Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit.

Science.gov (United States)

Swoboda, Sandra M; Earsing, Karen; Strauss, Kevin; Lane, Stephen; Lipsett, Pamela A

2004-02-01

To determine whether electronic monitoring of hand hygiene and voice prompts can improve hand hygiene and decrease nosocomial infection rates in a surgical intermediate care unit. Three-phase quasi-experimental design. Phase I was electronic monitoring and direct observation; phase II was electronic monitoring and computerized voice prompts for failure to perform hand hygiene on room exit; and phase III was electronic monitoring only. Nine-room, 14-bed intermediate care unit in a university, tertiary-care institution. All patient rooms, utility room, and staff lavatory were monitored electronically. All healthcare personnel including physicians, nurses, nursing support personnel, ancillary staff, all visitors and family members, and any other personnel interacting with patients on the intermediate care unit. All patients with an intermediate care unit length of stay >48 hrs were followed for nosocomial infection. Electronic monitoring during all phases, computerized voice prompts during phase II only. We evaluated a total of 283,488 electronically monitored entries into a patient room with 251,526 exits for 420 days (10,080 hrs and 3,549 patient days). Compared with phase I, hand hygiene compliance in patient rooms improved 37% during phase II (odds ratio, 1.38; 95% confidence interval, 1.04-1.83) and 41% in phase III (odds ratio, 1.41; 95% confidence interval, 1.07-1.84). When adjusting for patient admissions during each phase, point estimates of nosocomial infections decreased by 22% during phase II and 48% during phase III; when adjusting for patient days, the number of infections decreased by 10% during phase II and 40% during phase III. Although the overall rate of nosocomial infections significantly decreased when combining phases II and III, the association between nosocomial infection and individual phase was not significant. Electronic monitoring provided effective ongoing feedback about hand hygiene compliance. During both the voice prompt phase and post

Beam-ripple monitor with secondary electrons

International Nuclear Information System (INIS)

Sato, Shinji; Kanazawa, Mitsutaka; Noda, Koji; Takada, Eiichi; Komiyama, Akihito; Ichinohe, Ken-ichi; Sano, Yoshinobu

1997-01-01

To replace the scintillation-ripple monitor, we have developed a new monitor with a smaller destructive effect on the beam. In this monitor, we use secondary electrons emitted from an aluminum foil with a thickness of 2 μm. The signals of secondary electrons are amplified by an electron multiplier having a maximum gain of 10 6 . By using the new monitor, we could clearly observe the beam ripple with a beam intensity of 3.6x10 8 pps (particle per second). This monitor can also be used as an intensity monitor in the range of 10 4 - 10 9 pps. (author)

Attitudes toward Electronic Monitoring among Monitored Offenders and Criminal Justice Students.

Science.gov (United States)

Payne, Brian K.; Gainey, Randy R.

1999-01-01

Examines what 180 students think about electronic monitoring and compares their perceptions to those of 29 electronically-monitored offenders. Results show that students were less supportive of electronic monitoring but when asked about what offenders have to give up, they viewed the sanction more punitively than did offenders. Implications…

All that glisters is not gold: a comparison of electronic monitoring versus filled prescriptions--an observational study.

Science.gov (United States)

Wetzels, Gwenn E C; Nelemans, Patricia J; Schouten, Jan S A G; van Wijk, Boris L G; Prins, Martin H

2006-02-10

Poor compliance with antihypertensive medication is assumed to be an important reason for unsatisfactory control of blood pressure. Poor compliance is difficult to detect. Each method of measuring compliance has its own strengths and weaknesses. The aim of the present study was to compare patient compliance with antihypertensive drugs as measured by two methods, electronic monitoring versus refill compliance. 161 patients with a diagnosis of hypertension for at least a year prior to inclusion, and inadequate blood pressure control (systolic blood pressure > or = 160 mmHg and/or diastolic blood pressure > or = 95 mmHg) despite the use of antihypertensive drugs, were included. Patients' pharmacy records from 12 months prior to inclusion were obtained. Refill compliance was calculated as the number of days for which the pills were prescribed divided by the total number of days in this period. After inclusion compliance was measured with an electronic monitor that records time and date of each opening of the pillbox. Agreement between both compliance measures was calculated using Spearman's correlation coefficient and Cohen's kappa coefficient. There was very little agreement between the two measures. Whereas refill compliance showed a large range of values, compliance as measured by electronic monitoring was high in almost all patients with estimates between 90% and 100%. Cohen's kappa coefficient was 0.005. While electronic monitoring is often considered to be the gold standard for compliance measurements, our results suggest that a short-term electronic monitoring period with the patient being aware of electronic monitoring is probably insufficient to obtain valid compliance data. We conclude that there is a strong need for more studies that explore the effect of electronic monitoring on patient's compliance.

Effect of Electronic Monitoring on Social Welfare Dependence

DEFF Research Database (Denmark)

Andersen, Lars Højsgaard; Andersen, Signe Hald

2014-01-01

Research Summary We studied the effect on unemployment social welfare dependence of serving a sentence under elec-tronic monitoring rather than in prison, using Danish registry data and two policy shifts that extended the use of electronic monitoring in Denmark. We found electronic monitoring...... to experiences from other contexts. The experiences from Denmark are clear: Electronic monitoring is less harmful than imprisonment to the life course out-comes of offenders. Since electronic monitoring could also very well be less costly for the corrections administrations than imprisonment, efforts to extend...... the use of electronic monitoring in the United States could be accelerated....

Electronic monitoring of patients with bipolar affective disorder

DEFF Research Database (Denmark)

Jacoby, Anne Sophie; Faurholt-Jepsen, Maria; Vinberg, Maj

2012-01-01

Bipolar disorder is a great challenge to patients, relatives and clinicians, and there is a need for development of new methods to identify prodromal symptoms of affective episodes in order to provide efficient preventive medical and behavioural intervention. Clinical trials prove that electronic...

Real time monitoring of electron processors

International Nuclear Information System (INIS)

Nablo, S.V.; Kneeland, D.R.; McLaughlin, W.L.

1995-01-01

A real time radiation monitor (RTRM) has been developed for monitoring the dose rate (current density) of electron beam processors. The system provides continuous monitoring of processor output, electron beam uniformity, and an independent measure of operating voltage or electron energy. In view of the device's ability to replace labor-intensive dosimetry in verification of machine performance on a real-time basis, its application to providing archival performance data for in-line processing is discussed. (author)

500 MHz narrowband beam position monitor electronics for electron synchrotrons

International Nuclear Information System (INIS)

Mohos, I.; Dietrich, J.

1998-01-01

Narrowband beam position monitor electronics were developed in the Forschungszentrum Juelich-IKP for the orbit measurement equipment used at ELSA Bonn. The equipment uses 32 monitor chambers, each with four capacitive button electrodes. The monitor electronics, consisting of an rf signal processing module (BPM-RF) and a data acquisition and control module (BPM-DAQ), sequentially process and measure the monitor signals and deliver calculated horizontal and vertical beam position data via a serial network

500 MHz narrowband beam position monitor electronics for electron synchrotrons

Science.gov (United States)

Mohos, I.; Dietrich, J.

1998-12-01

Narrowband beam position monitor electronics were developed in the Forschungszentrum Jülich-IKP for the orbit measurement equipment used at ELSA Bonn. The equipment uses 32 monitor chambers, each with four capacitive button electrodes. The monitor electronics, consisting of an rf signal processing module (BPM-RF) and a data acquisition and control module (BPM-DAQ), sequentially process and measure the monitor signals and deliver calculated horizontal and vertical beam position data via a serial network.

A wearable “electronic patch” for wireless continuous monitoring of chronically diseased patients

DEFF Research Database (Denmark)

Haahr, Rasmus Grønbek; Duun, Sune; Thomsen, Erik Vilain

2008-01-01

We present a wearable health system (WHS) for non-invasive and wireless monitoring of physiological signals. The system is made as an electronic patch where sensors, low power electronics, and radio communication are integrated in an adhesive material of hydrocolloid polymer making it a sticking...

Polymedication Electronic Monitoring System (POEMS) - a new technology for measuring adherence.

Science.gov (United States)

Arnet, Isabelle; Walter, Philipp N; Hersberger, Kurt E

2013-01-01

Reliable and precise measurement of patient adherence to medications is feasible by incorporating a microcircuitry into pharmaceutical packages of various designs, such that the maneuvers needed to remove a dose of drug are detected, time-stamped, and stored. The principle is called "electronic medication event monitoring" but is currently limited to the monitoring of a single drug therapy. Our aims were introducing a new technology; a clear, self-adhesive polymer film, with printed loops of conductive wires that can be affixed to multidrug punch cards for the electronic adherence monitoring of multiple medication regimens (Polymedication Electronic Monitoring System, POEMS), and illustrating potential benefits for patient care. We present a preliminary report with one patient experience. Our illustrative case was supplied with a pre-filled 7-day multiple medication punch card with unit-of-use doses for specific times of the day (six pills in the morning cavity, two pills in the evening cavity, and one pill in case of insomnia in the bedtime cavity), with the new electronic film affixed on it. The intake times over 1 week were extremely skewed (median intake hours at 2:00 pm for the morning doses and at 6:40 pm for the evening doses). After an intervention aimed at optimizing the timing adherence, the morning and evening intake hours became more balanced, with 42.3% of correct dosing intervals (±3 h) for drugs with twice daily intake (vs. 0% before the intervention). The electronic monitoring of the entire therapy revealed an intake pattern that would have remained undiscovered with any other device and allowed a personalized intervention to correct an inadequate medication intake behavior. POEMS may guide health professionals when they need to optimize a pharmacotherapy because of suspected insufficient adherence. Further, knowing the intake pattern of the entire pharmacotherapy can elucidate unreached clinical outcome, drug-drug interactions, and drug resistance

Implementing an electronic hand hygiene monitoring system: Lessons learned from community hospitals.

Science.gov (United States)

Edmisten, Catherine; Hall, Charles; Kernizan, Lorna; Korwek, Kimberly; Preston, Aaron; Rhoades, Evan; Shah, Shalin; Spight, Lori; Stradi, Silvia; Wellman, Sonia; Zygadlo, Scott

2017-08-01

Measuring and providing feedback about hand hygiene (HH) compliance is a complicated process. Electronic HH monitoring systems have been proposed as a possible solution; however, there is little information available about how to successfully implement and maintain these systems for maximum benefit in community hospitals. An electronic HH monitoring system was implemented in 3 community hospitals by teams at each facility with support from the system vendor. Compliance rates were measured by the electronic monitoring system. The implementation challenges, solutions, and drivers of success were monitored within each facility. The electronic HH monitoring systems tracked on average more than 220,000 compliant HH events per facility per month, with an average monthly compliance rate >85%. The sharing of best practices between facilities was valuable in addressing challenges encountered during implementation and maintaining a high rate of use. Drivers of success included a collaborative environment, leadership commitment, using data to drive improvement, consistent and constant messaging, staff empowerment, and patient involvement. Realizing the full benefit of investments in electronic HH monitoring systems requires careful consideration of implementation strategies, planning for ongoing support and maintenance, and presenting data in a meaningful way to empower and inspire staff. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Electronic Monitoring Systems to Assess Urinary Incontinence: A Health Technology Assessment.

Science.gov (United States)

2018-01-01

Urinary incontinence is involuntary leakage of urine and can affect people of all ages. Incidence rises as people age, often because of reduced mobility or conditions affecting the nervous system, such as dementia and stroke. Urinary incontinence can be a distressing condition and can harm a person's physical, financial, social, and emotional well-being. People with urinary incontinence are susceptible to skin irritation, pressure sores, and urinary tract infections. Urinary incontinence is also associated with an increased risk of falls in older adults.This health technology assessment examined the effectiveness of, budget impact of, and patient values and preferences about electronic monitoring systems to assess urinary incontinence for residents of long-term care homes or geriatric hospital inpatients with complex conditions. A clinical evidence review of the published clinical literature was conducted to June 9, 2017. Critical appraisal of the clinical evidence included assessment of risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria to reflect the certainty of the evidence.We calculated the funding required for an electronic urinary incontinence monitoring system in the first year of implementation (when facilities would buy the systems) and in subsequent years.We interviewed six people with urinary incontinence and two caregivers, who described ways urinary incontinence affected daily life. We included one observational study in the clinical review. Most of the 31 participants in the observational study were female (78%) and required high levels of care, primarily because of cognitive impairment. The quality of evidence for all outcomes was very low owing to potential risk of bias and indirectness. We are consequently uncertain about how electronic monitoring systems affect management of urinary incontinence.For patients living in long-term care homes who are eligible for the technology, we

Monitor tables for electron beams in radiotherapy

International Nuclear Information System (INIS)

Christ, G.; Dohm, O.S.

2007-01-01

The application of electron beams in radiotherapy is still based on tables of monitor units, although 3-D treatment planning systems for electron beams are available. This have several reasons: The need for 3-D treatment planning is not recognized; there is no confidence in the calculation algorithm; Monte-Carlo algorithms are too time-consuming; and the effort necessary to measure basic beam data for 3-D planning is considered disproportionate. However, the increasing clinical need for higher dosimetric precision and for more conformal electron beams leads to the requirement for more sophisticated tables of monitor units. The present paper summarizes and discusses the main aspects concerning the preparation of tables of monitor units for electron beams. The measurement equipment and procedures for measuring basic beam data needed for tables of monitor units for electron beams are described for a standard radiation therapy linac. The design of tables of monitor units for standard electron applicators is presented; this design can be extended for individual electron inserts, to variable applicator surface distances, to oblique beam incidence, and the use of bolus material. Typical data of an Elekta linac are presented in various tables. (orig.)

Successful withdrawal from high-dose benzodiazepine in a young patient through electronic monitoring of polypharmacy: a case report in an ambulatory setting.

Science.gov (United States)

Loscertales, Hèctor R; Wentzky, Valerie; Dürsteler, Kenneth; Strasser, Johannes; Hersberger, Kurt E; Arnet, Isabelle

2017-05-01

Dependence on high-dose benzodiazepines (BZDs) is well known and discontinuation attempts are generally unsuccessful. A well established protocol for high-dose BZD withdrawal management is lacking. We present the case of withdrawal from high-dose lorazepam (>20 mg daily) in an unemployed 35-year-old male outpatient through agonist substitution with long-acting clonazepam and electronic monitoring over 28 weeks. All medicines were repacked into weekly 7 × 4 cavity multidose punch cards with an electronic monitoring system. The prescribed daily dosages of BZDs were translated into an optimal number of daily tablets, divided into up to four units of use. Withdrawal was achieved by individual leftover of a small quantity of BZDs that was placed in a separate compartment. Feedback with visualization of intake over the past week was given during weekly psychosocial sessions. Stepwise reduction was obtained by reducing the mg content of the cavities proportionally to the leftovers, keeping the number of cavities in order to maintain regular intake behavior, and to determine the dosage decrease. At week 28, the primary objectives were achieved, that is, lorazepam reduction to 5 mg daily and cannabis abstinence. Therapy was continued using multidrug punch cards without electronic monitoring to maintain the management system. At week 48, a smaller size weekly pill organizer with detachable daily containers was dispensed. At week 68, the patient's therapy was constant with 1.5 mg clonazepam + 5 mg lorazepam daily for anxiety symptoms and the last steps of withdrawal were started. Several key factors led to successful withdrawal from high-dose BZD in this outpatient, such as the use of weekly punch cards coupled with electronic monitoring, the patient's empowerment over the withdrawal process, and the collaboration of several healthcare professionals. The major implication for clinical care is reduction by following the leftovers, and not a diktat from the healthcare

Identifying professionals' needs in integrating electronic pain monitoring in community palliative care services: An interview study.

Science.gov (United States)

Taylor, Sally; Allsop, Matthew J; Bekker, Hilary L; Bennett, Michael I; Bewick, Bridgette M

2017-07-01

Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice. Qualitative study using face-to-face interviews. Data were analysed using framework analysis Setting/participants: Purposive sample of health professionals managing the palliative care of patients living in the community Results: A total of 15 interviews with health professionals took place. Three meta-themes emerged from the data: (1) uncertainties about integration of PainCheck and changes to current practice, (2) appraisal of current practice and (3) pain management is everybody's responsibility Conclusion: Even the most sceptical of health professionals could see the potential benefits of implementing an electronic patient-reported pain monitoring system. Health professionals have reservations about how PainCheck would work in practice. For optimal use, PainCheck needs embedding within existing electronic health records. Electronic pain monitoring systems have the potential to enable professionals to support patients' pain management more effectively but only when barriers to implementation are appropriately identified and addressed.

Electron beam energy monitoring using thermoluminescent dosimeters and electron back scattering

International Nuclear Information System (INIS)

Nelson, Vinod; Gray, Alison

2013-01-01

Periodic checks of megavoltage electron beam quality are a fundamental requirement in ensuring accurate radiotherapy treatment delivery. In the present work, thermoluminescent dosimeters (TLDs) positioned on either side of a lead sheet at the surface of a water equivalent phantom were used to monitor electron beam quality using the electron backscattering method. TLD100 and TLD100H were evaluated as upstream detectors and TLD200, TLD400 and TLD500 were evaluated as downstream detectors. The evaluation assessed the test sensitivity and correlation, long and short term reproducibility, dose dependence and glow curve features. A prototype of an in-air jig suitable for use in postal TLD dose audits was also developed and an initial evaluation performed. The results indicate that the TLD100-TLD200 combination provides a sensitive and reproducible method to monitor electron beam quality. The light weight and easily fabricated in-air jig was found to produce acceptable results and has the potential to be used by radiation monitoring agencies to carry out TLD postal quality assurance audits, similar to audits presently being conducted for photon beams. -- Highlights: ► Monitoring electron beam quality via electron backscattering was investigated. ► Different thermoluminescent materials were evaluated as detectors. ► A TLD100-TLD200 combination produced the most sensitive and reproducible results. ► An in-air jig was evaluated to allow measurements via postal dose audits

Pharmacist medication reviews to improve safety monitoring in primary care patients.

Science.gov (United States)

Gallimore, Casey E; Sokhal, Dimmy; Zeidler Schreiter, Elizabeth; Margolis, Amanda R

2016-06-01

Patients prescribed psychotropic medications within primary care are at risk of suboptimal monitoring. It is unknown whether pharmacists can improve medication safety through targeted monitoring of at risk populations. Access Community Health Centers implemented a quality improvement pilot project that included pharmacists on an integrated care team to provide medication reviews for patients. Aims were to determine whether inclusion of a pharmacist performing medication reviews within a primary care behavioral health (PCBH) practice is feasible and facilitates safe medication use. Pharmacists performed medication reviews of the electronic health record for patients referred for psychiatry consultation. Reviews were performed 1-3 months following consultation and focused on medications with known suboptimal monitoring rates. Reviews were documented within the EHR and routed to the primary care provider. Primary outcome measures were change in percentage up-to-date on monitoring and AIMS assessment, and at risk of experiencing drug interaction(s) between baseline and 3 months postreview. Secondary outcome was provider opinion of medication reviews collected via electronic survey. Reviews were performed for 144 patients. Three months postreview, percentage up-to-date on recommended monitoring increased 18% (p = .0001), at risk for drug interaction decreased 20% (p improved safety monitoring of psychotropic medications. Results identify key areas for improvement that other clinics considering integration of similar pharmacy services should consider. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Development of picosecond pulsed electron beam monitor. 2

International Nuclear Information System (INIS)

Hosono, Y.; Nakazawa, M.; Ueda, T.

1994-01-01

A picosecond pulsed electron beam monitor for a 35 MeV linear accelerator has been developed. The monitor consists of an electric SMA connector and aluminium pipe(inner diameter of 50mm). The following characteristics of this monitor were obtained, (a) the rise time is less than 17.5 ps (b) linearity of the monitor output voltage is proportional to the peak current of beam. It is shown that this monitor can be successfully used for bunch measurements of picosecond pulsed electron beam of 35 MeV linac. (author)

Electronic self-monitoring of mood using IT platforms in adult patients with bipolar disorder: A systematic review of the validity and evidence

DEFF Research Database (Denmark)

Faurholt-Jepsen, Maria; Munkholm, Klaus; Frost, Mads

2016-01-01

-monitoring is limited by methodological issues and by a lack of RCTs. Although the idea of electronic self-monitoring of mood seems appealing, studies using rigorous methodology investigating the beneficial as well as possible harmful effects of electronic self-monitoring are needed.......Background: Various paper-based mood charting instruments are used in the monitoring of symptoms in bipolar disorder. During recent years an increasing number of electronic self-monitoring tools have been developed. The objectives of this systematic review were 1) to evaluate the validity...... of electronic self-monitoring tools as a method of evaluating mood compared to clinical rating scales for depression and mania and 2) to investigate the effect of electronic self-monitoring tools on clinically relevant outcomes in bipolar disorder. Methods: A systematic review of the scientific literature...

A Review of Electronic Hand Hygiene Monitoring: Considerations for Hospital Management in Data Collection, Healthcare Worker Supervision, and Patient Perception.

Science.gov (United States)

McGuckin, Maryanne; Govednik, John

2015-01-01

Healthcare-associated infections (HAIs) in U.S. acute care hospitals lead to a burden of $96-$147 billion annually on the U.S. health system and affect 1 in 20 hospital patients (Marchetti & Rossiter, 2013). Hospital managers are charged with reducing and eliminating HAIs to cut costs and improve patient outcomes. Healthcare worker (HCW) hand hygiene (HH) practice is the most effective means of preventing the spread of HAIs, but compliance is at or below 50% (McGuckin, Waterman, & Govednik, 2009). For managers to increase the frequency of HCW HH occurrences and improve the quality of HH performance, companies have introduced electronic technologies to assist managers in training, supervising, and gathering data in the patient care setting. Although these technologies offer valuable feedback regarding compliance, little is known in terms of capabilities in the clinical setting. Less is known about HCW or patient attitudes if the system allows feedback to be shared. Early-adopting managers have begun to examine their experiences with HH technologies and publish their findings. We review peer-reviewed research on infection prevention that focused on the capabilities of these electronic systems, as well as the related research on HCW and patient interactions with electronic HH systems. Research suggests that these systems are capable of collecting data, but the results are mixed regarding their impact on HH compliance, reducing HAIs, or both and their costs. Research also indicates that HCWs and patients may not regard the technology as positively as industry or healthcare managers may have intended. When considering the adoption of electronic HH monitoring systems, hospital administrators should proceed with caution.

An Electron-Beam Profile Monitor Using Fresnel Zone Plates

International Nuclear Information System (INIS)

Nakamura, Norio; Sakai, Hiroshi; Iida, Kensuke; Shinoe, Kenji; Takaki, Hiroyuki; Fujisawa, Masami; Hayano, Hitoshi; Muto, Toshiya; Nomura, Masaharu; Kamiya, Yukihide; Koseki, Tadashi; Amemiya, Yoshiyuki; Aoki, Nobutada; Nakayama, Koichi

2004-01-01

We have developed a beam profile monitor using two Fresnel zone plates (FZPs) at the KEK-ATF (Accelerator Test Facility) damping ring to measure small electron-beam sizes for low-emittance synchrotron radiation sources. The monitor has a structure of an X-ray microscope, where two FZPs constitute an X-ray imaging optics. In the monitor system, the synchrotron radiation from the electron beam at the bending magnet is monochromatized to 3.235-keV X-rays by a crystal monochromator and the transverse electron-beam image is twenty-times magnified by the two FZPs and detected on an X-ray CCD camera. This monitor has the following advantages: (1) high spatial resolution, (2) non-destructive measurement, (3) real-time monitoring, and (4) direct electron-beam imaging. With the beam profile monitor, we have succeeded in obtaining a clear electron-beam image and measuring the extremely small beam size less than 10 μm. The measured magnification of the imaging optics was in good agreement with the design value

Electron beam halo monitor for a compact x-ray free-electron laser

Directory of Open Access Journals (Sweden)

Hideki Aoyagi

2013-03-01

Full Text Available An electron beam halo monitor using diamond-based detectors, which are operated in the ionization mode, has been developed for the SPring-8 Angstrom compact free-electron laser (SACLA to protect its undulator magnets from radiation damage. Diamond-based detectors are inserted in a beam duct to measure the intensity of the beam halo directly. To suppress the degradation of the electron beam due to the installation of the beam halo monitor, rf fingers with aluminum windows are newly employed. We evaluated the effect of radiation from the Al windows on the output signal both experimentally and by simulation. The operational results of the beam halo monitor employed in SACLA are presented.

Designing a patient monitoring system for bipolar disorder using Semantic Web technologies.

Science.gov (United States)

Thermolia, Chryssa; Bei, Ekaterini S; Petrakis, Euripides G M; Kritsotakis, Vangelis; Tsiknakis, Manolis; Sakkalis, Vangelis

2015-01-01

The new movement to personalize treatment plans and improve prediction capabilities is greatly facilitated by intelligent remote patient monitoring and risk prevention. This paper focuses on patients suffering from bipolar disorder, a mental illness characterized by severe mood swings. We exploit the advantages of Semantic Web and Electronic Health Record Technologies to develop a patient monitoring platform to support clinicians. Relying on intelligently filtering of clinical evidence-based information and individual-specific knowledge, we aim to provide recommendations for treatment and monitoring at appropriate time or concluding into alerts for serious shifts in mood and patients' non response to treatment.

Biometric monitor with electronics disposed on or in a neck collar

NARCIS (Netherlands)

2012-01-01

A highly portable biometric monitor is disclosed. At least one remote sensor member (12, 12') includes one or more biometric sensors (20, 22, 24, 25) configured for operative coupling with a patient. A neck collar (14, 114, 214, 314, 414) includes electronics (36, 40, 42, 44, 46, 48) for operating

The CMS Beam Halo Monitor electronics

International Nuclear Information System (INIS)

Tosi, N.; Fabbri, F.; Montanari, A.; Torromeo, G.; Dabrowski, A.E.; Orfanelli, S.; Grassi, T.; Hughes, E.; Mans, J.; Rusack, R.; Stifter, K.; Stickland, D.P.

2016-01-01

The CMS Beam Halo Monitor has been successfully installed in the CMS cavern in LHC Long Shutdown 1 for measuring the machine induced background for LHC Run II. The system is based on 40 detector units composed of synthetic quartz Cherenkov radiators coupled to fast photomultiplier tubes (PMTs). The readout electronics chain uses many components developed for the Phase 1 upgrade to the CMS Hadronic Calorimeter electronics, with dedicated firmware and readout adapted to the beam monitoring requirements. The PMT signal is digitized by a charge integrating ASIC (QIE10), providing both the signal rise time, with few nanosecond resolution, and the charge integrated over one bunch crossing. The backend electronics uses microTCA technology and receives data via a high-speed 5 Gbps asynchronous link. It records histograms with sub-bunch crossing timing resolution and is read out via IPbus using the newly designed CMS data acquisition for non-event based data. The data is processed in real time and published to CMS and the LHC, providing online feedback on the beam quality. A dedicated calibration monitoring system has been designed to generate short triggered pulses of light to monitor the efficiency of the system. The electronics has been in operation since the first LHC beams of Run II and has served as the first demonstration of the new QIE10, Microsemi Igloo2 FPGA and high-speed 5 Gbps link with LHC data

Electronic Adherence Monitoring in a High-Utilizing Pediatric Asthma Cohort: A Feasibility Study.

Science.gov (United States)

Kenyon, Chén Collin; Chang, Joyce; Wynter, Sheri-Ann; Fowler, Jessica C; Long, Jin; Bryant-Stephens, Tyra C

2016-06-22

Inner-city, minority children with asthma have the highest rates of morbidity and death from asthma and the lowest rates of asthma controller medication adherence. Some recent electronic medication monitoring interventions demonstrated dramatic improvements in adherence in lower-risk populations. The feasibility and acceptability of such an intervention in the highest-risk children with asthma has not been studied. Our objective was to assess the feasibility and acceptability of a community health worker-delivered electronic adherence monitoring intervention among the highest utilizers of acute asthma care in an inner-city practice. This was a prospective cohort pilot study targeting children with the highest frequency of asthma-related emergency department and hospital care within a local managed care Medicaid plan. The 3-month intervention included motivational interviewing, electronic monitoring of controller and rescue inhaler use, and outreach by a community health worker for predefined medication alerts. We measured acceptability by using a modified technology acceptability model and changes in asthma control using the Asthma Control Test (ACT). Given prominent feasibility issues, we describe qualitative patterns of medication use at baseline only. We enrolled 14 non-Hispanic black children with a median age of 3.5 years. Participants averaged 7.8 emergency or hospital visits in the year preceding enrollment. We observed three distinct patterns of baseline controller use: 4 patients demonstrated sustained use, 5 patients had periodic use, and 5 patients lapsed within 2 weeks. All participants initiated use of the electronic devices; however, no modem signal was transmitted for 5 or the 14 participants after a mean of 45 days. Of the 9 (64% of total) caregivers who completed the final study visit, all viewed the electronic monitoring device favorably and would recommend it to friends, and 5 (56%) believed that the device helped to improve asthma control. ACT

An energy monitor for electron accelerators

International Nuclear Information System (INIS)

Geske, G.

1990-01-01

A monitor useful for checks of the energy selector scale of medical electron accelerators was developed and tested. It consists of a linear array of flat ionization chambers sandwiched between absorber plates of low-Z material. The first chamber at the electron beam entrance may be used to produce a reference signal S r , if not another suitable reference signal is taken. The following chambers are electrically connected and deliver the measuring signal S m . A clinical dosimeter can be used for recording current or charge. The energy-dependent electron range parameters R p , R 50 and R 80 in water vary as linear functions of the ratio reference singal/measuring signal. The best linear fit was obtained for the half value layer R 50 . Three types of the energy monitor are described, and experimental results obtained with a linear accelerator and a betatron between 5 and 25 MeV are reported. Uncertainties for checks of R 50 with a calibrated energy monitor were not larger than 1 to 2 mm. Theoretical considerations by a computer model support these results. (orig./HP) [de

[Wireless device for monitoring the patients with chronic disease].

Science.gov (United States)

Ciorap, R; Zaharia, D; Corciovă, C; Ungureanu, Monica; Lupu, R; Stan, A

2008-01-01

Remote monitoring of chronic diseases can improve health outcomes and potentially lower health care costs. The high number of the patients, suffering of chronically diseases, who wish to stay at home rather then in a hospital increasing the need of homecare monitoring and have lead to a high demand of wearable medical devices. Also, extended patient monitoring during normal activity has become a very important target. In this paper are presented the design of the wireless monitoring devices based on ultra low power circuits, high storage memory flash, bluetooth communication and the firmware for the management of the monitoring device. The monitoring device is built using an ultra low power microcontroller (MSP430 from Texas Instruments) that offers the advantage of high integration of some circuits. The custom made electronic boards used for biosignal acquisition are also included modules for storage device (SD/MMC card) with FAT32 file system and Bluetooth device for short-range communication used for data transmission between monitoring device and PC or PDA. The work was focused on design and implementation of an ultra low power wearable device able to acquire patient vital parameters, causing minimal discomfort and allowing high mobility. The proposed wireless device could be used as a warning system for monitoring during normal activity.

S3 targets monitoring with an electron gun

Science.gov (United States)

Kallunkathariyil, J.; Stodel, Ch.; Marry, C.; Frémont, G.; Bastin, B.; Piot, J.; Clément, E.; Le Moal, S.; Morel, V.; Thomas, J.-C.; Kamalou, O.; Spitaëls, C.; Savajols, H.; Vostinar, M.; Pellemoine, F.; Mittig, W.

2018-05-01

The monitoring of targets under irradiation was investigated using a 20 keV electron beam. An integrated and automated electron beam deflection was developed allowing a monitoring over the whole surface of target materials. Thus, local defects could be identified on-line during an experiment performed at GANIL involving different materials irradiated with a focused krypton beam at 10.5 MeV/u. Performances of this target monitoring system are presented in this paper.

21 CFR 880.2420 - Electronic monitor for gravity flow infusion systems.

Science.gov (United States)

2010-04-01

... and Personal Use Monitoring Devices § 880.2420 Electronic monitor for gravity flow infusion systems. (a) Identification. An electronic monitor for gravity flow infusion systems is a device used to... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Electronic monitor for gravity flow infusion...

Real-time electron-beam dose monitoring

International Nuclear Information System (INIS)

McKeown, J.

1995-01-01

A new technique to monitor the integrated dose that a product receives in an irradiation facility is determined by collecting the charge that passes through the product. The technique allows the absorbed dose to be monitored as the irradiation is taking place, i.e. on-line and in real time. The procedure will also provide a means of directly measuring the electron energy, independent of the accelerator control system. The irradiation plant operator can immediately detect a problem of inadequate electron energy and take appropriate action. Examples taken on the IMPELA trademark accelerator at the Iotron Irradiation Facility in Vancouver are presented

Tests of an electron monitor for routine quality control measurements of electron energies

International Nuclear Information System (INIS)

Ramsay, E.B.; Reinstein, L.E.; Meek, A.G.

1991-01-01

The depth dose for electrons is sensitive to energy and the AAPM Task Group 24 has recommended that tests be performed at monthly intervals to assure electron beam energy constancy by verifying the depth for the 80% dose to within ±3 mm. Typically, this is accomplished by using a two-depth dose ratio technique. Recently, a new device, the Geske monitor, has been introduced that is designed for verifying energy constancy in a single reading. The monitor consists of nine parallel plate detectors that alternate with 5-mm-thick absorbers made of an aluminum alloy. An evaluation of the clinical usefulness of this monitor for the electron beams available on a Varian Clinac 20 has been undertaken with respect to energy discrimination. Beam energy changes of 3 mm of the 80% dose give rise to measurable output changes ranging from 1.7% for 20-MeV electron beams to 15% for 6-MeV electron beams

Monitoring compliance with transfusion guidelines in hospital departments by electronic data capture

DEFF Research Database (Denmark)

Norgaard, Astrid; De Lichtenberg, Trine Honnens; Nielsen, Jens

2014-01-01

-transfusion haemoglobin levels at the departmental level. In a tertiary care hospital, no such data were produced before this study. Our aim was to establish a Patient Blood Management database based on electronic data capture in order to monitor compliance with transfusion guidelines at departmental and hospital levels...

The electronic register patients with hypertensia in Tomsk Region

Directory of Open Access Journals (Sweden)

O. S. Kobyakova

2012-01-01

Full Text Available Within the limits of the regional program «Prevention and treatment of an arterial hypertension for the period of 2004—2008» the electronic register of the patients with hypertensia inTomskRegion has been created.The electronic register is a two-level system where interaction of two kinds of databases is carried out: the first level is the databases of separate medical organization; the second level is the central integrated database.The basic information for the electronic register are documents confirmed by the Health service Ministry of the Russian Federation, that is the coupon of the out-patient patient and a card of dynamic supervision over the patient with hypertensia.All the data about the patients, included in the register are subdivided into unchangeable and changeable ones.The electronic register is an effective control system providing local leading of health service bodies with qualitative and high-grade information in processes of preparation of decision-making and measure taken for prevention and treatment of hypertensia.The electronic register is an effective monitoring system, providing medical authority of important information for taking decisions establishment measures for prevention and treatment of hypertensia.

An energy monitor for electron accelerators

Energy Technology Data Exchange (ETDEWEB)

Geske, G. (Friedrich-Schiller-Universitaet, Jena (German Democratic Republic). Klinik und Poliklinik des Bereiches Medizin)

1990-09-01

A monitor useful for checks of the energy selector scale of medical electron accelerators was developed and tested. It consists of a linear array of flat ionization chambers sandwiched between absorber plates of low-Z material. The first chamber at the electron beam entrance may be used to produce a reference signal S{sub r}, if not another suitable reference signal is taken. The following chambers are electrically connected and deliver the measuring signal S{sub m}. A clinical dosimeter can be used for recording current or charge. The energy-dependent electron range parameters R{sub p}, R{sub 50} and R{sub 80} in water vary as linear functions of the ratio reference singal/measuring signal. The best linear fit was obtained for the half value layer R{sub 50}. Three types of the energy monitor are described, and experimental results obtained with a linear accelerator and a betatron between 5 and 25 MeV are reported. Uncertainties for checks of R{sub 50} with a calibrated energy monitor were not larger than 1 to 2 mm. Theoretical considerations by a computer model support these results. (orig./HP).

Conceptual design for real time monitoring of electron microbeam

International Nuclear Information System (INIS)

Kim, Ji Seok; Kim, Hyun Ki; Jang, Mee; Choi, Chang Woon; Sun, Gwang Min; Lee, Jai Ki

2008-01-01

It is recognized that the microbeam is powerful system to understand the interaction of ionizing radiation with cells. Especially, electron microbeam system is useful to investigate the effect of low-LET radiation for cells. Electron microbeam has been developed in KIRAMS. It can irradiate the small volume in cell level by collimator and electromagnetic field and give local dose to individual cell by controlling the number of electrons. When the electron microbeam irradiates the individual cell, however, there is a possibility to change the current and intended trajectory of electron beam. Because this possibility introduces the uncertainty of dose, it is necessary to monitor the trajectory and current of electron beam. This study deals with development of real time monitoring device to confirm beam quality and to control if necessary during experiment. Consequently we designed dual monitoring device to solve various factors. And we optimize the design by simulation. (author)

[Application of electronic fence technology based on GIS in Oncomelania hupensis snail monitoring].

Science.gov (United States)

Zhi-Hua, Chen; Yi-Sheng, Zhu; Zhi-Qiang, Xue; Xue-Bing, Li; Yi-Min, Ding; Li-Jun, Bi; Kai-Min, Gao; You, Zhang

2017-07-27

To study the application of Geographic Information System (GIS) electronic fence technique in Oncomelania hupensis snail monitoring. The electronic fence was set around the history and existing snail environments in the electronic map, the information about snail monitoring and controlling was linked to the electronic fence, and the snail monitoring information system was established on these bases. The monitoring information was input through the computer and smart phone. The electronic fence around the history and existing snail environments was set in the electronic map (Baidu map), and the snail monitoring information system and smart phone APP were established. The monitoring information was input and upload real-time, and the snail monitoring information was demonstrated in real time on Baidu map. By using the electronic fence technology based on GIS, the unique "environment electronic archives" for each snail monitoring environment can be established in the electronic map, and real-time, dynamic monitoring and visual management can be realized.

Stability of electron-beam energy monitor for quality assurance of the electron-beam energy from radiotherapy accelerators

International Nuclear Information System (INIS)

Chida, Koichi; Zuguchi, Masayuki; Saito, Haruo; Takai, Yoshihiro; Mitsuya, Masatoshi; Sakakida, Hideharu; Yamada, Shogo; Kohzuki, Masahiro

2002-01-01

Information on electron energy is important in planning radiation therapy using electrons. The Geske 3405 electron beam energy monitor (Geske monitor, PTW Nuclear Associates, Carle Place, NY, USA) is a device containing nine ionization chambers for checking the energy of the electron beams produced by radiotherapy accelerators. We wondered whether this might increase the likelihood of ionization chamber trouble. In spite of the importance of the stability of such a quality assurance (QA) device, there are no reports on the stability of values measured with a Geske monitor. The purpose of this paper was therefore to describe the stability of a Geske monitor. It was found that the largest coefficient of variation (CV) of the Geske monitor measurements was approximately 0.96% over a 21-week period. In conclusion, the stability of Geske monitor measurements of the energy of electron beams from a linear accelerator was excellent. (author)

Examining Big Brother's Purpose for Using Electronic Performance Monitoring

Science.gov (United States)

Bartels, Lynn K.; Nordstrom, Cynthia R.

2012-01-01

We examined whether the reason offered for electronic performance monitoring (EPM) influenced participants' performance, stress, motivation, and satisfaction. Participants performed a data-entry task in one of five experimental conditions. In one condition, participants were not electronically monitored. In the remaining conditions, participants…

Electronic Monitoring and Family Control in Probation and Parole.

Science.gov (United States)

Quinn, James F.; Holman, John E.

1992-01-01

Examined effects of electronic monitoring on family's contribution to external constraint of felony offenders under community supervision. Data from probationers and parolees (n=121) indicated that reported levels of family control did not change significantly during three months of electronic monitoring. Demographic variables, offense type, and…

Remote monitoring of cardiovascular implanted electronic devices: a paradigm shift for the 21st century.

Science.gov (United States)

Cronin, Edmond M; Varma, Niraj

2012-07-01

Traditional follow-up of cardiac implantable electronic devices involves the intermittent download of largely nonactionable data. Remote monitoring represents a paradigm shift from episodic office-based follow-up to continuous monitoring of device performance and patient and disease state. This lessens device clinical burden and may also lead to cost savings, although data on economic impact are only beginning to emerge. Remote monitoring technology has the potential to improve the outcomes through earlier detection of arrhythmias and compromised device integrity, and possibly predict heart failure hospitalizations through integration of heart failure diagnostics and hemodynamic monitors. Remote monitoring platforms are also huge databases of patients and devices, offering unprecedented opportunities to investigate real-world outcomes. Here, the current status of the field is described and future directions are predicted.

Bunch monitor for an S-band electron linear accelerator

International Nuclear Information System (INIS)

Otake, Yuji; Nakahara, Kazuo

1991-01-01

The measurement of bunch characteristics in an S-band electron linear accelerator is required in order to evaluate the quality of accelerated electron beams. A new-type bunch monitor has been developed which combines micro-stripline technology with an air insulator and wall-current monitoring technology. The obtained time resolution of the monitor was more than 150 ps. This result shows that the monitor can handle the bunch number of an S-band linac. The structure of the monitor is suitable for being installed in the vacuum area, since it is constructed of only metal and ceramic parts. It can therefore easily be employed in an actual machine

The CMS Beam Halo Monitor Electronics

CERN Document Server

AUTHOR|(CDS)2080684; Fabbri, F.; Grassi, T.; Hughes, E.; Mans, J.; Montanari, A.; Orfanelli, S.; Rusack, R.; Torromeo, G.; Stickland, D.P.; Stifter, K.

2016-01-01

The CMS Beam Halo Monitor has been successfully installed in the CMS cavern in LHC Long Shutdown 1 for measuring the machine induced background for LHC Run II. The system is based on 40 detector units composed of synthetic quartz Cherenkov radiators coupled to fast photomultiplier tubes. The readout electronics chain uses many components developed for the Phase 1 upgrade to the CMS Hadronic Calorimeter electronics, with dedicated firmware and readout adapted to the beam monitoring requirements. The PMT signal is digitized by a charge integrating ASIC (QIE10), providing both the signal rise time, with few ns resolution, and the charge integrated over one bunch crossing. The backend electronics uses microTCA technology and receives data via a high-speed 5 Gbps asynchronous link. It records histograms with sub-bunch crossing timing resolution and is readout by IPbus using the newly designed CMS data acquisition for non-event based data. The data is processed in real time and published to CMS and the LHC, providi...

Electronic self-monitoring seal

International Nuclear Information System (INIS)

Campbell, J.W.

1978-01-01

The Electronic Self-Monitoring Seal is a new type of security seal which allows continuous verification of the seal's identity and status. The identity information is a function of the individual seal, time, and seal integrity. A description of this seal and its characteristics are presented. Also described are the use cycle for the seal and the support equipment for programming and verifying the seal

Electronic Monitoring Of Storage And Transport Temperatures Of ...

African Journals Online (AJOL)

Electronic Monitoring Of Storage And Transport Temperatures Of Thermostable Newcastle ... 22) were monitored during storage and transport from vaccine production laboratory in Temeke, Dar es ... EMAIL FULL TEXT EMAIL FULL TEXT

Monitoring Hospitalized Adult Patients for Opioid-Induced Sedation and Respiratory Depression.

Science.gov (United States)

Jungquist, Carla R; Smith, Kirsten; Nicely, Kelly L Wiltse; Polomano, Rosemary C

2017-03-01

: Opioid analgesics are commonly administered to hospitalized patients to treat acute pain, but these drugs put patients at risk for serious adverse events, such as unintended advancing sedation, respiratory depression, and death. Nurses play an important role in keeping patients safe by making clinical decisions about the frequency and intensity with which patients receiving IV and epidural opioids should be monitored. To make sound clinical judgments, nurses must be aware of the factors that place patients at elevated risk for adverse opioid-related effects and know how to screen and assess patients for these risks. The authors review the literature on unintended advancing sedation and respiratory depression associated with opioid administration and present evidence-based recommendations for clinical decision making and patient monitoring, using both nursing assessments and electronic technologies.

A review on remote monitoring technology applied to implantable electronic cardiovascular devices.

Science.gov (United States)

Costa, Paulo Dias; Rodrigues, Pedro Pereira; Reis, António Hipólito; Costa-Pereira, Altamiro

2010-12-01

Implantable electronic cardiovascular devices (IECD) include a broad spectrum of devices that have the ability to maintain rhythm, provide cardiac resynchronization therapy, and/or prevent sudden cardiac death. The incidence of bradyarrhythmias and other cardiac problems led to a broader use of IECD, which turned traditional follow-up into an extremely heavy burden for healthcare systems to support. Our aim was to assess the impact of remote monitoring on the follow-up of patients with IECD. We performed a review through PubMed using a specific query. The paper selection process included a three-step approach in which title, abstract, and cross-references were analyzed. Studies were then selected using previously defined inclusion criteria and analyzed according to the country of origin of the study, year, and journal of publication; type of study; and main issues covered. Twenty articles were included in this review. Eighty percent of the selected papers addressed clinical issues, from which 94% referred clinical events identification, clinical stability, time savings, or physician satisfaction as advantages, whereas 38% referred disadvantages that included both legal and technical issues. Forty-five percent of the papers referred patient issues, from which 89% presented advantages, focusing on patient acceptance/satisfaction, and patient time-savings. The main downsides were technical issues but patient privacy was also addressed. All the papers dealing with economic issues (20%) referred both advantages and disadvantages equally. Remote monitoring is presently a safe technology, widely accepted by patients and physicians, for its convenience, reassurance, and diagnostic potential. This review summarizes the principles of remote IECD monitoring presenting the current state-of-the-art. Patient safety and device interaction, applicability of current technology, and limitations of remote IECD monitoring are also addressed. The use of remote monitor should consider

Trials and tribulations with electronic medication adherence monitoring in kidney transplantation.

Science.gov (United States)

Williams, Allison; Low, Jac Kee; Manias, Elizabeth; Dooley, Michael; Crawford, Kimberley

2016-01-01

Medication adherence in kidney transplantation is critical to prevent graft rejection. Testing interventions designed to support patients to take their prescribed medications following a kidney transplant require an accurate measure of medication adherence. In research, the available methods for measuring medication adherence include self-report, pill counts, prescription refill records, surrogate measures of medication adherence and medication bottles with a microchip-embedded cap to record bottle openings. Medication bottles with a microchip-embedded cap are currently regarded as the gold standard measure. This commentary outlines the challenges in measuring medication adherence using electronic medication monitoring of kidney transplant patients recruited from five sites. The challenges included obtaining unanimous stakeholder support for using this method, agreement on an index medication to measure, adequate preparation of the patient and training of pharmacy staff, and how to analyze data when periods of time were not recorded using the electronic adherence measure. Provision of this information will enable hospital and community pharmacists to implement approaches that promote the effective use of this adherence measure for optimal patient outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Patient monitoring in mobile health: opportunities and challenges.

Science.gov (United States)

Mohammadzadeh, Niloofar; Safdari, Reza

2014-01-01

In most countries chronic diseases lead to high health care costs and reduced productivity of people in society. The best way to reduce costs of health sector and increase the empowerment of people is prevention of chronic diseases and appropriate health activities management through monitoring of patients. To enjoy the full benefits of E-health, making use of methods and modern technologies is very important. This literature review articles were searched with keywords like Patient monitoring, Mobile Health, and Chronic Disease in Science Direct, Google Scholar and Pub Med databases without regard to the year of publications. Applying remote medical diagnosis and monitoring system based on mobile health systems can help significantly to reduce health care costs, correct performance management particularly in chronic disease management. Also some challenges are in patient monitoring in general and specific aspects like threats to confidentiality and privacy, technology acceptance in general and lack of system interoperability with electronic health records and other IT tools, decrease in face to face communication between doctor and patient, sudden interruptions of telecommunication networks, and device and sensor type in specific aspect. It is obvious identifying the opportunities and challenges of mobile technology and reducing barriers, strengthening the positive points will have a significant role in the appropriate planning and promoting the achievements of the health care systems based on mobile and helps to design a roadmap for improvement of mobile health.

