01

    Antimicrobial stewardship programs in hospitals seek to optimize antimicrobial prescribing in order to improve individual patient care as well as reduce hospital costs and slow the spread of antimicrobial resistance. With antimicrobial resistance on the rise worldwide and few new agents in development, antimicrobial stewardship programs are more important than ever in ensuring the continued efficacy of available antimicrobials. The design of antimicrobial management programs should be based o...

  12. 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

  13. 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

  14. The POIS (Parkland On-Line Information System) Implementation of the IBM Health Care Support/Patient Care System

    OpenAIRE

    Mishelevich, David J.; Hudson, Betty G.; Van Slyke, Donald; Mize, Elaine I.; Robinson, Anna L.; Brieden, Helen C.; Atkinson, Jack; Robertson, James

    1980-01-01

    The installation of major components of a comprehensive Hospital Information System (HIS) called POIS, the Parkland On-line Information System, including identified success factors is described for the Dallas County Hospital District (DCHD) known also as the Parkland Memorial Hospital. Installation of the on-line IBM Health Care Support (HCS) Registration and Admissions Packages occurred in 1976 and implementation of the HCS Patient Care System (PCS) began in 1977 which includes on-line suppo...

  15. Would you care for some integrated care in your fragmented health system? A participatory action research to improve integration between levels of care in a Belgian urban setting.

    OpenAIRE

    Belche, Jean; Duchesnes, Christiane; Darras, Christian; Van der Vennet, Jean; Monet, Francis; Unger, Jean-Pierre; Giet, Didier

    2016-01-01

    Integration between levels of care is not facilitated by the Belgian health system. Indeed, patients have uninhibited access to every level of care, there is no gatekeeping system, and no structural coordination between levels of care. Meanwhile, on one hand, the occurrence of more complex care situations in the ambulatory setting is enhancing the need for coordination while on the other hand, hospitals face financial constraints to provide care in the community. The aim of the research ...

  16. 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.

  17. Diabetes care for emerging adults: transition from pediatric to adult diabetes care systems

    OpenAIRE

    Lee, Young Ah

    2013-01-01

    With the increasing prevalence of diabetes mellitus in children, transitioning patients from childhood to adulthood are increasing. High-risk behaviors and poor glycemic control during the transition period increase the risk for hypoglycemia and hyperglycemia as well as chronic microvascular and macrovascular complications. Discussions regarding complications and preparations for transition must take place before the actual transition to adult care systems. Pediatric care providers should foc...

  18. 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.

  19. 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...

  20. Using Electronic Health Record Systems in Diabetes Care: Emerging Practices.

    Science.gov (United States)

    Veinot, Tiffany C; Zheng, Kai; Lowery, Julie C; Souden, Maria; Keith, Rosalind

    2010-01-01

    While there has been considerable attention devoted to the deployment of electronic health record (EHR) systems, there has been far less attention given to their appropriation for use in clinical encounters - particularly in the context of complex, chronic illness. The Department of Veterans' Affairs (VA) has been at the forefront of EHR adoption and, as such, provides a unique opportunity to examine a mature EHR system in widespread use. Moreover, with a high prevalence of diabetes in its patient population, the VA provides a useful platform for examining EHR use in the context of chronic disease care. We conducted a sequential, exploratory qualitative study at two VA Medical Centers in the Midwest. First, we conducted observations of 64 clinical consultations with diabetes patients. These observations involved 31 different health care providers. Second, using insights from these observations, we conducted in-depth, semi-structured interviews with 39 health care providers focusing on their use of information in diabetes patient care. Field notes and interview transcripts were analyzed using a grounded theory approach. Our analysis generated several categories of EHR use in clinical encounters: priming, structuring, assessing, informing, and continuing. We also outline some mismatches between EHR system design and VA diabetes care practices. We conclude by discussing implications of these emergent system uses for improving the software design of EHRs to better support chronic disease care, as well as for our understanding of the integration of technologies in health care. PMID:25264545

  1. 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…

  2. Obstacle detection using thermal imaging sensors for large passenger airplane

    OpenAIRE

    Shi, Jie

    2012-01-01

    This thesis addresses the issue of ground collision in poor weather conditions. As bad weather is an adverse factor when airplanes are taxiing, an obstacle detection system based on thermal vision is proposed to enhance the awareness of pilots during taxiing in poor weather conditions. Two infrared cameras are employed to detect the objects and estimate the distance of the obstacle. The distance is computed by stereo vision technology. A warning will be given if the distance is less than the ...

  3. Obstacles to Rural Residents' Consumption in China and the Countermeasures

    OpenAIRE

    Huang, Yi

    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...

  4. 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

  5. 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.

  6. Passive detection of subpixel obstacles for flight safety

    Science.gov (United States)

    Nixon, Matthew D.; Loveland, Rohan C.

    2001-12-01

    Military aircraft fly below 100 ft. above ground level in support of their missions. These aircraft include fixed and rotary wing and may be manned or unmanned. Flying at these low altitudes presents a safety hazard to the aircrew and aircraft, due to the occurrences of obstacles within the aircraft's flight path. The pilot must rely on eyesight and in some cases, infrared sensors to see obstacles. Many conditions can exacerbate visibility creating a situation in which obstacles are essentially invisible, creating a safety hazard, even to an alerted aircrew. Numerous catastrophic accidents have occurred in which aircraft have collided with undetected obstacles. Accidents of this type continue to be a problem for low flying military and commercial aircraft. Unmanned Aerial Vehicles (UAVs) have the same problem, whether operating autonomously or under control of a ground operator. Boeing-SVS has designed a passive, small, low- cost (under $100k) gimbaled, infrared imaging based system with advanced obstacle detection algorithms. Obstacles are detected in the infrared band, and linear features are analyzed by innovative cellular automata based software. These algorithms perform detection and location of sub-pixel linear features. The detection of the obstacles is performed on a frame by frame basis, in real time. Processed images are presented to the aircrew on their display as color enhanced features. The system has been designed such that the detected obstacles are displayed to the aircrew in sufficient time to react and maneuver the aircraft to safety. A patent for this system is on file with the US patent office, and all material herein should be treated accordingly.

  7. 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...

  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. 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.  

  10. A robot arm controller with obstacle avoidance using fuzzy logic

    International Nuclear Information System (INIS)

    This study is devoted to the development of a lower level robot arm control system, which allows obstacles to be avoided using a relatively rough path and without precise map information. To achieve autonomous arm movements, the overall arm motion is divided into an obstacle avoidance component and a target point adjustment component, and movement is selected with regard to the distance between the arm and the obstacle by a higher control unit. A fuzzy rule is used for mode selection in order to maintain continuous change of control mode. The control method applied to two degrees of freedom in two dimensional space was examined by numerical simulations. The simulations verified the autonomous obstacle avoidance capability and the ability to continuously control joint angles using fuzzy logic. (author)

  11. Structuring Community Care using Multi-Agent Systems

    Science.gov (United States)

    Beer, Martin D.

    Community care is a complex operation that requires the interaction of large numbers of dedicated individuals, managed by an equally wide range of organisations. They are also by their nature highly mobile and flexible, moving between clients in whatever order person receiving care is that they receive what they expect regularly, reliably and when they expect to receive it. Current systems are heavily provider focused on providing the scheduled care with as high apparent cost effectiveness as possible. Unfortunately, the lack of focus on the client often leads to inflexibility with expensive services being provided when they are not needed, large scale duplication of effort or inadequate flexibility to change the care regime to meet changing circumstances. Add to this the problems associated with the lack of integration of emergency and routing care and the extensive support given by friends and family and many opportunities exist to improve both the levels of support and the efficiency of care. The move towards Individual Care Plans requires much closer monitoring to ensure that the care specified for each individual is actually delivered and when linked with smart home technology in conjunction with appropriate sensors allows a much richer range of services to be offered which can be customised to meet the needs of each individual, giving them the assurance to continue to live independently.

  12. Managed care in four managed competition OECD health systems.

    Science.gov (United States)

    Shmueli, Amir; Stam, Piet; Wasem, Jürgen; Trottmann, Maria

    2015-07-01

    Managed care emerged in the American health system in the 1980s as a way to manage suppliers' induced demand and to contain insurers' costs. While in Israel the health insurers have always been managed care organizations, owning health care facilities, employing medical personnel or contracting selectively with independent providers, European insurers have been much more passive, submitting themselves to collective agreements between insurers' and providers' associations, accompanied by extensive government regulation of prices, quantities, and budgets. With the 1990s reforms, and the introduction of risk-adjusted "managed competition", a growing pressure to allow the European insurers to manage their own care - including selective contracting with providers - has emerged, with varying speed of the introduction of policy changes across the individual countries. This paper compares experiences with managed care in Israel, The Netherlands, Germany and Switzerland since the 1990s. After a brief description of the health insurance markets in the four countries, we focus comparatively on the emergence of managed care in the markets for ambulatory care and inpatient market care. We conclude with an evaluation of the current situation and a discussion of selected health policy issues. PMID:25776034

  13. 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.

  14. 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.

  15. 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

  16. The equity lens in the health care performance evaluation system.

    Science.gov (United States)

    Barsanti, Sara; Nuti, Sabina

    2014-01-01

    The main objective of this paper is to describe how indicators of the equity of access to health care according to socioeconomic conditions may be included in a performance evaluation system (PES) in the regional context level and in the planning and strategic control system of healthcare organisations. In particular, the paper investigates how the PES adopted, in the experience of the Tuscany region in Italy, indicators of vertical equity over time. Studies that testify inequality of access to health services often remain just a research output and are not used as targets and measurements in planning and control systems. After a brief introduction to the concept of horizontal and vertical equity in health care systems and equity measures in PES, the paper describes the 'equity process' by which selected health indicators declined by socioeconomic conditions were shared and used in the evaluation of health care institutions and in the CEOs' rewarding system, and subsequently analyses the initial results. Results on the maternal and child path and the chronicity care path not only show improvements in addressing health care inequalities, but also verify whether the health system responds appropriately to different population groups. PMID:23722829

  17. The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

    Directory of Open Access Journals (Sweden)

    Menizibeya Osain Welcome

    2011-01-01

    Full Text Available Objectives : As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods : Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results : Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion : The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine

  18. Organisational Culture Matters for System Integration in Health Care

    OpenAIRE

    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 ...

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

    OpenAIRE

    Joanna Kobza; Magdalena Syrkiewicz-Świtała

    2014-01-01

    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 be...

  20. [The Chilean Health Care System: the task ahead].

    Science.gov (United States)

    Goic, Alejandro

    2015-06-01

    The most important event in Chilean public health in the XXth Century was the creation of the National Health Service (NHS), in 1952. Systematic public policies for the promotion of health, disease prevention, medical care, and rehabilitation were implemented, while a number of more specific programs were introduced, such as those on infant malnutrition, complementary infant feeding, medical control of pregnant women and healthy infants, infant and adult vaccination, and essential sanitation services. In 1981, a parallel private health care system was introduced in the form of medical care financial institutions, which today cover 15% of the population, as contrasted with the public system, which covers about 80%. From 1952 to 2014, public health care policies made possible a remarkable improvement in Chile's health indexes: downward trends in infant mortality rate (from 117.8 to 7.2 x 1,000 live births), maternal mortality (from 276 to 18.5 x 100,000), undernourished children schooling, and years of primary school education, were significantly improved as well. Nevertheless, compared with OECD countries, Chile has a relatively low public investment in health (45.7% of total national investment), a deficit in the number of physicians (1.7 x 1,000 inhabitants) and nurses (4.8 x 1,000), in the number of hospital beds (2.1 x 1,000), and in the availability of generic drugs in the market (30%). Chile and the USA are the two OECD countries with the lowest public investment in health. A generalized dissatisfaction with the current Chilean health care model and the need of the vast majority of the population for timely access to acceptable quality medical care are powerful arguments which point to the need for a universal public health care system. The significant increase in public expenditure on health care which such a system would demand requires a sustainable growth of the Chilean economy. PMID:26230561

  1. 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

  2. Reviewing Security and Privacy Aspects in Combined Mobile Information System (CMIS) for health care systems

    OpenAIRE

    Kunwar, Ramesh; Al-Leddawi, Mustafa

    2007-01-01

    Medical area has been benefited by the use of ICT (Information and Communication Technology) in recent days. CMIS (Combined Mobile Information System), our proposed model system, is such a system targeted for health care system. IMIS (Integrated Mobile Information System), a system for diabetic healthcare, which is being developed in Blekinge Institute of Technology will be taken as a case study for our proposed system. CMIS is a multi-role system with core service being medical-care related ...

