WorldWideScience

Sample records for current healthcare environment

  1. Educating Medical Laboratory Technologists: Revisiting Our Assumptions in the Current Economic and Health-Care Environment

    Directory of Open Access Journals (Sweden)

    Regina Linder

    2012-08-01

    Full Text Available Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stakeholders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships.

  2. Designing better healthcare environments: interprofessional competencies in healthcare design.

    Science.gov (United States)

    Lamb, Gerri; Zimring, Craig; Chuzi, Joshua; Dutcher, Diane

    2010-07-01

    There has been considerable interest in bridging educational programs in the United States across healthcare, architecture, industrial design, and human computing disciplines to design more effective and safer healthcare environments. New combinations of professionals including those outside the traditional healthcare disciplines are coming together to solve quality and safety problems and to re-envision the physical and social design of healthcare organizations. Little is known about the knowledge and skills essential to integrate these diverse perspectives and pose innovative solutions. A set of seven interprofessional competencies were identified through review of the literature, interviews of faculty and leaders in the field, and experience of the authors teaching interprofessional courses in healthcare design. The relevance and feasibility of these competencies were assessed through expert review by faculty and consultants and implementation in multiple courses.

  3. Mobile healthcare in the home environment.

    Science.gov (United States)

    Price, Sheila; Summers, Ron

    2006-01-01

    Mobile healthcare provision in the home environment presents many challenges. Patients are becoming more informed about the management of chronic conditions and the use of technology to support the process is rising. Issues such as system interoperability, cost, security and training all have to be addressed to ensure effective use of mobile devices within the home healthcare arena. An aging population will impact upon traditional healthcare delivery methods.

  4. Architecture capabilities to improve healthcare environments.

    Science.gov (United States)

    Ebrahimi, Ali; Mardomi, Karim; Hassanpour Rahimabad, Kasra

    2013-01-01

    The physical environment of healthcare buildings has great importance in issues such as patient safety, functional efficiency, user satisfaction, healthcare outcomes, and energy and resources consumption. The present study assesses physical environments of Iranian healthcare buildings. This study was performed using a descriptive-analytical method. Data collection was carried out via a written questionnaire. Based on the findings of this study, "functional efficiency", "user satisfaction", "environmental issues", "patient safety", "accountability in incidents and disasters", and "flexibility" are regarded as the most issues in the country's hospitals. Also, none of the parameters is "without any problem" and has a "desirable status". According to the responses, all of the healthcare buildings in this research had flaws in their physical environment, which require attention. Thus, it is necessary to review and pay more attention to the architecture of the country's healthcare buildings.

  5. Architecture Capabilities to Improve Healthcare Environments

    Directory of Open Access Journals (Sweden)

    Ali Ebrahimi

    2013-01-01

    Full Text Available Background: The physical environment of healthcare buildings has great importance in issues such as patient safety, functional efficiency, user satisfaction, healthcare outcomes, and energy and resources consumption.Objectives: The present study assesses physical environments of Iranian healthcare buildings.Materials and Methods: This study was performed using a descriptive-analytical method. Data collection was carried out via a written questionnaire.Results: Based on the findings of this study, "functional efficiency", "user satisfaction", "environmental issues", "patient safety”, “accountability in incidents and disasters", and "flexibility" are regarded as the most issues in the country's hospitals. Also, none of the parameters is "without any problem" and has a "desirable status".Conclusions: According to the responses, all of the healthcare buildings in this research had flaws in their physical environment, which require attention. Thus, it is necessary to review and pay more attention to the architecture of the country's healthcare buildings.

  6. Group profile management in ubiquitous healthcare environment.

    Science.gov (United States)

    Fengou, Maria-Anna; Mantas, Georgios; Lymberopoulos, Dimitrios

    2012-01-01

    Nowadays, ubiquitous healthcare is of utmost importance in the patient-centric model. Furthermore, the personalization of ubiquitous healthcare services plays a very important role to make the patient-centric model a reality. The personalization of the ubiquitous healthcare services is based on the profiles of the entities participating in these services. In this paper, we propose a group profile management system in a ubiquitous healthcare environment. The proposed system is responsible for the dynamic creation of a group profile and its management.

  7. Access control mechanisms for distributed healthcare environments.

    Science.gov (United States)

    Sergl-Pommerening, Marita

    2004-01-01

    Today's IT-infrastructure provides more and more possibilities to share electronic patient data across several healthcare organizations and hospital departments. A strong requirement is sufficient data protection and security measures complying with the medical confidentiality and the data protection laws of each state or country like the European directive on data protection or the U.S. HIPAA privacy rule. In essence, the access control mechanisms and authorization structures of information systems must be able to realize the Need-To-Access principle. This principle can be understood as a set of context-sensitive access rules, regarding the patient's path across the organizations. The access control mechanisms of today's health information systems do not sufficiently satisfy this requirement, because information about participation of persons or organizations is not available within each system in a distributed environment. This problem could be solved by appropriate security services. The CORBA healthcare domain standard contains such a service for obtaining authorization decisions and administrating access decision policies (RAD). At the university hospital of Mainz we have developed an access control system (MACS), which includes the main functionality of the RAD specification and the access control logic that is needed for such a service. The basic design principles of our approach are role-based authorization, user rights with static and dynamic authorization data, context rules and the separation of three cooperating servers that provide up-to-date knowledge about users, roles and responsibilities. This paper introduces the design principles and the system design and critically evaluates the concepts based on practical experience.

  8. Managing change within the healthcare environment.

    Science.gov (United States)

    Lipcamon, James D

    2003-01-01

    In the healthcare environment, there are many catalysts for change, including federal and state regulations, increased utilization, patients' expectations, competition, declining reimbursement and the technologist shortage. Regardless of what organization you work in, change creates pressure internally. This is especially true of organizations that have not had to deal with much change. The three most common responses are: 1) senior managers tend to isolate themselves from the effects of change on staff members; 2) middle managers tend to feel squeezed between the need to implement change and the need to support staff members; and 3) employees tend to feel attacked and betrayed by change. The following five steps will help you work with your staff as you introduce and implement change: prepare your employees, plan thoroughly, develop a transitional line of authority, stay flexible during implementation, and encourage self-management, acknowledging those who helped make the change work. When change is implemented, it is important to understand that people will move through four stages of reaction: denial, resistance, exploration and commitment. As a general rule, individuals will go through all four stages, but the speed at which they move through them will be different. Managers need to assist employees who get stuck in certain stages. To implement change as successfully as possible, follow these four steps: communicate about change, deal with resistance, increase team involvement, and use visionary leadership.

  9. Integrated Environment for Ubiquitous Healthcare and Mobile IPv6 Networks

    Science.gov (United States)

    Cagalaban, Giovanni; Kim, Seoksoo

    The development of Internet technologies based on the IPv6 protocol will allow real-time monitoring of people with health deficiencies and improve the independence of elderly people. This paper proposed a ubiquitous healthcare system for the personalized healthcare services with the support of mobile IPv6 networks. Specifically, this paper discusses the integration of ubiquitous healthcare and wireless networks and its functional requirements. This allow an integrated environment where heterogeneous devices such a mobile devices and body sensors can continuously monitor patient status and communicate remotely with healthcare servers, physicians, and family members to effectively deliver healthcare services.

  10. Channel agnostic healthcare for resource constrained environments

    CSIR Research Space (South Africa)

    Alberts, Ronell

    2015-01-01

    Full Text Available be inappropriate. This ambient availability allows applications to communicate with remote platforms.  Sociable: Social mobile users handle several micro-contexts simultaneously. In situations where phones are shared the device can become the focus...; and  Municipal ward-based primary healthcare workers who work with allocated households to identify health problems and to promote active involvement in good health practice by communities. Non-communicable diseases, although often associated...

  11. Laboratory medicine in the new healthcare environment.

    Science.gov (United States)

    Ferraro, Simona; Braga, Federica; Panteghini, Mauro

    2016-04-01

    The 21st century challenge is to redesign healthcare systems to be safe, efficient, effective, timely, equitable and patient-centred. Although laboratory medicine is integral to many of these objectives involving prevention, diagnosis, treatment, and managing disease of patients, it suffers from poor visibility as a medical discipline and as a profession and fewer rewards for educational efforts when compared to other medical disciplines. Laboratory scientists are often perceived as managing machinery and equipment, but conversely they need to take a position of shared clinical leadership, showing the role of laboratory tests to guarantee optimal care for patients. This is however challenging because of some reluctance by laboratory professionals to involve themselves in test structuring and requesting and in the inspection of work as it arrives because it is assumed that all requests are clinically necessary; there is a poor communication and integration between clinical wards and laboratory; and, importantly, there is the need for an excellent cultural and scientific background of laboratory professionals for implementing outcome research and to act as knowledge managers and skilled clinical consultants. By combining the unique talent of performing quality laboratory assays with knowledge of the pathophysiologic rationale behind the tests, laboratory professionals have the expertise to advise their clinical colleagues in regard to the appropriate test selection and interpretation of laboratory results, thereby creating opportunities to define the added value and the pivotal role of laboratory medicine on healthcare delivery.

  12. Design research and the globalization of healthcare environments.

    Science.gov (United States)

    Shepley, Mardelle McCuskey; Song, Yilin

    2014-01-01

    Global healthcare practice has expanded in the past 20 years. At the same time the incorporation of research into the design process has gained prominence as a best practice among architects. The authors of this study investigated the status of design research in a variety of international settings. We intended to answer the question, "how pervasive is healthcare design research outside of the United States?" The authors reviewed the international literature on the design of healthcare facilities. More than 500 international studies and conference proceedings were incorporated in this literature review. A team of five research assistants searched multiple databases comparing approximately 16 keywords to geographic location. Some of those keywords included: evidence-based design, salutogenic design, design research, and healthcare environment. Additional articles were gathered by contacting prominent researchers and asking for their personal assessment of local health design research studies. While there are design researchers in most parts of the world, the majority of studies focus on the needs of populations in developed countries and generate guidelines that have significant cost and cultural implications that prohibit their implementation in developing countries. Additionally, the body of literature discussing the role of culture in healthcare environments is extremely limited. Design researchers must address the cultural implications of their studies. Additionally, we need to expand our research objectives to address healthcare design in countries that have not been previous considered. © 2014 Vendome Group, LLC.

  13. The integrated and evidence-based design of healthcare environments.

    NARCIS (Netherlands)

    van Hoof, J.; Rutten, P.G.S.; Struck, C.; Huisman, E.R.C.M.; Kort, H.S.M.

    2014-01-01

    van Hoof, J., Rutten, P.G.S., Struck, C., Huisman, E.R.C.M., Kort, H.S.M. (2014) The integrated and evidence-based design of healthcare environments. Architectural Engineering and Design Management doi:10.1080/17452007.2014.892471

  14. Individual differences in reactions towards color in simulated healthcare environments : The role of stimulus screening ability

    NARCIS (Netherlands)

    Dijkstra, K.; Pieterse, Marcel E.; Pruyn, Adriaan T.H.

    2008-01-01

    The notion that the physical healthcare environment can affect our mood and behavior is well established. Despite this, individual differences in sensitivity to environmental stimuli have not received much attention. With the current research showing the importance of individual differences in

  15. Individual differences in reactions towards color in simulated healthcare environments: The role of stimulus screening ability

    NARCIS (Netherlands)

    Dijkstra, K.; Pieterse, M.E.; Pruyn, A.Th.H.

    2008-01-01

    The notion that the physical healthcare environment can affect our mood and behavior is well established. Despite this, individual differences in sensitivity to environmental stimuli have not received much attention. With the current research showing the importance of individual differences in sensi

  16. Supporting nurses' transition to rural healthcare environments through mentorship.

    Science.gov (United States)

    Rohatinsky, Noelle K; Jahner, Sharleen

    2016-01-01

    The global shortage of rural healthcare professionals threatens the access these communities have to adequate healthcare resources. Barriers to recruitment and retention of nurses in rural facilities include limited resources, professional development opportunities, and interpersonal ties to the area. Mentorship programs have been used to successfully recruit and retain rural nurses. This study aimed to explore (i) employee perceptions of mentorship in rural healthcare organizations, (ii) the processes involved in creating mentoring relationships in rural healthcare organizations, and (iii) the organizational features supporting and inhibiting mentorship in rural healthcare organizations. This study was conducted in one rural health region in Saskatchewan, Canada. Volunteer participants who were employed at one rural healthcare facility were interviewed. A semi-structured interview guide that focused on exploring and gaining an understanding of participants' perceptions of mentorship in rural communities was employed. Data were analyzed using interpretive description methodology, which places high value on participants' subjective perspective and knowledge of their experience. All seven participants were female and employed as registered nurses or licensed practical nurses. Participants recognized that the rural environment offered unique challenges and opportunities for the transition of nurses new to rural healthcare. Participants believed mentorships facilitated this transition and were vital to the personal and professional success of new employees. Specifically, their insights indicated that this transition was influenced by three factors: rural community influences, organizational influences, and mentorship program influences. Facilitators for mentorships hinged on the close working relationships that facilitated the development of trust. Barriers to mentorship included low staff numbers, limited selection of volunteer mentors, and lack of mentorship

  17. Two RFID standard-based security protocols for healthcare environments.

    Science.gov (United States)

    Picazo-Sanchez, Pablo; Bagheri, Nasour; Peris-Lopez, Pedro; Tapiador, Juan E

    2013-10-01

    Radio Frequency Identification (RFID) systems are widely used in access control, transportation, real-time inventory and asset management, automated payment systems, etc. Nevertheless, the use of this technology is almost unexplored in healthcare environments, where potential applications include patient monitoring, asset traceability and drug administration systems, to mention just a few. RFID technology can offer more intelligent systems and applications, but privacy and security issues have to be addressed before its adoption. This is even more dramatical in healthcare applications where very sensitive information is at stake and patient safety is paramount. In Wu et al. (J. Med. Syst. 37:19, 43) recently proposed a new RFID authentication protocol for healthcare environments. In this paper we show that this protocol puts location privacy of tag holders at risk, which is a matter of gravest concern and ruins the security of this proposal. To facilitate the implementation of secure RFID-based solutions in the medical sector, we suggest two new applications (authentication and secure messaging) and propose solutions that, in contrast to previous proposals in this field, are fully based on ISO Standards and NIST Security Recommendations.

  18. Healthcare environments and spatial variability of healthcare associated infection risk: cross-sectional surveys.

    Directory of Open Access Journals (Sweden)

    Jean Gaudart

    Full Text Available Prevalence of healthcare associated infections remains high in patients in intensive care units (ICU, estimated at 23.4% in 2011. It is important to reduce the overall risk while minimizing the cost and disruption to service provision by targeted infection control interventions. The aim of this study was to develop a monitoring tool to analyze the spatial variability of bacteriological contamination within the healthcare environment to assist in the planning of interventions. Within three cross-sectional surveys, in two ICU wards, air and surface samples from different heights and locations were analyzed. Surface sampling was carried out with tryptic Soy Agar contact plates and Total Viable Counts (TVC were calculated at 48 hrs (incubation at 37 °C. TVCs were analyzed using Poisson Generalized Additive Mixed Model for surface type analysis, and for spatial analysis. Through three cross-sectional survey, 370 samples were collected. Contamination varied from place-to-place, height-to-height, and by surface type. Hard-to-reach surfaces, such as bed wheels and floor area under beds, were generally more contaminated, but the height level at which maximal TVCs were found changed between cross-sectional surveys. Bedside locations and bed occupation were risk factors for contamination. Air sampling identified clusters of contamination around the nursing station and surface sampling identified contamination clusters at numerous bed locations. By investigating dynamic hospital wards, the methodology employed in this study will be useful to monitor contamination variability within the healthcare environment and should help to assist in the planning of interventions.

  19. Versatile, immersive, creative and dynamic virtual 3-D healthcare learning environments: a review of the literature.

    Science.gov (United States)

    Hansen, Margaret M

    2008-09-01

    The author provides a critical overview of three-dimensional (3-D) virtual worlds and "serious gaming" that are currently being developed and used in healthcare professional education and medicine. The relevance of this e-learning innovation for teaching students and professionals is debatable and variables influencing adoption, such as increased knowledge, self-directed learning, and peer collaboration, by academics, healthcare professionals, and business executives are examined while looking at various Web 2.0/3.0 applications. There is a need for more empirical research in order to unearth the pedagogical outcomes and advantages associated with this e-learning technology. A brief description of Roger's Diffusion of Innovations Theory and Siemens' Connectivism Theory for today's learners is presented as potential underlying pedagogical tenets to support the use of virtual 3-D learning environments in higher education and healthcare.

  20. Decision making in high-velocity environments: implications for healthcare.

    Science.gov (United States)

    Stepanovich, P L; Uhrig, J D

    1999-01-01

    Healthcare can be considered a high-velocity environment and, as such, can benefit from research conducted in other industries regarding strategic decision making. Strategic planning is not only relevant to firms in high-velocity environments, but is also important for high performance and survival. Specifically, decision-making speed seems to be instrumental in differentiating between high and low performers; fast decision makers outperform slow decision makers. This article outlines the differences between fast and slow decision makers, identifies five paralyses that can slow decision making in healthcare, and outlines the role of a planning department in circumventing these paralyses. Executives can use the proposed planning structure to improve both the speed and quality of strategic decisions. The structure uses planning facilitators to avoid the following five paralyses: 1. Analysis. Decision makers can no longer afford the luxury of lengthy, detailed analysis but must develop real-time systems that provide appropriate, timely information. 2. Alternatives. Many alternatives (beyond the traditional two or three) need to be considered and the alternatives must be evaluated simultaneously. 3. Group Think. Decision makers must avoid limited mind-sets and autocratic leadership styles by seeking out independent, knowledgeable counselors. 4. Process. Decision makers need to resolve conflicts through "consensus with qualification," as opposed to waiting for everyone to come on board. 5. Separation. Successful implementation requires a structured process that cuts across disciplines and levels.

  1. Secure dissemination of electronic healthcare records in distributed wireless environments.

    Science.gov (United States)

    Belsis, Petros; Vassis, Dimitris; Skourlas, Christos; Pantziou, Grammati

    2008-01-01

    A new networking paradigm has emerged with the appearance of wireless computing. Among else ad-hoc networks, mobile and ubiquitous environments can boost the performance of systems in which they get applied. Among else, medical environments are a convenient example of their applicability. With the utilisation of wireless infrastructures, medical data may be accessible to healthcare practitioners, enabling continuous access to medical data. Due to the critical nature of medical information, the design and implementation of these infrastructures demands special treatment in order to meet specific requirements; among else, special care should be taken in order to manage interoperability, security, and in order to deal with bandwidth and hardware resource constraints that characterize the wireless topology. In this paper we present an architecture that attempts to deal with these issues; moreover, in order to prove the validity of our approach we have also evaluated the performance of our platform through simulation in different operating scenarios.

  2. Access control management for e-Healthcare in cloud environment

    Directory of Open Access Journals (Sweden)

    Lili Sun

    2014-03-01

    Full Text Available Data outsourcing is a major component for cloud computing that allows data owners to distribute resources to external services for users and organizations who can apply the resources. A crucial problem for owners is how to make sure their sensitive information accessed by legitimate users only using the trusted services but not authorized to read the actual information. With the increased development of cloud computing, it brings challenges for data security and access control when outsourcing users’ data and sharing sensitive data in cloud environment since it is not within the same trusted domain as data owners’. Access control policies have become an important issue in the security filed in cloud computing. Semantic web technologies represent much richer forms of relationships among users, resources and actions among different web applications such as clouding computing. However, Semantic web applications pose new requirements for security mechanisms especially in the access control models. This paper addresses existing access control methods and presents a semantic based access control model which considers semantic relations among different entities in cloud computing environment. We have enriched the research for semantic web technology with role-based access control that is able to be applied in the field of medical information system or e-Healthcare system. This work shows how the semantic web technology provides efficient solutions for the management of complex and distributed data in heterogeneous systems, and it can be used in the medical information systems as well.

  3. Islam and the healthcare environment: designing patient rooms.

    Science.gov (United States)

    Kopec, D A K; Han, Li

    2008-01-01

    Islam and the Muslim population are often the source of much misunderstanding and media-influenced misconceptions. Muslim patients who enter the healthcare environment are often weak and likely to experience feelings of vulnerability. Because of the complex and interwoven nature of culture and religion in a person's identity, it is important to consider patient belief systems and values when designing a patient's immediate environment. Through an exploration of literature related to culture and diversity and the beliefs and value system of the Muslim population, the authors were able to identify flexible design initiatives that could accommodate an array of cultural and spiritual practices. Islam and the Muslim population were chosen as the points of reference for this study because of the strong influence of the religion on the culture, and because of the many nuances that differ from the dominant culture within the United States. From these points of reference, a hypothetical design was developed for a patient room that considers differing notions of privacy, alternatives for cultural and religious practices, and ways to include symbolic meaning derived from attributes such as color.

  4. Design Quality in the Context of Healthcare Environments: A Scoping Review.

    Science.gov (United States)

    Anåker, Anna; Heylighen, Ann; Nordin, Susanna; Elf, Marie

    2017-07-01

    We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare. High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security. In addition, there are demands that decisions about the design of healthcare architecture be based on the best available information from credible research and the evaluation of existing building projects. The basic principles of Arksey and O'Malley's model of scoping review design were used. Data were derived from literature searches in scientific databases. A total of 18 articles and books were found that referred to design quality in a healthcare context. Design quality of physical healthcare environments involves three different themes: (i) environmental sustainability and ecological values, (ii) social and cultural interactions and values, and (iii) resilience of the engineering and building construction. Design quality was clarified herein with a definition. Awareness of what is considered design quality in relation to healthcare architecture could help to design healthcare environments based on evidence. To operationalize the concept, its definition must be clear and explicit and able to meet the complex needs of the stakeholders in a healthcare context, including patients, staff, and significant others.

  5. Physical environmental stimuli that turn healthcare facilities into healing environments through psychologically mediated effects: systematic review

    NARCIS (Netherlands)

    Dijkstra, Karin; Pieterse, Marcel; Pruyn, Ad

    2006-01-01

    Aim. This paper reports a systematic review to determine the effects of physical environmental stimuli in healthcare settings on the health and well-being of patients. Background. The concept of healing environments suggests that the physical environment of the healthcare setting can encourage the

  6. Distributed, signal strength-based indoor localization algorithm for use in healthcare environments.

    Science.gov (United States)

    Wyffels, Jeroen; De Brabanter, Jos; Crombez, Pieter; Verhoeve, Piet; Nauwelaers, Bart; De Strycker, Lieven

    2014-11-01

    In current healthcare environments, a trend toward mobile and personalized interactions between people and nurse call systems is strongly noticeable. Therefore, it should be possible to locate patients at all times and in all places throughout the care facility. This paper aims at describing a method by which a mobile node can locate itself indoors, based on signal strength measurements and a minimal amount of yes/no decisions. The algorithm has been developed specifically for use in a healthcare environment. With extensive testing and statistical support, we prove that our algorithm can be used in a healthcare setting with an envisioned level of localization accuracy up to room revel (or region level in a corridor), while avoiding heavy investments since the hardware of an existing nurse call network can be reused. The approach opted for leads to very high scalability, since thousands of mobile nodes can locate themselves. Network timing issues and localization update delays are avoided, which ensures that a patient can receive the needed care in a time and resources efficient way.

  7. A Survey on Wireless Body Area Networks for eHealthcare Systems in Residential Environments.

    Science.gov (United States)

    Ghamari, Mohammad; Janko, Balazs; Sherratt, R Simon; Harwin, William; Piechockic, Robert; Soltanpur, Cinna

    2016-06-07

    Current progress in wearable and implanted health monitoring technologies has strong potential to alter the future of healthcare services by enabling ubiquitous monitoring of patients. A typical health monitoring system consists of a network of wearable or implanted sensors that constantly monitor physiological parameters. Collected data are relayed using existing wireless communication protocols to a base station for additional processing. This article provides researchers with information to compare the existing low-power communication technologies that can potentially support the rapid development and deployment of WBAN systems, and mainly focuses on remote monitoring of elderly or chronically ill patients in residential environments.

  8. A Survey on Wireless Body Area Networks for eHealthcare Systems in Residential Environments

    Directory of Open Access Journals (Sweden)

    Mohammad Ghamari

    2016-06-01

    Full Text Available Current progress in wearable and implanted health monitoring technologies has strong potential to alter the future of healthcare services by enabling ubiquitous monitoring of patients. A typical health monitoring system consists of a network of wearable or implanted sensors that constantly monitor physiological parameters. Collected data are relayed using existing wireless communication protocols to a base station for additional processing. This article provides researchers with information to compare the existing low-power communication technologies that can potentially support the rapid development and deployment of WBAN systems, and mainly focuses on remote monitoring of elderly or chronically ill patients in residential environments.

  9. Role of the pharmacist in reducing healthcare costs: current insights

    Directory of Open Access Journals (Sweden)

    Dalton K

    2017-01-01

    Full Text Available Kieran Dalton, Stephen Byrne Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland Abstract: Global healthcare expenditure is escalating at an unsustainable rate. Money spent on medicines and managing medication-related problems continues to grow. The high prevalence of medication errors and inappropriate prescribing is a major issue within healthcare systems, and can often contribute to adverse drug events, many of which are preventable. As a result, there is a huge opportunity for pharmacists to have a significant impact on reducing healthcare costs, as they have the expertise to detect, resolve, and prevent medication errors and medication-related problems. The development of clinical pharmacy practice in recent decades has resulted in an increased number of pharmacists working in clinically advanced roles worldwide. Pharmacist-provided services and clinical interventions have been shown to reduce the risk of potential adverse drug events and improve patient outcomes, and the majority of published studies show that these pharmacist activities are cost-effective or have a good cost:benefit ratio. This review demonstrates that pharmacists can contribute to substantial healthcare savings across a variety of settings. However, there is a paucity of evidence in the literature highlighting the specific aspects of pharmacists’ work which are the most effective and cost-effective. Future high-quality economic evaluations with robust methodologies and study design are required to investigate what pharmacist services have significant clinical benefits to patients and substantiate the greatest cost savings for healthcare budgets. Keywords: pharmacoeconomics, pharmaceutical care, clinical pharmacy, cost-effectiveness, economic evaluation

  10. A novel approach to developing applications in the pervasive healthcare environment through the use of archetypes

    NARCIS (Netherlands)

    Cardoso de Moraes, João Luís; Lopes de Souza, Wanderley; Ferreira Pires, Luis; Tricai Cavalini, Luciana; Prado, do Antonio Francisco; Murgante, B.; Misra, S.; Carlini, M.; Torre, C.M.; Nguyen, H.Q.; Taniar, D.; Apduhan, B.O.; Gervasi, O.

    2013-01-01

    Pervasive Healthcare focuses on the use of new technologies, tools, and services, to help patients to play a more active role in the treatment of their conditions. Pervasive Healthcare environments demand a huge amount of information exchange, and specific technologies has been proposed to provide i

  11. Taking stock of current societal, political and academic stakeholders in the Canadian healthcare knowledge translation agenda

    Directory of Open Access Journals (Sweden)

    Scott-Findlay Shannon

    2007-10-01

    Full Text Available Abstract Background In the past 15 years, knowledge translation in healthcare has emerged as a multifaceted and complex agenda. Theoretical and polemical discussions, the development of a science to study and measure the effects of translating research evidence into healthcare, and the role of key stakeholders including academe, healthcare decision-makers, the public, and government funding bodies have brought scholarly, organizational, social, and political dimensions to the agenda. Objective This paper discusses the current knowledge translation agenda in Canadian healthcare and how elements in this agenda shape the discovery and translation of health knowledge. Discussion The current knowledge translation agenda in Canadian healthcare involves the influence of values, priorities, and people; stakes which greatly shape the discovery of research knowledge and how it is or is not instituted in healthcare delivery. As this agenda continues to take shape and direction, ensuring that it is accountable for its influences is essential and should be at the forefront of concern to the Canadian public and healthcare community. This transparency will allow for scrutiny, debate, and improvements in health knowledge discovery and health services delivery.

  12. A secure RFID mutual authentication protocol for healthcare environments using elliptic curve cryptography.

    Science.gov (United States)

    Jin, Chunhua; Xu, Chunxiang; Zhang, Xiaojun; Zhao, Jining

    2015-03-01

    Radio Frequency Identification(RFID) is an automatic identification technology, which can be widely used in healthcare environments to locate and track staff, equipment and patients. However, potential security and privacy problems in RFID system remain a challenge. In this paper, we design a mutual authentication protocol for RFID based on elliptic curve cryptography(ECC). We use pre-computing method within tag's communication, so that our protocol can get better efficiency. In terms of security, our protocol can achieve confidentiality, unforgeability, mutual authentication, tag's anonymity, availability and forward security. Our protocol also can overcome the weakness in the existing protocols. Therefore, our protocol is suitable for healthcare environments.

  13. Reducing the Ecological Footprint of Pharmaceutical Usage: Linkages Between Healthcare Practices and the Environment

    Science.gov (United States)

    The design of pharmaceuticals and the practices surrounding the lifecycle of their manufacture and usage are central to minimize their impacts on the environment and increase the sustainability of healthcare. Cradle-to-cradle design, as conceptualized by McDonough and Braungart, ...

  14. The effect of transforming care at the bedside initiative on healthcare teams' work environments.

    Science.gov (United States)

    Lavoie-Tremblay, Mélanie; O'Conner, Patricia; Harripaul, Anastasia; Biron, Alain; Ritchie, Judith; Lavigne, Genevieve L; Baillargeon, Sophie; Ringer, Justin; Macgibbon, Brenda; Taylor-Ducharme, Sharon; Sourdif, Jacynthe

    2014-02-01

    Different initiatives have been implemented in healthcare organizations to improve efficiency, such as transforming care at the bedside (TCAB). However, there are important gaps in understanding the effect of TCAB on healthcare teams' work environments. The specific aim of the study is to describe findings regarding the TCAB initiative effects on healthcare teams' work environments. A pretest and posttest study design was used for this study. The TCAB initiative was implemented in fall 2010 in a university health center in Montreal, Canada. The sample consisted of healthcare workers from four different care units. Statistically significant improvement was observed with the communicating specific information subscale from the measure of processes of care variable, and a significant difference was found between the support from colleagues variable, which was higher at baseline than postprogram. The differences for psychological demand, decisional latitude, and effort-reward were not significant. TCAB is an intervention that allows healthcare teams to implement change to improve patients' and families' outcomes. Ongoing energy should focus on how to improve communication among all members of the team and ensure their support. © 2013 Sigma Theta Tau International.

  15. Key tasks in healthcare marketing: assessing importance and current level of knowledge.

    Science.gov (United States)

    Kennett, Pamela A; Henson, Steve W; Crow, Stephen M; Hartman, Sandra J

    2005-01-01

    When examining the healthcare industry, the need for continuing education in internal functions (i.e., HR management) has been documented. However, equally important to success in the healthcare industry are external functions such as marketing. In an expansion of research on internally focused functions, we report findings from an exploratory study designed to examine the perceptions of executives about managerial skill needs in the externally focused area of marketing. Specifically, we examine eight key tasks in marketing and ask executives to rate the level of knowledge required for each and then to assess current, or actual, levels of knowledge in the field. Findings suggest that pricing strategy, product strategy, and segmentation and targeting were the tasks that require the most knowledge for healthcare marketers, and that they do, in fact, perceive various gaps in all of the areas examined. Implications and suggestions for future research are provided.

  16. Robots, multi-user virtual environments and healthcare: synergies for future directions.

    Science.gov (United States)

    Moon, Ajung; Grajales, Francisco J; Van der Loos, H F Machiel

    2011-01-01

    The adoption of technology in healthcare over the last twenty years has steadily increased, particularly as it relates to medical robotics and Multi-User Virtual Environments (MUVEs) such as Second Life. Both disciplines have been shown to improve the quality of care and have evolved, for the most part, in isolation from each other. In this paper, we present four synergies between medical robotics and MUVEs that have the potential to decrease resource utilization and improve the quality of healthcare delivery. We conclude with some foreseeable barriers and future research directions for researchers in these fields.

  17. [Study of the healthcare background and psychosocial environment of the Maghrebian immigrant population in Catalonia [Spain

    Science.gov (United States)

    Saura, Rosa Maria; Suñol, Rosa; Vallejo, Paula; Lahoz, Sonia; Atxotegui, Joseba; El Manouari, Mohamed

    2008-01-01

    The aim of this study was to gather information on the healthcare background and social environment of the Maghrebian immigrant population in Catalonia in order to guide the management and provision of social services and the work of the organizations supporting this collective. To gather data, we used a questionnaire exploring healthcare and social variables, including stressors and social support. Data collection was performed by pollsters in Arabic. We performed 403 interviews. Most interviewees had a health card providing access to public healthcare and knew where to access healthcare. The most frequently used services were primary care and emergency departments. In primary care, almost all of the interviewees were provided explanations, but 30% were unable to understand them properly. Health professionals seemed to have inadequate awareness of cultural and religious differences. Work, housing, distance from the family, and legal status were stressful factors for more than half of this population. Social support was low. Three quarters of the interviewees felt lonely. More than half of this population had completely or partially fulfilled their expectations of migration, while 11% felt they were in a worse situation. The main areas for improvement are the provision of information on conditions of healthcare access, promotion of social interaction, the use of associations for immigrants especially during the first phases of the migration process and facilitating religious activities. Health professionals should be provided with training in intercultural issues.

  18. Fever and Pain Management in Childhood: Healthcare Providers’ and Parents’ Adherence to Current Recommendations

    Directory of Open Access Journals (Sweden)

    Genny Raffaeli

    2016-05-01

    Full Text Available In order to evaluate the adherence of healthcare providers and parents to the current recommendations concerning fever and pain management, randomized samples of 500 healthcare providers caring for children and 500 families were asked to complete an anonymous questionnaire. The 378 health care providers (HCPs responding to the survey (75.6% included 144 primary care pediatricians (38.1%, 98 hospital pediatricians (25.9%, 62 pediatric residents (16.4%, and 71 pediatric nurses (19.6%; the 464 responding parents (92.8% included 175 whose youngest (or only child was ≤5 years old (37.7%, 175 whose youngest (or only child was aged 6–10 years (37.7%, and 114 whose youngest (or only child was aged 11–14 years (24.6%. There were gaps in the knowledge of both healthcare providers and parents. Global adherence to the guidelines was lower among the pediatric nurses than the other healthcare providers (odds ratio 0.875; 95% confidence interval 0.795–0.964. Among the parents, those of children aged 6–10 and 11–14 years old, those who were older, and those without a degree answered the questions correctly significantly less frequently than the others. These findings suggest that there is an urgent need to improve the dissemination of the current recommendations concerning fever and pain management among healthcare providers and parents in order to avoid mistaken and sometimes risky attitudes, common therapeutic errors, and the unnecessary overloading of emergency department resources. Pediatric nurses and parents with older children, those who are older, and those with a lower educational level should be the priority targets of educational programmes.

  19. Fever and Pain Management in Childhood: Healthcare Providers' and Parents' Adherence to Current Recommendations.

    Science.gov (United States)

    Raffaeli, Genny; Orenti, Annalisa; Gambino, Monia; Peves Rios, Walter; Bosis, Samantha; Bianchini, Sonia; Tagliabue, Claudia; Esposito, Susanna

    2016-05-13

    In order to evaluate the adherence of healthcare providers and parents to the current recommendations concerning fever and pain management, randomized samples of 500 healthcare providers caring for children and 500 families were asked to complete an anonymous questionnaire. The 378 health care providers (HCPs) responding to the survey (75.6%) included 144 primary care pediatricians (38.1%), 98 hospital pediatricians (25.9%), 62 pediatric residents (16.4%), and 71 pediatric nurses (19.6%); the 464 responding parents (92.8%) included 175 whose youngest (or only) child was ≤5 years old (37.7%), 175 whose youngest (or only) child was aged 6-10 years (37.7%), and 114 whose youngest (or only) child was aged 11-14 years (24.6%). There were gaps in the knowledge of both healthcare providers and parents. Global adherence to the guidelines was lower among the pediatric nurses than the other healthcare providers (odds ratio 0.875; 95% confidence interval 0.795-0.964). Among the parents, those of children aged 6-10 and 11-14 years old, those who were older, and those without a degree answered the questions correctly significantly less frequently than the others. These findings suggest that there is an urgent need to improve the dissemination of the current recommendations concerning fever and pain management among healthcare providers and parents in order to avoid mistaken and sometimes risky attitudes, common therapeutic errors, and the unnecessary overloading of emergency department resources. Pediatric nurses and parents with older children, those who are older, and those with a lower educational level should be the priority targets of educational programmes.

  20. Current situation of depression healthcare in Spain: results of a psychiatrists' survey

    Directory of Open Access Journals (Sweden)

    Belén Martín-Águeda

    2006-12-01

    Full Text Available Objective: To analyze the current situation of healthcare for depression in Spain, according to psychiatrists opinion, and how it has evolved over the last 20 years, comparativily with the results reported in previous studies of our group. Methods: Throughout 2002, we recorded the opinions of 101 specialists in psychiatry after asking them to fill out structured questionnaires in which they rated care, clinical, therapeutic and care quality. Results: The presence of depressive disorders in healthcare is substantial, despite the high figures for "concealed epidemiology", with an increase in these last 20 years of disorders comorbid with anxiety. Currently, most patients arrive at the psychiatrist having been referred by their general practitioners (GP, as there is now less reluctance in depressive patients to such referral. In the last years there has been an increase in pharmacological treatment, with adverse effects of the drugs representing the major obstacle to non-adherence to such treatment. Selective serotonin reuptake inhibitors (SSRIs constitute the pharmacological group of choice, and are the drugs most commonly used in the treatment of depression, together with venlafaxine. Areas where there is a need for improvement are time devoted to consultation, coordination between GPs and psychiatrists, waiting lists, and resources available to Mental Health Units. Conclusions: Current situation of depression healthcare in Spain has substantially changed in recent years, improving in some aspects, thanks, in part, to the attitudes of GPs with this disorder and to evolution of pharmacological treatment.

  1. 'I think it will eventually be done away with': Attitudes among healthcare professionals towards the current system of animal experimentation.

    Science.gov (United States)

    Dignon, Andrée

    2016-08-01

    This article describes a study of attitudes to the current system of animal experimentation (for the production of health interventions) among 52 UK healthcare professionals. These healthcare professionals participated in three separate focus groups (of 18, 17 and 17 participants) and were invited to respond to the question 'what is your opinion about the current system of animal testing?' The study focused specifically on their views of the current system (rather than their views of animal testing in general). The healthcare professionals were critical of the current system, particularly with regard to regulation, secrecy, validity, unnecessary suffering and welfare. © The Author(s) 2014.

  2. A secure RFID authentication protocol for healthcare environments using elliptic curve cryptosystem.

    Science.gov (United States)

    Zhao, Zhenguo

    2014-05-01

    With the fast advancement of the wireless communication technology and the widespread use of medical systems, the radio frequency identification (RFID) technology has been widely used in healthcare environments. As the first important protocol for ensuring secure communication in healthcare environment, the RFID authentication protocols derive more and more attentions. Most of RFID authentication protocols are based on hash function or symmetric cryptography. To get more security properties, elliptic curve cryptosystem (ECC) has been used in the design of RFID authentication protocol. Recently, Liao and Hsiao proposed a new RFID authentication protocol using ECC and claimed their protocol could withstand various attacks. In this paper, we will show that their protocol suffers from the key compromise problem, i.e. an adversary could get the private key stored in the tag. To enhance the security, we propose a new RFID authentication protocol using ECC. Detailed analysis shows the proposed protocol not only could overcome weaknesses in Liao and Hsiao's protocol but also has the same performance. Therefore, it is more suitable for healthcare environments.

  3. Interoperability in healthcare: major challenges in the creation of the enterprise environment

    Science.gov (United States)

    Lindsköld, L.; Wintell, M.; Lundberg, N.

    2009-02-01

    There is today a lack of interoperability in healthcare although the need for it is obvious. A new healthcare enterprise environment has been deployed for secure healthcare interoperability in the Western Region in Sweden (WRS). This paper is an empirical overview of the new enterprise environment supporting regional shared and transparent radiology domain information in the WRS. The enterprise environment compromises 17 radiology departments, 1,5 million inhabitants, using different RIS and PACS in a joint work-oriented network and additional cardiology, dentistry and clinical physiology departments. More than 160 terabytes of information are stored in the enterprise repository. Interoperability is developed according to the IHE mission, i.e. applying standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level 7 (HL7) to address specific clinical communication needs and support optimal patient care. The entire enterprise environment is implemented and used daily in WRS. The central prerequisites in the development of the enterprise environment in western region of Sweden were: 1) information harmonization, 2) reuse of standardized messages e.g. HL7 v2.x and v3.x, 3) development of a holistic information domain including both text and images, and 4) to create a continuous and dynamic update functionality. The central challenges in this project were: 1) the many different vendors acting in the region and the negotiations with them to apply communication roles/profiles such as HL7 (CDA, CCR), DICOM, and XML, 2) the question of whom owns the data, and 3) incomplete technical standards. This study concludes that to create a workflow that runs within an enterprise environment there are a number of central prerequisites and challenges that needs to be in place. This calls for negotiations on an international, national and regional level with standardization organizations, vendors, health management and health personnel.

  4. Perinatal data collection: current practice in the Australian nursing and midwifery healthcare context.

    Science.gov (United States)

    Craswell, Alison; Moxham, Lorna; Broadbent, Marc

    2013-01-01

    The collection of perinatal data within Queensland, Australia, has traditionally been achieved via a paper form completed by midwives after each birth. Recently, with an increase in the use of e-health systems in healthcare, perinatal data collection has migrated to an online system. It is suggested that this move from paper to an ehealth platform has resulted in improvement to error rates, completion levels, timeliness of data transfer from healthcare institutions to the perinatal data collection and subsequent publication of data items. Worldwide, perinatal data are collected utilising a variety of methods, but essentially data are used for similar purposes: to monitor outcome patterns within obstetrics and midwifery. This paper discusses current practice in relation to perinatal data collection worldwide and within Australia, with a specific focus on Queensland, highlights relevant issues for midwives, and points to the need for further research into the efficient use of an e-health platform for perinatal data collection.

  5. A comprehensive Reputation mechanism for ubiquitous healthcare environment exploiting cloud model.

    Science.gov (United States)

    Athanasiou, Georgia; Lymberopoulos, Dimitrios

    2016-08-01

    Absence of trust foundations may outweigh benefits of ubiquitous and personalized mental healthcare supervision provided within a Ubiquitous Healthcare environment (UH). Trust is composed by patient's Personal Interaction Experience (PIE) and social entourage accumulated PIE, i.e. Reputation (R). In this paper, a cloud-based Reputation mechanism is proposed. Since PIE is the elementary trust information source, also an Updating mechanism of PIE, is introduced, in this paper. Cloud materialization of combined mechanisms provides adaptability to UH Providers' dynamic behavior, facilitates detection of milking behaviors and complex malicious attacks while meets the challenge of limited accuracy in case of data sparseness. The effectiveness of the proposed mechanisms is verified via simulation in MATLAB.

  6. Environment protection: The current challenge in radioecology

    Science.gov (United States)

    Bréchignac, F.

    2012-04-01

    Radioecology, a multifaceted scientific discipline which addresses environmental issues relevant to radioprotection, has for a long time been focused on environmental transfers through the environment to feed the needs of human radioprotection. This quite anthropocentric initial scope is now moving to a more ecocentric view capable of assessing ecological risk mediated by ionising radiation. The central issue consists in reaching an ability to understand the effects of radiation on the environment components, from individual organisms up to populations of species and ecosystems, together with their interaction with the abiotic compartments. Dominated by operational goals, the system of radiological protection of the environment which is under development emphasises a concept based upon reference organisms supported by traditional toxicological data on individual organisms. Whilst there are immediate advantages to this approach (pragmatism, consistency with other approaches in use for man and biota), there are also clear limitations which need to be acknowledged and further considered. The most important probably is to rely on effects data gathered almost exclusively for individual organisms to meet protection goals which are usually set at population and ecosystem levels. Overcoming this limitation leads to scientific and methodological approaches featuring the ecosystem concept.

  7. Environment protection: The current challenge in radioecology

    Directory of Open Access Journals (Sweden)

    Bréchignac F.

    2012-04-01

    Full Text Available Radioecology, a multifaceted scientific discipline which addresses environmental issues relevant to radioprotection, has for a long time been focused on environmental transfers through the environment to feed the needs of human radioprotection. This quite anthropocentric initial scope is now moving to a more ecocentric view capable of assessing ecological risk mediated by ionising radiation. The central issue consists in reaching an ability to understand the effects of radiation on the environment components, from individual organisms up to populations of species and ecosystems, together with their interaction with the abiotic compartments. Dominated by operational goals, the system of radiological protection of the environment which is under development emphasises a concept based upon reference organisms supported by traditional toxicological data on individual organisms. Whilst there are immediate advantages to this approach (pragmatism, consistency with other approaches in use for man and biota, there are also clear limitations which need to be acknowledged and further considered. The most important probably is to rely on effects data gathered almost exclusively for individual organisms to meet protection goals which are usually set at population and ecosystem levels. Overcoming this limitation leads to scientific and methodological approaches featuring the ecosystem concept.

  8. Systematic review on embracing cultural diversity for developing and sustaining a healthy work environment in healthcare.

    Science.gov (United States)

    Pearson, Alan; Srivastava, Rani; Craig, Dianna; Tucker, Donna; Grinspun, Doris; Bajnok, Irmajean; Griffin, Pat; Long, Leslye; Porritt, Kylie; Han, Thuzar; Gi, Aye A

    2007-03-01

    Objectives  The objective of this review was to evaluate evidence on the structures and processes that support development of effective culturally competent practices and a healthy work environment. Culturally competent practices are a congruent set of workforce behaviours, management practices and institutional policies within a practice setting resulting in an organisational environment that is inclusive of cultural and other forms of diversity. Inclusion criteria  This review included quantitative and qualitative evidence, with a particular emphasis on identifying systematic reviews and randomised controlled trials. For quantitative evidence, other controlled, and descriptive designs were also included. For qualitative evidence, all methodologies were considered. Participants were staff, patients, and systems or policies that were involved or affected by concepts of cultural competence in the nursing workforce in a healthcare environment. Types of interventions included any strategy that had a cultural competence component, which influenced the work environment, and/or patient and nursing staff in the environment. The types of outcomes of interest to this review included nursing staff outcomes, patient outcomes, organisational outcomes and systems level outcomes. Search strategy  The search sought both published and unpublished literature written in the English language. A comprehensive three-step search strategy was used, first to identify appropriate key words, second to combine all optimal key words into a comprehensive search strategy for each database and finally to review the reference lists of all included reviews and research reports. The databases searched were CINAHL, Medline, Current Contents, the Database of Abstracts of Reviews of Effectiveness, The Cochrane Library, PsycINFO, Embase, Sociological Abstracts, Econ lit, ABI/Inform, ERIC and PubMed. The search for unpublished literature used Dissertation Abstracts International. Methodological

  9. Using a bespoke situated digital kiosk to encourage user participation in healthcare environment design.

    Science.gov (United States)

    Mackrill, J; Marshall, P; Payne, S R; Dimitrokali, E; Cain, R

    2017-03-01

    Involving users through participation in healthcare service and environment design is growing. Existing approaches and toolkits for practitioners and researchers are often paper based involving workshops and other more traditional design approaches such as paper prototyping. The advent of digital technology provides the opportunity to explore new platforms for user participation. This paper presents results from three studies that used a bespoke situated user participation digital kiosk, engaging 33 users in investigating healthcare environment design. The studies, from primary and secondary care settings, allowed participant feedback on each environment and proved a novel, engaging "21st century" way to participate in the appraisal of the design process. The results point toward this as an exciting and growing area of research in developing not just a new method of user participation but also the technology that supports it. Limitations were noted in terms of data validity and engagement with the device. To guide the development of user participation using similar situated digital devices, key lessons and reflections are presented. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Resilience of primary healthcare professionals working in challenging environments: a focus group study.

    Science.gov (United States)

    Matheson, Catriona; Robertson, Helen D; Elliott, Alison M; Iversen, Lisa; Murchie, Peter

    2016-07-01

    The modern primary healthcare workforce needs to be resilient. Early research framed professional resilience as avoiding 'burnout'; however, more recent literature has introduced the concept of positive adaptation to professional challenges, which results in individuals thriving in their role. To explore what primary health professionals working in challenging environments consider to be characteristics of resilience and what promotes or challenges professional resilience. A qualitative focus group in north east Scotland. Five focus groups were held with 20 health professionals (six GPs, nine nurses, four pharmacists, and a practice manager) based in rural or deprived city areas in the north east of Scotland. Inductive thematic analysis identified emerging themes. Personal resilience characteristics identified were optimism, flexibility and adaptability, initiative, tolerance, organisational skills, being a team worker, keeping within professional boundaries, assertiveness, humour, and a sense of self-worth. Workplace challenges were workload, information overload, time pressures, poor communication, challenging patients, and environmental factors (rural location). Promoters of professional resilience were strong management support, teamwork, workplace buffers, and social factors such as friends, family, and leisure activities. A model of health professional resilience is proposed that concurs with existing literature but adds the concept of personal traits being synergistic with workplace features and social networks. These facilitate adaptability and enable individual health professionals to cope with adversity that is inevitably part of the everyday experience of those working in challenging healthcare environments. © British Journal of General Practice 2016.

  11. Exploring the Impact of Toxic Attitudes and a Toxic Environment on the Veterinary Healthcare Team

    Science.gov (United States)

    Moore, Irene C.; Coe, Jason B.; Adams, Cindy L.; Conlon, Peter D.; Sargeant, Jan M.

    2015-01-01

    The objective of this qualitative study was to compare veterinarians’ and Registered Veterinary Technicians’ (RVT’s) perceptions of the veterinary healthcare team with respect to the impact of toxic attitudes and a toxic environment. Focus group interviews using a semi-structured interview guide and follow up probes were held with four veterinarian groups (23 companion animal veterinarians) and four Registered Veterinary Technician groups (26 RVTs). Thematic analysis of the discussions indicated both veterinarian and RVT participants felt team members with manifestations of toxic attitudes negatively impacted veterinary team function. These manifestations included people being disrespectful, being resistant to change, always wanting to be the “go to person,” avoiding conflict, and lacking motivation. When conflict was ignored, or when people with toxic attitudes were not addressed, a toxic environment often resulted. A toxic environment sometimes manifested when “broken communication and tension between staff members” occurred as a result of employees lacking confidence, skills, or knowledge not being managed properly. It also occurred when employees did not feel appreciated, when there was difficulty coping with turnover, and when there were conflicting demands. The presence of people manifesting a toxic attitude was a source of frustration for both veterinarian and RVT participants. Prompt and consistent attention to negative behaviors is recommended to reduce the development of a toxic environment. PMID:26779492

  12. Nanoporous aerogel as a bacteria repelling hygienic material for healthcare environment

    Science.gov (United States)

    Oh, Jun Kyun; Kohli, Nandita; Zhang, Yuanzhong; Min, Younjin; Jayaraman, Arul; Cisneros-Zevallos, Luis; Akbulut, Mustafa

    2016-02-01

    Healthcare-associated infections (HAIs) caused by pathogenic bacteria are a worldwide problem and responsible for numerous cases of morbidity and mortality. Exogenous cross-contamination is one of the main mechanisms contributing to such infections. This work investigates the potential of hydrophobically modified nanoporous silica aerogel as an antiadhesive hygienic material that can inhibit exogenous bacterial contamination. Nanoporous silica aerogels were synthesized via sol-gel polymerization of tetraethyl orthosilicate and hydrophobized using trimethylsilyl chloride. Bacterial adhesion characteristics were evaluated via dip-inoculation in suspensions of Gram-negative Escherichia coli O157:H7 and Gram-positive Staphylococcus aureus. The attachment of E. coli O157:H7 and S. aureus to hydrophobic nanoporous silica aerogel (HNSA) was found to be significantly lower than that to hydrophilic and hydrophobic nonporous silica materials: 99.91% (E. coli O157:H7) and 99.93% (S. aureus) reduction in comparison to hydrophilic nonporous silica, and 82.95% (E. coli O157:H7) and 84.90% (S. aureus) reduction in comparison to hydrophobic nonporous silica. These results suggest that the use of HNSA as surfaces that come into contact with bacterial pathogens in the healthcare environment can improve bacterial hygiene, and therefore may reduce the rate of HAIs.

  13. Nanoporous aerogel as a bacteria repelling hygienic material for healthcare environment.

    Science.gov (United States)

    Oh, Jun Kyun; Kohli, Nandita; Zhang, Yuanzhong; Min, Younjin; Jayaraman, Arul; Cisneros-Zevallos, Luis; Akbulut, Mustafa

    2016-02-26

    Healthcare-associated infections (HAIs) caused by pathogenic bacteria are a worldwide problem and responsible for numerous cases of morbidity and mortality. Exogenous cross-contamination is one of the main mechanisms contributing to such infections. This work investigates the potential of hydrophobically modified nanoporous silica aerogel as an antiadhesive hygienic material that can inhibit exogenous bacterial contamination. Nanoporous silica aerogels were synthesized via sol-gel polymerization of tetraethyl orthosilicate and hydrophobized using trimethylsilyl chloride. Bacterial adhesion characteristics were evaluated via dip-inoculation in suspensions of Gram-negative Escherichia coli O157:H7 and Gram-positive Staphylococcus aureus. The attachment of E. coli O157:H7 and S. aureus to hydrophobic nanoporous silica aerogel (HNSA) was found to be significantly lower than that to hydrophilic and hydrophobic nonporous silica materials: 99.91% (E. coli O157:H7) and 99.93% (S. aureus) reduction in comparison to hydrophilic nonporous silica, and 82.95% (E. coli O157:H7) and 84.90% (S. aureus) reduction in comparison to hydrophobic nonporous silica. These results suggest that the use of HNSA as surfaces that come into contact with bacterial pathogens in the healthcare environment can improve bacterial hygiene, and therefore may reduce the rate of HAIs.

  14. Construction and application of an intelligent air quality monitoring system for healthcare environment.

    Science.gov (United States)

    Yang, Chao-Tung; Liao, Chi-Jui; Liu, Jung-Chun; Den, Walter; Chou, Ying-Chyi; Tsai, Jaw-Ji

    2014-02-01

    Indoor air quality monitoring in healthcare environment has become a critical part of hospital management and policy. Manual air sampling and analysis are cost-inhibitive and do not provide real-time air quality data and response measures. In this month-long study over 14 sampling locations in a public hospital in Taiwan, we observed a positive correlation between CO(2) concentration and population, total bacteria, and particulate matter concentrations, thus monitoring CO(2) concentration as a general indicator for air quality could be a viable option. Consequently, an intelligent environmental monitoring system consisting of a CO(2)/temperature/humidity sensor, a digital plug, and a ZigBee Router and Coordinator was developed and tested. The system also included a backend server that received and analyzed data, as well as activating ventilation and air purifiers when CO(2) concentration exceeded a pre-set value. Alert messages can also be delivered to offsite users through mobile devices.

  15. Comprehensive systematic review of evidence on developing and sustaining nursing leadership that fosters a healthy work environment in healthcare.

    Science.gov (United States)

    Pearson, Alan; Laschinger, Heather; Porritt, Kylie; Jordan, Zoe; Tucker, Donna; Long, Leslye

    2007-06-01

    Objectives  The objective of this review was to appraise and synthesise the best available evidence on the feasibility, meaningfulness and effectiveness of nursing leadership attributes that contribute to the development and sustainability of nursing leadership to foster a healthy work environment. Inclusion criteria  This review considered quantitative and qualitative research papers that addressed the feasibility, meaningfulness and effectiveness of developing and sustaining nursing leadership to foster a healthy work environment in healthcare. Papers of the highest level of evidence ratings were given priority. Participants of interest were leaders and those who were affected by leadership, specifically staff and patients. Interventions of interest including positive leadership attributes, as well as system and policy constructs, that impact on the development and sustainability of nursing leadership within the healthcare environment were considered in the review. Search strategy  The search strategy sought to find both published and unpublished studies and papers, limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the paper. A second extensive search was then undertaken using all identified key words and index terms. Methodological quality  Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management, Assessment and Review of Information (SUMARI) package. Results  A total of 48 papers, experimental, qualitative and textual in nature, were included in the review. The majority of papers were descriptive and examined the relationships between leadership styles and characteristics and particular outcomes, such as satisfaction. Because of the diverse

  16. Current Impact, Future Prospects and Implications of Mobile Healthcare in India

    OpenAIRE

    Rishi Kappal; Amit Mehndiratta; Prabu Anandaraj; Athanasios Tsanas

    2014-01-01

    India has a diverse geographical landscape and predominately rural population. Telemedicine is identified as one of the technological pillars to support healthcare services in this region, but is associated with high cost and complex infrastructure, thus restricting its wider use. Mobile-based healthcare (m-Health) services may provide a practical, promising alternative approach to support healthcare facilities. India has a high mobile user base, both in cities and in rural regions. The appro...

  17. Healthy Lifestyle Medicine in the Traditional Healthcare Environment-Primary Care and Cardiac Rehabilitation.

    Science.gov (United States)

    Williams, Mark A; Kaminsky, Leonard A

    There is unquestioned value of the need to incorporate Healthy Lifestyle Medicine (HLM) within the traditional models of healthcare. Primary care providers are well positioned to implement HLM as a routine aspect of their healthcare practice. Unfortunately, barriers for this to occur, including poor professional training in the components of HLM and limitations in the time they have available to spend with patients, result in inadequate delivery of HLM from primary care providers. Thus, new approaches for the delivery of HLM need to be developed that would allow primary care providers better, and more, opportunities to make patient referrals. Ideally, this would start with creating a culture change within communities that embraces the importance on living a healthy lifestyle. One opportunity which should be considered is expanding access to currently available options, such as cardiac rehabilitation programs and worksite wellness programs. Both types of programs already provide key elements of HLM within their existing structure. However, new models also need to be developed. Community-based HL centers comprising HL specialists including counselors, exercise physiologists, dietitians, and physical therapists, could be developed and become core locations for the promotion of HLM.