Electronic monitoring in bipolar disorder

DEFF Research Database (Denmark)

Faurholt-Jepsen, Maria

2018-01-01

generated data (e.g. the number of text messages sent/day; the number of incoming and outgoing calls/day; the number of changes in cell tower IDs/day; and voice features) seem to reflect clinically assessed depressive and manic symptoms in bipolar disorder; 3) smartphone-based electronic self-monitoring had...

Daily electronic self-monitoring in bipolar disorder using smartphones - the MONARCA I trial: a randomized, placebo-controlled, single-blind, parallel group trial.

Science.gov (United States)

Faurholt-Jepsen, M; Frost, M; Ritz, C; Christensen, E M; Jacoby, A S; Mikkelsen, R L; Knorr, U; Bardram, J E; Vinberg, M; Kessing, L V

2015-10-01

The number of studies on electronic self-monitoring in affective disorder and other psychiatric disorders is increasing and indicates high patient acceptance and adherence. Nevertheless, the effect of electronic self-monitoring in patients with bipolar disorder has never been investigated in a randomized controlled trial (RCT). The objective of this trial was to investigate in a RCT whether the use of daily electronic self-monitoring using smartphones reduces depressive and manic symptoms in patients with bipolar disorder. A total of 78 patients with bipolar disorder according to ICD-10 criteria, aged 18-60 years, and with 17-item Hamilton Depression Rating Scale (HAMD-17) and Young Mania Rating Scale (YMRS) scores ≤17 were randomized to the use of a smartphone for daily self-monitoring including a clinical feedback loop (the intervention group) or to the use of a smartphone for normal communicative purposes (the control group) for 6 months. The primary outcomes were differences in depressive and manic symptoms measured using HAMD-17 and YMRS, respectively, between the intervention and control groups. Intention-to-treat analyses using linear mixed models showed no significant effects of daily self-monitoring using smartphones on depressive as well as manic symptoms. There was a tendency towards more sustained depressive symptoms in the intervention group (B = 2.02, 95% confidence interval -0.13 to 4.17, p = 0.066). Sub-group analysis among patients without mixed symptoms and patients with presence of depressive and manic symptoms showed significantly more depressive symptoms and fewer manic symptoms during the trial period in the intervention group. These results highlight that electronic self-monitoring, although intuitive and appealing, needs critical consideration and further clarification before it is implemented as a clinical tool.

SU-F-T-67: Correction Factors for Monitor Unit Verification of Clinical Electron Beams

Energy Technology Data Exchange (ETDEWEB)

Haywood, J [Mercy Health Partners, Muskegon, MI (United States)

2016-06-15

Purpose: Monitor units calculated by electron Monte Carlo treatment planning systems are often higher than TG-71 hand calculations for a majority of patients. Here I’ve calculated tables of geometry and heterogeneity correction factors for correcting electron hand calculations. Method: A flat water phantom with spherical volumes having radii ranging from 3 to 15 cm was created. The spheres were centered with respect to the flat water phantom, and all shapes shared a surface at 100 cm SSD. D{sub max} dose at 100 cm SSD was calculated for each cone and energy on the flat phantom and for the spherical volumes in the absence of the flat phantom. The ratio of dose in the sphere to dose in the flat phantom defined the geometrical correction factor. The heterogeneity factors were then calculated from the unrestricted collisional stopping power for tissues encountered in electron beam treatments. These factors were then used in patient second check calculations. Patient curvature was estimated by the largest sphere that aligns to the patient contour, and appropriate tissue density was read from the physical properties provided by the CT. The resulting MU were compared to those calculated by the treatment planning system and TG-71 hand calculations. Results: The geometry and heterogeneity correction factors range from ∼(0.8–1.0) and ∼(0.9–1.01) respectively for the energies and cones presented. Percent differences for TG-71 hand calculations drop from ∼(3–14)% to ∼(0–2)%. Conclusion: Monitor units calculated with the correction factors typically decrease the percent difference to under actionable levels, < 5%. While these correction factors work for a majority of patients, there are some patient anatomies that do not fit the assumptions made. Using these factors in hand calculations is a first step in bringing the verification monitor units into agreement with the treatment planning system MU.

Enhancing patient engagement and blood pressure management for renal transplant recipients via home electronic monitoring and web-enabled collaborative care.

Science.gov (United States)

Aberger, Edward W; Migliozzi, Daniel; Follick, Michael J; Malick, Tom; Ahern, David K

2014-09-01

Effective management of hypertension in chronic kidney disease and renal transplantation is a clinical priority and has societal implications in terms of preserving and optimizing the value of scarce organs. However, hypertension is optimally managed in only 37% of people with chronic kidney disease, and poor control can contribute to premature graft loss in renal transplant recipients. This article describes a telehealth system that incorporates home electronic blood pressure (BP) monitoring and uploading to a patient portal coupled with a Web-based dashboard that enables clinical pharmacist collaborative care in a renal transplant clinic. The telehealth system was developed and implemented as a quality improvement initiative in a renal transplant clinic in a large, 700-bed, urban hospital with the aim of improving BP in posttransplant patients. A convenience sample of 66 posttransplant patients was recruited by the clinical pharmacist from consecutive referrals to the Transplant Clinic. Preliminary results show statistically significant reductions in average systolic and diastolic BP of 6.0 mm Hg and 3.0 mm Hg, respectively, at 30 days after enrollment. Two case reports describe the instrumental role of home BP monitoring in the context of medication therapy management. Optimizing BP control for both pre- and post-renal transplant patients is likely to benefit society in terms of preserving scarce resources and reducing healthcare costs due to premature graft failure. Connected health systems hold great promise for supporting team-based care and improved health outcomes.

Flexible Sensing Electronics for Wearable/Attachable Health Monitoring.

Science.gov (United States)

Wang, Xuewen; Liu, Zheng; Zhang, Ting

2017-07-01

Wearable or attachable health monitoring smart systems are considered to be the next generation of personal portable devices for remote medicine practices. Smart flexible sensing electronics are components crucial in endowing health monitoring systems with the capability of real-time tracking of physiological signals. These signals are closely associated with body conditions, such as heart rate, wrist pulse, body temperature, blood/intraocular pressure and blood/sweat bio-information. Monitoring such physiological signals provides a convenient and non-invasive way for disease diagnoses and health assessments. This Review summarizes the recent progress of flexible sensing electronics for their use in wearable/attachable health monitoring systems. Meanwhile, we present an overview of different materials and configurations for flexible sensors, including piezo-resistive, piezo-electrical, capacitive, and field effect transistor based devices, and analyze the working principles in monitoring physiological signals. In addition, the future perspectives of wearable healthcare systems and the technical demands on their commercialization are briefly discussed. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Antipsychotic treatment dosing profile in patients with schizophrenia evaluated with electronic monitoring (MEMS®).

Science.gov (United States)

Acosta, Francisco J; Ramallo-Fariña, Yolanda; Bosch, Esperanza; Mayans, Teresa; Rodríguez, Carlos J; Caravaca, Ana

2013-05-01

Although the Medication Event Monitoring System (MEMS®) device offers accurate information on treatment dosing profile, such profile has never been studied in patients with schizophrenia. Enhancing our knowledge on this issue would help in developing intervention strategies to improve adherence to antipsychotic treatment in these patients. 74 outpatients with schizophrenia were monitored with the MEMS device for a 3-month period, for evaluation of antipsychotic treatment dosing profile, possible influence of medication schedule-related variables, adherence to treatment--considering dose intake within prescribed timeframes--and possible Hawthorne's effect of using the MEMS device. Dose-omission gaps occurred in 18.7% of monitoring days, most frequently during weekends, almost significantly. Almost one-third of prescribed doses were taken out of prescribed time. Neither the prescribed number of daily doses nor the indicated time of the day for dose intake (breakfast, dinner), were associated with correct antipsychotic dosing. Excess-dose was rare in general, and more frequent out of prescribed dose timeframe. No Hawthorne's effect was found for the MEMS device. Adherence reached only 35% according to a definition that included dose intake within prescribed timeframes. Antipsychotic treatment dosing was considerably irregular among patients with schizophrenia. Strategies to reduce dose-omission gaps and increase dosing within prescribed timeframes seem to be necessary. Gaining knowledge on precise oral antipsychotic dosing profiles or the influence of schedule-related variables may be useful to design strategies towards enhancing adherence. There appears to be no Hawthorne's effect associated with the use of MEMS devices in outpatients with schizophrenia. Copyright © 2013 Elsevier B.V. All rights reserved.

Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls?

Science.gov (United States)

Dexter, Eve N; Fields, Scott; Rdesinski, Rebecca E; Sachdeva, Bhavaya; Yamashita, Daisuke; Marino, Miguel

2016-01-01

Internet-based patient portals are increasingly being implemented throughout health care organizations to enhance health and optimize communication between patients and health professionals. The decision to adopt a patient portal requires careful examination of the advantages and disadvantages of implementation. This study aims to investigate 1 proposed advantage of implementation: alleviating some of the clinical workload faced by employees. A retrospective time-series analysis of the correlation between the rate of electronic patient-to-provider messages-a common attribute of Internet-based patient portals-and incoming telephone calls. The rate of electronic messages and incoming telephone calls were monitored from February 2009 to June 2014 at 4 economically diverse clinics (a federally qualified health center, a rural health clinic, a community-based clinic, and a university-based clinic) related to 1 university hospital. All 4 clinics showed an increase in the rate of portal use as measured by electronic patient-to-provider messaging during the study period. Electronic patient-to-provider messaging was significantly positively correlated with incoming telephone calls at 2 of the clinics (r = 0.546, P electronic patient-to-provider messaging was associated with increased use of telephone calls in 2 of the study clinics. While practices are increasingly making the decision of whether to implement a patient portal as part of their system of care, it is important that the motivation behind such a change not be based on the idea that it will alleviate clinical workload. © Copyright 2016 by the American Board of Family Medicine.

Monitoring the Quality of Services in Electronic Banking

OpenAIRE

Jovovic Radislav; Lekic Elvis; Jovovic Miroslav

2016-01-01

Successful development of electronic banking is in direct correlation with the quality of services in electronic banking. Therefore, it is necessary that the banks are familiar with the attributes of electronic services on which clients assess the bank’s quality and client’s satisfaction with them, in order to be able to monitor, correct and improve the performance of electronic banking. We start from the hypothesis that there are already developed theoretical models for measuring the quality...

Design of the AGS Booster Beam Position Monitor electronics

International Nuclear Information System (INIS)

Ciardullo, D.J.; Smith, G.A.; Beadle, E.R.

1991-01-01

The operational requirements of the AGS Booster Beam Position Monitor system necessitate the use of electronics with wide dynamic range and broad instantaneous bandwidth. Bunch synchronization is provided by a remote timing sequencer coupled to the local ring electronics via digital fiber-optic links. The Sequencer and local ring circuitry work together to provide single turn trajectory or average orbit and intensity information, integrated over 1 to 225 bunches. Test capabilities are built in for the purpose of enhancing BPM system accuracy. This paper describes the design of the Booster Beam Position Monitor electronics, and presents performance details of the front end processing, acquisition and timing circuitry

The Computer-based Health Evaluation Software (CHES: a software for electronic patient-reported outcome monitoring

Directory of Open Access Journals (Sweden)

Holzner Bernhard

2012-11-01

Full Text Available Abstract Background Patient-reported Outcomes (PROs capturing e.g., quality of life, fatigue, depression, medication side-effects or disease symptoms, have become important outcome parameters in medical research and daily clinical practice. Electronic PRO data capture (ePRO with software packages to administer questionnaires, storing data, and presenting results has facilitated PRO assessment in hospital settings. Compared to conventional paper-pencil versions of PRO instruments, ePRO is more economical with regard to staff resources and time, and allows immediate presentation of results to the medical staff. The objective of our project was to develop software (CHES – Computer-based Health Evaluation System for ePRO in hospital settings and at home with a special focus on the presentation of individual patient’s results. Methods Following the Extreme Programming development approach architecture was not fixed up-front, but was done in close, continuous collaboration with software end users (medical staff, researchers and patients to meet their specific demands. Developed features include sophisticated, longitudinal charts linking patients’ PRO data to clinical characteristics and to PRO scores from reference populations, a web-interface for questionnaire administration, and a tool for convenient creating and editing of questionnaires. Results By 2012 CHES has been implemented at various institutions in Austria, Germany, Switzerland, and the UK and about 5000 patients participated in ePRO (with around 15000 assessments in total. Data entry is done by the patients themselves via tablet PCs with a study nurse or an intern approaching patients and supervising questionnaire completion. Discussion During the last decade several software packages for ePRO have emerged for different purposes. Whereas commercial products are available primarily for ePRO in clinical trials, academic projects have focused on data collection and presentation in daily

Development of picosecond pulsed electron beam monitor

International Nuclear Information System (INIS)

Hosono, Y.; Nakazawa, M.; Ueda, T.; Kobayasi, T.; Yosida, Y.; Ohkuma, J.; Okuda, S.; Suemine, S.

1993-01-01

For the picosecond pulsed electron beam of a linear accelerator a simple monitor using an electric connector has been developed which is constructed with SMA, BNC, N type electric connector through pipe (inner diameter = 50 mm or 100 mm). Under the measurement conditions of peak current (26A-900A) and narrow pulse width (Pw = 10 ps(FWHM), Pw = 30 ps(FWHM)), the following characteristics of this monitor were obtained, (A) rise time is less than 25 ps (B) the amplitude of the monitor output pulse is proportional directly to the area of cross section of the electrode. (author)

A beam position monitor system for electron cooler in HIRFL-CSR

International Nuclear Information System (INIS)

Li Guohong; Li Jie; Yang Xiaodong; Yan Tailai; Ma Xiaoming

2010-01-01

The efficient electron cooling requires that the ion beam and electron beam are parallel and overlapped. In order to measure the positions of ion beam and electron beam simultaneously, a beam position monitor system is developed for the HIRFL-CSR electron cooler device, which probe consists of four capacitive cylinder linear-cut poles. One can get the both beam positions from the picking up signals of four poles by using Fourier transform (FFT) method. The measurement results show that the beam position monitor system is accurate. This system is suitable for investigating the relation between electron cooling processing and the angle of ion beam and electron beam. (authors)

Medication adherence monitoring: implications for patients and providers.

Science.gov (United States)

Gheorghiu, Bobby; Nayani, Seema

2018-05-01

Non-adherence to medication is a key worldwide issue and can lead to adverse patient outcomes and increased health system costs. Would a process facilitating notification of non-adherence infringe upon the autonomy of individuals or breach expectations of privacy? In contrast, patients who are not taking their medication could unknowingly be putting themselves at risk and all the while prescribers are unaware and without the opportunity to intervene. With the advent of electronic methods of medication adherence monitoring, this ethical dilemma now involves a new layer of complexity. We present two scenarios encountered in clinical practice that reflect issues occurring regularly in the Canadian healthcare system.

A Fast Non Intercepting Linac Electron Beam Position and Current Monitor

DEFF Research Database (Denmark)

Hansen, Jørgen-Walther; Wille, Mads

1982-01-01

A non-intercepting beam monitor consisting of four detecting loops is used to determine the spatial postion and current of a pulsed beam from an electron linear accelerator. The monitor detects the magnetic field radiated by the substructure of the electron bunches created by the accelerating...

Numerical Simulation and Mechanical Design for TPS Electron Beam Position Monitors

Science.gov (United States)

Hsueh, H. P.; Kuan, C. K.; Ueng, T. S.; Hsiung, G. Y.; Chen, J. R.

2007-01-01

Comprehensive study on the mechanical design and numerical simulation for the high resolution electron beam position monitors are key steps to build the newly proposed 3rd generation synchrotron radiation research facility, Taiwan Photon Source (TPS). With more advanced electromagnetic simulation tool like MAFIA tailored specifically for particle accelerator, the design for the high resolution electron beam position monitors can be tested in such environment before they are experimentally tested. The design goal of our high resolution electron beam position monitors is to get the best resolution through sensitivity and signal optimization. The definitions and differences between resolution and sensitivity of electron beam position monitors will be explained. The design consideration is also explained. Prototype deign has been carried out and the related simulations were also carried out with MAFIA. The results are presented here. Sensitivity as high as 200 in x direction has been achieved in x direction at 500 MHz.

Numerical Simulation and Mechanical Design for TPS Electron Beam Position Monitors

International Nuclear Information System (INIS)

Hsueh, H. P.; Kuan, C. K.; Ueng, T. S.; Hsiung, G. Y.; Chen, J. R.

2007-01-01

Comprehensive study on the mechanical design and numerical simulation for the high resolution electron beam position monitors are key steps to build the newly proposed 3rd generation synchrotron radiation research facility, Taiwan Photon Source (TPS). With more advanced electromagnetic simulation tool like MAFIA tailored specifically for particle accelerator, the design for the high resolution electron beam position monitors can be tested in such environment before they are experimentally tested. The design goal of our high resolution electron beam position monitors is to get the best resolution through sensitivity and signal optimization. The definitions and differences between resolution and sensitivity of electron beam position monitors will be explained. The design consideration is also explained. Prototype deign has been carried out and the related simulations were also carried out with MAFIA. The results are presented here. Sensitivity as high as 200 in x direction has been achieved in x direction at 500 MHz

Wound dressing with reusable electronics for wireless monitoring

KAUST Repository

Shamim, Atif

2016-10-20

A wound dressing device with reusable electronics for wireless monitoring and a method of making the same are provided. The device can be a smart device. In an embodiment, the device has a disposable portion including one or more sensors and a reusable portion including wireless electronics. The one or more sensors can be secured to a flexible substrate and can be printed by non-contact printing on the substrate. The disposable portion can be removably coupled to the one or more sensors. The device can include one or more sensors for wireless monitoring of a wound, a wound dressing, a body fluid exuded by the wound and/or wearer health.

Continuous monitoring of odours from a composting plant using electronic noses.

Science.gov (United States)

Sironi, Selena; Capelli, Laura; Céntola, Paolo; Del Rosso, Renato; Il Grande, Massimiliano

2007-01-01

The odour impact of a composting plant situated in an urbanized area was evaluated by continuously monitoring the ambient air close to the plant during a period of about 4 days using two electronic noses. One electronic nose was installed in a nearby house, and the other one inside the perimeter of the composting plant in order to compare the response of both instruments. The results of the monitoring are represented by tables that report the olfactory class and the odour concentration value attributed to the analyzed air for each of the 370 measurements carried out during the monitoring period. The electronic nose installed at the house detected the presence of odours coming from the composting plant for about 7.8% of the monitoring total duration. Of the odour detections, 86% (25 of 29 measurements) were classified as belonging to the olfactory class corresponding to the open air storage of the waste screening overflows heaps, which was therefore identified to be the major odour source of the monitored composting plant. In correspondence of the measurements during which the electronic nose inside the house detected the presence of odours from the composting plant, the olfactory classes recognized by both instruments coincide. Moreover, the electronic nose at the house detected the presence of odours from the composting plant at issue in correspondence of each odour perception of the house occupants. The results of the study show the possibility of using an electronic nose for environmental odours monitoring, which enables the classification of the quality of the air and to quantify the olfactory nuisance from an industrial source in terms of duration and odour concentration.

Educational Outcomes After Serving with Electronic Monitoring

DEFF Research Database (Denmark)

Larsen, Britt Østergaard

2016-01-01

are based on a comprehensive longitudinal dataset (n = 1013) constructed from multiple official administrative registers and including a high number of covariates. Results The EM-program increases the completion rates of upper secondary education by 18 % points among program participants 3 years post......Objectives The paper explores the effects of electronic monitoring (EM) on young offenders’ educational outcomes and contributes to the evaluation of EM as a non-custodial sanction with a new outcome measure. Methods The study is based on a natural experiment exploiting a reform in Denmark in 2006...... introducing electronic monitoring to all offenders under the age of 25 with a maximum prison sentence of 3 months. Information on program participation is used to estimate instrument variable models in order to assess the causal effects of EM on young offenders’ educational outcomes. The empirical analyses...

Electronic Performance Monitoring: An Organizational Justice and Concertive Control Perspective.

Science.gov (United States)

Alder, G. Stoney; Tompkins, Phillip K.

1997-01-01

Applies theories of organizational justice/concertive control to account for contradictions inherent in electronic monitoring of workers by organizations. Argues that results are usually positive when workers are involved in the design and implementation of monitoring systems, and monitoring is restricted to performance-related activities with…

High-stable secondary-emission monitor for accelerated electron beam current

International Nuclear Information System (INIS)

Prudnikov, I.A.; Saksaganskij, G.L.; Bazhanov, E.B.; Zabrodin, B.V.

1977-01-01

A secondary-emission monitor for a 10 to 30 MeV electron beam (beam current is 10 -4 to 10 -2 A) is described. The monitor comprises a measuring electrode unit, titanium discharge-type pump, getter made of porous titanium, all enclosed in a metal casing. The measuring unit comprises three electrodes made of 20 μm aluminium foil. The secondary emission coefficient (5.19%+-0.06% for the electron energy of 20 MeV) is maintained stable for a long time. The monitor detects pulses of up to some nanoseconds duration. It is reliable in operation, and is recommended for a wide practical application

Recent advances in electronic nose techniques for monitoring of fermentation process.

Science.gov (United States)

Jiang, Hui; Zhang, Hang; Chen, Quansheng; Mei, Congli; Liu, Guohai

2015-12-01

Microbial fermentation process is often sensitive to even slight changes of conditions that may result in unacceptable end-product quality. Thus, the monitoring of the process is critical for discovering unfavorable deviations as early as possible and taking the appropriate measures. However, the use of traditional analytical techniques is often time-consuming and labor-intensive. In this sense, the most effective way of developing rapid, accurate and relatively economical method for quality assurance in microbial fermentation process is the use of novel chemical sensor systems. Electronic nose techniques have particular advantages in non-invasive monitoring of microbial fermentation process. Therefore, in this review, we present an overview of the most important contributions dealing with the quality control in microbial fermentation process using the electronic nose techniques. After a brief description of the fundamentals of the sensor techniques, some examples of potential applications of electronic nose techniques monitoring are provided, including the implementation of control strategies and the combination with other monitoring tools (i.e. sensor fusion). Finally, on the basis of the review, the electronic nose techniques are critically commented, and its strengths and weaknesses being highlighted. In addition, on the basis of the observed trends, we also propose the technical challenges and future outlook for the electronic nose techniques.

The task of official personal monitoring in Germany using electronic dosimetry systems

International Nuclear Information System (INIS)

Huebner, Stephan; Wahl, Wolfgang; Busch, Frank; Martini, Ekkehard

2008-01-01

Full text: Since the establishment of the first German personal monitoring services as competent measuring bodies in the year 1952, official personal dosimetry is carried out using passive dosimeters such as film batches, RPL- and TL-dosimeters solely. On the other hand, electronic dosimeters are in use in some big institutions like Nuclear Power Plants, hospitals or industrial units for operational purposes. In most cases, these dosimeters are regulated by competent authorities. For more than 20 years electronic dosimeters proved their worth of being appropriate personal dosimeters. Since 2001 concepts to implement electronic personal dosimeters into the official individual monitoring of occupational exposed workers were developed in different research projects. The EU market of personal dosimetry changes to an open and competitive one, the number of outside workers, especially during the outages of Nuclear Power Plants increases, the landscape of customers is getting more and more heterogeneous. Being able to face these tasks of a sustainable personal monitoring requires the introduction of modern electronic dosimeters into to the official monitoring. Doing so, the needed prompt exchange of dose-data between different monitoring services as well as between the customers and the related monitoring service can be warranted. In cooperation with the industry, competent authorities and a research centre a method for official dosimetry using electronic dosimetry systems was developed, realised and tested successfully by the three big monitoring services of Germany. These investigations are supported by the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety. For this purpose a network between customers and monitoring services was built up in order to monitor people, who work in different places related to different measuring bodies in only one period of surveillance. (author)

Monitoring of alcoholic fermentation using near infrared and mid infrared spectroscopies combined with electronic nose and electronic tongue

International Nuclear Information System (INIS)

Buratti, S.; Ballabio, D.; Giovanelli, G.; Dominguez, C.M. Zuluanga; Moles, A.; Benedetti, S.; Sinelli, N.

2011-01-01

Graphical abstract: Application of non destructive methods for the monitoring of red wine fermentation in correlation with the evolution of chemical parameters. Highlights: → We monitored time-related changes in red wine fermentation process. → NIR and MIR spectroscopies, electronic nose and tongue were applied. → Data were kinetically modelled to identify critical points during fermentation. → NIR, MIR electronic nose and tongue were able to follow the fermentation process. → The models agreed with the evolution of chemical parameters. - Abstract: Effective fermentation monitoring is a growing need due to the rapid pace of change in the wine industry, which calls for fast methods providing real time information in order to assure the quality of the final product. The objective of this work is to investigate the potential of non-destructive techniques associated with chemometric data analysis, to monitor time-related changes that occur during red wine fermentation. Eight micro-fermentation trials conducted in the Valtellina region (Northern Italy) during the 2009 vintage, were monitored by a FT-NIR and a FT-IR spectrometer and by an electronic nose and tongue. The spectroscopic technique was used to investigate molecular changes, while electronic nose and electronic tongue evaluated the evolution of the aroma and taste profile during the must-wine fermentation. Must-wine samples were also analysed by traditional chemical methods in order to determine sugars (glucose and fructose) consumption and alcohol (ethanol and glycerol) production. Principal Component Analysis was applied to spectral, electronic nose and electronic tongue data, as an exploratory tool, to uncover molecular, aroma and taste modifications during the fermentation process. Furthermore, the chemical data and the PC1 scores from spectral, electronic nose and electronic tongue data were modelled as a function of time to identify critical points during fermentation. The results showed that

Monitoring of alcoholic fermentation using near infrared and mid infrared spectroscopies combined with electronic nose and electronic tongue

Energy Technology Data Exchange (ETDEWEB)

Buratti, S., E-mail: susanna.buratti@unimi.it [Department of Food Science and Technology, Universita degli Studi di Milano, Via Celoria 2, 20133 Milano (Italy); Ballabio, D. [Department of Environmental Sciences, University of Milano-Bicocca, Piazza della Scienza 1, 20126 Milano (Italy); Giovanelli, G. [Department of Food Science and Technology, Universita degli Studi di Milano, Via Celoria 2, 20133 Milano (Italy); Dominguez, C.M. Zuluanga [Instituto de Ciencia y Tecnologia de Alimentos, Universidad Nacional de Colombia, Ciudad Universitaria, Bogota (Colombia); Moles, A.; Benedetti, S.; Sinelli, N. [Department of Food Science and Technology, Universita degli Studi di Milano, Via Celoria 2, 20133 Milano (Italy)

2011-07-04

Graphical abstract: Application of non destructive methods for the monitoring of red wine fermentation in correlation with the evolution of chemical parameters. Highlights: > We monitored time-related changes in red wine fermentation process. > NIR and MIR spectroscopies, electronic nose and tongue were applied. > Data were kinetically modelled to identify critical points during fermentation. > NIR, MIR electronic nose and tongue were able to follow the fermentation process. > The models agreed with the evolution of chemical parameters. - Abstract: Effective fermentation monitoring is a growing need due to the rapid pace of change in the wine industry, which calls for fast methods providing real time information in order to assure the quality of the final product. The objective of this work is to investigate the potential of non-destructive techniques associated with chemometric data analysis, to monitor time-related changes that occur during red wine fermentation. Eight micro-fermentation trials conducted in the Valtellina region (Northern Italy) during the 2009 vintage, were monitored by a FT-NIR and a FT-IR spectrometer and by an electronic nose and tongue. The spectroscopic technique was used to investigate molecular changes, while electronic nose and electronic tongue evaluated the evolution of the aroma and taste profile during the must-wine fermentation. Must-wine samples were also analysed by traditional chemical methods in order to determine sugars (glucose and fructose) consumption and alcohol (ethanol and glycerol) production. Principal Component Analysis was applied to spectral, electronic nose and electronic tongue data, as an exploratory tool, to uncover molecular, aroma and taste modifications during the fermentation process. Furthermore, the chemical data and the PC1 scores from spectral, electronic nose and electronic tongue data were modelled as a function of time to identify critical points during fermentation. The results showed that NIR and MIR

Experiences in troubleshooting of neutron rem monitor electronics and its subsequent calibration

International Nuclear Information System (INIS)

Maithani, Atul; Dash, Amit Kumar; Vijayasekaran, P.; Mathews, Geo; Ajoy, K.C.; Dhanasekaran, A.

2014-01-01

This paper deals with the troubleshooting of the signal processing and counting electronics of two no's of Neutron Rem monitors and its subsequent calibration. Electronics servicing with respect to detection of fault in the circuit board, replacement of faulty ICs, circuits (Analog and Digital) tracing and installation of new rechargeable battery pack was done. Electronic calibration using Test pulse generator was carried out for dose rate measurements, amplitude measurements and discriminator level setting. Serial communication settings were checked with both HyperTerminal and software for the monitors. Neutron Source calibration was also carried out for both the monitors. (author)

Clinical outcomes of the inclusion of the therapeutic drug monitoring report in the electronic clinical record

Directory of Open Access Journals (Sweden)

Marina Sáez Belló

2016-12-01

Full Text Available Objectives: To assess the inclusion of the Therapeutic Drug Monitoring Report (TDMR in the Electronic Clinical Record (ECR. Method: An observational ambispective cohort study with a duration of 149 days: PRE (retrospective, 49 days with the TDMR printed in paper, and POST (prospective, 100 days with the TDMR included in the ECR. Exclusion criteria: Patients not hospitalized, applications for Therapeutic Drug Monitoring by Critical Care and Neonatal Units, as well as monitoring with an objective other than dose adjustment. Variables: Number of TDMRs prepared, number of patients admitted with TDMR, time of delay for treatment adjustment, defined as the number of adjustments made to the treatment within over or under 24 hours from the time of TDMR preparation, and medication errors (MEs associated with said delay, as well as the degree of acceptance of the TDMR. Results: 690 TDMRs were conducted in 391 patients, 339 in PRE (n = 206 and 351 in POST (n = 185. The number of treatment modifications made in under 24 hours increased from 73.9% in PRE to 87.3% in POST [RR = 1.2 (CI95% = 0.97-1.43. We identified 35 patients with ME, 9.7% of them in PRE and 8.1% in POST (RR = 0.84 (CI95% = 0.44-1.58]. The degree of acceptance of the pharmacist recommendation increased from 53.3% in PRE to 68.3% in POST [RR = 1.3 (CI95% = 1.02- 1.62]. Conclusions: The inclusion of the Therapeutic Drug Monitoring Report (TDMR in the Electronic Clinical Record increases the degree of acceptance of recommendations, and may reduce the delay in treatment modifications, reducing MEs and improving the process quality in terms of efficacy and safety

Study of an integrated electronic monitor for neutron beams

International Nuclear Information System (INIS)

Barelaud, B.; Nexon-Mokhtari, F.; Barrau, C.; Decossac, J.L.; Vareille, J.C.; Sarrabayrouse, G.

1994-01-01

Many neutron beams monitors in 10 keV - 50 keV range are perturbed by gamma radiation impact. This new monitor uses two silicon (junction) diodes operating coincidence detection, combined with an electronic threshold to eliminate gamma background noise. The results and analyses presented here only concern feasibility studies. (D.L.)

A telemedicine instrument for Internet-based home monitoring of thoracoabdominal motion in patients with respiratory diseases

Science.gov (United States)

da Silva Junior, Evert Pereira; Esteves, Guilherme Pompeu; Dames, Karla Kristine; Melo, Pedro Lopes de

2011-01-01

Changes in thoracoabdominal motion are highly prevalent in patients with chronic respiratory diseases. Home care services that use telemedicine techniques and Internet-based monitoring have the potential to improve the management of these patients. However, there is no detailed description in the literature of a system for Internet-based monitoring of patients with disturbed thoracoabdominal motion. The purpose of this work was to describe the development of a new telemedicine instrument for Internet-based home monitoring of thoracoabdominal movement. The instrument directly measures changes in the thorax and abdomen circumferences and transfers data through a transmission control protocol/Internet protocol connection. After the design details are described, the accuracy of the electronic and software processing units of the instrument is evaluated by using electronic signals simulating normal subjects and individuals with thoracoabdominal motion disorders. The results obtained during in vivo studies on normal subjects simulating thoracoabdominal motion disorders showed that this new system is able to detect a reduction in abdominal movement that is associated with abnormal thoracic breathing (p telemedicine scenarios, which can reduce the costs of assistance offered to patients with respiratory diseases.

Study of an integrated electronic monitor for neutron beams

Energy Technology Data Exchange (ETDEWEB)

Barelaud, B.; Nexon-Mokhtari, F.; Barrau, C.; Decossac, J.L.; Vareille, J.C. [Limoges Univ., 87 (France); Sarrabayrouse, G. [Centre National de la Recherche Scientifique (CNRS), 31 - Toulouse (France). Lab. d`Automatique et d`Analyse des Systemes

1994-12-31

Many neutron beams monitors in 10 keV - 50 keV range are perturbed by gamma radiation impact. This new monitor uses two silicon (junction) diodes operating coincidence detection, combined with an electronic threshold to eliminate gamma background noise. The results and analyses presented here only concern feasibility studies. (D.L.). 11 refs.

Patient monitoring using infrastructure-oriented wireless LANs.

Science.gov (United States)

Varshney, Upkar

2006-01-01

There is considerable interest in using wireless and mobile technologies in patient monitoring in diverse environments including hospitals and nursing homes. However, there has not been much work in determining the requirements of patient monitoring and satisfying these requirements using infrastructure-oriented wireless networks. In this paper, we derive several requirements of patient monitoring and show how infrastructure-oriented wireless LANs, such as versions of IEEE 802.11, can be used to support patient monitoring in diverse environments.

Electron beam emittance monitor for the SSC

International Nuclear Information System (INIS)

Tsyganov, E.; Meinke, R.; Nexsen, W.; Kauffmann, S.; Zinchenko, A.; Taratin, A.

1993-05-01

A nondestructive beam profile monitor for the Superconducting Super Collider (SSC) is presented using as a probe a low-energy electron beam interacting with the proton bunch charge. Results using a full Monte Carlo simulation code look promising for the transverse and longitudinal beam profile measurements

Diode readout electronics for beam intensity and position monitors for FELs

International Nuclear Information System (INIS)

Herrmann, S; Hart, P; Freytag, M; Pines, J; Weaver, M; Sapozhnikov, L; Nelson, S; Koglin, J; Carini, G A; Tomada, A; Haller, G

2014-01-01

LCLS uses Intensity-Position Monitors (IPM) to measure intensity and position of the FEL x-ray pulses. The primary beam passes through a silicon nitride film and four diodes, arranged in quadrants, detect the backscattered x-ray photons. The position is derived from the relative intensity of the four diodes, while the sum provides beam intensity information. In contrast to traditional synchrotron beam monitors, where diodes measure a DC current signal, the LCLS beam monitors have to cope with the pulsed nature of the FEL, which requires a large single shot dynamic range. A key component of these beam monitors is the readout electronics. The first generation of beam monitors showed some limitations. A new scheme with upgraded electronics, firmware and software was implemented resulting in a more robust and reliable measuring tool.

Privacy Issues of Electronic Monitoring Of Employees: A Cross-Cultural Examination Of Gender Differences

Directory of Open Access Journals (Sweden)

Raymond E. Taylor

2013-07-01

Full Text Available This manuscript presents the results of a study which examined the privacy issues of electronic monitoring of employees from a cross-cultural perspective comparing participants from Taiwan with those from the United States. The results of the study suggest that gender differences exist between Taiwanese and American respondents’ attitudes concerning privacy issues of electronic monitoring of employees. The study suggests that monitoring with notice was an important parameter in determining how privacy issues of electronic monitoring of employees were viewed by the participants.

Automated and electronically assisted hand hygiene monitoring systems: a systematic review.

Science.gov (United States)

Ward, Melissa A; Schweizer, Marin L; Polgreen, Philip M; Gupta, Kalpana; Reisinger, Heather S; Perencevich, Eli N

2014-05-01

Hand hygiene is one of the most effective ways to prevent transmission of health care-associated infections. Electronic systems and tools are being developed to enhance hand hygiene compliance monitoring. Our systematic review assesses the existing evidence surrounding the adoption and accuracy of automated systems or electronically enhanced direct observations and also reviews the effectiveness of such systems in health care settings. We systematically reviewed PubMed for articles published between January 1, 2000, and March 31, 2013, containing the terms hand AND hygiene or hand AND disinfection or handwashing. Resulting articles were reviewed to determine if an electronic system was used. We identified 42 articles for inclusion. Four types of systems were identified: electronically assisted/enhanced direct observation, video-monitored direct observation systems, electronic dispenser counters, and automated hand hygiene monitoring networks. Fewer than 20% of articles identified included calculations for efficiency or accuracy. Limited data are currently available to recommend adoption of specific automatic or electronically assisted hand hygiene surveillance systems. Future studies should be undertaken that assess the accuracy, effectiveness, and cost-effectiveness of such systems. Given the restricted clinical and infection prevention budgets of most facilities, cost-effectiveness analysis of specific systems will be required before these systems are widely adopted. Published by Mosby, Inc.

Development of an electronic nose for environmental odour monitoring.

Science.gov (United States)

Dentoni, Licinia; Capelli, Laura; Sironi, Selena; Del Rosso, Renato; Zanetti, Sonia; Della Torre, Matteo

2012-10-25

Exhaustive odour impact assessment should involve the evaluation of the impact of odours directly on citizens. For this purpose it might be useful to have an instrument capable of continuously monitoring ambient air quality, detecting the presence of odours and also recognizing their provenance. This paper discusses the laboratory and field tests conducted in order to evaluate the performance of a new electronic nose, specifically developed for monitoring environmental odours. The laboratory tests proved the instrument was able to discriminate between the different pure substances being tested, and to estimate the odour concentrations giving correlation indexes (R2) of 0.99 and errors below 15%. Finally, the experimental monitoring tests conducted in the field, allowed us to verify the effectiveness of this electronic nose for the continuous detection of odours in ambient air, proving its stability to variable atmospheric conditions and its capability to detect odour peaks.

Adherence to Biobehavioral Recommendations in Pediatric Migraine as Measured by Electronic Monitoring: The Adherence in Migraine (AIM) Study.

Science.gov (United States)

Kroon Van Diest, Ashley M; Ramsey, Rachelle; Aylward, Brandon; Kroner, John W; Sullivan, Stephanie M; Nause, Katie; Allen, Janelle R; Chamberlin, Leigh A; Slater, Shalonda; Hommel, Kevin; LeCates, Susan L; Kabbouche, Marielle A; O'Brien, Hope L; Kacperski, Joanne; Hershey, Andrew D; Powers, Scott W

2016-07-01

The purpose of this investigation was to examine treatment adherence to medication and lifestyle recommendations among pediatric migraine patients using electronic monitoring systems. Nonadherence to medical treatment is a significant public health concern, and can result in poorer treatment outcomes, decreased cost-effectiveness of medical care, and increased morbidity. No studies have systematically examined adherence to medication and lifestyle recommendations in adolescents with migraine outside of a clinical trial. Participants included 56 adolescents ages 11-17 who were presenting for clinical care. All were diagnosed with migraine with or without aura or chronic migraine and had at least 4 headache days per month. Medication adherence was objectively measured using electronic monitoring systems (Medication Event Monitoring Systems technology) and daily, prospective self-report via personal electronic devices. Adherence to lifestyle recommendations of regular exercise, eating, and fluid intake were also assessed using daily self-report on personal electronic devices. Electronic monitoring indicates that adolescents adhere to their medication 75% of the time, which was significantly higher than self-reported rates of medication adherence (64%). Use of electronic monitoring of medication detected rates of adherence that were significantly higher for participants taking once daily medication (85%) versus participants taking twice daily medication (59%). Average reported adherence to lifestyle recommendations of consistent noncaffeinated fluid intake (M = 5 cups per day) was below recommended levels of a minimum of 8 cups per day. Participants on average also reported skipping 1 meal per week despite recommendations of consistently eating three meals per day. Results suggest that intervention focused on adherence to preventive treatments (such as medication) and lifestyle recommendations may provide more optimal outcomes for children and adolescents with

A fuzzy model for processing and monitoring vital signs in ICU patients

Directory of Open Access Journals (Sweden)

Valentim Ricardo AM

2011-08-01

Full Text Available Abstract Background The area of the hospital automation has been the subject of much research, addressing relevant issues which can be automated, such as: management and control (electronic medical records, scheduling appointments, hospitalization, among others; communication (tracking patients, staff and materials, development of medical, hospital and laboratory equipment; monitoring (patients, staff and materials; and aid to medical diagnosis (according to each speciality. Methods In this context, this paper presents a Fuzzy model for helping medical diagnosis of Intensive Care Unit (ICU patients and their vital signs monitored through a multiparameter heart screen. Intelligent systems techniques were used in the data acquisition and processing (sorting, transforming, among others it into useful information, conducting pre-diagnosis and providing, when necessary, alert signs to the medical staff. Conclusions The use of fuzzy logic turned to the medical area can be very useful if seen as a tool to assist specialists in this area. This paper presented a fuzzy model able to monitor and classify the condition of the vital signs of hospitalized patients, sending alerts according to the pre-diagnosis done helping the medical diagnosis.

Behavior change techniques implemented in electronic lifestyle activity monitors: a systematic content analysis.

Science.gov (United States)

Lyons, Elizabeth J; Lewis, Zakkoyya H; Mayrsohn, Brian G; Rowland, Jennifer L

2014-08-15

Electronic activity monitors (such as those manufactured by Fitbit, Jawbone, and Nike) improve on standard pedometers by providing automated feedback and interactive behavior change tools via mobile device or personal computer. These monitors are commercially popular and show promise for use in public health interventions. However, little is known about the content of their feedback applications and how individual monitors may differ from one another. The purpose of this study was to describe the behavior change techniques implemented in commercially available electronic activity monitors. Electronic activity monitors (N=13) were systematically identified and tested by 3 trained coders for at least 1 week each. All monitors measured lifestyle physical activity and provided feedback via an app (computer or mobile). Coding was based on a hierarchical list of 93 behavior change techniques. Further coding of potentially effective techniques and adherence to theory-based recommendations were based on findings from meta-analyses and meta-regressions in the research literature. All monitors provided tools for self-monitoring, feedback, and environmental change by definition. The next most prevalent techniques (13 out of 13 monitors) were goal-setting and emphasizing discrepancy between current and goal behavior. Review of behavioral goals, social support, social comparison, prompts/cues, rewards, and a focus on past success were found in more than half of the systems. The monitors included a range of 5-10 of 14 total techniques identified from the research literature as potentially effective. Most of the monitors included goal-setting, self-monitoring, and feedback content that closely matched recommendations from social cognitive theory. Electronic activity monitors contain a wide range of behavior change techniques typically used in clinical behavioral interventions. Thus, the monitors may represent a medium by which these interventions could be translated for

Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis.

Science.gov (United States)

Ralston, J D; Cook, A J; Anderson, M L; Catz, S L; Fishman, P A; Carlson, J; Johnson, R; Green, B B

2014-01-01

We evaluated the role of home monitoring, communication with pharmacists, medication intensification, medication adherence and lifestyle factors in contributing to the effectiveness of an intervention to improve blood pressure control in patients with uncontrolled essential hypertension. We performed a mediation analysis of a published randomized trial based on the Chronic Care Model delivered over a secure patient website from June 2005 to December 2007. Study arms analyzed included usual care with a home blood pressure monitor and usual care with home blood pressure monitor and web-based pharmacist care. Mediator measures included secure messaging and telephone encounters; home blood pressure monitoring; medications intensification and adherence and lifestyle factors. Overall fidelity to the Chronic Care Model was assessed with the Patient Assessment of Chronic Care (PACIC) instrument. The primary outcome was percent of participants with blood pressure (BP) <140/90 mm Hg. At 12 months follow-up, patients in the web-based pharmacist care group were more likely to have BP <140/90 mm Hg (55%) compared to patients in the group with home blood pressure monitors only (37%) (p = 0.001). Home blood pressure monitoring accounted for 30.3% of the intervention effect, secure electronic messaging accounted for 96%, and medication intensification for 29.3%. Medication adherence and self-report of fruit and vegetable intake and weight change were not different between the two study groups. The PACIC score accounted for 22.0 % of the main intervention effect. The effect of web-based pharmacist care on improved blood pressure control was explained in part through a combination of home blood pressure monitoring, secure messaging, and antihypertensive medication intensification.

Commissioning of an electro-optic electron bunch length monitor at FLASH

International Nuclear Information System (INIS)

Breunlin, Jonas

2011-03-01

The demands on the electron beam qualities for free-electron lasers (FEL) are challenging in terms of high peak currents. At FLASH, the high-gain FEL in Hamburg, longitudinal bunch compression is performed to achieve the requested high charge densities in short bunches. The precise control of the bunch compression process requires advanced diagnostics on the longitudinal bunch profile. The bunch length monitor presented in this thesis is based on a non-destructive detection using the electro-optic effect. The focus is on a compact and reliable system for permanent bunch diagnostics. The monitor provides single-shot measurements of the longitudinal bunch profiles with lengths of a few picoseconds by spectrally encoding their charge distribution. First measurements for characterization purpose have been performed. It has been shown that the monitor is suitable for monitoring the longitudinal bunch profile behind the first bunch compressor at FLASH. Electron bunch profiles with slopes corresponding to a full width half maximum of about 1.4 ps have been detected. That is the intrinsic resolution limit of the utilized method. (orig.)

Statistical process control for electron beam monitoring.

Science.gov (United States)

López-Tarjuelo, Juan; Luquero-Llopis, Naika; García-Mollá, Rafael; Quirós-Higueras, Juan David; Bouché-Babiloni, Ana; Juan-Senabre, Xavier Jordi; de Marco-Blancas, Noelia; Ferrer-Albiach, Carlos; Santos-Serra, Agustín

2015-07-01

To assess the electron beam monitoring statistical process control (SPC) in linear accelerator (linac) daily quality control. We present a long-term record of our measurements and evaluate which SPC-led conditions are feasible for maintaining control. We retrieved our linac beam calibration, symmetry, and flatness daily records for all electron beam energies from January 2008 to December 2013, and retrospectively studied how SPC could have been applied and which of its features could be used in the future. A set of adjustment interventions designed to maintain these parameters under control was also simulated. All phase I data was under control. The dose plots were characterized by rising trends followed by steep drops caused by our attempts to re-center the linac beam calibration. Where flatness and symmetry trends were detected they were less-well defined. The process capability ratios ranged from 1.6 to 9.3 at a 2% specification level. Simulated interventions ranged from 2% to 34% of the total number of measurement sessions. We also noted that if prospective SPC had been applied it would have met quality control specifications. SPC can be used to assess the inherent variability of our electron beam monitoring system. It can also indicate whether a process is capable of maintaining electron parameters under control with respect to established specifications by using a daily checking device, but this is not practical unless a method to establish direct feedback from the device to the linac can be devised. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

How effective is electronic monitoring in mixed bottom-trawl fisheries?

NARCIS (Netherlands)

Helmond, van A.T.M.; Chen, C.; Poos, J.J.

2015-01-01

In the context of the landing obligation under the European Common Fisheries Policy, electronic monitoring (EM) is often presented as one of the solutions to fully document catches. EM includes video monitoring to record the catch handling process on board the vessels. This study evaluated the

Patient benefit from seamless implant monitoring

Directory of Open Access Journals (Sweden)

Karsten Wallbrück

2005-12-01

Full Text Available Background: Patients with electrostimulation devices visit the hospital regularly for follow-up. The workload of out-patient departments is ever increasing, but a less frequent check-up is unwanted, as it could impair reliability and effectiveness of the therapy. A system of remote patient monitoring might improve this situation by enabling identification of patients who benefit from a shortened time for corrective action after any undesired event. A completely automatic system for patient remote monitoring has been introduced (BIOTRONIK Home Monitoring, HM. Daily patient and device data are displayed on an internet site which allows authorized persons to follow the parameters trends. Several clinical studies are presently being conducted to investigate the benefit of HM in pacemaker and implantable cardioverter/defibrillator therapy. Preliminary results show the system’s ability to individualize implant therapy for the patients’ and the physicians’ benefits. Previous studies in heart failure (HF therapy have shown that hospital readmission rates, hospitalisation duration and also mortality can be reduced by patient monitoring programs. A recently started study investigating HM in heart failure therapy aims to define a HF-indicator that predicts a worsening of the patient’s status leading to hospitalisation. With such an indicator, the responsible physician could be alerted and the patient can be called in. Although several issues connected to Home Monitoring remain to be solved, the time has come for a more flexible patient management. The incorporation of modern information technology into cardiovascular implants offers a way to solve the conflict between limited resources and high quality medical therapy for an aging population.