  3. Care and Conversing in Dialogical Systems

    DEFF Research Database (Denmark)

    Steffensen, Sune Vork

    2012-01-01

    positions, a theory of dialogical systems is developed, on the basis of current thinking within the enactive program (e.g. De Jaegher and Di Paolo, 2007), the distributed language movement (e.g. Cowley, 2011b), and values-realizing theory (e.g. Hodges, 2009). Dialogical systems are systems of co...... in a tradition that is ecological, embodied and distributed. Its specific take on human interaction pursues these perspectives by claiming that language can neither be reduced to social rules in the micro-sociological domain, nor to biological properties of the individual being. As an alternative to these two...

  4. Fresnel diffraction by spherical obstacles

    Science.gov (United States)

    Hovenac, Edward A.

    1989-01-01

    Lommel functions were used to solve the Fresnel-Kirchhoff diffraction integral for the case of a spherical obstacle. Comparisons were made between Fresnel diffraction theory and Mie scattering theory. Fresnel theory is then compared to experimental data. Experiment and theory typically deviated from one another by less than 10 percent. A unique experimental setup using mercury spheres suspended in a viscous fluid significantly reduced optical noise. The major source of error was due to the Gaussian-shaped laser beam.

  5. The Durham Family Initiative: A Preventive System of Care

    Science.gov (United States)

    Dodge, Kenneth A.; Berlin, Lisa J.; Epstein, Matthew; Spitz-Roth, Adele; O'Donnell, Karen; Kaufman, Martha; Amaya-Jackson, Lisa; Rosch, Joel; Christopoulos, Christina

    2004-01-01

    This article describes the Durham Family Initiative (DFI), an innovative effort to bring together child welfare and juvenile justice systems to reach DFI's goal of reducing the child abuse rate in Durham, North Carolina, by 50% within the next 10 years. DFI will follow principles of a preventive system of care (PSoC), which focuses on nurturing…

  6. 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...

  7. The Role of Education in Systems of Care.

    Science.gov (United States)

    Liberton, Cindy J., Ed.; And Others

    Eight papers presented at a March 1993 conference address the role of education in systems of care for children's mental health. Papers have the following titles and authors: (1) "Interagency Collaboration through a School-Based Wraparound Approach: A Systems Analysis Summary of Project WRAP" (Lucille Eber and Carol Stieper); (2) "Baseline…

  8. 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.

  9. Motivation Driven Multiagent Systems Coordination in Health Care

    OpenAIRE

    Zhang, Peng; Bai, Guohua

    2005-01-01

    This paper explores MultiAgent Systems coordination from a socio-psychological point of view. Activity Theory is introduced to explain the coordination among intelligent agents. The hierarchy and motivation thinking from Activity Theory is used to define the motivation driven MultiAgent Systems coordination mechanism. Finally, we apply this mechanism into a health care scenario.

  10. 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.

  11. Difficulties reporting system in intensive care

    Directory of Open Access Journals (Sweden)

    Claudio Bianchin

    2008-02-01

    Full Text Available In 2005, Belluno Health Authority’s Resuscitation Unit took part in a regional project coordinated by Veneto Regional Health and Social Services to test an incident re p o rting system. The main aims were to experiment an electronic incident rep o rting sheet and the relative computerised procedure for data e n t ry and analysis with the aim of developing an incident rep o rting system. The Australian Incident Monitoring System (AIMS was designed to obtain information about the event, the context and concomitant causes. We observed 58 anonymous incident reports over a six-month period. The main incidents include issues relating to the management of medication, the a i rways, catheters and equipment. Most incidents had modest consequences or led to temporary disability and they often caused longer hospitalisation or further treatment and investigations. Communication problems, inadequate superv i s i o n , poor teamwork and difficulties in applying procedures and protocols were the contributory factors most frequently identified as the concomitant causes of the incidents. The report sheet and experience as a whole were evaluated favourably by the operators involved. This reporting system does not provide the real frequency of the adverse events, but it does provide useful information for improving patient safety.

  12. Effectively marketing prepaid medical care with decision support systems.

    Science.gov (United States)

    Forgionne, G A

    1991-01-01

    The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches. PMID:10111964

  13. 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.)

  14. 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

  15. Unfinished nursing care: An important performance measure for nursing care systems.

    Science.gov (United States)

    VanFosson, Christopher A; Jones, Terry L; Yoder, Linda H

    2016-01-01

    Performance measurement is a core administrative function and an essential component of organizational quality programs. The prevalence of performance measurement initiatives increased significantly after the release of the Institute of Medicine series on quality. Nursing performance measures are limited in their scope, resulting in an underrepresentation of process measures. Development of performance indicators that reflect how effectively organizational units actually transform nursing resources into nursing services should be a high priority. Unfinished nursing care is a nursing process performance measure that reflects the complexity of the nursing care environment and can be useful in comparing process performance across systems and organizations. Unfinished nursing care is congruent with many of the National Quality Forum requirements for endorsement and warrants further refinement as an important nurse-sensitive performance measure. PMID:26850334

  16. Infection control and changing health-care delivery systems.

    OpenAIRE

    Jarvis, W. R.

    2001-01-01

    In the past, health care was delivered mainly in acute-care facilities. Today, health care is delivered in hospital, outpatient, transitional care, long-term care, rehabilitative care, home, and private office settings. Measures to reduce health-care costs include decreasing the number of hospitals and the length of patient stays, increasing outpatient and home care, and increasing long-term care for the elderly. The home-care industry and managed care have become major providers of health ca...

  17. Managing health care system in small island countries: Palau.

    Science.gov (United States)

    Kuartei, Stevenson

    2006-09-01

    Managing health systems in small island countries carry with it challenges that are common with other small communities around the world but also articulates for unique challenges that are intrinsically that of small island countries. Sustainability of economies and the small population in small island countries in the Pacific dictates how health care services align and organize to meet the needs of their population. This paper is an attempt to outline possible strategies that could be implemented in view of the ever decreasing meager resources. It will outline a step approach toward realignment and reengineering a viable health care system that is hopefully both cost effective and outcome oriented. PMID:18181405

  18. 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.

  19. What is Clinical Safety in Electronic Health Care Record Systems?

    Science.gov (United States)

    Davies, George

    There is mounting public awareness of an increasing number of adverse clinical incidents within the National Health Service (NHS), but at the same time, large health care projects like the National Programme for IT (NPFIT) are claiming that safer care is one of the benefits of the project and that health software systems in particular have the potential to reduce the likelihood of accidental or unintentional harm to patients. This paper outlines the approach to clinical safety management taken by CSC, a major supplier to NPFIT; discusses acceptable levels of risk and clinical safety as an end-to-end concept; and touches on the future for clinical safety in health systems software.

  20. Digital remote viewing system for coronary care unit

    International Nuclear Information System (INIS)

    A digital remote viewing system developed for the coronary care unit at the UCLA Medical Center has been in clinical operation since March 1, 1987. The present system consists of three 512-line monitors, VAX 11/750, Gould IP8500 image processor and a broad-band communication system. The patients' images are acquired with a computed radiography system and are transmitted to the coronary care unit, which is five floors above the radiology department. This exhibit presents the architecture and the performance characteristics of the system. Also, the second-generation system, which consists of an intelligent local work station with three 1,024-line monitors and a fast digital communication network, will be introduced

  1. Reconfigurable point-of-care systems designed with interoperability standards.

    Science.gov (United States)

    Warren, Steve; Yao, Jianchu; Schmitz, Ryan; Lebak, Jeff

    2004-01-01

    Interoperability standards, if properly applied to medical system design, have the potential to decrease the cost of point-of-care monitoring systems while better matching systems to patient needs. This paper presents a brief editorial overview of future monitoring environments, followed by a short listing of smart-home and wearable-device efforts. This is followed by a summary of recent efforts in the Medical Component Design Laboratory at Kansas State University to address interoperability issues in point-of-care systems by incorporating the Bluetooth Host Controller Interface, the IEEE 1073 Medical Information Bus, and Health Level 7 (HL7) into a monitoring system that hosts wearable or nearby wireless devices. This wireless demonstration system includes a wearable electrocardiogram, wearable pulse oximeter, wearable data logger, weight scale, and LabVIEW base station. Data are exchanged between local and remote MySQL databases using the HL7 standard for medical information exchange. PMID:17270979

  2. 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

  3. New uses of legacy systems: examples in perinatal care.

    OpenAIRE

    Margolis, A; Vázquez, R.; Mendoza, G.; Zignago, A.; López, A.; Lucián, H.

    1999-01-01

    In this article, new uses of the Perinatal Information System at the Uruguayan Social Security health care facilities are described. The perinatal information system has been in place for over 13 years, with about 40 thousand clinical records on electronic files. A newly created Web interface allows a distributed access to existing perinatal information within the National Social Security Wide Area a Network. Perinatal data is also exported to a management information system, allowing to dyna...

  4. 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

  5. Health Care Performance Indicators for Health Information Systems.

    Science.gov (United States)

    Hyppönen, Hannele; Ronchi, Elettra; Adler-Milstein, Julia

    2016-01-01

    Health Information Systems (HISs) are expected to have a positive impact on quality and efficiency of health care. Rapid investment in and diffusion of HISs has increased the importance of monitoring the adoption and impacts of them in order to learn from the initiatives, and to provide decision makers evidence on the role of HISs in improving health care. However, reliable and comparable data across initiatives in various countries are rarely available. A four-phase approach is used to compare different HIS indicator methodologies in order to move ahead in defining HIS indicators for monitoring effects of HIS on health care performance. Assessed approaches are strong on different aspects, which provide some opportunities for learning across them but also some challenges. As yet, all of the approaches do not define goals for monitoring formally. Most focus on health care structural and process indicators (HIS availability and intensity of use). However, many approaches are generic in description of HIS functionalities and context as well as their impact mechanisms on health care for HIS benchmarking. The conclusion is that, though structural and process indicators of HIS interventions are prerequisites for monitoring HIS impacts on health care outputs and outcomes, more explicit definition is needed of HIS contexts, goals, functionalities and their impact mechanisms in order to move towards common process and outcome indicators. A bottom-up-approach (participation of users) could improve development and use of context-sensitive HIS indicators. PMID:27198102

  6. Nuclear power: obstacles and solutions

    International Nuclear Information System (INIS)

    Nuclear power has a history extending over more than 50 years; it has been pursued both for military power applications (primarily aircraft carrier and submarine propulsion) and for commercial power applications. Nuclear power has benefited from many hundreds of billions of dollars in research, development, design, construction, and operations expenditures, and has received substantial attention and support world-wide, having being implemented by most developed countries, including all of the G-7 countries, and several developing countries (for example, India, China, and Republic of Korea). In spite of this long history, massive development effort, and unprecedented financial commitment, nuclear power has failed to achieve commercial success, having captured less than 5% of the world's primary energy supply market. There are many factors contributing to the stagnation/decline of the commercial nuclear power business. These factors include: non competitive economics, lengthy construction schedules, large and demanding human resource requirements, safety concerns, proliferation concerns, waste management concerns, the high degree of government financial and political involvement necessary, and the incompatibility of the available nuclear power plant designs with most process heat applications due to their temperature limitations and/or large heat output. An examination of the obstacles to deployment of nuclear power plants of current design suggest a set of requirements for new nuclear power plants, which may overcome or circumvent these obstacles. These requirements include: inherent characteristics that will achieve reactor shutdown under any postulated accident condition; the removal of decay heat by natural and passive means; no safety dependence on operator actions and tolerant to operator error, and malicious or incompetent operator action; and, economic viability in relatively small unit sizes. Many innovative reactor technologies and concepts are under

  7. 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

  8. 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

  9. 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”.