  18. Current State and Future Development of Healthcare Management%健康管理现状与发展思考

    Institute of Scientific and Technical Information of China (English)

    郝璐; 陈黎明; 李书章

    2014-01-01

    目的:探讨健康管理改进途径,有效利用有限资源预防疾病、维护健康,提高健康管理水平。方法通过梳理国内外健康管理发展现状,分析我国健康管理特点与问题。结果我国健康管理水平逐渐提高,有社区卫生中心、医疗机构和体检中心模式,但健康管理产业仍需改进。结论加速健康管理产业三个转变;完善学科教育体系;加快健康管理信息服务平台建设;开展健康危险度评估。%Objective To discuss the approaches for improving healthcare management and efficiently uti-lizing limited resources for disease prevention and health promotion .Methods By reviewing literature on develop-ment of domestic and international healthcare management , the author analyzed the characteristics and issues of healthcare management in China .Results Healthcare management in China has been gradually improved .The current models include:community-based healthcare service , hospitals, and preventive physical examination cen-ter.However, healthcare management industry still needs to be improved .Conclusion We should accelerate the conversions in healthcare management industry , perfect health education system establish a platform for healthcare management information , establish a mechanism on health risk assessment .

  19. Crossing the Boundaries of Our Current Healthcare System by Integrating Ultra-Weak Photon Emissions with Metabolomics

    Science.gov (United States)

    Burgos, Rosilene C. Rossetto; van Wijk, Eduard P. A.; van Wijk, Roeland; He, Min; van der Greef, Jan

    2016-01-01

    The current healthcare system is hampered by a reductionist approach in which diagnostics and interventions focus on a specific target, resulting in medicines that center on generic, static phenomena while excluding inherent dynamic nature of biological processes, let alone psychosocial parameters. In this essay, we present some limitations of the current healthcare system and introduce the novel and potential approach of combining ultra-weak photon emission (UPE) with metabolomics technology in order to provide a dynamic readout of higher organizational systems. We argue that the combination of metabolomics and UPE can bring a new, broader, view of health state and can potentially help to shift healthcare toward more personalized approach that improves patient well-being. PMID:28018239

  20. Crossing the boundaries of our current healthcare system by integrating ultra-weak photon emissions with metabolomics

    Directory of Open Access Journals (Sweden)

    Rosilene Cristina Rossetto Burgos

    2016-12-01

    Full Text Available The current healthcare system is hampered by a reductionist approach in which diagnostics and interventions focus on a specific target, resulting in medicines that center on generic, static phenomena while excluding inherent dynamic nature of biological processes, let alone psychosocial parameters. In this essay, we present some limitations of the current healthcare system and introduce the novel and potential approach of combining ultra-weak photon emission (UPE with metabolomics technology in order to provide a dynamic readout of higher organizational systems. We argue that the combination of metabolomics and UPE can bring a new, broader, view of health state and can potentially help to shift healthcare towards more personalized approach that improves patient well-being.

  1. Do-it-yourself healthcare: The current landscape, prospects and consequences

    NARCIS (Netherlands)

    Carrera, Percivil Melendez; Dalton, Andrew R.H.

    2014-01-01

    The wider availability and increasing use of mHealth tools–covering health applications, smartphone plug-ins and gadgets is significant for healthcare. This trend epitomises broader trajectories in access to and delivery of healthcare, with greater consumer involvement and decentralisation. This

  2. A scoping review on bio-aerosols in healthcare and the dental environment.

    Science.gov (United States)

    Zemouri, Charifa; de Soet, Hans; Crielaard, Wim; Laheij, Alexa

    2017-01-01

    Bio-aerosols originate from different sources and their potentially pathogenic nature may form a hazard to healthcare workers and patients. So far no extensive review on existing evidence regarding bio-aerosols is available. This study aimed to review evidence on bio-aerosols in healthcare and the dental setting. The objectives were 1) What are the sources that generate bio-aerosols?; 2) What is the microbial load and composition of bio-aerosols and how were they measured?; and 3) What is the hazard posed by pathogenic micro-organisms transported via the aerosol route of transmission? Systematic scoping review design. Searched in PubMed and EMBASE from inception to 09-03-2016. References were screened and selected based on abstract and full text according to eligibility criteria. Full text articles were assessed for inclusion and summarized. The results are presented in three separate objectives and summarized for an overview of evidence. The search yielded 5,823 studies, of which 62 were included. Dental hand pieces were found to generate aerosols in the dental settings. Another 30 sources from human activities, interventions and daily cleaning performances in the hospital also generate aerosols. Fifty-five bacterial species, 45 fungi genera and ten viruses were identified in a hospital setting and 16 bacterial and 23 fungal species in the dental environment. Patients with certain risk factors had a higher chance to acquire Legionella in hospitals. Such infections can lead to irreversible septic shock and death. Only a few studies found that bio-aerosol generating procedures resulted in transmission of infectious diseases or allergic reactions. Bio-aerosols are generated via multiple sources such as different interventions, instruments and human activity. Bio-aerosols compositions reported are heterogeneous in their microbiological composition dependent on the setting and methodology. Legionella species were found to be a bio-aerosol dependent hazard to elderly

  3. Sampling and mass spectrometric analytical methods for five antineoplastic drugs in the healthcare environment.

    Science.gov (United States)

    Pretty, Jack R; Connor, Thomas H; Spasojevic, Ivan; Kurtz, Kristine S; McLaurin, Jeffrey L; B'Hymer, Clayton; Debord, D Gayle

    2012-03-01

    Healthcare worker exposure to antineoplastic drugs continues to be reported despite safe handling guidelines published by several groups. Sensitive sampling and analytical methods are needed so that occupational safety and health professionals may accurately assess environmental and biological exposure to these drugs in the workplace. To develop liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) analytical methods for measuring five antineoplastic drugs in samples from the work environment, and to apply these methods in validating sampling methodology. A single method for quantifying several widely used agents would decrease the number of samples required for method development, lower cost, and time of analysis. for measuring these drugs in workers' urine would also be useful in monitoring personal exposure levels. LC-MS/MS methods were developed for individual analysis of five antineoplastic drugs in wipe and air sample media projected for use in field sampling: cyclophosphamide, ifosfamide, paclitaxel, doxorubicin, and 5-fluorouracil. Cyclophosphamide, ifosfamide, and paclitaxel were also measured simultaneously in some stages of the work. Extraction methods for air and wipe samples were developed and tested using the aforementioned analytical methods. Good recoveries from the candidate air and wipe sample media for most of the compounds, and variable recoveries for test wipe samples depending on the surface under study, were observed. Alternate LC-MS/MS methods were also developed to detect cyclophosphamide and paclitaxel in urine samples. The sampling and analytical methods were suitable for determining worker exposure to antineoplastics via surface and breathing zone contamination in projected surveys of healthcare settings.

  4. Stress-reducing effects of indoor plants in the built healthcare environment: The mediating role of perceived attractiveness

    NARCIS (Netherlands)

    Dijkstra, K.; Pieterse, Marcel E.; Pruyn, Adriaan T.H.

    2008-01-01

    Objective: Natural elements in the built healthcare environment have shown to hold potential stress-reducing properties. In order to shed light on the underlying mechanism of stress-reducing effects of nature, the present study investigates whether the stress-reducing effects of indoor plants occur

  5. Current Challenges for Healthcare Services and the Opportunities Created by the Marketing Abilities

    Science.gov (United States)

    Purcărea, T; Purcărea, LV; Raţiu, M

    2008-01-01

    Life is changing dramatically, market position as part of life is becoming more and more important, and marketing, considered a key cultural architect of nowadays that involves voluntary relation exchanges between the communicating partners, is placing the patient in the center of most adequate action towards the medical future which represents his life quality. We think that the moment has come to resort to marketing as a new method to identify innovation opportunities in healthcare services' delivery, considering that the high quality of healthcare services, answering to demands of healthcare systems' consumers, represents a well recognized priority for the European citizens. Consequently, the model of ‘healthcare business’ has to rely on the value for patient by creating competition concerning the results at medical condition level. PMID:20108474

  6. Current challenges for healthcare services and the opportunities created by the marketing abilities.

    Science.gov (United States)

    Popa, Florian; Purcărea, Theodor; Purcărea, Victor Lorin; Raţiu, Monica

    2008-01-01

    Life is changing dramatically, market position as part of life is becoming more and more important, and marketing, considered a key cultural architect of nowadays that involves voluntary relation exchanges between the communicating partners, is placing the patient in the center of most adequate action towards the medical future which represents his life quality. We think that the moment has come to resort to marketing as a new method to identify innovation opportunities in healthcare services' delivery, considering that the high quality of healthcare services, answering to demands of healthcare systems' consumers, represents a well recognized priority for the European citizens. Consequently, the model of "healthcare business" has to rely on the value for patient by creating competition concerning the results at medical condition level.

  7. The Impact of Environmental Design on Doffing Personal Protective Equipment in a Healthcare Environment: A Formative Human Factors Trial.

    Science.gov (United States)

    Herlihey, Tracey A; Gelmi, Stefano; Cafazzo, Joseph A; Hall, Trevor N T

    2017-06-01

    OBJECTIVE To explore the impact of environmental design on doffing personal protective equipment in a simulated healthcare environment. METHODS A mixed-methods approach was used that included human-factors usability testing and qualitative questionnaire responses. A patient room and connecting anteroom were constructed for testing purposes. This experimental doffing area was designed to overcome the environmental failures identified in a previous study and was not constructed based on any generalizable hospital standard. RESULTS In total, 72 healthcare workers from Ontario, Canada, took part in the study and tested the simulated doffing area. The following environmental design changes were tested and were deemed effective: increasing prominence of color-coded zones; securing disinfectant wipes and hand sanitizer; outlining disposal bins locations; providing mirrors to detect possible contamination; providing hand rails to assist with doffing; and restricting the space to doff. Further experimentation and iterative design are required with regard to several important features: positioning the disposal bins for safety, decreasing the risk of contamination and user accessibility; optimal positioning of mirrors for safety; communication within the team; and positioning the secondary team member for optimal awareness. Additional design suggestions also emerged during this study, and they require future investigation. CONCLUSIONS This study highlights the importance of the environment on doffing personal protective equipment in a healthcare setting. Iterative testing and modification of the design of the environment (doffing area) are important to enhancing healthcare worker safety. Infect Control Hosp Epidemiol 2017;38:712-717.

  8. Analysis of exposure to electromagnetic fields in a healthcare environment: simulation and experimental study.

    Science.gov (United States)

    de Miguel-Bilbao, Silvia; Martín, Miguel Angel; Del Pozo, Alejandro; Febles, Victor; Hernández, José A; de Aldecoa, José C Fernández; Ramos, Victoria

    2013-11-01

    Recent advances in wireless technologies have lead to an increase in wireless instrumentation present in healthcare centers. This paper presents an analytical method for characterizing electric field (E-field) exposure within these environments. The E-field levels of the different wireless communications systems have been measured in two floors of the Canary University Hospital Consortium (CUHC). The electromagnetic (EM) conditions detected with the experimental measures have been estimated using the software EFC-400-Telecommunications (Narda Safety Test Solutions, Sandwiesenstrasse 7, 72793 Pfullingen, Germany). The experimental and simulated results are represented through 2D contour maps, and have been compared with the recommended safety and exposure thresholds. The maximum value obtained is much lower than the 3 V m(-1) that is established in the International Electrotechnical Commission Standard of Electromedical Devices. Results show a high correlation in terms of E-field cumulative distribution function (CDF) between the experimental and simulation results. In general, the CDFs of each pair of experimental and simulated samples follow a lognormal distribution with the same mean.

  9. Using the dual-level modeling approach to developing applications in the pervasive healthcare environment

    NARCIS (Netherlands)

    Cardoso de Moraes, João Luís; Lopes de Souza, Wanderley; Ferreira Pires, Luis; Cavalini, Luciana Tricai; Prado, do Antonio Francisco

    2013-01-01

    Health information technology is the area of IT involving the design, development, creation, use and maintenance of information systems for the healthcare industry. Automated and interoperable healthcare information systems are expected to lower costs, improve efficiency and reduce error, while also

  10. Cybersecurity and privacy issues for socially integrated mobile healthcare applications operating in a multi-cloud environment.

    Science.gov (United States)

    Al-Muhtadi, Jalal; Shahzad, Basit; Saleem, Kashif; Jameel, Wasif; Orgun, Mehmet A

    2017-05-01

    Social media has enabled information-sharing across massively large networks of people without spending much financial resources and time that are otherwise required in the print and electronic media. Mobile-based social media applications have overwhelmingly changed the information-sharing perspective. However, with the advent of such applications at an unprecedented scale, the privacy of the information is compromised to a larger extent if breach mitigation is not adequate. Since healthcare applications are also being developed for mobile devices so that they also benefit from the power of social media, cybersecurity privacy concerns for such sensitive applications have become critical. This article discusses the architecture of a typical mobile healthcare application, in which customized privacy levels are defined for the individuals participating in the system. It then elaborates on how the communication across a social network in a multi-cloud environment can be made more secure and private, especially for healthcare applications.

  11. The paradox of lean in healthcare: Stable processes in a reactive environment

    DEFF Research Database (Denmark)

    Nielsen, Anders Paarup; Edwards, Kasper

    2010-01-01

    different groups of healthcare professionals and 3) different rationalities in lean and professionals in healthcare. Through analysis of three cases it is concluded that the nature of work is significantly different from manufacturing primarily because of the reactive nature of work. Finally, different......The principles of lean are widely being adopted in the healthcare sector. Interestingly the realized benefits appear not to warrant the interest from managers and policy makers. This paper presents an analysis of 3 Danish healthcare organizations which all introduced lean initiatives. However, only...... a limited set of tools has been used and the productivity gains are limited focusing on peripheral activities and not the core medical activities. This apparent problem with lean in health care is hypothesized to be caused by 1) the nature of healthcare work, 2) the rationality and notion of validity among...

  12. The paradox of lean in healthcare: Stable processes in a reactive environment

    DEFF Research Database (Denmark)

    Nielsen, Anders Paarup; Edwards, Kasper

    2010-01-01

    different groups of healthcare professionals and 3) different rationalities in lean and professionals in healthcare. Through analysis of three cases it is concluded that the nature of work is significantly different from manufacturing primarily because of the reactive nature of work. Finally, different......The principles of lean are widely being adopted in the healthcare sector. Interestingly the realized benefits appear not to warrant the interest from managers and policy makers. This paper presents an analysis of 3 Danish healthcare organizations which all introduced lean initiatives. However, only...... a limited set of tools has been used and the productivity gains are limited focusing on peripheral activities and not the core medical activities. This apparent problem with lean in health care is hypothesized to be caused by 1) the nature of healthcare work, 2) the rationality and notion of validity among...

  13. Healthcare Team Performance in Time Critical Environments: Coordinating Events, Foraging, and System Processes

    Directory of Open Access Journals (Sweden)

    Barrett S. Caldwell

    2010-01-01

    Full Text Available This review paper addresses issues in how healthcare providers search, obtain, and share resources in provider teams. Based in part on a System of Systems (SoS analysis of provider coordination and resource flows, this paper expands the concepts of resource foraging theory and event dynamics to develop systematic methods for studying healthcare provider coordination. Process flow and human factors emphases from industrial engineering are used to address critical concerns of single-scale and multi-scale performance in healthcare delivery settings. Provider strategies for acquiring the information and resources needed for successful healthcare delivery are dependent on interactions between task requirements, time constraints, and provider coordination processes, as well as limitations of information and resource flow capabilities. These improved definitions and measures will enhance engineers' ability to contribute to improved patient care timeliness, effectiveness, quality, and safety.

  14. Making Good Decisions in Healthcare with Multi-Criteria Decision Analysis: The Use, Current Research and Future Development of MCDA.

    Science.gov (United States)

    Mühlbacher, Axel C; Kaczynski, Anika

    2016-02-01

    Healthcare decision making is usually characterized by a low degree of transparency. The demand for transparent decision processes can be fulfilled only when assessment, appraisal and decisions about health technologies are performed under a systematic construct of benefit assessment. The benefit of an intervention is often multidimensional and, thus, must be represented by several decision criteria. Complex decision problems require an assessment and appraisal of various criteria; therefore, a decision process that systematically identifies the best available alternative and enables an optimal and transparent decision is needed. For that reason, decision criteria must be weighted and goal achievement must be scored for all alternatives. Methods of multi-criteria decision analysis (MCDA) are available to analyse and appraise multiple clinical endpoints and structure complex decision problems in healthcare decision making. By means of MCDA, value judgments, priorities and preferences of patients, insurees and experts can be integrated systematically and transparently into the decision-making process. This article describes the MCDA framework and identifies potential areas where MCDA can be of use (e.g. approval, guidelines and reimbursement/pricing of health technologies). A literature search was performed to identify current research in healthcare. The results showed that healthcare decision making is addressing the problem of multiple decision criteria and is focusing on the future development and use of techniques to weight and score different decision criteria. This article emphasizes the use and future benefit of MCDA.

  15. Current and emergent strategies for disinfection of hospital environments.

    Science.gov (United States)

    Abreu, Ana C; Tavares, Rafaela R; Borges, Anabela; Mergulhão, Filipe; Simões, Manuel

    2013-12-01

    A significant number of hospital-acquired infections occur due to inefficient disinfection of hospital surfaces, instruments and rooms. The emergence and wide spread of multiresistant forms of several microorganisms has led to a situation where few compounds are able to inhibit or kill the infectious agents. Several strategies to disinfect both clinical equipment and the environment are available, often involving the use of antimicrobial chemicals. More recently, investigations into gas plasma, antimicrobial surfaces and vapour systems have gained interest as promising alternatives to conventional disinfectants. This review provides updated information on the current and emergent disinfection strategies for clinical environments.

  16. Mobile healthcare.

    Science.gov (United States)

    Morgan, Stephen A; Agee, Nancy Howell

    2012-01-01

    Mobile technology's presence in healthcare has exploded over the past five years. The increased use of mobile devices by all segments of the US population has driven healthcare systems, providers, and payers to accept this new form of communication and to develop strategies to implement and leverage the use of mobile healthcare (mHealth) within their organizations and practices. As healthcare systems move toward a more value-driven model of care, patient centeredness and engagement are the keys to success. Mobile healthcare will provide the medium to allow patients to participate more in their care. Financially, mHealth brings to providers the ability to improve efficiency and deliver savings to both them and the healthcare consumer. However, mHealth is not without challenges. Healthcare IT departments have been reluctant to embrace this shift in technology without fully addressing security and privacy concerns. Providers have been hesitant to adopt mHealth as a form of communication with patients because it breaks with traditional models. Our healthcare system has just started the journey toward the development of mHealth. We offer an overview of the mobile healthcare environment and our approach to solving the challenges it brings to healthcare organizations.

  17. Links among high-performance work environment, service quality, and customer satisfaction: an extension to the healthcare sector.

    Science.gov (United States)

    Scotti, Dennis J; Harmon, Joel; Behson, Scott J

    2007-01-01

    Healthcare managers must deliver high-quality patient services that generate highly satisfied and loyal customers. In this article, we examine how a high-involvement approach to the work environment of healthcare employees may lead to exceptional service quality, satisfied patients, and ultimately to loyal customers. Specifically, we investigate the chain of events through which high-performance work systems (HPWS) and customer orientation influence employee and customer perceptions of service quality and patient satisfaction in a national sample of 113 Veterans Health Administration ambulatory care centers. We present a conceptual model for linking work environment to customer satisfaction and test this model using structural equations modeling. The results suggest that (1) HPWS is linked to employee perceptions of their ability to deliver high-quality customer service, both directly and through their perceptions of customer orientation; (2) employee perceptions of customer service are linked to customer perceptions of high-quality service; and (3) perceived service quality is linked with customer satisfaction. Theoretical and practical implications of our findings, including suggestions of how healthcare managers can implement changes to their work environments, are discussed.

  18. Improving healthcare using Lean processes.

    Science.gov (United States)

    Baker, G Ross

    2014-01-01

    For more than a decade, healthcare organizations across Canada have been using Lean management tools to improve care processes, reduce preventable adverse events, increase patient satisfaction and create better work environments. The largest system-wide effort in Canada, and perhaps anywhere, is currently under way in Saskatchewan. The jury is still out on whether Lean efforts in that province, or elsewhere in Canada, are robust enough to transform current delivery systems and sustain new levels of performance. This issue of Healthcare Quarterly features several articles that provide a perspective on Lean methods in healthcare.

  19. Current healthcare in Bulgaria: time for predictive diagnostics and preventive medicine.

    Science.gov (United States)

    Dimitrov, Dimiter V

    2010-12-01

    Since 1990 Bulgaria gradually moved from monopolistic to market regulated economy and healthcare. In 2007 the country became member of the European Union and started to adopt EU legislations. However, significant gaps between the average European and Bulgarian level of social, health and economic efficiency remain to be narrowed. The major challenge is the demographic situation, where recent trends give alarming signals. Plans for reformation include transition towards out-patient palliative healthcare centers for the aging population as well as reduction of the costs with new electronic system of health insurance. The favorable location of the country at the Black Sea coast gives opportunities for medical tourism, which can provide quality health service for foreign customers. Finally, national platforms on prevention of major non-communicable diseases, such as obesity, cancer and diabetes, must be established as coordinated actions for the health and wellness of next generations.

  20. The contribution of Ghanaian pharmacists to mental healthcare: current practice and barriers

    Directory of Open Access Journals (Sweden)

    Boateng Edmund A

    2010-06-01

    Full Text Available Abstract Background There is scant knowledge of the involvement of developing country pharmacists in mental healthcare. The objectives of this study were: to examine the existing role of Ghanaian community and hospital pharmacists in the management of mental illness, and to determine the barriers that hinder pharmacists' involvement in mental healthcare in Ghana. Method A respondent self-completion questionnaire was randomly distributed to 120 superintendent community pharmacists out of an estimated 240 pharmacists in Kumasi, Ashanti Region of Ghana. A purposive sampling method was utilized in selecting two public psychiatric hospital pharmacists in Accra, the capital city of Ghana for a face-to-face interview. A semi-structured interview guide was employed. Results A 91.7% response rate was obtained for the community pharmacists' questionnaire survey. Approximately 65% of community pharmacists were not involved in mental health provision. Of the 35% who were, 57% counseled psychiatric patients and 44% of these dispensed medicines for mental illness. Perceived barriers that hindered community pharmacists' involvement in the management of mental health included inadequate education in mental health (cited by 81% of respondents and a low level of encounter with patients (72%. The psychiatric hospital pharmacists were mostly involved in the dispensing of medicines from the hospital pharmacy. Conclusion Both community and hospital pharmacists in Ghana were marginally involved in the provision of mental healthcare. The greatest barrier cited was inadequate knowledge in mental health.

  1. The definition of healthcare-associated pneumonia (HCAP) is insufficient for the medical environment in Japan: a comparison of HCAP and nursing and healthcare-associated pneumonia (NHCAP).

    Science.gov (United States)

    Kaku, Norihito; Yanagihara, Katsunori; Morinaga, Yoshitomo; Izumikawa, Koichi; Nagashima, Seiji; Kakeya, Hiroshi; Yamamoto, Yoshihiro; Fukuda, Minoru; Takatani, Hiroshi; Fukuda, Masaaki; Hashiguchi, Kohji; Kohno, Shigeru

    2013-02-01

    Healthcare-associated pneumonia (HCAP) is a new concept of pneumonia, which was proposed in the ATS/IDSA guidelines. The guidelines explain that HCAP patients should be treated with broad-spectrum antimicrobial drugs directed at multidrug-resistant pathogens. However, in Japan, there are many elderly people who received in-home care service. These patients seemed to be consistent with the concept of HCAP, but they did not meet the definition of HCAP. Therefore, the Japanese Respiratory Society modified the definition of HCAP according to the medical environmental in Japan. We retrospectively observed HCAP patients and nursing home and healthcare-associated pneumonia (NHCAP) patients who were hospitalized during 24 months at the Japanese Red Cross Nagasaki Genbaku Hospital (Nagasaki, Japan). Patient background, disease severity, identified pathogens, initial antibiotic regimens, and outcomes were compared. A total of 108 patients (77 HCAP and 31 NHCAP except HCAP patients) were evaluated. Of NHCAP except HCAP patients, 27 (87.1 %) were above 3 in the ECOG PS score. There were almost no significant differences between the two groups in characteristics, pneumonia severity, identified bacteria, initial antibiotic regimens, and response rate of initial antibiotic therapy. Although the in-hospital mortality of HCAP patients and NHCAP except HCAP patients was 9.1 % and 19.4 %, respectively, this difference did not reach statistical significance (P > 0.05). Our study suggested that, in the criteria of HCAP, some Japanese patients, who were consistent with the concept of HCAP, were classified as community-acquired pneumonia (CAP). Therefore, there is a need to change the definition of HCAP according to the medical environment in Japan.

  2. Current understanding of organically bound tritium (OBT) in the environment.

    Science.gov (United States)

    Kim, S B; Baglan, N; Davis, P A

    2013-12-01

    It has become increasingly recognized that organically bound tritium (OBT) is the more significant tritium fraction with respect to understanding tritium behaviour in the environment. There are many different terms associated with OBT; such as total OBT, exchangeable OBT, non-exchangeable OBT, soluble OBT, insoluble OBT, tritiated organics, and buried tritium, etc. A simple classification is required to clarify understanding within the tritium research community. Unlike for tritiated water (HTO), the environmental quantification and behaviour of OBT are not well known. Tritiated water cannot bio-accumulate in the environment. However, it is not clear whether or not this is the case for OBT. Even though OBT can be detected in terrestrial biological materials, aquatic biological materials and soil samples, its behaviour is still in question. In order to evaluate the radiation dose from OBT accurately, further study will be required to understand OBT measurements and determine OBT fate in the environment. The relationship between OBT speciation and the OBT/HTO ratio in environmental samples will be useful in this regard, providing information on the previous tritium exposure conditions in the environment and the current tritium dynamics. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  3. Developing Simulations in Multi-User Virtual Environments to Enhance Healthcare Education

    Science.gov (United States)

    Rogers, Luke

    2011-01-01

    Computer-based clinical simulations are a powerful teaching and learning tool because of their ability to expand healthcare students' clinical experience by providing practice-based learning. Despite the benefits of traditional computer-based clinical simulations, there are significant issues that arise when incorporating them into a flexible,…

  4. CURRENT STATUS AND FUTURE CHALLENGES OF HEALTHCARE WASTE MANAGEMENT IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Sri Irianti

    2013-07-01

    Full Text Available Abstrak Latar belakang: Dalam memberikan pelayanan kesehatan, rumah sakit maupun sarana pelayanan kesehatan lainnya menghasilkan limbah medik yang mempunyai risiko menularkan penyakit-penyakit  tular darah dan penyakit lainnya  apabila tidak dikelola secara aman. Tujuan:Diperolehnya gambaran tentang kondisi dan praktik Pengelolaan Limbah Layanan Kesehatan (PLLK di beberapa rumah sakit umum (RSU di Indonesia, agar dapat digunakan oleh RSU dan sarana pelayanan kesehatan lainnya untuk melaksanakan PLLK secara aman. Bahan dan Cara: Kajian berupa survei dilakukan oleh Direktorat Penyehatan Lingkungan dengan cara mengirimkan kuesioner terstruktur di100 RSU pada tahun 2004. Hanya 76 RSU yang mengisi kuesioner. Lingkup survei meliputi aspek sanitasi RSU, di antaranya PLLK yang meliputi variabel ketersedian unit organisasi yang bertanggungjawab dalam PLLK, rencana pengelolaan limbah medik , ketersediaan pedoman PLLK, praktik pemilahan dan teknologi pengolahan limbah medik. Hasil: Sebagian besar RSU telah mempunyai unit yang bertanggungjawab dalam PLLK, namun hanya sekitar 33% yang mempunyai rencana PLLK. Demikian pula hanya sekitar 30% RSU yang memilah limbahnya menjadi tiga kategori sesuai pedomanPLLK, walaupun lebih dari 60% RSU telah mempunyai buku pedoman PLLK sesuai dengan Keputusan Menteri Kesehatan No. 1204/2004. Insinerasi merupakan cara pemusnahan limbah yang dipilih oleh mayoritas RSU. Kesimpulan: Masih banyak RSU yang disurvei belum mengelola limbahnya sesuai dengan Keputusan Menteri Kesehatan No. 1204/2004 seperti diamanatkan oleh Peraturan Pemerintah tentang Pengelolaan Limbah Berbahaya dan Beracun termasuk  limbah layanan kesehatan. Kata kunci: fasilitas kesehatan, pengelolaan limbah layanan kesehatan, kebijakan, risiko kesehatan Abstract Background: In providing healthcare services, hospitals and other healthcare facilities generate medical wastes which can spread blood-borne diseases and other waste diseases if they do not manage their

  5. An analysis of the healthcare informatics and systems in Southeast Asia: a current perspective from seven countries.

    Science.gov (United States)

    Nguyen, Q T; Naguib, R N G; Abd Ghani, M K; Bali, R K; Lee, I M

    2008-01-01

    This paper presents an overview of the healthcare systems in Southeast Asia, with a focus on the healthcare informatics development and deployment in seven countries, namely, Singapore, Cambodia, Malaysia, Thailand, Laos, the Philippines and Vietnam. Brief geographic and demographic information is provided for each country, followed by a historical review of the national strategies for healthcare informatics development. An analysis of the state-of-the-art healthcare infrastructure is also given, along with a critical appraisal of national healthcare provisions.

  6. Doctors as managers of healthcare resources in Nigeria: Evolving roles and current challenges.

    Science.gov (United States)

    Ojo, Temitope Olumuyiwa; Akinwumi, Adebowale Femi

    2015-01-01

    Over the years, medical practice in Nigeria has evolved in scope and practice, in terms of changing disease patterns, patients' needs, and social expectations. In addition, there is a growing sentiment especially among the general public and some health workers that most doctors are bad managers. Besides drawing examples from some doctors in top management positions that have performed less creditably, critics also harp on the fact that more needs to be done to improve the training of doctors in health management. This article describes the role of doctors in this changing scene of practice and highlights the core areas where doctors' managerial competencies are required to improve the quality of healthcare delivery. Areas such as health care financing, essential drugs and supplies management, and human resource management are emphasized. Resources to be managed and various skills needed to function effectively at the different levels of management are also discussed. To ensure that doctors are well-skilled in managerial competencies, the article concludes by suggesting a curriculum review at undergraduate and postgraduate levels of medical training to include newer but relevant courses on health management in addition to the existing ones, whereas also advocating that doctors be incentivized to go for professional training in health management and not only in the core clinical specialties.

  7. Doctors as managers of healthcare resources in Nigeria: Evolving roles and current challenges

    Directory of Open Access Journals (Sweden)

    Temitope Olumuyiwa Ojo

    2015-01-01

    Full Text Available Over the years, medical practice in Nigeria has evolved in scope and practice, in terms of changing disease patterns, patients' needs, and social expectations. In addition, there is a growing sentiment especially among the general public and some health workers that most doctors are bad managers. Besides drawing examples from some doctors in top management positions that have performed less creditably, critics also harp on the fact that more needs to be done to improve the training of doctors in health management. This article describes the role of doctors in this changing scene of practice and highlights the core areas where doctors' managerial competencies are required to improve the quality of healthcare delivery. Areas such as health care financing, essential drugs and supplies management, and human resource management are emphasized. Resources to be managed and various skills needed to function effectively at the different levels of management are also discussed. To ensure that doctors are well-skilled in managerial competencies, the article concludes by suggesting a curriculum review at undergraduate and postgraduate levels of medical training to include newer but relevant courses on health management in addition to the existing ones, whereas also advocating that doctors be incentivized to go for professional training in health management and not only in the core clinical specialties.

  8. Let’s be effective, let the patients talk! Does ‘patient intelligence’ have an effect on improvements in quality within the healthcare environment?

    Directory of Open Access Journals (Sweden)

    Nadine van Dongen

    2009-10-01

    Full Text Available Nadine van DongenVan Dongen Research Ltd, London, UKAbstract: This paper examines the interaction of patients within the context of efficiency in the pharmaceutical environment. Measurements of quality standards in healthcare are reviewed with an emphasis on the question of whether ‘patient intelligence’ can improve quality standards in healthcare. Something given particular consideration is the ethical point of view versus the business point of view, in relation to the integration of patients into the decision-making process of a healthcare organization. The paper focuses on the formal and informal reasons for involvement of patients in corporate and/or market access strategies for healthcare organizations.Keywords: healthcare, decision-making process, efficiency, patient intelligence, patients

  9. Exploring chiropractic students' experiences of the educational environment in healthcare professional training: a qualitative study.

    Science.gov (United States)

    Palmgren, Per J; Laksov, Klara Bolander

    2015-08-05

    The educational environment has a significant impact on students' behavior, sense of well-being, and academic advancement. While various research methodologies have been used to explore the educational environment, there is a paucity of studies employing qualitative research methods. This study engages in an in-depth exploration of chiropractic students' experiences of the meaning of the educational environment. A qualitative approach was employed by interviewing 26 students in four focus group interviews at two different points in time. A conventional manifest and latent content analysis was chosen to investigate and interpret the experiences of the educational environment in an undergraduate chiropractic training institution in Sweden. The analysis resulted in five overarching themes: Personal growth; Being part of a community; A place of meaningfulness; Trust in a regulated system; and Scaffolding relationships. Early in the training, the meaning of the educational environment was experienced as part of a vocational community and the scaffolding of intra-institutional relationships. In later stages, the environment was experienced in terms of personal growth - balancing academic pressures and progress within the professional community - thus laying the foundations for autonomy and motivation. During the clinical training, the environment was experienced as where learning happens, thus creating a place of meaningfulness. Throughout the training, the formal and clinical environments were experienced as isolating, with little bridging between the two. A regulated system - conveying an operative organization with clear communication regarding what to expect - was experienced as important for an apt educational environment. We found that experiences of an educational environment are dynamic and change over time. When restructuring or evaluating curriculums, educational managers can consider the emerged themes as constituting facets relating to the educational

  10. A Trust Model for Ubiquitous Healthcare Environment on the Basis of Adaptable Fuzzy-Probabilistic Inference System.

    Science.gov (United States)

    Athanasiou, Georgia; Anastasopoulos, George C; Tiritidou, Eleni; Lymberopoulos, Dimitrios

    2017-07-28

    Trust is considered to be a determinant on psychologist selection which can ensure patient satisfaction. Hence, trust concept is essential to be introduced into Ubiquitous Healthcare (UH) environment oriented on patients with anxiety disorders. This is accomplished by Trust Model estimating psychologists' trustworthiness, a priory to service delivery, with the use of patient's and his/her acquaintances testimonies, i.e. Personal Interaction Experience (PIE) and Reputation (R). In this paper, Trust Model is proposed to be materialized via an Adaptable Cloud Inference System (ACIS) that performs Trust Value (TV) estimation. Taking advantage of cloud theory, the introduced ACIS estimates TVs via fuzzy-probabilistic reasoning incorporating a cloud relation operator (soft AND) which is proposed to be tuned by trust information sources consistency and coherency. Theoretical analysis along with comparative study conducted within MATLAB environment and experimental investigation verify the effectiveness of the proposed ACIS materialization under different conditions. Especially, the innovative features of ACIS enable TV to be estimated with 45.5% and 62% on average higher accuracy to that providing state-of-the-art Trust Models, within clean environment and under the influence of large scale collusive malicious attacks, respectively. The enhanced robustness permits the untrustworthy UH Providers to be discriminated with True Positive Rate at the range of 0.9 although 40% of R testimonies are erroneous. Finally, experimental investigation validates that the adoption of the proposed Trust Model for psychologists trustworthiness estimation facilitates patient satisfaction to be achieved into UH environment.

  11. Public health safety and environment in inadequate hospital and healthcare settings: a review.

    Science.gov (United States)

    Baguma, D

    2017-03-01

    Public health safety and environmental management are concerns that pose challenges worldwide. This paper briefly assesses a selected impact of the environment on public health. The study used an assessment of environmental mechanism to analyse the underlying different pathways in which the health sector is affected in inadequate hospital and health care settings. We reviewed the limited available evidence of the association between the health sector and the environment, and the likely pathways through which the environment influences health. The paper also models the use of private health care as a function of costs and benefits relative to public care and no care. The need to enhancing policies to improve the administration of health services, strengthening interventions on environment using international agreements, like Rio Conventions, including measures to control hospital-related infection, planning for human resources and infrastructure construction development have linkage to improve environment care and public health. The present study findings partly also demonstrate the influence of demand for health on the environment. The list of possible interventions includes enhancing policies to improve the administration of health services, strengthening Rio Conventions implementation on environmental concerns, control of environmental hazards and public health. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Synthetic hardware performance analysis in virtualized cloud environment for healthcare organization.

    Science.gov (United States)

    Tan, Chee-Heng; Teh, Ying-Wah

    2013-08-01

    The main obstacles in mass adoption of cloud computing for database operations in healthcare organization are the data security and privacy issues. In this paper, it is shown that IT services particularly in hardware performance evaluation in virtual machine can be accomplished effectively without IT personnel gaining access to actual data for diagnostic and remediation purposes. The proposed mechanisms utilized the hypothetical data from TPC-H benchmark, to achieve 2 objectives. First, the underlying hardware performance and consistency is monitored via a control system, which is constructed using TPC-H queries. Second, the mechanism to construct stress-testing scenario is envisaged in the host, using a single or combination of TPC-H queries, so that the resource threshold point can be verified, if the virtual machine is still capable of serving critical transactions at this constraining juncture. This threshold point uses server run queue size as input parameter, and it serves 2 purposes: It provides the boundary threshold to the control system, so that periodic learning of the synthetic data sets for performance evaluation does not reach the host's constraint level. Secondly, when the host undergoes hardware change, stress-testing scenarios are simulated in the host by loading up to this resource threshold level, for subsequent response time verification from real and critical transactions.

  13. Healthcare Providers' Formative Experiences with Race and Black Male Patients in Urban Hospital Environments.

    Science.gov (United States)

    Plaisime, Marie V; Malebranche, David J; Davis, Andrea L; Taylor, Jennifer A

    2016-12-07

    We explored health providers' formative personal and professional experiences with race and Black men as a way to assess their potential influence on interactions with Black male patients. Utilizing convenience sampling with snowballing techniques, we identified healthcare providers in two urban university hospitals. We compared Black and White providers' experiences based on race and level of training. We used the Gardener's Tale to conceptualize how racism may lead to racial health disparities. A semi-structured interview guide was used to conduct in-person interviews (n = 16). Using the grounded theory approach, we conducted three types of coding to examine data patterns. We found two themes reflective of personally mediated racism: (1) perception of Black males accompanied by two subthemes (a) biased care and (b) fear and discomfort and (2) cognitive dissonance. While this latter theme is more reflective of Jones's internalized racism level, we present its results because its novelty is compelling. Perception of Black males and cognitive dissonance appear to influence providers' approaches with Black male patients. This study suggests the need to develop initiatives and curricula in health professional schools that address provider racial bias. Understanding the dynamics operating in the patient-provider encounter enhances the ability to address and reduce health disparities.

  14. Beyond Relational: A Database Architecture and Federated Query Optimization in a Multi-Modal Healthcare Environment

    Science.gov (United States)

    Hylock, Ray Hales

    2013-01-01

    Over the past thirty years, clinical research has benefited substantially from the adoption of electronic medical record systems. As deployment has increased, so too has the number of researchers seeking to improve the overall analytical environment by way of tools and models. Although much work has been done, there are still many uninvestigated…

  15. Beyond Relational: A Database Architecture and Federated Query Optimization in a Multi-Modal Healthcare Environment

    Science.gov (United States)

    Hylock, Ray Hales

    2013-01-01

    Over the past thirty years, clinical research has benefited substantially from the adoption of electronic medical record systems. As deployment has increased, so too has the number of researchers seeking to improve the overall analytical environment by way of tools and models. Although much work has been done, there are still many uninvestigated…

  16. Exploring the impact of toxic attitudes and a toxic environment on the veterinary healthcare team

    Directory of Open Access Journals (Sweden)

    Irene eMoore

    2015-12-01

    Full Text Available AbstractThe objective of this qualitative study was to compare veterinarians’ and Registered Veterinary Technicians’ (RVT’s perceptions of the veterinary health care team with respect to the impact of toxic attitudes and a toxic environment. Focus group interviews using a semi-structured interview guide and follow up probes were held with 4 veterinarian groups (23 companion animal veterinarians and 4 Registered Veterinary Technician groups (26 RVTs. Thematic analysis of the discussions indicated both veterinarian and RVT participants felt team members with toxic attitudes negatively impacted veterinary team function. These attitudes included people being disrespectful, being resistant to change, always wanting to be the go to person, avoiding conflict, and lacking motivation. When conflict was ignored, or when people with toxic attitudes were not addressed, a toxic environment often resulted. A toxic environment sometimes manifested when broken communication and tension between staff members occurred as a result of employees lacking confidence, skills, or knowledge not being managed properly. It also occurred when employees did not feel appreciated, when there was difficulty coping with turnover, and when there were conflicting demands.The presence of people with a toxic attitude was a source of frustration for both veterinarian and RVT participants. Prompt and consistent attention to negative behaviors is recommended to reduce the development of a toxic environment.

  17. Progress of information technology in healthcare, current state, outlook toward future

    Directory of Open Access Journals (Sweden)

    Miroslav Dvořák

    2013-07-01

    Full Text Available Brief summary of reasons for development of Hospital Information Systems (HIS is described. We mention different concepts of HIS development. Primary negative attitude of physicians to the invasion of information technology to hospitals has been slowly changed. Extended teaching of fundamentals of computer science at medical universities is very important for a new generation of physicians. Modern methods of e‑learning allow using websites and medical atlases including presentations of surgical interventions in different branches of surgical medicine, physiotherapeutic methods, etc. Medical staff in hospitals may also profit from electronic tools used for education in medical informatics or for obligatory postgraduate courses. Software producing companies are obliged to teach potential users how to use implemented information systems effectively. E-learning is a good method how to teach new employees who need to start using the system. Telematics in health service and use of Internet data storages may be a trend in future development of information systems. Large amount of patient data in current databases is a big encouragement for expanded use of data mining and application of artificial intelligence methods in medical expert systems.

  18. [Impact of early benefit assessment on patients with epilepsy in Germany: Current healthcare provision and therapeutic needs].

    Science.gov (United States)

    Strzelczyk, A; Hamer, H M

    2016-04-01

    Epilepsy is one of the most common chronic neurological diseases and represents a significant burden for patients, their families and society. In more than 75 % of patients anticonvulsant therapy consists of valproate, carbamazepine, lamotrigine or levetiracetam. There is a need for polytherapy in drug-refractory patients and they suffer from negative effects on quality of life and employment that is associated with high indirect costs. To allow a comprehensive treatment in this patient group, access to new anticonvulsants with novel modes of action is needed; however, all applications for new antiepileptic drugs failed to prove added benefits during the Pharmaceutical Market Restructuring Act (AMNOG) in Germany. One of the main reasons is the mandatory definition of a standard comparative therapy. It remains unclear whether there will be studies in the future which will fulfill the requirements of the current version of AMNOG. Observational studies after approval and marketing of new antiepileptic drugs could be better alternatives to prove added benefits for individual patients in the current German healthcare system.

  19. Extending the role of a healthcare digital library environment to support orthopaedic research.

    Science.gov (United States)

    Miles-Board, Timothy; Carr, Leslie; Wills, Gary; Power, Guillermo; Bailey, Christopher; Hall, Wendy; Stenning, Matthew; Grange, Simon

    2006-06-01

    A digital archive, together with its users and its contents, does not exist in isolation; there is a cycle of activities which provides the context for the archive's existence. In arguing for the broadening of the traditional view of digital libraries as merely collections towards the processes of collecting and deploying, we have developed an extend ed digital library environment for orthopaedic surgeons which bridges the gap between the undertaking of experimental work and the dissemination of its results through electronic publication.

  20. Willingness of European healthcare workers to undergo vaccination against seasonal influenza: current situation and suggestions for improvement

    Directory of Open Access Journals (Sweden)

    George Kassianos

    2015-01-01

    Full Text Available Uptake of vaccination against seasonal influenza in healthcare workers (HCWs is, in general, low (vaccine coverage of 6–54%, as is awareness of its importance, and has been decreasing in most European Union (EU countries in recent years. By virtue of their working environment, HCWs are at an increased risk of influenza infection and of subsequently transmitting the virus to vulnerable patients, in whom disease burden is significant. It could be argued that a similar or higher target vaccination rate to that recommended for older age groups and people with chronic medical conditions (75% should be applied to HCWs, and the European Council recommends Member States to improve vaccination coverage in this population. In this context, better education of HCWs is needed to increase awareness and highlight the importance of HCW vaccination for the benefit of public health, particularly for their patients, who may be at risk of serious complications that could lead to disability or death. Secondary to these professional responsibilities, personal benefits (as well as benefits to close family and friends should also be emphasised. Misconceptions that create barriers to vaccination need to be discussed openly and objections placed in the context of public health.

  1. Adaptation and transformation through (un)learning: lived experiences of immigrant Chinese nurses in US healthcare environment.

    Science.gov (United States)

    Xu, Yu; Gutierrez, Antonio; Kim, Su Hyun

    2008-01-01

    This phenomenological study examined the lived experiences of Chinese nurses working in the US healthcare environment. In-depth interviews with 9 self-identified Chinese nurses were conducted in English and transcribed verbatim. Using Colaizzi's (In: Valle RS, King M, eds. Existential-Phenomenological Alternatives for Psychology. New York: Oxford University Press; 1978:48-71) 7-step procedure, the narrative data were independently analyzed by a team of researchers. Five primary themes emerged from the data: (a) communication as the most daunting challenge, especially during initial transition of their first job; (b) different and even conflicting professional values and roles/expectations of the nurse between the United States and China; (c) marginalization, inequality, and discrimination; (d) transformation through clinging to hope, (un)learning, and resilience; and (e) cultural dissonance. To a large extent, this study supported the findings in the general literature on international nurses, especially those from Asia. It also documented the uniqueness of this group of Chinese nurses, namely their ingenuity to turn challenges into opportunities, their high-level job satisfaction in spite of adversity, their desire for learning and execution of strategic plans for performance and career enhancement through further education, and their proactive measures to adapt to workplace demands. In addition, this study revealed both real and potential risks to patient safety and quality of care during the transition of these Chinese nurses. In light of these findings, implications for both practice and future research are elaborated, particularly in the context of the accreditation standards of healthcare organizations and national agenda for patient safety research.

  2. mHealth adoption in low-resource environments: a review of the use of mobile healthcare in developing countries.

    Science.gov (United States)

    Chib, Arul; van Velthoven, Michelle Helena; Car, Josip

    2015-01-01

    The acknowledged potential of using mobile phones for improving healthcare in low-resource environments of developing countries has yet to translate into significant mHealth policy investment. The low uptake of mHealth in policy agendas may stem from a lack of evidence of the scalable, sustainable impact on health indicators. The mHealth literature in low- and middle-income countries reveals a burgeoning body of knowledge; yet, existing reviews suggest that the projects yield mixed results. This article adopts a stage-based approach to understand the varied contributions to mHealth research. The heuristic of inputs-mechanism-outputs is proposed as a tool to categorize mHealth studies. This review (63 articles comprising 53 studies) reveals that mHealth studies in developing countries tend to concentrate on specific stages, principally on pilot projects that adopt a deterministic approach to technological inputs (n = 32), namely introduction and implementation. Somewhat less studied were research designs that demonstrate evidence of outputs (n = 15), such as improvements in healthcare processes and public health indicators. The review finds a lack of emphasis on studies that provide theoretical understanding (n = 6) of adoption and appropriation of technological introduction that produces measurable health outcomes. As a result, there is a lack of dominant theory, or measures of outputs relevant to making policy decisions. Future work needs to aim for establishing theoretical and measurement standards, particularly from social scientific perspectives, in collaboration with researchers from the domains of information technology and public health. Priorities should be set for investments and guidance in evaluation disseminated by the scientific community to practitioners and policymakers.

  3. Prevention of healthcare-associated infections in general practice: Current practice and drivers for change in a French study

    Directory of Open Access Journals (Sweden)

    M Gignon

    2012-01-01

    Full Text Available Purpose: The fight against Healthcare-associated infections is a public health priority and a major challenge for the safety and quality of care. The objective was to assess hygiene in general practitioners′ (GPs′ office and identify barriers to and drivers for better practice. Materials and Methods: We performed a cross-sectional study in which a questionnaire was sent to a randomly selected, representative sample of 800 GPs. We used a self-administered questionnaire. The first part assessed current practice and the second part focused on barriers and motivating factors for better practice. We performed a descriptive statistical analysis of the responses to closed questions and a qualitative analysis of the responses to open-ended questions. Results: Only a third of the GPs were aware of the current guidelines. Disposable equipment was used by 31% of the GPs. For the remainder, only 38% complied with the recommended procedures for sterilisation or disinfection. Seventy-two percent of the GPs washed their hands between consultations in the office. A significant minority of physicians disregarded the guidelines by never wearing gloves to perform sutures (11%, treat wounds (10%, fit intrauterine devices (18% or perform injections (18%. The main barriers to good practice were the high cost of modifications and lack of time/space. Two third of the GPs did not intend to change their practices. The drivers for change were pressure from patients (4.8 on a scale of 1 to 7, inspection by the health authorities (4.8 and the fear of legal action (4.4. Conclusions: Our results show that there are significant differences between current practice and laid-down professional guidelines. Policies for improvement of hygiene must take into account barriers and motivating factors.

  4. Microplastics in the marine environment: Current trends and future perspectives.

    Science.gov (United States)

    Barboza, Luís Gabriel Antão; Gimenez, Barbara Carolina Garcia

    2015-08-15

    Over the last decade, the presence of microplastics on marine environments has become an important environmental concern and focus of interest of many researches. Thus, to provide a more integrated view of the research trends regarding this topic, we use a scientometric approach to systematically assess and quantify advances in knowledge related to microplastics in the marine environment. The papers that we used for our assessment were obtained from the database Thomson Reuters (ISI Web of Science), between 2004 and 2014. Our results reveal the overall research performance in the study area of microplastics present in the marine environment over the past decade as a newly developed research field. It has been recognized that there are several important issues that should be investigated. Toward that end, based on the suggested directions on all papers reviewed, we point out areas/topics of interest that may guide future work in the coming years.

  5. Gene-environment interactions and alcohol use and dependence: current status and future challenges

    NARCIS (Netherlands)

    Zwaluw, C.S. van der; Engels, R.C.M.E.

    2009-01-01

    To discuss the current status of gene-environment interaction research with regard to alcohol use and dependence. Further, we highlight the difficulties concerning gene-environment studies. Overview of the current evidence for gene-environment interactions in alcohol outcomes, and of the associated

  6. Josephson current through a molecular transistor in a dissipative environment

    DEFF Research Database (Denmark)

    Novotny, T; Rossini, Gianpaolo; Flensberg, Karsten

    2005-01-01

    We study the Josephson coupling between two superconductors through a single correlated molecular level, including Coulomb interaction on the level and coupling to a bosonic environment. All calculations are done to the lowest, i.e., the fourth, order in the tunneling coupling and we find a suppr...

  7. Antimicrobial resistance in healthcare, agriculture and the environment: the biochemistry behind the headlines.

    Science.gov (United States)

    Venter, Henrietta; Henningsen, Michael L; Begg, Stephanie L

    2017-02-28

    The crisis of antimicrobial resistance (AMR) is one of the most serious issues facing us today. The scale of the problem is illustrated by the recent commitment of Heads of State at the UN to coordinate efforts to curb the spread of AMR infections. In this review, we explore the biochemistry behind the headlines of a few stories that were recently published in the public media. We focus on examples from three different issues related to AMR: (i) hospital-acquired infections, (ii) the spread of resistance through animals and/or the environment and (iii) the role of antimicrobial soaps and other products containing disinfectants in the dissemination of AMR. Although these stories stem from three very different settings, the underlying message in all of them is the same: there is a direct relationship between the use of antimicrobials and the development of resistance. In addition, one type of antimicrobial could select for cross-resistance to another type and/or for multidrug resistance. Therefore, we argue the case for increased stewardship to not only cover clinical use of antibiotics, but also the use of antimicrobials in agriculture and stewardship of our crucially important biocides such as chlorhexidine. © 2017 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  8. Body sensor networks for ubiquitous healthcare

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

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

  9. Current automation environment of PETROBRAS offshore production units

    Energy Technology Data Exchange (ETDEWEB)

    Moura, C.H.W.; Mendes, F.M.R.; Silva Filho, J.A.P.; Loureiro, P. [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    1996-12-31

    This paper aims to show the evolution of automation in PETROBRAS` off-shore production units during the last decade. It also displays the currently used standard architecture, describing the main aspects of each sub-system which is part of the entire automation system. The changes in PETROBRAS` purchasing policy, and their consequences, are also discussed. 2 figs.

  10. Change in Obesity Prevalence across the United States Is Influenced by Recreational and Healthcare Contexts, Food Environments, and Hispanic Populations.

    Directory of Open Access Journals (Sweden)

    Candice A Myers

    Full Text Available To examine change in county-level adult obesity prevalence between 2004 and 2009 and identify associated community characteristics.Change in county-level adult (≥20 years obesity prevalence was calculated for a 5-year period (2004-2009. Community measures of economic, healthcare, recreational, food environment, population structure, and education contexts were also calculated. Regression analysis was used to assess community characteristics associated (p<0.01 with change in adult obesity prevalence.Mean±SD change in obesity prevalence was 5.1±2.4%. Obesity prevalence decreased in 1.4% (n = 44 and increased in 98% (n = 3,060 of counties from 2004-2009. Results showed that both baseline levels and increases in physically inactive adults were associated with greater increases in obesity prevalence, while baseline levels of and increases in physician density and grocery store/supercenter density were related to smaller increases in obesity rates. Baseline levels of the Hispanic population share were negatively linked to changing obesity levels, while places with greater Hispanic population growth saw greater increases in obesity.Most counties in the U.S. experienced increases in adult obesity prevalence from 2004 to 2009. Findings suggest that community-based interventions targeting adult obesity need to incorporate a range of community factors, such as levels of physical inactivity, access to physicians, availability of food outlets, and ethnic/racial population composition.

  11. Limitations of eddy current testing in a fast reactor environment

    Science.gov (United States)

    Wu, Tao; Bowler, John R.

    2016-02-01

    The feasibility of using eddy current probes for detecting flaws in fast nuclear reactor structures has been investigated with the aim of detecting defects immersed in electrically conductive coolant including under liquid sodium during standby. For the inspections to be viable, there is a need to use an encapsulated sensor system that can be move into position with the aid of visualization tools. The initial objective being to locate the surface to be investigated using, for example, a combination of electromagnetic sensors and sonar. Here we focus on one feature of the task in which eddy current probe impedance variations due to interaction with the external surface of a tube are evaluated in order to monitor the probe location and orientation during inspection.

  12. CURRENT ENVIRONMENT STATE OF COASTAL MARINE WATER OF DAGESTAN

    Directory of Open Access Journals (Sweden)

    S. A. Guseinova

    2014-01-01

    Full Text Available Aim. We analysed current environmental state of the Dagestan coast of the Caspian Sea. Data on the spatial variability of contaminants in the coastal areas of the Dagestan segment of the Caspian Sea from the northern districts (Lopatin to the central (Sulak coastal land and, further, to the southern district (within Russian subsoil management confirm that it is caused by irregular contamination of the sea by above-ground sources. Location. Dagestan coastal area of the Caspian SeaMethods. Concentration analysis of background contamination of chemical agents in the Dagestan coastal water from northern districts (Lopatin to southern (Sulak coastal land during the period between 2004 and 2007.Results. Data on the spatial variability of contaminants in the coastal areas of the Dagestan segment of the Caspian Sea from the northern districts (Lopatin to the central (Sulak coastal land and, further, to the southern district (within Russian subsoil management confirm that it is caused by irregular contamination of the sea by above-ground sources.Main conclusions. The envisaged large-scale hydrocarbon resource development requires regular monitoring of sea currents on Makhachkala, Izberbash and Derbent roads.

  13. iMAGE cloud: medical image processing as a service for regional healthcare in a hybrid cloud environment.

    Science.gov (United States)

    Liu, Li; Chen, Weiping; Nie, Min; Zhang, Fengjuan; Wang, Yu; He, Ailing; Wang, Xiaonan; Yan, Gen

    2016-11-01

    To handle the emergence of the regional healthcare ecosystem, physicians and surgeons in various departments and healthcare institutions must process medical images securely, conveniently, and efficiently, and must integrate them with electronic medical records (EMRs). In this manuscript, we propose a software as a service (SaaS) cloud called the iMAGE cloud. A three-layer hybrid cloud was created to provide medical image processing services in the smart city of Wuxi, China, in April 2015. In the first step, medical images and EMR data were received and integrated via the hybrid regional healthcare network. Then, traditional and advanced image processing functions were proposed and computed in a unified manner in the high-performance cloud units. Finally, the image processing results were delivered to regional users using the virtual desktop infrastructure (VDI) technology. Security infrastructure was also taken into consideration. Integrated information query and many advanced medical image processing functions-such as coronary extraction, pulmonary reconstruction, vascular extraction, intelligent detection of pulmonary nodules, image fusion, and 3D printing-were available to local physicians and surgeons in various departments and healthcare institutions. Implementation results indicate that the iMAGE cloud can provide convenient, efficient, compatible, and secure medical image processing services in regional healthcare networks. The iMAGE cloud has been proven to be valuable in applications in the regional healthcare system, and it could have a promising future in the healthcare system worldwide.