Monitoring the Quality of Services in Electronic Banking

Directory of Open Access Journals (Sweden)

Jovovic Radislav

2016-09-01

Full Text Available Successful development of electronic banking is in direct correlation with the quality of services in electronic banking. Therefore, it is necessary that the banks are familiar with the attributes of electronic services on which clients assess the bank’s quality and client’s satisfaction with them, in order to be able to monitor, correct and improve the performance of electronic banking. We start from the hypothesis that there are already developed theoretical models for measuring the quality of e-banking services but they must be adjusted to the specific environment that is analysed in order to obtain reliable and quality information. The qualitative and quantitative research methods are applied in this paper in order to a get adjusted theoretical model (instrument for measuring the quality of electronic banking services. As a result of the conducted analysis, the initial theoretical model has been modified, so that the final version of the model (instrument for measuring quality of online banking allows obtaining reliable data, and information in the particular environment. And the results are: significant information about the quality of e-banking, modified theoretical model, information about the dimensions of quality of e-banking, customer satisfaction, and pathways and guidelines for the improvement of e-banking. The measuring of quality of electronic banking services in not one time activity but repeated one, as permanent monitoring strategy. This research is widely applicable even though it was conducted in the context of Montenegrin e-banking, since most of the banks in Montenegro are owned by well-known European banks, and it is expected that the obtained knowledge and information can be generalized.

Development of a high-resolution electron-beam profile monitor using Fresnel zone plates

International Nuclear Information System (INIS)

Nakamura, Norio; Sakai, Hiroshi; Muto, Toshiya; Hayano, Hitoshi

2004-01-01

We present a high-resolution and real-time beam profile monitor using Fresnel zone plates (FZPs) developed in the KEK-ATF damping ring. The monitor system has an X-ray imaging optics with two FZPs. In this monitor, the synchrotron radiation from the electron beam at the bending magnet is monochromatized by a crystal monochromator and the transverse electron beam image is twenty-times magnified by the two FZPs and detected on an X-ray CCD camera. The expected spatial resolution for the selected photon energy of 3.235 keV is less than 1 μm. With the beam profile monitor, we succeeded in obtaining a clear electron-beam image and measuring the extremely small beam size less than 10 μm. It is greatly expected that the beam profile monitor will be used in high-brilliance light sources and low-emittance accelerators. (author)

Monitoring of bedridden patients: development of a fall detection tool.

Science.gov (United States)

Vilas-Boas, M; Silva, P; Cunha, S R; Correia, M V

2013-01-01

Falls of patients are an important issue in hospitals nowadays; it causes severe injuries, increases hospitalization time and treatment costs. The detection of a fall, in time, provides faster rescue to the patient, preventing more serious injuries, as well as saving nursing time. The MovinSense® is an electronic device designed for monitoring patients to prevent pressure sores, and the main goal of this work was to develop a new tool for this device, with the purpose of detecting if the patient has fallen from the hospital bed, without changing any of the device's original features. Experiments for gathering data samples of inertial signals of falling from the bed were obtained using the device. For fall detection a sensitivity of 72% and specificity of 100% were reached. Another algorithm was developed to detect if the patient got out of his/her bed.

Warfarin monitoring in nursing homes assessed by case histories. Do recommendations and electronic alerts affect judgements?

Science.gov (United States)

Teruel, Reyes Serrano; Thue, Geir; Fylkesnes, Svein Ivar; Sandberg, Sverre; Kristoffersen, Ann Helen

2017-09-01

Older adults treated with warfarin are prone to complications, and high-quality monitoring is essential. The aim of this case history based study was to assess the quality of warfarin monitoring in a routine situation, and in a situation with an antibiotic-warfarin interaction, before and after receiving an electronic alert. In April 2014, a national web-based survey with two case histories was distributed among Norwegian nursing home physicians and general practitioners working part-time in nursing homes. Case A represented a patient on stable warfarin treatment, but with a substantial INR increase within the therapeutic interval. Case B represented a more challenging patient with trimethoprim sulfamethoxazole (TMS) treatment due to pyelonephritis. In both cases, the physicians were asked to state the next warfarin dose and the INR recall interval. In case B, the physicians could change their suggestions after receiving an electronic alert on the TMS-warfarin interaction. Three hundred and ninety eight physicians in 292 nursing homes responded. Suggested INR recall intervals and warfarin doses varied substantially in both cases. In case A, 61% gave acceptable answers according to published recommendations, while only 9% did so for case B. Regarding the TMS-warfarin interaction in case history B, the electronic alert increased the percentage of respondents correctly suggesting a dose reduction from 29% to 53%. Having an INR instrument in the nursing home was associated with shortened INR recall times. Practical advice on handling of warfarin treatment and drug interactions is needed. Electronic alerts as presented in electronic medical records seem insufficient to change practice. Availability of INR instruments may be important regarding recall time.

Wound dressing with reusable electronics for wireless monitoring

KAUST Repository

Shamim, Atif; Farooqui, Muhammad Fahad

2016-01-01

A wound dressing device with reusable electronics for wireless monitoring and a method of making the same are provided. The device can be a smart device. In an embodiment, the device has a disposable portion including one or more sensors and a

Automatic solar image motion measurements. [electronic disk flux monitoring

Science.gov (United States)

Colgate, S. A.; Moore, E. P.

1975-01-01

The solar seeing image motion has been monitored electronically and absolutely with a 25 cm telescope at three sites along the ridge at the southern end of the Magdalena Mountains west of Socorro, New Mexico. The uncorrelated component of the variations of the optical flux from two points at opposite limbs of the solar disk was continually monitored in 3 frequencies centered at 0.3, 3 and 30 Hz. The frequency band of maximum signal centered at 3 Hz showed the average absolute value of image motion to be somewhat less than 2sec. The observer estimates of combined blurring and image motion were well correlated with electronically measured image motion, but the observer estimates gave a factor 2 larger value.

An Electronic Patch for wearable health monitoring by reflectance pulse oximetry.

Science.gov (United States)

Haahr, Rasmus G; Duun, Sune B; Toft, Mette H; Belhage, Bo; Larsen, Jan; Birkelund, Karen; Thomsen, Erik V

2012-02-01

We report the development of an Electronic Patch for wearable health monitoring. The Electronic Patch is a new health monitoring system incorporating biomedical sensors, microelectronics, radio frequency (RF) communication, and a battery embedded in a 3-dimensional hydrocolloid polymer. In this paper the Electronic Patch is demonstrated with a new optical biomedical sensor for reflectance pulse oximetry so that the Electronic Patch in this case can measure the pulse and the oxygen saturation. The reflectance pulse oximetry solution is based on a recently developed annular backside silicon photodiode to enable low power consumption by the light emitting components. The Electronic Patch has a disposable part of soft adhesive hydrocolloid polymer and a reusable part of hard polylaurinlactam. The disposable part contains the battery. The reusable part contains the reflectance pulse oximetry sensor and microelectronics. The reusable part is 'clicked' into the disposable part when the patch is prepared for use. The patch has a size of 88 mm by 60 mm and a thickness of 5 mm.

Patients’ views on electronic patient information leaflets

Directory of Open Access Journals (Sweden)

Hammar T

2016-06-01

Full Text Available Background: Information in society and in health care is currently undergoing a transition from paper to digital formats, and the main source of information will probably be electronic in the future. Objective: To explore patients’ use and perceptions of the patient information leaflet included in the medication package, and their attitude towards a transition to an electronic version. Methods: The data was collected during October to November 2014 among individuals in South-Eastern Sweden, using a questionnaire (n=406, response rate 78% and interviews (n=15. Results: The questionnaire showed that the majority of the respondents (52% occasionally read the patient information leaflet, 37% always read it, and 11% never read it. Almost half of the patients (41% were positive towards reading the patient information leaflet electronically while 32% were hesitant and 26% neutral. A majority of the patients would request to get the patient information leaflet printed at the pharmacy if it was not included in the package. There were differences in attitude related to age and gender. The interviews showed that patients had mixed views on a transition to an electronic patient information leaflet. The patients perceived several positive aspects with an electronic patient information leaflet but were concerned about elderly patients. Conclusion: Although many were positive towards reading the patient information leaflet electronically, the majority prefer the patient information leaflet in paper form. Providing appropriate and useful eHealth services for patients to access the patient information leaflet electronically, along with education, could prepare patients for a transition to electronic patient information leaflet.

A fifth harmonic rf bunch monitor for the ANL-APS electron linac

International Nuclear Information System (INIS)

Nassiri, A.; Grelick, A.

1993-01-01

The function of a fifth harmonic (14.28 GHz) bunch monitor is to provide a signal which is proportional to the electron beam bunch size. The monitoring of the rf power signal at 14.28 GHz enables the operator to optimize the rf bunching of the beam at the end of the first accelerating section where the full bunching has been formed and remains mainly constant in size throughout the rest of the electron linac. A modified version of the SLAC original bunch monitor has been fabricated and its rf properties measured. This paper describes the design and the initial measurement results

A fifth harmonic RF bunch monitor for the ANL-APS electron linac

International Nuclear Information System (INIS)

Nassiri, A.; Grelick, A.

1993-01-01

The function of a fifth harmonic (14.28 GHz) bunch monitor is to provide a signal which is proportional to the electron beam bunch size. The monitoring of the rf power signal at 14.28 GHz enables the operator to optimize the rf bunching of the beam at the end of the first accelerating section where the full bunching has been formed and remains mainly constant in size throughout the rest of the electron linac. A modified version of the SLAC original bunch monitor has been fabricated and its rf properties measured. This paper describes the design and the initial measurements results

Accurate assessment of adherence: self-report and clinician report vs electronic monitoring of nebulizers.

Science.gov (United States)

Daniels, Tracey; Goodacre, Lynne; Sutton, Chris; Pollard, Kim; Conway, Steven; Peckham, Daniel

2011-08-01

People with cystic fibrosis have a high treatment burden. While uncertainty remains about individual patient level of adherence to medication, treatment regimens are difficult to tailor, and interventions are difficult to evaluate. Self- and clinician-reported measures are routinely used despite criticism that they overestimate adherence. This study assessed agreement between rates of adherence to prescribed nebulizer treatments when measured by self-report, clinician report, and electronic monitoring suitable for long-term use. Seventy-eight adults with cystic fibrosis were questioned about their adherence to prescribed nebulizer treatments over the previous 3 months. Self-report was compared with clinician report and stored adherence data downloaded from the I-Neb nebulizer system. Adherence measures were expressed as a percentage of the prescribed regimen, bias was estimated by the paired difference in mean (95% CI) patient and clinician reported and actual adherence. Agreement between adherence measures was calculated using intraclass correlation coefficients (95% CI), and disagreements for individuals were displayed using Bland-Altman plots. Patient-identified prescriptions matched the medical record prescription. Median self-reported adherence was 80% (interquartile range, 60%-95%), whereas median adherence measured by nebulizer download was 36% (interquartile range, 5%-84.5%). Nine participants overmedicated and underreported adherence. Median clinician report ranged from 50% to 60%, depending on profession. Extensive discrepancies between self-report and clinician report compared with nebulizer download were identified for individuals. Self- and clinician-reporting of adherence does not provide accurate measurement of adherence when compared with electronic monitoring. Using inaccurate measures has implications for treatment burden, clinician prescribing practices, cost, and accuracy of trial data.

Remote patient monitoring in chronic heart failure.

Science.gov (United States)

Palaniswamy, Chandrasekar; Mishkin, Aaron; Aronow, Wilbert S; Kalra, Ankur; Frishman, William H

2013-01-01

Heart failure (HF) poses a significant economic burden on our health-care resources with very high readmission rates. Remote monitoring has a substantial potential to improve the management and outcome of patients with HF. Readmission for decompensated HF is often preceded by a stage of subclinical hemodynamic decompensation, where therapeutic interventions would prevent subsequent clinical decompensation and hospitalization. Various methods of remote patient monitoring include structured telephone support, advanced telemonitoring technologies, remote monitoring of patients with implanted cardiac devices such as pacemakers and defibrillators, and implantable hemodynamic monitors. Current data examining the efficacy of remote monitoring technologies in improving outcomes have shown inconsistent results. Various medicolegal and financial issues need to be addressed before widespread implementation of this exciting technology can take place.

Development of a stripline-type position monitor for the KEK electron/positron linac

International Nuclear Information System (INIS)

Suwada, T.; Urano, T.; Lazos, A.; Kobayashi, H.

1994-01-01

A stripline-type beam-position monitor (BPM) is under development at the KEK electron/positron linac. This monitor will be installed in order to easily handle the orbit of a high-current electron beam (∼10 nC/pulse) generating a positron beam in the B-factory. The prototype BPM was tested at a test bench and then in the linac using a single-bunch electron beam. In this report some basic characteristics and the experimental results of the BPM are presented

Examining assumptions regarding valid electronic monitoring of medication therapy: development of a validation framework and its application on a European sample of kidney transplant patients

Directory of Open Access Journals (Sweden)

Steiger Jürg

2008-02-01

Full Text Available Abstract Background Electronic monitoring (EM is used increasingly to measure medication non-adherence. Unbiased EM assessment requires fulfillment of assumptions. The purpose of this study was to determine assumptions needed for internal and external validity of EM measurement. To test internal validity, we examined if (1 EM equipment functioned correctly, (2 if all EM bottle openings corresponded to actual drug intake, and (3 if EM did not influence a patient's normal adherence behavior. To assess external validity, we examined if there were indications that using EM affected the sample representativeness. Methods We used data from the Supporting Medication Adherence in Renal Transplantation (SMART study, which included 250 adult renal transplant patients whose adherence to immunosuppressive drugs was measured during 3 months with the Medication Event Monitoring System (MEMS. Internal validity was determined by assessing the prevalence of nonfunctioning EM systems, the prevalence of patient-reported discrepancies between cap openings and actual intakes (using contemporaneous notes and interview at the end of the study, and by exploring whether adherence was initially uncharacteristically high and decreased over time (an indication of a possible EM intervention effect. Sample representativeness was examined by screening for differences between participants and non-participants or drop outs on non-adherence. Results Our analysis revealed that some assumptions were not fulfilled: 1 one cap malfunctioned (0.4%, 2 self-reported mismatches between bottle openings and actual drug intake occurred in 62% of the patients (n = 155, and 3 adherence decreased over the first 5 weeks of the monitoring, indicating that EM had a waning intervention effect. Conclusion The validity assumptions presented in this article should be checked in future studies using EM as a measure of medication non-adherence.

Privacy Issues of Electronic Monitoring Of Employees: A Cross-Cultural Examination Of Gender Differences

OpenAIRE

Raymond E. Taylor

2013-01-01

This manuscript presents the results of a study which examined the privacy issues of electronic monitoring of employees from a cross-cultural perspective comparing participants from Taiwan with those from the United States. The results of the study suggest that gender differences exist between Taiwanese and American respondents’ attitudes concerning privacy issues of electronic monitoring of employees. The study suggests that monitoring with notice was an important parameter in determining ho...

Introduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" methodology

Directory of Open Access Journals (Sweden)

Chan Jasper FW

2011-05-01

Full Text Available Abstract Background MedSense is an electronic hand hygiene compliance monitoring system that provides Infection Control Practitioners with continuous access to hand hygiene compliance information by monitoring Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" guidelines. Unlike previous electronic monitoring systems, MedSense operates in open cubicles with multiple beds and does not disrupt existing workflows. Methods This study was conducted in a 6-bed neurosurgical intensive care unit with technical development and evaluation phases. Healthcare workers (HCWs wore an electronic device in the style of an identity badge to detect hand hygiene opportunities and compliance. We compared the compliance determined by the system and an infection control nurse. At the same time, the system assessed compliance by time of day, day of week, work shift, professional category of HCWs, and individual subject, while the workload of HCWs was monitored by measuring the amount of time they spent in patient zones. Results During the three-month evaluation phase, the system identified 13,694 hand hygiene opportunities from 17 nurses, 3 physiotherapists, and 1 healthcare assistant, resulting in an overall compliance of 35.1% for the unit. The per-indication compliance for Moment 1, 4, and simultaneous 1 and 4 were 21.3% (95%CI: 19.0, 23.6, 39.6% (95%CI: 37.3, 41.9, and 49.2% (95%CI: 46.6, 51.8, respectively, and were all statistically significantly different (p Conclusion MedSense provides an unobtrusive and objective measurement of hand hygiene compliance. The information is important for staff training by the infection control team and allocation of manpower by hospital administration.

Electronics and Calibration system for the CMS Beam Halo Monitor

CERN Document Server

Tosi, Nicolò; Fabbri, Franco L; Finkel, Alexey; Orfanelli, Stella; Loos, R; Montanari, Alessandro; Rusack, R; Stickland, David P

2014-01-01

In the context of increasing luminosity of LHC, it will be important to accurately measure the Machine Induced Background. A new monitoring system will be installed in the cavern of the Compact Muon Solenoid (CMS) experiment for measuring the beam background at high radius. This detector is composed of synthetic quartz Cherenkov radiators, coupled to fast photomultiplier tubes (PMT). The readout chain of this detector will make use of many components developed for the Phase 1 upgrade to the CMS Hadron Calorimeter electronics, with a dedicated firmware and readout adapted to the beam monitoring requirements. The PMT signal will be digitized by a charge integrating ASIC (QIE10), providing both the signal rise time and the charge integrated over one bunch crossing. The backend electronics will record bunch-by-bunch histograms, which will be published to CMS and the LHC using the newly designed CMS beam instrumentation specific DAQ. A calibration monitoring system has been designed to generate triggered pulses of...

Bosnian and American students' attitudes toward electronic monitoring: is it about what we know or where we come from?

Science.gov (United States)

Muftić, Lisa R; Payne, Brian K; Maljević, Almir

2015-06-01

The use of community corrections continues to grow across the globe as alternatives to incarceration are sought. Little research attention, however, has been directed at correctional alternatives from a global orientation. The purpose of this research study is to compare the way that a sample of criminal justice students from the United States (n = 118) and Bosnia and Herzegovina (n = 133) perceive electronic monitoring. Because electronic monitoring is a newer sentencing alternative and it is used differently in Bosnia and Herzegovina than it is in the United States, it is predicted that Bosnian students will view electronic monitoring differently than will students from the United States. This study finds that while students are largely supportive of electronic monitoring sentences, support is affected by offender type and student nationality. For example, Bosnian students are more supportive of electronic monitoring sentences for drug offenders while American students are more supportive of electronic monitoring sentences for juvenile offenders. Differences were also found across student groups when attitudes toward electronic monitoring and the costs and pains associated with electronic monitoring were assessed. Specifically, American students were less likely to view electronic monitoring as meeting the goals of rehabilitation and more likely to view the conditions and restrictions associated with electronic monitoring as being punitive than Bosnian students were. Implications from these findings, as well as limitations and suggestions for further research are discussed. © The Author(s) 2013.

Technology and Power. A Foucauldian Analysis of Electronic Monitoring Discourses

Directory of Open Access Journals (Sweden)

Anna Vitores

2007-05-01

Full Text Available The article aims to show the importance of FOUCAULT within social studies of science and technology. It also illustrates how a Foucauldian analysis can be useful for studies of science, technology and society focused on power effects. To accomplish these objectives we analyze the emergence of a specific techno-scientific innovation: the electronic monitoring of offenders. We map the discontinuities and discourse dispersions linked to those practices that constitute different materializations of this electronic device. Because we start from questions concerning power technologies, rather than simply analyzing the ideologies and knowledges that legitimate electronic monitoring and its technical reliability, we attend to the assemblage of discourses, rhetorics, vocabularies, techniques and procedures by which knowledge is intertwined and joins with the exercise of power. In this way, we show how one of FOUCAULT's technologies of power—disciplinary technology—is articulated, nourished and contradicted by other emergent logics drawing on new forms of regulation and social control. URN: urn:nbn:de:0114-fqs070225

On-line monitoring of food fermentation processes using electronic noses and electronic tongues: A review

International Nuclear Information System (INIS)

Peris, Miguel; Escuder-Gilabert, Laura

2013-01-01

Graphical abstract: -- Highlights: •This review paper deals with the applications of electronic noses and electronic tongues to the monitoring of fermentation processes. •Positive and negative aspects of the different approaches reviewed are analyzed. •Current and future endeavors in this field are also commented. -- Abstract: Fermentation processes are often sensitive to even slight changes of conditions that may result in unacceptable end-product quality. Thus, close follow-up of this type of processes is critical for detecting unfavorable deviations as early as possible in order to save downtime, materials and resources. Nevertheless the use of traditional analytical techniques is often hindered by the need for expensive instrumentation and experienced operators and complex sample preparation. In this sense, one of the most promising ways of developing rapid and relatively inexpensive methods for quality control in fermentation processes is the use of chemical multisensor systems. In this work we present an overview of the most important contributions dealing with the monitoring of fermentation processes using electronic noses and electronic tongues. After a brief description of the fundamentals of both types of devices, the different approaches are critically commented, their strengths and weaknesses being highlighted. Finally, future trends in this field are also mentioned in the last section of the article

On-line monitoring of food fermentation processes using electronic noses and electronic tongues: A review

Energy Technology Data Exchange (ETDEWEB)

Peris, Miguel, E-mail: mperist@qim.upv.es [Departamento de Química, Universidad Politécnica de Valencia, 46071 Valencia (Spain); Escuder-Gilabert, Laura [Departamento de Química Analítica, Universitat de Valencia, C/ Vicente Andrés Estellés s/n, E-46100 Burjasot, Valencia (Spain)

2013-12-04

Graphical abstract: -- Highlights: •This review paper deals with the applications of electronic noses and electronic tongues to the monitoring of fermentation processes. •Positive and negative aspects of the different approaches reviewed are analyzed. •Current and future endeavors in this field are also commented. -- Abstract: Fermentation processes are often sensitive to even slight changes of conditions that may result in unacceptable end-product quality. Thus, close follow-up of this type of processes is critical for detecting unfavorable deviations as early as possible in order to save downtime, materials and resources. Nevertheless the use of traditional analytical techniques is often hindered by the need for expensive instrumentation and experienced operators and complex sample preparation. In this sense, one of the most promising ways of developing rapid and relatively inexpensive methods for quality control in fermentation processes is the use of chemical multisensor systems. In this work we present an overview of the most important contributions dealing with the monitoring of fermentation processes using electronic noses and electronic tongues. After a brief description of the fundamentals of both types of devices, the different approaches are critically commented, their strengths and weaknesses being highlighted. Finally, future trends in this field are also mentioned in the last section of the article.

A Wireless Electronic Esophageal Stethoscope for Continuous Monitoring of Cardiovascular and Respiratory Systems during Anaesthesia

Directory of Open Access Journals (Sweden)

Parsaei H.

2017-03-01

Full Text Available Background: The basic requirements for monitoring anesthetized patients during surgery are assessing cardiac and respiratory function. Esophageal stethoscopes have been developed for this purpose, but these devices may not provide clear heart and lung sound due to existence of various noises in operating rooms. In addition, the stethoscope is not applicable for continues monitoring, and it is unsuitable for observing inaccessible patients in some conditions such as during CT scan. Objective: A wireless electronic esophageal stethoscope is designed for continues auscultation of heart and lung sounds in anesthetized patients. The system consists of a transmitter and a receiver. The former acquires, amplifies and transmits the acquired sound signals to the latter via a frequency modulation transmitter. The receiver demodulates, amplifies, and delivers the received signal to a headphone to be heard by anesthesiologist. Results: The usability and effectiveness of the designed system was qualitatively evaluated by 5 anesthesiologists in Namazi Hospital and Shahid Chamran Hospital, Shiraz, Iran on 30 patients in several operating rooms in different conditions; e.g., when electro surgery instruments are working. Fortunately, the experts on average ranked good quality for the heard heart and lung sounds and very good on the user friendly being of the instrument. Conclusion: Evaluation results demonstrate that the developed system is capable of capturing and transmitting heart and lung sounds successfully. Therefore, it can be used to continuously monitor anesthetized patients’ cardiac and respiratory function. Since via the instrument wireless auscultation is possible, it could be suitable for observing inaccessible patients in several conditions such as during CT scan.

A Wireless Electronic Esophageal Stethoscope for Continuous Monitoring of Cardiovascular and Respiratory Systems during Anaesthesia

Science.gov (United States)

Parsaei, H.; Vakily, A.; Shafiei, A.M.

2017-01-01

Background: The basic requirements for monitoring anesthetized patients during surgery are assessing cardiac and respiratory function. Esophageal stethoscopes have been developed for this purpose, but these devices may not provide clear heart and lung sound due to existence of various noises in operating rooms. In addition, the stethoscope is not applicable for continues monitoring, and it is unsuitable for observing inaccessible patients in some conditions such as during CT scan. Objective: A wireless electronic esophageal stethoscope is designed for continues auscultation of heart and lung sounds in anesthetized patients. The system consists of a transmitter and a receiver. The former acquires, amplifies and transmits the acquired sound signals to the latter via a frequency modulation transmitter. The receiver demodulates, amplifies, and delivers the received signal to a headphone to be heard by anesthesiologist. Results: The usability and effectiveness of the designed system was qualitatively evaluated by 5 anesthesiologists in Namazi Hospital and Shahid Chamran Hospital, Shiraz, Iran on 30 patients in several operating rooms in different conditions; e.g., when electro surgery instruments are working. Fortunately, the experts on average ranked good quality for the heard heart and lung sounds and very good on the user friendly being of the instrument. Conclusion: Evaluation results demonstrate that the developed system is capable of capturing and transmitting heart and lung sounds successfully. Therefore, it can be used to continuously monitor anesthetized patients’ cardiac and respiratory function. Since via the instrument wireless auscultation is possible, it could be suitable for observing inaccessible patients in several conditions such as during CT scan. PMID:28451580

Diagnostic value of different adherence measures using electronic monitoring and virologic failure as reference standards.

Science.gov (United States)

Deschamps, Ann E; De Geest, Sabina; Vandamme, Anne-Mieke; Bobbaers, Herman; Peetermans, Willy E; Van Wijngaerden, Eric

2008-09-01

Nonadherence to antiretroviral therapy is a substantial problem in HIV and jeopardizes the success of treatment. Accurate measurement of nonadherence is therefore imperative for good clinical management but no gold standard has been agreed on yet. In a single-center prospective study nonadherence was assessed by electronic monitoring: percentage of doses missed and drug holidays and by three self reports: (1) a visual analogue scale (VAS): percentage of overall doses taken; (2) the Swiss HIV Cohort Study Adherence Questionnaire (SHCS-AQ): percentage of overall doses missed and drug holidays and (3) the European HIV Treatment Questionnaire (EHTQ): percentage of doses missed and drug holidays for each antiretroviral drug separately. Virologic failure prospectively assessed during 1 year, and electronic monitoring were used as reference standards. Using virologic failure as reference standard, the best results were for (1) the SHCS-AQ after electronic monitoring (sensitivity, 87.5%; specificity, 78.6%); (2) electronic monitoring (sensitivity, 75%; specificity, 85.6%), and (3) the VAS combined with the SHCS-AQ before electronic monitoring (sensitivity, 87.5%; specificity, 58.6%). The sensitivity of the complex EHTQ was less than 50%. Asking simple questions about doses taken or missed is more sensitive than complex questioning about each drug separately. Combining the VAS with the SHCS-AQ seems a feasible nonadherence measure for daily clinical practice. Self-reports perform better after electronic monitoring: their diagnostic value could be lower when given independently.

Automated integration of continuous glucose monitor data in the electronic health record using consumer technology.

Science.gov (United States)

Kumar, Rajiv B; Goren, Nira D; Stark, David E; Wall, Dennis P; Longhurst, Christopher A

2016-05-01

The diabetes healthcare provider plays a key role in interpreting blood glucose trends, but few institutions have successfully integrated patient home glucose data in the electronic health record (EHR). Published implementations to date have required custom interfaces, which limit wide-scale replication. We piloted automated integration of continuous glucose monitor data in the EHR using widely available consumer technology for 10 pediatric patients with insulin-dependent diabetes. Establishment of a passive data communication bridge via a patient's/parent's smartphone enabled automated integration and analytics of patient device data within the EHR between scheduled clinic visits. It is feasible to utilize available consumer technology to assess and triage home diabetes device data within the EHR, and to engage patients/parents and improve healthcare provider workflow. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Electron stimulated carbon adsorption in ultra high vacuum monitored by Auger Electron Spectroscopy (AES)

CERN Document Server

Scheuerlein, C

2001-01-01

Electron stimulated carbon adsorption at room temperature (RT) has been studied in the context of radiation induced surface modifications in the vacuum system of particle accelerators. The stimulated carbon adsorption was monitored by AES during continuous irradiation by 2.5 keV electrons and simultaneous exposure of the sample surface to CO, CO2 or CH4. The amount of adsorbed carbon was estimated by measuring the carbon Auger peak intensity as a function of the electron irradiation time. Investigated substrate materials are technical OFE copper and TiZrV non-evaporable getter (NEG) thin film coatings, which are saturated either in air or by CO exposure inside the Auger electron spectrometer. On the copper substrate electron induced carbon adsorption from gas phase CO and CO2 is below the detection limit of AES. During electron irradiation of the non-activated TiZrV getter thin films, electron stimulated carbon adsorption from gas phase molecules is detected when either CO or CO2 is injected, whereas the CH4 ...

Associations Between Personality Traits and Adherence to Antidepressants Assessed Through Self-Report, Electronic Monitoring, and Pharmacy Dispensing Data: A Pilot Study.

Science.gov (United States)

Wouters, Hans; Amin, Darya F H; Taxis, Katja; Heerdink, Eibert R; Egberts, Antoine C G; Gardarsdottir, Helga

2016-10-01

Treatment with antidepressants is often compromised by substantial nonadherence. To understand nonadherence, specific medication-related behaviors and beliefs have been studied, but less is known about broader and temporally stable personality "traits." Furthermore, adherence has often been assessed by a single method. Hence, we investigated associations between the Big Five personality traits and adherence assessed by self-report, electronic drug use monitoring, and dispensing data. Using the Big Five Inventory, we assessed the personality traits "openness," "conscientiousness," "extraversion," "agreeableness," and "neuroticism" of patients treated with antidepressants who were invited through community pharmacies. Self-reported adherence was assessed with the Medication Adherence Rating Scale (score >24), electronic monitoring with medication event monitoring system (MEMS) devices (therapy days missed ≤ 10% and personality traits, the third and fourth quartiles of "conscientiousness" were associated with better self-reported adherence (odds ratio, 3.63; 95% confidence interval, 1.34-9.86 and odds ratio, 2.97; 95% confidence interval, 1.09-8.08; P ≤ 0.05). No relationships were found between personality traits and adherence assessed through electronic drug use monitoring or dispensing data. We therefore conclude that adherence to antidepressant therapy seems to be largely unrelated to personality traits.

Offenders' Perceptions of House Arrest and Electronic Monitoring

Science.gov (United States)

Martin, Jamie S.; Hanrahan, Kate; Bowers, James H., Jr.

2009-01-01

This article reports on a study designed to examine the perceptions of house arrest (HA) and electronic monitoring (EM) among offenders who have recently experienced this criminal sentence. Data were gathered via a self-administered questionnaire and follow-up interviews with a sample of offenders. Our primary areas of interest were to assess (a)…

The impacts of a pharmacist-managed outpatient clinic and chemotherapy-directed electronic order sets for monitoring oral chemotherapy.

Science.gov (United States)

Battis, Brandon; Clifford, Linda; Huq, Mostaqul; Pejoro, Edrick; Mambourg, Scott

2017-12-01

Objectives Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve. Methods A collaborative agreement was reached among oncology pharmacists, a pharmacy resident, two oncologists, and a physician assistant to establish a pharmacist-managed oral chemotherapy monitoring clinic at the VA Sierra Nevada Healthcare System. Drug-specific electronic order sets for prescribing and lab monitoring were created for initiating new drug therapy and prescription renewal. The order sets were created to be provider-centric, minimizing clicks needed to order necessary medications and lab monitoring. A standard progress note template was developed for documenting interventions made by the clinic. Patients new to an oral chemotherapy regimen were first counseled by an oncology pharmacist. The patients were then enrolled into the oral chemotherapy monitoring clinic for subsequent follow up and pharmacist interventions. Further, patients lacking monitoring or missing provider appointments were captured through a Clinical Dashboard developed by the US Department of Veterans Affairs (VA) Regional Office (VISN21) using SQL Server Reporting Services. Between September 2014 and April 2015, a total of 68 patients on different oral chemotherapy agents were enrolled into the clinic. Results Out of the 68 patients enrolled into the oral chemotherapy

Measuring Patient Adherence to Malaria Treatment: A Comparison of Results from Self-Report and a Customised Electronic Monitoring Device.

Science.gov (United States)

Bruxvoort, Katia; Festo, Charles; Cairns, Matthew; Kalolella, Admirabilis; Mayaya, Frank; Kachur, S Patrick; Schellenberg, David; Goodman, Catherine

2015-01-01

Self-report is the most common and feasible method for assessing patient adherence to medication, but can be prone to recall bias and social desirability bias. Most studies assessing adherence to artemisinin-based combination therapies (ACTs) have relied on self-report. In this study, we use a novel customised electronic monitoring device--termed smart blister packs--to examine the validity of self-reported adherence to artemether-lumefantrine (AL) in southern Tanzania. Smart blister packs were designed to look identical to locally available AL blister packs and to record the date and time each tablet was removed from packaging. Patients obtaining AL at randomly selected health facilities and drug stores were followed up at home three days later and interviewed about each dose of AL taken. Blister packs were requested for pill count and extraction of smart blister pack data. Data on adherence from both self-report verified by pill count and smart blister packs were available for 696 of 1,204 patients. There was no difference between methods in the proportion of patients assessed to have completed treatment (64% and 67%, respectively). However, the percentage taking the correct number of pills for each dose at the correct times (timely completion) was higher by self-report than smart blister packs (37% vs. 24%; psmart blister packs, 64% of patients completing treatment did not take the correct number of pills per dose or did not take each dose at the correct time interval. Smart blister packs resulted in lower estimates of timely completion of AL and may be less prone to recall and social desirability bias. They may be useful when data on patterns of adherence are desirable to evaluate treatment outcomes. Improved methods of collecting self-reported data are needed to minimise bias and maximise comparability between studies.

Measuring Patient Adherence to Malaria Treatment: A Comparison of Results from Self-Report and a Customised Electronic Monitoring Device.

Directory of Open Access Journals (Sweden)

Katia Bruxvoort

Full Text Available Self-report is the most common and feasible method for assessing patient adherence to medication, but can be prone to recall bias and social desirability bias. Most studies assessing adherence to artemisinin-based combination therapies (ACTs have relied on self-report. In this study, we use a novel customised electronic monitoring device--termed smart blister packs--to examine the validity of self-reported adherence to artemether-lumefantrine (AL in southern Tanzania.Smart blister packs were designed to look identical to locally available AL blister packs and to record the date and time each tablet was removed from packaging. Patients obtaining AL at randomly selected health facilities and drug stores were followed up at home three days later and interviewed about each dose of AL taken. Blister packs were requested for pill count and extraction of smart blister pack data.Data on adherence from both self-report verified by pill count and smart blister packs were available for 696 of 1,204 patients. There was no difference between methods in the proportion of patients assessed to have completed treatment (64% and 67%, respectively. However, the percentage taking the correct number of pills for each dose at the correct times (timely completion was higher by self-report than smart blister packs (37% vs. 24%; p<0.0001. By smart blister packs, 64% of patients completing treatment did not take the correct number of pills per dose or did not take each dose at the correct time interval.Smart blister packs resulted in lower estimates of timely completion of AL and may be less prone to recall and social desirability bias. They may be useful when data on patterns of adherence are desirable to evaluate treatment outcomes. Improved methods of collecting self-reported data are needed to minimise bias and maximise comparability between studies.

A New Electronic Monitoring Device to Measure Medication Adherence: Usability of the Helping Hand™

Directory of Open Access Journals (Sweden)

Sabina De Geest

2010-03-01

Full Text Available The aim of this study was to test the user performance, satisfaction and acceptability of the Helping Hand™ (B&O Medicom electronic medication adherence monitor. Using a mixed-method design, we studied 11 kidney transplant patients and 10 healthy volunteers during three weeks. Although testing showed positive usability aspects, several areas requiring technical improvement were identified: the most important obstacles to usability and acceptability were the weak sound signal, problems loading the medication, and the fact that only one medication could be used at a time.

Electronic monitoring of adherence to inhaled corticosteroids: an essential tool in identifying severe asthma in children.

Science.gov (United States)

Jochmann, Anja; Artusio, Luca; Jamalzadeh, Angela; Nagakumar, Prasad; Delgado-Eckert, Edgar; Saglani, Sejal; Bush, Andrew; Frey, Urs; Fleming, Louise J

2017-12-01

International guidelines recommend that severe asthma can only be diagnosed after contributory factors, including adherence, have been addressed. Accurate assessment of adherence is difficult in clinical practice. We hypothesised that electronic monitoring in children would identify nonadherence, thus delineating the small number with true severe asthma.Asthmatic children already prescribed inhaled corticosteroids were prospectively recruited and persistence of adherence assessed using electronic monitoring devices. Spirometry, airway inflammation and asthma control were measured at the start and end of the monitoring period.93 children (62 male; median age 12.4 years) were monitored for a median of 92 days. Median (range) monitored adherence was 74% (21-99%). We identified four groups: 1) good adherence during monitoring with improved control, 24% (likely previous poor adherence); 2) good adherence with poor control, 18% (severe therapy-resistant asthma); 3) poor adherence with good control, 26% (likely overtreated); and 4) poor adherence with poor control, 32%. No clinical parameter prior to monitoring distinguished these groups.Electronic monitoring is a useful tool for identifying children in whom a step up in treatment is indicated. Different approaches are needed in those who are controlled when adherent or who are nonadherent. Electronic monitoring is essential in a paediatric severe asthma clinic. Copyright ©ERS 2017.

[A design and study of a novel electronic device for cuff-pressure monitoring].

Science.gov (United States)

Wang, Shupeng; Li, Wei; Li, Wen; Song, Dejing; Chen, Desheng; Duan, Jun; Li, Chen; Li, Gang

2017-06-01

To design a novel electronic device for measuring the pressure in the cuff of the artificial airway; and to study the advantage of this device on continuous and intermittent cuff pressure monitoring. (1) a portable electronic device for cuff pressure measurement was invented, which could turn pressure signal into electrical signal through a pressure transducer. Meantime, it was possible to avoid pressure leak from the joint and the inside of the apparatus by modified Luer taper and sophisticated design. If the cuff pressure was out of the normal range, the apparatus could release a sound and light alarm. (2) Six traditional mechanical manometers were used to determine the cuff pressure in 6 tracheal tubes. The cuff pressure was maintain at 30 cmH 2 O (1 cmH 2 O = 0.098 kPa) by the manometer first, and repeated every 30 seconds for 4 times. (3) Study of continuous cuff pressure monitoring: We used a random number generator to randomize 6 tracheal tubes, 6 mechanical manometers and 6 our products by number 1-6, which has the same number of a group. Every group was further randomized into two balanced groups, one group used the mechanical manometer first, and the other used our product first. The baseline pressure was 30 cmH 2 O, measurement was performed every 4 hours for 6 times. When traditional mechanical manometer was used for cuff pressure monitoring, cuff pressure was decreased by an average of 2.9 cmH 2 O for each measurement (F = 728.2, P = 0.000). In study of continually monitoring, at each monitoring point, the pressure measured by electronic manometer was higher than the mechanical manometer. All the pressures measured by mechanical manometer were dropped below 20 cmH 2 O at 8th hour, and there was no pressure decrease below 20 cmH 2 O measured by electronic manometer in 24 hours by contrast. In study of intermittent monitoring, the same result was found. The pressure was dropped significantly with time when measured by mechanical manometer (F = 61.795, P

Measurement of an electron-beam size with a beam profile monitor using Fresnel zone plates

International Nuclear Information System (INIS)

Iida, K.; Nakamura, N.; Sakai, H.; Shinoe, K.; Takaki, H.; Fujisawa, M.; Hayano, H.; Nomura, M.; Kamiya, Y.; Koseki, T.; Amemiya, Y.; Aoki, N.; Nakayama, K.

2003-01-01

We present a non-destructive and real-time beam profile monitor using Fresnel zone plates (FZPs) and the measurement of an electron-beam size with this monitor in the KEK-Accelerator Test Facility (ATF) damping ring. The monitor system has the structure of a long-distance X-ray microscope, where two FZPs constitute an X-ray imaging optics. The synchrotron radiation from the electron beam at the bending magnet is monochromatized by a crystal monochromator and the transverse electron beam image is twenty times magnified by the two FZPs and detected on an X-ray CCD camera. The expected spatial resolution for the selected photon energy of 3.235 keV is sufficiently high to measure the horizontal and vertical beam sizes of the ATF damping ring. With the beam profile monitor, we succeeded in obtaining a clear electron-beam image and measuring the extremely small beam size less than 10 μm. The measured magnification of the X-ray imaging optics in the monitor system was in good agreement with the design value

Hand disinfection in a neonatal intensive care unit: continuous electronic monitoring over a one-year period.

Science.gov (United States)

Helder, Onno K; van Goudoever, Johannes B; Hop, Wim C J; Brug, Johannes; Kornelisse, René F

2012-10-08

Good hand hygiene compliance is essential to prevent nosocomial infections in healthcare settings. Direct observation of hand hygiene compliance is the gold standard but is time consuming. An electronic dispenser with built-in wireless recording equipment allows continuous monitoring of its usage. The purpose of this study was to monitor the use of alcohol-based hand rub dispensers with a built-in electronic counter in a neonatal intensive care unit (NICU) setting and to determine compliance with hand hygiene protocols by direct observation. A one-year observational study was conducted at a 27 bed level III NICU at a university hospital. All healthcare workers employed at the NICU participated in the study. The use of bedside dispensers was continuously monitored and compliance with hand hygiene was determined by random direct observations. A total of 258,436 hand disinfection events were recorded; i.e. a median (interquartile range) of 697 (559-840) per day. The median (interquartile range) number of hand disinfection events performed per healthcare worker during the day, evening, and night shifts was 13.5 (10.8 - 16.7), 19.8 (16.3 - 24.1), and 16.6 (14.2 - 19.3), respectively. In 65.8% of the 1,168 observations of patient contacts requiring hand hygiene, healthcare workers fully complied with the protocol. We conclude that the electronic devices provide useful information on frequency, time, and location of its use, and also reveal trends in hand disinfection events over time. Direct observations offer essential data on compliance with the hand hygiene protocol. In future research, data generated by the electronic devices can be supplementary used to evaluate the effectiveness of hand hygiene promotion campaigns.

Monitoring electronics during the experiments with the OSIRIS (HMI Berlin)

International Nuclear Information System (INIS)

Grebosz, J.

1992-01-01

This report presents the software to perform the constant monitoring of the electronics dedicated to control the multidetector system. It supervises the correct status of the gamma spectroscopy measurements. (author). 3 figs

75 FR 63434 - Availability of Compliance Guide for the Use of Video or Other Electronic Monitoring or Recording...

Science.gov (United States)

2010-10-15

...] Availability of Compliance Guide for the Use of Video or Other Electronic Monitoring or Recording Equipment in... the availability of a compliance guide on the use of video or other electronic monitoring or recording... providing this draft guide to advise establishments that video or other electronic monitoring or recording...

Renewal of beam position monitor electronics of the SPring-8 storage ring

International Nuclear Information System (INIS)

Sasaki, Shigeki; Fujita, Takahiro

2007-01-01

Signal processing electronics for the beam position monitors (BPM) of the SPring-8 Storage Ring were renewed during the summer shutdown period of 2006. The configurations of the electronics of before and after the alteration are described. The evaluation of the performance of the electronics is shown with the data taken by using the actual beams. (author)

Monitoring and control system of the Saclay electron linear accelerator

International Nuclear Information System (INIS)

Lafontaine, Antoine

1974-01-01

A description is given of the automatic monitoring and control system of the 60MeV electron linear accelerator of the Centre d'Etudes Nucleaires de Saclay. The paper is mostly concerned with the programmation of the system. However, in a real time device, there is a very close association between computer and electronics, the latter are therefore described in details and make up most of the paper. [fr

Electronic monitoring of offenders: an ethical review.

Science.gov (United States)

Bülow, William

2014-06-01

This paper considers electronic monitoring (EM) a promising alternative to imprisonment as a criminal sanction for a series of criminal offenses. However, little has been said about EM from an ethical perspective. To evaluate EM from an ethical perspective, six initial ethical challenges are addressed and discussed. It is argued that since EM is developing as a technology and a punitive means, it is urgent to discuss its ethical implications and incorporate moral values into its design and development.

Dynamics of Interocular Suppression in Amblyopic Children during Electronically Monitored Occlusion Therapy: First Insight.

Science.gov (United States)

Kehrein, Stephan; Kohnen, Thomas; Fronius, Maria

2016-06-01

Interocular suppression is assumed to be the mechanism leading to impaired visual acuity, especially in strabismic amblyopia. Little is known about the dynamics of suppression during treatment. The aim of our study was to assess the development of the depth of suppression and its relation to changes in visual acuity during electronically monitored occlusion treatment. In a prospective pilot study, 15 amblyopes (8 with and 7 without strabismus) aged 5 to 16 years (mean 10.24 years) were examined before initiation of patching and then every 3 to 6 weeks for 4 months. To quantify suppression, a red filter ladder (Sbisa bar) was used, attenuating the image of the dominant eye until the patients reported a binocular perception (diplopia, rivalry, color mixture) or a change in eye dominance. Acuity was assessed with crowded Landolt rings. Daily occlusion was recorded using occlusion dose monitors. The depth of interocular suppression showed a biphasic change: it increased significantly during the first month (P=0.02), while visual acuity improved (mean 0.14 log units ±0.13; Pocclusion and suppression changes was not statistically significant. This first insight into the functional changes during electronically monitored patching suggests a complex relationship between visual acuity and interocular suppression that seems to be influenced by the presence of strabismus. Knowledge of the dynamics of interocular suppression is crucial for enhancing the outcome of occlusion treatment and also for the evaluation of its future role compared to emerging dichoptic treatments.

Implementation and reimbursement of remote monitoring for cardiac implantable electronic devices in Europe: a survey from the health economics committee of the European Heart Rhythm Association.

Science.gov (United States)

Mairesse, Georges H; Braunschweig, Frieder; Klersy, Katherine; Cowie, Martin R; Leyva, Francisco

2015-05-01

Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) permits early detection of arrhythmias, device, and lead failure and may also be useful in risk-predicting patient-related outcomes. Financial benefits for patients and healthcare organizations have also been shown. We sought to assess the implementation and funding of RM of CIEDs, including conventional pacemakers (PMs), implantable cardioverter defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices in Europe. Electronic survey from 43 centres in 15 European countries. In the study sample, RM was available in 22% of PM patients, 74% of ICD patients, and 69% of CRT patients. The most significant perceived benefits were the early detection of atrial arrhythmias in pacemaker patients, lead failure in ICD patients, and worsening heart failure in CRT patients. Remote monitoring was reported to lead a reduction of in-office follow-ups for all devices. The most important reported barrier to the implementation of RM for all CIEDs was lack of reimbursement (80% of centres). Physicians regard RM of CIEDs as a clinically useful technology that affords significant benefits for patients and healthcare organizations. Remote monitoring, however, is perceived as increasing workload. Reimbursement for RM is generally perceived as a major barrier to implementation. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Nuclear electronic components of surface contamination monitor based on multi-electrode proportional counter

International Nuclear Information System (INIS)

Du Xiangyang; Zhang Yong; Han Shuping; Rao Xianming; Fang Jintu

2001-01-01

The nuclear electronic components applying in Portal Monitor and Hands and Feet Surface Contamination Monitor were based on modern integrated circuit are introduced. The detailed points in circuit design and manufacturing technique are analyzed

Wireless physiological monitoring system for psychiatric patients.