  10. Quality improvement and accountability in the Danish health care system.

    Science.gov (United States)

    Mainz, Jan; Kristensen, Solvejg; Bartels, Paul

    2015-12-01

    Denmark has unique opportunities for quality measurement and benchmarking since Denmark has well-developed health registries and unique patient identifier that allow all registries to include patient-level data and combine data into sophisticated quality performance monitoring. Over decades, Denmark has developed and implemented national quality and patient safety initiatives in the healthcare system in terms of national clinical guidelines, performance and outcome measurement integrated in clinical databases for important diseases and clinical conditions, measurement of patient experiences, reporting of adverse events, national handling of patient complaints, national accreditation and public disclosure of all data on the quality of care. Over the years, Denmark has worked up a progressive and transparent just culture in quality management; the different actors at the different levels of the healthcare system are mutually attentive and responsive in a coordinated effort for quality of the healthcare services. At national, regional, local and hospital level, it is mandatory to participate in the quality initiatives and to use data and results for quality management, quality improvement, transparency in health care and accountability. To further develop the Danish governance model, it is important to expand the model to the primary care sector. Furthermore, a national quality health programme 2015-18 recently launched by the government supports a new development in health care focusing upon delivering high-quality health care-high quality is defined by results of value to the patients. PMID:26443814

  11. 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.

  12. The Changing Medical Care System: Some Implications for Medical Education.

    Science.gov (United States)

    Foreman, Spencer

    1986-01-01

    The medical care system is undergoing widespread and significant changes. Individual hospitals may be disappearing as mergers, acquisitions, and a variety of multi-institutional arrangements become the dominant form and as a host of free-standing medical enterprises spread out into the community. (MLW)

  13. 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

  14. 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

  15. 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

  16. [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

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

    DEFF Research Database (Denmark)

    Halling, Anders; Kristensen, Troels

    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......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...... 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...

  18. 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.

  19. 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. 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 attitude based statistical measure. Full scale sea trials show a significant increase in obstacle tracking...

  20. 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;…

  1. The Durham Family Initiative: A Preventive System of Care

    OpenAIRE

    Dodge, Kenneth A.; Lisa J. Berlin; Epstein, Matthew; Spitz-Roth, Adele; O’Donnell, Karen; Kaufman, Martha; Amaya-Jackson, Lisa; Rosch, Joel; Christopoulos, Christina

    2004-01-01

    This article describes the Durham Family Initiative (DFI), an innovative effort to bring together child welfare and juvenile justice systems to reach DFI’s goal of reducing the child abuse rate in Durham, North Carolina, by 50% within the next 10 years. DFI will follow principles of a preventive system of care (PSoC), which focuses on nurturing the healthy parent-child relationship. A community collaborative of government agency directors has signed a memorandum of agreement to implement the ...

  2. HTRAK, a computerized health maintenance tracking system for primary care.

    OpenAIRE

    Frame, P. S.; Werth, P. L.

    1992-01-01

    This presentation describes a computerized health maintenance tracking system for primary care designed to be linked to the practice billing system. Providers enter health maintenance data along with billing data on an encounter form. Physician and patient reminders are generated once a year for all patients regardless of appointment status. Multiple entry options are available and the frequency of procedures can be varied for individual patients. Summary reports are generated to assist compl...

  3. 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 ...

  4. 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

  5. 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.

  6. Exploring the Perceived Obstacles to E-administration by Faculty Members of Eastern Mediterranean University

    OpenAIRE

    Rachel George, Malipula

    2015-01-01

    This thesis aims to explore the obstacles that hinder the application and implementation of E-administration as perceived by faculty members at Eastern Mediterranean University, North Cyprus. This study examined the degree of the Human Obstacles such as the human nature, the culture of closed doors, the lack of confidence in the protection, confidentiality and security of personal transactions; and Organizational obstacles such as the nature of organizational structure and the lack of systems...

  7. 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...

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. Applying principles of health system strengthening to eye care

    Science.gov (United States)

    Blanchet, Karl; Patel, Daksha

    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 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. PMID:22944762

  13. Virtual reshaping and invisibility in obstacle scattering

    International Nuclear Information System (INIS)

    We consider reshaping an obstacle virtually by using transformation optics in acoustic and electromagnetic scattering. Among the general virtual reshaping results, the virtual minification and virtual magnification in particular are studied. Stability estimates are derived for scattering amplitude in terms of the diameter of a small obstacle, which implies that the limiting case for minification corresponds to a perfect cloaking, i.e., the obstacle is invisible to detection

  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. 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.

  16. 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.

  17. 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

  18. Obstacle avoidance for kinematically redundant robots using an adaptive fuzzy logic algorithm

    International Nuclear Information System (INIS)

    In this paper the Adaptive Fuzzy Logic approach for solving the inverse kinematics of redundant robots in an environment with obstacles is presented. The obstacles are modeled as convex bodies. A fuzzy rule base that is updated via an adaptive law is used to solve the inverse kinematic problem. Additional rules have been introduced to take care of the obstacles avoidance problem. The proposed method has advantages such as high accuracy, simplicity of computations and generality for all redundant robots. Simulation results illustrate much better tracking performance than the dynamic base solution for a given trajectory in cartesian space, while guaranteeing a collision-free trajectory and observation of a mechanical joint limit

  19. [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

  20. 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.

  1. Preparing a health care delivery system for Space Station

    Science.gov (United States)

    Logan, J. S.; Stewart, G. R.

    1985-01-01

    NASA's Space Station is viewed as the beginning of man's permanent presence in space. This paper presents the guidelines being developed by NASA's medical community in preparing a quality, permanent health care delivery system for Space Station. The guidelines will be driven by unique Space Station requirements such as mission duration, crew size, orbit altitude and inclination, EVA frequency and rescue capability. The approach will emphasize developing a health care system that is modular and flexible. It will also incorporate NASA's requirements for growth capability, commonality, maintainability, and advanced technology development. Goals include preventing unnecessary rescue attempts, as well as maintaining the health and safety of the crew. Proper planning will determine the levels of prevention, diagnosis, and treatment necessary to achieve these goals.

  2. 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

  3. 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...

  4. 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...

  5. 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...

  6. Quality systems in health care: A sociotechnical approach

    OpenAIRE

    Harteloh, Peter

    2003-01-01

    textabstractIn this paper, we explore a sociotechnical approach to construct quality systems as an alternative to the traditional, ISO orientated approach. A sociotechnical approach is characterised as bottom-up, incremental, information technology facilitated and indicator driven. Its purpose is to ground quality assurance in medical practice and to provide meaning to those directly involved (patients, health care providers and medical professionals). Meaning depends on information. Accordin...

  7. Health care system reform. Ontario family physicians' reactions.

    OpenAIRE

    2001-01-01

    OBJECTIVE: To determine the effect on a cohort of family physicians of health care system reforms in Ontario and the relationship of reforms to their career satisfaction. DESIGN: Follow-up survey in 1999 of a cohort initially studied in 1993, posing many of the original questions along with some new ones. Four focus groups of other Ontario family physicians. SETTING: Family practices in Ontario. PARTICIPANTS: All family physicians who had received certification after completing a family medic...

  8. The Swedish health care system--an economist's view.

    Science.gov (United States)

    Blomqvist, A G

    1992-01-01

    This article compares the organization of the Swedish health care system with that in three other countries, the U.S., the U.K., and Canada, focussing on three main areas: (1) the provision and financing (public or private) of health insurance, including the question of the quality of the insurance protection offered; (2) the organization of the production of health services, and the economic incentives on the system's decision-makers (doctors, hospital managers, politicians, etc.). Possible answers are suggested to the question why one country (the U.K.) is able to provide health care to its population at an average cost considerably below that of the others: Differences in the quality of the insurance protection and health services; in the incentives on the system managers to exercise cost control; and in the incentives on service providers such as physicians, to consider cost-effectiveness when making treatment decisions. An attempt is made to suggest lessons for health care reform in Sweden and elsewhere. PMID:10119959

  9. 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

  10. Toward a 21st Century Quality-Measurement System for Managed-Care Organizations

    OpenAIRE

    Armstead, Rodney C.; Elstein, Paul; Gorman, John

    1995-01-01

    As the Nation's largest managed-care purchaser, the Health Care Financing Administration (HCFA) is working to develop a uniform data and performance-measurement system for all enrollees in managed-care plans. This effort will ultimately hold managed-care plans accountable for continuous improvement in the quality of care they provide and will provide information to consumers and purchasers to make responsible managed-care choices. The effort entails overhauling peer review organization (PRO) ...

  11. Quality and Safety in Health Care, Part XII: The Work System, Testing, and Clinical Reasoning.

    Science.gov (United States)

    Harolds, Jay A

    2016-07-01

    Donabedian felt the 3 major components affecting quality were process, structure, and outcome. Later investigators often substitute the word "structure" for a broader concept called the "work system." One component of the latter is the people involved, and for diagnosis, this often is best done with a diagnostic team. The work system in diagnosis has many obstacles to achieve optimum performance. There are also important problems with how tests are ordered and interpreted and clinical reasoning and biases. PMID:26975018

  12. 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...

  13. 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...

  14. 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

  15. 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

  16. Systemization of leadership for the systemization health care of health care: the unaddressed issue in health care reform.

    Science.gov (United States)

    Degeling, Pieter; Carr, Adrian

    2004-01-01

    The case literature strongly suggests that both in England and in Australia health care reforms have had very little impact in terms of "improved performance". It is in the context of a perceived failure in the implementation of the reforms that an interest has arisen in leadership at the level of individual clinical units (e.g an orthopaedics unit or birth unit), as the possible "fix" for bridging the promise-performance gap. Drawing upon extensive case studies that highlight the problem and context for appropriate forms of leadership, this paper argues that the appropriate discourse, in terms of leadership in health reform, needs to focus upon the issue of authorization. In making this argument, addresses the current conceptions of leadership that have been advanced in the discourse before offering some case study material that is suggestive of why attention should be focused on the issue of authorization. Illustrates how and why the processes of leading, central to implementing reform, cannot be construed as socially disembodied processes. Rather, leading and following are partial and partisan processes whose potential is circumscribed by participants' position-takings and what is authorized in the institutional settings in which they are located Argues that the "following" that clinical unit managers could command was shaped by the sub-cultures and "regulatory ideals" with which staff of each profession are involved In the interests of reform, policy players in health should not be focusing attention solely upon the performative qualities and potential leadership abilities of middle level management, but also on their own performance. They should consider how their actions affect what is authorized institutionally and which sets the scope and limits of the leadership-followership dialectic in clinical settings. PMID:15588011

  17. 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.