  14. IS Audit Considerations in Respect of Current Economic Environment

    Directory of Open Access Journals (Sweden)

    Vlasta Svata

    2011-01-01

    Full Text Available Accountancy organizations, regulatory bodies, standard setters, and other international organizations have developed guidance, articles, frameworks and resources on issues related to the global financial crisis. Now there is a clear and widely accepted need for more rigorous governance over companies´ systems of internal control. Historically there exist many different activities aiming to support effective enterprise governance (legislative acts, best practices, standards, frameworks. But all these activities may have reinforced the already-existing focus on enterprise governance, but they did not necessarily bring clarity to the topic. Therefore we can currently notice some changes aiming to improve the adoption and adaptation of best practices and standards within the area of enterprise governance. The paper discusses the changes in the Enterprise Governance of IT/IS, audit/assurance evolution, and intended Cobit improvements.

  15. The Current Situation of Healthcare Industry%浅谈医疗健康气体产业的发展现状

    Institute of Scientific and Technical Information of China (English)

    柴福莉

    2016-01-01

    简述了国内外医疗健康气体产业的发展现状。重点针对国外大型工业气体公司在医疗健康产业的发展,从医用气体产品、医用气体供给模式和相关服务三个方面,进行了较为详细的阐述。提出了医疗健康产业在我国及浙江省将迎来发展新契机,并将成为今后我国大型工业气体生产企业扩大业务领域的新重地。%The current situation of healthcare industry in the world is described. Especially the development of healthcare industry in the large-scale industrial gas enterprises in foreign countries is indicated from three aspects of ( medical gas products, supply modes and services) . There will be new opportunities for the development of healthcare industry in Zhe-jiang province and even China. The healthcare industry will become the important field that the large-scale industrial gas enterprises expand the business market in the future.

  16. Frequency of Klebsiella pneumoniae carbapenemase (KPC) and non-KPC-producing Klebsiella contamination of Healthcare workers and the environment

    Science.gov (United States)

    Rock, Clare; Thom, Kerri A.; Masnick, Max; Johnson, J. Kristie; Harris, Anthony D.; Morgan, Daniel J

    2014-01-01

    We examined contamination of healthcare worker (HCW) gown and gloves after caring for patients with Klebsiella Producing Carbapenemase-producing and non-KPC-producing Klebsiella as a proxy for horizontal transmission. Contamination rate with Klebsiella is similar to MRSA and VRE, with 14% (31/220) of HCW-patient interactions resulting in contamination of gloves and gowns. PMID:24602950

  17. Evaluation of Current Decision Rules and Healthcare Professional Practices for Detecting Osteoporosis Risk in the Young Adult Population

    OpenAIRE

    Willig, Amanda Lynn

    2004-01-01

    Osteoporosis is caused by a multitude of factors. An individual¡¯s risk for experiencing a bone fracture as a senior citizen increases without early intervention. Healthcare professionals do not have access to validated survey tools to identify young adults in need of osteoporosis prevention education, although survey tools to identify postmenopausal women at high risk for low bone mass are available. The purposes of this study were to evaluate three of these survey tools for use in a yo...

  18. Enhancing the Australian healthcare sector's responsiveness to environmental sustainability issues: suggestions from Australian healthcare professionals.

    Science.gov (United States)

    Dunphy, Jillian L

    2013-05-01

    Identify strategies to implement change across the Australian healthcare sector to better support social and natural environments. Methods. Qualitative analysis of semi-structured interviews with Australian healthcare professionals. Interviewees described multiple barriers to implementing change and numerous strategies to overcome these barriers. They argued that action must be taken at the individual and systemic levels to produce substantial and effective change. The strategies recommended fall into four main categories: altering workplace cultures and professional identities, community engagement, political activity, and change from within. The overarching goals of these strategies are to reduce negative impacts on the natural environment, and increase social equity within and across generations. By implementing the strategies described, a more cohesive effort to address sustainability issues across the sector can be made. This may improve local and global health, within current and future generations. WHAT IS KNOWN ABOUT THE TOPIC? Healthcare has a significant impact on the natural and social environments, which in turn have a significant impact upon health and healthcare. WHAT DOES THIS PAPER ADD? This paper describes strategies to alter healthcare to better support environmental sustainability. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Collective implementation of the described strategies may allow a more cohesive and effective response across the Australian healthcare sector, to enhance local and global health for current and future generations.

  19. 漫谈智慧医疗发展%The Current Status and Trends of Smart Healthcare

    Institute of Scientific and Technical Information of China (English)

    谢俊祥; 张琳

    2016-01-01

    智慧医疗通过更深入的智能化、更全面的互联互通、更透彻的感知和度量,实现医生、患者以及各医疗机构之间的高度协作,达到医疗信息的高度移动与共享,真正实现以患者为中心。本文旨在对智慧医疗的概念、组成、应用、存在问题等内容进行综述,以期对智慧医疗提出相应的发展建议。%Through a more in-depth, inteligent, a more comprehensive interoperability, a more thorough perception and measurement, Smart Healthcare has achived a high degree of colaboration among doctors, patients and medical institutions. It achieves a high degree of movement and sharing of medical information, truly realizing patient-centered. This paper summarizes the concept, traits and the existing problems and future directions of Smart Healthcare.

  20. Current views of health care design and construction: practical implications for safer, cleaner environments.

    Science.gov (United States)

    Bartley, Judene M; Olmsted, Russell N; Haas, Janet

    2010-06-01

    Infection preventionists (IP) play an increasingly important role in preventing health care-associated infection in the physical environment associated with new construction or renovation of health care facilities. The Guidelines for Design and Construction of Hospital and Healthcare Facilities, 2010, formerly known as "AIA Guidelines" was the origin of the "infection control risk assessment" now required by multiple agencies. These Guidelines represent minimum US health care standards and provide guidance on best practices. They recognize that the built environment has a profound affect on health and the natural environment and require that health care facilities be designed to "first, do no harm." This review uses the Guidelines as a blueprint for IPs' role in design and construction, updating familiar concepts to the 2010 edition with special emphasis on IP input into design given its longer range impact on health care-associated infection prevention while linking to safety and sustainability. Section I provides an overview of disease transmission risks from the built environment and related costs, section II presents a broad view of design and master planning, and section III addresses the detailed design strategies for infection prevention specifically addressed in the 2010 Facility Guidelines Institute edition.

  1. 76 FR 38399 - Assessing the Current Research, Policy, and Practice Environment in Public Health Genomics

    Science.gov (United States)

    2011-06-30

    ... HUMAN SERVICES Centers for Disease Control and Prevention Assessing the Current Research, Policy, and..., and other information helpful to assess the current research, policy, and practice environment in... Control and Prevention (CDC) has worked to integrate genomics into public health research, policy,...

  2. The current situation of impact of coal mine developing on environment in China and government proposal

    Energy Technology Data Exchange (ETDEWEB)

    Lu Yang [China University of Mining and Technology, Beijing (China). Ministry of Land and Resources

    2005-07-01

    Current environmental problems caused by coal mining in China, the importance of management of the environment, impact of coal mining on land and water resources, and upcoming coal development are discussed. It is suggested that the government should act in two ways: take responsibility for management of reclamation of mines existing before 1986, and set up mechanisms to protect the environment, starting with the publishing of relevant laws and regulations. Methods for solving environmental issues include: prepare a practical plan, establish an environmental control fund, establish a special fund to protect the environment, and develop new ways to combine protection of the biological environment and land reclamation. 5 refs., 3 tabs.

  3. Social sustainability in healthcare facilities: a rating tool for analysing and improving social aspects in environments of care.

    Science.gov (United States)

    Capolongo, Stefano; Gola, Marco; di Noia, Michela; Nickolova, Maria; Nachiero, Dario; Rebecchi, Andrea; Settimo, Gaetano; Vittori, Gail; Buffoli, Maddalena

    2016-01-01

    Nowadays several rating systems exist for the evaluation of the sustainability of buildings, but often their focus is limited to environmental and efficiency aspects. Hospitals are complex constructions in which many variables affect hospital processes. Therefore, a research group has developed a tool for the evaluation of sustainability in healthcare facilities. The paper analyses social sustainability issues through a tool which evaluates users' perception from a the quality and well-being perspective. It presents a hierarchical structure composed of a criteria and indicators system which is organised through a weighing system calculated by using the Analytic Network Process. The output is the definition of a tool which evaluates how Humanisation, Comfort and Distribution criteria can affect the social sustainability of a building. Starting from its application, it is evident that the instrument enables the improvement of healthcare facilities through several design and organisational suggestions for achieving healing and sustainable architectures.

  4. Offshore produced water management: A review of current practice and challenges in harsh/Arctic environments.

    Science.gov (United States)

    Zheng, Jisi; Chen, Bing; Thanyamanta, Worakanok; Hawboldt, Kelly; Zhang, Baiyu; Liu, Bo

    2016-03-15

    Increasing offshore oil and gas exploration and development in harsh/Arctic environments require more effective offshore produced water management, as these environments are much more sensitive to changes in water quality than more temperate climates. However, the number and scope of studies of offshore produced water management in harsh/Arctic environments are limited. This paper reviews the current state of offshore produced water management, impacts, and policies, as well as the vulnerability, implications and operational challenges in harsh/Arctic environments. The findings show that the primary contaminant(s) of concern are contained in both the dissolved oil and the dispersed oil. The application of emerging technologies that can tackle this issue is significantly limited by the challenges of offshore operations in harsh/Arctic environments. Therefore, there is a need to develop more efficient and suitable management systems since more stringent policies are being implemented due to the increased vulnerability of harsh/Arctic environments.

  5. Clinical compliance of viewing conditions in radiology reporting environments against current guidelines and standards

    Science.gov (United States)

    Daly, S.; Rainford, L.; Butler, M. L.

    2014-03-01

    Several studies have demonstrated the importance of environmental conditions in the radiology reporting environment, with many indicating that incorrect parameters could lead to error and misinterpretation. Literature is available with recommendations as to the levels that should be achieved in clinical practice, but evidence of adherence to these guidelines in radiology reporting environments is absent. This study audited the reporting environments of four teleradiologist and eight hospital based radiology reporting areas. This audit aimed to quantify adherence to guidelines and identify differences in the locations with respect to layout and design, monitor distance and angle as well as the ambient factors of the reporting environments. In line with international recommendations, an audit tool was designed to enquire in relation to the layout and design of reporting environments, monitor angle and distances used by radiologists when reporting, as well as the ambient factors such as noise, light and temperature. The review of conditions were carried out by the same independent auditor for consistency. The results obtained were compared against international standards and current research. Each radiology environment was given an overall compliance score to establish whether or not their environments were in line with recommended guidelines. Poor compliance to international recommendations and standards among radiology reporting environments was identified. Teleradiology reporting environments demonstrated greater compliance than hospital environments. The findings of this study identified a need for greater awareness of environmental and perceptual issues in the clinical setting. Further work involving a larger number of clinical centres is recommended.

  6. Factors Influencing Healthcare Service Quality

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2014-07-01

    Full Text Available Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.

  7. Effect of the electromagnetic environment on current fluctuations in driven tunnel junctions

    Science.gov (United States)

    Frey, Moritz; Grabert, Hermann

    2016-07-01

    We examine current fluctuations in tunnel junctions driven by a superposition of a constant and a sinusoidal voltage source. In standard setups, the external voltage is applied to the tunneling element via an impedance providing an electromagnetic environment of the junction. The modes of this environment are excited by the time-dependent voltage and are the source of Johnson-Nyquist noise. We determine the autocorrelation function of the current flowing in the leads of the junction in the weak tunneling limit up to terms of second order in the tunneling Hamiltonian. The driven modes of the electromagnetic environment are treated exactly by means of a unitary transformation introduced recently. Particular emphasis is placed on the spectral function of the current fluctuations. The spectrum is found to comprise three contributions: a term arising from the Johnson-Nyquist noise of the environmental impedance, a part due to the shot noise of the tunneling element, and a third contribution which comes from the cross correlation between fluctuations caused by the electromagnetic environment and fluctuations of the tunneling current. All three parts of the spectral function occur already for devices under dc bias. The spectral function of ac driven tunneling elements can be determined from the result for a dc bias by means of a photoassisted tunneling relation of the Tien-Gordon type. Specific results are given for an Ohmic environment and for a junction driven through a resonator.

  8. Current Status of Knowledge, Attitudes and Practices towards Healthcare Ethics among Doctors and Nurses from Northern India - A Multicentre Study

    Directory of Open Access Journals (Sweden)

    Mukul Chopra

    2013-07-01

    Full Text Available Background: Recent raise in litigation againsthealthcare practitioners is definitely an issueof immediate concern and may reflect an in-crease in unethical practices by them. Profes-sional relations between physicians and nursesmay have differences with respect to their atti-tudes towards patient-care. Aim and Objec-tives: To assess the knowledge of, and attitudesto healthcare ethics among north Indian physi-cians and nurses. Material and Methods: Thepresent cross sectional study was carried outamong 298 physicians and 107 nurses of threemedical colleges of northern India in the monthof July-August 2011 using pretested self ad-ministered questionnaire. Data analysis wasdone using SPSS version 20. Result and Con-clusion: There was a statistically significantdifference between the opinion of physiciansand nurses with respect to adherence to confi-dentiality, paternalistic attitude of doctors (doc-tors should do their best for the patient irre-spective of the patient’s opinion, informingclose relatives of a patients for consent proce-dures. The study highlighted gaps in the knowl-edge about practical aspects of health care eth-ics among physicians and nurses which theyencounter in day to day practice at workplace.Measures of workplace education like sensiti-zation workshops, CME’s, conferences onhealth care ethics would assist in bridging thisgap to a certain extent.

  9. Spurious claims for health-care products: an experimental approach to evaluating current UK legislation and its implementation.

    Science.gov (United States)

    Rose, Leslie B; Posadzki, Paul; Ernst, Edzard

    2012-01-01

    The lay media, and especially the Internet, contain many misleading claims for health products which have previously been inadequately regulated by consumer law. This was an experimental interventional survey within a consumer health-care setting. Three health products were chosen on the basis of being widely available on the UK market and having no available evidence of effectiveness. Twelve volunteers submitted 39 complaints to Consumer Direct (UK portal for the regulator Trading Standards) regarding false health claims, and 36 complaints were followed up for a maximum of 4.8 months. The mean time from submission of complaints to Consumer Direct to acknowledgement by the relevant Trading Standards office was 13 days. There were no responses from Trading Standards for 22% of complaints. At the end of the study one supplier had amended their website following Trading Standards advice, but did not stop all health claims. Another stopped advertising their product on the Internet and the third continued the health claims unchanged. EU directive 2005/29/EC is largely ineffective in preventing misleading health claims for consumer products in the UK.

  10. Risk factors and current health seeking patterns of migrants in northeastern Mexico: healthcare needs for a socially vulnerable population

    Directory of Open Access Journals (Sweden)

    Philippe eStoesslé

    2015-08-01

    Full Text Available This study identified risk factors for health and access to healthcare services of migrants during their journey across Mexico to the United States. Data were collected in shelters located in Monterrey, the largest city of northeastern Mexico, through a basic clinical examination and a survey completed by 75 migrants; 92% of them were undocumented Central Americans. During their transit, they are at a high risk of contracting, developing, and transmitting diseases. The need of working to survive affects health-seeking behavior and a constant fear of being traced keeps migrants away from public health services, which delays diagnosis and treatment of diseases. Negligent lifestyles, such as smoking, drinking (31.8% of men and 11.1% of women, and drug abuse (13% of men and 11% of women, were found. Regarding tuberculosis (TB, undocumented migrants are usually not screened, even though they come from countries with a high TB burden. Besides, they might be overexposed to TB because of their living conditions in overcrowded places with deficient hygiene, protection, and malnutrition (54.7% of the sample. Possible comorbidities like acquired immune deficiency syndrome (AIDS; 4% and diabetes (2.7%, but probably under-diagnosed were referred. Migrants have little TB knowledge, which is independent of their level of education or a previous experience of deportation. About one-third of the migrants were totally unfamiliar with TB-related symptoms, while 36% had correct knowledge of basic TB symptoms. We conclude that a shortage of information on the highly vulnerable migratory population combined with a lack of social support and health education among migrants may play a significant role in the spread of communicable diseases. We recommend that health authorities address this urgent, binational, public health concern, in order to prevent outbreaks of emerging infections.

  11. ESBL-producing Gram-negative organisms in the healthcare environment as a source of genetic material for resistance in human infections.

    Science.gov (United States)

    Muzslay, M; Moore, G; Alhussaini, N; Wilson, A P R

    2017-01-01

    The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in the healthcare setting and in the community despite established infection control guidelines indicates that these microorganisms may possess survival strategies that allow them to persist in the environment. To determine the extent and variation in endemic ESBL-carrying species in different ward environments, and to investigate the potential for cephalosporin resistance to be transferred from environmental isolates to human pathogens. Conventional microbiological methods were used to sample 1436 environmental surfaces for ESBL-producing bacteria. Transconjugation assays (broth mating experiments) were performed using environmental ESBL-producing isolates as donors and streptomycin-resistant Escherichia coli (NCTC 50237) as the recipient. The prevalence of ESBL-producing bacteria on surfaces in a non-outbreak setting was low (45/1436; 3.1%). The sites most likely to be contaminated were the drains of handwash basins (28/105; 26.7%) and floors (14/160; 8.8%). Fifty-nine ESBL-carrying organisms were isolated. Of these, Klebsiella spp. (33.9%), Enterobacter spp. (20.3%), Pantoea spp. (15.3%) and Citrobacter spp. (13.6%) were the most common isolates. ESBL determinants were transferred successfully from three representative environmental isolates (Pantoea calida, Klebsiella oxytoca, Raoultella ornithinolytica) to the human pathogen E. coli. ESBL-producing Gram-negative isolates were recovered from the hospital environment in the absence of any ESBL infection on the wards. The drains of handwash basins should be considered potential long-term reservoirs of multi-drug-resistant bacteria and drug resistance genes. These genes can reside in various genera of hardy environmental organisms and be a potential source of ESBL for more common human pathogens. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  12. The orthopaedist's role in healthcare system governance.

    Science.gov (United States)

    Probe, Robert A

    2013-06-01

    Historically, physicians as participants in healthcare governance were shunned because of perceived potential for conflict of interest. This maxim is being revisited as health systems begin to appreciate the value presented by physician leaders. This overview of the orthopaedist's role in healthcare governance will be addressed in three sections: first to identify the need for change in American healthcare, second to examine the role that physicians should play in governing over this inevitable change, and third to outline strategies for effective participation for those physicians wishing to play a role in healthcare governance. The PubMed data set was queried applying the search commands "governance AND (healthcare OR hospital) AND (doctor OR physician OR surgeon)" for the time period 1969 to 2012. In addition, the bibliographies of relevant articles were reviewed. This search strategy returned 404 titles. Abstract and article review identified 19 relevant to the topic. Bibliographic review identified five more articles of relevance forming the foundation for this review. The delivery of American health care will require change to face current economic realities. Organizations that embrace this change guided by the insight of physician governors are well positioned to recognize the simultaneous improvement in value and quality. Although few physicians are formally trained for these roles, multiple paths to becoming effective governors are available. In this environment of rapid change in healthcare delivery, the medical insight of physician leadership will prove invaluable. Governing bodies should reach out to talented physicians and administratively talented physicians should rise to this challenge.

  13. STRATEGIC MANAGEMENT OF COSTS - THE MAIN TOOL OF COMPETITIVE ADVANTAGE IN THE CURRENT ECONOMIC ENVIRONMENT

    Directory of Open Access Journals (Sweden)

    CORINA MICULESCU

    2012-05-01

    Full Text Available Both global and national hipercompetiţia and globalization are two phenomena that generate complexity and instability in the business. Therefore, the economic context in which organizations operate has changed a lot, the current environment characterized by globalization, increased competition, rapidly changing, market segmentation, changes in technology, demand volatility, the importance of information. These phenomena not only create a state of turmoil and turbulence in the competitive environment and generate changes in market conditions, but require changes and development in organizations. In these circumstances organizations worldwide are forced to adapt constantly, products and services to market needs to turn its attention to customer satisfaction, they need sophisticated production processes, internal processes flexible to respond quickly to changes environment.Therefore to achieve any competitive advantage, organizations must take the current economic environment strategies that integrate environmental opportunities, market and technology advantages in the most efficient way. In this context the question of modernization, the transformation cost information system, an adaptation to the realities and requirements of this, to change tools, processes and methods to meet current scientific and technical progress.

  14. Perception of community pharmacists toward their current professional role in the healthcare system of Dubai, United Arab Emirates

    OpenAIRE

    Rayes, Ibrahim Khalid; Hassali, Mohamed Azmi; Abduelmula R Abduelkarem

    2014-01-01

    The new paradigm to pharmacy profession has changed the focus of pharmacists from product-centered to patient-oriented. This change has brought new set of beliefs and assumptions on the way services should be delivered to pharmacy clients. The main aim of this study was to explore the perception of community pharmacists on their current professional role in Dubai. Key findings show that community pharmacists are more directed toward business than patients. They almost dispense all categories ...

  15. Perception of community pharmacists toward their current professional role in the healthcare system of Dubai, United Arab Emirates.

    Science.gov (United States)

    Rayes, Ibrahim Khalid; Hassali, Mohamed Azmi; Abduelkarem, Abduelmula R

    2015-07-01

    The new paradigm to pharmacy profession has changed the focus of pharmacists from product-centered to patient-oriented. This change has brought new set of beliefs and assumptions on the way services should be delivered to pharmacy clients. The main aim of this study was to explore the perception of community pharmacists on their current professional role in Dubai. Key findings show that community pharmacists are more directed toward business than patients. They almost dispense all categories of medicines over-the-counter without the need of prescriptions. However, a new trend of pharmacists in Dubai is to provide enhanced pharmacy services such as consultation to patients upon request.

  16. The Appliance Pervasive of Internet of Things in Healthcare Systems

    Directory of Open Access Journals (Sweden)

    Mir Sajjad Hussain Talpur

    2013-01-01

    Full Text Available In fact, information systems are the foundation of new productivity sources, medical organizational forms, and erection of a global economy. IoT based healthcare systems play a significant role in ICT and have contribution in growth of medical information systems, which are underpinning of recent medical and economic development strategies. However, to take advantages of IoT, it is essential that medical enterprises and community should trust the IoT systems in terms of performance, security, privacy, reliability and return-on-investment, which are open challenges of current IoT systems. For heightening of healthcare system; tracking, tracing and monitoring of patients and medical objects are more essential. But due to the inadequate healthcare situation, medical environment, medical technologies and the unique requirements of some healthcare applications, the obtainable tools cannot meet them accurately. The tracking, tracing and monitoring of patients and healthcare actors activities in healthcare system are challenging research directions for IoT researchers. State-of-the-art IoT based healthcare system should be developed which ensure the safety of patients and other healthcare activities. With this manuscript, we elaborate the essential role of IoT in healthcare systems; immense prospects of Internet of things in healthcare systems; extensive aspect of the use of IoT is dissimilar among different healthcare components and finally the participation of IoT between the useful research and present realistic applications. IoT and few other modern technologies are still in underpinning stage; mainly in the healthcare system.

  17. Gene by Environment Research to Prevent Externalizing Problem Behavior : Ethical Questions Raised from a Public Healthcare Perspective

    NARCIS (Netherlands)

    Chhangur, Rabia R.; Weeland, Joyce|info:eu-repo/dai/nl/328240583; Matthys, Walter; Overbeek, Geertjan|info:eu-repo/dai/nl/25233602X

    2015-01-01

    The main public health advantages of examining gene by environment interactions (i.e., G x E) in externalizing behavior lie in the realm of personalized interventions. Nevertheless, the incorporation of genetic data in randomized controlled trials is fraught with difficulties and raises ethical

  18. Gene by Environment Research to Prevent Externalizing Problem Behavior : Ethical Questions Raised from a Public Healthcare Perspective

    NARCIS (Netherlands)

    Chhangur, Rabia R.; Weeland, Joyce; Matthys, Walter; Overbeek, Geertjan

    2015-01-01

    The main public health advantages of examining gene by environment interactions (i.e., G x E) in externalizing behavior lie in the realm of personalized interventions. Nevertheless, the incorporation of genetic data in randomized controlled trials is fraught with difficulties and raises ethical ques

  19. Conductor of high electrical current at high temperature in oxygen and liquid metal environment

    Energy Technology Data Exchange (ETDEWEB)

    Powell, IV, Adam Clayton; Pati, Soobhankar; Derezinski, Stephen Joseph; Lau, Garrett; Pal, Uday B.; Guan, Xiaofei; Gopalan, Srikanth

    2016-01-12

    In one aspect, the present invention is directed to apparatuses for and methods of conducting electrical current in an oxygen and liquid metal environment. In another aspect, the invention relates to methods for production of metals from their oxides comprising providing a cathode in electrical contact with a molten electrolyte, providing a liquid metal anode separated from the cathode and the molten electrolyte by a solid oxygen ion conducting membrane, providing a current collector at the anode, and establishing a potential between the cathode and the anode.

  20. Possibilities for Healthcare Computing

    Institute of Scientific and Technical Information of China (English)

    Peter Szolovits

    2011-01-01

    Advances in computing technology promise to aid in achieving the goals of healthcare.We review how such changes can support each of the goá1s of healthcare as identified by the U.S.Institute of Medicine:safety,effectiveness,patient-centricity,timeliness,efficiency,and equitability.We also describe current foci of computing technology research aimed at realizing the ambitious goals for health information technology that have been set by the American Recovery and Reinvestment Act of 2009 and the Health Reform Act of 2010.Finally,we mention efforts to build health information technologies to support improved healthcare delivery in developing countries.

  1. The average direct current offset values for small digital audio recorders in an acoustically consistent environment.

    Science.gov (United States)

    Koenig, Bruce E; Lacey, Douglas S

    2014-07-01

    In this research project, nine small digital audio recorders were tested using five sets of 30-min recordings at all available recording modes, with consistent audio material, identical source and microphone locations, and identical acoustic environments. The averaged direct current (DC) offset values and standard deviations were measured for 30-sec and 1-, 2-, 3-, 6-, 10-, 15-, and 30-min segments. The research found an inverse association between segment lengths and the standard deviation values and that lengths beyond 30 min may not meaningfully reduce the standard deviation values. This research supports previous studies indicating that measured averaged DC offsets should only be used for exclusionary purposes in authenticity analyses and exhibit consistent values when the general acoustic environment and microphone/recorder configurations were held constant. Measured average DC offset values from exemplar recorders may not be directly comparable to those of submitted digital audio recordings without exactly duplicating the acoustic environment and microphone/recorder configurations.

  2. Plastics, the environment and human health: current consensus and future trends

    OpenAIRE

    Richard C. Thompson; Moore, Charles J.; Frederick S Vom Saal; Swan, Shanna H.

    2009-01-01

    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However...

  3. Plastics, the environment and human health: current consensus and future trends

    OpenAIRE

    Thompson, Richard C.; Moore, Charles J.; vom Saal, Frederick S.; Swan, Shanna H.

    2009-01-01

    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However...

  4. Distributed Denial of Service Attack Source Detection Using Efficient Traceback Technique (ETT) in Cloud-Assisted Healthcare Environment.

    Science.gov (United States)

    Latif, Rabia; Abbas, Haider; Latif, Seemab; Masood, Ashraf

    2016-07-01

    Security and privacy are the first and foremost concerns that should be given special attention when dealing with Wireless Body Area Networks (WBANs). As WBAN sensors operate in an unattended environment and carry critical patient health information, Distributed Denial of Service (DDoS) attack is one of the major attacks in WBAN environment that not only exhausts the available resources but also influence the reliability of information being transmitted. This research work is an extension of our previous work in which a machine learning based attack detection algorithm is proposed to detect DDoS attack in WBAN environment. However, in order to avoid complexity, no consideration was given to the traceback mechanism. During traceback, the challenge lies in reconstructing the attack path leading to identify the attack source. Among existing traceback techniques, Probabilistic Packet Marking (PPM) approach is the most commonly used technique in conventional IP- based networks. However, since marking probability assignment has significant effect on both the convergence time and performance of a scheme, it is not directly applicable in WBAN environment due to high convergence time and overhead on intermediate nodes. Therefore, in this paper we have proposed a new scheme called Efficient Traceback Technique (ETT) based on Dynamic Probability Packet Marking (DPPM) approach and uses MAC header in place of IP header. Instead of using fixed marking probability, the proposed scheme uses variable marking probability based on the number of hops travelled by a packet to reach the target node. Finally, path reconstruction algorithms are proposed to traceback an attacker. Evaluation and simulation results indicate that the proposed solution outperforms fixed PPM in terms of convergence time and computational overhead on nodes.

  5. North Atlantic Current and European environments during the declining stage of the last interglacial

    Science.gov (United States)

    Müller, Ulrich C.; Kukla, George J.

    2004-12-01

    This paper provides a tentative reconstruction of environmental shifts in Europe associated with changes of the North Atlantic Current and related meridional sea-surface temperature (SST) gradients. During most of the Eemian interglacial (ca. 126 115 ka), the North Atlantic Current extended far north into the Nordic Seas and European environments were comparable to those of the Holocene. However, ca. 115 ka an SST drop in the Nordic Seas marked a southward displacement of the North Atlantic Current. This hydrographic shift was associated with substantial cooling in northern Europe and drier conditions in the Mediterranean region. The polar timberline retreated southward from 69°N in northernmost Scandinavia to 52°N in central Europe, and thermophilous deciduous trees became extinct north of the 48th parallel. Woodlands persisted in southern Europe for another 5 k.y. well into marine isotope substage 5d. These conditions indicate steep vegetation and climate gradients at the inception of the last glacial.

  6. Uncovering the Pathogenic Landscape of Helminth (Opisthorchis viverrini) Infections: A Cross-Sectional Study on Contributions of Physical and Social Environment and Healthcare Interventions

    Science.gov (United States)

    Ong, Xueyuan; Sithithaworn, Paiboon; Namsanor, Jutamas; Taylor, David; Laithavewat, Luxana

    2016-01-01

    Background Helminth infections have proven recalcitrant to control by chemotherapy in many parts of Southeast Asia and indeed farther afield. This study isolates and examines the influence of different aspects of the physical and social environment, and uneven intervention effort contributing to the pathogenic landscape of human Opisthorchis viverrini infections. Methodology A cross-sectional survey, involving 632 participants, was conducted in four villages in northeast Thailand to examine the impact on prevalence and parasite burden of the reservoir dam environment, socio-economic, demographic, and behavioral factors, and health center intervention efforts. Formalin-ether concentration technique was used for diagnoses, and multivariate models were used for analyses. Principal Findings The importance attributed to O. viverrini infections varied among health centers in the four study villages. Villages where O. viverrini infections were not prioritized by the health centers as the healthcare focus were at a higher risk of infection (prevalence) with odds ratio (risk factor) of 5.73 (3.32–10.27) and p-value viverrini infections in the study area, was 11.4% higher in villages that prioritized O. viverrini infections than those that did not (p-value = 0.01). Landscape variation, notably proximity to reservoir, affects vulnerability of local population to infection. Infection intensity was higher in population located closer to the reservoir with risk ratio of 2.09 (1.12–4.02) and p-value < 0.01. Patterns of infection intensities among humans were found to match fish infection intensity, where higher infection intensities were associated with fish obtained from the reservoir waterbody type (p-value = 0.023). Conclusions/Significance This study demonstrated the importance of environmental influence and healthcare focus as risk factors of infections in addition to the socio-economic, demographic, and behavioral factors commonly explored in existing studies. The

  7. Toxic Workplace Environment: In Search for the Toxic Behaviours in Organizations with a Research in Healthcare Sector

    Directory of Open Access Journals (Sweden)

    Secil Bal TASTAN

    2017-06-01

    Full Text Available This study provides information on how to identify a toxic workplace; identifies the types of toxic worker behavior, including abusive supervision and workplace mobbing; discusses how toxic workplaces affect employees at all levels; and describes how toxic workplaces can become hostile work environments. For achieving knowledge about how such kind of behaviors and attitudes are perceived by the employees in the selected organizations, a qualitative study was designed. Following the qualitative research, a research study has been designed as a descriptive cross-sectional study which involved the questionnaire survey for primary data collection and analysis. As a result of both qualitative and quantitative studies, it was observed that types of toxic behaviors included tearing others down, passive aggressive leadership, destructive gossip, devious politics, a lot of negativity, abusive supervision, unfair policies, and aggression. The findings reported that there were two categories of toxic workplace environment named as "Behavioral Toxics" and "Contextual Toxics" which consisted four variables of "toxic behaviors of coworkers", "toxic behaviors of managers", "toxic social-structural factors" and "toxic climate".

  8. Acoustic Doppler current profiler measurements in coastal and estuarine environments: examples from the Tay Estuary, Scotland

    Science.gov (United States)

    Wewetzer, Silke F. K.; Duck, Robert W.; Anderson, James M.

    1999-08-01

    Acoustic Doppler current profilers (ADCPs) provide a means to measure the components of water current velocities in three dimensions. Such instruments have been used widely by the oil industry in deep offshore waters but their application to nearshore coastal and estuarine environments has been principally confined to the USA. Using examples of ADCP datasets acquired from the macrotidal Tay Estuary, eastern Scotland, the principles of field deployment, data acquisition and forms of output are critically summarised. It is shown, for the first time in the Tay Estuary, that vertical current velocities are significant and are particularly so in downwelling zones associated with the development and passage of axially convergent tidal fronts. The improved understanding of three-dimensional water and suspended sediment dynamics in coastal and estuarine waters is crucial to, inter alia, the sustainable management of effluent discharges and, in more general terms, it is predicted on the basis of the Tay case study, that ADCP measurements afford significant opportunities to refine understanding of geomorphological processes in a variety of aquatic environments worldwide.

  9. Social Influence on Information Technology Adoption and Sustained Use in Healthcare: A Hierarchical Bayesian Learning Method Analysis

    Science.gov (United States)

    Hao, Haijing

    2013-01-01

    Information technology adoption and diffusion is currently a significant challenge in the healthcare delivery setting. This thesis includes three papers that explore social influence on information technology adoption and sustained use in the healthcare delivery environment using conventional regression models and novel hierarchical Bayesian…

  10. The involvement of community leaders in healthcare, the environment and sanitation in áreas of social vulnerability.

    Science.gov (United States)

    Juliano, Ester Feche Guimarães de Arruda; Malheiros, Tadeu Fabrício; Marques, Rui Cunha

    2016-03-01

    The main purpose of this article is to identify access to: social assistance inclusion programs; assistance from health agents; public water supply services; and water saving practices, in areas of irregular occupation in Brazil. A stratified random sampling technique by clusters was adopted with a simple sampling strategy. In the universe of 14,079 households, 68 community leaders were identified, representing 6,800 households on average, in a normalized distribution (mean zero, standard deviation 1), deemed to include situations covering 96% of the cases with a margin of error of + or - 1% of the average. The theoretical approach proposes a reflection and verification through questionnaires on the mechanisms of exclusion. Poverty perpetuates the vicious circle of inequality, risks to health and the environment, and it is necessary that these should be considered in the policies and procedures for urban expansion. As a conclusion, various challenges were identified for serving areas of social-environmental vulnerability - the needs to: improve the low quality of health and water services in subnormal agglomerations; modify the behavior of the population accessing the networks in a clandestine manner; and to put inclusive governance mechanisms in place.

  11. Review of current activities to model and measure the orbital debris environment in low-earth orbit

    Science.gov (United States)

    Reynolds, R. C.

    A very active orbital debris program is currently being pursued at the NASA/Johnson Space Center (JSC), with projects designed to better define the current environment, to project future environments, to model the processes contributing to or constraining the growth of debris in the environment, and to gather supporting data needed to improve the understanding of the orbital debris problem and the hazard it presents to spacecraft. This paper is a review of the activity being conducted at JSC, by NASA, Lockheed Engineering and Sciences Company, and other support contractors, and presents a review of current activity, results of current research, and a discussion of directions for future development.

  12. HIGH-RESOLUTION MONITORING OF CURRENT RAPID TRANSFORMATIONS ON GLACIAL AND PERIGLACIAL ENVIRONMENTS

    Directory of Open Access Journals (Sweden)

    L. Carturan

    2014-01-01

    Full Text Available Glacial and periglacial environments are highly sensitive to climatic changes. Processes of cryosphere degradation may strongly impact human activities and infrastructures, and need to be monitored for improved understanding and for mitigation/adaptation. Studying glacial and periglacial environments using traditional techniques may be difficult or not feasible, but new remote sensing techniques like terrestrial and aerial laser scanner opened new possibilities for cryospheric studies. This work presents an application of the terrestrial laser scanner (TLS for monitoring the current rapid changes occurring on the Montasio Occidentale glacier (Eastern Italian alps, which is representative of low-altitude, avalanche-fed and debris-cover glaciers. These glaciers are quite common in the Alps but their reaction to climate changes is still poorly known. The mass balance, surface velocity fields, debris cover dynamics and effects of meteorological extremes were investigated by repeat high-resolution TLS scanning from September 2010 to October 2012. The results were encouraging and shed light on the peculiar response of this glacier to climatic changes, on its current dynamics and on the feedback played by the debris cover, which is critical for its preservation. The rapid transformations in act, combined with the unstable ice mass, large amount of loose debris and channeled runoff during intense rainfalls, constitute a potential area for the formation of large debris flows, as shown by field evidences and documented by the recent literature.

  13. The significance of personal learning environments (PLEs) in nursing education: Extending current conceptualizations.

    Science.gov (United States)

    Patterson, Christopher; Stephens, Moira; Chiang, Vico; Price, Ann M; Work, Fiona; Snelgrove-Clarke, Erna

    2017-01-01

    Personal learning environments (PLEs) have been shown to be a critical part of how students negotiate and manage their own learning. Understandings of PLEs appear to be constrained by narrow definitions that focus primarily on technological engagement with a range of web tools and associated applications. This paper addresses a gap in the literature around PLEs for students currently enrolled in undergraduate nursing degrees. To provide in-depth insights into how undergraduate students of nursing manage and experience their learning. This was an international multi-site qualitative study, utilizing focus groups. A schedule of 10 questions and nominal group techniques were used. Whilst the focus groups took place in very different geographical locations, there were strong similarities in student understandings of effective PLEs. These went well beyond current technological definitions. Findings were organized into three major themes; technologies, learning modalities and influencing factors. We propose a broader understanding of PLEs that acknowledges individual personal and cultural contexts which we call the personally significant learning environment (PSLE). There is a need for greater investigation of how students understand and systematize their PSLE. This paper and our findings will be of interest to educators, researchers and institutions for developing appropriate frameworks that may maximize learning outcomes, encourage cultural sensitivities and facilitate greater understandings of how to support students to create appropriate PSLEs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. The impact of healthcare workers job environment on their mental-emotional health. Coping strategies: the case of a local general hospital

    Directory of Open Access Journals (Sweden)

    Aristotelis Koinis

    2015-04-01

    Full Text Available Workplace stress can influence healthcare professionals’ physical and emotional well-being by curbing their efficiency and having a negative impact on their overall quality of life. The aim of the present study was to investigate the impact that work environment in a local public general hospital can have on the health workers’ mental-emotional health and find strategies in order to cope with negative consequences. The study took place from July 2010 to October 2010. Our sample consisted of 200 healthcare professionals aged 21-58 years working in a 240-bed general hospital and the response rate was 91.36%. Our research protocol was first approved by the hospital’s review board. A standardized questionnaire that investigates strategies for coping with stressful conditions was used. A standardized questionnaire was used in the present study Coping Strategies for Stressful Events, evaluating the strategies that persons employ in order to overcome a stressful situation or event. The questionnaire was first tested for validity and reliability which were found satisfactory (Cronbach’s α=0.862. Strict anonymity of the participants was guaranteed. The SPSS 16.0 software was used for the statistical analysis. Regression analysis showed that health professionals’ emotional health can be influenced by strategies for dealing with stressful events, since positive re-assessment, quitting and seeking social support are predisposing factors regarding the three first quality of life factors of the World Health Organization Quality of Life -BREF. More specifically, for the physical health factor, positive re-assessment (t=3.370, P=0.001 and quitting (t=−2.564, P=0.011 are predisposing factors. For the ‘mental health and spirituality’ regression model, positive re-assessment (t=5.528, P=0.000 and seeking social support (t=−1.991, P=0.048 are also predisposing factors, while regarding social relationships positive re-assessment (t=4.289, P=0

  15. Leadership strategies in healthcare.

    Science.gov (United States)

    Menaker, Ronald

    2009-01-01

    Healthcare is one of the largest and most important industries in the United States because it affects every individual in the nation. Numerous parties are stakeholders in healthcare, which contributes to the complexity of change efforts. Physicians and administrators play a significant role by providing direct care and influencing other decisions that impact the delivery of patient care. Success in the healthcare industry is influenced by numerous factors, some of which are controllable and others that are not. Understanding leadership and change management will be increasingly important to overcome resistance to change and to improve relationships, the core of leadership in an environment that will become more challenging. In what follows, different approaches to understanding leadership and change management are presented along with other leadership strategies to enhance the effectiveness of leaders. Raising leader awareness regarding transformational leadership behaviors and developing strategies to increase the use of these behaviors may be helpful to enhance organizational performance.

  16. Plastics, the environment and human health: current consensus and future trends.

    Science.gov (United States)

    Thompson, Richard C; Moore, Charles J; vom Saal, Frederick S; Swan, Shanna H

    2009-07-27

    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However, concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable. Around 4 per cent of world oil production is used as a feedstock to make plastics and a similar amount is used as energy in the process. Yet over a third of current production is used to make items of packaging, which are then rapidly discarded. Given our declining reserves of fossil fuels, and finite capacity for disposal of waste to landfill, this linear use of hydrocarbons, via packaging and other short-lived applications of plastic, is simply not sustainable. There are solutions, including material reduction, design for end-of-life recyclability, increased recycling capacity, development of bio-based feedstocks, strategies to reduce littering, the application of green chemistry life-cycle analyses and revised risk assessment approaches. Such measures will be most effective through the combined actions of the public, industry, scientists and policymakers. There is some urgency, as the quantity of plastics produced in the first 10 years of the current century is likely to approach the quantity produced in the

  17. Plastics, the environment and human health: current consensus and future trends

    Science.gov (United States)

    Thompson, Richard C.; Moore, Charles J.; vom Saal, Frederick S.; Swan, Shanna H.

    2009-01-01

    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However, concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable. Around 4 per cent of world oil production is used as a feedstock to make plastics and a similar amount is used as energy in the process. Yet over a third of current production is used to make items of packaging, which are then rapidly discarded. Given our declining reserves of fossil fuels, and finite capacity for disposal of waste to landfill, this linear use of hydrocarbons, via packaging and other short-lived applications of plastic, is simply not sustainable. There are solutions, including material reduction, design for end-of-life recyclability, increased recycling capacity, development of bio-based feedstocks, strategies to reduce littering, the application of green chemistry life-cycle analyses and revised risk assessment approaches. Such measures will be most effective through the combined actions of the public, industry, scientists and policymakers. There is some urgency, as the quantity of plastics produced in the first 10 years of the current century is likely to approach the quantity produced in the

  18. Healthcare regulatory concepts in Brazil.

    Science.gov (United States)

    Oliveira, Robson Rocha de; Elias, Paulo Eduardo Mangeon

    2012-06-01

    The healthcare regulatory concepts used in Brazilian scientific publications on healthcare management were reviewed. A typo-logical classification for regulatory concepts was developed from the most current ideas in five disciplines: life sciences, law, economics, sociology and political science. Four ideas stood out: control, balance, adaptation and direction, with greatest emphasis on the technical nature of regulation. The political nature of regulation was secondary. It was considered that dis-cussion of healthcare regulatory concepts was connected with comprehension of the role that the state plays in this sector. De-finition of the forms of state intervention is the key convergence point between the different ways of conceptualizing healthcare regulation.

  19. Extreme Environment Simulation - Current and New Capabilities to Simulate Venus and Other Planetary Bodies

    Science.gov (United States)

    Kremic, Tibor; Vento, Dan; Lalli, Nick; Palinski, Timothy

    2014-01-01

    Science, technology, and planetary mission communities have a growing interest in components and systems that are capable of working in extreme (high) temperature and pressure conditions. Terrestrial applications range from scientific research, aerospace, defense, automotive systems, energy storage and power distribution, deep mining and others. As the target environments get increasingly extreme, capabilities to develop and test the sensors and systems designed to operate in such environments will be required. An application of particular importance to the planetary science community is the ability for a robotic lander to survive on the Venus surface where pressures are nearly 100 times that of Earth and temperatures approach 500C. The scientific importance and relevance of Venus missions are stated in the current Planetary Decadal Survey. Further, several missions to Venus were proposed in the most recent Discovery call. Despite this interest, the ability to accurately simulate Venus conditions at a scale that can test and validate instruments and spacecraft systems and accurately simulate the Venus atmosphere has been lacking. This paper discusses and compares the capabilities that are known to exist within and outside the United States to simulate the extreme environmental conditions found in terrestrial or planetary surfaces including the Venus atmosphere and surface. The paper then focuses on discussing the recent additional capability found in the NASA Glenn Extreme Environment Rig (GEER). The GEER, located at the NASA Glenn Research Center in Cleveland, Ohio, is designed to simulate not only the temperature and pressure extremes described, but can also accurately reproduce the atmospheric compositions of bodies in the solar system including those with acidic and hazardous elements. GEER capabilities and characteristics are described along with operational considerations relevant to potential users. The paper presents initial operating results and concludes

  20. Optical Estimation of Depth and Current in a Ebb Tidal Delta Environment

    Science.gov (United States)

    Holman, R. A.; Stanley, J.

    2012-12-01

    A key limitation to our ability to make nearshore environmental predictions is the difficulty of obtaining up-to-date bathymetry measurements at a reasonable cost and frequency. Due to the high cost and complex logistics of in-situ methods, research into remote sensing approaches has been steady and has finally yielded fairly robust methods like the cBathy algorithm for optical Argus data that show good performance on simple barred beach profiles and near immunity to noise and signal problems. In May, 2012, data were collected in a more complex ebb tidal delta environment during the RIVET field experiment at New River Inlet, NC. The presence of strong reversing tidal currents led to significant errors in cBathy depths that were phase-locked to the tide. In this paper we will test methods for the robust estimation of both depths and vector currents in a tidal delta domain. In contrast to previous Fourier methods, wavenumber estimation in cBathy can be done on small enough scales to resolve interesting nearshore features.

  1. Evolutionary Psychology: How Psychological Mechanisms Shaped by Natural Selection for Ancestral Environments Produce Current Behaviours

    Institute of Scientific and Technical Information of China (English)

    Charles Crawford

    2009-01-01

    The central purpose of this paper is to explain how Darwin's theory of evolution by natural selection can be used in understanding current human behaviour. First, Darwin's logic is briefly described. Development is an important issue when applying evolutionary theory to human behaviour. The notion of innate developmental orga-nization of psychological mechanisms is introduced. The possible social and political outcomes produced when differ-ent levels of innate developmental organization are paired with different beliefs about it are considered. The notion of psychological mechanisms as evolved adaptations is considered in some detail. Then I discuss different ways evo-htionists think about how genes are involved in the development of adaptations. The paper concludes with a frame-work for considering how ancestral adaptations function in current environments and outlines some ways of studying them. In China and many other parts of the world people desire a more harmonious society. Ⅰ hope that this paper will be of some small help in achieving this great task.

  2. Mobile Healthcare System using NFC Technology

    OpenAIRE

    A Devendran; T Bhuvaneswari; Arun Kumar Krishnan

    2012-01-01

    Although primary care physicians are increasingly interested in adopting electronic medical record (EMR) systems, few use such systems in practice. Mobile devices offer new ways for users to access health care data and services in a secure and user-friendly environment. Mobile healthcare (m-healthcare) systems are regarded as a solution to healthcare costs without reducing the quality of patient care. We are developing a basic architecture for m-healthcare services using Near Field Communicat...

  3. Advanced healthcare materials

    CERN Document Server

    Tiwari, Ashutosh

    2014-01-01

    Advanced materials are attracting strong interest in the fundamental as well as applied sciences and are being extensively explored for their potential usage in a range of healthcare technological and biological applications. Advanced Healthcare Nanomaterials summarises the current status of knowledge in the fields of advanced materials for functional therapeutics, point-of-care diagnostics, translational materials, up and coming bio-engineering devices. The book highlights the key features which enable engineers to design stimuli-responsive smart nanoparticles, novel biomaterials, nan

  4. An assessment tool for developing healthcare managerial skills and roles.

    Science.gov (United States)

    Guo, Kristina L

    2003-01-01

    This article is based on a study to identify, and by doing so help develop, the skills and roles of senior-level healthcare managers related to the needs of the current healthcare environment. To classify these roles and skills, a qualitative study was conducted to examine the literature on forces in the healthcare environment and their impact on managers. Ten senior managers were interviewed, revealing six roles as the most crucial to their positions along with the skills necessary to perform those roles. A pilot study was conducted with these senior managers to produce a final assessment tool. This assessment tool helps managers to identify strengths and weaknesses, develop in deficient areas, and promote competence in all areas as demanded by the market and organization. This tool can be used by organizations in the recruitment process and in the training process.

  5. The SEDIBUD (Sediment Budgets in Cold Environments) Programme: Current activities and future key tasks

    Science.gov (United States)

    Beylich, A. A.; Lamoureux, S. F.; Decaulne, A.

    2012-04-01

    Projected climate change in cold regions is expected to alter melt season duration and intensity, along with the number of extreme rainfall events, total annual precipitation and the balance between snowfall and rainfall. Similarly, changes to the thermal balance are expected to reduce the extent of permafrost and seasonal ground frost and increase active layer depths. These effects will undoubtedly change surface environments in cold regions and alter the fluxes of sediments, nutrients and solutes, but the absence of quantitative data and coordinated process monitoring and analysis to understand the sensitivity of the Earth surface environment is acute in cold climate environments. The International Association of Geomorphologists (I.A.G./A.I.G.)SEDIBUD (Sediment Budgets in Cold Environments) Programme was formed in 2005 to address this existing key knowledge gap. SEDIBUD currently has about 400 members worldwide and the Steering Committee of this international programme is composed of ten scientists from eight different countries: Achim A. Beylich (Chair) (Norway), Armelle Decaulne (Secretary) (France), John C. Dixon (USA), Scott F. Lamoureux (Vice-Chair) (Canada), John F. Orwin (Canada), Jan-Christoph Otto (Austria), Irina Overeem (USA), Thorsteinn Saemundsson (Iceland), Jeff Warburton (UK), Zbigniew Zwolinski (Poland). The central research question of this global group of scientists is to: Assess and model the contemporary sedimentary fluxes in cold climates, with emphasis on both particulate and dissolved components. Initially formed as European Science Foundation (ESF) Network SEDIFLUX (2004-2006), SEDIBUD has further expanded to a global group of researchers with field research sites located in polar and alpine regions in the northern and southern hemisphere. Research carried out at each of the close to 50 defined SEDIBUD key test sites varies by programme, logistics and available resources, but typically represent interdisciplinary collaborations of

  6. Healthcare is primary.

    Science.gov (United States)

    Kumar, Raman

    2015-01-01

    India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2(nd) National Conference on Family Medicine and Primary Care 2015 (FMPC) brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care), the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

  7. Potentiality of big data in the medical sector: focus on how to reshape the healthcare system.

    Science.gov (United States)

    Jee, Kyoungyoung; Kim, Gang-Hoon

    2013-06-01

    The main purpose of this study was to explore whether the use of big data can effectively reduce healthcare concerns, such as the selection of appropriate treatment paths, improvement of healthcare systems, and so on. By providing an overview of the current state of big data applications in the healthcare environment, this study has explored the current challenges that governments and healthcare stakeholders are facing as well as the opportunities presented by big data. Insightful consideration of the current state of big data applications could help follower countries or healthcare stakeholders in their plans for deploying big data to resolve healthcare issues. The advantage for such follower countries and healthcare stakeholders is that they can possibly leapfrog the leaders' big data applications by conducting a careful analysis of the leaders' successes and failures and exploiting the expected future opportunities in mobile services. First, all big data projects undertaken by leading countries' governments and healthcare industries have similar general common goals. Second, for medical data that cuts across departmental boundaries, a top-down approach is needed to effectively manage and integrate big data. Third, real-time analysis of in-motion big data should be carried out, while protecting privacy and security.

  8. Education on human rights and healthcare: evidence from Serbia.

    Science.gov (United States)

    Vranes, Aleksandra Jovic; Mikanovic, Vesna Bjegovic; Vukovic, Dejana; Djikanovic, Bosiljka; Babic, Momcilo

    2015-03-01

    Ensuring and enforcing human rights in patient care are important to promote health and to provide quality and appropriate healthcare services. Therefore, continued medical education (CME) is essential for healthcare professionals to utilize their sphere of influence to affect change in healthcare practice. A total of 123 participants attended three CME courses. Course topics covered: (i) the areas of human rights and healthcare, (ii) rights, obligations and responsibilities of healthcare professionals in relation to human rights and the rights of patients, (iii) healthcare of vulnerable groups and (iv) access to essential medical services. Evaluation of the CME courses involved two components: evaluation of participants' performance and the participants' evaluation of the teaching process. The participants were assessed at the beginning and end of each course. Each of the courses was evaluated by the participants through a questionnaire distributed at the end of each course. Descriptive statistics was used for data interpretation. Knowledge of the healthcare professionals improved at the end of all the three courses. The participants assessed several aspects of the courses, including the course topics, educational methods, the course methods, organization, duration and dynamics as well as the physical environment and the technical facilities of the course, and rated each very highly. Our results corroborate the importance and necessity of courses to heighten awareness of the state of current healthcare and human rights issues to increase the involvement of healthcare professionals both locally and globally. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Healthcare Industry Improvement with Business Intelligence

    Directory of Open Access Journals (Sweden)

    Mihaela-Laura IVAN

    2015-01-01

    Full Text Available The current paper highlights the advantages of big data analytics and business intelligence in the healthcare industry. In the paper are reviewed the Real-Time Healthcare Analytics Solutions for Preventative Medicine provided by SAP and the different ideas realized by possible customers for new applications in Healthcare industry in order to demonstrate that the healthcare system can and should benefit from the new opportunities provided by ITC in general and big data analytics in particular.

  10. On-line monitoring of base current and forward emitter current gain of the voltage regulator's serial pnp transistor in a radiation environment

    Directory of Open Access Journals (Sweden)

    Vukić Vladimir Đ.

    2012-01-01

    Full Text Available A method of on-line monitoring of the low-dropout voltage regulator's operation in a radiation environment is developed in this paper. The method had to enable detection of the circuit's degradation during exploitation, without terminating its operation in an ionizing radiation field. Moreover, it had to enable automatic measurement and data collection, as well as the detection of any considerable degradation, well before the monitored voltage regulator's malfunction. The principal parameters of the voltage regulator's operation that were monitored were the serial pnp transistor's base current and the forward emitter current gain. These parameters were procured indirectly, from the data on the voltage regulator's load and quiescent currents. Since the internal consumption current in moderately and heavily loaded devices was used, the quiescent current of a negligibly loaded voltage regulator of the same type served as a reference. Results acquired by on-line monitoring demonstrated marked agreement with the results acquired from examinations of the voltage regulator's maximum output current and minimum dropout voltage in a radiation environment. The results were particularly consistent in tests with heavily loaded devices. Results obtained for moderately loaded voltage regulators and the risks accompanying the application of the presented method, were also analyzed.

  11. Uma Abordagem Para o Desenvolvimento de Aplicações no Cuidado de Saúde Pervasivo Através do Uso de Arquétipos (An Approach to Developing Applications in the Pervasive Healthcare Environment through the use of Archetypes)

    NARCIS (Netherlands)

    Cardoso de Moraes, João Luís; Lopes de Souza, Wanderley; Ferreira Pires, Luis; Cavalini, Luciana Tricai; Prado, do Antonio Francisco

    2013-01-01

    This paper proposes an approach to develop applications in the Pervasive Healthcare environment, through the use of Archetypes. Materials and methods: Pervasive Healthcare focuses on the use of new technologies, tools, and services, to help patients to play a more active role in the treatment of the

  12. Are current atomistic force fields accurate enough to study proteins in crowded environments?

    Directory of Open Access Journals (Sweden)

    Drazen Petrov

    2014-05-01

    Full Text Available The high concentration of macromolecules in the crowded cellular interior influences different thermodynamic and kinetic properties of proteins, including their structural stabilities, intermolecular binding affinities and enzymatic rates. Moreover, various structural biology methods, such as NMR or different spectroscopies, typically involve samples with relatively high protein concentration. Due to large sampling requirements, however, the accuracy of classical molecular dynamics (MD simulations in capturing protein behavior at high concentration still remains largely untested. Here, we use explicit-solvent MD simulations and a total of 6.4 µs of simulated time to study wild-type (folded and oxidatively damaged (unfolded forms of villin headpiece at 6 mM and 9.2 mM protein concentration. We first perform an exhaustive set of simulations with multiple protein molecules in the simulation box using GROMOS 45a3 and 54a7 force fields together with different types of electrostatics treatment and solution ionic strengths. Surprisingly, the two villin headpiece variants exhibit similar aggregation behavior, despite the fact that their estimated aggregation propensities markedly differ. Importantly, regardless of the simulation protocol applied, wild-type villin headpiece consistently aggregates even under conditions at which it is experimentally known to be soluble. We demonstrate that aggregation is accompanied by a large decrease in the total potential energy, with not only hydrophobic, but also polar residues and backbone contributing substantially. The same effect is directly observed for two other major atomistic force fields (AMBER99SB-ILDN and CHARMM22-CMAP as well as indirectly shown for additional two (AMBER94, OPLS-AAL, and is possibly due to a general overestimation of the potential energy of protein-protein interactions at the expense of water-water and water-protein interactions. Overall, our results suggest that current MD force fields

  13. Mental illness-related stigma in healthcare

    Science.gov (United States)

    Mantler, Ed; Szeto, Andrew

    2017-01-01

    Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments.

  14. Mobile Healthcare System using NFC Technology

    Directory of Open Access Journals (Sweden)

    A Devendran

    2012-05-01

    Full Text Available Although primary care physicians are increasingly interested in adopting electronic medical record (EMR systems, few use such systems in practice. Mobile devices offer new ways for users to access health care data and services in a secure and user-friendly environment. Mobile healthcare (m-healthcare systems are regarded as a solution to healthcare costs without reducing the quality of patient care. We are developing a basic architecture for m-healthcare services using Near Field Communication (NFC to facilitate the provisioning of healthcare to people anywhere, anytime using mobile devices that are connected through wireless communication technologies.