Science.gov (United States)

Rademeyer, A J; Blanckenberg, M M; Scheffer, C

2009-01-01

Patients in psychiatric hospitals that are sedated or secluded are at risk of death or injury if they are not continuously monitored. Some psychiatric patients are restless and aggressive, and hence the monitoring device should be robust and must transmit the data wirelessly. Two devices, a glove that measures oxygen saturation and a dorsally-mounted device that measures heart rate, skin temperature and respiratory rate were designed and tested. Both devices connect to one central monitoring station using two separate Bluetooth connections, ensuring a completely wireless setup. A Matlab graphical user interface (GUI) was developed for signal processing and monitoring of the vital signs of the psychiatric patient. Detection algorithms were implemented to detect ECG arrhythmias such as premature ventricular contraction and atrial fibrillation. The prototypes were manufactured and tested in a laboratory setting on healthy volunteers.

Quasi Real Time Data Analysis for Air Quality Monitoring with an Electronic Nose

Science.gov (United States)

Zhou, Hanying; Shevade, Abhijit V.; Pelletier, Christine C.; Homer, Margie L.; Ryan, M. Amy

2006-01-01

Cabin Air Quality Monitoring: A) Functions; 1) Incident monitor for targeted contaminants exceeding targeted concentrations. Identify and quantify. 2) Monitor for presence of compounds associated with fires or overheating electronics. 3) Monitor clean-up process. B) Characteristics; 1) Low mass, low power device. 2) Requires little crew time for maintenance and calibration. 3) Detects, identifies and quantifies selected chemical species at or below 24 hour SMAC.

Feasibility study of patient motion monitoring using tactile array sensor

International Nuclear Information System (INIS)

Kim, Tae Ho; Kang, Seong Hee; Kim, Dong Su; Cho, Min Seok; Kim, Kyeong Hyeon; Suh, Tae Suk; Kim, Si Yong

2014-01-01

The aim of this study is to evaluate patient pretreatment set-up error and intra-fraction motion using the tactile array sensors (Pressure Profile Systems Inc, Los Angeles, CA) which could measure distributed pressure profiles along the contacting surface and to check a feasibility of the sensor (tactile array sensor) in the patient motion monitoring. Laser alignment and optical camera based monitoring system are very useful for reduce patient set-up error but these systems could not monitor the blind area like patient's back position. Actually after patient alignment using laser or optical monitoring system, it was assumed that there is no error in the patient's back position (pressure profile distribution). But if an error occurs in the patient's back position, it will affect the radiation therapy accuracy. In spite of optical motion monitoring or using the immobilization tool, distributed pressure profiles of patient's back position was changed during inter and intra-fraction. For more accurate patient set-up, blind area (patient's back) monitoring was necessary. We expect that the proposed method will be very useful for make up for the weakness of optical monitoring method

Feasibility study of patient motion monitoring using tactile array sensor

Energy Technology Data Exchange (ETDEWEB)

Kim, Tae Ho; Kang, Seong Hee; Kim, Dong Su; Cho, Min Seok; Kim, Kyeong Hyeon; Suh, Tae Suk [Dept. of Biomedical Engineering, Research Institute of Biomedical Engineering, the Catholic University of Korea, Seoul (Korea, Republic of); Kim, Si Yong [Dept. of Radiation Oncology, Virginia Commonwealth University, Richmond (United States)

2014-11-15

The aim of this study is to evaluate patient pretreatment set-up error and intra-fraction motion using the tactile array sensors (Pressure Profile Systems Inc, Los Angeles, CA) which could measure distributed pressure profiles along the contacting surface and to check a feasibility of the sensor (tactile array sensor) in the patient motion monitoring. Laser alignment and optical camera based monitoring system are very useful for reduce patient set-up error but these systems could not monitor the blind area like patient's back position. Actually after patient alignment using laser or optical monitoring system, it was assumed that there is no error in the patient's back position (pressure profile distribution). But if an error occurs in the patient's back position, it will affect the radiation therapy accuracy. In spite of optical motion monitoring or using the immobilization tool, distributed pressure profiles of patient's back position was changed during inter and intra-fraction. For more accurate patient set-up, blind area (patient's back) monitoring was necessary. We expect that the proposed method will be very useful for make up for the weakness of optical monitoring method.

Visualizing Patient Journals by Combining Vital Signs Monitoring and Natural Language Processing

DEFF Research Database (Denmark)

Vilic, Adnan; Petersen, John Asger; Hoppe, Karsten

2016-01-01

This paper presents a data-driven approach to graphically presenting text-based patient journals while still maintaining all textual information. The system first creates a timeline representation of a patients’ physiological condition during an admission, which is assessed by electronically...... monitoring vital signs and then combining these into Early Warning Scores (EWS). Hereafter, techniques from Natural Language Processing (NLP) are applied on the existing patient journal to extract all entries. Finally, the two methods are combined into an interactive timeline featuring the ability to see...... drastic changes in the patients’ health, and thereby enabling staff to see where in the journal critical events have taken place....

A Review of the Condition Monitoring of Capacitors in Power Electronic Converters

DEFF Research Database (Denmark)

Soliman, Hammam Abdelaal Hammam; Wang, Huai; Blaabjerg, Frede

2015-01-01

Capacitor is one of the reliability critical components in power electronic systems. In the last two decades, many efforts in the academic research have been devoted to the condition monitoring of capacitors to estimate their health status. Industry applications demand more reliable power...... electronics products with preventive maintenance. Nevertheless, most of the developed capacitor condition monitoring technologies are rarely adopted by industry due to the complexity, increased cost and other relevant issues. An overview of the prior-art research in this area is therefore needed to justify....... Therefore, this paper firstly classifies the capacitor condition monitoring methods into three categories, then the respective technology evolution from 1993 to 2015 is summarized. Remarks on the state-of-the-art research and the future opportunities targeting for practical industry applications are given....

A Review of the Condition Monitoring of Capacitors in Power Electronic Converters

DEFF Research Database (Denmark)

Soliman, Hammam Abdelaal Hammam; Wang, Huai; Blaabjerg, Frede

2016-01-01

Capacitors are one type of reliability-critical components in power electronic systems. In the last two decades, many efforts in academic research have been devoted to the condition monitoring of capacitors to estimate their health status. Industry applications are demanding more reliable power...... electronics products with preventive maintenance. Nevertheless, most of the developed capacitor condition monitoring technologies are rarely adopted by industry due to the complexity, increased cost, and other relevant issues. An overview of the prior-art research in this area is therefore needed to justify......, this paper first classifies the capacitor condition monitoring methods into three categories, then the respective technology evolution in the last two decades is summarized. Finally, the state-of-the-art research and the future opportunities targeting for industry applications are given....

Intelligent MONitoring System for antiviral pharmacotherapy in patients with chronic hepatitis C (SiMON-VC

Directory of Open Access Journals (Sweden)

Luis Margusino-Framiñán

2017-01-01

Full Text Available Two out of six strategic axes of pharmaceutical care in our hospital are quality and safety of care, and the incorporation of information technologies. Based on this, an information system was developed in the outpatient setting for pharmaceutical care of patients with chronic hepatitis C, SiMON-VC, which would improve the quality and safety of their pharmacotherapy. The objective of this paper is to describe requirements, structure and features of Si- MON-VC. Requirements demanded were that the information system would enter automatically all critical data from electronic clinical records at each of the visits to the Outpatient Pharmacy Unit, allowing the generation of events and alerts, documenting the pharmaceutical care provided, and allowing the use of data for research purposes. In order to meet these requirements, 5 sections were structured for each patient in SiMON-VC: Main Record, Events, Notes, Monitoring Graphs and Tables, and Follow-up. Each section presents a number of tabs with those coded data needed to monitor patients in the outpatient unit. The system automatically generates alerts for assisted prescription validation, efficacy and safety of using antivirals for the treatment of this disease. It features a completely versatile Indicator Control Panel, where temporary monitoring standards and alerts can be set. It allows the generation of reports, and their export to the electronic clinical record. It also allows data to be exported to the usual operating systems, through Big Data and Business Intelligence. Summing up, we can state that SiMON-VC improves the quality of pharmaceutical care provided in the outpatient pharmacy unit to patients with chronic hepatitis C, increasing the safety of antiviral therapy.

Electronic health record use, intensity of hospital care, and patient outcomes.

Science.gov (United States)

Blecker, Saul; Goldfeld, Keith; Park, Naeun; Shine, Daniel; Austrian, Jonathan S; Braithwaite, R Scott; Radford, Martha J; Gourevitch, Marc N

2014-03-01

Previous studies have suggested that weekend hospital care is inferior to weekday care and that this difference may be related to diminished care intensity. The purpose of this study was to determine whether a metric for measuring intensity of hospital care based on use of the electronic health record was associated with patient-level outcomes. We performed a cohort study of hospitalizations at an academic medical center. Intensity of care was defined as the hourly number of provider accessions of the electronic health record, termed "electronic health record interactions." Hospitalizations were categorized on the basis of the mean difference in electronic health record interactions between the first Friday and the first Saturday of hospitalization. We used regression models to determine the association of these categories with patient outcomes after adjusting for covariates. Electronic health record interactions decreased from Friday to Saturday in 77% of the 9051 hospitalizations included in the study. Compared with hospitalizations with no change in Friday to Saturday electronic health record interactions, the relative lengths of stay for hospitalizations with a small, moderate, and large decrease in electronic health record interactions were 1.05 (95% confidence interval [CI], 1.00-1.10), 1.11 (95% CI, 1.05-1.17), and 1.25 (95% CI, 1.15-1.35), respectively. Although a large decrease in electronic health record interactions was associated with in-hospital mortality, these findings were not significant after risk adjustment (odds ratio 1.74, 95% CI, 0.93-3.25). Intensity of inpatient care, measured by electronic health record interactions, significantly diminished from Friday to Saturday, and this decrease was associated with length of stay. Hospitals should consider monitoring and correcting temporal fluctuations in care intensity. Copyright © 2014 Elsevier Inc. All rights reserved.

Real-time measurement and monitoring of absorbed dose for electron beams

Science.gov (United States)

Korenev, Sergey; Korenev, Ivan; Rumega, Stanislav; Grossman, Leon

2004-09-01

The real-time method and system for measurement and monitoring of absorbed dose for industrial and research electron accelerators is considered in the report. The system was created on the basis of beam parameters method. The main concept of this method consists in the measurement of dissipated kinetic energy of electrons in the irradiated product, determination of number of electrons and mass of irradiated product in the same cell by following calculation of absorbed dose in the cell. The manual and automation systems for dose measurements are described. The systems are acceptable for all types of electron accelerators.

Real-time measurement and monitoring of absorbed dose for electron beams

Energy Technology Data Exchange (ETDEWEB)

Korenev, Sergey E-mail: sergey_korenev@steris.com; Korenev, Ivan; Rumega, Stanislav; Grossman, Leon

2004-10-01

The real-time method and system for measurement and monitoring of absorbed dose for industrial and research electron accelerators is considered in the report. The system was created on the basis of beam parameters method. The main concept of this method consists in the measurement of dissipated kinetic energy of electrons in the irradiated product, determination of number of electrons and mass of irradiated product in the same cell by following calculation of absorbed dose in the cell. The manual and automation systems for dose measurements are described. The systems are acceptable for all types of electron accelerators.

Real-time measurement and monitoring of absorbed dose for electron beams

International Nuclear Information System (INIS)

Korenev, Sergey; Korenev, Ivan; Rumega, Stanislav; Grossman, Leon

2004-01-01

The real-time method and system for measurement and monitoring of absorbed dose for industrial and research electron accelerators is considered in the report. The system was created on the basis of beam parameters method. The main concept of this method consists in the measurement of dissipated kinetic energy of electrons in the irradiated product, determination of number of electrons and mass of irradiated product in the same cell by following calculation of absorbed dose in the cell. The manual and automation systems for dose measurements are described. The systems are acceptable for all types of electron accelerators

Automated electronic monitoring of circuit pressures during continuous renal replacement therapy: a technical report.

Science.gov (United States)

Zhang, Ling; Baldwin, Ian; Zhu, Guijun; Tanaka, Aiko; Bellomo, Rinaldo

2015-03-01

Automated electronic monitoring and analysis of circuit pressures during continuous renal replacement therapy (CRRT) has the potential to predict failure and allow intervention to optimise function. Current CRRT machines can measure and store pressure readings for downloading into databases and for analysis. We developed a procedure to obtain such data at intervals of 1 minute and analyse them using the Prismaflex CRRT machine, and we present an example of such analysis. We obtained data on pressures obtained at intervals of 1 minute in a patient with acute kidney injury and sepsis treated with continuous haemofiltration at 2 L/hour of ultrafiltration and a blood flow of 200 mL/minute. Data analysis identified progressive increases in transmembrane pressure (TMP) and prefilter pressure (PFP) from time 0 until 33 hours or clotting. TMP increased from 104 mmHg to 313 mmHg and PFP increased from from 131 mmHg to 185 mmHg. Effluent pressure showed a progressive increase in the negative pressure applied to achieve ultrafiltration from 0 mmHg to -168 mmHg. The inflection point for such changes was also identified. Blood pathway pressures for access and return remained unchanged throughout. Automated electronic monitoring of circuit pressure during CRRT is possible and provides useful information on the evolution of circuit clotting.

[Electronic fetal monitoring and management of adverse outcomes: how to perform and improve a training program for clinicians?].

Science.gov (United States)

Secourgeon, J-F

2012-10-01

Electronic fetal monitoring during labor is the most commonly used method to evaluate the fetal status, but it remains exposed to some criticism. By comparison with intermittent auscultation and in the light of the results of the great studies in the last 30 years, it may be accused its failure to improve the neonatal outcome and its responsibility in the increase on operative deliveries. Actually, the electronic fetal monitoring is a tool whose effectiveness is linked to the accuracy of the analysis developed by the clinician. Studies on assessment of the tracing interpretation indicate that there is always a lack of quality, which may be improved through training programs. It also reveals the benefit of the fetal blood sampling to reduce operative deliveries and the generalization of this method, in addition to electronic fetal monitoring, is recommended by referral agencies. More generally, the continuous monitoring is only a part of the patient safety strategy in the labour ward and we are currently observing, in some European countries and in the United States, the development of training programs concerning the management of the adverse outcomes in obstetrics. The good performances related to the quality of care are demonstrated by the findings of the studies performed in the centers that have implemented an active training policy. In France, the professionals directly involved in the field of the perinatology should benefit from such educational programs that could be organized within the care networks under the authority of referral agencies. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Creating a High-Frequency Electronic Database in the PICU: The Perpetual Patient.

Science.gov (United States)

Brossier, David; El Taani, Redha; Sauthier, Michael; Roumeliotis, Nadia; Emeriaud, Guillaume; Jouvet, Philippe

2018-04-01

Our objective was to construct a prospective high-quality and high-frequency database combining patient therapeutics and clinical variables in real time, automatically fed by the information system and network architecture available through fully electronic charting in our PICU. The purpose of this article is to describe the data acquisition process from bedside to the research electronic database. Descriptive report and analysis of a prospective database. A 24-bed PICU, medical ICU, surgical ICU, and cardiac ICU in a tertiary care free-standing maternal child health center in Canada. All patients less than 18 years old were included at admission to the PICU. None. Between May 21, 2015, and December 31, 2016, 1,386 consecutive PICU stays from 1,194 patients were recorded in the database. Data were prospectively collected from admission to discharge, every 5 seconds from monitors and every 30 seconds from mechanical ventilators and infusion pumps. These data were linked to the patient's electronic medical record. The database total volume was 241 GB. The patients' median age was 2.0 years (interquartile range, 0.0-9.0). Data were available for all mechanically ventilated patients (n = 511; recorded duration, 77,678 hr), and respiratory failure was the most frequent reason for admission (n = 360). The complete pharmacologic profile was synched to database for all PICU stays. Following this implementation, a validation phase is in process and several research projects are ongoing using this high-fidelity database. Using the existing bedside information system and network architecture of our PICU, we implemented an ongoing high-fidelity prospectively collected electronic database, preventing the continuous loss of scientific information. This offers the opportunity to develop research on clinical decision support systems and computational models of cardiorespiratory physiology for example.

Exhaled breath analysis using electronic nose in cystic fibrosis and primary ciliary dyskinesia patients with chronic pulmonary infections

DEFF Research Database (Denmark)

Joensen, Odin; Paff, Tamara; Haarman, Eric G

2014-01-01

The current diagnostic work-up and monitoring of pulmonary infections may be perceived as invasive, is time consuming and expensive. In this explorative study, we investigated whether or not a non-invasive exhaled breath analysis using an electronic nose would discriminate between cystic fibrosis...... (CF) and primary ciliary dyskinesia (PCD) with or without various well characterized chronic pulmonary infections. We recruited 64 patients with CF and 21 with PCD based on known chronic infection status. 21 healthy volunteers served as controls. An electronic nose was employed to analyze exhaled......, this method significantly discriminates CF patients suffering from a chronic pulmonary P. aeruginosa (PA) infection from CF patients without a chronic pulmonary infection. Further studies are needed for verification and to investigate the role of electronic nose technology in the very early diagnostic workup...

Patient Compliance With Electronic Patient Reported Outcomes Following Shoulder Arthroscopy.

Science.gov (United States)

Makhni, Eric C; Higgins, John D; Hamamoto, Jason T; Cole, Brian J; Romeo, Anthony A; Verma, Nikhil N

2017-11-01

To determine the patient compliance in completing electronically administered patient-reported outcome (PRO) scores following shoulder arthroscopy, and to determine if dedicated research assistants improve patient compliance. Patients undergoing arthroscopic shoulder surgery from January 1, 2014, to December 31, 2014, were prospectively enrolled into an electronic data collection system with retrospective review of compliance data. A total of 143 patients were included in this study; 406 patients were excluded (for any or all of the following reasons, such as incomplete follow-up, inaccessibility to the order sets, and inability to complete the order sets). All patients were assigned an order set of PROs through an electronic reporting system, with order sets to be completed prior to surgery, as well as 6 and 12 months postoperatively. Compliance rates of form completion were documented. Patients who underwent arthroscopic anterior and/or posterior stabilization were excluded. The average age of the patients was 53.1 years, ranging from 20 to 83. Compliance of form completion was highest preoperatively (76%), and then dropped subsequently at 6 months postoperatively (57%) and 12 months postoperatively (45%). Use of research assistants improved compliance by approximately 20% at each time point. No differences were found according to patient gender and age group. Of those completing forms, a majority completed forms at home or elsewhere prior to returning to the office for the clinic visit. Electronic administration of PRO may decrease the amount of time required in the office setting for PRO completion by patients. This may be mutually beneficial to providers and patients. It is unclear if an electronic system improves patient compliance in voluntary completion PRO. Compliance rates at final follow-up remain a concern if data are to be used for establishing quality or outcome metrics. Level IV, case series. Copyright © 2017 Arthroscopy Association of North

A total patient monitoring system for point-of-care applications

Science.gov (United States)

Whitchurch, Ashwin K.; Abraham, Jose K.; Varadan, Vijay K.

2007-04-01

Traditionally, home care for chronically ill patients and the elderly requires periodic visits to the patient's home by doctors or healthcare personnel. During these visits, the visiting person usually records the patient's vital signs and takes decisions as to any change in treatment and address any issues that the patient may have. Patient monitoring systems have since changed this scenario by significantly reducing the number of home visits while not compromising on continuous monitoring. This paper describes the design and development of a patient monitoring systems capable of concurrent remote monitoring of 8 patient-worn sensors: Electroencephalogram (EEG), Electrocardiogram (ECG), temperature, airflow pressure, movement and chest expansion. These sensors provide vital signs useful for monitoring the health of chronically ill patients and alerts can be raised if certain specified signal levels fall above or below a preset threshold value. The data from all eight sensors are digitally transmitted to a PC or to a standalone network appliance which relays the data through an available internet connection to the remote monitoring client. Thus it provides a real-time rendering of the patient's health at a remote location.

Dietary self-monitoring in patients with obstructive sleep apnea.

Science.gov (United States)

Hood, Megan M; Nackers, Lisa M; Kleinman, Brighid; Corsica, Joyce; Katterman, Shawn N

2014-01-01

Self-monitoring of food intake is a cornerstone of behavioral weight loss interventions, but its use has not been evaluated in the treatment of obese patients with obstructive sleep apnea (OSA). This pilot study described patterns of adherence to dietary self-monitoring in obese patients with OSA and determined associations between self-monitoring and weight loss, psychosocial functioning, and adherence to continuous positive airway pressure treatment. Participants completed a 6-week behavioral weight loss intervention focused on dietary self-monitoring. Approximately one-third of participants were adherent to self-monitoring throughout the course of the intervention and experienced more weight loss than those who did not self-monitor regularly. More frequent dietary self-monitoring also appeared to be associated with adherence to other health behaviors. These preliminary data suggest that use of dietary self-monitoring may be beneficial for promoting weight loss and adherence to other important health behaviors in OSA patients.

Detector and front-end electronics of a fissile mass flow monitoring system

International Nuclear Information System (INIS)

Paulus, M.J.; Uckan, T.; Lenarduzzi, R.; Mullens, J.A.; Castleberry, K.N.; McMillan, D.E.; Mihalczo, J.T.

1997-01-01

A detector and front-end electronics unit with secure data transmission has been designed and implemented for a fissile mass flow monitoring system for fissile mass flow of gases and liquids in a pipe. The unit consists of 4 bismuth germanate (BGO) scintillation detectors, pulse-shaping and counting electronics, local temperature sensors, and on-board local area network nodes which locally acquire data and report to the master computer via a secure network link. The signal gain of the pulse-shaping circuitry and energy windows of the pulse-counting circuitry are periodicially self calibrated and self adjusted in situ using a characteristic line in the fissile material pulse height spectrum as a reference point to compensate for drift such as in the detector gain due to PM tube aging. The temperature- dependent signal amplitude variations due to the intrinsic temperature coefficients of the PM tube gain and BGO scintillation efficiency have been characterized and real-time gain corrections introduced. The detector and electronics design, measured intrinsic performance of the detectors and electronics, and the performance of the detector and electronics within the fissile mass flow monitoring system are described

Electronic medication monitoring-informed counselling to improve adherence to combination antiretroviral therapy and virologic treatment outcomes: a meta-analysis

Directory of Open Access Journals (Sweden)

Nienke eLangebeek

2015-05-01

Full Text Available Background: Adherence to combination antiretroviral therapy (cART for HIV infection is a primary determinant of treatment success, but is often suboptimal. Previous studies have suggested that electronic medication monitoring-informed counselling is among the most effective adherence intervention components. Our objective was to review available evidence about the effectiveness of monitoring-informed counselling and to aggregate findings into quantitative estimates of the effect of such intervention on medication adherence and virologic treatment outcomes.Methods: We searched PubMed for papers reporting on randomized controlled trials (RCTs comparing intervention groups receiving monitoring-informed counselling as one of the intervention components versus control groups not receiving such counselling for their effect on medication adherence and viral load concentrations. The standardized mean difference (SMD in adherence and the odds ratio (OR of undetectable HIV RNA in intervention versus control groups were the common effect sizes. Random-effect models with inverse variance weights were used to aggregate findings into pooled effect estimates with 95% confidence limits. Results: A total of 13 studies were included. Adherence was significantly higher in intervention groups than in control groups (SMD 0.51, 95% CI 0.31 to 0.71. Patients in intervention groups were significantly more likely to have undetectable HIV RNA concentrations than patients in control groups (OR 1.35, 95% CI 1.12 to 1.63. However, in studies in which monitoring-informed counselling was the only intervention component, the difference in adherence and virologic response between intervention and control groups was not statistically significant.Conclusion: Electronic monitoring-informed counselling improved adherence and virologic response compared with control groups not receiving such counselling in studies in which it was one out of multiple intervention components, but not

Detection of Electronic Anklet Wearers’ Groupings throughout Telematics Monitoring

Directory of Open Access Journals (Sweden)

Paulo Lima Machado

2017-01-01

Full Text Available Ankle bracelets (anklets imposed by law to track convicted individuals are being used in many countries as an alternative to overloaded prisons. There are many different systems for monitoring individuals wearing such devices, and these electronic anklet monitoring systems commonly detect violations of circulation areas permitted to holders. In spite of being able to monitor individual localization, such systems do not identify grouping activities of the monitored individuals, although this kind of event could represent a real risk of further offenses planned by those individuals. In order to address such a problem and to help monitoring systems to be able to have a proactive approach, this paper proposes sensor data fusion algorithms that are able to identify such groups based on data provided by anklet positioning devices. The results from the proposed algorithms can be applied to support risk assessment in the context of monitoring systems. The processing is performed using geographic points collected by a monitoring center, and as result, it produces a history of groups with their members, timestamps, locations and frequency of meetings. The proposed algorithms are validated in various serial and parallel computing scenarios, and the correspondent results are presented and discussed. The information produced by the proposed algorithms yields to a better characterization of the monitored individuals and can be adapted to support decision-making systems used by authorities that are responsible for planning decisions regarding actions affecting public security.

Electronic device, system on chip and method for monitoring a data flow

NARCIS (Netherlands)

2012-01-01

An electronic device is provided which comprises a plurality of processing units (IP1-IP6), a network-based inter-connect (N) coupled to the processing units (IP1-IP6) and at least one monitoring unit (P1, P2) for monitoring a data flow of at least one first communication path between the processing

The highly reintegrative approach of electronic monitoring in the Netherlands

NARCIS (Netherlands)

Boone, M.M.; Kooij, van der M.; Rap, S.E.

2017-01-01

This contribution describes the way electronic monitoring (EM) is organized and implemented in the Netherlands. It will become clear that the situation in the Netherlands is characterized by, in particular, two features. The application of EM is highly interwoven with the Probation Service and its

Scaling-up health information systems to improve HIV treatment: An assessment of initial patient monitoring systems in Mozambique.

Science.gov (United States)

Hochgesang, Mindy; Zamudio-Haas, Sophia; Moran, Lissa; Nhampossa, Leopoldo; Packel, Laura; Leslie, Hannah; Richards, Janise; Shade, Starley B

2017-01-01

The rapid scale-up of HIV care and treatment in resource-limited countries requires concurrent, rapid development of health information systems to support quality service delivery. Mozambique, a country with an 11.5% prevalence of HIV, has developed nation-wide patient monitoring systems (PMS) with standardized reporting tools, utilized by all HIV treatment providers in paper or electronic form. Evaluation of the initial implementation of PMS can inform and strengthen future development as the country moves towards a harmonized, sustainable health information system. This assessment was conducted in order to 1) characterize data collection and reporting processes and PMS resources available and 2) provide evidence-based recommendations for harmonization and sustainability of PMS. This baseline assessment of PMS was conducted with eight non-governmental organizations that supported the Ministry of Health to provide 90% of HIV care and treatment in Mozambique. The study team conducted structured and semi-structured surveys at 18 health facilities located in all 11 provinces. Seventy-nine staff were interviewed. Deductive a priori analytic categories guided analysis. Health facilities have implemented paper and electronic monitoring systems with varying success. Where in use, robust electronic PMS facilitate facility-level reporting of required indicators; improve ability to identify patients lost to follow-up; and support facility and patient management. Challenges to implementation of monitoring systems include a lack of national guidelines and norms for patient level HIS, variable system implementation and functionality, and limited human and infrastructure resources to maximize system functionality and information use. This initial assessment supports the need for national guidelines to harmonize, expand, and strengthen HIV-related health information systems. Recommendations may benefit other countries with similar epidemiologic and resource

Patient activation and use of an electronic patient portal.

Science.gov (United States)

Ancker, Jessica S; Osorio, Snezana N; Cheriff, Adam; Cole, Curtis L; Silver, Michael; Kaushal, Rainu

2015-01-01

Electronic patient portals give patients access to personal medical data, potentially creating opportunities to improve knowledge, self-efficacy, and engagement in healthcare. The combination of knowledge, self-efficacy, and engagement has been termed activation. Our objective was to assess the relationship between patient activation and outpatient use of a patient portal. Survey. A telephone survey was conducted with 180 patients who had been given access to a portal, 113 of whom used it and 67 of whom did not. The validated patient activation measure (PAM) was administered along with questions about demographics and behaviors. Portal users were no different from nonusers in patient activation. Portal users did have higher education level and more frequent Internet use, and were more likely to have precisely 2 prescription medications than to have more or fewer. Patients who chose to use an electronic patient portal were not more highly activated than nonusers, although they were more educated and more likely to be Internet users.

Behavioral-Progress Monitoring Using the Electronic Daily Behavioral Report Card (e-DBRC) System

Science.gov (United States)

Burke, Mack D.; Vannest, Kimberly J.

2008-01-01

In this article, the authors present an overview of a Web-based electronic system for behavioral-progress monitoring. Behavioral-progress monitoring is necessary to evaluate responsiveness to behavioral interventions, the effects of positive behavioral support, and the attainment of individualized education program goals and objectives. The…

Gaming to improve vision: 21st century self-monitoring for patients with age-related macular degeneration.

Science.gov (United States)

Razavi, Hessom; Baglin, Elizabeth; Sharangan, Pyrawy; Caruso, Emily; Tindill, Nicole; Griffin, Susan; Guymer, Robyn

2017-11-13

Improved vision self-monitoring tools are required for people at risk of neovascular complications from age related macular degeneration (AMD). to report the self-monitoring habits of participants with intermediate AMD using the Amsler grid chart, and the use of personal electronic devices and gameplay in this over 50 year old cohort. single-centre descriptive study carried out at the Centre for Eye Research (CERA), Melbourne, Australia. 140 participants over 50 years of age, with a diagnosis of intermediate AMD and best-corrected visual acuity (BCVA) of ≥6/12 in each eye. structured questionnaire survey of participants who were enrolled in natural history of AMD studies at CERA. frequency of vision self-monitoring using the Amsler grid chart, and frequency of general use of personal electronic devices and gameplay. Of 140 participants with mean age of 70.5 years, 83.6% used an Amsler grid chart, but only 39.3% used it once per week. Most participants (91.4%) used one or more personal electronic devices. Of these, over half (54.7%) played games on them, among whom 39% played games once a day. Of participants aged 50-69 years, 92% (95%CI 85.1-98.9) were willing to play a game to monitor their vision, compared to 78% (95%CI 69.0-87.0) of those aged 70 years and older (P self-monitoring, leading to earlier detection in the next generation of patients with neovascular AMD. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

AN INTERNET RACK MONITOR-CONTROLLER FOR APS LINAC RF ELECTRONICS UPGRADE

Energy Technology Data Exchange (ETDEWEB)

Ma, Hengjie; Smith, Terry; Nassiri, Alireza; Sun, Yine; Doolittle, Lawrence; Ratti, Alex

2016-06-01

To support the research and development in APS LINAC area, the existing LINAC rf control performance needs to be much improved, and thus an upgrade of the legacy LINAC rf electronics becomes necessary. The proposed upgrade plan centers on the concept of using a modern, network-attached, rackmount digital electronics platform –Internet Rack Monitor-Controller (or IRMC) to achieve the goal of modernizing the rf electronics at a lower cost. The system model of the envisioned IRMC is basically a 3-tier stack with a high-performance DSP in the mid-layer to perform the core tasks of real-time rf data processing and controls. The Digital Front-End (DFE) attachment layer at bottom bridges the applicationspecific rf front-ends to the DSP. A network communication gateway, together with an embedded event receiver (EVR) in the top layer merges the Internet Rack MonitorController node into the networks of the accelerator controls infrastructure. Although the concept is very much in trend with today’s Internet-of-Things (IoT), this implementation has actually been used in the accelerators for over two decades.

Daily electronic self-monitoring of subjective and objective symptoms in bipolar disorder—the MONARCA trial protocol (MONitoring, treAtment and pRediCtion of bipolAr disorder episodes)

DEFF Research Database (Denmark)

Faurholt-Jepsen, Maria; Vinberg, Maj; Christensen, Ellen Margrethe

2013-01-01

Electronic self-monitoring of affective symptoms using cell phones is suggested as a practical and inexpensive way to monitor illness activity and identify early signs of affective symptoms. It has never been tested in a randomised clinical trial whether electronic self-monitoring improves outcomes...... in bipolar disorder. We are conducting a trial testing the effect of using a Smartphone for self-monitoring in bipolar disorder....

Automatic cross-sectioning and monitoring system locates defects in electronic devices

Science.gov (United States)

Jacobs, G.; Slaughter, B.

1971-01-01

System consists of motorized grinding and lapping apparatus, sample holder, and electronic control circuit. Low power microscope examines device to pinpoint location of circuit defect, and monitor displays output signal when defect is located exactly.

Present state and problems of radiological protection monitoring for high energy electron accelerator facilities in SPring-8

International Nuclear Information System (INIS)

Miyamoto, Yukihiro; Harada, Yasunori; Ueda, Hisao

1998-09-01

The present state and problems of the radiological protection monitoring for the high-energy electron accelerator are summarized. In the radiological protection monitoring for SPring-8, a third generation synchrotron radiation facility, there are many problems specific to the high-energy electron accelerator. This report describes the monitoring technique of pulsed radiation, high-energy radiation and low-energy radiation, and their problems. The management of induced radioactivity and the effects of electro-magnetic noise to monitoring instruments are also discussed. (author)

High current precision long pulse electron beam position monitor

CERN Document Server

Nelson, S D; Fessenden, T J; Holmes, C

2000-01-01

Precision high current long pulse electron beam position monitoring has typically experienced problems with high Q sensors, sensors damped to the point of lack of precision, or sensors that interact substantially with any beam halo thus obscuring the desired signal. As part of the effort to develop a multi-axis electron beam transport system using transverse electromagnetic stripline kicker technology, it is necessary to precisely determine the position and extent of long high energy beams for accurate beam position control (6 - 40 MeV, 1 - 4 kA, 2 μs beam pulse, sub millimeter beam position accuracy.) The kicker positioning system utilizes shot-to-shot adjustments for reduction of relatively slow (< 20 MHz) motion of the beam centroid. The electron beams passing through the diagnostic systems have the potential for large halo effects that tend to corrupt position measurements.

Challenges in implementing electronic hand hygiene monitoring systems.

Science.gov (United States)

Conway, Laurie J

2016-05-02

Electronic hand hygiene (HH) monitoring systems offer the exciting prospect of a more precise, less biased measure of HH performance than direct observation. However, electronic systems are challenging to implement. Selecting a system that minimizes disruption to the physical infrastructure and to clinician workflow, and that fits with the organization's culture and budget, is challenging. Getting front-line workers' buy-in and addressing concerns about the accuracy of the system and how the data will be used are also difficult challenges. Finally, ensuring information from the system reaches front-line workers and is used by them to improve HH practice is a complex challenge. We describe these challenges in detail and suggests ways to overcome them. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Electronic medication monitoring-informed counseling to improve adherence to combination anti-retroviral therapy and virologic treatment outcomes: a meta-analysis.

Science.gov (United States)

Langebeek, Nienke; Nieuwkerk, Pythia

2015-01-01

Adherence to combination anti-retroviral therapy for HIV infection is a primary determinant of treatment success, but is often suboptimal. Previous studies have suggested that electronic medication monitoring-informed counseling is among the most effective adherence intervention components. Our objective was to review available evidence about the effectiveness of monitoring-informed counseling and to aggregate findings into quantitative estimates of the effect of such intervention on medication adherence and virologic treatment outcomes. We searched PubMed for papers reporting on randomized controlled trials comparing intervention groups receiving monitoring-informed counseling as one of the intervention components versus control groups not receiving such counseling for their effect on medication adherence and viral load concentrations. The standardized mean difference (SMD) in adherence and the odds ratio (OR) of undetectable HIV RNA in intervention versus control groups were the common effect sizes. Random-effect models with inverse variance weights were used to aggregate findings into pooled effect estimates with 95% confidence limits (CI). A total of 13 studies were included. Adherence was significantly higher in intervention groups than in control groups (SMD 0.51, 95% CI 0.31-0.71). Patients in intervention groups were significantly more likely to have undetectable HIV RNA concentrations than patients in control groups (OR 1.35, 95% CI 1.12-1.63). However, in studies in which monitoring-informed counseling was the only intervention component, the difference in adherence and virologic response between intervention and control groups was not statistically significant. Electronic monitoring-informed counseling improved adherence and virologic response compared with control groups not receiving such counseling in studies in which it was one out of multiple intervention components, but not in studies where it was the only intervention component.

Electronic Monitoring of Sex Offenders: Identifying Unanticipated Consequences and Implications

Science.gov (United States)

Demichele, Matthew; Payne, Brian K.; Button, Deeanna M.

2008-01-01

In recent years, increased legislative attention has been given to strategies to supervise sex offenders in the community. Among other policies, several states have passed laws calling for the use of electronic monitoring technologies to supervise sex offenders in the community. When initially developed, this community-based sanction was designed…

Effects of House Arrest with Electronic Monitoring on DUI Offenders.

Science.gov (United States)

Courtright, Kevin E.; Berg, Bruce L.; Mutchick, Robert J.

1997-01-01

Evaluates the first 57 offenders who participated in an electronic monitoring (EM) program and compared them to offenders who went to jail. Analysis revealed no difference between the groups with respect to rearrest, revocations, and detainers filed. The overwhelming majority of EM offenders completed their period of supervision without incident.…

Improvements in electron beam monitoring and heat flux flatness at the JUDITH 2-facility

Energy Technology Data Exchange (ETDEWEB)

Weber, Thomas, E-mail: weber.th@gmx.de [Forschungszentrum Jülich, Institute of Energy and Climate Research, Jülich (Germany); Bürger, Andreas; Dominiczak, Karsten; Pintsuk, Gerald [Forschungszentrum Jülich, Institute of Energy and Climate Research, Jülich (Germany); Banetta, Stefano; Bellin, Boris [Fusion for Energy, Josep Pla, 2, Torres Diagonal Litoral B3, 08019 Barcelona (Spain); Mitteau, Raphael; Eaton, Russell [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St Paul Lez Durance Cedex (France)

2015-10-15

Highlights: • Monitoring of the much faster electron beam motion by IR camera through a synchronized frame triggering. • Estimation of the heat flux generated by electron beam guns based on calorimetry and FEM simulations. • Consideration of the inclined electron beam loading of rectangular-shaped objects. - Abstract: Three beryllium-armoured small-scale mock-ups and one semi-prototype for the ITER first wall were tested by the electron beam facility JUDITH 2 at Forschungszentrum Jülich. Both testing campaigns with cyclic loads up to 2.5 MW/m{sup 2} are carried out in compliance with the extensive quality and management specifications of ITER Organization (IO) and Fusion for Energy (F4E). Several dedicated calibration experiments were performed before the actual testing in order to fulfil the testing requirements and tolerances. These quality requests have been the motivation for several experimental setup improvements. The most relevant results of these activities, being the electron beam monitoring and the heat flux flatness verification, will be presented.

Improvements in electron beam monitoring and heat flux flatness at the JUDITH 2-facility

International Nuclear Information System (INIS)

Weber, Thomas; Bürger, Andreas; Dominiczak, Karsten; Pintsuk, Gerald; Banetta, Stefano; Bellin, Boris; Mitteau, Raphael; Eaton, Russell

2015-01-01

Highlights: • Monitoring of the much faster electron beam motion by IR camera through a synchronized frame triggering. • Estimation of the heat flux generated by electron beam guns based on calorimetry and FEM simulations. • Consideration of the inclined electron beam loading of rectangular-shaped objects. - Abstract: Three beryllium-armoured small-scale mock-ups and one semi-prototype for the ITER first wall were tested by the electron beam facility JUDITH 2 at Forschungszentrum Jülich. Both testing campaigns with cyclic loads up to 2.5 MW/m"2 are carried out in compliance with the extensive quality and management specifications of ITER Organization (IO) and Fusion for Energy (F4E). Several dedicated calibration experiments were performed before the actual testing in order to fulfil the testing requirements and tolerances. These quality requests have been the motivation for several experimental setup improvements. The most relevant results of these activities, being the electron beam monitoring and the heat flux flatness verification, will be presented.

A novel calorimetry technique for monitoring electron beam curing of polymer resins

International Nuclear Information System (INIS)

Chen, J.H.; Johnston, A.; Petrescue, L.; Hojjati, M.

2006-01-01

This paper describes the development of a calorimetry-based technique for monitoring of the curing of electron beam (EB) curable resins, including design of the calorimeter hardware and the development of an analytical model for calculating resin cure rates and radiation dose. Factors affecting the performance of the calorimeter were investigated. Experimental trials monitoring the curing of epoxy resin were conducted under single pass and multiple passes of EB irradiation. Results show that the developed calorimeter is a simple, inexpensive and reasonably accurate technique for monitoring the EB curing of cationic epoxies

SLIM (secondary emission monitor for low interception monitoring) an innovative non-destructive beam monitor for the extraction lines of a hadrontherapy centre

International Nuclear Information System (INIS)

Gibson, P.N.; Holzwarth, U.; Abbas, K.

2005-01-01

Real time monitoring of hadron therapy beam intensity and profile is a critical issue for the optimisation of dose delivery to carcinogenic tissue, patient safety and operation of the accelerator complex. For this purpose an innovative beam monitor, SLIM (Secondary electron emission for Low Interception Monitoring) is being developed in the framework of the EC-funded SUCIMA (Silicon Ultra-fast Cameras for electrons and gamma sources In Medical Application) project. The detector system is based on the secondary emission of electrons by a non-perturbative, sub-micron thick Al foil placed directly in the extracted beam path. The secondary electrons, accelerated by an electrostatic focusing system, are detected by a monolithic silicon position-sensitive sensor, which provides the beam intensity and its position with a precision of 1 mm at 10 kHz frame rate. The results of the laboratory tests of the first system prototype with thermoionic electrons emitted from a hot Tungsten wire are presented together with the measurements performed on a low intensity hadron beam at the Cyclotron of the Joint Research Centre in Ispra. (author)

Response of radiation monitoring labels to gamma rays and electrons

DEFF Research Database (Denmark)

Rahim, F. Abdel; Miller, Arne; McLaughlin, W.L.

1985-01-01

or location has been irradiated to high doses. Among labels available worldwide, a few are suitable for indicating absorbed dose regions of slightly less than 104 Gy (monitoring high dose ranges (i.e., sterilization dose levels of > 104 Gy or > 1 Mrad), and in some cases......, and differences in dose rate and radiation type (gamma rays and electron beams) were made on 15 kinds of labels. The results show that, for many types of indicators, diverse effects may give misleading conclusions unless countermeasures are taken. For example, some of the most commonly used labels, which contain...... permit somewhat more precise discrimination of dose levels, and may sometimes be useful for monitoring differences in local dose distributions or area monitoring of radiation damage probabilities around particle accelerators or large radionuclide sources....

Electronic database of patients in radiotherapy: Amedatos

International Nuclear Information System (INIS)

Perez Guevara, Adrian; Rodriguez Zayas, Michael; Gonzalez Perez, Yelina; Sola Rodriguez, Yeline; Reyes Gonzalez, Tommy; Caballero, Roberto

2009-01-01

Registration and monitoring of patients in the departments of radiotherapy in our country are taken manually, which is difficult when very large number of patients and treatment units in service. Due to these problems in the Department of Radiotherapy 'Hospital Hermanos Ameijeiras' AMEDATOS program was designed in Microsoft Excel. The main program relates different books, macros are used to improve visualization and facilitate the management of data on different sheets (dosimetry, Team, Daily Record, Record monitoring, patient data, dosimetry data, not treated and four sheets of Report). (Author)

[Electronic patient record as the tool for better patient safety].

Science.gov (United States)

Schneider, Henning

2015-01-01

Recent studies indicate again that there is a deficit in the use of electronic health records (EHR) in German hospitals. Despite good arguments in favour of their use, such as the rapid availability of data, German hospitals shy away from a wider implementation. The reason is the high cost of installing and maintaining the EHRs, for the benefit is difficult to evaluate in monetary terms for the hospital. Even if a benefit can be shown it is not necessarily evident within the hospital, but manifests itself only in the health system outside. Many hospitals only manage to partly implement EHR resulting in increased documentation requirements which reverse their positive effect.In the United States, electronic medical records are also viewed in light of their positive impact on patient safety. In particular, electronic medication systems prove the benefits they can provide in the context of patient safety. As a result, financing systems have been created to promote the digitalisation of hospitals in the United States. This has led to a large increase in the use of IT systems in the United States in recent years. The Universitätsklinikum Eppendorf (UKE) introduced electronic patient records in 2009. The benefits, in particular as regards patient safety, are numerous and there are many examples to illustrate this position. These positive results are intended to demonstrate the important role EHR play in hospitals. A financing system of the ailing IT landscape based on the American model is urgently needed to benefit-especially in terms of patient safety-from electronic medical records in the hospital.

Monitoring of patients treated with lithium for bipolar disorder: an international survey.

Science.gov (United States)

Nederlof, M; Heerdink, E R; Egberts, A C G; Wilting, I; Stoker, L J; Hoekstra, R; Kupka, R W

2018-04-14

Adequate monitoring of patients using lithium is needed for optimal dosing and for early identification of patients with (potential) ADEs. The objective was to internationally assess how health care professionals monitor patients treated with lithium for bipolar disorder. Using networks of various professional organizations, an anonymous online survey was conducted among health care professionals prescribing lithium. Target lithium serum levels and frequency of monitoring was assessed together with monitoring of physical and laboratory parameters. Reasons to and not to monitor and use of guidelines and institutional protocols, and local monitoring systems were investigated. The survey was completed by 117 health care professionals incorporating responses from twenty-four countries. All prescribers reported to monitor lithium serum levels on a regular basis, with varying target ranges. Almost all (> 97%) monitored thyroid and renal function before start and during maintenance treatment. Reported monitoring of other laboratory and physical parameters was variable. The majority of respondents (74%) used guidelines or institutional protocols for monitoring. In general, the prescriber was responsible for monitoring, had to request every monitoring parameter separately and only a minority of patients was automatically invited. Lithium serum levels, renal and thyroid function were monitored by (almost) all physicians. However, there was considerable variation in other monitoring parameters. Our results help to understand why prescribers of lithium monitor patients and what their main reasons are not to monitor patients using lithium.

An acoustic sensor for monitoring airflow in pediatric tracheostomy patients.

Science.gov (United States)

Ruscher, Thomas; Wicks Phd, Alexandrina; Muelenaer Md, Andre

2012-01-01

Without proper monitoring, patients with artificial airways in the trachea are at high risk for complications or death. Despite routine maintenance of the tube, dislodged or copious mucus can obstruct the airway. Young children ( 3yrs) have difficulty tending to their own tubes and are particularly vulnerable to blockages. They require external respiratory sensors. In a hospital environment, ventilators, end-tidal CO2 monitors, thermistors, and other auxiliary equipment provide sufficient monitoring of respiration. However, outpatient monitoring methods, such as thoracic impedance and pulse oximetry, are indirect and prone to false positives. Desensitization of caregivers to frequent false alarms has been cited in medical literature as a contributing factor in cases of child death. Ultrasonic time-of-flight (TOF) is a technique used in specialized industrial applications to non-invasively measure liquid and gas flow. Two transducers are oriented at a diagonal across a flow channel. Velocity measurement is accomplished by detecting slight variations in transit time of contra-propagating acoustic signals with a directional component parallel to air flow. Due to the symmetry of acoustic pathway between sensors, velocity measurements are immune to partial fouling in the tube from mucus, saliva, and condensation. A first generation proof of concept prototype was constructed to evaluate the ultrasonic TOF technique for medical tracheostomy monitoring. After successful performance, a second generation prototype was designed with a smaller form factor and more advanced electronics. This prototype was tested and found to measure inspired volume with a root-mean-square error < 2% during initial trials.

Medical narratives and patient analogs: the ethical implications of electronic patient records.