  18. 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 

  19. Oral health care systems in developing and developed countries

    DEFF Research Database (Denmark)

    Kandelman, Daniel; Arpin, Sophie; Baez, Ramon J;

    2012-01-01

    Health care systems are essential for promoting, improving and maintaining health of the population. Through an efficient health service, patients can be advised of disease that may be present and so facilitate treatment; risks factors whose modification could reduce the incidence of disease...... and illness in the future can be identified, and further, how controlling such factors can contribute to maintain a good quality of life. In developed countries, clinics or hospitals may be supported by health professionals from various specialties that allow their cooperation to benefit the patient......; 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...

  20. 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

    . For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of Int. J. Environ. Res. Public Health 2014, 11 9740 individualised care, trauma, additional vulnerability, and taboo concerning mental illness were...... of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field......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...

  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. 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.

  3. 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

  4. The Obstacle Detection and Measurement Based on Machine Vision

    Directory of Open Access Journals (Sweden)

    Xitao Zheng

    2010-12-01

    Full Text Available To develop a quick obstacle detection and measurement algorithm for the image-based autonomous vehicle (AV or computer assisted driving system, this paper utilize the previous work of object detection to get the position of an obstacle and refocus windows on the selected target. Further calculation based on single camera will give the detailed measurement of the object, like the height, the distance to the vehicle, and possibly the width. It adopts a two camera system with different pitch angles, which can perform real-time monitoring for the front area of the vehicle with different coverage. This paper assumes that the vehicle will move at an even speed on a flat road, cameras will sample images at a given rate and the images will be analyzed simultaneously. Focus will be on the virtual window area of the image which is proved to be related to the distance to the object and speed of the vehicle. Counting of the blackened virtual sub-area can quickly find the existence of an obstacle and the obstacle area will be cut to get the interested parameter measurements for the object evaluation.

  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. 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.

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. 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. PMID:24802645

  13. 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。

  14. 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...

  15. The study of optimal nursing position in health care delivery system in Iran

    OpenAIRE

    Shahshahani, Maryam Sadat; Salehi, Shayesteh; Rastegari, Mohammad; Rezayi, Abdollah

    2010-01-01

    BACKGROUND: In the recent decade, due to the overwhelming importance of health and prevention of diseases, nurses, the greatest part of the health care system, are acting in any position of the health care delivery system; because nursing have a key role in promotion of health and health care everywhere. The objective of this research was to study the desired positions of nursing in the health care delivery system in Iran. METHODS: This was a triangulation study done on three steps during 200...

  16. 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.

  17. Better care for the dying. Hawaii healthcare system develops a manual for end-of-life care.

    Science.gov (United States)

    Kalua, P M; Tan, S Y; Bacon, J G

    1999-01-01

    In early 1996, as it became clear that Americans were becoming increasingly concerned about end-of-life care, the leaders of St. Francis Healthcare System (SFHS), Honolulu, convened a meeting at which local people--community and parish representatives as well as healthcare professionals--discussed the matter. The meeting's participants identified 10 issues as essential in end-of-life care: decision making, pain management and comfort care, pastoral and spiritual care, psychosocial care, hospice and home care, cardiopulmonary resuscitation, futility, withholding and withdrawing treatment, artificial nutrition and hydration, physician-assisted suicide and euthanasia. The participants then divided themselves into 10 teams, each of which spent six months studying one of the identified essential issues. In each case, the team reviewed the relevant SFHS policies and procedures and compared them with national standards. The team also interviewed staff members about the policies and procedures, comparing the written versions with actual practices. Each team then wrote a chapter on its assigned issue, after which a core committee wove the chapters into an end-of-life care manual for SFHS. The manual was published in June 1997. The system's leaders currently use the manual to educate staff members in good end-of-life care. PMID:10351504

  18. 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.

  19. 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.

  20. 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)

  1. 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

  2. Sensor network infrastructure for a home care monitoring system.

    Science.gov (United States)

    Palumbo, Filippo; Ullberg, Jonas; Stimec, Ales; Furfari, Francesco; Karlsson, Lars; Coradeschi, Silvia

    2014-01-01

    This paper presents the sensor network infrastructure for a home care system that allows long-term monitoring of physiological data and everyday activities. The aim of the proposed system is to allow the elderly to live longer in their home without compromising safety and ensuring the detection of health problems. The system offers the possibility of a virtual visit via a teleoperated robot. During the visit, physiological data and activities occurring during a period of time can be discussed. These data are collected from physiological sensors (e.g., temperature, blood pressure, glucose) and environmental sensors (e.g., motion, bed/chair occupancy, electrical usage). The system can also give alarms if sudden problems occur, like a fall, and warnings based on more long-term trends, such as the deterioration of health being detected. It has been implemented and tested in a test environment and has been deployed in six real homes for a year-long evaluation. The key contribution of the paper is the presentation of an implemented system for ambient assisted living (AAL) tested in a real environment, combining the acquisition of sensor data, a flexible and adaptable middleware compliant with the OSGistandard and a context recognition application. The system has been developed in a European project called GiraffPlus. PMID:24573309

  3. 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.

  4. 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

  5. Insights on a New Era Under a Reforming Health Care System.

    Science.gov (United States)

    Mulvihill, James E.

    1995-01-01

    Economic and social trends that will affect the health care system are examined, including federal health care reform efforts, federal budget trimming through managed care and cost-cutting, declines in state spending, adoption of single-payer systems, growing competition in the private sector (mergers, alliances, acquisitions), dominance of health…

  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. 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

  8. Obstacle detection method, obstacle removing method, device and production line for practicing the methods

    International Nuclear Information System (INIS)

    The present invention provides techniques for detecting and removing obstacles, which can be applied to pipelines and vessels to be used in structures such as nuclear power structures and electric power generation facilities. Namely, when the pipelines or vessels are in any of the stages, namely, production, installation, before the use after installation and before the reuse after inspection, obstacles remaining in the pipelines and vessels are blown off by using a fluid jetting mechanism (air compressor). Elastic waves generated when the blown off obstacles abut against the pipelines and vessels are detected by using a sensor. As a result, the remaining obstacles can be detected during any one of the stages described above. The blowing is repeated till the absence of the obstacles is confirmed by elastic wave signals detected by the sensor. As a result, the remaining obstacles can be removed. (I.S.)

  9. Obstacle crossing in 7-9-year-old children with Down syndrome.

    Science.gov (United States)

    Chen, Hao-Ling; Yu, Wan-Hui; Yeh, Hsiu-Chen

    2016-01-01

    This study aimed to investigate obstacle crossing in 7-9-year-old children with Down syndrome (DS). Fifteen children with DS, age- and gender-matched with 15 typically developing (TD) children, were recruited to walk and cross obstacles with heights of 10%, 20% and 30% of their leg lengths. End-point and kinematic variables of obstacle crossing were obtained using a three-dimensional motion analysis system. The results showed that children with DS tend to adopt a lower speed and larger step width when they perceive instability. Moreover, unlike TD children, children with DS adopt a pelvic strategy (i.e., greater pelvic leading-side listing and forward rotation) to achieve a higher leading toe clearance with a longer step length, presumably for safety reasons. This pelvic strategy increased the frontal plane motion of the whole leg and trunk, and thus possibly stability, during obstacle crossing. However, this strategy may be inefficient. Trailing toe clearance did not differ significantly between two groups. The results of this study suggest that children with DS tend to use inefficient and conservative strategies for obstacle crossing. Knowledge of both end-point and kinematic control of obstacle crossing in children with DS is useful for understanding the mechanisms of obstacle-related falls. Moreover, obstacle crossing can be used as a task-oriented rehabilitation program for children with DS. PMID:26619373

  10. 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)…

  11. System impact research - increasing public health and health care system performance.

    Science.gov (United States)

    Malmivaara, Antti

    2016-06-01

    Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and

  12. 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.

  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. A proposed 'health literate care model' would constitute a systems approach to improving patients' engagement in care.

    Science.gov (United States)

    Koh, Howard K; Brach, Cindy; Harris, Linda M; Parchman, Michael L

    2013-02-01

    Improving health outcomes relies on patients' full engagement in prevention, decision-making, and self-management activities. Health literacy, or people's ability to obtain, process, communicate, and understand basic health information and services, is essential to those actions. Yet relatively few Americans are proficient in understanding and acting on available health information. We propose a Health Literate Care Model that would weave health literacy strategies into the widely adopted Care Model (formerly known as the Chronic Care Model). Our model calls for first approaching all patients with the assumption that they are at risk of not understanding their health conditions or how to deal with them, and then subsequently confirming and ensuring patients' understanding. For health care organizations adopting our model, health literacy would then become an organizational value infused into all aspects of planning and operations, including self-management support, delivery system design, shared decision-making support, clinical information systems to track and plan patient care, and helping patients access community resources. We also propose a measurement framework to track the impact of the new Health Literate Care Model on patient outcomes and quality of care. PMID:23381529

  16. 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...

  17. System Change: Quality Assessment and Improvement for Medicaid Managed Care

    OpenAIRE

    Smith, Wally R.; Cotter, J. James; Louis F Rossiter

    1996-01-01

    Rising Medicaid health expenditures have hastened the development of State managed care programs. Methods to monitor and improve health care under Medicaid are changing. Under fee-for-service (FFS), the primary concern was to avoid overutilization. Under managed care, it is to avoid underutilization. Quality enhancement thus moves from addressing inefficiency to addressing insufficiency of care. This article presents a case study of Virginia's redesign of Quality Assessment and Improvement (Q...

  18. Deterministic separation of suspended particles in a reconfigurable obstacle array

    Science.gov (United States)

    Du, Siqi; Drazer, German

    2015-11-01

    We use a macromodel of a flow-driven deterministic lateral displacement microfluidic system to investigate conditions leading to size-separation of suspended particles. This model system can be easily reconfigured to establish an arbitrary forcing angle, i.e. the orientation between the average flow field and the square array of cylindrical posts that constitutes the stationary phase. We also consider posts of different diameters, while maintaining a constant gap between them, to investigate the effect of obstacle size on particle separation. In all cases, we observe the presence of a locked mode at small forcing angles, in which particles move along a principal direction in the lattice. A locked-to-zigzag mode transition takes place when the orientation of the driving force reaches a critical angle. We show that the transition occurs at increasing angles for larger particles, thus enabling particle separation. Moreover, we observe a linear regression between the critical angle and the size of the particles, which allows us to estimate size-resolution in these systems. The presence of such a linear relation would guide the selection of the forcing angle in microfluidic systems, in which the direction of the flow field with respect to the array of obstacles is fixed. Finally, we present a simple model based on the presence of irreversible interactions between the suspended particles and the obstacles, which describes the observed dependence of the migration angle on the orientation of the average flow.

  19. [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

  20. [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

  1. 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

  2. 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...

  3. 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

  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. 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.

  6. 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...

  7. 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

  8. 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.

  9. 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

  10. 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.

  11. Overcoming obstacles against effective solar lighting interventions in South Asia

    International Nuclear Information System (INIS)

    Basing on our devised World Bank’s ‘Design Principles’ for effective renewable energy projects in developing countries and an in-depth analysis of our two solar lighting projects in Bangladesh and India, this paper explores three key obstacles that constrain poor people from obtaining solar lighting: financial exclusion, weak governance, and passive NGO and customer participation. The low take-up rate has a social and psychological impact. This paper recommends creating easy access to credit, establishing a robust complaint system, and developing strategic partnership to overcome the obstacles. - Research Highlights: ► To provide a critical analysis of the World Bank's 'Design Principles' for renewable energy policies in developing countries. ► To explain why some solar lighting projects do not work and how the barriers can be overcome. ► To highlight the roles of poverty, governance and technical support in solar lighting design.