  15. Innovative use of the integrative review to evaluate evidence of technology transformation in healthcare.

    Science.gov (United States)

    Phillips, Andrew B; Merrill, Jacqueline A

    2015-12-01

    Healthcare is in a period significant transformational activity through the accelerated adoption of healthcare technologies, new reimbursement systems that emphasize shared savings and care coordination, and the common place use of mobile technologies by patients, providers, and others. The complexity of healthcare creates barriers to transformational activity and has the potential to inhibit the desired paths toward change envisioned by policymakers. Methods for understanding how change is occurring within this complex environment are important to the evaluation of delivery system reform and the role of technology in healthcare transformation. This study examines the use on an integrative review methodology to evaluate the healthcare literature for evidence of technology transformation in healthcare. The methodology integrates the evaluation of a broad set of literature with an established evaluative framework to develop a more complete understanding of a particular topic. We applied this methodology and the framework of punctuated equilibrium (PEq) to the analysis of the healthcare literature from 2004 to 2012 for evidence of technology transformation, a time during which technology was at the forefront of healthcare policy. The analysis demonstrated that the established PEq framework applied to the literature showed considerable potential for evaluating the progress of policies that encourage healthcare transformation. Significant inhibitors to change were identified through the integrative review and categorized into ten themes that describe the resistant structure of healthcare delivery: variations in the environment; market complexity; regulations; flawed risks and rewards; change theories; barriers; ethical considerations; competition and sustainability; environmental elements, and internal elements. We hypothesize that the resistant nature of the healthcare system described by this study creates barriers to the direct consumer involvement and engagement

  16. Quality management in healthcare

    OpenAIRE

    Subhash S Dodwad

    2013-01-01

    Clinical governance and better human resource management practices are important planks in the current health policies emphasizing quality of patient care. There are numerous reasons why it is important to improve quality of healthcare, including enhancing the accountability of health practitioners and managers, resource efficiency, identifying, and minimizing medical errors while maximizing the use of effective care and improving outcomes, and aligning care to what users/patients want in add...

  17. Environment

    DEFF Research Database (Denmark)

    Valentini, Chiara

    2017-01-01

    The term environment refers to the internal and external context in which organizations operate. For some scholars, environment is defined as an arrangement of political, economic, social and cultural factors existing in a given context that have an impact on organizational processes and structures....... For others, environment is a generic term describing a large variety of stakeholders and how these interact and act upon organizations. Organizations and their environment are mutually interdependent and organizational communications are highly affected by the environment. This entry examines the origin...... and development of organization-environment interdependence, the nature of the concept of environment and its relevance for communication scholarships and activities....

  18. Big Data, Big Problems: A Healthcare Perspective.

    Science.gov (United States)

    Househ, Mowafa S; Aldosari, Bakheet; Alanazi, Abdullah; Kushniruk, Andre W; Borycki, Elizabeth M

    2017-01-01

    Much has been written on the benefits of big data for healthcare such as improving patient outcomes, public health surveillance, and healthcare policy decisions. Over the past five years, Big Data, and the data sciences field in general, has been hyped as the "Holy Grail" for the healthcare industry promising a more efficient healthcare system with the promise of improved healthcare outcomes. However, more recently, healthcare researchers are exposing the potential and harmful effects Big Data can have on patient care associating it with increased medical costs, patient mortality, and misguided decision making by clinicians and healthcare policy makers. In this paper, we review the current Big Data trends with a specific focus on the inadvertent negative impacts that Big Data could have on healthcare, in general, and specifically, as it relates to patient and clinical care. Our study results show that although Big Data is built up to be as a the "Holy Grail" for healthcare, small data techniques using traditional statistical methods are, in many cases, more accurate and can lead to more improved healthcare outcomes than Big Data methods. In sum, Big Data for healthcare may cause more problems for the healthcare industry than solutions, and in short, when it comes to the use of data in healthcare, "size isn't everything."

  19. The impact of clinical pharmacy services in China on the quality use of medicines: a systematic review in context of China's current healthcare reform.

    Science.gov (United States)

    Penm, Jonathan; Li, Yan; Zhai, Suodi; Hu, Yongfang; Chaar, Betty; Moles, Rebekah

    2014-10-01

    Recently, China initiated an ambitious healthcare reform aiming to provide affordable and equitable basic health care to all by 2020. To meet these goals, new policies issued by China's Ministry of Health mandate clinical pharmacy services be integrated into China's hospitals. This review aims to highlight the impact of clinical pharmacy services on the quality use of medicines in hospitals in China. Both English and Chinese databases were used. For the English databases, Web of Science, Medline, International Pharmaceutical Abstracts and Embase were searched using the following keywords ('pharmacists' OR 'pharmacy' OR 'pharmaceutical services/pharmaceutical care') AND ('China'). For the Chinese database, Chinese Biomedical Literature Database on disc was searched using the following keywords ('clinical pharmacist' OR 'clinical pharmacy' OR 'pharmaceutical care' OR 'pharmaceutical services'). Articles were then retrieved from WanFang database and China Knowledge Resource Integrated Database. A total of 75 published papers were included in this review. The majority of studies were conducted in the inpatient setting (68%), which included clinical pharmacy interventions such as educating doctors and patients, evaluating and monitoring the implementation of hospital policies and/or reviewing medications on the ward. In the outpatient setting, the majority of studies conducted involved educating patients. Clinical pharmacy services frequently focused on antimicrobials (44%). More than half of these studies employed an administrative intervention alongside the clinical pharmacy service. Clinical pharmacy services in China, with its unique healthcare system and cultural nuances, appear to positively influence patient care and the appropriate use of medications. From the published literature, it is expected that clinical pharmacy services can make a strong contribution to China's healthcare reform with further governmental and educational support. Published by Oxford

  20. PUBLIC FINANCING OF HEALTHCARE SERVICES

    Directory of Open Access Journals (Sweden)

    Agnieszka Bem

    2013-10-01

    Full Text Available Healthcare in Poland is mainly financed by public sector entities, among them the National Health Fund (NFZ, state budget and local government budgets. The task of the National Health Fund, as the main payer in the system, is chiefly currently financing the services. The state budget plays a complementary role in the system, and finances selected groups of services, health insurance premiums and investments in healthcare infrastructure. The basic role of the local governments is to ensure access to the services, mostly by performing ownership functions towards healthcare institutions.

  1. Sensing behaviour in healthcare design

    DEFF Research Database (Denmark)

    Thorpe, Julia Rosemary; Hysse Forchhammer, Birgitte; Maier, Anja

    2017-01-01

    We are entering an era of distributed healthcare that should fit and respond to individual needs, behaviour and lifestyles. Designing such systems is a challenging task that requires continuous information about human behaviour on a large scale, for which pervasive sensing (e.g. using smartphones...... specifically on activity and location data that can easily be obtained from smartphones or wearables. We further demonstrate how these are applied in healthcare design using an example from dementia care. Comparing a current and proposed scenario exemplifies how integrating sensor-derived information about...... user behaviour can support the healthcare design goals of personalisation, adaptability and scalability, while emphasising patient quality of life....

  2. Current understanding of microplastics in the environment: Occurrence, fate, risks, and what we should do.

    Science.gov (United States)

    Peng, Jinping; Wang, Jundong; Cai, Liqi

    2017-05-01

    Microplastics pollution has been documented in the global environment, including at sea, in freshwater and in atmospheric fallout. Ingestion of microplastics by multiple kinds of organisms has been reported and has received increasing attention, because microplastics not only act as a source of toxic chemicals but also a sink for toxic chemicals. To better understand the great concerns about microplastics and associated toxic chemicals potential exposed to the organisms ingesting the debris, we should know more about the occurrence, fate, and risks of microplastics in the environment. What we should do depends on this better understanding. Integr Environ Assess Manag 2017;13:476-482. © 2017 SETAC. © 2017 SETAC.

  3. Healthcare information technology and economics.

    Science.gov (United States)

    Payne, Thomas H; Bates, David W; Berner, Eta S; Bernstam, Elmer V; Covvey, H Dominic; Frisse, Mark E; Graf, Thomas; Greenes, Robert A; Hoffer, Edward P; Kuperman, Gil; Lehmann, Harold P; Liang, Louise; Middleton, Blackford; Omenn, Gilbert S; Ozbolt, Judy

    2013-01-01

    At the 2011 American College of Medical Informatics (ACMI) Winter Symposium we studied the overlap between health IT and economics and what leading healthcare delivery organizations are achieving today using IT that might offer paths for the nation to follow for using health IT in healthcare reform. We recognized that health IT by itself can improve health value, but its main contribution to health value may be that it can make possible new care delivery models to achieve much larger value. Health IT is a critically important enabler to fundamental healthcare system changes that may be a way out of our current, severe problem of rising costs and national deficit. We review the current state of healthcare costs, federal health IT stimulus programs, and experiences of several leading organizations, and offer a model for how health IT fits into our health economic future.

  4. Machine learning in healthcare informatics

    CERN Document Server

    Acharya, U; Dua, Prerna

    2014-01-01

    The book is a unique effort to represent a variety of techniques designed to represent, enhance, and empower multi-disciplinary and multi-institutional machine learning research in healthcare informatics. The book provides a unique compendium of current and emerging machine learning paradigms for healthcare informatics and reflects the diversity, complexity and the depth and breath of this multi-disciplinary area. The integrated, panoramic view of data and machine learning techniques can provide an opportunity for novel clinical insights and discoveries.

  5. LEAN thinking in Finnish healthcare.

    Science.gov (United States)

    Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

    2016-01-01

    Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

  6. Survival in extreme environments – on the current knowledge of adaptations in tardigrades

    DEFF Research Database (Denmark)

    Møbjerg, Nadja; Halberg, Kenneth Agerlin; Jørgensen, Aslak

    2011-01-01

    of the tardigrades and highlight species that are currently used as models for physiological and molecular investigations. Tardigrades are uniquely adapted to a range of environmental extremes. Cryptobiosis, currently referred to as a reversible ametabolic state induced by e.g. desiccation, is common especially...... to below )20 C, presumably relying on efficient DNA repair mechanisms and osmoregulation. This review summarizes the current knowledge on adaptations found among tardigrades, and presents new data on tardigrade cell numbers and osmoregulation....

  7. An Assessment of the Current LEO Debris Environment and the Need for Active Debris Removal

    Science.gov (United States)

    Liou, Jer-Chyi

    2010-01-01

    The anti-satellite test on the Fengun-1 C weather satellite in early 2007 and the collision between Iridium 33 and Cosmos 2251 in 2009 dramatically altered the landscape of the human-made orbital debris environment in the low Earth orbit (LEO). The two events generated approximately 5500 fragments large enough to be tracked by the U.S. Space Surveillance Network. Those fragments account for more than 60% increase to the debris population in LEO. However, even before the ASAT test, model analyses already indicated that the debris population (for those larger than 10 cm) in LEO had reached a point where the population would continue to increase, due to collisions among existing objects, even without any future launches. The conclusion implies that as satellites continue to be launched and unexpected breakup events continue to occur, commonly-adopted mitigation measures will not be able to stop the collision-driven population growth. To remediate the debris environment in LEO, active debris removal must be considered. This presentation will provide an updated assessment of the debris environment after the Iridium 33/Cosmos 2251 collision, an analysis of several future environment projections based on different scenarios, and a projection of collision activities in LEO in the near future. The need to use active debris removal to stabilize future debris environment will be demonstrated and the effectiveness of various active debris removal strategies will be quantified.

  8. Microplastics in freshwater and terrestrial environments: Evaluating the current understanding to identify the knowledge gaps and future research priorities.

    Science.gov (United States)

    Horton, Alice A; Walton, Alexander; Spurgeon, David J; Lahive, Elma; Svendsen, Claus

    2017-05-15

    Plastic debris is an environmentally persistent and complex contaminant of increasing concern. Understanding the sources, abundance and composition of microplastics present in the environment is a huge challenge due to the fact that hundreds of millions of tonnes of plastic material is manufactured for societal use annually, some of which is released to the environment. The majority of microplastics research to date has focussed on the marine environment. Although freshwater and terrestrial environments are recognised as origins and transport pathways of plastics to the oceans, there is still a comparative lack of knowledge about these environmental compartments. It is highly likely that microplastics will accumulate within continental environments, especially in areas of high anthropogenic influence such as agricultural or urban areas. This review critically evaluates the current literature on the presence, behaviour and fate of microplastics in freshwater and terrestrial environments and, where appropriate, also draws on relevant studies from other fields including nanotechnology, agriculture and waste management. Furthermore, we evaluate the relevant biological and chemical information from the substantial body of marine microplastic literature, determining the applicability and comparability of this data to freshwater and terrestrial systems. With the evidence presented, the authors have set out the current state of the knowledge, and identified the key gaps. These include the volume and composition of microplastics entering the environment, behaviour and fate of microplastics under a variety of environmental conditions and how characteristics of microplastics influence their toxicity. Given the technical challenges surrounding microplastics research, it is especially important that future studies develop standardised techniques to allow for comparability of data. The identification of these research needs will help inform the design of future studies, to

  9. The SCEC Community Modeling Environment (SCEC/CME) - An Overview of its Architecture and Current Capabilities

    Science.gov (United States)

    Maechling, P. J.; Jordan, T. H.; Minster, B.; Moore, R.; Kesselman, C.; SCEC ITR Collaboration

    2004-12-01

    The Southern California Earthquake Center (SCEC), in collaboration with the San Diego Supercomputer Center, the USC Information Sciences Institute, the Incorporated Research Institutions for Seismology, and the U.S. Geological Survey, is developing the Southern California Earthquake Center Community Modeling Environment (CME) under a five-year grant from the National Science Foundation's Information Technology Research (ITR) Program jointly funded by the Geosciences and Computer and Information Science & Engineering Directorates. The CME system is an integrated geophysical simulation modeling framework that automates the process of selecting, configuring, and executing models of earthquake systems. During the Project's first three years, we have performed fundamental geophysical and information technology research and have also developed substantial system capabilities, software tools, and data collections that can help scientist perform systems-level earthquake science. The CME system provides collaborative tools to facilitate distributed research and development. These collaborative tools are primarily communication tools, providing researchers with access to information in ways that are convenient and useful. The CME system provides collaborators with access to significant computing and storage resources. The computing resources of the Project include in-house servers, Project allocations on USC High Performance Computing Linux Cluster, as well as allocations on NPACI Supercomputers and the TeraGrid. The CME system provides access to SCEC community geophysical models such as the Community Velocity Model, Community Fault Model, Community Crustal Motion Model, and the Community Block Model. The organizations that develop these models often provide access to them so it is not necessary to use the CME system to access these models. However, in some cases, the CME system supplements the SCEC community models with utility codes that make it easier to use or access

  10. Vulnerability of the Barents Sea environment to climate changes: a review of the current assessments

    Energy Technology Data Exchange (ETDEWEB)

    Gelfan, A.; Danilov-Danilyan, V.

    2009-07-15

    Authors' conclusion: Climate change is not considered to be just 'one more stress' on the ecosystem, but rather it will create complex and dynamic changes in the environment that may alter the level of its vulnerability. Cumulative effects can be defined as changes to the environment that are caused by an action in combination with other past, present and future human actions (Environment Canada 2003). The magnitude and effects of multiple stresses can be equal to the sum of the individual effects (additive effects) or they may strengthen or weaken each other (positive or negative feedbacks). To understand complex interactions within the system atmosphere-land surface-ocean at regional scales and to assess influence of the environmental changes on the ecological conditions, sophisticated models should be developed allowing to account for regional peculiarities of these systems. Development of such models is considered as one of the main challenge of the Earth system science. (author)

  11. Implications of Current Reference Structures for Authority Work in Online Environments.

    Science.gov (United States)

    Watson, Mark R.; Taylor, Arlene G.

    1987-01-01

    Describes a study which examined (1) the percentage of personal and corporate name authority records in the Library of Congress authority file that do not contain any references, and (2) the percentage of references present on existing authority records that are not needed in an automatic right hand truncation, keyword searching environment. (CLB)

  12. Gene-Environment Interactions in Genome-Wide Association Studies: Current Approaches and New Directions

    Science.gov (United States)

    Winham, Stacey J.; Biernacka, Joanna M.

    2013-01-01

    Background: Complex psychiatric traits have long been thought to be the result of a combination of genetic and environmental factors, and gene-environment interactions are thought to play a crucial role in behavioral phenotypes and the susceptibility and progression of psychiatric disorders. Candidate gene studies to investigate hypothesized…

  13. Plasma environment during hot cathode direct current discharge plasma chemical vapor deposition of diamond films

    Institute of Scientific and Technical Information of China (English)

    朱晓东; 詹如娟; 周海洋; 胡敏; 温晓辉; 周贵恩; 李凡庆

    1999-01-01

    The plasma characteristics have been investigated in situ by using optical emission spectroscopy (OES) and the Langmuir probe during hot cathode direct current discharge plasma chemical vapor deposition of diamond films. The changes of atomic H and CH radical in the ground state have been calculated quantitatively according to the results of OES and the Langmuir probe measurement as discharge current density varied. It is shown that atomic H and CH radicals both in the ground state and in the excited state increase with the enhancement of the discharge current density in the plasma. The electron density and CH emission intensity increase linearly with the enhancement of discharge current densities. The generation of different carbon-containing radicals is related to the elevation of electron temperature. Combining the growth process of diamond films and the diagnostic results, it is shown that atomic H in the excited state may improve the diamond growth efficiently, and the increase of electron temperat

  14. Current Trends and Healthcare Resource Usage in the Hospital Treatment of Primary Malignant Brain Tumor in Japan: A National Survey Using the Diagnostic Procedure Combination Database (J-ASPECT Study-Brain Tumor)

    Science.gov (United States)

    YOSHIMOTO, Koji; KADA, Akiko; KUGA, Daisuke; HATAE, Ryusuke; MURATA, Hideki; AKAGI, Yojiro; NISHIMURA, Kunihiro; KUROGI, Ryota; NISHIMURA, Ataru; HATA, Nobuhiro; MIZOGUCHI, Masahiro; SAYAMA, Tetsuro; IIHARA, Koji

    2016-01-01

    We conducted this study to clarify the current trends and healthcare resource usage in the treatment of inpatients with primary malignant brain tumors. The Diagnostic Procedure Combination (DPC) data of all inpatients treated between 2013 and 2014 in the 370 core and branch hospitals enrolled in the Japanese Neurosurgical Society training program were collected. DPC is a discharge abstract and administrative claims database of inpatients. We assessed 6,142 primary, malignant brain tumor patients. Patient information, diagnostic information, treatment procedure, and healthcare resource usage were analyzed. Chemotherapy was the most frequent treatment (27% of cases), followed by surgery (13%) and surgery + chemo-radiotherapy (11%). Temozolomide (TMZ), the most frequently used chemotherapeutic drug, was administered to 1,236 patients. Concomitant TMZ and radiotherapy was administered to 816 patients, and was performed according to the Stupp regimen in many cases. The mean length of hospital stay (LOS) was 16 days, and the mean medical cost was 1,077,690 yen. The average medical cost of TMZ-only treatment was 1,138,620 yen whilst it was 4,424,300 yen in concomitant TMZ patients. The LOS was significantly shorter in high-volume than in low-volume hospitals, and the medical cost was higher in hospitals treating 21–50 patients compared to those treating 1–10 patients. However, the direct medical cost of TMZ treatment was the same across different volume hospitals. This is the first report of current trends and healthcare resource usage in the treatment of primary malignant brain tumor inpatients in the TMZ era in Japan. PMID:27680329

  15. Current Trends and Healthcare Resource Usage in the Hospital Treatment of Primary Malignant Brain Tumor in Japan: A National Survey Using the Diagnostic Procedure Combination Database (J-ASPECT Study-Brain Tumor).

    Science.gov (United States)

    Yoshimoto, Koji; Kada, Akiko; Kuga, Daisuke; Hatae, Ryusuke; Murata, Hideki; Akagi, Yojiro; Nishimura, Kunihiro; Kurogi, Ryota; Nishimura, Ataru; Hata, Nobuhiro; Mizoguchi, Masahiro; Sayama, Tetsuro; Iihara, Koji

    2016-11-15

    We conducted this study to clarify the current trends and healthcare resource usage in the treatment of inpatients with primary malignant brain tumors. The Diagnostic Procedure Combination (DPC) data of all inpatients treated between 2013 and 2014 in the 370 core and branch hospitals enrolled in the Japanese Neurosurgical Society training program were collected. DPC is a discharge abstract and administrative claims database of inpatients. We assessed 6,142 primary, malignant brain tumor patients. Patient information, diagnostic information, treatment procedure, and healthcare resource usage were analyzed. Chemotherapy was the most frequent treatment (27% of cases), followed by surgery (13%) and surgery + chemo-radiotherapy (11%). Temozolomide (TMZ), the most frequently used chemotherapeutic drug, was administered to 1,236 patients. Concomitant TMZ and radiotherapy was administered to 816 patients, and was performed according to the Stupp regimen in many cases. The mean length of hospital stay (LOS) was 16 days, and the mean medical cost was 1,077,690 yen. The average medical cost of TMZ-only treatment was 1,138,620 yen whilst it was 4,424,300 yen in concomitant TMZ patients. The LOS was significantly shorter in high-volume than in low-volume hospitals, and the medical cost was higher in hospitals treating 21-50 patients compared to those treating 1-10 patients. However, the direct medical cost of TMZ treatment was the same across different volume hospitals. This is the first report of current trends and healthcare resource usage in the treatment of primary malignant brain tumor inpatients in the TMZ era in Japan.

  16. Electronic healthcare information security

    CERN Document Server

    Dube, Kudakwashe; Shoniregun, Charles A

    2010-01-01

    The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

  17. Licensed Healthcare Facilities

    Data.gov (United States)

    California Department of Resources — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  18. Licensed Healthcare Facilities

    Data.gov (United States)

    California Department of Resources — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  19. Analysis of the PPBE Process in the Current Dynamic Political Environment

    Science.gov (United States)

    2008-06-01

    Complicated/ expensive systems - Business practices Legal - USA Patriot Act - Military prison scandals - CIA leak probe (Plume Affair) - Enron , Tyco...54 such as Enron , Tyco and WorldCom were prosecuted and received prison sentences for the roles they played in these scandals .114 These...of the author aided in shaping the environment. DoD Political -Vietnam War -Kennedy Assassination -Great Society Initiatives -Watergate Scandal

  20. Design Rework Prediction in Concurrent Design Environment: Current Trends and Future Research Directions

    OpenAIRE

    Arundachawat, Panumas; Roy, Rajkumar; Al-Ashaab, Ahmed; Shehab, Essam

    2009-01-01

    This paper aims to present state-of-the-art and formulate future research areas on design rework in concurrent design environment. Related literatures are analysed to extract the key factors which impact design rework. Design rework occurs due to changes from upstream design activities and/or by feedbacks from downstream design activities. Design rework is considered as negative iteration; therefore, value in design activities will be increased if design rework is reduced. Set-bas...

  1. Do biological medicinal products pose a risk to the environment?: a current view on ecopharmacovigilance.

    Science.gov (United States)

    Kühler, Thomas C; Andersson, Mikael; Carlin, Gunnar; Johnsson, Ann; Akerblom, Lennart

    2009-01-01

    The occurrence of active pharmaceutical substances in the environment is of growing concern. The vast majority of the compounds in question are of low molecular weight, intended for oral use and designed to tolerate, for example, the digestive enzymes in the upper alimentary tract, the harsh milieus found in the acidic stomach, or the microbe rich intestine. Accordingly, these xenobiotic compounds may, due to their inherent biological activity, constitute a risk to the environment. Biological medicinal products, for example recombinant human insulin or monoclonal antibodies, however, are different. They are primarily made up of oligomers or polymers of amino acids, sugars or nucleotides and are thus readily metabolized. They are therefore generally not considered to pose any risk to the environment. Certain classes of biological medicinal products, however, are associated with specific safety issues. Genetically modified organisms as vectors in vaccines or in gene therapy products have attracted much attention in this regard. Issues include the degree of attenuation of the live recombinant vaccine, replication restrictions of the vaccine vector, alteration of the host and tissue tropism of the vector, the possibility of reversion to virulence, and risk to the ecosystem. In this review we discuss the fate and the potential environmental impact of biological medicinal products following clinical use from an ecopharmacovigilance point of view, and review relevant policy documents and regulatory statements.

  2. Responding to biological incidents--what are the current issues in remediation of the contaminated environment?

    Science.gov (United States)

    Pottage, T; Goode, E; Wyke, S; Bennett, A M

    2014-11-01

    Since 2000 there have been a number of biological incidents resulting in environmental contamination with Bacillus anthracis, the causative agent of anthrax. These incidents include the US anthrax attacks in 2001, the US and UK drumming incidents in 2006-2008 and more recently, anthrax contamination of heroin in 2009/2010 and 2012/2013. Remediation techniques used to return environments to normal have varied between incidents, with different decontamination technologies being employed. Many factors need to be considered before a remediation strategy or recovery option can be implemented, including; cost, time (length of application), public perception of risk, and sampling strategies (and results) to name a few. These incidents have demonstrated that consolidated guidance for remediating biologically contaminated environments in the aftermath of a biological incident was required. The UK Recovery Handbook for Biological Incidents (UKRHBI) is a project led by Public Health England (PHE), formerly the Health Protection Agency (HPA) to provide guidance and advice on how to remediate the environment following a biological incident or outbreak of infection, and is expected to be published in 2015. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  3. Beyond the numbers: A user-centered design approach for personal reflective healthcare technologies

    NARCIS (Netherlands)

    Jimenez Garcia, J.C.

    2014-01-01

    The current healthcare paradigm shifts towards considering the patients’ home as the primary self-care environment. Health care is changing from being solely delivered by professionals in hospitals, to considering daily-life experiences and patients’ personal contexts. In order to meet this paradigm

  4. Leakage Current Phenomenon on Ceramics and Epoxy Resin as 20 kV Outdoor Insulator at Tropical Environment

    Directory of Open Access Journals (Sweden)

    Valdi Rizki Yandri

    2011-01-01

    Full Text Available This paper explains the research results of  leakage current, hydrophobicity and flashover voltage comparison on ceramics and epoxy  resin 20 kV outdoor insulator in a  chamber at tropical climate conditions. The waveform of leakage current (LC was measured using a digital oscilloscope. The digital data was transferred to a personal computer using a RS-232 cable. The digital data was analyzed using Fast Fourier Transform. The result showed that LC was affected by various environment conditions like temperature, humidity and pollution. LC of ceramics insulator was higher than epoxy resin insulator in low temperature, high humidity and high pollution condition.

  5. Integrating Healthcare Ethical Issues into IS Education

    Science.gov (United States)

    Cellucci, Leigh W.; Layman, Elizabeth J.; Campbell, Robert; Zeng, Xiaoming

    2011-01-01

    Federal initiatives are encouraging the increase of IS graduates to work in the healthcare environment because they possess knowledge of datasets and dataset management that are key to effective management of electronic health records (EHRs) and health information technology (IT). IS graduates will be members of the healthcare team, and as such,…

  6. IT Support for Healthcare Processes

    NARCIS (Netherlands)

    Lenz, R.; Reichert, M.U.

    2005-01-01

    Patient treatment processes require the cooperation of different organizational units and medical disciplines. In such an environment an optimal process support becomes crucial. Though healthcare processes frequently change, and therefore the separation of the flow logic from the application code se

  7. Monitoring DC stray current interference of steel sheet pile structures in railway environment

    NARCIS (Netherlands)

    Peelen, W.H.A.; Neeft, E.A.C.; Leegwater, G.; Kanten-Roos, W. van; Courage, W.M.G.

    2011-01-01

    Steel structures near DC powered railways are expected to be affected by stray current interference. This causes accelerated corrosion rates. Therefore steel is often not used as a building material in these cases, although certain advantages over the alternative material concrete exist. These

  8. Evaluation of current state of agricultural land using problem-oriented fuzzy indicators in GIS environment

    Science.gov (United States)

    Current state of agricultural lands is defined under influence of processes in soil, plants and atmosphere and is described by observation data, complicated models and subjective opinion of experts. Problem-oriented indicators summarize this information in useful form for decision of the same specif...

  9. Monitoring DC stray current interference of steel sheet pile structures in railway environment

    NARCIS (Netherlands)

    Peelen, W.H.A.; Neeft, E.A.C.; Leegwater, G.; Kanten-Roos, W. van; Courage, W.M.G.

    2011-01-01

    Steel structures near DC powered railways are expected to be affected by stray current interference. This causes accelerated corrosion rates. Therefore steel is often not used as a building material in these cases, although certain advantages over the alternative material concrete exist. These advan

  10. Shifting Currents: Science Technology Society and Environment in Northern Ontario Schools

    OpenAIRE

    2013-01-01

    The focus is on the practices of secondary science teachers in rural, resource-extraction-based communities in the boreal region of northern Ontario, Canada. In 2008 the Ontario Ministry of Education mandated that science teaching and learning should bring to the forefront consideration of the impacts of science on society and environment, and include environmental education; topics that are particularly pertinent given the location(s) of the study in logging and mining towns. Three years aft...

  11. Healthcare in Myanmar.

    Science.gov (United States)

    Latt, Nyi Nyi; Myat Cho, Su; Htun, Nang Mie Mie; Yu Mon Saw; Myint, Myat Noe Htin Aung; Aoki, Fumiko; Reyer, Joshua A; Yamamoto, Eiko; Yoshida, Yoshitoku; Hamajima, Nobuyuki

    2016-05-01

    Myanmar transitioned to a civilian government in March, 2011. Although the democratic process has accelerated since then, many problems in the field of healthcare still exist. Since there is a limited overview on the healthcare in Myanmar, this article briefly describes the current states surrounding health services in Myanmar. According to the Census 2014, the population in the Republic of the Union of Myanmar was 51,410,000. The crude birth rate in the previous one year was estimated to be 18.9 per 1,000, giving the annual population growth rate of 0.89% between 2003 and 2014. The Ministry of Health reorganized into six departments. National non-governmental organizations and community-based organizations support healthcare, as well as international non-governmental organizations. Since hospital statistics by the government cover only public facilities, the information on private facilities is limited. Although there were not enough medical doctors (61 per 100,000 population), the number of medical students was reduced from 2,400 to 1,200 in 2012 to ensure the quality of medical education. The information on causes of death in the general population could not be retrieved, but some data was available from hospital statistics. Although the improvement was marked, the figures did not reach the levels set by Millennium Development Goals 4 and 5. A trial prepaid health insurance system started in July 2015, to be followed by evaluation one year later. There are many international donors, including the Japan International Cooperation Agency, supporting health in Myanmar. With these efforts and support, a marked progress is expected in the field of healthcare.

  12. Biotemplated materials for sustainable energy and environment: current status and challenges.

    Science.gov (United States)

    Zhou, Han; Fan, Tongxiang; Zhang, Di

    2011-10-17

    Materials science will play a key role in the further development of emerging solutions for the increasing problems of energy and environment. Materials found in nature have many inspiring structures, such as hierarchical organizations, periodic architectures, or nanostructures, that endow them with amazing functions, such as energy harvesting and conversion, antireflection, structural coloration, superhydrophobicity, and biological self-assembly. Biotemplating is an effective strategy to obtain morphology-controllable materials with structural specificity, complexity, and related unique functions. Herein, we highlight the synthesis and application of biotemplated materials for six key areas of energy and environment technologies, namely, photocatalytic hydrogen evolution, CO(2) reduction, solar cells, lithium-ion batteries, photocatalytic degradation, and gas/vapor sensing. Although the applications differ from each other, a common fundamental challenge is to realize optimum structures for improved performances. We highlight the role of four typical structures derived from biological systems exploited to optimize properties: hierarchical (porous) structures, periodic (porous) structures, hollow structures, and nanostructures. We also provide examples of using biogenic elements (e.g., C, Si, N, I, P, S) for the creation of active materials. Finally, we disscuss the challenges of achieving the desired performance for large-scale commercial applications and provide some useful prototypes from nature for the biomimetic design of new materials or systems. The emphasis is mainly focused on the structural effects and compositional utilization of biotemplated materials. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Geared induction motor fault diagnosis by current, noise and vibration considering measurement environment

    Directory of Open Access Journals (Sweden)

    Ki-Seok Kim

    2017-01-01

    Full Text Available Lots of motors have been being used in industry. Therefore many studies have been carried out about the failure diagnosis of motors. In this paper, a diagnosis of gear fault connected to a motor shaft is studied. The fault diagnosis is executed through the comparison of normal gear and abnormal gear. In the abnormal gearbox, a tooth of the intermediate gear is damaged. The measured FFT data are compared with the normal data and analyzed for q-axis current, noise and vibration. Fault gear was found by comparing the FFT with normal FFT. From these, the difference between the normal and abnormal states can be seen by the frequency characteristic analysis for the current as well as noise and vibration.

  14. Survival in extreme environments - on the current knowledge of adaptations in tardigrades.

    Science.gov (United States)

    Møbjerg, N; Halberg, K A; Jørgensen, A; Persson, D; Bjørn, M; Ramløv, H; Kristensen, R M

    2011-07-01

    Tardigrades are microscopic animals found worldwide in aquatic as well as terrestrial ecosystems. They belong to the invertebrate superclade Ecdysozoa, as do the two major invertebrate model organisms: Caenorhabditis elegans and Drosophila melanogaster. We present a brief description of the tardigrades and highlight species that are currently used as models for physiological and molecular investigations. Tardigrades are uniquely adapted to a range of environmental extremes. Cryptobiosis, currently referred to as a reversible ametabolic state induced by e.g. desiccation, is common especially among limno-terrestrial species. It has been shown that the entry and exit of cryptobiosis may involve synthesis of bioprotectants in the form of selective carbohydrates and proteins as well as high levels of antioxidant enzymes and other free radical scavengers. However, at present a general scheme of mechanisms explaining this phenomenon is lacking. Importantly, recent research has shown that tardigrades even in their active states may be extremely tolerant to environmental stress, handling extreme levels of ionizing radiation, large fluctuation in external salinity and avoiding freezing by supercooling to below -20 °C, presumably relying on efficient DNA repair mechanisms and osmoregulation. This review summarizes the current knowledge on adaptations found among tardigrades, and presents new data on tardigrade cell numbers and osmoregulation.

  15. Gravity Currents: In the Environment and the Laboratory, Ellis Horwood Series in Environmental Sciences

    Science.gov (United States)

    Csanady, G. T.

    There are books and courses on experimental physics, thorough and rigorous, which contain only simple formulae and use only elementary algebra. The subject is explained in lucid and precise language, with the help of many sketches, photos, and diagrams. The book under review belongs to this genre and is in fact one of its most successful members.About half of the book is devoted to the description of a variety of natural phenomena in which gravity currents play an important role. The class of gravity currents is taken to be quite broad, to include almost any kind of quasi-horizontal motion caused by density differences. The range of natural phenomena surveyed is correspondingly great, from tidal bores through thunderstorms to the eruption of Mount St. Helens. The atmospheric examples are especially thorough and interesting. The broad panorama certainly brings home to the reader the many ways in which fluids (including fluidized rock) can move under the influence of gravity. However, not all of the examples show typical gravity behavior, nor are they all treated with equal thoroughness. The Gulf Stream is mentioned, and the variability of its position is shown in an illustration, but this is not connected with anything typical of gravity currents, nor is the important interplay between Earth rotation and such large-scale “gravity currents” (if one insists on calling them that) at all adequately explained.

  16. Script of Healthcare Technology

    DEFF Research Database (Denmark)

    Brodersen, Søsser Grith Kragh; Hansen, Meiken; Lindegaard, Hanne

    2015-01-01

    ABSTRACT Many new product designs are currently being implemented in the healthcare sector, and this presents designers with challenges involved in socially innovative design. In this paper, we argue that designing assistive technologies requires focus on multiple users and use practices. We see...... the design of assistive technologies as design of socio-material assemblies , which include an analysis of the products already used in relation to multiple users, their practices and wishes. In the article we focus on the challenges in the implementation of two types of robotic beds used for disability care...

  17. Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research.

    Science.gov (United States)

    Tuthill, Emily L; Chan, Jessica; Butler, Lisa M

    2015-01-01

    Exclusive breastfeeding (EBF) has been identified as the optimal nutrition and critical behavior in attaining human immunodeficiency virus (HIV)-free infant survival in resource-limited settings. Health-care providers (HCPs) in clinic- and community-settings throughout sub-Saharan Africa (sSA) provide infant-feeding counseling. However, rates of EBF at 6 months of age are suboptimal. HCPs are uniquely positioned to educate HIV-positive mothers and provide support by addressing known barriers to EBF. However, limited evidence exists on the experiences faced by HCPs in providing counseling on infant feeding to HIV-positive women. Our objective is to describe experiences faced by HCPs when delivering infant-feeding counseling in the context of HIV in program settings in sSA. We searched a range of electronic databases, including PubMed, CINAHL, and PsycINFO from January 1990 to February 2013, in addition to hand-searching, cross-reference searching, and personal communications. The search was limited to publications in English. Empirical studies of HCP experiences providing infant-feeding counseling in the prevention of mother-to-child transmission (PMTCT) of HIV programs in sSA were selected. We identified 10 peer-reviewed articles reporting HCP challenges in infant-feeding counseling that met inclusion criteria. Articles included qualitative, cross-sectional and mixed-method studies, and cumulatively reported 31 challenges faced by HCPs. Among the challenges identified, the most commonly reported were personal beliefs held by the HCPs toward infant feeding in the context of HIV, contradictory messages, staff workload, directive counseling styles, and a lack of practical strategies to offer mothers, often leading to improvised counseling approaches. Counseling strategies need to be developed that are relevant, meaningful, and responsive to the needs of both HCPs and mothers.

  18. Staying Relevant and Current with Online Learning in an Increasingly Global and Competitive Environment

    Directory of Open Access Journals (Sweden)

    Grace Lynch

    2012-08-01

    Full Text Available This paper outlines the success of online learning in the workplace with corporate partners through Open Universities Australia (OUA. OUA is recognized as the national leader in online higher education in Australia with over 200,000 students studying with OUA since 1993. The corporate program helps employees formalize or extend their current skills, reach the next level in their organization or pursue relevant interests through tertiary studies. The business sector sees OUA as a highly attractive solution to fostering a culture of professional development, engagement and inclusiveness.

  19. The Impact of Environmental Design on Teamwork and Communication in Healthcare Facilities: A Systematic Literature Review.

    Science.gov (United States)

    Gharaveis, Arsalan; Hamilton, D Kirk; Pati, Debajyoti

    2017-01-01

    The purpose of this systematic review is to investigate the current knowledge about the impact of healthcare facility design on teamwork and communication by exploring the relevant literature. Teamwork and communication are behavioral factors that are impacted by physical design. However, the effects of environmental factors on teamwork and communication have not been investigated extensively in healthcare design literature. There are no published systematic reviews on the current topic. Searches were conducted in PubMed and Google Scholar databases in addition to targeted design journals including Health Environmental Research & Design, Environment and Behavior, Environmental Psychology, and Applied Ergonomics. Inclusion criteria were (a) full-text English language articles related to teamwork and communication and (b) involving any healthcare built environment and space design published in peer-reviewed journals between 1984 and 2017. Studies were extracted using defined inclusion and exclusion criteria. In the first phase, 26 of the 195 articles most relevant to teamwork and 19 studies of the 147 were identified and reviewed to understand the impact of communication in healthcare facilities. The literature regarding the impact of built environment on teamwork and communication were reviewed and explored in detail. Eighteen studies were selected and succinctly summarized as the final product of this review. Environmental design, which involves nurses, support staff, and physicians, is one of the critical factors that promotes the efficiency of teamwork and collaborative communication. Layout design, visibility, and accessibility levels are the most cited aspects of design which can affect the level of communication and teamwork in healthcare facilities.

  20. Perpetual transitions in Romanian healthcare.

    Science.gov (United States)

    Spiru, Luiza; Traşcu, Răzvan Ioan; Turcu, Ileana; Mărzan, Mircea

    2011-12-01

    Although Romania has a long-lasting tradition in organized medical healthcare, in the last two decades the Romanian healthcare system has been undergoing a perpetual transition with negative effects on all parties involved. The lack of long-term strategic vision, the implementation of initiatives without any impact studies, hence the constant short-term approach from the policy makers, combined with the "inherited" low allocation from GDP to the healthcare system have contributed significantly to its current evolution. Currently, most measures taken are of the "fire-fighting" type, rather than looking to the broader, long time perspective. There should be no wonder then, that predictive and preventive services do not get the proper attention and support. Patient and physicians should step in and take action in regulating a system that was originally designed for them. But until this happens, the organizations with leadership skills and vision need to take action-and this has already started.

  1. Method for transferring data between at least one lagrangian buoy for measuring currents for ocean and costal environments and a base station, and lagrangian buoy for measuring currents for ocean and costal environments

    OpenAIRE

    Martínez-Ledesma, Miquel; Álvarez, Alberto; Vizoso, Guillermo; Tintoré, Joaquín

    2011-01-01

    [EN] Method for transferring data between at least one lagrangian buoy for measuring currents for ocean and coastal environments and a base station, which comprises capturing data by the buoy by means of the parameter-measuring sensors and the GPS receiver and storing said data in a first file which is segmented into packets of a maximum length defined by the SBD Iridium protocol for the subsequent sending thereof to the base station. The invention also relates to the lagrangian buoy for meas...

  2. The Impact of Neighborhood Social and Built Environment Factors across the Cancer Continuum: Current Research, Methodologic Considerations, and Future Directions

    Science.gov (United States)

    Gomez, Scarlett Lin; Shariff-Marco, Salma; De Rouen, Mindy; Keegan, Theresa H. M.; Yen, Irene H.; Mujahid, Mahasin; Satariano, William A.; Glaser, Sally L.

    2015-01-01

    Neighborhood social and built environments have been recognized as important contexts in which health is shaped. We review the extent to which these neighborhood factors have been addressed in population-level cancer research, with a scan of the literature for research that focuses on specific social and/or built environment characteristics and association with outcomes across the cancer continuum, including incidence, diagnosis, treatment, survivorship, and survival. We discuss commonalities and differences in methodologies across studies, current challenges in research methodology, and future directions in this research area. The assessment of social and built environment factors in relation to cancer is a relatively new field, with 82% of 34 reviewed papers published since 2010. Across the wide range of social and built environment exposures and cancer outcomes considered by the studies, numerous associations were reported. However, the directions and magnitudes of association varied, due in large part to the variation in cancer sites and outcomes being studied, but also likely due to differences in study populations, geographical region, and, importantly, choice of neighborhood measure and geographic scale. We recommend that future studies consider the life course implications of cancer incidence and survival, integrate secondary and self-report data, consider work neighborhood environments, and further develop analytical and statistical approaches appropriate to the geospatial and multilevel nature of the data. Incorporating social and built environment factors into research on cancer etiology and outcomes can provide insights into disease processes, identify vulnerable populations, and generate results with translational impact of relevance for interventionists and policy makers. PMID:25847484

  3. The current state of workers' pneumoconiosis in relationship to dusty working environments in Okayama Prefecture, Japan.

    Directory of Open Access Journals (Sweden)

    Takigawa T

    2002-12-01

    Full Text Available This study involved the examination of 1,006 chest x-ray films of workers from the industries devoted to shipyard welding, stone grinding, and refractory crushing in southern Okayama prefecture. Of the reviewed films, analysis was focused on subjects with a profusion rate of 0/1 as well as pneumoconiotic subjects (exhibiting profusion rates of 1/0 or greater in order to discover cases in the beginning stages. One-hundred-and-seventy-four films illustrated a profusion rate of 0/1 or greater, and the proportion of this profusion rate was revealed to be highest in shipyard welders. Even some workers under 40 years of age were found to have already developed pneumoconiosis. Of these 1,006 subjects, 30 volunteers permitted us to measure their personal dust exposure concentrations. The measured concentration of the shipyard welders' dust exposure (respirable dust; 3.3 86.3 mg/m3, total dust; 7.5-117.0 mg/m3 was higher than those of the other 2 industries. Statistical differences among the industries were observed in the respirable dust concentrations. A statistically significant positive correlation was demonstrated between the working duration in dusty environments and the rate of profusion. The present findings suggest the need for taking adequate measures in Okayama in order to prevent workers from developing, or to help retard the progression of, pneumoconiosis.

  4. High Temperature Corrosion studies on Pulsed Current Gas Tungsten Arc Welded Alloy C-276 in Molten Salt Environment

    Science.gov (United States)

    Manikandan, M.; Arivarasu, M.; Arivazhagan, N.; Puneeth, T.; Sivakumar, N.; Murugan, B. Arul; Sathishkumar, M.; Sivalingam, S.

    2016-09-01

    Alloy C-276 is widely used in the power plant environment due to high strength and corrosion in highly aggressive environment. The investigation on high- temperature corrosion resistance of the alloy C-276 PCGTA weldment is necessary for prolonged service lifetime of the components used in corrosive environments. Investigation has been carried out on Pulsed Current Gas Tungsten Arc Welding by autogenous and different filler wires (ERNiCrMo-3 and ERNiCrMo-4) under molten state of K2SO4-60% NaCl environment at 675oC under cyclic condition. Thermogravimetric technique was used to establish the kinetics of corrosion. Weight gained in the molten salt reveals a steady-state parabolic rate law while the kinetics with salt deposits displays multi-stage growth rates. PCGTA ERNiCrMo-3 shows the higher parabolic constant compared to others. The scale formed on the weldment samples upon hot corrosion was characterized by using X-ray diffraction, SEM and EDAX analysis to understand the degradation mechanisms. From the results of the experiment the major phases are identified as Cr2O3, Fe2O3, and NiCr2O4. The result showed that weld fabricated by ERNiCrMo-3 found to be more prone to degradation than base metal and ERNiCrMo-4 filler wire due to higher segregation of alloying element of Mo and W in the weldment

  5. Induced current density in the foetus of pregnant workers in high magnetic field environments.

    Science.gov (United States)

    Xue, C; Wood, A W; Dovan, T

    2004-12-01

    There are moves to limit by legislation the amount of electric and magnetic fields that workers and the general public are exposed to. In work locations near wiring, cables & equipment carrying high electric currents, there are situations in which the proposed magnetic field limits could be exceeded. Since the limits for the general public are more conservative than those for workers and since the foetus or a pregnant worker should be afforded the status of a member of the general public, it is important to assess a worst-case scenario for the purposes of a general code of practice. Three different magnetic field exposures are modelled, which include the worst case - the body of a pregnant woman at a smallest distance of 30 cm to the conductor. All computations were done by using Multiple Multipole Program (MMP), which is based on the Generalized Multipole Technique (GMT) from ETH (Swiss Federal Institute of Technology), Zurich, Switzerland. In a worst-case scenario the proposed basic restrictions would be exceeded slightly in both maternal and foetal tissue. With appropriate pre-placement assessment, these over-exposures can be avoided.

  6. Building effective clinical teams in healthcare.

    Science.gov (United States)

    Ezziane, Zoheir; Maruthappu, Mahiben; Gawn, Lynsey; Thompson, Emily A; Athanasiou, Thanos; Warren, Oliver J

    2012-01-01

    This article aims to review teamwork and the creation of effective teams within healthcare. By combining research material found in management, psychology and health services research the article explores the drivers increasing the importance of teamwork, reviews the current knowledge base on how to build a team and focuses on some of the barriers to effective team performance. The simultaneous inflation of healthcare costs and necessity to improve quality of care has generated a demand for novel solutions in policy, strategy, commissioning and provider organisations. A critical, but commonly undervalued means by which quality can be improved is through structured, formalised incentivisation and development of teams, and the ability of individuals to work collectively and in collaboration. Several factors appear to contribute to the development of successful teams, including effective communication, comprehensive decision making, safety awareness and the ability to resolve conflict. Not only is strong leadership important if teams are to function effectively but the concept and importance of followership is also vital. Building effective clinical teams is difficult. The research in this area is currently limited, as is the authors' understanding of the different requirements faced by those working in different areas of the health and social care environment. This article provides a starting place for those interested in leading and developing teams of clinicians.

  7. Healthcare information technology and medical-surgical nurses: the emergence of a new care partnership.

    Science.gov (United States)

    Moore, An'Nita; Fisher, Kathleen

    2012-03-01

    Healthcare information technology in US hospitals and ambulatory care centers continues to expand, and nurses are expected to effectively and efficiently utilize this technology. Researchers suggest that clinical information systems have expanded the realm of nursing to integrate technology as an element as important in nursing practice as the patient or population being served. This study sought to explore how medical surgical nurses make use of healthcare information technology in their current clinical practice and to examine the influence of healthcare information technology on nurses' clinical decision making. A total of eight medical surgical nurses participated in the study, four novice and four experienced. A conventional content analysis was utilized that allowed for a thematic interpretation of participant data. Five themes emerged: (1) healthcare information technology as a care coordination partner, (2) healthcare information technology as a change agent in the care delivery environment, (3) healthcare information technology-unable to meet all the needs, of all the people, all the time, (4) curiosity about healthcare information technology-what other bells and whistles exist, and (5) Big Brother is watching. The results of this study indicate that a new care partnership has emerged as the provision of nursing care is no longer supplied by a single practitioner but rather by a paired team, consisting of nurses and technology, working collaboratively in an interdependent relationship to achieve established goals.

  8. Saving lives: A meta-analysis of team training in healthcare.

    Science.gov (United States)

    Hughes, Ashley M; Gregory, Megan E; Joseph, Dana L; Sonesh, Shirley C; Marlow, Shannon L; Lacerenza, Christina N; Benishek, Lauren E; King, Heidi B; Salas, Eduardo

    2016-09-01

    As the nature of work becomes more complex, teams have become necessary to ensure effective functioning within organizations. The healthcare industry is no exception. As such, the prevalence of training interventions designed to optimize teamwork in this industry has increased substantially over the last 10 years (Weaver, Dy, & Rosen, 2014). Using Kirkpatrick's (1956, 1996) training evaluation framework, we conducted a meta-analytic examination of healthcare team training to quantify its effectiveness and understand the conditions under which it is most successful. Results demonstrate that healthcare team training improves each of Kirkpatrick's criteria (reactions, learning, transfer, results; d = .37 to .89). Second, findings indicate that healthcare team training is largely robust to trainee composition, training strategy, and characteristics of the work environment, with the only exception being the reduced effectiveness of team training programs that involve feedback. As a tertiary goal, we proposed and found empirical support for a sequential model of healthcare team training where team training affects results via learning, which leads to transfer, which increases results. We find support for this sequential model in the healthcare industry (i.e., the current meta-analysis) and in training across all industries (i.e., using meta-analytic estimates from Arthur, Bennett, Edens, & Bell, 2003), suggesting the sequential benefits of training are not unique to medical teams. Ultimately, this meta-analysis supports the expanded use of team training and points toward recommendations for optimizing its effectiveness within healthcare settings. (PsycINFO Database Record

  9. Measuring healthcare quality: the challenges

    NARCIS (Netherlands)

    van den Heuvel, J.; Niemeijer, G.C.; Does, R.J.M.M.

    2013-01-01

    Purpose - Current health care quality performance indicators appear to be inadequate to inform the public to make the right choices. The aim of this paper is to define a framework and an organizational setting in which valid and reliable healthcare information can be produced to inform the general p

  10. Globalization of healthcare.

    Science.gov (United States)

    2012-05-01

    Globalization-the increasing transnational circulation of money, goods, people, ideas, and information worldwide-is generally recognized as one of the most powerful forces shaping our current and future history. How is it affecting healthcare, and in that context, what is the purpose and significance of Global Advances in Health and Medicine (GAHM), publisher of this journal? Our goal is not homogenization but rather to provide an opportunity for integration, convergence, and collaboration across cultures. By respecting and conserving the richness and diversity of each new medicine, we embrace globalization. Globalization is of course not new; it began in the Renaissance and particularly with the 15th- and 16th-century voyages of exploration by Columbus, Magellan, and others. Since the beginning of time, there have been interactions and exchanges among different peoples and cultures. However, the current magnitude of globalization is unprecedented and yet still expanding rapidly.

  11. Legacy and currently used pesticides in the atmospheric environment of Lake Victoria, East Africa.

    Science.gov (United States)

    Arinaitwe, Kenneth; Kiremire, Bernard T; Muir, Derek C G; Fellin, Phil; Li, Henrik; Teixeira, Camilla; Mubiru, Drake N

    2016-02-01

    The Lake Victoria watershed has extensive agricultural activity with a long history of pesticide use but there is limited information on historical use or on environmental levels. To address this data gap, high volume air samples were collected from two sites close to the northern shore of Lake Victoria; Kakira (KAK) and Entebbe (EBB). The samples, to be analyzed for pesticides, were collected over various periods between 1999 and 2004 inclusive (KAK 1999-2000, KAK 2003-2004, EBB 2003 and EBB 2004 sample sets) and from 2008 to 2010 inclusive (EBB 2008, EBB 2009 and EBB 2010 sample sets). The latter sample sets (which also included precipitation samples) were also analyzed for currently used pesticides (CUPs) including chlorpyrifos, chlorthalonil, metribuzin, trifluralin, malathion and dacthal. Chlorpyrifos was the predominant CUP in air samples with average concentrations of 93.5, 26.1 and 3.54 ng m(-3) for the EBB 2008, 2009, 2010 sample sets, respectively. Average concentrations of total endosulfan (ΣEndo), total DDT related compounds (ΣDDTs) and hexachlorocyclohexanes (ΣHCHs) ranged from 12.3-282, 22.8-130 and 3.72-81.8 pg m(-3), respectively, for all the sample sets. Atmospheric prevalence of residues of persistent organic pollutants (POPs) increased with fresh emissions of endosulfan, DDT and lindane. Hexachlorobenzene (HCB), pentachlorobenzene (PeCB) and dieldrin were also detected in air samples. Transformation products, pentachloroanisole, 3,4,5-trichloroveratrole and 3,4,5,6-tetrachloroveratrole, were also detected. The five most prevalent compounds in the precipitation samples were in the order chlorpyrifos>chlorothalonil>ΣEndo>ΣDDTs>ΣHCHs with average fluxes of 1123, 396, 130, 41.7 and 41.3 ng m(-2)sample(-1), respectively. PeCB exceeded HCB in precipitation samples. The reverse was true for air samples. Backward air trajectories suggested transboundary and local emission sources of the analytes. The results underscore the need for a concerted

  12. The MINDMAP project: mental well-being in urban environments : Design and first results of a survey on healthcare planning policies, strategies and programmes that address mental health promotion and mental disorder prevention for older people in Europe.

    Science.gov (United States)

    Neumann, L; Dapp, U; Jacobsen, W; van Lenthe, F; von Renteln-Kruse, W

    2017-08-17

    The MINDMAP consortium (2016-2019) aims to identify opportunities provided by the urban environment for the promotion of mental well-being and functioning of older people in Europe by bringing together European cities with urban longitudinal ageing studies: GLOBE, HAPIEE, HUNT, LASA, LUCAS, RECORD, Rotterdam Study, Turin Study. A survey on mental healthcare planning policies and programmes dedicated to older persons covering the range from health promotion to need of nursing care was performed for profound data interpretation in Amsterdam, Eindhoven, Hamburg, Helsinki, Kaunas, Krakow, London, Nord-Trøndelag, Paris, Prague, Rotterdam and Turin. To collect detailed information on healthcare planning policies and programmes across these European cities to evaluate variations and to delineate recommendations for sciences, policies and planners using experience from evidence-based practice feedback from the MINDMAP cities. The MINDMAP partners identified experts in the 12 cities with the best background knowledge of the mental health sector. After pretesting, semi-structured telephone interviews (1-2 h) were performed always by the same person. A structured evaluation matrix based on the geriatric functioning continuum and the World Health Organization (WHO) Public Health Framework for Healthy Ageing was applied. A complete survey (12 out of 12) was performed reporting on 41 policies and 280 programmes on the city level. It appeared from extensive analyses that the focus on older citizens, specific target groups, and multidimensional programmes could be intensified. There is a broad variety to cope with the challenges of ageing in health, and to address both physical and mental capacities in older individuals and their dynamic interactions in urban environments.

  13. Lean in healthcare from employees' perspectives.

    Science.gov (United States)

    Drotz, Erik; Poksinska, Bozena

    2014-01-01

    The purpose of this paper is to contribute toward a deeper understanding of the new roles, responsibilities, and job characteristics of employees in Lean healthcare organizations. The paper is based on three cases studies of healthcare organizations that are regarded as successful examples of Lean applications in the healthcare context. Data were collected by methods including interviews, observations, and document studies. The implementation of Lean in healthcare settings has had a great influence on the roles, responsibilities, and job characteristics of the employees. The focus has shifted from healthcare professionals, where clinical autonomy and professional skills have been the guarding principles of patient care, to process improvement and teamwork. Different job characteristics may make it difficult to implement certain Lean practices in healthcare. Teamwork and decentralization of authority are examples of Lean practices that could be considered countercultural because of the strong professional culture and uneven power distribution, with doctors as the dominant decision makers. Teamwork, value flow orientation, and company-wide involvement in CI were associated with positive effects on the organizations' working environment, staff development, and organizational performance. In order to succeed with Lean healthcare, it is important to understand and recognize the differences in job characteristics between Lean manufacturing and healthcare. This paper provides insights into how Lean implementation changes the roles, responsibilities, and job characteristics of healthcare staff and the challenges and implications that may follow from this.

  14. Big Data Analytics in Healthcare

    Directory of Open Access Journals (Sweden)

    Ashwin Belle

    2015-01-01

    Full Text Available The rapidly expanding field of big data analytics has started to play a pivotal role in the evolution of healthcare practices and research. It has provided tools to accumulate, manage, analyze, and assimilate large volumes of disparate, structured, and unstructured data produced by current healthcare systems. Big data analytics has been recently applied towards aiding the process of care delivery and disease exploration. However, the adoption rate and research development in this space is still hindered by some fundamental problems inherent within the big data paradigm. In this paper, we discuss some of these major challenges with a focus on three upcoming and promising areas of medical research: image, signal, and genomics based analytics. Recent research which targets utilization of large volumes of medical data while combining multimodal data from disparate sources is discussed. Potential areas of research within this field which have the ability to provide meaningful impact on healthcare delivery are also examined.