Science.gov (United States)

Kluge, E H

1999-12-01

An electronic patient record consists of electronically stored data about a specific patient. It therefore constitutes a data-space. The data may be combined into a patient profile which is relative to a particular specialty as well as phenomenologically unique to the specific professional who constructs the profile. Further, a diagnosis may be interpreted as a path taken by a health care professional with a certain specialty through the data-space relative to the patient profile constructed by that professional. This way of looking at electronic patient records entails certain ethical implications about privacy and accessibility. However, it also permits the construction of artificial intelligence and competence algorithms for health care professionals relative to their specialties.

FERMILAB SWITCHYARD RESONANT BEAM POSITION MONITOR ELECTRONICS UPGRADE RESULTS

Energy Technology Data Exchange (ETDEWEB)

Petersen, T. [Fermilab; Diamond, J. [Fermilab; Liu, N. [Fermilab; Prieto, P. S. [Fermilab; Slimmer, D. [Fermilab; Watts, A. [Fermilab

2016-10-12

The readout electronics for the resonant beam position monitors (BPMs) in the Fermilab Switchyard (SY) have been upgraded, utilizing a low noise amplifier transition board and Fermilab designed digitizer boards. The stripline BPMs are estimated to have an average signal output of between -110 dBm and -80 dBm, with an estimated peak output of -70 dBm. The external resonant circuit is tuned to the SY machine frequency of 53.10348 MHz. Both the digitizer and transition boards have variable gain in order to accommodate the large dynamic range and irregularity of the resonant extraction spill. These BPMs will aid in auto-tuning of the SY beamline as well as enabling operators to monitor beam position through the spill.

Introduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" methodology.

Science.gov (United States)

Cheng, Vincent C C; Tai, Josepha W M; Ho, Sara K Y; Chan, Jasper F W; Hung, Kwan Ngai; Ho, Pak Leung; Yuen, Kwok Yung

2011-05-26

MedSense is an electronic hand hygiene compliance monitoring system that provides Infection Control Practitioners with continuous access to hand hygiene compliance information by monitoring Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" guidelines. Unlike previous electronic monitoring systems, MedSense operates in open cubicles with multiple beds and does not disrupt existing workflows. This study was conducted in a 6-bed neurosurgical intensive care unit with technical development and evaluation phases. Healthcare workers (HCWs) wore an electronic device in the style of an identity badge to detect hand hygiene opportunities and compliance. We compared the compliance determined by the system and an infection control nurse. At the same time, the system assessed compliance by time of day, day of week, work shift, professional category of HCWs, and individual subject, while the workload of HCWs was monitored by measuring the amount of time they spent in patient zones. During the three-month evaluation phase, the system identified 13,694 hand hygiene opportunities from 17 nurses, 3 physiotherapists, and 1 healthcare assistant, resulting in an overall compliance of 35.1% for the unit. The per-indication compliance for Moment 1, 4, and simultaneous 1 and 4 were 21.3% (95%CI: 19.0, 23.6), 39.6% (95%CI: 37.3, 41.9), and 49.2% (95%CI: 46.6, 51.8), respectively, and were all statistically significantly different (p monitored concurrently by the system and infection control nurse, the compliance were 88.9% and 95.6% respectively (p = 0.34), and the activity indices were 11.1 and 12.9 opportunities per hour, respectively. The hours from 12:00 to 14:00 had a notably lower compliance (21.3%, 95%CI: 17.2, 25.3) than nearly three quarters of the other periods of the day (p < 0.001). Nurses who used shared badges had significantly (p < 0.01) lower compliance (23.7%, 95%CI: 17.8, 29.6) than both the registered nurses (36.1%, 95%CI: 34.2, 37.9) and nursing officers (34

Carbon buildup monitoring using RBS: Correlation with secondary electrons

International Nuclear Information System (INIS)

Aguilera, E.F.; Rosales, P.; Martinez-Quiroz, E.; Murillo, G.; Fernandez, M.C.

2006-01-01

The RBS technique is applied to solve the problem of on-line monitoring of the carbon deposited on a thin backed foil under ion bombardment. An iterative method is used to reliably extract quantities such as number of projectiles and target thickness in spite of beam energy changes and detector unstabilities. Experimental values for secondary electron yields are also deduced. Results are reported for the thickness variation of thin carbon foils bombarded with carbon ions of energies between 8.95 and 13 MeV. A linear correlation of this variation is found with both, the ion fluence at target and the number of secondary electrons emitted. The correlation exists even though a wide range of beam currents, beam energies and bombarding times was used during the experiment. The measured electron yields show evidence for a change in the emission process between the original foils and the deposited layer, possibly due to a texture change

The added value of an electronic monitoring and alerting system in the management of medication-overuse headache

DEFF Research Database (Denmark)

Tassorelli, Cristina; Jensen, Rigmor; Allena, Marta

2017-01-01

of patients suffering from MOH after withdrawal from overused drugs. Information and communication technology represents a valid aid for optimizing the management of chronic conditions at risk of worsening or of relapsing. Trial registration The trial was registered at ClinicalTrials.gov (no. NCT02435056).......Background Medication-overuse headache (MOH) is a chronic disabling condition associated with a high rate of relapse. Methods We evaluated whether the adoption of electronic-assisted monitoring, advice and communication would improve the outcome over a follow-up of 6 months in a controlled...

Development of electronic tattoo for pulse rate monitoring: Materials perspective

Science.gov (United States)

Shinde, Shilpa Vikas; Sonavane, S. S.

2018-05-01

In India, there is a growing concern of the heart diseases and deaths due to heart failure. The severity of the problem can be minimised by efficient heart rate monitoring which can be used to provide before time caution to cater heart attack. Wearable sensor can be designed to sense the pulse. The sensor can be either placed near to heart or on the wrist to sense pulses and send pulse signals to the doctors. Such sensor should adhere to the skin for sufficiently long period without causing etching to the patient. It should also be bendable and stretchable like skin. This paper is a part of the research work carried out to develop patch type sensor, which is termed as Electronic Tattoo (ET). In pursuit for development of ET, we came across various designs and candidate materials which can be used for the ET. Thus, in this paper, we describe the process of selecting best suited method and material for the ET. It may also be noted that the sensor development is governed by the prevailing IEEE 802.15.6 standard.

When big brother is watching: goal orientation shapes reactions to electronic monitoring during online training.

Science.gov (United States)

Watson, Aaron M; Foster Thompson, Lori; Rudolph, Jane V; Whelan, Thomas J; Behrend, Tara S; Gissel, Amanda L

2013-07-01

Web-based training is frequently used by organizations as a convenient and low-cost way to teach employees new knowledge and skills. As web-based training is typically unproctored, employees may be held accountable to the organization by computer software that monitors their behaviors. The current study examines how the introduction of electronic performance monitoring may provoke negative emotional reactions and decrease learning among certain types of e-learners. Through motivated action theory and trait activation theory, we examine the role of performance goal orientation when e-learners are exposed to asynchronous and synchronous monitoring. We show that some e-learners are more susceptible than others to evaluation apprehension when they perceive their activities are being monitored electronically. Specifically, e-learners higher in avoid performance goal orientation exhibited increased evaluation apprehension if they believed asynchronous monitoring was present, and they showed decreased skill attainment as a result. E-learners higher on prove performance goal orientation showed greater evaluation apprehension if they believed real-time monitoring was occurring, resulting in decreased skill attainment. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Perioperative management and monitoring of a super-obese patient.

Science.gov (United States)

Pellis, Tommaso; Leykin, Yigal; Albano, Giovanni; Zannier, Gianfederico; Di Capua, Gabriella; Marzano, Bernardo; Gullo, Antonino

2004-01-01

Anesthetic management of super-obese patients is inferred from evidence which has been based on obese or morbidly obese patients. We present the perioperative management and monitoring of a 44-year-old 232-kg patient (BMI 70) admitted for laparoscopic gastric bypass surgery. Awake fiberoptic endotracheal intubation preceded induction with propofol and rocuronium. Anesthesia was maintained with desflurane and remifentanil. Desflurane was titrated on BIS values, whereas remifentanil was based on hemodynamic monitoring (invasive arterial pressure and HemoSonic). Rocuronium was administered based on ideal body weight and recovery of twitch tension. Safe and rapid extubation in the operating theatre was made possible by the use of short-acting agents coupled with continuous intraoperative monitoring. Recovery in the post-anesthesia care unit was uneventful, pain was managed with meperidine, and after 5 hours the patient was discharged to the surgical ward. Oxygen therapy and SpO2 monitoring were continued overnight. No desaturation episodes were recorded. Pain was managed with I.V. drip of ketorolac and tramadole.

Wearable impedance monitoring system for dialysis patients.

Science.gov (United States)

Bonnet, S; Bourgerette, A; Gharbi, S; Rubeck, C; Arkouche, W; Massot, B; McAdams, E; Montalibet, A; Jallon, P

2016-08-01

This paper describes the development and the validation of a prototype wearable miniaturized impedance monitoring system for remote monitoring in home-based dialysis patients. This device is intended to assess the hydration status of dialysis patients using calf impedance measurements. The system is based on the low-power AD8302 component. The impedance calibration procedure is described together with the Cole parameter estimation and the hydric volume estimation. Results are given on a test cell to validate the design and on preliminary calf measurements showing Cole parameter variations during hemodialysis.

DANBIO-powerful research database and electronic patient record

DEFF Research Database (Denmark)

Hetland, Merete Lund

2011-01-01

an overview of the research outcome and presents the cohorts of RA patients. The registry, which is approved as a national quality registry, includes patients with RA, PsA and AS, who are followed longitudinally. Data are captured electronically from the source (patients and health personnel). The IT platform...... as an electronic patient 'chronicle' in routine care, and at the same time provides a powerful research database....

Observing incidental harbour porpoise Phocoena phocoena bycatch by remote electronic monitoring

DEFF Research Database (Denmark)

Kindt-Larsen, Lotte; Dalskov, Jørgen; Stage, Bjarne

2012-01-01

to document bycatch of marine mammals, 6 Danish commercial gillnetters (10 to15 m in length) operating under the Danish catch quota management system were equipped with Remote Electronic Monitoring (REM) systems. The REM systems provided video footage, time and position of all net hauls and bycatches...

Patients' blood pressure knowledge, perceptions and monitoring practices in community pharmacies.

Science.gov (United States)

Lam, Jennifer Y; Guirguis, Lisa M

2010-07-01

Hypertension is a modifiable risk factor for cardiovascular disease. Despite this, patients often cannot or inaccurately estimate their risk factors. IN ORDER TO IMPROVE PHARMACIST INTERVENTIONS, WE SOUGHT TO: 1) find out patients' knowledge about blood pressure (BP) and their self-monitoring behaviors and 2) identify the relationships between these two elements. Specifically, if evaluation of BP control were related to knowledge of one's BP level and self-monitoring habits, and if knowledge of one's target and BP level varied with monitoring habits. Final year pharmacy students were trained and interviewed patients in community pharmacies as a required exercise in their pharmacy clerkship. Each student recruited a convenience sample of 5-10 patients who were on hypertension medication, and surveyed them regarding their BP targets, recent BP levels as well as monthly and home BP monitoring practices. One third of the 449 patients interviewed were able to report a blood pressure target with 26% reporting a JNC 7 recognized target. Three quarters of patients who reported a blood pressure target were able to report a blood pressure level, with 12% being at their self-reported target. Roughly two thirds of patients perceived their BP to be "about right", and slightly less than a third thought it to be "high". Sixty percent of patients monitor their BP monthly, but less than 50% of patients practice home BP monitoring. This study along with others before it point to the knowledge and self-management gaps in patients with chronic conditions. Furthermore, pharmacy students were able to use a brief intervention to screen patients during routine care. Pharmacists can help improve patient understanding and promote increased self-management through regular BP monitoring.

Secondary Electron Emission Beam Loss Monitor for LHC

CERN Document Server

Dehning, B; Holzer, E B; Kramer, Daniel

2008-01-01

Beam Loss Monitoring (BLM) system is a vital part of the active protection of the LHC accelerators' elements. It should provide the number of particles lost from the primary hadron beam by measuring the radiation field induced by their interaction with matter surrounding the beam pipe. The LHC BLM system will use ionization chambers as standard detectors but in the areas where very high dose rates are expected, the Secondary Emission Monitor (SEM) chambers will be employed because of their high linearity, low sensitivity and fast response. The SEM needs a high vacuum for proper operation and has to be functional for up to 20 years, therefore all the components were designed according to the UHV requirements and a getter pump was included. The SEM electrodes are made of Ti because of its Secondary Emission Yield (SEY) stability. The sensitivity of the SEM was modeled in Geant4 via the Photo-Absorption Ionization module together with custom parameterization of the very low energy secondary electron production. ...

Patient Perceptions of Electronic Health Records

Science.gov (United States)

Lulejian, Armine

2011-01-01

Research objective. Electronic Health Records (EHR) are expected to transform the way medicine is delivered with patients/consumers being the intended beneficiaries. However, little is known regarding patient knowledge and attitudes about EHRs. This study examined patient perceptions about EHR. Study design. Surveys were administered following…

Utilizing distributional analytics and electronic records to assess timeliness of inpatient blood glucose monitoring in non-critical care wards

Directory of Open Access Journals (Sweden)

Ying Chen

2016-04-01

Full Text Available Abstract Background Regular and timely monitoring of blood glucose (BG levels in hospitalized patients with diabetes mellitus is crucial to optimizing inpatient glycaemic control. However, methods to quantify timeliness as a measurement of quality of care are lacking. We propose an analytical approach that utilizes BG measurements from electronic records to assess adherence to an inpatient BG monitoring protocol in hospital wards. Methods We applied our proposed analytical approach to electronic records obtained from 24 non-critical care wards in November and December 2013 from a tertiary care hospital in Singapore. We applied distributional analytics to evaluate daily adherence to BG monitoring timings. A one-sample Kolmogorov-Smirnov (1S-KS test was performed to test daily BG timings against non-adherence represented by the uniform distribution. This test was performed among wards with high power, determined through simulation. The 1S-KS test was coupled with visualization via the cumulative distribution function (cdf plot and a two-sample Kolmogorov-Smirnov (2S-KS test, enabling comparison of the BG timing distributions between two consecutive days. We also applied mixture modelling to identify the key features in daily BG timings. Results We found that 11 out of the 24 wards had high power. Among these wards, 1S-KS test with cdf plots indicated adherence to BG monitoring protocols. Integrating both 1S-KS and 2S-KS information within a moving window consisting of two consecutive days did not suggest frequent potential change from or towards non-adherence to protocol. From mixture modelling among wards with high power, we consistently identified four components with high concentration of BG measurements taken before mealtimes and around bedtime. This agnostic analysis provided additional evidence that the wards were adherent to BG monitoring protocols. Conclusions We demonstrated the utility of our proposed analytical approach as a monitoring

A configurable electronics system for the ESS-Bilbao beam position monitors

Science.gov (United States)

Muguira, L.; Belver, D.; Etxebarria, V.; Varnasseri, S.; Arredondo, I.; del Campo, M.; Echevarria, P.; Garmendia, N.; Feuchtwanger, J.; Jugo, J.; Portilla, J.

2013-09-01

A versatile and configurable system has been developed in order to monitorize the beam position and to meet all the requirements of the future ESS-Bilbao Linac. At the same time the design has been conceived to be open and configurable so that it could eventually be used in different kinds of accelerators, independent of the charged particle, with minimal change. The design of the Beam Position Monitors (BPMs) system includes a test bench both for button-type pick-ups (PU) and striplines (SL), the electronic units and the control system. The electronic units consist of two main parts. The first part is an Analog Front-End (AFE) unit where the RF signals are filtered, conditioned and converted to base-band. The second part is a Digital Front-End (DFE) unit which is based on an FPGA board where the base-band signals are sampled in order to calculate the beam position, the amplitude and the phase. To manage the system a Multipurpose Controller (MC) developed at ESSB has been used. It includes the FPGA management, the EPICS integration and Archiver Instances. A description of the system and a comparison between the performance of both PU and SL BPM designs measured with this electronics system are fully described and discussed.

Blood Pressure Home Monitoring in Hypertensive Patients Attending ...

African Journals Online (AJOL)

Blood Pressure Home Monitoring in Hypertensive Patients Attending a Tertiary ... Sixty percent of the patients were aged 50 - 69 years. ... Patients with high BP readings reported that they exercise more and reduced their daily salt intake.

Monitoring the electron beam position at the TESLA test facility free electron laser

Energy Technology Data Exchange (ETDEWEB)

Kamps, T

2000-06-14

The operation of a free electron laser working in the Self Amplified Spontaneous Emission mode (SASE FEL) requires the electron trajectory to be aligned with very high precision in overlap with the photon beam. In order to ensure this overlap, one module of the SASE FEL undulator at the TESLA Test Facility (TTF) is equipped with a new type of waveguide beam position monitor (BPM). Four waveguides are arranged symmetrically around the beam pipe, each channel couples through a small slot to the electromagnetic beam field. The induced signal depends on the beam intensity and on the transverse beam position in terms of beam-to-slot distance. With four slot--waveguide combinations a linear position sensitive signal can be achieved, which is independent of the beam intensity. The signals transduced by the slots are transferred by ridged waveguides through an impedance matching stage into a narrowband receiver tuned to 12 GHz. The present thesis describes design, tests, and implementation of this new type of BPM. (orig.)

Lab-on-Skin: A Review of Flexible and Stretchable Electronics for Wearable Health Monitoring.

Science.gov (United States)

Liu, Yuhao; Pharr, Matt; Salvatore, Giovanni Antonio

2017-10-24

Skin is the largest organ of the human body, and it offers a diagnostic interface rich with vital biological signals from the inner organs, blood vessels, muscles, and dermis/epidermis. Soft, flexible, and stretchable electronic devices provide a novel platform to interface with soft tissues for robotic feedback and control, regenerative medicine, and continuous health monitoring. Here, we introduce the term "lab-on-skin" to describe a set of electronic devices that have physical properties, such as thickness, thermal mass, elastic modulus, and water-vapor permeability, which resemble those of the skin. These devices can conformally laminate on the epidermis to mitigate motion artifacts and mismatches in mechanical properties created by conventional, rigid electronics while simultaneously providing accurate, non-invasive, long-term, and continuous health monitoring. Recent progress in the design and fabrication of soft sensors with more advanced capabilities and enhanced reliability suggest an impending translation of these devices from the research lab to clinical environments. Regarding these advances, the first part of this manuscript reviews materials, design strategies, and powering systems used in soft electronics. Next, the paper provides an overview of applications of these devices in cardiology, dermatology, electrophysiology, and sweat diagnostics, with an emphasis on how these systems may replace conventional clinical tools. The review concludes with an outlook on current challenges and opportunities for future research directions in wearable health monitoring.

Ubiquitous computing for remote cardiac patient monitoring: a survey.

Science.gov (United States)

Kumar, Sunil; Kambhatla, Kashyap; Hu, Fei; Lifson, Mark; Xiao, Yang

2008-01-01

New wireless technologies, such as wireless LAN and sensor networks, for telecardiology purposes give new possibilities for monitoring vital parameters with wearable biomedical sensors, and give patients the freedom to be mobile and still be under continuous monitoring and thereby better quality of patient care. This paper will detail the architecture and quality-of-service (QoS) characteristics in integrated wireless telecardiology platforms. It will also discuss the current promising hardware/software platforms for wireless cardiac monitoring. The design methodology and challenges are provided for realistic implementation.

The role of nanotechnology and nano and micro-electronics in monitoring and control of cardiovascular diseases and neurological disorders

Science.gov (United States)

Varadan, Vijay K.

2007-04-01

Nanotechnology has been broadly defined as the one for not only the creation of functional materials and devices as well as systems through control of matter at the scale of 1-100 nm, but also the exploitation of novel properties and phenomena at the same scale. Growing needs in the point-of-care (POC) that is an increasing market for improving patient's quality of life, are driving the development of nanotechnologies for diagnosis and treatment of various life threatening diseases. This paper addresses the recent development of nanodiagnostic sensors and nanotherapeutic devices with functionalized carbon nanotube and/or nanowire on a flexible organic thin film electronics to monitor and control of the three leading diseases namely 1) neurodegenerative diseases, 2) cardiovascular diseases, and 3) diabetes and metabolic diseases. The sensors developed include implantable and biocompatible devices, light weight wearable devices in wrist-watches, hats, shoes and clothes. The nanotherapeutics devices include nanobased drug delivery system. Many of these sensors are integrated with the wireless systems for the remote physiological monitoring. The author's research team has also developed a wireless neural probe using nanowires and nanotubes for monitoring and control of Parkinson's disease. Light weight and compact EEG, EOG and EMG monitoring system in a hat developed is capable of monitoring real time epileptic patients and patients with neurological and movement disorders using the Internet and cellular network. Physicians could be able to monitor these signals in realtime using portable computers or cell phones and will give early warning signal if these signals cross a pre-determined threshold level. In addition the potential impact of nanotechnology for applications in medicine is that, the devices can be designed to interact with cells and tissues at the molecular level, which allows high degree of functionality. Devices engineered at nanometer scale imply a

Patient Posture Monitoring System Based on Flexible Sensors

Directory of Open Access Journals (Sweden)

Youngsu Cha

2017-03-01

Full Text Available Monitoring patients using vision cameras can cause privacy intrusion problems. In this paper, we propose a patient position monitoring system based on a patient cloth with unobtrusive sensors. We use flexible sensors based on polyvinylidene fluoride, which is a flexible piezoelectric material. Theflexiblesensorsareinsertedintopartsclosetothekneeandhipoftheloosepatientcloth. We measure electrical signals from the sensors caused by the piezoelectric effect when the knee and hip in the cloth are bent. The measured sensor outputs are transferred to a computer via Bluetooth. We use a custom-made program to detect the position of the patient through a rule-based algorithm and the sensor outputs. The detectable postures are based on six human motions in and around a bed. The proposed system can detect the patient positions with a success rate over 88 percent for three patients.

Cytomorphological monitoring in multimodality therapy of endometral cancer patients

International Nuclear Information System (INIS)

Galil-Ogly, G.A.; Titova, V.A.; Yarovaya, N.Yu.; Ingberman, Ya.Kh.; Bershchanskaya, A.M.; Pukhlikov, A.V.

1990-01-01

The paper is devoted to analysis of clinicomorphological data on the status of a primary endometrial tumor in 209 endometrial cancer patients, treated by radical and palliative radiation therapy (112 patients) and the combined method (88 patients) including preoperative intensive concentrated intracavitary irradiation and hormonotherapy. Dynamic cytological monitoring was performed during radiation therapy and in a period up to 12 mos. after the discontinuation of antitumor therapy. Dynamic cytomorphological monitoring is an important stage in patients who cannot be operated upon as a result of tumor spreading or somatic contraindications

Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 1: state of the art.

Science.gov (United States)

Johansen, Monika Alise; Henriksen, Eva; Horsch, Alexander; Schuster, Tibor; Berntsen, Gro K Rosvold

2012-10-03

Over the last two decades, the number of studies on electronic symptom reporting has increased greatly. However, the field is very heterogeneous: the choices of patient groups, health service innovations, and research targets seem to involve a broad range of foci. To move the field forward, it is necessary to build on work that has been done and direct further research to the areas holding most promise. Therefore, we conducted a comprehensive review of randomized controlled trials (RCTs) focusing on electronic communication between patient and provider to improve health care service quality, presented in two parts. Part 2 investigates the methodological quality and effects of the RCTs, and demonstrates some promising benefits of electronic symptom reporting. To give a comprehensive overview of the most mature part of this emerging field regarding (1) patient groups, (2) health service innovations, and (3) research targets relevant to electronic symptom reporting. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles published from 1990 to November 2011. Inclusion criteria were RCTs of interventions where patients or parents reported health information electronically to the health care system for health care purposes and were given feedback. Of 642 records identified, we included 32 articles representing 29 studies. The included articles were published from 2002, with 24 published during the last 5 years. The following five patient groups were represented: respiratory and lung diseases (12 studies), cancer (6), psychiatry (6), cardiovascular (3), and diabetes (1). In addition to these, 1 study had a mix of three groups. All included studies, except 1, focused on long-term conditions. We identified four categories of health service innovations: consultation support (7 studies), monitoring with clinician support (12), self-management with clinician support (9

Changing attitudes toward house arrest with electronic monitoring: the impact of a single presentation?

Science.gov (United States)

Gainey, Randy R; Payne, Brian K

2003-04-01

The notion that community support is critical for program success is a consistent theme in the literature on community-based corrections. Unfortunately, many citizens know very little about alternative sanctions, are misinformed about them, and do not view them favorably. At issue is whether information about alternative sanctions affects individuals' attitudes regarding them. To address this question, students in an upper division criminal justice course were surveyed before and after a presentation on electronic monitoring. Following the presentation, students were more likely to agree that electronic monitoring is punitive and that it meets several goals of the justice system. Implications for policy makers and educators are provided.

Device for monitoring electron-ion ring parameters

International Nuclear Information System (INIS)

Tyutyunnikov, S.I.; Shalyapin, V.N.

1982-01-01

The invention is classified as the method of collective ion acceleration. The device for electron-ion ring parameters monitoring is described. The invention is aimed at increasing functional possibilities of the device at the expense of the enchance in the number of the ring controlled parameters. The device comprises three similar plane mirrors installed over accelerating tube circumference and a mirror manufactured in the form of prism and located in the tube centre, as well as the system of synchrotron radiation recording and processing. Two plane mirrors are installed at an angle of 45 deg to the vertical axis. The angle of the third plane mirror 3 α and that of prismatic mirror 2 α to the vertical axis depend on geometric parameters of the ring and accelerating tube and they are determined by the expression α=arc sin R K /2(R T -L), where R K - ring radius, R T - accelerating tube radius, L - the height of segment, formed by the mirror and inner surface of the accelerating tube. The device suggested permits to determine longitudinal dimensions of the ring, its velocity and the number of electrons and ions in the ring

A Standards-Based Architecture Proposal for Integrating Patient mHealth Apps to Electronic Health Record Systems.

Science.gov (United States)

Marceglia, S; Fontelo, P; Rossi, E; Ackerman, M J

2015-01-01

Mobile health Applications (mHealth Apps) are opening the way to patients' responsible and active involvement with their own healthcare management. However, apart from Apps allowing patient's access to their electronic health records (EHRs), mHealth Apps are currently developed as dedicated "island systems". Although much work has been done on patient's access to EHRs, transfer of information from mHealth Apps to EHR systems is still low. This study proposes a standards-based architecture that can be adopted by mHealth Apps to exchange information with EHRs to support better quality of care. Following the definition of requirements for the EHR/mHealth App information exchange recently proposed, and after reviewing current standards, we designed the architecture for EHR/mHealth App integration. Then, as a case study, we modeled a system based on the proposed architecture aimed to support home monitoring for congestive heart failure patients. We simulated such process using, on the EHR side, OpenMRS, an open source longitudinal EHR and, on the mHealth App side, the iOS platform. The integration architecture was based on the bi-directional exchange of standard documents (clinical document architecture rel2 - CDA2). In the process, the clinician "prescribes" the home monitoring procedures by creating a CDA2 prescription in the EHR that is sent, encrypted and de-identified, to the mHealth App to create the monitoring calendar. At the scheduled time, the App alerts the patient to start the monitoring. After the measurements are done, the App generates a structured CDA2-compliant monitoring report and sends it to the EHR, thus avoiding local storage. The proposed architecture, even if validated only in a simulation environment, represents a step forward in the integration of personal mHealth Apps into the larger health-IT ecosystem, allowing the bi-directional data exchange between patients and healthcare professionals, supporting the patient's engagement in self

The LUCID detector ATLAS luminosity monitor and its electronic system

CERN Document Server

AUTHOR|(INSPIRE)INSPIRE-00378808; The ATLAS collaboration

2016-01-01

Starting from 2015 LHC is performing a new run, at higher center of mass energy (13 TeV) and with 25 ns bunch-spacing. The ATLAS luminosity monitor LUCID has been completely renewed, both on detector design and in the electronics, in order to cope with the new running conditions. The new detector electronics is presented, featuring a new read-out board (LUCROD), for signal acquisition and digitization, PMT-charge integration and single-side luminosity measurements, and the revisited LUMAT board for side-A-side-C combination. The contribution covers the new boards design, the firmware and software developments, the implementation of luminosity algorithms, the optical communication between boards and the integration into the ATLAS TDAQ system.

Evaluation of performance of electronic dosimeters for individual monitoring: tests in laboratory

International Nuclear Information System (INIS)

Garzon, W.J.; Khoury, H.J.; Barros, V.S.M. de; Medeiros, R.B.

2015-01-01

Electronic dosimeters based on direct ion storage technology are being widely used in many countries for individual monitoring in many applications of ionizing radiation. However, their use as routine dosimeter has been established in a few countries due to lack of accreditation or intercomparison programs. The objective of this study is to evaluate the performance of two direct íon storage dosimeters model available in the international market: the Miriom-Instadose-1 and RADOS DIS-1 to be eventually accepted for individual monitoring in Brazil. (author)

Electronic monitoring in combination with direct observation as a means to significantly improve hand hygiene compliance.

Science.gov (United States)

Boyce, John M

2017-05-01

Monitoring hand hygiene compliance among health care personnel (HCP) is an essential element of hand hygiene promotion programs. Observation by trained auditors is considered the gold standard method for establishing hand hygiene compliance rates. Advantages of observational surveys include the unique ability to establish compliance with all of the World Health Organization "My 5 Moments for Hand Hygiene" initiative Moments and to provide just-in-time coaching. Disadvantages include the resources required for observational surveys, insufficient sample sizes, and nonstandardized methods of conducting observations. Electronic and camera-based systems can monitor hand hygiene performance on all work shifts without a Hawthorne effect and provide significantly more data regarding hand hygiene performance. Disadvantages include the cost of installation, variable accuracy in estimating compliance rates, issues related to acceptance by HCP, insufficient data regarding their cost-effectiveness and influence on health care-related infection rates, and the ability of most systems to monitor only surrogates for Moments 1, 4, and 5. Increasing evidence suggests that monitoring only Moments 1, 4, and 5 provides reasonable estimates of compliance with all 5 Moments. With continued improvement of electronic monitoring systems, combining electronic monitoring with observational methods may provide the best information as part of a multimodal strategy to improve and sustain hand hygiene compliance rates among HCP. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Technology and Power. A Foucauldian Analysis of Electronic Monitoring Discourses

OpenAIRE

Anna Vitores; Miquel Domènech

2007-01-01

The article aims to show the importance of FOUCAULT within social studies of science and technology. It also illustrates how a Foucauldian analysis can be useful for studies of science, technology and society focused on power effects. To accomplish these objectives we analyze the emergence of a specific techno-scientific innovation: the electronic monitoring of offenders. We map the discontinuities and discourse dispersions linked to those practices that constitute different materializations ...

Individual monitoring with official electronic dosemeters in Germany - concepts and reality

International Nuclear Information System (INIS)

Martini, E.; Wahl, W.; Huebner, S.; Freynhagen, D.; Staemmler, M.

2005-01-01

Full text: Active (electronic) personal dosemeters (APD) are radiometers, which are equipped as active or passive dosimeters. They can directly indicate a dose rate and/or the dose integrated during a certain period (direct-indicating, active electronic personal dosemeters mentioned) or only over a separate reader (direct-selectable, passive electronic personal dosemeters mentioned). A concept is presented for the use of passive or active electronic personal dosemeters in Germany as official dosemeters, e.g. in hospitals. The concept features a net-based approach for secure data communication between readers for passive and active electronic personal dosemeters und the official personal dosimetry monitoring service(s), taking the German policies (StrISchV und RoeV in hospitals) into account. The net-based solution includes a processor controlled interface via TCP/IP connected to the dosimetry reader(s), und reader interfaces, an official interim data bank and all the necessary equipment such as PC, Raid-configuration, USV support, network connection and further details. Investigations have been started to achieve highest-level data manipulation security, data completeness und data correctness. (author)

The source of monoenergetic electrons for the monitoring of spectrometer in the KATRIN neutrino experiment

CERN Document Server

Slezák, Martin

The international project KATRIN (KArlsruhe TRItium Neutrino experiment) is a next-generation tritium $\\beta$-decay experiment. It is designed to measure the electron anti-neutrino mass by means of a unique electron spectrometer with sensitivity of 0.2 eV/c$^2$. This is an improvement of one order of magnitude over the last results. Important part of the measurement will rest in continuous precise monitoring of high voltage of the KATRIN main spectrometer. The monitoring will be done by means of conversion electrons emitted from a solid source based on $^{83}$Rb decay. Properties of several of these sources are studied in this thesis by means of the semiconductor $\\gamma$-ray spectroscopy. Firstly, measurement of precise energy of the 9.4 keV nuclear transition observed in $^{83}$Rb decay, from which the energy of conversion electrons is derived, is reported. Secondly, measurement of activity distribution of the solid sources by means of the Timepix detector is described. Finally, a report on measurement of r...

Monitoring the tracking performance of the ATLAS trigger for electrons in Z->ee decays

CERN Document Server

Langford, Jonathon

2016-01-01

This project was carried out to develop an algorithm which monitors the performance of the tracking system in the ATLAS trigger. The algorithm uses tag and probe methods to measure the efficiency of the tracking for electrons by looking at Z → ee candidates. Once this method is validated, the ultimate goal is to implement the algorithm into the High-Level-Trigger (HLT) of ATLAS whilst online. The advantage of this technique over traditional offline monitoring is continuous feedback during data taking and higher available statistics. In this report the results of an offline analysis are presented, showing electron tracking efficiencies between 96% and 99% across almost all regions of the inner detector (run 306278).

Clinical and biochemical monitoring of patients with fatty acid oxidation disorders

DEFF Research Database (Denmark)

Lund, Allan Meldgaard; Skovby, Flemming; Vestergaard, Helle

2010-01-01

complicated assessments by a neuropsychologist, speech therapist, or physical and occupational therapists. Paraclinical measurements are not used for short-chain and medium-chain disorders; electrocardiography (including 24 h monitoring) and echocardiography are done for most patients with long......Evidence-based guidelines for monitoring patients with disorders in fatty acid oxidation (FAO) are lacking, and most protocols are based on expert statements. Here, we describe our protocol for Danish patients. Clinical monitoring is the most important measure and has the main aims of checking...... carnitine is measured to monitor carnitine supplementation in patients with multiple acyl-coenzyme A dehydrogenase deficiency (MADD) and carnitine transporter deficiency (CTD) and to follow metabolic control and disclose deficiency states in other FAO disorders. We are evaluating long-chain acylcarnitines...

Investigating User Identification in Remote Patient Monitoring Devices.

Science.gov (United States)

Ondiege, Brian; Clarke, Malcolm

2017-09-13

With the increase in the number of people having a chronic disease, there is an increase in households having more than a single person suffering from the same chronic illness. One problem of monitoring such patients in their own home is that current devices have a limitation in the number of people who can use a single device. This study investigates the use of Near Field Communication (NFC) for identification in a multi-user environment. A mixed-method qualitative and quantitative approach was adopted, including focus groups, observations and a field trial. Data were collected in three phases. In Phase 1, five focus groups were conducted with patients to determine their beliefs, concerns and issues with using identification in remote patient monitoring devices. In Phase 2, participants were given a blood pressure monitor modified to include an NFC reader to enable identification. The modified device was given to patients living as a couple in the same household and both suffering from hypertension. Both patients used the device for a period of two weeks to observe their acceptance of the technology and determine their experience of usage. A total of 40 (20 couples) patients participated in the trial. Non-adherence to the full monitoring regimen was low and was mainly due to usability issues or commitments taking them away from the home and thus unable to take readings. After the trial period participants were invited to discuss their experiences with the technology in a focus group discussion (Phase 3), a total of five focus groups were conducted. Focus group discussions with the patients revealed that most participants liked using the system and were not apprehensive towards Healthcare Information Technology (HIT). The participants also had suggestions for improvements that could be made to the modified blood pressure monitor (such as, rechargeable in place batteries, integrate the components, easier to use cuff, and increased sensitivity of the NFC reader) that

Self-Monitoring Kidney Function Post Transplantation: Reliability of Patient-Reported Data.

Science.gov (United States)

van Lint, Céline; Wang, Wenxin; van Dijk, Sandra; Brinkman, Willem-Paul; Rövekamp, Ton Jm; Neerincx, Mark A; Rabelink, Ton J; van der Boog, Paul Jm

2017-09-26

The high frequency of outpatient visits after kidney transplantation is burdensome to both the recovering patient and health care capacity. Self-monitoring kidney function offers a promising strategy to reduce the number of these outpatient visits. The objective of this study was to investigate whether it is safe to rely on patients' self-measurements of creatinine and blood pressure, using data from a self-management randomized controlled trial. For self-monitoring creatinine, each participant received a StatSensor Xpress-i Creatinine Meter and related test material. For self-monitoring blood pressure, each participant received a Microlife WatchBP Home, an oscillometric device for blood pressure self-measurement on the upper arm. Both devices had a memory function and the option to download stored values to a computer. During the first year post transplantation, 54 patients registered their self-measured creatinine values in a Web-based Self-Management Support System (SMSS) which provided automatic feedback on the registered values (eg, seek contact with hospital). Values registered in the SMSS were compared with those logged automatically in the creatinine device to study reliability of registered data. Adherence to measurement frequency was determined by comparing the number of requested with the number of performed measurements. To study adherence to provided feedback, SMSS-logged feedback and information from the electronic hospital files were analyzed. Level of adherence was highest during months 2-4 post transplantation with over 90% (42/47) of patients performing at least 75% of the requested measurements. Overall, 87.00% (3448/3963) of all registered creatinine values were entered correctly, although values were often registered several days later. If (the number of) measured and registered values deviated, the mean of registered creatinine values was significantly lower than what was measured, suggesting active selection of lower creatinine values

[Electronic versus paper-based patient records: a cost-benefit analysis].

Science.gov (United States)

Neubauer, A S; Priglinger, S; Ehrt, O

2001-11-01

The aim of this study is to compare the costs and benefits of electronic, paperless patient records with the conventional paper-based charts. Costs and benefits of planned electronic patient records are calculated for a University eye hospital with 140 beds. Benefit is determined by direct costs saved by electronic records. In the example shown, the additional benefits of electronic patient records, as far as they can be quantified total 192,000 DM per year. The costs of the necessary investments are 234,000 DM per year when using a linear depreciation over 4 years. In total, there are additional annual costs for electronic patient records of 42,000 DM. Different scenarios were analyzed. By increasing the time of depreciation to 6 years, the cost deficit reduces to only approximately 9,000 DM. Increased wages reduce the deficit further while the deficit increases with a loss of functions of the electronic patient record. However, several benefits of electronic records regarding research, teaching, quality control and better data access cannot be easily quantified and would greatly increase the benefit to cost ratio. Only part of the advantages of electronic patient records can easily be quantified in terms of directly saved costs. The small cost deficit calculated in this example is overcompensated by several benefits, which can only be enumerated qualitatively due to problems in quantification.

BPcontrol. A Mobile App to Monitor Hypertensive Patients.

Science.gov (United States)

Carrera, Adrian; Pifarré, Marc; Vilaplana, Jordi; Cuadrado, Josep; Solsona, Sara; Mateo, Jordi; Solsona, Francesc

2016-12-07

Hypertension or high blood pressure is on the rise. Not only does it affect the elderly but is also increasingly spreading to younger sectors of the population. Treating this condition involves exhaustive monitoring of patients. The current mobile health services can be improved to perform this task more effectively. To develop a useful, user-friendly, robust and efficient app, to monitor hypertensive patients and adapted to the particular requirements of hypertension. This work presents BPcontrol, an Android and iOS app that allows hypertensive patients to communicate with their health-care centers, thus facilitating monitoring and diagnosis. Usability, robustness and efficiency factors for BPcontrol were evaluated for different devices and operating systems (Android, iOS and system-aware). Furthermore, its features were compared with other similar apps in the literature. BPcontrol is robust and user-friendly. The respective start-up efficiency of the Android and iOS versions of BPcontrol were 2.4 and 8.8 times faster than a system-aware app. Similar values were obtained for the communication efficiency (7.25 and 11.75 times faster for the Android and iOS respectively). When comparing plotting performance, BPcontrol was on average 2.25 times faster in the Android case. Most of the apps in the literature have no communication with a server, thus making it impossible to compare their performance with BPcontrol. Its optimal design and the good behavior of its facilities make BPcontrol a very promising mobile app for monitoring hypertensive patients.

One size fits all electronics for insole-based activity monitoring.

Science.gov (United States)

Hegde, Nagaraj; Bries, Matthew; Melanson, Edward; Sazonov, Edward

2017-07-01

Footwear based wearable sensors are becoming prominent in many areas of monitoring health and wellness, such as gait and activity monitoring. In our previous research we introduced an insole based wearable system SmartStep, which is completely integrated in a socially acceptable package. From a manufacturing perspective, SmartStep's electronics had to be custom made for each shoe size, greatly complicating the manufacturing process. In this work we explore the possibility of making a universal electronics platform for SmartStep - SmartStep 3.0, which can be used in the most common insole sizes without modifications. A pilot human subject experiments were run to compare the accuracy between the one-size fits all (SmartStep 3.0) and custom size SmartStep 2.0. A total of ~10 hours of data was collected in the pilot study involving three participants performing different activities of daily living while wearing SmartStep 2.0 and SmartStep 3.0. Leave one out cross validation resulted in a 98.5% average accuracy from SmartStep 2.0, while SmartStep 3.0 resulted in 98.3% accuracy, suggesting that the SmartStep 3.0 can be as accurate as SmartStep 2.0, while fitting most common shoe sizes.

Multi-channel electronics for secondary emission grid profile monitor of TTF linac

International Nuclear Information System (INIS)

Reingardt-Nikoulin, P.; Gaidash, V.; Mirzojan, A.; Kocharyan, V.; Noelle, D.

2004-01-01

According to the TTF beam experimental program, a measurement f the time dependence of the energy spread within the bunch train should be done by means of a standard device for profile measurements, that is Secondary Emission Grid (SEMG). SEMG on the high-energy TTF beam is placed in the focal plane of the magnet spectrometer. It should measure the total energy spread in the range from 0.1% up to a few percents for any single or any group of electron bunches in the bunch train of TTF Linac. SEMG profile measurements with new high sensitive electronics are described. Beam results of SEMG Monitor test are given for two modifications of an electronic preamplifier

The beam intensity and positron monitoring system of the Daresbury Electron Synchrotron (NINA)

International Nuclear Information System (INIS)

Poole, D.E.; Ring, T.; Peters, D.G.; Allen, J.

1976-01-01

The beam sensing system of NINA has been redesigned and rebuilt to provide comprehensive monitoring of beam intensity and position. The reasons for the change are stated, and the requirements and performance specification for the new system are listed. The report falls under the following heads: the sensing head; the head electronics unit; the line receiver unit; performance of installed monitors; display system and computer interface. The performance of the new system is summarized. (U.K.)

Simplifying ART cohort monitoring: Can pharmacy stocks provide accurate estimates of patients retained on antiretroviral therapy in Malawi?

Directory of Open Access Journals (Sweden)

Tweya Hannock

2012-07-01

Full Text Available Abstract Background Routine monitoring of patients on antiretroviral therapy (ART is crucial for measuring program success and accurate drug forecasting. However, compiling data from patient registers to measure retention in ART is labour-intensive. To address this challenge, we conducted a pilot study in Malawi to assess whether patient ART retention could be determined using pharmacy records as compared to estimates of retention based on standardized paper- or electronic based cohort reports. Methods Twelve ART facilities were included in the study: six used paper-based registers and six used electronic data systems. One ART facility implemented an electronic data system in quarter three and was included as a paper-based system facility in quarter two only. Routine patient retention cohort reports, paper or electronic, were collected from facilities for both quarter two [April–June] and quarter three [July–September], 2010. Pharmacy stock data were also collected from the 12 ART facilities over the same period. Numbers of ART continuation bottles recorded on pharmacy stock cards at the beginning and end of each quarter were documented. These pharmacy data were used to calculate the total bottles dispensed to patients in each quarter with intent to estimate the number of patients retained on ART. Information for time required to determine ART retention was gathered through interviews with clinicians tasked with compiling the data. Results Among ART clinics with paper-based systems, three of six facilities in quarter two and four of five facilities in quarter three had similar numbers of patients retained on ART comparing cohort reports to pharmacy stock records. In ART clinics with electronic systems, five of six facilities in quarter two and five of seven facilities in quarter three had similar numbers of patients retained on ART when comparing retention numbers from electronically generated cohort reports to pharmacy stock records. Among

A Prospective Randomized Trial on the Effect of Using an Electronic Monitoring Drug Dispensing Device to Improve Adherence and Compliance.

Science.gov (United States)

Henriksson, Jarmo; Tydén, Gunnar; Höijer, Jonas; Wadström, Jonas

2016-01-01

Outcome after renal transplantation depends on patient compliance and adherence for early detection of complications and identification of intervention opportunities. Compliance describes the degree to which patients follow medical advice and take their medications. Adherence has been defined as the extent to which a patients' behavior coincides with clinical prescriptions. Patients were randomized 7 to 14 days after transplantation into groups with (n = 40) and without (n = 40) an electronic medication dispenser (EMD). The EMD, which was used for the 1-year study period, recorded the date and time the patient took their medications and was monitored via a web-based application. Patients were monitored for 1 year regarding outpatient follow-up visits, emergency hospitalizations, renal biopsies, rejection episodes, renal function, and blood concentration of medications. Compliance in the intervention group was 97.8% (the control group was not assessed). Number of missed doses varied significantly by weekday (P = 0.033); patients were most likely to miss doses on Saturdays and Thursdays. Patients missed a total of 11 follow-up visits. During the study, 92 biopsies were performed on 55 patients (intervention group: 32 [17]; control group, 60 [38]). Biopsy-verified rejection was three times more common among controls (13 patients vs. 4; P = 0.054, not significant). Average P-creatinine level was slightly lower in the intervention group than the control group (131 vs. 150 μmol/L, not significant), whereas mean tacrolimus was similar (7.32 vs. 7.22 ng/mL, n.s.). The EMD is associated with high compliance, and there are also indications of a lower rejection rate.

Remote patient monitoring: Information reliability challenges

NARCIS (Netherlands)

Petkovic, M.

2009-01-01

An increasing number of extramural applications in the personal healthcare domain pose new challenges regarding the security of medical data. In this paper, we focus on remote patient monitoring systems and the issues around information reliability. In these systems medical data is not collected by

The Impact of the Perceived Purpose of Electronic Performance Monitoring on an Array of Attitudinal Variables

Science.gov (United States)

Wells, Deborah L.; Moorman, Robert H.; Werner, Jon M.

2007-01-01

As a form of performance monitoring, electronic performance monitoring (EPM) offers the opportunity for unobtrusive and continuous performance data gathering. These strengths can also make EPM stressful and threatening. Many features of performance evaluation systems, including the organizational purposes for which they are used, can affect…

HOSPITAL INFORMATION SYSTEMS: A STUDY OF ELECTRONIC PATIENT RECORDS

Directory of Open Access Journals (Sweden)

Pedro Luiz Cortês

2011-05-01

Full Text Available The importance of patient records, also known as medical records, is related to different needs and objectives, as they constitute permanent documents on the health of patients. With the advancement of information technologies and systems, patient records can be stored in databases, resulting in a positive impact on patient care. Based on these considerations, a research question that arises is “what are the benefits and problems that can be seen with the use of electronic versions of medical records?” This question leads to the formulation of the following hypothesis: although problems can be identified during the process of using electronic record systems, the benefits outweigh the difficulties, thereby justifying their use. To respond to the question and test the presented hypothesis, a research study was developed with users of the same electronic record system, consisting of doctors, nurses, and administrative personnel in three hospitals located in the city of São Paulo, Brazil. The results show that, despite some problems in their usage, the benefits of electronic patient records outweigh possible disadvantages.

MIMIC II: a massive temporal ICU patient database to support research in intelligent patient monitoring

Science.gov (United States)

Saeed, M.; Lieu, C.; Raber, G.; Mark, R. G.