  12. Localization of small obstacles in Stokes flow

    International Nuclear Information System (INIS)

    We want to detect small obstacles immersed in a fluid flowing in a larger bounded domain Ω in the three-dimensional case. We assume that the fluid motion is governed by the steady-state Stokes equations. We make a measurement on a part of the exterior boundary ∂Ω and then take a Kohn–Vogelius approach to locate these obstacles. We use here the notion of the topological derivative in order to determine the number of objects and their rough locations. Thus we first establish an asymptotic expansion of the solution of the Stokes equations in Ω when we add small obstacles inside. Then, we use it to find a topological asymptotic expansion of the considered Kohn–Vogelius functional which gives us the formula of its topological gradient. Finally, we make some numerical simulations exploring the efficiency and the limits of this method. (paper)

  13. 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.

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

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    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.%  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。

  16. How do integrated health care systems address racial and ethnic disparities in colon cancer?

    OpenAIRE

    Rhoads, KF; Patel, MI; Ma, Y.; Schmidt, LA

    2015-01-01

    © 2015 by American Society of Clinical Oncology. Purpose: Colorectal cancer (CRC) disparities have persisted over the last two decades. CRC is a complex disease requiring multidisciplinary care from specialists who may be geographically separated. Few studies have assessed the association between integrated health care system (IHS) CRC care quality, survival, and disparities. The purpose of this study was to determine if exposure to an IHS positively affects quality of care, risk of mortality...

  17. Role of individual psychotherapy of people diagnosed with schizophrenia in the Polish system of psychiatric care

    OpenAIRE

    Łukasz Cichocki

    2015-01-01

    This paper takes up the subject of the place and role of individual psychotherapy of people diagnosed with schizophrenia in the Polish system of psychiatric care. It describes various therapeutic contexts in which such psychotherapy can take place: inpatient ward, outpatient ward, ambulatory care, community care team. It also touches upon the issue of psychotherapy in contact with a chronically ill patient who participates in rehabilitation at occupational therapy workshops or at a day care c...

  18. 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

  19. The core of the Nordic health care system is not empty

    OpenAIRE

    Carl Hampus Lyttkens;; Terkel Christiansen; Unto Häkkinen; Oddvar Kaarboe; Matt Sutton; Anna Welander

    2016-01-01

    The Nordic countries are well-known for their welfare states. A very important feature of the welfare state is that it aims at easy and equal access to adequate health care for the entire population. For many years, the Nordic systems were automatically viewed as very similar, and they were placed in the same group when the OECD classified health care systems around the world. However, close inspection soon reveals that there are important differences between the health care systems of Denmar...

  20. 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.

  1. 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.

  2. On robust methodologies for managing public health care systems.

    Science.gov (United States)

    Nimmagadda, Shastri L; Dreher, Heinz V

    2014-01-01

    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. PMID:24445953

  3. 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.

  4. [Problems in the development of the emergency health care system].

    Science.gov (United States)

    Hasić, Z; Sisić, I

    2000-01-01

    Since February 1994, during and after 4-years supervision of American specialists, Emergency department of Zenica hospital has been trying to implement Anglo-American working system within the hospital framework (video). Principles of quality functioning of Emergency Medical Service (EMS) are based on: Population that depends on different demographic factors and prevention programme (education of population, quality functioning of health legislation). Pre-hospital treatment depends on good quality communication and transport. Hospital treatment based on good functioning of Emergency department and Intensive care unit as well as proper coordination with other specialties. Proper implementation of items stated above depends on top-class teaching and compulsory periodical screening of attained knowledge and skills, properly organized communication, transport and technical equipment. Emergency medicine is not only a sum of urgencies from the existing conditions but a special medical discipline and it has special and unique approach to diagnosis and therapy of acute health disorders. Therefore, a main weakness in the development of emergency medicine is: no recognition of emergency medicine as a unique specialty in the most European countries, non-existing departments of emergency medicine at medical faculties, no unification of BiH emergency medicine system, undeveloped monitoring and development evaluation of emergency medicine etc. The World Association of Emergency Medicine should have an important role for emergency medicine recognition, and in its future development through links with health legislation and educational associations (ACLS, ATLS, APLS). PMID:11117025

  5. 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...

  6. Obstacles to Studying Emerging Technologies.

    Science.gov (United States)

    Waetjen, L Elaine; Parvataneni, Ram; Varon, Shira; Saberi, Naghmeh Salamat; Jacoby, Vanessa L

    2015-08-01

    Laparoscopic radiofrequency ablation of uterine leiomyomas with a new Federal Drug Administration (FDA)-approved device, a device that delivers radiofrequency energy, is a novel procedure that aims to meet patient and physician demand for effective, minimally invasive leiomyoma treatment. However, as a new procedure, the durability of symptom relief, the safety in widespread use, and ultimately the comparative effectiveness of radiofrequency ablation of leiomyomas need further study. In June 2013, the University of California Fibroid Network, a collaboration of the five University of California Departments of Obstetrics and Gynecology, launched the Uterine Leiomyoma Treatment with Radiofrequency Ablation Study, an investigator-initiated early postmarket approval clinical trial of radiofrequency ablation of leiomyomas. In this commentary, we provide a review of the FDA approval process for medical devices using the device that delivers radiofrequency energy as a case study and describe significant limitations of this process that may adversely affect clinical care. We show how the deficiencies in the FDA process have challenged our ability to conduct independent early postmarket research evaluating the safety and long-term effectiveness of this novel technology. Our experience validates the Institute of Medicine's recommendation that advancements in surgical technology introducing new treatments without long-term effectiveness data, comparative study, or both should emerge onto the market under research conditions. Until the FDA requires more rigorous study of novel devices, we suggest ways of working together as a community of gynecologic surgeons to evaluate promising new technologies in early postmarket studies, putting research before widespread adoption of surgical innovation. PMID:26241430

  7. 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.

  8. 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. PMID:914402

  9. An assessment of auditory-guided locomotion in an obstacle circumvention task.

    Science.gov (United States)

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

    2016-06-01

    This study investigated how effectively audition can be used to guide navigation around an obstacle. Ten blindfolded normally sighted participants navigated around a 0.6 × 2 m obstacle while producing self-generated mouth click sounds. Objective movement performance was measured using a Vicon motion capture system. Performance with full vision without generating sound was used as a baseline for comparison. The obstacle's location was varied randomly from trial to trial: it was either straight ahead or 25 cm to the left or right relative to the participant. Although audition provided sufficient information to detect the obstacle and guide participants around it without collision in the majority of trials, buffer space (clearance between the shoulder and obstacle), overall movement times, and number of velocity corrections were significantly (p space between the participant and obstacle. Unlike visual guidance, participants did not always walk around the side that afforded the most space during auditory guidance. Mean buffer space was 1.8 times higher under auditory than under visual guidance. Results suggest that sound can be used to generate buffer space when vision is unavailable, allowing navigation around an obstacle without collision in the majority of trials. PMID:26879767

  10. 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

  11. 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

  12. 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 in the...... region over the obstacle dispersion can be ignored while nonlinearity cannot. The relevant governing equations for the near-field solution are therefore the nonlinear shallow water (NSW) equations. These are bidirectional and can be formulated in terms of a two-family system of characteristics. We...... 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...

  13. 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.

  14. 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.

  15. Blowing the Whistle on Day Care in New Jersey.

    Science.gov (United States)

    Hutner, Geraldine

    1979-01-01

    The author refutes arguments against day care, citing the needs of working women and the advantages of the day-care environment to young children. She considers the cost obstacles to expanded day-care service. (SJL)

  16. 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.

  17. Obstacle avoidance in social groups: new insights from asynchronous models.

    Science.gov (United States)

    Croft, Simon; Budgey, Richard; Pitchford, Jonathan W; Wood, A Jamie

    2015-05-01

    For moving animals, the successful avoidance of hazardous obstacles is an important capability. Despite this, few models of collective motion have addressed the relationship between behavioural and social features and obstacle avoidance. We develop an asynchronous individual-based model for social movement which allows social structure within groups to be included. We assess the dynamics of group navigation and resulting collision risk in the context of information transfer through the system. In agreement with previous work, we find that group size has a nonlinear effect on collision risk. We implement examples of possible network structures to explore the impact social preferences have on collision risk. We show that any social heterogeneity induces greater obstacle avoidance with further improvements corresponding to groups containing fewer influential individuals. The model provides a platform for both further theoretical investigation and practical application. In particular, we argue that the role of social structures within bird flocks may have an important role to play in assessing the risk of collisions with wind turbines, but that new methods of data analysis are needed to identify these social structures. PMID:25833245

  18. 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

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

    International Nuclear Information System (INIS)

    Propulsion by growing actin networks is a universal mechanism used in many different biological systems, ranging from the sheet-like lamellipodium of crawling animal cells to the actin comet tails induced by certain bacteria and viruses in order to move within their host cells. Although the core molecular machinery for actin network growth is well preserved in all of these cases, the geometry of the propelled obstacle varies considerably. During 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° or +70°/0°/ − 70° exhibit mutually exclusive stability, in agreement with earlier results for flat obstacles of very large lateral extension. We calculate and validate phase diagrams as a function of model parameters and show how this approach can be extended to obstacles with piecewise straight contours. For curved obstacles, we arrive at a partial differential equation in the continuum limit, which again is in good agreement with the computer simulations. In all cases, we can identify the same two fundamentally different orientation patterns, but only within an appropriate reference frame, which is adjusted to the local orientation of the obstacle contour. Our results suggest that two fundamentally different network architectures compete with each other in growing actin networks, irrespective of obstacle geometry, and clarify how simulated and electron tomography data have to be analyzed for non-flat obstacle geometries. (paper)

  20. 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...

  1. 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

  2. Learn to Avoid or Overcome Leadership Obstacles

    Science.gov (United States)

    D'Auria, John

    2015-01-01

    Leadership is increasingly recognized as an important factor in moving schools forward, yet we have been relatively random in how we prepare and support them. Four obstacles often block or diminish their effectiveness. Avoiding or overcoming each of these requires an underlying set of skills and knowledge that we believe can be learned and…

  3. 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.

  4. 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...

  5. 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...

  6. Investigating the health care delivery system in Japan and reviewing the local public hospital reform

    OpenAIRE

    Zhang X.; Oyama T

    2016-01-01

    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 ...

  7. 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...

  8. 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

  9. 78 FR 27485 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-05-10

    ... fiscal year FPL Federal poverty line FQHC Federally qualified health center FR Federal Register FTE Full... CFR Parts 412, 418, 482, et al. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed Fiscal...

  10. 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...

  11. 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... SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 792.90 Animal and other test system care. (a) There shall be standard operating procedures for the...

  12. Implications of managed care for health systems, clinicians, and patients.

    OpenAIRE

    Fairfield, G.; Hunter, D.J.; Mechanic, D.; Rosleff, F.

    1997-01-01

    The rhetoric and realities of managed care are easily confused. The rapid growth of managed care in the United States has had many implications for patients, doctors, employers, state and federal programmes, the health insurance industry, major medical institutions, medical research, and vulnerable patient populations. It has restricted patients' choice of doctors and limited access to specialists, reduced the professional autonomy and earnings of doctors, shifted power from the non-profit to...

  13. Incorporation of the Health Care System in the West

    OpenAIRE

    Floro Hermes Gomez Pineda

    2015-01-01

    Reflection is made from an interpretive perspective on the specific situation of the historical evolution of health care, since this became a way of intervening patients and an instrument for the healing of diseases, focusing on presentation of original sources that account for results of historical research completed, which range from the fifteenth century to the present day. To do this, try to understand (comprehend) the health care as an ideographic body of knowledge consisting of five pie...