  15. Big Data Analytics in Healthcare.

    Science.gov (United States)

    Belle, Ashwin; Thiagarajan, Raghuram; Soroushmehr, S M Reza; Navidi, Fatemeh; Beard, Daniel A; Najarian, Kayvan

    2015-01-01

    The rapidly expanding field of big data analytics has started to play a pivotal role in the evolution of healthcare practices and research. It has provided tools to accumulate, manage, analyze, and assimilate large volumes of disparate, structured, and unstructured data produced by current healthcare systems. Big data analytics has been recently applied towards aiding the process of care delivery and disease exploration. However, the adoption rate and research development in this space is still hindered by some fundamental problems inherent within the big data paradigm. In this paper, we discuss some of these major challenges with a focus on three upcoming and promising areas of medical research: image, signal, and genomics based analytics. Recent research which targets utilization of large volumes of medical data while combining multimodal data from disparate sources is discussed. Potential areas of research within this field which have the ability to provide meaningful impact on healthcare delivery are also examined.

  16. A review on emerging contaminants in wastewaters and the environment: current knowledge, understudied areas and recommendations for future monitoring.

    Science.gov (United States)

    Petrie, Bruce; Barden, Ruth; Kasprzyk-Hordern, Barbara

    2015-04-01

    of using an integrated analytical approach which compliments targeted and non-targeted screening with biological assays to measure ecological impact. With respect to current toxicity testing protocols, failure to consider the enantiomeric distribution of chiral compounds found in the environment, and the possible toxicological differences between enantiomers is concerning. Such information is essential for the development of more accurate environmental risk assessment.

  17. Fraud Detection in Healthcare

    Energy Technology Data Exchange (ETDEWEB)

    Chandola, Varun [ORNL; Schryver, Jack C [ORNL; Sukumar, Sreenivas R [ORNL

    2015-01-01

    We discuss the problem of fraud detection in healthcare in this chapter. Given the recent scrutiny of the ineciencies in the US healthcare system, identifying fraud has been on the forefront of the eorts towards reducing the healthcare costs. In this chapter we will focus on understanding the issue of healthcare fraud in detail, and review methods that have been proposed in the literature to combat this issue using data driven approach.

  18. Healthcare. Executive Summary

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This executive summary highlights several findings about healthcare. These are: (1) Healthcare is 18 percent of the U.S. economy, twice as high as in other countries; (2) There are two labor markets in healthcare: high-skill, high-wage professional and technical jobs and low-skill, low-wage support jobs; (3) Demand for postsecondary education in…

  19. Engineering the system of healthcare delivery

    National Research Council Canada - National Science Library

    Rouse, William B; Cortese, Denis A

    2010-01-01

    "As the United States continues to debate reform of its healthcare system, this book argues that providing health insurance for all without improving the delivery system will not improve the current...

  20. El marco sanitario y el entorno psicosocial de la población inmigrante magrebí en Cataluña Study of the healthcare background and psychosocial environment of the Maghrebian immigrant population in Catalonia (Spain

    Directory of Open Access Journals (Sweden)

    Rosa Maria Saura

    2008-12-01

    Full Text Available Introducción: Este estudio pretende obtener información sobre el marco sanitario y el entorno psicosocial de la población inmigrante magrebí en Cataluña, para orientar las actuaciones en planificación y provisión de servicios sociales y de las organizaciones que apoyan a este colectivo. Método: Se utilizó un cuestionario de creación propia que explora aspectos sanitarios y psicosociales, incluidos los factores estresores y de apoyo social. La recogida de datos se realizó mediante encuestadores y en lengua árabe. Resultados: Se realizaron 403 entrevistas. La mayoría de los encuestados tenían tarjeta sanitaria y sabían a dónde acudir para recibir asistencia. Los servicios más utilizados son los de atención primaria y urgencias hospitalarias. En atención primaria, casi todos los encuestados reciben explicaciones, pero un 30% no las comprende adecuadamente. Se percibe que los profesionales sanitarios no tienen muy en cuenta las diferencias culturales o religiosas. Trabajo, vivienda, alejamiento familiar y legalización son factores estresores para más de la mitad de esta población. El apoyo social es bajo. Tres cuartas partes de los encuestados se sienten solos. Más de la mitad de esta población ve cumplidas total o parcialmente sus expectativas migratorias y un 11% considera estar peor. Conclusiones: Las principales áreas de acción pasan por reforzar la información sobre condiciones de acceso al sistema sanitario, fomentar la interacción social y el asociacionismo entre los inmigrantes, especialmente durante las primeras fases del proceso migratorio, y facilitar las actividades religiosas. Parece importante formar a los profesionales sanitarios sobre las culturas de origen.Introduction: The aim of this study was to gather information on the healthcare background and social environment of the Maghrebian immigrant population in Catalonia in order to guide the management and provision of social services and the work of the

  1. On the supply of China's healthcare resources in a decentralized healthcare system

    OpenAIRE

    Zheng, Xinye; Wang, Jing; Li, Xilu; Yu, Yihua

    2013-01-01

    The structure of China’s current governance bears prominent features of fiscal decentralization. The supply of healthcare resources in China has clearly witnessed slower growth in the last two decades during which the fiscal decentralization process has taken place. Using China’s provincial panel data, we examine the determinants of healthcare resource supply while paying particular attention to the role of fiscal decentralization. We find that the supply of healthcare resources is inversely ...

  2. Healthcare Data Analytics on the Cloud

    Directory of Open Access Journals (Sweden)

    Indrajit Bhattacharya

    2012-04-01

    Full Text Available Meaningful analysis of voluminous health information has always been a challenge in most healthcare organizations. Accurate and timely information required by the management to lead a healthcare organization through the challenges found in the industry can be obtained using business intelligence (BI or business analytics tools. However, these require large capital investments to implement and support the large volumes of data that needs to be analyzed to identify trends. They also require enormous processing power which places pressure on the business resources in addition to the dynamic changes in the digital technology. This paper evaluates the various nuances of business analytics of healthcare hosted on the cloud computing environment. The paper explores BI being offered as Software as a Service (SaaS solution towards offering meaningful use of information for improving functions in healthcare enterprise. It also attempts to identify the challenges that healthcare enterprises face when making use of a BI SaaS solution.

  3. A systematic review of evidence on the professional practice of the nurse and developing and sustaining a healthy work environment in healthcare.

    Science.gov (United States)

    Pearson, Alan; Porritt, Kylie; Doran, Diane; Vincent, Leslie; Craig, Dianna; Tucker, Donna; Long, Leslye

    2006-09-01

    Objectives  The overall aim of this systematic review was to identify the best available evidence on the relationship between the knowledge, competencies and behaviours of nurses exhibiting professional practice in their workplace; and the development of a healthy work environment. Search strategy  The search strategy sought to find both published and unpublished studies written in the English language. An initial limited search of MEDLINE and CINAHL databases was undertaken to identify optimal search terms. A second extensive search using all identified key words and index terms was then undertaken. Methodological quality  Two independent reviewers assessed the methodological quality of retrieved papers using the corresponding checklist from the System for the Unified Management, Assessment and Review of Information (SUMARI) package. Results  Of the 4238 papers found in the search: 219 were selected for full paper retrieval; 19 of these papers were unable to be located; 200 full papers were assessed for methodological quality; 181 studies were excluded; and 19 were included in the review. Of these 19, four quantitative studies evaluated a professional nursing practice model and its impact on a variety of outcomes; five descriptive studies examined elements of nurses' professional practice and the impact these elements had on specified outcomes; and 10 qualitative papers examined varying behaviours, competencies and knowledge levels of nurses. Various methods were used, such as focus groups and open-ended interviews. Overall, the evidence suggests that professional practice has a positive impact on the work environment in terms of nurses' role satisfaction and patient outcomes. The evidence is, however, equivocal in many areas and the impact of the professional practice of the nurse requires further investigation. Conclusion  The results of the review suggest a number of recommendations for practice and research on creating a healthy work environment.

  4. A hospital information system based on Common Object Request Broker Architecture (CORBA) for exchanging distributed medical objects--an approach to future environment of sharing healthcare information.

    Science.gov (United States)

    Ohe, K

    1998-01-01

    Tightly related subsystems in a HIS have to exchange medical data flexibly by the data object rather than by the battery of the data. We developed a CPR subsystem based on Common Object Request Broker Architecture (CORBA) that retrieves and stores clinical information in the object-oriented database via Internet Intra-ORB Protocol (IIOP). The system is hybridized with the legacy HIS applications on the client terminals. We believe that our solution and the experiences will contribute to the future CORBA-based environment in which computerized patient information is shared among hospitals, clinics, and tightly related systems.

  5. [Development method of healthcare information system integration based on business collaboration model].

    Science.gov (United States)

    Li, Shasha; Nie, Hongchao; Lu, Xudong; Duan, Huilong

    2015-02-01

    Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.

  6. Corrosion Behavior of X80 Steel with Coupled Coating Defects under Alternating Current Interference in Alkaline Environment

    Science.gov (United States)

    Li, Zhong; Li, Caiyu; Qian, Hongchang; Li, Jun; Huang, Liang; Du, Cuiwei

    2017-01-01

    The corrosion behavior of X80 steel in the presence of coupled coating defects was simulated and studied under the interference of alternating current (AC) in an alkaline environment. The results from electrochemical measurements showed that the electrode potential of the coating defect with the smaller exposed area was lower than that with the larger area, which indicated that the steel with the smaller coating defect was more prone to corrosion. The result of weight loss tests also showed that the smaller coating defect had induced a higher corrosion rate. However, the corrosion rate of X80 steel at the larger coating defect decreased gradually with the increase of the larger defect area at a constant smaller defect area. The corrosion morphology images showed that the coating defects with smaller areas suffered from more severe pitting corrosion. PMID:28773078

  7. Current asthma, respiratory symptoms and airway infections among students in relation to the school and home environment in Japan.

    Science.gov (United States)

    Takaoka, Motoko; Suzuki, Kyoko; Norbäck, Dan

    2017-08-01

    To study associations between the school and home environment and current asthma, respiratory symptoms and airway infections among Japanese students. Japanese students (12-15 y) (N = 1048) in four schools responded to a questionnaire on respiratory health, allergy and the home environment. Temperature, relative air humidity (RH) and student density (students/m(2) floor area) was measured in the classrooms: dust was collected from floors and in classroom air and analysed for cat (Fel d 1) and dog (Can f 1) allergens. Health associations were analysed by multi-level logistic regression. Doctor's diagnosed asthma was common (13.4%), 8.8% reported cat allergy and 6.1% dog allergy. The median level in floor dust was 41 ng/g (IQR 23-92) for Fel d 1 and 101 ng/g (IQR 54-101) for Can f 1. The median level in air was 18.6 ng/ m(2)/ day (IQR5.9-25.1) for Fel d 1 and 18.6 ng/ m(2)/ day (IQR 6.0-13.3) for Can f 1. High RH, high student density and airborne cat allergen was associated with airway infections. In the home environment, recent indoor painting, new floor materials, odour, having cats as pets, window pane condensation in winter, and dampness in floor construction were associated with respiratory illness. High relative air humidity, high student density and airborne cat allergens at school may increase the risk of airway infections. Having cats as pets, chemical emissions from paint and new floor materials, odour and dampness can constitute domestic risk factors for respiratory symptoms while having dogs as pets could be protective.

  8. Healthcare professionals' perspectives on environmental sustainability.

    Science.gov (United States)

    Dunphy, Jillian L

    2014-06-01

    Human health is dependent upon environmental sustainability. Many have argued that environmental sustainability advocacy and environmentally responsible healthcare practice are imperative healthcare actions. What are the key obstacles to healthcare professionals supporting environmental sustainability? How may these obstacles be overcome? Data-driven thematic qualitative analysis of semi-structured interviews identified common and pertinent themes, and differences between specific healthcare disciplines. A total of 64 healthcare professionals and academics from all states and territories of Australia, and multiple healthcare disciplines were recruited. Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were de-identified to protect participant anonymity. Qualitative analysis indicated that Australian healthcare professionals often take more action in their personal than professional lives to protect the environment, particularly those with strong professional identities. The healthcare sector's focus on economic rationalism was a substantial barrier to environmentally responsible behaviour. Professionals also feared conflict and professional ostracism, and often did not feel qualified to take action. This led to healthcare professionals making inconsistent moral judgements, and feeling silenced and powerless. Constraints on non-clinical employees within and beyond the sector exacerbated these difficulties. The findings are consistent with the literature reporting that organisational constraints, and strong social identification, can inhibit actions that align with personal values. This disparity can cause moral distress and residue, leading to feelings of powerlessness, resulting in less ethical behaviour. The data highlight a disparity between personal and professional actions to address environmental sustainability. Given the constraints Australian healthcare professionals encounter, they are unlikely to

  9. Leveraging Devices, Data and Discovery for Smarter Healthcare in Japan

    OpenAIRE

    Sawa, Tomohiro

    2011-01-01

    Objectives Over the past decade, hospitals and clinics have gradually adopted hospital information systems, including provider order entries and electronic health records. Although these systems have helped to improve patient safety and efficiency of healthcare providers, not all healthcare providers and patients are satisfied with the current situation. Healthcare should be smarter. Thus, there is a need for state-of-the-art medical and healthcare devices that can handle massive amounts of d...

  10. [Current status of operations in community general support centers and the correlation of personal traits, work environment and occupational stress].

    Science.gov (United States)

    Yamaguchi, Yoshie

    2010-01-01

    The purpose of this study was to identify the current status of operations at community general support centers which provide coordination for elderly care and the correlation of personal traits, work environment and the occupational stress of the staff. Subjects of the study were 251 staff members of community general support centers. The current status of operations at the community general support centers and the personal traits, work environment, effort-remuneration imbalance model (ERI) and general health questionnaire (GHQ) were surveyed. The initial analysis involved a comparison by a chi-square test on: The effort-remuneration ratio (E/R ratio) of personal traits and work environment, risk of over-commitment (OC), and GHQ score. To explore the correlation between the E/R ratio of the three GHQ groups (low, middle and high score groups) and the OC value, one-way analysis of variance was performed. Out of the four basic functions of the community general support centers, 22.0% of the respondents noted that "establishment of a regional, comprehensive/multi-tiered service network" was functioning, and 50.4% of respondents noted that "comprehensive and continuous care management" was functioning. The average effort score was 15.5 +/- 5.3, approximately double the average value of preceding studies. Significant differences found in GHQ scores were related to working hours (pworking hours of 50 h or more" (OR: 10.38, 95% CI: 2.52-42.70), "Unstable employment" (OR: 2.75, 95% CI: 1.22-6.21) and "Anxiety related to task content" (OR: 17.04, 95% CI: 3.57-81.24). Items observed to have significant correlation with OC value risk factors were: "Weekly working hours of 50 h or more" (OR: 8.04, 95% CI: 1.99-32.41) and "Anxiety related to task content" (OR: 4.60, 95% CI: 2.04-10.37). We conclude that the basic functions of the community general support centers are not presently very functional. The stress levels of the community general support center staff are high and

  11. Visualizing desirable patient healthcare experiences.

    Science.gov (United States)

    Liu, Sandra S; Kim, Hyung T; Chen, Jie; An, Lingling

    2010-01-01

    High healthcare cost has drawn much attention and healthcare service providers (HSPs) are expected to deliver high-quality and consistent care. Therefore, an intimate understanding of the most desirable experience from a patient's and/or family's perspective as well as effective mapping and communication of such findings should facilitate HSPs' efforts in attaining sustainable competitive advantage in an increasingly discerning environment. This study describes (a) the critical quality attributes (CQAs) of the experience desired by patients and (b) the application of two visualization tools that are relatively new to the healthcare sector, namely the "spider-web diagram" and "promotion and detraction matrix." The visualization tools are tested with primary data collected from telephone surveys of 1,800 patients who had received care during calendar year 2005 at 6 of 61 hospitals within St. Louis, Missouri-based, Ascension Health. Five CQAs were found by factor analysis. The spider-web diagram illustrates that communication and empowerment and compassionate and respectful care are the most important CQAs, and accordingly, the promotion and detraction matrix shows those attributes that have the greatest effect for creating promoters, preventing detractors, and improving consumer's likelihood to recommend the healthcare provider.

  12. Current trends in health facility planning, design, and construction.

    Science.gov (United States)

    Beale, Craig; Kittredge, Frank D

    2014-01-01

    It is critical now more than ever for today's healthcare facilities to serve as more than just a backdrop to the care provided--they can, and should, be an integral part of that care. In addition to promoting efficacy, delighting the senses, and placing patients and families at ease, facilities need to be high-performing, sustainable, and healthy environments. Creating today's healthcare facilities requires breaking through barriers in unexpected ways, and it often requires looking outside the healthcare profession for guidance. In this article, we explore current trends in health facility planning, design, and construction. Our focus is on the buildings that serve as venues for the provision of healthcare services across the full continuum, from prevention to critical care. In particular, we discuss four current broad trends and conclude with thoughts on future developments.

  13. Wireless Sensor Networks for Healthcare Applications

    CERN Document Server

    Dishongh, Terrance J; Kuris, Ben

    2009-01-01

    This unique reference focuses on methods of application, validation and testing based on real deployments of sensor networks in the clinical and home environments. Key topics include healthcare and wireless sensors, sensor network applications, designs of experiments using sensors, data collection and decision making, clinical deployment of wireless sensor networks, contextual awareness medication prompting field trials in homes, social health monitoring, and the future of wireless sensor networks in healthcare.

  14. Caring for healthcare entrepreneurs - Towards successful entrepreneurial strategies for sustainable innovations in Dutch healthcare

    NARCIS (Netherlands)

    Janssen, M.; Moors, E.H.M.

    The sustainability of current healthcare systems is threatened by several societal developments, including an aging population, an increase of unmet medical needs and rising healthcare costs. A transition is needed in order to meet these threats and to achieve a proper balance between the demand for

  15. Caring for healthcare entrepreneurs - Towards successful entrepreneurial strategies for sustainable innovations in Dutch healthcare

    NARCIS (Netherlands)

    Janssen, M.; Moors, E.H.M.

    2013-01-01

    The sustainability of current healthcare systems is threatened by several societal developments, including an aging population, an increase of unmet medical needs and rising healthcare costs. A transition is needed in order to meet these threats and to achieve a proper balance between the demand for

  16. Individual, interpersonal, and organisational factors of healthcare conflict: A scoping review.

    Science.gov (United States)

    Kim, Sara; Bochatay, Naike; Relyea-Chew, Annemarie; Buttrick, Elizabeth; Amdahl, Chris; Kim, Laura; Frans, Elise; Mossanen, Matthew; Khandekar, Azhar; Fehr, Ryan; Lee, Young-Mee

    2017-05-01

    Unresolved conflicts among healthcare professionals can lead to difficult patient care consequences. This scoping review examines the current healthcare literature that reported sources and consequences of conflict associated with individual, interpersonal, and organisational factors. We identified 99 articles published between 2001 and 2015 from PubMed, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medical Database. Most reviewed studies relied on healthcare professionals' perceptions and beliefs associated with conflict sources and consequences, with few studies reporting behavioural or organisational change outcomes. Individual conflict sources included personal traits, such as self-focus, self-esteem, or worldview, as well as individuals' conflict management styles. These conflicts posed threats to one's physical, mental, and emotional health and to one's ability to perform at work. Interpersonal dynamics were hampered by colleagues' uncivil behaviours, such as low degree of support, to more destructive behaviours including bullying or humiliation. Perceptions of disrespectful working environment and weakened team collaboration were the main interpersonal conflict consequences. Organisational conflict sources included ambiguity in professional roles, scope of practice, reporting structure, or workflows, negatively affecting healthcare professionals' job satisfactions and intent to stay. Future inquiries into healthcare conflict research may target the following: shifting from research involving single professions to multiple professions; dissemination of studies via journals that promote interprofessional research; inquiries into the roles of unconscious or implicit bias, or psychological capital (i.e., resilience) in healthcare conflict; and diversification of data sources to include hospital or clinic data with implications for conflict sources.

  17. The healthcare system and provision of oral healthcare in European Union member states. Part 4: Greece.

    Science.gov (United States)

    Damaskinos, P; Koletsi-Kounari, H; Economou, C; Eaton, K A; Widström, E

    2016-03-11

    This paper presents a description of the healthcare system and how oral healthcare is organised and provided in Greece, a country in a deep economic and social crisis. The national health system is underfunded, with severe gaps in staffing levels and the country has a large private healthcare sector. Oral healthcare has been largely provided in the private sector. Most people are struggling to survive and have no money to spend on general and oral healthcare. Unemployment is rising and access to healthcare services is more difficult than ever. Additionally, there has been an overproduction of dentists and no development of team dentistry. This has led to under or unemployment of dentists in Greece and their migration to other European Union member states, such as the United Kingdom, where over 600 Greek dentists are currently working.

  18. The importance of patient engagement and the use of Social Media marketing in healthcare.

    Science.gov (United States)

    Koumpouros, Yiannis; Toulias, Thomas L; Koumpouros, Nicholas

    2015-01-01

    The present research aims to identify the application of social media for marketing or communication purposes in healthcare. We studied the opinion of healthcare professionals, organizations and health consumers, trying to identify the current status, trends and beliefs. The research reveals that healthcare organizations have to move forward and engage with their customers. The health consumers are more mature than the health providers. The descriptive characteristics of the sample's responses collected during the survey are presented. The current research tries to identify the application of social media for marketing or communication purposes in healthcare in Greece. The scope of the paper is to investigate the status in Greece and compare it with other countries. We studied the opinion of healthcare professionals, organizations and health consumers, trying to identify the current status, trends and beliefs. We formed adequate questionnaires which were distributed to the different target groups, while for statistical analysis we performed tests (in order to investigate the dependence between certain respondents' categories) as well as one-way ANOVA analysis for inference purposes. In this context, the results can depict the (average) behavior, as well as the homogeneity of the corresponding general population. The research conducted took into account the individualities of the Greek environment and revealed that both physicians and healthcare organizations have to move forward in order to engage with their customers. There is also a clear need to measure the effectiveness of any such media marketing effort. Most adopters are not yet-taking maximum advantage of the technology. Social networks are prevalent and several paradigms support their adoption for marketing purposes in the sensitive healthcare domain. Even though the expectations are ambitious, there is a lot of work to do in Greece in order to achieve the desired outcome. An important finding is that

  19. Board Governance: Transformational Approaches Under Healthcare Reform.

    Science.gov (United States)

    Zastocki, Deborah K

    2015-01-01

    Previous successes of healthcare organizations and effective governance practices in the pre-reform environment are not predictive of future success. Healthcare has been through numerous phases of growth and development using tried-and-true strategies. The challenge is that our toolbox does not contain what is needed to build the future healthcare delivery systems required in the post-reform world. Healthcare has had a parochial focus at the local level, with some broadening of horizons at the state and national levels. But healthcare delivery is now a global issue that requires a totally different perspective, and many countries are confronting similar issues. US healthcare reform initiatives have far-reaching implications. Compounding the reform dynamics are the simultaneously occurring, gamechanging accelerants such as enabling information technologies and mobile health, new providers of healthcare, increased consumer demands, and limited healthcare dollars, to name a few. Operating in this turbulent environment requires transformational board, executive, and physician leadership because traditional ways of planning for incremental change and attempting to time those adjustments can prove disastrous. Creating the legacy healthcare system for tomorrow requires governing boards and executive leadership to act today as they would in the desired future system. Boards need to create a culture that fosters.innovation with a tolerance for risk and some failure. To provide effective governance, boards must essentially develop new skills, expertise, and ways of thinking. The rapid rate of change requires board members to possess certain capabilities, including the ability to deal with ambiguity and uncertainty while demonstrating flexibility and adaptability, all with a driving commitment to metrics and results. This requires development plans for both individual members and the overall board. In short, the board needs to function differently, particularly regarding the

  20. Modeling the fate of Escherichia coli O157:H7 and Salmonella enterica in the agricultural environment: current perspective.

    Science.gov (United States)

    Ongeng, Duncan; Haberbeck, Leticia U; Mauriello, Gianluigi; Ryckeboer, Jaak; Springael, Dirk; Geeraerd, Annemie H

    2014-04-01

    The significance of fresh vegetable consumption on human nutrition and health is well recognized. Human infections with Escherichia coli O157:H7 and Salmonella enterica linked to fresh vegetable consumption have become a serious public health problem inflicting a heavy economic burden. The use of contaminated livestock wastes such as manure and manure slurry in crop production is believed to be one of the principal routes of fresh vegetable contamination with E. coli O157:H7 and S. enterica at preharvest stage because both ruminant and nonruminant livestock are known carriers of E. coli O157:H7 and S. enterica in the environment. A number of challenge-testing studies have examined the fate of E. coli O157:H7 and S. enterica in the agricultural environment with the view of designing strategies for controlling vegetable contamination preharvest. In this review, we examined the mathematical modeling approaches that have been used to study the behavior of E. coli O157:H7 and S. enterica in the manure, manure-amended soil, and in manure-amended soil-plant ecosystem during cultivation of fresh vegetable crops. We focused on how the models have been applied to fit survivor curves, predict survival, and assess the risk of vegetable contamination preharvest. The inadequacies of the current modeling approaches are discussed and suggestions for improvements to enhance the applicability of the models as decision tools to control E. coli O157:H7 and S. enterica contamination of fresh vegetables during primary production are presented.

  1. Improving Healthcare Logistics Processes

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes

    provision whilst providing high quality care. Logistics activities in hospitals provide a significant opportunity for cost containment in healthcare through the implementation of best practices. Literature provides little guidance on how to improve healthcare logistics processes. This study investigates......Healthcare costs are increasing due to an ageing population and more sophisticated technologies and treatments. At the same time, patients expect high quality care at an affordable cost. The healthcare industry has therefore experienced increasing pressures to reduce the cost of healthcare...... logistics processes in hospitals and aims to provide theoretically and empirically based evidence for improving these processes to both expand the knowledge base of healthcare logistics and provide a decision tool for hospital logistics managers to improve their processes. Case studies were conducted...

  2. The I.A.G. / A.I.G. SEDIBUD (Sediment Budgets in Cold Environments) Programme: Current and future activities

    Science.gov (United States)

    Beylich, Achim A.; Lamoureux, Scott; Decaulne, Armelle

    2013-04-01

    Projected climate change in cold regions is expected to alter melt season duration and intensity, along with the number of extreme rainfall events, total annual precipitation and the balance between snowfall and rainfall. Similarly, changes to the thermal balance are expected to reduce the extent of permafrost and seasonal ground frost and increase active layer depths. These effects will undoubtedly change surface environments in cold regions and alter the fluxes of sediments, nutrients and solutes, but the absence of quantitative data and coordinated geomorphic process monitoring and analysis to understand the sensitivity of the Earth surface environment is acute in cold climate environments. The International Association of Geomorphologists (I.A.G. / A.I.G. ) SEDIBUD (Sediment Budgets in Cold Environments) Programme was formed in 2005 to address this existing key knowledge gap. SEDIBUD currently has about 400 members worldwide and the Steering Committee of this international programme is composed of ten scientists from eight different countries: Achim A. Beylich (Chair) (Norway), Armelle Decaulne (Secretary) (France), John C. Dixon (USA), Scott F. Lamoureux (Vice-Chair) (Canada), John F. Orwin (Canada), Jan-Christoph Otto (Austria), Irina Overeem (USA), Thorsteinn Sæmundsson (Iceland), Jeff Warburton (UK) and Zbigniew Zwolinski (Poland). The central research question of this global group of scientists is to: Assess and model the contemporary sedimentary fluxes in cold climates, with emphasis on both particulate and dissolved components. Initially formed as European Science Foundation (ESF) Network SEDIFLUX (Sedimentary Source-to-Sink Fluxes in Cold Environments) (2004 - ), SEDIBUD has further expanded to a global group of researchers with field research sites located in polar and alpine regions in the northern and southern hemisphere. Research carried out at each of the close to 50 defined SEDIBUD key test sites varies by programme, logistics and available

  3. Parental Involvement and Home Environment in Music: Current and Former Students from Selected Community Music Programs in Brazil and the United States

    Science.gov (United States)

    Barnes, Gail V.; DeFreitas, Aureo; Grego, John

    2016-01-01

    The purpose of this study was to determine whether individuals' perceptions of parental involvement and home environment in music vary with nationality (Brazil/United States) and time frame (past/current). Past and current students from selected community music programs in the United States and Brazil completed the PI-HEM (Parental Involvement and…

  4. Social marketing in healthcare

    OpenAIRE

    Radha Aras

    2011-01-01

    BackgroundSocial marketing is an important tool in the delivery ofhealthcare services. For any healthcare programme orproject to be successful, community/consumer participationis required. The four principles of social marketing can guidepolicymakers and healthcare providers to successfully planand implement health programmes.AimTo review the existing literature in order to project thebenefits of social marketing in healthcare.MethodA search of periodical literature by the author involvingsoc...

  5. The US healthcare workforce and the labor market effect on healthcare spending and health outcomes.

    Science.gov (United States)

    Pellegrini, Lawrence C; Rodriguez-Monguio, Rosa; Qian, Jing

    2014-06-01

    has a differing effect on healthcare occupational employment per 100,000 people. Private healthcare spending positively impacts primary care physician employment ([Formula: see text] .001); whereas, Medicare spending drives up employment of physician assistants, registered nurses, and personal care attendants ([Formula: see text] .001). Medicaid and Medicare spending has a negative effect on surgeon employment ([Formula: see text] .05); the effect of private healthcare spending is positive but not statistically significant. Labor force participation, as opposed to unemployment, is a better proxy for measuring the effect of the economic environment on healthcare spending and health outcomes. Further, during economic contractions, Medicaid and Medicare's share of overall healthcare spending increases with meaningful effects on the configuration of state healthcare workforces and subsequently, provision of care for populations at-risk for worsening morbidity and mortality.

  6. Healthcare financing in Croatia

    Directory of Open Access Journals (Sweden)

    Nevenka Kovač

    2013-12-01

    Full Text Available Healthcare financing system is of crucial importance for the functioning of any healthcare system, especially because there is no country in the world that is able to provide all its residents with access to all the benefits afforded by modern medicine. Lack of resources in general and rising healthcare expenditures are considered a difficult issue to solve in Croatia as well. Since Croatia gained its independence, its healthcare system has undergone a number of reforms, the primary objective of which was to optimize healthcare services to the actual monetary capacity of the Croatian economy. The objectives of the mentioned re - forms were partially achieved. The solutions that have been offered until now, i.e. consolidation measures undertaken in the last 10 years were necessary; however, they have not improved the operating conditions. There is still the issue of the deficit from the previous years, i.e. outstanding payments, the largest in the last decade. Analysis of the performance of healthcare institutions in 2011 shows that the decision makers will have to take up a major challenge of finding a solution to the difficulties the Croatian healthcare system has been struggling with for decades, causing a debt of 7 billion kuna. At the same time, they will need to uphold the basic principles of the Healthcare Act, i.e. to provide access to healthcare and ensure its continuity, comprehensiveness and solidarity, keeping in mind that the National Budget Act and Fiscal Responsibility Act have been adopted.

  7. Wearable device implications in the healthcare industry.

    Science.gov (United States)

    Erdmier, Casey; Hatcher, Jason; Lee, Michael

    2016-01-01

    This manuscript analyses the impact of wearable device technology in the healthcare industry. The authors provide an exploration of the different types of wearable technology that are becoming popular or are emerging into the consumer market and the personal health information and other user data these devices collect. The applications of wearable technology to healthcare and wellness are discussed, along with the impact of these devices on the industry. Finally, an analysis is provided, describing the current regulations in the US and UK that govern wearable devices and the impact of these device regulations on users and healthcare professionals.

  8. Internal structure and current evolution of very small debris-covered glacier systems located in alpine permafrost environments

    Directory of Open Access Journals (Sweden)

    Jean-Baptiste eBosson

    2016-04-01

    Full Text Available This contribution explores the internal structure of very small debris-covered glacier systems located in permafrost environments and their current dynamical responses to short-term climatic variations. Three systems were investigated with electrical resistivity tomography and dGPS monitoring over a 3-year period. Five distinct sectors are highlighted in each system: firn and bare-ice glacier, debris-covered glacier, heavily debris-covered glacier of low activity, rock glacier and ice-free debris. Decimetric to metric movements, related to ice ablation, internal deformation and basal sliding affect the glacial zones, which are mainly active in summer. Conversely, surface lowering is close to zero (-0.04 m yr-1 in the rock glaciers. Here, a constant and slow internal deformation was observed (c. 0.2 m yr-1. Thus, these systems are affected by both direct and high magnitude responses and delayed and attenuated responses to climatic variations. This differential evolution appears mainly controlled by (1 the proportion of ice, debris and the presence of water in the ground, and (2 the thickness of the superficial debris layer.

  9. The Grid as a healthcare provision tool.

    Science.gov (United States)

    Hernández, V; Blanquer, I

    2005-01-01

    This paper presents a survey on HealthGrid technologies, describing the current status of Grid and eHealth and analyzing them in the medium-term future. The objective is to analyze the key points, barriers and driving forces for the take-up of HealthGrids. The article considers the procedures from other Grid disciplines such as high energy physics or biomolecular engineering and discusses the differences with respect to healthcare. It analyzes the status of the basic technology, the needs of the eHealth environment and the successes of current projects in health and other relevant disciplines. Information and communication technology (ICT) in healthcare is a promising area for the use of the Grid. There are many driving forces that are fostering the application of the secure, pervasive, ubiquitous and transparent access to information and computing resources that Grid technologies can provide. However, there are many barriers that must be solved. Many technical problems that arise in eHealth (standardization of data, federation of databases, content-based knowledge extraction, and management of personal data ...) can be solved with Grid technologies. The article presents the development of successful and demonstrative applications as the key for the take-up of HealthGrids, where short-term future medical applications will surely be biocomputing-oriented, and the future of Grid technologies on medical imaging seems promising. Finally, exploitation of HealthGrid is analyzed considering the curve of the adoption of ICT solutions and the definition of business models, which are far more complex than in other e-business technologies such ASP.

  10. Evaluating CRM Implementation in Healthcare Organization

    CERN Document Server

    Anshari, Muhammad

    2012-01-01

    Recently, many healthcare organizations are adopting CRM as a strategy, which involves using technology to organize, automate, and coordinate business processes, in managing interactions with their patients. CRM with the Web technology provides healthcare providers the ability to broaden their services beyond usual practices, and thus offers suitable environment using latest technology to achieve superb patient care. This paper discusses and demonstrates how a new approach in CRM based on Web 2.0 will help the healthcare providers improving their customer support, avoiding conflict, and promoting better health to patient. With this new approach patients will benefit from the customized personal service with full information access to perform self managed their own health. It also helps healthcare providers retaining the right customer. A conceptual framework of the new approach will be discussed.

  11. Healthcare. State Report

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This report projects education requirements linked to forecasted job growth in healthcare by state and the District of Columbia from 2010 through 2020. It complements a larger national report which projects educational demand for healthcare for the same time period. The national report shows that with or without Obamacare, the United States will…

  12. A risk management model for securing virtual healthcare communities.

    Science.gov (United States)

    Chryssanthou, Anargyros; Varlamis, Iraklis; Latsiou, Charikleia

    2011-01-01

    Virtual healthcare communities aim to bring together healthcare professionals and patients, improve the quality of healthcare services and assist healthcare professionals and researchers in their everyday activities. In a secure and reliable environment, patients share their medical data with doctors, expect confidentiality and demand reliable medical consultation. Apart from a concrete policy framework, several ethical, legal and technical issues must be considered in order to build a trustful community. This research emphasises on security issues, which can arise inside a virtual healthcare community and relate to the communication and storage of data. It capitalises on a standardised risk management methodology and a prototype architecture for healthcare community portals and justifies a security model that allows the identification, estimation and evaluation of potential security risks for the community. A hypothetical virtual healthcare community is employed in order to portray security risks and the solutions that the security model provides.

  13. Model of care for a changing healthcare system: are there foundational pillars for design?

    Science.gov (United States)

    Booker, Catriona; Turbutt, Adam; Fox, Robyn

    2016-04-01

    Currently, healthcare organisations are being challenged to provide optimal clinical services within budget limitations while simultaneously being confronted by aging consumers and labour and skill shortages. Within this dynamic and changing environment, the ability to remain responsive to patient needs while managing these issues poses further challenges. Development or review of the model of care (MOC) may provide a possible solution to support efficiencies in service provision. Although MOC are not readily understood or appreciated as an efficiency strategy, they can be more easily explained by considering several recurring pillars when developing or redesigning an MOC. Generic and recurring foundational pillars include integrated care models, team functioning and communication, leadership, change management and lean thinking. These foundational pillars should be incorporated into the development and application of MOC in order to achieve desired outcomes. However, sustainability requires continuous review to enable improvement and must be integrated into routine business. Moreover, successful review of MOC requires collaboration and commitment by all stakeholders. Leaders are critical to motivating clinicians and stakeholders in the review process. Further, it is imperative that leaders engage stakeholders to commit to support the agreed strategies designed to provide efficient and comprehensive healthcare services. Redesign of MOC can significantly improve patient care by applying the agreed strategies. In the current healthcare environment, these strategies can favourably affect healthcare expenditure and, at the same time, improve the quality of interprofessional health services.

  14. Healthcare professionals and the ethics of healthcare marketing.

    Science.gov (United States)

    Hammond, Kevin L; Jurkus, Anthony F

    1993-01-01

    The article explores marketing ethics considerations in the application of marketing to healthcare. While we realize that acceptance of healthcare marketing by all stakeholders is important for successful marketing, we emphasize its level of acceptance by healthcare professionals. The high levels of resistance to advertising and other forms of healthcare marketing by healthcare professionals has been largely based on the grounds that the practices are unethical. The nature of the resistance thus invites this exploration of healthcare marketing (and the marketing concept), marketing ethics, and the acceptance (rejection) by healthcare professionals of healthcare marketing.

  15. System integrational and migrational concepts and methods within healthcare

    DEFF Research Database (Denmark)

    Endsleff, F; Loubjerg, P

    1997-01-01

    In this paper an overview and comparison of the basic concepts and methods behind different system integrational implementations is given, including the DHE, which is based on the coming Healthcare Information Systems Architecture pre-standard HISA, developed by CEN TC251. This standard and the DHE...... (Distributed Healthcare Environment) not only provides highly relevant standards, but also provides an efficient and well structured platform for Healthcare IT Systems....

  16. Factors Influencing Healthcare Service Quality

    OpenAIRE

    Ali Mohammad Mosadeghrad

    2014-01-01

    Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production o...

  17. Social Responsibility and Healthcare in Finland.

    Science.gov (United States)

    Ahola-Launonen, Johanna

    2016-07-01

    This article examines current trends and prospects in Finnish healthcare literature and discussion. The Finnish healthcare system was long considered to manifest an equal, universal, and solidaristic welfare scheme. However, recent data reveals structural inequalities in access to healthcare that result in health differences among socioeconomic groups. The political will aims at tackling these inequalities, but the ideological trend toward responsibilization of the individual taking place across political spheres elsewhere in Europe creates potential challenges to this goal. The applications of this trend have a theoretical background in the responsibility-sensitive egalitarian-or luck egalitarian-tradition. The theory, which is unfit for real-life policy applications, has explicit appeal in considerations aiming at the responsibilization of the individual within the healthcare sector. It remains to be seen in which direction the Finnish welfare schemes will continue to develop.

  18. Oral healthcare in transition in Eastern Europe.

    Science.gov (United States)

    Widström, E; Eaton, K A; Borutta, A; Dybizbánska, E; Broukal, Z

    2001-06-09

    Big changes have occurred in the oral healthcare delivery systems of most Eastern European countries since the fall of the Berlin wall in 1989 and the demise of communism in the former USSR in 1991. In the new situation it was necessary to reform the political and social systems including healthcare. Reforms were started to improve the economy and, in comparison with Western Europe, the generally lower living standards. It is difficult to obtain comprehensive data on oral healthcare in Eastern European countries but this paper reports data from nine countries and provides a 'macro' view of the current situation in these countries. Many countries seem to have adopted a Bismarckian model for the provision of oral healthcare based on a sickness insurance system.

  19. Migrants' access to healthcare

    DEFF Research Database (Denmark)

    Norredam, Marie

    2011-01-01

    according to international human rights principles. The intention of this thesis is to increase the understanding of migrants' access to healthcare by exploring two study aims: 1) Are there differences in migrants' access to healthcare compared to that of non-migrants? (substudy I and II); and 2) Why......' healthcare entitlements. Different definitions of migration and ethnicity were investigated including: country of birth and residence status. Substudy I showed a tendency towards more advanced stage at diagnosis or unknown stage among most subgroups of migrant women with a history of cancer compared to non...

  20. Quality measurement in healthcare.

    Science.gov (United States)

    Lazar, Eliot J; Fleischut, Peter; Regan, Brian K

    2013-01-01

    Measurement is the basis for assessing potential improvements in healthcare quality. Measures may be classified into four categories: volume, structure, outcome, and process (VSOP). Measures of each type should be used with a full understanding of their cost and benefit. Although volume and structure measures are easily collected, impact on healthcare results is not always clear. Process measures are generally more difficult and expensive to collect, and the relationship between process and outcomes is only recently being explored. Knowledge of measure types and relationships among them, as well as emerging evidence on the role of patient satisfaction, must be used to guide improvements and ultimately for demonstrating value in healthcare.

  1. Using video-reflexive ethnography to capture the complexity of leadership enactment in the healthcare workplace.

    Science.gov (United States)

    Gordon, Lisi; Rees, Charlotte; Ker, Jean; Cleland, Jennifer

    2016-12-30

    Current theoretical thinking asserts that leadership should be distributed across many levels of healthcare organisations to improve the patient experience and staff morale. However, much healthcare leadership education focusses on the training and competence of individuals and little attention is paid to the interprofessional workplace and how its inherent complexities might contribute to the emergence of leadership. Underpinned by complexity theory, this research aimed to explore how interprofessional healthcare teams enact leadership at a micro-level through influential acts of organising. A whole (interprofessional) team workplace-based study utilising video-reflexive ethnography occurred in two UK clinical sites. Thematic framework analyses of the video data (video-observation and video-reflexivity sessions) were undertaken, followed by in-depth analyses of human-human and human-material interactions. Data analysis revealed a complex interprofessional environment where leadership is a dynamic process, negotiated and renegotiated in various ways throughout interactions (both formal and informal). Being able to "see" themselves at work gave participants the opportunity to discuss and analyse their everyday leadership practices and challenge some of their sometimes deeply entrenched values, beliefs, practices and assumptions about healthcare leadership. These study findings therefore indicate a need to redefine the way that medical and healthcare educators facilitate leadership development and argue for new approaches to research which shifts the focus from leaders to leadership.

  2. Performance management in healthcare: a critical analysis.

    Science.gov (United States)

    Hewko, Sarah J; Cummings, Greta G

    2016-01-01

    Purpose - The purpose of this paper is to explore the underlying theoretical assumptions and implications of current micro-level performance management and evaluation (PME) practices, specifically within health-care organizations. PME encompasses all activities that are designed and conducted to align employee outputs with organizational goals. Design/methodology/approach - PME, in the context of healthcare, is analyzed through the lens of critical theory. Specifically, Habermas' theory of communicative action is used to highlight some of the questions that arise in looking critically at PME. To provide a richer definition of key theoretical concepts, the authors conducted a preliminary, exploratory hermeneutic semantic analysis of the key words "performance" and "management" and of the term "performance management". Findings - Analysis reveals that existing micro-level PME systems in health-care organizations have the potential to create a workforce that is compliant, dependent, technically oriented and passive, and to support health-care systems in which inequalities and power imbalances are perpetually reinforced. Practical implications - At a time when the health-care system is under increasing pressure to provide high-quality, affordable services with fewer resources, it may be wise to investigate new sector-specific ways of evaluating and managing performance. Originality/value - In this paper, written for health-care leaders and health human resource specialists, the theoretical assumptions and implications of current PME practices within health-care organizations are explored. It is hoped that readers will be inspired to support innovative PME practices within their organizations that encourage peak performance among health-care professionals.

  3. IT Support for Healthcare Processes - Premises, Challenges, Perspectives

    NARCIS (Netherlands)

    Lenz, R.; Reichert, M.U.

    2007-01-01

    Healthcare processes require the cooperation of different organizational units and medical disciplines. In such an environment optimal process support becomes crucial. Though healthcare processes frequently change, and therefore the separation of the flow logic from the application code seems to be

  4. Healthcare facility valuation: don't forget the physician factor.

    Science.gov (United States)

    McCord, Christopher

    2005-08-01

    A fair market valuation of healthcare facilities should take into account the impact of physician customers. The "physician factor" affects the facility's competitive environment. Healthcare financial managers need to ensure that analysts understand the facility's competitive alternatives before determining its fair market value.

  5. Healthcare Associated Infections - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare-Associated Infections (HAI) measures - state data. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected...

  6. Healthcare Under Fire

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Tension between patients and hospital staff, insufficient health insurance coverage, and a limited supply of quality medical services are pressurizing China’s healthcare system reform Doctors and nurses, normally seen as protecting their patients, are in

  7. Healthcare Associated Infections - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare-Associated Infection (HAI) measures - provider data. These measures are developed by Centers for Disease Control and Prevention (CDC) and...

  8. Healthcare Associated Infections - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Healthcare-Associated Infections (HAI) measures - national data. These measures are developed by Centers for Disease Control and Prevention (CDC) and...

  9. Coproduction of healthcare service.

    Science.gov (United States)

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-07-01

    Efforts to ensure effective participation of patients in healthcare are called by many names-patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services.

  10. The Imminent Healthcare and Emergency Care Crisis in Japan

    Directory of Open Access Journals (Sweden)

    Suzuki, Tetsuji

    2008-05-01

    Full Text Available Objectives: Japan has a universal healthcare system, and this paper describes the reality of the healthcare services provided, as well as current issues with the system.Methods: Academic, government, and press reports on Japanese healthcare systems and healthcare guidelines were reviewed.Results: The universal healthcare system of Japan is considered internationally to be both low-cost and effective because the Japanese population enjoys good health status with a long life expectancy, while healthcare spending in Japan is below the average given by the Organization for Economic Corporation and Development (OECD. However, in many regions of Japan the existing healthcare resources are seriously inadequate, especially with regard to the number of physicians and other health professionals. Because healthcare is traditionally viewed as “sacred” work in Japan, healthcare professionals are expected to make large personal sacrifices. Also, public attitudes toward medical malpractice have changed in recent decades, and medical professionals are facing legal issues without experienced support of the government or legal professionals. Administrative response to the lack of resources and collaboration among communities are beginning, and more efficient control and management of the healthcare system is under consideration.Conclusion: The Japanese healthcare system needs to adopt an efficient medical control organization to ease the strain on existing healthcare professionals and to increase the number of physicians and other healthcare resources. Rather than continuing to depend on healthcare professionals being able and willing to make personal sacrifices, the government, the public and medical societies must cooperate and support changes in the healthcare system.

  11. Evolution of the Synthetic Environment in the FFSE Section: Survey of Current Usage of Synthetic Environment within FFSE and Recommendations for the Future

    Science.gov (United States)

    2005-11-01

    d’outils de modélisation et de simulation pour créer des expériences et des exercices virtuels pour DND, dans le but d’aider au développement de...différents outils, exercices et expériences, onze instances de simulations ont été identifiées et caractérisées. Ces instances sont décrites brièvement...Mission Rehearsal in a Synthetic Environment: Summary and Preliminary Analyses . (DRDC Ottawa TM 2004-200). Defence R&D Canada - Ottawa 5. B. Kim

  12. E-health and healthcare enterprise information system leveraging service-oriented architecture.

    Science.gov (United States)

    Hsieh, Sung-Huai; Hsieh, Sheau-Ling; Cheng, Po-Hsun; Lai, Feipei

    2012-04-01

    To present the successful experiences of an integrated, collaborative, distributed, large-scale enterprise healthcare information system over a wired and wireless infrastructure in National Taiwan University Hospital (NTUH). In order to smoothly and sequentially transfer from the complex relations among the old (legacy) systems to the new-generation enterprise healthcare information system, we adopted the multitier framework based on service-oriented architecture to integrate the heterogeneous systems as well as to interoperate among many other components and multiple databases. We also present mechanisms of a logical layer reusability approach and data (message) exchange flow via Health Level 7 (HL7) middleware, DICOM standard, and the Integrating the Healthcare Enterprise workflow. The architecture and protocols of the NTUH enterprise healthcare information system, especially in the Inpatient Information System (IIS), are discussed in detail. The NTUH Inpatient Healthcare Information System is designed and deployed on service-oriented architecture middleware frameworks. The mechanisms of integration as well as interoperability among the components and the multiple databases apply the HL7 standards for data exchanges, which are embedded in XML formats, and Microsoft .NET Web services to integrate heterogeneous platforms. The preliminary performance of the current operation IIS is evaluated and analyzed to verify the efficiency and effectiveness of the designed architecture; it shows reliability and robustness in the highly demanding traffic environment of NTUH. The newly developed NTUH IIS provides an open and flexible environment not only to share medical information easily among other branch hospitals, but also to reduce the cost of maintenance. The HL7 message standard is widely adopted to cover all data exchanges in the system. All services are independent modules that enable the system to be deployed and configured to the highest degree of flexibility

  13. Innovation in healthcare team feedback.

    Science.gov (United States)

    Plaza, Christine; Beard, Leslie; Fonzo, Anthony Di; Tommaso, Michael Di; Mujawaz, Yaman; Serra-Julia, Marcel; Morra, Dante

    2011-01-01

    Healthcare delivery is evolving from individual, autonomous practice to collaborative team practice. However, barriers such as professional autonomy, time constraints and the perception of error as failure preclude learning behaviours that can facilitate organizational learning and improvement. Although experimentation, engaging in questions and feedback, discussing errors and reflecting on results can facilitate learning and promote effective performance, the cultural barriers within healthcare can prevent or inhibit this type of behaviour among teams. At the University Health Network's Centre for Innovation in Complex Care, we realize the need for a tool that facilitates learning behaviour and is sensitive to the risk-averse nature of the clinical environment. The vehicle for the Team Feedback Tool is a web-based application called Rypple (www.rypple.com), which allows team members to provide anonymous, rapid-fire feedback on team processes and performance. Rypple facilitates communication, elicits feedback and provokes discussion. The process enables follow-up face-to-face team discussions and encourages teams to create actionable solutions for incremental changes to enhance team health and performance. The Team Feedback Tool was implemented and piloted in general internal medicine at the University Health Network's Toronto General Hospital from early May 2009 to July 2009 to address the issues of teamwork and learning behaviour in the clinical environment. This article explores the opportunities and barriers associated with the implementation of the Team Feedback Tool.

  14. Healthcare leadership's diversity paradox.

    Science.gov (United States)

    Silver, Reginald

    2017-02-06

    Purpose The purpose of this research study was to obtain healthcare executives' perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color. Design/methodology/approach A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified. Findings The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles. Research limitations/implications This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics. Practical implications The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of

  15. Sensing behaviour in healthcare design

    DEFF Research Database (Denmark)

    Thorpe, Julia Rosemary; Hysse Forchhammer, Birgitte; Maier, Anja

    2017-01-01

    specifically on activity and location data that can easily be obtained from smartphones or wearables. We further demonstrate how these are applied in healthcare design using an example from dementia care. Comparing a current and proposed scenario exemplifies how integrating sensor-derived information about...... and wearables) presents exciting opportunities. While mobile sensing approaches are fuelling research in many areas, their use in engineering design remains limited. In this work, we present a collection of common behavioural measures from literature that can be used for a broad range of applications. We focus...

  16. Quality management in healthcare

    Directory of Open Access Journals (Sweden)

    Subhash S Dodwad

    2013-01-01

    Full Text Available Clinical governance and better human resource management practices are important planks in the current health policies emphasizing quality of patient care. There are numerous reasons why it is important to improve quality of healthcare, including enhancing the accountability of health practitioners and managers, resource efficiency, identifying, and minimizing medical errors while maximizing the use of effective care and improving outcomes, and aligning care to what users/patients want in addition to what they need. "Quality in health is doing the right things for the right people at the right time, and doing them right first time and every time." Quality can also refer to the technical quality of care, to nontechnical aspects of service delivery such as clients′ waiting time and staff′s attitudes, and to programmatic elements such as policies, infrastructure, access, and management. In this oration/article quality initiatives like Reproductive and Child Health (RCH and National Rural Health Mission (NRHM of Government of India (GOI, which concentrate on improving the quality of infrastructure of vast rural health facilities including sub-center, primary health center, and community health center has been taken into account with focus on improving quality of health services also. United Nation Population Fund (UNFPA in collaboration with the GOI has proposed introducing quality assurance program for accessing and improving the quality of services at public sector health facilities. It is felt that improving the quality of health services in public sector will attract the client belonging to low economic strata, and surely will help in achieving the goal of the NRHM, that is, "Reaching the enriched with quality of health services."

  17. LEAN THINKING IN HEALTHCARE: REVIEW OF IMPLEMENTATION RESULTS

    Directory of Open Access Journals (Sweden)

    Marija Kovacevic

    2016-03-01

    Full Text Available For over decade, automotive industry originated lean concept has been successfully implemented in healthcare systems as a management method and philosophy with main focus on elimination of all types of wastes and looses in all tasks and processes so that time, materials, resources and medical procedures could be realized as effectively as it is possible. As main result lean concept implementation ensured to healthcare organizations to focus on their main core function and dedicate more time and efforts to patients without additional costs for them or healthcare system. However, lean implementation in healthcare could be much more difficult than in standard industrial environment and there are significant number of examples of lean in healthcare projects that failed to gain any measurable results and sustainable benefits from it. This paper presents review of some of the most successful implementations of lean tools and principles in healthcare organizations.

  18. Workplace incivility and burnout among Portuguese healthcare professionals

    OpenAIRE

    Ribeiro, Luisa; Nitzsche, Martina; Hipólito, João; Queiróz, Sandra; Jesus, Saúl de; Laneiro, Tito

    2017-01-01

    This study examines the relationship between workplace incivility, from three sources in the work environment, and burnout among 315 healthcare professionals from one hospital in the greater Lisbon area.

  19. Toolkit for healthcare facility design evaluation - some case studies

    CSIR Research Space (South Africa)

    De Jager, Peta

    2007-10-01

    Full Text Available Service delivery in the healthcare sector is profoundly affected by the built infrastructure provided to support it. In order for a hospital environment to function optimally, a key question is, is the infrastructure "fit for purpose...

  20. Toolkit for healthcare facility design evaluation - some case studies.

    CSIR Research Space (South Africa)

    De Jager, Peta

    2007-10-01

    Full Text Available Service delivery in the healthcare sector is profoundly affected by the built infrastructure provided to support it. In order for a hospital environment to function optimally, a key question is, is the infrastructure "fit for purpose...

  1. hospital waste management as primary healthcare ce ste ...

    African Journals Online (AJOL)

    User

    2014-04-02

    Apr 2, 2014 ... 2CENTRE FOR DISASTER RISK MANAGEMENT. 3DEPARTMENT OF ..... had knowledge of healthcare waste management plan. These 2 parameters .... Environmental Engineering Program, School of environment ...

  2. Customer privacy on UK healthcare websites.

    Science.gov (United States)

    Mundy, Darren P

    2006-09-01

    Privacy has been and continues to be one of the key challenges of an age devoted to the accumulation, processing, and mining of electronic information. In particular, privacy of healthcare-related information is seen as a key issue as health organizations move towards the electronic provision of services. The aim of the research detailed in this paper has been to analyse privacy policies on popular UK healthcare-related websites to determine the extent to which consumer privacy is protected. The author has combined approaches (such as approaches focused on usability, policy content, and policy quality) used in studies by other researchers on e-commerce and US healthcare websites to provide a comprehensive analysis of UK healthcare privacy policies. The author identifies a wide range of issues related to the protection of consumer privacy through his research analysis using quantitative results. The main outcomes from the author's research are that only 61% of healthcare-related websites in their sample group posted privacy policies. In addition, most of the posted privacy policies had poor readability standards and included a variety of privacy vulnerability statements. Overall, the author's findings represent significant current issues in relation to healthcare information protection on the Internet. The hope is that raising awareness of these results will drive forward changes in the industry, similar to those experienced with information quality.

  3. Beyond disclosure: A human rights approach to understanding queer women's interactions with healthcare providers when seeking sexual healthcare

    OpenAIRE

    Blackmore, Sarah Nicole

    2015-01-01

    This study explores interactions between queer women and healthcare providers within the context of sexual health and identifies barriers to and facilitators of equitable healthcare delivery. Constructivist grounded theory supplemented with situational mapping guided secondary analysis of nine participant interview transcripts from an original study on queer women’s health. The current study situates queer women’s sexual healthcare seeking within the broader social processes of heteronormativ...

  4. Assessment of Healthcare Decision-making Capacity.

    Science.gov (United States)

    Palmer, Barton W; Harmell, Alexandrea L

    2016-09-01

    It is often necessary for neuropsychologists, clinical psychologists, and other healthcare professionals to assess an individual's capacity to consent to treatment related to healthcare. This task can be challenging and requires a delicate balance of both respect for individuals' autonomy, as well as the protection of individuals with diminished capacity to make an autonomous decision. The purpose of the present review is to provide an overview of the conceptual model of decisional capacity as well as a brief summary of some of the currently available instruments designed to help evaluate medical decision making. In addition, current empirical literature on the relationship between neuropsychological abilities and decision-making capacity is discussed and a brief set of recommendations is provided to further aid clinicians or consultants when they are required to complete the ethically important but difficult task of making determinations about healthcare decision-making capacity.