2002-01-01

Development and evaluation of Intensive Care Unit (ICU) decision-support systems would be greatly facilitated by the availability of a large-scale ICU patient database. Following our previous efforts with the MIMIC (Multi-parameter Intelligent Monitoring for Intensive Care) Database, we have leveraged advances in networking and storage technologies to develop a far more massive temporal database, MIMIC II. MIMIC II is an ongoing effort: data is continuously and prospectively archived from all ICU patients in our hospital. MIMIC II now consists of over 800 ICU patient records including over 120 gigabytes of data and is growing. A customized archiving system was used to store continuously up to four waveforms and 30 different parameters from ICU patient monitors. An integrated user-friendly relational database was developed for browsing of patients' clinical information (lab results, fluid balance, medications, nurses' progress notes). Based upon its unprecedented size and scope, MIMIC II will prove to be an important resource for intelligent patient monitoring research, and will support efforts in medical data mining and knowledge-discovery.

Internet-Based Device-Assisted Remote Monitoring of Cardiovascular Implantable Electronic Devices

Science.gov (United States)

Pron, G; Ieraci, L; Kaulback, K

2012-01-01

Executive Summary Objective The objective of this Medical Advisory Secretariat (MAS) report was to conduct a systematic review of the available published evidence on the safety, effectiveness, and cost-effectiveness of Internet-based device-assisted remote monitoring systems (RMSs) for therapeutic cardiac implantable electronic devices (CIEDs) such as pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. The MAS evidence-based review was performed to support public financing decisions. Clinical Need: Condition and Target Population Sudden cardiac death (SCD) is a major cause of fatalities in developed countries. In the United States almost half a million people die of SCD annually, resulting in more deaths than stroke, lung cancer, breast cancer, and AIDS combined. In Canada each year more than 40,000 people die from a cardiovascular related cause; approximately half of these deaths are attributable to SCD. Most cases of SCD occur in the general population typically in those without a known history of heart disease. Most SCDs are caused by cardiac arrhythmia, an abnormal heart rhythm caused by malfunctions of the heart’s electrical system. Up to half of patients with significant heart failure (HF) also have advanced conduction abnormalities. Cardiac arrhythmias are managed by a variety of drugs, ablative procedures, and therapeutic CIEDs. The range of CIEDs includes pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. Bradycardia is the main indication for PMs and individuals at high risk for SCD are often treated by ICDs. Heart failure (HF) is also a significant health problem and is the most frequent cause of hospitalization in those over 65 years of age. Patients with moderate to severe HF may also have cardiac arrhythmias, although the cause may be related more to heart pump or haemodynamic failure. The presence of HF, however

Self-powered detector probes for electron and gamma-ray beam monitoring in high-power industrial accelerators

International Nuclear Information System (INIS)

Lone, M.A.

1992-08-01

A self-powered detector (SPD) is a simple passive device that consists of a coaxial probe with a metallic outer sleeve, a mineral oxide insulating layer, and a metallic inner core. SPDs are used in nuclear reactors for monitoring neutron and gamma ray fields. Responses of various SPDs to electron and gamma ray beams from industrial accelerators were investigated with Monte Carlo simulations. By judicious choice of transmission filters, threshold SPD probes were investigated for on-line monitoring of the beam energy spectrum of the high-power IMPELA industrial electron accelerator. (Author) (14 figs, 16 refs.)

[The Impact of Electronic Monitoring on Healthcare Associated Infections: The Role of the HViTAL Platform].

Science.gov (United States)

Oliveira, Rita Fontes; Castro, Lídia; Almeida, José Pedro; Alves, Carlos; Ferreira, António

2016-11-01

In Portugal, 9.8% of patients admitted were inflicted with healthcare associated infections, corresponding to a prevalence of 11.7%. The Hospital de São João has developed a business intelligence platform able to supervise (the patients), monitor (the clinical condition) and notify (the healthcare personnel): HViTAL. This study aims to assess the impact of electronic monitoring on healthcare associated infections since the year of HViTAL implementation. We evaluated data since January 2008 (moment from which computerized records exist) until December 2011, comparing them with subsequent data, those corresponding to January 2012 (implementation date of HViTAL) until 19 October 2015. There was an upward trend of infection parameters in the 2008 - 2011 period. Since January 2012 and October 2015, all parameters of the infection indicator showed a negative linear trend. The results are very suggestive that the HVITAL may have had an impact on improving parameters associated to healthcare associated infections. Basic measures of infection control were highlighted since 2005, with an increasing number of health professional awareness campaigns, a fact which, although not analyzed in this report, may also have contributed to the observed improvement. Our study did not include other variables such as investment in human capital. There was a clear improvement in all areas characterizing the healthcare associated infections, with obvious positive impact with the introduction of HViTAL.

Distributed Computing and Monitoring Technologies for Older Patients

DEFF Research Database (Denmark)

Klonovs, Juris; Haque, Mohammad Ahsanul; Krueger, Volker

This book summarizes various approaches for the automatic detection of health threats to older patients at home living alone. The text begins by briefly describing those who would most benefit from healthcare supervision. The book then summarizes possible scenarios for monitoring an older patient...

Breast Ultrasound Examination with Video Monitor System: A Satisfaction Survey among Patients

International Nuclear Information System (INIS)

Ryu, Jung Kyu; Kim, Hyun Cheol; Yang, Dal Mo

2010-01-01

The purpose of this study is to assess the patients satisfaction with a newly established video-monitor system and the associated basic items for performing breast ultrasound exams by conducting a survey among the patients. 349 patients were invited to take the survey and they had undergone breast ultrasound examination once during the 3 months after the monitor system has been introduced. The questionnaire was composed of 8 questions, 4 of which were about the basic items such as age, gender and the reason of their taking the breast ultrasound exam, their preference for the gender of the examiner and the desired length of time for the examination. The other 4 question were about their satisfaction with the video monitor. The patients were divided into two groups according to the purposes of taking the exams, which were screening or diagnostic purposes. The results were compared between these 2 groups. The satisfaction with the video monitor system was assessed by using a scoring system that ranged from 1 to 5. For the total patients, the screening group was composed of 124 patients and the diagnostic group was composed of 225. The reasons why the patients wanted to take the examinations in the diagnostic group varied. The questionnaire about the preference of the gender of the examiner showed that 81.5% in the screening group and 79.1% in the diagnostic group preferred a woman doctor. The required, suitable time for the breast ultrasound examination was 5 to 10 minutes or 10 to 15 minutes for about 70% of the patients. The mean satisfaction score for the video monitor system was as high as 3.95 point. The portion of patients in each group who answered over 3 points for their satisfaction with the monitor system was 88.7% and 94.2%, respectively. Our study showed that patients preferred 5-15 minutes for the length of the examination time and a female examiner. We also confirmed high patient satisfaction with the video monitor system

Breast Ultrasound Examination with Video Monitor System: A Satisfaction Survey among Patients

Energy Technology Data Exchange (ETDEWEB)

Ryu, Jung Kyu; Kim, Hyun Cheol; Yang, Dal Mo [East-West Neo Medical Center, Kyung-Hee University, Seoul (Korea, Republic of)

2010-03-15

The purpose of this study is to assess the patients satisfaction with a newly established video-monitor system and the associated basic items for performing breast ultrasound exams by conducting a survey among the patients. 349 patients were invited to take the survey and they had undergone breast ultrasound examination once during the 3 months after the monitor system has been introduced. The questionnaire was composed of 8 questions, 4 of which were about the basic items such as age, gender and the reason of their taking the breast ultrasound exam, their preference for the gender of the examiner and the desired length of time for the examination. The other 4 question were about their satisfaction with the video monitor. The patients were divided into two groups according to the purposes of taking the exams, which were screening or diagnostic purposes. The results were compared between these 2 groups. The satisfaction with the video monitor system was assessed by using a scoring system that ranged from 1 to 5. For the total patients, the screening group was composed of 124 patients and the diagnostic group was composed of 225. The reasons why the patients wanted to take the examinations in the diagnostic group varied. The questionnaire about the preference of the gender of the examiner showed that 81.5% in the screening group and 79.1% in the diagnostic group preferred a woman doctor. The required, suitable time for the breast ultrasound examination was 5 to 10 minutes or 10 to 15 minutes for about 70% of the patients. The mean satisfaction score for the video monitor system was as high as 3.95 point. The portion of patients in each group who answered over 3 points for their satisfaction with the monitor system was 88.7% and 94.2%, respectively. Our study showed that patients preferred 5-15 minutes for the length of the examination time and a female examiner. We also confirmed high patient satisfaction with the video monitor system

Patient Health Monitoring Using Wireless Body Area Network

Directory of Open Access Journals (Sweden)

Hsu Myat Thwe

2015-06-01

Full Text Available Abstract Nowadays remote patient health monitoring using wireless technology plays very vigorous role in a society. Wireless technology helps monitoring of physiological parameters like body temperature heart rate respiration blood pressure and ECG. The main aim of this paper is to propose a wireless sensor network system in which both heart rate and body temperature ofmultiplepatients can monitor on PC at the same time via RF network. The proposed prototype system includes two sensor nodes and receiver node base station. The sensor nodes are able to transmit data to receiver using wireless nRF transceiver module.The nRF transceiver module is used to transfer the data from microcontroller to PC and a graphical user interface GUI is developed to display the measured data and save to database. This system can provide very cheaper easier and quick respondent history of patient.

Single-shot beam-position monitor for x-ray free electron laser

Science.gov (United States)

Tono, Kensuke; Kudo, Togo; Yabashi, Makina; Tachibana, Takeshi; Feng, Yiping; Fritz, David; Hastings, Jerome; Ishikawa, Tetsuya

2011-02-01

We have developed an x-ray beam-position monitor for detecting the radiation properties of an x-ray free electron laser (FEL). It is composed of four PIN photodiodes that detect backscattered x-rays from a semitransparent diamond film placed in the beam path. The signal intensities from the photodiodes are used to compute the beam intensity and position. A proof-of-principle experiment at a synchrotron light source revealed that the error in the beam position is reduced to below 7 μm by using a nanocrystal diamond film prepared by plasma-enhanced chemical vapor deposition. Owing to high dose tolerance and transparency of the diamond film, the monitor is suitable for routine diagnostics of extremely intense x-ray pulses from the FEL.

Flexible and wearable electronic silk fabrics for human physiological monitoring

Science.gov (United States)

Mao, Cuiping; Zhang, Huihui; Lu, Zhisong

2017-09-01

The development of textile-based devices for human physiological monitoring has attracted tremendous interest in recent years. However, flexible physiological sensing elements based on silk fabrics have not been realized. In this paper, ZnO nanorod arrays are grown in situ on reduced graphene oxide-coated silk fabrics via a facile electro-deposition method for the fabrication of silk-fabric-based mechanical sensing devices. The data show that well-aligned ZnO nanorods with hexagonal wurtzite crystalline structures are synthesized on the conductive silk fabric surface. After magnetron sputtering of gold electrodes, silk-fabric-based devices are produced and applied to detect periodic bending and twisting. Based on the electric signals, the deformation and release processes can be easily differentiated. Human arterial pulse and respiration can also be real-time monitored to calculate the pulse rate and respiration frequency, respectively. Throat vibrations during coughing and singing are detected to demonstrate the voice recognition capability. This work may not only help develop silk-fabric-based mechanical sensing elements for potential applications in clinical diagnosis, daily healthcare monitoring and voice recognition, but also provide a versatile method for fabricating textile-based flexible electronic devices.

A 3-Month Randomized Controlled Pilot Trial of a Patient-Centered, Computer-Based Self-Monitoring System for the Care of Type 2 Diabetes Mellitus and Hypertension.

Science.gov (United States)

Or, Calvin; Tao, Da

2016-04-01

This study was performed to evaluate the effects of a patient-centered, tablet computer-based self-monitoring system for chronic disease care. A 3-month randomized controlled pilot trial was conducted to compare the use of a computer-based self-monitoring system in disease self-care (intervention group; n = 33) with a conventional self-monitoring method (control group; n = 30) in patients with type 2 diabetes mellitus and/or hypertension. The system was equipped with a 2-in-1 blood glucose and blood pressure monitor, a reminder feature, and video-based educational materials for the care of the two chronic diseases. The control patients were given only the 2-in-1 monitor for self-monitoring. The outcomes reported here included the glycated hemoglobin (HbA1c) level, fasting blood glucose level, systolic blood pressure, diastolic blood pressure, chronic disease knowledge, and frequency of self-monitoring. The data were collected at baseline and at 1-, 2-, and 3-month follow-up visits. The patients in the intervention group had a significant decrease in mean systolic blood pressure from baseline to 1 month (p computer-assisted and conventional disease self-monitoring appear to be useful to support/maintain blood pressure and diabetes control. The beneficial effects of the use of electronic self-care resources and support provided via mobile technologies require further confirmation in longer-term, larger trials.

Performance studies of the vibration wire monitor on the test stand with low energy electron beam

International Nuclear Information System (INIS)

Okabe, Kota; Yoshimoto, Masahiro; Kinsho, Michikazu

2015-01-01

In the high intensity proton accelerator as the Japan Proton Accelerator Research Complex (J-PARC) accelerators, serious radiation and residual dose is induced by a small beam loss such a beam halo. Therefore, diagnostics of the beam halo formation is one of the most important issues to control the beam loss. For the beam halo monitor, the vibration wire monitor (VWM) has a potential for investigating the beam halo and weak beam scanning. The VWM has a wide dynamic range, high resolution and the VWM is not susceptible to secondary electrons and electric noises. We have studied the VWM features as a new beam-halo monitor on the test stand with low energy electron gun. The frequency shift of the irradiated vibration wire was confirmed about wire material and the electron beam profile measured by using the VWM was consistent with the results of the Faraday cup measurement. Also we calculated a temperature distribution on the vibration wire which is irradiated by the electron beam with the numerical simulation. The simulations have been fairly successful in reproducing the transient of the irradiated vibration wire frequency measured by test stand experiments. In this paper, we will report a result of performance evaluation for the VWM on the test stands and discuss the VWM for beam halo diagnostic. (author)

Electronic hand hygiene monitoring as a tool for reducing health care-associated methicillin-resistant Staphylococcus aureus infection.

Science.gov (United States)

Kelly, J William; Blackhurst, Dawn; McAtee, Wendy; Steed, Connie

2016-08-01

Electronic monitoring of hand hygiene compliance using the World Health Organization's My 5 Moments for Hand Hygiene is a new innovation that has not yet been shown to reduce hospital infections. We analyzed existing data from 23 inpatient units over a 33-month period and found a significant correlation between unit-specific improvements in electronic monitoring compliance and reductions in methicillin-resistant Staphylococcus aureus infection rates (r = -0.37, P < .001). Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Data Of Daily Blood Pressure Monitoring In Patients With Rheumatoid Arthritis

Directory of Open Access Journals (Sweden)

A.P. Rebrov

2009-06-01

Full Text Available The aim of present work is to study the frequency of hypertension and the peculiarity of 24-hour blood pressure monitoring in patients with rheumatoid arthritis. We studied 584 patients with rheumatoid arthritis. Daily blood pressure monitoring was carried out in 46 patients with arthritis and 18 patients with essential hypertension. Frequency of hypertension was higher in patients with arthritis then in general population. Elevation of systolic blood pressure, heart rate and arterial blood pressure adequate decrease at night were developed to associate with advance of the disease.

Sharing electronic health records: the patient view

Directory of Open Access Journals (Sweden)

John Powell

2006-03-01

Full Text Available The introduction of a national electronic health record system to the National Health Service (NHS has raised concerns about issues of data accuracy, security and confidentiality. The primary aim of this project was to identify the extent to which primary care patients will allow their local electronic record data to be shared on a national database. The secondary aim was to identify the extent of inaccuracies in the existing primary care records, which will be used to populate the new national Spine. Fifty consecutive attenders to one general practitioner were given a paper printout of their full primary care electronic health record. Participants were asked to highlight information which they would not want to be shared on the national electronic database of records, and information which they considered to be incorrect. There was a 62% response rate (31/50. Five of the 31 patients (16% identified information that they would not want to be shared on the national record system. The items they identified related almost entirely to matters of pregnancy, contraception, sexual health and mental health. Ten respondents (32% identified incorrect information in their records (some of these turned out to be correct on further investigation. The findings in relation to data sharing fit with the commonly held assumption that matters related to sensitive or embarrassing issues, which may affect how the patient will be treated by other individuals or institutions, are most likely to be censored by patients. Previous work on this has tended to ask hypothetical questions concerning data sharing rather than examine a real situation. A larger study of representative samples of patients in both primary and secondary care settings is needed to further investigate issues of data sharing and consent.

Patients´ Use of Self-Monitored Readings for Managing Everyday Life with COPD

DEFF Research Database (Denmark)

Huniche, L.; Dinesen, B.; Nielsen, Carl

2013-01-01

exercise and other health behavior. Self-monitoring can produce a sense of security as readings provide grounds for explaining symptoms and widen the scope of possibilities for taking action. Patients experienced readings as encouraging, reassuring, depressing, worrisome, and at times disturbing. A few......OBJECTIVE: Effects of self-monitoring depend on how patients engage with readings and how this engagement is used for managing chronic disease. This article reports on a study of how chronic obstructive pulmonary disease (COPD) patients made use of readings during 16 weeks of self......-monitoring. PATIENTS AND METHODS: Semistructured interviews were conducted with 22 COPD patients three times each: at the beginning, halfway through, and after the monitoring device was collected. Spouses of nine interviewees were present during one or more interviews. The analysis of how patients used self...

Sedation and patient monitoring in vascular and interventional radiology

Energy Technology Data Exchange (ETDEWEB)

McDermott, V G.M.; Chapman, M E; Gillespie, I [Royal Infirmary, Edinburgh (United Kingdom)

1993-08-01

A postal survey of British and Irish interventional radiologists was carried out in 1991 to assess current practice with respect to sedation and monitoring of patients during angiography and interventional procedures. The response rate was 65%, 49% of patients are fasted prior to angiography and 68% prior to interventional procedures. Radiologists participate in obtaining consent in 60% of cases. Patients are often (50%) sedated for angiography and usually (62-94% depending on the procedure) sedated for interventional procedures. Nurses are present for most procedures, but are given the task of monitoring the patient's vital signs in only 49% of cases. Anaesthetists are present for less than 10% of interventional procedures. The findings indicate a wide variation in practice and a need to standardize practice at a uniform high level. (author).

Closed-orbit correction using the new beam position monitor electronic of Elsa Bonn

CERN Document Server

Dietrich, J; Keil, J

2000-01-01

RF and digital electronics, developed at the Forschungszentrum Jülich/IKP were integrated to form the new beam position monitor (BPM) system at the Electron Stretcher Accelerator (ELSA) of the University of Bonn. With this system the preservation of the polarization level during acceleration was currently improved by a good correction of the closed-orbit. All BPM offsets relative to the magnetic quadrupole centers were determined by the method of beam-based alignment. The optics functions measured by the BPM system are in good agreement with theoretical predictions.

Evaluatie pilot toepassing van technieken op gebied van electronic monitoring binnen een penitentiaire inrichting

NARCIS (Netherlands)

Bekkers, R.N.A.; te Velde, R.; Segers, J.; Bilderbeek, R.

2008-01-01

Publicatienummer 2006.051-0713; Een evaluatie van een pilot inzake de toepassing van technieken op gebied van electronic monitoring binnen een penitentiaire inrichting. Wat zijn de gevolgen voor de veiligheid (incidenten, ontvluchtingen) en welk inzicht biedt een kosten-batenanalyse?

DEGRO/DGK guideline for radiotherapy in patients with cardiac implantable electronic devices

International Nuclear Information System (INIS)

Gauter-Fleckenstein, Benjamin; Steil, Volker; Wenz, Frederik; Israel, Carsten W.; Dorenkamp, Marc; Dunst, Juergen; Roser, Mattias; Schimpf, Rainer; Schaefer, Joerg; Hoeller, Ulrike

2015-01-01

An increasing number of patients undergoing radiotherapy (RT) have cardiac implantable electronic devices [CIEDs, cardiac pacemakers (PMs) and implanted cardioverters/defibrillators (ICDs)]. Ionizing radiation can cause latent and permanent damage to CIEDs, which may result in loss of function in patients with asystole or ventricular fibrillation. Reviewing the current literature, the interdisciplinary German guideline (DEGRO/DGK) was developed reflecting patient risk according to type of CIED, cardiac condition, and estimated radiation dose to the CIED. Planning for RT should consider the CIED specifications as well as patient-related characteristics (pacing-dependent, previous ventricular tachycardia/fibrillation). Antitachyarrhythmia therapy should be suspended in patients with ICDs, who should be under electrocardiographic monitoring with an external defibrillator on stand-by. The beam energy should be limited to 6 (to 10) MV CIEDs should never be located in the beam, and the cumulative scatter radiation dose should be limited to 2 Gy. Personnel must be able to respond adequately in the case of a cardiac emergency and initiate basic life support, while an emergency team capable of advanced life support should be available within 5 min. CIEDs need to be interrogated 1, 3, and 6 months after the last RT due to the risk of latent damage. (orig.) [de

Monitoring of energetic characteristics of electron beams during formation of high-power pulsed bremsstrahlung

International Nuclear Information System (INIS)

Ivaschenko, D.M.; Mordasov, N.G.; Chlenov, A.M.

2005-01-01

A method and a device for monitoring the dynamic and integrated characteristics of high-power electron and bremsstrahlung beams of the pulse accelerators are proposed. The transfer functions for various types of a target in operating conditions of the pulse accelerator UIN-10 are presented. Possibilities if the integrated diagnostics of acceleration rate of the electron beams with simultaneous testing of the bremsstrahlung parameters as a local field point beyond the converting target are shown [ru

Depth of anaesthesia monitoring in obese patients: a randomized study of propofol-remifentanil

DEFF Research Database (Denmark)

Meyhoff, C S; Henneberg, S W; Jørgensen, B G

2009-01-01

BACKGROUND: In obese patients, depth of anaesthesia monitoring could be useful in titrating intravenous anaesthetics. We hypothesized that depth of anaesthesia monitoring would reduce recovery time and use of anaesthetics in obese patients receiving propofol and remifentanil. METHODS: We investig......BACKGROUND: In obese patients, depth of anaesthesia monitoring could be useful in titrating intravenous anaesthetics. We hypothesized that depth of anaesthesia monitoring would reduce recovery time and use of anaesthetics in obese patients receiving propofol and remifentanil. METHODS: We...... investigated 38 patients with a body mass index >or=30 kg/m(2) scheduled for an abdominal hysterectomy. Patients were randomized to either titration of propofol and remifentanil according to a cerebral state monitor (CSM group) or according to usual clinical criteria (control group). The primary end point.......04). During surgery, when the cerebral state index was continuously between 40 and 60, the corresponding optimal propofol infusion rate was 10 mg/kg/h based on ideal body weight. CONCLUSION: No significant reduction in time to eye opening could be demonstrated when a CSM was used to titrate propofol...

A configurable electronics system for the ESS-Bilbao beam position monitors

International Nuclear Information System (INIS)

Muguira, L.; Belver, D.; Etxebarria, V.; Varnasseri, S.; Arredondo, I.; Campo, M. del; Echevarria, P.; Garmendia, N.; Feuchtwanger, J.; Jugo, J.; Portilla, J.

2013-01-01

A versatile and configurable system has been developed in order to monitorize the beam position and to meet all the requirements of the future ESS-Bilbao Linac. At the same time the design has been conceived to be open and configurable so that it could eventually be used in different kinds of accelerators, independent of the charged particle, with minimal change. The design of the Beam Position Monitors (BPMs) system includes a test bench both for button-type pick-ups (PU) and striplines (SL), the electronic units and the control system. The electronic units consist of two main parts. The first part is an Analog Front-End (AFE) unit where the RF signals are filtered, conditioned and converted to base-band. The second part is a Digital Front-End (DFE) unit which is based on an FPGA board where the base-band signals are sampled in order to calculate the beam position, the amplitude and the phase. To manage the system a Multipurpose Controller (MC) developed at ESSB has been used. It includes the FPGA management, the EPICS integration and Archiver Instances. A description of the system and a comparison between the performance of both PU and SL BPM designs measured with this electronics system are fully described and discussed. -- Author-Highlights: • A versatile and configurable BPM system for the ESS-Bilbao Linac has been designed. • The design works for PU and SL detectors, both in continuous and pulsed wave modes. • Several tests at simulated beamlines at 352 MHz and 175 MHz have been performed. • The BPM system has been integrated in EPICS and Archiver

A configurable electronics system for the ESS-Bilbao beam position monitors

Energy Technology Data Exchange (ETDEWEB)

Muguira, L., E-mail: lmuguira@essbilbao.org [ESS-Bilbao, Edificio Rectorado, Vivero de Empresas, 48940 Leioa (Bizkaia) (Spain); Belver, D. [ESS-Bilbao, Edificio Rectorado, Vivero de Empresas, 48940 Leioa (Bizkaia) (Spain); Etxebarria, V. [University of Basque Country (UPV/EHU), Department of Electricity and Electronics, Science and Technology Faculty, 48940 Leioa (Bizkaia) (Spain); Varnasseri, S.; Arredondo, I.; Campo, M. del; Echevarria, P.; Garmendia, N.; Feuchtwanger, J. [ESS-Bilbao, Edificio Rectorado, Vivero de Empresas, 48940 Leioa (Bizkaia) (Spain); Jugo, J.; Portilla, J. [University of Basque Country (UPV/EHU), Department of Electricity and Electronics, Science and Technology Faculty, 48940 Leioa (Bizkaia) (Spain)

2013-09-01

A versatile and configurable system has been developed in order to monitorize the beam position and to meet all the requirements of the future ESS-Bilbao Linac. At the same time the design has been conceived to be open and configurable so that it could eventually be used in different kinds of accelerators, independent of the charged particle, with minimal change. The design of the Beam Position Monitors (BPMs) system includes a test bench both for button-type pick-ups (PU) and striplines (SL), the electronic units and the control system. The electronic units consist of two main parts. The first part is an Analog Front-End (AFE) unit where the RF signals are filtered, conditioned and converted to base-band. The second part is a Digital Front-End (DFE) unit which is based on an FPGA board where the base-band signals are sampled in order to calculate the beam position, the amplitude and the phase. To manage the system a Multipurpose Controller (MC) developed at ESSB has been used. It includes the FPGA management, the EPICS integration and Archiver Instances. A description of the system and a comparison between the performance of both PU and SL BPM designs measured with this electronics system are fully described and discussed. -- Author-Highlights: • A versatile and configurable BPM system for the ESS-Bilbao Linac has been designed. • The design works for PU and SL detectors, both in continuous and pulsed wave modes. • Several tests at simulated beamlines at 352 MHz and 175 MHz have been performed. • The BPM system has been integrated in EPICS and Archiver.

Heart Failure Patients Monitored With Telemedicine : Patient Satisfaction, a Review of the Literature

NARCIS (Netherlands)

Kraai, Imke H.; Luttik, Marie Louise; de Jong, Richard M.; de Vries, Arjen E.; van Dijk, Rene B.; Jaarsma, Tiny; Hillige, Hand L.

Background: Remote monitoring of the clinical status of heart failure patients has developed rapidly and is the subject of several trials. Patient satisfaction is an important outcome, as recommended by the U.S. Food and Drug Administration to use in clinical research, and should be included in

Patients' perspective of the design of provider-patients electronic communication services.

Science.gov (United States)

Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

2014-06-12

Information Delivery is one the most important tasks in healthcare practice. This article discusses patient's tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also described. The architecture and the methodology for the healthcare service portal are set out in the proposed system design.

Secure and Efficient Reactive Video Surveillance for Patient Monitoring

Directory of Open Access Journals (Sweden)

An Braeken

2016-01-01

Full Text Available Video surveillance is widely deployed for many kinds of monitoring applications in healthcare and assisted living systems. Security and privacy are two promising factors that align the quality and validity of video surveillance systems with the caliber of patient monitoring applications. In this paper, we propose a symmetric key-based security framework for the reactive video surveillance of patients based on the inputs coming from data measured by a wireless body area network attached to the human body. Only authenticated patients are able to activate the video cameras, whereas the patient and authorized people can consult the video data. User and location privacy are at each moment guaranteed for the patient. A tradeoff between security and quality of service is defined in order to ensure that the surveillance system gets activated even in emergency situations. In addition, the solution includes resistance against tampering with the device on the patient’s side.

Heart failure patients monitored with telemedicine: patient satisfaction, a review of the literature.

Science.gov (United States)

Kraai, I H; Luttik, M L A; de Jong, R M; Jaarsma, T; Hillege, H L

2011-08-01

Remote monitoring of the clinical status of heart failure patients has developed rapidly and is the subject of several trials. Patient satisfaction is an important outcome, as recommended by the U.S. Food and Drug Administration to use in clinical research, and should be included in studies concerning remote monitoring. The objective of this review is to describe the current state of the literature on patient satisfaction with noninvasive telemedicine, regarding definition, measurement, and overall level of patient satisfaction with telemedicine. The Pubmed, Embase, Cochrane, and Cinahl databases were searched using heart failure-, satisfaction-, and telemedicine-related search terms. The literature search identified 193 publications, which were reviewed by 2 independent reviewers. Fourteen articles were included. None of the articles described a clear definition or concept of patient satisfaction with telemedicine. Patient satisfaction with telemedicine was measured with self-developed questionnaires or face-to-face or telephonic interviews. None of the articles used the same questionnaire or telephonic survey to measure patient satisfaction. Only one questionnaire was assessed for validity and reliability. In general, patients seemed to be satisfied or very satisfied with the use of telemedicine. Measurement of patient satisfaction is still underexposed in telemedicine research and the measurement of patient satisfaction with telemedicine underappreciated with poorly constructed questionnaires. Copyright © 2011 Elsevier Inc. All rights reserved.

System theory in industrial patient monitoring: an overview.

Science.gov (United States)

Baura, G D

2004-01-01

Patient monitoring refers to the continuous observation of repeating events of physiologic function to guide therapy or to monitor the effectiveness of interventions, and is used primarily in the intensive care unit and operating room. Commonly processed signals are the electrocardiogram, intraarterial blood pressure, arterial saturation of oxygen, and cardiac output. To this day, the majority of physiologic waveform processing in patient monitors is conducted using heuristic curve fitting. However in the early 1990s, a few enterprising engineers and physicians began using system theory to improve their core processing. Applications included improvement of signal-to-noise ratio, either due to low signal levels or motion artifact, and improvement in feature detection. The goal of this mini-symposium is to review the early work in this emerging field, which has led to technologic breakthroughs. In this overview talk, the process of system theory algorithm research and development is discussed. Research for industrial monitors involves substantial data collection, with some data used for algorithm training and the remainder used for validation. Once the algorithms are validated, they are translated into detailed specifications. Development then translates these specifications into DSP code. The DSP code is verified and validated per the Good Manufacturing Practices mandated by FDA.

SLIM (SEM for Low Interception Monitoring) An Innovative Non-Destructive Beam Monitor for the Extraction Lines of a Hadrontherapy Centre

CERN Document Server

Badano, L; Pezzetta, M; Molinari, G

2003-01-01

Real time monitoring of hadrontherapy beam intensity and profile is a critical issue for the optimisation of the dose delivery to the patient carcinogenic tissue, the patient safety and the operation of the accelerator complex. For this purpose an innovative beam monitor, based on the secondary emission of electrons by a nonperturbative, sub-micron thick Al target placed directly in the extracted beam path, is being proposed. The secondary electrons, accelerated by an electrostatics focusing system, are detected by a monolithic silicon position sensitive sensor, which provides the beam intensity and its position with a precision of 1 mm at 10 kHz frame rate. The conceptual design and the engineering study optimised for hadrontherapy, together with the results of the preliminary tests of the first system prototype, will be presented.

Electron beam spectrum monitor using synchrotron light

International Nuclear Information System (INIS)

Reagan, D.; Hostetler, T.E.

1979-03-01

This instrument shows the positions, widths, and shapes of momentum spectra of SLAC beams. It uses synchrotron light produced when the beam is deflected by a magnet. Some of the light is focused on the face of an image splitter consisting of acrylic light pipes. The light pipes illuminate twelve photomultiplier tubes. Pulses from the PM tubes are integrated, multiplexed, and displayed on an oscilloscope. The resolution of the instrument is usually better than 0.2%. It has some advantages over the secondary emitter foil spectrum monitors (SEM's) currently in use at SLAC. It need never be put out of service to avoid disturbing the beam. It is as sensitive as the most sensitive SLAC SEM. (Its performance has been optimized for high-current beams; it can easily be made much more sensitive.) It provides information on a pulse-to-pulse basis and, with better cables, could indicate electron beam pulse shapes

ESUMS: a mobile system for continuous home monitoring of rehabilitation patients.

Science.gov (United States)

Strisland, Frode; Svagård, Ingrid; Seeberg, Trine M; Mathisen, Bjørn Magnus; Vedum, Jon; Austad, Hanne O; Liverud, Anders E; Kofod-Petersen, Anders; Bendixen, Ole Christian

2013-01-01

The pressure on the healthcare services is building up for several reasons. The ageing population trend, the increase in life-style related disease prevalence, as well as the increased treatment capabilities with associated general expectation all add pressure. The use of ambient healthcare technologies can alleviate the situation by enabling time and cost-efficient monitoring and follow-up of patients discharged from hospital care. We report on an ambulatory system developed for monitoring of physical rehabilitation patients. The system consists of a wearable multisensor monitoring device; a mobile phone with client application aggregating the data collected; a service-oriented-architecture based server solution; and a PC application facilitating patient follow-up by their health professional carers. The system has been tested and verified for accuracy in controlled environment trials on healthy volunteers, and also been usability tested by 5 congestive heart failure patients and their nurses. This investigation indicated that patients were able to use the system, and that nurses got an improved basis for patient follow-up.

Urine Creatinine Concentrations in Drug Monitoring Participants and Hospitalized Patients.

Science.gov (United States)

Love, Sara A; Seegmiller, Jesse C; Kloss, Julie; Apple, Fred S

2016-10-01

Urine drug testing is commonly performed in both clinical and forensic arenas for screening, monitoring and compliance purposes. We sought to determine if urine creatinine concentrations in monitoring program participants were significantly different from hospital in-patients and out-patients undergoing urine drug testing. We retrospectively reviewed urine creatinine submitted in June through December 2015 for all specimens undergoing urine drug testing. The 20,479 creatinine results were categorized as hospitalized patients (H) and monitoring/compliance groups for pain management (P), legal (L) or recovery (R). Median creatinine concentrations (interquartile range, mg/dL) were significantly different (P creatinine concentrations were significantly lower in the R vs. L group (Pcreatinine concentration and may indicate participants' attempts to tamper with their drug test results through dilution means. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Electronic Spatial Information System – tools for the monitoring of asbestos in Poland

Directory of Open Access Journals (Sweden)

Krówczyńska Małgorzata

2014-06-01

Full Text Available On January 1, 2005 the use of asbestos-containing products was banned in the European Union. According to the Act of 19 June 1997 banning the use of these products, their usage in Poland should be abated by the end of 2032. The whole process is being monitored by the Electronic Spatial Information System for the Monitoring of Asbestos Products Removal. The system design was based on a geodatabase. The research area of the study is the whole territory of Poland at the national, provincial and local level of detail. The monitoring process embraces spatial analysis through the preparation and interpretation of a range of maps. The results obtained from the deployed methods proved that the system has been useful for decision making purposes during the monitoring process. The proposed solutions were appreciated by the EU.

Silicon PIN diode based electron-gamma coincidence detector system for Noble Gases monitoring.

Science.gov (United States)

Khrustalev, K; Popov, V Yu; Popov, Yu S

2017-08-01

We present a new second generation SiPIN based electron-photon coincidence detector system developed by Lares Ltd. for use in the Noble Gas measurement systems of the International Monitoring System and the On-site Inspection verification regimes of the Comprehensive Nuclear-Test Ban Treaty (CTBT). The SiPIN provide superior energy resolution for electrons. Our work describes the improvements made in the second generation detector cells and the potential use of such detector systems for other applications such as In-Situ Kr-85 measurements for non-proliferation purposes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Performance monitoring and error significance in patients with obsessive-compulsive disorder.

Science.gov (United States)

Endrass, Tanja; Schuermann, Beate; Kaufmann, Christan; Spielberg, Rüdiger; Kniesche, Rainer; Kathmann, Norbert

2010-05-01

Performance monitoring has been consistently found to be overactive in obsessive-compulsive disorder (OCD). The present study examines whether performance monitoring in OCD is adjusted with error significance. Therefore, errors in a flanker task were followed by neutral (standard condition) or punishment feedbacks (punishment condition). In the standard condition patients had significantly larger error-related negativity (ERN) and correct-related negativity (CRN) ampliudes than controls. But, in the punishment condition groups did not differ in ERN and CRN amplitudes. While healthy controls showed an amplitude enhancement between standard and punishment condition, OCD patients showed no variation. In contrast, group differences were not found for the error positivity (Pe): both groups had larger Pe amplitudes in the punishment condition. Results confirm earlier findings of overactive error monitoring in OCD. The absence of a variation with error significance might indicate that OCD patients are unable to down-regulate their monitoring activity according to external requirements. Copyright 2010 Elsevier B.V. All rights reserved.

Monitoring in traumatic brain injury.

Science.gov (United States)

Matz, P G; Pitts, L

1997-01-01

In the past several years, improvements in technology have advanced the monitoring capabilities for patients with TBI. The primary goal of monitoring the patient with TBI is to prevent secondary insults to the brain, primarily cerebral ischemia. Cerebral ischemia may occur early and without clinical correlation and portends a poor outcome. Measurement of ICP is the cornerstone of monitoring in the patient with TBI. Monitoring of ICP provides a measurement of CPP and a rough estimation of CBF. However, with alterations in pressure autoregulation, measurement of CPP does not always allow for determination of CBF. To circumvent this problem, direct measurements of CBF can be performed using clearance techniques (133Xe, N2O, Xe-CT) or invasive monitoring techniques (LDF, TDF, NIRS). Although direct and quantitative, clearance techniques do not allow for continuous monitoring. Invasive CBF monitoring techniques are new, and artifactual results can be problematic. The techniques of jugular venous saturation monitoring and TCD are well established and are powerful adjuncts to ICP monitoring. They allow the clinician to monitor cerebral oxygen extraction and blood flow velocity, respectively, for any given CPP. Use of TCD may predict posttraumatic vasospasm before clinical sequelae. Jugular venous saturation monitoring may detect clinically occult episodes of cerebral ischemia and increased oxygen extraction. Jugular venous saturation monitoring optimizes the use of hyperventilation in the treatment of intracranial hypertension. Although PET and SPECT scanning allow direct measurement of CMRO2, these techniques have limited application currently. Similarly, microdialysis is in its infancy but has demonstrated great promise for metabolic monitoring. EEG and SEP are excellent adjuncts to the monitoring arsenal and provide immediate information on current brain function. With improvements in electronic telemetry, functional monitoring by EEG or SEP may become an important

Development of a method of absorbed dose on-line monitoring at product processing by scanned electron beam

International Nuclear Information System (INIS)

Pomatsalyuk, R.I.; Shevchenko, V.A.; Tenishev, A.Eh.; Titov, D.V.; Uvarov, V.L.

2016-01-01

The conditions of the contact-free absorbed dose monitoring at industrial product processing by electron beam are investigated. The method is based on analysing the collected charge in a stack monitor (SM) mounted down-stream of irradiated object. Using computer simulation on the basis of a modified transport code PENELOPE-2008, it is shown that by placing a filter of low-energy electrons before SM it is possible to obtain the one-to-one correlation dependence between the monitor charge and absorbed energy of radiation in the processed object. At a certain surface density of the filter, this dependence takes on the form similar to linear. The possibility to use an air gap between the object and SM as such a filter has been demonstrated. For the conditions of radiation plant with an electron accelerator LU-10 of NSC KIPT, the optimum distance of the SM location has been established. For the practical range of the electron energy, beam scan width and surface density of the irradiated product, the constants of ''product absorbed energy-to- SM charge '' linear dependence have been determined. The capability to establish the average absorbed dose in the object moving trough the irradiation zone on the SM current is shown. The calculation data are in satisfactory agreement with the results of measurements.

Monitoring non-pseudomorphic epitaxial growth of spinel/perovskite oxide heterostructures by reflection high-energy electron diffraction

Energy Technology Data Exchange (ETDEWEB)

Schütz, P.; Pfaff, F.; Scheiderer, P.; Sing, M.; Claessen, R. [Physikalisches Institut and Röntgen Center for Complex Material Systems (RCCM), Universität Würzburg, Am Hubland, D-97074 Würzburg (Germany)

2015-02-09

Pulsed laser deposition of spinel γ-Al{sub 2}O{sub 3} thin films on bulk perovskite SrTiO{sub 3} is monitored by high-pressure reflection high-energy electron diffraction (RHEED). The heteroepitaxial combination of two materials with different crystal structures is found to be inherently accompanied by a strong intensity modulation of bulk diffraction patterns from inelastically scattered electrons, which impedes the observation of RHEED intensity oscillations. Avoiding such electron surface-wave resonance enhancement by de-tuning the RHEED geometry allows for the separate observation of the surface-diffracted specular RHEED signal and thus the real-time monitoring of sub-unit cell two-dimensional layer-by-layer growth. Since these challenges are essentially rooted in the difference between film and substrate crystal structure, our findings are of relevance for the growth of any heterostructure combining oxides with different crystal symmetry and may thus facilitate the search for novel oxide heterointerfaces.

Salivary glucose in monitoring glycaemia in patients with type 1 diabetes mellitus: a systematic review.

Science.gov (United States)

Naing, Cho; Mak, Joon Wah

2017-01-01

Incidence of type 1 diabetes mellitus is increasing worldwide. Monitoring glycaemia is essential for control of diabetes mellitus. Conventional blood-based measurement of glucose requires venepuncture or needle prick, which is not free from pain and risk of infection. The non-invasiveness, ease and low-cost in collection made saliva an attractive alternative sample. The objective of this review was to systematically review the evidence on the relationship between salivary glucose level and blood glucose level in monitoring glycaemia in patients with type 1 diabetes mellitus. We searched studies which evaluate salivary glucose levels and serum glycaemia in type 1 diabetes mellitus in electronic databases of MEDLINE, EMBASE, Ovid and Google Scholar. We selected the eligible studies, following the inclusion criteria set for this review. Due to heterogeneity of studies, we conducted qualitative synthesis of studies. Ten observational studies were included in this review, including a total of 321 cases and 323 controls with ages between 3 and 61 years and the majority were males (62%). Two studies were done exclusively on children below 17 years old. The significant difference between salivary glucose levels in type 1 diabetes mellitus and controls were reported in 6 studies with 8 data sets. Five studies with 7 datasets reported the correlation coefficient between salivary glucose and blood glucose in patients with diabetes. Findings suggest that salivary glucose concentrations may be helpful in monitoring glycaemia in type 1 diabetes mellitus. However, the utility of using salivary glucose level to monitor glycaemia should be evaluated in future well designed, prospective studies with adequate number of participants with type 1 diabetes mellitus.

Effect of electronic time monitors on children's television watching: pilot trial of a home-based intervention.

Science.gov (United States)

Ni Mhurchu, Cliona; Roberts, Vaughan; Maddison, Ralph; Dorey, Enid; Jiang, Yannan; Jull, Andrew; Tin Tin, Sandar

2009-11-01

This pilot study evaluated the feasibility (recruitment, retention, and acceptability) and preliminary efficacy of a six-week home-based electronic time monitor intervention on New Zealand children's television watching in 2008. Twenty-nine children aged 9 to 12 years who watched more than 20 h of television per week (62% male, mean age 10.4 years) were randomised to either the intervention or the control group. The intervention group received an electronic TV time monitor for 6 weeks and advice to restrict TV watching to 1 h per day or less. The control group was given verbal advice to restrict TV watching. Participant retention at 6 weeks was 93%. Semi-structured interviews with intervention families confirmed moderate acceptability of TV time monitors and several perceived benefits including better awareness of household TV viewing and improved time planning. Drawbacks reported included disruption to parents' TV watching and increased sibling conflict. Time spent watching television decreased by 4.2 h (mean change [SD]: -254 [536] min) per week in the intervention group compared with no change in the control group (-3 [241] min), but the difference between groups was not statistically significant, p=0.77. Both groups reported decreases in energy intake from snacks and total screen time and increases in physical activity measured by pedometer and between-group differences were not statistically significant. Electronic TV time monitors are feasible to use for home-based TV watching interventions although acceptability varies between families. Preliminary findings from this pilot suggest that such devices have potential to decrease children's TV watching but a larger trial is needed to confirm effectiveness. Future research should be family-orientated; take account of other screen time activities; and employ TV time monitors as just one of a range of strategies to decrease sedentary behaviour.

Using Commercial Activity Monitors to Measure Gait in Patients with Suspected iNPH: Implications for Ambulatory Monitoring.

Science.gov (United States)

Gaglani, Shiv; Moore, Jessica; Haynes, M Ryan; Hoffberger, Jamie B; Rigamonti, Daniele

2015-11-17

This study seeks to validate the use of activity monitors to detect and record gait abnormalities, potentially identifying patients with idiopathic normal pressure hydrocephalus (iNPH) prior to the onset of cognitive or urinary symptoms. This study compared the step counts of four common activity monitors (Omron Step Counter HJ-113, New Lifestyles 2000, Nike Fuelband, and Fitbit Ultra) to an observed step count in 17 patients with confirmed iNPH. Of the four devices, the Fitbit Ultra (Fitbit, Inc., San Francisco, CA) provided the most accurate step count. The correlation with the observed step count was significantly higher (p<0.009) for the Fitbit Ultra than for any of the other three devices. These preliminary findings suggest that existing activity monitors have variable efficacy in the iNPH patient population and that the MEMS tri-axial accelerometer and algorithm of the Fitbit Ultra provides the most accurate gait measurements of the four devices tested.

Protocol for the "Michigan Awareness Control Study": A prospective, randomized, controlled trial comparing electronic alerts based on bispectral index monitoring or minimum alveolar concentration for the prevention of intraoperative awareness

Directory of Open Access Journals (Sweden)

Avidan Michael S

2009-11-01

Full Text Available Abstract Background The incidence of intraoperative awareness with explicit recall is 1-2/1000 cases in the United States. The Bispectral Index monitor is an electroencephalographic method of assessing anesthetic depth that has been shown in one prospective study to reduce the incidence of awareness in the high-risk population. In the B-Aware trial, the number needed to treat in order to prevent one case of awareness in the high-risk population was 138. Since the number needed to treat and the associated cost of treatment would be much higher in the general population, the efficacy of the Bispectral Index monitor in preventing awareness in all anesthetized patients needs to be clearly established. This is especially true given the findings of the B-Unaware trial, which demonstrated no significant difference between protocols based on the Bispectral Index monitor or minimum alveolar concentration for the reduction of awareness in high risk patients. Methods/Design To evaluate efficacy in the general population, we are conducting a prospective, randomized, controlled trial comparing the Bispectral Index monitor to a non-electroencephalographic gauge of anesthetic depth. The total recruitment for the study is targeted for 30,000 patients at both low and high risk for awareness. We have developed a novel algorithm that is capable of real-time analysis of our electronic perioperative information system. In one arm of the study, anesthesia providers will receive an electronic page if the Bispectral Index value is >60. In the other arm of the study, anesthesia providers will receive a page if the age-adjusted minimum alveolar concentration is Discussion Awareness during general anesthesia is a persistent problem and the role of the Bispectral Index monitor in its prevention is still unclear. The Michigan Awareness Control Study is the largest prospective trial of awareness prevention ever conducted. Trial Registration Clinical Trial NCT00689091

Monitoring patients with rheumatoid arthritis in routine care

DEFF Research Database (Denmark)

Hetland, Merete Lund; Jensen, Dorte Vendelbo; Krogh, Niels Steen

2014-01-01

disease activity, less disability and radiographic damage. By 2013, 19% of csDMARD (15% of bDMARD) patients were in ACR/Boolean remission. Coverage had increased to between 41% and 79% for patients with RA, for the bDMARD group it was 94%. CONCLUSIONS: Systematic monitoring of RA patients with real....../moderate/high disease activity (i.e. DAS28 (CRP-based, 4 variables) was calculated for each calendar year. RESULTS: From 2006-2013 the number of patients increased from 2,395 to 14,249. By 2013, 29.8% of patients were receiving bDMARD. Patients in the csDMARD group were older, had shorter disease duration, lower...