  14. 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)

  15. Mittag–Leffler's function, Vekua transform and an inverse obstacle scattering problem

    International Nuclear Information System (INIS)

    This paper studies a prototype of inverse obstacle scattering problems whose governing equation is the Helmholtz equation in two dimensions. An explicit method to extract information about the location and shape of unknown obstacles from the far-field operator with a fixed wave number is given. The method is based on an explicit construction of a modification of Mittag–Leffler's function via the Vekua transform and the study of the asymptotic behaviour; an explicit density in the Herglotz wavefunction that approximates the modification of Mittag–Leffler's function in the bounded domain surrounding unknown obstacles; a system of inequalities derived from Kirsch's factorization formula of the far-field operator. Then an indicator function which can be calculated from the far-field operator acting on the density is introduced. It is shown that the asymptotic behaviour of the indicator function yields information about the visible part of the exterior of the obstacles

  16. 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...

  17. Blueprint for action: steps toward a high-quality, high-value maternity care system.

    Science.gov (United States)

    Angood, Peter B; Armstrong, Elizabeth Mitchell; Ashton, Diane; Burstin, Helen; Corry, Maureen P; Delbanco, Suzanne F; Fildes, Barbara; Fox, Daniel M; Gluck, Paul A; Gullo, Sue Leavitt; Howes, Joanne; Jolivet, R Rima; Laube, Douglas W; Lynne, Donna; Main, Elliott; Markus, Anne Rossier; Mayberry, Linda; Mitchell, Lynn V; Ness, Debra L; Nuzum, Rachel; Quinlan, Jeffrey D; Sakala, Carol; Salganicoff, Alina

    2010-01-01

    Childbirth Connection hosted a 90th Anniversary national policy symposium, Transforming Maternity Care: A High Value Proposition, on April 3, 2009, in Washington, DC. Over 100 leaders from across the range of stakeholder perspectives were actively engaged in the symposium work to improve the quality and value of U.S. maternity care through broad system improvement. A multi-disciplinary symposium steering committee guided the strategy from its inception and contributed to every phase of the project. The "Blueprint for Action: Steps Toward a High Quality, High Value Maternity Care System", issued by the Transforming Maternity Care Symposium Steering Committee, answers the fundamental question, "Who needs to do what, to, for, and with whom to improve the quality of maternity care over the next five years?" Five stakeholder workgroups collaborated to propose actionable strategies in 11 critical focus areas for moving expeditiously toward the realization of the long term "2020 Vision for a High Quality, High Value Maternity Care System", also published in this issue. Following the symposium these workgroup reports and recommendations were synthesized into the current blueprint. For each critical focus area, the "Blueprint for Action" presents a brief problem statement, a set of system goals for improvement in that area, and major recommendations with proposed action steps to achieve them. This process created a clear sightline to action that if enacted could improve the structure, process, experiences of care, and outcomes of the maternity care system in ways that when anchored in the culture can indeed transform maternity care. PMID:20123180

  18. 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

  19. 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.

  20. 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...

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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。

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. Obstacle Avoiding Robot – A Promising One

    Directory of Open Access Journals (Sweden)

    RAKESH CHANDRA KUMAR

    2013-04-01

    Full Text Available In today’s world ROBOTICS is a fast growing and interesting field. ROBOT has sufficient intelligence to cover the maximum area of provided space. It has an infrared sensor which are used to sense the obstacles coming in between the path of ROBOT. It will move in a particular direction and avoid the obstacle which is coming in its path.Autonomous Intelligent Robots are robots that can perform desired tasks in unstructured environments without continuous human guidance. The minimum number of gearmotor allows the walking robot to minimize the power consumption while construct a program that can produce coordination of multi-degree of freedom for the movement of the robot. It is found that two gearmotors are sufficient to produce the basic walking robot and one voltage regulators are needed to control the load where it is capable of supplying enough current to drive two gearmotors for each wheel.

  14. Obstacle to e-government: Digital division

    OpenAIRE

    Fatih Çapar; Ömer Faruk Vural

    2013-01-01

    The issue of digital division; is defined as different sectors of society’s difference in rates of access to information and communication technologies. Digital division is the one of the greatest obstacles to the transition to an information society and the provision of e-government services. In this study, the subject of digital division, importance of reducing digital division and its effect of the transition to e-government were described, the issue of digital division in Turkey and the ...

  15. Obstacle Detection and Avoidance Autonomous Car

    OpenAIRE

    K.Vasavi; M.V.S.Praveen

    2014-01-01

    Driving models are needed by many researchers to improve traffic safety and to advance autonomous vehicle design. To be most useful, a driving model must state specifically what information is needed and how it is processed. So we developed an “Obstacle Avoidance and Detection Autonomous Car” based on sensor application. The essential part of this autonomous car is that it drives taking the energy from solar panel. This paper explains the method of interfacing the solar panel, relay circuit b...

  16. 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...

  17. 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...

  18. An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context

    OpenAIRE

    Claude Takenga; Rolf-Dietrich Berndt; Olivier Musongya; Joël Kitero; Remi Katoke; Kakule Molo; Basile Kazingufu; Malikwisha Meni; Mambo Vikandy; Henri Takenga

    2014-01-01

    The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which i...

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

    OpenAIRE

    Hjelm Katarina; Albin Björn; Chang Zhang Wen

    2010-01-01

    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...

  20. 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...

  1. 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...

  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)

    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

  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. 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.

  7. 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.

  8. 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 ...

  9. 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...

  10. 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.

  11. 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

  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. Novel wireless electroencephalography system with a minimal preparation time for use in emergencies and prehospital care

    OpenAIRE

    Jakab, Andrei; Kulkas, Antti; Salpavaara, Timo; Kauppinen, Pasi; Verho, Jarmo; Heikkilä, Hannu; Jäntti, Ville

    2014-01-01

    Background Although clinical applications such as emergency medicine and prehospital care could benefit from a fast-mounting electroencephalography (EEG) recording system, the lack of specifically designed equipment restricts the use of EEG in these environments. Methods This paper describes the design and testing of a six-channel emergency EEG (emEEG) system with a rapid preparation time intended for use in emergency medicine and prehospital care. The novel system comprises a quick-applicati...

  14. Effect of Collaborative Care System (CCS) on Blood Glucose Levels in Type 2 Diabetes Mellitus Outpatient

    OpenAIRE

    Nuryati Kuman; Bangunawati Rahajeng

    2016-01-01

    Some health system in various countries in the world is highly fragmented and is unable to resolve health problems. With collaborative care system, it is expected that DM patients can be managed well. We conducted a study to determine the effect of collaborative care system on blood glucose levels of patients with type 2 diabetes mellitus. This study uses a quasi-experimental design. Data was obtained by measuring random blood glucose levels in patients with type 2 diabetes mellitus. The samp...

  15. Development of a Daily Life Support System for Elderly Persons with Dementia in the Care Facility.

    Science.gov (United States)

    Takahashi, Yoshiyuki; Kawai, Toshihiro; Komeda, Takashi

    2015-01-01

    Taking care for dementia persons with BPSD is burdening on caregivers. To reduce caregivers' burdens and improve dementia persons' quality of life, monitoring and communication intervention system has been proposed. A part of the system, wandering and falling down detection system has been developed. It is designed based on the requirement of the caregivers working in the care facility. Functional test was carried out and had positive impressions from the caregivers. PMID:26294607

  16. Counseling and Wellness Services Integrated with Primary Care: A Delivery System That Works

    OpenAIRE

    Van Beek, Ken; Duchemin, Steve; Gersh, Geniene; Pettigrew, Susanne; Silva, Pamela; Luskin, Barb

    2008-01-01

    Introduction: The continuity and coordination of care between medical and behavioral health services is a major issue facing our health care delivery system. Barriers to basic communication between providers of medical services and providers of behavioral health services, include: no coordination of services, and poor recognition of the relationship between medical and behavioral issues.

  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. System and Patient Barriers to Care among People Living with HIV/AIDS in Houston/Harris County, Texas: HIV Medical Care Providers' Perspectives.

    Science.gov (United States)

    Mgbere, Osaro; Khuwaja, Salma; Bell, Tanvir K; Rodriguez-Barradas, Maria C; Arafat, Raouf; Essien, Ekere James; Singh, Mamta; Aguilar, Jonathan; Roland, Eric

    2015-01-01

    In the United States, a considerable number of people diagnosed with HIV are not receiving HIV medical care due to some barriers. Using data from the Medical Monitoring Project survey of HIV medical care providers in Houston/Harris County, Texas, we assessed the HIV medical care providers' perspectives of the system and patient barriers to HIV care experienced by people living with HIV/AIDS (PLWHA). The study findings indicate that of the 14 HIV care barriers identified, only 1 system barrier and 7 patient barriers were considered of significant (P ≤ .05) importance, with the proportion of HIV medical care providers' agreement to these barriers ranging from 73.9% (cost of health care) to 100% (lack of social support systems and drug abuse problems). Providers' perception of important system and patient barriers varied significantly (P ≤ .05) by profession, race/ethnicity, and years of experience in HIV care. To improve access to and for consistent engagement in HIV care, effective intervention programs are needed to address the barriers identified especially in the context of the new health care delivery system. PMID:24943655

  19. 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

  20. 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.

  1. 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

  2. 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; Ziebe, Søren; Mikkelsen Englund, Anne L; Hald, Finn; Boivin, Jacky; Schmidt, Lone

    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....

  3. 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)

  4. "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.

  5. 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...

  6. Silo clogging reduction by placing an obstacle above the outlet

    OpenAIRE

    Maza, D.; Arévalo, R.; Garcimartin, A.; Janda, A.; Zuriguel, I.; Lozano, C.

    2013-01-01

    We present an experimental study of the effect that an obstacle above the outlet of a silo has on the clogging probability. Both, the size of the ori ce and the obstacle position are varied for a chosen obstacle size and shape. If the position of the obstacle is properly selected the clogging probability can be importantly reduced. Indeed, as the outlet size is increased – and we approach the critical size above which there is not clogging – the obstacle effect is enhanced. For the ...

  7. 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...

  8. Community of Solution for the U.S. Health Care System: Lessons from the U.S. Educational System

    Science.gov (United States)

    DeVoe, Jennifer E.; Gold, Rachel

    2016-01-01

    The Folsom Group asserts that radical changes are needed to fix the health care system in the United States. The U.S. education system is one potential model to emulate. Could a future health care system-level community of solution be modeled after the U.S. education system? Could community health care services be planned, organized, and delivered at the neighborhood level by district, similar to the structure for delivering public education? Could community health centers, governed by community boards, serve every neighborhood? This essay imagines how U.S. health care system reforms could be designed using our public school system as a roadmap. Our intention is to challenge readers to recognize the urgent need for radical reform in the U.S. health care system, to introduce one potential model for reform, and to encourage creative thinking about other system-level communities of solution that could lead to profound change and improvements in the U.S. health care system. PMID:23657701

  9. Establishing a community-based lung cancer multidisciplinary clinic as part of a large integrated health care system: aurora health care.

    Science.gov (United States)

    Bjegovich-Weidman, Marija; Haid, Max; Kumar, Santhosh; Huibregtse, Carol; McDonald, Jean; Krishnan, Santosh

    2010-11-01

    A community cancer clinic, through cooperation with its parent health care system, developed a lung cancer multidisciplinary clinic (MDC) to enhance patient care and prevent out-migration to competing health care systems. The local medical and radiation oncologists collaborated with a thoracic surgeon from the tertiary care hospital in establishing the lung MDC. All the participating physicians are employed by the health care system. A cancer care coordinator assured that all necessary tests were obtained and available to the physicians at least 1 day before the clinic. The multidisciplinary team also included a pulmonologist and met every third week. Other sub-specialists were involved as necessary. Final treatment recommendations using National Comprehensive Cancer Network guidelines were made for each patient at the MDC visit. This clinic, once established, resulted in significant improvements in the quality of care, patient satisfaction and retention of patients. Time from diagnosis to initiation of treatment was reduced to a mean of 18 days from a mean of 24 days. The community cancer clinic had an increase in lung cancer patient care by 28% and a 9.1% increase in gross revenue. The tertiary care hospital benefited by providing all patients with definitive surgery, including minimally invasive surgery. The tertiary hospital thoracic surgeon had a 75% increase in referrals from the lung MDC geographic area over the previous year. This collaboration in the development of MDCs demonstrates how patients, caregivers, and the health care system benefit from MDCs. PMID:21358947

  10. 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

  11. 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.