  5. Knowledge, opinions and practices of healthcare workers related to infant feeding in the context of HIV

    Directory of Open Access Journals (Sweden)

    Liska Janse van Rensburg

    2016-12-01

    Conclusion: Healthcare workers' knowledge did not conform favourably with the current WHO guidelines. These healthcare workers were actively involved in the care of patients in the maternity wards where HIV-infected mothers regularly seek counselling on infant feeding matters.

  6. Consumer trust in healthcare organizations is waning. How will 21st century leaders bridge the gap?

    Science.gov (United States)

    Beard, Edward L

    2004-01-01

    Consumer trust in healthcare is crucial to the health and healing of individuals. This article explores the current status of consumer trust in healthcare and proposes several approaches to regaining trust that has been lost.

  7. How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

    Science.gov (United States)

    Bronkhorst, Babette

    2017-08-01

    Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

  8. The Cuban National Healthcare System: Characterization of primary healthcare services.

    Directory of Open Access Journals (Sweden)

    Keli Regina DAL PRÁ

    2015-10-01

    Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

  9. Study for the electric arc of alternative current at the single phase welding machine using the Matlab/Simulink environment

    Science.gov (United States)

    Baciu, I.; Ghiormez, L.; Vasar, C.

    2017-01-01

    In this paper is presented a mathematical model of the electric arc for an alternative current welding machine of low power. The electric arc model is based on dividing the voltage-current characteristic of the electric arc in many functioning zones. For the model of the entire welding machine are used real parameters as the ones of the proper welding machine. The voltage and current harmonics spectrum that is obtained during the welding process is presented. Also, the waveforms for the current and voltage of the electric arc plotted against time and the voltage-current characteristic of the electric arc are illustrated. The electric arc is considered as being supplied by alternative voltage from the electrical power network using a single phase transformer which has the output voltage of 80 volts. The model of the welding machine is developed in Simulink and the variations of some parameters of the electric arc are obtained by modifying of them in a Matlab function. Also, in this paper is presented the total harmonic distortion for the voltage and current of the electric arc obtained during simulation of the welding machine.

  10. The current status of diabetes professional educational standards and competencies in the UK--a position statement from the Diabetes UK Healthcare Professional Education Competency Framework Task and Finish Group.

    Science.gov (United States)

    Walsh, N; George, S; Priest, L; Deakin, T; Vanterpool, G; Karet, B; Simmons, D

    2011-12-01

    Diabetes is a significant health concern, both in the UK and globally. Management can be complex, often requiring high levels of knowledge and skills in order to provide high-quality and safe care. The provision of good, safe, quality care lies within the foundations of healthcare education, continuing professional development and evidence-based practice, which are inseparable and part of a continuum during the career of any health professional. Sound education provides the launch pad for effective clinical management and positive patient experiences. This position paper reviews and discusses work undertaken by a Working Group under the auspices of Diabetes UK with the remit of considering all health professional educational issues for people delivering care to people with diabetes. This work has scoped the availability of education for those within the healthcare system who may directly or indirectly encounter people with diabetes and reviews alignment to existing competency frameworks within the UK's National Health Service.

  11. Sensors for everyday life healthcare settings

    CERN Document Server

    Mukhopadhyay, Subhas; Jayasundera, Krishanthi; Swain, Akshya

    2017-01-01

    Sensors were developed to detect and quantify structures and functions of human body as well as to gather information from the environment in order to optimize the efficiency, cost-effectiveness and quality of healthcare services as well as to improve health and quality of life. This book offers an up-to-date overview of the concepts, modeling, technical and technological details and practical applications of different types of sensors. It also discusses the trends for the next generation of sensors and systems for healthcare settings. It is aimed at researchers and graduate students in the field of healthcare technologies, as well as academics and industry professionals involved in developing sensing systems for human body structures and functions, and for monitoring activities and health.

  12. Electronic Health Record (EHR and Cloud Security: The Current Issues

    Directory of Open Access Journals (Sweden)

    Emmanuel Kusi Achampong

    2014-02-01

    Full Text Available With the advent of the cloud computing and its associated challenges, building a secured electronic health record (EHR in a cloud computing environment has attracted a lot of attention in both healthcare industry and academic community. Cloud computing concept is becoming a popular information technology (IT infrastructure for facilitating EHR sharing and integration. In this study we discuss security concepts related to EHR sharing and integration in healthcare clouds and analyse the arising security and privacy issues in access and management of EHRs. This paper focus on the current challenges that comes with the use of the cloud computing for EHR purposes.

  13. Queueing for healthcare.

    Science.gov (United States)

    Palvannan, R Kannapiran; Teow, Kiok Liang

    2012-04-01

    Patient queues are prevalent in healthcare and wait time is one measure of access to care. We illustrate Queueing Theory-an analytical tool that has provided many insights to service providers when designing new service systems and managing existing ones. This established theory helps us to quantify the appropriate service capacity to meet the patient demand, balancing system utilization and the patient's wait time. It considers four key factors that affect the patient's wait time: average patient demand, average service rate and the variation in both. We illustrate four basic insights that will be useful for managers and doctors who manage healthcare delivery systems, at hospital or department level. Two examples from local hospitals are shown where we have used queueing models to estimate the service capacity and analyze the impact of capacity configurations, while considering the inherent variation in healthcare.

  14. A Practical approach for fault component network for Current and Voltage Phasor Diagram in Power Electronic Environment

    Directory of Open Access Journals (Sweden)

    Mr. Ashish Choubey

    2011-09-01

    Full Text Available In many large-scale power plants, the structure of its auxiliary power system is complex, and the coordination of its relay protections is difficult. To enhance power supply reliability for the user terminals in the case of the distribution system to avoid interference by the fault again, rapidly complete the automatic identification, positioning, automatic fault isolation, network reconfiguration until the resumption of supply of non-fault section, a microprocessor-based relay protection device has developed. As the fault component theory is widely used in microcomputer protection, and fault component exists in the network of fault component, it is necessary to build up the fault component network when short circuit fault emerging and to draw the current and voltage component phasor diagram at fault point. We proposed a special phase sequence component based on the boundary condition. We analysis the velocity according to the relationship between analysis formula and phasor diagram and current in fault component boundary conditions and sequence voltage and current in boundary conditions. The negative and zero sequence component current and voltage at fault point are the same as fault component. The positive sequence component current and voltage at fault point are different from the fault component. So we consider the positive sequences according to that sequences we analyze the fault point

  15. A Practical approach for fault component network for Current and Voltage Phasor Diagram in Power Electronic Environment

    Directory of Open Access Journals (Sweden)

    Ashish Choubey

    2011-12-01

    Full Text Available In many large-scale power plants, the structure of its auxiliary power system is complex, and the coordination of its relay protections is difficult. To enhance power supply reliability for the user terminals in the case of the distribution system to avoid interference by the fault again, rapidly complete the automatic identification, positioning, automatic fault isolation, network reconfiguration until the resumption of supply of non-fault section, a microprocessor-based relay protection device has developed. As the fault component theory is widely used in microcomputer protection, and fault component exists in the network of fault component, it is necessary to build up the fault component network when short circuit fault emerging and to draw the current and voltage component phasor diagram at fault point. We proposed a special phase sequence component based on the boundary condition. We analysis the velocity according to the relationship between analysis formula and phasor diagram and current in fault component boundary conditions and sequence voltage and current in boundary conditions. The negative and zero sequence component current and voltage at fault point are the same as fault component. The positive sequence component current and voltage at fault point are different from the fault component. So we consider the positive sequences according to that sequences we analyze the fault point.

  16. Leadership Styles and Effectiveness among C-Level Healthcare Executives

    Science.gov (United States)

    Mhoon-Walker, Etta J.

    2013-01-01

    Effective leadership is essential to circumnavigating the numerous obstacles confronting the healthcare industry. In addition, the current health system is suffering from a proficient leadership gap. However, identifying and developing executives with the greatest potential to become strong, up-and-coming healthcare C-level executive leaders can…

  17. How well are healthcare institutions prepared for disasters?

    NARCIS (Netherlands)

    Yzermans, J.

    2009-01-01

    Introduction: The better healthcare providers are educated and trained and the more they practice their skills, the more they are prepared when disaster strikes. However, little is known about the current state of preparedness for managing disasters among healthcare providers. Methods: Representativ

  18. A design thinking framework for healthcare management and innovation.

    Science.gov (United States)

    Roberts, Jess P; Fisher, Thomas R; Trowbridge, Matthew J; Bent, Christine

    2016-03-01

    The business community has learned the value of design thinking as a way to innovate in addressing people's needs--and health systems could benefit enormously from doing the same. This paper lays out how design thinking applies to healthcare challenges and how systems might utilize this proven and accessible problem-solving process. We show how design thinking can foster new approaches to complex and persistent healthcare problems through human-centered research, collective and diverse teamwork and rapid prototyping. We introduce the core elements of design thinking for a healthcare audience and show how it can supplement current healthcare management, innovation and practice.

  19. Costing Practices in Healthcare

    DEFF Research Database (Denmark)

    Chapman, Christopher; Kern, Anja; Laguecir, Aziza

    2014-01-01

    The rising cost of healthcare is a globally pressing concern. This makes detailed attention to the way in which costing is carried out of central importance. This article offers a framework for considering the interdependencies between a dominant element of the contemporary healthcare context, i.......e., Diagnosis Related Group (DRG) systems, and costing practices. DRG-based payment systems strongly influence costing practices in multiple ways. In particular, setting DRG tariffs requires highly standardized costing practices linked with specific skill sets from management accountants and brings other...

  20. Development and Application of a Wireless Sensor for Space Charge Density Measurement in an Ultra-High-Voltage, Direct-Current Environment.

    Science.gov (United States)

    Xin, Encheng; Ju, Yong; Yuan, Haiwen

    2016-10-20

    A space charge density wireless measurement system based on the idea of distributed measurement is proposed for collecting and monitoring the space charge density in an ultra-high-voltage direct-current (UHVDC) environment. The proposed system architecture is composed of a number of wireless nodes connected with space charge density sensors and a base station. The space charge density sensor based on atmospheric ion counter method is elaborated and developed, and the ARM microprocessor and Zigbee radio frequency module are applied. The wireless network communication quality and the relationship between energy consumption and transmission distance in the complicated electromagnetic environment is tested. Based on the experimental results, the proposed measurement system demonstrates that it can adapt to the complex electromagnetic environment under the UHVDC transmission lines and can accurately measure the space charge density.

  1. The role of family physicians contracted healthcare in China: A "Cardiotonic" or a "Band-Aid" for healthcare reform?

    Science.gov (United States)

    Tang, Qi; Song, Peipei; Xu, Lingzhong

    2016-09-05

    On June 6, 2016, as a mode expected to open a new prospect for tiered system of medical care in China, family physicians contracted healthcare was officially launched, intending to facilitate such healthcare be universal coverage by 2020.There are some doubts as to whether this goal is possible. The role of family physicians contracted healthcare in China should also be carefully identified. We hold that family physicians contracted healthcare will promote healthcare reform if it provides a "Cardiotonic" that alleviates the long-standing inequitable allocation of healthcare resources. However, this form of care faces many obstacles given the current state of medical care in China. It will just be a "Band-Aid" if the aforementioned issues of the shortage of family physicians, coordination with referring hospitals, and incomplete oversight are not resolved.

  2. Risk assessment of chlortetracycline, oxytetracycline, sulfamethazine, sulfathiazole, and erythromycin in aquatic environment: are the current environmental concentrations safe?

    Science.gov (United States)

    Ji, Kyunghee; Kim, Sunmi; Han, Sunyoung; Seo, Jihyun; Lee, Sangwoo; Park, Yoonsuk; Choi, Kyunghee; Kho, Young-Lim; Kim, Pan-Gyi; Park, Jeongim; Choi, Kyungho

    2012-10-01

    To understand potential risks of major pharmaceutical residues in waters, we evaluated ecotoxicities of five major veterinary pharmaceuticals, i.e., chlortetracycline, oxytetracycline, sulfamethazine, sulfathiazole, and erythromycin, which have been frequently detected in freshwater environment worldwide. We conducted acute and chronic toxicity tests using two freshwater invertebrates (Daphnia magna and Moina macrocopa) and a fish (Oryzias latipes). In general, D. magna exhibited greater sensitivity than M. macrocopa, and chronic reproduction was the most sensitive endpoints for both organisms. The population growth rate was adversely influenced by exposure to chlortetracycline, sulfamethazine, or sulfathiazole in water fleas, but reduction in population size was not expected. In O. latipes, the tested pharmaceuticals affected several reproduction related endpoints including time to hatch and growth. Based on the toxicity values from the present study and literature, algae appeared to be the most sensitive organism, followed by Daphnia and fish. Hazard quotients derived from measured environmental concentrations (MECs) and predicted no effect concentrations (PNECs) for erythromycin and oxytetracycline exceeded unity, suggesting that potential ecological effects at highly contaminated sites cannot be ruled out. Long-term consequences of veterinary pharmaceutical contamination in the environment deserve further investigation.

  3. Social marketing in healthcare

    Directory of Open Access Journals (Sweden)

    Radha Aras

    2011-08-01

    Full Text Available BackgroundSocial marketing is an important tool in the delivery ofhealthcare services. For any healthcare programme orproject to be successful, community/consumer participationis required. The four principles of social marketing can guidepolicymakers and healthcare providers to successfully planand implement health programmes.AimTo review the existing literature in order to project thebenefits of social marketing in healthcare.MethodA search of periodical literature by the author involvingsocial marketing and marketing concepts in health wascarried out. Items were identified initially through healthorientedindexing services such as Medline, Health STARand Cinahl, using the identifiers “social marketing“ and“marketing in health”. An extensive search was also carriedout on educational database ERIC.ResultsA literature review of various studies on social marketingindicated that the selection of the right product (accordingto the community need at the right place, with the rightstrategy for promotion and at the right price yields goodresults. However, along with technical sustainability(product, price, promotion and place, financialsustainability, institutional sustainability and marketsustainability are conducive factors for the success of socialmarketing.ConclusionThe purpose of this literature review was to ascertain thelikely effectiveness of social marketing principles andapproaches and behaviour change communication towardshealth promotion.It is important for all healthcare workers to understand andrespond to the public’s desires and needs and routinely useconsumer research to determine how best to help thepublic to solve problems and realise aspirations. Socialmarketing can optimise public health by facilitatingrelationship-building with consumers and making their liveshealthier.

  4. Organizational excellence in healthcare

    NARCIS (Netherlands)

    Does, R.J.M.M.; van den Heuvel, J.; Foley, K.J.; Hermel, P.

    2008-01-01

    Healthcare, as any other service operation, requires systematic innovation efforts to remain competitive, cost efficient and up to date. In this paper, we outline a methodology and present how principles of two improvement programs, i.e., Lean Thinking and Six Sigma, can be combined to provide an ef

  5. Building National Healthcare Infrastructure

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Thorseng, Anne

    2017-01-01

    This case chapter is about the evolution of the Danish national e-health portal, sundhed.dk, which provides patient-oriented digital services. We present how the organization behind sundhed.dk succeeded in establishing a national healthcare infrastructure by (1) collating and assembling existing ...

  6. Building National Healthcare Infrastructure

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Thorseng, Anne

    2017-01-01

    This case chapter is about the evolution of the Danish national e-health portal, sundhed.dk, which provides patient-oriented digital services. We present how the organization behind sundhed.dk succeeded in establishing a national healthcare infrastructure by (1) collating and assembling existing...

  7. Healthcare Fraud and Abuse

    OpenAIRE

    2009-01-01

    In Texas, a supplier of durable medical equipment was found guilty of five counts of healthcare fraud due to submission of false claims to Medicare. The court sentenced the supplier to 120 months of incarceration and restitution of $1.6 million.1

  8. Spirituality and healthcare organizations.

    Science.gov (United States)

    Graber, D R; Johnson, J A

    2001-01-01

    In recent years, the place of spirituality in organizations has become increasingly discussed and advocated. On a personal level, this may involve achieving personal fulfillment or spiritual growth in the workplace. In the broader sense, spirituality is considered by many to be essential in an organization's interactions with employees, customers, and the community. This article describes a possible role for greater spirituality in healthcare organizations, whose cultures in recent decades have largely excluded spirituality or religiousness. This is the consequence of an analytical, scientific perspective on human health; a reductionist paradigm in biomedical research; and the inevitable bureaucratization occurring in large healthcare organizations. However, in recent decades, numerous scientific articles supporting a connection between faith or religiousness and positive health outcomes have been published. Because individuals seek meaning when experiencing severe illnesses, and humans universally respond to compassion and caring, spirituality among healthcare workers and managers appears highly appropriate. The article describes organizational barriers to the greater inclusion of spirituality in healthcare and presents several approaches to developing a more caring organization. These include eliciting extensive input from all staff and clinicians in identifying core or common values, ethics, and a philosophy of caring. Programs should ensure that the views of nonreligious staff and patients are respected and that clear guidelines are established for the extent and nature of affective or spiritual support for patients.

  9. [Photography, language and healthcare].

    Science.gov (United States)

    Georgantelis, Cynthia

    2010-01-01

    Photography as an art is a way of accessing our emotions, naming them, understanding them and taking them into account in the healthcare relationship. A training session on the Photolangage method enables us not only to increase our knowledge but also to share our emotional experience and encourages reflection.

  10. Access to effective healthcare

    DEFF Research Database (Denmark)

    Høy, Bente

    2015-01-01

    Access to effective healthcare is in particular challenging for vulnerable and socially disadvantaged patients. Patients with chronic conditions are over-represented in these lower socioeconomic (LSES) groups. No generic review integrating the evidence on Self-Management support interventions in ...

  11. Untangling healthcare competition.

    Science.gov (United States)

    Harris, I C; McDaniel, R R

    1993-11-01

    Traditional approaches to competition may be inappropriate for healthcare providers. Neoclassical economics makes the implicit assumption that a single actor embodies consumption, compensation, and benefit from a transaction. In healthcare, this assumption does not hold. Instead, such actions are accomplished by three separate actors--consumers (physicians), customers (third-party payers), and clients (patients). A hospital simultaneously competes in three arenas. Hospitals compete for physicians along a technological dimension. Competition for third-party payers takes on a financial dimension. Hospitals compete for patients along a marketing dimension. Because of the complex marketplace interactions among hospital, patient, physician, and third-party payer, the role of price in controlling behavior is difficult to establish. The dynamics underlying the hospital selection decision--that is, the decision maker's expectations of services and the convenience of accessing services--must also be considered. Healthcare managers must understand the interrelationships involved in the three-pronged competitive perspective for several reasons. This perspective clarifies the multiple facets of competition a hospital faces. It also disentangles the actions previously fulfilled by the traditional single buyer. It illuminates the critical skills underlying the competition for each audience. Finally, it defines the primary criterion each audience uses in sorting among hospitals. Recognition of the multifaceted nature of competition among healthcare providers will help demystify market behavior and thereby improve internal organizational communication systems, managers' ability to focus on appropriate activities, and the hospital's ability to adapt to changing market conditions.

  12. Promoting healthcare innovation on the demand side.

    Science.gov (United States)

    Eisenberg, Rebecca S; Price, W Nicholson

    2017-04-01

    Innovation policy often focuses on fortifying the incentives of firms that develop and sell new products by offering them lucrative rights to exclude competitors from the market. Regulators also rely on these same firms-and on similar incentives-to develop information about the effects of their products in patients, despite their obvious conflict of interest. The result may be a distorted understanding that leads to overuse of expensive new medical technologies. Recent technological advances have put healthcare payers in an excellent position to play a larger role in future innovation to improve healthcare and reduce its costs. Insurance companies and integrated healthcare providers have custody of treasure troves of data about healthcare provision and outcomes that can yield valuable insights about the effects of medical treatment without the need to conduct costly clinical trials. Some integrated healthcare systems have seized upon this advantage to make notable discoveries about the effects of particular products that have changed the standard of care. Moreover, to the extent that healthcare payers can profit from reducing costs, they will seek to avoid inappropriate use of costly technologies. Greater involvement of payers in healthcare innovation thus offers a potential counterweight to the incentives of product sellers to promote excessive use of costly new products. In recent years, the federal government has sought to promote innovation through analysis of healthcare records in a series of initiatives; some picture insurers as passive data repositories, while others provide opportunities for insurers to take a more active role in innovation. In this paper, we examine the role of health insurers in developing new knowledge about the provision and effects of healthcare-what we call 'demand-side innovation'. We address the contours of this underexplored area of innovation and describe the behavior of participating firms. We examine the effects of current legal

  13. Patient satisfaction in outpatient healthcare services at secondary level vs. tertiary level

    Directory of Open Access Journals (Sweden)

    Velikj-Stefanovska Vesna

    2014-01-01

    Full Text Available Introduction. Patients satisfaction is a very important part of any clinical practice both for evaluation and improvement of healthcare services. Objective. The aim of this study was to determine patient satisfaction with public outpatient healthcare services at secondary and tertiary level and to assess possible differences between the two levels. Methods. In a quantitative cross-sectional study, a convenient sample of 646 patients who experienced public outpatient healthcare services at the secondary and tertiary level during the last two months were interviewed. Patient satisfaction questionnaires, with statements regarding various aspects of satisfaction, were completed during face-to-face interviews (response rate 84.6%. The research instrument was tested for internal consistency using the Cronbach’s coefficient alpha estimate. Results. The patients were significantly more satisfied in tertiary than in secondary outpatient healthcare facilities in almost all aspects of assessment related to general settings, nurse/administrative staff performance and physician performance (p<0.001. The patients in the secondary healthcare services (SHCS were more satisfied than in the tertiary healthcare services (THCS but only regarding the information on location (83.9% vs.78.3% and possibilities to enter and move inside the department (88.8% vs. 83.3%. Analysis of data for SHCS and THCS showed that there was no significant difference between the mean overall satisfaction scores with regard to patients’ gender, age, marital status, educational level, employment and number of visits. Conclusion. There is a need to improve the current level of patient-provider relationship and communication, as well as that of hospital environment, while special efforts should be made to address the problem of patient waiting time and hospital bureaucracy.

  14. The balanced scorecard: a potent tool for energizing and focusing healthcare organization management.

    Science.gov (United States)

    Chow, C W; Ganulin, D; Teknika, O; Haddad, K; Williamson, J

    1998-01-01

    The current environment for healthcare organizations contains many forces demanding unprecedented levels of change. These forces include changing demographics, increased customer expectations, increased competition, and intensified governmental pressure. Meeting these challenges will require healthcare organizations to undergo fundamental changes and to continuously seek new ways to create future value. This article provides explanation of a potent new management tool-the balanced scorecard-that can be used by healthcare organizations to meet these challenges. The article also presents the opinions of many high-level healthcare administrators that the balanced scorecard can be highly beneficial to healthcare organizations. It also summarizes these administrators' suggestions regarding the goals and measures that can make up an effective scorecard for a hospital as a whole, as well as for a specific subunit of a hospital. Interestingly, while no published report of balanced scorecard implementations in healthcare organizations exists, a number of administrators stated that they had fully implemented systems similar to the scorecard. These actions can be considered support for the scorecard's potential usefulness; at the same time, they suggest that some sharing of experiences will likely be available in the future. As all administrators are well aware, moving from concept to practice is often difficult. While the article includes some suggestions for scorecard development and implementation, each organization must engage in the full range of activities, from defining its mission to the selection of goals and strategies, and develop its own unique scorecard to assist progress toward the selected goals. As a starting point, Table 3 provides a timeline of some general events that may be common to all organizations during this process.

  15. Social marketing in healthcare.

    Science.gov (United States)

    Aras, Radha

    2011-01-01

    Social marketing is an important tool in the delivery of healthcare services. For any healthcare programme or project to be successful, community/consumer participation is required. The four principles of social marketing can guide policymakers and healthcare providers to successfully plan and implement health programmes. To review the existing literature in order to project the benefits of social marketing in healthcare. A search of periodical literature by the author involving social marketing and marketing concepts in health was carried out. Items were identified initially through health-oriented indexing services such as Medline, Health STAR and Cinahl, using the identifiers "social marketing" and "marketing in health". An extensive search was also carried out on educational database ERIC. A literature review of various studies on social marketing indicated that the selection of the right product (according to the community need) at the right place, with the right strategy for promotion and at the right price yields good results. However, along with technical sustainability (product, price, promotion and place), financial sustainability, institutional sustainability and market sustainability are conducive factors for the success of social marketing. The purpose of this literature review was to ascertain the likely effectiveness of social marketing principles and approaches and behaviour change communication towards health promotion. It is important for all healthcare workers to understand and respond to the public's desires and needs and routinely use consumer research to determine how best to help the public to solve problems and realise aspirations. Social marketing can optimise public health by facilitating relationship-building with consumers and making their lives healthier.

  16. The New England Healthcare EDI Network.

    Science.gov (United States)

    Glaser, John P; DeBor, Greg; Stuntz, Laurance

    2003-01-01

    The New England Healthcare EDI Network (NEHEN) is a collaborative of providers and payers in eastern Massachusetts that created, manages, and operates a shared insurance EDI infrastructure. NEHEN currently has 12 provider and three payer members, and supports over 1,000,000 insurance EDI transactions per month. This paper describes the philosophies that define the NEHEN business model and discusses its governance structure, technology, operational issues associated with its implementation, and its current status, along with lessons learned from the NEHEN undertaking.

  17. Current use of impact models for agri-environment schemes and potential for improvements of policy design and assessment

    DEFF Research Database (Denmark)

    Primdahl, Jorgen; Vesterager, Jens Peter; Finn, John A.

    2010-01-01

    Agri-Environment Schemes (AES) to maintain or promote environmentally-friendly farming practices were implemented on about 25% of all agricultural land in the EU by 2002. This article analyses and discusses the actual and potential use of impact models in supporting the design, implementation...... and evaluation of AES. Impact models identify and establish the causal relationships between policy objectives and policy outcomes. We review and discuss the role of impact models at different stages in the AES policy process, and present results from a survey of impact models underlying 60 agri-environmental...... schemes in seven EU member states. We distinguished among three categories of impact models (quantitative, qualitative or common sense), depending on the degree of evidence in the formal scheme description, additional documents, or key person interviews. The categories of impact models used mainly...

  18. [Consumer health-care information technology].

    Science.gov (United States)

    Sunyaev, A

    2013-06-01

    Consumer health-care information technology is intended to improve patients' opportunities to gather information about their own health. Ideally, this will be achieved through an improved involvement of existing data bases and an improved communication of information to patients and to care providers, if desired by patients. Additionally, further interconnection of existing and new systems and pervasive system design may be used. All consumer health-care information technology services are optional and leave patients in control of their medical data at all times. This article reflects the current status of consumer health-care information technology research and suggests further research areas that should be addressed. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Using technology to improve adolescent healthcare.

    Science.gov (United States)

    Hassan, Areej; Fleegler, Eric W

    2010-08-01

    To provide an overview of current technologies available for use in a primary healthcare setting, common indications for their use, and their effects on clinical practice. Technologies such as the internet and cell phones are an integral part of the daily lives of most adolescents. Many young people are comfortable using technology as part of their healthcare visits, especially when addressing sensitive issues. Over the past 5 years, a significant body of research has emerged introducing a variety of technologic modalities that screen for health-risk behaviors, educate patients about chronic diseases, promote preventive efforts, and provide interventions in the adolescent population. Findings suggest that integrating technology with clinical practice can improve quality of patient care. Technology can be used as an effective medium for the delivery of health information and interventions in an efficient, organized, and effective manner. Sharing knowledge of innovative tools, systems and programs will help develop further interventions and strategies to ensure optimal healthcare in young people.

  20. Physical restraint in healthcare settings.

    Science.gov (United States)

    Haidrani, Layla

    2017-03-30

    Essential facts In January, new guidance was drawn up for police and healthcare professionals, outlining for the first time how and when police officers should be involved in physically restraining people in healthcare settings in England and Wales.

  1. [Big data in medicine and healthcare].

    Science.gov (United States)

    Rüping, Stefan

    2015-08-01

    Healthcare is one of the business fields with the highest Big Data potential. According to the prevailing definition, Big Data refers to the fact that data today is often too large and heterogeneous and changes too quickly to be stored, processed, and transformed into value by previous technologies. The technological trends drive Big Data: business processes are more and more executed electronically, consumers produce more and more data themselves - e.g. in social networks - and finally ever increasing digitalization. Currently, several new trends towards new data sources and innovative data analysis appear in medicine and healthcare. From the research perspective, omics-research is one clear Big Data topic. In practice, the electronic health records, free open data and the "quantified self" offer new perspectives for data analytics. Regarding analytics, significant advances have been made in the information extraction from text data, which unlocks a lot of data from clinical documentation for analytics purposes. At the same time, medicine and healthcare is lagging behind in the adoption of Big Data approaches. This can be traced to particular problems regarding data complexity and organizational, legal, and ethical challenges. The growing uptake of Big Data in general and first best-practice examples in medicine and healthcare in particular, indicate that innovative solutions will be coming. This paper gives an overview of the potentials of Big Data in medicine and healthcare.

  2. Technology developments applied to healthcare/nursing.

    Science.gov (United States)

    Øyri, Karl; Newbold, Susan; Park, Hyeoun-Ae; Honey, Michelle; Coenen, Amy; Ensio, Anneli; Jesus, Elvio

    2007-01-01

    Future technology developments as applied to healthcare and particularly nursing were discussed. Emerging technologies such as genetics, small unobtrusive monitoring devices, use of information and communication technologies are as tools to not only facilitate but also promote communication among all parties of the healthcare process. These emerging technologies can be used for ubiquitous healthcare (u-health). The role of nursing in the u-health is fundamental and required for success and growth. Nursing's role will evolve as nurses become 'information-mediators' in a broader-sense than current role. All technologies will ultimately focus on the consumer through 'behind-the-scenes' data collection, which in turn will also allow nurses to analyze these data to improve care. We need to acknowledge an increased presence and or pervasiveness of information technologies as key components of quality healthcare. This sort of acknowledgment will help propel nursing, and healthcare, to increase use of these tools. To develop nurses with these types of skills the nursing education process will require a fundamental change to integrate these technology-sorts of tools as necessary elements for success.

  3. Lean six sigma in healthcare.

    Science.gov (United States)

    de Koning, Henk; Verver, John P S; van den Heuvel, Jaap; Bisgaard, Soren; Does, Ronald J M M

    2006-01-01

    Healthcare, as with any other service operation, requires systematic innovation efforts to remain competitive, cost efficient, and up-to-date. This article outlines a methodology and presents examples to illustrate how principles of Lean Thinking and Six Sigma can be combined to provide an effective framework for producing systematic innovation efforts in healthcare. Controlling healthcare cost increases, improving quality, and providing better healthcare are some of the benefits of this approach.

  4. People-centric sensing in assistive healthcare

    DEFF Research Database (Denmark)

    Giannetsos, Thanassis; Dimitriou, Tassos; Prasad, Neeli R.

    2011-01-01

    As the domains of pervasive computing and sensor networking are expanding, there is an ongoing trend towards assistive living and healthcare support environments that can effectively assimilate these technologies according to human needs. Most of the existing research in assistive healthcare...... follows a more passive approach and has focused on collecting and processing data using a static-topology and an application-aware infrastructure. However, with the technological advances in sensing, computation, storage, and communications, a new era is about to emerge changing the traditional view...... of sensor-based assistive environments where people are passive data consumers, with one where people carry mobile sensing elements involving large volumes of data related to everyday human activities. This evolution will be driven by people-centric sensing and will turn mobile phones into global mobile...

  5. Incineration: why this may be the most environmentally sound method of renal healthcare waste disposal.

    Science.gov (United States)

    James, Ray

    2010-09-01

    The environment and 'green' issues are currently being promoted in the healthcare sector through recently launched initiatives. This paper considers aspects of healthcare waste management, with particular reference to waste generated in dialysis units. With dialysis being dependent upon large amounts of disposables, it generates considerable volumes of waste. This paper focuses upon a typical haemodialysis unit, evaluating and quantifying the volumes and categories of waste generated. Each haemodialysis patient on thrice weekly dialysis generates some 323 kg per year of waste, of which 271 kg is classified as clinical. This equates to 1626 kg of (solid) clinical waste per dialysis bed, which is around three times the volume of clinical waste generated per general hospital bed. Waste disposal routes are considered and this suggests that present healthcare waste paradigms are outmoded. They do not allow for flexible approaches to solving what is a dynamic problem, and there is a need for new thinking models in terms of managing the unsustainable situation of disposal in constantly growing landfills. Healthcare waste management must be considered not only in terms of the environmental impact and potential long-term health effects, but also in terms of society's future energy requirements.

  6. Determining a healthcare organization's value.

    Science.gov (United States)

    Hahn, W

    1994-08-01

    As the consolidation activity among healthcare providers increases, it becomes more important than ever for healthcare financial managers to understand how to determine a healthcare organization's fair market value. There are many methods of determining an organization's value, but three general methods are the foundation of all others: the market comparable method, the underlying assets method, and the income, or cash flow, method.

  7. Current use of impact models for agri-environment schemes and potential for improvements of policy design and assessment.

    Science.gov (United States)

    Primdahl, Jørgen; Vesterager, Jens Peter; Finn, John A; Vlahos, George; Kristensen, Lone; Vejre, Henrik

    2010-06-01

    Agri-Environment Schemes (AES) to maintain or promote environmentally-friendly farming practices were implemented on about 25% of all agricultural land in the EU by 2002. This article analyses and discusses the actual and potential use of impact models in supporting the design, implementation and evaluation of AES. Impact models identify and establish the causal relationships between policy objectives and policy outcomes. We review and discuss the role of impact models at different stages in the AES policy process, and present results from a survey of impact models underlying 60 agri-environmental schemes in seven EU member states. We distinguished among three categories of impact models (quantitative, qualitative or common sense), depending on the degree of evidence in the formal scheme description, additional documents, or key person interviews. The categories of impact models used mainly depended on whether scheme objectives were related to natural resources, biodiversity or landscape. A higher proportion of schemes dealing with natural resources (primarily water) were based on quantitative impact models, compared to those concerned with biodiversity or landscape. Schemes explicitly targeted either on particular parts of individual farms or specific areas tended to be based more on quantitative impact models compared to whole-farm schemes and broad, horizontal schemes. We conclude that increased and better use of impact models has significant potential to improve efficiency and effectiveness of AES. (c) 2009 Elsevier Ltd. All rights reserved.

  8. Activity-Driven Computing Infrastructure - Pervasive Computing in Healthcare

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Christensen, Henrik Bærbak; Olesen, Anders Konring

    In many work settings, and especially in healthcare, work is distributed among many cooperating actors, who are constantly moving around and are frequently interrupted. In line with other researchers, we use the term pervasive computing to describe a computing infrastructure that supports work...... where users access a dynamic range of computing and software devices, where users can shift between devices, and where users move around while preserving their working environment. This paper describes our design of a pervasive activity-driven computing infrastructure. The main tenet in this approach...... is to preserve a user’s computational working context enabling him to shift between different devices while on the move and enabling him to interrupt and return to work-activities fluently. Furthermore, the infrastructure contains agents that propose new activities based on the user’s current context...

  9. [Healthcare value chain: a model for the Brazilian healthcare system].

    Science.gov (United States)

    Pedroso, Marcelo Caldeira; Malik, Ana Maria

    2012-10-01

    This article presents a model of the healthcare value chain which consists of a schematic representation of the Brazilian healthcare system. The proposed model is adapted for the Brazilian reality and has the scope and flexibility for use in academic activities and analysis of the healthcare sector in Brazil. It places emphasis on three components: the main activities of the value chain, grouped in vertical and horizontal links; the mission of each link and the main value chain flows. The proposed model consists of six vertical and three horizontal links, amounting to nine. These are: knowledge development; supply of products and technologies; healthcare services; financial intermediation; healthcare financing; healthcare consumption; regulation; distribution of healthcare products; and complementary and support services. Four flows can be used to analyze the value chain: knowledge and innovation; products and services; financial; and information.

  10. Healthcare Services Expenditure: A Case Study in Isfahan Province, Iran

    Directory of Open Access Journals (Sweden)

    Ferdosi

    2015-01-01

    Full Text Available Background Determining and understanding of healthcare costs and its financing method is one of the most important subjects understatement of which can cause such major problems as excessive health costs for households due to the high rate of out-of-pocket expenses. Objectives The current study aimed to analyze the healthcare costs and determine the share of Isfahan province, Iran, from the total healthcare costs of the country from 2006 to 2011. Materials and Methods It was a retrospective and descriptive-analytical study. The required statistical data were gathered from statistical yearbooks of the country and the province, the website of the World Bank, the statistics provided by the Healthcare Department of Isfahan and Kashan Universities of Medical Sciences and the statistical data provided by Iran Statistics Center in 2011, all covering the period of six years from 2006 to 2011. Excel software was used for data analysis and computations of the research. Results During this period, the annual growth average of healthcare and treatment costs were 12% and 20%, respectively. The share of the healthcare sector declined from 33% in 2006 to 25.4% in 2011. In other words, healthcare cost per capita, being about one second of the treatment cost per capita, reduced to a third of treatment per capita in 2011. Conclusions Efficient allocation of financial resources in the healthcare system based on specific goals and strategies, coordination of public and private sectors in providing healthcare services, the rising share of the healthcare sector in GDP of the province and the country, and the preference of prevention over treatment measures can affect achieving the healthcare system goals and surmount challenges such as pay-out-of-pocket and rising healthcare costs, particularly the costs of integrated treatment with full performance.

  11. Innovation Concepts in Healthcare

    CERN Document Server

    CERN. Geneva

    2010-01-01

    AbstractDemographic change and advances in medical science pose increased challenges to healthcare systems globally: The economic basis is aging and thus health is becoming more and more a productivity factor. At the same time, with today’s new communication possibilities the demand and expectations of effective medical treatment have been increased. This presentation will illustrate the need for the “industrialization” of healthcare in order to achieve highest results at limited budgets. Thereby, industrialization is not meaning the medical treatment based on the assembly line approach. Rather it is to recognize the cost of medical care as an investment with respective expectations on the return of the investment. Innovations in imaging and pharmaceutical products as well as in processes - that lead to similar medical results, but with lower efforts - are keys in such scenarios.BiographyProf. Dr. Hermann Requardt, 54, is a member of the Managing Board of Siemens AG and Chief Executive Officer of the He...

  12. Promoting healthcare innovation on the demand side

    Science.gov (United States)

    Eisenberg, Rebecca S.

    2017-01-01

    effects of current legal rules on demand-side innovation, including insurance regulation, intellectual property rules, privacy protections, and FDA regulation of new healthcare technologies. Throughout, we highlight many policy tools that government can use and is using to facilitate payer innovation outside the traditional toolkit of patents and exclusive rights. PMID:28852556

  13. Healthcare Industry Study

    Science.gov (United States)

    2003-01-01

    the system combine to produce an output that we call healthcare. That output can be measured in terms of access, cost and quality--the same market...may signal the early stages of a massive biological attack. Epidemiologists call this strategy “syndromic” surveillance because it looks for... Holahan . “How Much Medical Care Do the Uninsured U.S. and Who Pays for It?” Health Affairs, February 12, 2003. http://www.healthaffairs.org

  14. Strategic planning: how medical practices can succeed in a post-healthcare-reform world.

    Science.gov (United States)

    Howrigon, Ron

    2013-01-01

    This article addresses the recent trend of physicians being pressured to sell to hospitals in order to stay in practice. The author utilizes his experience in the healthcare industry to identify causes of this trend and ways in which physician groups can avoid finding themselves in these situations. The author uses real data from an existing medical practice to support his ideas and demonstrate how implementing change now will be beneficial for the success of this medical practice in the future. Objective practice evaluation and the execution of an efficient strategic plan are cited as the most important factors contributing to the financial solvency of medical practices in the current and future healthcare environment.

  15. Integrated healthcare information systems.

    Science.gov (United States)

    Miller, J

    1995-01-01

    When it comes to electronic data processing in healthcare, we offer a guarded, but hopeful, prognosis. To be sure, the age of electronic information processing has hit healthcare. Employers, insurance companies, hospitals, physicians and a host of ancillary service providers are all being ushered into a world of high speed, high tech electronic information. Some are even predicting that the health information business will grow from $20 billion to over $100 billion in a decade. Yet, out industry lags behind other industries in its overall movement to the paperless world. Selecting and installing the most advanced integrated information system isn't a simple task, as we've seen. As in life, compromises can produce less than optimal results. Nevertheless, integrated healthcare systems simply won't achieve their goals without systems designed to support the operation of a continuum of services. That's the reality! It is difficult to read about the wonderful advances in other sectors, while realizing that many trees still fall each year in the name of the health care industry. Yes, there are some outstanding examples of organizations pushing the envelop in a variety of areas. Yet from a very practical standpoint, many (like our physician's office) are still struggling or are on the sidelines wondering what to do. Given the competitive marketplace, organizations without effective systems may not have long to wonder and wait.

  16. Military Healthcare Battlefield Immunity.

    Science.gov (United States)

    Kelly, J C

    2012-12-01

    The combatant soldier on the battlefield remains protected from any claim in negligence by the doctrine of combat immunity for any negligent act or omission they may make when fighting. In other words, the combatant soldier does not owe a fellow soldier a duty of care on the battlefield, as the duty of care is non-justiciable. However, the non-combatant Military Healthcare Professional, although sometimes operating in the same hostile circumstances as the fighting soldier, is unlikely to benefit from combat immunity for any clinical negligence on the battlefield. This is because they continue to owe their patient a duty of care, although this has not been tested in the courts. This paper considers if any military healthcare professional could ever benefit from combat immunity, which is unlikely due to their non-combatant status. Instead, this paper suggests that a modified form of immunity; namely, Military Healthcare Battlefield Immunity could be a new, unique and viable doctrine, however, this could only be granted in rare circumstances and to a much lesser degree than combat immunity.

  17. Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis

    Science.gov (United States)

    Buttigieg, Sandra C.; Schuetz, Marcus; Bezzina, Frank

    2016-01-01

    The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state’s health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta. PMID:27683658

  18. Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis.

    Science.gov (United States)

    Buttigieg, Sandra C; Schuetz, Marcus; Bezzina, Frank

    2016-01-01

    The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state's health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta.

  19. Magnetic Reconnection in the Heliospheric Current Sheet: The Implications of the Different Environments Seen by the VoyagerSpacecraft

    Science.gov (United States)

    Swisdak, M. M.; Drake, J. F.; Opher, M.

    2014-12-01

    The magnetic field abutting the heliospheric current sheet (HCS) is primarily in the azimuthal direction, either east-to-west or west-to-east. Mis-alignment of the solar rotational and magnetic axesleads to the characteristic ballerina-skirt shape of the HCS and during the solar cycle there can be large excursions in the sheet's latitudinal extent. Voyager 2's observations of energetic electrondropouts are related to its crossing of this boundary. Magnetic reconnection is also thought to occur as the HCS compresses and narrows between the termination shock and the heliopause. Near theequator the two HCS field alignments are present in roughly equal amounts, while near the edges the distribution can be considerably skewed. This will lead to substantial differences in the environmentsof the two Voyager spacecraft since Voyager 1 is north of the equator, but firmly in the sector region, while Voyager 2 is south of the equator and skirting the edges of the sector region. We presentparticle-in-cell simulations demonstrating the consequences of the reconnection of asymmetric amounts of flux. In particular, we will discuss Voyager 2's remaining time in the heliosphere -- including theimplications for the solar wind velocity, energetic particle transport, and the expected structure of Voyager 2's heliopause crossing -- and compare it with the data collected from Voyager 1.

  20. Global Security Rule Sets An Analysis of the Current Global Security Environment and Rule Sets Governing Nuclear Weapons Release

    Energy Technology Data Exchange (ETDEWEB)

    Mollahan, K; Nattrass, L

    2004-09-30

    America is in a unique position in its history. In maintaining its position as the world's only superpower, the US consistently finds itself taking on the role of a global cop, chief exporter of hard and soft power, and primary impetus for globalization. A view of the current global situation shows an America that can benefit greatly from the effects of globalization and soft power. Similarly, America's power can be reduced significantly if globalization and its soft power are not handled properly. At the same time, America has slowly come to realize that its next major adversary is not a near peer competitor but terrorism and disconnected nations that seek nuclear capabilities. In dealing with this new threat, America needs to come to terms with its own nuclear arsenal and build a security rule set that will establish for the world explicitly what actions will cause the US to consider nuclear weapons release. This rule set; however, needs to be established with sensitivity to the US's international interests in globalization and soft power. The US must find a way to establish its doctrine governing nuclear weapons release without threatening other peaceful nations in the process.

  1. Exit interviews to reduce turnover amongst healthcare professionals.

    Science.gov (United States)

    Webster, Joan; Flint, Anndrea

    2014-08-19

    Exit interviews are widely used in healthcare organisations to identify reasons for staff attrition, yet their usefulness in limiting turnover is unclear. To determine the effectiveness of various exit interview strategies in decreasing turnover rates amongst healthcare professionals. We searched the Cochrane EPOC Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL), Issue 11, 2012; MEDLINE, Ovid (1950- ); EMBASE, Ovid (1947- ); CINAHL, EbscoHost (1980- ), and PsycINFO, OVID (1806-) between October 31 and November 6, 2012. We also screened the reference lists of included studies and relevant reviews; and searched trial registries for planned and on-going studies. We did not restrict searches by language or publication date. Randomised controlled trials, controlled clinical trials, controlled before-after studies and interrupted time series studies comparing turnover rates between healthcare professionals who had undergone one form of exit interview with another form of exit interview or with no interview. Two review authors independently assessed trial quality and extracted data. The original search identified 1560 citations, of which we considered 19 potentially relevant. The two authors independently reviewed the abstracts of these studies and retrieved the full texts of eight studies. We excluded all eight following independent assessment; they were either interviews, commentaries on how to do an exit interview or descriptive studies about reasons for leaving. We found no studies that matched our inclusion criteria. For this first update, we screened 2220 citations and identified no new studies. Evidence about the effectiveness of exit interviews to reduce turnover is currently not available. However, exit interviews may provide useful information about the work environment which, in turn, may be useful in the development of interventions to reduce turnover.

  2. Making the future of healthcare.

    Science.gov (United States)

    Gray, Muir

    2008-01-01

    Our healthcare services face radical changes. We are in the middle of the "third healthcare revolution", driven by patients, information technology, and knowledge. Attitudes are changing with a revolution called "consumerism", characterized by expectations for better healthcare and more transparent decision-making. As knowledge-based authority becomes increasingly important, knowledge management will be a major responsibility of healthcare management in the 21st century, and the ongoing information technology revolution will enable efficient knowledge communication to clinicians and patients. As professionals usually lag 1-2 decades behind the "Zeitgeist", the challenge is to adapt to the revolution and help shape the healthcare services of the future.

  3. Advances in the study of current-use non-PBDE brominated flame retardants and dechlorane plus in the environment and humans

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The fate of the high production volume,currently in use,and not regulated non-polybrominated diphenyl ether(PBDE) flame retardants,such as tetrabromobisphenol A(TBBPA) ,hexabromocyclododecane(HBCD) and dechlorane plus(DP),and the alternative flame retardants of PBDE,such as BTBPE and DBDPE,in the environment has attracted increasing attention and aroused concern due to the increasing regulation and phasing-out of PBDEs.This paper reviews the distribution,bioaccumulation,human exposure and environmental behavior of those non-PBDE flame retardants in various environmental compartments.The data gaps and needs for future research are discussed.

  4. Risk factors for stereotypic behavior and self-biting in rhesus macaques (Macaca mulatta): animal's history, current environment, and personality.

    Science.gov (United States)

    Gottlieb, Daniel H; Capitanio, John P; McCowan, Brenda

    2013-10-01

    Captive rhesus macaques sometimes exhibit undesirable abnormal behaviors, such as motor stereotypic behavior (MSB) and self-abuse. Many risk factors for these behaviors have been identified but the list is far from comprehensive, and large individual differences in rate of behavior expression remain. The goal of the current study was to determine which experiences predict expression of MSB and self-biting, and if individual differences in personality can account for additional variation in MSB expression. A risk factor analysis was performed utilizing data from over 4,000 rhesus monkeys at the California National Primate Research Center. Data were analyzed using model selection, with the best fitting models evaluated using Akaike Information Criterion. Results confirmed previous research that males exhibit more MSB and self-biting than females, MSB decreases with age, and indoor reared animals exhibit more MSB and self-biting than outdoor reared animals. Additionally, results indicated that animals exhibited less MSB and self-biting for each year spent outdoors; frequency of room moves and number of projects positively predicted MSB; pair separations positively predicted MSB and self-biting; pair housed animals expressed less MSB than single housed and grate paired animals; and that animals expressed more MSB and self-biting when in bottom rack cages, or cages near the room entrance. Based on these results we recommend limiting exposure to these risk factors when possible. Our results also demonstrated a relationship between personality and MSB expression, with animals low on gentle temperament, active in response to a human intruder, and high on novel object contact expressing more MSB. From these results we propose that an animal's MSB is related to its predisposition for an active personality, with active animals expressing higher rates of MSB.

  5. Providing Early Intervention within Natural Environments: A Cross-Cultural Comparison

    Science.gov (United States)

    Rantala, Anja; Uotinen, Sanna; McWilliam, R. A.

    2009-01-01

    The purposes of this study were to determine the state of current practice in early intervention in Finland and to compare them to American data. Professional women (N = 52), representing child care, elementary school, healthcare, and social work, completed the Families in Natural Environments Scale of Service Evaluation, a 34-item questionnaire…

  6. The metaphor of nurse as guest with ethical implications for nursing and healthcare.

    Science.gov (United States)

    Milton, Constance L

    2005-10-01

    Current healthcare advertising and customer relations terminology acknowledge that healthcare providers, including nurses, are to act as hosts for persons who enter into healthcare agencies and institutions. Indeed, much has been written aligning nursing and other healthcare services with consumer-oriented roles of the hospitality service industry commonly associated with hotels and restaurants. From a human becoming perspective, this article discusses possible ethical, administrative, and practice implications of nurses acting as guests entering into the lives of those we serve.

  7. Regional Healthcare Effectiveness

    Directory of Open Access Journals (Sweden)

    Olga Vladimirovna Kudelina

    2016-03-01

    Full Text Available An evaluation of healthcare systems effectiveness of the regions of the Russian Federation (federal districts was conducted using the Minmax method based on the data available at the United Interdepartmental Statistical Information System. Four groups of components (i.e. availability of resources; use of resources; access to resources and medical effectiveness decomposed into 17 items were analyzed. The resource availability was measured by four indicators, including the provision of doctors, nurses, hospital beds; agencies providing health care to the population. Use of resources was measured by seven indicators: the average hospital stay, days; the average bed occupancy, days; the number of operations per 1 physician surgical; the cost per unit volume of medical care: in outpatient clinics, day hospitals, inpatient and emergency care. Access to the resources was measured by three indicators: the satisfaction of the population by medical care; the capacity of outpatient clinics; the average number of visits to health facility. The medical effectiveness was also measured by three indicators: incidence with the "first-ever diagnosis of malignancy"; life expectancy at birth, years; the number of days of temporary disability. The study of the dynamics of the components and indexes for 2008–2012 allows to indicate a multidirectional influence on the regional healthcare system. In some federal districts (e.g. North Caucasian, the effectiveness decreases due to resource availability, in others (South, North Caucasian — due to the use of resources, in others (Far Eastern, Ural — due to access to resources. It is found that the effectiveness of the healthcare systems of the federal districts differs significantly. In addition, the built matrix proves the variability the of effectiveness (comparison of expenditures and results of healthcare systems of the federal districts of the Russian Federation: the high results can be obtained at high costs

  8. Improving Healthcare through Lean Management

    DEFF Research Database (Denmark)

    Nielsen, Anders Paarup; Edwards, Kasper

    2011-01-01

    The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...... still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading...

  9. Improving Healthcare through Lean Management

    DEFF Research Database (Denmark)

    Nielsen, Anders Paarup; Edwards, Kasper

    2011-01-01

    The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...... still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading...

  10. Development of Personal Wellness Information Model for Pervasive Healthcare

    Directory of Open Access Journals (Sweden)

    Antto Seppälä

    2012-01-01

    Full Text Available Pervasive healthcare and citizen-centered care paradigm are moving the healthcare outside the hospital environment. Healthcare delivery is becoming more personalized and decentralized, focusing on prevention and proactive services with a complete view of health and wellbeing. The concept of wellness has been used to describe this holistic view of health, which focuses on physical, social, and mental well-being. Pervasive computing makes it possible to collect information and offer services anytime and anywhere. To support pervasive healthcare with wellness approaches, semantic interoperability is needed between all actors and information sources in the ecosystem. This study focuses on the domain of personal wellness and analyzes related concepts, relationships, and environments. As a result of this study, we have created an information model that focuses on the citizens’ perspectives and conceptualizations of personal wellness. The model has been created based on empirical research conducted with focus groups.

  11. System Interoperability Study for Healthcare Information System with Web Services

    Directory of Open Access Journals (Sweden)

    J. K. Zhang

    2007-01-01

    Full Text Available This paper describes the use of a new distributed middleware technology ‘Web Services’ in the proposed Healthcare Information System (HIS to address the issue of system interoperability raised from existing Healthcare Information systems. With the development of HISs, hospitals and healthcare institutes have been building their own HISs for processing massive healthcare data, such as, systems built up for hospitals under the NHS (National Health Service to manage patients’ records. Nowadays many healthcare providers are willing to integrate their systems’ functions and data for information sharing. This has raised concerns in data transmission, data security and network limitation. Among these issues, system and language interoperability are one of most obvious issues since data and application integration is not an easy task due to differences in programming languages, system platforms, Database Management Systems (DBMS used within different systems. As a new distributed middleware technology, Web service brings an ideal solution to the issue of system and language interoperability. Web service has been approved to be very successful in many commercial applications (e.g. Amazon.com, Dell computer, etc., however it is different to healthcare information system. As the result, Web Service-based Integrated Healthcare Information System (WSIHIS is proposed to address the interoperability issue of existing HISs but also to introduce this new technology into the healthcare environment.

  12. TEAMWORK IN THE FAMILY HEALTHCARE STRATEGY

    Directory of Open Access Journals (Sweden)

    Ana Claudia Pinheiro Garcia

    2015-07-01

    Full Text Available Backgound and Objectives: The healthcare evaluation aims to improve the capacity to provide adequate assistance and better healthcare to the population. Through an evaluation process, one can rethink the practices that are being offered and subsidize managers for adequacy of services. The aim of this study is to evaluate teamwork, from the perspective of professionals who work in the family health strategy. Method: a descriptive cross-sectional study was performed. The population comprised healthcare professionals working with the family health strategy in the municipalities of the state of Espirito Santo with more than 50,000 inhabitants. Data collection was performed through a semi-structured questionnaire between July 2012 and August 2013. Results: there was a positive evaluation of the professionals regarding teamwork, with most considering the professional relationship always or most of the time good and respectful; the relationships were rarely considered to be confrontational; the organization of the activities was performed jointly, with rare occurrence of difficulties regarding domestic work and the community; the work was always or most of the time based on pre-established routines, as well as the capacity to review routines and procedures and the encouragement for community participation. Conclusion: One can observe the challenge and responsibility of healthcare professionals in acknowledging teamwork and its relevance to changes in the practices of care and management of the Brazilian Unified Health System. KEYWORDS: Health Evaluation; Primary Health care; Family Health; Working Environment.

  13. Building a Healthcare System's Innovation Program.

    Science.gov (United States)

    Conger, Michelle D

    2016-01-01

    OSF HealthCare, based in Peoria, Illinois, has developed an innovative strategy to adapt to the changes and forces disrupting the healthcare environment. This strategy evolved organically from the performance improvement efforts we began more than 15 years ago, as well as from the lessons we learned from years of research into the innovative practices and platforms of other healthcare institutions and of companies in other industries. More important, the strategy reflects our mission "to serve persons with the greatest care and love."The OSF innovation model has three components: internal innovations, partnering with external entities, and validating innovations through simulation. OSF has an ongoing and comprehensive commitment to innovation. Examples include our initiative to transform our model of care in primary care clinics by expanding access, reducing costs, and increasing efficiency; our partnerships with outside entities to find revolutionary solutions and products in which we can invest; and our establishment of a world-class simulation and education center.OSF HealthCare could not do any of this if it lacked the support of its people. To that end, we continue to work on embedding a culture of innovation across all of our facilities. Ours is a culture in which everyone is encouraged to voice creative ideas and no one is afraid to fail-all for the betterment of our organization and the patients we serve.

  14. Newborn healthcare in urban India

    Science.gov (United States)

    Sharma, J; Osrin, D; Patil, B; Neogi, S B; Chauhan, M; Khanna, R; Kumar, R; Paul, V K; Zodpey, S

    2016-01-01

    The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths. The available evidence suggests that socio-economic inequalities and poor environment pose major challenges for newborn health. Moreover, fragmented and weak public health system, multiplicity of actors and limited capacity of public health planning further constrain the delivery of quality and affordable health care service. Though healthcare is concentrated in urban areas, delay in deciding to seek health care, reaching a source of it and receiving appropriate care affects the health outcomes disproportionately. However, a few city initiatives and innovations piloted in different states and cities have brought forth the evidences of effectiveness of different strategies. Recently launched National Urban Health Mission (NUHM) provides an opportunity for strategic thinking and actions to improve newborn health outcomes in India. There is also an opportunity for coalescence of activities around National Health Mission (NHM) and Reproductive, Maternal, Newborn and Child Health+Adolescent (RMNCH+A) strategy to develop feasible and workable models in different urban settings. Concomitant operational research needs to be carried out so that the obstacles, approaches and response to the program can be understood. PMID:27924107

  15. Healthcare public key infrastructure (HPKI) and non-profit organization (NPO): essentials for healthcare data exchange.

    Science.gov (United States)

    Takeda, Hiroshi; Matsumura, Yasushi; Nakagawa, Katsuhiko; Teratani, Tadamasa; Qiyan, Zhang; Kusuoka, Hideo; Matsuoka, Masami

    2004-01-01

    To share healthcare information and to promote cooperation among healthcare providers and customers (patients) under computerized network environment, a non-profit organization (NPO), named as OCHIS, was established at Osaka, Japan in 2003. Since security and confidentiality issues on the Internet have been major concerns in the OCHIS, the system has been based on healthcare public key infrastructure (HPKI), and found that there remained problems to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority by contracting with the Ministry of Economics and Trading Industries in 2003. This paper describes the experimental design with NPO and the results of the study concerning message security and HPKI. The developed system has been operated practically in Osaka urban area.