Health status monitoring for ICU patients based on locally weighted principal component analysis.

Science.gov (United States)

Ding, Yangyang; Ma, Xin; Wang, Youqing

2018-03-01

Intelligent status monitoring for critically ill patients can help medical stuff quickly discover and assess the changes of disease and then make appropriate treatment strategy. However, general-type monitoring model now widely used is difficult to adapt the changes of intensive care unit (ICU) patients' status due to its fixed pattern, and a more robust, efficient and fast monitoring model should be developed to the individual. A data-driven learning approach combining locally weighted projection regression (LWPR) and principal component analysis (PCA) is firstly proposed and applied to monitor the nonlinear process of patients' health status in ICU. LWPR is used to approximate the complex nonlinear process with local linear models, in which PCA could be further applied to status monitoring, and finally a global weighted statistic will be acquired for detecting the possible abnormalities. Moreover, some improved versions are developed, such as LWPR-MPCA and LWPR-JPCA, which also have superior performance. Eighteen subjects were selected from the Physiobank's Multi-parameter Intelligent Monitoring for Intensive Care II (MIMIC II) database, and two vital signs of each subject were chosen for online monitoring. The proposed method was compared with several existing methods including traditional PCA, Partial least squares (PLS), just in time learning combined with modified PCA (L-PCA), and Kernel PCA (KPCA). The experimental results demonstrated that the mean fault detection rate (FDR) of PCA can be improved by 41.7% after adding LWPR. The mean FDR of LWPR-MPCA was increased by 8.3%, compared with the latest reported method L-PCA. Meanwhile, LWPR spent less training time than others, especially KPCA. LWPR is first introduced into ICU patients monitoring and achieves the best monitoring performance including adaptability to changes in patient status, sensitivity for abnormality detection as well as its fast learning speed and low computational complexity. The algorithm

A reliable transmission protocol for ZigBee-based wireless patient monitoring.

Science.gov (United States)

Chen, Shyr-Kuen; Kao, Tsair; Chan, Chia-Tai; Huang, Chih-Ning; Chiang, Chih-Yen; Lai, Chin-Yu; Tung, Tse-Hua; Wang, Pi-Chung

2012-01-01

Patient monitoring systems are gaining their importance as the fast-growing global elderly population increases demands for caretaking. These systems use wireless technologies to transmit vital signs for medical evaluation. In a multihop ZigBee network, the existing systems usually use broadcast or multicast schemes to increase the reliability of signals transmission; however, both the schemes lead to significantly higher network traffic and end-to-end transmission delay. In this paper, we present a reliable transmission protocol based on anycast routing for wireless patient monitoring. Our scheme automatically selects the closest data receiver in an anycast group as a destination to reduce the transmission latency as well as the control overhead. The new protocol also shortens the latency of path recovery by initiating route recovery from the intermediate routers of the original path. On the basis of a reliable transmission scheme, we implement a ZigBee device for fall monitoring, which integrates fall detection, indoor positioning, and ECG monitoring. When the triaxial accelerometer of the device detects a fall, the current position of the patient is transmitted to an emergency center through a ZigBee network. In order to clarify the situation of the fallen patient, 4-s ECG signals are also transmitted. Our transmission scheme ensures the successful transmission of these critical messages. The experimental results show that our scheme is fast and reliable. We also demonstrate that our devices can seamlessly integrate with the next generation technology of wireless wide area network, worldwide interoperability for microwave access, to achieve real-time patient monitoring.

Remote monitoring of implantable cardiac devices: current state and future directions.

Science.gov (United States)

Ganeshan, Raj; Enriquez, Alan D; Freeman, James V

2018-01-01

Recent evidence has demonstrated substantial benefits associated with remote monitoring of cardiac implantable electronic devices (CIEDs), and treatment guidelines have endorsed the use of remote monitoring. Familiarity with the features of remote monitoring systems and the data supporting its use are vital for physicians' care for patients with CEIDs. Remote monitoring remains underutilized, but its use is expanding including in new practice settings including emergency departments. Patient experience and outcomes are positive, with earlier detection of clinical events such as atrial fibrillation, reductions in inappropriate implantable cardioverter-defibrillator (ICD) shocks and potentially a decrease in mortality with frequent remote monitoring utilizaiton. Rates of hospitalization are reduced among remote monitoring users, and the replacement of outpatient follow-up visits with remote monitoring transmissions has been shown to be well tolerated. In addition, health resource utilization is lower and remote monitoring has been associated with considerable cost savings. A dose relationship exists between use of remote monitoring and patient outcomes, and those with early and high transmission rates have superior outcomes. Remote monitoring provides clinicians with the ability to provide comprehensive follow-up care for patients with CIEDs. Patient outcomes are improved, and resource utilization is decreased with appropriate use of remote monitoring. Future efforts must focus on improving the utilization and efficiency of remote monitoring.

Diagnostic Yield of Extended Cardiac Patch Monitoring in Patients with Stroke or TIA

Directory of Open Access Journals (Sweden)

Christie E Tung

2015-01-01

Full Text Available Background: It is important to evaluate patients with TIA or stroke for atrial fibrillation (AF because the detection of AF changes the recommended anti-thrombotic regimen from treatment with an antiplatelet agent to oral anticoagulation. This study describes the diagnostic yield of a patch-based, single-use, and water-resistant 14-day continuous cardiac rhythm monitor (ZIO Patch in patients with stroke or TIA.Methods: We obtained data from the manufacturer and servicer of the ZIO Patch (iRhythm Technologies. Patients who were monitored between January 2012 and June 2013 and whose indication for monitoring was TIA or stroke were included. The duration of monitoring, the number and type of arrhythmias, and the time to first arrhythmia were documented. Results: 1,171 monitoring reports were analyzed. The mean monitor wear time was 10.9 days and the median wear time was 13.0 days (interquartile range 7.2-14.0. The median analyzable time relative to the total wear time was 98.7% (IQR 96.0-99.5%. AF was present in 5.0% of all reports. The mean duration before the first episode of paroxysmal AF (PAF was 1.5 days and the median duration was 0.4 days. 14.3% of first PAF episodes occurred after 48 hours. The mean PAF burden was 12.7% of the total monitoring duration. Conclusion: Excellent quality of the recordings and very good patient compliance coupled with a substantial proportion of AF detection beyond the first 48 hours of monitoring suggest that the cardiac patch is superior to conventional 48-hour Holter monitors for AF detection in patients with stroke or TIA.

Diagnostic Yield of Extended Cardiac Patch Monitoring in Patients with Stroke or TIA.

Science.gov (United States)

Tung, Christie E; Su, Derek; Turakhia, Mintu P; Lansberg, Maarten G

2014-01-01

It is important to evaluate patients with transient ischemic attack (TIA) or stroke for atrial fibrillation (AF) because the detection of AF changes the recommended anti-thrombotic regimen from treatment with an antiplatelet agent to oral anticoagulation. This study describes the diagnostic yield of a patch-based, single-use, and water-resistant 14-day continuous cardiac rhythm monitor (ZIO Patch) in patients with stroke or TIA. We obtained data from the manufacturer and servicer of the ZIO Patch (iRhythm Technologies). Patients who were monitored between January 2012 and June 2013 and whose indication for monitoring was TIA or stroke were included. The duration of monitoring, the number and type of arrhythmias, and the time to first arrhythmia were documented. One thousand one hundred seventy-one monitoring reports were analyzed. The mean monitor wear time was 10.9 days and the median wear time was 13.0 days (interquartile range 7.2-14.0). The median analyzable time relative to the total wear time was 98.7% (IQR 96.0-99.5%). AF was present in 5.0% of all reports. The mean duration before the first episode of paroxysmal AF (PAF) was 1.5 days and the median duration was 0.4 days. 14.3% of first PAF episodes occurred after 48 h. The mean PAF burden was 12.7% of the total monitoring duration. Excellent quality of the recordings and very good patient compliance coupled with a substantial proportion of AF detection beyond the first 48 h of monitoring suggest that the cardiac patch is superior to conventional 48-h Holter monitors for AF detection in patients with stroke or TIA.

Development of two electronic bladder diaries: a patient and healthcare professionals pilot study.

Science.gov (United States)

Mangera, Altaf; Marzo, Alberto; Heron, Nicola; Fernando, Dayan; Hameed, Khawar; Soliman, Abdel-Hamid A; Bradley, Mike; Hosking, Ian; Abdel-Maguid, Mohamed; Levermore, Martin; Tindale, Wendy B; Chapple, Christopher

2014-09-01

Assess patients' preferences in a pilot crossover study of two different electronic voiding diaries against a standard paper diary. Assess urological health professional (HP) opinions on the electronic bladder diary reporting system. Two different electronic diaries were developed: (1) electronically read diary-a card with predefined slots read by a card reader and (2) e-diary-a handheld touch screen device. Data uploaded from either electronic diary produced an electronic report. We recruited 22 patients split into two cohorts for each electronic diary, 11 completed each type of electronic diary for 3 days either preceded or followed by a standard paper diary for 3 days. Both diaries were completed on the 7th day. Patients' perceptions of both diaries were recorded using a standardized questionnaire. A HP study recruited 22 urologists who were given the paper diary and the electronic reports. Time taken for analysis was recorded along with accuracy and HP preferences. The majority of patients (82%) preferred the e-diary and only 1/11 found it difficult to use. Patients had the same preference for the electronically read diary as the paper diary. The paper diary took 66% longer to analyze than the electronic report (P analyzed with an accuracy of 58% compared to 100%. Slightly more HP (9%) preferred the electronic report to the paper diary. This proposed e-diary with its intuitive interface has overcome previous deficiencies in electronic diaries with most patients finding the format user-friendly. Electronic reports make analysis and interpretation by HP quicker and more accurate. © 2013 Wiley Periodicals, Inc.

Introduction of a national electronic patient record in The Netherlands: some legal issues

NARCIS (Netherlands)

Ploem, Corrette; Gevers, Sjef

2011-01-01

The electronic patient record (EPR) is a major technological development within the healthcare sector. Many hospitals across Europe already use institution-based electronic patient records, which allow not only for electronic exchange of patient data within the hospital, but potentially also for

Monitoring system including an electronic sensor platform and an interrogation transceiver

Science.gov (United States)

Kinzel, Robert L.; Sheets, Larry R.

2003-09-23

A wireless monitoring system suitable for a wide range of remote data collection applications. The system includes at least one Electronic Sensor Platform (ESP), an Interrogator Transceiver (IT) and a general purpose host computer. The ESP functions as a remote data collector from a number of digital and analog sensors located therein. The host computer provides for data logging, testing, demonstration, installation checkout, and troubleshooting of the system. The IT transmits signals from one or more ESP's to the host computer to the ESP's. The IT host computer may be powered by a common power supply, and each ESP is individually powered by a battery. This monitoring system has an extremely low power consumption which allows remote operation of the ESP for long periods; provides authenticated message traffic over a wireless network; utilizes state-of-health and tamper sensors to ensure that the ESP is secure and undamaged; has robust housing of the ESP suitable for use in radiation environments; and is low in cost. With one base station (host computer and interrogator transceiver), multiple ESP's may be controlled at a single monitoring site.

Factors contributing to perceptions about policies regarding the electronic monitoring of sex offenders: the role of demographic characteristics, victimization experiences, and social disorganization.

Science.gov (United States)

Button, Deeanna M; Tewksbury, Richard; Mustaine, Elizabeth E; Payne, Brian K

2013-01-01

The purpose of this article is to explore factors contributing to perceptions about electronic monitoring policies governing sex offenders. Guided by Tannenbaum's theory of attribution and Shaw and McKay's theory of social disorganization, the authors examine the influence of demographic characteristics, victimization experiences, and neighborhood characteristics on perceptions about policies regarding the electronic monitoring of sex offenders. Ordinary least squares regression and logistic regression analyses of stratified telephone survey data reveal that factors associated with favorable views on the use of global positioning satellite monitoring for registered sex offenders appear to stem primarily from individuals' demographic characteristics. Experiential and neighborhood factors do provide some influence over individuals' views of electronic monitoring policies for sex offenders. Theoretical and policy implications are discussed.

Beam monitor system for an x-ray free electron laser and compact laser

Directory of Open Access Journals (Sweden)

Y. Otake

2013-04-01

Full Text Available A beam-monitor system for XFEL/SPring 8, “SACLA,” has been constructed. In order to maintain a stable self-amplified spontaneous emission (SASE interaction, the straightness and overlap of the axes to within 3  μm between the electron beams and the radiated x rays for an undulator section of about 100 m length is necessary. This straightness means relative alignment to an experimental target sample. Furthermore, a temporal stability of 30 fs in order to maintain a constant peak beam current is also necessary to conduct stable SASE lasing. The monitor system was developed to satisfy these spatial and temporal stability and resolution criteria. The system comprises spatial monitors, such as cavity-type beam-position monitors and screen monitors, as well as temporal measurement instruments, such as current monitors, waveguide spectrometers, coherent synchrotron-radiation detectors, a streak camera, and an rf deflector. Commissioning of SACLA started from March 2011, and the monitors performed sufficient roles to tune the beams for lasing. The achieved overall performances of the system, including data acquisition, are: the beam position monitor has a spatial resolution of 600 nm in rms; the bunch-length monitors show ability to observe bunch lengths from 1 ns in an injector with velocity bunching to less than 30 fs after three-stage bunch compressors. The less than 3  μm spatial resolution of the screen monitor was also confirmed during practical beam operation. Owing to these fulfilled performances, such as the high spatial and temporal resolutions, stable lasing of SACLA has been achieved.

Improving metabolic monitoring in patients maintained on antipsychotics in Penang, Malaysia.

Science.gov (United States)

Hor, Esther Sl; Subramaniam, Sivasangari; Koay, Jun Min; Bharathy, Arokiamary; Vasudevan, Umadevi; Panickulam, Joseph J; Ng, InnTiong; Arif, Nor Hayati; Russell, Vincent

2016-02-01

To evaluate the monitoring of metabolic parameters among outpatients maintained on antipsychotic medications in a general hospital setting in Malaysia and to assess the impact of a local monitoring protocol. By performing a baseline audit of files from a random sample of 300 patients prescribed antipsychotic medications for at least 1 year; we determined the frequency of metabolic monitoring. The findings informed the design of a new local protocol, on which clinical staff was briefed. We re-evaluated metabolic monitoring immediately after implementation, in a small sample of new referrals and current patients. We explored staff perceptions of the initiative with a follow-up focus group, 6 months post-implementation. The baseline audit revealed a sub-optimal frequency of metabolic parameter recording. Re-audit, following implementation of the new protocol, revealed improved monitoring but persisting deficits. Dialogue with the clinical staff led to further protocol modification, clearer definition of staff roles and use of a standard recording template. Focus group findings revealed positive perceptions of the initiative, but persisting implementation barriers, including cultural issues surrounding waist circumference measurement. Responding to challenges in achieving improved routine metabolic monitoring of patients maintained on antipsychotics required on-going dialogue with the clinical staff, in order to address both service pressures and cultural concerns. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Monitoring of biological odour filtration in closed environments with olfactometry and an electronic nose

NARCIS (Netherlands)

Willers, H.C.; Gijsel, de P.; Ogink, N.W.M.; Amico, D' A.; Martinelli, E.; Natale, Di C.; Ras, van N.; Waarde, van der J.

2004-01-01

Air treatment with a compact biological membrane filter, and air quality monitoring with an electronic nose were tested in the laboratory on air from a cage containing six mice. Additional analyses of air to and from the filter were performed using olfactometry and ammonia and hydrogen sulphide gas

Study of an integrated electronic monitor for neutron fields

Energy Technology Data Exchange (ETDEWEB)

Barelaud, B.; Nexon-Mokhtari, F.; Barrau, C.; Decossas, J.L.; Vareille, J.C. [Limoges Univ., 87 (France); Sarrabayrouse, G.J. [CNRS, 31 - Toulouse (France)

1995-12-31

The majority of the individual neutron monitors measure incorrectly in a certain energy range (10 keV-500 keV). For electronic devices, this problem is due to their high {gamma} sensitivity. To solve this problem a microelectronic detector design for neutron spectrometry is now being studied at LEPOFI. It is based on the measurement of the total energy which is deposited by {sup 6}Li (n, {alpha}) {sup 3}H or {sup 10}B (n {alpha}) {sup 7}Li reactions in silicon detectors. A new electronic sensor - for example a boron or lithium sandwich device -has been developed in collaboration with LAAS. Specific techniques for silicon sensor coating with boron have been developed and are briefly presented. The response of the detector has been computed using a model and a code developed at LEPOFI. Several parameters have been taken into account in the calculations: the type of layer, its thickness, the characteristics of the detector. The results of these simulations are discussed and calculated pulse height distributions for various designs are presented. The present status of the investigation only concerns thermal neutrons. (author).

Evaluation of a GEM and CAT-based detector for radiation therapy beam monitoring

International Nuclear Information System (INIS)

Brahme, A.; Danielsson, M.; Iacobaeus, C.; Ostling, J.; Peskov, V.; Wallmark, M.

2000-01-01

We are developing a radiation therapy beam monitor for the Karolinska Institute. This monitor will consist of two consecutive detectors confined in one gas chamber: a 'keV-photon detector', which will allow diagnostic quality visualization of the patient, and a 'MeV-photon detector', that will measure the absolute intensity of the therapy beam and its position with respect to the patient. Both detectors are based on highly radiation resistant gas and solid photon to electron converters, combined with GEMs and a CAT as amplification structures. We have performed systematic studies of the high-rate characteristics of the GEM and the CAT, as well as tested the electron transfer through these electron multipliers and various types of converters. The tests show that the GEM and the CAT satisfy all requirements for the beam monitoring system. As a result of these studies we successfully developed and tested a full section of the beam monitor equipped with a MeV-photon converter placed between the GEM and the CAT

pH monitoring in patients with benign voice disorders

DEFF Research Database (Denmark)

Grøntved, A M; West, F

2000-01-01

The aim of this study was to compare oesophageal pH-metry with laryngeal signs and symptoms in patients suspected of laryngeal reflux disease. A total of 60 patients with voice disorders, who were suspected of laryngeal reflux, were tested by single probe oesophageal pH monitoring. Thirty...

A practical approach for electron monitor unit calculation

International Nuclear Information System (INIS)

Choi, David; Patyal, Baldev; Cho, Jongmin; Cheng, Ing Y; Nookala, Prashanth

2009-01-01

Electron monitor unit (MU) calculation requires measured beam data such as the relative output factor (ROF) of a cone, insert correction factor (ICF) and effective source-to-surface distance (ESD). Measuring the beam data to cover all possible clinical cases is not practical for a busy clinic because it takes tremendous time and labor. In this study, we propose a practical approach to reduce the number of data measurements without affecting accuracy. It is based on two findings of dosimetric properties of electron beams. One is that the output ratio of two inserts is independent of the cone used, and the other is that ESD is a function of field size but independent of cone and jaw opening. For the measurements to prove the findings, a parallel plate ion chamber (Markus, PTW 23343) with an electrometer (Cardinal Health 35040) was used. We measured the outputs to determine ROF, ICF and ESD of different energies (5-21 MeV). Measurements were made in a Plastic Water(TM) phantom or in water. Three linear accelerators were used: Siemens MD2 (S/N 2689), Siemens Primus (S/N 3305) and Varian Clinic 21-EX (S/N 1495). With these findings, the number of data set to be measured can be reduced to less than 20% of the data points. (note)

Radioactive and electron microscope analysis of effluent monitor sample lines

International Nuclear Information System (INIS)

Kowalski, J.F.

1986-01-01

Effluent air sampling at nuclear power plant often leads to the question ''How representative is the sample of the effluent stream?'' Samples from radiation monitors are typically obtained at great distances from the sample nozzle because of high background concerns under postulated accidents. Sample line plateout during normal effluent sampling becomes the major concern. A US Nuclear Regulatory Commission inspection raised a concern that monitors were not collecting representative samples per ANSI standard N13.1. A comprehensive 2-yr study at Beaver Valley was performed during normal effluent releases in two phases: 1) weekly charcoal and glass fiber filter samples were analyzed for radioactivity for 6 months, and 2) nuclepore membrane filter samples were analyzed by electron microscope for 4- and 6-h periods. A specially designed test nozzle was directly inserted into an effluent stream for comparison with the radiation monitor samples. Particle behavior characteristics can be determined during effluent releases using a simple test probe. While particle plateout was the major purpose of the study, other particle behavior characteristics were evident and equally as important. Particle travel through long sample lines can also lead to (a) agglomeration or the coagulation of smaller particles to form larger ones, (b) particle splitting or fracturing upon impact with the sample line interior walls, and (c) resuspension of large particles in sample lines

Remote monitoring of heart failure: benefits for therapeutic decision making.

Science.gov (United States)

Martirosyan, Mihran; Caliskan, Kadir; Theuns, Dominic A M J; Szili-Torok, Tamas

2017-07-01

Chronic heart failure is a cardiovascular disorder with high prevalence and incidence worldwide. The course of heart failure is characterized by periods of stability and instability. Decompensation of heart failure is associated with frequent and prolonged hospitalizations and it worsens the prognosis for the disease and increases cardiovascular mortality among affected patients. It is therefore important to monitor these patients carefully to reveal changes in their condition. Remote monitoring has been designed to facilitate an early detection of adverse events and to minimize regular follow-up visits for heart failure patients. Several new devices have been developed and introduced to the daily practice of cardiology departments worldwide. Areas covered: Currently, special tools and techniques are available to perform remote monitoring. Concurrently there are a number of modern cardiac implantable electronic devices that incorporate a remote monitoring function. All the techniques that have a remote monitoring function are discussed in this paper in detail. All the major studies on this subject have been selected for review of the recent data on remote monitoring of HF patients and demonstrate the role of remote monitoring in the therapeutic decision making for heart failure patients. Expert commentary: Remote monitoring represents a novel intensified follow-up strategy of heart failure management. Overall, theoretically, remote monitoring may play a crucial role in the early detection of heart failure progression and may improve the outcome of patients.

Bunch-shape monitor for a picosecond single-bunch beam of a 35 MeV electron linear accelerator

International Nuclear Information System (INIS)

Hosono, Yoneichi; Nakazawa, Masaharu; Iguchi, Tetsuo

1995-01-01

A non-interactive-type bunch-shape and beam intensity monitor for a 35 MeV electron linear accelerator (linac) has been developed. The monitor consists of an electric SMA-type connector and an Al pipe of 50 mm inner diameter. Test measurements of the present monitor have been made under the conditions of the accelerated charges of lower than 27 nC/pulse and the pulse width ranging from 6 to 30 ps (Full Width at Half Maximum). The results show that the present monitor is applicable to bunch-shape measurement of the picosecond single-bunch beam. The monitor output is also found to be proportional to the beam intensity of more than 0.05 nC/pulse. (author)

A new system for continuous and remote monitoring of patients receiving home mechanical ventilation.

Science.gov (United States)

Battista, L

2016-09-01

Home mechanical ventilation is the treatment of patients with respiratory failure or insufficiency by means of a mechanical ventilator at a patient's home. In order to allow remote patient monitoring, several tele-monitoring systems have been introduced in the last few years. However, most of them usually do not allow real-time services, as they have their own proprietary communication protocol implemented and some ventilation parameters are not always measured. Moreover, they monitor only some breaths during the whole day, despite the fact that a patient's respiratory state may change continuously during the day. In order to reduce the above drawbacks, this work reports the development of a novel remote monitoring system for long-term, home-based ventilation therapy; the proposed system allows for continuous monitoring of the main physical quantities involved during home-care ventilation (e.g., differential pressure, volume, and air flow rate) and is developed in order to allow observations of different remote therapy units located in different places of a city, region, or country. The developed remote patient monitoring system is able to detect various clinical events (e.g., events of tube disconnection and sleep apnea events) and has been successfully tested by means of experimental tests carried out with pulmonary ventilators typically used to support sick patients.

An analysis of electronic health record-related patient safety incidents.

Science.gov (United States)

Palojoki, Sari; Mäkelä, Matti; Lehtonen, Lasse; Saranto, Kaija

2017-06-01

The aim of this study was to analyse electronic health record-related patient safety incidents in the patient safety incident reporting database in fully digital hospitals in Finland. We compare Finnish data to similar international data and discuss their content with regard to the literature. We analysed the types of electronic health record-related patient safety incidents that occurred at 23 hospitals during a 2-year period. A procedure of taxonomy mapping served to allow comparisons. This study represents a rare examination of patient safety risks in a fully digital environment. The proportion of electronic health record-related incidents was markedly higher in our study than in previous studies with similar data. Human-computer interaction problems were the most frequently reported. The results show the possibility of error arising from the complex interaction between clinicians and computers.

Connecting Smartphone and Wearable Fitness Tracker Data with a Nationally Used Electronic Health Record System for Diabetes Education to Facilitate Behavioral Goal Monitoring in Diabetes Care: Protocol for a Pragmatic Multi-Site Randomized Trial.

Science.gov (United States)

Wang, Jing; Coleman, Deidra Carroll; Kanter, Justin; Ummer, Brad; Siminerio, Linda

2018-04-02

Mobile and wearable technology have been shown to be effective in improving diabetes self-management; however, integrating data from these technologies into clinical diabetes care to facilitate behavioral goal monitoring has not been explored. The objective of this paper is to report on a study protocol for a pragmatic multi-site trial along with the intervention components, including the detailed connected health interface. This interface was developed to integrate patient self-monitoring data collected from a wearable fitness tracker and its companion smartphone app to an electronic health record system for diabetes self-management education and support (DSMES) to facilitate behavioral goal monitoring. A 3-month multi-site pragmatic clinical trial was conducted with eligible patients with diabetes mellitus from DSMES programs. The Chronicle Diabetes system is currently freely available to diabetes educators through American Diabetes Association-recognized DSMES programs to set patient nutrition and physical activity goals. To integrate the goal-setting and self-monitoring intervention into the DSMES process, a connected interface in the Chronicle Diabetes system was developed. With the connected interface, patient self-monitoring information collected from smartphones and wearable fitness trackers can facilitate educators' monitoring of patients' adherence to their goals. Feasibility outcomes of the 3-month trial included hemoglobin A 1c levels, weight, and the usability of the connected system. An interface designed to connect data from a wearable fitness tracker with a companion smartphone app for nutrition and physical activity self-monitoring into a diabetes education electronic health record system was successfully developed to enable diabetes educators to facilitate goal setting and monitoring. A total of 60 eligible patients with type 2 diabetes mellitus were randomized into either group 1) standard diabetes education or 2) standard education enhanced with

Monitoring of the upper urinary tract in patients with bladder cancer

Directory of Open Access Journals (Sweden)

Rajinikanth Ayyathurai

2011-01-01

Full Text Available Upper urinary tract (UUT transitional cell carcinoma (TCC is relatively rare tumor. Approximately 0.7-4% of patients with primary bladder cancer develops UUT-TCC. The symptoms related to an UUT-TCC often occur with an advanced stage which leads one to emphasize a surveillance strategy to monitor the UUT to allow for an earlier diagnosis. Although the risk of UUT-TCC after bladder cancer is well established, there is a paucity of recommendations suggesting the optimal method and frequency of monitoring the UUT and there is no consensus among them. This article reviews the recommendations on monitoring the UUT in patients with bladder cancer.

Monitoring system of energy characteristics of electron beam during shaping process of power bremsstrahlung pulses

International Nuclear Information System (INIS)

Mordasov, N.G.; Ulimov, V.N.; Bryksin, V.A.; Shiyan, V.D.

2005-01-01

One proposes a procedure and a device to monitor dynamic and integral characteristics of electron power beams of high-current pulsed accelerators (HCPA) operating under Bremsstrahlung radiation mode. One obtained static and dynamic transfer characteristics for various types of heterogenous targets-converters under operation of UIN-10 HCPA with up to 4 MeV energy electrons, up to 60 kA current and 6 x 10 -8 -2 x 10 -6 s pulse efficient duration. One demonstrated the capabilities of the complex diagnostics of acceleration of electron beams by HCPA with simultaneous determination of parameters of the Bremsstrahlung radiation at the local point of the field behind the target-converter [ru

Security in the Dutch electronic patient record system

NARCIS (Netherlands)

van 't Noordende, G.

2010-01-01

In this article, we analyze the security architecture of the Dutch Electronic Patient Dossier (EPD) system. Intended as a mandatory infrastructure for exchanging medical records of most if not all patients in the Netherlands among authorized parties (particularly, physicians), the EPD has to address

Use of an electronic medical record to monitor efficacy of diabetes ...

African Journals Online (AJOL)

The Malawian health sector has a strong tradition of systematic data collection for monitoring and evaluation of large-scale services. A highly successful adapted Directly Observed Treatment, Short course “DOTS” framework, based on patient registers and paperbased mastercards was introduced to facilitate the ...

Electronic patient record: what makes care providers use it?

NARCIS (Netherlands)

Michel-Verkerke, M.B.

2013-01-01

Despite the enormous progress that is made, many healthcare professionals still experience problems regarding patient information and patient records. For a long time the expectation is that an electronic patient record (EPR) will solve these problems. In this research the factors determining the

Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: The electronic Patient-reported Outcomes from Cancer Survivors (ePOCS system

Directory of Open Access Journals (Sweden)

Velikova Galina

2011-10-01

Full Text Available Abstract Background Cancer survivors can face significant physical and psychosocial challenges; there is a need to identify and predict which survivors experience what sorts of difficulties. As highlighted in the UK National Cancer Survivorship Initiative, routine post-diagnostic collection of patient reported outcome measures (PROMs is required; to be most informative, PROMs must be linked and analysed with patients' diagnostic and treatment information. We have designed and built a potentially cost-efficient UK-scalable electronic system for collecting PROMs via the internet, at regular post-diagnostic time-points, for linking these data with patients' clinical data in cancer registries, and for electronically managing the associated patient monitoring and communications; the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS system. This study aims to test the feasibility of the ePOCS system, by running it for 2 years in two Yorkshire NHS Trusts, and using the Northern and Yorkshire Cancer Registry and Information Service. Methods/Design Non-metastatic breast, colorectal and prostate cancer patients (largest survivor groups, within 6 months post-diagnosis, will be recruited from hospitals in the Yorkshire Cancer Network. Participants will be asked to complete PROMS, assessing a range of health-related quality-of-life outcomes, at three time-points up to 15 months post-diagnosis, and subsequently to provide opinion on the ePOCS system via a feedback questionnaire. Feasibility will be examined primarily in terms of patient recruitment and retention rates, the representativeness of participating patients, the quantity and quality of collected PROMs data, patients' feedback, the success and reliability of the underpinning informatics, and the system running costs. If sufficient data are generated during system testing, these will be analysed to assess the health-related quality-of-life outcomes reported by patients, and to explore

Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology

OpenAIRE

Singh, Om Prakash; Mekonnen, Dawit; Malarvili, M. B.

2015-01-01

This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620) followed by signal conditioning circuit with the operation amplifier (lm741). Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has ...

Conformable liquid metal printed epidermal electronics for smart physiological monitoring and simulation treatment

Science.gov (United States)

Wang, Xuelin; Zhang, Yuxin; Guo, Rui; Wang, Hongzhang; Yuan, Bo; Liu, Jing

2018-03-01

Conformable epidermal printed electronics enabled from gallium-based liquid metals (LMs), highly conductive and low-melting-point alloys, are proposed as the core to achieving immediate contact between skin surface and electrodes, which can avoid the skin deformation often caused by conventional rigid electrodes. When measuring signals, LMs can eliminate resonance problems with shorter time to reach steady state than Pt and gelled Pt electrodes. By comparing the contact resistance under different working conditions, it is demonstrated that both ex vivo and in vivo LM electrode-skin models have the virtues of direct and immediate contact with skin surface without the deformation encountered with conventional rigid electrodes. In addition, electrocardio electrodes composed of conformable LM printed epidermal electronics are adopted as smart devices to monitor electrocardiogram signals of rabbits. Furthermore, simulation treatment for smart defibrillation offers a feasible way to demonstrate the effect of liquid metal electrodes (LMEs) on the human body with less energy loss. The remarkable features of soft epidermal LMEs such as high conformability, good conductivity, better signal stability, and fine biocompatibility represent a critical step towards accurate medical monitoring and future smart treatments.

Development and daily use of an electronic oncological patient record for the total management of cancer patients: 7 years' experience.

Science.gov (United States)

Galligioni, E; Berloffa, F; Caffo, O; Tonazzolli, G; Ambrosini, G; Valduga, F; Eccher, C; Ferro, A; Forti, S

2009-02-01

We describe our experience with an electronic oncological patient record (EOPR) for the total management of cancer patients. The web-based EOPR was developed on the basis of a user-centred design including user education and training, followed by continuous assistance; user acceptance was monitored by means of three questionnaires administered after 2 weeks, 6 months and 6 years. The EOPR has been used daily for all in-ward, day hospital and ambulatory clinical activities since July 2000. The most widely appreciated functions are its rapid multipoint access, the self-updated summary of the patients' clinical course, the management of the entire therapeutic programme synchronised with working agendas and oncological teleconsultation. Security and privacy are assured by means of the separate storage of clinical and demographic data, with access protected by login and a password. The questionnaires highlighted appreciation of rapid data retrieval and exchange and the perception of improved quality of care, but also revealed a sense of additional work and a negative impact on doctor-patient relationships. Our EOPR has proved to be effective in the total management of cancer patients. Its user-centred design and flexible web technology have been key factors in its successful implementation and daily use.

Outward electron transfer by Saccharomyces cerevisiae monitored with a bi-cathodic microbial fuel cell-type activity sensor.

Science.gov (United States)

Ducommun, Raphaël; Favre, Marie-France; Carrard, Delphine; Fischer, Fabian

2010-03-01

A Janus head-like bi-cathodic microbial fuel cell was constructed to monitor the electron transfer from Saccharomyces cerevisiae to a woven carbon anode. The experiments were conducted during an ethanol cultivation of 170 g/l glucose in the presence and absence of yeast-peptone medium. First, using a basic fuel-cell type activity sensor, it was shown that yeast-peptone medium contains electroactive compounds. For this purpose, 1% solutions of soy peptone and yeast extract were subjected to oxidative conditions, using a microbial fuel cell set-up corresponding to a typical galvanic cell, consisting of culture medium in the anodic half-cell and 0.5 M K(3)Fe(CN)(6) in the cathodic half-cell. Second, using a bi-cathodic microbial fuel cell, it was shown that electrons were transferred from yeast cells to the carbon anode. The participation of electroactive compounds in the electron transport was separated as background current. This result was verified by applying medium-free conditions, where only glucose was fed, confirming that electrons are transferred from yeast cells to the woven carbon anode. Knowledge about the electron transfer through the cell membrane is of importance in amperometric online monitoring of yeast fermentations and for electricity production with microbial fuel cells. Copyright (c) 2009 John Wiley & Sons, Ltd.

Exploring a New Security Framework for Remote Patient Monitoring Devices

Directory of Open Access Journals (Sweden)

Brian Ondiege

2017-02-01

Full Text Available Security has been an issue of contention in healthcare. The lack of familiarity and poor implementation of security in healthcare leave the patients’ data vulnerable to attackers. The main issue is assessing how we can provide security in an RPM infrastructure. The findings in literature show there is little empirical evidence on proper implementation of security. Therefore, there is an urgent need in addressing cybersecurity issues in medical devices. Through the review of relevant literature in remote patient monitoring and use of a Microsoft threat modelling tool, we identify and explore current vulnerabilities and threats in IEEE 11073 standard devices to propose a new security framework for remote patient monitoring devices. Additionally, current RPM devices have a limitation on the number of people who can share a single device, therefore, we propose the use of NFC for identification in Remote Patient Monitoring (RPM devices for multi-user environments where we have multiple people sharing a single device to reduce errors associated with incorrect user identification. We finally show how several techniques have been used to build the proposed framework.

Nuclear electronics equipment for control and monitoring panel

International Nuclear Information System (INIS)

Roquefort, Henri

1980-09-01

The purpose of this document is to fix what terminology should be used, to define the main specifications of supplies and to specify the test methods recommended to check these specifications. This document applies to low and high voltage supply sub-units fed by AC or DC mains supply and delivering direct current under stabilised DC voltage. These sub-units are used in nuclear electronics equipment and especially for reactor monitoring. Following the definition of some terms, current notations and a bibliography, the characteristics section and the corresponding test methods section are developed. Each section deals in particular with: input and output characteristics, linearity and display errors, fluctuations, influence and operation errors, variations, drift (stability), variations with the main influence quantities: mains, temperature, load, transient variations, insulation, shielding, microbreakdowns, emergency supply, electromagnetic perturbation sensitivity, reliability, maintainability and characteristics specific to certain supplies used for the polarisation of radiation detectors [fr

Real-Time Management of Multimodal Streaming Data for Monitoring of Epileptic Patients.

Science.gov (United States)

Triantafyllopoulos, Dimitrios; Korvesis, Panagiotis; Mporas, Iosif; Megalooikonomou, Vasileios

2016-03-01

New generation of healthcare is represented by wearable health monitoring systems, which provide real-time monitoring of patient's physiological parameters. It is expected that continuous ambulatory monitoring of vital signals will improve treatment of patients and enable proactive personal health management. In this paper, we present the implementation of a multimodal real-time system for epilepsy management. The proposed methodology is based on a data streaming architecture and efficient management of a big flow of physiological parameters. The performance of this architecture is examined for varying spatial resolution of the recorded data.

Behavioral Reactivity Associated With Electronic Monitoring of Environmental Health Interventions--A Cluster Randomized Trial with Water Filters and Cookstoves.

Science.gov (United States)

Thomas, Evan A; Tellez-Sanchez, Sarita; Wick, Carson; Kirby, Miles; Zambrano, Laura; Abadie Rosa, Ghislaine; Clasen, Thomas F; Nagel, Corey

2016-04-05

Subject reactivity--when research participants change their behavior in response to being observed--has been documented showing the effect of human observers. Electronics sensors are increasingly used to monitor environmental health interventions, but the effect of sensors on behavior has not been assessed. We conducted a cluster randomized controlled trial in Rwanda among 170 households (70 blinded to the presence of the sensor, 100 open) testing whether awareness of an electronic monitor would result in a difference in weekly use of household water filters and improved cookstoves over a four-week surveillance period. A 63% increase in number of uses of the water filter per week between the groups was observed in week 1, an average of 4.4 times in the open group and 2.83 times in the blind group, declining in week 4 to an insignificant 55% difference of 2.82 uses in the open, and 1.93 in the blind. There were no significant differences in the number of stove uses per week between the two groups. For both filters and stoves, use decreased in both groups over four-week installation periods. This study suggests behavioral monitoring should attempt to account for reactivity to awareness of electronic monitors that persists for weeks or more.

Monitoring cardiac output during hyperbaric oxygen treatment of haemodynamically unstable patients

DEFF Research Database (Denmark)

Hansen, Marco Bo; Treschow, Frederik; Skielboe, Martin

2013-01-01

Patients suffering from necrotizing fasciitis (NF) are often haemodynamically unstable and require extended monitoring of cardiovascular parameters; yet this is limited during hyperbaric oxygen treatment (HBOT). We aimed to evaluate the use and safety of transoesophageal Doppler (TED) monitoring ...

Computerized x-ray dose-monitoring system

International Nuclear Information System (INIS)

Hummel, R.H.; Wesenberg, R.L.; Amundson, G.M.

1985-01-01

An x-ray dose-monitoring system using a small digital computer is described. Initially, and for every 6 months afterward, the system is calibrated using an exposure meter. For each exposure, the computer receives values of x-ray technique and beam geometry from the x-ray generator through a specially designed electronic interface. Then, by means of calibration data, entrance exposure, area exposure product, and integral dose are obtained and printed for each patient examined. The overall accuracy of the system is better than +/-20%. Operation is semiautomatic, requiring minimum operator intervention. Over 2000 patients have been monitored with the device. Because the system is computer-based, it offers the opportunity for statistical analysis of the data base created, as the results for each patient are stored on computer disk

Applications of aerospace technology in biomedicine. A technology transfer profile: Patient monitoring

Science.gov (United States)

Murray, D. M.

1971-01-01

NASA contributions to cardiovascular monitoring are described along with innovations in intracardiac blood pressure monitoring. A brief overview of the process of NASA technology transfer in patient monitoring is presented and a list of bioinstrumentation tech briefs and the number of requests for technical support is included.

Policy based Agents in Wireless Body Sensor Mesh Networks for Patient Health Monitoring

OpenAIRE

Kevin Miller; Suresh Sankaranarayanan

2009-01-01

There is presently considerable research interest in using wireless and mobile technologies in patient health monitoring particularly in hospitals and nursing homes. For health monitoring,, an intelligent agent based hierarchical architecture has already been published by one of the authors of this paper. Also, the technique of monitoring and notifying the health of patients using an intelligent agent, to the concerned hospital personnel, has also been proposed. We now present the details of ...

Smart home design for electronic devices monitoring based wireless gateway network using cisco packet tracer

Science.gov (United States)

Sihombing, Oloan; Zendrato, Niskarto; Laia, Yonata; Nababan, Marlince; Sitanggang, Delima; Purba, Windania; Batubara, Diarmansyah; Aisyah, Siti; Indra, Evta; Siregar, Saut

2018-04-01

In the era of technological development today, the technology has become the need for the life of today's society. One is needed to create a smart home in turning on and off electronic devices via smartphone. So far in turning off and turning the home electronic device is done by pressing the switch or remote button, so in control of electronic device control less effective. The home smart design is done by simulation concept by testing system, network configuration, and wireless home gateway computer network equipment required by a smart home network on cisco packet tracer using Internet Thing (IoT) control. In testing the IoT home network wireless network gateway system, multiple electronic devices can be controlled and monitored via smartphone based on predefined configuration conditions. With the Smart Ho me can potentially increase energy efficiency, decrease energy usage costs, control electronics and change the role of residents.

Patients' willingness to pay for electronic communication with their general practitioner.

Science.gov (United States)

Bergmo, Trine Strand; Wangberg, Silje Camilla

2007-06-01

Despite the common use of electronic communication in other aspects of everyday life, its use between patients and health care providers has been slow to diffuse. Possible explanations are security issues and lack of payment mechanisms. This study investigated how patients value secure electronic access to their general practitioner (GP). One hundred and ninety-nine patients were asked an open-ended willingness-to-pay (WTP) question as part of a randomised controlled trial. We compared the WTP values between two groups of respondents; one group had had the opportunity to communicate electronically with their GP for a year and the other group had not. Fifty-two percent of the total sample was willing to pay for electronic GP contact. The group of patients with access revealed a significantly lower WTP than the group without such access. Possible explanations are that the system had fewer benefits than expected, a presence of hypothetical bias or simply a preference for face-to-face encounters.

Monitoring compliance with transfusion guidelines in hospital departments by electronic data capture

Science.gov (United States)

Norgaard, Astrid; de Lichtenberg, Trine Honnens; Nielsen, Jens; Johansson, Pär I.

2014-01-01

Background The practice of transfusing red blood cells is still liberal in some centres suggesting a lack of compliance with guidelines recommending transfusion of red blood cells at haemoglobin levels of 6–8 g/dL in the non-bleeding patient. Few databases provide ongoing feedback of data on pre-transfusion haemoglobin levels at the departmental level. In a tertiary care hospital, no such data were produced before this study. Our aim was to establish a Patient Blood Management database based on electronic data capture in order to monitor compliance with transfusion guidelines at departmental and hospital levels. Materials and methods Hospital data on admissions, diagnoses and surgical procedures were used to define the populations of patients. Data on haemoglobin measurements and red blood cell transfusions were used to calculate pre-transfusion haemoglobin, percentage of transfused patients and transfusion volumes. Results The model dataset include 33,587 admissions, of which 10% had received at least one unit of red blood cells. Haemoglobin measurements preceded 96.7% of the units transfused. The median pre-transfusion haemoglobin was 8.9 g/dL (interquartile range 8.2–9.7) at the hospital level. In only 6.5% of the cases, transfusion was initiated at 7.3 g/dL or lower as recommended by the Danish national transfusion guideline. In 27% of the cases, transfusion was initiated when the haemoglobin level was 9.3 g/dL or higher, which is not recommended. A median of two units was transfused per transfusion episode and per hospital admission. Transfusion practice was more liberal in surgical and intensive care units than in medical departments. Discussion We described pre-transfusion haemoglobin levels, transfusion rates and volumes at hospital and departmental levels, and in surgical subpopulations. Initial data revealed an extensive liberal practice and low compliance with national transfusion guidelines, and identified wards in need of intervention. PMID

Electronic Detection of Delayed Test Result Follow-Up in Patients with Hypothyroidism.

Science.gov (United States)

Meyer, Ashley N D; Murphy, Daniel R; Al-Mutairi, Aymer; Sittig, Dean F; Wei, Li; Russo, Elise; Singh, Hardeep

2017-07-01

Delays in following up abnormal test results are a common problem in outpatient settings. Surveillance systems that use trigger tools to identify delayed follow-up can help reduce missed opportunities in care. To develop and test an electronic health record (EHR)-based trigger algorithm to identify instances of delayed follow-up of abnormal thyroid-stimulating hormone (TSH) results in patients being treated for hypothyroidism. We developed an algorithm using structured EHR data to identify patients with hypothyroidism who had delayed follow-up (>60 days) after an abnormal TSH. We then retrospectively applied the algorithm to a large EHR data warehouse within the Department of Veterans Affairs (VA), on patient records from two large VA networks for the period from January 1, 2011, to December 31, 2011. Identified records were reviewed to confirm the presence of delays in follow-up. During the study period, 645,555 patients were seen in the outpatient setting within the two networks. Of 293,554 patients with at least one TSH test result, the trigger identified 1250 patients on treatment for hypothyroidism with elevated TSH. Of these patients, 271 were flagged as potentially having delayed follow-up of their test result. Chart reviews confirmed delays in 163 of the 271 flagged patients (PPV = 60.1%). An automated trigger algorithm applied to records in a large EHR data warehouse identified patients with hypothyroidism with potential delays in thyroid function test results follow-up. Future prospective application of the TSH trigger algorithm can be used by clinical teams as a surveillance and quality improvement technique to monitor and improve follow-up.

A Framework for the Comparison of Mobile Patient Monitoring Systems

NARCIS (Netherlands)

Pawar, P.; Jones, Valerie M.; van Beijnum, Bernhard J.F.; Hermens, Hermanus J.

A mobile patient monitoring system makes use of mobile computing and wireless communication technologies for continuous or periodic measurement and analysis of biosignals of a mobile patient. In a number of trials these systems have demonstrated their user-friendliness, convenience and effectiveness

Healthcare Blockchain System Using Smart Contracts for Secure Automated Remote Patient Monitoring.

Science.gov (United States)

Griggs, Kristen N; Ossipova, Olya; Kohlios, Christopher P; Baccarini, Alessandro N; Howson, Emily A; Hayajneh, Thaier

2018-06-06

As Internet of Things (IoT) devices and other remote patient monitoring systems increase in popularity, security concerns about the transfer and logging of data transactions arise. In order to handle the protected health information (PHI) generated by these devices, we propose utilizing blockchain-based smart contracts to facilitate secure analysis and management of medical sensors. Using a private blockchain based on the Ethereum protocol, we created a system where the sensors communicate with a smart device that calls smart contracts and writes records of all events on the blockchain. This smart contract system would support real-time patient monitoring and medical interventions by sending notifications to patients and medical professionals, while also maintaining a secure record of who has initiated these activities. This would resolve many security vulnerabilities associated with remote patient monitoring and automate the delivery of notifications to all involved parties in a HIPAA compliant manner.

Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology.

Science.gov (United States)

Singh, Om Prakash; Mekonnen, Dawit; Malarvili, M B

2015-01-01

This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620) followed by signal conditioning circuit with the operation amplifier (lm741). Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has been processed in Labview where the digital filter techniques have been implemented to remove the noise from the acquired signal. After processing, the algorithm was developed to calculate the heart rate and to analyze the arrhythmia condition. Finally, SMTP technology has been added in our work to make device more communicative and much more cost-effective solution in telemedicine technology which has been key-problem to realize the telediagnosis and monitoring of ECG signals. The technology also can be easily implemented over already existing Internet.