  12. 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 of...

  13. 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

  14. The main issues and the ways of improvement of health care for patients with diseases of the circulatory system

    OpenAIRE

    Sazanova G.Yu.

    2014-01-01

    Regulations and publications on the provision of quality health care for patients with diseases of the circulatory system of the native scientists have been studied. The majority of the issues concerns the disorganization of health care standards: the uneven distribution of diagnostic resources mostly in the hospitals and preventive health care organizations. The proposed ways to improve the patient care have been analyzed.

  15. HEALTH CARE GUIDE TO POLLUTION PREVENTION IMPLEMENTATION THROUGH ENVIRONMENTAL MANAGEMENT SYSTEMS

    Science.gov (United States)

    The Health Care Guide to Pollution Prevention Implementation through Environmental Management Systems provides example EMS procedures and forms used in four ISO 14001 EMS certified hospitals. The latest revisions include more EMS hospital case studies, more compliance resources, ...

  16. The Nuka System of Care: improving health through ownership and relationships.

    Science.gov (United States)

    Gottlieb, Katherine

    2013-01-01

    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. PMID:23984269

  17. 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.

  18. 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.

  19. 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.

  20. Nuclear. Four obstacles to closing Fessenheim

    International Nuclear Information System (INIS)

    The new President of France has decided to close the Fessenheim nuclear power plant at the end of 2016. However the closing procedure has not yet started, and the shutdown and dismantling process appears complex and could be very costly. The four main obstacles to the closing of Fessenheim are: the absence of any legal text concerning Fessenheim closure, a highly expensive operation (with indemnifications for the plant's partners), a dismantling that could be not so profitable to French industries, and the social constraints of the plant shutdown (thousands of jobs are at risk)

  1. 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

  2. Components of Equity-Oriented Health Care System: Perspective of Iranian Nurses

    OpenAIRE

    2014-01-01

    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 ...

  3. 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...

  4. 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...

  5. 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

  6. 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.

  7. Transforming primary care: vision and reality: a whole systems approach to developing the workforce

    OpenAIRE

    Jackson, C; Manley, K.

    2015-01-01

    Assumptions underpinning presentation – whole systems approaches and the skills required for culture change. Developing a shared purpose for primary care. Drawing on: - Whole systems approach to urgent and emergency care - Implementing shared values - Developing shared purposes across organisations: EKHUFT/Community Trust/Mental Health Trust - Developing the skills sets to be leaders: - Aspiring Consultant Programme - CLP programmes across the multi-disciplinary team ...

  8. Evaluation of Arizona Health Care Cost Containment System, 1984-85

    OpenAIRE

    McCall, Nelda; Henton, Douglas; Haber, Susan; Paringer, Lynn; Crane, Michael; Wrightson, William; Freund, Deborah

    1987-01-01

    In this article, we describe the evaluation of the Arizona Health Care Cost Containment System (AHCCCS), Arizona's alternative to the acute care portion of Medicaid. We provide an assessment of implementation of the program's innovative features during its second 18 months of operation, from April 1984 through September 1985. Included in the evaluation are assessments of the administration of the program, provider relations, eligibility, enrollment and marketing, information systems, quality ...

  9. Implementation of genomic medicine in a health care delivery system: a value proposition?

    Science.gov (United States)

    Wade, Joanne E; Ledbetter, David H; Williams, Marc S

    2014-03-01

    The United States health care system is undergoing significant change and is seeking innovations in care delivery and reimbursement models that will lead to improved value for patients, providers, payers, and employers. Genomic medicine has the potential to be a disruptive innovation that if implemented intelligently can improve value. The article presents the perspective of the leaders of a large integrated healthcare delivery system regarding the decision to invest in implementation of genomic medicine. PMID:24619641

  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. 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...

  12. 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…

  13. 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

  14. A systems thinking approach to analysis of the Patient Protection and Affordable Care Act.

    Science.gov (United States)

    Williams, John C

    2015-01-01

    The public health community is challenged with understanding the many complexities presented by systems thinking and its applications in systems modeling. The model presented encompasses multiple variables needed (eg, model building) for the construction of a conceptual system model of the Patient Protection and Affordable Care Act (ACA). The model tracks the ACA from inception, through passage, March 2010, to its current state. Justification for the need to reform the current health care system rests, in part, on the heels of social justice. Proponents of the ACA have long argued that health reform was needed by the millions of uninsured person who suffered from health disparities, took little advantage of health prevention advice, and faced issues of access to providers as well as insurers. In addition the ACA seeks to address our uncontrollable spending on health care delivery. This article highlights the ACA from a systems perspective. The conceptual model presented encompasses both health reform variables (eg, health care provisions, key legislative components, system environment) and system variables (eg, inputs, outputs, feedback, and throughput) needed to understand current health care reform efforts from a systems perspective. The model presented shows how the interrelationships and interconnections of elements of a system come together to achieve its purpose or goal. PMID:25414950

  15. 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

  16. 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.

  17. 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.

  18. 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...

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. 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.

  4. 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.

    Science.gov (United States)

    de Lusignan, Simon; Pearce, Christopher; Munro, Neil

    2013-01-01

    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. PMID:24629650

  5. Integrating traditional medicine into modern health care systems: examining the role of Chinese medicine in Taiwan.

    Science.gov (United States)

    Chi, C

    1994-08-01

    Since the World Health Organization officially promoted traditional medicine in developing countries in 1978, there have been increasing interests among developing countries in integrating traditional medicine into a national health care system. Most of these policies, however, tend to be the policy of coexistence instead of integration. This paper focuses on the rationale, strategies, and process of integrating traditional medicine into a modern health care system by using the experience of Chinese medicine in Taiwan as an example. After briefly describing the changing roles of Chinese medicine in Taiwan, the author critically reviews the government policies and regulations on Chinese medicine. Research findings and government statistics on the demand and supply of Chinese medicine are also described to provide some insights for developing recommendations for an appropriate integration policy. To effectively integrate traditional medicine into a modern health care system, this paper suggests that such integration should begin at the grass roots level, that is with the training of physicians and practitioners. A successful, integrated health care system would facilitate more efficient use of domestic medical resources, and enhance self-sufficiency in health development for resource poor countries. Integrating traditional medicine into a modern health care system, moreover, can benefit industrialized nations as well. After recommending several strategies for integration, the author proposes a further development of a unified medical system as the final stage of full integration. This unified medical system should be an inclusive medical system, which could help countries to expand the available medical resources. PMID:7939847

  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. 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

  8. The Role of System Alignment in Care and Education of Children from Birth to Grade 3

    Science.gov (United States)

    Ma, Xin; Shen, Jianping; Krenn, Huilan Y.; Yuan, Jing; Hu, Shanshan

    2015-01-01

    The emerging concept of system alignment refers to how different systems in care and education of young children can be integrated to work together as a whole system that is more effective, efficient, and equitable to produce excellent outcomes in children. The purpose of this article is to provide a review of the existing literature on system…

  9. 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.

  10. Fair equality of opportunity critically reexamined: the family and the sustainability of health care systems.

    Science.gov (United States)

    Engelhardt, H Tristram

    2012-12-01

    A complex interaction of ideological, financial, social, and moral factors makes the financial sustainability of health care systems a challenge across the world. One difficulty is that some of the moral commitments of some health care systems collide with reality. In particular, commitments to equality in access to health care and to fair equality of opportunity undergird an unachievable promise, namely, to provide all with the best of basic health care. In addition, commitments to fair equality of opportunity are in tension with the existence of families, because families are aimed at advantaging their own members in preference to others. Because the social-democratic state is committed to fair equality of opportunity, it offers a web of publicly funded entitlements that make it easier for persons to exit the family and to have children outside of marriage. In the United States, in 2008, 41% of children were born outside of wedlock, whereas, in 1940, the percentage was only 3.8%, and in 1960, 5%, with the further consequence that the social and financial capital generated through families, which aids in supporting health care in families, is diminished. In order to explore the challenge of creating a sustainable health care system that also supports the traditional family, the claims made for fair equality of opportunity in health care are critically reconsidered. This is done by engaging the expository device of John Rawls's original position, but with a thin theory of the good that is substantively different from that of Rawls, one that supports a health care system built around significant copayments, financial counseling, and compulsory savings, with a special focus on enhancing the financial and social capital of the family. This radical recasting of Rawls, which draws inspiration from Singapore, is undertaken as a heuristic to aid in articulating an approach to health care allocation that can lead past the difficulties of social-democratic policy. PMID

  11. 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.

  12. Interaction of debris with a solid obstacle: Numerical analysis

    International Nuclear Information System (INIS)

    The subject of this research is the propagation of a cloud of solid particles formed from an explosion-damaged construction. The main objective is the interaction of the cloud (debris) with a solid beam located at some distance from the explosion. The mathematical model involves the flow of the gas using standard conservation equations, and this part of the model is solved numerically. The solid particles are treated as a system of solid points (so-called Lagrangian approach), whose motion is the result of the flowing gas as well as collisions with obstacles. These two issues are described respectively by Newton's second law and the hard-sphere model. The model is used to simulate various cases where the influence of different parameters like the value of the pressure of the explosion, the particle size, the number of particles and the obstacle location are investigated. The results are presented as snapshots of particle location, and also as the particle total momentum during collision with the beam.

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. [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

  4. 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

  5. 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

  6. Method for surmounting an obstacle by a robot vehicle

    Science.gov (United States)

    Wilcox, Brian H.; Ohm, Timothy R.

    1994-12-01

    Surmounting obstacles in the path of a robot vehicle is accomplished by rotating the wheel forks of the vehicle about their transverse axes with respect to the vehicle body so as to shift most of the vehicle weight onto the rear wheels, and then driving the vehicle forward so as to drive the now lightly-loaded front wheels (only) over the obstacle. Then, after the front wheels have either surmounted or completely passed the obstacle (depending upon the length of the obstacle), the forks are again rotated about their transverse axes so as to shift most of the vehicle weight onto the front wheels. Then the vehicle is again driven forward so as to drive the now lightly-loaded rear wheels over the obstacle. Once the obstacle has been completely cleared and the vehicle is again on relatively level terrain, the forks are again rotated so as to uniformly distribute the vehicle weight between the front and rear wheels.

  7. A method for surmounting an obstacle by a robot vehicle

    Science.gov (United States)

    Wilcox, Brian H.; Ohm, Timothy R.

    1992-10-01

    Surmounting obstacles in the path of a robot vehicle is accomplished by rotating the wheel forks of the vehicle about their transverse axes with respect to the vehicle body so as to shift most of the vehicle weight onto the rear wheels, and then driving the vehicle forward so as to drive the now lightly-loaded front wheels (only) over the obstacle. Then, after the front wheels have either surmounted or completely passed the obstacle (depending upon the length of the obstacle), the forks are again rotated about their transverse axes so as to shift most of the vehicle weight onto the front wheels. Then the vehicle is again driven forward so as to drive the now lightly-loaded rear wheels over the obstacle. Once the obstacle has been completely cleared and the vehicle is again on relatively level terrain, the forks are again rotated so as to uniformly distribute the vehicle weight between the front and rear wheels.