  16. The standardized patient encounter: a dynamic educational approach to enhance students' clinical healthcare skills.

    Science.gov (United States)

    Herge, E Adel; Lorch, Arlene; Deangelis, Tina; Vause-Earland, Tracey; Mollo, Kimberly; Zapletal, Audrey

    2013-01-01

    Occupational therapy educators are challenged to prepare students entering the profession to be skilled in assessment, critical thinking, self-analysis, and decision-making. Simulation is an effective strategy used in medical and nursing curriculums to develop or enhance critical thinking, self-analysis, and decision-making skills. Through simulated learning activities, such as encounters with standardized patients (SP), students develop skills in decision-making, clinical reasoning, and interpersonal communication, skills necessary to function effectively in the current health care environment. This paper describes the process for integrating SP encounters in a professional healthcare curriculum for occupational therapy graduate students. Evidence that supports the use of simulation in healthcare curriculums for health profession students is explored. An example of an SP encounter in one occupational therapy course is described to illustrate how students engage in higher-level thinking as they administer an assessment tool and interact with an SP. The process of developing and evaluating the SP encounter is described and the outcomes are presented. The authors believe the SP experience is a viable teaching method in preparing competent, reflective practitioners for tomorrow's healthcare environment.

  17. Current studies on nursing work environment and strategies for improvement of nursing work environment%护理工作环境的研究探讨与改革策略

    Institute of Scientific and Technical Information of China (English)

    尤黎明; 刘佳丽; 郑晶; 刘可

    2016-01-01

    The important role of nursing work environment has received much attention in the management of nursing workforce and the quality of health care services. This paper analyzed current studies on nursing work environment, and suggested that the government and hospital administrators pay more attention to the development of nursing workforce, adequate clinical nurse staffing levels and promoting healthy work environment for nurses.%护理工作环境在护士队伍建设和护理服务质量管理中的重要地位在近年来受到广泛关注。本文分析了国内外护理工作环境的研究结果及国外护理工作环境的改革策略,建议我国各级卫生行政部门和医疗卫生机构重视护理人才队伍建设,切实保障临床护理人力配置,共同努力构建健康的护理工作环境。

  18. Constructing Healthcare Spaces

    DEFF Research Database (Denmark)

    Harty, Chris; Holm Jacobsen, Peter; Tryggestad, Kjell

    2015-01-01

    The aim of this paper is to inquire into the role of project visualisations in shaping healthcare spaces and practices. The study draws upon an ethnographic field study from a large on-going hospital construction project in Denmark, and focuses on the early phases of on-boarding the design team...... process), 2.Organisational space (work processes and their spatial-temporal dimension) and; 3. Economic space (cost estimations and budgets). In practice, our findings show that the visualisations of different yet connected project spaces and the development of future clinical practices is related...

  19. Constructing Healthcare Spaces

    DEFF Research Database (Denmark)

    Harty, Chris; Holm Jacobsen, Peter; Tryggestad, Kjell

    2015-01-01

    The aim of this paper is to inquire into the role of project visualisations in shaping healthcare spaces and practices. The study draws upon an ethnographic field study from a large on-going hospital construction project in Denmark, and focuses on the early phases of on-boarding the design team...... into the project organisation. The theoretical contribution concerns the ways in which project visualisations plays an active role in developing novel conceptions of space and how these are mobilized in the process of on-boarding, in terms of 1. Design space (especially the engagement of users in the design...

  20. The clinical experiences of dyslexic healthcare students

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Fred [Directorate of Radiography, School of Health Care Professions, University of Salford, Allerton Building, Salford, Greater Manchester M6 6PU (United Kingdom)], E-mail: f.j.murphy@salford.ac.uk

    2009-11-15

    This paper reflects on the experiences of healthcare students with dyslexia in order to raise awareness of the potential challenges for dyslexic student radiographers and their clinical educators. With widening participation policies it is likely that the number of student radiographers with specific learning difficulties such as dyslexia will continue to increase. A review of the literature associated with dyslexia in healthcare education was performed in order to provide an overview of the current position. Although Higher Education Institutions (HEIs) have embraced the support and learning opportunities for dyslexic students at university, evidence would suggest that this is not reflected in the clinical departments. The current literature strongly suggests that since the risk of errors with clinical information is far more significant within the clinical placement, there is an immediate requirement for greater understanding, robust support and risk assessment systems. This review considers the problems experienced by dyslexic students, coping strategies they employ and the possible implications for clinical radiography education.

  1. Radiation Environment at LEO in the frame of Space Monitoring Data Center at Moscow State University - recent, current and future missions

    Science.gov (United States)

    Myagkova, Irina; Kalegaev, Vladimir; Panasyuk, Mikhail; Svertilov, Sergey; Bogomolov, Vitaly; Bogomolov, Andrey; Barinova, Vera; Barinov, Oleg; Bobrovnikov, Sergey; Dolenko, Sergey; Mukhametdinova, Ludmila; Shiroky, Vladimir; Shugay, Julia

    2016-04-01

    Radiation Environment of Near-Earth space is one of the most important factors of space weather. Space Monitoring Data Center of Moscow State University provides operational control of radiation conditions at Low Earth's Orbits (LEO) of the near-Earth space using data of recent (Vernov, CORONAS series), current (Meteor-M, Electro-L series) and future (Lomonosov) space missions. Internet portal of Space Monitoring Data Center of Skobeltsyn Institute of Nuclear Physics of Lomonosov Moscow State University (SINP MSU) http://swx.sinp.msu.ru/ provides possibilities to control and analyze the space radiation conditions in the real time mode together with the geomagnetic and solar activity including hard X-ray and gamma- emission of solar flares. Operational data obtained from space missions at L1, GEO and LEO and from the Earth's magnetic stations are used to represent radiation and geomagnetic state of near-Earth environment. The models of space environment that use space measurements from different orbits were created. Interactive analysis and operational neural network forecast services are based on these models. These systems can automatically generate alerts on particle fluxes enhancements above the threshold values, both for SEP and relativistic electrons of outer Earth's radiation belt using data from GEO and LEO as input. As an example of LEO data we consider data from Vernov mission, which was launched into solar-synchronous orbit (altitude 640 - 83 0 km, inclination 98.4°, orbital period about 100 min) on July 8, 2014 and began to receive scientific information since July 20, 2014. Vernov mission have provided studies of the Earth's radiation belt relativistic electron precipitation and its possible connection with atmosphere transient luminous events, as well as the solar hard X-ray and gamma-emission measurements. Radiation and electromagnetic environment monitoring in the near-Earth Space, which is very important for space weather study, was also realised

  2. 基层妇幼保健院感染管理现状与对策%Current situation and countermeasure of infection management in grass-roots healthcare hospital of women and children

    Institute of Scientific and Technical Information of China (English)

    王银玲

    2011-01-01

    OBJECTIVE To explore the general problems and propose countermeasure on infection management in the healthcare hospital of women and children. METHODS From May to Jul 2009, the corresponding measures were proposed to the problems in the check of hospital infection on 7 hospitals of women and children and the effects were evaluated in Nov. RESULTS Infection management organizations was imperfect, the awareness to the management was weak, the construction layout was irrational and the management of medical waste control irregular etc. is the common problems on Infection Management in the grass-roots healthcare hospital of women and children. CONCLUSION Through perfecting the organization, strengthening the training, establishing the concept of infection prevention according to the actual situation to improve building layout, controlling the link of quality in time and focusing on the effective management to the outstanding problems, the good effects on infection control can be achieved.%目的 探讨基层妇幼院感染管理中存在的共性问题,提出对策.方法 对2009年5-7月晋城地区7所妇幼院医院感染管理督导检查中发现的问题提出相应措施,于11月进行效果评估.结果 感染管理组织机构不健全、管理意识淡薄、建筑布局不合理、医疗废物管理不规范等,是目前基层妇幼院感染管理中存在的共性问题.结论 通过健全组织机构、加强培训、树立感染控制意识、改进建筑布局、实时环节质量控制、注重突出问题的有效管理对基层妇幼院感染控制有良好效果.

  3. Mapping the Tidewater Submarine and Ice-Marginal Environment Using Interferometric Bathymetry, Ground-Based LiDAR and Current Velocities; Hubbard Glacier, Alaska

    Science.gov (United States)

    Finnegan, D. C.; Lawson, D. E.; Butler, W.; Waller, T.; Pratt, T.

    2009-12-01

    The seasonal advance and retreat of tidewater glaciers is a relatively well-documented phenomenon. But our understanding of the processes and conditions within the ice-marginal submarine environment that drive or result from this activity is limited. Capturing holistic information within this environment such as bathymetric topography, hydrographic measurements and geospatial information about the terminus itself is often limited to discrete measurements far from the terminus grounding line or lack the detail and scale necessary to identify features that may be indicative of process. To understand these processes, it is essential to accurately obtain data at resolutions that are sufficient to understand the geologic and marine environment. This paper describes the results of a first-of-its-kind survey of the submarine and ice-marginal terrestrial environment of the Hubbard Glacier tidewater terminus. Hubbard Glacier is the largest non-polar tidewater glacier in the world. It encompasses an area of 3500 sq km and flows 120 km from the flanks of Mt Logan (5959 m) in the Wrangell St. Elias Mountains (Canada) to sea level where its terminus widens to ~13 km. In contrast to most glaciers in Southeast Alaska, Hubbard Glacier continues to advance and thicken and is predicted to continue for the foreseeable future. We utilize a multi-sensor fusion approach that integrates high-resolution interferometric (swath-based) multibeam bathymetry with high-resolution ground-based LiDAR topography and current velocity profiles to provide a detailed look at the section of the glacier where significant ice advance and potential ice-damming occurs. Through simultaneous collection of these data we are able to precisely map the topography of the sea floor adjacent to and at the grounding line of the ice terminus while simultaneously mapping the ice terminus and surrounding terrain to create a complete 3D topographic model of the aerial and submarine environment. These data allow for

  4. Waste management in primary healthcare centres of Iran.

    Science.gov (United States)

    Mesdaghinia, Alireza; Naddafi, Kazem; Mahvi, Amir Hossein; Saeedi, Reza

    2009-06-01

    The waste management practices in primary healthcare centres of Iran were investigated in the present study. A total of 120 primary healthcare centres located across the country were selected using the cluster sampling method and the current situation of healthcare waste management was determined through field investigation. The quantities of solid waste and wastewater generation per outpatient were found to be 60 g outpatient(-1) day(-1) and 26 L outpatient(-1) day(-1), respectively. In all of the facilities, sharp objects were separated almost completely, but separation of other types of hazardous healthcare solid waste was only done in 25% of the centres. The separated hazardous solid waste materials were treated by incineration, temporary incineration and open burning methods in 32.5, 8.3 and 42.5% of the healthcare centres, respectively. In 16.7% of the centres the hazardous solid wastes were disposed of without any treatment. These results indicate that the management of waste materials in primary healthcare centres in Iran faced some problems. Staff training and awareness, separation of healthcare solid waste, establishment of the autoclave method for healthcare solid waste treatment and construction of septic tanks and disinfection units in the centres that were without access to a sewer system are the major measures that are suggested for improvement of the waste management practices.

  5. [Improving healthcare and its manageability].

    Science.gov (United States)

    Eddes, Eric Hans

    2013-01-01

    Healthcare in the Netherlands is facing serious challenges. With an ageing population, the consumption of healthcare is on the rise. Quality needs to go up while costs have to go down. The Netherlands Institute for Social Research estimates that healthcare costs, as a percentage of the Gross Domestic Product, will rise from 13% in 2011 (90 billion euros) up to 31% in 2040. Clear choices need to be made in the near future; otherwise, the cost of healthcare will become prohibitive. This commentary explains why volume-directed healthcare alone is not the magic answer. Besides criteria related to process and structure, we are also in need of robust and valid data. Clinical auditing combined with patient-reported outcome measures (PROMs) and financial data will give the additional tools needed to improve and manage healthcare.

  6. Global implications of China's healthcare reform.

    Science.gov (United States)

    Yan, Fei; Tang, Shenglan; Zhang, Jian

    2016-01-01

    The ongoing healthcare reform in China has a powerful spillover effect beyond the health sector and the borders of China. A successful completion of the Chinese reform will offer a new model for social justice development, shift the global economy toward sustainability and create a new hub for science and technology in medical and health science. However, reforming the healthcare system in the most populated country is a daunting task. China will not live up to its promise, and all the potentials may end with hype not hope if coherent national strategies are not constructed and state-of-the-art navigation is not achieved with staggering domestic and global challenges. The cost of failure will be immensely high, socioeconomic costs for Chinese and an opportunity cost for the world as a whole. A full appreciation of the global implications of China's healthcare reform is crucial in keeping China receptive toward good practices evidence-approved elsewhere and open minded to fulfill its international obligations. More critically, the appreciation yields constructive engagements from global community toward a joint development and global prosperity. The current report provides a multiple disciplinary assessment on the global implications of the healthcare reform in China.

  7. How can healthcare standards be standardised?

    Science.gov (United States)

    Shaw, Charles D

    2015-10-01

    International travel, medical tourism and trade have created a demand for reliable assessment of healthcare provision across borders, and for information which is accessible to patients, insurers and referring institutions. External assessment schemes for healthcare providers may be clustered into three types: statutory regulation and institutional licensing, International Standardization Organisation certification, and voluntary systems such as peer review and healthcare accreditation. Increasing complexity of healthcare provision, pressures for public accountability and expectations of professional self-governance place a burden on the inspectors and the inspected. If only to contain costs of external assessment and to increase access to reliable information for patients and insurers, the three approaches must work together rather than compete. This paper summarises the origins, aims, authority and methods of the three general models, describing current pressures and opportunities for convergence (between systems and across borders) in the UK and in Europe. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Lean in healthcare: the unfilled promise?

    Science.gov (United States)

    Radnor, Zoe J; Holweg, Matthias; Waring, Justin

    2012-02-01

    In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the 'tool level'. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining 'customer value' that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily 'professional' in origin but actually more 'organisational' and 'managerial' and, if not addressed could severely constrain Lean's impact on healthcare productivity at the systems level. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Information Technology for Healthcare

    Directory of Open Access Journals (Sweden)

    Abbas Yazdanpanah

    2016-04-01

    Full Text Available The article produced below hopes to focus on the use of information technology solutions for improving healthcare delivery systems. It explains evolution of IT-Enhanced healthcare from Telemedicine to e-health, including definition and requirements of telemedical systems. It also traces the evolution of contemporary telemedical systems and the challenges faced by future technologies including legal and formal aspects of telemedicine as well as its acceptance among users. It overviews access to telecommunication technologies, with basic requirements for such communications. It also presents the requirements and architectures of Internet-based medical systems, with focus on Internet telemedical services, Web services and portal technologies. The next-generation point-of-care information systems are also discussed. This article also covers security and safety of telemedical systems in context of legal acts affecting the security of e-medical systems. Wireless hospital and telecare applications with requirements for mobile access from PDA devices to medical database are also considered. Electronic health records describe the progress in constructing a common set of data structures contained in medical records and reports on the main standardization efforts. Decision support systems in medicine covers knowledge based and expert systems which support physicians in making medical decisions by providing interactive tools, Since e-health network services are available over the Internet it covers the requirements and architecture of telematics networks and the organizational models for such networks.

  10. Pharmacovigilance: Empowering healthcare professionals

    Directory of Open Access Journals (Sweden)

    Mugoša Snežana S.

    2015-01-01

    Full Text Available Introduction: Spontaneous reporting of adverse reactions is of greatest importance for obtaining information about adverse drug reactions (ADRs after granting the marketing authorization. The most important role and also the greatest responsibility belong to healthcare professionals. Their active participation is a prerequisite for the existence of an effective national drug safety monitoring. Methods: This paper examines the legislative framework concerning the pharmacovigilance system in Montenegro. The information was collected from scientific articles and the website of the Agency for Medicines and Medical Devices of Montenegro. Topic: Key segments of pharmacovigilance system are presented, with a special reference to the importance of spontaneous reporting of ADRs, results of spontaneous reporting of ADRs according to the latest Agency's Annual report on the results of spontaneous reporting of adverse reactions to medicines, possible reasons for underreporting ADRs, as well as the new EU regulation on pharmacovigilance. Conclusions: Spontaneous reporting of ADRs remains the cornerstone of pharmacovigilance systems. Hence, continuous education of healthcare professionals is needed, with the aim of improving their awareness of the importance of ADRs and risk factors that lead to them, in order to reduce the incidence of ADRs and to increase the number of reported suspected ADRs.

  11. Designing role of online health educators in healthcare services.

    Science.gov (United States)

    Anshari, Muhammad; Almunawar, Mohammad Nabil

    2015-01-01

    Web technology provides healthcare organizations the ability to broaden services beyond usual practices, and thus provides a particularly advantageous environment to achieve complex e-health goals. Furthermore, introducing web technology in healthcare services may add value to the overall healthcare process. Web technology helps healthcare organizations to extend the online health services (e-health) beyond their traditional mechanism. The changes enable customers (patients) to participate more in the process of healthcare, such as through their ability to generate personal health data to their personalized web-based interface. It allows patients to have greater control of information flow between healthcare organizations and customers, and among customers themselves. In this study the authors investigate the extended role of healthcare staff that provide e-health services. The authors have developed e-health models that accommodate customers' participation to engage more actively in the healthcare system. Through the model the authors developed a prototype--namely Clinic 2.0. Clinic 2.0 is set up to facilitate interactions between healthcare providers and customers. In the proposed systems, the authors introduced Online Health Educator (OHE)--a healthcare staff that is specifically responsible for administering Clinic 2.0. The authors have conducted a survey in Indonesia to draw the expectation of participants regarding the important role of OHE in Clinic 2.0 through a semi-structured interview conducted with participants to further investigate the pivotal roles of OHE. The authors found that e-health services need OHE to achieve customers' satisfaction.

  12. [Patients requiring high healthcare spending].

    Science.gov (United States)

    Niehaus, F

    2008-03-01

    Data from private insurance companies make it possible to analyse how healthcare spending is distributed across individuals, how it depends on the age of the people and how it changes over time. Within age groups, healthcare spending is less concentrated if recipients are older. Over the analysed period of time, a considerable levelling of expenses takes place. These findings lead to the conclusion that the ageing population will result in a greater and more evenly spread utilisation of healthcare facilities.

  13. Smart Cards Applications in the Healthcare System

    Directory of Open Access Journals (Sweden)

    Claudiu Oltean

    2011-06-01

    Full Text Available Current medical system based on medical records and health books is outdated and no longer meets the new requirements. Essential information security in terms of data privacy, integrity and authenticity, is not assured. Healthcare fraud with medical records is quite easy, because there is no security features to prevent this. Obtaining prescription drugs is slowly, the patient is forced in most cases, to go to the pharmacy staff to get their prescription. Another issue is data portability because each clinic can use a proprietary format of medical records, which is not always standardized. Modern and efficient healthcare system can be achieved by introducing smart cards and related software. Their introduction in addition to the portability and data security, reduce costs for both patient and medical institutions. The result will be increase confidence and patient satisfaction in medical institutions. Developed software package includes software applications which manage medical archive to smartcard, in a secure form and a software module which can be used for e-commerce transactions. All developed software application meets current standards for data security. Implementation of such solutions in practice would significantly reduce current costs in healthcare system.

  14. Healthcare system responsiveness in Jiangsu Province, China.

    Science.gov (United States)

    Chao, Jianqian; Lu, Boyang; Zhang, Hua; Zhu, Liguo; Jin, Hui; Liu, Pei

    2017-01-13

    The perceived responsiveness of a healthcare system reflects its ability to satisfy reasonable expectations of the public with respect to non-medical services. Recently, there has been increasing attention paid to responsiveness in evaluating the performance of a healthcare system in a variety of service settings. However, the factors that affect the responsiveness have been inconclusive so far and measures of improved responsiveness have not always thoroughly considered the factors. The aim of this study was to evaluate both the responsiveness of the healthcare system in Jiangsu Province, China, the factors that influence responsiveness and the measures of improved responsiveness considering it, as determined by a responsiveness survey. A multistage, stratified random sampling method was used to select 1938 adult residents of Jiangsu Province in 2011. Face-to-face interviews were conducted using a self-designed questionnaire modeled on the World Health Organization proposal. The final analysis was based on 1783 (92%) valid questionnaires. Canonical correlation analysis was used to assess the factors that affect responsiveness. The average score of all responsiveness-related domains in the surveyed healthcare system was satisfactory (7.50 out of a maximum 10.0). The two highest scoring domains were dignity and confidentiality, and the two lowest scoring domains choice and prompt attention. The factors affecting responsiveness were age, regional economic development level, and geographic area (urban vs. rural). The responsiveness regarding basic amenities was rated worse by the elderly than by younger respondents. Responsiveness ranked better by those with a poorer economic status. Choice in cities was better than in rural regions. The responsiveness of the Jiangsu healthcare system was considered to be satisfactory but could be improved by offering greater choice and providing more prompt attention. Perceptions of healthcare system responsiveness differ with age

  15. Using Business Intelligence Tools for Predictive Analytics in Healthcare System

    Directory of Open Access Journals (Sweden)

    Mihaela-Laura IVAN

    2016-05-01

    Full Text Available The scope of this article is to highlight how healthcare analytics can be improved using Business Intelligence tools. Healthcare system has learned from the previous lessons the necessity of using healthcare analytics for improving patient care, hospital administration, population growth and many others aspects. Business Intelligence solutions applied for the current analysis demonstrate the benefits brought by the new tools, such as SAP HANA, SAP Lumira, and SAP Predictive Analytics. In detailed is analyzed the birth rate with the contribution of different factors to the world.

  16. Analysis of currently available data for characterising the risk of engineered nanomaterials to the environment and human health--lessons learned from four case studies.

    Science.gov (United States)

    Aschberger, Karin; Micheletti, Christian; Sokull-Klüttgen, Birgit; Christensen, Frans M

    2011-08-01

    Production volumes and the use of engineered nanomaterials in many innovative products are continuously increasing, however little is known about their potential risk for the environment and human health. We have reviewed publicly available hazard and exposure data for both, the environment and human health and attempted to carry out a basic risk assessment appraisal for four types of nanomaterials: fullerenes, carbon nanotubes, metals, and metal oxides (ENRHES project 2009(1)). This paper presents a summary of the results of the basic environmental and human health risk assessments of these case studies, highlighting the cross cutting issues and conclusions about fate and behaviour, exposure, hazard and methodological considerations. The risk assessment methodology being the basis for our case studies was that of a regulatory risk assessment under REACH (ECHA, 2008(2)), with modifications to adapt to the limited available data. If possible, environmental no-effect concentrations and human no-effect levels were established from relevant studies by applying assessment factors in line with the REACH guidance and compared to available exposure data to discuss possible risks. When the data did not allow a quantitative assessment, the risk was assessed qualitatively, e.g. for the environment by evaluating the information in the literature to describe the potential to enter the environment and to reach the potential ecological targets. Results indicate that the main risk for the environment is expected from metals and metal oxides, especially for algae and Daphnia, due to exposure to both, particles and ions. The main risks for human health may arise from chronic occupational inhalation exposure, especially during the activities of high particle release and uncontrolled exposure. The information on consumer and environmental exposure of humans is too scarce to attempt a quantitative risk characterisation. It is recognised that the currently available database for both

  17. A framework for designing a healthcare outcome data warehouse.

    Science.gov (United States)

    Parmanto, Bambang; Scotch, Matthew; Ahmad, Sjarif

    2005-09-06

    Many healthcare processes involve a series of patient visits or a series of outcomes. The modeling of outcomes associated with these types of healthcare processes is different from and not as well understood as the modeling of standard industry environments. For this reason, the typical multidimensional data warehouse designs that are frequently seen in other industries are often not a good match for data obtained from healthcare processes. Dimensional modeling is a data warehouse design technique that uses a data structure similar to the easily understood entity-relationship (ER) model but is sophisticated in that it supports high-performance data access. In the context of rehabilitation services, we implemented a slight variation of the dimensional modeling technique to make a data warehouse more appropriate for healthcare. One of the key aspects of designing a healthcare data warehouse is finding the right grain (scope) for different levels of analysis. We propose three levels of grain that enable the analysis of healthcare outcomes from highly summarized reports on episodes of care to fine-grained studies of progress from one treatment visit to the next. These grains allow the database to support multiple levels of analysis, which is imperative for healthcare decision making.

  18. [The Marketing of Healthcare Services in ENT-Clinics].

    Science.gov (United States)

    Teschner, M; Lenarz, T

    2016-07-01

    The provision of healthcare services in Germany is based on fundamental principles of solidarity and is highly regulated. The question arises which conditions exist for marketing for healthcare services in ENT-clinics in Germany. The marketing options will be elicited using environmentally analytical considerations. The objectives can be achieved using measures derived from external instruments (service policy, pricing policy, distribution policy or communications policy) or from an internal instrument (human resources policy). The policy environment is particularly influenced by the regulatory framework, which particularly restricts the scope for both the pricing and communications policies. All measures must, however, reflect ethical frameworks, which are regarded as the fundamental premise underlying healthcare services and may be at odds with economic factors. Scope for flexibility in pricing exists only within the secondary healthcare market, and even there only to a limited extent. The significance of price in the marketing of healthcare services is thus very low. If marketing activities are to succeed, a market analysis must be carried out exploring the relevant factors for each individual provider. However, the essential precondition for the marketing of healthcare services is trust. The marketing of healthcare services differs from that of business management-oriented enterprises in other branches of economy. In the future the importance of marketing activities will increase. © Georg Thieme Verlag KG Stuttgart · New York.

  19. The A to Z of healthcare data breaches.

    Science.gov (United States)

    Kobus, Theodore J

    2012-01-01

    There currently exists a myriad of privacy laws that impact a healthcare entity, including more than 47 notification laws that require notification when a data breach occurs, as well as the breach notification requirements of the Health Information Technology for Economic and Clinical Health Act. Given the plethora of issues a healthcare entity faces, there are certain principles that can be built into an organization's philosophy that will comply with the law and help protect it from reputational harm.

  20. Hawai‘i's Nursing Workforce: Keeping Pace with Healthcare

    OpenAIRE

    LeVasseur, Sandra A; Qureshi, Kristine

    2015-01-01

    Nursing is the largest segment of the healthcare workforce, but over the next decade even more nurses will be required. Changing population demographics, new technologies, and evolving models of healthcare will stimulate expansion of nursing roles and the need for a highly educated nursing workforce. The current nursing workforce is aging, and large numbers of retirements are anticipated. By 2025, the United States is expected to experience a nursing shortage; in Hawai‘i this shortfall is for...

  1. Leading healthcare in complexity.

    Science.gov (United States)

    Cohn, Jeffrey

    2014-12-01

    Healthcare institutions and providers are in complexity. Networks of interconnections from relationships and technology create conditions in which interdependencies and non-linear dynamics lead to surprising, unpredictable outcomes. Previous effective approaches to leadership, focusing on top-down bureaucratic methods, are no longer effective. Leading in complexity requires leaders to accept the complexity, create an adaptive space in which innovation and creativity can flourish and then integrate the successful practices that emerge into the formal organizational structure. Several methods for doing adaptive space work will be discussed. Readers will be able to contrast traditional leadership approaches with leading in complexity. They will learn new behaviours that are required of complexity leaders, along with challenges they will face, often from other leaders within the organization.

  2. Burnout among healthcare professionals.

    Science.gov (United States)

    Wood, Ben D; Killion, Jeffrey B

    2007-01-01

    *From many accounts healthcare professionals are at increased risk for professional burnout. Professional burnout is generally described as prolonged stress that impairs one's ability to perform his or her job in demanding situations. *Precursors to professional burnout include, but are not limited to, employee workload, chronic fatigue, compassion fatigue, balance between family and career, sickness absence, and loss of confidence. *Administrators must watch for early signs of professional burnout to improve retention and promote employee morale. To reduce professional burnout, administrators must implement strategies to reduce burnout while also promoting productivity. *When professional burnout occurs, management must consider each employee's generational differences. All generations have differing values, beliefs, and opinions that influence his or her work ethic in regard to employee productivity.

  3. Infrastructures for healthcare

    DEFF Research Database (Denmark)

    Langhoff, Tue Odd; Amstrup, Mikkel Hvid; Mørck, Peter

    2017-01-01

    of classifications, on the entire Danish population. However, in the Autumn of 2014, the system was temporarily shut down due to a lawsuit filed by two general practitioners. In this article, we ask why and identify a political struggle concerning authority, control, and autonomy related to a transformation...... adding new actors or purposes to a system without due consideration to the nature of the infrastructure. We argue that while long-term information infrastructures are dynamic by nature and constantly impacted by actors joining or leaving the project, each activity of adding new actors must take reverse...... synergy into account, if not to risk breaking down the fragile nature of otherwise successful information infrastructures supporting research on healthcare....

  4. Antitrust and affiliations among healthcare providers: the need for a level playing field.

    Science.gov (United States)

    Heightchew, A

    1997-01-01

    Under pressure to remain competitive in the rapidly changing healthcare industry, policy leaders and healthcare administrators face the challenge of resolving antitrust matters arising from the creation of innovative healthcare provider affiliations. Although guidance from the Federal Trade Commission (FTC) is available, development of new affiliations is hindered due to contradictory rulings and ambiguous guidelines. Provider associations are further disadvantaged by a federal act granting insurance companies antitrust exemption, which enables insurance companies to affiliate more easily. Current antitrust regulations create unequal market powers, resulting in the development of inefficient systems. Softening antitrust laws in favor of provider-sponsored healthcare affiliations will provide for the flexibility necessary for effective healthcare reform.

  5. LightForce photon-pressure collision avoidance: Efficiency analysis in the current debris environment and long-term simulation perspective

    Science.gov (United States)

    Yang Yang, Fan; Nelson, Bron; Aziz, Jonathan; Carlino, Roberto; Dono Perez, Andres; Faber, Nicolas; Foster, Cyrus; Frost, Chad; Henze, Chris; Karacalıoğlu, Arif Göktuğ; Levit, Creon; Marshall, William; Mason, James; O'Toole, Conor; Swenson, Jason; Worden, Simon P.; Stupl, Jan

    2016-09-01

    This work provides an efficiency analysis of the LightForce space debris collision avoidance scheme in the current debris environment and describes a simulation approach to assess its impact on the long-term evolution of the space debris environment. LightForce aims to provide just-in-time collision avoidance by utilizing photon pressure from ground-based industrial lasers. These ground stations impart minimal accelerations to increase the miss distance for a predicted conjunction between two objects. In the first part of this paper we will present research that investigates the short-term effect of a few systems consisting of 20 kW class lasers directed by 1.5 m diameter telescopes using adaptive optics. The results found such a network of ground stations to mitigate more than 85 percent of conjunctions and could lower the expected number of collisions in Low Earth Orbit (LEO) by an order of magnitude. While these are impressive numbers that indicate LightForce's utility in the short-term, the remaining 15 % of possible collisions contain (among others) conjunctions between two massive objects that would add large amount of debris if they collide. Still, conjunctions between massive objects and smaller objects can be mitigated. Hence, we choose to expand the capabilities of the simulation software to investigate the overall effect of a network of LightForce stations on the long-term debris evolution. In the second part of this paper, we will present the planned simulation approach for that effort. For the efficiency analysis of collision avoidance in the current debris environment, we utilize a simulation approach that uses the entire Two Line Element (TLE) catalog in LEO for a given day as initial input. These objects are propagated for one year and an all-on-all conjunction analysis is performed. For conjunctions that fall below a range threshold, we calculate the probability of collision and record those values. To assess efficiency, we compare a baseline

  6. Home-based Healthcare Technology

    DEFF Research Database (Denmark)

    Verdezoto, Nervo

    of these systems target a specific treatment or condition and might not be sufficient to support the care management work at home. Based on a case study approach, my research investigates home-based healthcare practices and how they can inform future design of home-based healthcare technology that better account...

  7. [Knowledge management and healthcare organizations].

    Science.gov (United States)

    Favaretti, Carlo

    2013-10-01

    The present scenario is characterized by a high "environmental turbulence". Healthcare professionals and organizations must increase their knowledge, skills and attitudes for choosing wisely. Healthcare organizations are complex adaptive systems which should use integrated governance systems: knowledge management should be a strategic goal. These organizations should become learning organizations: they should build and renovate their knowledge in a systematic, explicit and definite way.

  8. Healthcare technology in the home

    DEFF Research Database (Denmark)

    Ballegaard, Stinne Aaløkke

    2011-01-01

    The dissertation explores through ethnographic field studies ways in which negotiations and transformations take place when healthcare technology is introduced to the home. With the increased focus on tele-medical solutions and on supporting patient self-care through new healthcare technologies...

  9. Healthcare Systems and Other Applications

    NARCIS (Netherlands)

    van Kasteren, T.L.M.; Kröse, B.J.A.

    2007-01-01

    This Works in Progress department discusses eight projects related to healthcare. The first project aims to aid people with mild dementia. The second project plans to simplify the delivery of healthcare services to the elderly and cognitively disabled, while the third project is developing models fo

  10. Freeform electronics for advanced healthcare

    KAUST Repository

    Hussain, Muhammad Mustafa

    2017-02-16

    Freeform (physically flexible, stretchable and reconfigurable) electronics can be critical enabler for advanced personalized healthcare. With increased global population and extended average lifetime of mankind, it is more important than ever to integrate advanced electronics into our daily life for advanced personalized healthcare. In this paper, we discuss some critical criteria to design such electronics with enabling applications.

  11. Healthcare Systems and Other Applications

    NARCIS (Netherlands)

    van Kasteren, T.L.M.; Kröse, B.J.A.

    2007-01-01

    This Works in Progress department discusses eight projects related to healthcare. The first project aims to aid people with mild dementia. The second project plans to simplify the delivery of healthcare services to the elderly and cognitively disabled, while the third project is developing models

  12. Enhanced semantic interpretability by healthcare standards profiling.

    Science.gov (United States)

    Lopez, Diego M; Blobel, Bernd G M E

    2008-01-01

    Several current healthcare standards support semantic interoperability. These standards are far to be completely adopted in health information system development, however. The objective of this paper is to provide a method and necessary tooling for reusing healthcare standards by exploiting the extensibility mechanisms of UML, by that way supporting the development of semantically interoperable systems and components. The method identifies first the models and tasks in the software development process in which health care standards can be reused. Then, the selected standard is formalized as a UML profile. Finally that profile is applied to system models, annotating them with the standard semantics. The supporting tools are Eclipse-based UML modeling tools. The method is integrated into a comprehensive framework for health information systems development. The feasibility of the approach is exemplified by a scenario reusing HL7 RIM and DIMs specifications. The approach presented is also applicable for harmonizing different standard specifications.

  13. Public Healthcare Organizations: Leadership or Management?

    Directory of Open Access Journals (Sweden)

    Maite Martínez-Gonzalez

    2016-11-01

    Full Text Available This article studies the type of leadership that managers are currently exercising in the Catalan health system in Catalonia. A questionnaire (MQL-5X was sent to 120 people occupying management positions in healthcare centers and hospitals as well as 14 others who also hold such positions in these healthcare centers and hospitals, were interviewed. The mixed methods research design attests that the Catalan health system is managed through a structure of simultaneous transformational and transactional leadership. However, the efficacy of this system is conditioned purely by the communicative competence that a manager may or may not possess, as the system itself makes no effort to encourage transformational leadership. Transformation leadership inspires positive change, conveys a clear vision and enhances morale, motivation and job performance. It galvanizes a team into changing their expectations and perceptions and motivates them to work towards common goals.

  14. Implementing healthcare information security: standards can help.

    Science.gov (United States)

    Orel, Andrej; Bernik, Igor

    2013-01-01

    Using widely spread common approaches to systems security in health dedicated controlled environments, a level of awareness, confidence and acceptance of relevant standardisation is evaluated. Patients' information is sensitive, so putting appropriate organisational techniques as well as modern technology in place to secure health information is of paramount importance. Mobile devices are becoming the top priorities in advanced information security planning with healthcare environments being no exception. There are less and less application areas in healthcare without having a need for a mobile functionality which represents an even greater information security challenge. This is also true in emergency treatments, rehabilitation and homecare just to mention a few areas outside hospital controlled environments. Unfortunately quite often traditional unsecured communications principles are still in routine use for communicating sensitive health related information. The security awareness level with users, patients and care professionals is not high enough so potential threats and risks may not be addressed and the respective information security management is therefore weak. Standards like ISO/IEC 27000 ISMS family, the ISO/IEC 27799 information security guidelines in health are often not well known, but together with legislation principles such as HIPAA, they can help.

  15. Obesity and Healthcare Avoidance: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Robert D McGuigan

    2015-03-01

    Full Text Available This review addresses the issue of health care avoidance and obesity. English language journal articles published between 1990 and 2012 that addressed the review question|“is being overweight or obese an unrecognized factor in healthcare avoidance?” were located using major databases. A modified JADAD scoring system was then used to assess papers. Ten papers were identified which directly addressed the review question. A positive relationship exists between obesity and healthcare avoidance. The major contributory factors were being female, have a diagnosed mental health problem and perceived or actual bias and discrimination by health professionals. The review also highlights the importance of the relationship between healthcare professionals and their patients, and the physical environment in which interactions occur as these may contribute to avoidance behaviors. Concern about obesity is rising and while there has been much discussion about strategies to reduce obesity this review highlights the need for thinking more broadly about the way in which overweight and obese individuals interact with preventative health strategies.

  16. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    OpenAIRE

    Kizito Kuchibanda; Mayo, Aloyce W.

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interv...

  17. Mobile healthcare applications: system design review, critical issues and challenges.

    Science.gov (United States)

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Connolly, Martin J

    2015-03-01

    Mobile phones are becoming increasingly important in monitoring and delivery of healthcare interventions. They are often considered as pocket computers, due to their advanced computing features, enhanced preferences and diverse capabilities. Their sophisticated sensors and complex software applications make the mobile healthcare (m-health) based applications more feasible and innovative. In a number of scenarios user-friendliness, convenience and effectiveness of these systems have been acknowledged by both patients as well as healthcare providers. M-health technology employs advanced concepts and techniques from multidisciplinary fields of electrical engineering, computer science, biomedical engineering and medicine which benefit the innovations of these fields towards healthcare systems. This paper deals with two important aspects of current mobile phone based sensor applications in healthcare. Firstly, critical review of advanced applications such as; vital sign monitoring, blood glucose monitoring and in-built camera based smartphone sensor applications. Secondly, investigating challenges and critical issues related to the use of smartphones in healthcare including; reliability, efficiency, mobile phone platform variability, cost effectiveness, energy usage, user interface, quality of medical data, and security and privacy. It was found that the mobile based applications have been widely developed in recent years with fast growing deployment by healthcare professionals and patients. However, despite the advantages of smartphones in patient monitoring, education, and management there are some critical issues and challenges related to security and privacy of data, acceptability, reliability and cost that need to be addressed.

  18. Managing hospital doctors and their practice: what can we learn about human resource management from non-healthcare organisations?

    Science.gov (United States)

    Trebble, Timothy M; Heyworth, Nicola; Clarke, Nicholas; Powell, Timothy; Hockey, Peter M

    2014-11-21

    Improved management of clinicians' time and practice is advocated to address increasing demands on healthcare provision in the UK National Health Service (NHS). Human resource management (HRM) is associated with improvements in organisational performance and outcomes within and outside of healthcare, but with limited use in managing individual clinicians. This may reflect the absence of effective and transferrable models. The current systems of managing the performance of individual clinicians in a secondary healthcare organisation were reviewed through the study of practice in 10 successful partnership organisations, including knowledge worker predominant, within commercial, public and voluntary sector operating environments. Reciprocal visits to the secondary healthcare environment were undertaken. Six themes in performance related HRM were identified across the external organisations representing best practice and considered transferrable to managing clinicians in secondary care organisations. These included: performance measurement through defined outcomes at the team level with decision making through local data interpretation; performance improvement through empowered formal leadership with organisational support; individual performance review (IPR); and reward, recognition and talent management. The role of the executive was considered essential to support and implement effective HRM, with management of staff performance, behaviour and development integrated into organisational strategy, including through the use of universally applied values and effective communication. These approaches reflected many of the key aspects of high performance work systems and strategic HRM. There is the potential to develop systems of HRM of individual clinicians in secondary healthcare to improve practice. This should include both performance measurement and performance improvement but also engagement at an organisational level. This suggests that effective HRM and

  19. A Framework for Healthcare Planning and Control

    NARCIS (Netherlands)

    Hans, Elias W.; van Houdenhoven, Mark; Hulshof, P.J.H.; Hall, Randolph

    2012-01-01

    Rising expenditures spur healthcare organizations to organize their processes more efficiently and effectively. Unfortunately, healthcare planning and control lags behind manufacturing planning and control. We analyze existing planning and control concepts or frameworks for healthcare operations

  20. Generation Y in healthcare: leading millennials in an era of reform.

    Science.gov (United States)

    Piper, Llewellyn E

    2012-01-01

    The healthcare workforce has grown with the addition of a new group of physicians, nurses, allied health professionals, administrators, and support staff who belong to America's youngest generation now in the workforce-generation Y, or the millennials. This generation consists of more than 70 million people, the oldest of whom are now in their late 20s and early 30s. With traits and workplace expectations that differ from those observed in other generations, and with a size that threatens to overtake the total number of baby boomers, generation Yers are positioned to influence (if not drastically change) current leadership approaches. The common traits that define or are associated with generation Y workers are often regarded as barriers yet provide healthcare leaders with a clear guide to understanding these employees and drawing out their best qualities and performance. For the organization to fulfill its social contract to provide high-quality, cost-effective, and safe healthcare, it must satisfy the needs and manage the expectations of those who directly deliver these services. This is especially important in today's environment, which is marked by the still-fluid stipulations of the Affordable Care Act (ACA), changed consumer expectations, and public demands for transparency and accountability.

  1. The emergence of managed care in Europe. Some thoughts on the politics of healthcare reform.

    Science.gov (United States)

    Elze, C

    1998-01-01

    It is the purpose of this paper to demonstrate that healthcare reform in Europe can be successful only if it leads to more efficient resource use while maintaining a large degree of equity in the system. Globalisation is undermining the social contracts that established Europe's egalitarian societies after World War II. While socialised healthcare will continue to be an essential building block of social cohesion, public expenditures must be contained. The only approach to maintaining equity of access and financing in the face of a mounting resource constraint is to embark upon a radical re-engineering of the entire healthcare supply chain, introducing and adapting proven US managed-care techniques to the European environment. Through enabling legislation, most European countries are in a phase of testing the feasibility, cost effectiveness and quality enhancement potential of managed-care approaches, before applying them more broadly. While political opposition to change on the part of those whose current positions are threatened continues to run high, the practice of medicine can be expected to converge on the basis of standards of care and information technology over the next 10 to 15 years.

  2. LightForce Photon-pressure Collision Avoidance: Efficiency Analysis in the Current Debris Environment and Long-Term Simulation Perspective

    Science.gov (United States)

    Yang, Fan Y.; Nelson, Bron; Carlino, Roberto; Perez, Andres D.; Faber, Nicolas; Henze, Chris; Karacahoglu, Arif G.; O'Toole, Conor; Swenson, Jason; Stupl, Jan

    2015-01-01

    This work provides an efficiency analysis of the LightForce space debris collision avoidance scheme in the current debris environment and describes a simulation approach to assess its impact on the long-term evolution of the space debris environment. LightForce aims to provide just-in-time collision avoidance by utilizing photon pressure from ground-based industrial lasers. These ground stations impart minimal accelerations to increase the miss distance for a predicted conjunction between two objects. In the first part of this paper we will present research that investigates the short-term effect of a few systems consisting of 10kW class lasers directed by 1.5 m diameter telescopes using adaptive optics. The results found such a network of ground stations to mitigate more than 85 percent of conjunctions and could lower the expected number of collisions in Low Earth Orbit (LEO) by an order of magnitude. While these are impressive numbers that indicate LightForce's utility in the short-term, the remaining 15 percent of possible collisions contain (among others) conjunctions between two massive objects that would add large amount of debris if they collide. Still, conjunctions between massive objects and smaller objects can be mitigated. Hence we choose to expand the capabilities of the simulation software to investigate the overall effect of a network of LightForce stations on the long-term debris evolution. In the second part of this paper, we will present the planed simulation approach for that effort.

  3. MARKETING PLANNING IN HEALTHCARE INDUSTRY

    Directory of Open Access Journals (Sweden)

    Bobeica Ana Amaria

    2013-04-01

    Full Text Available The purpose of this paper is to develop a perspective on what is important or critical to the discipline of healthcare marketing by analyzing the marketing plan from the institutional (or organizational perspective. This “salience issue” is complicated by the structural problems in healthcare such as new advertising programs, advances in medical technology, and the escalating costs of care in the recent economic situation of world economic crisis. Reviewing a case study, the paper examines how marketing managers face increasingly difficult management and it emphasizes one more time the importance of marketing in the internal organizational structure. Also it shows the direct connection between the marketing strategy, the Quality of Healthcare and marketing planning in the internal organization of Private Healthcare Practice in Romania. Also it concludes that marketing planning in healthcare has to be very precised in order to achieve some major objectives: customer care, financial stability, equilibrium between stakeholders and shareholders and future improvement in communication to customers. The marketing strategies and programs discussed in this paper follow the analysis of the 4Ps of Healthcare Marketing Services and propose call to action plans and possibilities that might result in a more particular case study analysis of the Romanian Healthcare Market.

  4. IT-support for healthcare professionals acting in major incidents

    DEFF Research Database (Denmark)

    Kristensen, Margit; Kyng, Morten; Nielsen, Esben Toftdahl

    2005-01-01

    This paper focuses on development of it support for healthcare professionals acting in major incidents. We introduce the participatory design approach as adequate for analysis, design and development of technologies for use in complex environments and situations, and describe the actual participa......This paper focuses on development of it support for healthcare professionals acting in major incidents. We introduce the participatory design approach as adequate for analysis, design and development of technologies for use in complex environments and situations, and describe the actual...... the BlueBio biomonitor prototype, a wireless multifunction biomonitor. BlueBio data can be accessed by the healthcare professionals independent of where they are located and displayed on different types of devices tailored to the needs of the individual professional. Finally we discuss some challenges...... regarding the prototype development process....

  5. Healthcare financing in Yemen.

    Science.gov (United States)

    Holst, Jens; Gericke, Christian A

    2012-01-01

    Yemen is a low-middle-income country where more than half of the population live in rural areas and lack access to the most basic health care. At US$40 per capita, Yemen's annual total health expenditure (THE) is among the lowest worldwide. This study analyses the preconditions and options for implementing basic social health protection in Yemen. It reveals a four-tiered healthcare system characterised by high geographic and financial access barriers mainly for the poor. Out-of-pocket payments constitute 55% of THE, and cost-sharing exemption schemes are not well organised. Resource-allocation practices are inequitable because about 30% of THE gets spent on treatment abroad for a small number of patients, mainly from better-off families. Against the background of a lack of social health protection, a series of small-scale and often informal solidarity schemes have developed, and a number of public and private companies have set up health benefit schemes for their employees. Employment-based schemes usually provide reasonable health care at an average annual cost of YR44 000 (US$200) per employee. In contrast, civil servants contribute to a mandatory health-insurance scheme without receiving any additional health benefits in return. A number of options for initiating a pathway towards a universal health-insurance system are discussed. Copyright © 2012 John Wiley & Sons, Ltd.

  6. [Healthcare patient loyalty].

    Science.gov (United States)

    Ameri, Cinzia; Fiorini, Fulvio

    2016-01-01

    If the "old economy" preached standardization of products/services in order to reduce costs, the "new economy" is based on the recognition of the needs and the management of information. It is aimed at providing better and more usable services. One scenario is a national health service with regional management but based on competition between hospitals/companies.This led to a different handling of the user/patient, which has become the center of the health system: marketing seeks to retain the patient, trying to push a client-patient to not change their healthcare service provider. In costs terms, it is more economical to retain a customer rather than acquire a new one: a satisfied customer is also the best sounding board for each company. Customer equity is the management of relations with patients which can result in a greater customer value: it is possible to recognize an equity of the value, of the brand and of the report. Loyalty uses various marketing activities (basic, responsive, responsible, proactive and collaborative): each hospital/company chooses different actions depending on how many resources it plans to invest in loyalty.

  7. Evaluating Lean in healthcare.

    Science.gov (United States)

    Burgess, Nicola; Radnor, Zoe

    2013-01-01

    The purpose of this paper is to present findings relating to how Lean is implemented in English hospitals. Lean implementation snapshots in English hospitals were conducted by content analysing all annual reports and web sites over two time periods, giving a thorough analysis of Lean's status in English healthcare. The article identifies divergent approaches to Lean implementation in English hospitals. These approaches are classified into a typology to facilitate an evaluation of how Lean is implemented. The findings suggest that implementation tends to be isolated rather than system-wide. A second dataset conveys Lean implementation trajectory across the time period. These data signal Lean's increasing use by English hospitals and shows progression towards an increasingly systemic approach. Data were collected using content analysis methods, which relies on how "Lean" methods were articulated within the annual report and/or on the organisation's web site, which indicates approaches taken by hospital staff implementing Lean. This research is the first to examine more closely "how" Lean is implemented in English hospitals. The emergent typology could prove relevant to other public sector organizations and service organisations more generally. The research also presents a first step to understanding Lean thinking in the English NHS. This article empirically analyses Lean implementation in English hospitals. It identifies divergent approaches that allow inferences about how far Lean is implemented in an organisation. Data represent a baseline for further analysis so that Lean implementation can be tracked.

  8. [Tuberculosis in healthcare workers].

    Science.gov (United States)

    Nienhaus, A

    2009-01-01

    Perception and knowledge of the TB-infection risk in healthcare workers (HCWs) changed profoundly in Germany during the past few years. Molecular-epidemiological studies and a comprehensive review of the existing evidence concerning the infection risk for HCWs lead to the conclusion that TB in HCWs is often caused by infection at the workplace. In the Hamburg Fingerprint Study, 80 % of the TB cases in HCWs were caused by infections at the workplace. In a similar Dutch study 43 % of all cases were work-related. Besides of the well-known risks in TB wards and laboratories, an increased risk for infection should be assumed for paramedics, in emergency rooms, for HCWs caring for the elderly or for workers with close contact to high-risk groups (homeless people, i. v. drug users, migrants from high-incidence countries). TB in a HCW working in these fields can be recognised as an occupational disease (OD) without identifying a particular source of infection. For all other HCWs, the German occupational disease law requires the identification of a source case before TB in an HCW can be accepted as an OD. Even though the proportion of work-related TB in HCWs is higher than was assumed before previously, the prevalence of latent TB infection (LTBI) is lower than expected. In an ongoing evaluation study of the interferon-gamma release assay (IGRA) LTBI prevalence in HCWs is 10 %. Prevention strategies in Germany should be reconsidered in the light of these new findings.

  9. LEAN HEALTHCARE SUPPLY CHAIN MANAGEMENT: MINIMIZING WASTE AND COSTS

    Directory of Open Access Journals (Sweden)

    Catia M L Machado

    2014-12-01

    Full Text Available The purpose of this research is to investigate the management models applied in the supply chain providing services in healthcare organizations, considering the lenses of lean. The aim of this is to develop a model of supply chain management focusing on the identification and minimization of waste, assisting in decision making and contributing to the quality of services and as a consequence the reduction of the costs involved in healthcare supply chain. The philosophies of continuous improvement and lean techniques have a role to play in helping healthcare to provide quality service and support to reduce costs in the current budget constraints. In the supply chain of hospitals the financial costs can be around 40% of its budget (MASOUMI et al. 2012; SOUZA et al., 2013. This article sheds light on the improvement in decision making and the effect of reducing costs in the healthcare supply chain. In this sense, the research intend to expand knowledge related to supply chain management in the area of ​​provision of healthcare services through the use of the philosophy of continuous improvement and lean principles, helping healthcare to provide quality service within their current budget constraints.

  10. Faith, Trust and the Perinatal Healthcare Maze in Urban India

    Directory of Open Access Journals (Sweden)

    S. Raman

    2014-05-01

    Full Text Available How women access and utilise health services through pregnancy, childbirth and infancy needs to be understood if we are to improve the delivery of and access to appropriate healthcare. Drawing on ethnographic observations of clinic encounters and in-depth interviews with women in Bangalore, South India, this paper reports on the complexities of negotiating healthcare throughout the perinatal continuum in urban India. Key themes identified include faith and trust in health services, confusion over right to healthcare; and the contested nature of choice for women. What is revealed is a socially restrictive framework that results in choices that seem arbitrary, irrational and self-defeating; poor women being particularly vulnerable. Given the current policy support for public-private-partnerships in reproductive healthcare delivery in India, both public and private health services need to move substantially to achieve true partnership and provide care that is respectful and valued by women and children in urban India.

  11. Cognitive continuum theory in interprofessional healthcare: A critical analysis.

    Science.gov (United States)

    Parker-Tomlin, Michelle; Boschen, Mark; Morrissey, Shirley; Glendon, Ian

    2017-07-01

    Effective clinical decision making is among the most important skills required by healthcare practitioners. Making sound decisions while working collaboratively in interprofessional healthcare teams is essential for modern healthcare planning, successful interventions, and patient care. The cognitive continuum theory (CCT) is a model of human judgement and decision making aimed at orienting decision-making processes. CCT has the potential to improve both individual health practitioner, and interprofessional team understanding about, and communication of, clinical decision-making processes. Examination of the current application of CCT indicates that this theory could strengthen interprofessional team clinical decision making (CDM). However, further research is needed before extending the use of this theoretical framework to a wider range of interprofessional healthcare team processes. Implications for research, education, practice, and policy are addressed.

  12. Preparedness of Lithuanian general practitioners to provide mental healthcare services

    DEFF Research Database (Denmark)

    Jaruseviciene, Lina; Sauliune, Skirmante; Jarusevicius, Gediminas

    2014-01-01

    BACKGROUND: A large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners' (GPs) experience in mental healthcare and their perceptions about how to increase...... their involvement in the field. METHODS: In this cross-sectional study, a 41-item questionnaire was distributed to a random sample of 797 Lithuanian GPs in order to investigate current practices in their provision of mental healthcare as well as their suggestions for the improvement of mental healthcare services...... specialists with whom 32% of the respondents discuss the management of their patients with a mental disorder. Collaboration with psychologists and social workers was almost threefold lower (11.6% and 12.5%). Capacity-building of GPs was found to be among the most promising initiatives to improve mental health...

  13. Complexity leadership: a healthcare imperative.

    Science.gov (United States)

    Weberg, Dan

    2012-01-01

    The healthcare system is plagued with increasing cost and poor quality outcomes. A major contributing factor for these issues is that outdated leadership practices, such as leader-centricity, linear thinking, and poor readiness for innovation, are being used in healthcare organizations. Complexity leadership theory provides a new framework with which healthcare leaders may practice leadership. Complexity leadership theory conceptualizes leadership as a continual process that stems from collaboration, complex systems thinking, and innovation mindsets. Compared to transactional and transformational leadership concepts, complexity leadership practices hold promise to improve cost and quality in health care. © 2012 Wiley Periodicals, Inc.

  14. Healthcare ethics: a pedagogical goldmine.

    Science.gov (United States)

    Bennett-Woods, Deb

    2005-01-01

    The author explores how a well designed and delivered course in healthcare ethics can meet multiple curricular goals in a health administration program. The basic philosophy, content, and methods of instruction are presented along with discussion of the effectiveness of using ethics as a platform for development of critical analysis and decision-making skills. The author illustrates how the course meets specific curricular criteria for program accreditation by the Commission on Accreditation of Healthcare Management Education (CAHME). Finally, a number of specific challenges related to the design and delivery of an effective course in healthcare ethics are addressed including course design, materials of instruction, and faculty.

  15. How the awareness of u-healthcare service and health conditions affect healthy lifestyle: an empirical analysis based on a u-healthcare service experience.

    Science.gov (United States)

    Youm, Sekyoung; Park, Seung-Hun

    2015-04-01

    The objectives of this study are (1) to establish a ubiquitous healthcare (u-healthcare) center for those who wish to use u-healthcare, allowing them to experience the service, and (2) to evaluate the users' awareness and expectations of the service based on their overall assessment. To establish the u-healthcare center, a kiosk, devices for health checkup, a body-type examination system, and a physical fitness assessment system were installed. Also, a u-healthcare Web site was developed. A survey was conducted on 280 individuals who visited the u-healthcare center and used the service, to determine (1) individual awareness of u-healthcare before using the service and their change of perception after use, (2) factors that affect the use of u-healthcare, and (3) the effects of disease awareness on exercise habits. Only 25.4% of the participants were aware of u-healthcare, and only 36% who saw the u-healthcare center recognized that it was where the u-healthcare service was provided. The group of individuals who were willing to use the u-healthcare showed statistically significant differences in their satisfaction with the overall environment of the center, as well as the specificity of the descriptions, examination results, kindness of the staff, and their responses. Additionally, the group of individuals who were diagnosed with chronic diseases and the group who were not showed statistically significant differences in the number of days on which they exercised lightly or took a walk. To promote the usage of u-healthcare service, the understanding of the service and the credibility of examination results need to be increased by sharing successful cases. Furthermore, to expand the use of the system that allows a person to regularly check his or her state of health, a lifelong periodical management system linked with another medical welfare program will be needed.

  16. Assessing the effects of urbanization on the environment with soil legacy and current-use insecticides: a case study in the Pearl River Delta, China.