The monitoring system using laser light for the patient movement during radiation therapy

International Nuclear Information System (INIS)

Sano, Naoki; Onishi, Hiroshi; Yamaguchi, Motoshi; Kuriyama, Kengo; Akiyama, Saburou; Nakamura, Osamu; Araki, Tsutomu

1997-01-01

Purpose: The purpose of this study is to evaluate the usefulness of a newly developed real-time patient movement monitoring system built into the patient positioning light from the frontal and horizontal view. Materials and Techniques: This system is composed of 4 parts. They are a laser light projector, a retro-reflected tape, a sensor of photo-diode, and an alarm devise. First, this system projects a laser light for the patient movement monitor into the center of the crossed lines of the patient positioning light. The laser light (a diameter of 1.5mm and power of 0.5mW) for the patient movement monitor has a different wave length(633nm) from the patient positioning light. Then it is reflected into the direction of incidence with a retro-reflection tape affixed on three patient positioning points. And the system has a photo-diode which can sense the reflected laser light. This retro-reflected tape is made of tiny high reflective beads of glass which is fixed on a sheet with the thickness of 0.12mm and is able to be cut into any shape. This has a maximum retro-reflection angle of 70 degrees. We can select a tolerance of the patient movement by changing its shape and size. A buzzer strikes and a lamp is turned on to alarm for the error when the retro-reflected laser light is not sensed with the photo-diode. Results: The real-time monitoring accuracy of this system is only 0.17mm in the dimension of error for a selected tolerance of the phantom examination. Conclusion: This patient positioning system can be made simply and inexpensively and has a high monitoring accuracy. We can apply this system for a high-precision irradiation such as the three dimensional irradiation and small target irradiation

How much do diabetic patients know about self monitoring of their ...

African Journals Online (AJOL)

Conclusion: Although majority of the patients knew about self monitoring of their blood glucose, the practice of it was quite poor. SMBG especially using glucometers still needs to be emphasized and compliance advised. Keywords: Self monitoring of blood glucose (SMBG), Diabetes mellitus, Glucometer ...

What are the pros and cons of electronically monitoring inhaler use in asthma? A multistakeholder perspective

Science.gov (United States)

Howard, Sam; Lang, Alexandra; Sharples, Sarah; Shaw, Dominick

2016-01-01

Introduction Electronic monitoring devices (EMDs) are the optimal method for collecting objective data on inhaler use in asthma. Recent research has investigated the attitudes of patients with asthma towards these devices. However, no research to date has formally considered the opinions of stakeholders and decision-makers in asthma care. These individuals have important clinical requirements that need to be taken into account if EMDs are to be successfully provisioned, making collecting their opinions on the key barriers facing these devices a valuable process. Methods Three rounds of surveys in a Delphi format were used to assess the most important pros and cons of EMDs for asthma care in a sample of 31 stakeholders which included healthcare professionals and members of clinical commissioning groups. Results The respondents identified 29 pros and 32 cons. Pros that were rated as most important included new visual evidence to aid clinical discussions with a patient and an increase in patient involvement and motivation. The cons that were rated as most important included a need for more clinical evidence of the effectiveness of EMDs, as well as better clarity over who has responsibilities in managing, interpreting and discussing data with a patient. Conclusions The research provides a guide for EMD developers by highlighting where these devices may provide the most benefit as well as prioritising the key issues that need addressing if they are to be used effectively in everyday asthma care. PMID:27933181

An electronic intervention to improve safety for pain patients co-prescribed chronic opioids and benzodiazepines.

Science.gov (United States)

Zaman, Tauheed; Rife, Tessa L; Batki, Steven L; Pennington, David L

2018-03-29

Co-prescribing opioids and benzodiazepines increases overdose risk. A paucity of literature exists evaluating strategies to improve safety of co-prescribing. This study evaluated an electronic intervention to improve safety for patients co-prescribed chronic opioids for pain and benzodiazepines at 3 and 6 months. A prospective cohort study was conducted from December 2015 through May 2016 at San Francisco Veterans Affairs Health Care System. A clinical dashboard identified 145 eligible patients prescribed chronic opioids and benzodiazepines. Individualized taper and safety recommendations were communicated to prescribers via electronic medical record progress note and encrypted e-mail at baseline. Primary outcome was number of patients co-prescribed chronic opioids and benzodiazepines. Secondary outcomes included daily dose of opioids and benzodiazepines and number prescribed ≥100 mg morphine equivalent daily dose. Safety outcomes included number with opioid overdose education and naloxone distribution, annual urine drug screening, annual prescription drug monitoring program review, and signed opioid informed consent. Linear mixed models and generalized estimating equations were used to examine within-group change in outcomes between baseline and 3 and 6 months. Among the 145 patients, mean (standard deviation) age was 62 (11) years and 91.7% (133/145) were male. Number co-prescribed significantly decreased from 145/145 (100%) at baseline to 93/139 (67%) at 6-month follow-up (odds ratio [OR] = 0.53, 95% confidence interval [CI]: 0.34-0.81, P = .003). Mean opioid and benzodiazepine doses significantly decreased from 84.61 to 65.63 mg (95% CI: 8.32-27.86, P improve safety for patients co-prescribed chronic opioids for pain and benzodiazepines.

Hand disinfection in a neonatal intensive care unit: continuous electronic monitoring over a one-year period

NARCIS (Netherlands)

Helder, O.K.; van Goudoever, J.B.; Hop, W.C.J.; Brug, J.; Kornelisse, R.F.

2012-01-01

Background: Good hand hygiene compliance is essential to prevent nosocomial infections in healthcare settings. Direct observation of hand hygiene compliance is the gold standard but is time consuming. An electronic dispenser with built-in wireless recording equipment allows continuous monitoring of

A Novel Electronic Device for Measuring Urine Flow Rate: A Clinical Investigation

OpenAIRE

Aliza Goldman; Hagar Azran; Tal Stern; Mor Grinstein; Dafna Wilner

2017-01-01

Objective: Currently, most vital signs in the intensive care unit (ICU) are electronically monitored. However, clinical practice for urine output (UO) measurement, an important vital sign, usually requires manual recording of data that is subject to human errors. In this study, we assessed the ability of a novel electronic UO monitoring device to measure real-time hourly UO versus current clinical practice. Design: Patients were connected to the RenalSense Clarity RMS Sensor Kit with a sensor...

Tool Monitoring and Electronic Event Logging for Sheet Metal Forming Processes

Directory of Open Access Journals (Sweden)

Gerd Heiserich

2010-06-01

Full Text Available This contribution describes some innovative solutions regarding sensor systems for tool monitoring in the sheet metal industry. Autonomous and tamper-proof sensors, which are integrated in the forming tools, can detect and count the strokes carried out by a sheet metal forming press. Furthermore, an electronic event logger for documentary purposes and quality control was developed. Based on this technical solution, new business models such as leasing of sheet metal forming tools can be established for cooperation among enterprises. These models allow usage-based billing for the contractors, taking the effectively produced number of parts into account.

Brain state-dependence of electrically evoked potentials monitored with head-mounted electronics.

Science.gov (United States)

Richardson, Andrew G; Fetz, Eberhard E

2012-11-01

Inferring changes in brain connectivity is critical to studies of learning-related plasticity and stimulus-induced conditioning of neural circuits. In addition, monitoring spontaneous fluctuations in connectivity can provide insight into information processing during different brain states. Here, we quantified state-dependent connectivity changes throughout the 24-h sleep-wake cycle in freely behaving monkeys. A novel, head-mounted electronic device was used to electrically stimulate at one site and record evoked potentials at other sites. Electrically evoked potentials (EEPs) revealed the connectivity pattern between several cortical sites and the basal forebrain. We quantified state-dependent changes in the EEPs. Cortico-cortical EEP amplitude increased during slow-wave sleep, compared to wakefulness, while basal-cortical EEP amplitude decreased. The results demonstrate the utility of using portable electronics to document state-dependent connectivity changes in freely behaving primates.

Response monitoring in de novo patients with Parkinson's disease.

Directory of Open Access Journals (Sweden)

Rita Willemssen

Full Text Available BACKGROUND: Parkinson's disease (PD is accompanied by dysfunctions in a variety of cognitive processes. One of these is error processing, which depends upon phasic decreases of medial prefrontal dopaminergic activity. Until now, there is no study evaluating these processes in newly diagnosed, untreated patients with PD ("de novo PD". METHODOLOGY/PRINCIPAL FINDINGS: Here we report large changes in performance monitoring processes using event-related potentials (ERPs in de novo PD-patients. The results suggest that increases in medial frontal dopaminergic activity after an error (Ne are decreased, relative to age-matched controls. In contrast, neurophysiological processes reflecting general motor response monitoring (Nc are enhanced in de novo patients. CONCLUSIONS/SIGNIFICANCE: It may be hypothesized that the Nc-increase is at costs of dopaminergic activity after an error; on a functional level errors may not always be detected and correct responses sometimes be misinterpreted as errors. This pattern differs from studies examining patients with a longer history of PD and may reflect compensatory processes, frequently occurring in pre-manifest stages of PD. From a clinical point of view the clearly attenuated Ne in the de novo PD patients may prove a useful additional tool for the early diagnosis of basal ganglia dysfunction in PD.

Is patient confidentiality compromised with the electronic health record?: a position paper.

Science.gov (United States)

Wallace, Ilse M

2015-02-01

In order for electronic health records to fulfill their expected benefits, protection of privacy of patient information is key. Lack of trust in confidentiality can lead to reluctance in disclosing all relevant information, which could have grave consequences. This position paper contemplates whether patient confidentiality is compromised by electronic health records. The position that confidentiality is compromised was supported by the four bioethical principles and argued that despite laws and various safeguards to protect patients' confidentiality, numerous data breaches have occurred. The position that confidentiality is not compromised was supported by virtue ethics and a utilitarian viewpoint and argued that safeguards keep information confidential and the public feels relatively safe with the electronic health record. The article concludes with an ethically superior position that confidentiality is compromised with the electronic health record. Although organizational and governmental ways of enhancing the confidentiality of patient information within the electronic health record facilitate confidentiality, the ultimate responsibility of maintaining confidentiality rests with the individual end-users and their ethical code of conduct. The American Nurses Association Code of Ethics for nurses calls for nurses to be watchful with data security in electronic communications.

From B. F. Skinner to Spiderman to Martha Stewart: The Past, Present and Future of Electronic Monitoring of Offenders

Science.gov (United States)

Burrell, William D.; Gable, Robert S.

2008-01-01

Electronic monitoring was originally designed as a system to facilitate the rehabilitation of young adult offenders. The concept was not well-received, and the first judicially sanctioned program was not initiated until 20 years later. Adoption of the technology then spread rapidly. The primary use of monitoring has evolved from being an adjunct…

Measurements made in the SPS with a rest gas profile monitor by collecting electrons

International Nuclear Information System (INIS)

Fischer, C.; Koopman, J.

2000-01-01

Measurements have regularly been performed during the 1999 run, using the Rest Gas Monitor installed in the SPS. The exploited signal resulted from electrons produced by ionization of the rest gas during the circulating beam passage. A magnetic field parallel to the electric extraction field was applied to channel the electrons. Proton beam horizontal transverse distributions were recorded during entire SPS acceleration cycles, between 14 GeV/c and 450 GeV/c and for different beam structures and bunch intensities. The influence of several parameters on the measured beam profiles was investigated. Results are presented and analyzed in order to determine the performance that can be expected

Trends in monitoring patients with aneurysmal subarachnoid haemorrhage

DEFF Research Database (Denmark)

Springborg, J B; Frederiksen, H-J; Eskesen, V

2005-01-01

After aneurysmal subarachnoid haemorrhage (SAH), the clinical outcome depends upon the primary haemorrhage and a number of secondary insults in the acute post-haemorrhagic period. Some secondary insults are potentially preventable but prevention requires prompt recognition of cerebral or systemic...... implemented monitoring system provides answers but it also raises valuable new questions challenging our current understanding of the brain injury after SAH....... complications. Currently, several neuro-monitoring techniques are available; this review describes the most frequently used techniques and discusses indications for their use, and their value in diagnosis and prognosis. None of the techniques, when considered in isolation, has proved sufficient after SAH...... with the conventional monitoring systems, for example intracranial pressure measurements, transcranial Doppler ultrasound and modern neuro-imaging, direct assessment of biochemical markers by intracerebral microdialysis is promising in the advancement of neurointensive care of patients with SAH. A successfully...

Patient-centered technological assessment and monitoring of depression for low-income patients.

Science.gov (United States)

Wu, Shinyi; Vidyanti, Irene; Liu, Pai; Hawkins, Caitlin; Ramirez, Magaly; Guterman, Jeffrey; Gross-Schulman, Sandra; Sklaroff, Laura Myerchin; Ell, Kathleen

2014-01-01

Depression is a significant challenge for ambulatory care because it worsens health status and outcomes, increases health care utilizations and costs, and elevates suicide risk. An automatic telephonic assessment (ATA) system that links with tasks and alerts to providers may improve quality of depression care and increase provider productivity. We used ATA system in a trial to assess and monitor depressive symptoms of 444 safety-net primary care patients with diabetes. We assessed system properties, evaluated preliminary clinical outcomes, and estimated cost savings. The ATA system is feasible, reliable, valid, safe, and likely cost-effective for depression screening and monitoring for low-income primary care population.

Program controlled system for measuring and monitoring the electron coherent radiation spectrum of Yerevan synchrotron

International Nuclear Information System (INIS)

Adamyan, F.V.; Vartapetyan, G.A.; Galumyan, P.I.

1980-01-01

An automatic system for measurement, processing and control of energy spectrum of polarized photons realized at the Yerevan electron synchrotron is described. For measuring energy spectra of intensive high energy photon beams a pair spectrometer is used which comprises an aluminium target-converter, an analizing magnet and 2 telescopes of scintillation counters for electron-positron pairs registration. the procedure of spectra measurement by the pair spectrometer is reduced to determining the converted e + e - pairs yield at certain values of the H field intensity of the analizing magnet. An algorithm of the data express-processing for operative monitoring of peak energy stability of electron coherent radiation spectrum is given. The spectra measurement results obtained under real experimental conditions are presented

Flexible polymer transistors with high pressure sensitivity for application in electronic skin and health monitoring.

Science.gov (United States)

Schwartz, Gregor; Tee, Benjamin C-K; Mei, Jianguo; Appleton, Anthony L; Kim, Do Hwan; Wang, Huiliang; Bao, Zhenan

2013-01-01

Flexible pressure sensors are essential parts of an electronic skin to allow future biomedical prostheses and robots to naturally interact with humans and the environment. Mobile biomonitoring in long-term medical diagnostics is another attractive application for these sensors. Here we report the fabrication of flexible pressure-sensitive organic thin film transistors with a maximum sensitivity of 8.4 kPa(-1), a fast response time of 15,000 cycles and a low power consumption of monitoring, which may lead to the use of flexible pressure sensors in mobile health monitoring and remote diagnostics in cardiovascular medicine.

Adaptive online monitoring for ICU patients by combining just-in-time learning and principal component analysis.

Science.gov (United States)

Li, Xuejian; Wang, Youqing

2016-12-01

Offline general-type models are widely used for patients' monitoring in intensive care units (ICUs), which are developed by using past collected datasets consisting of thousands of patients. However, these models may fail to adapt to the changing states of ICU patients. Thus, to be more robust and effective, the monitoring models should be adaptable to individual patients. A novel combination of just-in-time learning (JITL) and principal component analysis (PCA), referred to learning-type PCA (L-PCA), was proposed for adaptive online monitoring of patients in ICUs. JITL was used to gather the most relevant data samples for adaptive modeling of complex physiological processes. PCA was used to build an online individual-type model and calculate monitoring statistics, and then to judge whether the patient's status is normal or not. The adaptability of L-PCA lies in the usage of individual data and the continuous updating of the training dataset. Twelve subjects were selected from the Physiobank's Multi-parameter Intelligent Monitoring for Intensive Care II (MIMIC II) database, and five vital signs of each subject were chosen. The proposed method was compared with the traditional PCA and fast moving-window PCA (Fast MWPCA). The experimental results demonstrated that the fault detection rates respectively increased by 20 % and 47 % compared with PCA and Fast MWPCA. L-PCA is first introduced into ICU patients monitoring and achieves the best monitoring performance in terms of adaptability to changes in patient status and sensitivity for abnormality detection.

Display methods of electronic patient record screens: patient privacy concerns.

Science.gov (United States)

Niimi, Yukari; Ota, Katsumasa

2013-01-01

To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.

Control and monitoring systems for electron beam flue gas treatment technology

International Nuclear Information System (INIS)

Chmielewski, A.G.; Licki, J.; Mazurekc, J.; Nelskic, L.; Sobolewskic, L.

2011-01-01

The reliable and accurate measurements of gas parameters in essential points of industrial plant are necessary for its proper operation and control. Natural flue gases there are only at the inlet. At other points of plant gas parameters are strongly modified by process control system. The principal role of process monitoring system is to provide the Computer System for Monitoring and Control with continuous recording of process parameters. The main goal of control system is to obtain the optimal SO 2 and NO x removal efficiencies by control of amount of spray water at the spray cooler, amount of NH 3 injection to flue gas and adjustment of electron beam current. The structure of the process control system is based on algorithms describing functional dependence of SO 2 and NO x removal efficiencies. The best available techniques should be applied for measurements of flue gases parameters at essential points of installation and for digital control system to assist plant operators in the analysis and optimization of plant operation, including integrated emission control. (author)

Control and monitoring systems for electron beam flue gas treatment technology

Energy Technology Data Exchange (ETDEWEB)

Chmielewski, A. G. [Institute of Nuclear Chemistry and Technology, Warsaw (Poland); Licki, J. [Institute of Atomic Energy, Otwock-Świerk (Poland); Mazurekc, J.; Nelskic, L.; Sobolewskic, L. [Dolna Odra Group, Pomorzany Power Plant, Szczecin (Poland)

2011-07-01

The reliable and accurate measurements of gas parameters in essential points of industrial plant are necessary for its proper operation and control. Natural flue gases there are only at the inlet. At other points of plant gas parameters are strongly modified by process control system. The principal role of process monitoring system is to provide the Computer System for Monitoring and Control with continuous recording of process parameters. The main goal of control system is to obtain the optimal SO{sub 2} and NO{sub x} removal efficiencies by control of amount of spray water at the spray cooler, amount of NH{sub 3} injection to flue gas and adjustment of electron beam current. The structure of the process control system is based on algorithms describing functional dependence of SO{sub 2} and NO{sub x} removal efficiencies. The best available techniques should be applied for measurements of flue gases parameters at essential points of installation and for digital control system to assist plant operators in the analysis and optimization of plant operation, including integrated emission control. (author)

Wire Position Monitoring with FPGA based Electronics

International Nuclear Information System (INIS)

Eddy, N.; Lysenko, O.

2009-01-01

This fall the first Tesla-style cryomodule cooldown test is being performed at Fermilab. Instrumentation department is preparing the electronics to handle the data from a set of wire position monitors (WPMs). For simulation purposes a prototype pipe with a WMP has been developed and built. The system is based on the measurement of signals induced in pickups by 320 MHz signal carried by a wire through the WPM. The wire is stretched along the pipe with a tensioning load of 9.07 kg. The WPM consists of four 50 (Omega) striplines spaced 90 o apart. FPGA based digitizer scans the WPM and transmits the data to a PC via VME interface. The data acquisition is based on the PC running LabView. In order to increase the accuracy and convenience of the measurements some modifications were required. The first is implementation of an average and decimation filter algorithm in the integrator operation in the FPGA. The second is the development of alternative tool for WPM measurements in the PC. The paper describes how these modifications were performed and test results of a new design. The last cryomodule generation has a single chain of seven WPMs (placed in critical positions: at each end, at the three posts and between the posts) to monitor a cold mass displacement during cooldown. The system was developed in Italy in collaboration with DESY. Similar developments have taken place at Fermilab in the frame of cryomodules construction for SCRF research. This fall preliminary cryomodule cooldown test is being performed. In order to prepare an appropriate electronic system for the test a prototype pipe with a WMP has been developed and built, figure 1. The system is based on the measurement of signals induced in pickups by 320 MHz signal carried by a wire through the WPM. The 0.5 mm diameter Cu wire is stretched along the pipe with a tensioning load of 9.07 kg and has a length of 1.1 m. The WPM consists of four 50 (Omega) striplines spaced 90 o apart. An FPGA based digitizer

Using Electronic Patient Records to Discover Disease Correlations and Stratify Patient Cohorts

DEFF Research Database (Denmark)

Roque, Francisco S.; Jensen, Peter B.; Schmock, Henriette

2011-01-01

Electronic patient records remain a rather unexplored, but potentially rich data source for discovering correlations between diseases. We describe a general approach for gathering phenotypic descriptions of patients from medical records in a systematic and non-cohort dependent manner. By extracting...... phenotype information from the free-text in such records we demonstrate that we can extend the information contained in the structured record data, and use it for producing fine-grained patient stratification and disease co-occurrence statistics. The approach uses a dictionary based on the International...

Analysis of abused drugs by selected ion monitoring: quantitative comparison of electron impact and chemical ionization

International Nuclear Information System (INIS)

Foltz, R.L.; Knowlton, D.A.; Lin, D.C.K.; Fentiman, A.F. Jr.

1975-01-01

A comparison was made of the relative sensitivities of electron impact and chemical ionization when used for selected ion monitoring analysis of commonly abused drugs. For most of the drugs examined chemical ionization using ammonia as the reactant gas gave the largest single m/e ion current response per unit weight of sample. However, if maximum sensitivity is desired it is important to evaluate electron impact and chemical ionization with respect to both maximum response and degree of interference from background and endogenous materials

Implementation and evaluation of a pharmacist-led electronic visit program for diabetes and anticoagulation care in a patient-centered medical home.

Science.gov (United States)

Hawes, Emily M; Lambert, Erika; Reid, Alfred; Tong, Gretchen; Gwynne, Mark

2018-04-13

Results of a study evaluating quality-of-care, financial, and patient satisfaction outcomes of pharmacist-conducted telehealth visits for diabetes management and warfarin monitoring are reported. A retrospective pre-post study was conducted to determine the impact of an electronic visit (e-visit) program targeting 2 groups of outpatients: adults with uncontrolled diabetes and warfarin-treated adults performing patient self-testing (PST) for monitoring of International Normalized Ratio (INR) values. A total of 36 patients participated in the e-visit program during the 2-year study period. Among warfarin-treated patients, the percentage of INR values in the desired range increased relative to preenrollment values (from 62.5% to 72.7%, p = 0.07), and the frequency of extreme INR values (values of 5.0) decreased (from 4.8% to 0.01%, p = 0.01); the margin per patient was $300 during the first year and $191 annually thereafter. In the diabetes group, a decrease from baseline in glycosylated hemoglobin values of 3.4 percentage points was observed at 5.7 months after enrollment ( p management of diabetes through e-visits, often in combination with in-person visits, generated revenue while significantly improving clinical outcomes. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Ultra-stable implanted 83Rb/83mKr electron sources for the energy scale monitoring in the KATRIN experiment

CERN Document Server

Zboril, M.; Beck, M.; Bonn, J.; Dragoun, O.; Jakubek, J.; Johnston, K.; Kovalik, A.; Otten, E.W.; Schlösser, K.; Slezak, M.; Spalek, A.; Thümmler, T.; Venos, D.; Zemlicka, J.; Weinheimer, C.

2013-01-01

The KATRIN experiment aims at the direct model-independent determination of the average electron neutrino mass via the measurement of the endpoint region of the tritium beta decay spectrum. The electron spectrometer of the MAC-E filter type is used, requiring very high stability of the electric filtering potential. This work proves the feasibility of implanted 83Rb/83mKr calibration electron sources which will be utilised in the additional monitor spectrometer sharing the high voltage with the main spectrometer of KATRIN. The source employs conversion electrons of 83mKr which is continuously generated by 83Rb. The K-32 conversion line (kinetic energy of 17.8 keV, natural line width of 2.7 eV) is shown to fulfill the KATRIN requirement of the relative energy stability of +/-1.6 ppm/month. The sources will serve as a standard tool for continuous monitoring of KATRIN's energy scale stability with sub-ppm precision. They may also be used in other applications where the precise conversion lines can be separated fr...

System for Collecting Biosignal Data from Multiple Patient Monitoring Systems.

Science.gov (United States)

Yoon, Dukyong; Lee, Sukhoon; Kim, Tae Young; Ko, JeongGil; Chung, Wou Young; Park, Rae Woong

2017-10-01

Biosignal data include important physiological information. For that reason, many devices and systems have been developed, but there has not been enough consideration of how to collect and integrate raw data from multiple systems. To overcome this limitation, we have developed a system for collecting and integrating biosignal data from two patient monitoring systems. We developed an interface to extract biosignal data from Nihon Kohden and Philips monitoring systems. The Nihon Kohden system has a central server for the temporary storage of raw waveform data, which can be requested using the HL7 protocol. However, the Philips system used in our hospital cannot save raw waveform data. Therefore, our system was connected to monitoring devices using the RS232 protocol. After collection, the data were transformed and stored in a unified format. From September 2016 to August 2017, we collected approximately 117 patient-years of waveform data from 1,268 patients in 79 beds of five intensive care units. Because the two systems use the same data storage format, the application software could be run without compatibility issues. Our system collects biosignal data from different systems in a unified format. The data collected by the system can be used to develop algorithms or applications without the need to consider the source of the data.

Development of an electronic manometer for intrapleural pressure monitoring.

Science.gov (United States)

Krenke, Rafał; Guć, Maciej; Grabczak, Elżbieta Magdalena; Michnikowski, Marcin; Pałko, Krzysztof Jakub; Chazan, Ryszarda; Gólczewski, Tomasz

2011-01-01

Measurement of intrapleural pressure is useful during various pleural procedures. However, a pleural manometer is rarely available. The aim of this study was to (1) construct an electronic pleural manometer, (2) assess the accuracy of the measurements done with the new device, (3) calculate the costs of the manometer construction and (4) perform an initial evaluation of the device in a clinical setting. Only widely accessible elements were used to construct the device. A vascular pressure transducer was used to transform pressure into an electronic signal. Reliability of the measurements was evaluated in a laboratory setting in a prospective, single-blind manner by comparing the results with those measured by a water manometer. Functionality of the device was assessed during therapeutic thoracentesis. The cost of the new pleural manometer was calculated. We built a small, portable device which can precisely measure intrapleural pressure. The measurement results showed very high agreement with those registered with a water manometer (r = 0.999; p electronic manometer during therapeutic thoracentesis showed it was easy to use. The total time needed for 6 measurements after withdrawal of different volumes of pleural fluid in 1 patient did not exceed 6 min. The total cost of the device was calculated to be electronic pleural manometer at modest costs. The device is easy to use and enables data display and storage in the personal computer. Copyright © 2011 S. Karger AG, Basel.

Public Perceptions of GPS Monitoring for Convicted Sex Offenders: Opinions on Effectiveness of Electronic Monitoring to Reduce Sexual Recidivism.

Science.gov (United States)

Budd, Kristen M; Mancini, Christina

2017-09-01

In the United States, electronic monitoring (EM) and global positioning systems (GPS) are new applications that are used to extensively monitor and track convicted sex offenders. What is unclear though are public perceptions of this strategy. This research examines public perceptions of a national sample of Americans on the use of GPS/EM with convicted sex offenders as a method to reduce their sexual recidivism. Using a multinomial regression model, we analyze the effects of sex offender myths and parental status on public perceptions that sex offender GPS/EM is very effective in reducing sexual recidivism. Findings suggest that public perceptions of effectiveness are partially driven by myths and also that parents are unsure of this strategy. The analysis contributes to the growing body of knowledge on public perceptions of GPS/EM to manage sex offenders in communities. Implications of the study and areas for future research are discussed in light of the findings.

Rugged and breathable forms of stretchable electronics with adherent composite substrates for transcutaneous monitoring

Science.gov (United States)

Jang, Kyung-In; Han, Sang Youn; Xu, Sheng; Mathewson, Kyle E.; Zhang, Yihui; Jeong, Jae-Woong; Kim, Gwang-Tae; Webb, R. Chad; Lee, Jung Woo; Dawidczyk, Thomas J.; Kim, Rak Hwan; Song, Young Min; Yeo, Woon-Hong; Kim, Stanley; Cheng, Huanyu; Rhee, Sang Il; Chung, Jeahoon; Kim, Byunggik; Chung, Ha Uk; Lee, Dongjun; Yang, Yiyuan; Cho, Moongee; Gaspar, John G.; Carbonari, Ronald; Fabiani, Monica; Gratton, Gabriele; Huang, Yonggang; Rogers, John A.

2014-09-01

Research in stretchable electronics involves fundamental scientific topics relevant to applications with importance in human healthcare. Despite significant progress in active components, routes to mechanically robust construction are lacking. Here, we introduce materials and composite designs for thin, breathable, soft electronics that can adhere strongly to the skin, with the ability to be applied and removed hundreds of times without damaging the devices or the skin, even in regions with substantial topography and coverage of hair. The approach combines thin, ultralow modulus, cellular silicone materials with elastic, strain-limiting fabrics, to yield a compliant but rugged platform for stretchable electronics. Theoretical and experimental studies highlight the mechanics of adhesion and elastic deformation. Demonstrations include cutaneous optical, electrical and radio frequency sensors for measuring hydration state, electrophysiological activity, pulse and cerebral oximetry. Multipoint monitoring of a subject in an advanced driving simulator provides a practical example.

Rugged and breathable forms of stretchable electronics with adherent composite substrates for transcutaneous monitoring.

Science.gov (United States)

Jang, Kyung-In; Han, Sang Youn; Xu, Sheng; Mathewson, Kyle E; Zhang, Yihui; Jeong, Jae-Woong; Kim, Gwang-Tae; Webb, R Chad; Lee, Jung Woo; Dawidczyk, Thomas J; Kim, Rak Hwan; Song, Young Min; Yeo, Woon-Hong; Kim, Stanley; Cheng, Huanyu; Rhee, Sang Il; Chung, Jeahoon; Kim, Byunggik; Chung, Ha Uk; Lee, Dongjun; Yang, Yiyuan; Cho, Moongee; Gaspar, John G; Carbonari, Ronald; Fabiani, Monica; Gratton, Gabriele; Huang, Yonggang; Rogers, John A

2014-09-03

Research in stretchable electronics involves fundamental scientific topics relevant to applications with importance in human healthcare. Despite significant progress in active components, routes to mechanically robust construction are lacking. Here, we introduce materials and composite designs for thin, breathable, soft electronics that can adhere strongly to the skin, with the ability to be applied and removed hundreds of times without damaging the devices or the skin, even in regions with substantial topography and coverage of hair. The approach combines thin, ultralow modulus, cellular silicone materials with elastic, strain-limiting fabrics, to yield a compliant but rugged platform for stretchable electronics. Theoretical and experimental studies highlight the mechanics of adhesion and elastic deformation. Demonstrations include cutaneous optical, electrical and radio frequency sensors for measuring hydration state, electrophysiological activity, pulse and cerebral oximetry. Multipoint monitoring of a subject in an advanced driving simulator provides a practical example.

Electronic Nose Testing Procedure for the Definition of Minimum Performance Requirements for Environmental Odor Monitoring

Directory of Open Access Journals (Sweden)

Lidia Eusebio

2016-09-01

Full Text Available Despite initial enthusiasm towards electronic noses and their possible application in different fields, and quite a lot of promising results, several criticalities emerge from most published research studies, and, as a matter of fact, the diffusion of electronic noses in real-life applications is still very limited. In general, a first step towards large-scale-diffusion of an analysis method, is standardization. The aim of this paper is describing the experimental procedure adopted in order to evaluate electronic nose performances, with the final purpose of establishing minimum performance requirements, which is considered to be a first crucial step towards standardization of the specific case of electronic nose application for environmental odor monitoring at receptors. Based on the experimental results of the performance testing of a commercialized electronic nose type with respect to three criteria (i.e., response invariability to variable atmospheric conditions, instrumental detection limit, and odor classification accuracy, it was possible to hypothesize a logic that could be adopted for the definition of minimum performance requirements, according to the idea that these are technologically achievable.

Feasibility study of patient motion monitoring by using tactile array sensors

Science.gov (United States)

Kim, Tae-Ho; Kang, Seong-Hee; Kim, Dong-Su; Cho, Min-Seok; Kim, Kyeong-Hyeon; Suh, Tae-Suk; Kim, Siyong

2015-07-01

An ideal alignment method based on the external anatomical surface of the patient should consider the entire region of interest. However, optical-camera-based systems cannot blindly monitor such areas as the patient's back, for example. Furthermore, collecting enough information to correct the associated deformation error is impossible. The study aim is to propose a new patient alignment method using tactile array sensors that can measure the distributed pressure profiles along the contact surface. The TactArray system includes one sensor, a signal-conditioning device (USB drive/interface electronics, power supply, and cables), and a PC. The tactile array sensor was placed between the patient's back and the treatment couch, and the deformations at different location on the patient's back were evaluated. Three healthy male volunteers were enrolled in this study, and pressure profile distributions (PPDs) were obtained with and without immobilization. After the initial pretreatment setup using the laser alignment system, the PPD of the patient's back was acquired. The results were obtained at four different times and included a reference PPD dataset. The contact area and the center-of-pressure value were also acquired based on the PPD data for a more elaborate quantitative data analysis. To evaluate the clinical feasibility of using the proposed alignment method for reducing the deformation error, we implemented a real-time self-correction procedure. Despite the initial alignment, we confirmed that PPD variations existed in both cases of the volunteer studies (with and without the use of the immobilization tool). Additionally, we confirmed that the contact area and the center of pressure varied in both cases, and those variations were observed in all three volunteers. With the proposed alignment method and the real-time selfcorrection procedure, the deformation error was significantly reduced. The proposed alignment method can be used to account for the limitation of

Construction process and read-out electronics of amorphous silicon position detectors for multipoint alignment monitoring

Energy Technology Data Exchange (ETDEWEB)

Koehler, C.; Schubert, M.B.; Lutz, B.; Werner, J.H. [Steinbeis-Transferzentrum fuer Angewandte Photovoltaik und Duennschichttechnik, Stuttgart (Germany); Alberdi, J.; Arce, P.; Barcala, J.M.; Calvo, E. [CIEMAT, Madrid (Spain); Ferrando, A. [CIEMAT, Madrid (Spain)], E-mail: antonio.ferrando@ciemat.es; Josa, M.I.; Molinero, A.; Navarrete, J.; Oller, J.C.; Yuste, C. [CIEMAT, Madrid (Spain); Calderon, A.; Fernandez, M.G.; Gomez, G.; Gonzalez-Sanchez, F.J.; Martinez-Rivero, C.; Matorras, F. [Instituto de Fisica de Cantabria IFCA/CSIC-University of Cantabria, Santander (Spain)] (and others)

2009-09-01

We describe the construction process of large-area high-performance transparent amorphous silicon position detecting sensors. Details about the characteristics of the associated local electronic board (LEB), specially designed for these sensors, are given. In addition we report on the performance of a multipoint alignment monitoring application of 12 sensors in a 13 m long light path.

Self-monitoring to increase physical activity in patients with cardiovascular disease: a systematic review and meta-analysis.

Science.gov (United States)

Kanejima, Yuji; Kitamura, Masahiro; Izawa, Kazuhiro P

2018-04-30

It is important to encourage physical activity in patients with cardiovascular disease (CVD), and self-monitoring is considered to contribute to increased physical activity. However, the effects of self-monitoring on CVD patients remain to be established. In this study, we examined the influence of self-monitoring on physical activity of patients with CVD via a systematic review and meta-analysis. Screening of randomized controlled trials only was undertaken twice on PubMed (date of appraisal: August 29, 2017). The inclusion criteria included outpatients with CVD, interventions for them, daily step counts as physical activity included in the outcome, and self-monitoring included in the intervention. Assessments of the risk of bias and meta-analysis in relation to the mean change of daily step counts were conducted to verify the effects of self-monitoring. From 205 studies retrieved on PubMed, six studies were included, with the oldest study published in 2005. Participants included 693 patients of whom 541 patients completed each study program. Their mean age was 60.8 years, and the ratio of men was 79.6%. From these 6 studies, a meta-analysis was conducted with 269 patients of 4 studies including only RCTs with step counts in the intervention group and the control group, and self-monitoring significantly increased physical activity (95% confidence interval, 1916-3090 steps per day, p monitoring combined with other behavior change techniques. The results suggest that self-monitoring of physical activity by patients with CVD has a significantly positive effect on their improvement. Moreover, the trend toward self-monitoring combined with setting counseling and activity goals, and increased intervention via the internet, may lead to the future development and spread of self-monitoring for CVD patients.

iAssist: a software framework for intelligent patient monitoring.

Science.gov (United States)

Brouse, Christopher; Dumont, Guy; Yang, Ping; Lim, Joanne; Ansermino, J Mark

2007-01-01

A software framework (iAssist) has been developed for intelligent patient monitoring, and forms the foundation of a clinical monitoring expert system. The framework is extensible, flexible, and interoperable. It supports plugins to perform data acquisition, signal processing, graphical display, data storage, and output to external devices. iAssist currently incorporates two plugins to detect change point events in physiological trends. In 38 surgical cases, iAssist detected 868 events, of which clinicians rated more than 50% as clinically significant and less than 7% as artifacts. Clinicians found iAssist intuitive and easy to use.

Attitudes of heart failure patients and health care providers towards mobile phone-based remote monitoring.

Science.gov (United States)

Seto, Emily; Leonard, Kevin J; Masino, Caterina; Cafazzo, Joseph A; Barnsley, Jan; Ross, Heather J

2010-11-29

Mobile phone-based remote patient monitoring systems have been proposed for heart failure management because they are relatively inexpensive and enable patients to be monitored anywhere. However, little is known about whether patients and their health care providers are willing and able to use this technology. The objective of our study was to assess the attitudes of heart failure patients and their health care providers from a heart function clinic in a large urban teaching hospital toward the use of mobile phone-based remote monitoring. A questionnaire regarding attitudes toward home monitoring and technology was administered to 100 heart failure patients (94/100 returned a completed questionnaire). Semi-structured interviews were also conducted with 20 heart failure patients and 16 clinicians to determine the perceived benefits and barriers to using mobile phone-based remote monitoring, as well as their willingness and ability to use the technology. The survey results indicated that the patients were very comfortable using mobile phones (mean rating 4.5, SD 0.6, on a five-point Likert scale), even more so than with using computers (mean 4.1, SD 1.1). The difference in comfort level between mobile phones and computers was statistically significant (Pmobile phones to view health information (mean 4.4, SD 0.9). Patients and clinicians were willing to use the system as long as several conditions were met, including providing a system that was easy to use with clear tangible benefits, maintaining good patient-provider communication, and not increasing clinical workload. Clinicians cited several barriers to implementation of such a system, including lack of remuneration for telephone interactions with patients and medicolegal implications. Patients and clinicians want to use mobile phone-based remote monitoring and believe that they would be able to use the technology. However, they have several reservations, such as potential increased clinical workload, medicolegal

Emerging role of digital technology and remote monitoring in the care of cardiac patients.

Science.gov (United States)

Banchs, Javier E; Scher, David Lee

2015-07-01

Current available mobile health technologies make possible earlier diagnosis and long-term monitoring of patients with cardiovascular diseases. Remote monitoring of patients with implantable devices and chronic diseases has resulted in better outcomes reducing health care costs and hospital admissions. New care models, which shift point of care to the outpatient setting and the patient's home, necessitate innovations in technology. Copyright © 2015 Elsevier Inc. All rights reserved.

Wearable and flexible electronics for continuous molecular monitoring.

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Yang, Yiran; Gao, Wei

2018-04-03

Wearable biosensors have received tremendous attention over the past decade owing to their great potential in predictive analytics and treatment toward personalized medicine. Flexible electronics could serve as an ideal platform for personalized wearable devices because of their unique properties such as light weight, low cost, high flexibility and great conformability. Unlike most reported flexible sensors that mainly track physical activities and vital signs, the new generation of wearable and flexible chemical sensors enables real-time, continuous and fast detection of accessible biomarkers from the human body, and allows for the collection of large-scale information about the individual's dynamic health status at the molecular level. In this article, we review and highlight recent advances in wearable and flexible sensors toward continuous and non-invasive molecular analysis in sweat, tears, saliva, interstitial fluid, blood, wound exudate as well as exhaled breath. The flexible platforms, sensing mechanisms, and device and system configurations employed for continuous monitoring are summarized. We also discuss the key challenges and opportunities of the wearable and flexible chemical sensors that lie ahead.

Characteristics of electronic patient-provider messaging system utilisation in an urban health care organisation

Directory of Open Access Journals (Sweden)

Sean Patrick Mikles

2014-12-01

Full Text Available Introduction Research suggests that electronic messaging can improve patient engagement. Studies indicate that a ‘digital divide’ may exist, where certain patient populations may be using electronic messaging less frequently. This study aims to determine which patient characteristics are associated with different levels of usage of an electronic patient-provider messaging system in a diverse urban population.Methods Cross-sectional electronic health record data were extracted for patients 10 years of age or older who live in New York City and who visited a set of clinics between 1 July 2011 and 30 June 2012. Regression analyses determined which participant characteristics were associated with the sending of electronic messages.Results Older, female, English-speaking participants of white race who received more messages, had any diagnoses, more office visits and a provider who sent messages were more likely to send more messages. Non-Millennial, non-white participants who received fewer messages, had more office visits, any diagnoses, a provider who saw fewer patients with patient portal accounts, lived in a low socioeconomic status neighbourhood, and did not have private insurance were more likely to send zero messages.Conclusion This study found significant differences in electronic messaging usage based on demographic, socioeconomic and health-related patient characteristics. Future studies are needed to support these results and determine the causes of observed associations.

Neonatal Nurses Experience Unintended Consequences and Risks to Patient Safety With Electronic Health Records.

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Dudding, Katherine M; Gephart, Sheila M; Carrington, Jane M

2018-04-01

In this article, we examine the unintended consequences of nurses' use of electronic health records. We define these as unforeseen events, change in workflow, or an unanticipated result of implementation and use of electronic health records. Unintended consequences experienced by nurses while using electronic health records have been well researched. However, few studies have focused on neonatal nurses, and it is unclear to what extent unintended consequences threaten patient safety. A new instrument called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire has been validated, and secondary analysis using the tool explored the phenomena among neonatal nurses (N = 40). The purposes of this study were to describe unintended consequences of use of electronic health records for neonatal nurses and to explore relationships between the phenomena and characteristics of the nurse and the electronic health record. The most frequent unintended consequences of electronic health record use were due to interruptions, followed by a heavier workload due to the electronic health record, changes to the workflow, and altered communication patterns. Neonatal nurses used workarounds most often with motivation to better assist patients. Teamwork was moderately related to higher unintended consequences including patient safety risks (r = 0.427, P = .007), system design (r = 0.419, P = .009), and technology barriers (r = 0.431, P = .007). Communication about patients was reduced when patient safety risks were high (r = -0.437, P = .003). By determining the frequency with which neonatal nurses experience unintended consequences of electronic health record use, future research can be targeted to improve electronic health record design through customization, integration, and refinement to support patient safety and better outcomes.

Organic electronics based pressure sensor towards intracranial pressure monitoring

Science.gov (United States)

Rai, Pratyush; Varadan, Vijay K.

2010-04-01

The intra-cranial space, which houses the brain, contains cerebrospinal fluid (CSF) that acts as a fluid suspension medium for the brain. The CSF is always in circulation, is secreted in the cranium and is drained out through ducts called epidural veins. The venous drainage system has inherent resistance to the flow. Pressure is developed inside the cranium, which is similar to a rigid compartment. Normally a pressure of 5-15 mm Hg, in excess of atmospheric pressure, is observed at different locations inside the cranium. Increase in Intra-Cranial Pressure (ICP) can be caused by change in CSF volume caused by cerebral tumors, meningitis, by edema of a head injury or diseases related to cerebral atrophy. Hence, efficient ways of monitoring ICP need to be developed. A sensor system and monitoring scheme has been discussed here. The system architecture consists of a membrane less piezoelectric pressure sensitive element, organic thin film transistor (OTFT) based signal transduction, and signal telemetry. The components were fabricated on flexible substrate and have been assembled using flip-chip packaging technology. Material science and fabrication processes, subjective to the device performance, have been discussed. Capability of the device in detecting pressure variation, within the ICP pressure range, is investigated and applicability of measurement scheme to medical conditions has been argued for. Also, applications of such a sensor-OTFT assembly for logic sensor switching and patient specific-secure monitoring system have been discussed.

Monitoring Thermal Conditions in Footwear

Science.gov (United States)

Silva-Moreno, Alejandra. A.; Lopez Vela, Martín; Alcalá Ochoa, Noe

2006-09-01

Thermal conditions inside the foot were evaluated on a volunteer subject. We have designed and constructed an electronic system which can monitors temperature and humidity of the foot inside the shoe. The data is stored in a battery-powered device for later uploading to a host computer for data analysis. The apparatus potentially can be used to provide feedback to patients who are prone to having skin breakdowns.

[Profile of patients with diabetes type 1: insulinotherapy and self-monitoring].

Science.gov (United States)

Almeida, Henriqueta Galvanin Guidio de; Campos, Joao Jose Batista; Kfouri, Christiane; Tanita, Marcos Toshiyuki; Dias, Adriana Espinosa; Souza, Marizia Marcos de

2002-01-01

A study carried out in Londrina - PR, with the cohort of local patients from Brazilian Study on the incidence of Diabetes Mellitus Type 1 (EDID). To know the insulin treatment and the plan for glycemic self-monitoring used by these patients; to verify their knowledge as for what they consider the optimization of these parameters and limitations of use. A survey was conducted with objective questions to 63 patients of the cohort. The average age was 13 years, without gender predominance. It was verified that most of the patients, 79.36%, (n=50) took at least 2 daily applications of insulin. All of them used insulin NPH in one (n=13) or two (n=50) doses. The use of regular insulin, in variable programs, was associated to the NPH in 41.27% (n=26) of the patients (The most frequent insulin type used was human 53.97% (n=34). Of the patients not making use of human insulin, 44.83% (n=13) considered it of high cost and 95.24% (n=60) would make use of it if it was distributed by the Government Unified Health System. As for the monitoring, 63.40% (n=40) took the tests up to 7 times a week, 20.63% (n=13) from 15 to 21 and only 1 patient from 29 to 35 tests. The high cost was the reason for 48.21% (n=27) not to take the tests; 58.73% (n=37) would take the test in the blood and 33.33% (n=21) either in the blood or in the urine if they were given the reactive ribbons. In this cohort of patients, although the human insulin is already adopted as the use of choice, the outline insulin treatment plan is still traditional and the monitoring is far behind the ideal.

Premature awakening and underuse of neuromuscular monitoring in a registry of patients with butyrylcholinesterase deficiency

DEFF Research Database (Denmark)

Thomsen, J L; Nielsen, C V; Palmqvist, D F

2015-01-01

, neuromuscular monitoring, and postoperative respiratory complications, defined as arterial oxygen desaturation prematurely awakened if anaesthesia had been terminated while the patient was still...... paralysed. RESULTS: We included 123 patients. Neuromuscular monitoring was applied before awakening in 48 (39%) patients. A nerve stimulator was never used or only after attempted awakening in the remaining 75 (61%) patients. Premature awakening occurred in 75 (100%) and 14 (29%) of the unmonitored...

Perceptions of Caribbean type 2 diabetes patients on self-monitoring of blood glucose

DEFF Research Database (Denmark)

Ezenwaka, C. E.; Olukoga, A.; Onuoha, P.

2012-01-01

Context: The views of type 2 diabetes (T2DM) patients have not been considered in the debate on the role of self-monitoring of blood glucose (SMBG) in the management of T2DM. Objective: To assess the views of T2DM patients on SMBG. Methods: Two previously trained research assistants used a struct......Context: The views of type 2 diabetes (T2DM) patients have not been considered in the debate on the role of self-monitoring of blood glucose (SMBG) in the management of T2DM. Objective: To assess the views of T2DM patients on SMBG. Methods: Two previously trained research assistants used...

Disruption or innovation? A qualitative descriptive study on the use of electronic patient-physician communication in patients with advanced cancer.