  8. Computing the obstacle number of a plane graph

    CERN Document Server

    Johnson, Matthew P

    2011-01-01

    An obstacle representation of a plane graph G is V(G) together with a set of opaque polygonal obstacles such that G is the visibility graph on V(G) determined by the obstacles. We investigate the problem of computing an obstacle representation of a plane graph (ORPG) with a minimum number of obstacles. We call this minimum size the obstacle number of G. First, we show that ORPG is NP-hard by reduction from planar vertex cover, resolving a question posed by [8]. Second, we give a reduction from ORPG to maximum degree 3 planar vertex cover. Since this reduction preserves solution values, it follows that ORPG is fixed parameter tractable (FPT) and admits a polynomial-time approximation scheme (PTAS).

  9. A web-based communication system for the integrated care setting of cerebral palsy: parents' experiences in a 6-month pilot in three Dutch care regions

    OpenAIRE

    Gulmans, J.; Vollenbroek-Hutten, M.M.R.; Gemert-Pijnen, van, Julia E.W.C.; Harten, van, W.H.

    2012-01-01

    Introduction: To improve communication in the integrated care setting of children with cerebral palsy, we developed a web-based system for parent-professional and inter-professional communication. The present study aimed to evaluate parents' experiences regarding the system's contribution to their communication with professionals during a 6-months pilot in three Dutch care regions. In addition, factors associated with parents' system use and non-use were analyzed. Theory and methods: The syst...

  10. 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.

  11. [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

  12. 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

  13. 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

  14. 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.

  15. The Effectiveness of Inpatient Rehabilitation in the Acute Postoperative Phase of Care After Transtibial or Transfemoral Amputation: Study of an Integrated Health Care Delivery System

    OpenAIRE

    Stineman, Margaret G.; Kwong, Pui L.; Kurichi, Jibby E.; Prvu-Bettger, Janet A.; Vogel, W Bruce; Maislin, Greg; Bates, Barbara E.; Reker, Dean M.

    2008-01-01

    Stineman MG, Kwong PL, Kurichi JE, Prvu-Bettger JA, Vogel WB, Maislin G, Bates BE, Reker DM. The effectiveness of inpatient rehabilitation in the acute postoperative phase of care after transtibial or transfemoral amputation: study of an integrated health care delivery system. Arch Phys Med Rehabil 2008;89:1863-72.

  16. The Day Care Needs of the Indigent Children of West Virginia, with Recommendations for a Model Day Care Program and Delivery System. Volume 2.

    Science.gov (United States)

    Hodges, Walter L.; And Others

    This volume describes and discusses six major proposals for a complete model system of day care for indigent children in West Virginia. The recommendations include: (1) developing more specific objectives to be accomplished for children, parents, care providers, and the state; (2) developing a public education program designed to help parents…

  17. Line-bisectioning and obstacle avoidance: evidence for separate strategies.

    Science.gov (United States)

    Ross, Alasdair I; Schenk, Thomas; Hesse, Constanze

    2014-09-01

    Previous studies have frequently applied a combination of line-bisection tasks (in which participants indicate the middle of a line) and obstacle avoidance tasks (in which participants move their hand between two obstacles) with the aim of revealing perception-action dissociations in certain neurological disorders, such as visual form agnosia and optic ataxia. However, valid conclusions about the underlying processing pathways can only be drawn if participants apply the same strategy in both tasks (i.e. finding the middle between the obstacles). Yet, this assumption has never been tested directly. In this experiment, we investigated whether participants perform obstacle avoidance and line-bisectioning using similar strategies by manipulating the position of the obstacles and the start position of the hand relative to the obstacles. Our results indicate that the lateral hand position during obstacle avoidance does not only vary as a function of obstacle location but also strongly depends on the start position. Moreover, participants showed increased sensitivity to obstacle shifts occurring closer to the hand's start position. In contrast, during line-bisectioning the sensitivity to obstacles shifts was unaffected by the hand's start position. The findings suggest that during obstacle-avoidance the need to keep a safe distance from the obstacles is balanced with the requirement to minimise energetic demands. In contrast, the main intention during line-bisectioning is to move to the perceived midpoint as accurately as possible. The fact that very different constraints underlie trajectory planning in both tasks implies that caution has to be taken when interpreting differences in performance levels. PMID:24951918

  18. 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.

  19. An Analytical Approach to Avoid Obstacles in Mobile Robot Navigation

    OpenAIRE

    Alexandre Santos Brandão; Mário Sarcinelli-Filho; Ricardo Carelli

    2013-01-01

    A nonlinear supervised globally stable controller is proposed to reactively guide a mobile robot to avoid obstacles while seeking a goal. Whenever the robot detects an object nearby, its orientation is changed to be aligned with the tangent to the border of the obstacle. Then, the robot starts following it, looking for a feasible path to its goal. The supervisor is responsible for deciding which path to take when the robot faces some particular obstacle configurations that are quite difficult...

  20. On cylindrically converging shock waves shaped by obstacles

    Energy Technology Data Exchange (ETDEWEB)

    Eliasson, V; Henshaw, W D; Appelo, D

    2007-07-16

    Motivated by recent experiments, numerical simulations were performed of cylindrically converging shock waves. The converging shocks impinged upon a set of zero to sixteen regularly space obstacles. For more than two obstacles the resulting diffracted shock fronts formed polygonal shaped patterns near the point of focus. The maximum pressure and temperature as a function of number of obstacles were studied. The self-similar behavior of cylindrical, triangular and square-shaped shocks were also investigated.

  1. 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...

  2. Gas entrainment induced by vortex behind an obstacle. 2

    International Nuclear Information System (INIS)

    In the previous study gas entrainment by vortex is studied using semicylindrical a obstacle. In that case, flow patterns were categorized into four cases. In this study we perform fundamental experiments using with a cylindrical obstacle. The experimental results show that the relative locations of the obstacle, outlet and wall affects the patterns of flow and gas entrainment, which are categorized into six cases due to antisymmetry in the geometry. (author)

  3. 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

  4. 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.

  5. 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.

  6. Do Consumers Use Information to Choose a Health-Care Provider System?

    OpenAIRE

    Feldman, Roger; Christianson, Jon; Schultz, Jennifer

    2000-01-01

    This study examines the use of information by employees in the Buyers Health Care Action Group, a purchasing coalition of large employers in Minneapolis. BHCAG employers contract directly with multiple health-care provider systems and attempt to inform employees about those choices. Shortly after the close of the 1998 open-enrollment period, a survey of 927 BHCAG employees with single-coverage health insurance was conducted. Seventy-six percent of the employees relied on information from thei...

  7. Setting up a health care quality management system in a multidisciplinary clinical research center

    Directory of Open Access Journals (Sweden)

    L. V. Laktionova

    2014-07-01

    Full Text Available The paper discusses the issues of setting up a quality management system in a multidisciplinary specialized clinical research center. It describes the experience with information technologies used in a prophylactic facility to set up effective out- and inpatient health care control. Measures to optimize work under present-day conditions to upgrade the quality of health care are given using the federal health facility as an example.

  8. Using geographic information system tools to improve access to MS specialty care in Veterans Health Administration

    OpenAIRE

    William J. Culpepper, II, PhD, MA; Diane Cowper-Ripley, PhD; Eric R. Litt, BA; Tzu-Yun McDowell, MA; Paul M. Hoffman, MD

    2010-01-01

    Access to appropriate and timely healthcare is critical to the overall health and well-being of patients with chronic diseases. In this study, we used geographic information system (GIS) tools to map Veterans Health Administration (VHA) patients with multiple sclerosis (MS) and their access to MS specialty care. We created six travel-time bands around VHA facilities with MS specialty care and calculated the number of VHA patients with MS who resided in each time band and the number of patient...

  9. Trauma in elderly people: access to the health system through pre-hospital care1

    OpenAIRE

    da Silva, Hilderjane Carla; Pessoa, Renata de Lima; de Menezes, Rejane Maria Paiva

    2016-01-01

    Objective: to identify the prevalence of trauma in elderly people and how they accessed the health system through pre-hospital care. Method: documentary and retrospective study at a mobile emergency care service, using a sample of 400 elderly trauma victims selected through systematic random sampling. A form validated by experts was used to collect the data. Descriptive statistical analysis was applied. The chi-square test was used to analyze the association between the variables. Results: Tr...

  10. 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. PMID:11293008

  11. Ensuring the security and privacy of information in mobile health-care communication systems

    OpenAIRE

    Ademola P. Abidoye; Henry O. Nyongesa; Ronald Februarie; Kehinde K. Agbele; Ademola O. Adesina

    2011-01-01

    The sensitivity of health-care information and its accessibility via the Internet and mobile technology systems is a cause for concern in these modern times. The privacy, integrity and confidentiality of a patient’s data are key factors to be considered in the transmission of medical information for use by authorised health-care personnel. Mobile communication has enabled medical consultancy, treatment, drug administration and the provision of laboratory results to take place outside the hosp...

  12. Personalized medicine – a tailored health care system: challenges and opportunities

    OpenAIRE

    Louca, Soulla

    2012-01-01

    Abstract The vision of the future health care should be a system in which patient care is consistently improved through the use of information on the individual patient’s genomes and their downstream products. This requires the exploration of strategic relationships among various disciplines such as life sciences, mathematics, physics, chemistry, and information and communication technology, and constellation thinking to propose new ways for the diagnosis and therapy o...

  13. Critical care management of systemic mastocytosis: when every wasp is a killer bee

    OpenAIRE

    van der Weide, Hinke Y.; van Westerloo, David J.; van den Bergh, Walter M.

    2015-01-01

    Since the critical care physician will most likely be involved in a life-threatening expression of systemic mastocytosis, recognition of this disease is of utmost importance in the critical care management of these patients. Mastocytosis is a severely under-recognized disease because it typically occurs secondary to another condition and thus may occur more frequently than assumed. In this article, we will review the current knowledge on the treatment of mastocytosis crises with an emphasis o...

  14. 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.

  15. 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.

  16. Investing in CIS: obstacles and strategies

    International Nuclear Information System (INIS)

    The CIS (Community of Independent States) needs the help of foreign investments to develop its huge hydrocarbon potentialities. Because of the uncertainties concerning the legal and fiscal context of their activities, the role of the international oil companies has remained limited so far. These problems were discussed in May 1996 during an important ''General Session'' of the OTC 96 congress. Proven and explored onshore oil reserves in Russia are enormous, in particular in Western and Eastern Siberia. However, the economically most interesting resources are located in the offshore zones of the Barents, Pechora and Kara seas and of Eastern Siberia and Okhotsk. This paper describes the last years decay of oil production in CIS and its causes, in particular the obstacles to foreign investments (exportation and transport taxes), the recent contracts and joint-ventures with American major companies (Exxon, Amoco..), and the situation of the Russian industry in petroleum engineering and field exploitation materials. (J.S.)

  17. 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)

  18. 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

  19. A Secured Health Care Application Architecture for Cyber-Physical Systems

    CERN Document Server

    Wang, Jin; Lee, Sungyoung; Shu, Lei; Xia, Feng

    2012-01-01

    Cyber-physical systems (CPS) can be viewed as a new generation of systems with integrated control, communication and computational capabilities. Like the internet transformed how humans interact with one another, cyber-physical systems will transform how people interact with the physical world. Currently, the study of CPS is still in its infancy and there exist many research issues and challenges ranging from electricity power, health care, transportation and smart building etc. In this paper, an introduction of CPeSC3 (cyber physical enhanced secured wireless sensor networks (WSNs) integrated cloud computing for u-life care) architecture and its application to the health care monitoring and decision support systems is given. The proposed CPeSC3 architecture is composed of three main components, namely 1) communication core, 2) computation core, and 3) resource scheduling and management core. Detailed analysis and explanation are given for relevant models such as cloud computing, real time scheduling and secu...

  20. 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.