    Science.gov (United States)

    Wei, Yan-Li; Bao, Lian-Jun; Wu, Chen-Chou; He, Zai-Cheng; Zeng, Eddy Y

    2015-05-01

    To evaluate the impacts of anthropogenic events on the rapid urbanized environment, the levels of legacy organochlorine pesticides (OCPs) and current-use insecticides (CUPs), i.e., dichlorodiphenyltrichloroethane and its metabolites (DDTs), hexachlorocyclohexanes (HCHs), pyrethroids and organophosphates in soil of the Pearl River Delta (PRD) and surrounding areas were examined. Spatial concentration distributions of legacy OCPs and CUPs shared similar patterns, with higher concentrations occurred in the central PRD with more urbanization level than that in the PRD's surrounding areas. Furthermore, relatively higher concentrations of OCPs and CUPs were found in the residency land than in other land-use types, which may be attributed to land-use change under rapid urbanization. Moderate correlations between gross domestic production or population density and insecticide levels in fifteen administrative districts indicated that insecticide spatial distributions may be driven by economic prosperity. The soil-air diffusive exchanges of DDTs and HCHs demonstrated that soil was a sink of atmospheric o,p'-DDE, o,p'-DDD, p,p'-DDD and o,p'-DDT, and was a secondary source of HCHs and p,p'-DDT to atmosphere. The soil inventories of DDTs and HCHs (100 ± 134 and 83 ± 70 tons) were expected to decrease to half of their current values after 18 and 13 years, respectively, whereas the amounts of pyrethroids and organophosphates (39 and 6.2 tons) in soil were estimated to decrease after 4 and 2 years and then increase to 87 and 1.0 tons after 100 years. In this scenario, local residents in the PRD and surrounding areas will expose to the high health risk for pyrethroids by 2109. Strict ban on the use of technical DDTs and HCHs and proper training of famers to use insecticides may be the most effective ways to alleviate the health effect of soil contamination.

  17. A new generation of healthcare buildings in South Africa: complexities and opportunities for greening

    CSIR Research Space (South Africa)

    De Jager, Peta

    2012-07-01

    Full Text Available , efficient, healing environment desirable for healthcare delivery. In South Africa there has been a commitment to transform the healthcare sector through the introduction of the national health insurance system which is to be unfolded over a 14 year period...

  18. An architecture for message exchange in pervasive healthcare based on the use of intelligent agents

    NARCIS (Netherlands)

    Cardoso de Moraes, João Luís; Lopes de Souza, Wanderley; Ferreira Pires, Luis; Cavalini, Luciana Tricai; Prado, do Antonio Francisco; Cavalini, L.T.

    2013-01-01

    Aims: This paper proposes an architecture for the exchange of context-aware messages in Pervasive Healthcare environments. Materials and methods: In Pervasive Healthcare, novel information and communication technologies are applied to support the provision of health services anywhere, at anytime, a

  19. Designing Collaborative Healthcare Technology for the Acute Care Workflow

    Directory of Open Access Journals (Sweden)

    Michael Gonzales

    2015-10-01

    Full Text Available Preventable medical errors in hospitals are the third leading cause of death in the United States. Many of these are caused by poor situational awareness, especially in acute care resuscitation scenarios. While a number of checklists and technological interventions have been developed to reduce cognitive load and improve situational awareness, these tools often do not fit the clinical workflow. To better understand the challenges faced by clinicians in acute care codes, we conducted a qualitative study with interprofessional clinicians at three regional hospitals. Our key findings are: Current documentation processes are inadequate (with information recorded on paper towels; reference guides can serve as fixation points, reducing rather than enhancing situational awareness; the physical environment imposes significant constraints on workflow; homegrown solutions may be used often to solve unstandardized processes; simulation scenarios do not match real-world practice. We present a number of considerations for collaborative healthcare technology design and discuss the implications of our findings on current work for the development of more effective interventions for acute care resuscitation scenarios.

  20. Vaccine hesitancy and healthcare providers.

    Science.gov (United States)

    Paterson, Pauline; Meurice, François; Stanberry, Lawrence R; Glismann, Steffen; Rosenthal, Susan L; Larson, Heidi J

    2016-12-20

    While most people vaccinate according to the recommended schedule, this success is challenged by individuals and groups who delay or refuse vaccines. The aim of this article is to review studies on vaccine hesitancy among healthcare providers (HCPs), and the influences of their own vaccine confidence and vaccination behaviour on their vaccination recommendations to others. The search strategy was developed in Medline and then adapted across several multidisciplinary mainstream databases including Embase Classic & Embase, and PschInfo. All foreign language articles were included if the abstract was available in English. A total of 185 articles were included in the literature review. 66% studied the vaccine hesitancy among HCPs, 17% analysed concerns, attitudes and/or behaviour of HCPs towards vaccinating others, and 9% were about evaluating intervention(s). Overall, knowledge about particular vaccines, their efficacy and safety, helped to build HCPs own confidence in vaccines and their willingness to recommend vaccines to others. The importance of societal endorsement and support from colleagues was also reported. In the face of emerging vaccine hesitancy, HCPs still remain the most trusted advisor and influencer of vaccination decisions. The capacity and confidence of HCPs, though, are stretched as they are faced with time constraints, increased workload and limited resources, and often have inadequate information or training support to address parents' questions. Overall, HCPs need more support to manage the quickly evolving vaccine environment as well as changing public, especially those who are reluctant or refuse vaccination. Some recommended strategies included strengthening trust between HCPs, health authorities and policymakers, through more shared involvement in the establishment of vaccine recommendations. Copyright © 2016. Published by Elsevier Ltd.

  1. Cyberterrorism: is the U.S. healthcare system safe?

    Science.gov (United States)

    Harries, David; Yellowlees, Peter M

    2013-01-01

    The Internet has brought with it many benefits; key among them has been its ability to allow the expansion of communication and transfer of all kinds of information throughout the U.S. healthcare system. As a consequence, healthcare has become increasingly dependent on the activities carried out in that environment. It is this very dependence that increases the likelihood of individuals or organizations conducting activities through the Internet that will cause physical and/or psychological harm. These activities have become known by the term "cyberterrorism." In the healthcare landscape this can appear in a variety of forms, such as bringing down a hospital computer system or publicly revealing private medical records. Whatever shape it takes, the general effects are the same: patient care is compromised, and trust in the health system is diminished. Fortunately no significant cyber attack has been successfully launched against a U.S. healthcare organization to date. However, there is evidence to suggest that cyber threats are increasing and that much of the U.S. healthcare system is ill equipped to deal with them. Securing cyberspace is not an easy proposition as the threats are constantly changing, and recognizing that cyberterrorism should be part of a broader information technology risk management strategy, there are several"best practices" that can be adopted by healthcare organizations to protect themselves against cyber attacks.

  2. Process mining in healthcare: A literature review.

    Science.gov (United States)

    Rojas, Eric; Munoz-Gama, Jorge; Sepúlveda, Marcos; Capurro, Daniel

    2016-06-01

    Process Mining focuses on extracting knowledge from data generated and stored in corporate information systems in order to analyze executed processes. In the healthcare domain, process mining has been used in different case studies, with promising results. Accordingly, we have conducted a literature review of the usage of process mining in healthcare. The scope of this review covers 74 papers with associated case studies, all of which were analyzed according to eleven main aspects, including: process and data types; frequently posed questions; process mining techniques, perspectives and tools; methodologies; implementation and analysis strategies; geographical analysis; and medical fields. The most commonly used categories and emerging topics have been identified, as well as future trends, such as enhancing Hospital Information Systems to become process-aware. This review can: (i) provide a useful overview of the current work being undertaken in this field; (ii) help researchers to choose process mining algorithms, techniques, tools, methodologies and approaches for their own applications; and (iii) highlight the use of process mining to improve healthcare processes.

  3. Incentives and intrinsic motivation in healthcare.

    Science.gov (United States)

    Berdud, Mikel; Cabasés, Juan M; Nieto, Jorge

    It has been established in the literature that workers within public organisations are intrinsically motivated. This paper is an empirical study of the healthcare sector using methods of qualitative analysis research, which aims to answer the following hypotheses: 1) doctors are intrinsically motivated; 2) economic incentives and control policies may undermine doctors' intrinsic motivation; and 3) well-designed incentives may encourage doctors' intrinsic motivation. We conducted semi-structured interviews à-la-Bewley with 16 doctors from Navarre's Healthcare Service (Servicio Navarro de Salud-Osasunbidea), Spain. The questions were based on current theories of intrinsic motivation and incentives to test the hypotheses. Interviewees were allowed to respond openly without time constraints. Relevant information was selected, quantified and analysed by using the qualitative concepts of saturation and codification. The results seem to confirm the hypotheses. Evidence supporting hypotheses 1 and 2 was gathered from all interviewees, as well as indications of the validity of hypothesis 3 based on interviewees' proposals of incentives. The conclusions could act as a guide to support the optimal design of incentive policies and schemes within health organisations when healthcare professionals are intrinsically motivated. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Healthcare Fraud and Abuse

    Science.gov (United States)

    Rudman, William J; Eberhardt, John S; Pierce, William; Hart-Hester, Susan

    2009-01-01

    In Texas, a supplier of durable medical equipment was found guilty of five counts of healthcare fraud due to submission of false claims to Medicare. The court sentenced the supplier to 120 months of incarceration and restitution of $1.6 million.1 Raritan Bay Medical Center agreed to pay the government $7.5 million to settle allegations that it defrauded the Medicare program, purposely inflating charges for inpatient and outpatient care, artificially obtaining outlier payments from Medicare.2 AmeriGroup Illinois, Inc., fraudulently skewed enrollment into the Medicaid HMO program by refusing to register pregnant women and discouraging registration for individuals with preexisting conditions. Under the False Claims Act and the Illinois Whistleblower Reward and Protection Act, AmeriGroup paid $144 million in damages to Illinois and the U.S. government and $190 million in civil penalties.3 In Florida, a dermatologist was sentenced to 22 years in prison, paid $3.7 million in restitution, forfeited an addition $3.7 million, and paid a $25,000 fine for performing 3,086 medically unnecessary surgeries on 865 Medicare beneficiaries.4 In Florida, a physician was sentenced to 24 months incarceration, ordered to pay $727,000 in restitution for cash payments where the physician signed blank prescriptions and certificates for medical necessity for patients he never saw.5 The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) found that providers in 8 out of 10 audited states received an estimated total of $27.3 million in Medicaid overpayments for services claimed after beneficiaries' deaths.6 PMID:20169019

  5. Control of corruption in healthcare.

    Science.gov (United States)

    Ahmed, Armin; Azim, Afzal

    2015-01-01

    A recently published article on corruption in Indian healthcare in the BMJ has triggered a hot debate and numerous responses (1, 2, 3, 4). We do agree that corruption in Indian healthcare is a colossal issue and needs to be tackled urgently (5). However, we want to highlight that corruption in healthcare is not a local phenomenon confined to the Indian subcontinent, though India does serve as a good case study and intervention area due to the magnitude of the problem and the country's large population (6). Good governance, strict rules, transparency and zero tolerance are some of the strategies prescribed everywhere to tackle corruption. However, those entrusted with implementing good governance and strict rules in India need to go through a process of introspection to carry out their duties in a responsible fashion. At present, it looks like a no-win situation. In this article, we recommend education in medical ethics as the major intervention for dealing with corruption in healthcare.

  6. Your Heart Failure Healthcare Team

    Science.gov (United States)

    ... them know how you're doing. With good teamwork and communication, you can improve the quality of ... Failure Recognition and Knowing Your Options Planning Ahead Communicating with Your Healthcare Provider Overcoming Barriers to Shared ...

  7. Lean Six Sigma in Healthcare

    NARCIS (Netherlands)

    de Koning, H.; Verver, J.P.S.; van den Heuvel, J.; Bisgaard, S.; Does, R.J.M.M.

    2006-01-01

    Keywords: Cost reduction; efficiency; innovation; quality improvement; service management. Abstract Healthcare, as any other service operation, requires systematic innovation efforts to remain competitive, cost efficient and up to date. In this article, we outline a methodology and present examples

  8. Lean Six Sigma in Healthcare

    NARCIS (Netherlands)

    de Koning, H.; Verver, J.P.S.; van den Heuvel, J.; Bisgaard, S.; Does, R.J.M.M.

    2006-01-01

    Keywords: Cost reduction; efficiency; innovation; quality improvement; service management. Abstract Healthcare, as any other service operation, requires systematic innovation efforts to remain competitive, cost efficient and up to date. In this article, we outline a methodology and present examples

  9. Pseudomonas aeruginosa in Healthcare Settings

    Science.gov (United States)

    ... Address What's this? Submit What's this? Submit Button Pseudomonas aeruginosa in Healthcare Settings Recommend on Facebook Tweet ... and/or help treat infections? What is a Pseudomonas infection? Pseudomonas infection is caused by strains of ...

  10. Leveraging Digital Innovation in Healthcare

    DEFF Research Database (Denmark)

    Brown, Carol V.; Jensen, Tina Blegind; Aanestad, Margun

    2014-01-01

    and security concerns, fragmented markets, and misaligned incentives across stakeholders. The panel will focus on this apparent paradox and highlight the potential of big data, cloud and mobile computing for achieving better health. The panel co-chairs will introduce differences in healthcare delivery...... investments in digital infrastructures. New technologies are leveraged to achieve widespread 24x7 disease management, patients’ wellbeing, home-based healthcare and other patient-centric service innovations. Yet, digital innovations in healthcare face barriers in terms of standardization, data privacy...... landscapes in selected countries. Then panelists with expertise in digital data streams, cloud, and mobile computing will present concrete examples of healthcare service innovations that have the potential to address one or more of the global goals. ECIS attendees are invited to join a debate about...

  11. Business process modeling in healthcare.

    Science.gov (United States)

    Ruiz, Francisco; Garcia, Felix; Calahorra, Luis; Llorente, César; Gonçalves, Luis; Daniel, Christel; Blobel, Bernd

    2012-01-01

    The importance of the process point of view is not restricted to a specific enterprise sector. In the field of health, as a result of the nature of the service offered, health institutions' processes are also the basis for decision making which is focused on achieving their objective of providing quality medical assistance. In this chapter the application of business process modelling - using the Business Process Modelling Notation (BPMN) standard is described. Main challenges of business process modelling in healthcare are the definition of healthcare processes, the multi-disciplinary nature of healthcare, the flexibility and variability of the activities involved in health care processes, the need of interoperability between multiple information systems, and the continuous updating of scientific knowledge in healthcare.

  12. Strategies to Improve Healthcare Websites

    OpenAIRE

    Johnson, Constance; Peterson, Susan K; Turley, James P.; Ensor, Joe; Amos, Christopher; Spitz, Margaret; Levin, Bernard; Berry, Donald

    2006-01-01

    Healthcare websites that are influential in healthcare decision-making must be evaluated for accuracy, readability and understandability by the average population. Most existing frameworks for designing and evaluating interactive websites focus on the utility and usability of the site. Although these are significant to the design of the basic site, they are not sufficient. We have developed an iterative framework that considers additional attributes.

  13. Strategies to Improve Healthcare Websites

    Science.gov (United States)

    Johnson, Constance; Peterson, Susan K.; Turley, James P.; Ensor, Joe; Amos, Christopher; Spitz, Margaret; Levin, Bernard; Berry, Donald

    2006-01-01

    Healthcare websites that are influential in healthcare decision-making must be evaluated for accuracy, readability and understandability by the average population. Most existing frameworks for designing and evaluating interactive websites focus on the utility and usability of the site. Although these are significant to the design of the basic site, they are not sufficient. We have developed an iterative framework that considers additional attributes. PMID:17238588

  14. Pediatric home healthcare: a paradox.

    Science.gov (United States)

    Krepper, R; Young, A; Cummings, E

    1994-01-01

    Although parents may welcome having their ill child cared for at home, they are not prepared to compromise privacy and family rituals, nor share control of their child. The purpose of this article is to provide a snapshot of problems that parents have encountered with pediatric home healthcare. Home care parents offer suggestions for other parents and home healthcare nurses and agencies, encouraging them to be proactive in preventing potential problems.

  15. HEALTHCARE: A COMPLEX SERVICE SYSTEM

    Institute of Scientific and Technical Information of China (English)

    James M. TIEN; Pascal J. GOLDSCHMIDT-CLERMONT

    2009-01-01

    Healthcare is indeed a complex service system, one requiring the technobiology approach of systems engineering to underpin its development as an integrated and adaptive system. In general, healthcare services are carried out with knowledge-intensive agents or components which work together as providers and consumers to create or co-produce value. Indeed, the engineering design of a healthcare system must recognize the fact that it is actually a complex integration of human-centered activities that is increasingly dependent on information technology and knowledge. Like any service system, healthcare can be considered to be a combination or recombination of three essential components-people (characterized by behaviors, values, knowledge, etc.), processes (characterized by collaboration, customization, etc.) and products (characterized by software, hardware, infrastructures, etc.). Thus, a healthcare system is an integrated and adaptive set of people, processes and products. It is, in essence, a system of systems which objectives are to enhance its efficiency (leading to greater interdependency) and effectiveness (leading to improved health). Integration occurs over the physical, temporal, organizational and functional dimensions, while adaptation occurs over the monitoring, feedback, cybernetic and learning dimensions. In sum, such service systems as healthcare are indeed complex, especially due to the uncertainties associated with the human-centered aspects of these systems. Moreover, the system complexities can only be dealt with methods that enhance system integration and adaptation.

  16. Six Sigma in healthcare delivery.

    Science.gov (United States)

    Liberatore, Matthew J

    2013-01-01

    The purpose of this paper is to conduct a comprehensive review and assessment of the extant Six Sigma healthcare literature, focusing on: application, process changes initiated and outcomes, including improvements in process metrics, cost and revenue. Data were obtained from an extensive literature search. Healthcare Six Sigma applications were categorized by functional area and department, key process metric, cost savings and revenue generation (if any) and other key implementation characteristics. Several inpatient care areas have seen most applications, including admission, discharge, medication administration, operating room (OR), cardiac and intensive care. About 42.1 percent of the applications have error rate as their driving metric, with the remainder focusing on process time (38 percent) and productivity (18.9 percent). While 67 percent had initial improvement in the key process metric, only 10 percent reported sustained improvement. Only 28 percent reported cost savings and 8 percent offered revenue enhancement. These results do not favorably assess Six Sigma's overall effectiveness and the value it offers healthcare. Results are based on reported applications. Future research can include directly surveying healthcare organizations to provide additional data for assessment. Future application should emphasize obtaining improvements that lead to significant and sustainable value. Healthcare staff can use the results to target promising areas. This article comprehensively assesses Six Sigma healthcare applications and impact.

  17. Serial murder by healthcare professionals.

    Science.gov (United States)

    Yorker, Beatrice Crofts; Kizer, Kenneth W; Lampe, Paula; Forrest, A R W; Lannan, Jacquetta M; Russell, Donna A

    2008-01-01

    The prosecution of Charles Cullen, a nurse who killed at least 40 patients over a 16-year period, highlights the need to better understand the phenomenon of serial murder by healthcare professionals. The authors conducted a LexisNexis search which yielded 90 criminal prosecutions of healthcare providers that met inclusion criteria for serial murder of patients. In addition we reviewed epidemiologic studies, toxicology evidence, and court transcripts, to provide data on healthcare professionals who have been prosecuted between 1970 and 2006. Fifty-four of the 90 have been convicted; 45 for serial murder, four for attempted murder, and five pled guilty to lesser charges. Twenty-four more have been indicted and are either awaiting trial or the outcome has not been published. The other 12 prosecutions had a variety of legal outcomes. Injection was the main method used by healthcare killers followed by suffocation, poisoning, and tampering with equipment. Prosecutions were reported from 20 countries with 40% taking place in the United States. Nursing personnel comprised 86% of the healthcare providers prosecuted; physicians 12%, and 2% were allied health professionals. The number of patient deaths that resulted in a murder conviction is 317 and the number of suspicious patient deaths attributed to the 54 convicted caregivers is 2113. These numbers are disturbing and demand that systemic changes in tracking adverse patient incidents associated with presence of a specific healthcare provider be implemented. Hiring practices must shift away from preventing wrongful discharge or denial of employment lawsuits to protecting patients from employees who kill.

  18. The Learning Healthcare System and Cardiovascular Care: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Maddox, Thomas M; Albert, Nancy M; Borden, William B; Curtis, Lesley H; Ferguson, T Bruce; Kao, David P; Marcus, Gregory M; Peterson, Eric D; Redberg, Rita; Rumsfeld, John S; Shah, Nilay D; Tcheng, James E

    2017-04-04

    The learning healthcare system uses health information technology and the health data infrastructure to apply scientific evidence at the point of clinical care while simultaneously collecting insights from that care to promote innovation in optimal healthcare delivery and to fuel new scientific discovery. To achieve these goals, the learning healthcare system requires systematic redesign of the current healthcare system, focusing on 4 major domains: science and informatics, patient-clinician partnerships, incentives, and development of a continuous learning culture. This scientific statement provides an overview of how these learning healthcare system domains can be realized in cardiovascular disease care. Current cardiovascular disease care innovations in informatics, data uses, patient engagement, continuous learning culture, and incentives are profiled. In addition, recommendations for next steps for the development of a learning healthcare system in cardiovascular care are presented. © 2017 American Heart Association, Inc.

  19. Telecommunication technology used in home healthcare.

    Science.gov (United States)

    Mishra, Sumant; Nayak, C G; Shet, K C; George, V I

    2011-01-01

    Current telemedicine applications are usually developed for doctors to do consultation and case study between several hospitals. Patients see doctor at home via Internet becomes possible and it might be a part of lifestyle in the future. Telemedicine has been an active area of research for over 30 years. In the past, several telemedicine applications using wired EPABX telecommunications equipment were provided whereas now-a-days the evolution of wireless communication means enabling telemedicine systems to operate everywhere in the world, thus expanding telemedicine benefits, services and applications. How these applications are used in healthcare delivery and what are the technologies used in this system are explained in this paper.

  20. Compassion fatigue in military healthcare teams.

    Science.gov (United States)

    Owen, Regina Peterson; Wanzer, Linda

    2014-02-01

    Since the onset of the Iraq war and Afghanistan conflicts, military healthcare teams have had increasing exposure to the traumatic effects of caring for wounded warriors, leading to a phenomenon termed compassion fatigue. The purpose of this integrative review was to develop a proposed definition for compassion fatigue in support of these teams. There is no current standardized formal definition, and this lack of clarity can inhibit intervention. Seven main themes evolved from the literature review and were integrated with the core elements of the Bandura Social Cognitive Theory Model as the first step in developing a uniformed definition.

  1. Performance of Zirconia for Dental Healthcare

    Directory of Open Access Journals (Sweden)

    Ralf J. Kohal

    2010-02-01

    Full Text Available The positive results of the performance of zirconia for orthopedics devices have led the dental community to explore possible esthetical and mechanical outcomes using this material. However, questions regarding long-term results have opened strong and controversial discussions regarding the utilization of zirconia as a substitute for alloys for restorations and implants. This narrative review presents the current knowledge on zirconia utilized for dental restorations, oral implant components, and zirconia oral implants, and also addresses laboratory tests and developments, clinical performance, and possible future trends of this material for dental healthcare.

  2. Healthcare Policy in Romania. Frameworks and Challenges

    Directory of Open Access Journals (Sweden)

    Buţiu Călina Ana

    2016-07-01

    Full Text Available The objective of the paper is to review some of the healthcare policy issues of Romania and identify those challenges which may be addressed through social intervention. Based on statistical data, documents, reports and applicable laws one will review the health condition of Romanian population and the state of the national health system, and will examine the broad strategies and policies currently under the scrutiny of appropriate ministries. The findings of the study suggest looking at health policies also through the lens of social inclusion.

  3. Current global status of social healthcare system for mental disorders in children and adolescents:with system and defense continuity%全球儿童和青少年精神障碍的防治现状具有系统性和防护的连续性

    Institute of Scientific and Technical Information of China (English)

    苏巧荣; 苏林雁; 耿耀国

    2005-01-01

    OBJECTIVE: To review the current global status of social healthcare systems for mental disorders in children and adolescents, which provide systematic and continuous protection against mental disorders.DATA SOURCES: A computer-based search for relevant English articles in Medline database published between January 1980 and March 2005 was conducted with the key words of "mental disorder, children and adolescents, care". The Chinese full-text periodical database and Wanfang database were also searched for relevant Chinese articles published between January 1990 and March 2005 using equivalent Chinese key words of "mental disorder, children and adolescents, care".STUDY SELECTION: The articles that reviewed the current status of social healthcare system for mental disorders in children and adolescents were included for analysis, and those not categorized as reviews were excluded.DATA EXTRACTION: Totally 58 related articles were collected, among which 13 met the inclusion criteria and 45 were excluded.DATA SYNTHESIS: The current status of social healthcare systems for mental disorders in children and adolescents in Europe, North America,South America, Australia, Asia and Africa were described. The prevention and treatment for mental disorders in Europe and North America were well developed. The training, education and research of mental disease in children in South America were still developing, and the healthcare system in Australia needs further improvement. Lack of professional physicians is the major problem in Asia, whereas a complete protective system has not been well established in Africa and the families assume the role of primary defense against the disorder.CONCLUSION: The comprehensive healthcare services for mental disorders in children and adolescents has been lacking globally. Policy development, cultural understanding in the healthcare, recognition of the important role of nongovernmental organizations, epidemiological research, and professional training

  4. The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review.

    Science.gov (United States)

    Parmelli, Elena; Flodgren, Gerd; Beyer, Fiona; Baillie, Nick; Schaafsma, Mary Ellen; Eccles, Martin P

    2011-04-03

    Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. In recent years, increasing emphasis has been placed on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. We searched the following electronic databases: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies (controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) analyses). Studies could be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. The search strategy yielded 4,239 records. After the full text assessment, two CBA studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes. Both were at high risk of

  5. Directions in healthcare research: pointers from retailing and services marketing.

    Science.gov (United States)

    Van Rompay, Thomas L J; Tanja-Dijkstra, Karin

    2010-01-01

    Although the importance of the environment in relation to healing processes has been well established, empirical evidence for environmental effects on patient well-being and behavior is sparse. In addition, few attempts have been made to integrate insights from related fields of research such as retailing and services marketing with findings from healthcare studies. In this paper, relevant findings and insights from these domains are discussed. What insights and findings from retailing and services marketing are (potentially) of interest to the healthcare context, and how should one interpret and follow up on these results in healthcare environments? Research in retailing and services marketing indicates that physical environmental factors (i.e., music and scent) and social environmental factors (i.e., crowded conditions) may affect consumer satisfaction and well-being. In addition, environmental effects have been shown to vary with contextual factors (e.g., the type of environment) and consumer needs (e.g., the extent to which consumers value social contact or stimulation in a specific setting). Although the evidence base for environmental factors in health environments is steadily growing, few attempts have been made to integrate findings from both domains. The findings presented indicate that environmental variables such as music and scent can contribute to patient well-being and overall satisfaction. In addition, findings suggest that these variables may be used to counteract the negative effects resulting from crowded conditions in different healthcare units. Taking into account recent developments in the healthcare industry, the importance of creating memorable and pleasant patient experiences is likely to grow in the years to come. Hence, the finding that subtle and relatively inexpensive manipulations may affect patient well-being in profound ways should inspire follow-up research aimed at unraveling the specifics of environmental influences in health

  6. Survival and development strategy of the hospital library in the environment of the healthcare reform%医改环境下医院图书馆生存与发展策略

    Institute of Scientific and Technical Information of China (English)

    陈小忠; 尹东宁; 陈励和; 陈春英; 张园; 杨继玉

    2013-01-01

    Objectives:To discuss the survival and development strategy of hospital library under the background of the healthcare reform. Methods:By using the questionnaire and case study, the experience in library services of hospital libraries in China were summarized. By studying the practices of public libraries, university libraries and combining with the situation of hospital library, ways that suit for hospital libraries were explored. Results:The large-scale hospital library staff structure is relatively more reasonable and the professional quality is relatively high. They have a certain scale of the electronic reading room and foreign electronic resources database. Hospital libraries are combined with its own resources and the needs of readers to carry out a wide variety of information services and have had good reputation. Conclusions:Highly educated librarians are the key resources of library services. Plenty of books funding is the foundation to carry out the library service. Excellent hospital library provides the reader service project is similar. Build the library boutique service for this unit case to provide literature support for leadership decision-making and hospital development. Grasp the mainstream of medical staff needs and participate in regional library consortium.%  目的:在医改背景下,探讨医院图书馆生存、发展的策略。方法:应用问卷调查法与案例分析法,总结国内大型医院图书馆的图书情报服务经验,探讨其他医院图书馆复制的可能性;研究公共图书馆、高校图书馆的先进经验,结合医院图书馆的实际情况,探索适合医院图书馆可持续发展的道路。结果:大型医院图书馆人员结构比较合理、专业素质比较高,具有一定规模的电子阅览室及中外文电子资源数据库。各馆都在结合自身的资源优势和读者的需求开展多种多样的信息服务且获得了读者的认可和好评。结论:高学历

  7. Cautioning Health-Care Professionals

    Science.gov (United States)

    Schut, Henk; Boerner, Kathrin

    2017-01-01

    Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to “prescribe” stages. Basically, this perspective endorses the idea that bereaved people go through a set pattern of specific reactions over time following the death of a loved one. It has frequently been interpreted prescriptively, as a progression that bereaved persons must follow in order to adapt to loss. It is of paramount importance to assess stage theory, not least in view of the current status of the maladaptive “persistent complex bereavement-related disorder” as a category for further research in DSM-5. We therefore review the status and value of this approach. It has remained hugely influential among researchers as well as practitioners across recent decades, but there has also been forceful opposition. Major concerns include the absence of sound empirical evidence, conceptual clarity, or explanatory potential. It lacks practical utility for the design or allocation of treatment services, and it does not help identification of those at risk or with complications in the grieving process. Most disturbingly, the expectation that bereaved persons will, even should, go through stages of grieving can be harmful to those who do not. Following such lines of reasoning, we argue that stage theory should be discarded by all concerned (including bereaved persons themselves); at best, it should be relegated to the realms of history. There are alternative models that better represent grieving processes. We develop guidelines to enhance such a move beyond the stage approach in both theory and practice. PMID:28355991

  8. Building Healthcare - Patient Relationship with CRM 2.0: Lesson Learnt from Prita Mulyasari's Case

    CERN Document Server

    Anshari, Muhammad

    2012-01-01

    Healthcare is implementing CRM as a strategy for managing interactions and communication with patients which involves using Information and Communication Technology (ICT) to organize, automate, and coordinate business processes. CRM with the Web technology provides healthcare the ability to broaden service beyond its usual practices, and thus provides a particular advantageous environment for them that want to use ICT to achieve complex healthcare goal. This paper we will discuss and demonstrate how a new approach in CRM will help the healthcare increasing their customer support, and promoting better health to patient. The patients benefited from the customized personal service so that they have full information access to perform self managed their own health and the healthcare provider will have a loyal and retains the right customer. A conceptual framework of approach will be highlighted. Customer centric paradigm in social network's era and value creation of healthcare's business process will be taken into...

  9. 漫说养生%On Healthcare

    Institute of Scientific and Technical Information of China (English)

    何任

    2011-01-01

    TCM healthcare has long history, however, from the complete meaning, healthcare from "3 reasons theory" is the real keeping good health, so we shall pay attention to spiritual healthcare, climate healthcare, diet healthcare, living healthcare and nourishing healthcare.%中医的养生学说源远流长,但从完整的意义上说,以"三因学说"来考虑养生,才是真正的谈养生,所以必须注重精神养生、气候养生、饮食养生、起居养生、进补养生.

  10. Antibiotic use, resistance development and environmental factors: a qualitative study among healthcare professionals in Orissa, India

    Science.gov (United States)

    2010-01-01

    Background Antibiotic resistance is a major public health problem affecting both current and future generations. The influence of environmental factors on antibiotic use and resistance development in bacteria is largely unknown. This study explored the perceptions of healthcare providers on antibiotic use and resistance development in relation to environmental factors i.e. physical, natural, social and behavioural factors. Methods A qualitative interview study was conducted using face-to-face, semi-structured interviews among registered allopathic doctors, veterinarians and drug dispensers in Orissa, India. The interview transcripts were analyzed using latent content analysis. Results The main findings of this study relate to two themes: 'Interrelationship between antibiotic use, resistance development and environment' and 'Antibiotic management contributing to the development and spread of resistance'. The interviewees viewed the following as possible contributors to antibiotic use/misuse and resistance development: changes in the natural and physical environment i.e. climate variability, pollution, physiography and population growth; the socioeconomic environment affecting health-seeking behaviour and noncompliance with medication; a lack of healthcare facilities and poor professional attitudes; and ineffective law enforcement regarding medicine dispensing and disposal. Conclusions Generally, the interviewees perceived that although behavioural and social environmental factors are major contributors to resistance development, changes in the physical and natural environment also influence development of antibiotic resistance. The respondents also perceived that there is a lack of information about, and poor awareness of, what constitutes prudent use of antibiotics. They suggested a need for information, education, dissemination and proper implementation and enforcement of legislation at all levels of the drug delivery and disposal system in order to improve

  11. IT-enabled Quality Management implementations in Small Healthcare Institutions: Method and Case Study

    NARCIS (Netherlands)

    Smit, Koen; Mens, Joris; Versendaal, Johan; Sewberath Misser, Navin; Ravesteijn, Pascal

    2013-01-01

    In the dynamic environment of increasing regulations, increasing patient demand, decentralization of budgets and enforcement of efficiency, small sized healthcare institutions in the Netherlands are having a difficult time. Although these service providers are usually capable of flexibly delivering

  12. Guiding healthcare technology implementation: a new integrated technology implementation model.

    Science.gov (United States)

    Schoville, Rhonda R; Titler, Marita G

    2015-03-01

    Healthcare technology is used to improve delivery of safe patient care by providing tools for early diagnosis, ongoing monitoring, and treatment of patients. This technology includes bedside physiologic monitors, pulse oximetry devices, electrocardiogram machines, bedside telemetry, infusion pumps, ventilators, and electronic health records. Healthcare costs are a challenge for society, and hospitals are pushed to lower costs by discharging patients sooner. Healthcare technology is being used to facilitate these early discharges. There is little understanding of how healthcare facilities purchase, implement, and adopt technology. There are two areas of theories and models currently used when investigating technology: technology adoption and implementation science. Technology adoption focuses mainly on how the end users adopt technology, whereas implementation science describes methods, interventions, and variables that promote the use of evidence-based practice. These two approaches are not well informed by each other. In addition, amplifying the knowledge gap is the limited conceptualization of healthcare technology implementation frameworks. To bridge this gap, an all-encompassing model is needed. To understand the key technology implementation factors utilized by leading healthcare facilities, the prevailing technology adoption and implementation science theories and models were reviewed. From this review, an integrated technology implementation model will be set forth.

  13. A qualitative analysis of interprofessional healthcare team members' perceptions of patient barriers to healthcare engagement.

    Science.gov (United States)

    Powell, Rhea E; Doty, Amanda; Casten, Robin J; Rovner, Barry W; Rising, Kristin L

    2016-09-20

    issues was increased visibility of the health system within communities to foster trust and help providers gain a better understanding of unique community needs. This work explored interprofessional healthcare team members' perceptions of patient barriers to healthcare engagement. Participants identified barriers related to social determinants of health, complex system organization, and patient mistrust of the health system. Participants offered concrete suggestions to address these barriers, with suggestions supporting current healthcare reform efforts that aim at addressing social determinants and improving health system coordination and adding new insight into how systems might work to improve patient and community trust.

  14. Accreditation and Participatory Design in the Health-Care Sector

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Scheuer, John Damm; Hertzum, Morten

    2015-01-01

    We reconsider the role of participatory design approaches emphasizing the current context of the accreditation regime imposed on the Danish healthcare sector. We describe effects-driven IT development as an instrument supporting sustained participatory design. Effects-driven IT development includ......-based thinking. We describe and compare effects- driven IT development with accreditation and discuss the prospects and challenges for this approach to participatory design within the healthcare domain.......We reconsider the role of participatory design approaches emphasizing the current context of the accreditation regime imposed on the Danish healthcare sector. We describe effects-driven IT development as an instrument supporting sustained participatory design. Effects-driven IT development includes...... specifying, realizing, and measuring effects from using an information technology. This approach aligns with much of the logic inherent in accreditation and it supports challenging parts of the accreditation process. Effects-driven IT development furthermore might support effects related to clinical evidence...

  15. Am I my brother's keeper? A survey of 10 healthcare professions in the Netherlands about experiences with impaired and incompetent colleagues

    NARCIS (Netherlands)

    Weenink, J.; Westert, G.P.; Schoonhoven, L.; Wollersheim, H.C.H.; Kool, R.B.

    2015-01-01

    BACKGROUND: Dealing with poor individual performance of healthcare professionals is essential in patient safety management. The objective of the current study was to explore potential differences regarding experiences with impaired and incompetent colleagues between a broad range of healthcare profe

  16. Healthcare worker competencies for disaster training

    Directory of Open Access Journals (Sweden)

    Kelen Gabor D

    2006-03-01

    Full Text Available Abstract Background Although training and education have long been accepted as integral to disaster preparedness, many currently taught practices are neither evidence-based nor standardized. The need for effective evidence-based disaster training of healthcare staff at all levels, including the development of standards and guidelines for training in the multi-disciplinary health response to major events, has been designated by the disaster response community as a high priority. We describe the application of systematic evidence-based consensus building methods to derive educational competencies and objectives in criteria-based preparedness and response relevant to all hospital healthcare workers. Methods The conceptual development of cross-cutting competencies incorporated current evidence through a systematic consensus building process with the following steps: (1 review of peer-reviewed literature on relevant content areas and educational theory; (2 structured review of existing competencies, national level courses and published training objectives; (3 synthesis of new cross-cutting competencies; (4 expert panel review; (5 refinement of new competencies and; (6 development of testable terminal objectives for each competency using similar processes covering requisite knowledge, attitudes, and skills. Results Seven cross-cutting competencies were developed: (1 Recognize a potential critical event and implement initial actions; (2 Apply the principles of critical event management; (3 Demonstrate critical event safety principles; (4 Understand the institutional emergency operations plan; (5 Demonstrate effective critical event communications; (6 Understand the incident command system and your role in it; (7 Demonstrate the knowledge and skills needed to fulfill your role during a critical event. For each of the cross-cutting competencies, comprehensive terminal objectives are described. Conclusion Cross-cutting competencies and objectives

  17. Healthy workplaces and teamwork for healthcare workers need public engagement.

    Science.gov (United States)

    Matthews, Sue; Macdonald-Rencz, Sandra

    2007-01-01

    This response challenges the healthcare system to take full responsibility for the work environments created for health human resources. While the need for healthy work environments and teamwork in healthcare are inarguable, the fact is they are not a reality in today's health system. The authors suggest strategies to address this issue and identify the person or groups that should take responsibility, including governments, organizations, individuals and the public. Strategies include ensuring that policies do not contradict one another and holding each level responsible for the outcomes of a healthy work environment - retention and recruitment of health human resources, better patient/client outcomes and healthcare costs. The need for strong and appropriate leadership for health human resources with "content knowledge" is discussed, along with recommendations for measuring the performance and success of healthy work environments and teamwork. The authors conclude that collaboration at the micro, meso and macro levels is required to facilitate the true change that is needed to improve the work environments of health human resources.

  18. Using Logic Programming to Detect Activities in Pervasive Healthcare

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak

    2002-01-01

    In this experience paper we present a case study in using logic programming in a pervasive computing project in the healthcare domain. An expert system is used to detect healthcare activities in a pervasive hospital environment where positions of people and things are tracked. Based on detected...... activities an activity-driven computing infrastructure provides computational assistance to healthcare staff on mobile-and pervasive computing equipment. Assistance range from simple activities like fast log-in into the electronic patient medical record system to complex activities like signing for medicine...... given to specific patients. We describe the role of logic programming in the infrastructure and discuss the benefits and problems of using logic programming in a pervasive context....

  19. Application of magic in healthcare: A scoping review.

    Science.gov (United States)

    Lam, Michael T; Lam, Helen R; Chawla, Lalit

    2017-02-01

    Scoping review. The art and science of magic traces back to ancient days. Physicians are often compared to magicians metaphorically. Nonetheless, there exist various genuine applications of magic in the healthcare setting. To explore and summarize the literature reporting the applications of magic tricks or any derived techniques in healthcare or clinical environments. A literature search was performed on ten databases: Medline, Embase, CINAHL, Cochrane Central, Cochrane Database of Systematic Reviews, PEDro, Scopus, the International Index to Performing Arts, General OneFile and Newstand, to identify references related to the application of magic in healthcare. Relevant studies were charted, categorized, and summarized. 29 relevant references were found, consisting of 20 peer-reviewed publications and nine popular literature articles. Five distinct applications of magic in the clinical setting were identified. The literature showed an overall lack of academic evidence. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  20. Satisfaction measurement instruments for healthcare service users: a systematic review

    Directory of Open Access Journals (Sweden)

    Renato Santos de Almeida

    2015-01-01

    Full Text Available Patient satisfaction surveys can be an interesting way to improve quality and discuss the concept of patient-centered care. This study aimed to conduct a systematic review of the validated patient satisfaction measurement instruments applied in healthcare. The systematic review searched the MEDLINE/PubMed, LILACS, SciELO, Scopus and Web of Knowledge. The search strategy used the terms: "Patient Satisfaction" AND "Patient centered care" AND "Healthcare survey OR Satisfaction questionnaire" AND "Psychometric properties". 37 studies were included and almost all studies showed that satisfaction is a multidimensional construct. In these studies, 34 different instruments were used and most surveys contained the dimension patient-healthcare professional interactions, physical environment and management process. The COSMIN score for methodological quality showed that most of them scored a good or fair average. We can conclude that there is not a gold standard instrument for patient satisfaction assessment but some dimensions are essential for this construct.

  1. Healthcare employers' policies on nurse education.

    Science.gov (United States)

    Pittman, Patricia; Herrera, Carolina-Nicole S; Horton, Katherine; Thompson, Pamela A; Ware, Jamie M; Terry, Margaret

    2013-01-01

    The 2010 recommendation that the proportion of registered nurses with BSN (bachelor of science in nursing) degrees in the nursing workforce should increase from the current 40% to 80% by the year 2020 has shifted the focus on nurses educational progression from state legislatures-where changes in entry-level requirements were debated for decades-to the executive suites of large healthcare providers. The recommendation, contained in the report titled The Future of Nursing: Leading Change, Advancing Health, by the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine, suggests that human resources policies for nurses have the potential to double the rates of college degree completions (IOM, 2010). We surveyed 447 nurse executives in hospitals, nurse-led clinics, and home and hospice companies to explore the current practices of healthcare employers with regard to this recommendation. Almost 80% of respondents reported that their institution either preferred or required newly hired nurses to have a bachelor's degree, and 94% of the facilities offered some level of tuition reimbursement. Only 25%, however, required their nurses to earn a BSN or offered salary differentials on the basis of educational attainment (9%). We conclude that if employers are serious about wanting a more highly educated nurse workforce, they need to adopt requirements for degree completion and wage differentials in the coming years. The likelihood that such policies will be widely adopted, however, is dramatically affected by the dynamics of nursing supply and demand.

  2. Some perspectives on affordable healthcare systems in China.

    Science.gov (United States)

    Zhang, Y T; Yan, Y S; Poon, C C Y

    2007-01-01

    Consistent with the global population trend, China is becoming an aging society. Over one-fifth of the world's elderly population (aged 65 and over) lives in China. Statistics show that the elderly populace in China constitutes 8% of the total population in 2006 and the percentage will be tripled to become 24% in 2050. As a result, there is inevitably an increase in the prevalence of chronic disease that accounted for almost 80% of all deaths in China in 2005. On the other hand, from 1978 to 2003, the total expenditure on healthcare in China increased from 11.02 billion RMB up to 658.41 billion RMB, and in terms of GDP, it is an increase from 3.04% to 5.62%. The annual average increase (12.1%) in healthcare investment is therefore even higher than the annual rate of GDP increase (9.38%) during the last two decades. Meeting the long-term healthcare needs of this growing elderly population and escalating healthcare expenditure pose a grim challenge to the current Chinese healthcare system and the solvency of state budgets. In fact, the healthcare services in China have become less accessible since the early 1980s when its costs soared up. The rising costs have prevented many Chinese people from seeking early medical care. The phenomenon has created a wide disparity in seeking healthcare between urban and rural areas. These trends are of particular concern to the elderly, who have higher healthcare needs yet lesser means to afford the services. Furthermore, according to the 3rd National Health Service Survey, 79.1% of rural residents and 44.8% of urban citizens did not have any form of medical insurance. Such a low percentage of coverage of medical insurance indicates that many people may not be able to afford medical services when they suffer from severe diseases. Therefore, there is a great need of a more effective and low-cost healthcare system. A new system that can allow multi-level, multi-dimensional and standardized healthcare services for urban and rural

  3. Characterisation of impacts on the environment of an idealised offshore wind farm foundation, under waves and the combination of waves and currents

    Science.gov (United States)

    García-Hermosa, Isabel; Abcha, Nizar; Brossard, Jérôme; Bennis, Anne-Claire; Ezersky, Alexander; Gross, Marcus; Iglesias, Gregorio; Magar, Vanesa; Miles, Jon; Mouazé, Dominique; Perret, Gaële; Pinon, Grégory; Rivier, Aurélie; Rogan, Charlie; Simmonds, David

    2015-04-01

    Offshore wind technology is currently the most widespread and advanced source of marine renewable energy. Offshore wind farms populate waters through the North Sea and the English Channel. The UK and French governments devised deadlines to achieve percentages of electricity from renewable sources by 2020, these deadlines and the direct translation of land based wind farm technology to the offshore environment resulted in the rapid expansion of the offshore wind energy. New wind farms have been designed with a larger number of masts and are moving from shallow offshore banks to deeper waters and in order to produce more power the diameters of monopoles masts are becoming larger to support larger turbines. The three-partner EU INTERREG funded project OFELIA (http://www.interreg-ofelia.eu/) aims to establish a cross-channel (between the UK and France) research collaboration to improve understanding of the environmental impacts of offshore wind farm foundations. The objective of the present study is to characterise changes in the hydrodynamics and sea bed in the vicinity of an offshore wind farm mast and in the wake area under wave and wave-current conditions corresponding to events in the French wind farm site of Courseulles-sur-mer (offshore of Lower Normandy, in the English Channel). Experiments were carried out in two laboratory facilities: a wave flume of 35 m long, 0.9 m wide and 1.2 m in depth with regular and irregular waves (García-Hermosa et al., 2014); and a wave and current flume of 17 m long, 0.5 m wide and 0.4 m depth with regular waves, currents from 180° to the waves and a mobile bed (Gunnoo et al., 2014). Flow velocity measurements were taken with an Acoustic Dopple Velocimeter (ADV) at various points around the cylinder and Particle Image Velocitmetry (PIV) techniques were applied to larger areas upstream and downstream of the cylinder. During the assessment of waves and currents' effects on the bed evolution were assessed using a laser and camera

  4. Visioning future emergency healthcare collaboration

    DEFF Research Database (Denmark)

    Söderholm, Hanna M.; Sonnenwald, Diane H.

    2010-01-01

    New video technologies are emerging to facilitate collaboration in emergency healthcare. One such technology is 3D telepresence technology for medical consultation (3DMC) that may provide richer visual information to support collaboration between medical professionals to, ideally, enhance patient...... care in real time. Today only an early prototype of 3DMC exists. To better understand 3DMC's potential for adoption and use in emergency healthcare before large amounts of development resources are invested we conducted a visioning study. That is, we shared our vision of 3DMC with emergency room...... physicians, nurses, administrators, and information technology (IT) professionals working at large and small medical centers, and asked them to share their perspectives regarding 3DMC's potential benefits and disadvantages in emergency healthcare and its compatibility and/or lack thereof...

  5. Systems design for remote healthcare

    CERN Document Server

    Bonfiglio, Silvio

    2014-01-01

    This book provides a multidisciplinary overview of the design and implementation of systems for remote patient monitoring and healthcare. Readers are guided step-by-step through the components of such a system and shown how they could be integrated in a coherent framework for deployment in practice. The authors explain planning from subsystem design to complete integration and deployment, given particular application constraints. Readers will benefit from descriptions of the clinical requirements underpinning the entire application scenario, physiological parameter sensing techniques, information processing approaches and overall, application dependent system integration. Each chapter ends with a discussion of practical design challenges and two case studies are included to provide practical examples and design methods for two remote healthcare systems with different needs. ·         Provides a multi-disciplinary overview of next-generation mobile healthcare system design; ·         Includes...

  6. Healthcare innovation – The Epital

    DEFF Research Database (Denmark)

    Hesseldal, Louise; Kayser, Lars

    2016-01-01

    There is an ongoing debate about how best to organize healthcare innovation. This article introduces and illustrates an alternative way of doing so by studying an emerging informal and inter-organizational network (IION) in practice. Taking an ethnographic research approach, the authors propose...... the concept of a potluck feast to describethe nature of an IION and the dynamics within it. The relationship between the project andthe actors is explored by introducing Steven Brown’s reading of Michel Serres’ concept of the parasite. The unique way of organizing healthcare innovation studied in the article...... the emergence and dynamics of IIONs. In this way, this article contributes to the field of healthcare innovation and how to organize it, and may inspire those who are already in or intend to study this field....

  7. Healthcare in Australia.

    Science.gov (United States)

    Dalton-Brown, Sally

    2016-07-01

    No single issue has dominated health practitioners' ethical debates in 2014 in Australia, but a controversial decision on gene patenting and the media focus on "Dr. Death," euthanasia campaigner Dr. Philip Nitschke, have given new life to these two familiar (and global) debates. Currently a dying with dignity bill, drafted by the Australian Green Party, is under examination. The Senate inquiry into the bill received more than 663 submissions, with 57% opposed and 43% in support of the bill, which has now been referred to a Senate committee. Will this be another of Australia's failed attempts to legalize euthanasia? The trial of Dr. Nitschke begins on November 10, 2014.

  8. Liverpool's healthcare future safeguarded.

    Science.gov (United States)

    Lewis, David

    2014-03-01

    David Lewis, Principal and design lead for the London studio of international design and architecture firm, NBBJ, and part of the Carillion consortium designing the new Royal Liverpool University Hospital with HKS for The Royal Liverpool and Broadgreen University Hospitals NHS Trust, describes how the masterplan will seek to more clearly define the urban space of the street, restore public access to the centre of the site, and 'knit' the hospital more fully into fabric of Liverpool than is the case with the current, 1970s-built, Royal Liverpool University Hospital.

  9. Assistive Robotics in Robotics for healthcare, roadmap study for the EC

    NARCIS (Netherlands)

    Gelderblom, G.J.; Wilt, M. de; Cremers, G.; Rensma, A.

    2009-01-01

    To gain understanding in the current status of Robotics in healthcare the European Commission issued a roadmap study into this domain. This paper reports on the main characteristics and results of this study. The study covered the wide domain of Healthcare and in this paper the domains relevant for

  10. Telematic Requirements for a Mobile and Wireless Healthcare System derived from Enterprise Models

    NARCIS (Netherlands)

    Widya, I.; Halteren, van A.; Jones, V.; Bults, R.; Konstantas, D.; Vierhout, P.A.M.; Peuscher, J.; Jevtic, D.; Mikuc, M.

    2003-01-01

    A challenge of current innovation in healthcare processes is to improve the time to treatment. This paper addresses the benefits of telematic services and mobile & wireless devices such as vital sign sensors and head mounted cameras for healthcare processes. It explores the telematic requirements fo

  11. Improving the Quality and Cost of Healthcare Delivery: The Potential of Radio Frequency Identification (RFID) Technology

    Science.gov (United States)

    Vilamovska, Anna-Marie

    2010-01-01

    The study investigated whether an upcoming class of health information technology (HIT) can be used to address currently outstanding issues in the quality and cost of healthcare delivery. Expert interviews and a literature review were used to describe the 2009 universe of in- and outpatient healthcare RFID applications and to identify those…

  12. Improving the Quality and Cost of Healthcare Delivery: The Potential of Radio Frequency Identification (RFID) Technology

    Science.gov (United States)

    Vilamovska, Anna-Marie

    2010-01-01

    The study investigated whether an upcoming class of health information technology (HIT) can be used to address currently outstanding issues in the quality and cost of healthcare delivery. Expert interviews and a literature review were used to describe the 2009 universe of in- and outpatient healthcare RFID applications and to identify those…

  13. Rehabilitation robotics in robotics for healthcare ; a roadmap study for the European Commission

    NARCIS (Netherlands)

    Gelderblom, G.J.; Wilt, M.de; Cremers, G.; Rensma, A.R.

    2009-01-01

    To gain understanding in the current status of Robotics in healthcare the European Commission issued a roadmap study into this domain. This paper reports on the main characteristics and results of this study. The study covered the wide domain of Healthcare and in this paper the domains relevant for

  14. Assistive Robotics in Robotics for healthcare, roadmap study for the EC

    NARCIS (Netherlands)

    Gelderblom, G.J.; Wilt, M. de; Cremers, G.; Rensma, A.

    2009-01-01

    To gain understanding in the current status of Robotics in healthcare the European Commission issued a roadmap study into this domain. This paper reports on the main characteristics and results of this study. The study covered the wide domain of Healthcare and in this paper the domains relevant for

  15. Rehabilitation robotics in robotics for healthcare ; a roadmap study for the European Commission

    NARCIS (Netherlands)

    Gelderblom, G.J.; Wilt, M.de; Cremers, G.; Rensma, A.R.

    2009-01-01

    To gain understanding in the current status of Robotics in healthcare the European Commission issued a roadmap study into this domain. This paper reports on the main characteristics and results of this study. The study covered the wide domain of Healthcare and in this paper the domains relevant for

  16. Predicting Personal Healthcare Management: Impact of Individual Characteristics on Patient Use of Health Information Technology

    Science.gov (United States)

    Sandefer, Ryan Heath

    2017-01-01

    The use of health information and health information technology by consumers is a major factor in the current healthcare systems' effort to address issues related to quality, cost, and access. Patient engagement in the healthcare process through access to information related to diagnoses, procedures, and treatment has the potential to improve…

  17. Perceptions of traditional, complementary and alternative medicine among conventional healthcare practitioners in Accra, Ghana:Implications for integrative healthcare

    Institute of Scientific and Technical Information of China (English)

    Irene A Kretchy; Harry A Okere; Joseph Osafo; Barima Afrane; Joseph Sarkodie; Philip Debrah

    2016-01-01

    OBJECTIVE: Integrative medicine refers to ongoing efforts to combine the best of conventional and evidence-based complementary therapies. While this effort for colaboration is increasing, traditional complementary and alternative medicine (TM-CAM) remains poorly integrated into the current healthcare system of Ghana. At present, it is not clear if practitioners of mainstream medicine favor integrative medicine. The present study, therefore, sought to explore the perceptions of conventional healthcare professionals on integrative medicine. METHODS: A qualitative design composed of semi-structured interviews was conducted with 23 conventional healthcare professionals comprising pharmacists, physicians, nurses and dieticians from two quasi-government hospitals in Accra, Ghana. RESULTS: Participants’ knowledge of TM-CAM was low, and although they perceived alternative medicine as important to current conventional healthcare in Ghana, they expressed anxieties about the potential negative effects of the use of TM-CAM. This paradox was found to account for the low levels of use among these professionals, as wel as the low level of recommendation to their patients. The practitioners surveyed recommended that alternative medicine could be integrated into mainstream alopathic healthcare in Ghana through improving knowledge, training as wel as addressing concerns of safety and effi cacy. These fi ndings are discussed under the themes: the knowledge gap, the paradox of TM-CAM, experience of use and prescription, and guided integration. We did not observe any differences in views among the participants. CONCLUSION:The conventional healthcare professionals were ready to accept the idea of integrative medicine based on knowledge of widespread use and the potential role of TM-CAM products and practices in improving healthcare delivery in the country. However, to achieve an institutional integration, practitioners’ understanding of TM-CAM must be improved, with specifi c

  18. How do healthcare consumers process and evaluate comparative healthcare information? A qualitive study using cognitive interviews

    NARCIS (Netherlands)

    Damman, O.C.; Hendriks, M.; Rademakers, J.; Delnoij, D.M.J.; Groenewegen, P.P.

    2009-01-01

    Background: To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods: Using semi-structured cognitive interviews, interviewees

  19. How do healthcare consumers process and evaluate comparative healthcare information? A qualitative study using cognitive interviews.

    NARCIS (Netherlands)

    Damman, O.C.; Hendriks, M.; Rademakers, J.; Delnoij, D.; Groenewegen, P.

    2009-01-01

    Background: To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods: Using semi-structured cognitive interviews, interviewees

  20. RFID in the healthcare supply chain: usage and application.

    Science.gov (United States)

    Kumar, Sameer; Swanson, Eric; Tran, Thuy

    2009-01-01

    The purposes of this study are to first, determine the most efficient and cost effective portions of the healthcare supply chain in which radio frequency identification devices (RFID) can be implemented. Second, provide specific examples of RFID implementation and show how these business applications will add to the effectiveness of the healthcare supply chain. And third, to describe the current state of RFID technology and to give practical information for managers in the healthcare sector to make sound decisions about the possible implementation of RFID technology within their organizations. Healthcare industry literature was reviewed and examples of specific instances of RFID implementation were examined using an integrated simulation model developed with Excel, @Risk and Visio software tools. Analysis showed that the cost of implementing current RFID technology is too expensive for broad and sweeping implementation within the healthcare sector at this time. However, several example applications have been identified in which this technology can be effectively leveraged in a cost-effective way. This study shows that RFID technology has come a long way in the recent past and has potential to improve healthcare sector productivity and efficiency. Implementation by large companies such as Wal-mart has helped to make the technology become much more economical in its per unit cost as well as its supporting equipment and training costs. The originality of this study lies in the idea that few practical and pragmatic approaches have been taken within the academic field of study for the implementation of RFID into the healthcare supply chain. Much of the research has focused on specific companies or portions of the supply chain and not the entire supply chain. Also, many of the papers have discussed the future of the supply chain that is heavily dependent on advances in RFID technology. A few viable applications of how RFID technology can be implemented in the healthcare